Urology Journal[JOURNAL]
Sun
200 papers
Treatment of Unconsummated Marriage in Psychogenic Erectile Dysfunction among Iranian Couples.
Foroutan SK, Jadid-Milani M, Lashani Z … +1 more , Khayyamfar F
Urol J · 2026 Jun · PMID 42251511 · Publisher ↗
PURPOSE: Sexual dysfunction associated with psychological reasons is one of the factors impacting unfulfilled marriages. There are limited data on treatment outcomes in this context. The aim of this study was determining...
PURPOSE: Sexual dysfunction associated with psychological reasons is one of the factors impacting unfulfilled marriages. There are limited data on treatment outcomes in this context. The aim of this study was determining the treatment of unconsummated marriage in psychogenic erectile dysfunction in Iranian Couples. MATERIALS AND METHODS: A total of 66 cases were selected from individuals referred to the Family Health Clinic (from 2006 to 2019), who had unconsummated marriages and experienced psychogenic erectile dysfunction, meeting the inclusion criteria for the study. Research tools included couples' demographic information, face-to-face interviews, and the International Index of Erectile Function (IIEF). The treatment was based on couple's therapy. In the initial session, a comprehensive assessment of the couples' condition was conducted, and research instruments were completed. Additionally, during this session, the formation of psychogenic erectile dysfunction and the lack of successful foreplay were discussed. In subsequent sessions, desensitization, instruction on foreplay, and intercourse were addressed. Treatment success was defined as the ability to achieve complete vaginal penetration. Data was analyzed using SPSS 16 software. RESULTS: All 66 couples continued the treatment until they achieved successful vaginal penetration. All International Index of Erectile Function (IIEF) domains improved significantly after couple-based behavioral therapy in men with psychogenic erectile dysfunction in unconsummated marriages (all p < .001; large effect sizes for most domains). No significant associations were found between educational level, place of residence, engagement duration, or marriage duration and post-treatment scores (all p > 0.05). Male age correlated negatively with overall ED (r = -.314, P = .001), erectile function (r = -.361, P = .003), intercourse satisfaction (r = -.365, P = .003), and overall satisfaction (r = -.266, P = .031). Similar negative associations were observed for female age with overall ED (r = -.371, P = .002), erectile function (r = -.354, P = .004), intercourse satisfaction (r = -.344, P = .005), and overall satisfaction (r = -.246, P = .047). CONCLUSION: Psychogenic erectile dysfunction in unconsummated marriage can be addressed through couple-based therapy.
The Impact of Body Mass Index on Quantitative 24-h Urine Chemistries in Pediatric Urolithiasis: A Systematic Review and Meta-Analysis.
Zhong J, Yang B, Liu Y … +3 more , Jiang Y, Liu J, Zeng T
Urol J · 2026 Jun · PMID 42251510 · Publisher ↗
PURPOSE: To study the effect of body mass index (BMI) on 24-h urine quantitative analysis in pediatric urolithiasis, and to explore whether obesity and overweight promote the formation of urinary calculi in children. MAT...
PURPOSE: To study the effect of body mass index (BMI) on 24-h urine quantitative analysis in pediatric urolithiasis, and to explore whether obesity and overweight promote the formation of urinary calculi in children. MATERIALS AND METHODS: A comprehensive search of EMBASE, PubMed, the Cochrane Library, Web of Science, and Scopus was conducted in March 2024 and updated in October 2025 to identify all related studies. BMI was used to specify body size. Predetermined inclusion and exclusion criteria were used to screen each article. Data from appropriate studies were extracted, and a meta-analysis was performed using Stata 14.0 software. RESULTS: Eight studies, including 1033 children with urolithiasis who underwent 24-h urine collection for chemical analysis, were included in this meta-analysis. The BMI ≥ 85th percentile group exhibited significantly higher uric acid excretion (SMD = 0.756, 95% CI = 0.092-1.420, P = .026). No statistically significant differences were found in calcium (SMD = -0.320, 95% CI = -0.600 to -0.050, P = .519), 24-h urine volume (SMD = -0.310, 95% CI = -0.790 to 0.160, P = .555), magnesium (SMD = -0.470, 95% CI = -0.820 to -0.120, P = .471), phosphate (SMD = -0.360, 95% CI = -0.610 to -0.110, P = .805), oxalate (SMD = -0.110, 95% CI = -0.390 to 0.170, P = .315), citrate (SMD = -0.190, 95% CI = -0.680 to 0.290, P = .057), or sodium (SMD = 0.200, 95% CI = -0.390 to 0.800, P = .050) excretion between the two groups. Sensitivity analyses confirmed the robustness of these findings. CONCLUSION: While overweight/obese children with urolithiasis demonstrate higher urinary uric acid excretion, the absence of significant differences in other key urinary risk factors suggests that BMI alone should not be considered a separate and definitive risk factor for pediatric urolithiasis.
Association between Plasma Uric Acid Level and Mortality Rate in Children with Sepsis and Acute Kidney Injury.
Sadeghi Bojd S, Soleimani G, Yaghoubi S … +3 more , Sarhadi S, Khazaei N, Nikbakht J
Urol J · 2026 Jun · PMID 42251509 · Publisher ↗
PURPOSE: Acute kidney injury (AKI) is a common condition in hospitalized patients that can have a significant impact on outcomes, including an increase in overall complications and mortality rates. Criteria such as serum...
PURPOSE: Acute kidney injury (AKI) is a common condition in hospitalized patients that can have a significant impact on outcomes, including an increase in overall complications and mortality rates. Criteria such as serum creatinine level, urinary output, and scoring systems such as KDIGO in acute conditions do not have acceptable specificity and sensitivity to evaluate kidney function. Therefore, this study was conducted to determine the relationship between plasma uric acid level and mortality rate in patients with sepsis and acute kidney failure. MATERIALS AND METHODS: In this descriptive-analytical (cross-sectional) study, 52 children aged from one month to 15 years with sepsis (based on qSOFA criteria) and acute kidney failure (based on serum creatinine level) admitted to the PICU of Ali Bin Abi Taleb Hospital from October 1401 to October 1402 were included and studied by the census method. Within 48 hours after admission to the ICU, blood samples were collected to check serum uric acid levels, electrolytes, albumin, complete blood count (CBC), kidney function tests, arterial blood gases, and chest x-rays. All patients were followed up until discharge or death due to progression of kidney failure. Finally, the findings of the research were analyzed using SPSS version 26 statistical software. RESULTS: The mean age of patients was 3.66 ± 4.92 years. The number of deaths in the hyperuricemia group was significantly higher than in the normal uric acid group (P = 0.03); an odds ratio of 3.45 indicates that a high level of uric acid is a risk factor for death. In this study, the duration of hospitalization was longer in those who survived (P = 0.02). A particularly strong predictor in our analysis was the qSOFA score (P < 0.001), highlighting its critical role in determining outcome. Serum uric acid level and qSOFA scale showed no significant difference overall (P = 0.76); subgroup analysis among surviving and deceased patients between uric acid and the qSOFA scale presented the same result (P = 0.203 and P = 0.29, respectively). CONCLUSION: The level of uric acid can be considered a laboratory variable to predict the prognosis of patients.
Patterns and Outcomes of Patient Complaints Against Urologists: A Seven-Year Retrospective Analysis in Iran.
Shahrokhi M, Behnam Shakiba, Ameri M … +2 more , Ali Mohammadi AM, Vahedi V
Urol J · 2026 May · PMID 42249634 · Publisher ↗
We conducted a retrospective cross-sectional analysis of 288 complaints filed against urologists between 2017 and 2023 at the Forensic Medicine Organization in Shemiranat, Tehran. The number of complaints increased stead...
We conducted a retrospective cross-sectional analysis of 288 complaints filed against urologists between 2017 and 2023 at the Forensic Medicine Organization in Shemiranat, Tehran. The number of complaints increased steadily, peaking in 2023 (n = 66) and reaching a nadir in 2020 (n = 13), likely reflecting the impact of the COVID-19 pandemic. Most complainants were male (89.6%), and patients aged >60 years comprised the largest group (31.3%). Complaints were overwhelmingly directed at specialist urologists (97.6%), with subspecialists accounting for only 2.4%. Cases more frequently originated from public hospitals (66.3%) than from private institutions (33.7%).
Clinical Features and Treatment Outcomes of Large Bladder Tumors Nearly Filling the Bladder.
Akarken I, Tarhan H, Karaoz F … +3 more , Deliktas H, Dere Y, Sahin H
Urol J · 2026 Jun · PMID 41618669 · Publisher ↗
PURPOSE: The prognosis and clinical management of bladder tumors nearly occupying the entire bladder cavity remain poorly defined due to limited available data. This study aimed to evaluate the clinical features and trea...
PURPOSE: The prognosis and clinical management of bladder tumors nearly occupying the entire bladder cavity remain poorly defined due to limited available data. This study aimed to evaluate the clinical features and treatment outcomes of patients presenting with bladder tumors nearly filling the bladder at initial diagnosis. MATERIALS AND METHODS: After obtaining ethical approval, a retrospective analysis was conducted on 51 patients diagnosed between 2017 and 2024 with primary bladder tumors nearly filling the bladder. All underwent transurethral resection of bladder tumor (TURBT). The clinical and pathological data were analyzed using descriptive statistics and multivariable logistic regression. RESULTS: The mean age was 76.24 ± 11.7 years, with a median follow-up of 9.73 months (range: 3-84 months). Hematuria was the most frequent symptom (74.5%). Muscle-invasive disease was identified in 43.1% of cases at initial diagnosis, exceeding the 25% generally reported in newly diagnosed bladder cancer cohorts (p < .001). Complete resection was achieved in 68.6%, while 31.4% required repeat TURBT (re-TURBT). Among patients initially diagnosed with non-muscle-invasive tumors, 31.1% were found to have muscle invasion upon second resection. Treatments comprised intravesical immunotherapy (48.6%), radical cystectomy (25.7%), chemoradiation (14.3%), and systemic chemotherapy (11.4%). CONCLUSION: Bladder tumors nearly filling the bladder cavity are associated with high rates of muscle invasion and pose significant challenges in treatment and management. Larger, prospective multicenter studies are warranted to validate these findings and optimize management in this high-risk population.
Is there any Relationship between Sleeping Position and Varicocele?
Mehrabi S, Bazarganipour F, Heidari Z … +1 more , Taghavi SA
Urol J · 2026 Jun · PMID 41618668 · Publisher ↗
PURPOSE: Varicocele is the abnormal dilatation of the veins of the pampiniform plexus, which is considered one of the most common factors related to infertility in men. The aim of the present study was to investigate whe...
PURPOSE: Varicocele is the abnormal dilatation of the veins of the pampiniform plexus, which is considered one of the most common factors related to infertility in men. The aim of the present study was to investigate whether a relationship exists between sleeping position and the presence of varicocele. MATERIALS AND METHODS: In this case-control study, 231 adult infertile men who were referred to the Kowsar Infertility Center, Yasuj, Iran, were divided into two groups: a control group including 113 infertile patients without varicocele, and a case group of 118 infertile patients with varicocele. After the first visit by the urologist and determining the presence or absence of varicocele, as well as the clinical grading of the varicocele, the patients completed demographic, clinical, and sleep position questionnaires. RESULTS: The findings of the current study indicated a significant relationship between the presence of varicocele and the faller-down (lying on the abdomen) sleeping position. There was also a significant positive correlation between this position and the degree of varicocele (p =0.003). CONCLUSION: The faller-down or prone position during sleep has a meaningful relationship with varicocele, which may be due to increased intra-abdominal pressure. More studies are needed to confirm this hypothesis.
Comparison of Super Mini Percutaneous Nephrolithotomy (smPCNL) and Extracorporeal Shock Wave Lithotripsy (ESWL) in Pediatric 1-2 cm Kidney Stones: A Single-Center Retrospective Controlled Study.
Sevim M, Demir M, Eryılmaz R … +2 more , Aslan R, Taken K
Urol J · 2026 May · PMID 41618667 · Publisher ↗
PURPOSE: To compare outcomes of super mini percutaneous nephrolithotomy (smPCNL) with extracorporeal shock wave lithotripsy (ESWL) for stones 1-2 cm. MATERIALS AND METHODS: After receiving ethics committee approval for t...
PURPOSE: To compare outcomes of super mini percutaneous nephrolithotomy (smPCNL) with extracorporeal shock wave lithotripsy (ESWL) for stones 1-2 cm. MATERIALS AND METHODS: After receiving ethics committee approval for this study (Date: 10/09/2021 Decision No: 2021/10-01), the files of patients who underwent smPCNL and ESWL for kidney stones between January 2017 and June 2021 by the Urology Department of Van YYU Dursun Odabaşı Medical Center were retrospectively scanned. A total of 300 patients' data were scanned retrospectively. After applying the exclusion criteria and omitting ESWL patients whose sessions were not completed, a total of 159 patients, including 82 in the ESWL group and 77 in the smPCNL group, were included in our study. RESULTS: The mean age in the ESWL group was 6.72 ± 3.71, and the mean age in the smPCNL group was 6.63 ± 3.59 (range: 1-18 years). There was no significant difference in the age profile between the groups (p = .87). Regarding the direction of the stone procedure in the smPCNL group, the procedure was performed on the right side in 42 patients (54.54%) and on the left side in 35 patients (45.46%). In the ESWL group, the procedure was performed on the right side in 38 patients (46.35%) and on the left side in 44 patients (53.65%). No statistically significant difference was found between the groups in terms of side direction (p = .38). The mean body mass index (BMI) in the ESWL group was 20.10 ± 2.01, while it was 20.23 ± 2.05 in the smPCNL group. No statistically significant difference was observed between the two groups in terms of BMI (p =.68). The mean stone size in the ESWL group was calculated as 13.74 ± 1.91 mm (10-20 mm) and 149.75 ± 45.46 mm², which would provide more accurate results. The mean value in the smPCNL group was 14.06 ± 2.6 mm (10-20 mm) and 150.87 ± 50.34 mm². No statistically significant difference was found between the groups in terms of stone size (p(mm)=.37, p(mm²)=.88). Among 82 patients treated with ESWL, 21 (25.6%) were stone-free after the first session, increasing to 40 (48.8%) by the end of the second session, and to 50 (61.0%) at the end of the third session. In terms of sedoanalgesia, 19 patients (23.20%) were exposed to 1 session, 16 (19.5%) were exposed to 2 sessions, and 31 (37.80%) were exposed to 3 sessions. Sixteen (19.5%) patients did not receive anesthesia. When evaluated in terms of the need for re-intervention, it was observed in 22 patients (26.8%) in the ESWL group and 4 patients (5.2%) in the smPCNL group (p = .0003). In the comparison of the stone-free rate of the smPCNL and ESWL groups, a statistically significant difference was observed in both the early and late periods (p = .001). When comparing the early and late periods of smPCNL (p = .79) and ESWL (p = .19) within their own groups, no statistical difference was observed. When smPCNL and ESWL were classified according to the Clavien-Dindo classification in terms of complications, no statistically significant difference was observed (p = .51). CONCLUSION: ESWL remains the preferred first-line option for many pediatric patients due to its safety and non-invasive nature. However, smPCNL provides higher single-session stone-free rates for 10-20 mm renal stones and may reduce repeated anesthesia exposure. SmPCNL should be considered a viable first-line alternative to achieve higher stone-free rates without increasing complication risks. Prospective, multicenter randomized trials are warranted.
A Intravesical Brucella Abortus S19 (BAS19) Vaccine As A Potential Alternative To Bacillus Calmette-Guerin (BCG) Immunotherapy: A Preclinical Study In Rats.
Benlioğlu C, Kalyenci B, Yucel MO … +4 more , Çift A, Türk A, Aydıntürk B, Sayiner HS
Urol J · 2026 May · PMID 41618666 · Publisher ↗
PURPOSE: This preliminary study aims to evaluate the immunogenicity and local immune response triggered by the intravesical administration of Brucella abortus S19 (BAS19) in a tumor-free rat model as a potential alternat...
PURPOSE: This preliminary study aims to evaluate the immunogenicity and local immune response triggered by the intravesical administration of Brucella abortus S19 (BAS19) in a tumor-free rat model as a potential alternative to Bacillus Calmette-Guerin (BCG) in bladder cancer immunotherapy. The primary objective is to investigate immune activation and safety in the bladder, establishing a foundation for future studies assessing its therapeutic efficacy against urothelial carcinoma. MATERIALS AND METHODS: Nineteen female Wistar albino rats received intravesical BAS19 instillations and were euthanized after 3 and 6 weeks. Blood samples and cystectomy tissues were collected. The systemic immune response was assessed using the Rose Bengal agglutination test, immunocapture agglutination test, and blood cultures. Bladder tissues were examined histopathologically and stained immunohistochemically to evaluate local immune responses, specifically analyzing the expression of CD4, CD8, TLR4, and TNF-α. RESULTS: Higher Brucella-specific immunocapture titers and increased epithelial inflammation were observed in rats treated with BAS19 for 6 weeks. Moreover, significantly enhanced staining of CD4+, CD8+, and TNF-α in inflammatory cells was detected in this group. TLR4 expression was observed in all BAS19-treated rats, regardless of the exposure duration. CONCLUSION: Intravesical BAS19 administration in rats induced strong local immune responses via CD4+, CD8+, TNF-α, and TLR4 expression without systemic toxicity. These results suggest that BAS19 may mimic BCG's immunological pathways, particularly through TLR4 signaling. With its safety, low cost, and immunogenicity, BAS19 emerges as a promising immunotherapeutic candidate for further bladder cancer research.
Fruit Extract of Black Pepper (Piper Nigrum L.) Ameliorates Male Reproductive Dysfunction in Alloxan-Induced Diabetic Rats.
Hadibrata E, Sutyarso S, Busman H … +4 more , Setiawan WA, Nurcahyani N, Mustofa S, Dewi Ps R
Urol J · 2026 Jun · PMID 41618665 · Publisher ↗
PURPOSE: Diabetes mellitus is a chronic hyperglycemic condition leading to metabolic problems that cause organ damage and result in serious complications. Long-term complications of diabetes can cause serious health prob...
PURPOSE: Diabetes mellitus is a chronic hyperglycemic condition leading to metabolic problems that cause organ damage and result in serious complications. Long-term complications of diabetes can cause serious health problems, such as sexual and reproductive dysfunction in men and women. Black pepper (Piper nigrum L.) is a medicinal plant proven to increase testosterone hormone levels, sexual function (libido), and spermatogenesis parameters in male rats. In this study, the effect of black pepper fruit extract on sexual function and reproductive function (fertility) in alloxan-induced diabetic male rats was evaluated. MATERIALS AND METHODS: A total of 30 male Sprague Dawley rats (Rattus norvegicus), aged 2.5 to 3 months and weighing 100-150 g, were divided into five groups of 6 individuals each. Group I consisted of rats given only standard feed. Group II consisted of alloxan-induced hyperglycemic rats given standard feed. Groups III and IV were alloxan-induced hyperglycemic rats given black pepper extract at 122.5 and 245 mg/kg BW, respectively, for 8 days. Group V consisted of alloxan-induced hyperglycemic rats given sildenafil therapy or zinc plus ascorbic acid. After 8 days of treatment, the erectile function and libido of the rats were assessed, followed by an evaluation of spermatozoa and testicular histology. Data were analyzed using ANOVA with significance set at p < 0.05. RESULTS: Alloxan-induced diabetic rats showed significant impairment in erectile function, libido, sperm quality, and testicular histology (p < 0.001 vs. control). Administration of black pepper extract at a dose of 122.5 mg/kg BW increased total penile reflexes (9.33 ± 1.03 vs. 6.00 ± 1.26 in the diabetes group, p = 0.002) and improved libido, with a decrease in courtship latency (5.50 ± 0.55 s vs. 21.00 ± 9.47 s, p = 0.013) and an increase in mounting frequency (18.05 ± 5.99 vs. 7.17 ± 1.83, p = 0.009). The extract dose of 245 mg/kg BW increased sperm concentration (158.16 ± 29.80 vs. 12.6 ± 1.3 ×10⁶, p < 0.001), progressive sperm motility (65.0 ± 35% vs. 27.0 ± 30%, p = 0.006), and normal sperm morphology (82.9 ± 5.7% vs. 35.0 ± 10.8%, p < 0.001). The number of Leydig cells increased significantly in the 122.5 mg/kg BW extract group (59.33 ± 4.08 vs. 30.50 ± 3.86; p < 0.001) compared to the diabetes group. There was no significant difference in spermatogonia count (640 ± 86.5 vs. 491 ± 37.0; p = 0.119). CONCLUSION: Piper nigrum fruit extract ameliorates sexual dysfunction and reproductive impairment in alloxan-induced diabetic rats, particularly at 122.5 mg/kg BW, with significant improvements in erectile function, libido, sperm quality, and testicular histology. These findings suggest its potential as a natural therapeutic agent for diabetes-related male reproductive dysfunction.
Machine Learning-Based Prediction of Urolithiasis Recurrence Using Patient's Clinical Data, Demography, and CT Findings.
Homayoun H, Mousavirad SJ, Zareian Baghdadabad L … +4 more , Arabzadeh Bahri R, Menbari Oskouie I, Mohammadi A, Aghamir SMK
Urol J · 2026 Jan · PMID 41618589 · Publisher ↗
PURPOSE: Urolithiasis is the condition of forming stones inside urinary tract with diverse shape, size, and location. The sooner urolithiasis is diagnosed, the easier it is to treat and prevent complication. This study a...
PURPOSE: Urolithiasis is the condition of forming stones inside urinary tract with diverse shape, size, and location. The sooner urolithiasis is diagnosed, the easier it is to treat and prevent complication. This study aims to propose a method for predicting urolithiasis recurrence based on machine learning methods. MATERIALS AND METHODS: The proposed method uses clinical data, demographics, and CT findings of 4246 patients who were referred to the clinic once or multiple times within three years. The proposed method has three main phases of data engineering and pre-processing, machine learning prediction model development, and performance evaluation. In addition, the performance of six machine learning-based classifiers is evaluated by performance metric calculation, ROC curve analysis, calibration analysis, and decision curve analysis. RESULTS: The results of 10 independent repeats of the proposed method using a train/test split evaluation strategy reveal that the best-performing classifier is random forest with the area under the ROC curve, sensitivity, and positive predictive value of 0.64, 0.87, and 0.84, respectively. On the other hand, k-fold cross-validation: A comma is needed after "hand" and before "k-fold" evaluation strategy reveals that the best-performing classifier again is RF, with the area under the ROC curve, sensitivity, and positive predictive value of 0.63, 0.90, and 0.83, respectively. Moreover, the brier score of 0.18 shows that this classifier is well-calibrated among other evaluated classifiers. CONCLUSION: This study presents a practical application of predictive machine learning methods for predicting urolithiasis recurrence with clinically acceptable accuracy compared to traditional scoring systems. To select the best classifier, six different predictive ML models have been evaluated using different performance metrics and analysis tools.
Comparing Complications, Functional And Oncological Outcomes Of Partial Versus Total Adrenalectomy: A Systematic Review And Meta-Analysis Of Literature.
Kashi AH, Simforoush N, Zargar H … +3 more , Sotoudeh M, Nikbakht MJ, Golmohammadi M
Urol J · 2026 Jan · PMID 41618588 · Publisher ↗
PURPOSE: Surgical management is a key component in treating adrenal masses, particularly when they are functional or large. However, the choice between partial adrenalectomy (PA) and total adrenalectomy (TA) remains cont...
PURPOSE: Surgical management is a key component in treating adrenal masses, particularly when they are functional or large. However, the choice between partial adrenalectomy (PA) and total adrenalectomy (TA) remains controversial. Therefore, this systematic review and meta-analysis aimed to evaluate whether surgical outcomes differ between patients undergoing PA versus TA. MATERIALS AND METHODS: Following PRISMA 2020 guidelines, we systematically searched PubMed, Scopus, Web of Science, and the Cochrane Library for studies published up to April 2025. Nineteen studies were included, and methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was conducted to estimate pooled outcomes. RESULTS: A total of 19 studies comprising 3,165 patients were included, of whom 1,084 underwent partial adrenalectomy (PA) and 2,081 underwent total adrenalectomy (TA). PA was associated with a significantly higher risk of tumor recurrence compared with TA (RR = 2.64, 95% CI 1.55-4.51), while no significant differences were observed for metastasis or mortality. In contrast, PA significantly reduced the risk of postoperative steroid dependence (RR = 0.44, 95% CI 0.34-0.55) and adrenal insufficiency (RR = 0.49, 95% CI 0.34-0.70). Perioperative complications were less frequent following PA (RR = 0.56, 95% CI 0.40-0.78), particularly mild complications, with no differences in severe complications. There were no significant differences in operative time or intraoperative blood loss between the two techniques. Subgroup analyses demonstrated higher recurrence rates in pheochromocytoma among patients undergoing PA, compared with Conn's adenoma. Perioperative complications were less frequent in PA in patients with Conn's adenoma. No significant differences were observed regarding surgical laterality (left vs. right) or the operative approach (transperitoneal vs. retroperitoneal laparoscopic / robotic surgery). CONCLUSION: PA offers superior preservation of adrenal function and fewer mild perioperative complications compared with TA, but shows a higher risk of tumor recurrence in pheochromocytoma patients. PA was not associated with higher recurrence in Conn's patients. Other surgical and oncological outcomes were similar, underscoring the need to individualize the choice of procedure based on tumor type and patient factors.
Efficacy And Safety of Sacral Neuromodulation in the Treatment of Females with Refractory Idiopathic Non-Obstructive Urinary Retention.
Ismail MB, Abdullhussein W, Alwaeli H
Urol J · 2026 May · PMID 41255038 · Publisher ↗
PURPOSE: Non-obstructive urinary retention (NOUR) is the inability to empty the bladder with no physical obstruction to urine flow. It can occur as a result of neurological disorders or be idiopathic. In younger women, i...
PURPOSE: Non-obstructive urinary retention (NOUR) is the inability to empty the bladder with no physical obstruction to urine flow. It can occur as a result of neurological disorders or be idiopathic. In younger women, it may be caused by Fowler's syndrome (FS), a rare disorder in which the urethral sphincter fails to relax to allow urine to pass normally. This study covers both idiopathic NOUR and FS. Sacral neuromodulation (SNM) has been introduced as an effective option for patients with NOUR. MATERIALS AND METHODS: Forty-two patients (aged 17 to 61 years) suffering from refractory NOUR who had a successful first-stage SNM with the Interstim II device, and in whom the second stage was completed, were prospectively studied in the department of neurogenic bladder and neuromodulation in our hospital from February 2016 to August 2019 to evaluate the efficacy and safety of SNM. RESULTS: The study included forty-two women with NOUR: 20 (47%) with FS and 22 (53%) with idiopathic NOUR. Their mean age was 27.2 ± 12.4 years. Thirty-eight (90%) of them had a successful trial phase (responders) with more than 50% improvement in their voiding parameters. After continued follow-up, a clinical success rate of 79% (30 out of 38 cases) was achieved, with a median follow-up period of 28 ± 8 months. The voiding parameters of these 38 patients showed statistically significant improvement after SNM. Their post-void residual volume dropped significantly from 330 ± 77 mL to 97 ± 55 mL (P < 0.001), average voided volume increased from 60 ± 23 mL to 265 ± 99 mL (P < 0.001), and the number of clean intermittent catheterizations per day fell from 5.6 ± 1 to 1.3 ± 1.6 (P < 0.001). The total number of patients who required surgical revision was 10 (26.4%), for reasons including malfunction due to external trauma in four patients (10.5%), continuous pain in four (10.5%), and device infection in two (5%). CONCLUSION: SNM is an effective and safe option for women with refractory idiopathic non-obstructive urinary retention and Fowler's syndrome.
Effects of Synbiotic Supplementation on Blood and Urinary Concentrations of Factors Related to Kidney Stone Formation in Overweight or Obese Patients with Hyperoxaluria: A Randomized Controlled Trial.
Maddahi N, Zamani B, Nadjarzadeh A … +4 more , Basiri A, Tabibi H, Kashefi M, Tabatabai SA
Urol J · 2026 May · PMID 41255037 · Publisher ↗
PURPOSE: This study investigated the impact of synbiotics on blood and urinary concentrations of factors related to kidney stone formation in overweight or obese patients with hyperoxaluria. MATERIALS AND METHODS: A rand...
PURPOSE: This study investigated the impact of synbiotics on blood and urinary concentrations of factors related to kidney stone formation in overweight or obese patients with hyperoxaluria. MATERIALS AND METHODS: A randomized double-blind clinical trial was conducted involving forty-four patients assigned to either synbiotic or placebo groups. Participants received their respective capsules twice daily for 12 weeks. Blood and 24-hour urine samples were collected at baseline and week 12 for biochemical analyses. RESULTS: Urinary oxalate significantly decreased in the synbiotic group compared with both baseline (P=.001) and placebo (P=.001). Other biochemical markers showed no significant differences, while urine volume increased in both groups without between-group variance. CONCLUSION: Synbiotic supplementation significantly reduced urinary oxalate but did not affect other blood or urinary parameters associated with kidney stone formation.
Diagnostic Effectiveness of Contralateral Testicular Hypertrophy in Children with Non-Palpable Testicles.
Kılıç S
Urol J · 2026 May · PMID 41255036 · Publisher ↗
PURPOSE: To evaluate the effectiveness of contralateral testicular volume measurements in differentiating monorchidism from intra-abdominal viable testes in children with non-palpable testes (NPt). MATERIALS AND METHODS:...
PURPOSE: To evaluate the effectiveness of contralateral testicular volume measurements in differentiating monorchidism from intra-abdominal viable testes in children with non-palpable testes (NPt). MATERIALS AND METHODS: The data of 179 patients who underwent surgery for undescended testes between January 2017 and January 2024 were retrospectively reviewed. The study included 33 patients with unilateral non-palpable testes. Testicular volumes were measured by ultrasonography 6-12 months prior to diagnostic laparoscopy, and the surgical findings were recorded. RESULTS: Diagnostic laparoscopy was performed on 33 children with non-palpable testes. For five patients, staged orchiopexy was planned due to the testes being 2 cm or more away from the internal inguinal ring. In 22 patients, inguinal orchiopexy was performed as the testes were around the internal inguinal ring (AIR). In the remaining six patients, no testes were found; the spermatic cord and vessels terminated at the internal inguinal ring (vanishing) or were atrophic (nubbin). There was a significant difference in the contralateral testicular volumes between patients with vanishing testes and those with intra-abdominal viable testes (p < 0.001). Additionally, there was a statistically significant difference in the contralateral testicular volumes between the AIR group and those with testes remote from the internal inguinal ring (RIR) (p = 0.03). CONCLUSION: The preoperative ultrasonographic measurement of the contralateral testicular volume in children with a unilateral non-palpable testis can provide valuable information about the nature of the intra-abdominal testis. The presence of a hypertrophic contralateral testis can guide surgeons prior to laparoscopy and is valuable for counseling parents about potential diagnoses.
Long Non Coding RNAs as Prognostic Factors or Diagnostic Biomarkers of Renal Transplant Rejection: A Systematic Review and Meta Analysis.
Zareian Baghdadabad L, Arabzadeh Bahri R, Shobeiri P … +3 more , Menbari Oskouie I, Oliveira Reis L, Aghamir SMK
Urol J · 2026 Jan · PMID 41255034 · Publisher ↗
PURPOSE: Acute rejection (AR) of a kidney graft in renal transplant recipients is associated with microvascular injury leading to graft dysfunction and failure. Long noncoding RNAs (lncRNAs) may serve as markers for vasc...
PURPOSE: Acute rejection (AR) of a kidney graft in renal transplant recipients is associated with microvascular injury leading to graft dysfunction and failure. Long noncoding RNAs (lncRNAs) may serve as markers for vascular injury and AR. We aimed to identify lncRNA biomarkers associated with graft loss after renal transplantation. MATERIALS AND METHODS: We searched PubMed, Scopus, Embase, and Web of Science. Odds ratios (ORs), hazard ratios (HRs), and their 95% confidence intervals (95% CIs) were calculated to assess effect sizes. All graphical designs and statistical analyses were performed using STATA version 17 (StataCorp LP, College Station, TX, USA) and the meta package. RESULTS: Of 291 initially identified articles, 10 met eligibility criteria and were included in the systematic review; 3 provided sufficient data for meta‑analysis. The pooled area under the curve (AUC) for lncRNA measurement in diagnosing acute kidney rejection was 0.79 in adults and 0.75 in pediatric populations, indicating good diagnostic accuracy. Leave‑one‑out sensitivity analyses confirmed the stability of these findings. However, the pooled HR for the prognostic value of lncRNAs was 0.81 (95% CI: 0.63-1.04), which was not statistically significant. CONCLUSION: Assessment of lncRNA levels in plasma or urine appears promising as a diagnostic biomarker for acute kidney rejection. The prognostic value of lncRNAs in the course of acute kidney rejection requires further evaluation.
Weighted Correlation Gene Networks and Gene Set Enrichment Analysis Revealed New Potential Genetic Etiologies Associated with Cryptorchidism.
Huang W, Liu J, Liu Z … +1 more , Xu Y
Urol J · 2026 Jan · PMID 41255033 · Publisher ↗
PURPOSE: Despite its prevalence, the etiology and pathogenesis of cryptorchidism remain poorly understood. This study aimed to identify potential biomarkers associated with cryptorchidism development using bioinformatics...
PURPOSE: Despite its prevalence, the etiology and pathogenesis of cryptorchidism remain poorly understood. This study aimed to identify potential biomarkers associated with cryptorchidism development using bioinformatics methodologies. MATERIALS AND METHODS: We utilized three microarray datasets from the Gene Expression Omnibus (GEO) database, comparing gene expression profiles between cryptorchidism patients and control individuals. Differentially expressed genes (DEGs) were identified using statistical analysis. Subsequently, we constructed a gene co-expression network using weighted gene co-expression network analysis (WGCNA) to identify modules of genes highly associated with the cryptorchid phenotype. Hub genes within these modules were identified using cross-validation and multiple algorithms. RESULTS: A total of 1,539 differentially expressed genes were identified between cryptorchidism patients and controls. WGCNA revealed a gene module strongly associated with the cryptorchidism phenotype. Ten genes (CDH1, CS, G6PD, HSPA5, KEAP1, NEDD8, POLR2J, JUN, SOD2, and TXN) with the highest association to cryptorchidism were identified in this module. Single‑gene gene set enrichment analysis (ssGSEA) showed that these hub genes were mainly enriched in metabolism-, translation-, and inflammation‑related processes. Notably, several key genes are involved in oxidative stress responses. CONCLUSION: This study identified a credible set of hub genes associated with cryptorchidism. Some of these genes have been shown to affect testicular development or spermatogenesis through mechanisms such as inflammation and oxidative stress, while others have not been fully studied in the context of cryptorchidism. These hub genes may provide new biomarkers for cryptorchidism risk assessment and warrant further investigation to clarify their specific roles.
A Prospective Comparative Study of Renal Function in Live Renal Donors Who Underwent Open and Laparoscopic Nephrectomy.
Farshid S, Tayyebi Azar A, Habibi B … +1 more , Pasha A
Urol J · 2026 Jan · PMID 41108099 · Publisher ↗
INTRODUCTION: Open nephrectomy surgery in a kidney donor involves pain and many risks after the surgery, which leads to the inability to perform normal activities. For this reason, today the laparoscopic nephrectomy meth...
INTRODUCTION: Open nephrectomy surgery in a kidney donor involves pain and many risks after the surgery, which leads to the inability to perform normal activities. For this reason, today the laparoscopic nephrectomy method is preferred in order to avoid complications and to return to normal life sooner. However, it is very critical to assess the impact of modifying the surgical technique on the outcome of kidney donation. Thus, the present study was undertaken with the following specific objective: a comparative study of the renal profile of live kidney donors who have undergone open and laparoscopic nephrectomy. MATERIALS AND METHODS: The study in the present report was cross-sectional in nature. Participants included 91 kidney donors who had undergone either open nephrectomy (n = 46) or laparoscopic nephrectomy (n = 45). Data on the level of initial basic renal function, the duration of surgery, and the duration of hospitalization, together with the course of renal function in the 6 months after surgery, were collected. The data were analyzed using the Statistical Package for the Social Sciences, version 27 (SPSS version 27). RESULTS: The mean age of kidney donors was 29.4 ± 4.8 years, and all patients were male (100%). Body mass index and weight were comparable between the open and laparoscopic nephrectomy groups, with no statistically significant differences (P > 0.05). The mean duration of surgery in the open nephrectomy group (2.37 ± 0.30 hours) was significantly shorter than that in the laparoscopic group (3.37 ± 0.13 hours) (P < 0.001). The mean length of hospital stay was significantly shorter in the laparoscopic group (3.31 ± 0.31 days) compared to the open group (4.06 ± 0.04 days) (P < 0.001). GFR decreased significantly in both groups at discharge and 6 months postoperatively compared to baseline (paired t-test, all P < 0.001), but there was no significant difference in GFR between groups at any time point (P > 0.05). Both groups experienced a significant postoperative decline in hemoglobin, with a greater reduction in the open group (-1.59 ± 0.79 g/dL) compared to the laparoscopic group (-1.05 ± 0.95 g/dL) (P = 0.004). White blood cell counts increased postoperatively in both groups, with no significant difference between them (P = 0.118). Surgical complications included transection of the superior polar artery in 5.5% of cases. CONCLUSION: In laparoscopic nephrectomy, the time of surgery is longer, but the days of hospitalization after surgery do not differ and do not negatively affect the return of donor kidney function compared to the open method. Moreover, post-surgical problems have not been very frequent and are manageable in the best way possible.
A rare anomaly of the Mullerian system: OHVIRA syndrome. Comprehensive literature review and report of seven cases.
Bosnali O, Arabul Aydoğdu S, Moralıoğlu S … +2 more , Atcı ŞN, Armay Ö
Urol J · 2026 Jan · PMID 41108098 · Publisher ↗
PURPOSE: Müllerian anomalies are rare, and the obstructed hemivagina and ipsilateral renal anomaly/agenesis (OHVIRA) syndrome is the rarest. Its subtle and nonspecific symptoms cause delays in diagnosis, especially in pr...
PURPOSE: Müllerian anomalies are rare, and the obstructed hemivagina and ipsilateral renal anomaly/agenesis (OHVIRA) syndrome is the rarest. Its subtle and nonspecific symptoms cause delays in diagnosis, especially in prepuberty. This study aims to remind this rare anomaly and review its symptoms, clinical and radiological findings, and treatment in pre- and post-pubertal girls. MATERIALS AND METHODS: We conducted a retrospective chart review of cases of OHVIRA syndrome that were diagnosed and treated between May 2018 and June 2024. We evaluated the results and reviewed relevant literature. RESULTS: Seven patients were diagnosed with OHVIRA syndrome during the study period. Two patients were diagnosed in the pre-pubertal period, and all post-pubertal cases, except one, underwent surgery. Five (71%) of the seven patients had left-sided obstructed hemivagina with ipsilateral renal agenesis. CONCLUSION: OHVIRA syndrome is a rare condition. Its diagnosis and management depend on the patient's age, symptoms, familiarity with the syndrome, and teamwork. Although a renal anomaly is part of the triad of this syndrome, OHVIRA syndrome often remains undiagnosed during infancy, even in cases of prenatally diagnosed renal agenesis. Screening for OHVIRA syndrome and associated urinary anomalies in cases of renal agenesis, particularly in prepubertal cases, is crucial.
Totally Ultrasound-Guided Supine Mini-PCNL Without Ureteral Catheter in Hydronephrotic Kidney; A Matched-Pair Analysis.
Çanakcı C, Özkaptan O, Dinçer E … +3 more , Can U, Çağlar KC, Türkyılmaz O
Urol J · 2026 Jan · PMID 41108097 · Publisher ↗
PURPOSE: To investigate the safety and efficacy of supine percutaneous nephrolithotomy performed completely under ultrasound guidance without fluoroscopy and ureteral catheterization in kidneys with hydronephrosis. MATER...
PURPOSE: To investigate the safety and efficacy of supine percutaneous nephrolithotomy performed completely under ultrasound guidance without fluoroscopy and ureteral catheterization in kidneys with hydronephrosis. MATERIALS AND METHODS: This retrospective study analyzed the data of 30 patients (Group 1) with kidney stones larger than 2 cm and Grade 2 or higher hydronephrosis who underwent ultrasound-guided supine percutaneous nephrolithotomy without ureteral catheterization and fluoroscopy between January 2022 and November 2024. The data of these patients were compared using matched-pair analysis (1:1) with patients who underwent supine percutaneous nephrolithotomy under ultrasound and fluoroscopy guidance with ureteral catheterization (Group 2) in the same period. The groups were compared regarding access time, operation time, stone-free rates, blood loss, and complications. RESULTS: There were no statistically significant differences between the two groups in terms of age, gender, side, stone diameter, stone volume, stone density, hydronephrosis grade and Guy's stone score. Access time was significantly shorter in Group 1 (11.3 ± 3.9 minutes vs. 13.9 ± 4.7 minutes, respectively, 95% CI: 0.3-4.9, p = .026). The mean operation time was 64.4 ± 19.4 in Group 1 and 102.3 ± 31.2 in Group 2, and this difference was statistically significant (95% CI: 24.2-51.6, p = .001). There was no significant difference between the two groups in terms of postoperative 1st month stone-free rates (83.3% vs 86.6%, respectively, p = .723 Conclusion: Compared with standard supine mini percutaneous nephrolithotomy, totally ultrasound guided supine mini percutaneous nephrolithotomy without ureteral catheter is an effective, safe and feasible surgery.
Dorsal Penile Curvature in Children: A Review.
Karabulut R, Turkyilmaz Z, Kaya C … +3 more , Türker LN, Atan A, Sonmez K
Urol J · 2025 Oct · PMID 40914840 · Publisher ↗
PURPOSE: To review the current literature on dorsal penile curvature (DPC) in children, including its etiology, diagnosis, and principles of treatment. MATERIALS AND METHODS: A literature review was conducted on DPC in c...
PURPOSE: To review the current literature on dorsal penile curvature (DPC) in children, including its etiology, diagnosis, and principles of treatment. MATERIALS AND METHODS: A literature review was conducted on DPC in children, focusing on its etiology (e.g., skin tethering, corporal disproportion), association with other conditions such as hypospadias and epispadias, and surgical treatment methods. RESULTS: DPC is a rare condition, often associated with neonatal circumcision, hypospadias, or epispadias. The etiology includes skin ties, fibrotic tissues, and asymmetric corporal development. Spontaneous resolution can occur, especially in cases following circumcision. Surgical correction is typically considered for curvatures of 30° or greater that are functionally concerning. Common surgical techniques include ventral plication, wedge resection (Nesbit procedure), and grafting. CONCLUSION: While mild DPC often requires no intervention, surgical correction should be considered for significant curvatures (≥ 30°) to prevent future functional issues. Cases that develop after neonatal circumcision may resolve spontaneously.
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