Urology Annals最新文献

{"title":"Economic impact of potassium citrate in urolithiasis: A narrative review and economic evidence synthesis.","authors":"Arianna Pischetola, Ali Talyshinskii, Wissam Kamal, Bhaskar K Somani","doi":"10.4103/ua.ua_37_26","DOIUrl":"10.4103/ua.ua_37_26","url":null,"abstract":"<p><strong>Objectives: </strong>Recurrent urolithiasis causes substantial healthcare and economic burden due to high recurrence rates and need for repeated interventions. Potassium citrate effectively prevents stone recurrence, yet its cost-effectiveness compared with nontreatment remains unclear. We aimed to evaluate the economic impact of potassium citrate therapy in the prevention and management of urolithiasis.</p><p><strong>Materials and methods: </strong>A structured narrative review was conducted to evaluate the economic impact of potassium citrate therapy in urolithiasis. Databases were searched for studies assessing costs, cost-effectiveness, or healthcare resource utilization related to potassium citrate. Due to substantial heterogeneity in analytic perspective, outcomes, time horizons, and healthcare system context, findings were synthesized narratively rather than quantitatively.</p><p><strong>Results: </strong>The economic evidence base was limited but consistent in demonstrating a meaningful reduction in stone recurrence with potassium citrate therapy. Two decision-analytic economic evaluations showed that potassium citrate substantially lowers recurrence rates compared with conservative management, translating into reduced downstream healthcare utilization. Economic outcomes were most favorable in patients with high baseline recurrence risk and in healthcare systems with lower medication acquisition costs. Across models, recurrence risk, drug pricing, and treatment adherence emerged as clear and reproducible drivers of economic value. No studies incorporated quality-adjusted life years or health utility outcomes.</p><p><strong>Conclusion: </strong>Potassium citrate is a clinically effective and economically reasonable preventive therapy for recurrent urolithiasis, particularly in high-risk and hypocitraturic patients. When targeted to appropriate populations, it reduces recurrence and can offset downstream treatment costs. The current evidence supports potassium citrate as a key component of preventive stone management.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"199-205"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680116","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":"Assessing the quality and readability of patient information available for shockwave lithotripsy: Human versus artificial intelligence comparison of resources and quality measurements - A benchmarking study from European association of urology (EAU) endourology.","authors":"Ravanth Baskaran, Omar Al-Gholmy, Wissam Kamal, Carlotta Nedbal, Frederic Panthier, Olivier Traxer, Naeem Bhojani, Joe Philip, Bhaskar K Somani","doi":"10.4103/ua.ua_42_26","DOIUrl":"10.4103/ua.ua_42_26","url":null,"abstract":"<p><p>Shockwave lithotripsy (SWL) is a noninvasive method for removing stones, primarily used for small, uncomplicated urinary stones, as the number of kidney stone cases continues to rise. With rising patient numbers, online information must be accurate and easy to understand. We assessed the quality and readability of SWL information available online and compared it with leaflets created by generative artificial intelligence (AI). The top 20 search results for four SWL-related terms on Google, Yahoo, and Bing were collected and duplicates removed. Generative Artificial Intelligence (GAI) platforms such as ChatGPT, Gemini, and DeepSeek generated a patient leaflet. Two authors evaluated quality using DISCERN and JAMA scores and readability using Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL). Later, ChatGPT reviewed the AI-generated information with DISCERN. A total of 68 websites were included. The quality assessments showed average websites with AI-leaflet DISCERN scores of 52.4 (±8.91) and 58.7 (±5.03), JAMA Benchmark scores of 2.22 (±1.10) and 0, FRES of 52.1 (±13.8) and 51.5 (±8.05), and FKGL scores of 9.04 (±2.36) and 8.93 (±1.10). No significant differences were seen in DISCERN (<i>P</i> = 0.224), FRES (<i>P</i> = 0.652), and FKGL (<i>P</i> = 0.866), but differences in JAMA scores were significant (<i>P</i> = 0.0010). A difference was also noted in the author-rated and the AI-rated DISCERN scores. There is a deficiency in high-quality SWL information that meets global readability standards. As more individuals use GAI-resources trained on online data, it is crucial to improve their quality for patients and carers. Doing so enables them to make informed decisions and promotes their well-being during treatment, resulting in improved comfort and outcomes.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"215-224"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680090","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":"Erratum: Prevalence and management of testicular incidentaloma in men with male factor infertility: Experience of a high-volume tertiary center.","authors":"","doi":"10.4103/ua.ua_141_26","DOIUrl":"10.4103/ua.ua_141_26","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.4103/ua.ua_97_25.].</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"278"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680056","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":"Correlation of renal cell carcinoma grade and presence of parasitic vessels on preoperative computed tomography scans.","authors":"Bader H Alsaikhan, Mohamed Ahmad Alsalem, Mohammed Aloqayli, Musaed Almofdhi, Nawaf Najmi, Ziyad Almutairi, Tariq Alnofaie, Manerh Bin Mosa, Abdullah Mohammed Alkhayal, Ghassan Ibrahim Alhajress","doi":"10.4103/ua.ua_145_25","DOIUrl":"10.4103/ua.ua_145_25","url":null,"abstract":"<p><strong>Background: </strong>Parasitic (collateral) vessels observed on contrast-enhanced computed tomography (CT) have been associated with aggressive tumor behavior in renal cell carcinoma (RCC). However, their correlation with tumor grade remains insufficiently characterized.</p><p><strong>Aims and objectives: </strong>To evaluate the association between the presence of parasitic vessels on preoperative CT scans and histopathological tumor grade in patients with RCC.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 306 patients who underwent nephrectomy for histologically confirmed RCC between January 2016 and December 2024 at a tertiary care center. Preoperative CT scans were independently reviewed for the presence of parasitic vessels. Associations between imaging findings and clinicopathological variables were analyzed using Chi-square and t-tests. Significant variables were entered into multivariate logistic regression analysis.</p><p><strong>Results: </strong>Parasitic vessels were identified in 158 patients (51.6%). Their presence was significantly associated with larger tumor size (>4 cm), higher T stage, lymphovascular invasion, central necrosis, microvascular invasion, rhabdoid features, and higher tumor grade (<i>P</i> < 0.001). Multivariate analysis demonstrated that tumor size >4 cm (AOR 6.920; 95% CI 4.091-11.707), stage 1 and 2 disease, lymphovascular invasion, central necrosis, and grades 1-3 were independent predictors of parasitic vessel presence.</p><p><strong>Conclusion: </strong>Parasitic vessels on preoperative CT are significantly correlated with higher tumor grade and adverse pathological features in RCC. Their identification may serve as a noninvasive imaging biomarker for tumor aggressiveness and assist in preoperative risk stratification.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"246-252"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680074","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":"Assessment of factors associated with delayed diagnosis of cryptorchidism and orchidopexy.","authors":"Nuwayyir Abdullah Alqasimi, Lujain Hatim Aljohani, Naif Mohammed Alzahrani, Faisal Bader Almuqbil, Hesham Naser Alotaibi, Moayad Yasser Alamoudi, Ali Abdulaziz Alyami, Ahmad Shammari, Yasser Jamalalail, Fayez Al Modhen, Tariq Burki","doi":"10.4103/ua.ua_150_25","DOIUrl":"10.4103/ua.ua_150_25","url":null,"abstract":"<p><strong>Background: </strong>Undescended testis (UDT) is a congenital anomaly. Early orchidopexy preserves fertility and reduces the risk of malignancy. However, delays in diagnosis and surgeries remain common in Saudi Arabia.</p><p><strong>Objectives: </strong>Our study aims to determine the hospital-based proportion of UDT at our facility and factors associated with delayed orchidopexy in patients with a diagnosis or suspicion of UDT. This hospital-based study does not estimate population-level incidence or prevalence.</p><p><strong>Methodology: </strong>This study included children (0-14 years) with cryptorchidism (2018-2023). SPSS v25 analyzed data from the hospital's database, with descriptive statistics, Chi-square tests, <i>t</i>-tests, and multivariate logistic regression (<i>P</i> < 0.05).</p><p><strong>Results: </strong>Multivariate analysis identified that referrals from pediatric physicians had an odds ratio (OR) of 2.512 (<i>P</i> = 0.041) for delayed surgery, while normal testis at birth reduced the OR 0.184 (<i>P</i> = 0.005).</p><p><strong>Conclusion: </strong>In our center, orchidopexy timing is significantly delayed, and the hospital-based proportion of UDT represents a substantial clinical burden. In our center, delays are associated with unstructured referral pathways and inadequate neonatal screening. Standardizing referrals and implementing structured neonatal screening are crucial.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"259-265"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680036","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":"Supine minitubeless percutaneous nephrolithotomy for the management of renal stones in paediatric population: A prospective single-centre experience.","authors":"Nitesh Kumar, Bhaskar K Somani","doi":"10.4103/ua.ua_44_26","DOIUrl":"10.4103/ua.ua_44_26","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the feasibility, safety, and efficacy of supine minitubeless percutaneous nephrolithotomy (PCNL) for managing renal stones in paediatric patients.</p><p><strong>Patients and methods: </strong>A prospective, observational, single-surgeon study was conducted at Ford Hospital and Research Centre over 2 years, including paediatric patients (<14 years) presenting with renal stones. Patient demographics, stone characteristics, intraoperative parameters, postoperative outcomes, stone-free rates (SFRs), complications, and hospital stay were recorded. Statistical analysis was performed using XLSTAT 2021. Double-J stents were placed in all cases without a nephrostomy tube. SFR was defined as complete clearance or residual fragments <2 mm in the computed tomography scan. The Clavien-Dindo system was used for grading the complications.</p><p><strong>Results: </strong>Fifty paediatric patients were analyzed. The mean age was 6.45 years. Mean stone size was 15.24 mm, with a mean Hounsfield Unit of 829.54 ± 161.94. Mean operative time was 38.38 min. Stone-free status was achieved in 96% of patients at 3 months, with two patients requiring retrograde intrarenal surgery for residual stones. The mean haemoglobin drop was 0.51 g/dL and the mean hospital stay was 1.4 days. Minor Clavien-Dindo Grade I/II complications occurred in 12% of cases (fever 4%, pain 6%, and mild ascites 2%), all resolving spontaneously. No major complications or blood transfusions occurred.</p><p><strong>Conclusion: </strong>Supine mini-tubeless PCNL appears to be a safe and effective surgical management of paediatric renal stones, offering high SFRs with minimal complications, and short hospital stays. This technique may represent a useful minimally invasive treatment option, particularly when flexible ureteroscopy is limited.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"266-272"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680146","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":"Potassium citrate for stone prevention - Quantifying benefit through the number needed to treat: A narrative review.","authors":"Ali Talyshinskii, Arianna Pischetola, Wissam Kamal, Bhaskar Kumar Somani","doi":"10.4103/ua.ua_36_26","DOIUrl":"10.4103/ua.ua_36_26","url":null,"abstract":"<p><p>To define how reliable the benefits of potassium citrate (KCit) for stone prevention are framing this in terms of the number needed to treat (NNT). A targeted search of PubMed/MEDLINE, Embase, and the Cochrane Library was conducted through January 2025. For studies reporting recurrence rates in treatment and control groups, absolute risk reduction (ARR) and NNT were calculated. Two pivotal randomized trials in recurrent calcium stone formers demonstrated large ARRs with KCit or potassium-magnesium citrate, lowering 3-year recurrence rates from approximately 60%-80% in placebo groups to 10%-30% with therapy. Corresponding ARRs were around 50%, yielding NNTs of approximately 2 over 3 years. Evidence is strongest for calcium oxalate disease; data for calcium phosphate and brushite stones remain limited. In uric acid and cystine stones, alkalinization is first-line therapy, although precise NNT estimates are unavailable. KCit is one of the most effective preventive pharmacotherapies in nephrolithiasis. In recurrent calcium stone formers, treating two to three patients for approximately 3 years prevents one recurrence, representing a highly favorable benefit-risk profile when appropriately monitored and individualized by stone phenotype.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"206-214"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680140","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":"Challenging the gold standard: Flank-free modified supine versus prone position in the management of complex renal stones.","authors":"Mohamed Ahmed Mohamed El Taher, Ahmed Mohamed Moeen, Ahmed Shehata El Azab, Yaser Mahmoud Abdel-Salam","doi":"10.4103/ua.ua_3_26","DOIUrl":"10.4103/ua.ua_3_26","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to compare the safety, efficacy, and operative outcomes of the flank-free modified supine position versus the standard prone position for percutaneous nephrolithotomy (PCNL) in patients with complex renal stones.</p><p><strong>Materials and methods: </strong>In this prospective randomized controlled trial (May 2022-November 2024), 178 patients with complex renal stones (Guy's Stone Score II-IV) were randomized 1:1 to undergo PCNL in the flankfree modified supine position (<i>n</i> = 89) or standard prone position (<i>n</i> = 89). The primary outcome was stone-free rate (SFR), defined as no residual fragments ≥ 4 mm on noncontrast computed tomography at 3 months. Secondary outcomes included operative time, hemoglobin drop, and complications graded using the Clavien-Dindo classification.</p><p><strong>Results: </strong>Baseline characteristics and stone complexity were comparable between groups. Mean operative time was significantly shorter in the supine group (72.61 ± 8.07 vs. 92.80 ± 6.90 min; <i>P</i> < 0.001). SFR was 91.0% in the supine group versus 85.4% in the prone group (<i>P</i> = 0.245). There were no significant differences in hemoglobin drop or overall complication rates. The prone group utilized a higher proportion of lower pole punctures (74.6% vs. 61.8%), whereas the supine group required significantly more middle (22.5% vs. 9.0%) and upper pole (11.2% vs. 2.2%) access (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Flank-free modified supine PCNL is a safe and effective alternative to standard prone PCNL for complex renal stones, providing significantly shorter operative time and favorable ergonomics without compromising stone clearance or safety.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"273-277"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680063","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":"Prostatic calculi in men with chronic prostatitis and chronic pelvic pain syndrome: A systematic review (2015-2025).","authors":"Prasenjit Bhowmik, Muhammad Umair Shafiq, Anil Krishan, Mustafa Ahmad, Abdulla Khaleel Alwadi, Banan Osman","doi":"10.4103/ua.ua_179_25","DOIUrl":"10.4103/ua.ua_179_25","url":null,"abstract":"<p><p>Prostatic calculi are frequently detected on transrectal ultrasound (TRUS) and computed tomography (CT), yet their clinical relevance in prostatitis remains uncertain. To systematically evaluate the association between prostatic calculi and prostatitis-related outcomes in adult men. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic review was conducted. PubMed, Ovid Embase, CINAHL, and Google Scholar were searched for studies published between January 1, 2015 and October 31, 2025. Eligible studies assessed prostatic calculi by presence, burden, location, or density and compared outcomes with men without calculi or with lower burden. Outcomes included prostatitis diagnoses, validated symptom measures (National Institutes of Health-chronic prostatitis symptom index [NIH-CPSI], International Prostate Symptom Score [IPSS], International Index of Erectile Function - 5), inflammatory markers, and treatment response. Risk of bias was assessed using the Critical Appraisal Skills Programme tool. A total of 198 records were identified, of which 10 studies were included. Most were cross-sectional, with one prospective CP/chronic pelvic pain syndrome cohort. Greater calcification burden and peri-urethral distribution were associated with higher NIH-CPSI and IPSS scores and less favorable symptom improvement following medical therapy. CT-based cohorts reported associations between higher-density calculi and worse lower urinary tract symptoms, erectile dysfunction, pelvic pain, and reduced quality of life. A prostatectomy series demonstrated bacterial biofilm within calcifications, providing biological plausibility. Prostatic calculi - particularly when extensive or peri-urethral - are associated with increased symptom burden and may identify men with more refractory disease. However, current evidence is observational and heterogeneous, with incomplete confounder control. Standardized imaging classifications and prospective studies are required to clarify causal relationships and inform management strategies.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"235-245"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680153","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":"Visualizing grades of hematuria for communication enhancement and continuous bladder irrigation guidance.","authors":"Thanapat Layangool, Thanisorn Pattanasuwon, Weerayut Wiriyabanditkul, Sarayut Kanjanatarayon, Nattapong Binsri, Satit Siriboonrid, Vittaya Jiraanankul","doi":"10.4103/ua.ua_176_25","DOIUrl":"10.4103/ua.ua_176_25","url":null,"abstract":"<p><strong>Introduction: </strong>Gross hematuria often requires continuous bladder irrigation (CBI) to prevent clot retention. Decisions to initiate, adjust, or discontinue CBI rely on subjective visual assessment, causing practice variability. This study aimed to develop a consensus-based visual hematuria scale to guide CBI management and improve communication.</p><p><strong>Materials and methods: </strong>Ten simulated hematuria specimens (20%-0.04% hematocrit) were prepared using packed red blood cells and normal saline. Urologists and residents (≥1 year CBI experience) evaluated specimens in person or through photographs. Participants identified threshold specimens for four actions: (1) notifying an urologist, (2) increasing CBI rate, (3) decreasing CBI rate, and (4) stopping CBI. Data were analyzed using mode, interquartile range (IQR), and appropriate exact tests.</p><p><strong>Results: </strong>Of 150 respondents, 145 met the inclusion criteria (54.5% residents, 45.5% urologists). Modes (IQR) for each action were: Notify - 1 (IQR = 2), Increase rate - 5 (IQR = 2), Decrease rate - 8 (IQR = 2), and Stop - 9 (IQR = 2). Exact agreement ranged from 26.2% to 44.8%, while adjacent agreement (within ± 1 grade) demonstrated strong consensus, ranging from 61.4% to 93.1%. Responses did not differ significantly between urologists and residents. On-site and online responses differed slightly regarding the \"increase rate\" threshold (<i>P</i> = 0.011).</p><p><strong>Conclusion: </strong>This multi-center survey identified consensus thresholds for a 4-point visual hematuria grading scale. This scale is intended to serve as a communication aid to standardize the language in CBI management. While this consensus provides a foundation, further studies are needed to validate the proposed grading system in real-world settings and incorporate additional clinical parameters.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 3","pages":"253-258"},"PeriodicalIF":0.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680214","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}