BMC Urology最新文献

{"title":"A prospective study on the management of urinary bladder injuries in a military hospital in Yemen.","authors":"Nasser Albaddai, Khaled Alkohlany, Aziz Shamsan, Wael Alsaqaf, Abdullah Al-Sakkaf, Ahmed Farei, Abdaljaleel Al-Baidai","doi":"10.1186/s12894-025-01863-y","DOIUrl":"10.1186/s12894-025-01863-y","url":null,"abstract":"<p><strong>Background: </strong>Urinary bladder (UB) injuries pose significant challenges in conflict zones, yet evidence on optimal management in resource-limited settings remains scarce. This study evaluates outcomes of conservative and surgical approaches for UB injuries in war-torn Yemen.</p><p><strong>Methods: </strong>This prospective observational study was conducted at a tertiary military hospital in Sana'a, Yemen, from February 2021 to January 2023. Forty-four patients with traumatic UB injuries were enrolled. Injuries were classified by mechanism, AAST grade, and anatomical location. Conservative management included catheterization and antibiotics, while surgical intervention was guided by injury severity and associated trauma. Outcomes included healing confirmed by cystography, complication rates (Clavien-Dindo classification), and length of hospital stay.</p><p><strong>Results: </strong>Of 44 patients (95.5% male; mean age 26.8 ± 8.6 years), 77.3% underwent surgical repair, primarily for penetrating injuries and high-grade bladder trauma. Conservative management was applied in 22.7% of low-grade extraperitoneal cases. Surgical success rate was 97.1%, while conservative success reached 80%. Most patients (82.4%) had extraperitoneal injuries; associated trauma was common, including pelvic/femur fractures (68.2%) and abdominal/pelvic organ injuries (36.4%). Complications occurred in 36.4% of patients, with 13.6% being moderate to severe (Grade III-IV). No bladder injury-related mortalities occurred. Pelvic fractures significantly increased the odds of surgical repair (OR 4.2, p = 0.001) and late sepsis (OR 5.6, p = 0.02).</p><p><strong>Conclusion: </strong>In conflict settings, surgical repair remains critical for high-grade UB injuries, while conservative management is viable for select low-grade cases. Prolonged hospitalization reflects polytrauma burden rather than surgical intervention itself.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"178"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682007","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":"Optilume balloon dilation for radiation induced posterior urethral stenosis: a multi-institutional experience.","authors":"Brian Ceballos, Eshan G Joshi, Kayla Graham, Luke Shumaker, Katherine Englander, Victoria Stowasser, J Patrick Selph, Lucas Wiegand, Kevin Heinsimer, Maxim McKibben, Maia VanDyke, Steven Hudak, Allen Morey, Adam Baumgarten","doi":"10.1186/s12894-025-01829-0","DOIUrl":"10.1186/s12894-025-01829-0","url":null,"abstract":"<p><strong>Introduction: </strong>Radiation induced urethral stenosis disease represents a complex subset of patients with higher rates of recurrence after treatment. Optilume^®, a Paclitaxel drug-coated balloon, has been utilized in anterior urethral strictures with promising results. Although urethroplasty is traditionally regarded as the gold standard for treating radiation-induced posterior urethral stenosis, it can be an invasive and challenging procedure with potential side effects. We aim to evaluate the efficacy of the Optilume^® drug-coated balloon as a minimally invasive treatment option for radiation-induced posterior urethral stenosis.</p><p><strong>Methods: </strong>A retrospective, multi-institutional review was conducted on male patients who underwent Optilume^® drug-coated balloon dilation from January 1, 2022, to November 1, 2023. The study involved five surgeons across four institutions. Patients were investigated based on their history of radiation-induced posterior urethral stenosis, and comparisons were made regarding demographics, characteristics of urethral stenosis, and outcomes, including surgical success and complications.</p><p><strong>Results: </strong>Among the 56 patients with radiation-induced posterior urethral stenosis evaluated across all four institutions, 37 men had at least 90-day follow-up data. Of these 37 patients, 30 (81.1%) were deemed successful, defined as being free from repeat intervention. Although 6 patients (10.7%) experienced complications, none were greater than Clavien IIIb, with the most common complication being acute urinary retention.</p><p><strong>Conclusion: </strong>Although radiation-induced urethral stenosis is typically associated with high rates of recurrence following conservative treatment, Optilume^® drug-coated balloon represents an alternative endoscopic treatment option with encouraging short-term results.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"177"},"PeriodicalIF":1.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667225","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":"Correction: Pharmacological non-hormonal treatment options for male infertility: a systematic review and network meta-analysis.","authors":"Bassel H Al Wattar, Michael P Rimmer, Jhia J Teh, Scott C Mackenzie, Omar F Ammar, Carolyn Croucher, Eleni Anastasiadis, Patrick Gordon, Allan Pacey, Kevin McEleny, Phillipa Sangster","doi":"10.1186/s12894-025-01874-9","DOIUrl":"10.1186/s12894-025-01874-9","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"174"},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667223","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":"Effects of flow rate on pressure and nephrons during flexible ureteroscopy with intelligent control of renal pelvic pressure: an in-vivo pig model.","authors":"Yao Lei, Huang Xin, Kuang Jin, Song Leming, Deng Xiaolin","doi":"10.1186/s12894-025-01846-z","DOIUrl":"10.1186/s12894-025-01846-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of flow rate on pressure and nephron injury during flexible ureteroscopy with intelligent renal pelvic pressure (RPP) control in an in vivo pig model.</p><p><strong>Methods: </strong>Twelve kidneys from six female pigs were randomly divided into six groups. Pressure-controlled (PC) and non-pressure-controlled (NPC) groups were continuously perfused at a flow rate of 50 mL/min (group A), 100 mL/min (group B), and 150 mL/min (group C) for 30 min. Color Doppler ultrasound detected exosmosis of the perirenal fluid. Nephron biopsies were performed in the upper, middle, and lower regions. Pressure changes and pathological conditions of the tissue at different flow rates and pressure control values were compared.</p><p><strong>Results: </strong>RPP values for groups A, B, and C were 8.70 ± 1.02, 20.50 ± 3.03, and 45.97 ± 9.57 mmHg, respectively, and the difference was statistically significant in NPC groups (P < 0.05). RPP values with 10 mmHg control value were 9.43 ± 1.50, 9.97 ± 1.69, and 8.77 ± 1.77 mmHg, respectively. With 0 mm Hg control value, they were 0.40 ± 0.67, -0.40 ± 1.35, and 0.33 ± 1.03 mmHg, respectively, and with - 10 mmHg control value, -9.00 ± 1.34, -11.30 ± 1.15, and - 9.27 ± 1.62 mmHg, respectively. Values fluctuated around the set value, with clinically non-significant differences within 2 mmHg. Pathological examination showed that the nephron structure changed in the NPC group, with more marked changes associated with increasing flow rate. No changes were observed in the nephron morphology in the PC group regardless of perfusion flow rate.</p><p><strong>Conclusion: </strong>Flexible ureteroscopy with intelligent RPP control can effectively monitor and control pressure under different perfusion flow conditions and prevent nephron injury.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"175"},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667224","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 case of artificial urinary sphincter implantation in a patient who underwent both urethroplasty and ileal neobladder construction.","authors":"Hibiki Hirose, Tadashi Tabei, Yushi Araki, Hideki Ouchi, Takuma Nirei, Kazuki Kobayashi","doi":"10.1186/s12894-025-01871-y","DOIUrl":"10.1186/s12894-025-01871-y","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"176"},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667222","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":"Posterior conduit fixation with retroperitonealization of uretero-ileal anastomosis after open radical cystectomy reduces the postoperative complication rate: a retrospective, matched-paired single-center analysis.","authors":"Vukovic Marko, Kavaric Petar, Magdelinic Aleksandar, Albijanic Marko, Rebronja Almir, Sabovic Eldin","doi":"10.1186/s12894-025-01869-6","DOIUrl":"10.1186/s12894-025-01869-6","url":null,"abstract":"<p><strong>Background: </strong>Our study aimed to assess the efficacy of posterior conduit fixation with retroperitoneal ureteroileal anastomosis (UIA) in reducing perioperative complications after radical cystectomy (RC) with ileal conduit (IC) urinary diversion.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study, including 150 patients who underwent either modified IC technique (extraperitonealized anastomosis with posterior conduit fixation; n = 79) or the conventional IC technique (n = 71). The primary endpoints were the incidence of clinical parastomal hernia (PSH) and ileus. Secondary endpoints included operative time, postoperative complication rates, and length of hospital stay (LOS). Multivariate logistic regression was performed to identify predictors of early and late stoma- related complications.</p><p><strong>Results: </strong>The modified group showed significantly lower incidence of both early and late postoperative complications, including ileus and PSH, compared to the conventional group (8.86% vs. 28.1%, p = 0.01 and 7.6% vs. 17%, p = 0.03, respectively) after a median follow-up of 34 months. Corresponding hazard ratios were 0.312 (95% CI: 0.047-0.798, p = 0.01) for early complications and 0.267 (95% CI: 0.105-0.611, p = 0.03) for late complications.</p><p><strong>Conclusion: </strong>The results support our hypothesis that extraperitoneal ureteroileal anastomosis combined with posterior conduit fixation effectively reduces the risk of both early and late postoperative complications, including parastomal hernia and ileus.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"173"},"PeriodicalIF":1.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641796","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":"Genetic alterations of prostate cancer: in localized and metastatic prostate cancer.","authors":"Chang Eil Yoon, San Kang, Seung Ah Rhew, Hyeok Jae Kwon, Dongho Shin, Hyong Woo Moon, Mee Young Kim, Ji Youl Lee","doi":"10.1186/s12894-025-01840-5","DOIUrl":"10.1186/s12894-025-01840-5","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"166"},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636267","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":"Radical nephrectomy with inferior vena caval thrombectomy for level I to IV tumor thrombus: long-term single-center experience.","authors":"Pavel Navratil, Jiri Chalupnik, Miroslav Louda, Petr Habal, Pavel Zacek, Milos Brodak, Jaroslav Pacovsky","doi":"10.1186/s12894-025-01854-z","DOIUrl":"10.1186/s12894-025-01854-z","url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma (RCC) is a prevalent kidney malignancy known for its aggressive nature and potential to extend into the renal vein or inferior vena cava (IVC), affecting patient prognosis and treatment strategies.</p><p><strong>Objective: </strong>To assess the long-term outcomes and effectiveness of radical nephrectomy with IVC thrombectomy in patients with RCC presenting with level I-IV IVC thrombus.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 164 adult patients treated for RCC with IVC thrombectomy at a tertiary care center from January 2004 to December 2023. Data including demographics, clinical characteristics, tumor specifics, surgical details, complications, and survival rates were meticulously reviewed.</p><p><strong>Results: </strong>Among the patients, the mean age was 63.7 years, predominantly male (69.5%). The histological profile showed a majority of clear cell carcinoma (95.7%), with most tumors located on the right side (71.3%). Thrombus levels were distributed across I-IV, with 41 (25%) patients presenting with level I, 33 (20.1%) with level II, 55 (33.5%) with level III, and 35 (21.4%) with level IV thrombi. The mean operation time and blood loss increased with thrombus level. Perioperative complications were recorded in 57.3% of patients, and over half of the patients experienced disease recurrence (54.9%). The overall 5-year survival rate stood at 42.1%, with notably better survival in patients with level I thrombi.</p><p><strong>Conclusion: </strong>Radical nephrectomy with IVC thrombectomy provides a potential for long-term control in patients with RCC and IVC thrombus, although it is associated with significant morbidity. Multidisciplinary care and expert surgical intervention are crucial for improving patient outcomes. The variability in survival rates across thrombus levels underscores the need for individualized treatment approaches.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"169"},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636269","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":"Comparison of the effectiveness of single-dose levofloxacin with single-dose fosfomycin pre-urodynamic study related to the incidence of urinary tract infection: a randomized controlled trial.","authors":"Harrina Erlianti Rahardjo, Fina Widia, Cindy Wijaya, Kevin Leonardo, Alfred Tanjung, Muhammad Hanif Arfiananda, Fatimah Nuwwaaridya Fitriani, Rahmat Aidil Fajar Siregar, Andika Afriansyah","doi":"10.1186/s12894-025-01839-y","DOIUrl":"10.1186/s12894-025-01839-y","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"172"},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636265","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":"The role of Pan-Immune inflammation value and systemic Immune-Inflammation index as potential biomarkers in predicting infectious complications following retrograde intrarenal surgery.","authors":"Bedreddin Kalyenci, Ferhat Çoban, Hasan Sulhan, Mehmet Özgür Yücel, Can Benlioğlu, Gazi Kaz, Tayfun Şahinkanat, Ali Çift","doi":"10.1186/s12894-025-01859-8","DOIUrl":"10.1186/s12894-025-01859-8","url":null,"abstract":"<p><strong>Background: </strong>To predict postoperative infectious complications by utilizing hemogram parameters and derived inflammation indices and to analyze patient-related risk factors to propose a nomogram.</p><p><strong>Methods: </strong>The data of patients who underwent retrograde intrarenal surgery were reviewed. The patients were categorized into two groups: those without infectious complications (Group A) and those with infectious complications (Group B). Infectious complications were defined as fever persisting above 38 °C for 48 h and the presence of two or more systemic inflammatory response syndrome (SIRS) criteria. Hemogram parameters and inflammation indices were examined to predict infectious complications. The study utilized neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), along with the pan-immune-inflammation value (PIV) and systemic immune-inflammation index (SII).</p><p><strong>Results: </strong>The data of 658 cases were evaluated. No infectious complications were observed in 610 cases (92.7%), while 33 cases (5.0%) developed fever, and 15 cases (2.3%) met the criteria for SIRS. The optimal cut-off values for distinguishing between groups were determined as follows: >2.66 for NLR, > 122.5 for PLR, < 2.81 for LMR, > 619.4 for SII, and > 500.2 for PIV. Patients with PIV > 500.2 exhibited a 13.737-fold increase (95% confidence interval [CI]: 7.260-25.994) in infectious complications compared to those with PIV ≤ 500.2, making PIV the strongest predictor. The most significant factors in differentiating between the groups were, in order of importance, Charlson comorbidity index, stone volume, preoperative serum creatinine level, and preoperative double-J stent placement. These factors were analyzed using multivariate logistic regression alongside PIV and SII, and two models were constructed. The predictive power of Model 1 was determined as Cox & Snell R² = 0.269 and Nagelkerke R² = 0.661, while Model 2 had a Cox & Snell R² value of 0.264 and a Nagelkerke R² value of 0.648.</p><p><strong>Conclusion: </strong>PIV and SII, derived from hemogram parameters, serve as predictive inflammatory indices for postoperative infectious complications. They provide valuable preoperative insight into the patient's immune and systemic inflammatory responses. When combined with other risk factors, these indices allow for the prediction of postoperative infectious complications.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"168"},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636270","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}