The Canadian journal of urology最新文献

{"title":"Bladder cancer patients hospitalized in a medicine ward including three fuo cases following bacillus calmette-guérin immunotherapy.","authors":"George Liatsos, Kalliopi Zioutou, Konstantinos Avramidis, Konstantinos Vamvakaris, Maria Potamiti-Komi, Dimitrios Vassilopoulos","doi":"10.32604/cju.2026.072711","DOIUrl":"10.32604/cju.2026.072711","url":null,"abstract":"<p><strong>Objectives: </strong>Bladder cancer (BC) is a prevalent malignancy with evolving treatment strategies and an increasingly aging patient population, resulting in a growing and complex burden of hospitalizations that extends beyond urological care and remains insufficiently characterized in real-world Internal Medicine settings. This study aimed to analyze the clinical data and outcomes for patients with BC admitted to the medicine ward. Additionally, this research presents three cases of fever of unknown origin, which all exhibited identical clinical and laboratory findings but ultimately resulted in different disease diagnoses.</p><p><strong>Methods: </strong>This retrospective case-series study included all adult patients with BC admitted to the Internal Medicine ward of a tertiary referral hospital between 1 January 2020, and 31 December 2024. Data acquisition was performed through a systematic search of electronic discharge records using the ICD-10 code C67. Data recording involved detailed review of electronic medical records to collect demographic characteristics, clinical history, cancer-related treatments, causes of hospitalization, and outcomes. Three patients previously treated with intravesical Bacillus Calmette-Guérin (iBCG) who presented with fever of unknown origin were analyzed in detail. Data analysis comprised descriptive statistics and comparative testing using Fisher's exact test and unpaired two-tailed Student's t-test, with p < 0.05 considered statistically significant.</p><p><strong>Results: </strong>We identified 77 hospitalizations among 67 BC patients who were predominantly male, with a mean age of 75.2. A high prevalence of metabolic syndrome comorbidities and chronic obstructive pulmonary disease was documented. In addition, 31.1% of patients had metastatic BC, 22.9% had a second malignancy, 49.2% had undergone urological surgeries, and 38% had received chemotherapy or immunotherapy other than iBCG. The most common causes of hospitalization were infections, anemia/transfusions, a newly diagnosed metastatic disease, and acute renal failure. The mortality in this cohort was high (17%), with the leading cause of death again being an infection. Among patients who had previously received BCG immunotherapy, three cases of fever of unknown origin were noticed, and despite identical clinical settings, they were identified with different diseases [metastatic disease, infection caused by Bacillus Calmette-Guérin (BCGitis), and Hodgkin's lymphoma], necessitating individualized therapeutic medications.</p><p><strong>Conclusions: </strong>BC patients in the Internal Medicine unit are generally older adults, often dealing with several chronic conditions and a considerable cancer burden. They are predominantly admitted due to infections, which points to the urgent need for effective infection prevention strategies for this vulnerable population. When BC patients have a fever lasting more than seven days following BCG instill","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"349-360"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848858","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":"Effectiveness and safety of external physical vibration lithecbole for upper urinary stone expulsion: a systematic review and meta-analysis.","authors":"Yifan Huang, Bingzhi Han, Zikai Huang, Qianhao Huang, Tao Wang, Yuedong Chen","doi":"10.32604/cju.2026.070466","DOIUrl":"10.32604/cju.2026.070466","url":null,"abstract":"<p><strong>Objectives: </strong>The external physical vibration lithecbole (EPVL) is a new device. It is clinically employed to improve the stone-free rate (SFR). However, it is not widely accepted in clinical practice due to the lack of high-level evidentiary support and a standard protocol. This study aimed to evaluate the effectiveness and safety of external physical vibration lithecbole (EPVL) as an adjunct to extracorporeal shock wave lithotripsy (ESWL) or retrograde intrarenal surgery (RIRS) for upper urinary tract stones.</p><p><strong>Methods: </strong>We systematically searched PubMed, Web of Science, Embase, the China National Knowledge Infrastructure (CNKI), and the Cochrane Library from inception to 13 January 2026, for randomized controlled trials (RCTs) comparing EPVL plus standard care with standard care alone, and we pooled relative risks (RR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Nine RCTs involving 1418 patients were analyzed. Compared with standard care alone, EPVL significantly increased early stone-free rates at about 1 week (RR 1.44, 95% CI 1.18-1.77, p < 0.001) and 2 weeks (RR 1.40, 95% CI 1.20-1.63, p < 0.001) after ESWL or RIRS, with greater benefit for lower-pole (RR 1.56, 95% CI 1.25-1.96, p < 0.001) and renal pelvic stones (RR 1.54, 95% CI 1.10-2.14, p = 0.01). EPVL was associated with a lower rate of overall complications (RR 0.58, 95% CI 0.46-0.73, p < 0.001); specifically, it was linked to lower risks of hematuria (RR 0.64, 95% CI 0.48-0.86, p = 0.002) and urinary tract infection-related findings (RR 0.28, 95% CI 0.14-0.57, p < 0.001).</p><p><strong>Conclusions: </strong>Adjunctive EPVL improves short-term stone clearance after ESWL or RIRS without adding measurable risk and may also be associated with a reduced incidence of complications. Where available, EPVL can be considered as a non-invasive option to enhance fragment clearance, particularly for lower-pole renal stones. Further multicenter trials are needed to confirm long-term outcomes and generalizability.</p><p><strong>Trial registration: </strong>PROSPERO CRD42024600537.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"309-323"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848849","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":"Barriers to urologic care following spinal cord injury.","authors":"Mark W Shilling, Shawn L Fernandez, George J Ryan, Juila G Kim, David C Majure, Frances M Alba, Reza Ehsanian","doi":"10.32604/cju.2025.070606","DOIUrl":"10.32604/cju.2025.070606","url":null,"abstract":"<p><strong>Background: </strong>Individuals with spinal cord injury (SCI) are at high risk for developing neurogenic bladder or neurogenic lower urinary tract dysfunction (NLUTD), which can lead to severe complications and negatively impact quality of life. Despite the critical need for timely urologic care, barriers to access remain poorly understood, particularly in resource-limited settings. This study aims to identify systemic and perceived barriers to urologic follow-up for individuals with SCI treated at an academic medical center.</p><p><strong>Methods: </strong>A single-center, observational study was conducted on individuals presenting with a diagnosis code indicative of complete SCI at an academic hospital between October 2015 and October 2023. Data were extracted from electronic medical records using ICD-10 codes for SCI, and phone interviews were conducted to assess symptoms, quality of life, and perceived barriers to care. Descriptive statistics summarized the findings. Univariate and multivariate Firth logistic regression analyses were performed to analyze for possible covariates impacting the odds of follow-up or having obtained a urodynamics study.</p><p><strong>Results: </strong>Of 213 records, 136 met the inclusion criteria. Among them, only 17 (13%) received a urology consultation during their hospital stay, and 28 (21%) had been seen in a urology clinic post-injury. Phone interviews with 42 patients revealed that 93% reported NLUTD symptoms, with a mean quality of life impact score of 7.3. Barriers identified included availability (71%), accessibility (45%), accommodation (69%), affordability (43%), and acceptability (31%) barriers. Firth logistic regression demonstrated that male sex was associated with lower odds (OR = 0.205, 95% CI: 0.048, 0.772, p = 0.02) of having obtained a urodynamics study.</p><p><strong>Conclusion: </strong>Significant gaps in urologic care for individuals with SCI exist. Statistically significant variation in management via Firth logistic regression analyses also demonstrates potential disparities in follow-up and management. Addressing these challenges requires improved discharge planning, increased healthcare accessibility, and innovative care models such as telemedicine. Future research should explore broader geographic regions and interventions to improve outcomes.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"427-440"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating pain management strategies following hypospadias repair: a survey of pediatric urologists.","authors":"Jaisa Kaufmann, Max Bouvette, Abdul Qadar, Dominic Frimberger, Adam Rensing, Bhalaajee Meenakshi-Sundaram","doi":"10.32604/cju.2026.074190","DOIUrl":"10.32604/cju.2026.074190","url":null,"abstract":"<p><strong>Background: </strong>Pediatric opioid use has been associated with serious adverse effects, including persistent use and overdose. Recent studies have shown that opioid needs may be minimal following outpatient pediatric urologic surgery. Post-operative pain regimens following pediatric penile surgery are not standardized. This study aimed to identify current opioid prescribing practices following hypospadias repair.</p><p><strong>Methods: </strong>An online survey was administered to members of the Societies for Pediatric Urology, including eight questions surrounding physician demographics, hypospadias repair case volume, attitudes regarding opioid prescription in pediatric urology, and post-operative pain regimens. Responses were stratified for analysis.</p><p><strong>Results: </strong>A total of 88 of 350 members responded to the survey, achieving a response rate of 25%. Most respondents practiced in an academic setting (73%) and had a case volume between 0-50 hypospadias repairs annually (76%). Only 26% of respondents reported using a standardized post-operative pain regimen following hypospadias repair. Respondents with higher case volumes were less likely to prescribe opioids. Following hypospadias repair, 61% of respondents reported regularly prescribing opioids, while 58% felt opioids are overprescribed following pediatric urologic procedures.</p><p><strong>Conclusions: </strong>This study demonstrates wide variability in opioid prescribing patterns and attitudes among pediatric urologists. Despite growing evidence that opioids may not be necessary following pediatric urologic surgery, over half of pediatric urologists regularly prescribe opioids following hypospadias repair. Additionally, over half of the respondents believe opioids are over-prescribed. These findings represent an opportunity to improve opioid stewardship, which is meaningful given the ongoing opioid crisis. This demonstrates the need for evidence-based pain management guidelines following hypospadias repair.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"451-457"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848911","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":"Overweight status predicts improved overall survival after radical nephroureterectomy for upper tract urothelial carcinoma.","authors":"Shu-Yu Wu, Ching-Chia Li, Wen-Jeng Wu, Kuan-Hua Huang, Chien-Liang Liu, Shian-Shiang Wang, Jian-Ri Li, Han-Yu Weng, Ta-Yao Tai, Pi-Che Chen, Ian-Seng Cheong, Chung-You Tsai, Pai-Yu Cheng, Jian-Hua Hong, Chung-Hsin Chen, Jen-Shu Tseng, Wun-Rong Lin, Yuan-Hong Jiang, Yu-Khun Lee, Po-Hung Lin, See-Tong Pang, Yung-Tai Chen, Wei-Chieh Chen, Chia-Chang Wu, Thomas Y Hsueh, Hsu-Che Huang, Wei-Yu Lin, Chia-Cheng Yu, Jen-Kai Fang, Chih-Chin Yu, Yao-Chou Tsai","doi":"10.32604/cju.2025.069390","DOIUrl":"10.32604/cju.2025.069390","url":null,"abstract":"<p><strong>Introduction: </strong>Upper urinary tract urothelial carcinoma (UTUC) is a rare malignancy, particularly in the ureter, and is associated with high rates of recurrence and metastasis. Although body mass index (BMI) has been associated with prognosis in multiple cancer types, its role as a predictive factor in UTUC is still debated. This study aimed to investigate how BMI influences survival outcomes in patients with UTUC treated with radical nephroureterectomy (RNU).</p><p><strong>Methods: </strong>This multi-center retrospective analysis by the Taiwan UTUC Collaboration Group involved 2503 patients who underwent treatment across 19 hospitals from 1988 to 2022. Patients were categorized into normal (18.5 ≤ BMI < 24), overweight (24 ≤ BMI < 27), and obese (BMI ≥ 27) groups. Demographic, clinical, and pathological data were analyzed. Overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and intravesical recurrence-free survival (IVRFS) were assessed using Kaplan-Meier analysis and Cox proportional hazards models.</p><p><strong>Results: </strong>The median follow-up period was 44.2 months. In multivariable analysis, overweight patients demonstrated significantly better OS compared with normal-weight patients (p = 0.033), and the obesity group showed a favorable, though not statistically significant, trend toward better OS. However, BMI was not an independent predictor of CSS, DFS, or IVRFS. Independent predictors of worse outcomes included older age, end-stage renal disease, ureteral tumor location, tumor size ≥3 cm, and high-grade urothelial carcinoma. Tumor stage and grade were comparable across BMI groups.</p><p><strong>Conclusions: </strong>Overweight status was associated with better OS in patients with UTUC treated with RNU, while BMI had no significant impact on CSS, DFS, or IVRFS. These findings suggest a potential protective effect of higher BMI on OS, warranting further investigation in prospective studies. However, BMI alone should not guide clinical decisions and may instead reflect broader patient health characteristics.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"325-337"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848901","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":"Observations of high variability in DNA fragmentation of epididymal sperm in men.","authors":"Manish Kuchakulla, Hriday P Bhambhvani, Robert Fisch, Runzhuo Ma, Jonathan Gal, Marc Goldstein","doi":"10.32604/cju.2025.071275","DOIUrl":"10.32604/cju.2025.071275","url":null,"abstract":"<p><strong>Objectives: </strong>Men with obstructive azoospermia (OA) or infertility often require surgical sperm retrieval for assisted reproductive techniques. While sperm can be successfully obtained from either the testis or epididymis in these patients, sperm DNA integrity may differ between retrieval sites, which could influence reproductive outcomes. This study aimed to determine whether bilateral epididymal and/or testicular sperm extraction is necessary in men with OA or infertility and elevated DNA fragmentation index (DFI).</p><p><strong>Methods: </strong>We retrospectively analyzed men who underwent bilateral testicular biopsy and/or microscopic epididymal sperm aspiration (MESA) by a single surgeon from 2020-2022. TUNEL assays were performed to assess DFI (normal ≤15%). The primary endpoint of the study was to evaluate the variability in DFI between the right and left testes/epididymis in men undergoing sperm extraction.</p><p><strong>Results: </strong>In total, 24 men met criteria to be included in this analysis who underwent sperm extraction with DFI analysis via MESA and/or testicular biopsy. Among patients with OA, testicular sperm demonstrated significantly lower DFI compared to epididymal sperm on both sides (right testis 9.52 vs. right epididymis 17.61, p = 0.01; left testis 9.22 vs. left epididymis 14.71, p = 0.04). For each individual patient with OA, the mean intra-patient difference in DFI between right and left epididymal sperm was significantly higher than the mean intra-patient difference in DFI between right and left testicular sperm (12.09% ± 6.58, compared to 2.27% ± 1.59, p < 0.001, respectively).</p><p><strong>Conclusion: </strong>Bilateral epididymal sperm extraction may be warranted in men with OA given the observed intra-patient variability in DNA fragmentation between epididymides. Conversely, bilateral testicular extraction may be unnecessary, as no significant difference in DNA fragmentation variability was observed between sperm retrieved from either testicle.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"441-449"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848855","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":"Penile fracture and concomitant severe urethral trauma-a case report and discussion of surgical approach.","authors":"Angelos Samaras, Stefan Aufderklamm, Bastian Amend, Viktoria Stühler, Arnulf Stenzl, Igor Tsaur, Steffen Rausch","doi":"10.32604/cju.2025.068588","DOIUrl":"10.32604/cju.2025.068588","url":null,"abstract":"<p><strong>Background: </strong>Penile fracture is a rare urological emergency, especially when it involves a urethral injury.</p><p><strong>Case description: </strong>Here, we report the case of a 41-year-old male patient with penile trauma during sexual intercourse, presenting with typical clinical signs of corpus cavernosum rupture and gross hematuria. Emergency surgical exploration revealed an additional partial urethral injury (approximately 1.5 cm in length), which was primarily closed. Surgical management included a vertical penoscrotal incision, evacuation of hematoma, double-layer re-approximation of the urethra, closure of the tunica albuginea, and placement of both transurethral and suprapubic catheters. The postoperative course was uneventful, with diazepam administered to suppress erections and full functional recovery at 6-month follow-up.</p><p><strong>Conclusion: </strong>This case highlights the importance of prompt diagnosis, a tailored surgical approach, and urinary diversion in the setting of urethral trauma.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"477-481"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848866","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":"Transperineal approach for penetrating injury of corpus spongiosum and bulbous urethra caused by vesicourethral foreign body: a case report.","authors":"Kazuki Yanagida, Daisuke Watanabe, Hazuki Inoue, Takashi Ujiie, Akio Mizushima","doi":"10.32604/cju.2025.068677","DOIUrl":"10.32604/cju.2025.068677","url":null,"abstract":"<p><strong>Background: </strong>Vesicourethral foreign bodies are frequently encountered in urological emergency departments; however, cases of penetrating injury to the corpus spongiosum penis and bulbous urethra are rare.</p><p><strong>Case description: </strong>A 64-year-old man presented with difficulty removing a foreign body that he had inserted into his urethra for masturbation. Abdominal computed tomography (CT) revealed a rod-shaped foreign body lodged from the bulbous urethra to the posterior wall of the bladder. Cystoscopy confirmed penetration of the foreign body into the urethral sponge at the bulbous urethra. An attempt was made to remove the foreign body transurethrally, but it was unsuccessful, leading to the establishment of a cystostomy and subsequent hospitalization. Under general anesthesia, the foreign object was removed through a perineal incision, revealing a bamboo skewer with an attached rubber tube. No postoperative complications were noted. Urethrography performed six months postoperatively showed no urethral stricture, and the patient established spontaneous urination without erectile or ejaculatory dysfunction.</p><p><strong>Conclusions: </strong>In cases of penetrating urethral injury, where the wound is often sharp, perineal surgery should be considered on par with the transurethral approach, as it does not affect the patient's postoperative quality of life if infection complications are monitored carefully.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"483-487"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848926","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":"Management of retained bullet fragments from posterior urethra after gunshot wound: a case report.","authors":"Sarah M Kodres-O'Brien, Mackenzie Koellermeier, Nayan Shah, Peter Langenstroer","doi":"10.32604/cju.2025.069550","DOIUrl":"10.32604/cju.2025.069550","url":null,"abstract":"<p><strong>Background: </strong>Retained bullet fragments in the genitourinary tract following gunshot wound is rare and require removal.</p><p><strong>Case description: </strong>We present the case of a retained bullet in the prostate following a gunshot wound to the pelvis, which was endoscopically removed. A urethral catheter and suprapubic tube were placed. The patient then had migration of a second bullet fragment into the prostatic urethra six weeks later, requiring open removal.</p><p><strong>Conclusions: </strong>This case shows that several approaches can be considered to remove retained bullet fragments from the urinary tract. Furthermore, access to the bladder via a suprapubic tube can be beneficial.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"471-476"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848877","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":"Nonlinear association between estimated glucose disposal rate and kidney stones: a cross-sectional study.","authors":"Zhenzhen Yang, Linxin Jiang, Shan Yin","doi":"10.32604/cju.2025.069717","DOIUrl":"10.32604/cju.2025.069717","url":null,"abstract":"<p><strong>Objectives: </strong>Kidney stone disease is increasingly prevalent and may be linked to metabolic factors such as insulin resistance, but there is currently no direct evidence connecting estimated glucose disposal rate (eGDR) to kidney stones. This study aimed to investigate the relationship between eGDR and kidney stone prevalence.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2007-2018, including 29,753 participants aged 20 years and older. Weighted multivariable logistic regression and nonlinear models were employed to assess the relationship between eGDR and self-reported kidney stone history.</p><p><strong>Results: </strong>Among participants, 9.90% reported having kidney stones. Multivariable analysis revealed that higher eGDR values were associated with decreased odds of kidney stones (odds ratio [OR] = 0.92, 95% CI: 0.89-0.94). Participants in the highest eGDR tertile demonstrated approximately half the odds of kidney stones compared to those in the lowest tertile (adjusted OR = 0.52, 95% CI: 0.43-0.64). Nonlinear analysis identified a threshold effect at eGDR = 7.95, with significant inverse associations only observed above this threshold (OR = 0.81, 95% CI: 0.71-0.92).</p><p><strong>Conclusions: </strong>This study identifies a nonlinear relationship between eGDR and kidney stones, with a threshold effect at eGDR = 7.95. The inverse association was significant only when eGDR exceeded this threshold, suggesting the potential utility of eGDR as a clinical indicator for kidney stone risk assessment. Prospective studies are needed to establish causal relationships.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"261-270"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848891","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}