BMC Urology[JOURNAL]
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200 papers
Giant renal hilar angiomyolipoma with Mayo level II venous tumor thrombus: a rare case report and literature review.
Pan W, Li Y, Fan C … +2 more , Hu P, Mi H
BMC Urol · 2026 Mar · PMID 41826918 · Full text
We present the case of a 54-year-old woman with an incidentally discovered left renal hilar mass. Imaging examination revealed a large, heterogeneous mass of fat density in the left renal pelvis, accompanied by a tumor t...
We present the case of a 54-year-old woman with an incidentally discovered left renal hilar mass. Imaging examination revealed a large, heterogeneous mass of fat density in the left renal pelvis, accompanied by a tumor thrombus extending into the renal vein and inferior vena cava (IVC), consistent with a Mayo level II thrombus—a finding reported in fewer than 50 cases worldwide. A preoperative diagnosis of renal angiomyolipoma (RAML) was established. Despite the patient’s strong preference for nephron-sparing surgery (NSS), intraoperative findings of extensive hilar invasion and calyceal involvement, along with significant hemorrhage, necessitated conversion to radical left nephrectomy with IVC thrombectomy. Histopathological examination confirmed the diagnosis of classic RAML, as indicated by positive immunohistochemical staining for Human Melanoma Black 45 (HMB45), Melanoma Antigen Recognized by T-cells 1 (Melan-A), and Smooth Muscle Actin (SMA), and negative staining for Cytokeratins (CK), S-100 Protein (S-100), and Desmin. The tumor thrombus was derived from the RAML. The patient recovered well postoperatively, with no recurrence or metastasis observed at the 8-month follow-up. This case underscores the surgical challenges of large hilar RAMLs with venous extension and highlights the importance of preoperative planning and intraoperative adaptability.
Correction: Three-dimensional image reconstruction technology in laparoscopic pyeloplasty for horseshoe kidney-associated ureteropelvic junction obstruction: a case series study.
Kandori S, Kojo K, Hoshi A … +13 more , Takahashi R, Sakurai H, Isoda B, Suzuki S, Yamaguchi A, Tanuma K, Nitta S, Shiga M, Nagumo Y, Ikeda A, Kawahara T, Mathis BJ, Nishiyama H
BMC Urol · 2026 Mar · PMID 41821034 · Full text
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Correction: Quantitative analysis of time-related parameters in uroflowmetry curve patterns in patients with benign prostatic hyperplasia and bladder outlet obstruction: a single-center retrospective study.
Zeng X, Shen H, Luo D … +1 more , Jin T
BMC Urol · 2026 Mar · PMID 41820946 · Full text
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Low Chimney Cutaneous Ureterostomy (LCCU): a novel technique for supra-vesical urinary diversion.
Soliman A, Elghazeery M, Youssif M … +1 more , Mokhless I
BMC Urol · 2026 Mar · PMID 41820914 · Full text
BACKGROUND: Supra-vesical urinary diversion is rarely needed in current pediatric urology practice. Developments in reconstructive surgery, pediatric endoscopy, and anesthesia have promoted early definitive management of...
BACKGROUND: Supra-vesical urinary diversion is rarely needed in current pediatric urology practice. Developments in reconstructive surgery, pediatric endoscopy, and anesthesia have promoted early definitive management of majority of indicated congenital obstructive uropathies. Ureterostomy is an effective alternative for decompressing upper urinary tract; however, none of current techniques provide an optimal diversion. End ureterostomy (EU) and low-loop ureterostomy (LLU) do not allow urinary bladder cycling especially in bilateral cases and those with solitary kidneys. EU cannot drain the urinary bladder with a refluxing ureter. Sober’s ureterostomy allows immediate elimination of high intrarenal pressure together with urinary bladder cycling; however, it is inconvenient for family in care, and closure requires another separate procedure. Herein, we evaluate feasibility, efficacy, and complications of low chimney cutaneous ureterostomy (LCCU) as a new supra-vesical urinary diversion procedure. METHODS: After obtaining ethical approval (IRB No. 00012098), data from 11 patients who underwent cutaneous ureterostomy (CU) for 13 ureters using this technique between 2008 and 2023 were collected and reviewed retrospectively. Indications for LCCU were ureterovesical junction obstruction (UVJO) or high-grade vesicoureteral reflux (VUR) with dilatation either primary or secondary to bladder outlet obstruction. Reversal of LCCU was performed in seven patients with nine ureters, together with ureteral reimplantation through the same incision. RESULTS: All patients showed improvement in the upper urinary tract following diversion. Reversal of LCCU was performed after a median time of 13 months (6-22) with maintained improvement of the upper urinary tract. CONCLUSION: LCCU is a safe method for supra-vesical urinary diversion with satisfactory results. This technique maintains the blood supply to the lower ureteral segment and the surgical field intact for the definitive procedure. The location of the stoma makes its care easy for the family and enables its reversal with ureteral reimplantation using a single incision.
The association between ZJU index and kidney stone risk: a machine learning approach on NHANES 2007-2018.
Lin Y, Zhou J, Lv J … +1 more , Shen B
BMC Urol · 2026 Mar · PMID 41814274 · Full text
BACKGROUND: The Zhejiang University (ZJU) Index has emerged as a comprehensive metabolic indicator and demonstrated significant association with various diseases. The goal of this study was to investigate the potential r...
BACKGROUND: The Zhejiang University (ZJU) Index has emerged as a comprehensive metabolic indicator and demonstrated significant association with various diseases. The goal of this study was to investigate the potential relationship between ZJU index and kidney stones. METHODS: A cross-sectional study analyzed participants’ demographic, socioeconomic, and laboratory data from NHANES 2007–2018. Weighted multivariate logistic regression, restricted cubic spline (RCS) models, and stratified analysis were applied to validate the relationship between ZJU index and kidney stone. Machine learning based analysis was employed to further improve the predictive performance and identify key predictors. RESULTS: A total of 11,317 participants were enrolled in our study and 1,115 were classified as kidney stone former. Significant differences were observed between the kidney stone formers and non-kidney stone formers in variables such as gender, race, age, education, marital status, recreational activities, hypertension, diabetes mellitus and BMI. Weighted logistic regression analysis revealed a significant positive association between ZJU index and kidney stone risk (OR = 1.03, 95% CI: 1.01–1.04) after maximal adjustment for the covariates. Participants in the highest ZJU tertile faced a 74% higher odds of nephrolithiasis than those in the lowest tertile (OR = 1.74, 95% CI: 1.34–2.26). RCS analysis indicated ZJU index raise the risk of stone formation in a non-linear dose-response manner. In the stratified analysis, we observed that the positive association was maintained across most subgroups, except for individuals younger than 40 or from other race. A significant interaction between ZJU index and marital status was detected (Pinteraction=0.042). Among the three machine learning models, XGBoost model exhibited the best predictive performance, with an area under the curve (AUC) of 0.638. SHAP analysis ranked ZJU index as the most influential predictor for nephrolithiasis. CONCLUSION: Our study provided additional evidence supporting the role of ZJU index as an effective metabolic biomarker for kidney stone risk prediction. Further clinical and epidemiological study should be warranted to unveil a more precise cause-effect relationship between them.
Identification of risk factors and construction of a nomogram for predicting postoperative stone recurrence in patients with infective upper urinary tract stones.
Wei GG, Yang QS, Chen HR … +6 more , Yang Y, Tang JF, Kwan KJS, Lu ZQ, Xiong L, Xu X
BMC Urol · 2026 Mar · PMID 41807984 · Full text
BACKGROUND: Infection-related upper urinary tract stones (struvite and/or carbonate apatite) are prone to early postoperative recurrence. This study aimed to identify predictors of 6-month recurrence and develop a pragma...
BACKGROUND: Infection-related upper urinary tract stones (struvite and/or carbonate apatite) are prone to early postoperative recurrence. This study aimed to identify predictors of 6-month recurrence and develop a pragmatic risk-prediction nomogram to support individualized follow-up. METHODS: A retrospective single-center study was conducted in 148 patients with infection-related stones confirmed by infrared spectroscopy who underwent surgical removal between January 2019 and December 2023. Patients were randomly allocated to a modeling cohort (n = 104) and a validation cohort (n = 44) using a 7:3 non-stratified split (internal split-sample validation only). Candidate predictors and outcomes were complete for all patients, and no imputation was required. Recurrence within 6 months was defined as new stone formation or a > 2-fold increase in residual fragment size on ultrasound or plain computed tomography (CT). Multivariable logistic regression was used to identify independent predictors and to construct a nomogram. Model performance was assessed using discrimination, calibration, and decision curve analysis. RESULTS: In the modeling group, the stone recurrence rate was 44.2% (n = 46/104), while in the validation group it was 70.5% (n = 31/44). Compared to non-recurrence cases, patients in the recurrence group had significantly higher rates of residual stones (72% vs. 22%, P < 0.001), renal atrophy (33% vs. 9%, P = 0.002), and positive urine cultures at six-month follow-up (39% vs. 3%, P = 0.008), as well as higher median CT values [821 HU (IQR 592–1003) vs. 511 HU (IQR 416–864), P = 0.004]. Multivariate logistic regression identified residual stones (OR = 6.19, 95% CI: 2.12–18.08, P = 0.001), positive urine culture during follow-up (OR = 9.71, 95% CI: 1.73–54.41, P = 0.010), and CT value (OR = 1.02, 95% CI: 1.00–1.04, P = 0.026) as independent predictors of recurrence. A nomogram constructed using these three factors showed strong predictive performance, with an area under curve of 0.86 (95% CI: 0.77–0.93) in the modeling group and 0.75 (95% CI: 0.59–0.91) in the validation group. Calibration curves demonstrated good agreement between predicted and observed recurrence risk, and decision curve analysis indicated favorable clinical utility of the model. CONCLUSIONS: Residual stones, positive follow-up urine culture, and higher CT attenuation values were identified as independent predictors of early recurrence after surgery for infection-related upper urinary tract stones. The nomogram showed acceptable internal performance but requires external validation.
Learning curve comparison between hand-assisted and retroperitoneoscopic living donor nephrectomy using risk-adjusted cumulative sum analysis.
Shingaki K, Kaba A, Kubo S … +4 more , Hisadome Y, Nakafusa Y, Kaku K, Noguchi H
BMC Urol · 2026 Mar · PMID 41803848 · Full text
OBJECTIVE: This study aimed to clarify how learning patterns differ between hand-assisted laparoscopic donor nephrectomy(HALDN) and retroperitoneoscopic donor nephrectomy (RDN) by applying risk-adjusted CUSUM analysis, w...
OBJECTIVE: This study aimed to clarify how learning patterns differ between hand-assisted laparoscopic donor nephrectomy(HALDN) and retroperitoneoscopic donor nephrectomy (RDN) by applying risk-adjusted CUSUM analysis, with the goal of supporting surgical education and decision-making in donor nephrectomy. METHODS: We retrospectively analyzed 128 consecutive living donor nephrectomies performed at a single center, comprising 64 HALDN and 64 RDN cases. Each surgical approach was consistently performed by a different surgeon. Inverse probability weighting (IPW) was used to adjust for background differences using covariates including sex, age, BMI, MAP score, and vascular anatomy. Risk-adjusted CUSUM analysis was conducted for operative time and blood loss, and segmented regression was used to identify inflection points and slope transitions in the learning curve. RESULTS: Baseline characteristics were adjusted using IPW to account for differences between the HALDN and RDN groups. The inflection point in operative time appeared at the 11.8th case for HALDN and at the 34.6th case for RDN. In HALDN, the slope improved from + 103.5 to − 20.9, while in RDN, it changed from + 19.8 to − 30.5. RDN reached CUSUM zero-crossing at case 55, while HALDN did not cross zero. For blood loss, the inflection point was at case 6.6 (HALDN) and 37.8 (RDN), with post-inflection slopes of − 11.5 and − 18.6, respectively. These findings suggest HALDN allows early stabilization, whereas RDN shows greater improvement after achieving proficiency. CONCLUSION: HALDN enables earlier stabilization, whereas RDN shows greater improvement after proficiency. These findings may inform surgical planning and training in donor nephrectomy.
Meta-analysis of the association between CTCs and survival outcomes in urothelial carcinoma.
Zhou Q, Bao G, Liu M … +1 more , Gong L
BMC Urol · 2026 Mar · PMID 41796287 · Full text
OBJECTIVE: To systematically evaluate the correlations between the characteristics of circulating tumor cells (CTCs) and survival outcomes in patients with urothelial carcinoma (UC) receiving first-line chemotherapy. MET...
OBJECTIVE: To systematically evaluate the correlations between the characteristics of circulating tumor cells (CTCs) and survival outcomes in patients with urothelial carcinoma (UC) receiving first-line chemotherapy. METHODS: A comprehensive search was conducted in the PubMed, Embase, Web of Science, and Cochrane Library databases to collect relevant English observational studies (cohort studies or case-control studies) focusing on patients with UC receiving first-line chemotherapy and investigating the associations between CTC characteristics and survival outcomes (progression-free survival [PFS], overall survival [OS]), published from the establishment of the databases to August 2025. Two researchers independently screened the literature based on predefined inclusion and exclusion criteria, extracted the data, and evaluated the quality using the Newcastle-Ottawa Scale (NOS). The main combined indicator was the hazard ratio (HR) and its 95% confidence interval (CI). Statistical analysis was performed using RevMan 5.3 software. The I² statistic was used to assess heterogeneity, and Egger’s test and sensitivity analysis were used to evaluate publication bias and the stability of the results. RESULTS: A total of 6 studies involving 577 patients with urothelial carcinoma were finally included. The results of the Meta-analysis showed that patients with high-risk CTC characteristics (CTC positivity, high CTC count, or expression of specific molecular markers) had a significantly higher risk of disease progression (HR = 2.84, 95% CI [1.66, 4.83], Z = 3.83, P < 0.001). They also had a significantly higher risk of death (HR = 3.05, 95% CI [1.74, 5.32], Z = 3.91, P < 0.001). CONCLUSION: High-risk CTC characteristics are strong predictors of poor survival outcomes in UC. CTC-based liquid biopsy holds promise for risk stratification, especially in metastatic patients, and should be integrated into future prospective trials to validate its utility in guiding individualized therapy.
Rupture of mycotic aneurysm complicating deceased donor renal transplantation: a dual case report.
Shah AS, Lk G, Chawla A … +4 more , Agarwal A, Avb K, Tinaikar A, Singh S
BMC Urol · 2026 Mar · PMID 41794749 · Full text
BACKGROUND: Mycotic aneurysms of the transplant renal artery (TRA) are rare but life-threatening complications following renal transplantation, often resulting in graft loss and high mortality. Prompt recognition and tim...
BACKGROUND: Mycotic aneurysms of the transplant renal artery (TRA) are rare but life-threatening complications following renal transplantation, often resulting in graft loss and high mortality. Prompt recognition and timely management are essential to prevent catastrophic haemorrhage and improve patient outcomes. CASE PRESENTATION: We report two cases of ruptured mycotic aneurysms in cadaveric renal allografts. Both patients were on maintenance haemodialysis and underwent deceased donor kidney transplantation. In the first case, the patient presented two weeks postoperatively with haemodynamic instability and intra-abdominal bleeding. Imaging revealed active contrast extravasation near the arterial anastomosis. Emergency exploration revealed a ruptured mycotic aneurysm, necessitating graft nephrectomy; despite antifungal therapy, the patient succumbed to rebleeding. In the second case, the patient presented with fever and hypotension ten days post-transplant. Imaging revealed absent graft perfusion with peri-graft collection. Graft nephrectomy was performed, and histopathology confirmed fungal arteritis. The patient responded to antifungal therapy and recovered, albeit with graft loss. CONCLUSION: Ruptured mycotic aneurysms of the transplant renal artery (TRA) can have catastrophic outcomes. Despite early diagnosis and initiation of antifungal therapy, graft nephrectomy may be unavoidable in cases with rupture and hemodynamic compromise. Emphasis should be placed on strict aseptic protocols during organ retrieval and handling. Routine culture of preservation fluid may aid in early detection of fungal contamination, enabling timely intervention and potential graft salvage.
Outcomes of Retzius-sparing robot-assisted radical prostatectomy in men aged ≥ 75 years.
Fransis K, Bouziotis J, Tappero S … +3 more , De Wachter S, Dirix P, De Win G
BMC Urol · 2026 Mar · PMID 41787493 · Full text
BACKGROUND: Robot-assisted radical prostatectomy using the Retzius-sparing approach (RS-RARP) is increasingly adopted, yet evidence regarding outcomes in men aged ≥ 75 years remains extremely limited. OBJECTIVE: This stu...
BACKGROUND: Robot-assisted radical prostatectomy using the Retzius-sparing approach (RS-RARP) is increasingly adopted, yet evidence regarding outcomes in men aged ≥ 75 years remains extremely limited. OBJECTIVE: This study evaluated perioperative, oncological, and functional outcomes of RS-RARP in elderly patients. METHODS: A total of 608 men who underwent RS-RARP between 2016 and 2023 were included. Patients were divided into two groups: <75 years (n = 548) and ≥ 75 years (n = 60). Preoperative characteristics, surgical parameters, complications, pathological findings, and continence status up to 12 months were compared. RESULTS: Men aged ≥ 75 years presented more often with larger prostates, higher biopsy ISUP grades, and more intermediate/high-risk disease. Non–nerve-sparing procedures were more frequently performed in the elderly group and operative time, blood loss, hospital stay and complication rates were similar between the two groups. The rate of early urinary continence recovery was lower among older patients, but by 12 months continence rates were nearly identical. Elderly patients showed more advanced pathological tumor stages, more PSA persistence and a higher need for adjuvant hormonal therapy, while rates of positive surgical margins and biochemical recurrence were comparable. CONCLUSIONS: RS-RARP can be safely offered to selected patients aged ≥ 75 years without compromising perioperative safety or oncological control. Despite delayed continence recovery, one-year functional outcomes are equivalent, supporting RS-RARP as a viable treatment option for appropriately chosen elderly men with localized prostate cancer.
Utility of prostate-specific antigen density and its correlation with Gleason grade groups: a hospital-based cross-sectional study among patients with prostate-related urinary symptoms at Bugando Medical Centre, Mwanza, Tanzania.
Jackson N, Elias E, Igenge J … +8 more , Ottoman O, Matiku S, Idd S, Mremi A, Mbulwa C, Kahima J, Kidenya B, Rambau P
BMC Urol · 2026 Mar · PMID 41787439 · Full text
BACKGROUND: At Bugando Medical Centre, prostate cancer contributes to 39% of all cancers in male patients admitted to the Oncology department, and the majority have high Gleason grades. Although Prostate-specific antigen...
BACKGROUND: At Bugando Medical Centre, prostate cancer contributes to 39% of all cancers in male patients admitted to the Oncology department, and the majority have high Gleason grades. Although Prostate-specific antigen density (PSAD) has been shown to improve the diagnostic accuracy of prostate cancer and to triage patients for prostate biopsy, there is a significant variation across geographical locations. METHODS: A hospital-based cross-sectional study among patients with prostate-related urinary symptoms at Bugando Medical Centre, Mwanza, Tanzania. The study analyzed prostate-specific antigen levels, prostate volume, and total PSA using Maglumi 2000 and a computer system. Histopathological examination involved transrectal biopsy, TURP, and open prostatectomy. The optimal cutoff for PSA density was determined using the receiver operating characteristic curve. RESULTS: Of the 287 patients, the overall mean age of 71.2 (± 10.2) years. 99 (34.5%) participants were diagnosed with prostate cancer. The area under the curve for prostate-specific antigen density and PSA was 0.9094 (0.8761–0.9426) and 0.8932 (0.8569–0.9295), respectively. The PSAD optimal cut-off was 0.23ng/ml2, giving sensitivity of 86.9% and specificity of 82.4% for prostate cancer prediction. Using this cutoff reduces prostate biopsies by 54.5%. There was a weak positive correlation (Spearman’s rho (ρ) = 0.2456) between prostate-specific antigen density and Gleason grade groups. CONCLUSIONS: The correlation between PSAD and Gleason grade groups observed in this study suggests that higher PSAD is associated with more aggressive cancer. This makes PSAD a valuable tool in guiding biopsy decisions, risk stratification, and treatment planning in patients with prostate-related urinary symptoms.
Effect of vitamin B12 replacement therapy in patients with premature ejaculation with B12 deficiency.
Ustun F, Bulbul E, Arslan K … +1 more , Caner N
BMC Urol · 2026 Feb · PMID 41761181 · Full text
BACKGROUND: Vitamin B12 plays a key role in the serotonergic pathway; we predicted that B12 replacement could be beneficial in the treatment of premature ejaculation (PE) in patients with B12 deficiency. We aimed to inve...
BACKGROUND: Vitamin B12 plays a key role in the serotonergic pathway; we predicted that B12 replacement could be beneficial in the treatment of premature ejaculation (PE) in patients with B12 deficiency. We aimed to investigate the response to vitamin B12 replacement in PE patients with vitamin B12 deficiency. METHODS: Between January 2025 and June 2025, a total of 152 individuals were included in this study, comprising 92 patients aged 18–45 who were diagnosed with PE and 60 healthy controls. The blood vitamin B12 levels of all participants were examined. Thirty-four patients with PE who presented with vitamin B12 deficiency were re-evaluated for ejaculation time after vitamin B12 replacement. RESULTS: The mean blood vitamin B12 level was 237.8 ± 91.4 ng/L in the PE group and 297 ± 141.7 ng/L in the control group (p = 0.002). Following vitamin B12 replacement in the PE group with vitamin B12 deficiency, there was a statistically significant decrease in Premature Ejaculation Diagnostic Tool (PEDT) scores, a significant increase in Premature Ejaculation Profile (PEP) scores, and an increase in intravaginal latency time (p < 0.001). Of the patients diagnosed with PE who received B12 replacement therapy, 25 (73.5%) were satisfied with the treatment, while 9 (26.5%) were dissatisfied. Treatment satisfaction rates were 87.5% in those with lifelong PE and 61.1% in those with acquired PE (p = 0.082). CONCLUSION: In PE patients with B12 deficiency, normalizing blood B12 levels may be a viable treatment option. This is the first study to assess the effect of B12 replacement in PE patients with vitamin B12 deficiency.
Nursing strategies for managing urological disorders in aging populations: a comprehensive review.
Liu H, Wu J
BMC Urol · 2026 Feb · PMID 41749176 · Full text
Urological disorders are increasingly common in aging populations, with conditions such as benign prostatic hyperplasia (BPH), prostate cancer, urinary incontinence (UI), and repeated urinary tract infections (UTIs) affe...
Urological disorders are increasingly common in aging populations, with conditions such as benign prostatic hyperplasia (BPH), prostate cancer, urinary incontinence (UI), and repeated urinary tract infections (UTIs) affecting a growing number of individuals. Nurses play a central role in managing these conditions, addressing the complex needs of older adults who often face multiple health issues, polypharmacy, and mental health challenges. This review explores how nurses apply evidence-based practices to care for elderly patients with urological disorders, emphasizing patient-centered approaches and interdisciplinary collaboration. Key focus areas include assessing and managing urinary symptoms, implementing behavioral strategies, utilizing technologies like remote urology, and promoting bladder health. The review highlights the importance of patient education, family support, and UTI prevention, particularly regarding catheter use. By synthesizing current research, this review underscores the vital role of nursing in improving outcomes and quality of life for older adults, advocating for the integration of urological nursing into senior healthcare systems and guiding future research and practice.
Exploratory analysis of CaSR gene polymorphisms and haplotypes in relation to urolithiasis in the Qiongnan population of Hainan, China: a small-sample case-control study.
Wang J, Liu G, Zhang X … +3 more , Chen G, Liang B, Liang L
BMC Urol · 2026 Feb · PMID 41742099 · Full text
BACKGROUND: Calcium urolithiasis arises from complex interactions between environmental and genetic factors regulating calcium metabolism. The calcium-sensing receptor (CaSR) is essential for maintaining calcium homeosta...
BACKGROUND: Calcium urolithiasis arises from complex interactions between environmental and genetic factors regulating calcium metabolism. The calcium-sensing receptor (CaSR) is essential for maintaining calcium homeostasis, yet population-specific genetic effects remain insufficiently characterized. METHODS: A case–control study was conducted in the Qiongnan region of Hainan Province, including 50 patients with urolithiasis and 54 matched controls. Five CaSR single-nucleotide polymorphisms (rs7652589, rs6776158, rs1501899, rs1801725, and rs1042636) were genotyped by Sanger sequencing. Genotype–phenotype associations were assessed under multiple inheritance models, and haplotype analyses were performed to evaluate combined variant effects. RESULTS: None of the five CaSR SNPs showed a significant association with urolithiasis after multivariable adjustment. Four major haplotypes were identified, and the AGAGA haplotype was nominally associated with a markedly reduced risk of urolithiasis (adjusted OR = 0.217, 95% CI = 0.054–0.872, P = 0.031). No significant relationship was found between CaSR variants and stone composition. CONCLUSIONS: The CaSR AGAGA haplotype showed a nominal association with reduced susceptibility; however, given the limited sample size and low post-hoc power, these findings should be interpreted as exploratory and require validation in larger, independent cohorts.
Enhanced recovery after radical cystectomy for bladder cancer: a prospective observational case -control study.
Habicher M, Swoboda C, Hauptmann A … +8 more , Koch C, Diemer T, Paul AC, Markmann M, Schneck E, Wagenlehner F, Wolff M, Sander M
BMC Urol · 2026 Feb · PMID 41742085 · Full text
INTRODUCTION: The perioperative management of patients undergoing major surgical interventions is a dynamic field, continually striving for advancements in quality, reduction of complications, and cost-effectiveness. The...
INTRODUCTION: The perioperative management of patients undergoing major surgical interventions is a dynamic field, continually striving for advancements in quality, reduction of complications, and cost-effectiveness. The implementation of Enhanced Recovery After Surgery (ERAS) pathways has demonstrated remarkable success in various surgical disciplines, particularly in colorectal procedures. This study investigates whether the implementation of an ERAS protocol for radical cystectomy for bladder cancer at our institution results in a reduced complication rate compared to traditional standards.DRKS00035673 (retrospective) on 13th December 2024. METHODS: This prospective observational case-control pilot study was conducted at the University Hospital Giessen, Germany. Following ethics committee approval, 30 patients were enrolled: 15 patients received perioperative management based on prevailing standard operating procedures, and the subsequent 15 patients were managed according to the newly developed ERAS protocol. The multidisciplinary team included urologists, anaesthesiologists, nursing staff, ICU staff, pharmacists, physiotherapists, dietitians, and administrative staff. Key components of the ERAS protocol included optimized pain management, early nutrition, thrombosis prophylaxis, intraoperative goal directed therapy and early mobilization. The primary outcome was the complication rate until the 30th postoperative day, while secondary outcomes included ICU and hospital mortality, length of stay, and quality of life assessed by the EQ-5D-5L questionnaire. RESULTS: Thirty patients were included in the final analysis. Patients in the control group underwent radical cystectomy between September 2018 and December 2019, and those in the ERAS group between July 2020 and March 2021. There were no significant differences in basic characteristics between the groups. The primary outcome showed numeric but no statistically significant difference in complication rates (86.7% in the control group vs. 60% in the ERAS group, p=0.21). However, the cumulative POMS score was significantly higher in the control group (7.87 vs. 2.87, p<0.01), and the Clavien-Dindo score was significantly lower in the ERAS group (p=0.02). Quality of life was significantly improved in the ERAS group on the 7th and 30th postoperative day. CONCLUSION: Our pilot study suggests feasibility of ERAS implementation in radical cystectomy. The primary endpoint (overall complication rate) did not differ significantly between groups; however, ERAS was associated with lower complication severity and improved early postoperative quality of life, which should be interpreted as exploratory given the small, non-randomised sequential design. Larger multicentre prospective implementation studies are warranted to confirm these findings and to evaluate the influence of protocol adherence and individual ERAS elements. TRIAL REGISTRATION: DRKS00035673 (retrospective) on 13th December 2024
Correlation analysis of HER2 expression with clinicopathological features and prognosis based on data from 444 patients with urothelial carcinoma.
Luo J, Cheng Z, Chen L … +7 more , Li X, Guo Z, Wu J, Ye L, Huang H, Wang J, Wei Y
BMC Urol · 2026 Feb · PMID 41736029 · Full text
BACKGROUND: Urothelial carcinoma (UC) is a common malignancy with a poor prognosis in advanced stages, characterized by high heterogeneity, recurrence risk, and chemotherapy resistance. There is a clinical lack of reliab...
BACKGROUND: Urothelial carcinoma (UC) is a common malignancy with a poor prognosis in advanced stages, characterized by high heterogeneity, recurrence risk, and chemotherapy resistance. There is a clinical lack of reliable prognostic markers. Human epidermal growth factor receptor 2 (HER2) is a key oncogene and therapeutic target. Its correlation with clinicopathological features in Chinese UC patients remains controversial, leading to unclear biomarker value and limiting the precise application of therapies like RC48-ADC. Therefore, clarifying the association between HER2 expression and UC pathological staging and prognosis is crucial for optimizing treatment. METHODS: Clinical data of 444 UC patients admitted to Fujian Provincial Hospital from January 2020 to August 2024 were retrospectively analyzed. HER2 expression was detected by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). Spearman's rank correlation coefficient was used to clarify the association between HER2 and clinicopathological characteristics, and Kaplan-Meier method and Cox regression model were applied to analyze its prognostic value. RESULTS: The high HER2 expression rate (IHC 2+/3+) was 40.05%. High HER2 expression was significantly correlated with Age, History, Routine Urine Test indices, Pathological Grade, Ki67 index, p53 expression, and treatment options (all P<0.05). Multivariate Cox regression analysis confirmed that high HER2 expression was an independent risk factor for UC Recurrence (HR=2.496, P=0.044) but not significantly associated with Metastasis (P=0.923). CONCLUSION: HER2 is highly expressed in UC patients in the Fujian region, correlating with aggressive clinicopathological features. It can serve as a reliable biomarker for predicting recurrence risk, guiding postoperative management and targeted therapy selection.
Indonesian update of urethral stricture characteristics and treatment patterns.
Daniswara N, Putra DE, Soebadi MA … +43 more , Renaldo J, Irdam GA, Soeroto AA, Parardya A, Hutasoit YI, Wallad CK, Soebhali B, Prayudi NG, Duarsa GWK, Pramana IBP, Ertandri L, Nasution R, Hendry M, Arianto E, Sufriadi S, Yashar MA, Syahrir S, Wardaya SAT, Nandana PI, Hutauruk ES, Perdana NR, Mardihusodo HR, Ardiansyah F, Rulianov R, Ariwicaksono C, Ingratoeboen WO, Prihadi JC, Gumilar OB, Sitompul AP, Afriansyah A, Nugroho F, Nababan P, Tansol C, Tobing ERPL, Palinrungi MAA, Priyosantoso BA, Soerohardjo I, Khalillulah SA, Agil A, Wibowo E, Adi K, Satyagraha P, InaGURS
BMC Urol · 2026 Feb · PMID 41736018 · Full text
OBJECTIVE: To evaluate the clinical profile and treatment patterns of urethral stricture (US) in Indonesia, the world’s fourth most populous country. Since 2012, Indonesia has expanded access to reconstructive urology se...
OBJECTIVE: To evaluate the clinical profile and treatment patterns of urethral stricture (US) in Indonesia, the world’s fourth most populous country. Since 2012, Indonesia has expanded access to reconstructive urology services, supported by 19 genitourinary consultants and multiple referral centers nationwide. METHODS: A multicenter retrospective study was conducted involving urologists from 38 hospitals across Indonesia. Data from patients treated for US between 2019 and 2023 were collected, including demographics, stricture characteristics (site and etiology), and treatment modalities. Stricture length was recorded but excluded from the primary analysis due to inconsistent reporting across participating centers. Surgical procedures were categorized as direct vision internal urethrotomy (DVIU), urethral dilatation, excision and primary anastomosis (EPA), and substitution urethroplasty. RESULTS: A total of 3,055 patients were included, with a mean age of 49.3 years (SD 18.8; range 1–91); 99.3% were male. The leading causes of US were iatrogenic (38.4%), trauma (38.0%), and infection (17.7%), followed by idiopathic (5.4%), and congenital (0.5%). The bulbar urethra was the most commonly affected anatomical site (24.3%), followed by membranous (13.9%), pendular (7.6%), and panurethral strictures (11.6%). Surgical reconstruction was the primary approach in 65.7% of cases, including Excision and Primary Anastomosis (EPA) in 33.1% and urethroplasty in 32.6%. Augmentation urethroplasty using oral mucosal grafts was performed in 16.6%. Endoscopic management—primarily Direct Vision Internal Urethrotomy (DVIU) and dilatation—was employed in 30.5% of patients. CONCLUSIONS: Reconstructive surgery, particularly urethroplasty, is now the dominant modality for US management in Indonesia. The predominance of trauma-related urethral strictures reflects epidemiological patterns commonly observed in developing and middle-income countries. However, a national registry and expanded training in reconstructive urology are crucial to further enhance outcomes and standardize care delivery across Indonesia.
Clinical predictors of symptom and quality-of-life improvement with antimuscarinics in overactive bladder: a 12-month prospective cohort study in Türkiye.
Alci M, Taskiran D, Ozdemir B
BMC Urol · 2026 Feb · PMID 41731466 · Full text
OBJECTIVE: Antimuscarinic therapy is a first-line pharmacological treatment for overactive bladder (OAB), but individual response is highly variable. This study aimed to evaluate the effects of antimuscarinic therapy on...
OBJECTIVE: Antimuscarinic therapy is a first-line pharmacological treatment for overactive bladder (OAB), but individual response is highly variable. This study aimed to evaluate the effects of antimuscarinic therapy on symptom severity and quality of life (QoL) and to identify key clinical predictors of treatment response in a prospective cohort. MATERIALS AND METHODS: A prospective observational cohort study was conducted at a gynecology outpatient clinic between August 2023 and August 2024. A total of 168 patients diagnosed with OAB who completed one year of antimuscarinic therapy (solifenacin, tolterodine, fesoterodine, or oxybutynin) were included. Disease-specific QoL was assessed using the Incontinence Quality of Life (I-QOL) questionnaire, and symptom severity was measured with the Incontinence Severity Index (ISI) at baseline and after three months. Multiple linear regression analysis was performed to identify independent predictors of changes in I-QOL and ISI scores. RESULTS: Antimuscarinic therapy led to significant improvements in both QoL and symptom severity. The mean total I-QOL score increased from 35.42 (± 13.32) to 61.18 (± 15.10) (p < 0.001), and the mean ISI score decreased from 10.68 (± 1.59) to 6.69 (± 1.70) (p < 0.001). However, regression analysis revealed that the therapeutic response was significantly moderated by specific factors. The experience of moderate to severe side effects, particularly dry mouth and constipation, was the strongest negative predictor of QoL improvement (β = -5.87, p = 0.001). Furthermore, increasing age (β = -0.028, p = 0.007), postmenopausal status (β = 0.585, p = 0.045), and the presence of metabolic comorbidities (diabetes/hypertension) were independently associated with diminished improvement in incontinence severity. CONCLUSION: While effective, the benefit of antimuscarinic therapy in OAB is not uniform and is substantially limited by treatment-related side effects, advanced age, menopausal status, and metabolic comorbidities. These easily identifiable clinical factors should be used to personalize treatment selection, optimize patient counseling, and improve long-term management strategies, moving beyond a one-size-fits-all approach to OAB care.
Parenchymatous invasive renal pelvis carcinoma in retrograde intrarenal surgery patients: a case report.
Xu Y, Xiong L, Cao R … +3 more , Zheng C, An H, Zhang Y
BMC Urol · 2026 Feb · PMID 41724966 · Full text
BACKGROUND: The concomitant presentation of upper urinary tract calculi and renal pelvis urothelial carcinoma is exceptionally rare in clinical practice. Parenchymal-invasive renal pelvis carcinoma often exhibits atypica...
BACKGROUND: The concomitant presentation of upper urinary tract calculi and renal pelvis urothelial carcinoma is exceptionally rare in clinical practice. Parenchymal-invasive renal pelvis carcinoma often exhibits atypical imaging features, further complicating diagnosis. As both conditions share haematuria as a cardinal symptom, this overlap frequently leads to the misdiagnosis of one entity for the other. CASE PRESENTATION: We reported the symptoms and diagnosis of two cases of upper urinary tract stones with renal pelvis cancer that detected between May 2023 and December 2024. Two patients were newly diagnosed with upper urinary tract calculi for the first time. Lumbar pain was the primary symptom in both patients. Preoperative abdominal computed tomography (CT) showed only localized low-density soft tissue mass of the renal parenchyma (Tis or T1 stage), which was interpreted as focal inflammatory changes in the renal cortex due to combined renal pelvis infection, hydronephrosis, and nephrolithiasis. An absence of metastases was detected on CTU. Both patients subsequently underwent radical tumor surgery, and postoperative pathology confirmed high-grade invasive urothelial carcinoma in both patients. CONCLUSION: Atypical imaging findings of upper urinary tract stones with renal pelvic cancer is often overlooked or misdiagnosed as infectious diseases. Abdominal CT may fail to detect small renal pelvic tumors. Renal pelvic cancer should be suspected in patients with papillary tumors observed during RIRS. Evaluation of the renal pelvic mucosa should include local biopsy, CTU, and urinary exfoliative cytology. Radical surgery is indicated for such cases.
Primary angiosarcoma of the seminal vesicle: a detailed case report and literature review of an extremely rare urological malignancy.
Albayeh A, Fadel D, Nabbout G … +2 more , Ghadieh HE, Al Ayoubi M
BMC Urol · 2026 Feb · PMID 41721277 · Full text
Primary angiosarcoma of the seminal vesicle is an exceptionally rare genitourinary malignancy, with very few cases reported in the literature. Due to its rarity, nonspecific presentation, and lack of standardized treatme...
Primary angiosarcoma of the seminal vesicle is an exceptionally rare genitourinary malignancy, with very few cases reported in the literature. Due to its rarity, nonspecific presentation, and lack of standardized treatment protocols, diagnosis and management remain challenging. This case adds to the limited body of evidence by describing clinical presentation, diagnostic workup, therapeutic approach, and early treatment response in one of the few documented cases worldwide.A 52-year-old male presented with persistent genitourinary symptoms and had been treated for three years as a case of chronic prostatitis without clinical improvement. Further evaluation revealed findings suspicious for a malignant seminal vesicle lesion.Comprehensive diagnostic assessment, including imaging and histopathological evaluation, confirmed primary angiosarcoma of the seminal vesicle. The patient underwent multimodal therapy consisting of chemotherapy and radiotherapy. Post-treatment evaluation demonstrated an early complete metabolic response on imaging studies. However, follow-up duration was limited to two months following completion of therapy.Primary angiosarcoma of the seminal vesicle is a rare and diagnostically challenging tumor that may mimic benign urological conditions, potentially delaying diagnosis. Multimodal treatment involving chemoradiation may provide early therapeutic response, particularly in patients with inoperable disease. Nevertheless, longer follow-up is essential given the aggressive nature and high recurrence risk associated with angiosarcoma. Further molecular and genetic research is required to identify targeted treatment strategies for this rare malignancy.
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