BMC Urology最新文献

{"title":"Virulence genes and antimicrobial resistance profiles of Klebsiella pneumoniae isolated from urinary tract infections.","authors":"Mahsa Maqsoodi, Elahe Tajbakhsh, Hassan Momtaz","doi":"10.1186/s12894-026-02167-5","DOIUrl":"https://doi.org/10.1186/s12894-026-02167-5","url":null,"abstract":"<p><strong>Introduction: </strong>Klebsiella pneumoniae (K. pneumoniae) is an opportunistic pathogen associated with urinary tract infections (UTIs) and exhibits increasing antibiotic resistance and virulence.</p><p><strong>Methods: </strong>Ten K. pneumoniae isolates from UTIs were analyzed for antibiotic susceptibility using the disc diffusion method and classified as multidrug-resistant (MDR) if resistant to at least three antibiotic classes. PCR was employed to detect virulence genes (mrkA, mrkD, capP, entB) and resistance determinants (blaSHV, dfrA1, tetB, aadA1, sul1, qnr).</p><p><strong>Results: </strong>All isolates were resistant to tetracycline, and 80% showed resistance to ampicillin-sulbactam. Six isolates (60%) were MDR. Virulence genes mrkA and mrkD were present in 70% of isolates, while capP and entB were detected in 60%. Resistance genes blaSHV, aadA1, tetB, sul1, dfrA1, and qnr were detected in 80%, 60%, 100%, 40%, 30%, and 40% of isolates, respectively. MDR isolates generally carried more virulence factors than non-MDR isolates.</p><p><strong>Conclusion: </strong>Although the study involves a limited number of isolates, the coexistence of multidrug resistance and multiple virulence genes highlights the potential clinical risk of K. pneumoniae in UTIs. These findings underscore the importance of ongoing surveillance and cautious antibiotic use.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856014","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 low-grade Inflammation Score (INFLA-Score) as a predictor of overall survival in prostate cancer: a UK biobank cohort study.","authors":"Suxin Jiang, Xiaojie Zheng, Hao Qiu, Ning Tao, Hengqing An","doi":"10.1186/s12894-026-02078-5","DOIUrl":"https://doi.org/10.1186/s12894-026-02078-5","url":null,"abstract":"<p><strong>Objective: </strong>Inflammation plays a crucial role in the progression and prognosis of prostate cancer (PCa). The aim of this study was to investigate the association of the low-grade inflammation score (INFLA-score) with overall survival in patients with prostate cancer.</p><p><strong>Methods: </strong>Utilizing data from the UK Biobank, we included 13,166 men diagnosed with PCa. The predictive accuracy of systemic inflammatory biomarkers for overall survival was assessed and compared using the C-statistic. Survival curves were plotted using the Kaplan-Meier method and differences in in overall survival between groups were compared by the log-rank test. Restricted cubic spline (RCS) curves were used to explore the relationship between biomarkers and survival. Independent prognostic biomarkers associated with overall survival (OS) were determined using multivariable Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>The INFLA-score demonstrated the highest predictive accuracy for overall survival among all evaluated biomarkers, with a C-statistic of 0.556 (0.544,0.567). Patients with a high INFLA-score had significantly worse overall survival (shorter survival time) than those with a low INFLA-score (33.76% vs. 66.24%; log-rank p < 0.001). RCS analysis revealed a significant dose-response relationship between the INFLA-score and survival in PCa patients. After adjusting for potential confounders, a high INFLA-score remained an independent predictor of poor OS (HR = 1.24, 95% CI: 1.15-1.33, p < 0.001).</p><p><strong>Conclusions: </strong>The INFLA-score was independently associated with overall survival of PCa patients. As an easily obtainable and integrative measure of low-grade inflammation, it shows significant promise for clinical application in risk stratification and survival prediction.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856047","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":"Effects of vacuum-assisted access sheath in mini-percutaneous nephrolithotomy on early postoperative pain and analgesic requirement: a retrospective analysis.","authors":"Hüseyin Biçer, Vildan Kölükçü","doi":"10.1186/s12894-026-02171-9","DOIUrl":"https://doi.org/10.1186/s12894-026-02171-9","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aimed to evaluate the effect of vacuum-assisted access sheath use during mini-percutaneous nephrolithotomy (mini-PCNL) on early postoperative pain intensity and analgesic requirements in the treatment of renal pelvic stones.</p><p><strong>Methods: </strong>A total of 150 patients who underwent mini-PCNL for a single renal pelvic stone ≥ 20 mm were retrospectively included. Patients who underwent standard mini-PCNL were classified as Group 1, while those treated with a vacuum-assisted access sheath were assigned to Group 2. Demographic characteristics, perioperative parameters, pain assessed by visual analog scale (VAS), and analgesic requirements were compared between the groups.</p><p><strong>Results: </strong>The two groups were comparable in terms of mean age, body mass index, comorbidity status, ASA scores, degree of hydronephrosis, distance between skin puncture, fluoroscopy time, stone size, and stone density (p > 0.05). Operative time and length of hospital stay were significantly longer in Group 1 (77.97 ± 15.72 min and 3.28 ± 1.56 days, respectively) compared with Group 2 (p < 0.001). The incidence of high-grade fever and urinary tract infections requiring additional antibiotic therapy was significantly higher in Group 1 (p = 0.044 and p = 0.032, respectively). Hemoglobin decrease was also more pronounced in Group 1 (p < 0.001). Postoperative VAS scores were significantly lower in Group 2 than in Group 1 (p < 0.001). The absolute between-group differences in VAS at rest were 1.37 points at 1 h, 1.68 points at 6 h, and 1.81 points at 24 h. For dynamic VAS, the corresponding absolute differences were 2.38, 2.09, and 2.05 points, respectively. Furthermore, the number of patients requiring rescue analgesia was markedly higher in Group 1 (p < 0.001). In addition, Group 1 demonstrated a shorter mean time to rescue analgesia and higher analgesic dosage compared with Group 2 (p = 0.002 and p = 0.019, respectively). In multivariate analysis, vacuum-assisted access sheath use remained an independent predictor of both lower postoperative pain scores and reduced analgesic requirement, with an approximately 90% reduction in the odds of rescue analgesia use after adjustment for operative time and intraoperative remifentanil consumption.</p><p><strong>Conclusion: </strong>Vacuum-assisted access sheath use was associated with lower early postoperative pain scores and reduced analgesic requirements; however, prospective controlled studies are needed to confirm these findings.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856108","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 effect of tranexamic acid in perioperative bleeding transfusion in radical cystectomy: a systematic review and meta-analysis.","authors":"Pedro Faria Makabe, Luís Fernando Ferreira Cavalcante, Bruno Yuamoto, Sophia Massafelli Battistuta, Giovanna Ristori Costa, Luís Guilherme Giacon Meloni, Felipe Endrigo Gonçalves Vilela, Isadora Silva Fanucci Bueno, Roni de Carvalho Fernandes, Luis Gustavo Morato de Toledo","doi":"10.1186/s12894-026-02162-w","DOIUrl":"https://doi.org/10.1186/s12894-026-02162-w","url":null,"abstract":"<p><strong>Introduction: </strong>Tranexamic acid (TXA) is an antifibrinolytic agent with demonstrated benefits in various surgical procedures, including urological surgeries. However, its effect on radical cystectomy (RC) remains uncertain, largely due to limited data from an earlier meta-analysis that combined RC with substantially different urological procedures, as well as conflicting results from two recently published meta-analyses specifically evaluating the impact of TXA on RC.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was registered in PROSPERO (CRD42024628394) and conducted following PRISMA and Cochrane guidelines. Randomized controlled trials (RCTs) and observational studies comparing TXA versus no TXA in patients undergoing RC. Primary endpoints included perioperative blood transfusion (PBT) and venous thromboembolism (VTE). Random-effects models with Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment were used to calculate pooled risk ratios (RR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Three studies (one RCT and two propensity-score matched observational studies) involving 1,344 patients (673 TXA; 671 control) were included. The pooled analysis for PBT showed a non-significant reduction in risk (RR 0.69; 95% CI 0.25-1.86; p = 0.25; I2 = 81%). Similarly, the risk of VTE was not significantly different between groups, although a potential trend toward increased risk was noted (RR 1.60; 95% CI 0.80-3.17; p = 0.10; I2 = 0%).</p><p><strong>Conclusions: </strong>Current evidence is underpowered to confirm the efficacy or safety of TXA during radical cystectomy. While no significant benefit or harm was identified, the wide confidence intervals necessitate further large-scale randomized trials to provide definitive clinical guidance.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833995","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":"Correction: Development of machine learning prediction models for postoperative outcomes in adult male circumcision.","authors":"Leonid Shpaner, Giuseppe Saitta","doi":"10.1186/s12894-026-02126-0","DOIUrl":"10.1186/s12894-026-02126-0","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"26 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833966","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":"Clinical value of VI-RADS score in predicting repeat transurethral resection in primary bladder cancer: a prospective observational study.","authors":"Anar Aghayev, Hüseyin Mert Durak, Emre Hepşen, Engin Dinç, Osman Raif Karabacak","doi":"10.1186/s12894-026-02131-3","DOIUrl":"https://doi.org/10.1186/s12894-026-02131-3","url":null,"abstract":"<p><strong>Background: </strong>Repeat transurethral resection of bladder tumor (TURBT) is recommended in selected patients with newly diagnosed bladder cancer to improve staging accuracy and detect residual disease, but it also increases morbidity and treatment burden. The Vesical Imaging-Reporting and Data System (VI-RADS) has shown high accuracy for predicting muscle invasion, whereas its role in identifying patients who undergo repeat TURBT remains unclear. This study evaluated the clinical value of VI-RADS for predicting repeat TURBT status in primary bladder cancer.</p><p><strong>Methods: </strong>This single-center prospective observational study included 59 patients with newly diagnosed primary bladder tumors who underwent preoperative multiparametric magnetic resonance imaging and initial TURBT. VI-RADS scores were assigned by an experienced radiologist blinded to pathological findings. Associations between VI-RADS and clinicopathological variables were examined using Spearman's correlation analysis. Diagnostic performance for predicting repeat TURBT status was assessed by receiver operating characteristic analysis. Univariable and multivariable logistic regression models were used to identify independent predictors of undergoing repeat TURBT.</p><p><strong>Results: </strong>Repeat TURBT was performed in 31 patients (52.5%). Higher VI-RADS categories were more frequently observed among patients who underwent repeat TURBT, whereas lower categories predominated in the single-TURBT group. Among patients undergoing repeat TURBT, residual malignancy was identified in 66.7% of VI-RADS 4 lesions and 88.9% of VI-RADS 5 lesions. VI-RADS correlated significantly with tumor grade, invasion depth, tumor size, and number of surgical procedures. ROC analysis showed modest discriminatory ability for predicting repeat TURBT status (AUC 0.635, 95% CI 0.491-0.778; p = 0.066). At a cutoff of VI-RADS ≥ 3, sensitivity was 70.4% and specificity was 59.4%. In multivariable analysis, only invasion depth at initial TURBT independently predicted repeat TURBT.</p><p><strong>Conclusions: </strong>VI-RADS was associated with pathological tumor severity and with repeat TURBT status, but it did not independently predict undergoing repeat TURBT. These findings support VI-RADS as an adjunctive preoperative tool rather than a stand-alone determinant for repeat resection decisions.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811405","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":"Urinary exosomal miRNA profiling reveals sensitive non-invasive detection of bladder cancer.","authors":"Garima Singh, Anil Kumar, Lalit Kumar, Neelu Mishra, Shristy Bhattacharjee, Kunal Yadav, Yashasvi Singh, Ujwal Kumar, Sameer Trivedi, Samarendra K Singh","doi":"10.1186/s12894-026-02130-4","DOIUrl":"https://doi.org/10.1186/s12894-026-02130-4","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762936","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":"Anesthetic management of primary renal sarcoma with Mayo IV tumor thrombus using moderate hypothermic circulatory arrest and antegrade cerebral perfusion: a case report.","authors":"Zhaoyu Huang, Suli Chen, Guohua Zhang, Liangyuan Lu, Yanjun Lin","doi":"10.1186/s12894-026-02161-x","DOIUrl":"https://doi.org/10.1186/s12894-026-02161-x","url":null,"abstract":"<p><strong>Background: </strong>Primary renal sarcomas in adults are rare, accounting for 1% of all renal tumors. They progress rapidly and are resistant to radiotherapy and chemotherapy. Currently, surgery is the only effective treatment.</p><p><strong>Case presentation: </strong>A 49-year-old man was admitted with a left kidney mass and inferior vena cava (IVC) tumor thrombus extending into the right atrium (Mayo grade IV). He underwent laparoscopic radical nephrectomy and tumor thrombus removal under extracorporeal circulation with moderate hypothermic circulatory arrest (25 °C) and bilateral selective antegrade cerebral perfusion. This technique ensured minimal bleeding while providing effective protection for the brain and coagulation system. The total circulatory arrest time was 91 min, with stable cerebral oxygen saturation throughout.</p><p><strong>Conclusions: </strong>Moderate hypothermic circulatory arrest combined with bilateral antegrade cerebral perfusion, along with a multidisciplinary perioperative management strategy, ensured a favorable prognosis for this patient with a Mayo level IV tumor thrombus. This report aims to provide a reference for the perioperative management of patients with Mayo grade IV tumor thrombi.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762925","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":"Neoadjuvant hormone therapy plus robot-assisted radical prostatectomy improves pathologic outcomes in high-risk prostate cancer: a retrospective cohort study.","authors":"Junhong Fan, Shuang Liu, Ziyu Li, Yuting Xv, Teng Li, Shang Huang, Chunxiang Feng, Jiumin Liu, Dong Li, Fenglian Jiang","doi":"10.1186/s12894-026-02153-x","DOIUrl":"https://doi.org/10.1186/s12894-026-02153-x","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762866","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":"Assessment of aminoglycosides and β-lactam resistance genes among uropathogens; a prospective-cross sectional study.","authors":"Jadoon Khan, Nosheen Basharat, Asma Sadiq, Shahid Ali, Hayat Khan, Ijaz Ali, Abebe Bogale, Ahmed Al-Emam, Hesham M Hassan","doi":"10.1186/s12894-026-02154-w","DOIUrl":"https://doi.org/10.1186/s12894-026-02154-w","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762945","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}