Urologia Journal最新文献

{"title":"Evaluating the Role of MRI in Localizing Undescended Testes: Retrospective Correlation with Operative Findings in an Indian Population.","authors":"Devashish Kaushal, Kumar Madhavan, Shushant Shandilya, Amanpreet Singh Guliani, Aditya Sood","doi":"10.1177/03915603261440274","DOIUrl":"10.1177/03915603261440274","url":null,"abstract":"<p><strong>Background: </strong>Undescended testes (UDT) is a common congenital anomaly in male children. Accurate localization is critical for effective surgical planning. MRI, including Diffusion Weighted Imaging (DWI), offers potential advantages.</p><p><strong>Objective: </strong>To evaluate MRI, particularly with DWI sequences, in identifying non-palpable undescended testes and to compare imaging findings with intraoperative outcomes in Indian pediatric patients.</p><p><strong>Methods: </strong>This retrospective study included 32 patients. MRI (T1, T2, DWI sequences) findings were compared with intraoperative observations. Diagnostic accuracy and statistical measures were computed.</p><p><strong>Results: </strong>MRI correctly localized 29 of 32 testes. Testes appeared hypointense on T1, hyperintense on T2, and showed restricted diffusion on DWI. Sensitivity: 96.7%, Specificity: 100%, PPV: 100%, NPV: 66.7%, Accuracy: 96.9%. The Chi-square test yielded a <i>p</i>-value of 0.001.</p><p><strong>Conclusion: </strong>MRI with DWI significantly aids in UDT localization. Despite limitations, it remains a valuable preoperative tool.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"819-823"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864616","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":"Creatinine and hemoglobin/creatinine ratio as predictors of 12-month recurrence after direct visual internal urethrotomy for short-segment (<2 cm) bulbar urethral strictures.","authors":"Rıdvan Kayar, Kemal Kayar, Haşim Çaçan, Emre Tokuc, Metin İshak Öztürk","doi":"10.1177/03915603261447735","DOIUrl":"10.1177/03915603261447735","url":null,"abstract":"<p><strong>Background: </strong>Urethral stricture (US) disease frequently recurs after direct visual internal urethrotomy (DVIU). This study investigated the prognostic value of serum creatinine, estimated glomerular filtration rate (eGFR), and the hemoglobin/creatinine (Hgb/Cre) ratio for predicting 12-month recurrence in short-segment bulbar US.</p><p><strong>Methods: </strong>A retrospective cohort of 237 patients undergoing DVIU for isolated bulbar US <2 cm between 2012 and 2024 was analyzed. Demographics, comorbidities, laboratory parameters, and uroflowmetry were recorded. Renal function markers (creatinine, eGFR) and Hgb/Cre ratio were evaluated using receiver operating characteristic (ROC) analysis, Kaplan-Meier survival curves, and multivariable logistic regression.</p><p><strong>Results: </strong>Recurrence occurred in 103 patients (43.5%) within 12 months (median: 6 months). Patients with recurrence had higher creatinine (1.10 vs 0.99 mg/dL, <i>p</i> < 0.001), lower eGFR (74.0 vs 88.0 mL/min/1.73 m², <i>p</i> < 0.001), and lower Hgb/Cre ratios (12.13 vs 14.28, <i>p</i> = 0.002). Endoscopic surgery-related etiology was strongly associated with recurrence (70.8% vs 47.0%, <i>p</i> = 0.001), whereas age, hemoglobin, Qmax, and PVR showed no significant relationship. In multivariable models, elevated creatinine (OR 3.47, 95% CI 1.82-6.60), reduced Hgb/Cre ratio (OR 0.90, 95% CI 0.85-0.95), and lower eGFR (OR 0.975, 95% CI 0.964-0.987) independently predicted recurrence. Kaplan-Meier analysis demonstrated significantly higher recurrence in patients with creatinine ⩾ 1.02 mg/dL, eGFR ⩽ 80.5 mL/min/1.73 m², and Hgb/Cre ratio ⩽ 13.26.</p><p><strong>Conclusions: </strong>Elevated serum creatinine, reduced eGFR, and a lower Hgb/Cre ratio are independent predictors of 12-month recurrence following DVIU for short-segment bulbar US. Demographic and uroflowmetric parameters showed limited predictive value, whereas iatrogenic etiology markedly increased recurrence risk. Incorporating renal function markers into risk stratification may guide patient selection and support timely consideration of urethroplasty or drug-coated balloon dilatation (Optilume) in high-risk individuals. Prospective multicenter studies are warranted.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"796-804"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821372","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":"Prophylactic antibiotics and urinary tract infections after robot-assisted radical cystectomy: A narrative review.","authors":"Saim Mahmood Khan, Jawairya Muhammad Hussain, Fatima Fayyaz Dar, Mohammad Uzair Achakzai, Hammad Jawed, Malaika Irshad, Afrah Abdul Sattar, Surraiya Riaz Mahmood Khan","doi":"10.1177/03915603261456339","DOIUrl":"10.1177/03915603261456339","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted radical cystectomy (RARC) is a growingly preferred minimally invasive technique for bladder extraction and urinary reconstruction. Postoperative urinary tract infections (UTIs) remain one of the most common complications.</p><p><strong>Objective: </strong>This narrative review examines the role of prophylactic antibiotics in reducing UTIs following RARC, with attention to risk factors, antimicrobial resistance patterns, and emerging non-antibiotic preventive strategies.</p><p><strong>Methodology: </strong>A literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for English-language articles published between January 2014 and October 2025. Search terms included \"urinary tract infection,\" \"radical cystectomy,\" \"antibiotic prophylaxis,\" \"drug resistance,\" and \"non-antibiotic strategies.\" Clinical trials, meta analysis, and randomized controlled trials were prioritized. Key themes included UTI prevalence, bacterial resistance trends, prophylactic approaches, and the potential applicability of adjunctive non-antibiotic measures.</p><p><strong>Results: </strong>UTI incidence after RARC ranges from 14% to 39%, typically within 30 days but occasionally up to 90 days. Risk is influenced by patient factors such as age, female sex, and obesity, as well as surgical variables. Prophylactic antibiotics are associated with reduced UTI rates, though optimal duration remains uncertain. Evidence suggests short-course regimens are often effective, while extended prophylaxis may benefit selected high-risk patients. However, rising resistance, particularly to fluoroquinolones and cephalosporins, complicates empirical treatment.</p><p><strong>Conclusion: </strong>Prophylactic antibiotics after RARC reduce postoperative UTIs and related complications. However, conflicting RCT evidence and lack of consensus on duration require balancing benefits against risks of antimicrobial resistance and <i>Clostridioides difficile</i> infection. A comprehensive strategy-including culture-guided therapy, protocol adherence, and non-antibiotic preventive measures-may optimize outcomes.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"634-645"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550752","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":"Tumor site as predictors of pathologic progression in high-grade T1 bladder cancer.","authors":"Dor Golomb, Fahed Atamna, Yuval Avda, Mia Leonov Polak, Orit Raz","doi":"10.1177/03915603261444890","DOIUrl":"10.1177/03915603261444890","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between tumor location and progression or recurrence after initial transurethral resection of bladder tumor (TURBT) in patients with high grade (HG) T1 urothelial carcinoma.</p><p><strong>Methods: </strong>This retrospective cohort analysis included patients diagnosed with HG-T1 bladder cancer from 2020 to 2024. Patients were stratified by tumor location: anterior/posterior wall, lateral walls, bladder neck, trigone, dome. Residual disease or upstaging at restaging TURBT was assessed via follow-up restaging TURBT. Associations were tested using chi-square, univariate, and multivariate models.</p><p><strong>Results: </strong>A total of 80 patients with high-grade T1 urothelial carcinoma were included. The median age was 73 years (range 45-89) and 92.8% (77) were male. The mean tumor size was 2.6 cm, and 91.3% of tumors were completely resected. Tumors were most commonly located in the lateral wall (36.3%) and posterior wall (31.3%). Worsening on restaging TURBT was most frequent in posterior wall (48.4%) and bladder neck tumors (50%). Lateral wall tumors worsened in 37.0%, anterior wall in 23.1%, and none from the trigone. Posterior wall tumors showed higher odds of worsening versus dome tumors in univariate analysis (OR 2.50, <i>p</i> = 0.34), though not statistically significant. Multivariable analysis adjusting for clinical and tumor factors also found non-significant increased odds for posterior wall tumors versus lateral wall and dome (OR 1.26, <i>p</i> = 0.71).</p><p><strong>Conclusion: </strong>Posterior wall and bladder neck tumors showed the highest descriptive rates of residual disease or upstaging at restaging TURBT, but multivariable analysis did not demonstrate statistically significant independent associations. These findings may warrent closer surveillance or earlier intervention in select cases.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"669-673"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782400","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":"A randomized controlled trial on the impact of bovhyaluronidase azoximer on ejaculate biofilms in patients with chronic prostatitis.","authors":"Morozov Andrey, Vovdenko Stanislav, Bragina Elizaveta, Boldyreva Margarita, Mhitaryan Ofelia, Zubkov Dmitry, Allenov Sergey, Korolev Dmitry, Evdokimov Mikhail, Rapoport Leonid, Gazimiev Magomed, Spivak Leonid","doi":"10.1177/03915603261453123","DOIUrl":"10.1177/03915603261453123","url":null,"abstract":"<p><strong>Background: </strong>Bacterial biofilms play a key role in antibiotic resistance, infection recurrence, and reduced pathogen detection in prostatic secretion. Bovhyaluronidase azoximer is a biofilm-disrupting agent. This trial aimed to evaluate its effects on biofilms and clinical outcomes in patients with chronic prostatitis and associated infertility.</p><p><strong>Methods: </strong>Patients with chronic bacterial prostatitis and infertility completed the NIH-CPSI, IPSS, and QoL questionnaires, underwent microbiological culture of prostatic secretion, ejaculate, or the third portion of urine, light and electron microscopy of ejaculate before and after treatment. Patients were randomized into two groups treated with antibiotics combined with bovhyaluronidase azoximer, and antibiotics alone.</p><p><strong>Results: </strong>The experimental group showed greater improvements on the NIH-CPSI scale (MD -3.04, 95%CI: -3.77 to -2.3, <i>p</i> < 0.001). Significant reduction in bacterial colony count and neutrophil levels were detected in the experimental group. Ejaculate clearance from neutrophils and bacteria was more frequent in experimental group (41% vs 7.2%, <i>p</i> = 0.01; 41.7% vs 12.1%, <i>p</i> = 0.043). Electron microscopy revealed disappearance of the intercellular matrix of bacterial microcolonies only in the experimental group. Recurrence rates were significantly lower at both 6 months and 12 months in the experimental group.</p><p><strong>Conclusions: </strong>The combined use of bovhyaluronidase azoximer with antibiotics significantly improved symptoms, reduced leukocyte and bacterial counts, and lowered recurrence rates in patients with chronic prostatitis. Post-treatment microscopy confirmed the disruption of biofilm structures, suggesting enhanced microbial clearance.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"767-776"},"PeriodicalIF":1.3,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266254","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":"Self-removal of suprapubic catheter after retzius sparing robot-assisted radical prostatectomy: A feasibility audit.","authors":"Eddy Lilly, Dimitrios Papadopoulos, Konstantinos Pagonis, Danny Carbin Darlington, Venkata Murthy Kusuma, Matthew Perry, Dimitrios Moschonas, Wissam Abou Chedid","doi":"10.1177/03915603261494703","DOIUrl":"https://doi.org/10.1177/03915603261494703","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>We conducted a prospective audit to evaluate the feasibility of suprapubic catheter self-removal and what factors can interfere with the decision of self-removal, in post RS-RARP patients.</p><p><strong>Material and methods: </strong>Forty-four patients had a SPC inserted following a RS-RARP from January 2024 until May 2024, 36 of them opted for self-removal. Feedback was obtained 4 weeks post operatively regarding catheter related symptoms and the complexity of self-removal procedure.</p><p><strong>Results: </strong>Most patients reported minimal overall pain (median = 2), with penile pain most frequently rated as none (mode = 1). Bladder cramps and overall problem perception were also low (median = 1); 65.9% of patients reported no bladder cramps, and 61.4% had no issues with SPC management. Factors such as overall pain (<i>p</i> = 0.234), penile pain (<i>p</i> = 0.286), and overall problem perception (<i>p</i> = 0.643) did not significantly influence the decision of SPC self-removal. However, bladder cramp frequency had impacted the self-removal decision (<i>p</i> = 0.029). The majority (80.6%) found self-removal easy, with only 11.1% considering it complicated. Most patients also recommended self-removal, reinforcing its overall feasibility. The perceived complexity of self-removal was associated with likelihood to recommend the procedure (<i>p</i> < 0.001). Additionally, penile pain correlated with bladder cramps (<i>p</i> = 0.006) and overall problem perception (<i>p</i> = 0.003), suggesting discomfort in one area may reflect a broader negative experience affecting patients' decision making regarding self-removal, as patients with higher bladder cramps were less likely to recommend self-removal (<i>p</i> = 0.008).</p><p><strong>Conclusion: </strong>SPC self-removal after RS-RARP appeared feasible and acceptable in a selected group of patients supported by structured education and specialist nurse follow-up. These findings should be interpreted cautiously given the small single-center sample, absence of randomization, and use of a non-validated questionnaire. Further comparative studies are required before wider implementation can be recommended.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261494703"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138245","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":"Global trends and hotspots in bladder cancer: A bibliometric analysis (2016-2025).","authors":"Rakesh Heer, Mehrdad Farrokhi","doi":"10.1177/03915603261483766","DOIUrl":"https://doi.org/10.1177/03915603261483766","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder cancer research has experienced a rapid increase in publication output with the emergence of new themes in diagnosis and treatment. The expanding literature makes it challenging to identify overarching trends and key developments. Therefore, a bibliometric analysis is warranted to systematically evaluate global research patterns, thematic evolution, and influential contributions within this dynamic field.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted using the Scopus database to retrieve articles and reviews on bladder cancer published between 2016 and December 2025. The search was performed in titles, abstracts, and keywords using predefined bladder cancer-related terms. Data were analyzed using VOSviewer and the Bibliometrix package in R.</p><p><strong>Results: </strong>Between 2016 and 2025, a total of 49,014 publications related to bladder cancer, limited to Articles and Reviews indexed in Scopus, were included in the bibliometric analyses. The most frequent terms in bladder cancer research over the past 10 years were urothelial carcinoma, cancer immunotherapy, prognosis, biomarkers, chemotherapy, and radical cystectomy. The most cited terms included survival, cancer immunotherapy, and tumor microenvironment, and trending topics were tumor microenvironment, immune checkpoint inhibitors, and muscle-invasive bladder cancer. Thematic mapping identified one motor theme (urothelial carcinoma, chemotherapy, radical cystectomy) and two niche themes, including \"cell cycle,\" \"metastasis,\" and \"apoptosis,\" and \"mortality,\" \"upper urinary tract urothelial carcinoma,\" and \"meta-analysis.\"</p><p><strong>Conclusions: </strong>Frequent keywords such as biomarkers, prognosis, non-muscle invasive bladder cancer, chemotherapy, and radical cystectomy, together with highly cited and recently prominent terms including tumor microenvironment and immune checkpoint inhibitors, reflect areas of substantial research activity and evolving scientific interest. Thematic evolution analyses further indicate changing patterns in keyword co-occurrence over time, particularly for non-muscle invasive bladder cancer, upper urinary tract urothelial carcinoma, and meta-analysis. The translation of these trends into clinical practice requires further evidence synthesis, clinical trials, guideline evaluation, and broader stakeholder input.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261483766"},"PeriodicalIF":1.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070131","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":"Renal transplantation in congenital heart diseases: A systematic review of outcomes and challenges.","authors":"Nayab Magsi, Maheen Afaq, Abdul Ahad Ahsan, Kanza Farhan, Fasih Mehmood, Maria Aslam, Dinesh Kumar","doi":"10.1177/03915603261486075","DOIUrl":"https://doi.org/10.1177/03915603261486075","url":null,"abstract":"<p><strong>Background: </strong>Congenital heart disease (CHD) patients increasingly survive into adulthood, yet chronic kidney disease (CKD) is common. End-stage renal disease management is challenging due to hemodynamic instability and perioperative risks. Renal transplantation may improve survival and function, but outcomes are poorly characterized.</p><p><strong>Objective: </strong>To evaluate graft and patient survival, complications, and clinical considerations in pediatric and adult CHD patients undergoing renal transplantation.</p><p><strong>Methods: </strong>A PRISMA-compliant systematic review was conducted across PubMed, Embase, Cochrane, Scopus, and Google Scholar through September 2025. Studies reporting renal transplantation outcomes in pediatric or adult CHD populations were included. Data extraction covered study characteristics, demographics, graft and patient survival, complications, and follow-up. Risk of bias was assessed using Joanna Briggs Institute and Newcastle-Ottawa tools. Narrative synthesis was performed.</p><p><strong>Results: </strong>Seventeen studies (12 case reports, 4 retrospective cohorts, 1 case series) including pediatric (1.2-18 years) and adult (up to 54 years) CHD patients were analyzed. Graft survival was generally favorable, with preserved renal function in most patients. Patient survival was high and comparable to non-CHD recipients, though complex CHD increased perioperative risk. Perioperative complications included prolonged ventilation, transfusion requirements, and extended hospitalization. Urological complications were common, while acute rejection and delayed graft function were infrequent. Cardiovascular events were rare. Multidisciplinary perioperative management improved outcomes.</p><p><strong>Conclusion: </strong>Renal transplantation is feasible and effective in pediatric and adult CHD populations. Careful patient selection and multidisciplinary care yield high graft and patient survival despite increased perioperative complexity.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261486075"},"PeriodicalIF":1.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070171","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":"Optical internal urethrotomy alone versus optical internal urethrotomy with intralesional triamcinolone acetonide for short-segment anterior urethral stricture: A prospective randomised controlled trial.","authors":"Venkata Ramana Korrapati, Lakshmi Kandhan L, Venkateshen Palanisamy, Natarajan Kumaresan, T Chandru, Rubina Singh","doi":"10.1177/03915603261486072","DOIUrl":"https://doi.org/10.1177/03915603261486072","url":null,"abstract":"<p><p>Urethral stricture recurrence after optical internal urethrotomy (OIU) is well documented, with published rates of 40%-68% at 1 year. This prospective randomised controlled trial assigned 50 male patients with primary short-segment (< 2 cm) inflammatory bulbar urethral strictures to OIU augmented by intralesional triamcinolone acetonide 40 mg (Group A, <i>n</i> = 25) or OIU alone (Group B, <i>n</i> = 25) at a tertiary urology unit in Chennai, India (January-December 2024). Primary outcome was maximum urinary flow rate (Qmax) at 1 month post-catheter removal; secondary outcome was cumulative stricture recurrence at 8 months. Baseline characteristics were comparable between groups. At 1 month, mean Qmax was 15.76 ± 1.98 ml/s in Group A versus 14.24 ± 1.98 ml/s in Group B (mean difference + 1.52 ml/s, 95% CI 0.39-2.65; <i>p</i> = 0.0092; Cohen's <i>d</i> = 0.767). Cumulative 8-month recurrence was 12% (<i>n</i> = 3) in Group A and 40% (<i>n</i> = 10) in Group B (relative risk 0.30, 95% CI 0.09-0.96; absolute risk reduction 28%; number needed to treat 3.6; Fisher exact <i>p</i> = 0.051). No serious adverse events were attributable to triamcinolone. Intralesional triamcinolone acetonide at the time of OIU improves early urinary flow and reduces short-term recurrence with a favourable safety profile.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261486072"},"PeriodicalIF":1.3,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070158","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":"Validation of non-stent criteria post-endoscopic stone management. Contemporary study.","authors":"Ihab A Hekal, Jana I Hekal, Yousef I Hekal","doi":"10.1177/03915603261489669","DOIUrl":"https://doi.org/10.1177/03915603261489669","url":null,"abstract":"<p><strong>Objective: </strong>To validate the \"5-Not's\" (Hekal's) criteria for selecting candidates for stentless procedures following endoscopic urinary stone management, and to evaluate their applicability across both semi-rigid and flexible endoscopic modalities for renal and ureteral stones.</p><p><strong>Methods: </strong>A cohort of 60 consecutive patients undergoing endoscopic treatment for urinary stones between October 2025 and March 2026 was enrolled. Exclusion criteria included severe obstructive hydronephrosis, concurrent urinary tract infection, a history of shockwave lithotripsy, and congenital urinary tract anomalies. All procedures were performed by a single surgeon without ureteral dilation. Patients were categorized based on whether they fulfilled the 5-Not's criteria (Group A, <i>n</i> = 23) or did not (Group B, <i>n</i> = 37). A stentless post-operative approach was the primary intent for all patients, with stent insertion performed only when clinically indicated. Stenting rates, secondary ureteroscopy requirements, and the diagnostic sensitivity and specificity of the criteria were evaluated.</p><p><strong>Results: </strong>Single stones were present in 95.6% of Group A and 83.8% of Group B cases (<i>p</i> = 0.164). Flexible ureteroscopy was utilized in 60.8% of Group A and 54.1% of Group B cases (<i>p</i> = 0.680). Postoperative ureteral stenting was required in 21.7% (5/23) of Group A patients and 43.2% (16/37) of Group B patients, <i>p</i> = 0.090. The combined criteria demonstrated an overall specificity of 76.2% and a sensitivity of 46.2%. Individually, the stone size cutoff ⩽ 8 mm yielded a sensitivity of 89.7% and a specificity of 52.3%, while the operative time cutoff ⩽ 40 min yielded a sensitivity of 92.3% and a specificity of 52.3%. The BMI cutoff ⩽ 27 demonstrated a sensitivity of 51.3% and a specificity of 57.1%.</p><p><strong>Conclusion: </strong>The 5-Not's criteria provide a valid, reproducible, and clinically applicable framework for endoscopic urinary stone management. The criteria serve as a reliable confirmatory tool (high specificity) to safely select ideal candidates for stentless procedures, rather than an exclusive screening mechanism to rule out patients who fail to meet all five criteria.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261489669"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040719","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}