Frontiers in urology最新文献

{"title":"Case Report: Isolated male epispadias in adult: a rare case report.","authors":"Rifki Adhi Nofrian, Joko Pitoyo, Safendra Siregar, Albert Ciam, Muhammad Fadel Yudawa","doi":"10.3389/fruro.2026.1811127","DOIUrl":"10.3389/fruro.2026.1811127","url":null,"abstract":"<p><strong>Introduction: </strong>Isolated male epispadias is a rare congenital anomaly characterized by dorsal urethral displacement, typically corrected during infancy. Cases presenting for the first time in adulthood are exceedingly rare and pose unique challenges regarding surgical reconstruction and psychosexual well-being.</p><p><strong>Case presentation: </strong>A 35-year-old continent male presented with a dorsal midshaft urethral meatus and associated chordee, seeking correction prior to marriage. The patient underwent a modified Cantwell-Ransley procedure, involving degloving, chordee excision, and ventral transposition of the urethral plate. Postoperative recovery was noted for transient minor glans necrosis, which healed spontaneously. At the three-month follow-up, the patient achieved a functional result with a peak flow rate () of 16 ml/s and an IIEF-5 score of 22/25.</p><p><strong>Conclusions: </strong>Surgical correction of isolated epispadias in adulthood is feasible and offers significant benefits. The modified Cantwell-Ransley technique is a reliable approach for restoring anatomical integrity and sexual function.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1811127"},"PeriodicalIF":1.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870663","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":"Liquid-based genomic profiling in high-risk localized prostate cancer.","authors":"Fabiana Bettoni, Elisângela Monteiro Coser, Ernande Xavier Dos Santos, Amanda Rafaela Alves Canteli, Romualdo Morandi Filho, Vandeclécio Lira, Livia Loureiro, Marcia Dellamano, Raul Torrieri, Maria José Ferreira Alves, Leonardo Cardili, David Queiroz Borges Muniz, Éder Nisi Ilário, Roger Chammas, William Carlos Nahas, Diogo Assed Bastos, Anamaria Aranha Camargo","doi":"10.3389/fruro.2026.1789586","DOIUrl":"10.3389/fruro.2026.1789586","url":null,"abstract":"<p><strong>Background: </strong>Tumor genomic profiling using liquid biopsies offers a minimally invasive alternative to tissue biopsy-based approach, with advantages in accessibility, tumor heterogeneity representation, and repeatability. While established in metastatic prostate cancer, its feasibility in localized disease remains unclear due to low ctDNA levels.</p><p><strong>Methods: </strong>We evaluated the feasibility and performance of tissue and liquid-based genomic profiling in patients with high-risk localized prostate cancer enrolled in a phase 2 neoadjuvant trial. Genomic DNA from formalin-fixed paraffin-embedded (FFPE) tissue and cell-free DNA from plasma were analyzed using Illumina TruSight Oncology 500 panels and DRAGEN™ pipelines, with in-house filtering of artifacts and germline variants.</p><p><strong>Results: </strong>Of 22 FFPE tissue biopsies, only 54.5% (12/22) yielded usable data, with failures due to low DNA quality or quantity. All 27 plasma samples (100%) were successfully sequenced, despite low ctDNA levels. Both approaches identified an average of 3.5 genomic variants per sample, including alterations in <i>SPOP</i>, <i>ATRX</i>, <i>ATM</i>, and <i>ARID1B</i>. Liquid-based genomic profiling achieved superior coverage and depth, enabling sensitive detection of low-frequency mutations. Concordance analysis was limited by the small number of matched samples (<i>n</i> = 4).</p><p><strong>Conclusions: </strong>Liquid-based genomic profiling is feasible and achieved high sequencing success rates in high-risk localized prostate cancer. Although concordance analysis was limited, plasma-based profiling showed robust sequencing performance and detected biologically relevant alterations. These findings support liquid biopsy as a complementary approach for molecular characterization, particularly when tissue samples are limited or of suboptimal quality. Larger studies are required to establish concordance and clinical utility.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1789586"},"PeriodicalIF":1.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790993","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: Dual giant neobladder stones weighing 950 grams following 18-year loss to follow-up: surgical management and prevention strategies.","authors":"Youssef Maachi, Amine Boustani, Amine Salim Lalaoui, Amine Slaoui, Tarik Karmouni, Abdellatif Koutani, Khalid Elkhader","doi":"10.3389/fruro.2026.1757555","DOIUrl":"10.3389/fruro.2026.1757555","url":null,"abstract":"<p><strong>Background: </strong>Neobladder urolithiasis represents a significant long-term complication following radical cystectomy with orthotopic reconstruction, with incidence ranging from 3-9% for ileal neobladders to as high as 43% for Kock pouch configurations. Giant stones are rare and usually result from prolonged gaps in surveillance combined with inadequate preventive measures.</p><p><strong>Patient presentation: </strong>This is a case of a 78-year-old male presenting with progressive lower urinary tract symptoms after 18 years without urological follow-up following radical cystoprostatectomy and ileal neobladder reconstruction for muscle-invasive bladder cancer (pT2N0M0) performed in 2006. He had relocated geographically one year post-surgery and stopped all urological care, never performing self-catheterization or bladder irrigation as instructed. Computed tomography revealed two massive neobladder stones measuring 10×8×6 cm and 9×7×8 cm with 1,300 Hounsfield Units density. Open cystolithotomy successfully removed both calculi with a combined weight of 950 grams in 90 minutes with minimal blood loss of 100 mL and no complications. Stone analysis confirmed a pure struvite-carbonate apatite composition secondary to chronic Proteus mirabilis infection. The patient was discharged on postoperative day 3. Follow-up at 1, 3, 6, and 12 months demonstrated complete symptom resolution, stone-free status on imaging, and stable renal function. However, the patient was subsequently lost to follow-up again after 12 months despite multiple attempts at contact.</p><p><strong>Conclusions: </strong>This case, representing one of the heaviest dual-stone presentations documented in neobladder patients (950g combined weight), demonstrates that complete surgical excision via open cystolithotomy remains the treatment of choice for giant neobladder calculi. The exceptionally prolonged 18-year surveillance gap enabled progressive bilateral stone development, emphasizing the absolute necessity of lifelong structured follow-up programs for all urinary diversion patients. Comprehensive preventive strategies including daily bladder irrigation with 500-1000 mL normal saline, adequate hydration (≥2.5 L daily), aggressive infection control with surveillance cultures every 3-6 months and suppressive antibiotic prophylaxis when indicated, and regular imaging surveillance are essential to prevent such severe complications. Even after prolonged follow-up loss and massive stone development, curative intervention can achieve excellent outcomes when patients subsequently engage with comprehensive preventive protocols, as demonstrated by this patient's stone-free status during the 12-month compliant period.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1757555"},"PeriodicalIF":1.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724162","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":"Thulium fiber laser enucleation of the prostate with SOLTIVE™ SuperPulsed laser systems: a prospective evaluation of early outcomes in an Asian cohort.","authors":"Brian W H Siu, David K W Leung, Rachel S K Wong, Chris H M Wong, Alex Q Liu, Chi Hang Yee, Jeremy Y C Teoh, Peter K F Chiu, Chi Fai Ng, Ka Lun Lo","doi":"10.3389/fruro.2026.1753089","DOIUrl":"10.3389/fruro.2026.1753089","url":null,"abstract":"<p><strong>Introduction: </strong>Thulium fiber laser (TFL) technology, with its shorter wavelength and higher water absorption coefficient compared to Holmium: YAG laser, offers theoretical advantages in tissue ablation efficiency and safety profile. We aim to evaluate the early safety and feasibility of Thulium fiber laser enucleation of prostate (ThuFLEP) using the SOLTIVE™ SuperPulsed Laser Systems in the first Asian cohort.</p><p><strong>Methods: </strong>Thirty-two consecutive men underwent ThuFLEP between October 2022 and September 2025. The primary outcome was the rate of Clavien-Dindo grade ≥3 complications as a safety and feasibility signal, along with assessment of short-to-medium-term functional outcomes. Data are presented as median (interquartile range, IQR). Changes in PSA were analyzed using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>The median prostate size was 60 ml (IQR 49.8-76.0 ml), with 50% of patients being catheter dependent. Median operation time was 87 minutes (IQR 73-100 mins). Median enucleated adenoma weight was 31 g (IQR 20-39 g). No Clavien-Dindo grade ≥3 complications occurred. Catheter-free rate was 87.5% on day 1 and 100% by day 14. At 3-month follow-up, median IPSS was 4 (IQR 1-8), median Qmax was 21.5 ml/s (IQR 12.9-28.4 ml/s), with significant PSA reduction (from 6.05 to 1.20 ng/ml; p<0.001). At 12 months (n=25), median Qmax was 21.9 ml/s (IQR 15.2-26.8 ml/s), median IPSS was 2 (IQR 1-5), and there was no surgical or medical retreatment.</p><p><strong>Conclusion: </strong>ThuFLEP demonstrates early safety and feasibility in this Asian cohort, including catheter-dependent patients. Larger, multicenter studies with longer follow-up are warranted to confirm its safety and efficacy.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier NCT05292235.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1753089"},"PeriodicalIF":1.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693943","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":"Correction: A hybrid combination of <i>in vitro</i> cultured buccal mucosal cells using two different methodologies, complementing each other in successfully repairing a stricture-inflicted human male urethral epithelium.","authors":"Akio Horiguchi, Toshihiro Kushibiki, Yoshine Mayumi, Masayuki Shinchi, Kenichiro Ojima, Yusuke Hirano, Shojiro Katoh, Masaru Iwasaki, Surya Prakash Vaddi, Koji Ichiyama, Rajappa Senthilkumar, Senthilkumar Preethy, Samuel J K Abraham","doi":"10.3389/fruro.2026.1813098","DOIUrl":"10.3389/fruro.2026.1813098","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fruro.2025.1720445.].</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1813098"},"PeriodicalIF":1.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679188","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":"Breaking barriers in male infertility: the power of artificial intelligence-driven solutions.","authors":"Laura Ibañez Vazquez, Natalia Pérez Romero, Daniel Tueti Silva, Sarelis Infante, Claudia González-Santander, Irene De La Parra, Isabel Galante Romo, Juan A Gómez Rivas, Jesús Moreno Sierra","doi":"10.3389/fruro.2026.1719894","DOIUrl":"10.3389/fruro.2026.1719894","url":null,"abstract":"<p><p>Infertility is defined as the inability of a sexually active couple, not using contraception, to achieve a spontaneous pregnancy within 12 months. It affects an estimated 8% to 12% of couples worldwide, with 30% to 50% of cases attributable, either primarily or in part, to male factors. Despite the increasing number of assisted reproductive technology (ART) procedures performed globally, improvements in fertilization and pregnancy outcomes have been limited. The need to improve diagnostic accuracy and therapeutic efficiency has driven the development of artificial intelligence (AI) in reproductive medicine. This narrative review aims to explore how AI is transforming the diagnosis and treatment of male infertility. AI technologies are nowadays being used to automate and refine semen analysis, providing more reliable assessments of sperm morphology, motility, and concentration. These innovations enable clinicians to improve the prediction of semen quality and to identify which patients might benefit most from specific interventions, such as sperm retrieval in cases of non-obstructive azoospermia or the selection of optimal sperm cells for reproductive techniques. Moreover, advanced AI algorithms-including support vector machines, deep neural networks, and decision trees-outperform traditional methods, offering greater precision and reducing subjectivity in laboratory evaluations. Additionally, AI is being utilized to estimate the chances of success with assisted reproductive techniques, assess sperm DNA fragmentation, and guide the selection of sperm. The integration of AI into clinical practice not only enables more accessible and personalized diagnoses but also opens new perspectives for the development of individualized treatments, optimizing reproductive outcomes. However, further multicenter validation of AI-based models, methodological standardization, and careful consideration of ethical and privacy issues are necessary before widespread clinical adoption.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1719894"},"PeriodicalIF":1.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624951","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":"Transperineal versus transrectal systematic prostate biopsy in routine clinical practice: a real-world comparative study.","authors":"Anouar El Ghazzaly, Mohammed Mrabeti, Abdesamad El Bahri, Larbi Hamedoun, Mohammed Tetou, Mohammed Alami, Ahmed Ameur","doi":"10.3389/fruro.2026.1806961","DOIUrl":"10.3389/fruro.2026.1806961","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate biopsy is the reference standard for confirming prostate cancer in men with clinical suspicion. The transrectal (TR) route is widely used but carries a risk of infectious complications and may sample anterior regions less effectively. Transperineal (TP) biopsy has emerged as a safer alternative with lower infectious risk. However, real-world comparative evidence between the routes is limited in some settings. The objective is to compare the diagnostic yield, tissue quality, and complications of systematic TR versus TP prostate biopsy in a Moroccan tertiary center.</p><p><strong>Methods: </strong>In this retrospective study, 139 men with suspected prostate cancer underwent systematic biopsy via TR or TP biopsy. Analyses were restricted to systematic cores. Biopsy quality was assessed by median core length. Complications were graded using the Clavien-Dindo classification.</p><p><strong>Results: </strong>A total of 139 men underwent systematic biopsy. Baseline clinical characteristics were similar across most variables, except DRE, between groups. TP yielded a longer median core length than TR (p = 0.02). In contrast, detection rates of clinically significant prostate cancer (csPCa) were similar (40.3% for TR vs 38.9% for TP). Several clinical factors were associated with csPCa detection, including higher PSA, higher PSA density, suspicious DRE, and higher PI-RADS category. In contrast, anterior lesion location was associated with a lower risk of csPCa. Regarding complications, infectious complications were more common after TR biopsy (7.5% compared to 1.4%). Additionally, acute urinary retention was seen in 6.0% of TR cases and 8.3% of TP cases. No Clavien-Dindo grade III or higher events were reported.</p><p><strong>Conclusion: </strong>TP systematic biopsy provides csPCa detection comparable to TR biopsy, yields longer cores, and shows a lower observed rate of infectious complications, supporting TP adoption to reduce infectious morbidity without compromising diagnostic performance.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1806961"},"PeriodicalIF":1.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624918","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":"Absence of bladder cancer cells in surgical smoke from robot-assisted radical cystectomy: a prospective study.","authors":"Kosuke Shibamori, Kohei Hashimoto, Ko Okabe, Takeshi Maehana, Tetsuya Shindo, Yuki Kyoda, Ko Kobayashi, Toshiaki Tanaka, Satoshi Takahashi, Naoya Masumori","doi":"10.3389/fruro.2026.1714844","DOIUrl":"10.3389/fruro.2026.1714844","url":null,"abstract":"<p><p>After robot-assisted radical cystectomy (RARC) for bladder cancer, urologists occasionally encounter distinct recurrences, including port site recurrence and peritoneal dissemination. We hypothesize that the surgical smoke generated during RARC could contain bladder cancer cells, potentially leading to dissemination. Initially, we examined the cytology of the exhaust smoke filters used during laparoscopic radical cystectomy; however, no cancer cells were detected. Subsequently, we conducted digital PCR analysis for the <i>PIK3CA</i> (E545K) gene mutation in surgical smoke collected through a water trap system during RARC. However, we were unable to detect any mutated genes. We subjected T24 bladder cancer cell line pellets to electrocoagulation vaporization and subsequently captured the surgical smoke through a vacuum system. However, we could not detect the <i>TERT</i> (C228T) mutation in the smoke. Consequently, we proceeded with exosome analysis of the smoke obtained from electrocoagulated pellets and the supernatant of T24 cells as the control. The exosome levels in smoke were significantly lower than that in controls. Based on these findings, we concluded that the surgical smoke produced during RARC does not contain cancer cells, genes, or exosomes.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1714844"},"PeriodicalIF":1.7,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610867","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":"A rare case of penile granulomatosis with polyangiitis: case report and multidisciplinary management approach.","authors":"Matteo Coschignano, Nicolò Schifano, Benedetta Pennella, Sara Baldini, Ilaria Zais, Alessio Villano, Paolo Capogrosso, Gabriele Antonini, Alberto Batticciotto, Antonella Cappelli, Federico Dehò","doi":"10.3389/fruro.2026.1790745","DOIUrl":"10.3389/fruro.2026.1790745","url":null,"abstract":"<p><p>Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis presenting with penile involvement in approximately 1% of male patients diagnosed with the disease, making genital manifestations exceedingly rare in this context. We aimed to describe here the case of a 34-year-old male patient with a history of GPA presenting to our attention for a genital ulcer that required a coordinated multidisciplinary management. A 34-year-old man with a known history of systemic GPA presented to the Accident and Emergency (A&E) Department with a dorsal penile shaft abscess that progressed into a necrotic ulcer consistent with a localization of GPA (active vasculitis) based on histopathological examination. The patient underwent escharotomy and split-thickness skin grafting (STSG), which failed to take possibly due to local infection with methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and/or suspected persistent vasculitic activity. Targeted antimicrobial therapy, corticosteroid-based immunosuppression, and hyperbaric oxygen therapy (HBOT) were subsequently implemented, eventually obtaining secondary-intention wound healing. The total hospital stay was 21 weeks. The patient reported a penile curvature of approximately 110° during erection, resulting in the inability to engage in penetrative intercourse. The Visual Analogue Scale (VAS) for the aesthetic and functional outcomes was reported as unsatisfactory (i.e., 2 out of 5). Penile involvement in GPA necessitates a coordinated multidisciplinary approach. Surgical management of GPA-associated large penile skin defects using STSG should be attempted to minimize the hospital stay and to optimize the aesthetic and functional outcomes; however, patients should be informed about a higher likelihood of complications in this setting. The second-intention healing process for large genital skin defects due to GPA may require long hospital stays and may be associated with severe functional issues despite optimal medical management. HBOT may be beneficial in select cases of GPA with genital involvement. Further studies are needed to develop evidence-based guidelines for the management of GPA genital lesions.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1790745"},"PeriodicalIF":1.7,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610796","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":"Advancements in the use of enemas for treating urinary calculi.","authors":"Min Ling, Yujie Li, Liuyang Yang, Qinqin Song, Yu Sun, Chong Zhang, Yuhao Zhao, Shuaishuai Song, Li Xu, Yang Zhang, Hongbing Gu, Shengli Wang, Qilun Zhang, Yongfei Yang","doi":"10.3389/fruro.2026.1737660","DOIUrl":"10.3389/fruro.2026.1737660","url":null,"abstract":"<p><p>Urinary calculi are a prevalent condition within the urinary system, with treatment options ranging from traditional surgical and non-invasive methods to emerging alternative therapies. Recently, enema therapy utilizing traditional Chinese medicine (TCM) and Western medicine has gained attention as a non-conventional approach, offering unique advantages in managing urinary stones. Unlike conventional oral or surgical treatments, enema therapy enables direct colonic drug delivery, reduces systemic adverse effects, and may modulate gut microbiota and oxalate metabolism, thereby providing a novel mechanistic basis for stone prevention and expulsion. This paper provides a comprehensive review of the mechanisms, clinical applications, and safety considerations of TCM and Western medicine enema therapies. For the first time, we systematically integrate traditional theoretical frameworks with modern biomedical evidence, including microbiota-mediated oxalate degradation and detailed clinical operation parameters, to highlight the complementary and synergistic effects of combined TCM-Western medicine enemas. By analyzing both their individual and combined effects, this study aims to furnish clinicians with valuable insights to optimize treatment strategies and promote further development of enema therapy for urinary calculi.</p>","PeriodicalId":73113,"journal":{"name":"Frontiers in urology","volume":"6 ","pages":"1737660"},"PeriodicalIF":1.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576459","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}