BMC Urology最新文献

{"title":"CT and MRI features of renal inflammatory myofibroblastic tumor and its differential diagnosis from clear cell renal cell carcinoma and chromophobe renal cell carcinoma: a study of 13 cases from two centers.","authors":"Hongyang Du, Jingyun Wu, Qi Shen, Chang Rong, Kexin Wang, Jing Liu, Jianxing Qiu, He Wang, Naishan Qin","doi":"10.1186/s12894-026-02136-y","DOIUrl":"10.1186/s12894-026-02136-y","url":null,"abstract":"<p><strong>Background: </strong>To compare the CT and MRI features of renal inflammatory myofibroblastic tumor (IMT) with those of clear cell renal cell carcinoma (ccRCC) and chromophobe renal cell carcinoma (ChRCC).</p><p><strong>Methods: </strong>Clinical and imaging data of 13 patients with pathologically confirmed renal IMT, along with 52 patients with ccRCC and 52 with ChRCC treated at two centers between January 2013 and February 2025 were retrospectively obtained, and the lesions' location, shape, margin, size, secondary changes, density or signal characteristics, and enhancement degree with pattern were analyzed. The clear cell likelihood score (ccLS) was used for the evaluation of MRI characteristics.</p><p><strong>Results: </strong>The renal IMT cohort comprised 9 males and 4 females (mean age, 54.2 ± 8.61 years). All lesions were solitary, measuring 1.7-14.4 cm. Notably, ill-defined margins were detected in 9/13 (69.2%), perirenal fascia thickening in 8/13 (61.5%), and non-enhancing region in 3/13 (23.1%). There was no hemorrhage, central scar or calcification. Unenhanced CT showed a mean attenuation of 43.7 HU. On contrast-enhanced CT, 77.8% (7/9) exhibited mild-moderate enhancement, with 55.6% (5/9) showing progressive enhancement and 33.3% (3/9) demonstrating a \"slow-in and slow-out\" pattern. MRI revealed hypointense or isointense signal on T1WI and T2WI, while 87.5% (7/8) showed restricted diffusion on DWI and arterial-to-delayed enhancement ratio < 1.5. No lesions exhibited microscopic fat or segmental enhancement inversion. The ccLS for renal IMTs were predominantly 1-2. Compared to ccRCCs and ChRCCs, renal IMTs more commonly exhibited ill-defined margins (P1 = 0.037, P2 < 0.001), perirenal fascia thickening (P1 = 0.014, P2 < 0.001) and higher unenhanced CT attenuation (P1 = 0.016, P2 = 0.030). Two renal IMT cases showed suspected postoperative recurrence or metastasis.</p><p><strong>Conclusions: </strong>CT and MRI imaging features can facilitate the diagnosis of renal IMT and differentiate it from ccRCC and ChRCC.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052509","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 and imaging predictors of urachal carcinoma: the role of gross hematuria and calcification in a single-center retrospective study.","authors":"Kinh Luan Thai, Phan Nhat Duy Le, Thanh Tuan Nguyen, Xuan Thai Ngo","doi":"10.1186/s12894-026-02188-0","DOIUrl":"10.1186/s12894-026-02188-0","url":null,"abstract":"<p><strong>Background: </strong>Urachal anomalies are rare entities in the adult population with significant malignant potential. This study aims to comprehensively describe clinical and paraclinical characteristics, as well as to analyze and evaluate prognostic factors for urachal carcinoma, thereby facilitating early diagnosis and effective management.</p><p><strong>Methods: </strong>We conducted a retrospective study on patients diagnosed with urachal anomalies from 2017 to 2025. Data regarding clinical characteristics, imaging findings, treatment modalities, and clinical outcomes were collected for both benign and malignant cases. Additionally, survival outcomes were specifically analyzed for patients with urachal carcinoma.</p><p><strong>Results: </strong>A total of 112 patients were included, comprising 8.9% cases of urachal carcinoma, while infection was the predominant presentation (72.3%). Surgical management differed significantly by pathology, with urachal excision and partial cystectomy performed in 80.0% of malignant cases versus 23.9% of benign cases. Multivariate logistic regression identified hematuria (Odds Ratio (OR) 14.1; 95% Confidence Interval (CI) 1.3-153.6; p = 0.03) and calcification (OR 13.5; 95% CI 1.7-109.2; p = 0.01) as significant independent predictors of malignancy. Histologically, adenocarcinoma was the major subtype (80%), with most tumors being Sheldon stage IIIA or IV. Overall survival (OS) showed a steep decline, recorded at 90.0%, 60.0%, and 15.0% at 1, 3, and 5 years, respectively.</p><p><strong>Conclusions: </strong>Gross hematuria and calcification serve as critical, independent predictors of urachal malignancy. Given the aggressive nature and poor overall prognosis (5-year OS of only 15.0%), the presence of these indicators necessitates an aggressive diagnostic workup and prompt radical surgical intervention (en-bloc urachal excision with partial cystectomy) to optimize long-term patient outcomes.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041231","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":"Aggressive chronic prostatitis mimicking locally advanced prostate cancer with apparent extraprostatic extension: a case report.","authors":"Ozkan Ozdemir","doi":"10.1186/s12894-026-02195-1","DOIUrl":"10.1186/s12894-026-02195-1","url":null,"abstract":"<p><strong>Background: </strong>Multiparametric prostate MRI (mpMRI) is widely used for prostate cancer detection and local staging. Imaging features such as marked diffusion restriction, intense contrast enhancement, and apparent extraprostatic extension are typically associated with aggressive malignancy. However, inflammatory conditions may rarely mimic locally advanced prostate cancer, potentially leading to overstaging and inappropriate treatment.</p><p><strong>Case presentation: </strong>A 49-year-old man presented with nonspecific lower urinary tract symptoms and a serum prostate-specific antigen level of 2.7 ng/mL. mpMRI revealed a large mass-like peripheral zone lesion with marked diffusion restriction, rapid early enhancement, and imaging features suggestive of extraprostatic extension, leading to a PI-RADS 5 assessment and suspicion of locally advanced prostate cancer. Despite aggressive imaging findings, systematic biopsy demonstrated chronic prostatitis without malignancy. Following antibiotic therapy, short-term follow-up mpMRI showed marked regression of the lesion with resolution of diffusion restriction and contrast enhancement, confirming an inflammatory etiology.</p><p><strong>Conclusions: </strong>Aggressive chronic prostatitis may closely mimic locally advanced prostate cancer on mpMRI, including apparent extraprostatic extension. Recognition of this diagnostic pitfall and careful radiologic-clinical correlation are essential to avoid overstaging and unnecessary definitive treatment.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027265","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":"Could miRNAs be used as markers for distinguishing undescended testes from retractile testes? A prospective controlled pilot/exploratory study.","authors":"Mevlüt Keleş, Erdal Benli, Sercan Ergün, Abdullah Çırakoğlu, İbrahim Yazıcı, Nurullah Kadim, Tevfik Noyan, Dilbeste Demir, Mesrur Selçuk Sılay","doi":"10.1186/s12894-026-02175-5","DOIUrl":"10.1186/s12894-026-02175-5","url":null,"abstract":"<p><strong>Background: </strong>Undescended testes (UDTs) are common in male infants. Untreated UDT poses risks such as infertility (IF), testicular cancer (TC), and testicular torsion (TT). Retractile testes (RTs) sporadically ascend from the scrotum. UDT requires early surgical correction, whereas RT requires only periodic follow-up. Differentiating these conditions is challenging, making clinical biomarkers potentially useful. The aim of our study was to examine the use of miRNAs as biomarkers in the differential diagnosis of UDT and RT which are difficult to differentiate.</p><p><strong>Methods: </strong>This prospective pilot/exploratory study included 10 boys with UDT (operated), 9 with RT (followed), and 9 controls. Only palpable (unilateral or bilateral) UDT cases were included, excluding nonpalpable types. To ensure accurate RT diagnosis, initial physician examinations were performed in three positions (supine, semi-supine, standing), followed by a 1-month parental examination (twice daily). Only RT patients whose testes spent > 50% of their time in the scrotum were included. The exclusion criteria also included prior inguinal/scrotal surgery, defective datasets, or unsuitable serum samples. Parent consent and serum samples were collected to evaluate miR-210, miR-34c, and miR-449a expression via real-time PCR.</p><p><strong>Results: </strong>Statistical analysis revealed no significant difference in miR-34c (p = 0.157) or miR-210 (p = 0.950) expression. However, the miR-449a level differed significantly between the groups (p = 0.033). Dunn-Bonferroni post hoc correction revealed significantly greater miR-449a in the RT group than in the UDT group (p < 0.05). No difference in miR-449a expression was found between the control and UDT groups (p > 0.05). Serum miR-449a demonstrated significant diagnostic potential in differentiating UDT from retractile testis (AUC: 0.822, p = 0.017) with 90.0% sensitivity and 77.8% specificity. These findings suggest that miR-449a could serve as a promising non-invasive biomarker to distinguish true undescended testis from its clinical mimics.</p><p><strong>Conclusions: </strong>Serum miRNA levels represent a potential tool for differentiating UDT from RT. Our pilot/exploratory study partially corroborates this, but comprehensive prospective randomized trials with larger cohorts are essential to definitively clarify miRNA alterations for precise distinction.</p><p><strong>Trial registration: </strong>This prospective case-control study was registered to clinicaltrials.gov database, 'retrospectively'. The trial registration number is: NCT07315737, the unique protocol ID is: 2022/25.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027248","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":"HSF4 promotes renal cell carcinoma progression and is associated with PI3K/Akt pathway.","authors":"Yue Li, Hao Xie, Changming Dong, Tianxi Yu, Shuang Wu, Xin Cui, Chongjun Xiang, Huiying Tao, Ning Liang, Jiahao Guo, Yufan Yang, Jinshan Yang, Xinxin Li, Jiazi Cha, Wenting Wang, Chunhua Lin","doi":"10.1186/s12894-026-02196-0","DOIUrl":"10.1186/s12894-026-02196-0","url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma (RCC) is a common urological malignancy, accounting for approximately 2% of global cancer-related mortality. Heat shock factors (HSFs) are transcription factors that regulate cell stress reaction. However, the exact mode of action of HSF4 in cancer, particularly RCC, is still unknown.</p><p><strong>Objective: </strong>To investigate the expression pattern of HSF4 in RCC and its potential molecular mechanism (especially the association with the PI3K/Akt pathway), so as to identify a new therapeutic target for RCC.</p><p><strong>Methods: </strong>Bioinformatics analyses were performed to assess HSF4 expression and its prognosis relevance in RCC. The effects of HSF4 on RCC were studied with both in vitro and in vivo experiments. The transcriptome sequencing results were analyzed for both the gene knockdown and control RCC cells to predict relevant RCC signaling pathways.</p><p><strong>Results: </strong>Our experimental results indicate that HSF4 knockdown can prevent the occurrence and spread of RCC in the body, as well as the growth and invasion of RCC cells. Mechanistically, HSF4 knockdown led to a significant decrease in the protein levels of PI3K, p-AKT, β-catenin, and c-Myc. These findings demonstrate that HSF4 promotes RCC progression by concurrently activating the PI3K/AKT and Wnt/β-catenin signaling pathways.</p><p><strong>Conclusion: </strong>Our findings identify that HSF4 is highly expressed in RCC and can promote the occurrence and development of RCC. Therefore, HSF4 may be a potential therapeutic target for RCC.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013686","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":"Overcoming surgical challenges with robotic assistance: robot-assisted nephrectomy of a failed renal allograft after complex en-bloc dual kidney transplantation.","authors":"Xinji Yang, Zhanyi Zhang, Weilong Shi, Herong Zhu, Wenbin Zhang, Shudong Zhang, Qiming Zhang, Xiaofei Hou","doi":"10.1186/s12894-026-02148-8","DOIUrl":"10.1186/s12894-026-02148-8","url":null,"abstract":"<p><p>We present the case of a 37-year-old male who underwent infant donor en-bloc dual kidney transplantation (EBKT) and subsequently developed left allograft failure with severe refractory urinary tract infection secondary to long-standing ureteropelvic junction obstruction and hydronephrosis. After failure of conservative anti-infective therapy to control recurrent infection, the patient underwent successful robot-assisted extracapsular allograft nephrectomy (ECAN), with the primary surgical indication of eradicating the source of refractory infection in the obstructed, completely non-functional allograft. The procedure was completed in 145 min with minimal blood loss (20 mL). The patient was discharged on postoperative day 5 with complete resolution of symptoms and preserved function of the contralateral viable graft. This case demonstrates that robot-assisted surgery offers a safe and precise surgical option for failed allograft nephrectomy after complex pediatric EBKT, with favorable perioperative outcomes in this specific scenario involving distorted anatomy and severe adhesions.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027251","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":"Lack of real-world evidence on active surveillance in Chinese patients with prostate cancer: insights from a 10-year cohort and a physician survey.","authors":"Peng Xian, Pan Li, Gangjun Yuan, Junyong Dai, Fang Yuan, Yanping Song, Dawei Zhu, Teng Zhang, Haike Lei, Jun Li, Nan Liu","doi":"10.1186/s12894-026-02193-3","DOIUrl":"10.1186/s12894-026-02193-3","url":null,"abstract":"<p><strong>Background: </strong>Active surveillance (AS) is an established management strategy for low-risk prostate cancer (PCa). However, its real-world implementation in China remains limited. This study aimed to present the outcomes of patients with early-stage PCa undergoing AS and to identify the main obstacles encountered in the promotion of AS.</p><p><strong>Methods: </strong>We conducted a two-part study consisting of a prospective observational cohort of patients who elected for AS at a tertiary cancer center (2012-2017) and a nationwide cross-sectional survey of urologists assessing their knowledge, attitudes, and practice patterns regarding AS. Clinical outcomes, adherence to follow-up, and treatment conversion were evaluated in the cohort. Survey responses were analyzed across hospital level and physician seniority.</p><p><strong>Results: </strong>Among the 452 patients with localized PCa evaluated during the study period, 20 met the eligibility criteria and selected AS. After a median follow-up period of 118 months, 13 patients transitioned to definitive treatment, most commonly because of suspected disease progression. Three deaths occurred, one of which was a PCa-specific death. Adherence to scheduled PSA monitoring was high, whereas repeat biopsy compliance was low. The survey included 343 valid physician responses. Familiarity with AS eligibility and follow-up protocols was significantly higher among physicians in academic hospitals and those with senior titles. However, < 10% reported having structured AS follow-up programs, and most perceived patient anxiety and preference for surgery as major barriers to AS implementation.</p><p><strong>Conclusions: </strong>AS may be a feasible management option for carefully selected Chinese patients. Efforts to expand AS use in China should prioritize patient education, structured follow-up systems, national registry development, and supportive health policy measures.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013733","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":"Bladder-sparing chemoradiotherapy following neoadjuvant chemotherapy for muscle-invasive bladder cancer: a retrospective cohort study.","authors":"Bahram Mofid, Anya Jafari, Nasser Simforoosh, Abbas Basiri, Maryam Siavashpour, Zahra Siavashpour, Mohammad Sajjad Zabihi, Mahdi Ghajari, Abolfazl Razzaghdoust","doi":"10.1186/s12894-026-02187-1","DOIUrl":"10.1186/s12894-026-02187-1","url":null,"abstract":"<p><strong>Purpose: </strong>Radical cystectomy following cisplatin-based neoadjuvant chemotherapy (NAC) is still the standard approach for managing muscle-invasive bladder cancer (MIBC); however, a substantial proportion of patients are not candidates for surgery or cisplatin-based chemotherapy. The role of NAC followed by chemoradiation (CRT) in a bladder-preserving approach is not well established. This study aimed to evaluate the feasibility, survival outcomes, and prognostic factors associated with NAC followed by definitive CRT.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed MIBC patients treated with NAC and subsequent CRT between 2010 and 2023. Overall survival (OS) and event-free survival (EFS) were analyzed using the Kaplan-Meier method and Cox proportional hazards models.</p><p><strong>Results: </strong>Among 224 MIBC patients treated with NAC, 132 patients received bladder-preserving CRT after NAC. The median OS for the entire cohort was 58 months (95% CI: 37.63-78.37). Median OS was significantly longer in patients with clinical complete response (cCR) compared with those without (73 vs. 29 months, p = 0.007). Median EFS was also superior in the cCR group (50 vs. 23 months, p = 0.022). In multivariable Cox regression analysis, achievement of cCR was independently associated with superior OS (HR 0.52, 95% CI 0.30-0.92, p = 0.028) and EFS (HR 0.54, 95% CI 0.32-0.93, p = 0.036). Moreover, the presence of baseline hydronephrosis predicted significantly worse OS (HR 2.37, 95% CI 1.32-4.25, p = 0.006) but showed no association with EFS. The type of NAC regimen (cisplatin vs. carboplatin) had no independent effect on survival.</p><p><strong>Conclusion: </strong>NAC followed by CRT is a feasible bladder-preserving approach for selected patients with MIBC, including those ineligible for cystectomy or cisplatin. Achievement of cCR is the most robust prognostic factor for both OS and EFS, supporting its role as a surrogate endpoint in this setting. These findings provide novel evidence for integrating NAC into bladder-preserving strategies and highlight clinical factors that may guide individualized treatment selection. A prospective randomized trial is warranted.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013694","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 suction and standard ureteral access sheath versus sheathless flexible ureteroscopy in management of upper ureteral and renal calculi.","authors":"Fouad Zanaty, Mohammed Ali, Fatma Elserafy, Mohammed Abozaid","doi":"10.1186/s12894-026-02099-0","DOIUrl":"10.1186/s12894-026-02099-0","url":null,"abstract":"<p><strong>Purpose: </strong>Comparative effectiveness of suction versus traditional ureteral access sheath (UAS) remains an area of ongoing research. We aim to compare the outcomes of retrograde intrarenal surgery (RIRS) with suction and standard UAS versus without UAS in the management of renal and upper ureteric stones, with a specific focus on operative efficiency, stone-free rates, and postoperative complications.</p><p><strong>Methods: </strong>This study was conducted between October 2023 and January 2025, including 90 patients with renal stones ≤ 3 cm and upper ureteric stones ≤ 1.5 cm. Patients were divided into three groups by random Allocation Software (version 2): Group A1 (standard UAS, n = 30), Group A2 (suction UAS, n = 30), and Group B (no UAS, n = 30). Operative time, vision quality, stone clearance, complications, and hospital stay were assessed.</p><p><strong>Results: </strong>Group A2 had the shortest mean operative time (70.1 ± 10.3 min) with significantly better vision compared to Group A1 (114.3 ± 27.0 min) and Group B (125.0 ± 28.01 min) (p < 0.001). Residual stone rates were lowest in Group A2 (3.3%) compared to Group A1 (10.0%) and Group B (26.7%) (p = 0.035). The need for a second procedure was significantly higher in Group B (26.7%) compared to Group A1 (10.0%) and absent in Group A2 (p = 0.002). Hospital stay was significantly shorter in Group A2 compared to Group A1 and Group B (p = 0.005). Fever incidence (Clavien Grade II) was significantly higher in Group B (23.3%) compared to Group A1 (16.7%) and absent in Group A2 (p = 0.005).</p><p><strong>Conclusion: </strong>Suction ureteral access sheaths in flexible ureteroscopic lithotripsy for renal stones ≤ 3 cm and upper ureteric stones ≤ 1.5 cm was associated with improved stone clearance, reduced operative time and hospital stay, provide better endoscopic vision, minimized infectious complications and need for second procedure, compared to standard UAS or no sheath. However, outcomes may be influenced by surgeon experience and familiarity with suction-assisted systems. Prospective multicenter studies with larger sample sizes and varying surgeon experience levels are recommended.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"26 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013678","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 as an imaging-based predictor of difficult ureter during ureteroscopic lithotripsy: a retrospective analysis.","authors":"Ye Chen, Jun Zhang, Linbo Li, Yuanjing Shen, Xinwu Guo, Gang Li","doi":"10.1186/s12894-026-02189-z","DOIUrl":"10.1186/s12894-026-02189-z","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the value of ureteral wall thickness (UWT) obtained from non-contrast computed tomography (NCCT) for predicting difficult ureter (DU) among patients receiving ureteroscopic lithotripsy (URS).</p><p><strong>Methods: </strong>Patients with unilateral ureteral stones managed by URS were retrospectively reviewed. According to intraoperative findings, they were classified into DU or non-DU group. UWT was measured at the level of the stone on preoperative NCCT. Multivariate logistic regression was used to identify independent predictors. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff value of UWT for predicting DU.</p><p><strong>Results: </strong>A total of 271 patients managed with URS were enrolled in the study, with 67 (24.72%) in the DU group and 204 (75.28%) in the non-DU group. The mean UWT in the DU group was 3.77 ± 1.24 mm, which was significantly higher than that in the non-DU group. Multivariate logistic regression revealed that UWT was an independent risk factor for DU, with an OR of 2.139 (95% CI: 1.634-2.79). The ROC curve demonstrated that a UWT cutoff of 2.9 mm provided the best threshold for predicting DU, with sensitivity and specificity levels of 77.6% and 71.6%, with an area under the ROC curve (AUC) of 0.786. Moreover, a UWT greater than 2.9 mm was associated with abnormal endoscopic findings during surgery, prolonged operative time, and a reduced stone-free rate.</p><p><strong>Conclusion: </strong>UWT is an independent risk factor for DU. Preoperative measurement of UWT holds significant value in predicting DU. These findings may assist in surgical planning before URS.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013695","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}