BMC Urology最新文献

{"title":"Effects of pre-procedural video education and intra-procedural virtual reality on anxiety and pain during flexible cystoscopy: a randomized controlled trial.","authors":"Murat Beyatlı, Hasan Samet Güngör, Resul Sobay, Abdurrahman İnkaya, Nurullah Mustafa Şişik, Muhammed Emre Topçu, Mehmet Umut Evci, Tuncel Uzel, Ferhat Yakup Suçeken, Ahmet Tahra, Eyüp Veli Küçük","doi":"10.1186/s12894-026-02239-6","DOIUrl":"10.1186/s12894-026-02239-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the effects of pre-procedural video education and intra-procedural distraction using virtual reality (VR) nature videos on patient anxiety and pain perception during office-based flexible cystoscopy.</p><p><strong>Methods: </strong>In this single-center, four-arm, parallel-group randomized controlled trial, 240 adult patients scheduled for flexible cystoscopy were enrolled. Participants were randomized into four groups: Video + VR- (n = 60), Video + VR + (n = 60), Video- VR + (n = 60), and Video- VR- (control, n = 60). Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory (STAI), and pain was measured with a visual analog scale (VAS). Intergroup comparisons were performed using nonparametric tests, and outcome assessors were blinded to group allocation.</p><p><strong>Results: </strong>Pain scores differed significantly among groups (H = 44.604, p < 0.001). The lowest pain scores were observed in the Video + VR + group (4.3 ± 1.1), while the highest were in the control group (5.7 ± 1.1). Reductions in STAI-S (state anxiety) scores also showed significant group differences (H = 28.311, p < 0.001). Compared with the control group, the Video + VR + group demonstrated significant improvements in both VAS (p < 0.001, r = 0.610) and STAI-S reduction (p < 0.001, r = -0.493), with large effect sizes. Analyses based on baseline STAI-T (trait anxiety) scores indicated that the interventions were effective regardless of initial anxiety levels, with the combined Video + VR + approach consistently providing the greatest benefit.</p><p><strong>Conclusion: </strong>The combination of pre-procedural video education and intra-procedural VR distraction was associated with the greatest reduction in pain and anxiety during flexible cystoscopy. These findings support the potential value of multimodal approaches for improving patient comfort during urologic procedures.</p><p><strong>Trial registration: </strong>Registered on 05 September 2025 in the ISRCTN registry ( ISRCTN22513446 ).</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359627","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 social media videos meet patients' information needs for benign prostatic hyperplasia? A repeated cross-sectional study.","authors":"Chengyang Tian, Weibo Wang, Junyue Tao, Guangyue Luo, Jun Zhou","doi":"10.1186/s12894-026-02234-x","DOIUrl":"10.1186/s12894-026-02234-x","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is a common urological condition among older men and can cause lower urinary tract symptoms (LUTS). As patients increasingly seek disease-related information through social media, evaluations of the quality, reliability, and transparency of patient-facing BPH content remain limited.</p><p><strong>Methods: </strong>Repeated cross-sectional searches were conducted on Bilibili and TikTok on December 1, 16, and 31, 2025. Basic video characteristics were extracted. Video reliability, quality, and transparency were assessed using the modified DISCERN (mDISCERN), Global Quality Score (GQS), and the Journal of the American Medical Association (JAMA) benchmark criteria, respectively. Exploratory supplementary assessments of content coverage and accessibility-related features were conducted using the content coverage checklist (CCC) and video accessibility checklist (VAC). Potentially misleading or harmful information signals were also descriptively assessed. Spearman correlation analysis and ordinal logistic regression were performed to examine associations between video characteristics and assessment scores.</p><p><strong>Results: </strong>A total of 217 videos were included. Overall, the median (IQR) scores were 3.00 (2.00-3.00) for mDISCERN, 3.00 (2.00-3.00) for GQS, and 2.00 (2.00-2.00) for JAMA. In exploratory supplementary analyses, the median (IQR) scores were 3.00 (2.00-4.00) for CCC and 6.00 (5.00-6.00) for VAC. Potentially misleading or harmful information signals were observed in 29 videos (13.4%). Videos published by professional individuals and professional institutions had significantly higher mDISCERN, GQS, and JAMA scores than those published by non-professional individuals (all P < 0.001). Spearman correlation analysis and ordinal logistic regression indicated that engagement metrics were not independent predictors of assessment scores.</p><p><strong>Conclusions: </strong>Overall, BPH-related videos on social media showed moderate reliability, quality, and transparency, but consistently high-value content remained limited. A minority of videos also contained potentially misleading or harmful information signals. Videos from professional sources tended to provide higher-quality information, whereas user engagement was not a reliable indicator of content quality. These findings suggest that urologists and healthcare institutions may have an important role in providing more structured, understandable, and patient-oriented digital education for men seeking BPH information online.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343845","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":"Outcomes in patients undergoing benign prostatic hyperplasia surgical re-treatment with holmium laser enucleation of the prostate compared to treatment-naïve patients.","authors":"Jenny Guo, Jacob W McDevitt, Jack T Peterson, Amir Patel, Nabila Khondakar, Perry Xu, Amy Krambeck","doi":"10.1186/s12894-026-02227-w","DOIUrl":"10.1186/s12894-026-02227-w","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgical therapies for benign prostatic hyperplasia (BPH) are increasingly utilized but may have limited long-term durability, leading some patients to require re-treatment. Holmium laser enucleation of the prostate (HoLEP) is a size-independent option, but outcomes after prior BPH intervention remain incompletely characterized. We compared perioperative, postoperative, and functional outcomes of HoLEP in re-treatment versus treatment-naïve HoLEP.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients undergoing HoLEP at a tertiary center between February 2021 and August 2025. Patients with prior surgical or minimally invasive BPH interventions were propensity score-matched 1:1 to treatment-naïve patients by prostate specimen weight. Perioperative variables, postoperative outcomes, and functional measures were compared.</p><p><strong>Results: </strong>We identified 418 re-treatment patients who were matched to 418 treatment-naïve controls. Re-treatment patients were older and had higher rates of prior urinary retention and urinary tract infection. Operative time, laser energy usage, and intraoperative complication rates were similar between cohorts. Overall, 90-day complication rates did not differ (6.5% vs. 5.5%, p = 0.66), though emergency department visits were more frequent in re-treatment patients (9.1% vs. 5.3%, p = 0.044). Both groups experienced comparable improvements in American Urological Association symptom and quality of life scores. Postoperative Michigan Incontinence Symptom Index severity scores were lower in the re-treatment cohort (4.9 ± 6.1 vs. 6.4 ± 6.5, p = 0.038).</p><p><strong>Conclusions: </strong>HoLEP performed after prior BPH intervention demonstrates perioperative safety and functional outcomes comparable to treatment-naïve HoLEP, supporting its role as a durable and effective treatment for recurrent or persistent BPH symptoms.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327114","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":"Robot-assisted versus laparoscopic partial nephrectomy for multiple ipsilateral renal tumours: surgical, functional and oncological outcomes.","authors":"Changwei Shi, Cheng Peng, Jialong Song, Li Wang, Deqiang Lv, Yibo Chen, Senming Cao, Xinran Chen, Xin Ma, Qingbo Huang","doi":"10.1186/s12894-026-02224-z","DOIUrl":"10.1186/s12894-026-02224-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the outcomes of laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) for the treatment of multiple ipsilateral renal tumours (MIRT). The primary outcomes were perioperative results, including the rate of postoperative complications and 'Trifecta' achievement. The secondary outcomes included renal functional preservation and oncological survival.</p><p><strong>Methods: </strong>We retrospectively analysed the data of patients with MIRT who underwent LPN or RAPN between 2010 and 2024. Propensity score matching (1:1) was performed to adjust for potential baseline confounders, resulting in a final matched cohort of 19 patients per group. Perioperative data and functional, oncological, and survival outcomes were reviewed.</p><p><strong>Results: </strong>In the matched cohort, the RAPN group was associated with significantly fewer postoperative complications (10.5% vs. 47.4%, P = 0.029). Notably, 88.9% (8/9) of the complications in the LPN group were Clavien-Dindo grade I. The RAPN group also showed a higher 'Trifecta' rate (63.2% vs. 21.1%, P = 0.020) and shorter postoperative hospital stay (4 vs. 6 days; P = 0.044). At 12 months postoperatively, the RAPN group demonstrated significantly lower absolute (9.1 vs. 18.4 µmol/L, P = 0.041) and percentage changes (12.0% vs. 25.9%, P = 0.024) in serum creatinine (Scr). No significant differences were identified in disease-free survival (P = 0.386), cancer-specific survival (P = 0.678), or overall survival (P = 0.116).</p><p><strong>Conclusions: </strong>For patients with MIRT, RAPN demonstrates superior perioperative results and better preservation of renal function compared to LPN. These findings support the use of robotics as the preferred minimally invasive strategy for complex cases with two ipsilateral renal lesions, potentially enhancing surgical safety and functional outcomes.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315948","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":"Variant histology in urothelial carcinoma: associated factors and survival impact after radical cystectomy.","authors":"Emre Uzun, Serkan Ozen, Samet Senel, Hasan Batuhan Arabaci, Antonios Koudonas, Huseyin Gultekin, Yalcin Kizilkan, Cavit Ceylan, Cuneyt Ozden","doi":"10.1186/s12894-026-02232-z","DOIUrl":"10.1186/s12894-026-02232-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the factors associated with variant histology (VH) and prognostic significance of VH in urothelial carcinoma (UC) among patients undergoing radical cystectomy (RC) with ileal conduit urinary diversion.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 317 patients who underwent RC with ileal conduit diversion between 2019 and 2025. Patients were categorized based on the presence of VH in the final pathology. Demographic, clinical, perioperative, and pathological data were compared. Logistic regression was performed to identify factors associated with VH, while Kaplan-Meier and uni-multivariable Cox regression analyses evaluated overall survival (OS) and cancer-specific survival (CSS).</p><p><strong>Results: </strong>VH was detected in 139 patients (43.8%), with squamous differentiation being the most prevalent variant, observed in 80 patients of the 317 patients who underwent RC with ileal conduit urinary diversion. Presence of hydronephrosis, clinical lymph node positivity and WBC > 7695 g/dl were defined as factors associated with VH in multivariate logistic regression analysis. Kaplan-Meier survival analysis illustrated a statistically significant reduction in OS and CSS among patients harboring VH compared to those with pure UC following RC and ileal conduit urinary diversion (53.8 vs. 36.8 months for OS and 68 vs. 53 months for CSS, log-rank test, p < 0.001). Multivariable Cox regression analysis revealed that presence of variant histology was associated with reduced OS (HR = 1.624; 95% CI = 1.094-2.411; p = 0.016) and CSS (HR = 1.945; 95% CI = 1.043-3.626; p = 0.036).</p><p><strong>Conclusion: </strong>VH in UC is associated with advanced disease and poorer survival outcomes following RC. Certain preoperative factors-hydronephrosis, clinical lymphadenopathy, and elevated WBC-may be associated with the presence of VH. Early recognition of these features could guide individualized treatment strategies and improve prognostic assessment. However, the retrospective and single-center nature of this study may introduce selection and information bias, and the findings should be interpreted with caution until validated by prospective multicenter trials.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148306930","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":"Unilateral primary adrenal high-grade B-cell lymphoma treated with R-CHOP chemotherapy: a case report and literature review.","authors":"Ferhat Yakup Suçeken, Ayşe Nur İhvan, Aydan Arslan, Hakan Keski","doi":"10.1186/s12894-026-02229-8","DOIUrl":"10.1186/s12894-026-02229-8","url":null,"abstract":"<p><strong>Background: </strong>Primary adrenal lymphoma (PAL) is a rare and aggressive extranodal lymphoma that may radiologically mimic primary adrenal carcinoma, often leading to diagnostic uncertainty and potentially unnecessary surgical intervention. Early tissue diagnosis is essential for accurate management.</p><p><strong>Case presentation: </strong>A 71-year-old man was evaluated for persistent left upper quadrant abdominal pain and progressive fatigue. Cross-sectional imaging revealed a large, heterogeneous mass originating from the left adrenal gland with radiologic features suggestive of local invasion. Based on the initial radiologic impression, primary adrenal carcinoma was suspected, and surgical intervention was planned accordingly. However, further review by an experienced radiologist raised suspicion of a lymphoproliferative disorder. A computed tomography-guided core needle biopsy was subsequently performed, and histopathological analysis confirmed the diagnosis of high-grade B-cell lymphoma with a Ki-67 proliferation index of approximately 80%. The patient received six cycles of well-tolerated R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). Post-treatment imaging revealed complete resolution of the adrenal mass. At the 24-month follow-up, the patient remained in complete remission, with no evidence of disease recurrence.</p><p><strong>Conclusions: </strong>This case underscores the importance of multidisciplinary assessment and image-guided biopsy in the evaluation of adrenal masses. Avoiding unnecessary surgery through early tissue diagnosis enabled effective systemic treatment. In selected patients, R-CHOP chemotherapy may result in long-term disease control, even in elderly individuals with large unilateral adrenal tumors.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300922","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":"Evaluation of ChatGPT-4o's and DeepSeek R1's responses to urological problems: a comparative study.","authors":"Hanbo Lu, Yusa Zhang, Zhan Wang, Yang Zhao, Jiang Liu, Dongxu Qiu, Yushi Zhang","doi":"10.1186/s12894-026-02228-9","DOIUrl":"10.1186/s12894-026-02228-9","url":null,"abstract":"<p><strong>Background: </strong>Urology presents unique challenges for AI systems, requiring both extensive medical knowledge and advanced reasoning. While large language models (LLMs) like GPT-4 have shown promise in medical education and decision support, their performance in urology remains underexplored.</p><p><strong>Objective: </strong>To provide a time-stamped comparison of two representative large language models available at the time of evaluation, ChatGPT-4o and DeepSeek R1, in answering urology-related single-choice questions, and to evaluate their accuracy, stability, and response consistency across different response configurations.</p><p><strong>Methods: </strong>A total of 809 single-choice questions from the Chinese National Qualification Examination for Attending Physicians in Urology were administered to ChatGPT-4o and DeepSeek R1. Each model was tested under three configurations: basic mode, deep-thinking mode, and web-enabled retrieval. Accuracy was calculated for each configuration, and statistical comparisons were performed using McNemar's test. Stability across reasoning modes was assessed by comparing performance variability. Additional analyses examined performance differences between short-answer and case-based clinical questions.</p><p><strong>Results: </strong>ChatGPT-4o achieved accuracy rates of 78.12%, 73.79%, and 78.99% in basic, deep-thinking, and web-enabled retrieval modes, respectively. DeepSeek R1 outperformed ChatGPT-4o across all configurations, with accuracy rates of 83.19%, 81.46%, and 84.55%, respectively. All between-model differences were statistically significant (p < 0.001). DeepSeek R1 demonstrated greater internal stability across reasoning modes, whereas ChatGPT-4o showed notable variability. In subgroup analyses, DeepSeek R1 exhibited a more pronounced advantage in complex, case-based clinical questions. Both models performed consistently across urological disease categories, and findings were limited to the Chinese-language context in which the evaluation was conducted.</p><p><strong>Conclusion: </strong>DeepSeek R1 showed superior performance compared with ChatGPT-4o in both accuracy and stability when answering urology-related examination questions, particularly in complex case-based scenarios. These results suggest that optimized LLMs may have potential utility in urology education and examination-style question answering, especially within Chinese-language environments. However, these findings should not be interpreted as evidence of readiness for real-world clinical decision support, and further validation in clinically realistic settings is required.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293456","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":"Purple catheter syndrome (PUBS): a mystery in a post stroke patient with Klebsiella - should we be concerned?","authors":"Induja K, Ravi Gaur, Nitesh Manohar Gonnade, Vibhor Tak, Kuntal Kumar Sinha, Nagma Sheenam, Abins T K","doi":"10.1186/s12894-026-02089-2","DOIUrl":"10.1186/s12894-026-02089-2","url":null,"abstract":"<p><strong>Background: </strong>Purple urine bag syndrome (PUBS) is an unusual but recognizable manifestation characterized by a striking purple hue in the urinary collection system. This phenomenon results from bacterial enzymatic breakdown of tryptophan in the presence of alkaline urine. While often benign, PUBS can indicate an underlying infection, particularly in individuals with long-term catheterization and other risk factors, such as immobility and constipation.</p><p><strong>Case presentation: </strong>We describe the case of a woman in her 40s with a prior cerebrovascular accident who was bedbound and dependent on a long-term indwelling catheter. She developed discoloration of her urine bag without systemic symptoms. Urine analysis revealed an alkaline pH and significant pyuria, and culture confirmed infection with Klebsiella pneumoniae. Management involves replacing the catheter, initiating culture-directed antibiotic therapy with levofloxacin, optimizing bowel habits, and promoting hydration. These interventions led to a full resolution of the discoloration and infection.</p><p><strong>Conclusion: </strong>Although visually alarming, PUBS often serves as a subtle clinical indicator of underlying urinary tract pathology. This case highlights the necessity of a multifactorial management approach, including microbiological evaluation, catheter hygiene, bowel regulation, and patient education. Early recognition of PUBS may help prevent escalation to more severe complications in vulnerable, catheter-dependent patients.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293503","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":"Concurrent septic shock and massive renal hematoma following flexible ureteroscopy resulting in emergency nephrectomy: a case report.","authors":"Elsayed Abdelhalim, Mohamed Galal, Ali Ibrahim, Mohamed Abd Elaty, Khaled Magdy Zeinelabden, Hossam Nabeeh, Diaa-Eldin Taha, Tarek Abdelbaky","doi":"10.1186/s12894-026-02199-x","DOIUrl":"10.1186/s12894-026-02199-x","url":null,"abstract":"<p><strong>Background: </strong>Flexible ureteroscopy (FURS) is widely considered a safe and effective modality for renal stone management. Severe infectious and hemorrhagic complications are uncommon but may be life-threatening.</p><p><strong>Case-presentation: </strong>A 75-year-old man was referred to our tertiary center with hemodynamic instability following FURS performed at an outside institution for the treatment of a renal calculus. He presented with septic shock and acute anemia. Contrast-enhanced computed tomography revealed a massive perirenal hematoma compressing the renal parenchyma. Despite aggressive resuscitation, broad-spectrum antibiotics, and intensive care management, the patient's clinical condition deteriorated. Emergency nephrectomy was performed as a life-saving intervention.</p><p><strong>Conclusion: </strong>This case highlights the potential for rare combined septic and hemorrhagic complications following FURS. Early recognition and timely referral to specialized centers are critical to reducing mortality and optimizing patient outcomes.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148275970","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":"Prognostic role of preoperative plasma fibrinogen-to-albumin ratio in urological carcinomas: a systematic review and meta-analysis.","authors":"Zhengqing Bao, Jiaqi An, Guizhong Li, Jianwei Wang","doi":"10.1186/s12894-026-02226-x","DOIUrl":"10.1186/s12894-026-02226-x","url":null,"abstract":"<p><strong>Background: </strong>Growing evidence indicates that the pre-operative ratio of fibrinogen to albumin (FAR/AFR) can act as a prognostic predictor for different kinds of cancer. Although a previous meta-analysis briefly involved urological malignancies, it only incorporated one study for bladder cancer (BC) and one for renal cell carcinoma (RCC) with limited data. To date, a comprehensive and systematic quantitative assessment of plasma FAR/AFR as a prognostic indicator in urological cancers remains lacking.</p><p><strong>Objective: </strong>This meta-analysis intended to comprehensively investigate the prognostic significance of plasma FAR/AFR in individuals with urological malignancies.</p><p><strong>Methods: </strong>A thorough search of the PubMed, Embase, and Web of Science databases was carried out up to March 2026, leading to the incorporation of 6 studies for this meta-analysis. The research computed hazard ratios (HRs) together with their 95% confidence intervals (CIs) to evaluate disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS).</p><p><strong>Results: </strong>The study included a total of 1,603 participants. Patients suffering from RCC and BC who showed an increase in pre-operation FAR or a decrease in pre-operation AFR had poorer overall survival (combined HR = 2.36, 95% CI = 1.92-2.91; p < 0.001), cancer-specific survival (combined HR = 2.27, 95% CI = 1.77-2.91; p = 0.003), and disease-free survival (combined HR = 2.32, 95% CI = 1.62-3.31; p < 0.001).Analysis based on cancer type showed that an increased pre-surgical FAR or a decreased pre-surgical AFR was associated with poorer overall survival in RCC) (combined HR = 3.19, 95% CI = 1.84-5.54, p < 0.001) and also in BC (combined HR = 2.25, 95% CI = 1.80-2.81, p < 0.001).</p><p><strong>Conclusions: </strong>Increased FAR or decreased AFR act as independent markers of unfavorable survival prognosis in patients with RCC and BC.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270505","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}