BMC Urology最新文献

{"title":"Emergency management of ureteral stones with SWL: is there any advantage over elective approach?","authors":"Rasim Guzel, Ahmet Fatih Kanberoglu, Salih Yildirim, Gamze Simsek, Kemal Sarica","doi":"10.1186/s12894-026-02213-2","DOIUrl":"10.1186/s12894-026-02213-2","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal timing of extracorporeal shock wave lithotripsy (ESWL) for ureteral stones remains unclear. This study aimed to compare the clinical and radiological outcomes of emergency versus elective ESWL in patients presenting with ureteral calculi.</p><p><strong>Methods: </strong>In this retrospective study, 66 patients who underwent ESWL at our institution between June 2023 and December 2024 were included. Patients were categorized into emergency (n = 32) and elective (n = 34) ESWL groups. All procedures were performed using a Modulith SLK Inline lithotripter (Storz Medical, Switzerland) with up to 3,000 shocks per session at 60-90 shocks per minute under NSAID analgesia. Demographic characteristics, stone-related parameters (size, volume, density), procedural variables (session number, duration), stone-free (SF) rates, post-procedural emergency visits, and infectious complications were analyzed. Stone-free status was assessed 7 days after the final ESWL session.</p><p><strong>Results: </strong>There were no significant differences between the emergency and elective groups regarding age, sex, body mass index (BMI), or comorbidities. Stones in the emergency ESWL group were significantly larger (8.2 ± 2.65 mm vs. 7.7 ± 1.74 mm; p = 0.023) while stone volume was similar. The number of ESWL sessions and total procedure duration did not differ significantly. Stone-free rates were comparable between groups (65.6% vs. 67.6%; p = 0.862). Post-treatment emergency department visits (31.3% vs. 20.6%; p = 0.322) and infectious complications (15.6% vs. 5.9%; p = 0.199) did not differ significantly.</p><p><strong>Conclusion: </strong>Emergency ESWL was associated with stone-free rates comparable to elective ESWL in carefully selected patients, despite a larger mean stone size in the emergency ESWL group. However, the numerically higher infectious complication rate in the emergency group warrants cautious interpretation. These findings suggest that emergency ESWL may represent a feasible early treatment option for selected patients with symptomatic ureteral stones.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204320","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":"Immunotherapy in bladder cancer: a systematic review of clinical trials and therapeutic advances.","authors":"Ahmed Alasker, Mohammad Alghafees, Talah Nammor, Naif Alanazi, Turki Alferayan, Abdulaziz Almanie, Mohammed Alrashed, Yousef Almarzouq, Abdullah Alammari","doi":"10.1186/s12894-026-02209-y","DOIUrl":"https://doi.org/10.1186/s12894-026-02209-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Bladder cancer poses significant morbidity, mortality, and healthcare burdens globally. While non-muscle-invasive bladder cancer often initially responds to intravesical Bacillus Calmette-Guérin, many patients become unresponsive to Bacillus Calmette-Guérin, resulting in recurrence or progression. Emerging immunotherapies, including checkpoint inhibitors (Pembrolizumab, Atezolizumab, Durvalumab), intravesical gene therapies (Nadofaragene Firadenovec, Cretostimogene Grenadenorepvec), and novel cytokine-based therapies, present promising alternatives. This systematic review thoroughly synthesizes existing clinical evidence from phase 2 and 3 trials, critically assessing immunotherapeutic options for bladder cancer treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive search was systematically conducted across four databases: PubMed, Cochrane, Web of Science and Scopus strictly adhering to PRISMA guidelines and retrospectively registered. Included studies evaluated immunotherapies in non-muscle-invasive bladder cancer and selected muscle-invasive bladder cancer populations. Two reviewers independently performed study screening, data extraction, and risk-of-bias assessments using the Cochrane Risk-of-Bias tool. Results were synthesized both qualitatively, incorporating detailed comparative analyses and robust statistical descriptions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 778 studies were initially identified. Intravesical Cretostimogene Grenadenorepvec demonstrated the highest complete response [1] rate (75.2%), with impressive durability (83% maintaining response ≥ 12 months). Intravesical Nadofaragene Firadenovec also exhibited notable efficacy (CR 53.4%, median duration 9.69 months). Nogapendekin Alfa Inbakicept combined with Bacillus Calmette-Guerin achieved a robust CR (71%) and a remarkably sustained response (median 26.6 months). Systemic Pembrolizumab showed moderate efficacy (43.5% 12-month disease-free survival) but raised significant toxicity concerns (14% grade ≥ 3 adverse events). Intravesical therapies consistently provided superior cystectomy avoidance (≥ 89% at 12 months) compared to systemic treatments. Safety profiles significantly favored intravesical therapies, which had predominantly mild (grade 1-2) adverse events, while systemic therapies reported notable severe toxicities and treatment-related fatalities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Intravesical immunotherapies, particularly Nogapendekin Alfa Inbakicept and Bacillus Calmette-Guerin and Nadofaragene, demonstrate superior efficacy, significant response durability, and favorable safety profiles in treating bladder cancer compared to systemic checkpoint inhibitors, which display moderate efficacy and notable safety concerns. These findings strongly support prioritizing intravesical therapies in non-muscle-invasive bladder cancer management, especially for patients who are unresponsive to Bacillus Calmette-Guerin. Future research s","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204111","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":"Preoperative superselective transarterial ICG-lipiodol embolization for endophytic renal tumors in robot-assisted partial nephrectomy: a preliminary feasibility report.","authors":"Chia-Chih Hsieh, Ting-Yi Chiang, Wen-Hsin Tseng, Chien-Liang Liu, Reng-Hong Wu, Steven K Huang, Allen W Chiu","doi":"10.1186/s12894-026-02216-z","DOIUrl":"10.1186/s12894-026-02216-z","url":null,"abstract":"<p><p>Partial nephrectomy for small, anatomically complex renal tumors presents significant navigational challenges. This study aims to evaluate the synergistic hemostatic and navigational utility and surgical outcomes of preoperative superselective indocyanine green (ICG) embolization during retroperitoneal robot-assisted partial nephrectomy (RAPN). We retrospectively reviewed 32 patients who underwent retroperitoneal RAPN for small renal masses (< 4 cm). Patients were stratified by preoperative intervention: 9 patients (28.1%) received superselective transarterial delivery of an ICG-lipiodol mixture with coil embolization 3 h prior to surgery, while 23 patients (71.9%) underwent standard RAPN. A uniform main renal artery clamping protocol was maintained across both cohorts to evaluating the combined utility of ICG. Strikingly, the ICG cohort consisted entirely of completely endophytic tumors (E3 component: 100% vs. 13%, p < 0.001). Despite this extreme anatomical complexity, the ICG group demonstrated significantly shorter median operative time (90.0 vs. 100.2 min, p = 0.049) and lower median estimated blood loss (100 vs. 350 mL, p = 0.039). Consequently, the perioperative blood transfusion rate was lower in the ICG group (11.1% vs. 60.9%, p = 0.018). Median warm ischemia time (16.48 vs. 16.78 min, p = 0.900) and postoperative renal function changes at day 1, 6 months, and 1 year were comparable between groups. No gastrointestinal or embolization-related complications were observed. Our preliminary experience demonstrates that preoperative superselective ICG embolization serves as a feasible and safe adjunct during RAPN for completely endophytic tumors. By providing a synergistic combination of direct local hemostasis and real-time fluorescent navigation, this tailored approach facilitates precise tumor localization. While these initial findings suggest potential perioperative advantages, they should be interpreted as exploratory signals awaiting further validation in larger, well-balanced cohorts.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204068","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":"Association between CYP2C19 gene polymorphisms and analgesic response to meperidine in emergency department patients with renal colic: a prospective observational study.","authors":"Sena Baykara Sayili, Aylin Koseler, Bulent Erdur","doi":"10.1186/s12894-026-02217-y","DOIUrl":"10.1186/s12894-026-02217-y","url":null,"abstract":"<p><strong>Background: </strong>Renal colic is a urologic emergency that presents with characteristic severe pain and is mostly seen in emergency services. The preferred medications are NSAIDs, paracetamol and opioids, but considering the severity of pain, opioid analgesics should be advised. The aim of this study is to determine the relationship between meperidine efficacy and CYP2C19 gene polymorphisms.</p><p><strong>Methods: </strong>This prospective observational study was conducted between 01.07.2017 and 01.10.2018 in the Pamukkale University Faculty of Medicine Emergency Department. Our study subjects included 203 patients with renal colic and 102 individuals presenting with abdominal pain but not diagnosed with renal colic were included only for genetic frequency analysis; this group was not included in the intervention safety/efficacy analyses. 203 patients were given 100 mg of meperidine and observed 60 min later, and vital signs, laboratory values, etc., were recorded.</p><p><strong>Results: </strong>The age and sex distributions were similar between the case and control groups. There was no statistically significant difference between the sexes in visual analog scale (VAS) scores at any time (0.min-15.min-30.min-60.min). The normal-activity/rapid metabolizer groups had significantly lower 30- and 60-min VAS scores than did the moderate-activity groups. The percentages of VAS decreases at 30 and 60 min from baseline were significantly greater in the normal-activity rapid metabolizer group than in the moderate-activity group. This study revealed that the efficacy of the drug was not affected by age, sex or stone location. The VAS score decreased significantly at all time intervals. Additionally, the decrease in the VAS score between 0 and 15 min after drug administration was similar in each genotype group, but after 30 min, it was remarkable for the CYP2C19 1/1 genotype. During follow-up, 11 patients had drug-related adverse events (most commonly nausea and dizziness). No serious events occurred, and no additional interventions or hospitalizations were required.</p><p><strong>Conclusions: </strong>This study suggested that the effectiveness of meperidine in treating renal colic may be influenced by the genetic polymorphism of CYP2C19 in the patient. The pain response was markedly reduced in individuals with the CYP2C19 *1/*1 genotype. The age, sex, and stone localization groups were seemingly comparable with respect to the efficacy of meperidine. It is advisable to consider the genetic profile in individualized treatment approaches, with the aim of increasing drug efficacy and optimizing dose adjustments.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197320","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":"Diagnostic value of PSA-based markers in prostate cancer: a retrospective analysis stratified by body mass index.","authors":"Tao Yang, Qiang Zhang, Ziyang Liu, Jia Tian, Xiaohua Hu, Zhiyong Lv","doi":"10.1186/s12894-026-02208-z","DOIUrl":"10.1186/s12894-026-02208-z","url":null,"abstract":"<p><strong>Objective: </strong>Body mass index (BMI) influences the accuracy of prostate-specific antigen (PSA) in prostate cancer (PCa) diagnostic performance. This study investigates the effect of BMI on conventional PSA-based markers and evaluates a novel age-adjusted PSA density parameter (A-PSAD) to optimize diagnostic performance strategies across different BMI groups.</p><p><strong>Results: </strong>The cohort comprised 307 low-BMI (91 PCa, 216 benign) and 356 high-BMI (109 PCa, 247 benign) patients. In the low-BMI group, A-PSAD yielded the highest diagnostic efficacy (AUC = 0.714), outperforming PSAD (0.685) and total PSA (TPSA, 0.588). In the high-BMI group, A-PSAD also demonstrated superior performance (AUC = 0.793) compared to PSAD (0.774) and TPSA (0.613). A-PSAD's overall diagnostic value was significantly higher than conventional markers across both groups (P < 0.01). Furthermore, LASSO regression identified four optimal predictive variables for the low-BMI group and seven for the high-BMI group; A-PSAD consistently emerged as a core independent predictor in both.</p><p><strong>Conclusion: </strong>BMI significantly modulates the diagnostic efficacy of PCa diagnostic performance indicators. A-PSAD demonstrates robust, superior diagnostic value across varying BMI categories, serving as a promising primary diagnostic performance tool to optimize individualized pre-biopsy risk stratification.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194565","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":"Perioperative complications of laparoscopic sacrohysteropexy versus sacrocolpopexy with subtotal hysterectomy for pelvic organ prolapse.","authors":"Shada Alanazi, Najd Alshammari, Arwa Jrais, Nawal Alharbi, Mai Alsaadoon, Yaseer Alanazi, Jawaher Alsahabi","doi":"10.1186/s12894-026-02211-4","DOIUrl":"10.1186/s12894-026-02211-4","url":null,"abstract":"<p><strong>Background: </strong>Pelvic organ prolapse (POP) affects 23.4% of women in Saudi Arabia. Laparoscopic sacrocolpopexy is the established surgical gold standard; however, whether concomitant hysterectomy confers additional perioperative risk remains debated.</p><p><strong>Methods: </strong>This retrospective cohort study included 179 women who underwent laparoscopic sacrocolpopexy with subtotal hysterectomy (n = 119) or laparoscopic sacrohysteropexy (n = 60) at two tertiary referral centers in Riyadh, Saudi Arabia, between 2009 and 2024. Intraoperative and postoperative complications, perioperative hemoglobin change, and hospital stay duration were compared between groups.</p><p><strong>Results: </strong>The sacrocolpopexy group was significantly older (P = 0.004). Organ injury occurred in 0.6% of cases overall. Blood transfusion was required exclusively in the sacrohysteropexy group (3.3% vs. 0.0%, P = 0.045). Both groups demonstrated a statistically significant postoperative hemoglobin decline - sacrocolpopexy: 124.52 ± 15.07 to 110.60 ± 13.77 g/L; sacrohysteropexy: 125.27 ± 13.20 to 110.29 ± 12.18 g/L (P < 0.001) - with no significant between-group difference (P = 0.747) and neither decline reaching clinical significance. Sacrohysteropexy was associated with shorter hospitalization (44.6% vs. 24.6% discharged within two postoperative days, P = 0.012). Reoperation rates and symptom resolution were comparable between groups.</p><p><strong>Conclusions: </strong>No significant between-group differences in perioperative morbidity were detected. Sacrohysteropexy was associated with shorter hospital stay; however, the clinical relevance of the higher transfusion rate is uncertain, given the small event count. Given baseline group non-comparability and the retrospective design, these results should be regarded as exploratory. The surgical approach should be individualized based on patient characteristics and the surgeon's expertise. Prospective randomized trials are warranted.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175293","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":"Minimally invasive treatment of emphysematous pyelonephritis in diabetic patients: a comparative study.","authors":"Shilin Li, Jingjing Zheng, Yue Song, Lianhui Fan","doi":"10.1186/s12894-026-02142-0","DOIUrl":"10.1186/s12894-026-02142-0","url":null,"abstract":"<p><p>OBJECTIVE: Emphysematous pyelonephritis (EPN) is a rare but high-mortality infectious disease most commonly seen in diabetic patients, and the timing of percutaneous catheter drainage (PCD) is crucial for its prognosis. METHODS: A retrospective analysis was conducted on data of 18 patients diagnosed with diabetes mellitus complicated EPN who were treated in the Urology of the General Hospital of Northern Theater Command between November 2019 and March 2024. The patient cohort was stratified into two groups according to the timing of PCD implementation: the Early PCD group (E-PCD group, n = 11) (≤ 24 h) and the Delayed Salvage PCD group (DS-PCD group, n = 7) (converted to PCD after failure of conservative pharmacotherapy). By comparing of the comprehensive indicators, the clinical value of early PCD was clarified. RESULT: The general status recovery time, average hospitalization time, average recovery time, and the recovery time of related infection indicators at multiple sampling time points after treatment in the E-PCD group were significantly shorter than those in the DS-PCD group. The volume change rate of pus cavity of E-PCD was significantly higher than that of DS-PCD group at different unit time periods respectively. CONCLUSIONS: Compared with delayed salvage PCD, early ultrasound-guided PCD within 24 h in diabetic patients with EPN can effectively drain pus, quickly control infection symptoms, and accelerate patient recovery. </p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155454","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":"Efficacy and safety of optical navigation system versus conventional fluoroscopy in sacral neuromodulation electrode implantation: a prospective randomized controlled trial.","authors":"Zhou Ziqin, Song Xin, Gu Yinjun, Lv Tingting, Fang Weilin, Huang Jin, L V Jianwei","doi":"10.1186/s12894-026-02198-y","DOIUrl":"10.1186/s12894-026-02198-y","url":null,"abstract":"<p><strong>Background: </strong>Precise Stage I electrode implantation is critical for the success of sacral neuromodulation (SNM); however, conventional fluoroscopy-guided puncture is limited by reliance on bony landmarks and significant radiation exposure. This study evaluated the clinical value of an optical navigation system (ONS) combined with multimodal image fusion for SNM electrode implantation.</p><p><strong>Methods: </strong>A prospective, single-blind, randomized controlled trial was conducted between March 2024 and June 2025. Eighty patients with refractory lower urinary tract dysfunction (including neurogenic bladder, overactive bladder, and interstitial cystitis/bladder pain syndrome) undergoing SNM were randomly assigned (1:1) to receive either ONS-assisted puncture (experimental group, n = 40) or conventional X-ray guidance (control group, n = 40). The primary outcome was the conversion rate to Stage II permanent implantation. Secondary outcomes included the number of puncture attempts, puncture time, total operative time, radiation dose, minimum effective voltage, and perioperative complications.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. The Stage II conversion rate was significantly higher in the ONS group than in the control group (87.5% vs. 62.5%, P < 0.05). Patients in the ONS group required fewer median puncture attempts [2.0 (2.0, 2.2) vs. 5.0 (4.0, 7.0), P < 0.01] and shorter puncture time [7.5 (5.8, 10.2) min vs. 16.0 (12.0, 25.0) min, P < 0.01]. Intraoperative radiation exposure was substantially reduced in the ONS group [145.5 (108.4, 202.3) mGy vs. 473.3 (354.5, 635.2) mGy, P < 0.01]. Furthermore, the minimum effective voltage was significantly lower in the ONS group [1.8 (1.8, 2.5) V vs. 2.8 (1.8, 3.0) V, P = 0.010], suggesting superior electrode-neural positioning accuracy. No surgical complications occurred in either group.</p><p><strong>Conclusions: </strong>ONS combined with multimodal image fusion significantly improves the precision of SNM electrode implantation, reduces surgical trauma and radiation exposure, and increases Stage II conversion rates. This technique demonstrates stable clinical efficacy across various etiologies of refractory lower urinary tract dysfunction and represents a valuable navigation tool warranting broader clinical adoption.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry #ChiCTR2500098093 3/3/2025.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161889","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":"Association between inflammatory burden index and erectile dysfunction: a retrospective case-control study.","authors":"Ayhan Arslan, Erdal Benli, Ahmet Yüce, Fatih Sevgi","doi":"10.1186/s12894-026-02215-0","DOIUrl":"10.1186/s12894-026-02215-0","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is a vascular disease associated with systemic inflammation and endothelial dysfunction. The role of inflammatory markers in the pathogenesis of ED is gaining increasing importance. This study aimed to evaluate the relationship between the Inflammatory Burden Index (IBI), calculated by combining C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR), and erectile dysfunction.</p><p><strong>Methods: </strong>This retrospective study included 126 patients with erectile dysfunction and 128 healthy controls who presented to the urology outpatient clinic between January 2023 and October 2025. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5). NLR was calculated as the ratio of absolute neutrophil count to absolute lymphocyte count, and IBI was obtained using the formula CRP × NLR. Diagnostic performance was examined using ROC analysis. Multivariate logistic regression analysis was performed to identify independent risk factors for erectile dysfunction.</p><p><strong>Results: </strong>IBI values were found to be significantly higher in the ED group compared to the control group (median 3.31 vs. 0.91, p < 0.001). No significant difference was found between the groups in terms of NLR. There was no significant difference in IBI values between the ED severity groups (p = 0.346). ROC analysis showed modest discriminatory ability of IBI for ED (AUC = 0.754; 95% CI: 0.696-0.813; p < 0.001). Based on the Youden index, the optimal cutoff value was 3.785, with sensitivity 43.7% and specificity 84.3% (Youden index = 0.280). Additionally, a weak positive correlation was found between IBI and body mass index (r = 0.197; p = 0.027). In multivariate logistic regression analysis, diabetes mellitus and cardiovascular disease were identified as independent predictors of erectile dysfunction, while IBI was not found to be an independent predictor.</p><p><strong>Conclusions: </strong>IBI levels were significantly higher in patients with erectile dysfunction and may reflect systemic inflammatory burden associated with ED. However, because IBI was not an independent predictor in multivariable analysis and its discriminatory performance remained modest, its clinical utility as a standalone diagnostic or screening marker appears limited.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161865","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":"Digital tracking of ureteral stents with the stentless application: clinical outcomes in 200 patients.","authors":"Lorin Giurgiu, Matei Maximilian Buzoianu, Paul Alexandru Medan, Iulia Andras, Florentin Dobrotă, Răzvan Peia, Silviu Petrișor Vranău, Ștefana Medan, Bianca Rus, Răzvan Ognean, Ioan Coman, Nicolae Crișan","doi":"10.1186/s12894-026-02137-x","DOIUrl":"10.1186/s12894-026-02137-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objectives: &lt;/strong&gt;Ureteral double-J stents (UDJS) are frequently placed in urologic practice for a range of indications, including ureteral obstruction, strictures, stone disease, peri- and post-ureteroscopy, and following ureteral reconstruction or reimplantation. Recent studies suggest that approximately 13% of inserted stents become overdue or neglected, which can lead to serious, potentially life-threatening complications. We therefore aimed to develop a smartphone application to track patients with UDJS and reduce the incidence of overdue indwelling ureteral stents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;For the development of the application, we worked with a specialized team of programmers. To facilitate universal access to the complete patient database, a cloud-based database was implemented. The application was designed to send a Short Message Service (SMS) to the patients and their general practitioner to remind the timing for UDJS extraction. We prospectively enrolled a total of 200 patients who underwent UDJS insertion for any indication by six urologists from June 2023, to March 2024. The patients were divided into two groups: the first group was monitored using the Stentless mobile application, while the second group was monitored using an electronic patient registry. The two groups were compared with respect to stent overdue times and complete loss-to-follow-up rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In this study, a total of 200 patients were enrolled non-randomly and assigned to one of the study groups. 100 patients assigned to group 1 (mobile application group) and 100 to group 2 (electronic registry group). Among these, 187 patients (93.5%) underwent unilateral ureteral stent placement, while 13 patients (6.5%) required bilateral stent placements. The study also included patients with long-term indwelling stents, with the maximum stent replacement interval extending up to 360 days. The median indwelling time across the cohort was 17 days (range 14-360), reflecting the inclusion of long-term stents. In group 1, no patients missed their scheduled stent removal appointments, corresponding to an LTFU rate of 0% and no overdue removals. In group 2, four patients failed to attend their scheduled appointments (p = 0.121). These patients were identified through the electronic patient registry and subsequently contacted for follow-up. The delay in stent removal among these four patients was (7, 10, 13, and 60 days) beyond the planned appointment date. Notably, one patient from group 2 presented with an encrusted stent requiring two flexible ureteroscopy procedures for removal. Ultimately, all ureteral stents were successfully removed in an office-based setting, ensuring complete management for all participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;By notifying the patient and general practitioner with a mobile phone text message automatically transmitted from the application, there is the potential to i","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161930","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}