World Journal of Urology最新文献

{"title":"BLAST-bladder lithiasis assessment of surgical treatment in real-world practice. A global prospective multicentre registry by EAU Endourology.","authors":"Vineet Gauhar, Steffi Kar Kei Yuen, Thomas Herrmann, Jaisukh Kalathia, Amelia Pietropaolo, Khi Yung Fong, Arun Chawla, Tianyu Li, Alexey Martov, Zelimkhan Tokhtiev, Giorgio Mazzon, Amish Mehta, Yash Pamecha, Lin Xiong, Angelo Cormio, Ender Cem Bulut, Nariman Gadzhiev, Sohani Dassanayake, Azizbek Shomarufov, Lim Tze Ying Benjamin, Theodoros Tokas, Gunal Ozgur, Luca Boeri, Yunteng Huang, Yasser Gamil Elnagar, Zijie Chai, Bohan Wang, William Lay Keat Ong, Benedikt Becker, Abdul Haseeb, Lazaros Tzelves, Alba Sierra, Thiago Hota, Mallikarjuna Chiruvella, Deepak Ragoori, Chi-Fai Ng, Daniele Castellani, Bhaskar Somani","doi":"10.1007/s00345-026-06813-3","DOIUrl":"10.1007/s00345-026-06813-3","url":null,"abstract":"<p><strong>Purpose: </strong>This registry aimed to establish a comprehensive global database to characterise contemporary real-world surgical approaches to bladder stones and to describe postoperative stone-free rate (SFR) and complications according to the surgical treatment route.</p><p><strong>Methods: </strong>The BLAST (Bladder Lithiasis Assessment of Surgical Treatment) registry prospectively enrolled 805 patients across 31 centres in 16 countries between May 2025 and February 2026. Patients underwent transurethral intervention (TI, n = 741), percutaneous suprapubic (PSI, n = 39), or open surgery (OI, n = 25). Postoperative SFR was graded using cross-sectional computer tomography, or ultrasonography, X-ray, or flexible cystoscopy, as Grade A (100% complete clearance), Grade B (single residual fragment), Grade C (multiple residual fragments). Perioperative complications were classified by the Clavien-Dindo criteria.</p><p><strong>Results: </strong>The cohort was predominantly male across all groups. TI patients were older (median 66 vs 60 and 59 years; p = 0.023) and presented with smaller stones (median 2.1 vs 3.0 cm in both other groups; p < 0.001). A history of urinary tract reconstruction was markedly more prevalent in the PSI cohort (23.1% vs 3.5% and 4.0%; p < 0.001). Median hospital stay was significantly shorter following TI (2 vs 3 days; p < 0.001), accompanied by a shorter duration of catheterisation (p < 0.001). Early complications within 48 h were most frequent after OI (48.0% vs 18.6% and 17.9%; p = 0.001), although major complications (Clavien-Dindo ≥ 3) remained rare and comparable across all modalities. No mortality was recorded. Grade A SFR was achieved in 95.5% of TI, 84.6% of PSI, and 100% of OI (p = 0.001). Reintervention for residual fragments was required significantly more often following PSI (10.3% vs 1.3% and 0%; p < 0.001).</p><p><strong>Conclusion: </strong>Transurethral cystolithotripsy was the predominant approach in this real-world international cohort and was associated with high stone clearance and shorter postoperative recovery. Percutaneous and open approaches were selectively used in patients with larger stone burdens, complex anatomy, prior urinary tract reconstruction, or specific urethral limitations. These findings describe contemporary treatment patterns and observed outcomes rather than comparative treatment effectiveness.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic factors associated with postoperative events and reintervention after secondary urethroplasty in children with urethral strictures after hypospadias repair.","authors":"Chang Li, Zihan Ye, Hongsong Chen, Zhicheng Zhang, Lilu Qin, Shengde Wu, Deying Zhang, Guanghui Wei, Xing Liu","doi":"10.1007/s00345-026-06861-9","DOIUrl":"10.1007/s00345-026-06861-9","url":null,"abstract":"<p><strong>Purpose: </strong>To describe long-term outcomes of secondary urethroplasty for post-hypospadias urethral stricture in children and identify anatomic factors associated with a broad composite postoperative event endpoint.</p><p><strong>Methods: </strong>We retrospectively reviewed 104 boys ≤ 12 years treated at a tertiary paediatric urology centre between 2010 and 2021. The primary outcome was a broad composite postoperative event endpoint comprising postoperative complications or additional urethral intervention for suspected impaired patency. Cox regression assessed associated factors. Receiver operating characteristic (ROC) analysis identified a cohort-derived threshold for radiographic stricture length (LUS), and Kaplan-Meier analysis assessed composite-event-free survival.</p><p><strong>Results: </strong>Median follow-up was 5.5 years. Overall, 63/104 boys (60.6%) met the composite endpoint, whereas 35/104 (33.7%) underwent unplanned reoperation. Prostatic utricle (aHR 1.78, 95% CI 1.01-3.14), longer LUS (aHR 1.14 per 1-cm increase, 95% CI 1.00-1.30), and baseline residual/recurrent ventral curvature (aHR 1.89, 95% CI 1.01-3.53) were independently associated with the composite endpoint. A cohort-derived LUS threshold of 1.8 cm yielded an AUC of 0.714 (95% CI 0.614-0.813), 77.8% sensitivity, 58.5% specificity, 74.2% positive predictive value, and 63.2% negative predictive value. Children with LUS ≥ 1.8 cm had lower composite-event-free survival.</p><p><strong>Conclusion: </strong>In this single-centre salvage cohort, postoperative morbidity and treatment burden after secondary urethroplasty for post-hypospadias urethral stricture were substantial. Longer LUS, prostatic utricle, and baseline residual/recurrent ventral curvature were anatomic factors associated with the composite endpoint. The cohort-derived 1.8-cm threshold may provide a practical marker for risk stratification, family counselling, and postoperative surveillance, but requires independent paediatric validation.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimental and clinical studies: a scoping review of intrarenal pressure in percutaneous nephrolithotomy.","authors":"Carlo Giulioni, Daniele Castellani, Angelo Cafarelli, Federico Falsetti, Luca Spinozzi, Yu X T Law, Henry Yue-Hong Meng, Steffi Kar Kei Yuen, Yi Quan Tan, Wei Zheng So, Ryan W Y Yuen, Amelia Pietropaolo, Vineet Gauhar","doi":"10.1007/s00345-026-06819-x","DOIUrl":"10.1007/s00345-026-06819-x","url":null,"abstract":"<p><strong>Purpose: </strong>Intrarenal pressure (IRP) plays a critical role in the safety of percutaneous nephrolithotomy (PCNL), with elevated pressures associated with inflammatory and infectious complications. This scoping review aims to synthesize experimental and clinical evidence on factors influencing IRP during PCNL and to evaluate the impact of contemporary techniques and adjunctive technologies on pressure control and clinical outcomes.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Embase, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were systematically searched from inception to July 2025. Experimental and clinical studies assessing IRP during standard, miniaturized, and suction-assisted PCNL were included. Primary outcomes were mean and peak IRP and determinants of pressure variation. Secondary outcomes included the stone-free rate (SFR) and pressure-related complications.</p><p><strong>Results: </strong>Thirty-five studies (13 experimental and 22 clinical) were included. Across all models, IRP was highly sensitive to irrigation modality, tract size, outflow patency, and suction use. Miniaturized PCNL systems consistently generated higher and more variable IRP due to restricted passive drainage. Gravity-fed irrigation maintained lower and more stable pressures than pressurized systems. Suction-assisted sheaths and pressure-regulated platforms significantly reduced mean and peak IRP, limited pressure fluctuations, and shortened the duration of exposure to unsafe pressure levels. Importantly, suction-assisted PCNL achieved equal or superior SFR compared with non-suction techniques.</p><p><strong>Conclusion: </strong>IRP is a pivotal and modifiable element of PCNL safety. Suction-assisted and pressure-regulated technologies effectively mitigate IRP elevations without compromising efficacy. Standardization of IRP monitoring and the definition of clinically meaningful pressure thresholds are necessary to optimize future PCNL practice.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stage-specific prognostic value of PSA in prostate cancer: a multicentre KAMU-ON study.","authors":"Hiroaki Iwamoto, Kouji Izumi, Kazuaki Machioka, Ren Toriumi, Takashi Shima, Masakazu Nozaki, Tomohiro Hori, Takahiro Inaba, Ryunosuke Nakagawa, Taiki Kamijima, Suguru Kadomoto, Tomoyuki Makino, Renato Naito, Hiroshi Yaegashi, Kazuyoshi Shigehara, Takahiro Nohara, Tohru Miyagi, Chikashi Seto, Yoshifumi Kadono, Atsushi Mizokami","doi":"10.1007/s00345-026-06837-9","DOIUrl":"10.1007/s00345-026-06837-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether the prognostic value of initial prostate-specific antigen (PSA) differs according to disease stage in patients with prostate cancer.</p><p><strong>Methods: </strong>This multicentre retrospective cohort study used data from the Kaga Million Uro-Oncology Network (KAMU-ON) registry. Patients diagnosed between 1993 and 2024 with available data on overall survival, initial PSA, Grade Group, and disease stage were included. Disease stage was classified as localised, nonmetastatic advanced, or metastatic. Restricted cubic spline analyses and multivariable Cox proportional hazards models evaluated stage-specific associations between PSA and overall survival.</p><p><strong>Results: </strong>Among 7747 patients, 5578 had localised disease, 1223 had nonmetastatic advanced disease, and 946 had metastatic disease. The median follow-up was 58.0 months. PSA-survival associations differed significantly across disease stages (P for interaction = 0.0014). In localised disease, mortality risk increased progressively with higher PSA levels. In nonmetastatic advanced disease, the association was attenuated. In metastatic disease, a non-linear association was observed, with increased mortality risk at both lower and higher PSA levels. Patients with metastatic disease and PSA < 3.5 ng/mL had a higher estimated mortality risk than those with PSA 3.5-<10 ng/mL (adjusted HR 5.86, 95% CI 2.22-15.43), although this subgroup comprised only eight patients.</p><p><strong>Conclusion: </strong>The prognostic value of initial PSA appeared to differ according to disease stage. These findings generate the hypothesis that low PSA may have different prognostic implications across disease stages. External validation is required, particularly for the very low-PSA metastatic subgroup.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suprapubic transvesical adenoma resection versus robot-assisted simple prostatectomy for prostates ≥ 80 mL: an exploratory early-outcome comparison.","authors":"B Bucca, A Brassetti, R S Flammia, P Dell'Oglio, F Presicce, M Lo Re, F Chierigo, O Dalpiaz, G Simone, C Gozzi","doi":"10.1007/s00345-026-06848-6","DOIUrl":"10.1007/s00345-026-06848-6","url":null,"abstract":"<p><strong>Purpose: </strong>Robot-assisted simple prostatectomy (RASP) is an established but resource-intensive option for large benign prostatic enlargement. Suprapubic transvesical adenoma resection of the prostate (STAR-P) is a recently described bipolar endoscopic technique that resects the adenoma through a suprapubic access, avoiding transurethral instrumentation. We compared their early outcomes in prostates ≥ 80 mL.</p><p><strong>Methods: </strong>In an exploratory, non-randomized, two-centre analysis of prospectively maintained data, we compared baseline, perioperative and one-month outcomes, changes from baseline, and a composite endpoint [Trifecta: maximum urinary flow rate (Qmax) > 15 mL/s, International Prostate Symptom Score (IPSS) < 8, no postoperative complications], with a logistic model adjusting for age and baseline IPSS.</p><p><strong>Results: </strong>Sixty-one patients were included (26 STAR-P, 35 RASP). STAR-P patients were older (69.5 vs. 64.0 years; p = 0.019), with higher baseline IPSS (29.5 vs. 25.0; p = 0.005) and more often a prominent median lobe (84.6% vs. 48.6%; p = 0.006). Catheterization was shorter after STAR-P (3 vs. 7 days; p < 0.001), whereas postoperative Qmax was higher after RASP (24.0 vs. 13.8 mL/s; p = 0.002). STAR-P showed a greater IPSS reduction and a smaller haemoglobin decrease; ΔQmax did not differ (p = 0.100). No major bleeding event occurred after STAR-P versus nine (26%) after RASP. Trifecta did not differ (42% vs. 54%; p = 0.440), but the study had only 15% power for this comparison.</p><p><strong>Conclusion: </strong>STAR-P and RASP showed distinct early profiles rather than superiority of either technique: STAR-P favoured shorter catheterization, lower symptoms and less bleeding, whereas RASP produced stronger early flow improvement. Whether avoiding the urethra reduces urethral morbidity remains an untested hypothesis.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic and robotic management of symptomatic calyceal diverticula: a systematic review on behalf of YAU and EAU endourology.","authors":"Theodoros Spinos, Rifat Ergul, Angelis Peteinaris, Gernot Ortner, Amelia Pietropaolo, Theodoros Tokas, Evangelos Liatsikos, Panagiotis Kallidonis, Bhaskar Somani, Begoña Ballesta Martinez","doi":"10.1007/s00345-026-06846-8","DOIUrl":"10.1007/s00345-026-06846-8","url":null,"abstract":"<p><strong>Introduction: </strong>Calyceal diverticula (CD) are outpouchings of the pelvicalyceal system into the renal parenchyma. The purpose of this systematic review is to summarize the outcomes associated with laparoscopic and robotic-assisted approaches for the management of symptomatic CD.</p><p><strong>Materials and methods: </strong>Our findings were structured according to the PRISMA statement. We queried three electronic databases, PubMed, Cochrane Library, and Web of Science, to systematically review the literature. Relying on the March 2009 guidelines from the Oxford Centre for Evidence-Based Medicine, two authors independently judged the quality and evidence level of the final articles.</p><p><strong>Results: </strong>Nine studies were included in final qualitative synthesis. The operative time ranged from 80 to 172 (107-197) minutes, while Estimated Blood Loss ranged from 40 (5-100) to 150 (50-300) ml. The Grade I-II complications according to Clavien-Dindo Classification System ranged from 0% to 66.7%, while no Grade III-IV complications were reported in either of the nine studies. The rate of patients reporting flank pain recurrence during the follow-up period ranged from 0% to 28.5%, while recurrence of the diverticulum ranged from 0% to 33.3%. None of the patients with flank pain or diverticulum recurrence needed a reoperation.</p><p><strong>Conclusions: </strong>The findings of this systematic review suggest that laparoscopic and robotic approaches are feasible and have shown favorable outcomes in selected patients with symptomatic CD, particularly in cases with complex anatomy or after failed endourological treatment. However, the available evidence remains limited.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Surgeon-led vs. nurse-led postoperative follow-up after DiLEP: impact on erectile function recovery and patient-reported outcomes\".","authors":"Anwar Khan, Usha Yada, Pramila D'Souza","doi":"10.1007/s00345-026-06648-y","DOIUrl":"10.1007/s00345-026-06648-y","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: \"DART-VAG: initial clinical experience with a novel autologous technique for penile girth augmentation\".","authors":"Joshua Levin, Buğra Çetin","doi":"10.1007/s00345-026-06851-x","DOIUrl":"10.1007/s00345-026-06851-x","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up outcomes and independent predictors of surgical failure following posterior urethroplasty for pelvic fracture-associated urethral strictures.","authors":"Jie Wang, Guanglin Huang, Guizhong Li, Jianwei Wang","doi":"10.1007/s00345-026-06804-4","DOIUrl":"https://doi.org/10.1007/s00345-026-06804-4","url":null,"abstract":"<p><strong>Purpose: </strong>To report long-term follow-up outcomes of posterior urethroplasty for pelvic fracture urethral strictures and identify independent predictors of surgical failure.</p><p><strong>Methods: </strong>We retrospectively enrolled patients who underwent delayed posterior urethroplasty for pelvic fracture urethral injury at our center between December 2018 and December 2024. Perioperative and follow-up data were collected and analyzed. Patients with less than 12 months of postoperative follow-up were excluded.</p><p><strong>Results: </strong>Seventy-six male patients were included. Median (IQR) age was 51.5 (40.5, 57.8) years. Injury mechanisms included crush trauma (n = 40, 52.6%), traffic accidents (n = 22, 29.0%), and falls (n = 14, 18.4%). Complete urethral obliteration was present in 54 patients (71.0%), and post-injury erectile dysfunction in 43 (56.6%). Thirty-two patients (42.1%) had prior urethral interventions. All procedures were successful. Median (IQR) urethral defect length was 2.5 (2.0, 3.5) cm. Direct anastomosis was performed in 48 patients (63.2%), and adjunctive maneuvers in 28 (36.8%). Median (IQR) follow-up was 30.0 (15.0, 59.5) months. Treatment success was achieved in 60 patients (79.0%), and failure in 16 (21.0%). On multivariate analysis, prior intervention (OR 11.558, 95% CI 1.356-98.515, P = 0.025) and longer urethral defect length (OR 4.394, 95% CI 1.262-15.292, P = 0.020) were independent predictors of surgical failure.</p><p><strong>Conclusions: </strong>Posterior urethroplasty is safe and effective for pelvic fracture urethral strictures with favorable long-term functional outcomes. Prior intervention and longer urethral defect length are independent predictors of surgical failure.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retroperitoneal lymph node dissection for isolated node recurrence of renal cell carcinoma after nephrectomy: a systematic review.","authors":"Alberto Costa Silva, Noel Clarke, Aziz Gulamhusein","doi":"10.1007/s00345-026-06853-9","DOIUrl":"10.1007/s00345-026-06853-9","url":null,"abstract":"<p><strong>Purpose: </strong>Isolated retroperitoneal lymph node recurrence after nephrectomy for renal cell carcinoma (RCC) occurrs in approximately 1-3% of patients. The optimal management of this condition remains undefined. This systematic review aims to evaluate perioperative and oncologic outcomes following retroperitoneal lymph node dissection (RPLND) for isolated nodal recurrence of RCC after nephrectomy.</p><p><strong>Methods: </strong>A systematic literature search was performed in MEDLINE/PubMed and Embase (January 2000-August 2025) according to PRISMA 2020 guidelines (PROSPERO ID: CRD420251167754). Data extracted included patient demographics, perioperative parameters, and oncologic outcomes. The risk of bias was assessed using the ROBINS-I tool.</p><p><strong>Results: </strong>Seven retrospective studies published between 2008 and 2022 met inclusion criteria, encompassing 144 patients. Median age ranged from 57 to 65 years, with a predominance of clear-cell histology (60-100%). The median interval between nephrectomy and recurrence was 9.6-25 months. Median operative time ranged from 155 to 271 min, with estimated blood loss between 200 and 575 mL and hospital stay of 2-6 days. Overall complication rates were 26-47%, with major (Clavien ≥ III) complications in approximately 10%. Median recurrence-free or progression-free survival ranged from 9 to 19.5 months, and 5-year cancer-specific survival from 61% to 74%. Adverse prognostic factors included a disease-free interval ≤ 12 months, high-grade tumors, pN1 status, and nodal metastasis > 3 cm.</p><p><strong>Conclusions: </strong>RPLND is an option for isolated retroperitoneal nodal recurrence of RCC after nephrectomy. Prospective multicentre studies are warranted to define optimal patient selection, the role of minimally invasive techniques, and integration with contemporary systemic immunotherapy.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}