Research and Reports in Urology最新文献

{"title":"Emphysematous Urinary Tract Infections in Regional Australia: Retrospective Review of Risk Factors, Microbiology, Management and Outcomes from 38 Cases.","authors":"Matthew A Wright-Smith, Margaret Mansbridge, Simon W Pridgeon","doi":"10.2147/RRU.S585101","DOIUrl":"10.2147/RRU.S585101","url":null,"abstract":"<p><strong>Background: </strong>Emphysematous urinary tract infections (EUTI) are a dangerous and rare complication of urinary tract infection. Recent advances in management have reduced mortality and need for emergency nephrectomy. However, there remains a paucity of data concerning this condition in a regional Australian setting, despite a high observed incidence at our institution. We aimed to evaluate the risk factors, microbiological profile, clinical management, and outcomes of emphysematous urinary infections in our center.</p><p><strong>Methods: </strong>A retrospective review of all patients diagnosed with EUTI in a single regional hospital over a 5-year period in rural Australia.</p><p><strong>Results: </strong>Thirty-eight cases of EUTI were identified. Diabetes (76%) and female gender (79%) were common risk factors. <i>E. coli</i> was the most common organism (n = 26; 68%), followed by <i>K. pneumoniae</i> (n = 5; 13%). About 62% of patients were indigenous or Torres Strait Islander, and 55% were from a rural or remote locality. About 52% of patients required acute surgical intervention, 16% required admission to the intensive care unit (ICU). All patients were managed with a nephron-sparing approach and none required nephrectomy, with only a single EUTI-related mortality encountered. There was a high rate of antimicrobial resistance encountered (76%) with extended spectrum beta-lactamase-producing <i>E. coli</i> identified in 15% of patients.</p><p><strong>Conclusion: </strong>Our retrospective study of EUTI provides the first Australian data regarding this rare disease, particularly in a regional setting. Despite high rates of antimicrobial resistance, a low mortality rate was achieved using a nephron-sparing approach.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"585101"},"PeriodicalIF":2.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468675","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":"Protective Effects of Cyclosporin H Against Sepsis-Induced Acute Kidney Injury via Modulation of Fpr1 Signaling and Inhibiting Pyroptosis.","authors":"Hangwei Feng, Linqian Jiang, Cuilian Weng","doi":"10.2147/RRU.S578231","DOIUrl":"10.2147/RRU.S578231","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify potential targets and mechanisms of sepsis-associated acute kidney injury (SA-AKI) using transcriptomic analysis.</p><p><strong>Methods: </strong>First, SA-AKI model was established by intraperitoneal LPS injection. Second, transcriptome sequencing was performed to analyze key targets and mechanisms in SA-AKI. Finally, we investigated the therapeutic effects of the Fpr1 inhibitor Cyclosporin H on the SA-AKI model.</p><p><strong>Results: </strong>H&E staining revealed intact renal structure in the control group, while the SA-AKI group showed structural damage, glomerular atrophy, and inflammatory cell infiltration. Serum levels of blood urea nitrogen and creatinine were significantly elevated in the SA-AKI group compared to controls (P<0.001). ELISA detection showed significantly higher TNF-α and IL-1β levels in both serum and kidney tissues of the SA-AKI group (P<0.001). Transcriptome analysis identified 209 differentially expressed genes between SA-AKI and control groups, with 194 upregulated and 15 downregulated genes. GO and KEGG analyses indicated that these genes primarily participated in leukocyte migration, phagocytosis, leukocyte chemotaxis, chemokine signaling pathways, and viral protein-cytokine interactions. qPCR confirmed significantly higher expression of Ubd, Fpr1, Fpr2, C3, B2m, and Itgam in the SA-AKI group (P<0.01). Following Cyclosporin H intervention, renal tissue damage was significantly ameliorated, with reduced renal function indicators and inflammatory markers. Additionally, TUNEL staining and transmission electron microscopy showed decreased TUNEL-positive cells, reduced mitochondrial damage, and fewer pyroptotic features after Cyclosporin H treatment. Western blot analysis demonstrated significantly decreased levels of ASC, Caspase-1, NLRP3, and IL-1β proteins after Cyclosporin H intervention (P<0.001).</p><p><strong>Conclusion: </strong>Fpr1 may serve as a key mediator in the SA-AKI. Cyclosporin H may improve sepsis-induced kidney injury and inflammation by inhibiting pyroptosis, providing a potential early therapeutic intervention.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"578231"},"PeriodicalIF":2.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444881","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":"Salvage Therapy for Relapsed/Refractory Testicular Germ Cell Tumors: King Faisal Hospital and Research Center, Riyadh Experience.","authors":"Muhammad Shahzad Rauf, Hazza A Alzahrani, Ali Alhanash, Fahad Almugbel, Ali Alqahtani, Ahmed Alzahrani, Tusneem Ahmed M Elhassan, Huda Syed, Mohammed Saad Alharbi, Ali Aljubran, Shouki Bazarbashi","doi":"10.2147/RRU.S588704","DOIUrl":"10.2147/RRU.S588704","url":null,"abstract":"<p><strong>Purpose: </strong>Optimal salvage treatment for relapsed/refractory germ cell tumors in men remains controversial. The options include conventional-dose chemotherapy (CDCT) and high-dose chemotherapy with autologous stem cell transplantation (HDCT-ASCT). There is currently a lack of data from the Middle East on this topic. This study presents the largest single-institution experience in the region.</p><p><strong>Methods: </strong>We retrospectively examined patients aged 14 years or older, treated at King Faisal Hospital and Research Center, Riyadh, between 2010 and 2022. Patients previously received first-line, cisplatin-based chemotherapy. The treatment consisted of either CDCT or HDCT-ASCT. The primary endpoints were event-free survival (EFS) and overall survival (OS).</p><p><strong>Results: </strong>Study included 46 patients, of whom 24 and 22 received CDCT and HDCT-ASCT, respectively. Using the IPFSG prognostic model as per local institutional practice, patients in the very low, low, and intermediate risk groups received CDCT. In the 24-patient CDCT group, 16 (66%) were high/very high risk, and only 2 (8%) demonstrated primary refractoriness. Contrarily, of the 22 patients who received HDCT-ASCT, 20 (91%) were classified as high/very high risk, and 17 (77%) were primary refractory to first-line treatment. The HDCT-ASCT cohort was heavily weighted toward high/very high risk. HDCT-ASCT group (59%) had a higher complete remission rate than the CDCT group (59% vs 41%). With a median follow-up of 35 months, the 3-year OS was 60% in the CDCT group and 53% in the HDCT-ASCT group, whereas the 3-year EFS rates were 54% and 43%, respectively.</p><p><strong>Discussion: </strong>Results indicated that HDCT-ASCT achieved a superior response rate compared with CDCT, despite an adverse prognostic profile and numerically comparable survival outcomes with the lower-risk cohort treated with CDCT. These findings suggest that the selection of higher-risk patients for a more intensive therapy is an effective strategy. However, direct comparison is limited by the retrospective nature.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"588704"},"PeriodicalIF":2.4,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390794","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":"Contemporary Management Strategies for Peyronie's Disease: A Comprehensive Review.","authors":"Yousif M Basheer, Fatma Ahmed, Basheer Basheer, Giuseppe Mucci, Ranjith Ramasamy","doi":"10.2147/RRU.S544753","DOIUrl":"10.2147/RRU.S544753","url":null,"abstract":"<p><p>Peyronie's disease (PD) is an acquired fibrotic condition of the tunica albuginea that is characterized by penile curvature, deformity, pain, and impaired sexual function. PD is prevalent among all ages and is responsible for significant psychological distress. This review summarizes the current knowledge on PD, covering its epidemiology, risk factors, and natural history, along with a comprehensive overview of the medical, intralesional, and surgical options. While the traditional treatments are well-described in previous publications, the focus of the current review is on new biologic and regenerative treatments. Increasing attention to therapies such as platelet-rich plasma and stem cells is representative of the larger trend toward attempts at modifying the underlying fibrotic process, as opposed to merely correcting deformity. By integrating evolving regenerative strategies with proven therapeutic options and prioritizing patient-centered counselling, future PD care may become increasingly individualized, effective, and less invasive.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"544753"},"PeriodicalIF":2.4,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12951859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348887","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":"Differential Effects of Uropathogenic and Non-Uropathogenic <i>E. coli</i> on the Mouse Urobiome and Urine NGAL Levels.","authors":"Olivia Kathryn Lamanna, Rong Hu, Mark Khemmani, Alan J Wolfe, Suzanne L Groah, Catherine S Forster","doi":"10.2147/RRU.S580953","DOIUrl":"10.2147/RRU.S580953","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether urine neutrophil gelatinase-associated lipocalin (uNGAL) or urobiome alterations can differentiate urinary tract infections (UTI) from asymptomatic bacteriuria (ASB).</p><p><strong>Methods: </strong>Female 8-week-old C57BL/6 mice were instilled with either <i>Escherichia coli</i> CFT073 (UTI model, n=12), <i>E. coli</i> 83972 (ASB model, n=12), or saline (control, n=3). uNGAL was measured daily for 3 days post-instillation. Urobiome composition was assessed pre- and post-instillation using 16S rRNA sequencing. At day 3, kidneys were harvested for culture. Comparisons were made across groups for uNGAL levels and urobiome diversity.</p><p><strong>Results: </strong>Baseline β diversity did not differ between groups. Post-instillation, β diversity significantly differed across groups (p=0.01), driven by increased relative abundance of <i>E. coli</i> in UTI mice compared to ASB mice. Median uNGAL levels increased significantly in both UTI and ASB groups relative to controls, but no significant difference was observed between UTI and ASB groups.</p><p><strong>Conclusion: </strong>Introduction of a uropathogenic <i>E. coli</i> strain reduced urobiome diversity, while a non-uropathogenic strain did not, suggesting strain-specific effects on microbial ecology. Bladder instillation itself also altered the urobiome. Elevated uNGAL levels were observed in both UTI and ASB models, indicating that while uNGAL reflects bacterial exposure, it does not distinguish between uropathogenic and non-uropathogenic <i>E. coli</i>. These findings highlight urobiome analysis as a potential tool for differentiating UTI from ASB, whereas uNGAL alone is insufficient.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"580953"},"PeriodicalIF":2.4,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345095","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":"Fibroepithelial Polyp of the Proximal Ureter Presenting as Chronic Hematuria and Hydronephrosis in an Adolescent: A Case Report.","authors":"Anas Saad, Omar Al Ayoubi, Alaa Senjab, Grace Tannous, Mohammed Alrayes, Anas Elroueili","doi":"10.2147/RRU.S593280","DOIUrl":"10.2147/RRU.S593280","url":null,"abstract":"<p><p>Fibroepithelial polyps of the ureter are rare benign lesions that can produce long-standing obstruction and hematuria and may be misinterpreted as calculi or malignancy, risking delayed diagnosis and renal injury. We report the case of a 17-year-old male with a 10-year history of intermittent left flank pain and recurrent macroscopic hematuria, whose recent symptom progression prompted imaging that revealed grade-3 left hydronephrosis and a focal intraluminal soft-tissue density at the ureteral transition zone. Diagnostic ureteroscopy demonstrated a fungating polypoid mass in the upper third of the left ureter; endoscopic biopsy and subsequent histopathology confirmed a fibroepithelial ureteral polyp. The lesion was managed by segmental ureteral excision with primary end-to-end anastomosis; postoperative recovery was uneventful and follow-up intravenous pyelography showed normal renal drainage. This case highlights the diagnostic challenge posed by ureteral fibroepithelial polyps and reinforces the role of ureteroscopic assessment with targeted biopsy to enable kidney-sparing treatment and prevent unnecessary radical surgery.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"593280"},"PeriodicalIF":2.4,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12947754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326852","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":"Metastatic Primary Intratesticular Rhabdomyosarcoma in an Adolescent with Rapid Early Response to VAC Chemotherapy: A Case Report and Literature Review of 99 Cases.","authors":"Mohammad Alaa Aldakak, Ahmad Al-Bitar, Aows Dayoub, Maher Saifo","doi":"10.2147/RRU.S579811","DOIUrl":"10.2147/RRU.S579811","url":null,"abstract":"<p><strong>Background: </strong>Primary intratesticular rhabdomyosarcoma (PTRMS) is an exceptionally rare malignancy and may be clinically indistinguishable from more common scrotal conditions or germ cell tumors prior to orchiectomy. Evidence to guide management is limited, and treatment is typically extrapolated from pediatric and adolescent/young adult rhabdomyosarcoma protocols.</p><p><strong>Case presentation: </strong>A 17-year-old male presented with progressive, painless enlargement of the right testis. Cross-sectional imaging demonstrated a large intratesticular mass with extensive retroperitoneal and pelvic lymphadenopathy causing grade II hydronephrosis due to ureteral compression, bilateral pulmonary nodules, and axillary lymphadenopathy. He underwent radical inguinal orchiectomy. Histopathology showed a high-grade malignant neoplasm involving the testis, epididymis, and spermatic cord with focal vascular invasion; immunohistochemistry was strongly positive for SMA, desmin, and MyoD1, supporting rhabdomyosarcoma. A double-J ureteral stent was placed, and systemic therapy with vincristine, actinomycin D, and cyclophosphamide (VAC) was initiated. After three cycles, follow-up imaging demonstrated complete radiologic resolution of pulmonary metastases, marked regression of nodal disease (including axillary involvement), and resolution of hydronephrosis with ongoing clinical improvement.</p><p><strong>Literature review: </strong>In a PubMed-based review of 87 eligible articles comprising 99 individual cases of primary testicular or paratesticular rhabdomyosarcoma, the mean age at presentation was 19.76 years (SD 14.44). Tumors were predominantly paratesticular (80.8%) rather than intratesticular (19.2%). Among cases reporting staging data, nodal involvement at presentation was observed in 31.5% and distant metastasis in 25.6%. Treatment most commonly included surgery plus chemotherapy (54.5%) or trimodality therapy with surgery, chemotherapy, and radiotherapy (24.2%).</p><p><strong>Conclusion: </strong>PTRMS can present with advanced nodal and distant metastases yet remain chemosensitive. This case highlights a brisk response of disseminated intratesticular rhabdomyosarcoma to VAC chemotherapy and supports comprehensive staging and response-adapted multidisciplinary management. The complete case-level extraction and full citations are provided in the Supplementary material.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"579811"},"PeriodicalIF":2.4,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220785","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":"Quinolone Resistance and Virulence Genes Prevalence of Uropathogenic <i>Escherichia coli</i> Isolated from Kidney Transplant Recipients with Urinary Tract Infections in Tehran, Iran.","authors":"Ghazaleh Talebi, Mehrzad Sadredinamin, Mojdeh Hakemi-Vala, Atefeh Najafikhah, Amin Alizadeh","doi":"10.2147/RRU.S577044","DOIUrl":"10.2147/RRU.S577044","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation is the last suggested treatment option for patients with end-stage kidney disease. Uropathogenic <i>Escherichia coli</i> (UPEC) is a leading cause of urinary tract infections (UTIs) in transplant recipients. The rising resistance rates to therapeutic antibiotics and the presence of various virulence factors in <i>E. coli</i> pose serious concerns for this vulnerable population. This study aimed to investigate quinolone resistance and key virulence genes in UPEC isolates from kidney transplant recipients.</p><p><strong>Materials and methods: </strong>Fifty <i>E. coli</i> isolates were collected from kidney transplant recipients diagnosed with UTIs who were referred to Yekta, Gholhak, and Labbafi Nezhad Hospital laboratories in Tehran, Iran, from 2022 to 2024. Antimicrobial susceptibility testing (AST) was performed using the Kirby-Bauer disc diffusion method. Additionally, polymerase chain reaction (PCR) was conducted to detect the presence of <i>ompT, fimH, hlyA, aac (6')-Ib, qnrA</i>, and <i>qnrB</i> genes.</p><p><strong>Results: </strong>The resistance rates for the following antibiotics were as follows: ampicillin (94%), amoxicillin-clavulanate (54%), ampicillin-sulbactam (64%), piperacillin-tazobactam (54%), cefazolin (88%), cefepime (70%), cefotaxime (80%), cefoxitin (48%), cefpodoxime (80%), doripenem (16%), ertapenem (20%), meropenem (72%), imipenem (18%), gentamicin (34%), tobramycin (44%), amikacin (28%), ciprofloxacin (62%), trimethoprim/sulfamethoxazole (70%), nitrofurantoin (20%), and fosfomycin (86%). Additionally, the frequencies of quinolone-associated resistance genes were reported, with <i>aac (6')-Ib</i> at 30%, <i>qnrA</i> at 18%, and <i>qnrB</i> at 8%. The distribution of virulence genes includes <i>ompT</i> at 40%, <i>fimH</i> at 82%, and <i>hlyA</i> at 10%.</p><p><strong>Discussion and conclusion: </strong>The rising resistance rates to ciprofloxacin, combined with the higher prevalence of a specific virulence gene in <i>E. coli</i> isolates from kidney transplant recipients with UTIs, underscore the need for phenotypic and molecular antimicrobial susceptibility testing. Additionally, analyzing virulence genes is crucial for developing effective treatment strategies and preventing <i>E. coli</i> infections in UTI patients.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"577044"},"PeriodicalIF":2.4,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575141","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":"Safety of Single-Dose Oral Cefaclor Prophylaxis in Transperineal Prostate Biopsy.","authors":"Sohei Iwagami, Haruka Miyai, Masaya Nishihata","doi":"10.2147/RRU.S586606","DOIUrl":"10.2147/RRU.S586606","url":null,"abstract":"<p><strong>Purpose: </strong>Transperineal prostate biopsy is essential for diagnosing prostate cancer; however, infection remains a clinically significant issue. We evaluated the safety and outcome of a single, prophylactic oral dose of cefaclor 500mg during transperineal prostate biopsy.</p><p><strong>Patients and methods: </strong>This retrospective observational study included 127 patients who underwent transperineal prostate biopsy for suspected prostate cancer at our institution between April 2024 and October 2025. Biopsies were performed transperineally under spinal anesthesia. Cefaclor 500 mg was administered orally 30 minutes pre-operatively as a prophylactic antibiotic. We collected information on laboratory data, medication history, comorbidities, frailty, and infection risk for analysis.</p><p><strong>Results: </strong>Among 127 patients, 73 (57.8%) were classified as prefrail or frail and 27 (21.2%) were identified as at risk of infection. The median initial prostate-specific antigen level was 9.92 ng/mL (interquartile range, 6.55-17.3 ng/mL). Fifty patients (39.3%) with polypharmacy and seventy-one (55.9%) with multimorbidity were noted. All patients were discharged after a 2-day hospital stay. Complications were observed in 36 patients (28.3%). Grade 1 and grade 2 Clavien-Dindo complications occurred in 33 patients (25.9%) and 3 patients (2.3%; urinary retention in 2 patients, fever in 1), respectively. One patient (0.7%) developed a urinary tract infection and underwent additional oral antibiotic therapy. No cases of rehospitalization or sepsis occurred. Among patients who underwent biopsy, 90 (70.8%) tested positive for cancer.</p><p><strong>Conclusion: </strong>Single-dose oral cefaclor prophylaxis in TPB appears to be safe, with no serious post-procedural infections observed. Its effectiveness in frail or high-risk patients requires confirmation in future large prospective studies.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"586606"},"PeriodicalIF":2.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487106","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":"Sequential Intravesical Gemcitabine and Docetaxel for Non-Muscle Invasive Bladder Cancer: A Narrative Review Across Risk Groups.","authors":"Mahdi Hemmati Ghavshough, Melinda Z Fu, Raeesa Islam, Disha Patel, Saum Ghodoussipour, Vignesh T Packiam","doi":"10.2147/RRU.S584499","DOIUrl":"10.2147/RRU.S584499","url":null,"abstract":"<p><strong>Background: </strong>Non-muscle-invasive bladder cancer (NMIBC) accounts for the majority of newly diagnosed bladder cancer cases and is characterized by high rates of recurrence and progression. Intravesical Bacillus Calmette-Guérin (BCG) remains the standard of care for high-risk disease; however, treatment intolerance, failure, and global supply shortages have prompted investigation of alternative intravesical therapies.</p><p><strong>Objective: </strong>To summarize and critically appraise the existing clinical evidence evaluating sequential intravesical gemcitabine and docetaxel (Gem/Doce) in NMIBC, across different clinical contexts.</p><p><strong>Methods: </strong>We performed a narrative review of published clinical studies assessing sequential intravesical Gem/Doce in patients with BCG-unresponsive, BCG-exposed, and selected treatment-naïve NMIBC. Reported oncologic outcomes, including recurrence-free survival, progression, cystectomy rates, and treatment-related adverse events, were reviewed. Emerging exploratory approaches, including biomarker-based risk stratification, were also described.</p><p><strong>Results: </strong>Across multiple retrospective and prospective studies, Gem/Doce has demonstrates favorable recurrence-free survival, and acceptable safety profiles, particularly in patients with BCG-unresponsive or previously treated high-risk NMIBC. Reported rates of progression and cystectomy are generally low, and treatment discontinuation due to toxicity is uncommon. Exploratory studies have evaluated AI-assisted histologic biomarkers as potential tools for risk stratification and hypothesis-generating treatment selection; however, these approaches remain investigational and require prospective validation.</p><p><strong>Conclusion: </strong>Current evidence suggests that sequential intravesical Gem/Doce is a well-tolerated bladder-sparing option with encouraging oncologic outcomes, particularly in patients with recurrent or BCG-unresponsive NMIBC. While early data have explored its use in treatment-naïve settings, definitive conclusions regarding its role as first-line therapy require validation in prospective randomized trials.</p>","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"18 ","pages":"584499"},"PeriodicalIF":2.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575169","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}