BMC Urology最新文献

{"title":"Prospective randomized analysis of operating time and safety of laparoscopic pyeloplasty with or without TriSect rapide® in adult patients with ureteropelvic junction obstruction.","authors":"Bastian Hummel, Gereon Schaelte, Bogdan Baleanu-Curaj, Stefan Istin, Tibor Szarvas, David Schroeders, Boris Hadaschik, Christian Niedworok","doi":"10.1186/s12894-026-02257-4","DOIUrl":"10.1186/s12894-026-02257-4","url":null,"abstract":"<p><strong>Background: </strong>Multifunctional instruments like the TriSect rapide^® (Erbe Elektromedizin GmbH, Tübingen, Germany) aim to simplify complex surgical procedures by integrating dissection, cutting, and coagulation in a single device. This study aims to evaluate its clinical utility in laparoscopic pyeloplasty. Specifically, we sought to determine whether the use of the TriSect rapide^® could significantly reduce the preparatory phase of laparoscopic pyeloplasty by 30% or more compared to conventional instruments.</p><p><strong>Methods: </strong>In this prospective, randomized trial, 22 patients undergoing laparoscopic pyeloplasty for ureteropelvic junction (UPJ) obstruction were allocated to receive surgery using either the TriSect rapide^® instrument set or conventional instruments. The primary endpoint was the duration of the operation (preparation time). Secondary outcomes were perioperative complications and reported quality of life.</p><p><strong>Results: </strong>The median follow-up was 46 weeks. No significant differences were observed between groups regarding demographic factors, renal function, or intra- and perioperative complications. The intervention group demonstrated a significantly shorter preparation time (83 ± 29.8 vs. 122 ± 32.5 min, p = 0.009), resulting in a reduced total operative time (170 ± 32.0 vs. 211 ± 41.6 min, p = 0.017) and shorter anesthesia duration (221 ± 41.0 vs. 259 ± 41.5 min, p = 0.046). Reconstruction time did not differ significantly (87 ± 14.6 vs. 89 ± 11.1 min, p = 0.639). Complication rates according to the Clavien-Dindo classification were comparable between groups (p = 0.935). Quality-of-life analysis using the RAND SF-36 questionnaire revealed no between-group differences at either time point, although both groups showed significant postoperative improvement compared with baseline (p < 0.001).</p><p><strong>Conclusion: </strong>The use of the TriSect rapide® multifunctional device in laparoscopic pyeloplasty is safe and effective for preparation, dissection and incision. Its application significantly reduces preparation time by approximately 32% without increasing perioperative complications or affecting postoperative quality of life. These findings support the clinical value of multifunctional instruments in improving procedural efficiency while maintaining safety in reconstructive urologic surgery.</p><p><strong>Trial registration: </strong>In compliance with international guidelines for clinical trial transparency, this study was retrospectively registered in the ISRCTN registry (registration number: ISRCTN15328718) on August 7, 2025.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454715","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 single-institutional analysis of laparoscopic 3D radical cystectomy with intracorporeal urinary diversion.","authors":"Matei M Buzoianu, Iulia Andras, Stefan Vesa, Lorin Giurgiu, Paul Medan, Stefana Medan, Andrei Popa, Emanuel Cata, Emanuela Ionutas, Marius Apetrei, Ioan Coman, Nicolae Crisan","doi":"10.1186/s12894-026-02254-7","DOIUrl":"10.1186/s12894-026-02254-7","url":null,"abstract":"<p><strong>Introduction: </strong>In centers with limited access to robotic platforms, the laparoscopic approach represents a feasible alternative for complex urological procedures such as radical cystectomy with intracorporeal urinary diversion. Although technically demanding, outcomes may become comparable to those reported for robotic surgery once the learning curve is overcome. This study aims to evaluate this hypothesis.</p><p><strong>Methods: </strong>We included patients who underwent laparoscopic radical cystectomy (LRC) between 2017 and 2025 at the Urology Department of the Municipal Clinical Hospital Cluj-Napoca. The optimal urinary diversion was chosen based on patient characteristics. Perioperative, postoperative, and oncological outcomes were evaluated as well as the impact of learning curve on these characteristics.</p><p><strong>Results: </strong>We identified 124 patients who underwent LRC. Median estimated blood loss (EBL) was 300 mL (IQR 200-450 mL), and perioperative transfusions were required in 26 cases. A standard pelvic lymphadenectomy yielded a median of 14 lymph nodes (IQR 10-17). Major complications were encountered in 15% of cases. At 12 months follow-up, uretero-ileal strictures were identified in 8 patients with intracorporeal urinary diversion. Total operative time, EBL and the rate of major complications were significantly influenced by surgeon experience.</p><p><strong>Conclusion: </strong>The laparoscopic approach, even in complex procedures such as radical cystectomy with intracorporeal urinary diversion, respects the principles of minimally invasive surgery and represents an alternative for centers with limited access to robotic platforms.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444443","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":"Trends in rates and outcomes of benign prostatic hyperplasia surgeries: a retrospective cohort study using the ACS-NSQIP database (2008-2021).","authors":"Jad Najdi, Maya T Herrera, Baraa Al Jardali, Marwan Zein, Rami W Nasr","doi":"10.1186/s12894-026-02255-6","DOIUrl":"10.1186/s12894-026-02255-6","url":null,"abstract":"<p><strong>Background: </strong>Advancements in surgical techniques have led to a shift in the types of procedures performed for BPH. This study aims to analyze trends in rates and outcomes of surgical procedures for BPH between 2008 and 2021.</p><p><strong>Methods: </strong>Using the ACS-NSQIP database, patients who underwent BPH surgery between 2008 and 2021 were identified. Trends, baseline characteristics and perioperative outcomes were collected for transurethral resection of prostate (TURP), photo-vaporization of prostate (PVP), Laser enucleation of the prostate (LEP) and simple prostatectomy.</p><p><strong>Results: </strong>A total of 99,291 BPH procedures were recorded, increasing from 850 in 2008 to 11,005 in 2021. TURP was the most performed procedure with rates rising from 56.1% in 2008 to 65.2% in 2021. PVP was the second most performed procedure, with rates decreasing from 41.6% in 2008 to 22.5% in 2021. LEP procedures were not recorded prior to 2011 after which the number increased from 82 (2.6%) procedures in 2011 to 971 (8.8%) in 2021. Simple prostatectomy had a relatively stable rate over the course of 14 years (1.8%-3.4%). Over time, a reduction in hospital stay (1.3 to 1.1 days, p < 0.001), and an increase in operative time were observed (55 min ± 31.81 to 66 min ± 46.6, p < 0.001).</p><p><strong>Conclusions: </strong>There has been a noticeable shift in the surgical management of BPH between 2008 and 2021, with a clear trend favoring novel techniques. Utilizing these approaches has led to improvements in perioperative outcomes. Further research is necessary to evaluate long-term outcomes and cost-effectiveness of novel techniques.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444431","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":"Nephroscopic management of partial bladder perforation by an intrauterine device with extravesical main body: a case report and treatment-oriented classification.","authors":"Haiying Niu, Ruirui Ge, Jiajia Wang, Shijie Yao, Quanxin Qu","doi":"10.1186/s12894-026-02256-5","DOIUrl":"10.1186/s12894-026-02256-5","url":null,"abstract":"<p><p>The intrauterine device (IUD) is an important and highly effective means of contraception. Migration of the IUD, post implantation, out of the uterus is an infrequent complication, and an IUD partially perforating the bladder is even more infrequently reported. The authors report a 44-year-old woman who had a copper-M IUD inserted into her uterus 16 years ago. Six months later an unexpected pregnancy occurred and an elective suction abortion was performed without ultrasound check before or after surgery. A copper-T IUD was inserted immediately after completion of the abortion but she was subsequently lost to follow-up. Before detection of the ectopic state of the IUD, she complained of lower quadrant abdominal pain following urination for one month. Physical examination revealed mild tenderness upon deep palpation of the suprapubic area. A series of imaging studies had been performed to confirm the exact position of the ectopic IUD. Transabdominal ultrasound showed a linear hyperechoic foreign body embedded in the right side of the bladder wall, a plain abdominal X-ray showed an M-shaped IUD on the right side of the pelvis, an abdominal CT scan found a portion of one arm penetrated the right anterior bladder wall, and nephroscopy demonstrated a one-centimeter of penetration depth and surrounding calculus formation. The IUD arm was gently pulled into the bladder with forceps and was subsequently removed through the urethra. A Foley catheter was later placed into the bladder for one week to manage the bladder perforation. The patient made an uneventful recovery.This case demonstrates that partial bladder perforation with the IUD body outside the bladder can be successfully managed via transurethral nephroscopy. A stepwise imaging strategy (ultrasound → KUB → CT) is essential for surgical planning. We propose a treatment-oriented classification and a replicable clinical pathway integrating multidisciplinary collaboration and tailored technology selection.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429753","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":"Latent profile analysis of health-related quality of life in patients with bladder cancer and abdominal wall stomas: a multicenter cross-sectional study.","authors":"Jiahui Ren, Jingya Lu, Zhufeng Xiong, Yonghui Zhang, Hui Hong, Meiyun Yang","doi":"10.1186/s12894-026-02253-8","DOIUrl":"10.1186/s12894-026-02253-8","url":null,"abstract":"<p><p>Abdominal wall stomas in bladder cancer patients can severely impact physical, psychological, and social adjustment. However, individual differences in patients' self-reported outcomes and their influencing factors require further investigation. This multicenter cross-sectional study aimed to identify latent profiles of health-related quality of life among bladder cancer patients with abdominal wall stomas and to examine demographic and clinical factors associated with profile membership.We evaluated 598 patients who underwent radical cystectomy with an abdominal wall stoma between September 2020 and September 2023 in the urology departments of five tertiary hospitals in Beijing, Henan and Jiangxi, China. Data were collected via a self-designed general profile questionnaire and the Chinese Patient Self-Reported Outcome Scale for Bladder Cancer with Abdominal Wall Stoma (PROS-BCAS). Latent profile analysis identified three patient subgroups: \"Balanced high-quality type\" (n = 339, 56.7%), \"Unbalanced type\" (n = 148, 24.7%), and \"Low-level type\" (n = 111, 18.6%). Significant differences were observed across the physical, psychological, social, and treatment-related domains among the three profiles. Multinomial logistic regression showed that lower monthly household income, out-of-pocket medical payment, limited stoma self-care ability, younger age, and complications were associated with membership in poorer health-status profiles. These findings indicate substantial heterogeneity in patient-reported outcomes among bladder cancer patients with abdominal wall stomas. Clinicians should prioritize vulnerable patients with socioeconomic disadvantage, insufficient stoma self-care ability, and complications, and provide targeted economic, educational, psychological, and social support to improve health-related quality of life.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435135","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":"Biochemical recurrence following definitive treatment of prostate cancer in Brazil: a retrospective cohort study.","authors":"Murilo de Almeida Luz, Jonatas Pereira, Ronald Kool, Wagner Eduardo Matheus, Roberto Soler, Marcos Freire, Giovanni Bomfim, Sarah Carolina Gonçalves","doi":"10.1186/s12894-026-02249-4","DOIUrl":"10.1186/s12894-026-02249-4","url":null,"abstract":"<p><strong>Background: </strong>Despite apparent cure after treatment of localized prostate cancer (PC), a significant proportion of patients who undergo radical prostatectomy (RP) or radiotherapy (RT) will experience biochemical recurrence (BCR) within 10 years. This study was conducted to evaluate the main aspects of BCR after primary definitive treatment in a real-world setting in Brazil.</p><p><strong>Methods: </strong>In this retrospective, single-center, observational cohort study, data were extracted from electronic medical records of patients aged ≥18 years with PC, treated at one clinical site in Brazil, who underwent definitive curative-intent treatment during January 1, 2005-December 31, 2018. The primary objective was to estimate 5-year BCR rate, defined per European Association of Urology (EAU) criteria as PSA >0.2 ng/mL after RP, or PSA nadir + 2 ng/mL above nadir after RT.</p><p><strong>Results: </strong>Of 971 patients included, 131 (13.5%) experienced BCR within 5 years. Of these, 48 (36.6%) patients underwent RP as primary definitive treatment; 33 (25.2%) underwent RT. Of 5-year BCR patients, 40 (30.5%) underwent computed tomography, and 27 (20.6%) underwent bone scintigraphy. In addition, 69 (52.7%) were deemed non-metastatic hormone-sensitive PC (nmHSPC; 29 high risk, 33 low risk) and 30 (22.9%) were diagnosed with metastatic hormone-sensitive PC (mHSPC). The median time from definitive treatment to BCR was shorter for patients with high-risk BCR nmHSPC than low-risk BCR (27.7 vs 37.0 months, respectively).</p><p><strong>Conclusions: </strong>This retrospective cohort study provides the first real-world characterisation of BCR after definitive treatment in Brazil, demonstrating that patients with high-risk nmHSPC BCR experienced earlier recurrence and shorter time to first-line treatment than low-risk patients. These data highlight the need for improved post-treatment monitoring and earlier therapeutic intervention in high-risk BCR populations in Brazil.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435190","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":"Comparative outcomes of flexible ureterorenoscopy with high-power holmium: YAG laser and flexible, navigable suction access sheath vs mini-percutaneous nephrolithotomy in 2-3 cm kidney stones treatment: a prospective cohort study.","authors":"Muzaffer Tansel Kılınç, Yunus Emre Göger, Ömer Faruk Çavdar, Hakan Hakkı Taşkapu, Mehmet Serkan Özkent","doi":"10.1186/s12894-026-02250-x","DOIUrl":"10.1186/s12894-026-02250-x","url":null,"abstract":"<p><strong>Background: </strong>In this prospective controlled cohort study, we aimed to compare the safety and efficacy of Retrograde intrarenal surgery (RIRS) combined with high-power holmium:YAG laser and vacuum-assisted, flexible, navigable access sheaths (FANS) vs. mini-percutaneous nephrolithotomy (miniPCNL) in 2-3 cm kidney stones.</p><p><strong>Methods: </strong>Between June 2022 and June 2024, 60 patients with 2-3 cm in diameter kidney stones, aged 18 years or older, were prospectively included. Patients were classified into two groups based on their decision: RIRS (Group 1) and miniPCNL (Group 2). Patient demographic data, preoperative creatinine, and hemoglobin levels were recorded. Stone-related factors were evaluated using preoperative tomography. Creatinine and hemoglobin values were measured on the first postoperative day. Stone-free status (SFRs) was evaluated on the first postoperative day and at the first month. Hospital stays and complications were assessed. This study was retrospectively registered to ClinicalTrials.gov (ID = NCT07349992) on January 16, 2026.</p><p><strong>Results: </strong>Patient demographic data, preoperative creatinine levels, hemoglobin levels, and stone-related factors were comparable between the groups. The prestenting rate was higher in Group 1 (16.6%, 95% CI: 3.3-30) than in Group 2 (0%, 95% CI: 0-0, p = 0.02). The operative time and complication rates were comparable between the groups. The fluoroscopy time was lower in Group 1 (p < 0.001). The mean hemoglobin decrease was greater in Group 2 (p < 0.001). Stone-free status was comparable on the first day and first month. Hospital stay was shorter in Group 1 (p < 0.001).</p><p><strong>Conclusions: </strong>Retrograde intrarenal surgery combined with a high-power holmium:YAG laser and FANS shows comparable outcomes to miniPCNL for 2-3 cm kidney stones, yielding a similar SFRs with lower hemoglobin decrease, shorter hospitalization time, and reduced fluoroscopy exposure. However, increased prestenting rates should be considered.</p><p><strong>Trial registration: </strong>This study was retrospectively registered to ClinicalTrials.gov (ID = NCT07349992) on January 16, 2026.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419166","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":"Exploring the response shift effects on patient-reported outcomes among postoperative bladder cancer patients: a qualitative study in China.","authors":"Yanqing Kang, Gaoting Zhong, Ya Zhang, Ziling Chang, Tianmeng Wang, Mei Huang, Rui Gao, Ning Li, Aili Lv","doi":"10.1186/s12894-026-02247-6","DOIUrl":"10.1186/s12894-026-02247-6","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer significantly impacts patients' quality of life, making patient-reported outcomes (PROs) a crucial component of clinical evaluation and care. However, patients' internal standards, values, or conceptualizations may change over time due to diagnosis or treatment experiences-a phenomenon known as response shift -which can threaten the validity of longitudinal PRO assessments and remains underexplored in this population. This study aims to explore response shift in the evaluation of PROs among bladder cancer patients and to identify its underlying mechanisms, using a phenomenological qualitative design.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted between December 2023 and October 2024 in the urological wards of a tertiary-level hospital in China. Purposive sampling was used to recruit 14 patients with bladder cancer. Colaizzi's phenomenological analysis method was used to analyze the data.</p><p><strong>Results: </strong>Three themes were identified as relevant to response shift effects on PROs of bladder cancer patients: multidimensional preoperative and postoperative stressors as triggering antecedents of response shift; cognitive adjustment strategies constituting response shift mechanisms; two divergent adaptive outcomes after exposure to bladder cancer stress.</p><p><strong>Conclusions: </strong>Response shift was observed in PROs three months after surgery for bladder cancer. Understanding the mechanisms behind response shift can help healthcare professionals interpret patient feedback more accurately and optimize personalized care strategies.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419150","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":"Prostatic morphometric parameters and ureteral access sheath placement failure during retrograde intrarenal surgery: a retrospective cohort study.","authors":"Ahmet Yıldırım Balık, Necati Ekici, Burak Ayvacık, Arda Taşkın Taşkıran, Mehmet Ali Özel, Ekrem Başaran, Dursun Baba, Alpaslan Yüksel","doi":"10.1186/s12894-026-02251-w","DOIUrl":"10.1186/s12894-026-02251-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the potential effect of benign prostatic hyperplasia-related prostatic morphometric parameters on ureteral access sheath (UAS) placement failure in male patients scheduled for retrograde intrarenal surgery (RIRS).</p><p><strong>Methods: </strong>Between September 2019 and March 2025, 151 male patients scheduled for RIRS due to renal stones at a tertiary referral center were evaluated retrospectively after applying strict exclusion criteria to obtain a more homogeneous cohort. Patients with a preoperative ureteral stent, prior prostate surgery, alpha-blocker use, urethral or ureteral stricture, or unsuccessful passage of a 7.5 Fr semirigid ureteroscope were excluded. Patients were divided into UAS Successful (n = 93) and UAS Failure (n = 58) groups. Demographic characteristics, including body mass index (BMI), were obtained from the medical records. Hydronephrosis status and prostatic morphometric parameters, including intravesical prostatic protrusion (IPP), prostate volume (PV), prostatic urethral angle (PUA), and prostatic urethral length (PUL), were assessed on preoperative computed tomography by an experienced radiologist.</p><p><strong>Results: </strong>In comparative analyses, no statistically significant differences were found between the groups in terms of age, BMI, stone characteristics, or any of the assessed prostatic morphometric parameters (p > 0.05). Preoperative hydronephrosis was more frequent in the UAS Failure Group than in the UAS Successful Group (70.7% vs. 51.6%; p = 0.020). In univariable analysis, preoperative hydronephrosis was associated with higher odds of UAS placement failure (OR: 2.261; 95% CI: 1.127-4.537; p = 0.022). In the adjusted multivariable model, preoperative hydronephrosis remained independently associated with UAS placement failure (adjusted OR: 2.247; 95% CI: 1.103-4.581; p = 0.026), whereas none of the prostatic morphometric parameters showed an independent association. Length of hospital stay was significantly longer in the UAS Failure Group (p = 0.005).</p><p><strong>Conclusion: </strong>Prostatic morphometric parameters were not significantly associated with UAS placement failure, whereas preoperative hydronephrosis may be a potential factor associated with UAS placement failure. Given the selected nature of this cohort, larger multicenter studies including patients with a wider range of prostatic anatomy are needed to validate these findings.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419100","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":"Added value of PHI in predicting lymph node invasion in prostate cancer: an external validation.","authors":"Jiong Fu, Xiaozhou Zhou, Yang Liu, Hao Deng, Huawang Lyu, Zhiwen Chen","doi":"10.1186/s12894-026-02243-w","DOIUrl":"10.1186/s12894-026-02243-w","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the predictive performance of the Briganti 2017 and MSKCC nomograms with the addition of Prostate Health Index (PHI) in a Chinese cohort of prostate cancer patients undergoing robot-assisted radical prostatectomy and extended pelvic lymph node dissection.</p><p><strong>Methods: </strong>This single-center retrospective study included 473 prostate cancer patients who underwent robot-assisted radical prostatectomy with extended pelvic lymph node dissection from Dec. 2021 to Dec. 2025. The two nomograms were validated, and PHI was incorporated as a continuous variable. Model performance was assessed using AUC, calibration plots, and decision curve analysis, with the DeLong test for AUC comparison. This study was registered in the Medical Research Registration and Filing Information System of the National Health Security Information Platform of China (Registration No.: MR-50-25-036796, retrospectively registered).</p><p><strong>Results: </strong>Lymph node invasion (pN1) was confirmed in 26.0% (123/473) of the cohort. The original Briganti 2017 and MSKCC nomograms had AUCs of 0.69 (95% CI: 0.61-0.79) and 0.71 (95% CI: 0.62-0.78) with satisfactory calibration. PHI incorporation significantly improved discrimination, raising their AUCs to 0.787 (absolute improvement 0.093, P < 0.01) and 0.782 (absolute improvement 0.077, P < 0.01), respectively. Decision curve analysis showed PHI expanded the threshold probability range of positive net benefit from 10% to 30% to 10%-40% for both models.</p><p><strong>Conclusion: </strong>The Briganti 2017 and MSKCC nomograms showed acceptable predictive performance for lymph node invasion in Chinese prostate cancer patients. PHI enhances their discriminatory ability and clinical utility, supporting its use as a valuable preoperative biomarker for pN1 in prostate cancer.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419188","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}