Urologia Journal最新文献

{"title":"A randomized controlled trial comparing alpha-blocker (tamsulosin) and a phyto-complex (Solidago virga-aurea, Phyllantus niruri, Epilobium angustifolium, Peumus boldus and Ononis spinosa) in the treatment of ureteral stent-related symptoms.","authors":"Giacomo Gallo, Antonio Cicione, Antonio Nacchia, Riccardo Lombardo, Sara Riolo, Alessandro Guercio, Daniele Fiasconaro, Cosimo De Nunzio","doi":"10.1177/03915603261454171","DOIUrl":"10.1177/03915603261454171","url":null,"abstract":"<p><strong>Background: </strong>Aim of our study is to compare phytotherapy (a combination of extracts of Solidago virga-aurea, Phyllantus niruri, Epilobium angustifolium, Peumus boldus and Ononis spinosa) versus Tamsulosin effect on double J stent-related symptoms.</p><p><strong>Materials and methods: </strong>Between October 2021 and October 2022, 60 patients undergoing double J stent positioning were randomly divided into 2 (group 1, <i>n</i>: 30, group 2, <i>n</i>: 30). Each patient randomly received Tamsulosin 0.4 mg (one capsule per day, group 1) or phyto-complex (one capsule filled with extracts per day, group 2) for 1 month in an open label setting. Ureteral stent-related morbidity indices including urinary symptom, pain, general health, quality of work, sexual score and additional problems measured by Ureteral Symptom Score Questionnaire (USSQ) at the 1st, 7th and 21st (double J stent removal) day after stent positioning (labeled as Day 1, Day 7, and Day 21, respectively) were evaluated.</p><p><strong>Results: </strong>Although both treatments resulted in an improvement from baseline in each USSQ parameter, the only statistically significant difference between the two groups was detected in terms of urinary symptoms domain of the USSQ at 7 and 21 days (respectively -6.1 ± 5.5 vs -4.6 ± 5.1 and -5.2 ± 6.7 vs -4.4 ± 5.9) in favor of the tamsulosin group, while no statistically significant differences were detected in terms of improvements in pain, general health, quality of work, sexual score and additional problems (<i>p</i> value >0.05).</p><p><strong>Conclusions: </strong>According to our results, we suggest that this combination of extracts could be as effective as Tamsulosin 0.4 mg to minimize stent-related urinary symptoms and improve general health in patients with double J stent.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"753-760"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing ejaculatory function after prostate resection: A stratified meta-analysis of anatomical preservation strategies.","authors":"Syah Mirsya Warli, Satria Gohtama","doi":"10.1177/03915603261450670","DOIUrl":"10.1177/03915603261450670","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of ejaculation-preserving (EP) prostate resection techniques on postoperative ejaculatory and urinary outcomes in men with benign prostatic obstruction (BPO), and to determine whether additional bladder-neck preservation provides further functional benefit compared with peri-verumontanum-only preservation.</p><p><strong>Methods: </strong>This meta-analysis was conducted in accordance with PRISMA 2020 guidelines. A systematic search of PubMed, Cochrane Library, and ScienceDirect up to June 2025 identified randomized controlled trials comparing EP and standard prostate resection. Studies were stratified by anatomical extent of preservation: peri-verumontanum only versus peri-verumontanum with bladder-neck preservation. Data were analyzed using a random-effects model in Review Manager v5.4, and study quality was assessed using the Cochrane Risk-of-Bias 2.0 tool.</p><p><strong>Results: </strong>Eight randomized controlled trials including 580 patients were analyzed. EP prostate resection improved antegrade ejaculation preservation compared with standard resection while maintaining comparable urinary and erectile outcomes. Subgroup analysis revealed no additional functional advantage from extending preservation beyond the peri-verumontanum.</p><p><strong>Conclusion: </strong>EP techniques are associated with improved preservation of antegrade ejaculation while maintaining comparable short term urinary outcomes. Peri-verumontanum preservation appears to provide comparable functional outcomes to approaches extending preservation up to bladder neck. However, these findings remain exploratory and require validation in future larger, methodologically robust studies.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"601-613"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of thulium fiber laser enucleation of the prostate (ThuFLEP) and holmium laser enucleation of the prostate (HoLEP) in the management of benign prostatic hyperplasia: A systematic review and meta-analysis.","authors":"Basri Çakıroğlu, Tuğrul Cem Gezmiş","doi":"10.1177/03915603261440216","DOIUrl":"10.1177/03915603261440216","url":null,"abstract":"<p><strong>Objective: </strong>To systematically compare thulium fiber laser enucleation of the prostate (ThuFLEP) with holmium laser enucleation of the prostate (HoLEP) in terms of efficacy, safety, and perioperative outcomes in men undergoing surgical treatment for benign prostatic hyperplasia (BPH).</p><p><strong>Materials and methods: </strong>This systematic review and meta-analysis was conducted according to the PRISMA 2020 guidelines and registered in PROSPERO (CRD420251057100). PubMed, Scopus, Web of Science, EMBASE, and Google Scholar were searched up to March 2025 for randomized controlled trials and comparative observational studies that evaluated ThuFLEP versus HoLEP. The primary outcomes were perioperative parameters (operative time, catheterization duration, and length of hospital stay) and functional outcomes (International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax)). Secondary outcomes included blood loss, transfusion rate, and postoperative complications graded using the Clavien-Dindo classification.</p><p><strong>Results: </strong>Twelve studies comprising 1248 patients (624 ThuFLEP and 624 HoLEP) met the inclusion criteria. Both techniques yielded comparable functional improvements, with no meaningful differences in the postoperative IPSS, Qmax, or post-void residual volume. ThuFLEP showed perioperative advantages, including a shorter operative time (mean difference (MD) -12.4 min; 95% CI -20.1 to -4.7), shorter catheterization duration (MD -0.58 days; 95% CI -0.81 to -0.35), and shorter hospital stay (MD -0.73 days; 95% CI -1.02 to -0.44). Bleeding-related outcomes favored ThuFLEP, with lower estimated blood loss and fewer transfusions. Overall postoperative complication rates and high-grade complications (Clavien-Dindo ⩾ III) were similar between the groups.</p><p><strong>Conclusions: </strong>ThuFLEP provides functional outcomes equivalent to those of HoLEP while offering improved perioperative efficiency and favorable bleeding-related outcomes. Both procedures appear to be safe and effective for treating BPH. Further large multicenter randomized trials with long-term follow-up are needed to confirm durability and evaluate cost-effectiveness.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"560-572"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Rezūm therapy in young men: A multi-center study.","authors":"Sagi Shprits, Mario Bitar, Omar Buksh, Abbas Hammoud, Naeem Bhojani, Bilal Chughtai, Kevin C Zorn, Luca Cindolo, Giovanni Ferrari, Katherine Lajkosz, Dean Elterman","doi":"10.1177/03915603261452348","DOIUrl":"10.1177/03915603261452348","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to evaluate the outcomes of the Rezūm procedure in men aged 50 years or younger, focusing on changes in urinary symptoms and quality of life.</p><p><strong>Methods: </strong>A prospective registry was created as part of the International Rezūm Registry database at two high-volume centers. The study reviewed data from patients monitored between April 2019 and August 2024. All patients aged 50 years or younger had their baseline medical and BPH history recorded, which included uroflowmetry measurements (Qmax and PVR) and validated questionnaires such as the International Prostate Symptom Score (IPSS), IPSS Quality of Life (QoL), Benign Prostatic Hyperplasia Impact Index (BPHII) and International Index of Erectile Function-15 (IIEF-15). Data were collected at baseline and at 3, 6, and 12 months following the procedure.</p><p><strong>Results: </strong>Fourteen patients were included, with a mean age of 49.6 years (SD 1.05). The mean baseline prostate volume was 54.3 cc (SD: 22.0). At baseline, the mean IPSS was 24.3 ± 5.9, which significantly improved to 10.5 ± 5.8 at 6 months and 11.6 ± 5.4 at 12 months. The IPSS QoL score improved from 4.8 ± 0.9 at baseline to 2.4 ± 1.7 at 12 months. Qmax increased from 7.9 ± 4.5 mL/s to 17.8 ± 6.1 mL/s at 12 months. PVR decreased from 197.6 ± 270.2 mL to 51 ± 77 mL at 12 months. IIEF scores showed no significant differences.</p><p><strong>Conclusion: </strong>The Rezūm procedure demonstrates significant efficacy in improving urinary symptoms and quality of life in men under 50.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"699-704"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144701","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":"Penile prosthesis in transgender males: A narrative review.","authors":"Sotirios Kapsalos-Dedes, Themistoklis Bellos, Stamatios Katsimperis, Aggelos Tzoras, Fotios Gasparos, Nikolaos Kostakopoulos, Lazaros Tzelves, Panagiotis Stamatakos, Nikolaos Ferakis, Petros Drettas","doi":"10.1177/03915603261450683","DOIUrl":"10.1177/03915603261450683","url":null,"abstract":"<p><p>Penile prosthesis implantation plays a crucial role in gender-affirming surgery (GAS) for transgender men, helping align physical traits with their gender identity. Phalloplasty, which involves creating a neophallus, often includes penile prosthesis implantation to restore erectile function and enable sexual intercourse.This non-systematic review analyzed studies from PubMed and MEDLINE databases (2000-February 2025), focusing on original studies, excluding animal models and non-English studies. The review explores the types of penile prosthesis, surgical techniques, patient outcomes, and complications.The three main types of penile prosthesis are the two-piece inflatable, semi-rigid (malleable), and three-piece inflatable. The three-piece inflatable prosthesis is most commonly used in transgender men due to its natural erectile and flaccid states. While inflatable devices offer superior functionality, they are more prone to complications such as mechanical failure, infection, and device migration. Malleable prosthesis, though easier to implant and less prone to failure, can cause discomfort and esthetic issues due to their semi-rigid state. Functional success rates for penile prosthesis implantation in transgender men range from 70% to 85%, with high patient satisfaction despite complications. Psychologically, implantation often reduces gender dysphoria, improving self-esteem and sexual function. However, unique challenges remain, such as scarring and the absence of erectile tissue in the neophallus.Advancements in prosthetic design, surgical techniques, and tissue engineering aim to reduce complications and enhance both the physical and psychological well-being of transgender men.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"614-620"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic value of computed tomography in the management of patients with acute flank pain: An observational cohort study.","authors":"Samuel Johan Sårheim, Patrick Juliebø-Jones, Øyvind Ulvik","doi":"10.1177/03915603261445189","DOIUrl":"10.1177/03915603261445189","url":null,"abstract":"<p><strong>Introduction: </strong>The need for immediate CT in patients with acute flank pain is debated. We aimed to study the diagnostic value and therapeutic impact of CT in these patients. Furthermore, to identify factors associated with intervention and determine who would benefit from acute imaging.</p><p><strong>Material and methods: </strong>A retrospective review was performed of patients with acute flank pain admitted to the emergency department at Haukeland University Hospital between June 2023-June 2024. In total, 289 patients with 319 referrals were included in the study.</p><p><strong>Results: </strong>A total of 142 women and 147 men, with a median age of 48 years (IQR 35-60) were registered. Acute CT was performed in 197 cases (62%), and a cause for flank pain was determined in 159 (81%). A ureteral stone was detected in 122 (62%). Acute ureteroscopy was performed in 48 (39%) of these, while 27 (22%) were drained with a JJ-stent or nephrostomy tube only. Irrespective of the cause for acute flank pain, 234 patients (73%) received conservative treatment only. Patients needing intervention had higher levels of CRP (52 vs 15 mg/L, <i>p</i> < 0.001) and creatinine (108 vs 87 μmol/L, <i>p</i> < 0.001) compared to those treated conservatively. 219 patients (69%) had CT at follow-up after 3-4 weeks. A persistent ureteral stone needing ureteroscopy was registered in 40 (19%).</p><p><strong>Conclusion: </strong>CT in patients with acute flank pain may be reserved for complicated cases with signs of infection, elevated CRP and creatinine levels. In uncomplicated cases, CT can safely be deferred until follow-up after 3-4 weeks.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"730-735"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782385","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":"Vietnamese cohort study on non-renal cell carcinoma kidney cancers: Identifying tumor size as an independent prognostic factor.","authors":"Kinh Luan Thai, Doan Ngoc Tran Nguyen, Nhu Quang Tran, Ryan W Dobbs, Se Young Choi, Tuan Thanh Nguyen, Xuan Thai Ngo","doi":"10.1177/03915603261445175","DOIUrl":"10.1177/03915603261445175","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney cancer is the third most common malignancy of the urinary system. Non-renal cell carcinoma kidney cancer (non-RCC kidney cancer), though accounting for only 15%-20% of cases, displays distinct biological features and prognosis, require specific diagnosis and therapeutic strategies. This study aims to determine the clinical and paraclinical characteristics, the histopathological subtypes and factors associated with overall survival of patients diagnosed with non-RCC kidney cancer.</p><p><strong>Patients and methods: </strong>We conducted a retrospective single-center cohort study on 81 patients diagnosed with non-RCC kidney cancer at Cho Ray Hospital between January 2019 and April 2024. Data were collected from medical records, including clinical, imaging, and histopathological characteristics. Statistical analysis was performed using Stata 14.0 software.</p><p><strong>Results: </strong>The mean age of the patients was 57.2 ± 15.2 years, with males comprising 65.4% of the cohort. A significant 95.1% of patients were diagnosed after being presented with symptoms. The most common symptoms were flank pain (58.9%) and gross hematuria (25.9%). The average tumor size was 8.3 ± 4.5 cm, with renal sarcoma showing the largest average tumor size of 13.32 ± 4.13 cm. The histopathological distribution was as follows: squamous cell carcinoma (SCC; 40.7%), upper tract urothelial carcinoma (UTUC; 30.9%), sarcoma (21%), lymphoma (3.7%), and metastatic kidney cancer (2.5%). Larger tumor size was associated with worse overall survival (OS) in exploratory analysis (HR = 1.12, 95% CI: 1.001-1.26, <i>p</i> = 0.049).</p><p><strong>Conclusions: </strong>Non-RCC kidney cancers present with a variety of clinical features, predominantly in males, and are generally diagnosed after symptom onset. SCC and UTUC are the most common histopathological subtypes. Early identification and accurate pathological classification are essential for optimal treatment strategies and prognosis.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"646-652"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could the grafted Snodgrass technique be a standard approach for repair of distal hypospadias with a narrow urethral plate? A comparative study.","authors":"Tarek Ahmed Mahmoud, Ahmed Mamdouh Abd Elhamed, Ahmed Shawky Gebaly, Ahmed Mahmoud Mohammed, Elnisr Rashed Mohamed, Ahmed M Reyad","doi":"10.1177/03915603261445195","DOIUrl":"10.1177/03915603261445195","url":null,"abstract":"<p><strong>Objective: </strong>Our purpose was to compare the Grafted Tubularized Incised Plate repair (Snodgraft) with the classic Tubularized Incised Plate (Snodgrass repair) in patients with narrow urethral plate (<8 mm).</p><p><strong>Methods: </strong>The study was conducted at the Urology Department of Sohag University Hospitals. Patients were randomly allocated in to two groups Group I underwent classic Snodgrass repair and Group II underwent Snodgraft technique. Patients were followed up 3 weeks, 3 months, and 1 year postoperatively. Cosmetic and functional outcomes were assessed using the Hypospadias Objective Penile Evaluation (HOPE) score.</p><p><strong>Results: </strong>Patient preoperative characteristics were comparable in both groups regarding age, meatus location, glans width, and the width of urethral plate. The mean operative time was significantly longer in Group II 108.6 ± 16.7 versus 75.6 ± 10.9 min in Group I (<i>p</i> value < 0.001). The mean follow-up for both groups was 10.7 ± 1.6 and 11.2 ± 1.2 months, respectively. Regarding the outcome, complications were reported in 10 cases (13.3%) of Group I and eight cases (10.7%) of group II in the form of complete dehiscence, meatal stenosis and urethrocutaneous fistula. All the cases which were considered successful (86.7% of group I and 89.3% of group II) had a vertical slit shaped urethral meatus at the ventral tip of the glans penis and by application of the HOPE score no significant difference were reported between both groups (<i>p</i> value = 0.695).</p><p><strong>Conclusion: </strong>Snodgraft technique is technically more demanding with longer operative time than the classic Snodgrass technique. Although it can be safely applied in cases with a narrow urethral plate and achieves comparable outcomes to the classic Snodgrass repair, it does not demonstrate clear superiority to justify adoption as the standard approach.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"824-829"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do we have to do ureteric reimplantation during augmentation cystoplasty in patients with spastic neurogenic bladder?","authors":"Mohammed Bassil Ismail","doi":"10.1177/03915603261457529","DOIUrl":"10.1177/03915603261457529","url":null,"abstract":"<p><strong>Introduction: </strong>If medical treatment and/or interventional methods have failed, and high intravesical pressure and urinary incontinence or recurring urinary tract infections persist combined with present vesicoureteral reflux and impaired renal function, surgical treatment in terms of bladder augmentation is indicated.</p><p><strong>Aim of the study: </strong>The main objective of this study was to evaluate whether we have to do ureteral reimplantation in patients with spastic neurogenic bladder during augmentation.</p><p><strong>Patients and methods: </strong>A total of 72 patients with spastic neurogenic bladder with VUR were included in the study. The median age at surgery was 12 years, ranging from 3 to 27 years. All of them underwent augmentation cystoplasty for the period between 2016 and 2023. The changes in VUR grade and urodynamic findings were retrospectively evaluated.</p><p><strong>Results: </strong>The median follow-up after AC surgery was 1.5 years, ranging from 0.3 to 2.3 years. The changes in vesicoureteral reflux (VUR) grade before and after surgery: VUR was detected in 72 patients, involving 89 ureters. Among the 89 ureters, the reflux grade was V in 31, IV in 34, III in 23, I in 11. Postoperative VCUG revealed that the reflux resolved in 74 ureters (83%) and was downgraded in 15 ureters (17%). During urodynamics, it was observed that the bladder capacity at which VUR occurred significantly increased from 50 to 450 mL (<i>p</i> < 0.05). However, there was no significant change in detrusor pressure at the onset of VUR.</p><p><strong>Conclusion: </strong>In patients with spastic neurogenic bladder undergoes augmentation cystoplasty: Routine ureteral reimplantation may not be necessary.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"815-818"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of traumatic injury to kidney allograft: A narrative review.","authors":"Lucio Dell'Atti","doi":"10.1177/03915603261452340","DOIUrl":"10.1177/03915603261452340","url":null,"abstract":"<p><p>Trauma to a transplanted organ is rare, but clinicians increasingly confront this scenario with the rise in transplantations. Renal trauma requires multidisciplinary treatment, and guidelines are necessary for standardizing medical care. However, there are no diagnostic and treatment protocols for traumatic renal injury in transplanted kidneys. This review aims to consolidate current knowledge on the interdisciplinary approach to managing injuries of transplanted kidneys, with a focus on blunt trauma to the abdomen and pelvis. Transplanted kidneys, typically placed in the iliac fossa in a heterotopic, extraperitoneal position are more exposed to direct trauma, particularly in motor vehicle accidents. In the emergency setting, the initial imaging is often an Ultrasound scan. This bedside ultrasound helps identify free fluid in the abdomen, indicating possible bleeding and guiding the need for surgical intervention. However, Ultrasound scan is operator-dependent and has limited sensitivity for low-grade renal trauma. Hemodynamically stable patients, or those who stabilize with resuscitative efforts, should undergo contrast-enhanced CT or MRI for a more accurate assessment. Therapeutic strategies may include conservative management, radiological interventions such as angioembolization, or surgical exploration, depending on hemodynamic stability, the severity of injury, and the degree of graft dysfunction. Surgical intervention is reserved for patients who are hemodynamically unstable despite resuscitative efforts or who fail conservative treatment. Management of renal trauma in this population of patients requires a multidisciplinary approach involving transplant surgeons, nephrologists, interventional radiologists, and trauma specialists. Prospective and multicenter studies are lacking, and further research is warranted to compare outcomes of operative, non-operative, and interventional radiologic approaches in high-grade injuries (grades IV and V), and establish criteria for follow-up imaging in renal trauma.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"591-600"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}