BMC Urology最新文献

{"title":"Correlation between total prostate specific antigen and histological grading of prostate cancer in Kenyan mission hospital: a five-year retrospective review.","authors":"Chinonso Paul Shu, Marius J Tchinde, Tsamayem Georter James Sop, Signang Alberic Ndonku, Paul Irungu Juma","doi":"10.1186/s12894-025-01795-7","DOIUrl":"https://doi.org/10.1186/s12894-025-01795-7","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (CaP) is the leading non-cutaneous cancer in men of African descent, with the higher mortality rates found in sub-Saharan Africa. Early diagnosis, staging, and management of prostate cancer could help curb its mortality rate in SSA. However, access to precise radiological imaging for staging purposes is limited in our setting. We sought to evaluate the correlation between total prostate specific antigen (tPSA) and histological grading of CaP in our resource-limited setting.</p><p><strong>Method: </strong>We conducted a retrospective review of records of patients treated for biopsy-proven CaP at the AICKH diagnosed between January 2018 and December 2022. We excluded patients who were already on any sort of treatment of bladder outlet obstruction and incomplete charts. We used Spearman correlation coefficients, and ANOVA to evaluate the relationship between tPSA and various grading parameters. A P-value less than 0.05 was considered significant.</p><p><strong>Results: </strong>We included 327 medical records. The mean tPSA was 112 ± 4.5ng/ml. The most common Gleason score and grade group were 8 (33.8%) and 4 (33.8%) respectively. Perineural involvement was present in 33% of our population. The tPSA had a positive correlation with Gleason score (rho = 0.253, p < 0.001), grade group (rho = 0.296, p < 0.001), perineural involvement (rho = 0.241, p = 0.001) and proportion of sample invasion (rho = 0.171, p = 0.005). A linear and homogenous variance existed in mean tPSA across increasing Gleason score (p < 0.001).</p><p><strong>Conclusion: </strong>tPSA is a good predictor of the severity of CaP in resource-limited settings and can be used to inform management decisions.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"112"},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974450","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":"Pediatric adrenocortical carcinoma complicated by uric acid nephrolithiasis: a unique case report.","authors":"Mao Zhang, Wenping Guo, Hengping Li, Xinsheng Xi","doi":"10.1186/s12894-025-01801-y","DOIUrl":"https://doi.org/10.1186/s12894-025-01801-y","url":null,"abstract":"<p><strong>Background: </strong>Adrenocortical carcinoma (ACC) is an exceedingly rare malignancy in children, typically presenting with Cushing's syndrome due to excessive hormone secretion. The occurrence of uric acid nephrolithiasis in pediatric ACC patients is exceptionally uncommon.</p><p><strong>Case presentation: </strong>We report the case of a 5-year-old boy who exhibited symptoms of Cushing's syndrome over a period of 10 months, including rapid weight gain, moon face, and increased chest and back hair growth. Laboratory tests revealed elevated cortisol, 17-hydroxyprogesterone, and testosterone levels. Imaging studies identified a 6.6 × 5.6 cm mass in the left adrenal gland, which was confirmed as ACC through biopsy and immunohistochemistry. One day prior to the scheduled adrenalectomy, the patient developed renal colic due to multiple kidney stones, as evidenced by emergency CT scans showing bilateral nephrolithiasis and a stone in the left upper ureter with mild hydronephrosis. Postoperatively, the patient spontaneously expelled brick-red uric acid stones. With glucocorticoid replacement therapy, his hormonal levels and clinical symptoms normalized within a year. A four-year follow-up revealed no recurrence of ACC or urolithiasis, and his hormonal parameters remained within normal ranges.</p><p><strong>Conclusion: </strong>This case highlights the rare association between ACC and uric acid nephrolithiasis in children. The spontaneous passage of uric acid stones provides insights into the link between stone formation and metabolic disorders, emphasizing the need for comprehensive endocrine and metabolic assessments in pediatric ACC management.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"109"},"PeriodicalIF":1.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961671","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":"An observational 3-year follow-up study for postoperative renal function changes assessed by ^{99 m}Tc-DTPA scintigraphy and predictive factors after miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery.","authors":"Hyomyoung Lee, Yerzhan Sharapatov, Hyeji Park, Christine Joy Castillo, Majed Alharthi, Mohammad Zogan, Sung Yong Cho","doi":"10.1186/s12894-025-01761-3","DOIUrl":"10.1186/s12894-025-01761-3","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate changes in relative renal function three years after miniaturized percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) and to identify significant predictors associated with renal function aggravation.</p><p><strong>Methods: </strong>From 2019 to 2023, 355 patients aged 20 and above who underwent mini-PCNL or RIRS for the treatment of renal stones > 10 mm in maximal diameter were prospectively included in this study, with those who had separate renal function serially traced being included. Among them, 93 patients were included in the analysis. Renal function was evaluated using 99 mTc-DTPA before surgery, and at 3 months, 1, 2, and 3 years postoperatively.</p><p><strong>Results: </strong>A difference in preoperative renal function of > 10% between the contralateral and operative sides was observed in 79 patients (84.9%). Among those in the abnormal renal function group, 42 patients (53.2%) showed stability, 31 (39.2%) showed aggravation, and 6 (7.6%) showed improvement in renal function at postoperative 3 years. Functional changes did not differ significantly between the types of surgery. Significant predictors of renal function aggravation included higher preoperative creatinine levels, preoperative hydronephrosis, and S-ReSC > 3.</p><p><strong>Conclusion: </strong>A key point of this study is that it is important to explain to patients who do not show recovery within 1 to 2 years that there is a 42.1% chance their renal function may deteriorate over time. Clinicians should be particularly attentive to renal function in patients with higher preoperative creatinine levels, preoperative hydronephrosis, and S-ReSC > 3, requiring closer monitoring and management.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"108"},"PeriodicalIF":1.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971950","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":"Impact of concomitant medications on the oncologic efficacy of systemic therapy in patients with advanced or metastatic urothelial carcinoma: a systematic review and meta-analysis.","authors":"Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Marcin Miszczyk, Tamás Fazekas, Robert J Schulz, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Pawel Rajwa, Koichiro Wada, Katharina Oberneder, Piotr Chlosta, Pierre I Karakiewicz, Motoo Araki, Shahrokh F Shariat","doi":"10.1186/s12894-025-01754-2","DOIUrl":"https://doi.org/10.1186/s12894-025-01754-2","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICI) and chemotherapy, including antibody-drug conjugates, are widely used for the treatment of patients with advanced unresectable or metastatic urothelial carcinoma (UC). The majority of elderly patients receive concomitant medications to address various comorbidities. We aimed to evaluate the impact of concomitant medications on oncological outcomes in patients with advanced unresectable or metastatic UC treated with systemic therapy.</p><p><strong>Material & methods: </strong>In August 2024, three datasets were queried for studies evaluating concomitant medications in patients with advanced unresectable or metastatic UC. The review protocol was registered in PROSPERO (CRD42024547335). The primary outcome was overall survival (OS). A fixed- or random-effects model was used for meta-analysis depending on the heterogeneity.</p><p><strong>Results: </strong>We identified 16 eligible studies (3 prospective and 13 retrospective) comprising 4,816 patients. Most reported concomitant medications included proton pump inhibitors (PPIs), antibiotics, steroids, and opioids. The use of concomitant PPIs, antibiotics, steroids or opioids during ICI therapy was associated with worsened OS (PPIs: HR: 1.43, 95% CI: 1.31-1.57, p < 0.001; antibiotics: HR: 1.2, 95% CI: 1.04-1.38, p = 0.01; steroids: HR: 1.45, 95% CI: 1.25-1.67, p < 0.001; and opioids: HR: 1.74, 95% CI: 1.46-2.07, p < 0.001). Concomitant use of antibiotics during chemotherapy did not impact OS (HR: 1.01, 95% CI: 0.67-1.51).</p><p><strong>Conclusions: </strong>When treating advanced unresectable or metastatic UC with ICI therapy, we need to pay attention to concomitant medications, such as PPIs and antibiotics to avoid reducing the efficacy of ICI therapy. The mechanism of action of these drugs on ICI efficacy requires further examination.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"107"},"PeriodicalIF":1.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978427","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":"Multidisciplinary management of a Spondyloarthritis presenting with bladder involvement as the initial clinical symptom: a rare case report.","authors":"Lingmin Song, Shengdong Li, Jingjing Yu, Guobin Weng","doi":"10.1186/s12894-025-01796-6","DOIUrl":"https://doi.org/10.1186/s12894-025-01796-6","url":null,"abstract":"<p><strong>Background: </strong>Spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases that can present with diverse extra-articular manifestations. However, bladder involvement as the primary clinical presentation has not been previously reported.</p><p><strong>Case presentation: </strong>We present a case report of a 55-year-old male with a 20-year history of recurrent left lower abdominal pain and lower urinary tract symptoms (LUTS). Despite multiple treatments for presumed chronic prostatitis and cystitis, symptoms persisted. Imaging revealed bladder wall alterations and inflammatory changes in bilateral sacroiliac joints. Laboratory tests showed positive HLA-B27 expression. Histopathological examination of bladder tissue demonstrated chronic inflammation with eosinophilic infiltration and vasculitis. These findings led to a diagnosis of SpA, despite the absence of typical musculoskeletal symptoms. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor (TNF) inhibitors resulted in complete resolution of urological symptoms and normalization of bladder morphology. After one month of continuous management, the patient experienced significant relief from left lower abdominal pain (NRS 2-3) and LUTS. The patient reported complete alleviation of pain (NRS 0) and LUTS at the three-month follow-up. No recurrence was observed during a 1-year follow-up period.</p><p><strong>Conclusions: </strong>This case highlights the potential for SpA to manifest primarily with urological symptoms, emphasizing the need for clinicians to consider systemic inflammatory conditions in cases of refractory LUTS. The successful diagnosis and management underscore the importance of interdisciplinary collaboration between urology and rheumatology.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"106"},"PeriodicalIF":1.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977049","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":"Pressure bag irrigation vs manual pressure and gravity drainage for reducing patient discomfort during flexible cystoscopy, A Study protocol for a randomised double blinded controlled trial.","authors":"David Armany, Ankur Dhar, Ashan Canagasingham, Lawrence H C Kim, Audrey Wang","doi":"10.1186/s12894-025-01753-3","DOIUrl":"https://doi.org/10.1186/s12894-025-01753-3","url":null,"abstract":"<p><strong>Background: </strong>Flexible cystoscopy is widely used for the diagnosis and surveillance of various urological conditions and is commonly performed in an outpatient setting under local anaesthesia. Various adjuncts have been proposed to reduce patient discomfort, with the most notable being the manual bag squeeze method. This approach elevates irrigation fluid pressure, induces hydrodistension, and has received a strong recommendation from the European Association of Urology (EAU). However, the manual bag squeeze method is limited by inconsistencies in the pressure applied by individuals and the need for additional staff members to perform the procedure. This trial aims to assess the efficacy of standardised pressure bags in elevating irrigation fluid pressure during flexible cystoscopy and its impact on reducing mean pain scores, compared to conventional gravity drainage and the manual bag squeeze manoeuvre.</p><p><strong>Methods: </strong>A randomised, controlled, double blinded, single-centre, parallel-group trial will be conducted. Participants scheduled to undergo flexible cystoscopy will be recruited, screened for eligibility and randomised to one of three study groups: (1) Intervention 1 - Pressure bag Group, (2) Intervention 2 - Manual bag squeeze group, and (3) Control - Gravity drainage group with a simulated bag squeeze. Randomisation will be stratified based on participants' history of prior flexible cystoscopy. The primary outcome is the mean pains score reported by participants immediately after the procedure, assessed using a Numerical Rating Scale (NRS). Secondary outcomes include Patient Reported Outcome Measures (PROMIS) surveys at day 7 post flexible cystoscopy to evaluate for pain intensity (1a), Pain inference (short form 6a) and emotional distress-anxiety (Short form 4a), as well as the incidence of complications reported at day 30 post-procedure.</p><p><strong>Discussion: </strong>This trial will evaluate the role of pressure bags to elevated fluid irrigation pressure and its effect on reducing patient discomfort during flexible cystoscopy using a rigorous methodology. If proven to be effective, pressure bag fluid irrigation has the potential to be implemented as one of the standards of practice for flexible cystoscopies.</p><p><strong>Trial registration: </strong>Australian New Zealand Clinical Trials Registry (ANZCTR). Prospective Registration Number: ACTRN12623000799651. Date of Registration 26/07/2023.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"105"},"PeriodicalIF":1.7,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976746","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":"Sarcomatoid prostate carcinoma: a case report.","authors":"Hamza Hafiani, Ismail Hafiani, Mohamed Hafiani","doi":"10.1186/s12894-025-01790-y","DOIUrl":"https://doi.org/10.1186/s12894-025-01790-y","url":null,"abstract":"<p><strong>Background: </strong>Sarcomatoid carcinoma of the prostate is an extremely rare and aggressive variant of prostate cancer, posing significant diagnostic and therapeutic challenges due to its mixed histological features. It represents less than 0.1% of prostate cancer cases and is characterized by the presence of both glandular and sarcomatoid components.</p><p><strong>Case presentation: </strong>We report the case of a 58-year-old male from rural Morocco who presented with a two-month history of urinary symptoms. Initial imaging revealed prostatic enlargement and a PSA level of 9ng/l, prompting further investigation with CT imaging, which identified a significant prostatic abscess. Surgical drainage unexpectedly revealed a hard mass, leading to transrectal biopsies and subsequent histopathological analysis confirming the diagnosis of sarcomatoid prostate carcinoma. The patient underwent radical prostatectomy post-diagnosis.</p><p><strong>Conclusions: </strong>Sarcomatoid carcinoma of the prostate remains a diagnostic challenge due to its rarity and mixed histological features. This case highlights the importance of considering sarcomatoid carcinoma in the differential diagnosis of prostate malignancies, especially in patients with atypical presentations such as prostatic abscesses. Early recognition and appropriate management are crucial for optimizing patient outcomes in such cases.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"104"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966092","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":"Spinal epidural abscess post-ureteroscopy: a case report.","authors":"Stephanie N Washington, David D Kim, Luke F Reynolds","doi":"10.1186/s12894-025-01789-5","DOIUrl":"https://doi.org/10.1186/s12894-025-01789-5","url":null,"abstract":"<p><strong>Background: </strong>Spinal epidural abscess (SEA) is an uncommon but potentially life-threatening infection that requires prompt identification and treatment. Early SEAs may present with non-specific symptoms, including fever, chills, headache, and back pain, before progressing to neurologic dysfunction. To our knowledge, there have been no reports of immunocompetent patients with a history of recurrent UTIs presenting with SEA following ureteroscopy (URS) and lithotripsy (LL).</p><p><strong>Case presentation: </strong>In this article, we present two cases of spinal abscess formation after ureteroscopy in patients with histories of recurrent urinary tract infections but without previous spinal pathology. Both patients required procedural intervention and one patient sustained lasting neurological deficits.</p><p><strong>Conclusions: </strong>It is important that urologists be aware of this possible complication to ensure the early diagnosis of the disease to facilitate appropriate management.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"100"},"PeriodicalIF":1.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977222","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":"Spermatocytic tumor coexisting with a contralateral inguinoscrotal undifferentiated sarcoma: a case report.","authors":"Lisa Surer, Pia Kraft, Yasmin Heiniger, Nadim Abo Youssef, Michel Bihl, Hubert John, Peter Bode","doi":"10.1186/s12894-025-01770-2","DOIUrl":"https://doi.org/10.1186/s12894-025-01770-2","url":null,"abstract":"<p><strong>Background: </strong>Spermatocytic tumors represent uncommon neoplasms of the testes and are mostly indolent with favorable prognosis in the non-metastatic stage. Rarely, they can undergo sarcomatous transformation, significantly worsening prognosis. This case highlights a patient harboring a testicular spermatocytic tumor and a concomitant sarcoma of the contralateral inguinoscrotal soft tissue, not related to the spermatocytic tumor.</p><p><strong>Case presentation: </strong>A 77-year-old male patient presented with a left scrotal mass and a suspected right inguinoscrotal hernia. Laboratory values showed a slightly elevated alpha-1-fetoprotein, while beta-human chorionic gonadotropin and lactate dehydrogenase were within normal limits. Ultrasound imaging revealed a diffusely enlarged, inhomogeneous left testis, highly suspicious for testicular malignancy. Staging revealed no lymphatic or distant metastases. The patient underwent left radical orchiectomy. Histological analysis revealed a spermatocytic tumor of the left testis. Intraoperatively, a gelatinous mass in the contralateral right inguinoscrotal area was discovered and biopsied. The mass on the right was identified as a sarcomatous tumor. Subsequent management entailed radiotherapy, followed by radical resection and scrotectomy with preperitoneal mesh reinforcement. Pathologic workup including molecular genetic testing showed different immunohistochemical and molecular profiles in both tumors. This led to the final diagnosis of a coexisting undifferentiated sarcoma.</p><p><strong>Discussion and conclusions: </strong>Despite being uncommon and generally less aggressive compared to other testicular malignancies, spermatocytic tumors necessitate vigilance for potential sarcomatous transformation. In this case, a sarcomatous transformation of a spermatocytic tumor was excluded and diagnostics instead revealed an even rarer case of a coexisting undifferentiated sarcoma of the contralateral inguinoscrotal soft tissue. To our knowledge, this is the first reported case of a spermatocytic tumor with a coexisting, unrelated sarcoma. The rarity of these entities underlines the importance of multidisciplinary team meetings for accurate diagnosis and optimal treatment-related decisions.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"101"},"PeriodicalIF":1.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976015","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":"Surgical treatment of lower urinary tract symptoms secondary to benign prostatic obstruction: an analysis and meta-synthesis of available guidelines.","authors":"Laurenz S Matter, Orlando Burkhardt, Pavel Lyatoshinsky, Jennifer Blarer, Roland Seiler, Dominik Abt","doi":"10.1186/s12894-025-01788-6","DOIUrl":"https://doi.org/10.1186/s12894-025-01788-6","url":null,"abstract":"<p><strong>Purpose: </strong>The increase in minimally invasive treatments (MITs) for lower urinary tract symptoms secondary to benign prostatic obstruction (LUTS/BPO) has diversified surgical options, often outpacing solid evidence. The variety of available treatments, while beneficial, can confound physicians. Clinical guidelines provide direction but often differ due to varied evidence interpretation.</p><p><strong>Methods: </strong>We have analyzed the available guidelines on the surgical treatment of LUTS/BPO updated within the last three years, focusing on those offering specific procedural recommendations. We compared recommendations, analyzed discrepancies, and developed a consensus algorithm that incorporated all pertinent advice.</p><p><strong>Results and limitations: </strong>Out of 14 guidelines, four met the inclusion criteria. Major challenges were inconsistent nomenclature and a lack of clear recommendations, especially for newer procedures such as Temporary Implantable Nitinol Device (iTIND™), Prostate Artery Embolization (PAE), Robotic Assisted Simple Prostatectomy (RASP), and Water Vapor Thermal Therapy (Rezūm™). Despite these issues, a consensus algorithm could be synthesized.</p><p><strong>Conclusions and clinical implications: </strong>Guidelines for the treatment of LUTS/BPO present a disparate picture, with consensus mostly on older, well-established procedures due to substantial evidence. Newer interventions display significant variation in guideline recommendations and evidence interpretation. The consensus algorithm created from current guidelines offers a synthesized overview of recommendations, underscoring the need for standardized evidence criteria for guideline recommendations. Our work emphasizes the evolving complexity in LUTS/BPO management, aiming to aid urologists in decision-making and patient counseling by providing a clear and comprehensive tool.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"99"},"PeriodicalIF":1.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954660","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}