Urologia Journal最新文献

{"title":"Postoperative ileus following radical cystectomy in current urological practice: Incidence and risk factors.","authors":"Mohamed Javid Raja Iyub, Pushan Prabhakar, Arjun Pon Avudaiappan, Deerush Kannan Sakthivel, Mukesh Roy, Manuel Ozambela, Murugesan Manoharan","doi":"10.1177/03915603261426557","DOIUrl":"10.1177/03915603261426557","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative Ileus (POI) is a common complication after Radical Cystectomy (RC), often leading to delayed recovery and extended hospital stay. Given the developments in perioperative techniques and the implementation of enhanced recovery protocols, it is essential to evaluate the risk factors contributing to POI. Our objective was to analyze various risk factors that impact the incidence of POI after RC in contemporary practice.</p><p><strong>Methods: </strong>A retrospective study of bladder cancer patients who underwent RC with ileal conduit or neobladder was conducted. Baseline characteristics and perioperative variables were compared between patients with and without POI. Logistic regression was used to identify the risk factors for the development of POI.</p><p><strong>Results: </strong> Of the 269 patients who underwent RC in the study period, 25 (9.29%) patients developed POI. The POI cohort demonstrated significantly increased age (<i>p</i> < 0.029), a higher American Society of Anesthesiologists (ASA) class status (<i>p</i> < 0.001), and a history of chronic obstructive pulmonary disease (COPD) (<i>p</i> < 0.019). Although the result remained marginal, the day of passage of flatus after RC (<i>p</i> = 0.052) showed a tendential association with POI. The logistic regression analysis revealed that age (<i>p</i> = 0.01), ASA class status (<i>p</i> = 0.010), Charlson Comorbidity Index (<i>p</i> = 0.0216), history of COPD (<i>p</i> = 0.02), and preoperative hemoglobin (<i>p</i> = 0.0382) were identified to be independent risk factors for POI.</p><p><strong>Conclusion: </strong>POI remains a notable complication after RC. Age, comorbidity burden, ASA class, history of COPD, and preoperative hemoglobin were identified as independent risk factors. These findings reinforce the multifactorial nature of POI and emphasize the need for early recognition of these factors for reducing POI following RC. Furthermore, this could also enable targeted preoperative optimization, such as anemia correction, pulmonary prehabilitation, and comprehensive perioperative planning for older patients and those with high ASA scores.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"376-383"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494371","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":"Multicenter study on the effectiveness of entomological extract-based therapy in men with lower urinary symptoms associated with benign prostatic hyperplasia and chronic prostatitis.","authors":"George Kasyan, Lyubov Khodyreva, Bagrat Grigoryan, Vladimir Dyakov","doi":"10.1177/03915603261421805","DOIUrl":"10.1177/03915603261421805","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Benign prostatic hyperplasia (BPH) and chronic prostatitis (CP) are common causes of lower urinary tract symptoms (LUTS) in men. This multicenter study evaluated the efficacy of an entomological extract-based treatment (EEBT) as monotherapy and in combination with standard drugs.</p><p><strong>Materials and methods: </strong>A total of 6375 men with LUTS (IPSS ⩾ 10, Qmax 5-15 mL/s) were included; 1498 had BPH, 3060 had CP, and 1817 had both. Group I received EEBT monotherapy, while Group II underwent combination therapy with α1-adrenergic blockers, NSAIDs, antibiotics, and other agents. Outcomes were assessed after 30 days using NIH-CPSI, IPSS, IIEF-5, QoL, Qmax, prostate volume, and residual urine.</p><p><strong>Results: </strong>Both regimens significantly improved LUTS. In BPH patients, monotherapy reduced prostate and residual urine volumes and improved IIEF-5, whereas combination therapy provided greater symptom relief. In CP patients, both regimens improved NIH-CPSI, IPSS, and urinary flow, with monotherapy showing superior QoL benefits. In men with BPH + CP, monotherapy favored erectile function, while combination therapy improved IPSS. All subgroups demonstrated significant gains in Qmax. Treatment was well tolerated; only mild Clavien-Dindo grade I and II adverse events were reported, with no serious complications.</p><p><strong>Conclusion: </strong>EEBT is effective as both monotherapy and in combination therapy for LUTS associated with BPH and CP, supporting its role in personalized treatment strategies.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"421-425"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195757","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 role of Bladder EpiCheck^® test in predicting residual tumor after transurethral resection of bladder cancer: Results from a pilot study.","authors":"Patrizio Pacini, Luca Orecchia, Anastasios D Asimakopoulos, Matteo Manfredi, Serena Lavorgna, Serena Travaglini, Simone Pletto, Nunzia Abbate, Valeria Feliciangeli, Enrico Finazzi Agrò, Francesco Porpiglia, Roberto Miano","doi":"10.1177/03915603261440213","DOIUrl":"10.1177/03915603261440213","url":null,"abstract":"<p><p>Bladder EpiCheck^® (Nucleix Ltd, Israel) is a molecular urine assay detecting DNA methylation alterations associated with bladder cancer. This pilot study aimed to evaluate its diagnostic performance in predicting residual tumor in patients undergoing re-transurethral resection of bladder tumor (reTURB) according to international guidelines. After ethical approval, 79 patients were prospectively enrolled at two academic centers. Voided urine samples were collected before initial TURB and analyzed, generating an EpiScore from 0 to 100, considered positive when ⩾60. Fifty-seven percent of patients showed a positive result and entered the second phase. Twenty-two had an indication for reTURB, and 13 finally underwent surgery with a second preoperative urine test. Among 10 patients with a negative pre-reTURB EpiScore, 9 had no residual tumor and one had Ta high-grade disease. Among 3 patients with a positive pre-reTURB EpiScore, 1 had T1 high-grade cancer and 2 had negative pathology, although 1 developed T1 high-grade disease within 3 months. Sensitivity, specificity, negative predictive value and positive predictive value were 50%, 82%, 90% and 33%, respectively. The high negative predictive value suggests that Bladder EpiCheck^® may help identify patients without residual tumor and potentially avoid unnecessary Re-TURB. Larger prospective multicenter studies are required to confirm these findings.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"389-395"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700195","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":"Retraction notice.","authors":"","doi":"10.1177/03915603241288993","DOIUrl":"10.1177/03915603241288993","url":null,"abstract":"","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"539"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629251","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":"Kidney transplantation in the transgender population: Lights and shadows.","authors":"Lucio Dell'Atti","doi":"10.1177/03915603261427628","DOIUrl":"10.1177/03915603261427628","url":null,"abstract":"<p><p>Transgender individuals are gradually increasing in worldwide. Hormonal therapies may impact cardiovascular mortality, kidney function and transplant stability, the inverse is also true: immunosuppressive agents, particularly high-dose glucocorticoids used to treat acute rejection episodes, may adversely affect mental health, potentially complicating gender-affirming treatment. We aim to provide a comprehensive summary of the status of kidney transplantation in transgender individuals. A comprehensive search was conducted using MeSH keywords, including: \"transgender,\" \"kidney function,\" \"hormone therapy,\" \"renal transplantation.\" One investigator screened articles for eligibility within the PubMed, MEDLINE, Google Scholar databases. A total of 36 full-text articles were systematically analyzed based on predefined inclusion criteria. The analysis revealed available data, though limited to case-level evidence, support the safety and efficacy of kidney transplantation in transgender individuals receiving gender-affirming hormone therapy (GAHT). Continued hormone therapy is not only medically feasible but essential for the well-being and identity affirmation of transgender patients. Treatment plans must be personalized, taking into account comorbid psychiatric conditions, medication side effect profiles, and the patient's goals related to physical appearance and gender identity. Preoperative evaluation should include thorough endocrinologic and psychiatric assessment, and postoperative care should be guided by ongoing collaboration between transplant teams, endocrinologists, and mental health specialists. The presence of GAHT should not preclude transplantation but rather prompt careful, individualized assessment and interdisciplinary management. Establishing standardized protocols and inclusive clinical pathways will be key to ensuring that transgender patients receive equitable and affirming access to life-saving kidney transplantation.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"317-324"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435942","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 outcomes of laser and pneumatic lithotripsy for solitary mid and lower ureteric stones.","authors":"Adityananda Mohapatra, Nabnita Patnaik, Amiya Shankar Paul, Kallam Chandana Reddy, Nihar Ranjan Pradhan, Kumar Guru Mishra","doi":"10.1177/03915603261439614","DOIUrl":"10.1177/03915603261439614","url":null,"abstract":"<p><strong>Introduction: </strong>The management of ureteric stones has been revolutionized by minimally invasive techniques, with Holmium:YAG laser lithotripsy (LL) and pneumatic lithotripsy (PL) being two primary modalities. While effective, they differ in mechanism, cost, and potential complications. This study aims to compare the intraoperative and postoperative outcomes of LL versus PL for solitary mid and lower ureteric stones.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 178 patients who underwent ureteroscopic lithotripsy at SCB Medical College, Cuttack. Patients were divided into two groups: Group 1 (LL, <i>n</i> = 97), and Group 2 (PL, <i>n</i> = 81). Demographic data, operative time, hospital stay, and postoperative complications (ureteral perforation, hematuria, stricture, stone migration, UTI, fever) were compared using appropriate statistical tests, with a <i>p</i> < 0.05 considered significant.</p><p><strong>Results: </strong>The groups were well-matched at baseline. A significantly higher rate of stone migration was observed in the PL group (19.8%) compared to the LL group (2.1%; <i>p</i> = 0.001). The mean operative time was longer for LL (20.76 ± 2.98 min) than for PL (14.78 ± 3.67 min; <i>p</i> = 0.04). However, the mean hospital stay was significantly shorter for the LL group (26.67 ± 3.28 h) compared to the PL group (32.78 ± 4.18 h; <i>p</i> = 0.02). The incidence of other complications was comparable between the two groups.</p><p><strong>Conclusion: </strong>Both modalities are effective for managing ureteric stones. However, LL is superior in preventing stone retropulsion and leading to a shorter hospital stay. The choice of lithotripsy depends on available resources, stone characteristics, and surgical expertise.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"468-473"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700204","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":"MMP9 in macrophages: A pivotal biomarker associated with immune dysregulation in interstitial cystitis/bladder pain syndrome.","authors":"Xingyou Dong, Zhen Guo, Xiaohui Chen, Shixue Liu, Chao He, Chun Chen, Jiang Zhao","doi":"10.1177/03915603261440236","DOIUrl":"10.1177/03915603261440236","url":null,"abstract":"<p><strong>Background: </strong>Studies suggest that immune abnormalities play a significant role in the pathophysiology of interstitial cystitis/bladder pain syndrome (IC/BPS), yet reliable targets and biomarkers for immune intervention remain unidentified. The aim of this study was to explore the immune key targets and biomarkers that are crucial in IC/BPS.</p><p><strong>Methods: </strong>Single-cell RNA sequencing (scRNA-seq) and bulk RNA sequencing (bulk RNA-seq) data were integrated to analyze the immune microenvironment in IC/BPS. scRNA-seq data (GSE164557) were processed with the Seurat package, while bulk RNA-seq data (GSE11783, GSE11839, GSE28242, GSE57560) were batch-corrected using limma. Differential expression analysis was performed with limma, and immune cell infiltration was assessed through CIBERSORT. A binary classification machine learning model was built using 14 algorithms to identify key genes. Functional enrichment and gene regulatory networks were analyzed using GSEA, ORA, and pySCENIC.</p><p><strong>Results: </strong>Our findings revealed substantial dysregulation of immune cell homeostasis in IC/BPS patients, characterized by aberrant macrophage polarization and T cell subset dysregulation. MMP9 has been identified as a key gene that is highly expressed in IC/BPS, particularly in macrophages. Functional annotation showed that MMP9 expression is positively correlated with the enrichment of immune pathways such as leukocyte activation and phagocytosis, and single-cell analysis demonstrated enhanced phagocytic activity in MMP9+ macrophages. Additionally, potential MMP9-targeting drugs, including teriflunomide, captopril, minocycline, and ilomastat, were identified through CMap database screening and molecular docking.</p><p><strong>Conclusion: </strong>This study highlights MMP9 as a key macrophage biomarker in IC/BPS, where its elevated expression is closely linked to enhanced phagocytic activity and the activation of immune-related signaling pathways.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"505-518"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782236","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":"Radiotherapy effects on the lower urinary tract: A review of long-term complications and their management.","authors":"Anna C E Sarafis, Jennifer Locke","doi":"10.1177/03915603261426607","DOIUrl":"10.1177/03915603261426607","url":null,"abstract":"<p><p>Radiotherapy of the pelvis and abdomen can have significant negative long-term effects on the bladder and urethra. Applying the PICO criteria, we reviewed the MEDLINE/PUBMED databases over a 10-year period for literature on the incidence and prevalence of late adverse effects of radiotherapy on the lower urinary tract; the work-up and management of these adverse effects. Overactive bladder, hemorrhagic cystitis, fistula, stress urinary incontinence, bladder neck contracture, urethral stricture, and secondary malignancy were investigated as late complications of radiotherapy on the bladder and urethra. These sequalae may present in the decades following radiotherapy usually with greater symptom severity than those non-irradiated and will often have less favourable outcomes with traditional management strategies that are applied in the absence of radiation. Experimental therapies are being trialed. Our findings reinforce that patients with radiotherapy-related complications most often have poorer outcomes with traditional management strategies such as male urethral slings for stress incontinence and fistula repair, however this review identified successful outcomes for treatments such as the artificial urethral sphincter for incontinence, and hyperbaric oxygen therapy for hemorrhagic cystitis. Further research is required - particularly with a focus on the irradiated female population.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"325-337"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436006","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":"Evaluating the reimbursement and cost-effectiveness of ureteroscopy for treating ureteral calculi: Pre-stented versus non-stented primary procedures.","authors":"Reut Shashar, Nicola Fazaa, Lihi Blumen, Michael Mullerad, Oleg Goldin, Gilad E Amiel, Azik Hoffman","doi":"10.1177/03915603261439613","DOIUrl":"10.1177/03915603261439613","url":null,"abstract":"<p><strong>Objective: </strong>Ureteroscopy (URS) is a primary treatment for ureteral calculi, but its cost-effectiveness depends on whether it is performed as a primary procedure or after pre-stenting. While pre-stenting may improve access and reduce intraoperative complications, it adds procedural costs. This study evaluates the total reimbursed expenditures associated with URS in pre-stented versus non-stented patients within the Israeli healthcare system to determine the most cost-effective strategy.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 228 patients who underwent URS for ureteral stones between 2020 and 2021. Clinical parameters, stone characteristics, and healthcare utilization were recorded. Reimbursement costs were calculated based on emergency department visits, hospitalization, ureteric stent placement, operative time, and additional procedures. Cost-effectiveness was assessed by comparing total expenditures with clinical outcomes.</p><p><strong>Results: </strong>Pre-stented patients had larger stones (8.3 ± 4.1 vs 6.7 ± 3.2 mm, <i>p</i> < 0.001) and longer operative times (28.0 ± 22.7 vs 21.5 ± 11.7 min, <i>p</i> = 0.006). Stone-free rates at 3 months were similar (89.3% vs 87.7%, <i>p</i> = 0.70). Primary URS resulted in significantly lower costs for distal ureter stones, while costs at other locations were not significantly different ($5932 vs $6369, <i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>Primary URS and pre-stented URS yield comparable clinical outcomes. However, primary URS is more cost-effective for distal ureter stones, emphasizing the importance of economic considerations in treatment selection. These findings reflect reimbursed expenditures and not a formal cost-utility analysis.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"462-467"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700216","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":"Hematuria-related readmission after transurethral resection of bladder tumor in patients receiving antiplatelet therapy.","authors":"Abdullah Ilktac, Bayram Dogan, Fatih Gevher, Muzaffer Akcay, Habib Akbulut, Yusuf O Ilbey","doi":"10.1177/03915603261430487","DOIUrl":"10.1177/03915603261430487","url":null,"abstract":"<p><strong>Introduction: </strong>Managing patients on antiplatelet (AP) therapy undergoing transurethral resection of bladder cancer (TURBT) is challenging due to bleeding and thromboembolic risks.</p><p><strong>Methods: </strong>We retrospectively analyzed patients who underwent TURBT between January 2020 and December 2024. Patients were divided into an AP group and a control group without AP therapy. Demographic, perioperative, and postoperative parameters, including low-molecular-weight heparin (LMWH) bridging, were evaluated. The primary endpoint was readmission due to hematuria within 30 days; secondary outcomes included rehospitalization, clot retention, and reoperation. Logistic regression analyses identified predictors of readmission.</p><p><strong>Results: </strong>A total of 103 patients were included, with 40 in the AP group and 63 in the control group. Readmission with hematuria occurred in 10% of AP patients versus 6.3% of controls (<i>p</i> = 0.707). All readmissions in the AP group involved clopidogrel users, alone or with acetylsalicylic acid (ASA), while none occurred in ASA-only users (<i>p</i> = 0.004). Rehospitalization was observed only in the AP group (7.5% vs 0%, <i>p</i> = 0.055). LMWH bridging (OR = 18.40, 95%CI = 2.93-115.40, <i>p</i> = 0.002) and clopidogrel use (OR = 10.88, 95% CI = 2.2851.94, <i>p</i> = 0.003) predicted readmission in univariable analysis but not multivariable models.</p><p><strong>Conclusion: </strong>Perioperative ASA monotherapy appears safe, while clopidogrel use may increase the risk of hematuria-related readmission and warrants closer monitoring.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"370-375"},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494387","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}