Advances in Urology最新文献

{"title":"Optimizing Intermittent Catheterization Following Spinal Cord Injury: A Narrative Review Using the WHO Health System Building Blocks Framework.","authors":"Yacoub Abuzied, Aidalina Mahmud, Rasmieh Al-Amer, Azura Abdul Halain, Salimah Japar","doi":"10.1155/aiu/5056389","DOIUrl":"10.1155/aiu/5056389","url":null,"abstract":"<p><strong>Objectives: </strong>This narrative review examines intermittent catheterization (IC) for individuals with spinal cord injury (SCI) from a health systems perspective. Although IC is considered the preferred standard of care for neurogenic bladder after SCI, its long-term effectiveness depends on healthcare systems' ability to provide integrated, sustainable, and patient-centered care. The review explores system-level challenges and strategies to optimize IC delivery using the World Health Organization (WHO) Health System Building Blocks framework.</p><p><strong>Methods: </strong>A structured literature search was conducted across CINAHL, MEDLINE, PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between January 2015 and June 2026. Relevant evidence addressing clinical outcomes, healthcare delivery, workforce capacity, access to catheter technologies, financing, and governance was synthesized using the WHO Health System Building Blocks framework. Key studies informing the review are summarized in Table 1.</p><p><strong>Results: </strong>Significant systemic barriers to effective IC implementation remain despite strong clinical evidence supporting its use. Key challenges included limited access to catheter supplies, inadequate workforce training, fragmented follow-up services, and inconsistent patient education. Across the reviewed literature, service delivery, workforce capacity, and access to essential technologies emerged as the most influential determinants of successful IC implementation and long-term adherence. The findings further indicated that successful IC delivery depends on the interaction and integration of multiple health system domains rather than any single component in isolation.</p><p><strong>Conclusion: </strong>Optimizing IC outcomes in SCI requires stronger health systems that support coordinated, accessible, and sustainable care. Integrating IC services into broader health system strengthening initiatives may reduce preventable complications, improve quality of life (QoL), and support Sustainable Development Goal 3 (SDG 3) on health and well-being.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"5056389"},"PeriodicalIF":0.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668229","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":"Effects of Endourologic Devices and Connectors on Irrigation Flow Through the Flexible Ureteroscope Working Channel.","authors":"Oleksandr Chepeliuk, Rinat Lasmanovich, Isaias Caballero Lopez, Dina Orkin, Miki Haifler, Dorit E Zilberman, Zohar A Dotan, Asaf Shvero, Nir Kleinmann","doi":"10.1155/aiu/7192796","DOIUrl":"10.1155/aiu/7192796","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of different connector types and commonly used endourologic devices on irrigation fluid flow through the working channel of a flexible ureteroscope.</p><p><strong>Methods: </strong>Irrigation flow was measured under a 200-cm H₂O pressure head using three connector types (Tuohy-Borst, UroLok, and Check-Flo) and a standard Y-set connection. Instruments tested included Piranha biopsy forceps, Segura hemisphere basket, Glidewire guidewire, and two laser fibers (200 μm and 365 μm). Each condition was repeated six times. Descriptive statistics were calculated, and one-way ANOVA was used to assess differences between groups.</p><p><strong>Results: </strong>With an empty channel, the standard Y-set connection achieved the highest mean flow (115.8 ± 4.3 mL/min), followed by Tuohy-Borst (113.0 ± 1.6), UroLok (100.2 ± 1.3), and Check-Flo (80.4 ± 0.5) (<i>p</i> < 0.001). Inserting instruments markedly reduced flow. The Piranha forceps and Glidewire guidewire produced the largest reduction (∼96-97%). A larger instrument diameter or the absence of a smooth coating significantly reduced flow across all connectors. With small-caliber instruments, connector design played a greater role: relative flow reduction was greatest with Tuohy-Borst (50.6%) and lowest with Check-Flo (38.0%). In absolute terms, UroLok yielded the highest median flow with laser fibers (38.7 mL/min), followed by Tuohy-Borst (37.5 mL/min) and Check-Flo (34.7 mL/min).</p><p><strong>Conclusion: </strong>Both connector choice and instrument size significantly affect irrigation flow in flexible ureteroscopy. Large-diameter instruments almost abolish flow regardless of connector, whereas with smaller instruments, connector design influences performance. These findings emphasize the importance of selecting optimal connector-instrument combinations to maintain intraoperative visibility.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"7192796"},"PeriodicalIF":0.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652956","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":"Monitoring Intrarenal Pressure vs. Irrigation Fluid Absorption for Infection Prevention in Ureteroscopy.","authors":"Guilin Wang, Yutong Lu, Zhichun Yang, Jiangtao Bai, Jun Mi, Qiqi He, Zhiping Wang","doi":"10.1155/aiu/3521554","DOIUrl":"10.1155/aiu/3521554","url":null,"abstract":"<p><p>As ureteroscopy (URS) is increasingly utilized, preventing and managing severe postoperative infections-such as urosepsis-has become a clinical priority. Elevated intrarenal pressure (IRP) and irrigation fluid absorption (IFA) represent two core pathophysiological steps in the translocation of bacteria and endotoxins into the bloodstream. This review compares the clinical utility and technological maturity of IRP and IFA monitoring during URS. The analysis indicates that IRP is the instantaneous physical driving force for pyelovenous backflow, whereas IFA is the integrated outcome of multidimensional variables, including the pressure gradient, operative time and tissue permeability. Consequently, monitoring a single dimension may be insufficient to comprehensively assess infection risk. IRP monitoring (e.g., using a ureteral access sheath with a pressure-sensing channel or a flexible URS with an integrated pressure sensor) offers the advantage of real-time feedback, potentially playing a key role in maintaining low IRP and proactively preventing intrarenal backflow. However, it cannot account for the cumulative effect of time or changes in tissue permeability. IFA monitoring, despite its inherent lag, may provide a more comprehensive quantitative measure of the pathogenic load absorbed by the patient, suggesting potential predictive and warning value for the occurrence of infection; however, clinically validated thresholds and prospective evidence are currently lacking. In the future, with advancements in monitoring technology, the development of automated closed-loop systems integrating high-precision IRP monitoring, real-time IFA monitoring, intelligent irrigation and negative pressure suction holds promise for maximizing the balance between surgical efficacy and patient safety, provided that future studies can establish evidence-based intervention triggers.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"3521554"},"PeriodicalIF":0.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583437","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 Impact of Intraoperative Dexamethasone and Mannitol on Postoperative Inflammatory Response in Totally Tubeless Percutaneous Nephrolithotomy: A Prospective, Double-Blind, Controlled Clinical Trial.","authors":"Ehsan Zemanati Yar, Iman Menbari Oskouie, Abdolreza Mohammadi, Mahdi Najarzadegan, Mohammadreza Nikoobakht, Roghayeh Koohi Ortakand, Seyed Reza Hosseini, Seyed Mohammad Kazem Aghamir","doi":"10.1155/aiu/9465166","DOIUrl":"10.1155/aiu/9465166","url":null,"abstract":"<p><strong>Background and aims: </strong>Dexamethasone, a corticosteroid, reduces inflammation, while mannitol, a diuretic, improves renal blood flow and stone clearance. This study examines the impact of dexamethasone and mannitol during surgery on infection rates, pain control, and analgesic needs in totally tubeless PCNL (TTPCNL) patients.</p><p><strong>Methods: </strong>This double-blind, controlled clinical trial at a single center involved 121 patients undergoing TTPCNL. Participants were randomly divided into four groups: control, dexamethasone, mannitol, and dexamethasone-mannitol (DM). Postoperative outcomes included pain intensity measured using the visual analog scale (VAS) at 6 and 24 hours after tubleless PCNL. Patients with moderate-to-severe pain received rescue analgesia (paracetamol and ketorolac). Additional outcomes included length of hospital stay (LOS), serum interleukin-6 (IL-6) levels, gross hematuria, stone-free rate (SFR), Clavien-Dindo grade (CDG), and postoperative complications, including sepsis, systemic inflammatory response syndrome (SIRS), hemoglobin decline, the need for angiography, hospital readmission, and acute kidney injury (AKI).</p><p><strong>Results: </strong>This study included 81 male participants (66.9%), with a mean age of 50.9 ± 12.2 years. Patients treated with dexamethasone, either alone or with mannitol, showed significant reductions in postoperative SIRS (<i>p</i> value < 0.001), hemoglobin drop (<i>p</i> value < 0.001), hospital stay duration (<i>p</i> value < 0.001), CDG (<i>p</i> value < 0.001), postoperative pain (<i>p</i> value < 0.001), and analgesic use (<i>p</i> value = 0.015). IL-6 levels in DM group were significantly lower compared to others (<i>p</i> = 0.002). There were no significant reductions in occurrence of AKI, readmission, angiography, sepsis, and SFR.</p><p><strong>Conclusions: </strong>The intraoperative use of dexamethasone and mannitol during TTPCNL effectively mitigated postoperative inflammatory responses. This was achieved by reducing levels of IL-6 and decreasing the occurrence of SIRS. Additionally, patients experienced a shorter postoperative hospital stay, lower VAS pain score, lower CDG, and lower analgesic consumption. <b>Trial Registration:</b> Iranian Registry of Clinical Trials (IRCT): IRCT20190305042939N1.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"9465166"},"PeriodicalIF":0.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576309","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 of Levocetirizine in Reducing Double-J Stent-Related Symptoms: A Double-Blind Pilot Randomized Controlled Trial.","authors":"Marc Elias, Rami Halaby, Anthony Mina, Ziad Azar, Serge Assaf, Ghida El-Khoury, Maryline Ghosh, Sabine Breidy, Charbel Hachem, Charbel Dabal, Antoine Kassis, Raghid El-Khoury, Rodrigue Saad","doi":"10.1155/aiu/9326991","DOIUrl":"10.1155/aiu/9326991","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to evaluate the safety and efficacy of levocetirizine in reducing ureteral stent-related symptoms.</p><p><strong>Methods: </strong>In this single-center randomized controlled trial, 85 patients requiring double-J stent placement, 3 patients were excluded and 82 were allocated to start preoperatively levocetirizine 5 mg daily (Group B <i>n</i> = 41) or placebo (Group A <i>n</i> = 41) from stent insertion until stone removal. Primary outcomes were assessed using the Ureteral Stent Symptom Questionnaire (USSQ) and visual analog scale (VAS) for pain. Secondary outcomes included macroscopic assessment of ureteral inflammation and stent calcification during ureteroscopy for stone removal within 20 days.</p><p><strong>Results: </strong>Out of 82 participants included, three patients were excluded before analysis due to loss to follow-up or hospitalized for UTI that mimics stent-related symptoms. 79 patients were considered for final analysis. Group B showed a statistically significant reduction in stent-related morbidity USSQ across all subgroups compared to the placebo group and a lower VAS pain score (<i>p</i> < 0.05). Macroscopic assessment during stent removal also demonstrated statistically significantly less ureteral inflammation in Group B (17.07%) vs. 82.93% in Group A (<i>p</i> < 0.005).</p><p><strong>Conclusion: </strong>This pilot study indicates that levocetirizine effectively reduces stent-related symptoms and maintains a good safety profile. These findings suggest that levocetirizine may be a well-tolerated adjunct therapy for managing stent discomfort. <b>Trial registration:</b> Clinical trial.gov.identifier: LBCTR2025075754.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"9326991"},"PeriodicalIF":0.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576325","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 Effect of the Area Deprivation Index on Surgical Outcomes for Benign Cystectomy.","authors":"Maxwell Sandberg, David Thole, Randall Bissette, Madeline Sandberg, Dylan Wolff, Lindsay Schwartz, Ethan Weitzman, Gregory Russell, Robert Evans, Alejandro Rodriguez","doi":"10.1155/aiu/6140836","DOIUrl":"10.1155/aiu/6140836","url":null,"abstract":"<p><strong>Introduction: </strong>The impact of socioeconomic status (SES) on surgical outcomes is often underrecognized. Benign cystectomy (BC) for nononcologic bladder disease carries high morbidity but remains understudied. We evaluated the effect of SES on postoperative outcomes and healthcare utilization following BC.</p><p><strong>Methods: </strong>We retrospectively reviewed all BCs performed at our institution from 2012 to 2025. Neighborhood-level socioeconomic disadvantage was measured using the area deprivation index (ADI; scale 1-10), with higher scores indicating greater deprivation. Patients were stratified into deciles (ADID). ADI reflects area-level socioeconomic conditions rather than individual-level characteristics and therefore may not capture patient-specific socioeconomic factors. Surgical outcomes, emergency department (ED) utilization, and 90-day readmissions were compared across ADID groups.</p><p><strong>Results: </strong>Among 183 patients, the median ADI was 5 (IQR 4-8). Preoperative comorbidities, urinary diversion type, operative time, length of stay, and in-hospital complication rates were similar across ADID groups. ED visits and 90-day readmission rates did not differ by SES (<i>p</i> > 0.05). On multivariable analysis, Indiana pouch diversion was associated with higher odds of postoperative complications (OR, 4.2; 95% CI, 1.4-12.8; <i>p</i> < 0.05). Both Indiana pouch (OR, 4.1; 95% CI, 1.3-13.1; <i>p</i> < 0.05) and a neobladder (OR, 3.7; 95% CI, 1.4-9.8; <i>p</i> < 0.05) were associated with a greater likelihood of readmission within 90 days of discharge.</p><p><strong>Conclusions: </strong>SES, as measured by ADID, was not significantly associated with outcomes or postoperative healthcare utilization. BC carries high morbidity regardless of SES. These findings warrant prospective validation.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"6140836"},"PeriodicalIF":0.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576281","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":"Optimal Timing for Ureteral Stent Removal After Ureteroscopy to Minimize Morbidity: A Single-Center Prospective Comparative Study.","authors":"Muhammad Abdullah Rahman Shwani","doi":"10.1155/aiu/5753359","DOIUrl":"10.1155/aiu/5753359","url":null,"abstract":"<p><strong>Objective: </strong>To compare patient-reported morbidity across three ureteral stent removal protocols after ureteroscopy (URS) and holmium laser lithotripsy.</p><p><strong>Patients and methods: </strong>We prospectively recruited 180 patients undergoing URS for unilateral ureteric or renal stones (1-1.5 cm) from January 2021 to December 2024 at a single academic center. All procedures were performed by a single surgeon using a semirigid or flexible ureteroscope, holmium laser lithotripsy, and placement of a 6Fr × 26 cm double-J stent. Patients were sequentially allocated into three groups based on stent removal timing: Group A (24-48 h, <i>n</i> = 60), Group B (3-5 days, <i>n</i> = 60), and Group C (7-14 days, <i>n</i> = 60). The primary outcome was the Ureteral Stent Symptom Questionnaire (USSQ) total score. Secondary outcomes included Visual Analog Scale (VAS) pain score at Day 7, opioid tablet consumption, complication rates (Clavien-Dindo), patient satisfaction (1-10 scale), and days to return to normal activities. Propensity score analysis was performed to adjust for potential confounding.</p><p><strong>Results: </strong>Baseline characteristics were similar across groups. Group A had the lowest USSQ total score (68.4 ± 12.6 vs. 76.8 ± 13.4 in Group B vs. 89.7 ± 15.2 in Group C; <i>p</i> < 0.001). VAS pain score at Day 7 was also lowest in Group A (2.1 ± 1.2 vs. 3.9 ± 1.5 in Group B vs. 4.8 ± 1.8 in Group C; <i>p</i> < 0.001). Opioid tablets consumed were fewer in Group A (2.3 ± 2.1 vs. 5.6 ± 2.9 in Group B vs. 8.4 ± 3.6 in Group C; <i>p</i> < 0.001). Complication rates did not differ significantly between groups (<i>p</i> = 0.42). Patient satisfaction was highest in Group A (8.9 ± 1.1 vs. 7.5 ± 1.4 in Group B vs. 6.2 ± 1.8 in Group C; <i>p</i> < 0.001), and return to normal activities was fastest in Group A (3.2 ± 1.4 vs. 5.9 ± 1.9 in Group B vs. 8.7 ± 2.3 days in Group C; <i>p</i> < 0.001). On multivariable analysis, longer stent duration was the strongest independent predictor of higher USSQ score (<i>β</i> = 0.42, <i>p</i> < 0.001), followed by female sex (<i>β</i> = 0.18, <i>p</i> = 0.02) and age under 50 years (<i>β</i> = 0.15, <i>p</i> = 0.04).</p><p><strong>Conclusion: </strong>In this prospective comparative study, stent removal at 24-48 h was associated with lower morbidity, earlier return to activities, and higher patient satisfaction compared to later removal, without an observed increase in complications. These findings suggest that early removal may be beneficial in appropriately selected patients without contraindications. Removal at 3-5 days may represent a practical alternative when earlier removal is not feasible. Adequately powered randomized trials are needed to confirm these findings.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"5753359"},"PeriodicalIF":0.6,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403427","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":"¹⁸F-PSMA-1007 PET/CT Demonstrates Higher Accuracy for Biochemically Recurrent Prostate Cancer Compared to Contemporary Conventional Imaging.","authors":"Zachary Stanton, Bonnie Woloschuk, Alexander Tamm, Ryan Hung, Adwait Trivedi, Michael Kolinsky, Nawaid Usmani, Lindsay Rowe, Ronald Moore, Frank Wuest, Jonathan Abele","doi":"10.1155/aiu/8550174","DOIUrl":"10.1155/aiu/8550174","url":null,"abstract":"<p><strong>Purpose: </strong>The goal of this study was to compare the accuracy of ¹⁸F-PSMA-1007 PET/CT to contemporary conventional imaging (contrast-enhanced CT scan of the chest, abdomen, and pelvis and a ^99mTc-MDP whole body bone scan with SPECT/CT of the torso) in the setting of biochemically recurrent prostate cancer.</p><p><strong>Methods: </strong>This prospective nonrandomized Phase II cohort study clinical trial included 85 patients with biochemically recurrent prostate cancer (previous therapy). ¹⁸F-PSMA-1007 whole body PET/CT imaging was performed in all patients, with conventional imaging (contrast-enhanced CT scan of the chest, abdomen, and pelvis and a ^99mTc-MDP whole body bone scan with SPECT/CT of the torso) then performed within 12 days. PROMISE criteria were used for PET/CT interpretation. After a minimum 1-year follow-up period, lesion-level and patient-level analyses were performed based on previously published reference criteria (Lawhn-Heath et al. 2019). The accuracy data were compared. Referring physicians were surveyed to help determine if the scans altered treatment. Categorical variables were compared using the McNemar test (<i>p</i> < 0.05 significant).</p><p><strong>Results: </strong>53 patients with a total of 72 evaluable lesions were included in the analysis. ¹⁸F-PSMA-1007 PET/CT had a higher sensitivity than conventional imaging on a lesion level (100% compared with 58.3%) and higher overall accuracy on a patient level (90.6% compared with 62.3%, <i>p</i> < 0.05). The referring physicians felt that the ¹⁸F-PSMA-1007 PET/CT scans were beneficial to the clinical care of the patient in 90.6% of cases.</p><p><strong>Conclusion: </strong>Overall, the findings support the use of ¹⁸F-PSMA-1007 over conventional imaging in the evaluation of patients with biochemically recurrent prostate cancer. <b>Trial Registration:</b> ClinicalTrials.gov.identifier: NCT04733768.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"8550174"},"PeriodicalIF":0.6,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434705","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":"Pediatric Urological Emergencies at a Regional Hospital in Burkina Faso: A Series of 28 Cases.","authors":"Hassami Sawadogo, Abdoul-Karim Paré, Abdoul-Karim Ouattara, Fatao Ouédraogo, Békaye Ouédraogo, Tiéoulé Mamadou Traoré, Clotaire Alexis Marie Kiemdiba Donega Yaméogo, Brahima Kirakoya, Adama Ouattara","doi":"10.1155/aiu/1195422","DOIUrl":"10.1155/aiu/1195422","url":null,"abstract":"<p><strong>Background: </strong>Pediatric urological emergencies are potentially serious conditions that can compromise functional or even vital prognosis if not managed promptly. In sub-Saharan Africa, their true incidence and management modalities remain poorly documented, particularly in regional-level hospitals. This study aims to describe the epidemiological, clinical, therapeutic, and outcome aspects of pediatric urological emergencies managed at the Regional Hospital Center of Dédougou, Burkina Faso.</p><p><strong>Patients and methods: </strong>A retrospective descriptive study was conducted from April 1, 2025, to March 31, 2026, in the surgery department of the Regional Hospital Center of Dédougou. All children aged 0 to 15 years admitted for a urological emergency and who received specialized care were included.</p><p><strong>Results: </strong>Twenty-eight (28) patients were identified, with a mean age of 8.22 years (range: 0-15 years) and a male-to-female ratio of 27:1. Traumatic emergencies accounted for 42.85% of cases (<i>n</i> = 12), dominated by scrotal trauma (<i>n</i> = 6), including three cases of bovine goring. Functional and vascular emergencies represented 35.7% (<i>n</i> = 10), mainly testicular torsions (<i>n</i> = 6) with a mean consultation delay of 65.3 h and an orchiectomy rate of 66.7% (4/6). Obstructive emergencies accounted for 17.85% (<i>n</i> = 5). Overall outcomes were favorable in all 28 patients, with no mortality recorded.</p><p><strong>Conclusion: </strong>In our setting, pediatric urological emergencies are dominated by trauma and are characterized by significant consultation delays. Strengthening community awareness, healthcare worker training, and regulation of traditional practices is essential to improve functional prognosis.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"1195422"},"PeriodicalIF":0.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148358966","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":"Clinical Characteristics and Diagnostic Pathways of Emphysematous Cystitis in a University Hospital: A Retrospective Observational Study.","authors":"Tenei Ohno, Katsumi Shigemura, Kazuki Yanagida, Satoshi Kobayashi, Hazuki Inoue, Masahiro Goto, Kazuki Takei, Hideyuki Minagawa, Itsuki Yoshimura, Tomoyuki Kaneko, Yasufumi Miyake, Hiroshi Oba, Takeo Fukagawa, Ken Kozuma, Tohru Nakagawa","doi":"10.1155/aiu/9078899","DOIUrl":"10.1155/aiu/9078899","url":null,"abstract":"<p><strong>Background and aims: </strong>Emphysematous cystitis (EC) is an uncommon but clinically important form of complicated urinary tract infection characterized by gas within the bladder wall and/or bladder lumen. Because EC may present with urinary symptoms, nonspecific systemic symptoms, or incidental computed tomography (CT) findings, its diagnostic process in tertiary hospitals remains clinically relevant. This study aimed to describe the clinical characteristics, diagnostic pathways, microbiological findings, treatment, and outcomes of EC in a university hospital.</p><p><strong>Methods: </strong>We retrospectively reviewed 45 patients diagnosed with EC based on abdominal CT findings at Teikyo University Hospital between October 2010 and March 2024. Data on clinical presentation, comorbidities, microbiological findings, treatment, and clinical outcomes were extracted from electronic medical records.</p><p><strong>Results: </strong>A total of 45 patients were analyzed, including 25 males and 20 females, with a median age of 79 years (range: 31-97 years). Diabetes mellitus was present in 21 patients. The most frequently detected urinary pathogens were <i>Escherichia coli</i> (<i>n</i> = 21), including extended-spectrum β-lactamase-producing strains (<i>n</i> = 7), and <i>Klebsiella pneumoniae</i> (<i>n</i> = 9). In blood culture, <i>K. pneumoniae</i> (<i>n</i> = 7), <i>E. coli</i> (<i>n</i> = 5), including extended-spectrum β-lactamase-producing strains (<i>n</i> = 2), and <i>Staphylococcus epidermidis</i> (<i>n</i> = 2) were detected. Most patients were managed conservatively; urinary catheter placement was performed in 35 patients. Regarding EC treatment outcomes, 34 patients recovered or improved, 10 died during the clinical course, and 1 had an unknown or unclear outcome. No deaths were judged to be directly attributable to EC itself. Retrospective review of the clinical course leading to CT detection of EC suggested four diagnostic pathways.</p><p><strong>Conclusion: </strong>EC occurred mainly in elderly patients with comorbidities and was frequently detected by CT in diverse clinical contexts. These diagnostic pathways are a descriptive summary of how EC was detected in this cohort, rather than a validated prognostic or treatment-guiding classification.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"9078899"},"PeriodicalIF":0.6,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343804","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}