Urology research & practice最新文献

{"title":"Radical Nephroureterectomy in the Very Elderly: A Single-Center Experience of Patients Aged ≥85 Years.","authors":"Shu Gozu, Shugo Yajima, Gaku Okumura, Erika Ikezoe, Naoki Imasato, Kohei Hirose, Madoka Kataoka, Yasukazu Nakanishi, Hitoshi Masuda","doi":"10.5152/tud.2026.25125","DOIUrl":"10.5152/tud.2026.25125","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of upper tract urothelial carcinoma is increasing with population aging, yet evidence regarding radical nephroureterectomy (RNU) in very elderly patients is limited. This study evaluated perioperative outcomes, complications, and oncological results of RNU in patients aged ≥85 years compared with younger counterparts.</p><p><strong>Methods: </strong>A total of 305 patients who underwent RNU between April 2003 and December 2024 at a tertiary institution were retrospectively reviewed. After excluding those with incomplete data (n = 4), non-urothelial histology (n = 8), or undeterminable pathology (n = 9), 284 patients were eligible. Group A included 24 patients aged ≥85 years, range 85-94 years, and group B included 260 patients <85 years, range 46-84 years. Clinicopathological features, operative outcomes, complications, and survival were compared. Temporal trends and restricted mean survival time (RMST) analyses were also performed.</p><p><strong>Results: </strong>Baseline characteristics were similar (all P > .05). Median laparoscopic operative time was shorter in group A (206 vs. 235 minutes, P = .029). Estimated blood loss, transfusion, and complication rates (10.6% overall; major 2.2%) did not differ (all P > .05). Pathological outcomes were comparable (all P > .05). Adjuvant therapy was less frequent in group A (0% vs. 21.2%, P = .006). Follow-up was 16.3 vs. 35.2, with no differences in survival (all P > .05). The RMST showed shorter survival in group A.</p><p><strong>Conclusion: </strong>The RNU appears feasible in carefully selected patients aged ≥85 years, with perioperative and oncological outcomes broadly comparable to those of younger patients. Chronological age alone should not contraindicate surgery. Restricted mean survival time offers complementary insights into survival estimation in this high-risk population. Cite this article as: Gozu S, Yajima S, Okumura G, et al. Radical nephroureterectomy in the very elderly: A single-center experience of patients aged ≥85 years. Urol Res Pract. 2026, 52, 0125, doi: 10.5152/tud.2026.25125.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"52 ","pages":"1-8"},"PeriodicalIF":1.1,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter Study on Integrating Prostate Magnetic Resonance Imaging with Prostate-Specific Antigen Density for Risk-Adapted Biopsy Strategy in a South Korean Cohort.","authors":"Seung-Ju Lee, Dong Ho Shin, Hee Youn Kim","doi":"10.5152/tud.2026.26014","DOIUrl":"10.5152/tud.2026.26014","url":null,"abstract":"<p><strong>Objective: </strong>Combining Prostate Imaging-Reporting and Data System (PI-RADS) with prostate-specific antigen density (PSAD) may improve the detection of clinically significant prostate cancer (csPCa) while reducing unnecessary biopsies. This study aimed to evaluate csPCa detection rates using PI-RADS and PSAD, identify optimal PSAD cutoffs, and assess biopsy strategies to optimize csPCa detection and reduce unnecessary procedures within a South Korean cohort.</p><p><strong>Methods: </strong>This multicenter retrospective study included 3117 biopsy-naïve patients from 2 tertiary hospitals in South Korea (2020-2025) who underwent magnetic resonance imaging-based transperineal prostate biopsy. Patients were stratified into PI-RADS groups (1-2, 3, 4-5) and PSAD categories (<0.10, 0.10-0.15, 0.15-0.20, and ≥0.20). Receiver-operating characteristic (ROC) curve analyses validated PSAD cut-offs, and biopsy strategies were compared for csPCa detection and biopsy avoidance.</p><p><strong>Results: </strong>The overall csPCa detection rate was 47.1%. PI-RADS 4-5 patients had high detection rates across all PSAD levels (20.1%-76.5%), while PI-RADS 1-2 and 3 patients with PSAD ≥ 0.15 showed elevated rates (15.2%-16.9% and 25.0%-35.7%, respectively). ROC curve analyses identified optimal PSAD cut-offs of 0.155 (area under the ROC curve (AUC), 0.708) for PI-RADS 1-2 and 0.145 (AUC, 0.749) for PI-RADS 3. The proposed strategy (PI-RADS ≥ 4 or PI-RADS 1-2 or 3 with PSAD ≥ 0.15) outperformed other strategies, avoiding 448 (14.4%) biopsies, missing 28 (1.9%) csPCa cases, and achieving a negative predictive value of 93.8%.</p><p><strong>Conclusion: </strong>Integrating PI-RADS with PSAD enhances risk stratification for csPCa, maintaining high diagnostic accuracy while reducing unnecessary procedures. Cite this article as: Lee SJ, Shin DH, Kim HY. Multicenter study on integrating prostate magnetic resonance imaging with prostate-specific antigen density for risk-adapted biopsy strategy in a South Korean cohort. Urol Res Pract. 2026, 52, 0014, doi: 10.5152/tud.2026.26014.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"52 ","pages":"1-6"},"PeriodicalIF":1.1,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-Dependent Endocrine Signaling as a Modifiable Therapeutic Variable in Advanced Prostate Cancer.","authors":"Ivan Bivolarski","doi":"10.5152/tud.2026.25129","DOIUrl":"10.5152/tud.2026.25129","url":null,"abstract":"","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"52 ","pages":"1-2"},"PeriodicalIF":1.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13174961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transurethral Bipolar Enucleation vs. Transurethral Monopolar Enucleation of the Prostate for the Treatment of Bladder Outlet Obstruction Due to Benign Prostatic Hyperplasia.","authors":"Ahmed G Mohamed, Osama Sayed, Ramy Nageib Masoud, Amr Medhat Massoud, Sherif Abdel Rahman Abdul Hay, Ahmed Abdelbary, Mohamed F Elebiary, Hany Fathy","doi":"10.5152/tud.2026.25075","DOIUrl":"10.5152/tud.2026.25075","url":null,"abstract":"<p><p>  Objective: To compare the feasibility of bipolar transurethral enucleation (B-TUEP) and monopolar transurethral enucleation (M-TUEP) for the management of benign prostatic obstruction.</p><p><strong>Methods: </strong>This prospective randomized study involved 160 patients: 80 patients who were subjected to B-TUEP; and 80 patients who were subjected to M-TUEP. Patients were evaluated preoperatively and for 1 year postoperatively.</p><p><strong>Results: </strong>At the 12-month follow-up, no statistically significant intergroup differences were observed in operative time, resected tissue weight, International Prostate Symptom Score, or maximum urinary flow rate. Postoperative rates of re-catheterization for acute urinary retention, urinary incontinence, and urinary tract infections were also comparable between groups. However, the B-TUEP group exhibited significantly less intraoperative bleeding (P < .001). The M-TUEP group experienced significantly longer postoperative catheterization, and hospital stays (P < .001). Furthermore, the M-TUEP group demonstrated significantly lower mean intraoperative serum sodium levels (P < .001), with 1 patient experiencing TUR (Transurethral resection) syndrome.</p><p><strong>Conclusion: </strong>The findings indicate comparable efficacy between M-TUEP and B-TUEP for benign prostatic hyperplasia treatment, although B-TUEP demonstrates superior safety. Monopolar transurethral enucleation of the prostate remains a safe and effective alternative in the absence of bipolar technology. Cite this article as: Mohamed AG, Sayed O, Masoud RN, et al. Transurethral bipolar enucleation vs. transurethral monopolar enucleation of the prostate for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia. Urol Res Pract. 2026, 52, 0075 doi: 10.5152/ tud.2026.25075.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"52 ","pages":"1-7"},"PeriodicalIF":1.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13174962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting Human Epidermal Growth Factor Receptor 2 in Bladder Cancer: Evaluating Its Role as a More Robust Clinicopathological Biomarker Compared to Programmed Death Ligand 1 Expression.","authors":"Ankur Mittal, Kunal Malhotra, Vikas Panwar, Sanjeev Kishore, Mohammed Taher, Avin Singhal","doi":"10.5152/tud.2026.25061","DOIUrl":"10.5152/tud.2026.25061","url":null,"abstract":"<p><p>  Objective: This retrospective cross-sectional analytical study evaluated the clinicopathological associations of programmed death ligand 1 (PD-L1) and human epidermal growth factor receptor 2 (HER2/neu) expression in 250 patients with urothelial carcinoma of the urinary bladder, with particular emphasis on their relationship to tumor stage and lymph node involvement.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on 250 patients with urothelial carcinoma who underwent immunohistochemical evaluation of PD-L1, using a tumor proportion score (TPS) of ≥1%, and HER2/neu with 3+ considered positive. Formalin-fixed paraffin-embedded tissue from transurethral resection of bladder tumor and cystectomy specimens was analyzed by immunohistochemistry. The HER2/ neu was scored using a standard 0-3+ system, and PD-L1 expression was assessed by TPS. Associations were tested using chi-square or Fisher's exact tests. Multivariable logistic regression evaluated whether HER2/neu independently predicted nodal involvement after adjustment for age, sex, tumor stage, and morphology. Statistical significance was set at P < .05.</p><p><strong>Results: </strong>The HER2/neu 3+ positivity was present in 100/250 patients (40%) and was significantly associated with nodal involvement (P = .019). On multivariable logistic regression, HER2/neu is independently associated with nodal involvement, reflecting aggressive tumor biology (adjusted OR 2.41; 95% CI 1.33-4.36; P = .004). Among node-negative patients (N0, n = 200), 35.5% were HER2/neu positive, rising stepwise to 50.0% in N1, 54.5% in N2, and 71.4% in N3 disease, supporting a relationship between HER2/ neu overexpression and nodal progression. In contrast, PD-L1 positivity (TPS ≥1%) was observed in 129/250 patients (51.6%) and was not significantly associated with age, sex, tumor stage, nodal status, grade, multiplicity, or morphology (all P > .05).</p><p><strong>Conclusion: </strong>The HER2/neu was an independent clinicopathological biomarker associated with nodal involvement and aggressive tumor biology in urothelial carcinoma. PD-L1 showed limited clinicopathological utility in this cohort, though it retains predictive value for immune checkpoint inhibitor therapy.   Cite this article as: Mittal A, Malhotra K, Panwar V, Kishore S, Taher M, Singhal A. Targeting human epidermal growth factor receptor 2 in bladder cancer: evaluating its role as a more robust clinicopathological biomarker compared to programmed death ligand 1 expression. Urol Res Pract. 2026, 52, 0061, doi: 10.5152/tud.2026.25061.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"52 ","pages":"1-6"},"PeriodicalIF":1.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13174960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Flexible and Navigable Suction Ureteral Access Sheath Versus Conventional Ureteric Access Sheath in RIRS: A Systematic Review and Meta-Analysis.","authors":"Ankur Mittal, Anumanchi Dattasai Subramanyam, Vikas Kumar Panwar, Kunal Malhotra, Kirti Rana, Dharam Dev, Shikhar Garg","doi":"10.5152/tud.2026.25119","DOIUrl":"10.5152/tud.2026.25119","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of flexible and navigable suction ureteral access sheath (FANS) versus conventional ureteric access sheath (C-UAS) in Retrograde Intrarenal Surgery (RIRS) for renal stone disease through meta-analysis and trial sequential analysis (TSA). The FANS technology has emerged as a potential solution, incorporating active suction mechanisms to enhance stone clearance and visualization.</p><p><strong>Methods: </strong>PubMed, EMBASE, Cochrane, and Scopus were searched from 2000 to June 2025 for randomized controlled trials (RCTs) and prospective studies comparing FANS vs. C-UAS in adult RIRS. The primary outcome was stone-free rates at various time points; secondary outcomes included complications, operative, and recovery parameters. The risk of bias was assessed, and random-effects meta-analyses with subgroup, meta-regression, TSA, and Bayesian modeling were performed.</p><p><strong>Results: </strong>Fifteen studies comprising 11 RCTs and 4 observational studies with 3030 participants were included. Flexible and navigable suction ureteral access sheath achieved a significantly higher immediate stone-free rate (79.1% vs. 54.5%; Relative Risk (RR): 1.47, 95% CI: 1.23-1.7; P < .001). Significant heterogeneity was noted (I2 = 89.3%). The absolute risk difference was 24.6% (number needed to treat = 6). Stone-free rates favored FANS at 30 days (93.5% vs. 82.7%; RR = 1.13) and 3 months (96.2% vs. 88.4%; RR = 1.09), both statistically significant. Flexible and navigable suction ureteral access sheath reduced overall complications by 52% (9.7% vs. 20.2%). Benefits were greatest for stones >20 mm (RR = 2.14), density ≥1000 HU (RR = 1.94), and non-pre-stented patients (RR = 1.37). Trial sequential analysis (3030 patients; 106.4% information size) confirmed FANS superiority. Machine learning prediction of stone-free success showed high accuracy (Area Under the ROC Curve [AUC] = 0.89).</p><p><strong>Conclusion: </strong>Flexible and navigable suction ureteral access sheath shows clear superiority, improving immediate stone-free rates by 47% with notable safety benefits, TSA confirms evidence sufficiency. Cite this article as: Mittal A, Subramanyam AD, Panwar VK, Malhotra K, et al. Comparison of flexible and navigable suction ureteral access sheath versus conventional ureteric access sheath in RIRS: A systematic review and meta-analysis. Urol Res Pract. 2026, 52, 0119, doi:10.5152/tud.2026.25119.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"52 ","pages":"1-12"},"PeriodicalIF":1.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysregulation of microRNAs and Centromere Protein Genes in Prostate Cancer and Metastatic Progression.","authors":"Makbule Nihan Somuncu, İlknur Karalezli, Yunus Emre Göger, Ayşe Gül Zamani, Mahmut Selman Yıldırım, Asuman Deveci, Mustafa Cihat Avunduk, Giray Karalezli","doi":"10.5152/tud.2026.26143","DOIUrl":"10.5152/tud.2026.26143","url":null,"abstract":"<p><strong>Objective: </strong>Accurate prediction of disease progression and metastatic potential remains a major challenge in prostate cancer management. This study aimed to evaluate the expression profiles of selected microRNAs (miRNAs) and cell cycle-related genes as centromere protein genes (CENPs) in prostate cancer and to explore their potential clinical relevance in distinguishing metastatic disease.</p><p><strong>Methods: </strong>Formalin-fixed paraffin-embedded prostate tissue samples from patients with benign prostatic hyperplasia, localized prostate cancer, and metastatic prostate cancer were analyzed. Quantitative real-time polymerase chain reaction (PCR) (qRTPCR) was used to assess the expression of miRNAs targeted CENPs as well as CENPA, CENPC, HJURP, and AURKB. Expression patterns were further validated in the metastatic prostate cancer cell line PC3. Relative expression levels were calculated using the 2-ΔΔCt (cycle threshold) method.</p><p><strong>Results: </strong>Expression analysis of selected miRNAs revealed a significant upregulation of hsa-miR-4755-5p in the metastatic PCa (P = .027), despite no significant differences in fold change. Additionally, hsa-miR-5680 showed a significantly higher fold change in the metastatic group compared to controls (P = .034). Although not statistically significant (P > .05), hsa-miR-5688, hsa-miR-20a-5p, and hsa-miR-4500 demonstrated a consistent trend toward downregulation, as indicated by lower ΔΔCt values in both PCa and metastatic groups relative to controls. In PCa cell line CENPA, CENPC,and HJURP expression levels increased over time, whereas AURKB was downregulated.</p><p><strong>Conclusion: </strong>The findings indicate that combined dysregulation of specific microRNAs and centromere-associated genes characterizes metastatic prostate cancer. This molecular signature may provide clinically relevant information for risk stratification and warrants further investigation as a potential adjunct to conventional prognostic markers in prostate cancer. Cite this article as: Somuncu MN, Karalezli I, Göger YE, et al. Dysregulation of microRNAs and centromere protein genes in prostate cancer and metastatic progression. Urol Res Pract., 52, 0143, doi:10.5152/tud.2026.26143.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"52 ","pages":"1-8"},"PeriodicalIF":1.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Standard TRUS-Guided Prostate Biopsy the End of the Game?","authors":"Erdal Benli, Nurullah Kadim, Ahmet Yüce, Abdullah Çırakoğlu, Mevlüt Keleş, Ayhan Arslan","doi":"10.5152/tud.2026.25103","DOIUrl":"10.5152/tud.2026.25103","url":null,"abstract":"<p><strong>Objective: </strong>Prostate cancer (PCa) remains a major cause of morbidity and mortality among men worldwide, and histopathologic tissue sampling plays a pivotal role in diagnosis. Although transrectal ultrasound-guided prostate needle biopsy (TRUS biopsy) has been the standard diagnostic technique for decades, its effectiveness has increasingly been questioned with the widespread adoption of cognitive and magnetic resonance imaging (MRI)-targeted biopsy techniques. The aim of this study wa to present the clinical outcomes and costs of TRUS-guided prostate biopsy performed in the clinic and to compare its costs with those of MRI-targeted biopsy.</p><p><strong>Materials and methods: </strong>Data from 221 patients who underwent prostate biopsy were retrospectively analyzed. Patient comorbidities, prostate-specific antigen levels, digital rectal examination findings, histopathologic results, and biopsy-related costs were recorded. Cost data for MRI-targeted biopsy were obtained from 9 private hospitals located in different regions of the country.</p><p><strong>Results: </strong>Prostate cancer was detected in 40.3% (n = 89) of the 221 patients. Clinically significant PCa was identified in 29.9% (n = 66), whereas malignancy could not be excluded in 1.4% (n = 3). The mean cost of TRUS-guided prostate biopsy performed in the clinic was calculated as US $26.8. In contrast, based on data obtained from 9 hospitals, the reported mean cost of MRI-targeted biopsy was US $1449.</p><p><strong>Conclusion: </strong>Transrectal ultrasound-guided prostate needle biopsy remains an effectivemand highly cost-efficient diagnostic method in patients with suspected PCa. This technique may be particularly valuable in clinical settings where access to MRI-targeted biopsy is limited.   Cite this article as: Benli E, Kadim N, Yüce A, Çırakoğlu A, Keleş M, Arslan A. Is standard TRUS-guided prostate biopsy the end of the game? Urol Res Pract. 2025;51(6): 237-241.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"51 6","pages":"237-241"},"PeriodicalIF":1.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holmium Laser Enucleation of the Prostate Vs. Bipolar Transurethral Resection of the Prostate for Small-Volume Prostates: A Comparative Analysis of Clinical Outcomes.","authors":"Abdullah Gölbaşı, Burak Elmaağaç, Hüseyin Biçer, Ali Yasin Özercan, Sefa Günal, Murat Keske","doi":"10.5152/tud.2026.25132","DOIUrl":"10.5152/tud.2026.25132","url":null,"abstract":"<p><strong>Objective: </strong>Benign prostatic hyperplasia is a common cause of lower urinary tract symptoms (LUTS) in aging men. While transurethral resection of the prostate (TURP) is the traditional surgical standard, holmium laser enucleation of the prostate (HoLEP) has emerged as a safe and effective alternative. Evidence comparing both techniques in small prostates (<50 mL) remains limited.</p><p><strong>Methods: </strong>This retrospective study included male patients aged 40-80 years who underwent bipolar TURP (B-TURP) or HoLEP between 2023 and 2025 for LUTS refractory to medical therapy, with prostate volume <50 mL. Pre- and postoperative parameters, including operative time, resected tissue weight, irrigation volume, hospital stay, catheterization time, and functional scores (International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), peak urinary flow rate (Qmax), postvoid residual urine (PVR)) were compared.</p><p><strong>Results: </strong>No significant differences were found between groups regarding age, body mass index, comorbidities, prostate-specific antigen, prostate volume, ICIQ-SF scores, IIEF-5, complication rates, or postoperative hemoglobin decrease (all P > .05). Holmium laser enucleation of the prostate showed longer operative time, greater irrigation use, and higher resected tissue weight/percentage (P = .03, .02, <.001, <.001), while hospital stay and catheterization were shorter (both P < .001). Both procedures improved Qmax and IPSS and reduced PVR (all P < .001); the increase in Qmax was greater in HoLEP (P = .025).</p><p><strong>Conclusion: </strong>Both B-TURP and HoLEP are safe and effective for small prostates; however, HoLEP offers advantages in resected tissue weight, Qmax improvement, and shorter hospital stay/catheterization.   Cite this article as: G.lbaşı A, Elmaağa. B, Bi.er H, .zercan AY, Günal S, Keske M. Holmium laser enucleation of the prostate vs. bipolar transurethral resection of the prostate for small-volume prostates: A comparative analysis of clinical outcomes. Urol Res Pract. 2025;51(6):225-229.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"51 6","pages":"225-229"},"PeriodicalIF":1.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde Intrarenal Renal Surgery versus Supine Mini Percutaneous Nephrolithotripsy in Treatment of Renal Pelvic Stones Less than 2 cm, Randomized Clinical Study.","authors":"Ahmed Hakim Abdelgawad, Mamdouh Abdelhamid Elhawy, Al Ayman Hussein Fathy Hussein, Tarek Kh Fathelbab, Amr Kamal Rabea Tolba, Ahmed Mohamed Fawzy","doi":"10.5152/tud.2026.25121","DOIUrl":"10.5152/tud.2026.25121","url":null,"abstract":"<p><strong>Objective: </strong>Retrograde intrarenal surgery (RIRS) is the first-line treatment for kidney stones between 1 and 2 cm and can serve as an alternative to percutaneous nephrolithotomy for larger stones in high-risk patients, including those with bleeding disorders, obesity, renal congenital abnormalities, or solitary kidneys. We aimed to compare the safety and efficacy of supine mini-percutaneous nephrolithotomy (PCNL) versus RIRS for the treatment of renal pelvic stones less than 2 cm.</p><p><strong>Methods: </strong>This prospective, randomized, double-blinded study included 50 patients aged >18 years, of both sexes, with renal stones <2 cm. Patients were randomized into 2 equal groups: Group A underwent supine mini-PCNL, while Group B underwent RIRS. Stone and patient characteristics, SFR, and perioperative events were compared between groups.</p><p><strong>Results: </strong>A total of 50 patients equally distributed into the 2 groups. Operative time was significantly lower in Group A than in Group B (P < .05), while fluoroscopic time was significantly higher in Group A than in Group B (P < .05). Also, hospital stay was significantly longer in Group A compared to Group B (P < .001). SFR and retreatments were comparable between both groups. Complications were also similar, with no significant differences observed.</p><p><strong>Conclusions: </strong>Supine mini-PCNL remains an effective option for achieving high stone clearance with a shorter operative time while avoiding ureteral access manipulation, while RIRS provides advantages such as reduced radiation exposure, shorter hospitalization but with a higher need for stenting and secondary procedures. Supine mini- PCNL is not inferior to RIRS in the treatment of less than 2 cm renal stones.   Cite this article as: Abdelgawad AH, Elhawy MA, Hussein AAHF, Fathelbab TK, Tolba AKR, Fawzy AM. Retrograde intrarenal renal surgery versus supine mini percutaneous nephrolithotripsy in treatment of renal pelvic stones less than 2 cm, randomized clinical study. Urol Res Pract. 2025;51(6): 230-236.</p>","PeriodicalId":101337,"journal":{"name":"Urology research & practice","volume":"51 6","pages":"230-236"},"PeriodicalIF":1.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}