BMC Urology最新文献

{"title":"Intracorporeal versus extracorporeal urinary diversion during robotic radical cystectomy: outcomes from a large single-institutional study.","authors":"Bing Yan, Yuan Liu, Yuwei Li, Ji Zheng, Peng He, Xuemei Li, Yuting Liu, Xiaozhou Zhou, Zhiwen Chen","doi":"10.1186/s12894-025-01872-x","DOIUrl":"https://doi.org/10.1186/s12894-025-01872-x","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, there has been a significant increase in the use of robot-assisted radical cystectomy (RARC) with fully intracorporeal urinary diversion. Utilizing data from a single, high-volume institutional database, this study aimed to evaluate and compare perioperative outcomes and complications associated with intracorporeal urinary diversion (ICUD) versus extracorporeal urinary diversion (ECUD) following RARC.</p><p><strong>Methods: </strong>This study included 405 patients with bladder cancer who underwent RARC at our institution between July 2016 and April 2023. Data were retrospectively reviewed and compared between ICUD and ECUD groups. The 90-day major complications (MC90), 90-day overall complications (OC90), and perioperative and pathological outcomes were evaluated. Statistical analyses were performed using the Pearson chi-square test, Mann-Whitney U test, Kaplan-Meier tests, and multivariable regression analysis.</p><p><strong>Results: </strong>Following RARC, 230 patients underwent ICUD and 175 underwent ECUD. No significant differences in demographics or oncological characteristics were observed between the two groups, except for a higher proportion of females in the ICUD group. Notably, ICUD was associated with significantly reduced median operative time (319 min vs. 370 min, p < 0.01) and lower median estimated blood loss (300 ml vs. 500 ml, p < 0.01). Postoperative recovery was faster in the ICUD group. However, the OC90, MC90, overall survival, and recurrence-free survival were comparable between the two groups.</p><p><strong>Conclusions: </strong>Compared with ECUD, ICUD significantly improved perioperative outcomes, including operative time, estimated blood loss, and postoperative recovery, without compromising long-term oncological survival or complication rates.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"179"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The recurrence and multi-organ involvement of giant penile plexiform neurofibroma in an adult with neurofibromatosis type 1: a case report.","authors":"Junhao Chu, Zhihui Zhang, Huisheng Yuan, Jiajun Kan, Zilong Wang, Muwen Wang","doi":"10.1186/s12894-025-01881-w","DOIUrl":"https://doi.org/10.1186/s12894-025-01881-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder with malignant potential, affecting various anatomical regions, predominantly the head and neck. Urogenital involvement is relatively uncommon. In particular, penile neurofibromatosis is exceedingly rare, with fewer than 20 cases documented globally. In China, only four pediatric cases have been reported, with no known occurrences in adults. To date, no recurrent penile plexiform neurofibromas have been reported in adults. Here, we report a rare case of a recurrent giant penile plexiform neurofibroma, accompanied by multiple neurofibromas involving the prostate, bladder, and retroperitoneum, in an adult NF1 patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case report: &lt;/strong&gt;A 37-year-old male patient initially presented to the Department of Urology, Shandong First Medical University Affiliated Provincial Hospital, on April 17, 1994 (at the age of 8), with a seven-year history of painless penile enlargement. He underwent resection of the penile mass, with histopathological analysis confirming a diagnosis of plexiform neurofibroma. Following surgery, the penile morphology normalized. However, at the age of 20, he experienced recurrent painless penile enlargement but did not pursue further medical evaluation. On October 7, 2023, the patient was readmitted due to right flank pain and hydronephrosis. Physical examination revealed marked penile enlargement with a palpable large mass and multiple café-au-lait macules across the body. Although the patient had no urinary complaints, he was unable to achieve normal erectile function. Laboratory findings indicated an elevated serum creatinine level of 124.20 µmol/L. Imaging modalities, including computed tomography urography (CTU), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT), identified a massive penile tumor with concomitant multiple tumors in the prostate, bladder, and retroperitoneum. Penile tumor biopsy confirmed the diagnosis of plexiform neurofibroma. Immunohistochemical analysis demonstrated S-100 (+), recombinant human SOX10 protein (SOX10) (+), and Ki-67+ (&lt; 1%). Given the histopathological results and clinical findings, the patient was diagnosed with neurofibromatosis type 1. To alleviate right flank pain, percutaneous nephrostomy was performed, resulting in a reduction in serum creatinine to 90.80 µmol/L within three days post-procedure, with subsequent symptom relief. Owing to extensive tumor infiltration and financial limitations, the patient opted against radical surgery or systemic therapy. He was subsequently discharged and has since been monitored with biannual follow-ups, including regular nephrostomy tube replacement. As of the latest follow-up, his clinical status remains stable without evidence of significant disease progression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This case report describes a rare adult patient with neurofibromatosis type 1, presenting wi","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"180"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective study on the management of urinary bladder injuries in a military hospital in Yemen.","authors":"Nasser Albaddai, Khaled Alkohlany, Aziz Shamsan, Wael Alsaqaf, Abdullah Al-Sakkaf, Ahmed Farei, Abdaljaleel Al-Baidai","doi":"10.1186/s12894-025-01863-y","DOIUrl":"https://doi.org/10.1186/s12894-025-01863-y","url":null,"abstract":"<p><strong>Background: </strong>Urinary bladder (UB) injuries pose significant challenges in conflict zones, yet evidence on optimal management in resource-limited settings remains scarce. This study evaluates outcomes of conservative and surgical approaches for UB injuries in war-torn Yemen.</p><p><strong>Methods: </strong>This prospective observational study was conducted at a tertiary military hospital in Sana'a, Yemen, from February 2021 to January 2023. Forty-four patients with traumatic UB injuries were enrolled. Injuries were classified by mechanism, AAST grade, and anatomical location. Conservative management included catheterization and antibiotics, while surgical intervention was guided by injury severity and associated trauma. Outcomes included healing confirmed by cystography, complication rates (Clavien-Dindo classification), and length of hospital stay.</p><p><strong>Results: </strong>Of 44 patients (95.5% male; mean age 26.8 ± 8.6 years), 77.3% underwent surgical repair, primarily for penetrating injuries and high-grade bladder trauma. Conservative management was applied in 22.7% of low-grade extraperitoneal cases. Surgical success rate was 97.1%, while conservative success reached 80%. Most patients (82.4%) had extraperitoneal injuries; associated trauma was common, including pelvic/femur fractures (68.2%) and abdominal/pelvic organ injuries (36.4%). Complications occurred in 36.4% of patients, with 13.6% being moderate to severe (Grade III-IV). No bladder injury-related mortalities occurred. Pelvic fractures significantly increased the odds of surgical repair (OR 4.2, p = 0.001) and late sepsis (OR 5.6, p = 0.02).</p><p><strong>Conclusion: </strong>In conflict settings, surgical repair remains critical for high-grade UB injuries, while conservative management is viable for select low-grade cases. Prolonged hospitalization reflects polytrauma burden rather than surgical intervention itself.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"178"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optilume balloon dilation for radiation induced posterior urethral stenosis: a multi-institutional experience.","authors":"Brian Ceballos, Eshan G Joshi, Kayla Graham, Luke Shumaker, Katherine Englander, Victoria Stowasser, J Patrick Selph, Lucas Wiegand, Kevin Heinsimer, Maxim McKibben, Maia VanDyke, Steven Hudak, Allen Morey, Adam Baumgarten","doi":"10.1186/s12894-025-01829-0","DOIUrl":"10.1186/s12894-025-01829-0","url":null,"abstract":"<p><strong>Introduction: </strong>Radiation induced urethral stenosis disease represents a complex subset of patients with higher rates of recurrence after treatment. Optilume^®, a Paclitaxel drug-coated balloon, has been utilized in anterior urethral strictures with promising results. Although urethroplasty is traditionally regarded as the gold standard for treating radiation-induced posterior urethral stenosis, it can be an invasive and challenging procedure with potential side effects. We aim to evaluate the efficacy of the Optilume^® drug-coated balloon as a minimally invasive treatment option for radiation-induced posterior urethral stenosis.</p><p><strong>Methods: </strong>A retrospective, multi-institutional review was conducted on male patients who underwent Optilume^® drug-coated balloon dilation from January 1, 2022, to November 1, 2023. The study involved five surgeons across four institutions. Patients were investigated based on their history of radiation-induced posterior urethral stenosis, and comparisons were made regarding demographics, characteristics of urethral stenosis, and outcomes, including surgical success and complications.</p><p><strong>Results: </strong>Among the 56 patients with radiation-induced posterior urethral stenosis evaluated across all four institutions, 37 men had at least 90-day follow-up data. Of these 37 patients, 30 (81.1%) were deemed successful, defined as being free from repeat intervention. Although 6 patients (10.7%) experienced complications, none were greater than Clavien IIIb, with the most common complication being acute urinary retention.</p><p><strong>Conclusion: </strong>Although radiation-induced urethral stenosis is typically associated with high rates of recurrence following conservative treatment, Optilume^® drug-coated balloon represents an alternative endoscopic treatment option with encouraging short-term results.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"177"},"PeriodicalIF":1.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Pharmacological non-hormonal treatment options for male infertility: a systematic review and network meta-analysis.","authors":"Bassel H Al Wattar, Michael P Rimmer, Jhia J Teh, Scott C Mackenzie, Omar F Ammar, Carolyn Croucher, Eleni Anastasiadis, Patrick Gordon, Allan Pacey, Kevin McEleny, Phillipa Sangster","doi":"10.1186/s12894-025-01874-9","DOIUrl":"10.1186/s12894-025-01874-9","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"174"},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of flow rate on pressure and nephrons during flexible ureteroscopy with intelligent control of renal pelvic pressure: an in-vivo pig model.","authors":"Yao Lei, Huang Xin, Kuang Jin, Song Leming, Deng Xiaolin","doi":"10.1186/s12894-025-01846-z","DOIUrl":"10.1186/s12894-025-01846-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of flow rate on pressure and nephron injury during flexible ureteroscopy with intelligent renal pelvic pressure (RPP) control in an in vivo pig model.</p><p><strong>Methods: </strong>Twelve kidneys from six female pigs were randomly divided into six groups. Pressure-controlled (PC) and non-pressure-controlled (NPC) groups were continuously perfused at a flow rate of 50 mL/min (group A), 100 mL/min (group B), and 150 mL/min (group C) for 30 min. Color Doppler ultrasound detected exosmosis of the perirenal fluid. Nephron biopsies were performed in the upper, middle, and lower regions. Pressure changes and pathological conditions of the tissue at different flow rates and pressure control values were compared.</p><p><strong>Results: </strong>RPP values for groups A, B, and C were 8.70 ± 1.02, 20.50 ± 3.03, and 45.97 ± 9.57 mmHg, respectively, and the difference was statistically significant in NPC groups (P < 0.05). RPP values with 10 mmHg control value were 9.43 ± 1.50, 9.97 ± 1.69, and 8.77 ± 1.77 mmHg, respectively. With 0 mm Hg control value, they were 0.40 ± 0.67, -0.40 ± 1.35, and 0.33 ± 1.03 mmHg, respectively, and with - 10 mmHg control value, -9.00 ± 1.34, -11.30 ± 1.15, and - 9.27 ± 1.62 mmHg, respectively. Values fluctuated around the set value, with clinically non-significant differences within 2 mmHg. Pathological examination showed that the nephron structure changed in the NPC group, with more marked changes associated with increasing flow rate. No changes were observed in the nephron morphology in the PC group regardless of perfusion flow rate.</p><p><strong>Conclusion: </strong>Flexible ureteroscopy with intelligent RPP control can effectively monitor and control pressure under different perfusion flow conditions and prevent nephron injury.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"175"},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of artificial urinary sphincter implantation in a patient who underwent both urethroplasty and ileal neobladder construction.","authors":"Hibiki Hirose, Tadashi Tabei, Yushi Araki, Hideki Ouchi, Takuma Nirei, Kazuki Kobayashi","doi":"10.1186/s12894-025-01871-y","DOIUrl":"10.1186/s12894-025-01871-y","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"176"},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior conduit fixation with retroperitonealization of uretero-ileal anastomosis after open radical cystectomy reduces the postoperative complication rate: a retrospective, matched-paired single-center analysis.","authors":"Vukovic Marko, Kavaric Petar, Magdelinic Aleksandar, Albijanic Marko, Rebronja Almir, Sabovic Eldin","doi":"10.1186/s12894-025-01869-6","DOIUrl":"10.1186/s12894-025-01869-6","url":null,"abstract":"<p><strong>Background: </strong>Our study aimed to assess the efficacy of posterior conduit fixation with retroperitoneal ureteroileal anastomosis (UIA) in reducing perioperative complications after radical cystectomy (RC) with ileal conduit (IC) urinary diversion.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study, including 150 patients who underwent either modified IC technique (extraperitonealized anastomosis with posterior conduit fixation; n = 79) or the conventional IC technique (n = 71). The primary endpoints were the incidence of clinical parastomal hernia (PSH) and ileus. Secondary endpoints included operative time, postoperative complication rates, and length of hospital stay (LOS). Multivariate logistic regression was performed to identify predictors of early and late stoma- related complications.</p><p><strong>Results: </strong>The modified group showed significantly lower incidence of both early and late postoperative complications, including ileus and PSH, compared to the conventional group (8.86% vs. 28.1%, p = 0.01 and 7.6% vs. 17%, p = 0.03, respectively) after a median follow-up of 34 months. Corresponding hazard ratios were 0.312 (95% CI: 0.047-0.798, p = 0.01) for early complications and 0.267 (95% CI: 0.105-0.611, p = 0.03) for late complications.</p><p><strong>Conclusion: </strong>The results support our hypothesis that extraperitoneal ureteroileal anastomosis combined with posterior conduit fixation effectively reduces the risk of both early and late postoperative complications, including parastomal hernia and ileus.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"173"},"PeriodicalIF":1.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic alterations of prostate cancer: in localized and metastatic prostate cancer.","authors":"Chang Eil Yoon, San Kang, Seung Ah Rhew, Hyeok Jae Kwon, Dongho Shin, Hyong Woo Moon, Mee Young Kim, Ji Youl Lee","doi":"10.1186/s12894-025-01840-5","DOIUrl":"10.1186/s12894-025-01840-5","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"166"},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radical nephrectomy with inferior vena caval thrombectomy for level I to IV tumor thrombus: long-term single-center experience.","authors":"Pavel Navratil, Jiri Chalupnik, Miroslav Louda, Petr Habal, Pavel Zacek, Milos Brodak, Jaroslav Pacovsky","doi":"10.1186/s12894-025-01854-z","DOIUrl":"10.1186/s12894-025-01854-z","url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma (RCC) is a prevalent kidney malignancy known for its aggressive nature and potential to extend into the renal vein or inferior vena cava (IVC), affecting patient prognosis and treatment strategies.</p><p><strong>Objective: </strong>To assess the long-term outcomes and effectiveness of radical nephrectomy with IVC thrombectomy in patients with RCC presenting with level I-IV IVC thrombus.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 164 adult patients treated for RCC with IVC thrombectomy at a tertiary care center from January 2004 to December 2023. Data including demographics, clinical characteristics, tumor specifics, surgical details, complications, and survival rates were meticulously reviewed.</p><p><strong>Results: </strong>Among the patients, the mean age was 63.7 years, predominantly male (69.5%). The histological profile showed a majority of clear cell carcinoma (95.7%), with most tumors located on the right side (71.3%). Thrombus levels were distributed across I-IV, with 41 (25%) patients presenting with level I, 33 (20.1%) with level II, 55 (33.5%) with level III, and 35 (21.4%) with level IV thrombi. The mean operation time and blood loss increased with thrombus level. Perioperative complications were recorded in 57.3% of patients, and over half of the patients experienced disease recurrence (54.9%). The overall 5-year survival rate stood at 42.1%, with notably better survival in patients with level I thrombi.</p><p><strong>Conclusion: </strong>Radical nephrectomy with IVC thrombectomy provides a potential for long-term control in patients with RCC and IVC thrombus, although it is associated with significant morbidity. Multidisciplinary care and expert surgical intervention are crucial for improving patient outcomes. The variability in survival rates across thrombus levels underscores the need for individualized treatment approaches.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"169"},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}