Frontiers in urology最新文献

{"title":"Contrast-enhanced voiding urosonography - urodynamics in patients with neurogenic bladder dysfunction: a pilot study within pediatric urological practice.","authors":"Alexandra Wilke, Tina Hörz, Monica Pleul, Carola Hörz, Katrin Schuchardt, Guido Fitze, Christian Kruppa","doi":"10.3389/fruro.2026.1891758","DOIUrl":"10.3389/fruro.2026.1891758","url":null,"abstract":"<p><strong>Background: </strong>The progressive loss of kidney function is a major cause of morbidity and mortality in children with neurogenic bladder dysfunction. A consequent follow-up, including repeated urodynamics combined with detection of vesicoureteral reflux (VUR) is crucial for the individual treatment of the urinary tract. The aim of our study is to investigate whether contrast-enhanced voiding urosonography -urodynamics (ceVUS-UD) can be used in routine urological diagnostics. Due to its radiation-free nature in a more comfortable environment, this would allow the examination to be performed frequently enabling more accurate monitoring of bladder function.</p><p><strong>Methods: </strong>Since January 2025, 19 patients with neurogenic bladder dysfunction have undergone simultaneous ceVUS as part of urodynamic follow-up. The children were 11.4 years old on average (9 male, 10 female) and showed one of the following underlying conditions: spina bifida, detrusor hyperactivity after spinal cord injury, caudal regression syndrome, epispadias, infantile cerebral palsy or myotonic dystrophy type 1. Two-thirds of the patients performed self-intermittent catheterization.</p><p><strong>Results: </strong>CeVUS-UD can be safely performed as part of routine urodynamic testing without interfering with urological measurements. Previously unknown secondary VUR (sVUR) was detected in six patients (31.6%). In one case, a significant decrease of vesical pressure during the occurrence of reflux was observed. For five children, this led to a change in treatment .</p><p><strong>Conclusions: </strong>In this study, CeVUS-UD provides a feasible, safe and radiation-free tool for characterizing neurogenic bladder dysfunction. Whether ceVUS-UD can serve as an alternative to video urodynamics (VUD), and whether routine monitoring of sVUR translates into improved long-term kidney outcomes, remains to be established in further studies.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1891758"},"PeriodicalIF":1.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5-α-reductase inhibitors and the risk of suicide and neuropsychiatric symptoms: a meta-analysis of observational studies.","authors":"Federica Fraenza, Valerio Liguori, Ciro Pentella, Consiglia Riccardi, Francesca Futura Bernardi, Annalisa Capuano, Cristina Scavone","doi":"10.3389/fruro.2026.1881635","DOIUrl":"10.3389/fruro.2026.1881635","url":null,"abstract":"<p><strong>Introduction: </strong>5-alpha-reductase inhibitors (5-ARIs), such as finasteride and dutasteride, are effective in reducing prostate volume and urinary symptoms; however, these drugs are associated with specific adverse events, including suicidal ideation, anxiety, and self-harm.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of observational studies was conducted in PubMed, Embase and Web of Science on July 16, 2025, with no time restrictions. Studies involved individuals diagnosed with benign prostatic hyperplasia (BPH) or androgenetic alopecia (AGA), and experiencing suicide and neuropsychiatric events, including anxiety, depression and intentional self-harm (ISH) during the treatment with 5-ARIs. This study followed the PRISMA statement.</p><p><strong>Results: </strong>Eleven studies were included in the systematic review, of which nine were eligible for meta-analysis. Comparisons included 5-ARI users versus non-users or alpha-blocker users. Overall, no statistically significant differences were observed between groups (HR 1.07, 95% CI: 0.76-1.51), with substantial heterogeneity across studies (I² = 59%).</p><p><strong>Conclusion: </strong>This meta-analysis found no significant association between 5-ARIs and the risk of suicide or neuropsychiatric events in patients with benign prostatic hyperplasia or androgenetic alopecia. Nevertheless, given regulatory concerns regarding suicidal ideation, continued real-world monitoring through active surveillance and prospective observational studies remain warranted.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251106035, identifier CRD420251106035.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1881635"},"PeriodicalIF":1.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Efficacy and safety outcomes after slings or artificial urinary sphincter implantation for non-neurogenic male stress urinary incontinence: a systematic review' for more clarity.","authors":"Cyrille Guillot-Tantay, Sabrina de Cillis, Paolo Geretto, Luis Vale, Manuela Tutolo, Fabiana Cancrini, Véronique Phé, Nadir I Osman, Mikolaj Przydacz","doi":"10.3389/fruro.2026.1852334","DOIUrl":"https://doi.org/10.3389/fruro.2026.1852334","url":null,"abstract":"<p><strong>Introduction: </strong>Our objective was to conduct a systematic review of studies comparing male slings (MS) and Artificial Urinary Sphincter (AUS) in terms of efficacy and safety in men with Stress Urinary Incontinence (SUI).</p><p><strong>Methods: </strong>We conducted a systematic review including all studies comparing MS and AUS in adult men with SUI. All synthetic MS were included. The primary outcome was the postoperative continence rate defined as either no pad use or one safety pad.</p><p><strong>Results: </strong>Of 133 references screened, after exclusion of duplicates, 18 papers were eligible for a full-text analysis and 9 studies (5921 patients) were included in the qualitative synthesis. Among these, one was a randomized controlled trial and eight were cohort studies. The cure rate varied from 14% to 94% for the AUS and 11% to 69% for the MS. Of the five studies reported both devices, two (40%) reported a continence rate above 70% for AUS. Eight of the nine studies (88.9%) reported safety outcomes. Urethral erosion was less frequent after male slings than after artificial urinary sphincter implantation, whereas urinary retention was more frequent after male slings in most studies.</p><p><strong>Conclusion: </strong>In comparative studies, continence proportions were generally higher after artificial urinary sphincter implantation, while the complication profiles of the two devices differ, with more erosion after the sphincter and more urinary retention after the sling. Confidence in these findings is limited by clinical heterogeneity, confounding by indication and inconsistent outcome definitions. Standardised outcome reporting and randomised data are needed.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD42024539539.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1852334"},"PeriodicalIF":1.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized non-inferiority within-patient trial of density gradient processing of sequential ejaculates versus centrifugation-free sperm separation device for ICSI in men with elevated sperm DNA fragmentation- study protocol.","authors":"Vipin Chandra, Shashank Sanagoudar, Jayesh Shinde, Naval Shah, Isha Suwalka, Sandro C Esteves","doi":"10.3389/fruro.2026.1913330","DOIUrl":"https://doi.org/10.3389/fruro.2026.1913330","url":null,"abstract":"<p><strong>Background: </strong>Pathological sperm DNA fragmentation (SDF) has been associated with impaired fertilization, compromised embryo development, recurrent pregnancy loss, and lower pregnancy rates in assisted reproductive technology (ART). Two same-day strategies proposed to reduce SDF prior to <i>in vitro</i> fertilization/intracytoplasmic sperm injection (IVF/ICSI) are: (i) processing a second ejaculate obtained after a short abstinence interval using density gradient centrifugation (DGC), and (ii) selecting sperm from the first ejaculate using a centrifugation-free sperm separation device (CFSS). Although both approaches may enrich sperm populations with lower DNA damage, direct comparative evidence regarding reproductive outcomes remains limited.</p><p><strong>Methods and analysis: </strong>This prospective, multicenter, within-patient, sibling-oocyte randomized non-inferiority trial will be conducted at nine tertiary ART centers in India. Couples undergoing ICSI will be eligible if the male partner is aged 21-45 years with elevated SDF (DNA fragmentation index >20% by sperm chromatin dispersion assay within 90 days before enrollment) and the female partner is aged 21-35 years and expected to yield at least four metaphase II oocytes. On the day of oocyte retrieval, the first ejaculate collected after 2-3 days of abstinence will undergo processing using the LensHooke^® CA0 centrifugation-free sperm separation device, whereas a second ejaculate obtained 1-3 hours later will be processed using conventional DGC. Sibling metaphase II oocytes will be randomized 1:1 to ICSI using sperm from either intervention arm. Embryos will be cultured to the blastocyst stage and graded according to standardized criteria. If both arms generate at least one transferable blastocyst (≥3BB), the embryo selected for the first transfer will be randomized according to its arm of origin; otherwise, transfer will proceed using the available embryo(s) according to a predefined rescue strategy. The primary outcome is ongoing pregnancy rate at 12 weeks' gestation following transfer of an embryo originating from the randomized study arm. Secondary outcomes include post-processing SDF and sperm parameters, normal fertilization, blastocyst formation and quality, implantation, biochemical and clinical pregnancy. Non-inferiority of DGC processing of the second ejaculate compared with centrifugation-free sperm selection will be assessed using a predefined absolute non-inferiority margin of 10 percentage points.</p><p><strong>Ethics and dissemination: </strong>The study protocol has been approved by the institutional review boards of all participating centers. Written informed consent will be obtained from all participants. Study findings will be disseminated through peer-reviewed publications and scientific meetings.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/, identifier NCT07626359.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1913330"},"PeriodicalIF":1.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Reappearance of spermatozoa following multicomponent lifestyle modification in men with previously diagnosed azoospermia: a case series.","authors":"Michael Enwere, Mohamed Toufic El-Hussein, Emmanuel Davies, Laurens Holmes","doi":"10.3389/fruro.2026.1903697","DOIUrl":"https://doi.org/10.3389/fruro.2026.1903697","url":null,"abstract":"<p><p>Azoospermia, defined as the absence of spermatozoa in the ejaculate, is a severe form of male infertility, and the potential effects of intensive lifestyle modification on sperm production remain uncertain. We describe three adult men whose available pre-intervention records reported azoospermia and who undertook a multicomponent lifestyle programme centred on a predominantly raw, whole-food, plant-based diet, prescribed hydration, progressive physical activity, sleep and stress-management guidance, reduced alcohol consumption, and avoidance of ultra-processed and animal-derived foods. Clinical records, serial semen analyses, and available hormonal assessments were retrospectively reviewed. Approximately 10 weeks after programme initiation, spermatozoa were detected in all three participants, with concentrations of 1.6, 2.0, and 2.2 × 10⁶/mL, respectively, at the first sperm-positive assessments; these values remained within a severe oligozoospermic range, and motility and subsequent trajectories varied. Two participants had previously received fertility-directed hormonal therapies, and one had undergone unsuccessful testicular sperm extraction. Participants also reported improvements in body weight, sleep, physical-activity tolerance, libido, perceived energy, and general well-being, with no major adverse events documented. Complete etiologic assessment, genetic testing, objective adherence measures, and uniform documentation of semen-analysis methods were not available for all participants. This uncontrolled case series documents a clinically notable temporal association between initiation of an intensive lifestyle programme and subsequent detection of spermatozoa in men with previously reported azoospermia. Causality cannot be established, and the individual contributions of diet and other programme components remain uncertain. Prospective controlled studies using standardized andrologic assessment, comprehensive etiologic investigation, objective adherence measures, and prespecified reproductive outcomes are warranted.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1903697"},"PeriodicalIF":1.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of sperm DNA fragmentation with abstinence duration, seminal oxidative stress and age: a call to consider abstinence in andrological diagnostics.","authors":"Ralf Henkel, Mohamed Arafa, Ahmad Majzoub, Haitham El Bardisi, Mausumi Das","doi":"10.3389/fruro.2026.1926391","DOIUrl":"10.3389/fruro.2026.1926391","url":null,"abstract":"<p><strong>Introduction: </strong>According to World Health Organization (WHO) recommendations, the abstinence period for a semen analysis is 2 to 7 days. Other professional medical societies recommend shorter abstinence periods. Since sperm DNA fragmentation (SDF) is positively associated with oxidative stress, age and abstinence, this study aimed at investigating a threshold of abstinence for the diagnostic use of SDF testing.</p><p><strong>Methods: </strong>In this retrospective study, SDF (HaloSperm) and oxidative stress (MiOXSYS) were tested in 2782 consecutive patients, attending the Department of Urology at Hamad Medical Corporation in Doha, Qatar. Patients were stratified according to the abstinence.</p><p><strong>Results: </strong>Results showed significant trends of higher SDF and oxidative stress with longer periods of abstinence. ROC curve analysis with 20% SDF as classification variable resulted in thresholds of >4 days for abstinence, >37 years for age and 59.9 mV for oxidation-reduction potential. Multiple linear regression analysis revealed abstinence, age and oxidative stress as strong independent predictors of high SDF.</p><p><strong>Discussion: </strong>When requesting and interpreting an SDF test, abstinence, age and oxidative stress have to be considered. A maximum of 4 days of abstinence is recommended.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1926391"},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomic model versus R.E.N.A.L. nephrometry score for predicting the likelihood of undergoing partial nephrectomy in clear cell renal cell carcinoma.","authors":"Fa-de Liu, Hui-Li Yu, Du-Jian Wang, Xiao-Bing Ju, Yan-Hao Yang","doi":"10.3389/fruro.2026.1928982","DOIUrl":"https://doi.org/10.3389/fruro.2026.1928982","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a CT-based radiomic model for predicting partial nephrectomy (PN) in clear cell renal cell carcinoma (ccRCC) and compare it with the R.E.N.A.L. Nephrometry Score (RNS).</p><p><strong>Methods: </strong>This retrospective study included 413 ccRCC patients who underwent PN or radical nephrectomy. The RNS was calculated from preoperative CT. Radiomic features were extracted from corticomedullary-phase CT. Reproducibility was assessed using intraclass correlation coefficients (ICCs). LASSO regression was used for feature selection and Rad-score construction. Multivariable logistic regression models were built based on the total RNS sum and the Rad-score. Performance was evaluated by AUC, calibration, and decision curve analysis.</p><p><strong>Results: </strong>Of 1210 extracted features (after excluding general_info fields), 851 showed good to excellent reproducibility (ICC > 0.75). The radiomic model (6 selected features) achieved an AUC of 0.886 (95% CI: 0.81-0.91) in the internal validation cohort, significantly outperforming the RNS model (AUC = 0.793, 95% CI: 0.72-0.85; DeLong test, P = 0.015). The radiomic model also demonstrated better calibration (Brier score: 0.11 vs. 0.16) and higher clinical net benefit. SHAP analysis identified tumor size and texture heterogeneity as the strongest predictors.</p><p><strong>Conclusion: </strong>A CT-based radiomic model provides superior accuracy over the RNS for preoperatively predicting PN likelihood in ccRCC and holds significant potential to augment surgical decision-making and personalize treatment planning. Prospective multi-center validation is warranted before routine clinical adoption.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1928982"},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compound steep-pulse irreversible electroporation for prostate ablation in Beagle dogs: parameter evaluation and short-term safety.","authors":"Zhijin Chen, Linli Zhao, Zhenhua Zhang, Zhongbao Luo","doi":"10.3389/fruro.2026.1721078","DOIUrl":"https://doi.org/10.3389/fruro.2026.1721078","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the ablation performance and short-term safety of compound steep-pulse irreversible electroporation (CSP-IRE) and to refine treatment parameters for prostate ablation in a canine model.</p><p><strong>Methods: </strong>Twenty healthy male Beagles were included in a sequential, stepwise parameter-optimization experiment. Single-pulse and compound-pulse protocols were compared, followed by evaluation of electric-field parameters, interelectrode spacing, and electrode insertion depth. Ablation area was assessed histopathologically, while procedure-related muscle contraction and perioperative clinical and laboratory findings were evaluated.</p><p><strong>Results: </strong>The compound-pulse protocol produced a larger ablation area than the 5-μs and 50-μs single-pulse protocols (307.27 vs 39.30 and 64.44 mm², respectively). Mean ablation areas in the low-, medium-, and high-parameter groups were 39.74 ± 43.45, 175.46 ± 94.08, and 228.49 ± 41.26 mm², respectively. The medium- and high-parameter groups produced significantly larger ablation areas than the low-parameter group (P < 0.05), with no significant difference between the medium- and high-parameter groups. However, the high-parameter group induced greater muscle contraction than the medium-parameter group (P < 0.05). Mean ablation areas at interelectrode spacings of 10, 14, and 18 mm were 83.93 ± 25.31, 226.25 ± 108.25, and 216.20 ± 64.17 mm², respectively. Increasing the insertion depth from 10 to 20 mm resulted in only a modest increase in ablation area (83.93 ± 25.31 vs 90.10 ± 32.92 mm²). No serious adverse events were observed during the 7-day follow-up, and no clinically relevant changes were detected in erythrocyte, hemoglobin, or platelet measures, although transient leukocytosis occurred.</p><p><strong>Discussion: </strong>The compound-pulse protocol demonstrated greater ablation efficacy than the single-pulse protocols. The medium-parameter protocol provided a favorable balance between ablation area and procedure-related muscle contraction. These findings support the short-term feasibility of CSP-IRE and provide a basis for further parameter refinement and validation.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1721078"},"PeriodicalIF":1.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: cytoreductive prostatectomy after platinum-etoposide chemotherapy for <i>de novo</i> metastatic prostatic small cell neuroendocrine carcinoma.","authors":"Yanxin Wang, Qiwu Wang, Hang Yang","doi":"10.3389/fruro.2026.1934905","DOIUrl":"https://doi.org/10.3389/fruro.2026.1934905","url":null,"abstract":"<p><strong>Objective: </strong>To describe the diagnostic challenges, treatment response, and potential benefits and risks of cytoreductive surgery in <i>de novo</i> metastatic prostatic small cell neuroendocrine carcinoma (SCNEC).</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical course of one patient with <i>de novo</i> metastatic prostatic SCNEC.</p><p><strong>Results: </strong>A 50-year-old man presented in June 2022 with progressive dysuria for more than 1 year and acute urinary retention for 1 day. Transurethral resection of the prostate (TURP) was performed to relieve obstruction, and review of the specimen supported SCNEC. Staging ¹⁸F-FDG PET/CT showed an FDG-avid prostate, multiple lymph nodes, and bilateral non-FDG-avid pulmonary nodules without a dominant pulmonary primary; a prostatic primary with clinically suspected pulmonary metastases was favored, although the lung lesions were not biopsied. Seven cycles of etoposide plus cisplatin (EP) produced marked local regression, including a reduction in prostate volume from 72 to 17 cm³, but residual tumor persisted and a RECIST response category could not be assigned retrospectively. Cytoreductive laparoscopic radical prostatectomy was performed in February 2023. Postoperative pathology showed a mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN). A vesicourethral anastomotic leak improved conservatively, and urinary obstruction improved for approximately 3 months. Disease progressed in July 2023, and irinotecan plus carboplatin provided no durable clinical disease control. The patient died in December 2023, approximately 18 months after diagnosis.</p><p><strong>Conclusion: </strong>EP can produce substantial but temporary regression in metastatic prostatic SCNEC. This case did not establish a survival benefit from surgery, although temporary relief of urinary obstruction was reported. Systemic therapy should remain the priority, and surgery should be limited to carefully selected local-control or palliative indications.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1934905"},"PeriodicalIF":1.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravesical gas explosion after sequential greenlight laser prostate vaporization and plasma electrocoagulation: a case report and literature review.","authors":"Jia Wei, Qinya Zeng, Yangcai Wang, Guangming Yan","doi":"10.3389/fruro.2026.1845524","DOIUrl":"10.3389/fruro.2026.1845524","url":null,"abstract":"<p><strong>Background: </strong>Intravesical gas explosion resulting in full-thickness intraperitoneal bladder rupture is an extremely rare but potentially life-threatening complication following transurethral prostate surgery, with very few cases reported in the context of Greenlight laser vaporization of the prostate (LVP) and plasma electrocoagulation.</p><p><strong>Case presentation: </strong>A 50-year-old man with chronic urinary retention and benign prostatic hyperplasia (BPH) underwent LVP. During hemostasis, a sudden loud popping sound was noted, followed by an intravesical explosion and subsequent bladder rupture. Emergent laparoscopic exploration confirmed a full-thickness intraperitoneal bladder rupture, which was surgically repaired. The patient required an 11-day intensive care unit stay and prolonged urethral catheterization due to reduced bladder capacity. At 1-year follow-up, the catheter had been successfully removed, and the patient remained under conservative follow-up.</p><p><strong>Conclusion: </strong>Intravesical gas explosion is a rare but potentially severe complication of transurethral prostate surgery. This case demonstrates that the complication may occur during hemostasis following LVP and highlights the importance of intraoperative vigilance and preventive measures.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1845524"},"PeriodicalIF":1.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}