Urology[JOURNAL]
Sun
200 papers
The role of microRNAs-23b and 27b in migration, invasion and proliferation of T24 bladder cancer cells.
Fakhouri F, Candido P, Pimenta R … +7 more , Guimarães VR, Nebó G, Passerotti C, da Silva CE, Nahas WC, Leite KRM, Reis ST
BMC Urol · 2026 Jul · PMID 42401923 · Full text
BACKGROUND: Bladder cancer (BC) is the sixth most common cancer among men worldwide and represents a significant cause of morbidity and mortality. High-grade BC is associated with an increased risk of progression to musc...
BACKGROUND: Bladder cancer (BC) is the sixth most common cancer among men worldwide and represents a significant cause of morbidity and mortality. High-grade BC is associated with an increased risk of progression to muscle-invasive and metastatic disease, negatively impacting patient prognosis. Despite advances in molecular characterization, therapeutic strategies remain limited, and the identification of novel molecular targets is essential. MicroRNAs (miRNAs) are small non-coding RNAs involved in post-transcriptional gene regulation and play critical roles in tumor development and progression. Among them, miRNA-23b and miRNA-27b have been implicated in several malignancies; however, their functional role in high-grade BC remains incompletely understood. This study aimed to evaluate the expression levels of miRNAs-23b and 27b in a high-grade BC cell line and to investigate their effects on cell migration, invasion, and proliferation, exploring their potential therapeutic relevance. METHODS: The high-grade BC T24 cell line was used. Cells were divided into four groups: Control (no transfection), negative control (Scramble), miRNA-23b mimic, and miRNA-27b mimic. Relative miRNA expression levels were determined by quantitative polymerase chain reaction (qPCR). Functional assays included wound healing (migration), Matrigel invasion assay, and colony formation assay (proliferation). Statistical analyses were performed to compare groups, and p-values < 0.05 were considered statistically significant. RESULTS: Transfection resulted in significant overexpression of miRNA-23b and miRNA-27b compared to both Scramble (p = 0.0344 and p = 0.0386, respectively) and Control groups (p = 0.0343 and p = 0.0390, respectively). Both miRNA-23b and miRNA-27b significantly reduced cell migration compared to Scramble (p = 0.0286). Additionally, miRNA-23b significantly decreased invasion compared to Scramble and Control (p < 0.0001), with similar findings observed for miRNA-27b (p < 0.0001). No statistically significant differences were observed in colony formation among groups. CONCLUSIONS: Overexpression of miRNA-23b and miRNA-27b significantly reduced migration and invasion in a high-grade BC cell line, without affecting proliferation. These findings suggest that both miRNAs may act as tumor suppressors in high-grade BC and represent promising candidates for future therapeutic development in bladder cancer.
"Editorial Comment on "Vaginal Estrogen Prescription is Associated with Reduced Rates of Serious Adverse Outcomes in Women of All Age Groups With Recurrent Urinary Tract Infection: An Epic Cosmos Database Analysis".
Lenherr SM, Rubin RS
Urology · 2026 Jul · PMID 42401401 · Publisher ↗
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The True Oral History of Buccal Mucosal Grafts for Male Urethral Stricture Repair.
Naha U, Buchinsky DS, Rogozinski F … +1 more , Bresler L
Urology · 2026 Jul · PMID 42401400 · Publisher ↗
OBJECTIVE: To record the history of the adoption and utilization of the surgical technique of buccal mucosal grafts for urologic procedures. METHODS: Academic and historic medical articles available on PubMed and open se...
OBJECTIVE: To record the history of the adoption and utilization of the surgical technique of buccal mucosal grafts for urologic procedures. METHODS: Academic and historic medical articles available on PubMed and open search engines were reviewed for information linked to physicians who have utilized buccal mucosal grafts from 1894 to 2021. RESULTS: In the late 19th and early 20th centuries, oral grafts were primarily used by ophthalmologists. Dr. Kirill Sapezhko was the pioneering urologist who applied this surgical technique for urethral stricture disease, publishing his case series in 1894. Almost 50 years later in 1941, Dr. Graham Humby in London published a case report on the use of oral mucosa for treatment of hypospadias in an 8-year-old patient. There was then a large gap in reports for several decades. Articles commonly recognized as milestone publications do not appear until 1992 from Dr. R. A. Bürger in Germany and Dr. Antonio Dessanti in Italy. Literature involving buccal mucosal grafts then expanded exponentially and it has become the gold standard for anterior urethral stricture repair. CONCLUSIONS: The literature inconsistently recognizes Dr. Sapezhko's innovation of oral mucosal grafts in urethral stricture repair. The history of oral mucosal grafts highlights how knowledge can be lost for periods of time, which can cause lack of widespread acknowledgement of the origin of surgical techniques.
Information quality and reliability of pheochromocytoma-related videos on tiktok and Kwai: a cross-sectional study.
Luo J, Chen Z, Cao R … +1 more , Wang K
BMC Urol · 2026 Jul · PMID 42399874 · Full text
BACKGROUND: Short-video platforms are major sources of health information, yet the quality of pheochromocytoma-related content is unclear. We assessed and compared the quality and reliability of related videos on TikTok...
BACKGROUND: Short-video platforms are major sources of health information, yet the quality of pheochromocytoma-related content is unclear. We assessed and compared the quality and reliability of related videos on TikTok and Kwai. METHODS: Using the Chinese keyword "," we searched TikTok and Kwai (24-25 Dec 2025) with a newly created account and retrieved the first 120 videos from each platform under the default "comprehensive" ranking. After exclusions, 178 videos were included (TikTok, n = 100; Kwai, n = 78). Video metrics, uploader characteristics, and content features were extracted. Quality and reliability were assessed using GQS (1-5) and mDISCERN (0-5) by two blinded reviewers, with disagreements resolved by a third reviewer. We compared video characteristics and GQS/mDISCERN scores between TikTok and Kwai, and performed subgroup analyses by uploader identity and physician specialty. Nonparametric tests and Spearman correlation analyses were conducted using R 4.1.3. RESULTS: Median video length was 73.0 s; median GQS and mDISCERN were both 2.0, indicating generally low quality and reliability. Most videos were posted by healthcare personnel (81.5%), predominantly urologists (50.6%). TikTok videos were longer and had higher likes, comments, and collections (all P < 0.001). mDISCERN was higher on TikTok (P = 0.047), while GQS did not differ (P = 0.580). Video length correlated with GQS (r = 0.46) and mDISCERN (r = 0.41), whereas engagement metrics were not reliable proxies for credibility. CONCLUSIONS: Pheochromocytoma-related short videos on TikTok and Kwai show limited quality and reliability despite professional authorship. Improvements should prioritize verifiable sources and decision-relevant risk framing, supported by platform-level quality labeling and distribution strategies.
Virtual reality-based 3D prostate models for robot-assisted radical prostatectomy: a prospective exploratory study of membranous urethral length and early urinary continence recovery.
Azhar RA, Albarakaty AM, Saikali S … +1 more , Elkoushy M
BMC Urol · 2026 Jul · PMID 42399872 · Full text
OBJECTIVES: To prospectively explore the feasibility and histopathological concordance of virtual reality (VR)-based 3D prostate models in robot-assisted radical prostatectomy (RARP) and to evaluate the association betwe...
OBJECTIVES: To prospectively explore the feasibility and histopathological concordance of virtual reality (VR)-based 3D prostate models in robot-assisted radical prostatectomy (RARP) and to evaluate the association between VR-derived membranous urethral length (MUL) and early urinary continence recovery. METHODS: VR-based 3D prostate models were generated for 35 patients with localized prostatic adenocarcinoma who underwent RARP. Tumor localization, extraprostatic extension (EPE), and seminal vesicle invasion (SVI) on the 3D models were compared with the final histopathology using Cohen's kappa coefficient and standard diagnostic accuracy measures. Urinary continence was assessed using the Expanded Prostate Cancer Index Composite (EPIC) survey, with social continence defined as the use of no pads or one safety pad per day and complete continence defined as zero pad use. Continence recovery was evaluated at 1, 3, and 6 months. RESULTS: The mean patient age in the cohort was 63.2 years, the mean prostate-specific antigen (PSA) concentration was 13.36 ng/mL, and the mean prostate volume was 52.7 cc. Nerve-sparing surgery was performed in 74.3% of the patients, and extended pelvic lymph node dissection was performed in 20%. Pathologic stage ≥T3a occurred in 45.7% of patients, with a Gleason score ≤ 7 in 71.4%, an SVI in 14.3%, and positive margins in 2.9%. Perioperative complications were minimal (5.7%), with no transfusions. Continence recovery occurred in 85.7% of the patients at 3 months and 91.4% at 6 months. MUL correlated negatively with pad use at 3 months (Spearman's ρ = - 0.52), and a 14-mm MUL cutoff was associated with early continence recovery (AUC = 0.86). VR 3D models showed almost perfect agreement with the final histopathology for extraprostatic extension (EPE) (κ = 0.88; accuracy 94.3%) and perfect agreement for SVI (κ = 1.00). CONCLUSIONS: VR-based 3D prostate models may represent a useful adjunct for surgical planning in RARP and could help inform nerve-sparing strategies. MUL, as measured by these models, may be a valuable factor associated with early urinary continence recovery. These exploratory findings should be interpreted with caution and require confirmation in larger, multicenter prospective studies with longer follow-up periods.
Early urinary decompression and mortality in septic obstructing ureteral stones: a nationwide comparative-effectiveness study.
Dogha MM, Hassan AA, Mohamed OM … +7 more , Farag M, Nouh IS, Ibrahim MH, Mesbah AA, Elebiary MF, Abdelkhalek NA, Moalwi A
BMC Urol · 2026 Jul · PMID 42399868 · Full text
BACKGROUND: Septic obstructing ureteral stones are a time-critical urological emergency. Although urgent drainage is recommended, uncertainty persists regarding the comparative effectiveness of decompression strategies a...
BACKGROUND: Septic obstructing ureteral stones are a time-critical urological emergency. Although urgent drainage is recommended, uncertainty persists regarding the comparative effectiveness of decompression strategies and the influence of timing in real-world practice. METHODS: We analyzed adults with sepsis or septic shock and obstructing ureteral stones (n = 9,172) from the U.S. HCUP National Inpatient Sample (2016-2022). Exposures included any decompression (ureteral stent or percutaneous nephrostomy [PCN]) versus conservative care, and decompression timing (same-day [day 0] vs. ≥ day 1; ≤ 24 h vs. > 24 h). The primary outcome was in-hospital mortality; secondary outcomes were acute kidney injury (AKI), mechanical ventilation, dialysis, and length of stay. Adjusted associations were estimated using propensity score matching, overlap weighting, instrumental variable (IV) analysis, and landmark/time-dependent survival models with a prespecified 12-variable adjustment set. RESULTS: Overall mortality was 2.5%. Decompression was associated with lower mortality than conservative care (1.6% vs. 4.0%; risk difference - 2.4% [95% CI - 3.2 to - 1.7]; number needed to treat ≈ 41). Late decompression (> 24 h) versus early (≤ 24 h) was associated with higher odds of mortality (OR 2.17 [1.38-3.41]), AKI, ventilation, and dialysis. In exploratory analyses among decompressed patients, PCN showed higher adjusted mortality than stenting (5.5% vs. 2.8%; OR 2.05 [1.31-3.09]); IV results were directionally consistent but likely reflect residual confounding by indication and feasibility. CONCLUSION: Urgent decompression, particularly within 24 h, was associated with lower in-hospital mortality and fewer organ-failure outcomes. Modality differences should be interpreted as hypothesis-generating; PCN remains essential when retrograde stenting is not feasible.
Preventing Postpartum Pelvic Floor Dysfunction: Clinical Evidence and Policy Gaps in U.S. Coverage of Pelvic Floor Muscle Therapy.
Dalton R, Buchinsky D, Cohen J … +4 more , Urrea K, DeLancey JO, Pope R, Yousif A
Urology · 2026 Jul · PMID 42398784 · Publisher ↗
OBJECTIVES: To evaluate the evidence supporting preventive pelvic floor muscle therapy (PFMT) in reducing pregnancy associated pelvic floor dysfunction (PFD) and assess the alignment of insurance coverage, clinical guide...
OBJECTIVES: To evaluate the evidence supporting preventive pelvic floor muscle therapy (PFMT) in reducing pregnancy associated pelvic floor dysfunction (PFD) and assess the alignment of insurance coverage, clinical guidelines, and legislative initiatives with current evidence in the United States (U.S.). Despite growing evidence supporting PFMT, U.S. insurers restrict coverage to treatment of dysfunction rather than its prevention. METHODS: We review the pathophysiologic mechanisms linking childbirth to PFD, summarize the evidence supporting preventive PFMT, and evaluate U.S. insurance coverage practices, PFMT implementation guidelines, and relevant legislation. International approaches to pelvic floor health promotion are also examined. RESULTS: Vaginal birth places significant mechanical strain on the pelvic floor, frequently injuring the structures responsible for maintaining continence and preventing pelvic organ prolapse (POP). Evidence from a 2020 Cochrane review, RCTs, and other meta-analyses demonstrates that antenatal PFMT significantly reduces the risk of urinary incontinence (UI) during pregnancy and postpartum. The preventive efficacy of postpartum PFMT remains less clearly defined, as many studies evaluate mixed populations of continent and incontinent patients vs strictly continent. U.S. insurance does not cover preventive PFMT, resulting in significant out-of-pocket costs. Clinical and public health guidelines inconsistently address preventive PFMT, and legislative efforts remain limited. CONCLUSIONS: Preventive PFMT represents an evidence-based strategy for reducing pregnancy associated PFD. Aligning clinical guidelines, insurance coverage, and legislative initiatives with current evidence may improve access to preventive pelvic floor care and strengthen maternal health outcomes.
Editorial Comment on "Through the Eyes of the Applicant: A Qualitative Study of the Urology Residency Match".
Johnson S, Lloyd G
Urology · 2026 Jul · PMID 42398783 · Publisher ↗
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Quality of services and patient reported outcomes for prostate cancer in Tanzania: the role of patients' satisfaction from a cross-sectional study.
Nyongole O, Munishi C, Kimu N … +13 more , Shirima GV, Sangeda RZ, Mseti M, Lugina E, Kiwara F, Sirili N, Chacha F, Nicholaus B, Mruma H, Frumence G, Simba D, Urassa D, Sunguya B
BMC Urol · 2026 Jul · PMID 42393670 · Full text
BACKGROUND: The increasing global burden of prostate cancer challenges the quality of services in low- and middle-income countries (LMICs) due to infrastructure and limitations in human resources for health. Higher quali...
BACKGROUND: The increasing global burden of prostate cancer challenges the quality of services in low- and middle-income countries (LMICs) due to infrastructure and limitations in human resources for health. Higher quality of services as perceived by patients, is associated with improved health-related quality of life (HRQoL). This study was designed to assess patients' satisfaction with the quality of services and its association with HRQoL among prostate cancer patients. METHODS: The hospital-based cross-sectional study was conducted among 248 systematically sampled prostate cancer patients under treatment from five tertiary hospitals in Tanzania. The standard patient satisfaction questionnaire and the Expanded Prostate Cancer Index Composite (EPIC) were used to measure HRQoL. Descriptive analysis was used to determine levels and characteristics of patients' satisfaction with quality of services and HRQoL, while regression analysis was conducted to examine the association between patients' satisfaction and HRQoL. RESULTS: Of the sampled prostate cancer patients, 169 (68.3%) experienced delays in seeking treatment, and a high proportion (85.4%) presented with clinically advanced stage of prostate cancer. Two-thirds of the patients were not satisfied with the quality of services. Key areas of dissatisfaction included long waiting times (75.4%), limited counselling services (77.4%), and a lack of opportunity to discuss their problems with doctors (67.3%). The overall HRQoL score was low (36 out of 60 score), with sexual domain scoring the lowest (5.81%). A unit increase in patient satisfaction was associated with five-times increase in HRQoL β-coefficient 5.25 95%, CI (2.42, 8.08). CONCLUSIONS: Patient satisfaction is a primary driver of health-related quality of life, suggesting that system-level improvements are more vital for patients reported outcomes than biological factors alone. Improving these outcomes requires targeted policy shifts, decentralized care, and stronger financial protections for patients. Key areas of improvements include waiting time and tailored counselling services.
The relationship between premature ejaculation and depressive symptoms in HIV-infected men: a multicenter case-control study.
Evlice O, Bülbül E, Üstün F … +4 more , Deniz M, Basutçu A, Şahinoğlu S, Arslan Y
BMC Urol · 2026 Jul · PMID 42393646 · Full text
BACKGROUND: Depressive symptoms are common among people living with HIV (PLWH) and may adversely affect sexual function. However, the relationship between HIV infection and premature ejaculation (PE) has not been clearly...
BACKGROUND: Depressive symptoms are common among people living with HIV (PLWH) and may adversely affect sexual function. However, the relationship between HIV infection and premature ejaculation (PE) has not been clearly defined. This study aimed to evaluate depressive symptoms in HIV-infected men and investigate their association with PE. METHODS: This multicenter case-control study included 112 HIV-infected men and 110 age-matched healthy controls who presented to infectious diseases outpatient clinics between March and September 2025. All participants completed the Turkish validated versions of the Premature Ejaculation Diagnostic Tool (PEDT) and the Beck Depression Inventory (BDI). PE was defined as a PEDT score ≥ 11. RESULTS: The mean age of PLWH was 36.3 ± 11.9 years, compared with 39.6 ± 10.8 years in the control group. Both PEDT and BDI scores were significantly higher in PLWH than in controls (p < 0.001 for both). PE was present in 49 (43.8%) HIV-infected men and 23 (20.9%) controls (p < 0.001). Among PLWH, those with PE had significantly higher BDI scores than those without PE (16.8 ± 10.1 vs. 10.7 ± 8.9, p = 0.009). In multivariable logistic regression analysis, BDI score remained independently associated with PE after adjustment for erectile function, age, and disease duration. CONCLUSIONS: HIV-infected men demonstrated higher rates of PE and more severe depressive symptoms compared with healthy controls. Among PLWH, depressive symptom severity remained significantly associated with PE after adjustment for erectile function, age, and disease duration.
The "perfect storm" in bladder oncology: a case of diverticular carcinoma with plasmacytoid features and its clinical ramifications.
Fan Q, Fu Z, Zheng X … +1 more , Wang G
BMC Urol · 2026 Jul · PMID 42393617 · Full text
BACKGROUND: Carcinoma arising within a bladder diverticulum is a rare and diagnostically challenging entity. Its management is further complicated by aggressive histological variants such as plasmacytoid urothelial carci...
BACKGROUND: Carcinoma arising within a bladder diverticulum is a rare and diagnostically challenging entity. Its management is further complicated by aggressive histological variants such as plasmacytoid urothelial carcinoma (PUC). The anatomical lack of muscularis propria in diverticula predisposes to early extra‑diverticular spread and impedes accurate clinical staging. The coexistence of a diverticular location and plasmacytoid histology creates a high‑risk clinical scenario with limited evidence to guide therapy. CASE PRESENTATION: A 74‑year‑old male with a history of high‑grade urothelial carcinoma, previously treated with transurethral resection and two cycles of neoadjuvant chemotherapy (gemcitabine plus cisplatin), was found on imaging to have a persistent tumor within a right‑sided bladder diverticulum. He underwent robot‑assisted laparoscopic radical cystectomy. Histopathological examination confirmed high‑grade PUC with 40% squamous differentiation. The tumor invaded peridiverticular adipose tissue (pT3a) and exhibited extensive lymphovascular invasion (> 10 vessels). Immunohistochemistry was positive for GATA3 (weak), p63, CD138 (partial), and CK7 (weak positivity), with PD‑L1 expression (Combined Positive Score = 5), Focal weak membranous E-cadherin staining in approximately 30% of tumor cells, HER2 equivocal (2+). Surgical margins and lymph nodes were negative. The patient was disease‑free at the 3‑month postoperative follow‑up. However, 5 months after surgery, pelvic MRI revealed metastatic lesions, consistent with stage IV disease (rT0N+M1). He subsequently received palliative radiotherapy to the pelvis (200 cGy×25f) and combined targeted therapy (disitamab vedotin 120 mg) plus immunotherapy (toripalimab 240 mg). At the last follow‑up in May 2026 (approximately 7 months postoperatively), he was clinically stable without severe symptoms and continued outpatient radiotherapy. CONCLUSION: This case highlights the diagnostic and therapeutic complexities of managing high‑grade PUC within a bladder diverticulum. It underscores the essential role of high‑quality cross‑sectional imaging for assessing extra‑diverticular extension, the need for meticulous pathological evaluation to identify this aggressive variant, and the centrality of radical surgery. The presence of lymphovascular invasion and PD‑L1 expression supports the consideration of multimodal strategies and close surveillance. Given the rarity of this dual‑pathology entity, collaborative reporting is crucial to optimize management and improve outcomes.
A comparative study of robot-assisted laparoscopic radical cystectomy combined with urinary diversion: preoperative indicators and survival outcomes analysis at a single center.
Liu C, Zhu Y, Liao Y … +3 more , Yang X, Zhao C, Zhang N
BMC Urol · 2026 Jul · PMID 42393607 · Full text
OBJECTIVE: To compare the preoperative indexes and survival outcomes between da Vinci robot-assisted radical cystectomy (RARC) and laparoscopic radical cystectomy (LRC), and to analyze the clinical differences among the...
OBJECTIVE: To compare the preoperative indexes and survival outcomes between da Vinci robot-assisted radical cystectomy (RARC) and laparoscopic radical cystectomy (LRC), and to analyze the clinical differences among the three types of urinary diversion modalities, namely, intracorporeal ileal neobladder (Studer type), Bricker's procedure, and ureterocutaneostomy. METHODS: A total of 194 patients who underwent minimally invasive radical cystectomy in the Department of Urology of the Affiliated Hospital of Zunyi Medical University from January 2010 to December 2024 were retrospectively analyzed and divided into the laparoscopic group (152 patients) and the robotic group (42 patients) according to surgical modalities. Perioperative indexes and survival outcomes of the two groups were compared, and the clinical differences among the three urinary diversion modalities were analyzed. RESULTS: The duration of surgery was significantly shorter in the robotic group than in the laparoscopic group (5.17 h vs. 6.75 h, P<0.001), but there was no significant difference in overall survival and complication rates between the two groups. Among the urinary diversion modalities, the median survival was the longest in the intracorporeal ileal neobladder group (55 months), which was significantly better than that of the Bricker procedure (25 months) and ureterocutaneostomy (13 months) (P<0.001). Multifactorial analysis showed that elevated ASA classification (HR=14.99-20.16) and male gender (HR=1.96) were independent risk factors in the laparoscopic group, whereas prolonged operative duration was associated with a reduced risk (HR=0.56). In patients with the Bricker procedure, ASA classification (P=0.001) and gender (P=0.032) significantly influenced prognosis. CONCLUSION: Robot-assisted radical cystectomy (RARC) has significant short-term surgical advantages over laparoscopic radical cystectomy (LRC). Among different urinary diversion methods, intracorporeal ileal neobladder is associated with longer survival, although this largely reflects patient selection bias. The choice of specific surgical approach should be based on a comprehensive consideration of the patient's individual circumstances.
Untangling the anterolateral periprostatic neurovasculature and its implications for nerve-sparing radical prostatectomy.
Nabavizadeh B, Hill CR, Hu JC
Nat Rev Urol · 2026 Jul · PMID 42386986 · Publisher ↗
Abstract loading — click title to view on PubMed.
Effects of pre-procedural video education and intra-procedural virtual reality on anxiety and pain during flexible cystoscopy: a randomized controlled trial.
Beyatlı M, Güngör HS, Sobay R … +8 more , İnkaya A, Şişik NM, Topçu ME, Evci MU, Uzel T, Suçeken FY, Tahra A, Küçük EV
BMC Urol · 2026 Jul · PMID 42380921 · Full text
BACKGROUND: This study aimed to investigate the effects of pre-procedural video education and intra-procedural distraction using virtual reality (VR) nature videos on patient anxiety and pain perception during office-bas...
BACKGROUND: This study aimed to investigate the effects of pre-procedural video education and intra-procedural distraction using virtual reality (VR) nature videos on patient anxiety and pain perception during office-based flexible cystoscopy. METHODS: In this single-center, four-arm, parallel-group randomized controlled trial, 240 adult patients scheduled for flexible cystoscopy were enrolled. Participants were randomized into four groups: Video + VR- (n = 60), Video + VR + (n = 60), Video- VR + (n = 60), and Video- VR- (control, n = 60). Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory (STAI), and pain was measured with a visual analog scale (VAS). Intergroup comparisons were performed using nonparametric tests, and outcome assessors were blinded to group allocation. RESULTS: Pain scores differed significantly among groups (H = 44.604, p < 0.001). The lowest pain scores were observed in the Video + VR + group (4.3 ± 1.1), while the highest were in the control group (5.7 ± 1.1). Reductions in STAI-S (state anxiety) scores also showed significant group differences (H = 28.311, p < 0.001). Compared with the control group, the Video + VR + group demonstrated significant improvements in both VAS (p < 0.001, r = 0.610) and STAI-S reduction (p < 0.001, r = -0.493), with large effect sizes. Analyses based on baseline STAI-T (trait anxiety) scores indicated that the interventions were effective regardless of initial anxiety levels, with the combined Video + VR + approach consistently providing the greatest benefit. CONCLUSION: The combination of pre-procedural video education and intra-procedural VR distraction was associated with the greatest reduction in pain and anxiety during flexible cystoscopy. These findings support the potential value of multimodal approaches for improving patient comfort during urologic procedures. TRIAL REGISTRATION: Registered on 05 September 2025 in the ISRCTN registry (ISRCTN22513446).
Editorial Comment on "A Histopathologic Assessment of Prostate Ductal Anatomy in Relation to Micro-Ultrasound".
Fu H, Wynn M, Millan B
Urology · 2026 Jun · PMID 42379317 · Publisher ↗
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Renal metastasis of adenocarcinoma of the gastrointestinal tract with unknown primary site: a case report and review of the literature.
Li J, Ren X, Wang Z … +4 more , Zhuang Y, Baoerbieke Y, Zhang Y, Zeng J
Ther Adv Urol · 2026 · PMID 42369180 · Full text
Cancer of unknown primary (CUP) is an aggressive malignancy with a persistently poor prognosis. Renal metastases from an occult primary adenocarcinoma are exceptionally rare and diagnostically challenging, frequently mim...
Cancer of unknown primary (CUP) is an aggressive malignancy with a persistently poor prognosis. Renal metastases from an occult primary adenocarcinoma are exceptionally rare and diagnostically challenging, frequently mimicking primary kidney cancer. This case report details a rare instance of metastatic adenocarcinoma to the kidney from an occult primary origin, initially misclassified as primary renal cell carcinoma. A 60-year-old male patient was admitted to our department for further evaluation of a cystic-solid right renal mass. Staging revealed synchronous extrarenal metastases. Subsequent immunohistochemical analysis indicated gastrointestinal differentiation, yet exhaustive diagnostic workup failed to identify the primary tumor site. The patient underwent radical nephrectomy followed by biomarker-guided FLOT (fluorouracil, leucovorin, oxaliplatin, and docetaxel) chemotherapy combined with camrelizumab immunotherapy, achieving a progression-free survival of approximately 7 months, accompanied by a temporary decline in tumor markers. Tumor recurrence manifested at 11 months postoperatively as pulmonary progression, at which point retrospective molecular profiling of the archived specimen revealed an amplification, providing a molecular rationale for subsequent targeted therapy. This case highlights the crucial roles of multidisciplinary collaboration and molecular technology in resolving diagnostic dilemmas and identifying actionable targets in CUP. It offers two key clinical takeaways: diagnostically, a solitary kidney mass with other metastases should prompt consideration of a renal metastasis, even though primary kidney cancer is more common. Therapeutically, while the identified biomarker provided a rationale for precision therapy, the resulting clinical benefit was limited and transient. This suggests that the aggressive biology and spatial heterogeneity typical of CUP can attenuate the long-term efficacy of biomarker-guided interventions.
Complete pathological response in patients with bladder cancer: predictors and outcomes.
Ghoreifi A, Dudinec JV, Refugia JM … +4 more , Zahir M, Nabavizadeh R, Shah AM, Abern MR
Ther Adv Urol · 2026 · PMID 42369179 · Full text
Pathologic complete response (pCR) in bladder cancer, most often defined as pT0N0 at radical cystectomy (RC) following transurethral resection of the bladder tumor with/without neoadjuvant therapy, has emerged as a power...
Pathologic complete response (pCR) in bladder cancer, most often defined as pT0N0 at radical cystectomy (RC) following transurethral resection of the bladder tumor with/without neoadjuvant therapy, has emerged as a powerful prognostic marker. Predicting pCR before RC and understanding its prognostic nuances are increasingly important as perioperative chemotherapy and immunotherapy evolve. In this study, we reviewed the contemporary evidence regarding definitions and clinical contexts of pCR in bladder cancer; clinical, pathological, imaging, molecular, and liquid-biopsy predictors of pCR; and outcomes and recurrence patterns in patients achieving pCR. We found out that pCR rates vary widely according to treatment regimen, patient selection, and underlying tumor biology, ranging from 5%-15% after transurethral resection alone, 25%-35% with cisplatin-based chemotherapy, and up to 40% with combination chemoimmunotherapy. However, regardless of upfront treatment modality, pCR correlates with significantly improved overall survival and recurrence-free survival. A growing body of evidence has identified predictors of pCR spanning clinical and histopathologic features, molecular and genomic alterations, particularly DNA damage response gene mutations, immune biomarkers (e.g., tumor mutational burden and immune gene expression signatures), advanced imaging with multiparametric magnetic resonance imaging and vesical imaging reporting and data system-based assessment, and circulating tumor DNA dynamics. Among these, circulating tumor DNA clearance during neoadjuvant therapy has demonstrated particularly strong predictive and prognostic value. Despite the favorable outcomes associated with pCR, recurrence risk is not negligible, especially among ypT0 patients, highlighting the importance of risk-adapted postoperative surveillance. In parallel, bladder-preserving strategies for carefully selected patients achieving a clinical complete response remain investigational, limited by imperfect concordance between clinical and pathologic response and requiring rigorous multimodal assessment and close follow-up. Collectively, contemporary data indicate that no single biomarker is sufficient to reliably predict pCR; rather, integrated multimodal models offer the greatest potential to refine neoadjuvant treatment selection, inform bladder preservation, and individualize surveillance while maintaining oncologic safety.
Predisposing factors for angioembolization in persistent hematuria after percutaneous nephrolithotomy: a retrospective analysis.
Alfiel A, Mohammadi A, Mahdi Mehrabi M … +5 more , Ashtari S, Alaedini F, Guitynavard F, Nikoofar P, Aghamir SMK
Ther Adv Urol · 2026 · PMID 42369178 · Full text
BACKGROUND: Hemorrhage is one of the most significant complications of percutaneous nephrolithotomy (PCNL) and may lead to clinically significant persistent hematuria requiring digital subtraction angiography (DSA) and t...
BACKGROUND: Hemorrhage is one of the most significant complications of percutaneous nephrolithotomy (PCNL) and may lead to clinically significant persistent hematuria requiring digital subtraction angiography (DSA) and transcatheter arterial embolization (TAE). Identifying predictors of TAE may improve perioperative planning and risk stratification. OBJECTIVES: To determine predictors of need for TAE in patients evaluated with DSA for persistent post-PCNL hemorrhage. DESIGN: Single-center retrospective observational study. METHODS: From 2021 to 2024, a total of 2947 tubeless PCNL procedures were performed at our institution. Consecutive adult patients who developed clinically significant persistent post-PCNL hemorrhage and underwent DSA were assessed. Persistent hematuria was operationally defined as severe visible hematuria persisting for >24 h despite conservative management or recurrent severe hematuria after initial stabilization. DSA referral followed predefined escalation criteria after failure of conservative measures, including hemodynamic instability, Hb drop ⩾3 g/dL within 24 h or progressive decline, transfusion requirement ⩾2 units within 24 h, and/or recurrent clot retention requiring clot evacuation and/or continuous bladder irrigation. TAE was performed only when DSA demonstrated a culprit vascular lesion. RESULTS: The mean age of the study population was 55.1 ± 10.6 years, and 68% were male. Among the 100 patients who underwent DSA for persistent post-PCNL hemorrhage, 36 (36%) required TAE, while 64 (64%) had normal angiographic findings and were managed conservatively. On multivariable logistic regression analysis, diabetes mellitus (odds ratio (OR) 7.42), larger stone size (OR 1.27 per mm), higher stone density (OR 1.007 per Hounsfield unit), greater skin-to-stone distance (OR 1.14 per mm), and longer operative time (OR 1.18 per minute) independently predicted the need for TAE. Pseudoaneurysm was identified in 77.8% of embolized patients and arteriovenous fistula in 22.2%. Selective coil embolization achieved 100% clinical success without the need for repeat embolization, surgical exploration, or nephrectomy. CONCLUSION: Among patients undergoing DSA for clinically significant persistent post-PCNL hemorrhage, diabetes mellitus, larger stone size, higher stone density, greater skin-to-stone distance, and longer operative time were independently associated with the need for TAE.
Effect of needle disinfection with different antiseptic agents on infectious complications after TRUS-guided prostate biopsy: a prospective randomized study.
Çağlayan MS, Kestel M, Ekici M … +4 more , Aydin C, Öztürk Mİ, Taşcı A, Baykam MM
Ther Adv Urol · 2026 · PMID 42369177 · Full text
BACKGROUND: Transrectal ultrasound-guided prostate biopsy (TRUS-guided biopsy) remains widely used for the diagnosis of prostate cancer, but it is associated with a risk of infectious complications despite antibiotic pro...
BACKGROUND: Transrectal ultrasound-guided prostate biopsy (TRUS-guided biopsy) remains widely used for the diagnosis of prostate cancer, but it is associated with a risk of infectious complications despite antibiotic prophylaxis. OBJECTIVES: To evaluate the effect of disinfecting the prostate biopsy needle with different antiseptic agents after each core sampling on post-procedural infectious complications. DESIGN: A prospective, randomized, single-center clinical study. METHODS: Between February and May 2025, 240 patients undergoing TRUS-guided prostate biopsy were randomly assigned to four groups ( = 60 each): no needle disinfection, povidone-iodine disinfection, 10% formalin disinfection, or 70% isopropyl alcohol disinfection after each biopsy core. All patients received standardized empirical antibiotic prophylaxis based on the institutional protocol and local antibiogram data. Prophylaxis consisted of oral cefixime initiated on the day of biopsy and continued for 5-7 days. Patients were actively followed for 30 days for febrile urinary tract infection, hospitalization, sepsis, and microbiological culture results. RESULTS: The rate of febrile urinary tract infection was highest in the non-disinfection group (11.6%). No cases of fever, hospitalization, or sepsis were observed in the formalin group. Povidone-iodine and isopropyl alcohol disinfection were associated with lower infection rates than no disinfection, but were less effective than formalin. was the most frequently isolated microorganism in positive cultures. CONCLUSION: Disinfection of the biopsy needle after each core sampling is associated with a meaningful reduction in infectious complications following TRUS-guided prostate biopsy. Among the evaluated agents, 10% formalin demonstrated the greatest protective effect; however, further multicenter studies with longer follow-up are required to confirm long-term safety and generalizability. TRIAL REGISTRATION: This trial was prospectively registered at ClinicalTrials.gov (Identifier: NCT06836271; Local trial ID: HititUrology001).
Can social media videos meet patients' information needs for benign prostatic hyperplasia? A repeated cross-sectional study.
Tian C, Wang W, Tao J … +2 more , Luo G, Zhou J
BMC Urol · 2026 Jun · PMID 42366358 · Full text
BACKGROUND: Benign prostatic hyperplasia (BPH) is a common urological condition among older men and can cause lower urinary tract symptoms (LUTS). As patients increasingly seek disease-related information through social...
BACKGROUND: Benign prostatic hyperplasia (BPH) is a common urological condition among older men and can cause lower urinary tract symptoms (LUTS). As patients increasingly seek disease-related information through social media, evaluations of the quality, reliability, and transparency of patient-facing BPH content remain limited. METHODS: Repeated cross-sectional searches were conducted on Bilibili and TikTok on December 1, 16, and 31, 2025. Basic video characteristics were extracted. Video reliability, quality, and transparency were assessed using the modified DISCERN (mDISCERN), Global Quality Score (GQS), and the Journal of the American Medical Association (JAMA) benchmark criteria, respectively. Exploratory supplementary assessments of content coverage and accessibility-related features were conducted using the content coverage checklist (CCC) and video accessibility checklist (VAC). Potentially misleading or harmful information signals were also descriptively assessed. Spearman correlation analysis and ordinal logistic regression were performed to examine associations between video characteristics and assessment scores. RESULTS: A total of 217 videos were included. Overall, the median (IQR) scores were 3.00 (2.00-3.00) for mDISCERN, 3.00 (2.00-3.00) for GQS, and 2.00 (2.00-2.00) for JAMA. In exploratory supplementary analyses, the median (IQR) scores were 3.00 (2.00-4.00) for CCC and 6.00 (5.00-6.00) for VAC. Potentially misleading or harmful information signals were observed in 29 videos (13.4%). Videos published by professional individuals and professional institutions had significantly higher mDISCERN, GQS, and JAMA scores than those published by non-professional individuals (all P < 0.001). Spearman correlation analysis and ordinal logistic regression indicated that engagement metrics were not independent predictors of assessment scores. CONCLUSIONS: Overall, BPH-related videos on social media showed moderate reliability, quality, and transparency, but consistently high-value content remained limited. A minority of videos also contained potentially misleading or harmful information signals. Videos from professional sources tended to provide higher-quality information, whereas user engagement was not a reliable indicator of content quality. These findings suggest that urologists and healthcare institutions may have an important role in providing more structured, understandable, and patient-oriented digital education for men seeking BPH information online.
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