International Urology and Nephrology最新文献

{"title":"Synergistic relaxation of ureteral smooth muscle by doxazosin and vardenafil: experimental implications for medical expulsive therapy.","authors":"Bulent Uysal, Erbay Tumer, Eyup Kaplan, Fatma Tore, Muzaffer Eroglu, Hamdiye Celikaslan, Recep Dokuyucu","doi":"10.1007/s11255-026-05157-6","DOIUrl":"https://doi.org/10.1007/s11255-026-05157-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the relaxant effects of doxazosin (an α₁-adrenergic receptor blocker) and vardenafil (a phosphodiesterase type 5 inhibitor) on rabbit ureteral smooth muscle using an in vitro organ-bath model, and to determine whether sequential administration enhances relaxation, particularly in different ureteral segments.</p><p><strong>Methods: </strong>Ureteral segments (middle and distal) were obtained from 15 adult male New Zealand White rabbits and mounted in organ baths containing oxygenated Krebs-Henseleit solution at 37 °C. Each ureteral segment (middle and distal) obtained from the animals was treated as an independent experimental unit. Thus, a total of 15 middle and 15 distal ureteral segments were analyzed (n = 15 per group). Contractions were induced by 60 mmol/L KCl, and relaxation responses to doxazosin and vardenafil-applied separately or sequentially-were recorded isometrically. The degree of relaxation was expressed as a percentage of the initial KCl-induced contraction. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test.</p><p><strong>Results: </strong>Both doxazosin and vardenafil produced significant relaxation in KCl-precontracted tissues (p < 0.001). In the middle ureter, relaxation responses were 47.3 ± 3.6% for doxazosin and 33.7 ± 3.5% for vardenafil. In the distal ureter, relaxation increased to 54.6 ± 2.2% and 40.8 ± 2.2%, respectively. Sequential administration of doxazosin followed by vardenafil yielded the greatest relaxation (84.1 ± 3.9% in middle, 88.4 ± 3.1% in distal segments; p < 0.001), whereas the reverse order produced a lower but still significant response (57.4 ± 4.8% and 80.5 ± 4.4%, respectively). Overall, distal segments exhibited greater pharmacologic sensitivity than middle ones.</p><p><strong>Conclusion: </strong>Doxazosin and vardenafil both exert potent relaxant effects on ureteral smooth muscle, with enhanced efficacy when administered sequentially-especially in distal segments. These findings provide mechanistic insight into the synergistic interaction between α₁-adrenergic blockade and PDE5 inhibition and support the rationale for combination therapy in facilitating distal ureteral stone passage.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of papillary vs non-papillary access to the calyces in patients undergoing percutaneous lithotripsy: a GRADE-assessed systematic review and meta-analysis.","authors":"Fahad Amin, Ammad Abid, Waleeja Rehaam, Tehreem Talab, Faheem Ullah, Zainab Saleem, Mahnoor Sultana, Abu-Bakr Ahmed","doi":"10.1007/s11255-026-05176-3","DOIUrl":"https://doi.org/10.1007/s11255-026-05176-3","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous nephrolithotomy (PCNL) access is traditionally obtained via papillary puncture to minimize bleeding, though non-papillary access is frequently utilized in everyday clinical practice due to practical considerations such as anatomical variations and stone location. Because existing comparative studies have yielded inconsistent findings, this systematic review and meta-analysis aimed to synthesize existing evidence evaluating the safety and efficacy of papillary versus non-papillary access during PCNL.</p><p><strong>Methods: </strong>A comprehensive systematic search of databases, including PubMed, Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov, alongside grey literature, was conducted from inception until December 2025. Randomized controlled trials and observational studies comparing papillary and non-papillary access for renal calculi in patients undergoing PCNL were included. Data were pooled using a random-effects model to calculate mean differences (MD) and odds ratios (OR) alongside their 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of six studies comprising 856 patients met the inclusion criteria. Pooled analyses demonstrated no statistically significant differences between the papillary and non-papillary access groups regarding hemoglobin drop (MD 0.09 g/dL, 95% CI -0.19 to 0.37), transfusion rates (OR 1.28, 95% CI 0.59 to 2.74), changes in postoperative serum creatinine levels (MD 0.02 mg/dL, 95% CI -0.03 to 0.07), duration of hospital stay (MD 0.08 days, 95% CI -0.28 to 0.44), stone-free status (OR 1.20, 95% CI 0.76 to 1.89), or operative duration (MD 2.81 min, 95% CI -2.06 to 7.68). Heterogeneity across most outcomes was minimal. Meta-regression identified stone size as the only significant moderator, which negatively influenced operative duration.</p><p><strong>Conclusion: </strong>Papillary and non-papillary access techniques during PCNL appear to provide comparable clinical outcomes with no significant differences in major perioperative parameters. The clinical decision-making regarding the selection of access technique should be individualized, considering patient anatomy, stone characteristics, and surgical expertise rather than strict adherence to a single standardized puncture strategy.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the feasibility and safety of 48-h short-stay pathway for robot-assisted laparoscopic partial nephrectomy: a propensity score-matched analysis.","authors":"Caihong Tang, Ningping Chu, Chenghao Shi, Zhongwen Chang, Taoyue Zhao, Hong He, Yiman Zhang, Lingling Jing","doi":"10.1007/s11255-026-05154-9","DOIUrl":"https://doi.org/10.1007/s11255-026-05154-9","url":null,"abstract":"<p><strong>Objective: </strong>To compare perioperative outcomes between the 48-h short-stay pathway and traditional inpatient management for patients undergoing robot-assisted partial nephrectomy (RAPN), and to evaluate the feasibility, safety, recovery efficiency, and economic benefits of the 48-h short-stay pathway.</p><p><strong>Methods: </strong>This retrospective study included 175 patients who underwent RAPN between February 2022 and June 2024. Patients were assigned to a 48-h short-stay group (n = 60) or a traditional inpatient group (n = 115). A 1:1 propensity score matching (PSM) was conducted to balance baseline characteristics, including age, sex, BMI, comorbidities, tumor features, surgeon identity, and surgical year. Perioperative outcomes, recovery indicators, complications, and medical costs were compared.</p><p><strong>Results: </strong>After PSM, 53 matched pairs were analyzed. The short-stay group showed significantly shorter operative time, less intraoperative blood loss, shorter warm ischemia time, earlier mobilization, earlier oral intake, faster bowel function recovery, and shorter bed rest (all P < 0.05). The short-stay group had 71.7% of patients discharged on postoperative day (POD) 1 and 100% within 48 h, while the traditional group had 22.6% on POD1, 33.96% on POD2, and 43.4% on POD ≥ 3 (P < 0.001). Both total and postoperative hospital stays were significantly shorter in the short-stay group (2.00 vs. 6.00 days, P < 0.001), with lower hospitalization costs (P < 0.001). Postoperative creatinine was lower in the short-stay group (P = 0.023), while creatinine change was comparable (P = 0.063). Complication rates, emergency department visits, and 30-day readmission rates were similar between groups (all P > 0.05). The short-stay group had a significantly lower drain placement rate (P = 0.002) without increased adverse events.</p><p><strong>Conclusion: </strong>The 48-h short-stay pathway for selected patients undergoing RAPN is feasible and safe. It accelerates postoperative recovery, shortens hospital stay, reduces medical costs, and optimizes healthcare resource utilization, without compromising safety or oncological early outcomes.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety evaluation of finerenone and identification of factors contributing to nephrotoxicity: re-analysis using FDA adverse event reporting system data.","authors":"Chunhui Du, Zhenyu Zhao","doi":"10.1007/s11255-026-05163-8","DOIUrl":"https://doi.org/10.1007/s11255-026-05163-8","url":null,"abstract":"<p><strong>Background: </strong>To evaluate finerenone-associated adverse events (AEs) and to investigate the association between finerenone use and renal injury via data mining of the Food and Drug Administration Adverse Event Reporting System (FAERS).</p><p><strong>Methods: </strong>To minimize statistical bias, the data extraction period was set from database inception (2004) to provide a stable background for disproportionality analysis. Four disproportionality algorithms (ROR, PRR, BCPNN, and MGPS) and stricter case-screening methods were employed to improve analytical precision. Additionally, a clinical priority evaluation was conducted to rank clinical risks and surveillance levels for these AEs. Supplementary analysis was performed to assess the relationship between finerenone and renal injury, as well as associated risk factors.</p><p><strong>Results: </strong>A total of 1316 finerenone-related reports were identified. 30 AEs were detected as significantly positive signals, with most being related to renal function (15 PTs, 50%), blood pressure (5 PTs, 16.67%), and blood potassium (4 PTs, 13.33%). Among them, blood glucose increased, blood creatine increased, and flank pain were new potential AEs. Acute kidney injury, hyperkalemia, renal impairment, glomerular filtration rate decreased, blood creatinineincreased, blood potassium increased, and hyponatremia exhibited moderate clinical priority levels and warrant further study. Signals reflecting renal injury were detected in patients regardless of baseline nephropathy. Male sex, taking more than 3 drugs, and using amlodipine may be risk factors for finerenone-related nephrotoxicity.</p><p><strong>Conclusions: </strong>These results highlight new finerenone-related AEs, provide ranked guidance for pharmacovigilance through clinical priority evaluation, and clarify factors that influence renal injury, providing guidance for individualized treatment and improved drug safety.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penile cancer and lymph node management: a call for standardization.","authors":"Achille Aveta, Vincenzo Iossa, Gianluca Spena, Roberto Contieri, Alessandro Izzo, Francesco Passaro, Antonio Tufano, Vittorio Imperatore, Sisto Perdonà, Lorenzo Romano, Carlo Giulioni, Angelo Cafarelli, Pierluigi Russo, Fabio Crocerossa, Francesco Lasorsa, Giuseppe Lucarelli, Matteo Ferro, Raffaele Balsamo, Celeste Manfredi, Davide Arcaniolo, Salvatore Siracusano, Savio Domenico Pandolfo","doi":"10.1007/s11255-025-04911-6","DOIUrl":"10.1007/s11255-025-04911-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare and organize recommendations from the most eminent international guidelines on the staging and treatment of lymph node (LN) involvement in penile cancer (PC). Early recognition and appropriate management of nodal disease remain the cornerstone of care, influencing both survival and treatment-related morbidity.</p><p><strong>Methods: </strong>This study compares and organize recommendations form the most eminent international guidelines-including NCCN, ESMO-EURACAN, and EAU-ASCO-on the staging and treatment of lymph node involvement in penile cancer.</p><p><strong>Results: </strong>Open inguinal LN dissection (ILND) remains the standard treatment for not superficial cancers and its morbidity has driven interest in minimally invasive surgical approaches, such as video-endoscopic inguinal lymphadenectomy (VEIL), including its robot-assisted variant (RA-VEIL). Their role is well defined in clinically node-negative (cN0) patients but remains investigational in node-positive (cN+) cases. For cN3 disease and pelvic node involvement, multimodal strategies including chemotherapy, surgery, and radiotherapy are required.</p><p><strong>Conclusion: </strong>The variability among guidelines underscores the need for collaborative efforts and high-quality prospective trials to refine and standardize treatment recommendations.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1571-1578"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Analysis of acute glomerulonephritis disease burden and incidence trends in China, 1990-2021\".","authors":"Attiqa Khan, Waqar Muhammad, Mohammad Adil Khan, Mansoor Ijaz Bhatti, Fnu Karishma, Ali Karim","doi":"10.1007/s11255-025-04836-0","DOIUrl":"10.1007/s11255-025-04836-0","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1869-1870"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Treatment outcomes and comparative survival analysis of intraductal carcinoma of the prostate.","authors":"Taylor Stamey, Kristen Armel, Andrew W Ju, Shoujun Chen, Musharraf Navaid, Arjun Bhatt, Michael C Larkins","doi":"10.1007/s11255-025-04774-x","DOIUrl":"10.1007/s11255-025-04774-x","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1885"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Metformin attenuates endoplasmic reticulum stress in diabetic kidney disease: mechanistic insights and future perspectives.","authors":"Bin Huang, Wenjie Wen","doi":"10.1007/s11255-025-04799-2","DOIUrl":"10.1007/s11255-025-04799-2","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1889"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: comparison of the quality of life and biochemical characteristics of patients undergoing hemodialysis and peritoneal dialysis: a systematic review and meta‑analysis.","authors":"Xiaoyu Yu, Shiping Qi, Guirong Hu","doi":"10.1007/s11255-025-04803-9","DOIUrl":"10.1007/s11255-025-04803-9","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1849-1850"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin use linked to decreased risk of pelvic organ prolapse: insights from NHANES data.","authors":"Zhe Du, Zhao Tian, Linru Fu, Xiuqi Wang, Xinyi Wang, Tao Xu, Zhijing Sun","doi":"10.1007/s11255-025-04849-9","DOIUrl":"10.1007/s11255-025-04849-9","url":null,"abstract":"<p><strong>Purpose: </strong>Preclinical evidence suggests that metformin may mitigate pelvic organ prolapse (POP) by altering the gene expression of human vaginal fibroblasts in a beneficial direction, but clinical validation is lacking. This study aimed to explore the association between metformin use and POP risk.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2012. POP was defined by self-reported vaginal bulging. Multivariable logistic regression models were used to assess associations between metformin use and POP in high-risk subgroups (hypertension or smoking), with adjustments for demographic, comorbidity, and obstetric/gynecologic factors. Associations between inflammatory and oxidative stress biomarkers and POP were also analyzed.</p><p><strong>Results: </strong>Three hundred and thirty of 9344 included women reported POP. Among 668 metformin users (630 with diabetes, 36 with prediabetes), 37 had POP. (Pre)diabetes was a risk factor for POP (OR = 1.52, P = 0.007). POP prevalence was lower in metformin-treated (pre)diabetes subgroups with hypertension (OR = 0.32, P = 0.045) or smoking (OR = 0.09, P = 0.022), independent of glycemic control, while thiazolidinediones, sulfonylureas, and insulin did not show the effect. C-reactive protein was higher in POP individuals (0.56 ± 0.98 mg/dL vs. 0.44 ± 0.73 mg/dL) and associated with POP (OR = 1.30, P = 0.020), especially in smokers (OR = 1.50, P = 0.002), but not in metformin users. Other biomarkers (systemic immune-inflammation index, ferritin, alkaline phosphatase, bilirubin, albumin, iron, γ-glutamyl transferase, and uric acid) showed no significant associations.</p><p><strong>Conclusion: </strong>This is the first clinical study that suggests metformin may reduce POP risk in specific high-inflammatory subgroups, potentially via anti-inflammatory pathways. The findings warrant further prospective studies and mechanistic validation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1661-1670"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}