Archivio Italiano di Urologia e Andrologia最新文献

{"title":"Does the use of a small-diameter 22Fr resectoscope sheath reduce urethral stricture after transurethral resection of the prostate?","authors":"Ahmet Şanlı, Guven Erbay","doi":"10.4081/aiua.2026.14989","DOIUrl":"https://doi.org/10.4081/aiua.2026.14989","url":null,"abstract":"<p><strong>Purpose: </strong>Urethral stricture represents a significant late complication of transurethral resection of the prostate (TURP), leading to deterioration in urinary function and quality of life. This study aimed to compare the impact of 22Fr and 26Fr continuous-flow resectoscope sheaths on postoperative urethral stricture formation and perioperative outcomes.  Methods: Patients who underwent bipolar TURP between 2021 and 2025 were retrospectively evaluated. Patients were divided according to sheath size into 22Fr (n = 135) and 26Fr (n = 145) groups. The primary endpoint was postoperative urethral stricture. A multivariable Cox proportional hazards model with Firth's penalized likelihood correction was used to identify independent predictors of stricture. Stricture-free survival was analyzed using Kaplan-Meier curves and compared with the log-rank test.</p><p><strong>Results: </strong>Urethral stricture occurred in 5 patients (3.7%) in the 22Fr group and 22 patients (15.2%) in the 26Fr group (p = 0.0011). Operation time was shorter in the 26Fr group, while functional outcomes were comparable between groups. In multivariable Firth's penalized Cox regression analysis, use of a 26Fr sheath was the only independent predictor of urethral stricture (adjusted HR 4.08; 95% CI 1.16-14.37; p = 0.029). Kaplan-Meier analysis demonstrated a significantly higher cumulative incidence of urethral stricture in the 26Fr group (log-rank p = 0.003).</p><p><strong>Conclusions: </strong>Use of a 22Fr resectoscope sheath is associated with a significantly lower hazard of postoperative urethral stricture without compromising functional outcomes. Sheath diameter represents a clinically relevant and modifiable technical factor that may significantly influence long-term urethral morbidity after TURP.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14989"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844418","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":"Initial safety and efficacy of holmium laser enucleation of the prostate: real world evidence from a tertiary centre.","authors":"Sailantra Sivathasan, Lit Kiat Tan, Brayan Samuel, Chandrarajan Shah, Chigozie Onyeze, Amit Kalpee","doi":"10.4081/aiua.2026.14705","DOIUrl":"https://doi.org/10.4081/aiua.2026.14705","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the initial safety and efficacy of Holmium enucleation of the prostate (HoLEP) in managing benign prostatic hypertrophy (BPH) in a single tertiary centre.</p><p><strong>Materials & methods: </strong>A retrospective cohort study was conducted focusing on a single tertiary hospital in which data was collected from electronic medical records which includes demographic information, preoperative characteristics, surgical details, and post-operative outcomes; complications were classified using the Clavien-Dindo classification.</p><p><strong>Results: </strong>104 patients with BPH and lower urinary tract symptoms (LUTS) were analysed in this study, with a mean prostate volume of 109.3 ± 47.2 ml. The mean change in post void residual volume (PVR) was (-)75%, whilst the mean change in maximum flow rate (QMax) was (+)109%. 21/104 (19%) patients presented with post-operative complications, the majority of these (13) were Grade I complications with three patients being Grade III. Increasing age (p = 0.014) was shown to have contributed to complications. Pre-operative anticoagulation was shown to yield no significance (p = 0.066).</p><p><strong>Conclusion: </strong>HoLEP remains a viable treatment modality for BPH especially in larger prostates (> 100 ml). However, considerations regarding post-operative outcomes should be taken when offering this treatment to more elderly patients. Additionally, HoLEP provides a good treatment option for patients on anticoagulation.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14705"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844446","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":"High mortality and clinical characteristics of Fournier's gangrene: a 10-year retrospective study from an Indonesian tertiary hospital.","authors":"Fandy Ahmad, Besut Daryanto, Athaya Febriantyo Purnomo","doi":"10.4081/aiua.2026.15121","DOIUrl":"https://doi.org/10.4081/aiua.2026.15121","url":null,"abstract":"<p><strong>Introduction: </strong>Fournier's gangrene (FG) is a rare but life-threatening necrotizing soft tissue infection with persistently high mortality. Data describing long-term clinical profiles and outcomes of FG in Indonesia remain limited.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted including all patients diagnosed with Fournier's gangrene at RSUD Dr. Saiful Anwar Malang between 2014 and 2024. Demographic characteristics, comorbidities, microbiological findings, Fournier's Gangrene Severity Index (FGSI), and outcomes were analyzed descriptively. Associations between age and comorbidity burden were evaluated using one-way ANOVA and chi-square tests.</p><p><strong>Results: </strong>A total of 119 patients were included, with a mean age of 54.39 ± 12.11 years. Most patients were aged 56-65 years (37.81%). Renal impairment was the most frequently documented comorbidity (26.1%), while 33.6% of patients had no recorded comorbid conditions. Increasing age was significantly associated with greater comorbidity burden (p < 0.001). FGSI analysis was available in 44 patients and demonstrated very high mortality among patients with FGSI > 9 (95%). Mortality among patients with FGSI ≤ 9 also remained high (77.3%), suggesting limited prognostic discrimination in this cohort. Microbiological cultures were available in 33 patients, with Escherichia coli as the most common isolate (53.3%). Antibiotic sensitivity testing showed low sensitivity to meropenem (27.27%) and ciprofloxacin (21.21%).</p><p><strong>Conclusions: </strong>Fournier's gangrene in this tertiary center predominantly affected older patients and was associated with high mortality. Limited prognostic discrimination of FGSI and notable antimicrobial resistance patterns highlight the importance of early recognition and locally tailored management strategies.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"15121"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844368","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":"Metabolic parameters, insulin resistance surrogates, and Peyronie's disease: a cross-sectional analysis of disease presence and curvature severity.","authors":"Abdullah Akdag, Ertugrul Arikiz, Eymen Ozer, Enes Yavuz, Turan Ozdemir, Murat Oksuzoglu, Halil Lutfi Canat","doi":"10.4081/aiua.2026.14907","DOIUrl":"https://doi.org/10.4081/aiua.2026.14907","url":null,"abstract":"<p><strong>Methods: </strong>This retrospective, cross-sectional study included 317 adult men, comprising 123 patients diagnosed with PD and 192 control subjects without clinical evidence of PD. Demographic data, body mass index (BMI), comorbidities, and fasting laboratory parameters (glucose, total cholesterol, LDL, HDL, and triglycerides) were collected. TG/HDL ratio and TyG index were calculated using established formulas. Between-group comparisons were performed using Mann-Whitney U and chi-square or Fisher's exact tests, with false discovery rate correction for multiple comparisons. Multivariable binary logistic regression analysis was conducted to identify independent predictors of PD presence. Within the PD cohort, associations between penile curvature degree and metabolic parameters were evaluated using Spearman's correlation analysis.</p><p><strong>Results: </strong>Patients with PD had a significantly lower median BMI compared to controls (25.0 vs. 27.3 kg/m², p < 0.001). LDL-cholesterol and total cholesterol levels were lower in the PD group on univariable analysis; however, these differences did not remain significant after correction for multiple testing. No significant differences were observed between groups for fasting glucose, triglycerides, HDL, TG/HDL ratio, or TyG index. In multivariable analysis, BMI emerged as the only independent predictor of PD presence (OR 0.83 per kg/m² increase, 95% CI 0.76-0.90; p < 0.001). No metabolic parameter, including insulin resistance surrogates, was independently associated with PD. Among PD patients, penile curvature degree showed no significant correlation with BMI, lipid profile components, TG/HDL ratio, or TyG index.</p><p><strong>Conclusions: </strong>In this cohort, BMI - but not lipid profile components or insulin resistance surrogate markers - was independently associated with the presence of Peyronie's disease, while metabolic factors were not related to curvature severity. These findings suggest that systemic metabolic dysregulation may play a limited role in PD development and phenotypic expression, highlighting the importance of local tissue-specific mechanisms in disease pathogenesis.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14907"},"PeriodicalIF":1.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844388","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":"Clinical validation of the acute cystitis symptom score in the Kazakh language.","authors":"Anuar Amanov, Yakub Khakhazov, Chingis Baimenov, Alizhan Kozhamzharov, Mirzaakhmet Zhanadilov, Kurt G Naber, Florian M E Wagenlehner, Jakhongir Alidjanov, Yerzhan Sharapatov, Ulanbek Zhanbyrbekuly","doi":"10.4081/aiua.2026.14920","DOIUrl":"https://doi.org/10.4081/aiua.2026.14920","url":null,"abstract":"<p><strong>Background: </strong>The Acute Cystitis Symptom Score (ACSS) is an internationally validated patient-reported outcome (PRO) tool for diagnosing and monitoring acute uncomplicated cystitis (AC) in women, available in several language versions. The current study reports the linguistic and clinical validation of the Kazakh version of the ACSS.</p><p><strong>Methods: </strong>Linguistic validation followed internationally accepted guidelines for the cultural adaptation of PRO instruments. The current validation study included 100 Kazakhspeaking women. All respondents participated in cognitive debriefing to ensure clarity and comprehensibility of the translated PRO. Participants completed diagnostic Part A of the Kazakh version of the ACSS at initial admission and follow- up Part B at each follow-up visit. Descriptive statistics were used to summarise demographic characteristics. The comparative analysis included parametric and nonparametric tests where appropriate. Reliability of the Kazakh version of the ACSS was measured using Cronbach's alpha and splithalf reliability. Diagnostic performance was assessed by sensitivity and specificity. Statistical significance was set at p = 0.05.</p><p><strong>Results: </strong>Sixty-seven women with AC (mean age 39.24 ± 13.66 years) and 33 without evidence of urinary tract pathology (mean age 44.94 ± 17.99 years) were included in the Patient and Control groups, respectively. No significant demographic differences were observed between groups. Median scores in the \"Typical\" domain were significantly higher in Patients than in Controls (5.00 vs 0.00). Internal consistency was high for the \"Typical\" (Cronbach's α = 0.86) and \"QoL\" (α = 0.91) domains. Split-half reliability analysis showed a correlation coefficient of 0.65, a Spearman-Brown coefficient of 0.79, and a Guttman split-half coefficient of 0.77. The sensitivity and specificity of the Kazakh version of the ACSS, using the predefined cut-off value of 6 based on the \"Typical\" domain summary score, were 0.85 and 0.90, respectively.</p><p><strong>Conclusions: </strong>The Kazakh version of the ACSS demonstrates good reliability and strong discriminative ability, supporting its use in the clinical assessment of AC in Kazakh-speaking women.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14920"},"PeriodicalIF":1.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of percutaneous nephrolithotomy in a resource-limited setting: a retrospective study.","authors":"Radman Ghaleb, Sultan Qaid, Noaman Almashraki, Nagm Aldean Haider, Ebrahim Al-Shami, Basam Musleh Musleh, Jamil Muleky, Faisal Ahmed","doi":"10.4081/aiua.2026.14940","DOIUrl":"https://doi.org/10.4081/aiua.2026.14940","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous nephrolithotomy (PCNL) is the gold standard for managing large renal calculi; however, data on its long-term efficacy in resource-limited settings such as Yemen are scarce. We evaluated the outcomes and complications of PCNL surgery in resource limited settings over a nine-year period in a high-volume centre in Ibb City, Yemen.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 1,458 patients who underwent PCNL between October 2016 and June 2025. Data included patient demographics, stone characteristics, surgical techniques (standard, mini-PCNL, and supine), and outcomes. The stone-free rate (SFR) was defined as the absence of fragments greater than 4 mm on follow-up imaging at three months. Complications were classified using the Clavien-Dindo system.</p><p><strong>Results: </strong>The cohort comprised 763 (52.3%) males and 695 (47.7%) females with a mean age of 43.8±17.5 years (range: 2-87 years). Staghorn calculi were present in 647 cases (44.4%). Prone lower-pole access was the predominant approach (58.2%), with a progressive institutional shift toward mini-PCNL (5.7%), supine PCNL (3.1%), and ultrasound-guided access (1.4%) in later years. The primary stone-free rate after a single session was 76.0%, increasing to a final SFR of 92.6% following auxiliary interventions including repeat PCNL, ureteroscopy (2.8%), ESWL (1.5%), and conservative management of clinically insignificant residual fragments (6.0%). Major complications (Clavien-Dindo Grade III-V) occurred in 1.44% of cases, including colonic perforation (0.41%) and conversion to open surgery (0.62%). Mortality rate was 0.14% (n=2). Minor complications (Grade I-II) affected 17.4% of patients, predominantly postoperative pain (7.3%) and transient fever (5.3%).</p><p><strong>Conclusions: </strong>This large series demonstrates that PCNL can be performed with high stone-free rates and acceptable morbidity in resource-limited settings despite a high prevalence of complex staghorn calculi. The progressive adoption of miniaturized and supine techniques reflects institutional adaptability and confirms the feasibility of implementing contemporary endourological standards in low-resource environments.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"98 1","pages":"14940"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582558","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":"Antimicrobial resistance in <i>Mycoplasma genitalium</i> and <i>Mycoplasma hominis</i>: a systematic review in urology.","authors":"Jorge Llaca-Díaz, Nestor Casillas-Vega","doi":"10.4081/aiua.2026.14694","DOIUrl":"10.4081/aiua.2026.14694","url":null,"abstract":"<p><strong>Introduction: </strong>Mycoplasma genitalium and Mycoplasma hominis are urogenital mycoplasmas associated with urethritis, prostatitis, epididymitis, and pelvic inflammatory disease. In the last decade, acquired resistance to macrolides and fluoroquinolones in M. genitalium, together with intrinsic and acquired resistance to tetracyclines in M. hominis, have emerged as growing challenges in urology and sexual medicine.</p><p><strong>Material and methods: </strong>A systematic review was conducted following the PRISMA guideline, searching PubMed, Scopus, and Web of Science (2015-2025). Clinical, epidemiological, and molecular studies describing genetic resistance mechanisms, as well as meta-analyses and clinical guidelines, were included. After applying inclusion and exclusion criteria, 42 articles were selected.</p><p><strong>Results: </strong>In M. genitalium, macrolide resistance is associated with mutations in 23S rRNA (A2058G, A2059G), while fluoroquinolone resistance is linked to variants in parC and gyrA (S83I, D87N). In M. hominis, intrinsic macrolide resistance is complemented by the presence of tet(M), which contributes to doxycycline treatment failures. Globally, macrolide resistance in M. genitalium reaches 30-50% in Europe and the Americas, and over 60% in Asia; dual macrolide-fluoroquinolone resistance is emerging, with epidemic foci in Japan and China. In M. hominis, tetracycline resistance ranges from 10-30%, with regional variability.</p><p><strong>Conclusions: </strong>Antimicrobial resistance in M. genitalium and M. hominis limits the effectiveness of traditional empirical therapies and requires the implementation of molecular detection and resistance testing. Resistance-guided treatment and epidemiological surveillance are essential to optimize clinical management and curb the spread of multidrug-resistant strains.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"14694"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127024","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":"Adipose-derived mesenchymal stem cell secretome promotes testicular regeneration following chemically induced injury: a review of preclinical studies.","authors":"Nadya Nathalia Evangelista, Indah Dian Shafira, Nova Sylviana, Andri Rezano","doi":"10.4081/aiua.2026.14735","DOIUrl":"https://doi.org/10.4081/aiua.2026.14735","url":null,"abstract":"<p><strong>Introduction: </strong>Male infertility is a rising problem globally with male factors contributing up to 50% of all couple infertility cases. The sperm quality decline raises serious concerns regarding future population sustainability and male reproductive health. Adipose-derived mesenchymal stem cell (AdMSC) secretome, defined as a cell-free product comprising paracrine factors secreted by these cells, has emerged as a promising cell-free regenerative therapy for testicular injury, offering advantages of accessibility and therapeutic potential. This systematic review aimed to evaluate the effectiveness of AdMSC secretome in chemically induced testicular injury models.</p><p><strong>Methods: </strong>A systematic literature search was conducted across four electronic databases (PubMed, Google Scholar, OVID and Cochrane) covering publications from 2015 to 2025. Preclinical studies investigating the therapeutic effects of AdMSC secretome in murine models of chemically induced testicular injury were included.</p><p><strong>Results: </strong>Three preclinical studies utilizing male murine models were analysed. Testicular injury was induced using busulfan, doxorubicin or acrylamide. AdMSC secretome was administered via intra-testicular injection (n=2) and intravenous injection (n=1). All studies demonstrated partial regeneration of seminiferous tubule in secretome-treated groups compared with controls. Two studies reported reduced cellular apoptosis using TUNEL assay and acridine orange staining. An increase in Leydig cell numbers was observed following secretome treatment, while Sertoli cells remained unchanged. One study identified vascular endothelial growth factor (VEGF) as a key paracrine mediator, with anti-VEGF intervention abolishing the therapeutic effect. Testosterone levels were consistently higher in secretome-treated groups compared to those receiving AdMSC transplantation.</p><p><strong>Conclusions: </strong>AdMSC secretome demonstrates therapeutic potential in chemically-induced testicular injury by promoting seminiferous tubule regeneration, reducing apoptosis, and enhancing Leydig cell recovery, with VEGF playing a critical mechanistic role. These findings support the potential AdMSC secretome as a cell-free regenerative approach for male infertility.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"98 1","pages":"14735"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582506","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":"Diagnostic performance and cost-effectiveness of portable digital pH meters and traditional dipsticks for urine pH monitoring in patients at risk of recurrent urolithiasis.","authors":"Juan Antonio Galán, Athanasios Papatsoris, Guzmán Ordaz, Bernat Isern","doi":"10.4081/aiua.2026.14746","DOIUrl":"https://doi.org/10.4081/aiua.2026.14746","url":null,"abstract":"<p><strong>Introduction: </strong>Urolithiasis affects up to 10% of the population and recurs in more than 50% of cases within ten years. Urinary pH plays a pivotal role in stone prevention, but dipstick testing, the most commonly used method, lacks accuracy, precision and reliability. Only portable digital pH meters classified as medical devices offer superior accuracy, sensitivity, specificity, and resolution, enabling more reliable urinary pH monitoring than dipstick testing. Nevertheless, their comparative cost-effectiveness remains unclear.  Methods: we conducted a systematic review and cost-effectiveness analysis comparing a portable digital pH meter with dipsticks for urinary pH monitoring in recurrent stone formers. Following PrIsMA 2020 guidelines, studies reporting on accuracy, precision, or costs were included. Data were pooled using random-effects models. Cost estimates were derived from the European market sources and adjusted for inflation. Outcomes included analytical validity, cost per effective unit, number needed to treat (NNT), and cost per quality-adjusted life-year (QALy) gained.</p><p><strong>Results: </strong>Thirteen studies involving 2,801 participants were included in the quantitative synthesis. The portable digital pH meter consistently outperformed dipsticks across all evaluated parameters, demonstrating higher explained variance (r2 0.97 vs 0.54), finer resolution (0.1 vs 0.5 pH units), and lower systematic bias (0.06 vs 0.36). The cost per effective unit was lowest for the portable digital pH meter (€ 179) compared with once-daily (€ 354) and twice-daily dipstick testing (€ 708). In compliance-adjusted models, the cost per lithiasis episode prevented was € 590 for the portable digital pH meter vs €1,169 and € 2.337 for dipsticks. In a simulated 1.,000-patient cohort, the portable digital pH meter yielded the lowest total costs (€ 601.376) and the greatest QALy gain (17.84), demonstrating a dominant result, being both more effective and less costly than all alternatives.</p><p><strong>Conclusions: </strong>The portable digital pH meter demonstrated superior analytical performance and cost-effectiveness compared with dipsticks for urinary pH monitoring. Its broader implementation may enhance preventive strategies, reduce stone recurrence, and decrease the overall healthcare burden associated with recurrent urolithiasis. Considering these findings, the portable digital pH meters may warrant consideration for inclusion in major clinical guidelines on urolithiasis and for reimbursement by healthcare systems, potentially supporting their broader adoption in clinical practice.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"98 1","pages":"14746"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582569","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":"Epidemiology of urolithiasis: between big data and field research.","authors":"Alberto Trinchieri","doi":"10.4081/aiua.2026.15172","DOIUrl":"https://doi.org/10.4081/aiua.2026.15172","url":null,"abstract":"<p><p>The combined analysis of Global Burden od Disease (GBD) data and traditional systematic reviews still appears to be the preferable approach for studying the epidemiology of urolithiasis, pending the resolution of the critical issues of GBD studies regarding the reliability and completeness of their sources, possible biases in data collection and data modeling.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"98 1","pages":"15172"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582572","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}