Translational andrology and urology最新文献

{"title":"Extraction of atrial tumor thrombus in renal cell carcinoma via a complete transabdominal approach.","authors":"Kaitlin Pardue, E Joy Trimble, Sanjay Patel, Michael Cookson, Kofi Vandyck, Lacy Harville, Brian Cross","doi":"10.21037/tau-2026-0485","DOIUrl":"https://doi.org/10.21037/tau-2026-0485","url":null,"abstract":"<p><p>Surgical resection is the mainstay treatment of renal cell carcinoma (RCC) offering a 5-year survival rate of 70-80%. Associated vena cava tumor thrombus adds complexity to surgical planning especially when the thrombus extends above the diaphragm. Those who do not undergo treatment of the primary cancer as well as the associated thrombus have poor mortality outcomes. Cardiopulmonary bypass (CPB) has been the mainstay for level IV thrombectomy since first introduced. While it has advantages, it is also associated with multisystem failure, hypothermia, and coagulopathy. We sought to describe our experience using a completely transabdominal thrombectomy technique in select patients with level IV tumor thrombus. Patient selection depended upon multidisciplinary coordination between urologic oncology, cardiothoracic surgery, and cardiac anesthesiology. Eleven patients at our institution underwent completely transabdominal level IV inferior vena cava (IVC) tumor thrombectomy<i>.</i> All had successful retrieval of thrombus without the use of CPB or need for sternotomy. Intraoperative surgical and anesthetic technique is described. Although two patients were lost to follow up, only three of the remaining patients were found to have recurrence of disease. Further studies are necessary to best elucidate the ideal candidate for this surgical approach as well as evaluate long term outcomes compared with traditional therapies. We propose transabdominal IVC tumor thrombectomy is a safe surgical option in select patients with level IV tumor thrombus.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"345"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184473","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":"DUSP13 promotes prostate cancer progression by regulating the ERK1/2 pathway.","authors":"Qing Lu, Xiaobao Chen, Zhenlin Chen, Jing Lin, Yiming Su","doi":"10.21037/tau-2026-0341","DOIUrl":"https://doi.org/10.21037/tau-2026-0341","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) remains a leading cause of cancer-related morbidity and mortality in men, and patients who progress to castration-resistant prostate cancer (CRPC) derive only limited benefit from currently available treatments; novel therapeutic targets are therefore urgently needed. Dual specificity phosphatase 13 (DUSP13) belongs to the DUSP family, whose members dephosphorylate mitogen-activated protein kinases (MAPKs) and display either tumor-suppressive or tumor-promoting activity in a context-dependent manner. Emerging evidence implicates DUSP13 in several malignancies, but its expression and function in PCa, and whether it acts through the ERK1/2 pathway, remain unknown. This study aimed to elucidate the function of DUSP13 in PCa.</p><p><strong>Methods: </strong>DUSP13 expression in the normal prostate epithelial-derived cell line RWPE-1 and in the PCa cell lines PC-3, DU145 and LNCaP was examined by Western blot and quantitative reverse transcription polymerase chain reaction (qRT-PCR). DUSP13 was silenced in PC-3 and DU145 cells using lentiviral short hairpin RNAs (shRNAs); a second, independent shRNA targeting a distinct site was used to exclude off-target effects. Cell proliferation, migration, invasion and apoptosis were assessed by cell counting kit-8 (CCK-8), wound-healing (scratch), transwell and flow cytometry assays, respectively. Tumor growth was evaluated in a PC-3 subcutaneous xenograft model in BALB/c nude mice. Proteins of the ERK1/2 pathway were detected by Western blot, and the MAPK/ERK kinase (MEK) inhibitor PD98059 was used in rescue experiments.</p><p><strong>Results: </strong>DUSP13 protein and mRNA levels were higher in PCa cells than in RWPE-1 cells. DUSP13 knockdown suppressed proliferation, migration and invasion, promoted apoptosis, and attenuated xenograft tumor growth <i>in vivo</i>. Mechanistically, DUSP13 knockdown increased p-ERK1/2 levels, whereas PD98059 alone did not significantly alter proliferation, invasion or apoptosis and partially reversed the anti-tumor phenotypes induced by DUSP13 knockdown. All key findings were reproduced with a second independent shRNA.</p><p><strong>Conclusions: </strong>DUSP13 promotes PCa progression by inhibiting ERK1/2 phosphorylation, suggesting that targeting DUSP13 may be a potential therapeutic strategy for PCa, including castration-resistant disease.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"327"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184504","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":"Peripherally acting μ-opioid receptor antagonists for recovery of bowel function after radical cystectomy: a systematic review and meta-analysis.","authors":"Emma Powell, Sam McDonald, Jayne Lim, Dickon Hayne","doi":"10.21037/tau-2026-0432","DOIUrl":"https://doi.org/10.21037/tau-2026-0432","url":null,"abstract":"<p><strong>Background: </strong>Postoperative ileus (POI) is common after radical cystectomy (RC) and contributes to prolonged hospital stay, increased healthcare costs, and reduced patient quality of life. Peripherally acting μ-opioid receptor antagonists (PAMORAs), including alvimopan, naloxegol, and methylnaltrexone, have been investigated as strategies to reduce POI while preserving opioid-mediated analgesia. Previous systematic reviews have shown benefit of PAMORAs, particularly alvimopan, in abdominal procedures such as bowel resection and hysterectomy, but evidence specific to RC remains heterogeneous and limited. We aimed to evaluate whether incorporation of PAMORAs (alvimopan, naloxegol, or methylnaltrexone) into enhanced recovery pathways reduces POI compared with enhanced recovery pathways alone in patients undergoing RC.</p><p><strong>Methods: </strong>A literature search of PubMed, MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) was conducted to identify studies evaluating PAMORAs for prevention of POI following RC. Search terms included alvimopan, naloxegol, methylnaltrexone, and RC. Eligible study designs included randomized controlled trials (RCTs), non-randomized trials, and observational studies comparing PAMORAs with placebo or standard care. Two independent reviewers extracted data using Covidence software. Outcomes included time to gastrointestinal recovery, time to first flatus, time to first bowel movement, length of stay (LOS), POI incidence, adverse events (including cardiovascular events), and costs. Results were summarized in a Summary of Findings table.</p><p><strong>Results: </strong>Across included studies, PAMORAs were associated with improved postoperative gastrointestinal recovery, although certainty of evidence varied. PAMORAs shortened time to first flatus by approximately 1 day [mean difference (MD) =-0.97 days; 95% confidence interval (CI): -1.07 to -0.87] across six observational studies with no detectable heterogeneity (I²=0%), but certainty of evidence was very low due to non-randomized designs and risk of bias. Time to first bowel movement was reduced by approximately 1.3 days (MD =-1.30 days; 95% CI: -1.81 to -0.79) across nine studies, although substantial heterogeneity was observed (I²=84%).</p><p><strong>Conclusions: </strong>PAMORAs appear to improve postoperative gastrointestinal recovery following RC. However, overall certainty of evidence remains low due to reliance on non-randomized studies and heterogeneity. Alvimopan has the strongest supporting evidence, while data for naloxegol and methylnaltrexone remain limited.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"338"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184544","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":"Nerve-sparing radical cystectomy in the era of perioperative enfortumab vedotin plus pembrolizumab: reappraising the value of functional preservation.","authors":"Shugo Yajima, Hitoshi Masuda","doi":"10.21037/tau-2026-0681","DOIUrl":"https://doi.org/10.21037/tau-2026-0681","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"322"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184576","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":"Feasibility and early outcomes of salvage robot-assisted radical prostatectomy after focal therapy failure for localized prostate cancer.","authors":"Xinping Wang, Haifeng Huang, Jiyuan Sun, Yifan Sun, Xinyi Wang, Chenxi Ma, Gutian Zhang, Qun Lu, Hongqian Guo","doi":"10.21037/tau-2026-0439","DOIUrl":"https://doi.org/10.21037/tau-2026-0439","url":null,"abstract":"<p><strong>Background: </strong>Focal therapy (FT) provides an intermediate treatment option between active surveillance and radical therapy for localized prostate cancer. While local recurrence remains an important clinical concern, and post-treatment anatomical changes may complicate the detection and localization of recurrent lesions. This study aimed to evaluate the feasibility and early outcomes of salvage robot-assisted radical prostatectomy (S-RARP) after FT failure and to explore the potential incremental value of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) over multiparametric magnetic resonance imaging (mpMRI) for recurrence localization.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on eight patients who underwent S-RARP following recurrence after primary FT. Patient demographics, imaging data (mpMRI and PSMA PET/CT), and surgical outcomes were analyzed. Pathological specimens were examined using whole-mount sections.</p><p><strong>Results: </strong>This study of 8 patients undergoing S-RARP after FT recurrence found that, despite pathological upgrading and out-of-field recurrence being common at recurrence, the salvage procedure was technically feasible, and was associated with promising early outcomes, including negative surgical margins in all cases, no biochemical recurrence during a median follow-up of 21 months, and recovery of urinary continence. PSMA PET/CT could identify suspicious recurrent lesions that are negative on mpMRI.</p><p><strong>Conclusions: </strong>S-RARP appeared to be a technically feasible salvage treatment with promising early oncological and functional outcomes, due to the high incidence of pathological upgrading and multifocal recurrence of FT. PSMA PET/CT may complement mpMRI in post-FT surveillance and may help identify recurrence when mpMRI findings are equivocal or negative.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"333"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184497","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 gut microbiota-testis axis: mechanisms and implications for male reproductive health.","authors":"Longjie Gu, Yinwei Chen, Lei Jin, Yi Liu","doi":"10.21037/tau-2026-0520","DOIUrl":"https://doi.org/10.21037/tau-2026-0520","url":null,"abstract":"<p><strong>Background and objective: </strong>Infertility affects approximately 8-12% of couples worldwide, with male factors accounting for nearly half of all cases. The gut microbiota is widely recognized as a key regulator of host physiology, yet its specific role in male reproductive health remains to be elucidated. This narrative review synthesizes current evidence on the \"gut microbiota-testis axis\" and provides a critical evaluation of the strength of evidence derived from different study designs.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search in PubMed/MEDLINE up to May 2026 using Boolean search strategies combining terms related to the gut microbiota (e.g., \"Gastrointestinal Microbiome\", \"gut microbiota\", \"gut microbiome\") with terms related to male reproduction (e.g., \"Semen Analysis\", \"Spermatozoa\", \"Infertility, Male\", \"semen quality\", \"sperm quality\"). Separate search strategies were developed for human and animal studies. Literature screening and data extraction were performed independently by two reviewers according to predefined inclusion and exclusion criteria.</p><p><strong>Key content and findings: </strong>Although human studies remain preliminary, several genera, including <i>Anaerotruncus</i>, <i>Bacteroides</i>, and <i>Faecalibacterium prausnitzii</i>, have been reproducibly associated with semen quality, with microbial metabolites such as butyrate, trimethylamine-N-oxide (TMAO), and succinate potentially serving as important mediators. At the mechanistic level, microbiota-derived metabolic and inflammatory signals act on Leydig cells, Sertoli cells, and germ cells, thereby influencing testosterone synthesis and spermatogenesis. Fecal microbiota transplantation (FMT) experiments in animal models have provided direct evidence for these causal links.</p><p><strong>Conclusions: </strong>The gut microbiota-testis axis has emerged as a critical physiological pathway linking the microbiome to male reproductive function. This review provides an evidence-based framework for understanding this axis and highlights key knowledge gaps that must be addressed. Future research should integrate large-scale longitudinal cohorts, mechanistic exploration, and randomized controlled trials with fertility outcomes as primary endpoints to advance the field from descriptive correlations toward mechanism-driven clinical translation.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"350"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183986","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":"Short-term perioperative safety and long-term follow-up after robotic-assisted resection of non-renal, non-adrenal retroperitoneal tumors: a 10-year retrospective cohort study.","authors":"Youyun Zhang, Guoqing Ding, Gonghui Li","doi":"10.21037/tau-2026-0428","DOIUrl":"https://doi.org/10.21037/tau-2026-0428","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Open surgery remains the conventional approach for large retroperitoneal tumors because of limited operative space, complex vascular anatomy, potential bleeding risk, and oncological concerns. However, evidence regarding robotic-assisted laparoscopic resection for retroperitoneal tumors larger than 10 cm remains limited. This study aimed to evaluate the feasibility, safety, perioperative outcomes, and follow-up results of robotic-assisted laparoscopic resection for non-renal and non-adrenal retroperitoneal tumors, with particular focus on tumors larger than 10 cm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively reviewed patients who underwent robotic-assisted laparoscopic resection of retroperitoneal tumors at our institution between November 2015 and November 2024. Tumors of renal or adrenal origin were excluded based on postoperative pathological diagnosis. Patients were stratified according to maximum tumor diameter into three groups: &gt;10, &gt;6 to &lt;10, and &lt;6 cm. Baseline characteristics, operative variables, perioperative outcomes, pathological findings, and follow-up results were compared among the three groups. The primary descriptive endpoints were conversion, estimated blood loss, transfusion, postoperative intensive care unit admission, operative time, and postoperative hospital stay. Comparisons were exploratory and unadjusted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 207 patients were included, comprising 27 patients in the &gt;10 cm group, 52 in the &gt;6 to &lt;10 cm group, and 128 in the &lt;6 cm group. There were no significant differences among the groups in age, body mass index, sex distribution, American Society of Anesthesiologists grade, transfusion rate, conversion rate, postoperative intensive care unit admission, or follow-up duration.  Two procedures (1.0%) were converted to open surgery. After inclusion of the 3,000 mL bleeding conversion, mean blood loss in the &gt;10 cm group was 300.42±658.94 mL (F=6.4952, P=0.002). Operative time and postoperative hospital stay were longer in the &gt;10 cm group. Malignancy was more frequent in tumors larger than 6 cm than in tumors smaller than 6 cm. In the &gt;10 cm group, liposarcoma, ganglioneuroma, and paraganglioma were the most common pathological diagnoses. In the liposarcoma-specific review, 14 patients underwent 18 robotic procedures; six developed local recurrence, and one died of metastatic disease during follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Robotic-assisted laparoscopic resection was technically feasible in this selected cohort for selected non-renal and non-adrenal retroperitoneal tumors larger than 10 cm when performed in experienced centers. Although larger tumors were associated with longer operative time and postoperative hospital stay, conversion and transfusion rates were low, one major bleeding conversion illustrates an important limitation. For large benign tumors, perioperative outcomes were broadly comparable with those of smaller tumors","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"339"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184605","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":"Beyond penile pain: is it time to reconsider phase-based treatment strategies in Peyronie's disease?","authors":"Du Geon Moon","doi":"10.21037/tau-2026-0731","DOIUrl":"https://doi.org/10.21037/tau-2026-0731","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"321"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184291","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":"Erratum: Infection following inflatable penile prosthesis placement: a real-world comparison of device selection and patient characteristics.","authors":"","doi":"10.21037/tau-20262-07","DOIUrl":"https://doi.org/10.21037/tau-20262-07","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.21037/tau-2025-267.].</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"353"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184423","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-energy extracorporeal shock wave therapy for interstitial cystitis/bladder pain syndrome: mechanisms, evidence, and translational perspectives-a narrative review.","authors":"Xueting Sun, Huiying Chen, Lu Wang, Yanting Shen, Fei Wang","doi":"10.21037/tau-2026-0595","DOIUrl":"https://doi.org/10.21037/tau-2026-0595","url":null,"abstract":"<p><strong>Background and objective: </strong>Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic heterogeneous disorder characterized by persistent bladder-related pain, urinary symptoms, and substantial impairment in quality of life. Despite currently available multimodal treatment strategies, therapeutic outcomes vary among patients, highlighting the need to further investigate non-invasive approaches targeting inflammation, tissue repair, and sensory dysfunction. Low-energy extracorporeal shock wave therapy (ESWT) has been investigated as a non-invasive intervention with potential regenerative and neuromodulatory effects in IC/BPS. Its clinical relevance and translational applicability require further clinical validation. This narrative review summarizes the biological rationale, current clinical evidence, and translational considerations of low-energy ESWT in IC/BPS.</p><p><strong>Methods: </strong>PubMed/MEDLINE and Web of Science Core Collection were searched for English-language studies published from January 1, 2010 to May 31, 2026. Relevant clinical, preclinical, and mechanistic studies were narratively synthesized.</p><p><strong>Key content and findings: </strong>Among 53 relevant publications, 13 original studies formed the main evidence base. Preclinical studies suggest that low-energy ESWT may affect inflammation, oxidative stress, urothelial barrier function, angiogenesis, and neural sensitization. Clinical studies, including randomized controlled trials and prospective investigations, have reported improvements mainly in pain-related outcomes among selected patient populations, whereas effects on symptom scores, voiding outcomes, bladder capacity, and long-term outcomes remain uncertain. Heterogeneity in protocols, patient characteristics, and outcome measures limits interpretation.</p><p><strong>Conclusions: </strong>Low-energy ESWT remains an investigational adjunctive treatment for IC/BPS, and current evidence is insufficient to support routine clinical use. Future studies should prioritize adequately powered, sham-controlled trials with standardized treatment protocols, prespecified phenotype stratification, harmonized outcome assessment, and longer follow-up to determine whether clinically meaningful and durable benefit exists and which patients, if any, are most likely to benefit.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"15 9","pages":"349"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184574","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}