Translational andrology and urology最新文献

{"title":"Low-intensity pulsed ultrasound for erectile dysfunction: a systematic review and limited quantitative synthesis.","authors":"Yu Zhang, Zhi-Shen Li, Yu-Yun Wu, Wen-Bao Wang, Xia Cao, Yan He, Chao-Hua Deng","doi":"10.21037/tau-2026-0548","DOIUrl":"https://doi.org/10.21037/tau-2026-0548","url":null,"abstract":"<p><strong>Background: </strong>Low-intensity pulsed ultrasound (LIPUS) is a non-invasive therapy for erectile dysfunction (ED), but evidence is geographically concentrated, heterogeneous, and largely patient-reported. Because LIPUS differs biophysically from low-intensity extracorporeal shockwave therapy (Li-ESWT), this review evaluated short-term efficacy, safety, and protocol evidence without cross-modality pooling.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 principles, we searched PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, Scopus, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), China National Knowledge Infrastructure (CNKI), Wanfang Data, the VIP Journal Integration Platform (VIP), the Chinese Biomedical Literature Database (SinoMed), and references through 8 June 2026. Clinical studies of adult men with ED receiving LIPUS were eligible; Li-ESWT-only and non-human studies were excluded. This systematic review was re-registered in OSF Registries on 2 September 2026 (updated ID: 7b9ed; https://osf.io/7b9ed/) after the original record (former ID: 7s9kF) became inaccessible due to technical link failure, with no core protocol modifications. Literature search was completed on 8 June 2026 before data synthesis; no eligibility criteria, outcomes, or effect estimates were altered post-extraction. Two reviewers screened, extracted data, assessed risk of bias with design-appropriate tools, and rated certainty using Grading of Recommendations Assessment, Development and Evaluation (GRADE).</p><p><strong>Results: </strong>Six Chinese studies involving 659 participants were included. One double-blind sham-controlled randomized trial provided the main efficacy evidence. At 12 weeks, LIPUS improved the five-item International Index of Erectile Function (IIEF-5) score versus sham (mean difference =3.38, 95% confidence interval: 2.60-4.16) and increased clinically meaningful response (risk ratio =3.38, 95% confidence interval: 1.78-6.39; 67.5% <i>vs.</i> 20.0%); certainty was low. Two randomized studies compared three versus two weekly sessions with a fixed total number; Chen <i>et al.</i> [2022] met source-defined non-inferiority margins, but did not establish equivalence, superiority, optimal dosing, or cross-device generalizability. Combination/adjuvant evidence was heterogeneous and narratively synthesized. Complete penile Doppler data were available in only six participants. No serious device-related adverse event or discontinuation was reported; follow-up was no longer than 12 weeks.</p><p><strong>Conclusions: </strong>Based on current low-certainty evidence, LIPUS remains investigational and cannot be recommended for routine clinical use in ED at this time. International multicenter sham-controlled trials with standardized acoustic reporting, objective hemodynamic endpoints, transparent adverse-ev","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"343"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of outcomes of open, laparoscopic, and robot-assisted laparoscopic pyeloplasty in children with pelviureteric junction obstruction: a systematic review and meta-analysis.","authors":"Panagiotis Nikolinakos, Nikolaos Chatzikrachtis, Abhisekh Chatterjee, Ivo Donkov, Samuel Bishara, Evgenia Lani, Marina Maria Antonaraki, Mohamed Eldaneen, Joseph M Norris, Katie McComb, Zisis Kratiras, Konstantinos Nastos, Karl H Pang, Nikolaos Zavras","doi":"10.21037/tau-2026-0252","DOIUrl":"https://doi.org/10.21037/tau-2026-0252","url":null,"abstract":"<p><strong>Background: </strong>Pelviureteric junction obstruction (PUJO) is a leading cause of hydronephrosis in children, and pyeloplasty remains the most frequently performed robot-assisted procedure in this population. This systematic review and meta-analysis aimed to compare outcomes and complication rates across open pyeloplasty (OP), laparoscopic pyeloplasty (LP), and robot-assisted laparoscopic pyeloplasty (RALP).</p><p><strong>Methods: </strong>The PRISMA guidelines were followed. No external funding was received. MEDLINE, PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to February 2026. Studies including ≥10 patients aged <16 years who underwent dismembered pyeloplasty were eligible. Risk of bias (RoB) was assessed using RoB 2, the Newcastle-Ottawa Scale, and JBI tools. Certainty of evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE).</p><p><strong>Results: </strong>Thirty-eight studies (n=3,159) met the inclusion criteria; 13 were meta-analysed. LP demonstrated longer operative time than OP [mean difference (MD), 21.58 min, 95% confidence interval (CI): 4.28-38.88] (P=0.01). Operative time was comparable between RALP and LP (MD, -1.92 min, 95% CI: -45.75 to 41.72) (P=0.93). LP was associated with shorter hospital stay than OP (MD, -2.33 days, 95% CI: -4.61 to -0.05) (P=0.04). RALP showed reduced length of stay (LOS) compared to LP (MD, -0.89, 95% CI: -1.35 to -0.36) (P=0.0007). Success rates were comparable between OP and LP and between OP and RALP; RALP demonstrated higher success rates when compared to LP [odds ratio (OR) 2.78, 95% CI: 1.09-7.11] (P=0.03). Minor and major complication rates were comparable across all approaches. Certainty of evidence ranged from low to very low across outcomes.</p><p><strong>Conclusions: </strong>All approaches achieve high success with comparable complication profiles. Minimally invasive techniques, particularly RALP, are associated with shorter hospital stay. Higher-quality prospective data are needed.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"331"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copper homeostasis dysregulation promotes malignant transformation of renal tubular epithelial cells via the ROS/NF-κB/AID signaling axis.","authors":"Yun Yuan, Rubin Chen, Bingqing Xu, Shouxian Cheng, Junfei Wang, Ying Xiong, Zhifei Che, Hualei Chen","doi":"10.21037/tau-2026-0795","DOIUrl":"https://doi.org/10.21037/tau-2026-0795","url":null,"abstract":"<p><strong>Background: </strong>Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cell carcinoma and is characterized by aggressive biological behavior and poor clinical outcomes. However, the molecular mechanisms underlying the malignant transformation of renal tubular epithelial cells are not yet fully understood. This study aimed to investigate the role of copper homeostasis dysregulation in regulating the reactive oxygen species/nuclear factor-kappa B/activation-induced cytidine deaminase (ROS/NF-κB/AID) signaling axis during ccRCC progression.</p><p><strong>Methods: </strong>Copper ion levels, ROS accumulation, and the expression of copper transport proteins, NF-κB pathway-associated molecules, AID, and epithelial-mesenchymal transition (EMT)-related proteins were examined in ccRCC tissues, chronic nephritis tissues, adjacent non-tumor tissues, renal cancer cell lines (786-O and 769-P), and human renal tubular epithelial cells (HK-2). The copper chelator triethylenetetramine (TETA), copper (II) chloride (CuCl₂), ROS scavenger N-acetyl-L-cysteine (NAC), hydrogen peroxide (H₂O₂), NF-κB inhibitor pyrrolidine dithiocarbamate (PDTC), and NF-κB activator lipopolysaccharide (LPS) were used to modulate signaling pathways. Cell proliferation, migration, and invasion were evaluated by 5-Ethynyl-2'-deoxyuridine (EdU) assay, colony formation, wound-healing, and Transwell invasion assays.</p><p><strong>Results: </strong>Copper levels were significantly elevated in the ccRCC tissues and renal cancer cells, accompanied by increased ROS accumulation, NF-κB signaling activation, aberrant AID overexpression, and enhanced EMT progression. Exogenous copper treatment promoted the proliferation, migration, and invasion of HK-2 cells, whereas copper chelation markedly suppressed these malignant phenotypes. Mechanistically, copper accumulation was associated with increased ROS production and activation of NF-κB signaling, accompanied by increased AID expression and EMT progression. ROS or NF-κB inhibition significantly attenuated AID expression and EMT-associated alterations. Further, TETA, NAC, and PDTC effectively reduced intracellular copper accumulation, suppressed ROS/NF-κB/AID signaling, and inhibited malignant biological behaviors in renal cancer cells.</p><p><strong>Conclusions: </strong>Copper homeostasis dysregulation promotes the malignant transformation of renal tubular epithelial cells through activation of the ROS/NF-κB/AID signaling axis. These findings suggest that targeting copper metabolism and the ROS/NF-κB/AID pathway represents a promising therapeutic strategy for ccRCC.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"344"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic urinary tract reconstruction for iatrogenic ureteral injuries: a retrospective observational study from a single high-volume referral center.","authors":"Minoru Nakazono, Fumihiko Urabe, Hidetsugu Takahashi, Ryutaro Fukagai, Kazuhiro Takahashi, Kosuke Iwatani, Masahiro Fujikawa, Takahiro Kimura, Hirokazu Abe","doi":"10.21037/tau-2026-0581","DOIUrl":"https://doi.org/10.21037/tau-2026-0581","url":null,"abstract":"<p><strong>Background: </strong>Iatrogenic ureteral injuries are challenging complications that may require complex urinary tract reconstruction. Although laparoscopic approaches have been increasingly adopted, detailed clinical outcomes of laparoscopic reconstruction for iatrogenic ureteral injuries remain limited. This study aimed to evaluate the surgical outcomes of laparoscopic urinary tract reconstruction for iatrogenic ureteral injuries at a single high-volume referral center.</p><p><strong>Methods: </strong>We conducted a retrospective single-center observational cohort study of consecutive patients who underwent laparoscopic ureteral reconstruction for iatrogenic ureteral injuries at Kameda Medical Center, Japan, between January 2012 and December 2024. Patients who underwent reconstruction for non-iatrogenic ureteral injuries or open surgery were excluded. The reconstructive procedures included ureteroneocystostomy (n=14), ureteroneocystostomy with a Boari flap (n=7), and ileal interposition using an isolated ileal segment (n=4). The perioperative outcomes, including operative time, blood loss, complications, and hospital stay, were analyzed. The long-term outcomes were assessed with respect to surgical success, which was defined as the absence of recurrent obstruction or the need for further intervention.</p><p><strong>Results: </strong>Twenty-five consecutive patients were included. The median patient age was 51 years, and 92% of the patients were female. Gynecological procedures, most commonly hysterectomies, accounted for 80% of all injuries. The median interval between injury and repair was 261 days. The median operative time was 291 min, and the median blood loss was 20 mL. None of the procedures required conversion to open surgery. Five patients experienced Clavien-Dindo grade ≥III complications. Reoperation was required in three cases (two after ileal interposition and one after Boari flap), all of which ultimately achieved successful reconstruction.</p><p><strong>Conclusions: </strong>Laparoscopic ureteral reconstruction is feasible and effective for iatrogenic ureteral injuries, with acceptable morbidity and high success rates. These results highlight the value of minimally invasive reconstructive strategies and may inform surgical decision-making in similar high-volume settings.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"335"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-glucose cotransporter 2 inhibitors <i>vs.</i> glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors for incident and recurrent urolithiasis: a European Association of Urology Endourology systematic review.","authors":"Arianna Pischetola, Francesco Esperto, Arman Tsaturyan, Ali Talyshinski, Selcuk Guven, Abhishek Singh, Bhaskar Kumar Somani","doi":"10.21037/tau-2026-0541","DOIUrl":"https://doi.org/10.21037/tau-2026-0541","url":null,"abstract":"<p><strong>Background: </strong>Urolithiasis is a recurrent metabolic condition associated with obesity, metabolic syndrome, and type 2 diabetes (T2D), yet the relationship between modern antidiabetic drug classes and stone risk remains incompletely defined. This systematic review aimed to evaluate comparative clinical-event evidence on sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1 RA), and dipeptidyl peptidase-4 inhibitor (DPP-4i) in relation to incident, recurrent, or severe urolithiasis outcomes.</p><p><strong>Methods: </strong>This systematic review (PROSPERO ID: CRD420261366483) was reported according to PRISMA 2020. The PICO framework was: (P) adults receiving antidiabetic pharmacotherapy; (I) SGLT2i use; (C) GLP-1 RA, DPP-4i, or other active antidiabetic therapies; and (O) incident, recurrent, or severe urolithiasis events. MEDLINE, Embase, Cochrane CENTRAL, and Scopus were searched from inception through April 2026, with additional studies identified through reference-list screening. Risk of bias was assessed using ROBINS-I. Findings were synthesized narratively.</p><p><strong>Results: </strong>Six comparative clinical-event studies met inclusion criteria. All were observational studies using active antidiabetic comparators. Across studies, SGLT2i use was consistently associated with lower urolithiasis risk compared with GLP-1 RA or DPP-4i <i>vs.</i> GLP-1 RA, SGLT2i were associated with lower incident and recurrent urolithiasis outcomes, with hazard ratios (HRs) ranging from 0.51 to 0.69 and rate ratios from 0.58 to 0.82 <i>vs.</i> DPP-4i, SGLT2i were associated with lower incident, recurrent, and procedure-requiring stone outcomes, with HRs ranging from 0.33 to 0.84 and rate ratios from 0.63 to 0.73. The absolute risk reduction appeared greatest among patients with prior or recently active urolithiasis. All included studies were judged to have moderate overall risk of bias.</p><p><strong>Conclusions: </strong>SGLT2i use was consistently associated with lower incident, recurrent, and procedure-requiring urolithiasis risk <i>vs.</i> GLP-1 RA or DPP-4i. Absolute risk differences were greatest among patients with prior or recently active urolithiasis. Given the observational evidence and moderate risk of bias, prospective studies with prespecified stone outcomes are needed.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"347"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-dimensional computational fluid dynamics study of urine flow in the prostatic fossa after benign prostatic hyperplasia surgery: a single-patient model.","authors":"Huanrui Wang, Weiyu Zhang, Zehua Ding, Tao Xu, Kexin Xu","doi":"10.21037/tau-2026-0434","DOIUrl":"https://doi.org/10.21037/tau-2026-0434","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Transurethral enucleation techniques such as holmium laser enucleation of the prostate (HoLEP) have become increasingly popular as an alternative to conventional transurethral resection of the prostate (TURP). Yet enucleation leaves a wider prostatic fossa than tissue-sparing TURP, and whether a larger post-operative lumen consistently yields better voiding remains uncertain. To address this question, we used a single-patient, two-dimensional computational fluid dynamics (CFD) model to investigate how prostatic fossa geometry modulates urinary flow and energy loss during mid-voiding.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sagittal prostate magnetic resonance imaging (MRI) from a 63-year-old benign prostatic hyperplasia (BPH) patient was segmented in COMSOL Multiphysics 6.1 to construct an idealized two-dimensional CFD model of the lower urinary tract. The prostatic urethra was approximated as a curved ellipsoid and urethra as an S-shaped tube, the relative angle was measured from the mid-sagittal image. Eight experimental groups were designed with prostatic urethral diameters ranging from 0.8 to 2.2 cm at 0.2 cm intervals (prostatic urethral diameter ratio, defined as prostatic urethral diameter divided by 0.6-cm urethral diameter; range, 1.33-3.67). A transient simulation (0-2 s) was run with a fixed inlet velocity of 0.25 m/s and outlet pressure of 0 Pa using the realizable k-ε turbulence model. Outlet velocity at the external urethral meatus and inlet pressure at the bladder neck were recorded, and turbulent kinetic energy (TKE) and turbulent dissipation rate were sampled along a horizontal cut line at the midpoint of the prostatic urethra.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Outlet velocity at the external urethral meatus increased minimally with prostatic urethral diameter (0.5152-0.5180 m/s, relative change 0.54%), a difference of doubtful clinical relevance. Under the constant inflow condition of this study, prostatic urethral diameter therefore has almost no effect on outlet velocity. Mean inlet pressure followed a U-shaped curve, reaching a minimum of 292.5 Pa at a prostatic urethral diameter ratio of 2.33. Turbulence, identified from elevated TKE and dissipation rate, appeared in the low-velocity zone at the dorsal aspect of the median lobe when the prostatic urethral diameter was ≥1.4 cm. Larger cavities were associated with higher turbulence intensity, greater TKE and dissipation rate, and longer stabilization time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In a single-patient, two-dimensional CFD model, turbulence emerged in the prostatic fossa once the prostatic urethral diameter exceeded 1.4 cm, and the inlet pressure required to maintain flow was minimal at a diameter ratio of 2.33. These findings suggest that an over-widened fossa is associated with higher inlet pressure and increased turbulence. Whether this translates into clinically meaningful differences in voiding requires validation under physiologic conditio","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"334"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does social media help to uncover pathology in men, or turn them into patients?","authors":"Olufenwa Milhouse, Paige Bird, Denis Mesa Cruz","doi":"10.21037/tau-2026-0627","DOIUrl":"https://doi.org/10.21037/tau-2026-0627","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"352"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-intensity extracorporeal shockwave therapy for chronic prostatitis/chronic pelvic pain syndrome: a retrospective single-center observational study in Japan.","authors":"Takashi Hirayama, Yudai Matsuoka, Masashi Oae","doi":"10.21037/tau-2026-0381","DOIUrl":"https://doi.org/10.21037/tau-2026-0381","url":null,"abstract":"<p><strong>Background: </strong>Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a heterogeneous condition that can remain symptomatic despite conventional therapy. Low-intensity extracorporeal shock wave therapy (Li-ESWT) has shown symptomatic benefits in previous clinical studies; however, real-world evidence from Japanese clinical practice remains limited. This study aimed to evaluate the effectiveness and safety of a standardized four-session Li-ESWT protocol in patients with treatment-refractory CP/CPPS at a Japanese outpatient urology clinic.</p><p><strong>Methods: </strong>This retrospective, single-center observational study included 19 consecutive patients with CP/CPPS who underwent Li-ESWT between July 2023 and June 2025. Treatment was administered once weekly for four weeks using 3,000 pulses per session at an energy flux density of 0.25-0.35 mJ/mm² and a frequency of 8.0 Hz. The primary outcome was the change in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score from baseline to immediately after completion of treatment. Secondary outcomes included changes in pain, urinary, and quality-of-life (QoL) domain scores.</p><p><strong>Results: </strong>All 19 patients completed treatment. The mean NIH-CPSI total score decreased from 25.9±5.4 at baseline to 21.6±7.5 after treatment (mean change, -4.32±4.27; P<0.001). Six patients (31.6%) achieved a clinically meaningful improvement of at least 6 points, while 16 (84.2%) showed some overall symptom improvement. Significant improvements were observed in the pain domain (11.5±3.2 to 9.2±3.5, P<0.01) and QoL domain (10.1±1.4 to 8.5±2.7, P<0.01), whereas the urinary domain did not significantly improve (4.3±3.2 to 3.9±3.6, P=0.31). No serious adverse events were observed.</p><p><strong>Conclusions: </strong>In this small retrospective Japanese cohort with persistent symptoms despite conservative treatment, a standardized four-session Li-ESWT protocol was associated with improvement in overall NIH-CPSI scores, particularly in pain and QoL, and was well tolerated. Larger prospective controlled studies with longer follow-up are needed to confirm these findings.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"342"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical procedure and efficacy of KangDuo robot-assisted pyeloplasty for horseshoe kidney.","authors":"Tongchen He, Xiang Wang, Zhihua Li, Pan Song, Qian Yang, Jiyu Yang, Han Bao, Rui Yang, Xicai Zhang, Shubo Fan, Xinfei Li, Kunlin Yang, Hui Jiang, Xuesong Li","doi":"10.21037/tau-2026-0586","DOIUrl":"https://doi.org/10.21037/tau-2026-0586","url":null,"abstract":"<p><strong>Background: </strong>Ureteropelvic junction obstruction (UPJO) in horseshoe kidney (HSK) is surgically challenging because of aberrant anatomy. Robot-assisted pyeloplasty may overcome some limitations of laparoscopy, but data on the Chinese-developed KangDuo (KD) robotic system in HSK are lacking. This study evaluated the surgical procedure and efficacy of KD robot-assisted pyeloplasty for UPJO in HSK.</p><p><strong>Methods: </strong>This retrospective study included 14 adult patients with HSK and UPJO who underwent KD robot-assisted dismembered pyeloplasty between March 2021 and December 2025. Seven procedures used KD-SR1000 and seven used KD-SR2000. Perioperative outcomes, complications, renal function, and follow-up data were analyzed.</p><p><strong>Results: </strong>All 14 procedures were completed successfully without conversion or intraoperative complications. Preoperatively, 12 patients (85.7%) presented with flank pain, 7 patients (50.0%) had concomitant renal calculi, and 5 patients (35.7%) required preoperative stent insertion. Mean operative time was 200.7 minutes, and median blood loss was 20 mL. One postoperative urinary tract infection (Clavien-Dindo II) occurred. Postoperatively, mean serum creatinine improved from 77.8±17.3 to 69.6±16.6 μmol/L, and mean eGFR improved from 93.8±14.9 to 104.1±13.2 mL/min/1.73 m².All procedures achieved technical success, with no need for reintervention during follow-up.</p><p><strong>Conclusions: </strong>KD robot-assisted pyeloplasty is safe and feasible for UPJO in HSK and provides satisfactory mid-term outcomes. Larger prospective comparative studies are warranted to confirm these findings and assess cost-effectiveness.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"336"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of the state of urinary diversion: ileal conduit, neobladder, continent cutaneous, and cutaneous ureterostomy.","authors":"Maxwell Louis Sandberg, David Thole, Randall Bissette, Beamlak Worku, Ethan Weitzman, Kimberly Waggener, Ashok Hemal","doi":"10.21037/tau-2026-0370","DOIUrl":"https://doi.org/10.21037/tau-2026-0370","url":null,"abstract":"<p><strong>Background and objective: </strong>Several urinary diversion (UD) options are available after radical cystectomy (RC); however, there is a paucity of comparative evidence to guide patient counseling and shared decision-making. Level I evidence is limited in this domain and controversy exists regarding key clinical points like how patient age, comorbidities, renal function, tumor characteristics, functional expectations, surgeon experience, quality-of-life priorities, and long-term complication profiles should influence UD choice. The purpose of this narrative review is to provide surgical information and clinical points on ileal conduits (ICs), neobladders, continent cutaneous diversions, and cutaneous ureterostomies (CUs).</p><p><strong>Methods: </strong>A primary literature review was performed through 03/01/2026 followed by a second final review through 07/26/2026 on the aforementioned UDs using a multitude of keywords. Articles were indexed in PubMed, PubMed Central, Google Scholar, Directory of Open Access Journals, and Cochrane Library. Societal guidelines on bladder cancer were also reviewed and incorporated into the review. All articles were in the English language. Additionally, surgical textbooks were reviewed for key surgical steps. Search terms were predefined and refined to capture studies addressing surgical technique, patient selection, complications, and clinical implications.</p><p><strong>Key content and findings: </strong>ICs are the most frequently utilized in contemporary practice. They are useful for their broad patient eligibility and minimal upkeep for patients. Complications like ileus, stricture, leak, and metabolic derangements are common. The neobladder allows patients the ability to retain urinary continence, but rates are not defined enough in the literature. Continent cutaneous diversions are not as frequently used after RC, and there are a broad range of choices at the disposal of the surgeon. These are often considered the most technically difficult to create, and there is a window for prospective research on the UDs given the paucity of data currently in the literature. CUs have minimal restrictions on eligibility and avoid bowel work and are a useful option for frail and elderly patients.</p><p><strong>Conclusions: </strong>UD selection should be a combination of surgeon ability, patient comorbidities, and patient preference through shared decision making.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"348"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}