Frontiers in urology最新文献

{"title":"Use of androgen suppression therapy at salvage radiotherapy in recurrent prostate cancer: a systematic review with meta-analysis.","authors":"Maria Juliana Chaves Medina, Rodolfo Varela Ramírez, Wilfredo Donoso Donoso, Jaime Moreno-Chaparro, Javier Eslava-Schmalbach","doi":"10.3389/fruro.2026.1836469","DOIUrl":"10.3389/fruro.2026.1836469","url":null,"abstract":"<p><strong>Introduction: </strong>Salvage radiotherapy (SRT) is one of the treatment options after progression following surgical management, with effectiveness varying according to patient risk and clinical-pathological characteristics.</p><p><strong>Objective: </strong>To compare the effectiveness of SRT alone versus SRT combined with androgen deprivation therapy (ADT) in men with biochemical recurrence.</p><p><strong>Methods: </strong>We conducted a systematic review with advanced searches in MEDLINE (PubMed), EMBASE, SCOPUS, Cochrane CENTRAL, and LILACS for the period 1990-2024. Two independent reviewers performed study selection (titles/abstracts and full text) and data extraction. Risk of bias was assessed with ROBINS-I and RoB 2.0. A random-effects meta-analysis was used to pool effect estimates. PROSPERO registration: CRD42025640604.</p><p><strong>Results: </strong>Thirteen studies were included. Nine reported overall survival (OS) and biochemical progression-free survival (b-PFS) respectively, four clinical progression-free survival (c-PFS), and eight metastasis-free survival (MFS). Combined SRT+ADT was associated with improved b-PFS (HR 0.51; 95% CI 0.45-0.57; I²=0%) and MFS (HR 0.71; 95% CI 0.60-0.84; I²=39%), whereas the remaining meta-analyzed outcomes showed no consistent benefit or were limited by heterogeneity. Regarding toxicity, the most frequent adverse events were endocrine and sexual, related to hormonal blockade, gynecomastia and erectile dysfunction.</p><p><strong>Conclusions: </strong>Combined SRT + ADT improves biochemical disease control and may reduce the risk of metastasis in selected patients with biochemical recurrence after radical postatectomy, whereas the effect on overall survival remains uncertain. Individualized management requires risk stratification when deciding on the addition and duration of ADT to optimize oncologic outcomes.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/, identifier CRD42025640604.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1836469"},"PeriodicalIF":1.7,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868131","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":"Impact of protocolized intravesical instillation after TURBT on men's sexual quality of life:a retrospective cohort study.","authors":"Xiaoqing Wang, Tuan Wang, Sen Hu, Libo Liu, Xiaoli Zhang, Beibei Zhang, Wenwen Jia, Jiangyu Xue","doi":"10.3389/fruro.2026.1880004","DOIUrl":"10.3389/fruro.2026.1880004","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether protocolized intravesical gemcitabine instillation after transurethral resection of bladder tumor (TURBT) is associated with men's sexual quality of life, assessed using the Sexual Life Quality Questionnaire (SLQQ), compared with a single immediate postoperative instillation.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 244 men with non-muscle-invasive bladder cancer undergoing TURBT between January 2021 and May 2024. Patients received either protocolized intravesical gemcitabine (weekly for 8 weeks, then monthly for 6 months) or a single immediate postoperative instillation. The primary outcome was the 8-month SLQQ score. Secondary outcomes included the International Index of Erectile Function-5 (IIEF-5) and urinary symptom-related quality-of-life (QOL) score. Between-group comparisons, difference-in-differences (DID), correlation analyses, multivariable regression, and multiple-imputation sensitivity analyses were performed.</p><p><strong>Results: </strong>Baseline SLQQ scores were comparable between groups. At 8 months, the protocol cohort had significantly lower SLQQ scores than controls (21.78 ± 8.77 vs. 37.13 ± 8.56; mean difference -15.35, 95% CI -17.54 to -13.16; Cohen's d=-1.77; P<0.001). The decline in SLQQ was greater in the protocol cohort (DID -15.27, 95% CI -18.18 to -12.36). Postoperative IIEF-5 was strongly correlated with SLQQ (r=0.938), whereas urinary symptom-related QOL showed a weak negative correlation (r=-0.232). Sensitivity analyses consistently demonstrated an approximately 15-point between-group difference after adjustment for baseline SLQQ and additional imputed clinical covariates.</p><p><strong>Conclusions: </strong>Protocolized intravesical gemcitabine following TURBT was associated with poorer postoperative sexual quality of life. This association remained robust across multiple sensitivity analyses, supporting routine sexual-health assessment during NMIBC survivorship.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1880004"},"PeriodicalIF":1.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852081","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":"Glucagon-like peptide-1 receptor agonist versus other anti-diabetic agents on patients with prostate cancer undergoing androgen-deprivation therapy.","authors":"Sheng-Chi Huang, Wan-Yu Cheng, Cheng-You Hou, Jheng-Yan Wu, Chih-Cheng Lai, Wen-Hsin Tseng","doi":"10.3389/fruro.2026.1855180","DOIUrl":"10.3389/fruro.2026.1855180","url":null,"abstract":"<p><p>Patients with prostate cancer (PCa) undergoing androgen deprivation therapy (ADT) frequently develop cardiometabolic complications, particularly those with type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) provide cardiovascular and renal benefits in diabetic populations, but comparative evidence with other glucose-lowering therapies in men receiving ADT remains limited. We conducted a retrospective cohort study using the TriNetX network. Adults with T2D and PCa undergoing ADT who received GLP-1RA, dipeptidyl peptidase-4 inhibitors (DPP-4is), or sodium-glucose cotransporter-2 inhibitors (SGLT2is) between January 2005 and December 2025 were included. Propensity score matching generated balanced cohorts for two comparisons: GLP-1RA versus DPP-4i and GLP-1RA versus SGLT2i. The primary outcome was all-cause mortality; secondary outcomes were major adverse cardiovascular events (MACEs), major adverse kidney events (MAKEs), and thrombotic events. After matching, 659 patients per group were included in the GLP-1RA versus DPP-4i comparison and 1,009 per group in the GLP-1RA versus SGLT2i comparison. Compared with DPP-4i, GLP-1RA use was associated with lower all-cause mortality (HR, 0.60; 95% CI, 0.46-0.79), MAKEs (HR, 0.63; 95% CI, 0.48-0.81), and thrombotic events (HR, 0.53; 95% CI, 0.32-0.89), whereas MACEs were similar (HR, 0.87; 95% CI, 0.63-1.12). Compared with SGLT2i, GLP-1RA use was associated with lower all-cause mortality (HR, 0.76; 95% CI, 0.59-0.99), whereas no significant differences were observed for MACEs, MAKEs, or thrombotic events. These neutral findings should be interpreted cautiously because the limited number of events may have reduced statistical power to detect modest between-group differences. In conclusion, among men with PCa receiving ADT and comorbid T2D, GLP-1RA use was associated with lower all-cause mortality than both DPP-4i and SGLT2i, with additional reductions in kidney and thrombotic events versus DPP-4i. GLP-1RAs may represent a favorable therapeutic option in this metabolically and vascularly vulnerable population. Prospective studies are warranted to confirm these associations and clarify the underlying mechanisms.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1855180"},"PeriodicalIF":1.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802581","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":"Artificial intelligence and machine learning in neurogenic lower urinary tract dysfunction and spinal cord injury: current status, emerging technologies, and ethical perspectives.","authors":"Patrick M F Levien, Jürgen Pannek","doi":"10.3389/fruro.2026.1931923","DOIUrl":"10.3389/fruro.2026.1931923","url":null,"abstract":"<p><p>Artificial intelligence (AI) and machine learning are increasingly applied across urology, with particular promise for the management of neurogenic lower urinary tract dysfunction (NLUTD) in individuals with spinal cord injury (SCI). There is also particular promise in the management of NLUTD, a complex, lifelong condition affecting individuals with SCI and also occurring in the context of multiple sclerosis, Parkinson's disease, and other neurological disorders. This article provides a comprehensive analysis of AI's current and emerging role in neuro-urology, with dedicated focus on the specific challenges and opportunities presented by NLUTD and SCI. We review the epidemiological and clinical burden of neurogenic bladder dysfunction. We further examine AI applications in uro-oncology, functional urology, digital pathology, and robotic surgery, integrating these with the specialized perspective of neuro-urology. The particular vulnerability of individuals with SCI to algorithmic bias, access inequity, and assistive technology dependency is critically discussed. We identified five key domains where AI may transform care for patients with NLUTD: automated urodynamic interpretation including detection of detrusor overactivity and detrusor-sphincter dyssynergia, predictive risk stratification for renal deterioration, closed-loop neuromodulation, remote digital monitoring, and AI-assisted rehabilitation support. Alongside the substantial opportunities, we articulate the ethical, moral, and societal responsibilities that accompany AI integration in this population, emphasizing that patients with SCI and NLUTD deserve not merely inclusion in AI development but active partnership as co-designers of the technologies that will shape their lives.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1931923"},"PeriodicalIF":1.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889662","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 of an implantable tibial neuromodulation system for overactive bladder with urgency urinary incontinence: an open-label, single arm trial.","authors":"Fuyuan Zheng, Yongjun Guan, Weilin Fang, Tingting Lv, Jin Huang, Xin Song, Jianwei Lv","doi":"10.3389/fruro.2026.1865760","DOIUrl":"10.3389/fruro.2026.1865760","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the safety and efficacy of a domestically developed implantable tibial neuromodulation system (iTNS) in the treatment of overactive bladder (OAB) in patients with urgency urinary incontinence (UUI).</p><p><strong>Methods: </strong>A prospective single-center open-label trial was conducted. A total of 10 participants underwent iTNS device implantation, followed by device activation at 2-4 weeks post-implantation. Follow-up evaluations were performed at 1, 3, and 6 months post-implantation, including 3-day bladder diaries, validated questionnaires, and symptom satisfaction surveys. The primary endpoint was a ≥50% reduction in UUI episodes per day at 6 months.</p><p><strong>Results: </strong>At 6 months, the iTNS system achieved a 90% response rate (9/10 patients), among whom 40% (4/10) attained ≥3 consecutive dry days. A delayed therapeutic onset was observed: a significant reduction in UUI episodes emerged at 3 months (from 3.235 to 0.766 episodes per day) and 6 months (from 3.235 to 0.632 episodes per day). Quality of life was significantly improved at 6 months, as indicated by the changes in validated questionnaires (OAB-Q: 69.5 ± 11.76 to 44.4 ± 12.06; OABSS: 9 ± 1.155 to 6.2 ± 2.394). Additionally, 80% of patients reported satisfaction with their symptoms at the 6-month endpoint.</p><p><strong>Conclusions: </strong>The domestically developed iTNS system is safe and effective for the treatment of UUI in patients with OAB. It exhibits a strong ability to significantly reduce or completely resolve UUI symptoms, with a favorable safety profile.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1865760"},"PeriodicalIF":1.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13414830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622951","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":"Predictors of recurrence after vesicovaginal fistula repair: a systematic review of surgical and patient-related factors.","authors":"Mohammad Shazib Faridi, Lubna Inam, Vyomesh Rastogi","doi":"10.3389/fruro.2026.1878604","DOIUrl":"10.3389/fruro.2026.1878604","url":null,"abstract":"<p><strong>Background: </strong>Repair of vesicovaginal fistula (VVF) is highly effective, with primary success rates of 80-95%; however, recurrence is reported in 10-30% of cases. Factors influencing recurrence include fistula size and tissue characteristics.</p><p><strong>Methods: </strong>This systematic review identifies predictive factors for VVF recurrence by reviewing 21 studies published between 1994 and 2025 that met PRISMA criteria, and by analyzing the surgical outcomes from PubMed/MEDLINE data for various etiologies of VVF. Eligible studies reporting predictors of VVF repair were assessed for bias using the modified Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>The following factors were consistently identified as predictors of VVF recurrence: fistula size greater than 2-3cm (odds ratio [OR]: 1.0-6.0), severe peri-fistula fibrosis (OR: 2.7 to 12.0), involvement of the urethra and/or bladder neck (OR: 0.4 to 9.0) and multiple fistulas (OR: 4.0 to 8.0). The following protective factors were identified: early intervention, surgery performed in a specialist center, and the use of interposition flaps. The Goh and Panzi classifications assist in the predictive risk stratification of patients. Most studies had a low to moderate risk of bias. Due to the heterogeneous nature of the studies, there was considerable variation in study design, etiology, and surgical technique; therefore, narrative synthesis rather than meta-analysis was performed. In most cases, secondary VVF repair has been documented to improve surgical outcomes; however, results for previously failed repairs remain contradictory.</p><p><strong>Conclusion: </strong>Using validated predictive factors for preoperative risk stratification may improve global VVF surgical outcomes. Closing the gap in surgical outcomes between regions and optimizing surgical techniques will require further prospective research and the development of predictive models.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1878604"},"PeriodicalIF":1.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407312","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":"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}