Frontiers in urology最新文献

{"title":"Durable disease control after multimodal therapy and platinum-based chemotherapy rechallenge in advanced clear cell adenocarcinoma of the urethra with lymph node metastases: a case report.","authors":"Akihiro Maeda, Shohei Tobu, Shuhei Kusano, Maki Kawasaki, Hiroaki Kakinoki, Mitsuru Noguchi","doi":"10.3389/fruro.2026.1865730","DOIUrl":"10.3389/fruro.2026.1865730","url":null,"abstract":"<p><strong>Background: </strong>Clear cell adenocarcinoma of the urethra (CCAU) is an extremely rare subtype of primary urethral carcinoma. Owing to its low incidence, the optimal treatment strategy for advanced or metastatic disease remains unclear. We report a case of advanced CCAU with lymph node metastases that achieved long-term disease control following multimodal therapy.</p><p><strong>Case presentation: </strong>A 60-year-old woman presented with urinary retention and was diagnosed with primary urethral clear cell adenocarcinoma (cT4N2M0) with pelvic lymph node metastases. Neoadjuvant gemcitabine plus cisplatin (GC) chemotherapy achieved a partial response and was followed by robot-assisted radical cystourethrectomy combined with hysterectomy, vaginectomy, and pelvic lymph node dissection. Pathological examination revealed ypT4N2M0 disease with negative surgical margins. Adjuvant nivolumab was initiated but was discontinued because of immune-related hypothyroidism and nodal recurrence. Comprehensive genomic profiling demonstrated microsatellite stability, a low tumor mutational burden (1 mutation/Mb), and MET and MYC amplifications. As no actionable alterations were identified, GC chemotherapy was reintroduced and again achieved a partial response. The patient remains progression-free 32 months after diagnosis.</p><p><strong>Conclusions: </strong>This case suggests that multimodal treatment combining radical surgery and platinum-based chemotherapy may contribute to durable disease control in selected patients with advanced CCAU and lymph node metastasis. Although genomic profiling did not directly guide therapy in this case, molecular characterization may provide a basis for future individualized treatment strategies for this rare malignancy.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1865730"},"PeriodicalIF":1.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439297","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":"The effects of locally administered aminophylline in patients undergoing ureteroscopic lithotripsy: a systematic review with exploratory meta-analysis.","authors":"Mansour Alnazari, Ahmad Badawi, Osama Alamri, Abdullah Alsehli, Omar Alamri, Mohammed Alhusayni, Abdullah Alghamdi, Amr Mahran","doi":"10.3389/fruro.2026.1822923","DOIUrl":"10.3389/fruro.2026.1822923","url":null,"abstract":"<p><strong>Purpose: </strong>Aminophylline, a methylxanthine derivative, acts as a smooth muscle relaxant through non-competitive inhibition of phosphodiesterase. It has been suggested to facilitate ureteroscopic lithotripsy by relaxing ureteral smooth muscle. The aim of this systematic review is to assess the available evidence on locally administered aminophylline in patients undergoing ureteroscopic lithotripsy and, where feasible, to perform an exploratory meta-analysis to estimate pooled effects.</p><p><strong>Methods: </strong>A systematic search was conducted through November 2025. Three randomized controlled trials (RCTs) met the inclusion criteria. The primary outcome was residual stone proportions (derived from the stone-free rate). Secondary outcomes included operative time, postoperative ureteral stenting, and auxiliary procedures. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB-2) tool. This review was registered with PROSPERO (CRD420251229352).</p><p><strong>Results: </strong>Three RCTs enrolling 310 patients (155 receiving aminophylline and 155 receiving placebo) were included. Local aminophylline was associated with significantly fewer residual stones (RR 0.3; 95% CI: 0.13, 0.69; <i>p</i> = 0.025; I² = 0%) and fewer auxiliary procedures (RR 0.15; 95% CI: 0.06, 0.38; <i>p <</i>0.001; I² = 0%). Reductions in operative time and postoperative ureteral stenting were observed in the primary analysis; however, these did not remain statistically significant after applying the Hartung-Knapp-Sidik-Jonkman (HKSJ) correction.</p><p><strong>Conclusion: </strong>This exploratory meta-analysis provides preliminary evidence that locally administered aminophylline may reduce residual stone fragments and auxiliary procedures during ureteroscopic lithotripsy. Reductions in operative time and ureteral stenting did not retain statistical significance in sensitivity analyses and should be considered hypothesis-generating. These findings should be interpreted with caution, given the low certainty of the evidence. Adequately powered randomized trials are required to validate these results.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD420251229352.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1822923"},"PeriodicalIF":1.7,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371324","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":"Investigation of bioimpedance as a method for wearable noninvasive bladder volume measurements in individuals with spinal cord injury or disease: protocol of a feasibility study.","authors":"Judith Jantine Willemijn van Beek, Kanika Dheman, Sabrina Amrein, Michele Magno, Diego Paez-Granados, Jürgen Pannek, Jörg Krebs","doi":"10.3389/fruro.2026.1799957","DOIUrl":"10.3389/fruro.2026.1799957","url":null,"abstract":"<p><strong>Introduction: </strong>Neurogenic lower urinary tract dysfunction (NLUTD) is a frequent consequence of spinal cord injury or disease (SCI/D). It can lead to impaired bladder emptying, urinary incontinence, and recurrent urinary tract infections. For those unable to empty their bladder effectively, intermittent catheterization (IC) is the recommended first-line management. Clinical guidelines advise catheterization four to six times daily to prevent bladder overdistension (i.e., bladder volume > 500 ml), yet fixed schedules are often impractical due to fluctuating daily factors. Personalized scheduling is particularly challenging for individuals with SCI/D who lack bladder sensation. Consequently, a noninvasive and unobtrusive method for bladder volume monitoring is needed. Electrical bioimpedance (BI) is a promising solution, as it measures the impedimetric response of tissue to an applied electrical signal and should detect changes related to bladder filling. This may enable continuous, dynamic volume estimation and support individualized bladder management.</p><p><strong>Methods and analysis: </strong>This multi-center observational feasibility study evaluates a BI sensor for noninvasive bladder volume monitoring across three phases. Phase 1 assesses feasibility in individuals without SCI/D. Phase 2 includes individuals with chronic SCI/D and NLUTD to determine the difference between BI-derived bladder volume and the clinical gold standard (bladder volume determined by catheterization). Effects of abdominal adiposity and muscle activity on BI-signals will also be analyzed. Phase 3 examines the usability of a BI-based wearable during six hours of real-life use in wheelchair users reliant on intermittent catheterization. Sixty participants will be enrolled across all phases. The primary outcome is the difference in bladder volume (mL) between BI measurements and catheterized volumes in individuals with SCI/D. Secondary outcomes include physiological and motion parameters possibly affecting BI measurements. Analyses will be descriptive, focusing on signal quality, feasibility, and measurement agreement.</p><p><strong>Discussion: </strong>This multi-phase feasibility study evaluates whether a BI sensor can measure bladder volume in individuals with SCI/D and NLUTD noninvasively and continuously. By validating BI in controlled and real-life settings, the study aims to determine its feasibility and potential as an alternative to current bladder volume assessment methods.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1799957"},"PeriodicalIF":1.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347526","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":"The role of leptin in reproductive dysfunction in patients with varicocele: a systematic review and meta-analysis.","authors":"Yan Zhang, Yangming Li, Xiaodan Du, Ye Dong, Honglong Jia, Jian Qiu, Bin He, Shengzhuo Liu, Sikui Shen, Yuchun Zhu","doi":"10.3389/fruro.2026.1835856","DOIUrl":"10.3389/fruro.2026.1835856","url":null,"abstract":"<p><strong>Background: </strong>The mechanism of leptin's role in female infertility has been demonstrated, however, the relationship between it and infertile patients with varicocele has yet to be determined. This study aimed to evaluate role of leptin in reproductive dysfunction in patients with varicocele.</p><p><strong>Methods: </strong>A computerized literature search was independently conducted by two researchers in PubMed, EMBASE, Web of Science, ScienceDirect, and Cochrane Library up to July 2025. The search terms were as follows: 'leptin', 'varicocele' and 'infertility'. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The meta-analysis was performed using Review Manager version 5.1 and R version 4.0.5.</p><p><strong>Results: </strong>36 studies were retrieved and 5 studies were included for meta-analysis. We found that the expression of leptin in seminal plasma in infertile patients with varicocele were significantly higher than controls (SMD, 2.72; 95%CI, 1.05-4.39; I2 = 96%, p=0.001). In contrast, the serum leptin levels did not show statistically significant differences (SMD, 1.26; 95%CI -0.73-3.26; I2 = 96%, p=0.21) between patients and controls. Seminal plasma leptin levels had a moderate negative correlation with sperm concentration (r=-0.54; 95%CI, -0.77 - -0.19; p<0.01). Additionally, seminal plasma leptin levels had a strong negative correlation with sperm progressive motility (r=-0.71; 95%CI, -0.93 - -0.09; p<0.01).</p><p><strong>Conclusions: </strong>The expression of leptin in seminal plasma was significantly higher in infertile patients with varicocele. Seminal plasma leptin levels had a negative correlation with sperm concentration and progressive motility. Leptin in seminal plasma seemed to have a negative effect on the reproductive function of patients with varicocele.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1835856"},"PeriodicalIF":1.7,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297515","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":"Hysterectomy and the risk of urinary incontinence: a systematic review and meta-analysis.","authors":"Liping Wang, Leilei Gao, Xuechai Bai, Juan Gu","doi":"10.3389/fruro.2026.1816956","DOIUrl":"10.3389/fruro.2026.1816956","url":null,"abstract":"<p><strong>Object: </strong>To evaluate the association between hysterectomy and the risk of developing urinary incontinence (UI) based on observational studies.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Embase, and Cochrane Library for observational studies from inception to December 14, 2025, using medical subject headings (MeSH) and keywords. The risk of bias and the quality of evidence were assessed using the Newcastle-Ottawa Scale (NOS), the Agency for Healthcare Research and Quality (AHRQ) criteria, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, respectively. To derive overall summary estimates of odds ratios (OR), a random-effects meta-analysis was performed, complemented by subgroup analyses to explore potential effect modifiers. And the presence of publication bias was evaluated through funnel plots and Egger's regression test.</p><p><strong>Results: </strong>This meta-analysis is registered with PROSPERO (CRD42024587774) and follows PRISMA guidelines, including 12 studies with a cumulative total of 146,759 individuals who underwent hysterectomy. The pooled analysis revealed a significant association between hysterectomy and an increased risk of UI, yielding an OR of 1.31, (95% CI: 1.03-1.66, I² = 88.5%, <i>P</i> = 0.029). Subgroup analyses showed that the risk of UI was notably higher among patients who underwent abdominal hysterectomy (OR = 1.21, 95% CI: 1.10-1.34, I² = 0.0%, <i>P</i> = 0.000). Furthermore, it was observed that the incidence of UI was particularly elevated in studies conducted in Asia, while no significant association was reported for regions such as Europe and North America.</p><p><strong>Conclusion: </strong>Hysterectomy is associated with an increased risk of urinary incontinence, based on synthesized evidence from observational studies.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD42024587774.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1816956"},"PeriodicalIF":1.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297408","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":"Comparative outcomes of focal HIFU versus active surveillance in low- and intermediate-risk localized prostate cancer: a 75-month retrospective cohort study.","authors":"Mohammad Jaabou, Maurizio Buscarini, Osama Zaytoun, Zachary Dovey, Brooke Hildebrand, Modassar Awan, Maida Bada, Mohammad Al Ogaili, Ahmad Rabie","doi":"10.3389/fruro.2026.1801127","DOIUrl":"10.3389/fruro.2026.1801127","url":null,"abstract":"<p><strong>Objective: </strong>Focal high-intensity focused ultrasound (HIFU) is a minimally invasive treatment for localized prostate cancer. Its comparative effectiveness against active surveillance (AS) remains underexplored in patients eligible for either strategy.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 635 men with localized prostate cancer treated between 2018 and 2023: 303 received focal HIFU and 332 underwent AS. Only low-risk and favorable intermediate-risk patients per NCCN guidelines were included (PSA <20 ng/mL, stage ≤T2b, ISUP ≤2, <50% positive cores). Multiparametric MRI and targeted biopsies confirmed eligibility. Outcomes included progression to clinically significant prostate cancer (csPC: ISUP ≥3 or ISUP 2 with PIRADS ≥4), radical treatment-free survival, PSA kinetics, and functional outcomes (IPSS, IIEF-5, continence).</p><p><strong>Results: </strong>Baseline characteristics were comparable. At 12 months, csPC-free survival was higher with HIFU in intermediate-risk patients (95.8% vs. 84.0%, p=0.0018) and low-risk patients (97.6% vs. 88.3%, p=0.0035). At a median follow-up of 75 months, HIFU maintained superior csPC-free rates in both risk groups. Radical treatment-free survival was similar in both low and intermediate risk group 76% vs 77.1% and 83.2% vs 80.3% respectively, time to radical treatment was significantly longer in the HIFU group. PSA reductions at 3 and 6 months were greater with HIFU. Functional outcomes, including erectile function, continence, and urinary symptoms, were comparable between groups.</p><p><strong>Conclusions: </strong>Focal HIFU offers better short-term oncological control and delays the need for radical treatment compared to AS, with similar preservation of urinary and sexual function. These results support its use in selected patients seeking a balance between cancer control and quality of life.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1801127"},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165843","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":"Current views on sustainability in urology: findings from the North Central Section of American Urological Association membership survey.","authors":"Chloe Shi, Susanna Wang, Ryan Steinberg, John O DeLancy, Keow Goh, Sarah Adelstein, Pankaj Dangle, Frank C Lin, Adam Miller, Matthew Gettman","doi":"10.3389/fruro.2026.1818561","DOIUrl":"10.3389/fruro.2026.1818561","url":null,"abstract":"<p><strong>Objective: </strong>The United Nations defines sustainability as meeting needs of the present without compromising future generations. While often equated to \"saving the planet\", sustainability is a diverse topic. Healthcare generates >5% of CO₂ emissions worldwide, yet sustainability efforts in urology are limited. The North Central Section of the American Urological Association (NCSAUA) recently convened a Sustainability Task Force to address this topic. This study queried members on sustainability in urologic practice.</p><p><strong>Methods: </strong>Following literature review on sustainability in surgery/urology, a 19-item anonymous REDCap survey was developed and distributed via email to NCSAUA members (N = 1607). The survey assessed current best practice, institutional/personal sustainability, and demographics. Responses were compiled and summarized using descriptive statistics.</p><p><strong>Results: </strong>Survey response rate was 4.9% (79/1607). Respondents were most commonly from metropolitan areas (82%), male (71%), and in practice for 5-14 years (29%). Sustainability topics were prioritized as: (1) financial, (2) future workforce, (3) environmental. Over half (56%) reported no institutional sustainability programs or were unaware of them. Instrument (67%), computer (68%), and paper (65%) recycling were supported by a majority of respondents. However, only 28% and 29% of respondents reported current institutional use of instrument and computer recycling, respectively. Telemedicine was infrequent, with most urologists (58%) conducting 0-5% of visits virtually.</p><p><strong>Conclusions: </strong>Current institutional and urologic practice emphasis on sustainability is low. Respondents ranked highest sustainability priorities as financial and future workforce. Efforts to address environmental sustainability were also supported, namely reduction of disposables and waste. The findings support the development of targeted programs to advance sustainability priorities widely.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1818561"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267115","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":"Next-generation imaging in prostate cancer.","authors":"Ahmed Rabie, Maurizio Buscarini, Osama Zaytoun","doi":"10.3389/fruro.2026.1829407","DOIUrl":"10.3389/fruro.2026.1829407","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Early detection of clinically significant prostate cancer (csPCa) remains a major challenge in urologic oncology. Although prostate-specific antigen (PSA) screening and systematic transrectal ultrasound- guided biopsy has historically been the main diagnostic approaches, these strategies are associated with both overdiagnosis of indolent disease and underdetection of clinically significant tumors. Recent advances in imaging technologies-including multiparametric magnetic resonance imaging (mpMRI), high-resolution micro-ultrasound (MUS), and prostate-specific membrane antigen positron emission tomography (PSMA PET)-have significantly improved the diagnostic pathway for prostate cancer. In parallel, artificial intelligence (AI)-based algorithms have emerged as promising tools for enhancing image interpretation and reducing diagnostic variability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This review aims to summarize current evidence regarding the diagnostic performance of micro- ultrasound, mpMRI, and PSMA PET in prostate cancer detection and to explore the potential role of artificial intelligence in integrating these imaging modalities to improve diagnostic accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature search was performed using PubMed and MEDLINE databases for articles published between January 2013 and December 2024. The following search strategy was employed using combinations of MeSH terms and keywords: ('prostate cancer' OR 'prostate neoplasm' OR 'prostatic carcinoma') AND ('micro-ultrasound' OR 'high-resolution micro-ultrasound' OR 'micro-US' OR 'PRI-MUS' OR 'ExactVu') OR ('multiparametric MRI' OR 'mpMRI' OR 'multi-parametric magnetic resonance imaging' OR 'PI-RADS') OR ('PSMA PET' OR 'prostate-specific membrane antigen' OR '68Ga-PSMA' OR '18F-DCFPyL' OR 'PSMA-11') OR ('artificial intelligence' OR 'machine learning' OR 'deep learning' OR 'radiomics' OR 'neural network'). Only English-language, peer-reviewed original research articles, systematic reviews, meta-analyses, and major consensus guidelines were included. Case reports, editorials, conference abstracts, and non-peer-reviewed publications were excluded. Two authors (A.R. and O.Z.) independently screened titles and abstracts for relevance. Full texts of potentially eligible articles were retrieved and assessed against predefined inclusion criteria: (1) evaluation of mpMRI, micro-ultrasound, or PSMA PET for prostate cancer detection, localization, or staging; (2) reported diagnostic accuracy metrics (sensitivity, specificity, AUC) or biopsy outcomes; (3) sample size ≥20 patients for original studies. Disagreements were resolved by consensus with a third author (M.B.). Reference lists of included articles were hand-searched for additional relevant studies. A narrative synthesis was conducted due to heterogeneity in study designs, populations, and outcome measures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Multiparametric MRI has become a cornerstone in","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1829407"},"PeriodicalIF":1.7,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13259704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254908","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":"Urodynamic characteristics of different types of detrusor overactivity in patients with benign prostatic obstruction.","authors":"Xiao Zeng, Bo Huang, Hong Shen, De-Yi Luo, Tao Jin","doi":"10.3389/fruro.2026.1845544","DOIUrl":"10.3389/fruro.2026.1845544","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study aimed to investigate whether the presence or the absence of detrusor overactivity (DO) in patients with urodynamic-confirmed benign prostatic obstruction (BPO) leads to alterations in urodynamic parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study is a retrospective analysis of patients with urodynamic-confirmed BPO [Bladder Outlet Obstruction Index (BOOI) &gt;40]. Patients with a clinical diagnosis of benign prostatic hyperplasia (BPH) or benign prostatic enlargement (BPE) were initially screened, but only those with BOOI &gt; 40 were included. Based on the presence or absence of DO during urodynamics, patients were categorized into two groups: BPO with DO and BPO without DO. Subsequently, the BPO with DO group was further stratified according to DO subtype into BPO with terminal DO (TDO) and BPO with phasic DO (PDO). Differences in the urodynamic parameters and the DO-related indices among these groups were then evaluated. In addition, correlations between the DO-related indicators and the urodynamic parameters within each DO subtype were further examined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 75 patients assigned to the BPO with DO group and 71 to the BPO without DO group. There was a statistically significant difference in the maximum cystometric capacity (MCC) and bladder compliance (BC) between the BPO with DO group and the BPO without DO group: 259.05 ± 44.54 &lt;i&gt;vs.&lt;/i&gt; 273.13 ± 36.69 (&lt;i&gt;p&lt;/i&gt; = 0.04) and 158.71 ± 83.86 &lt;i&gt;vs&lt;/i&gt;. 210.95 ± 82.58 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), respectively. The BPO with PDO group comprised 38 patients, while the BPO with TDO cohort included 37 patients. There exists a statistically significant difference between MCC and BC: 291.50 (248.75-301.75) &lt;i&gt;vs&lt;/i&gt;. 250.00 (210.00-296.00) (&lt;i&gt;p&lt;/i&gt; = 0.02) and 184.00 (150.50-286.75) &lt;i&gt;vs&lt;/i&gt;. 103.00 (85.00-141.50) (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), respectively. Univariate regression analysis revealed a statistically significant negative correlation between the maximum contraction amplitude of DO and BC exclusively within the BPO with TDO cohort (&lt;i&gt;r&lt;/i&gt; &lt;sub&gt;s&lt;/sub&gt; = -0.34, &lt;i&gt;p&lt;/i&gt; = 0.03). Multivariable analysis confirmed this independent correlation (&lt;i&gt;β&lt;/i&gt; = -0.33, 95%CI = -0.59 to -0.07, &lt;i&gt;p&lt;/i&gt; &lt; 0.05). Age was identified as an independent risk factor for DO (OR = 1.19, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and first desire to void (FD) as an independent protective factor (OR = 0.98, &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This preliminary study indicates that DO is associated with storage-phase urodynamic alterations in BPO patients, with no notable association with the voiding phase parameters. Multivariable analysis identified age as an independent risk factor for DO and FD as an independent protective factor. TDO is associated with more pronounced storage-phase changes than PDO. In the TDO subgroup, the correlation between BC and DO contraction amplitude was independent of age. However, several other comparisons remain unadjusted; there","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1845544"},"PeriodicalIF":1.7,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201274","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: Low-frequency tibial nerve stimulation: demonstrating a novel therapeutic option for Fowler's syndrome through a pilot case series.","authors":"Aidan McConnell-Trevillion, Ingrid Hoeritzauer, Helen Simpson, Jalesh N Panicker, Jon Stone, Dani Coombe, Kianoush Nazarpour","doi":"10.3389/fruro.2026.1854503","DOIUrl":"10.3389/fruro.2026.1854503","url":null,"abstract":"<p><p>Fowler's Syndrome is a critically under-researched area of Women's Urological health. The condition, which causes severe urinary retention in the absence of any obvious obstructive pathology, lacks any non-invasive options for treatment. Transcutaneous Tibial Nerve Stimulation (TTNS) is an established treatment strategy for disorders of incontinence that is non-invasive, safe, and efficacious. Computer based modelling and preliminary animal experimentation indicates that ultra-low frequency TTNS (1-2 Hz) may induce an excitatory effect on bladder function that is of particular therapeutic relevance to Fowler's Syndrome. Therefore, the present case series describes a three-armed randomised-control (crossover) pilot study conducted from a biomechanical perspective in a population suffering from Fowler's Syndrome. The study aimed to address the question of if the novel application of low-frequency TTNS could ameliorate the symptoms of Fowler's Syndrome. Patients (<i>N</i> = 6) were administered either ultra-low frequency TTNS (1 Hz) or placebo. The objective outcome measure of the study was the change in voiding efficiency in response to intervention. 50% (<i>N</i> = 3) participants displayed a positive response to treatment, with a median increase in Voiding Efficiency of 6.3 to 12.6% across test conditions. Two participants displayed a negative response to the intervention, (median -3.6 to -20.9%) which may have been due to placebo effects but should be considered in future. The study indicated that TTNS may be capable of ameliorating the symptoms of Fowler's Syndrome, to a significant degree in one case. The work provides a foundation for future clinical research. The authors hope that should the results be confirmed by further clinical study they will have considerable impact on patient care.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1854503"},"PeriodicalIF":1.7,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13229719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165938","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}