Advances in Urology最新文献

{"title":"Are Big Prostates a Challenge? Correlation Between Prostate Volume and Detection Rate in Fusion Biopsy of the Prostate.","authors":"Toni Franz, Tom Sicker, Julian Lueke, Benny Dinh, Christoph Breininger, Theodore Spinos, Evangelos Liatsikos, Jens-Uwe Stolzenburg","doi":"10.1155/aiu/5999882","DOIUrl":"10.1155/aiu/5999882","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the relationship between prostate cancer (PCa) detection rates and prostate volume. Prostate volume may influence the diagnostic performance of MRI-ultrasound (MRI-US) fusion biopsy. Enlarged prostate glands present specific challenges, including reduced specificity of prostate-specific antigen (PSA), anatomical alterations of the transition zone, and potential limitations in biopsy accuracy.</p><p><strong>Material and methods: </strong>We retrospectively analyzed 1300 consecutive patients with elevated PSA and/or abnormal digital rectal examination (DRE) who underwent MRI-US fusion-guided biopsy between 2014 and 2023. Patients were stratified into five prostate volume groups (< 30, 30-54.9, 55-79.9, 80-119.9, and ≥ 120 mL). For PI-RADS-based analyses, three volume categories (< 50, 50-100, and > 100 mL) were applied. Detection rates for overall PCa and clinically significant prostate cancer (csPCa) were assessed.</p><p><strong>Results: </strong>A total of 1203 patients were included. The overall cancer detection rate was 62.0% (746/1203), with 39.5% (475/1203) classified as clinically significant. Detection rates decreased significantly with increasing prostate volume, from 82.3% in prostates < 30 mL to 28.9% in prostates ≥ 120 mL (<i>p</i> < 0.01). Intermediate groups showed detection rates of 67.1%, 50.2%, and 48.5% for volumes of 30-54.9, 55-79.9, and 80-119.9 mL, respectively. A similar trend was observed for csPCa detection (59.4%, 42.3%, 27.4%, 31.5%, and 24.4%; <i>p</i> < 0.05). In multivariable analysis, prostate volume remained an independent predictor of cancer detection (OR: 0.99, <i>p</i> < 0.01). Stratified by PI-RADS category, detection rates consistently declined with increasing prostate size. For PI-RADS 5 lesions, detection decreased from 87.1% in prostates < 50 mL to 83.1% in 50-100 mL and 69.2% in > 100 mL (<i>p</i> < 0.01). Comparable trends were observed for PI-RADS 4 lesions (78.5%, 64.0%, and 50.0%) and PI-RADS 3 lesions (45.9%, 40.7%, and 31.8%; <i>p</i> < 0.05). Additionally, larger prostates were associated with a higher proportion of anterior lesions and a decreasing rate of positive DREs.</p><p><strong>Conclusion: </strong>Prostate volume is an independent determinant of cancer detection in MRI-US fusion biopsy. Larger prostate glands are associated with significantly reduced detection rates across all PI-RADS categories. These findings highlight the need to consider prostate volume in diagnostic decision-making and to adapt biopsy strategies in patients with enlarged prostates.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"5999882"},"PeriodicalIF":0.6,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262911","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 to \"Prognostic Value of Serum Cystatin C for Predicting Contrast-Induced Nephropathy in Elderly Individuals Aged Over 80 years\".","authors":"","doi":"10.1155/aiu/9824973","DOIUrl":"10.1155/aiu/9824973","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/aiu/9478896.].</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"9824973"},"PeriodicalIF":0.6,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148262846","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":"Sacrocolpopexy Using Polyvinylidene Fluoride Mesh: A Systematic Review and Meta-Analysis.","authors":"Mahdi Norouzi, Mahtab Zargham, Farshad Gholipour, Shayan Ghanouni, Raheleh Karimi, Farshid Alizadeh","doi":"10.1155/aiu/1620419","DOIUrl":"10.1155/aiu/1620419","url":null,"abstract":"<p><strong>Background and aims: </strong>This review aimed to assess the clinical outcomes and complications of polyvinylidene fluoride (PVDF) mesh in sacrocolpopexy (SCP).</p><p><strong>Methods: </strong>A systematic search was conducted on Google Scholar, PubMed, Web of Science, Scopus, and Embase up to October 2024. All study designs employing PVDF mesh in SCP were included. Demographic features, mesh types, surgical method, surgical outcomes, and mesh exposure, among other outcomes and complications, were extracted by two independent researchers. The registered protocol is available online on PROSPERO (ID: CRD42023405734).</p><p><strong>Results: </strong>Out of 319 studies screened, 12 were finally included in the systematic review and meta-analysis, encompassing 1093 female patients who underwent SCP. Four studies employed polypropylene (PP) as the comparator. Abdominal sacrocolpopexy (ASC) was used by six studies, five adhered to the laparoscopic method and one used both. Meta-analysis indicated pooled prevalence rates close to 0% for mesh exposure, recurrence, sexual dysfunction (SD), and reoperation in the PVDF group; however, small sample sizes and wide confidence intervals diminish the definitive conclusion. The prevalence of urge urinary incontinence (UUI) was 33%, while both stress urinary incontinence (SUI) and <i>de novo</i> incontinence had a prevalence of 6%. However, the differences between PVDF and PP outcomes and complications were not statistically significant.</p><p><strong>Conclusion: </strong>No significant differences were found between PVDF mesh and PP. Our findings highlight the need for further robust evidence to indicate the possible differences between PVDF and conventional materials, especially PP.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"1620419"},"PeriodicalIF":0.6,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248748","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 to \"Metabolic Profiling Reveals Insights Into Bladder Cancer Pathogenesis and Recurrence\".","authors":"","doi":"10.1155/aiu/9810919","DOIUrl":"10.1155/aiu/9810919","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/aiu/6524384.].</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"9810919"},"PeriodicalIF":2.3,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148051838","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":"Metabolic Profiling Reveals Insights Into Bladder Cancer Pathogenesis and Recurrence.","authors":"Hüseyin Saygın, Serkan Bolat, Demet Kablan, Hayrettin Yavuz, Meltem Kurt Yenihan, Adem Kır, Abuzer Öztürk, Akif Doğan, Onur Şenol, Halef Okan Doğan, Esat Korğalı","doi":"10.1155/aiu/6524384","DOIUrl":"10.1155/aiu/6524384","url":null,"abstract":"<p><p>Bladder cancer is characterized by abnormal cell proliferation within the bladder lining, yet the molecular mechanisms underlying its pathogenesis remain incompletely understood. This study aimed to identify metabolic differences between bladder cancer patients and healthy controls, as well as between patients with and without cancer recurrence, to elucidate the molecular mechanisms underlying disease progression and recurrence. A total of 102 participants were enrolled, comprising 82 individuals diagnosed with bladder cancer and 20 healthy controls. Based on cystoscopy and pathology findings, bladder cancer patients were further categorized into two groups: 29 with tumor recurrence and 41 without recurrence. Urinary metabolic profiling was conducted using ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF/MS). Data acquisition, classification, and metabolite identification were performed using Mass Profiler Professional and the XCMS online platform (https://xcmsonline.scripps.edu). Compared to healthy controls, patients exhibited downregulation of 11-hydroxyandrosterone and prostaglandin E2 (PGE2), while (±)12-hydroxyeicosatetraenoic acid ([±]12-HETE), 5α-dihydrodeoxycorticosterone, and 21-hydroxypregnenolone were upregulated. Notably, 11-hydroxyandrosterone was further downregulated in patients with recurrent disease compared to those without recurrence. The highest area under the curve (AUC) values for distinguishing bladder cancer and recurrence were observed for (±)12-HETE and PGE2. Elucidating the roles of steroid hormones and arachidonic acid metabolism in bladder cancer may provide critical insights into its molecular mechanisms and facilitate the development of novel therapeutic and diagnostic strategies to improve outcomes for patients.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"6524384"},"PeriodicalIF":0.6,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148051949","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":"Drug-Coated Balloon (Optilume^®) Shows a Low Reintervention Rate in Patients With Bulbar Urethral Strictures: Real-World Data From Two German Centers.","authors":"Juan Jose Menendez-Suarez, Georgi Tosev, Hendrik Borgmann, Johannes Salem, Timur Kuru","doi":"10.1155/aiu/8510976","DOIUrl":"10.1155/aiu/8510976","url":null,"abstract":"<p><strong>Background: </strong>Bulbar urethral strictures are a common cause of lower urinary tract symptoms (LUTSs) in men and frequently recur after standard endoscopic treatments. There is growing interest in identifying less invasive techniques that provide durable outcomes compared to conventional endoscopic methods. Optilume has shown favorable outcomes in prospective trials, but real-world evidence, especially including treatment-naïve patients, remains limited.</p><p><strong>Methods: </strong>We performed a retrospective study in two German urology practices, including 40 men with symptomatic bulbar urethral strictures. Symptoms were assessed using the International Prostate Symptom Score (IPSS) and IPSS-derived quality-of-life (QoL) score at baseline and at follow-up. The primary endpoints were changes in IPSS and QoL; secondary endpoints included reintervention and safety. Nonparametric paired testing (Wilcoxon) and correlation analysis (Pearson) were applied.</p><p><strong>Results: </strong>Median follow-up was 29.5 months. IPSS improved from a median of 19.5 (2-35) to 6.0 (0-26), and QoL improved from 5.0 (0-6) to 1.0 (0-5) (<i>p</i> < 0.000001). The median absolute change was ΔIPSS -10.5 overall; ΔIPSS was -16.5 in treatment-naïve patients and -9.5 in previously treated patients. Median ΔQoL was -4.0 overall (-3.5 treatment-naïve; -4.0 previously treated). One patient (2.5%) was scheduled for reintervention due to subjective dissatisfaction despite IPSS improvement. Treatment-naïve patients showed a trend toward better outcomes.</p><p><strong>Conclusions: </strong>Optilume demonstrated excellent mid-term outcomes (median follow-up: 29.5 months) in the treatment of bulbar urethral strictures, with significant improvements in symptom burden and QoL and a low reintervention rate (2.5%) in a real-world two-center cohort with a nonsignificant trend toward greater symptomatic improvement in treatment-naïve individuals. These findings support Optilume as a viable minimally invasive option. Larger prospective studies incorporating stricture-specific patient-reported outcome measures and comparative designs are needed to confirm long-term effectiveness, cost considerations, and optimal patient selection.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"8510976"},"PeriodicalIF":0.6,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832129","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 Analysis of Robotic and Laparoscopic Partial Nephrectomy: Insights Into Precision and Efficiency.","authors":"Murad Asali, Galeb Asali","doi":"10.1155/aiu/5540611","DOIUrl":"10.1155/aiu/5540611","url":null,"abstract":"<p><strong>Background: </strong>Partial nephrectomy represents a nephron-sparing strategy aimed at preserving renal function while balancing increased technical complexity and potential oncological considerations. Innovations in minimally invasive surgery, especially laparoscopic (LPN) and robotic-assisted partial nephrectomy (RPN), have markedly enhanced patient recovery durations and facilitated increased surgical precision. This study compares the outcomes of these approaches across key surgical parameters.</p><p><strong>Methods: </strong>This retrospective analysis included 205 patients who underwent LPN (143) or RPN (62) between 2008 and 2024. The parameters examined encompassed ischemia time, blood loss, tumor diameter (as assessed by CT and pathology), and postoperative recovery. Statistical methods: <i>t</i>-tests, ANOVA, and Fisher's exact tests, were utilized to assess group differences.</p><p><strong>Results: </strong>No significant differences were found in ischemia time (LPN: 22.3 min vs. RPN: 20.6 min, <i>p</i> = 0.391) or blood loss (LPN: 78.97 mL vs. RPN: 90.11 mL, <i>p</i> = 0.676). Tumor diameters were similar between groups for CT and pathology (<i>p</i> > 0.05). Analysis of bulldog usage revealed that both vein (<i>p</i> = 0.023) and artery (<i>p</i> = 0.046) clamps significantly reduced bleeding. However, bulldog utilization showed no significant impact on operating time (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>This study demonstrates that, within a single-surgeon experience, transition from LPN to RPN can be achieved safely, with comparable perioperative outcomes. These findings support feasibility rather than superiority of robotic surgery, and broader conclusions regarding patient benefit or cost require prospective randomized evaluation.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"5540611"},"PeriodicalIF":0.6,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925378","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":"Prognostic Value of Serum Cystatin C for Predicting Contrast-Induced Nephropathy in Elderly Individuals Aged Over 80 Years.","authors":"Xiangxiang Wang, Zhixiang Bian, Rui Zhu, Shunjie Chen","doi":"10.1155/aiu/9478896","DOIUrl":"10.1155/aiu/9478896","url":null,"abstract":"<p><strong>Objective: </strong>To explore the predictive value of serum cystatin C (CysC) for contrast-induced acute kidney injury (CI-AKI) in elderly individuals.</p><p><strong>Methods: </strong>The study included 102 elderly patients (80 years) who underwent percutaneous coronary interventions at the Fourth People's Hospital of Shanghai Affiliated to Tongji University between September 2020 and January 2024. Based on their diagnosis, they were divided into those with CI-AKI (<i>n</i> = 10) and those without CI-AKI (<i>n</i> = 92). A fully automated biochemical analyzer was used to measure the serum CysC levels at baseline and 48 h after coronary angiography or percutaneous coronary intervention in the two groups, and the association of serum CysC levels and other relevant clinical indicators with the occurrence of CI-AKI was evaluated to determine the predictive value of baseline serum CysC for diagnosing contrast agent-induced nephropathy based on receiver operating characteristic curves.</p><p><strong>Results: </strong>Age, serum CysC, and serum creatinine levels were significantly higher in the CI-AKI group than in the non-CI-AKI group. Serum CysC was found to be a predictor of CI-AKI based on an area under the curve of 0.731 (95% confidence interval = 0.569-0.893).</p><p><strong>Conclusion: </strong>The occurrence of contrast-induced nephropathy is related to age, serum CysC, and serum creatinine levels. In particular, serum CysC had high predictive value for CI-AKI in those aged above 80 years.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"9478896"},"PeriodicalIF":0.6,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757295","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":"Real-World Outcomes of Combination Therapy With Radium-223 and Enzalutamide Compared With Enzalutamide Alone in Patients With Metastatic Castration-Resistant Prostate Cancer.","authors":"Kenichi Hata, Yuma Goto, Masaki Hashimoto, Yusuke Takahashi, Yuki Takiguchi, Shun Saito, Yuya Iwamoto, Yuki Enei, Keigo Sakanaka, Akira Hisakane, Taisuke Yamazaki, Fumihiko Urabe, Takafumi Yanagisawa, Shunsuke Tsuzuki, Tatsuya Shimomura, Takahiro Kimura, Takanori Tojo, Hirohito Kobayashi","doi":"10.1155/aiu/2359934","DOIUrl":"10.1155/aiu/2359934","url":null,"abstract":"<p><p>Radium-223 and enzalutamide have shown survival benefits in metastatic castration-resistant prostate cancer, and recent trial data suggest a potential synergy in combination. However, real-world data on their combined use, especially regarding fracture risk and prior androgen receptor signaling inhibitor exposure, are limited. In this study, we aimed to evaluate the efficacy and safety of adding radium-223 to enzalutamide compared with enzalutamide alone in patients with bone metastatic castration-resistant prostate cancer. We retrospectively included patients treated with radium-223 plus enzalutamide (the combination group) or enzalutamide alone (the enzalutamide group), and compared progression-free survival, overall survival, prostate-specific antigen kinetics, alkaline phosphatase kinetics, and treatment-emergent adverse events. A total of 17 and 18 patients were included in the combination and enzalutamide groups, and the median age and follow-up duration were 75 years and 23 months, respectively. The median progression-free survival was significantly longer in the combination group (22 months [95% confidence interval (CI): 16.7-32.4]) than that in the enzalutamide group (5 months [95% CI: 6.3-25.2], <i>p</i> = 0.048). However, there was no significant difference in overall survival (combination: not reached [95% CI: 31.1-44.8] vs. enzalutamide: not reached [95% CI: 28.9-56.5], <i>p</i> = 0.602). In the combination group, there was no significant difference in progression-free and overall survival between patients with and without prior androgen receptor signaling inhibitor therapy. Fractures occurred in one (5.9%) and two (11.1%) patients in the combination and enzalutamide groups, respectively. In conclusion, the combination of radium-223 and enzalutamide did not improve overall survival in patients with metastatic castration-resistant prostate cancer. However, it significantly prolonged progression-free survival without increasing the risk of fractures when bone health agents were administered. Furthermore, prior exposure to androgen receptor signaling inhibitors was not associated with oncological outcomes of the combination therapy.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2026 ","pages":"2359934"},"PeriodicalIF":0.6,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688419","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":"Comprehensive 90-Day Morbidity Assessment Following Robot-Assisted Radical Cystectomy With Intracorporeal Diversion.","authors":"Anas Elyan, Laura Wimmer, Jan Ebbing, Helge H Seifert, Abolfazl Hosseini, Ashkan Mortezavi","doi":"10.1155/aiu/5585494","DOIUrl":"10.1155/aiu/5585494","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate perioperative morbidity following robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) during the transition from open surgery at a single academic center, and to provide detailed complication profiles to guide surgical teams and patient counseling.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 111 consecutive patients undergoing iRARC between 2017 and 2023. Perioperative outcomes and complications were assessed at 30 and 90 days, using the Clavien-Dindo (CD) classification. Complications were further categorized by etiology and severity. Detailed incidence rates and management strategies were recorded per patient.</p><p><strong>Results: </strong>A total of 163 complications occurred within 90 days, with 129 (79%) recorded within 30 days. Early complications were predominantly low-grade (<i>n</i> = 96, 74%), while 33 (26%) were high-grade. Systemic complications 108 (84%) outnumbered primary surgical events 21 (16%). Among early high-grade complications, cardiovascular and respiratory events were the most common (<i>n</i> = 9, 27%), followed by infectious (<i>n</i> = 7, 21%) and genitourinary complications (<i>n</i> = 7, 21%). Incidence rates for events were calculated on a per-patient basis: acute coronary syndrome 1.2%, pneumonia 2.7%, arrhythmias 2.7%, thrombosis 1.8%, pulmonary embolism 0.9%, insufficiency of the ileal anastomosis 0.9%, urinary tract infections 32.4%, and infected lymphoceles 8.1%. Genitourinary complications, including ureteral strictures (6.3%) and urinary leakage (3.6%), required frequent endourological interventions. Despite minimally invasive surgery and strict ERAS protocol implementation, paralytic ileus occurred in 19.8% of patients but was managed conservatively in all cases. Thirty-four additional complications occurred between days 30 and 90, including 16 high-grade events. The 90-day mortality rate was 1.8%. In the multivariable analysis, no independent predictors of high-grade complications were identified. Variables including BMI, clinical stage ≥ cT2, age, sex, and neoadjuvant chemotherapy showed no significant association (all <i>p</i> ≥ 0.20).</p><p><strong>Conclusion: </strong>iRARC is feasible and associated with an acceptable safety profile during the learning curve. Most complications were systemic and not directly related to the surgical technique, underscoring the need for multidisciplinary perioperative management. Detailed incidence data of specific complications provide valuable insights for realistic patient counseling and heightened awareness among care teams.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2025 ","pages":"5585494"},"PeriodicalIF":0.6,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12746349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759654","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}