Archivos Espanoles De Urologia最新文献

{"title":"Comprehensive Management of Complex and Refractory Urolithiasis: Minimally Invasive Techniques, Perioperative Optimisation, and Recurrence Prevention.","authors":"Yibo Chen, Haote Chen, Xinpei Wu, Jingyu Zhu","doi":"10.56434/j.arch.esp.urol.aeu015","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu015","url":null,"abstract":"<p><strong>Background: </strong>Complex and refractory urolithiasis represents a growing clinical challenge, characterised by a large stone burden, recurrent disease, anatomical abnormalities, infection, and metabolic risk factors, all of which complicate management and increase morbidity. Contemporary management has shifted toward risk-stratified, minimally invasive strategies supported by advances in endourology, perioperative optimisation, and individualised patient assessment. To synthesise current evidence on the diagnostic evaluation, risk stratification, minimally invasive management, perioperative optimisation, special population management, and emerging techniques relevant to complex and refractory urolithiasis.</p><p><strong>Methods: </strong>A structured narrative review of the published literature and contemporary guideline recommendations was conducted, focusing on comparative outcomes of extracorporeal shock wave lithotripsy (ESWL), ureteroscopy (URS), percutaneous nephrolithotomy (PCNL), and endoscopic combined intrarenal surgery (ECIRS), along with perioperative care principles and technological innovations. Evidence from recent clinical studies, systematic reviews, and international guidelines was synthesised qualitatively.</p><p><strong>Results: </strong>ESWL retains a limited role in carefully selected low-complexity stones, whereas URS provides effective management for ureteric and moderate sized renal calculi. PCNL-based approaches demonstrate the highest stone-free rates for stones >20 mm, staghorn calculi, and anatomically complex disease, with miniaturised techniques and ECIRS offering potential morbidity reduction in selected cases. This review integrates surgical, perioperative, and preventive strategies into a unified clinical framework for high-risk stone disease. Outcomes are strongly influenced by perioperative infection control, metabolic optimisation, anticoagulation management, and structured postoperative surveillance. Management of special populations including patients with a solitary kidney, chronic kidney disease (CKD), paediatric patients, pregnant women, anatomical abnormalities, and those receiving anticoagulant therapy, requires individualised multidisciplinary care. Emerging technologies such as artificial intelligence-assisted imaging, augmented-reality guidance, single-use URS, and advanced laser technologies remain promising but investigational due to limited prospective evidence.</p><p><strong>Conclusions: </strong>Optimal management of complex and refractory urolithiasis depends on accurate risk stratification, appropriate selection among minimally invasive modalities, comprehensive perioperative optimisation, and individualised care in vulnerable populations. Future progress requires prospective comparative studies, standardised outcome reporting, and patient-centred evaluation of emerging technologies to ensure evidence-based improvement in long-term renal outcomes and quality of life.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1102-1114"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Stone-Free Rates and Systemic Inflammatory Response Between Intelligent Pressure-Controlled and Conventional Mini-Percutaneous Nephrolithotomy in Patients With Kidney Stones.","authors":"Lei Wang, Zhe Xu, Zhao Wang, Jingyu Gao","doi":"10.56434/j.arch.esp.urol.aeu016","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu016","url":null,"abstract":"<p><strong>Background: </strong>Elevated intrarenal pressure during mini-percutaneous nephrolithotomy (mini-PCNL) may worsen systemic inflammation and affect stone clearance. This study compared stone-free rates and incidence of systemic inflammatory response syndrome (SIRS) between intelligent pressure-controlled and conventional mini-PCNL after propensity score matching (PSM).</p><p><strong>Methods: </strong>This retrospective cohort study included patients undergoing primary mini-PCNL for kidney stones (April 2022-April 2025). After PSM, patients were divided into a conventional mini-PCNL group (n = 136) and an intelligent pressure-controlled group (n = 136). Primary outcomes included stone-free rates (residual fragments <4 mm) at postoperative day 1, month 1, and month 3, and SIRS incidence. Secondary outcomes included operative time, blood loss, hospital stay, pain scores, inflammatory markers, and complications.</p><p><strong>Results: </strong>The intelligent pressure-controlled group had a significantly higher immediate stone-free rate (<i>p</i> < 0.001), lower SIRS incidence (<i>p</i> = 0.040), shorter operative time (<i>p</i> = 0.006), less blood loss (<i>p</i> = 0.002), shorter hospital stay (<i>p</i> = 0.022), lower pain scores (<i>p</i> = 0.008), and lower postoperative C-reactive protein and procalcitonin levels (all <i>p</i> < 0.001). Total complication rate was lower in the intelligent pressure-controlled group than in the conventional group (11.76% vs. 25.00%, <i>p</i> = 0.005).</p><p><strong>Conclusions: </strong>Intelligent pressure-controlled mini-PCNL was associated with higher immediate stone-free rates, lower SIRS incidence, and better perioperative outcomes than conventional mini-PCNL in this retrospective matched comparison. Causality cannot be inferred due to the retrospective, non-randomised design. Findings warrant confirmation in prospective randomised trials.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1222-1230"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application of WeChat Platform-Integrated Continuous Nursing Care in Patients Discharged With a Single-J Stent Following Radical Cystectomy.","authors":"Mengling Hu, Hanxiao Zhang","doi":"10.56434/j.arch.esp.urol.aeu009","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu009","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to explore the effectiveness of a WeChat-based continuous nursing programme for patients discharged with a single-J stent after radical cystectomy.</p><p><strong>Methods: </strong>In this retrospective study (October 2021-August 2023), 100 patients were selected via propensity score matching, with 50 patients in each group. The convention group received standard urological nursing care and regular telephone follow-ups. The continuous nursing group received additional structured care via a WeChat integrated care platform based on the convention group. The two groups were compared at baseline and at 3 and 6 months post-discharge regarding self-management, complications, satisfaction, psychological status and quality of life. Additionally, the following were evaluated: renal function (serum creatinine, blood urea nitrogen and estimated glomerular filtration rate (eGFR)); stent removal outcomes (on-time completion and patency); readmission rates; and specialist-classified complications.</p><p><strong>Results: </strong>At 3 and 6 months post-discharge, the continuous nursing group showed significantly higher self-management (111.92 ± 5.40/127.20 ± 4.99 vs. 107.40 ± 3.76/121.08 ± 4.62) and quality of life scores (72.58 ± 4.78/80.22 ± 5.10 vs. 68.72 ± 4.51/73.40 ± 4.85), as well as lower anxiety/depression levels than the convention group (all <i>p</i> < 0.05). The continuous nursing group also showed superior renal function (lower serum creatinine/blood urea nitrogen, and a higher eGFR), better stent outcomes (on-time removal: 92.0% vs. 70.0%; patency: 96.0% vs. 78.0%), fewer symptoms of urinary irritation (10.0% vs. 32.0%), lower readmission rates (8.0% vs. 26.0%), and fewer complications (22.0%/10.0% vs. 42.0%/28.0%) (all <i>p</i> < 0.05). Nursing satisfaction was also significantly higher in the continuous nursing group.</p><p><strong>Conclusions: </strong>In this single-centre retrospective cohort study, WeChat-based continuous nursing care was associated with improved self-management and quality of life, as well as lower complication rates in selected patients with single-J stents. This study used WeChat exclusively as the nursing protocol platform. The applicability of this nursing model to other mobile health tools remains hypothetical and requires future research. Causal inferences cannot be drawn due to study design limitations.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1179-1190"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the Prevention and Nursing Care of Postoperative Complications After Benign Prostatic Hyperplasia Surgery.","authors":"Wen Gao, Xiaomin Yue, Gui Wang","doi":"10.56434/j.arch.esp.urol.aeu018","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu018","url":null,"abstract":"<p><p>Benign prostatic hyperplasia (BPH) is a common disease among middle‑aged and older men worldwide and tends to progress over time. For patients with severe BPH, surgery is still the main treatment and is generally considered the most definitive option. With the growing use of various surgical techniques, such as transurethral resection of the prostate (TURP) and laser enucleation, the prevention and management of postoperative complications have become key determinants of patient outcomes. This narrative review aimed to explore the mechanisms and risk factors for common complications after BPH surgery, including bleeding, urinary incontinence, urethral stricture, bladder neck contracture (BNC), urinary tract infection (UTI), and deep vein thrombosis (DVT). Furthermore, prevention strategies and nursing interventions are summarised from two perspectives. Current evidence suggests that the nursing approach has shifted from simply monitoring for problems to active prevention. Going forward, precision nursing based on risk assessment, evidence‑based practice, and smart healthcare technologies represents an important direction for postoperative care in BPH. Future efforts should focus on integrating preoperative prehabilitation, meticulous intraoperative management, dynamic postoperative management, and remote follow-up into a comprehensive nursing pathway, while conducting multicentre studies to validity its clinical value.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1091-1101"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Diagnostic Performance of Two-Dimensional Ultrasound and Colour Doppler Ultrasound and Associated Sonographic Features in Ureteral Stones of Different Diameters.","authors":"Linghong Yu, Wanyan Li, Jian Zhou","doi":"10.56434/j.arch.esp.urol.aeu017","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu017","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the diagnostic performance of two-dimensional ultrasound (2D-US) and colour Doppler flow imaging (CDFI) for ureteral stones of different diameters, and to analyse CDFI-associated sonographic features.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 150 patients with suspected ureteral stones who were admitted to the urology department of our hospital between January 2022 and December 2025. All patients underwent both 2D-US and CDFI examination, with non-contrast computed tomography (NCCT) as the gold standard. The overall diagnostic performance of the two ultrasound modalities was compared, including the detection rate and CDFI-associated sonographic features of stones of different diameters. In addition, the correlation between stone diameter, twinkling artifact intensity, and ureteral jet abnormalities were analysed.</p><p><strong>Results: </strong>Among 150 suspected patients, 104 were diagnosed with ureteral stones by NCCT, and 46 were negative. The 104 stone-positive patients were classified into small-diameter (<6 mm), medium-diameter (6-8 mm), and large-diameter (>8 mm) stone groups. CDFI improved paired diagnostic accuracy by 14.0 percentage points (95% confidence interval, 6.6-21.4; exact McNemar <i>p</i> < 0.001). Detection rate of CDFI was higher for stones <6 mm (95.83% vs 62.50%, <i>p</i> = 0.008) and 6-8 mm (87.88% vs 72.73%, <i>p</i> = 0.002), whereas no difference was observed for stones >8 mm (92.86% vs 100.00%, <i>p</i> = 1.000). Twinkling artifact intensity (H = 12.428, <i>p</i> = 0.002) and ureteral jet abnormalities (H = 9.877, <i>p</i> = 0.007) differed among the three stone-diameter groups. Maximum stone diameter correlated positively with twinkling artifact intensity (Spearman r = 0.582, <i>p</i> < 0.001) and ureteral jet abnormalities (r = 0.543, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>CDFI has advantages over 2D-US in diagnosing ureteral stones, especially for small-diameter stones. Twinkling artifact intensity and abnormal ureteral jet signals at the ureteral orifice are closely associated with stone diameter and can serve as important auxiliary indicators for diagnosing ureteral stones of different diameters.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1231-1239"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversion From Cutaneous Ureterostomy to Ileal Conduit in Frail Patients: A Descriptive Case Series.","authors":"Fernando Korkes, Miellio Galdino, Henrique Bürger, Daisy Archila, José Henrique Santiago, Matheus Cardoso Morrone, Matheus Marino, João Ishida","doi":"10.56434/j.arch.esp.urol.aeu014","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu014","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous ureterostomy is frequently selected for frail patients undergoing radical cystectomy due to its reduced operative complexity. However, long-term complications such as urinary tract infections (UTIs), stomal stenosis, and catheter dependence are common. Delayed conversion to ileal conduit has been proposed as a reconstructive strategy after clinical stabilization.</p><p><strong>Case presentation: </strong>Five frail patients underwent radical cystectomy with cutaneous ureterostomy followed by delayed conversion to ileal conduit. Conversion occurred 10-36 months later due to recurrent complications or improvement in clinical status. Postoperative complications occurred in four patients (80%), including UTIs requiring antibiotics (Clavien-Dindo II), urinary fistula (Clavien-Dindo I), and ureteroileal stricture requiring surgical revision (Clavien-Dindo IIIb).</p><p><strong>Conclusions: </strong>Delayed conversion is feasible but is associated with significant morbidity and should remain individualized.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1264-1268"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structured Bladder Function Training Added to Usual Glycaemic Management for Preventing Urinary Tract Infection in Patients With Type 2 Diabetes Mellitus and Neurogenic Bladder: A Retrospective Study.","authors":"Zhonghao Lin, Xueyun Chen, Yanhua Zheng, Huiqing Ruan","doi":"10.56434/j.arch.esp.urol.aeu005","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu005","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effects of adding structured bladder function training to usual glycaemic and urological management on urinary tract infection (UTI) in patients with type 2 diabetes mellitus (T2DM) and neurogenic bladder.</p><p><strong>Methods: </strong>This retrospective cohort study included 97 patients treated between April 2022 and April 2025. According to documented management pathways, patients received either usual care (usual glycaemic and urological care) alone (n = 47) or usual care plus structured bladder function training (n = 50) and were followed for 6 months. Glycaemic indices [fasting plasma glucose (FPG), 2-hour plasma glucose (2h PG), glycated hemoglobin A1c (HbA1c)], post-void residual urine volume (PVR), urodynamic parameters (Q_max, Q_ave, voided volume), and recurrent symptomatic UTI were analysed.</p><p><strong>Results: </strong>Both groups showed significant improvements in glycaemic indices over time. Because glycaemic management was similar between groups, glycaemic results were interpreted as reflecting routine diabetes care rather than the effect of bladder function training. PVR decreased significantly, with significant group, time, and interaction effects (all <i>p</i> < 0.001), and remained lower in the bladder function training group during follow-up. Urodynamic parameters improved in both groups, with greater improvements in the bladder function training group. The cumulative recurrent symptomatic UTI rate was significantly lower in the bladder function training group (8.00% vs. 25.53%, <i>p</i> = 0.008).</p><p><strong>Conclusions: </strong>In this retrospective cohort, adding structured bladder function training to usual glycaemic and urological management was associated with improved voiding function and reduced UTI in patients with T2DM and neurogenic bladder.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1171-1178"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparisons of Clinical Outcomes Between the Three-Lobe and Two-Lobe Techniques in Holmium Laser Enucleation of the Prostate for Elderly Patients With Benign Prostatic Hyperplasia.","authors":"Fuchen Xie, Huizhen Li, Peng Li, Xuedong Chen","doi":"10.56434/j.arch.esp.urol.aeu021","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu021","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical outcomes and urodynamic parameters of the three-lobe and two-lobe techniques of holmium laser enucleation of the prostate (HoLEP) in elderly patients with benign prostatic hyperplasia (BPH).</p><p><strong>Methods: </strong>This retrospective study included 150 elderly patients with BPH admitted to Lishui People's Hospital between May 2021 and May 2025. Patients were divided into a control group (three-lobe technique, n = 72) and an observation group (two-lobe technique, n = 78) according to different surgical techniques. Baseline characteristics, perioperative outcomes, urodynamic parameters, health economics indicators (total hospitalisation cost and material cost), and complication rates were compared between the two groups. Univariate and multivariate linear regression analysis were used to adjust for confounding factors, including age, body mass index, preoperative prostate volume, comorbidities, and surgeon experience, and to evaluate the independent impact of the surgical technique on each outcome.</p><p><strong>Results: </strong>The observation group showed better results than the control group in terms of operation time, intraoperative blood loss, hospital stay, and resected prostate weight. At 6 months postoperatively, both groups showed significant improvements in International Prostate Symptom Score (IPSS) and Quality of Life (QoL) scores compared with preoperative values. The observation group showed better urodynamic parameters and a trend toward a lower complication rate, but there was no significant difference compared with the control group (<i>p</i> = 0.054). There was no significant difference in total hospitalisation costs and material costs between the two groups (<i>p</i> > 0.05). Multivariate linear regression analysis revealed that, after adjusting for confounding factors, the two-lobe technique was significantly superior to the three-lobe technique in terms of operation time, hospital stay, bladder compliance (BC), maximum cystometric capacity (BCC), and maximum urine flow rate (Q_max).</p><p><strong>Conclusions: </strong>Compared with the three-lobe technique, the two-lobe HoLEP technique has certain advantages in terms of operation time, hospital stay and postoperative urodynamic parameters when treating elderly BPH. There was no statistical significance in intraoperative blood loss and complication rate. Further verification is needed in the future.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1191-1198"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Risk Factors and Development of a Prediction Model for Postoperative Urinary Retention Following Radical Hysterectomy for Cervical Cancer Based on Preoperative Urodynamic Profiling.","authors":"Bo Li, Shuang Li, Zhanwang Tan, Xiaohua Lin","doi":"10.56434/j.arch.esp.urol.aeu006","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu006","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop and internally validate a risk prediction model for postoperative urinary retention (POUR) after radical hysterectomy for cervical cancer by integrating preoperative urodynamic parameters and clinical indicators.</p><p><strong>Methods: </strong>Clinical data of 295 patients with cervical cancer undergoing radical hysterectomy at our institution (July 2023-June 2025) were retrospectively analysed. Patients were assigned to a training cohort (n = 207) and an internal validation cohort (n = 88) at a ratio of 7:3. All underwent preoperative urodynamic examinations documenting first sensation of filling (FSF), maximum cystometric capacity (MCC), maximum flow rate (Q_max), detrusor pressure at Q_max (PdetQ_max), and bladder compliance (BC). In the training cohort, patients were divided into urinary retention and non-retention groups based on postoperative urinary retention status. Multivariate logistic regression identified influencing factors and developed a nomogram prediction model, whose performance was evaluated by receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curve.</p><p><strong>Results: </strong>The POUR group had a higher prevalence of diabetes and higher postvoid residual volume (PVR), but lower Q_max, FSF, MCC, BC, and PdetQ_max than the non-POUR group (all <i>p</i> < 0.05). Multivariate logistic regression identified diabetes history, Q_max, FSF, MCC, BC, PdetQ_max, and PVR as independent factors for POUR (<i>p</i> < 0.05). The nomogram achieved under the curves (AUCs) (95% confidence interval (CI)) of 0.901 (0.859-0.942) in the training cohort and 0.883 (0.804-0.931) in the validation cohort. DCA showed a positive net benefit across all thresholds, exceeding both default strategies. Internal validation revealed close alignment of the calibration curve with the ideal curve (Hosmer-Lemeshow χ² = 5.841, <i>p</i> = 0.557).</p><p><strong>Conclusions: </strong>A nomogram incorporating preoperative urodynamic parameters and clinical features was successfully developed and validated. This model demonstrated good discrimination, calibration, and clinical utility for predicting the risk of POUR following radical hysterectomy for cervical cancer. It may facilitate the early identification of high-risk patients and support personalized management strategies.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1162-1170"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Thulium Fibre Laser and Holmium:YAG Laser in Flexible Ureteroscopic Lithotripsy for 1-2 cm Lower Pole Kidney Stones.","authors":"Jiacheng Zhang, Jinguo Xiong, Zhonghao Zhao, Zhihua Cao","doi":"10.56434/j.arch.esp.urol.aeu020","DOIUrl":"https://doi.org/10.56434/j.arch.esp.urol.aeu020","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of thulium fibre laser (TFL) and holmium:yttrium aluminum garnet (Ho:YAG) laser in flexible ureteroscopic lithotripsy for 1-2 cm lower pole kidney stones.</p><p><strong>Methods: </strong>This retrospective analysis included 160 patients with 1-2 cm lower pole stones (LPSs) admitted to our hospital between January 2024 and December 2025. Patients were assigned to a TFL group and a Ho:YAG group according to the surgical technique used. After applying propensity score matching (PSM), two matched groups with 60 cases each were obtained. Outcome variables included surgery-related indicators, postoperative recovery indicators, stone-free rate (SFR), and postoperative complications.</p><p><strong>Results: </strong>The operation time, lithotripsy time, hospital stay, first ambulation time, and urethral catheter indwelling time in the TFL group were significantly shorter than those in the Ho:YAG group (all <i>p</i> < 0.05). The incidence of intraoperative stone retropulsion and the visual analogue scale (VAS) score at 24 h postoperatively were significantly lower in the TFL group than in the Ho:YAG group (both <i>p</i> < 0.05). At 4 weeks postoperatively, the SFR was significantly higher in the TFL group than in the Ho:YAG group (93.33% vs. 80.00%; <i>p</i> < 0.05), and the overall complication rate was significantly lower in the TFL group than in the Ho:YAG group (6.67% vs. 20.00%; <i>p</i> < 0.05). Stratified analysis showed that TFL was associated with shorter operation time and lithotripsy time across different stone sizes and densities. Furthermore, in patients with a diameter ≥1.5 cm, the SFR was higher in the TFL group than in the Ho:YAG group. The SFR in the Ho:YAG group was significantly lower in large-diameter stones than in small-diameter stones, whereas the TFL group showed consistently high SFR (>90%) across all subgroups.</p><p><strong>Conclusions: </strong>Compared with Ho:YAG laser, TFL was associated with better efficiency and perioperative outcomes in flexible ureteroscopic lithotripsy for 1-2 cm LPSs. TFL may provide more consistent fragmentation efficacy in larger stones and may reduce the risk of stone retropulsion and postoperative complications.</p>","PeriodicalId":48852,"journal":{"name":"Archivos Espanoles De Urologia","volume":"79 7","pages":"1207-1213"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}