BMC Urology[JOURNAL]
Sun
200 papers
Comparative analysis of loop-tail versus double J ureteral stents in diabetic patients: effects on stent-related symptoms and encrustations.
He M, Song H, Yang K … +4 more , Liu T, Zhao H, Zhu H, Ding M
BMC Urol · 2026 Feb · PMID 41715066 · Full text
OBJECTIVE: To evaluate stent-related symptoms (SRS) and the encrustation of stents in diabetic patients receiving loop-tail (LT) stents versus conventional double J (DJ) stents following uncomplicated flexible ureteroren...
OBJECTIVE: To evaluate stent-related symptoms (SRS) and the encrustation of stents in diabetic patients receiving loop-tail (LT) stents versus conventional double J (DJ) stents following uncomplicated flexible ureterorenoscopy (fURS). PATIENTS AND METHODS: This study retrospectively analyzed data collected from diabetic patients who underwent fURS between July 2022 and May 2025. A total of 108 patients were eligible in this study, including 56 patients received conventional DJ stents and 52 patients received LT stents. Stent-related symptoms were assessed using the Chinese validated version of the Ureteric Stent Symptom Questionnaire (USSQ) at 3 day and 4 weeks post-stent insertion. Encrustation of stents was assessed upon stent removal. Statistical analyses were conducted to compare USSQ domains, encrustation scores, and complications between the two groups. RESULTS: There were no significant differences between the two groups in USSQ domains at 3 days post-stent insertion. At 4 weeks, the LT group demonstrated a significantly better outcome in the urinary symptoms domain (P = 0.037) and visual analogue scale (VAS) for pain (P = 0.042) compared with the DJ group. Patients in the LT group reported lower scores of urinary frequency (P = 0.003), incomplete emptying (P = 0.031), burning at voiding (P = 0.047), and pain interfering with life (P = 0.015) than those in the DJ group. Encrustation scores in bladder segment were significantly lower in the LT group than in the DJ group (p < 0.001). No significant differences were found between the two groups in the incidence of stent-related complications. CONCLUSIONS: In diabetic patients, LT stents are associated with fewer stent-related urinary symptoms and less pain. They also show lower encrustation scores compared to conventional DJ stents at 4 weeks post-insertion. LT stents may be a preferable option for LT stent placement in diabetic patients undergoing fURS.
Investigation of the hematological parameters in women with Interstitial Cystitis/Bladder Pain Syndrome and their relationship with disease severity.
Altan M, Dogan AE, Sandikci F … +1 more , Cimen S
BMC Urol · 2026 Feb · PMID 41709272 · Full text
OBJECTIVE: Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is an important public health problem that mainly affects middle-aged female patients. Diagnosis of IC/BPS is difficult as there is no disease-specific diag...
OBJECTIVE: Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is an important public health problem that mainly affects middle-aged female patients. Diagnosis of IC/BPS is difficult as there is no disease-specific diagnostic test. Our study evaluated routine hematological parameters in female IC/BPS patients to determine their potential utility in supporting diagnosis and reflecting disease severity. METHODS: Fifty female IC/BPS patients and 50 age-matched healthy controls were compared regarding neutrophil, lymphocyte, platelet counts, mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). In the patient group, correlations between these parameters and O’Leary-Sant Interstitial Cystitis Symptom Index (ICSI) scores were analyzed. RESULTS: Neutrophil, lymphocyte, platelet counts, and MPV values were similar between groups, whereas NLR was significantly higher in IC/BPS patients (2.34 vs. 1.85, p < 0.001). Among patients, lymphocyte counts were higher in those with ICSI ≥ 14 compared with ICSI < 14 (1.90 vs. 1.62, p = 0.009). CONCLUSION: Elevated NLR may serve as an adjunctive marker supporting the diagnostic evaluation of IC/BPS, while lymphocyte count may be related to symptom severity. These routinely available parameters could offer additional clinical insight; however, their role should be confirmed in larger, prospective studies.
Impact of diabetes mellitus on stone access and surgical outcomes in patients undergoing ureteroscopic lithotripsy: a retrospective cohort study.
Küçük E, Güler H, Ordulu R … +5 more , Aydın M, Öztürk U, Kırdağ MK, Ünaldı I, Atilla MK
BMC Urol · 2026 Feb · PMID 41703526 · Full text
OBJECTIVES: This study aimed to assess the independent effect of diabetes mellitus (DM) on ureteral stone access and surgical outcomes in patients undergoing ureteroscopic lithotripsy (URS). MATERIALS AND METHODS: Betwee...
OBJECTIVES: This study aimed to assess the independent effect of diabetes mellitus (DM) on ureteral stone access and surgical outcomes in patients undergoing ureteroscopic lithotripsy (URS). MATERIALS AND METHODS: Between February 2024 and August 2024, 149 patients were included in the study: 50 with DM (Group 1) and 99 without DM (Group 2). Patients aged 18 to 80 years who were scheduled for surgery for ureteral calculi in our hospital were included in the study. Patients with any systemic disease other than DM, patients with previous surgery for kidney stones or ureteral calculi, patients undergoing diagnostic URS, pregnant women, patients with oncologic diseases, and patients with one kidney were excluded. RESULTS: There were statistically significant differences between the groups in age, height, BMI, and stone volume (p<0.001, p<0.001, p=0.004, p=0.004, respectively). The rate of successful scope passage to the stone was significantly lower in patients with diabetes mellitus compared to non-diabetic patients (58.0% vs. 85.9%, p<0.001). The stone-free rate was also significantly higher in group 2 (p=0.033). Patients with DM had a significantly lower likelihood of successful scope passage to the stone, indicating a substantial and statistically significant contribution of this variable to the model (p<0.001). CONCLUSION: Diabetes mellitus was associated with a lower rate of successful scope passage to the stone during ureteroscopic lithotripsy, and this association persisted after multivariable adjustment. However, due to the retrospective design and limited sample size, these findings require confirmation in larger prospective studies.
Evaluation of animal models for urethral stricture: a systematic review.
Ortac M, Ekerhult TO, Ozervarli MF … +1 more , Atala A
BMC Urol · 2026 Feb · PMID 41699566 · Full text
PURPOSE: Male urethral strictures are relatively common but can be challenging to treat. Varying urethroplasty surgery techniques and the use of different grafts show mixed outcomes. Many animal models have been used to...
PURPOSE: Male urethral strictures are relatively common but can be challenging to treat. Varying urethroplasty surgery techniques and the use of different grafts show mixed outcomes. Many animal models have been used to study urethral stricture disease. The aim of this article is to review current animal models for urethral strictures as described in the contemporary literature. MATERIALS AND METHODS: A systematic literature search was conducted in the PubMed and Web of Science databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search included all original and review articles published in English over the past three decades, up to January 2025. Keywords used were: “urethral stricture,” “animal model,” “urethral disease,” “preclinical studies,” “rat,” “mice,” “rabbit,” “pig,” “swine” and their combinations. RESULTS: Rat, rabbit, and pig animal models have been widely used for the creation of urethral strictures. Methods to create urethral strictures in rodents include mostly the use of TGF-β1 and electrocoagulation. Several additional methods have been used in rabbits, including endoscopic resection, radiofrequency coagulation, holmium laser and injection of bleomycin. In the porcine model, electro- and thermocoagulation have been used. Each method used for the creation of urethral strictures has its own set of advantages and limitations. CONCLUSION: Since the human penis has a unique anatomy, no animal model can fully simulate clinical urethral stricture disease. However, despite each model’s limitations, sufficient options are available to address most clinical research questions. Model selection should depend on the specific research goals and anatomical or technical requirements.
Comparative value of postoperative inflammatory indices in predicting recurrence in T3 stage renal cell carcinoma: superiority of the Cally index.
Sesli M, Ozdes AA, Basaranoglu M … +3 more , Karakeci A, Orhan İ, Akbay E
BMC Urol · 2026 Feb · PMID 41699556 · Full text
BACKGROUND: This study evaluated the comparative efficacy of postoperative inflammatory indices (C-reactive protein–Albumin–Lymphocyte Index [Cally Index], Neutrophil-to-Lymphocyte Ratio [NLR], Platelet-to-Lymphocyte Rat...
BACKGROUND: This study evaluated the comparative efficacy of postoperative inflammatory indices (C-reactive protein–Albumin–Lymphocyte Index [Cally Index], Neutrophil-to-Lymphocyte Ratio [NLR], Platelet-to-Lymphocyte Ratio [PLR] and Systemic Inflammation Response Index [SIRI] ) in predicting disease-free survival in patients undergoing radical nephrectomy for T3 stage renal cell carcinoma (RCC). METHODS: We retrospectively analyzed 142 patients who underwent radical nephrectomy for T3 stage RCC between January 2015 and December 2023. Inflammatory indices measured on postoperative days 7–14 were calculated. Optimal cut-off values were determined using ROC curve analysis. Univariate and multivariate Cox regression analyses were performed for disease-free survival assessment. RESULTS: During a median follow-up of 36 months, 33.8% of patients developed recurrence. ROC analysis showed that the Cally Index (Area Under the Curve [AUC]: 0.73) demonstrated superior predictive accuracy compared to SIRI (AUC: 0.69), NLR (AUC: 0.70), and PLR (AUC: 0.66) (p < 0.001). In multivariate analysis, low Cally Index (< 4.5) emerged as the strongest independent prognostic factor (Hazard Ratio [HR]: 2.86, 95% CI: 1.92–4.26, p < 0.001), followed by Fuhrman grade 3–4 (HR: 2.14), SIRI (HR: 1.98), tumor size > 7 cm (HR: 1.82), NLR (HR: 1.76), PLR (HR: 1.65), and lymphovascular invasion (HR: 1.58). Harrell’s C-index values for the Cally Index-based model were significantly higher than other index models. CONCLUSION: Postoperative Cally Index shows superior prognostic value in predicting disease recurrence in T3 stage RCC compared to other inflammatory indices. This finding suggests that an integrated approach evaluating both inflammation and nutritional status may provide clinical benefit in postoperative risk stratification and individualized follow-up strategies. TRIAL REGISTRATION: Not applicable.
How lesions proportional density shapes MRI cognitive fusion biopsy outcomes; finding the needle in the haystack.
Sen V, Sarikaya EA, Sinirsiz C … +7 more , Karabacak CA, Ozer MS, Altay C, Tuna B, Yorukoglu K, Bozkurt O, Celebi I
BMC Urol · 2026 Feb · PMID 41691232 · Full text
OBJECTIVE: To evaluate the importance of lesion density (lesion volume/prostate volume) on prostate cancer (PCa) and clinically significant prostate cancer (csPCa) detection rates in cognitive targeted biopsy (cTB). MATE...
OBJECTIVE: To evaluate the importance of lesion density (lesion volume/prostate volume) on prostate cancer (PCa) and clinically significant prostate cancer (csPCa) detection rates in cognitive targeted biopsy (cTB). MATERIALS AND METHODS: 300 consecutive patients who underwent combined transrectal cTB and systematic transrectal prostate biopsy were included retrospectively. Lesion density was calculated as the largest lesion volume divided by prostate volume. According to ROC analysis and Youden’s index, patients were grouped into low lesion density (Low-LD) and high lesion density (High-LD) groups. Detection rates of PCa and csPCa were compared. Subgroup analyses were performed for high PI-RADS lesions ( 4–5) and anatomical zones. RESULTS: Mean lesion diameter and prostate volume were 14.1 ± 7.2 mm and 83.9 ± 42.8 mm³, respectively. High lesion density was independently associated with csPCa in univariate and multivariate analysis (p < 0.05). PCa and csPCa detection rates were significantly higher in the High-LD group (53.6% vs. 32.0%, p < 0.001; and 37.1% vs. 16.7%, p < 0.001, respectively). Similar results were observed when only MRI-targeted cores were analysed. Subgroup analysis of PI-RADS 4–5 lesions confirmed that csPCa detection rates were also higher in High-LD group (39.0% vs. 21.5%, p = 0.005). csPCa detection was lowest in anterior lesions, especially in Low-LD patients (6%). CONCLUSIONS: Lesion density significantly affects the diagnostic accuracy of cTB. Patients with low lesion density have lower csPCa detection rates and may benefit from software-assisted fusion targeting over cognitive targeting.
Correction: Outcomes of nephrostomy and double J stent in malignant ureteral obstruction in the Palestinian practice.
Ghannam E, Musleh H, Ahmad T … +3 more , Mustafa M, Odeh R, Shawahna R
BMC Urol · 2026 Feb · PMID 41691227 · Full text
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Migration of radioactive seeds to the paravertebral venous system after prostate cancer brachytherapy: a case series and literature review.
Zhang Y
BMC Urol · 2026 Feb · PMID 41691224 · Full text
BACKGROUND: At our institution, we began using I-125 prostate brachytherapy in 2009. To date, approximately 510 patients have been treated, and we have observed only 14 cases of seed migration. We present three cases of...
BACKGROUND: At our institution, we began using I-125 prostate brachytherapy in 2009. To date, approximately 510 patients have been treated, and we have observed only 14 cases of seed migration. We present three cases of prostate brachytherapy radioactive particles migration to the Paravertebral Venous System with long-term follow up. CASE PRESENTATION: Case 1: A 76-year-old male with intermediate-risk prostate carcinoma (clinical stage T2cN0M0; Gleason score3 + 4; prostate-specific antigen level of 18.51) underwent brachytherapy(I-125). Postoperation pelvic CT scan shown one seed were migrated to the Paravertebral Venous System. Case 2: Male, 77 years old, initial PSA 23.75 ng/ml, ECT shown no obvious abnormal signs. Biopsy pathology: (bilateral) prostate cancer, Gleason score 4 + 3, The pelvic CT scan shown one seed was displaced to the Paravertebral Venous System. Case 3: A 77-year-old Male whose initial PSA49.19 ng/ml, ECT shown third lumbar vertebrae bone metastasis suspected. Right prostate gland cancer Gleason score 4 + 5=9. T2N0M1.Endocrine therapy was started immediately post-surgery. Post-operative imaging on day 1 revealed two seeds had migrated into the paravertebral venous system.The patient in case1 who declined endocrine therapy passed away at 60 months post-surgery. The others shows satisfactory results in terms of PSA. Adding endocrine therapy timely may achieve better results. CONCLUSION: Although migration of radioactive particles to the paravertebral venous system after prostate cancer brachytherapy is extremely rare, it does not seem to significantly affect treatment efficacy or the long-term prognosis of patients.
A 41-Year-Old male with multifocal "grape-like" ureteral carcinoma involving nearly the entire ureter: a case report and management discussion.
Li Y, Liang N, Dong C … +7 more , Tao H, Yu T, Wu S, Xie H, Guo J, Lv W, Lin C
BMC Urol · 2026 Feb · PMID 41680729 · Full text
Ureteral carcinoma, a rare malignancy typically presenting as a solitary ureteral lesion. Early diagnosis is challenging due to nonspecific clinical symptoms and subtle radiographic findings. We describe a 41-year-old ma...
Ureteral carcinoma, a rare malignancy typically presenting as a solitary ureteral lesion. Early diagnosis is challenging due to nonspecific clinical symptoms and subtle radiographic findings. We describe a 41-year-old male with an unusually extensive ureteral tumor that nearly occupied the full length of the right ureter. Multi-regional genomic sequencing demonstrated a branched evolutionary pattern and a complex mutational landscape.
Single-position versus traditional retroperitoneal laparoscopic nephroureterectomy for UTUC: long-term survival and perioperative outcomes.
Zhao K, Huang J, He Y … +9 more , Dong B, Zhang R, Zhang Z, Yin X, Yang X, Jiang G, Bae WJ, Wang K, Zhu G
BMC Urol · 2026 Feb · PMID 41680709 · Full text
BACKGROUND: Traditional retroperitoneal laparoscopic radical nephroureterectomy (TRLRNU) for upper tract urothelial carcinoma (UTUC) requires intraoperative repositioning, increasing operative time and risk. A modified s...
BACKGROUND: Traditional retroperitoneal laparoscopic radical nephroureterectomy (TRLRNU) for upper tract urothelial carcinoma (UTUC) requires intraoperative repositioning, increasing operative time and risk. A modified single-position approach (SRLRNU) may improve perioperative efficiency. METHODS: We retrospectively analyzed 276 UTUC patients who underwent either SRLRNU (n = 131) or TRLRNU (n = 145) from 2020 to 2024. In SRLRNU, patients remained in a fixed oblique lateral decubitus position throughout, enabling complete nephroureterectomy and bladder cuff excision without repositioning. Detailed surgical steps and port configurations were standardized and are presented in this study. Perioperative and oncologic outcomes were compared between groups. Survival analyses were conducted using Kaplan–Meier and Cox regression models. Subgroup analyses were performed according to tumor stage and pathological characteristics. RESULTS: The SRLRNU group showed significantly shorter operative time (124.47 ± 42.54 min vs. 160.11 ± 51.43 min, p < 0.001) and reduced blood loss (47.61 ± 140.75 ml vs. 71.45 ± 108.42 ml, p < 0.001), without compromising margin status or complication rates. No significant differences were observed in OS, CSS, PFS, or RFS between the two groups (all p > 0.05). Univariable and multivariable analysis suggested T stage, age, and ASA score as independent predictors of OS in the SRLRNU group. Hypoalbuminemia was significantly less frequent in the SRLRNU group (60.31% vs. 77.24%, p = 0.002). CONCLUSION: SRLRNU appears to be a safe and efficient alternative to TRLRNU, offering improved perioperative efficiency. Oncologic outcomes were comparable between groups during mid-term follow-up; however, given the retrospective design and follow-up imbalance, these findings should be interpreted as exploratory. Further studies with longer and more balanced follow-up are warranted.
Automatic classification of kidney stone components based on smartphone microscopy and the GoogLeNet model.
Du Y, Liang Y, Li P … +16 more , Xu Y, Zhen X, Li L, Huang M, Zhan Y, Li G, Wu Z, Anson CHF, Zhou C, Aimaierjiang A, Chen J, Tang K, Guo Y, Guo Z, Bian J, Lai D
BMC Urol · 2026 Feb · PMID 41673817 · Full text
BACKGROUND: To develop an automated classification system for urinary stone composition by integrating smartphone-based microscopic imaging (TIPSCOPE) with the GoogLeNet architecture, with the goal of enabling rapid, acc...
BACKGROUND: To develop an automated classification system for urinary stone composition by integrating smartphone-based microscopic imaging (TIPSCOPE) with the GoogLeNet architecture, with the goal of enabling rapid, accurate, and cost-effective analysis of stone composition. METHODS: A total of 140 surgically extracted kidney stone samples were collected and classified into four categories: calcium oxalate (66 cases), uric acid (32 cases), carbonate apatite (26 cases), and magnesium ammonium phosphate hexahydrate (16 cases). Microscopic images of the stones were acquired using the TIPSCOPE device paired with a Realme GT5 smartphone, resulting in a dataset of 840 images. The classification model was trained using the Adam optimizer, with 90% of the dataset allocated for training and 10% reserved for testing. RESULTS: The overall accuracy of the system reached 85.7%. Performance metrics for each category were as follows: uric acid stones: F1 = 0.92 (precision = 0.90, recall = 0.95); magnesium ammonium phosphate hexahydrate stones: F1 = 0.95 (precision = 0.90, recall = 1.00); calcium oxalate stones: F1 = 0.86 (precision = 0.85, recall = 0.88); carbonate apatite stones: F1 = 0.69 (precision = 0.77, recall = 0.63). CONCLUSION: This study successfully developed a kidney stone composition classification system integrating a smartphone-based microscope with a deep learning model, achieving an overall classification accuracy of 85.7%. The system exhibited strong performance in classifying uric acid and magnesium ammonium phosphate hexahydrate stones. With its low cost, efficiency, and portability, this system offers an economical and practical diagnostic solution for resource-limited regions.
Dwell time of percutaneous nephrostomies in pregnancy - what is the optimal exchange interval?
Khanna Y, Huynh TNA, Wei G … +2 more , Morkos K, Ranasinghe W
BMC Urol · 2026 Feb · PMID 41673662 · Full text
BACKGROUND: If procedural intervention is indicated, options for management of obstructive uropathy in pregnancy include ureteric stenting, primary ureteroscopy (for calculi), or percutaneous nephrostomy. Early encrustat...
BACKGROUND: If procedural intervention is indicated, options for management of obstructive uropathy in pregnancy include ureteric stenting, primary ureteroscopy (for calculi), or percutaneous nephrostomy. Early encrustation/blockage of nephrostomy tubes in pregnancy has been described, due to glomerular hyperfiltration/hypercalcuria. Some authors describe shorter exchange intervals (i.e. 3-weekly), while AUA guidelines recommend exchange 4–6 weekly. This study aims to evaluate outcomes of nephrostomy insertion during pregnancy in a tertiary centre in Melbourne, Australia. METHODS: Seventeen patients underwent percutaneous nephrostomy insertion during pregnancy from 2013 to 2023, in a tertiary centre in Melbourne, Australia. Data collected retrospectively included indication for nephrostomy, radiation exposure, dwell time, blockage/dislodgement rates, urological and obstetric outcomes. RESULTS: Of 17 pregnant patients, indication for nephrostomy included ureteric calculus (n = 13), transplant hydronephrosis (n = 1), ureteric clot obstruction (n = 1), obstructive cervical malignancy (n = 1), and infected PUJO (n = 1). Mean age was 32.5 years (SD 5.7 years), whilst mean gestation stage was 25.0 weeks (SD 9.4 weeks). Regarding radiation exposure – mean DAP was 219.7 uGym2, mean air kerma 33.6 mGy, and mean fluoroscopy time 1.5 min. Mean nephrostomy dwell time was 37.45 days/5.35 weeks (SD 25.1 days), while median dwell time was 31 days (IQR 21.5–45 days). There were no peri-procedural urological or major obstetric complications. CONCLUSION: In our pregnant cohort (albeit small), mean nephrostomy dwell time was notably greater than previously described (5.35 weeks in our cohort vs. ~ 3 weeks in the literature). This finding aligns with AUA guidelines for nephrostomy exchange 4–6 weekly in pregnancy. Larger volume prospective data is required to establish appropriate exchange intervals for nephrostomies in pregnancy.
Fasting blood glucose to HDL-C ratio as a potential biomarker for prostate cancer risk classification.
Özkan S, Börekoğlu A
BMC Urol · 2026 Feb · PMID 41673650 · Full text
AIM: Although a relationship has been demonstrated between prostate cancer (PCa), benign prostatic hyperplasia (BPH), and insulin resistance, the results are inconclusive. The aim of this study was to investigate the pot...
AIM: Although a relationship has been demonstrated between prostate cancer (PCa), benign prostatic hyperplasia (BPH), and insulin resistance, the results are inconclusive. The aim of this study was to investigate the potential value of the fasting blood glucose-to-high-density lipoprotein cholesterol ratio (GHR) in classifying PCa and BPH risks. MATERIALS AND METHODS: This retrospective analysis examined 185 patients who were recently diagnosed with PCa and 185 age-matched patients with BPH. Preoperative blood test and biopsy results were obtained, and patients with PCa were divided into low-, intermediate-, and high-risk groups using the D’Amico risk classification. The fasting blood glucose (FBG), total cholesterol, triglycerides, HbA1c, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), hemogram parameters, lipid ratios, and GHR levels of the two groups and prostate risk groups were compared. RESULTS: FBG levels and GHR were significantly higher in patients with PCa than in those with BPH (P < 0.001). No significant differences were found between the two groups in terms of total cholesterol, LDL-C, HDL-C, triglyceride levels, or lipid ratios. FBG and GHR levels were significantly higher in the intermediate- and high-risk PCa groups than in the low-risk group (p < 0.001). Spearman’s correlation analysis revealed weak but significant positive correlations between PCa risk and FBG (r = 0.242, p = 0.001) and GHR (r = 0.158, p = 0.031). CONCLUSION: These findings suggest that glycemic dysfunction may play a more prominent role in PCa development than lipid parameters and that GHR may serve as a potential biomarker for PCa risk stratification. However, further research is needed in the form of larger prospective studies to confirm these results and determine the clinical utility of GHR in PCa risk assessment and disease progression monitoring.
Development of machine learning prediction models for postoperative outcomes in adult male circumcision.
Shpaner L, Saitta G
BMC Urol · 2026 Feb · PMID 41668020 · Full text
BACKGROUND: Male circumcision is among the most commonly performed and clinically endorsed surgical procedures globally, deeply rooted in medical, cultural, and religious traditions. While circumcision confers well-docum...
BACKGROUND: Male circumcision is among the most commonly performed and clinically endorsed surgical procedures globally, deeply rooted in medical, cultural, and religious traditions. While circumcision confers well-documented health benefits such as reduced infection and inflammation, adult patients often experience variable outcomes related to anatomical variations and comorbidities, emphasizing the importance of optimizing procedural planning. METHODS: The objective of this study was to develop and internally validate prediction models for short-term postoperative complications following adult male circumcision. This retrospective study evaluated the ability of supervised machine learning models (logistic regression [LR], random forest [RF], and support vector machines [SVM]) to predict short-term postoperative complications following adult male circumcision, using procedural and intraoperative variables, including surgical modality (scalpel- and clamp-based (traditional) vs. laser-based), intraoperative blood loss, and operative technique. Data from 194 adult male patients (≥ 18 years) who underwent circumcision between 2023 and 2024 at a single clinical center in Milan, Italy, were analyzed. Models were trained using standardized preprocessing pipelines and evaluated via stratified 10-fold cross-validation using classification metrics, calibration curves, and SHapley Additive exPlanations (SHAP)-based interpretability analysis. RESULTS: The SVM model demonstrated superior predictive performance, achieving the highest area under the curve of the receiver operating characteristic (AUC ROC) of 0.907, sensitivity of 0.862, average precision of 0.832, and the lowest Brier score of 0.105. SHAP analysis identified intraoperative blood loss and surgical technique as the strongest predictors of postoperative complications. CONCLUSIONS: These findings support the clinical utility of interpretable machine learning models for individualized risk prediction in adult circumcision, guiding tailored preoperative decisions, particularly in high-risk or resource-limited clinical settings. Study strengths include rigorous evaluation and interpretability, while limitations encompass single-center data and the absence of external validation. Therefore, future research should assess generalizability across more diverse surgical populations and healthcare environments.
Establishment and validation of a predictive model for renal injury caused by unilateral upper urinary tract stone obstruction based on dynamic renal scintigraphy.
Zang MY, Zhang YQ, Xu XB … +3 more , Zhang JJ, Zhao Y, Han CH
BMC Urol · 2026 Feb · PMID 41668014 · Full text
OBJECTIVE: This study aimed to develop and validate a predictive model for assessing the risk of renal impairment due to unilateral upper urinary tract stone obstruction, leveraging easily accessible clinical indicators...
OBJECTIVE: This study aimed to develop and validate a predictive model for assessing the risk of renal impairment due to unilateral upper urinary tract stone obstruction, leveraging easily accessible clinical indicators to overcome the limitations of traditional renal function markers and the impracticality of Dynamic Renal Scintigraphy (DRS) in routine clinical practice. METHODS: A multicenter, retrospective cohort study was conducted with 370 patients who had unilateral upper urinary tract stones and underwent DRS. Patients were split into training (n = 259) and validation (n = 111) groups. Initial screening of 16 candidate variables led to the identification of five key predictors via LASSO regression: age, asymptomatic status, maximum stone cross-sectional area, urine white blood cell count, and hydronephrosis Society for Fetal Urology (SFU) grade. A nomogram was developed to visualize the model, and its performance was assessed using ROC curves, calibration plots, and decision curve analysis (DCA). RESULTS: The model demonstrated robust discrimination, with AUC values of 0.742 (95% CI: 0.61-0.82) in the training set and 0.793 (95% CI: 0.675-0.911) in the validation set. Calibration curves confirmed high accuracy, and DCA highlighted significant clinical value. Older age, asymptomatic presentation, larger stone size, elevated urine white blood cells, and higher SFU grade were independently linked to a higher risk of renal impairment. CONCLUSION: The proposed nomogram offers a practical, non-invasive method for early identification of patients at high risk of renal impairment from unilateral upper urinary tract stone obstruction, enabling timely intervention and optimized resource utilization. This model is particularly beneficial in primary care settings where DRS is unavailable, providing a cost-effective alternative to mitigate irreversible renal damage.
Correction: Effectiveness of methenamine hippurate in preventing urinary tract infections: an updated systematic review, meta-analysis and trial sequential analysis of randomized controlled trials.
De Oliveira GC, Hobaica NC, Porto BC … +4 more , Passerotti CC, Da Silva Sardenberg RA, Otoch JP, Da Cruz JAS
BMC Urol · 2026 Feb · PMID 41664093 · Full text
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Evaluation of safety reporting in interventional trials of benign prostatic hyperplasia: a registry-publication comparison study.
Itani M, Livsey T, Keefer K … +6 more , Elghzali A, Sherry R, Harris T, Archer D, Ford AI, Vassar M
BMC Urol · 2026 Feb · PMID 41664086 · Full text
PURPOSE: To assess the concordance of adverse event reporting between clinical trial registries and their corresponding publications for interventions treating benign prostatic hyperplasia. MATERIALS AND METHODS: We cond...
PURPOSE: To assess the concordance of adverse event reporting between clinical trial registries and their corresponding publications for interventions treating benign prostatic hyperplasia. MATERIALS AND METHODS: We conducted a registry-to-publication comparison study to evaluate the completeness and concordance of adverse event reporting in benign prostatic hyperplasia. Studies were identified via searches of ClinicalTrials.gov studies with results posted from September 2009 to December 2024. We identified corresponding publications via ClinicalTrials.gov, PubMed, Google Scholar, pharmaceutical company portals, and Cochrane reviews. Data extraction was performed independently and in duplicate by masked reviewers. A quantitative analysis used descriptive statistics, Bland-Altman plots, funnel plots, and regression to assess concordance and identify predictors of incomplete reporting. Due to the study's focus on concordance, traditional risk of bias assessment was not conducted, however robust systematic review methods were employed. RESULTS: Of 36 included benign prostatic hyperplasia trials, registry reporting of adverse events was more complete than in publications. Post-Final Rule, overall adverse events and death reporting improved in registries but declined or remained inconsistent in manuscripts. Over 70% of trials showed discrepancies in serious adverse events counts, with most publications underreporting events compared to ClinicalTrials.gov. CONCLUSIONS: In benign prostatic hyperplasia trials, adverse event data were more complete in ClinicalTrials.gov than in corresponding publications. Serious harm reporting was inconsistent, and post-Final Rule improvements in registry data were not mirrored in print. These gaps risk distorting clinical interpretation and highlight the need for aligned reporting standards to ensure transparent, patient-relevant safety communication. TRIAL REGISTRATION: Registered on the Open Science Framework.
Patient-reported outcomes after single-stage spiral preputial graft urethroplasty for panurethral strictures: a single-centre prospective study.
Thakkar S, Joshi P, Bhadranavar S … +4 more , Navarro J, Barot P, Kandhari P, Kulkarni S
BMC Urol · 2026 Feb · PMID 41664003 · Full text
BACKGROUND: Panurethral strictures, involving the entire anterior urethra, present a significant reconstructive challenge. While buccal mucosal grafts are commonly used, limitations in graft length and donor site morbidi...
BACKGROUND: Panurethral strictures, involving the entire anterior urethra, present a significant reconstructive challenge. While buccal mucosal grafts are commonly used, limitations in graft length and donor site morbidity persist. The spiral preputial graft (SPG) offers a promising alternative, enabling long, hairless grafts without additional donor morbidity. This study prospectively evaluates patient-reported outcomes (PROs) following single-stage SPG urethroplasty for panurethral strictures. METHODS: A prospective interventional study was conducted between January 2021 and June 2024 at a tertiary urology center. Fifty-five patients undergoing SPG urethroplasty were included. Exclusion criteria included Lichen Sclerosus, prior urethroplasty, and inadequate preputial skin. PROs were assessed preoperatively and postoperatively using the Lower Urinary Tract Symptom (LUTS) score, Visual Analogue Scale (VAS) for health status, treatment satisfaction, and quality of life (QoL) impact. Statistical significance was set at p < 0.05. RESULTS: Median LUTS scores improved significantly from 18 to 2 (p < 0.001), and mean VAS scores increased from 59.36 to 84.4 (p < 0.001). QoL improvement was reported by 83.6% of patients. The overall success rate—defined as symptom relief without secondary endoscopic or open intervention—was 83.7%. CONCLUSION: Single-stage SPG urethroplasty is a technically feasible, reproducible, and effective alternative to oral grafting for panurethral strictures. It results in significant improvements in urinary symptoms, health perception, and patient satisfaction. These findings support broader adoption of the SPG technique in appropriately selected patients, with an emphasis on integrating PROs into surgical outcome assessment.
Microsurgical varicocelectomy versus laparoscopic surgery versus embolization for varicocele: a retrospective cost-effectiveness analysis.
Wang J, Jiang H, Lan J
BMC Urol · 2026 Feb · PMID 41656240 · Full text
BACKGROUND: Varicocele is one of the most common causes of male infertility. Although multiple surgical and interventional methods are available, their cost-effectiveness remains insufficiently studied. This study aimed...
BACKGROUND: Varicocele is one of the most common causes of male infertility. Although multiple surgical and interventional methods are available, their cost-effectiveness remains insufficiently studied. This study aimed to compare short-term clinical outcomes and cost-effectiveness of microsurgical and laparoscopic varicocelectomy, reporting embolization outcomes as exploratory data owing to the limited number of cases. METHODS: A retrospective analysis was conducted on 113 patients with varicocele who were admitted to our hospital between June 2022 and May 2025. Based on the surgical approach, patients were categorized into three groups: microsurgical (n = 42), embolization (n = 8), and laparoscopic (n = 63). Owing to the small size of the embolization cohort, primary comparative and cost-effectiveness analyses were performed for the microsurgical and laparoscopic groups, while embolization outcomes were reported descriptively. Preoperative and postoperative measures, including sperm concentration, percentage of forward-moving spermatozoa (PR%), maximum diameter of the spermatic vein, surgical cost, and postoperative complications, were compared and analyzed. All procedures were performed by senior urologists experienced in varicocele repair, and postoperative complications were recorded. A cost-effectiveness analysis was performed by calculating the cost-effectiveness ratio (CER) and incremental CER based on hospitalization costs and improvements in semen parameters. RESULTS: All 113 patients successfully completed surgical treatment. Intra-group comparisons showed that all three surgical approaches led to significant postoperative improvements compared with the preoperative period (P < 0.05). Inter-group comparisons indicated that the improvement in PR% was significantly greater in the microsurgical group than in the laparoscopy group (P < 0.05). Cost-effectiveness analysis revealed that microsurgery yielded the lowest CERs for sperm concentration improvement (CER: 410.13) and PR% improvement (CER: 220.78), with incremental analysis demonstrating that microsurgery was superior to laparoscopic surgery. CONCLUSIONS: In this single-center retrospective cohort, microsurgical varicocelectomy was associated with superior short-term improvement in PR% and more favorable cost-effectiveness compared with laparoscopic varicocelectomy. Embolization outcomes were exploratory because of the limited sample size and should be interpreted with caution. Further multicenter studies with larger embolization cohorts and longer follow-up are warranted.
Association between polyunsaturated fatty acid intake and proteinuria in the US adult population: a study from the NHANES database.
Zhang H, Zeng QY, Zhang P
BMC Urol · 2026 Feb · PMID 41652579 · Full text
BACKGROUND: Moderate consumption of polyunsaturated fatty acids has been shown to confer a protective effect against proteinuria and to slow the progression of chronic kidney disease. OBJECTIVE: This study aimed to syste...
BACKGROUND: Moderate consumption of polyunsaturated fatty acids has been shown to confer a protective effect against proteinuria and to slow the progression of chronic kidney disease. OBJECTIVE: This study aimed to systematically examine the relationship between polyunsaturated fatty acid intake and proteinuria in the U.S. population, with the goal of providing a foundation for dietary interventions in patients with kidney disease. METHDS: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2012 and 2015–2018. Various statistical methods, including descriptive analysis, multivariate logistic regression, the XGBoost machine learning model, and receiver operating characteristic (ROC) curves, were employed to evaluate the relationship between polyunsaturated fatty acid intake and the risk of proteinuria. RESULTS: An analysis of the NHANES database, after controlling for various variables such as demographic characteristics and lifestyle factors, revealed that polyunsaturated fatty acid intake was significantly associated with the risk of proteinuria (OR = 0.99; 95% CI: 0.98–0.99; p < 0.001). These findings suggest that moderate intake of polyunsaturated fatty acids may have a protective effect against proteinuria. CONCLUSION: The results of this study, derived from a comprehensive analysis of NHANES data, suggest that moderate intake of polyunsaturated fatty acids may help delay the progression of renal disease and could serve as a potential dietary intervention strategy for patients with renal disease.
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