BMC Urology最新文献

{"title":"Retrograde intrarenal surgery with intelligent pressure control: experience from a primary hospital in China.","authors":"Xin Liu, Wangsheng Huo, Yanjun Wang, Hui Chai, Libin Chen, Hui Meng, Zhihong Gong, Hongze Zhang, Jian Lang, Zhantian An, Wei Wei","doi":"10.1186/s12894-025-01910-8","DOIUrl":"https://doi.org/10.1186/s12894-025-01910-8","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the clinical outcomes of conventional retrograde intrarenal surgery (RIRS) and RIRS with intelligent pressure control, as well as to identify factors influencing the stone-free rate (SFR).</p><p><strong>Materials and methods: </strong>We conducted a retrospective review of 101 patients treated with either conventional RIRS or RIRS with intelligent pressure control from September 2023 to September 2024. Clinical and stone-related parameters were collected for comparison between the two methods, and factors affecting SFR were examined using univariate and multivariate logistic regression analyses.</p><p><strong>Results: </strong>The SFR was significantly higher in the intelligent pressure control group compared to the conventional RIRS group (89.8% vs. 73.1%, p = 0.032). No statistically significant differences were found between the two groups regarding operative time or post-operative hospital stays. The incidence of post-operative fever was lower in the intelligent pressure control group than in the conventional RIRS group (2.0% vs. 9.8%), although this difference did not reach statistical significance (p = 0.205). Univariate analysis identified stone size, stone density, number, location, and surgical method as factors associated with SFR. Multivariate analysis further confirmed that stone size, density, and surgical method significantly impacted SFR.</p><p><strong>Conclusion: </strong>RIRS with intelligent pressure control significantly improves the stone-free rate compared to conventional RIRS, without increasing complications, hospitalization duration, or operative time. Additionally, stone size and density were influential factors for SFR.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"218"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943820","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 outcomes of neobladder or augmentation after cystectomy in locally advanced colorectal cancer involving urinary tract: case series.","authors":"Chunwoo Lee, Wook Nam, Chan Wook Kim, Yong Sik Yoon, Dalsan You","doi":"10.1186/s12894-025-01904-6","DOIUrl":"https://doi.org/10.1186/s12894-025-01904-6","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"221"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943700","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":"Ureteral wall thickness at the ureterovesical junction as a significant factor in predicting medical expulsive therapy of ureterovesical junction stones.","authors":"Tiancan Yang, Jian Ji, Yafei Wang, Xiaowen Gao, Lingmin Lei, Lvyang Chen, Shicheng Fan, Zhida Wu, Wei Pu, Yunbo Shang","doi":"10.1186/s12894-025-01890-9","DOIUrl":"https://doi.org/10.1186/s12894-025-01890-9","url":null,"abstract":"<p><strong>Background: </strong>To evaluate ureteral wall thickness (UWT) at the ureterovesical junction (UVJ) measured by ultrasound for predicting spontaneous passage (SP) of uncomplicated UVJ stones.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed 170 patients ≥ 18 years old, and size ≤ 10 mm of single UVJ stone, who were examined and treated in the Third People's Hospital of Yunnan Province from January 2020 to January 2024. The analysis included the size of the stones, the maximum UWT at the stone site measured by ultrasound, the degree of hydronephrosis, and the time of stone removal.According to the different results after four weeks of medical expulsive therapy (MET), the patients were separated into two categories: Stone-passing group (SPG) and non-stone-passing group (NSPG). Univariate and multivariate logistic regression analysis were utilised to evaluate the clinical predictors of MET.The receiver operating characteristic (ROC) curve was employed to evaluate the accuracy of the UWT at the UVJ in predicting successful MET.</p><p><strong>Results: </strong>The SPG comprised 112 cases (65.9%), while the NSPG consisted of 58 cases (34.2%). Univariate analysis, employing both the chi-square test and the Mann-Whitney U test, revealed that gender, age, stone side and degree of hydronephrosis were not statistically significant. However, stone size and UWT were found to be influencing factors in regard to stone removal. Binary logistic regression analysis demonstrated that UWT and size were independent influencing factor of MET. The ROC analysis indicated that 3.705 mm was the ideal threshold for UWT, with sensitivity and specificity levels of 72.4% and 68.7%, with an area under the ROC curve (AUC) of 0.737.</p><p><strong>Conclusions: </strong>The UWT at the UVJ has a high predictive value for the MET of stones at this position, thus avoiding the adverse consequences of delayed stone discharge caused by unnecessary surgical operation and MET.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"215"},"PeriodicalIF":1.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943867","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":"Orchiectomy and scrotectomy as genital gender-affirming surgery: novel surgical technique and patient-reported outcomes.","authors":"Kitan Zoltin, Briar Shannon, Ryan Timar, Gaines Blasdel, Nabeel Shakir","doi":"10.1186/s12894-025-01867-8","DOIUrl":"https://doi.org/10.1186/s12894-025-01867-8","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"217"},"PeriodicalIF":1.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943715","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":"Patients' experiences of a standardized care pathway for suspected bladder cancer due to macroscopic hematuria.","authors":"Lisa Karlsson, Anette Ek-Steinum, Viola Nyman, Suleiman Abuhasanein","doi":"10.1186/s12894-025-01898-1","DOIUrl":"https://doi.org/10.1186/s12894-025-01898-1","url":null,"abstract":"<p><strong>Objective: </strong>To explore patients' experiences navigating the Standardized Care Pathway (SCP) for macroscopic hematuria through semi-structured interviews.</p><p><strong>Methods and materials: </strong>An interview study was conducted to explore patients' experiences of SCP for macroscopic hematuria. The study employed content analysis with an inductive approach, as described by Lundman and Graneheim, to explore both explicit and implicit patterns in the data. Informants were recruited from an outpatient clinic for investigation of macroscopic hematuria, with interview questions derived from literature and clinical experience. Researchers immersed themselves in the data through repeated readings of transcripts, identifying meaning units that were coded and analyzed to develop subcategories reflecting similarities and differences.</p><p><strong>Results: </strong>Twelve patients, with a median age of 71 years (58% women), participated in the study. Among them, one was diagnosed with urinary bladder cancer (UBC). The findings highlight a mix of appreciation and questioning associated with the SCP process, as patients valued the efficiency of one stop policy for testing but also experienced heightened anxiety. A lack of detailed and patient-centred communication emerged as a key issue, with primary care centers providing insufficient information.</p><p><strong>Conclusions: </strong>Although SCP is effective, it prompts consideration of whether it is suitable for all patients. A more individually tailored approach might be more appropriate, prioritizing rapid evaluation for those with a high likelihood of cancer while directing others to a standard diagnostic route. Continuing the one-stop policy was seen as beneficial.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"216"},"PeriodicalIF":1.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943750","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":"Migration of a urethral foreign body into the scrotum in an adolescent: a case report.","authors":"Ye Wu, Jian-He Wu, Xian-Ya He, Yi-Ming Zeng, Yong-Jun Yang, Yuan-Wei Li, Qiang Lu","doi":"10.1186/s12894-025-01886-5","DOIUrl":"https://doi.org/10.1186/s12894-025-01886-5","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"210"},"PeriodicalIF":1.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943721","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":"Does patient age influence procedural management of kidney trauma?","authors":"Nizar Hakam, Behzad Abbasi, Umar Ghaffar, Kevin D Li, Hiren Patel, Charles P Jones, Joseph Cuschieri, Benjamin N Breyer","doi":"10.1186/s12894-025-01879-4","DOIUrl":"https://doi.org/10.1186/s12894-025-01879-4","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to examine the association between patient age and procedural intervention, especially nephrectomy, in patients with renal trauma in the National Trauma Data Bank (NTDB).</p><p><strong>Materials and methods: </strong>We queried the 2013-2020 NTDB for adult renal trauma patients with an American Association for the Surgery of Trauma (AAST) grade. Patients without AAST grade or with no sign of life were excluded. We constructed a multinomial logistic regression model to demonstrate the association between age and procedural interventions (renal angioembolization, renorrhaphy and nephrectomy). Models were adjusted for patient, hospital, and clinical factors.</p><p><strong>Results: </strong>Our cohort was comprised of 49,884 patients with renal trauma aged 18-89 years, of which 691 (1.4%), 995 (1.9%), and 3,366 (6.8%) underwent angioembolization, renorrhaphy, and nephrectomy, respectively. After adjusting for relevant variables, the risks of nephrectomy and angioembolization were positively associated with patient age, particularly in those 40 years of age and older. Adjusted risk of nephrectomy (OR 0.07 per 10 years of age, 95% CI 0.03-0.11, p < 0.001) and angioembolization (OR 0.19 per 10 years of age, 95% CI 0.14-0.24, p < 0.001) ranged between ≈ 0.6% and ≈ 1%, and between ≈ 0.3% and ≈ 1% across the patient age range, respectively. Plots depicting marginal effect of age is demonstrated that in patients above 35-40 years of age, a 1-year increase in age is associated with a progressively higher increase in risk of both nephrectomy and angioembolization. The adjusted risk of Renorrhaphy (OR -0.003 per 10 years of age, 95% CI -0.06-0.06, p = 0.92) did not vary substantially with age and the marginal effect of age was negligible across all ages.</p><p><strong>Conclusions: </strong>Older patients with renal trauma are more likely to receive procedural intervention namely nephrectomy and renal angioembolization. These results suggest possible age-related cognitive bias in renal trauma management.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"208"},"PeriodicalIF":1.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943235","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":"Artificial intelligence-based prediction of treatment failure and medication non-adherence in overactive bladder management.","authors":"Mert Başaranoğlu, İsa Kamil Taşdemir, Erdem Akbay, Hasan Erdal Doruk","doi":"10.1186/s12894-025-01911-7","DOIUrl":"https://doi.org/10.1186/s12894-025-01911-7","url":null,"abstract":"<p><strong>Background: </strong>Overactive bladder management presents significant challenges, with treatment failures and medication non-adherence posing substantial barriers to patient outcomes. Early prediction of these challenges could enable timely interventions and treatment modifications.</p><p><strong>Objectives: </strong>To develop and validate an artificial intelligence-based prediction model for early identification of treatment failure and medication non-adherence in overactive bladder patients, with specific focus on different pathological subgroups including diabetic neuropathy.</p><p><strong>Methods: </strong>In this single-center retrospective study (January 2018-April 2025), we analyzed data from 285 patients with overactive bladder. We developed and validated artificial intelligence models using comprehensive clinical parameters, including ultrasonography findings, uroflowmetry results, standardized voiding diaries, and disease-specific questionnaire outcomes. Primary outcome measures were treatment failure and medication non-adherence at three months.</p><p><strong>Results: </strong>The gradient boosting model achieved an accuracy of 87.3% (95% CI: 84.1-90.5%) for predicting treatment failure and 85.1% (95% CI: 81.8-88.4%) for predicting medication non-adherence. Key predictive factors included early changes in bladder wall thickness (OR: 3.82, 95% CI: 2.14-6.81), diabetes duration > 7 years (OR: 2.73, 95% CI: 1.58-4.72), and urgency improvement < 25% (OR: 2.94, 95% CI: 1.76-4.92). Treatment failure rates varied significantly among pathological subgroups, with highest rates in diabetic neuropathy (42.8%) and lowest in idiopathic OAB (28.6%, p = 0.024). Among treatment failure patients, 68.4% proceeded to advanced therapies, with differential success patterns across subgroups.</p><p><strong>Conclusions: </strong>Our artificial intelligence model effectively identifies patients at risk of treatment failure and medication non-adherence in overactive bladder management. This approach enables early identification of high-risk patients, potentially improving treatment outcomes and healthcare resource utilization through timely intervention and treatment modification.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"209"},"PeriodicalIF":1.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943763","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":"Financial toxicity in lower urinary tract symptoms amongst men.","authors":"Wilson Sui, Pablo Suarez, Heiko Yang, Maria Camila Velasquez Escobar, Feres Camargo Maluf, Taylor Hall, Sultan Al Azzawi, Lavanya Gupta, Thomas Chi","doi":"10.1186/s12894-025-01895-4","DOIUrl":"https://doi.org/10.1186/s12894-025-01895-4","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"213"},"PeriodicalIF":1.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943210","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":"Can the degree of ureteral stone impaction better predict surgical success and complications? a new classification system.","authors":"Emre Şam, Mustafa Yağmur, Muhammed Çağrı Akkuş, Deniz Öztürk Koçakgöl, Büşra Emir, Mehmet Sefa Altay, Fatih Akkaş, Ekrem Güner","doi":"10.1186/s12894-025-01912-6","DOIUrl":"https://doi.org/10.1186/s12894-025-01912-6","url":null,"abstract":"<p><strong>Background: </strong>According to our hypothesis, a classification system that grades stone impaction may better predict surgical success and complications. Therefore, we developed a new classification system, and in this study, we aimed to evaluate the effect of stone impaction and its degree on success and complications of ureteroscopic lithotripsy (URS-L), as well as to investigate preoperative factors predicting stone impaction and its degree.</p><p><strong>Methods: </strong>Data of patients over the age of 18 years who underwent URS-L for a single ureteral stone were prospectively collected. First, stone impaction was determined by the primary surgeon using a Likert scale. Subsequently, non-impacted and impacted stones were further divided into two subgroups and classified according to the degree of stone impaction between Grades 1 and 4. Patient characteristics, preoperative non-contrast computed tomography (CT) findings, laboratory values, and intraoperative and postoperative outcomes were analyzed. Stone-free status was defined as the absence of residual stones > 2 mm on non-contrast CT at postoperative month 1.</p><p><strong>Results: </strong>The study included a total of 211 patients. Operative time, ureteral injury, degree of ureteral injury, failure (nephrostomy placement), hospital stay, and stone-free rates differed significantly between impacted and non-impacted stones. When evaluated by degree of impaction, significant differences were identified in operative time, presence of pyuria, ureteral injury, degree of ureteral injury, failure, hospital stay, and stone-free status. Colic severity, time from pain onset to surgery, location (upper ureter), stone volume, peri-calculus ureteral wall thickness (PUWT), and presence of severe hydronephrosis were found to be predictive factors of stone impaction, while female gender, stone location (upper ureter), and PUWT were independent predictors of Grade 4 stones.</p><p><strong>Conclusions: </strong>This study showed that stone impaction and the new classification system are associated with surgical outcomes. Not all non-impacted or impacted stones are the same, and grading according to the interaction of the stone with the ureteral wall can better predict surgical outcomes.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"212"},"PeriodicalIF":1.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943705","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}