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        <title>Frontiers in Urology | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/urology</link>
        <description>RSS Feed for Frontiers in Urology | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-08-17T17:31:36.612+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1836469</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1836469</link>
        <title><![CDATA[Use of androgen suppression therapy at salvage radiotherapy in recurrent prostate cancer: a systematic review with meta-analysis]]></title>
        <pubdate>2026-08-17T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Maria Juliana Chaves Medina</author><author>Rodolfo Varela Ramírez</author><author>Wilfredo Donoso Donoso</author><author>Jaime Moreno-Chaparro</author><author>Javier Eslava-Schmalbach</author>
        <description><![CDATA[IntroductionSalvage radiotherapy (SRT) is one of the treatment options after progression following surgical management, with effectiveness varying according to patient risk and clinical-pathological characteristics.ObjectiveTo compare the effectiveness of SRT alone versus SRT combined with androgen deprivation therapy (ADT) in men with biochemical recurrence.MethodsWe conducted a systematic review with advanced searches in MEDLINE (PubMed), EMBASE, SCOPUS, Cochrane CENTRAL, and LILACS for the period 1990–2024. Two independent reviewers performed study selection (titles/abstracts and full text) and data extraction. Risk of bias was assessed with ROBINS-I and RoB 2.0. A random-effects meta-analysis was used to pool effect estimates. PROSPERO registration: CRD42025640604.ResultsThirteen studies were included. Nine reported overall survival (OS) and biochemical progression-free survival (b-PFS) respectively, four clinical progression-free survival (c-PFS), and eight metastasis-free survival (MFS). Combined SRT+ADT was associated with improved b-PFS (HR 0.51; 95% CI 0.45-0.57; I²=0%) and MFS (HR 0.71; 95% CI 0.60-0.84; I²=39%), whereas the remaining meta-analyzed outcomes showed no consistent benefit or were limited by heterogeneity. Regarding toxicity, the most frequent adverse events were endocrine and sexual, related to hormonal blockade, gynecomastia and erectile dysfunction.ConclusionsCombined SRT + ADT improves biochemical disease control and may reduce the risk of metastasis in selected patients with biochemical recurrence after radical postatectomy, whereas the effect on overall survival remains uncertain. Individualized management requires risk stratification when deciding on the addition and duration of ADT to optimize oncologic outcomes.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/, identifier CRD42025640604.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1880004</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1880004</link>
        <title><![CDATA[Impact of protocolized intravesical instillation after TURBT on men’s sexual quality of life:a retrospective cohort study]]></title>
        <pubdate>2026-08-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xiaoqing Wang</author><author>Tuan Wang</author><author>Sen Hu</author><author>Libo Liu</author><author>Xiaoli Zhang</author><author>Beibei Zhang</author><author>Wenwen Jia</author><author>Jiangyu Xue</author>
        <description><![CDATA[ObjectiveTo determine whether protocolized intravesical gemcitabine instillation after transurethral resection of bladder tumor (TURBT) is associated with men’s sexual quality of life, assessed using the Sexual Life Quality Questionnaire (SLQQ), compared with a single immediate postoperative instillation.MethodsWe conducted a retrospective cohort study of 244 men with non–muscle-invasive bladder cancer undergoing TURBT between January 2021 and May 2024. Patients received either protocolized intravesical gemcitabine (weekly for 8 weeks, then monthly for 6 months) or a single immediate postoperative instillation. The primary outcome was the 8-month SLQQ score. Secondary outcomes included the International Index of Erectile Function-5 (IIEF-5) and urinary symptom–related quality-of-life (QOL) score. Between-group comparisons, difference-in-differences (DID), correlation analyses, multivariable regression, and multiple-imputation sensitivity analyses were performed.ResultsBaseline SLQQ scores were comparable between groups. At 8 months, the protocol cohort had significantly lower SLQQ scores than controls (21.78 ± 8.77 vs. 37.13 ± 8.56; mean difference −15.35, 95% CI −17.54 to −13.16; Cohen’s d=−1.77; P<0.001). The decline in SLQQ was greater in the protocol cohort (DID −15.27, 95% CI −18.18 to −12.36). Postoperative IIEF-5 was strongly correlated with SLQQ (r=0.938), whereas urinary symptom–related QOL showed a weak negative correlation (r=−0.232). Sensitivity analyses consistently demonstrated an approximately 15-point between-group difference after adjustment for baseline SLQQ and additional imputed clinical covariates.ConclusionsProtocolized intravesical gemcitabine following TURBT was associated with poorer postoperative sexual quality of life. This association remained robust across multiple sensitivity analyses, supporting routine sexual-health assessment during NMIBC survivorship.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1855180</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1855180</link>
        <title><![CDATA[Glucagon-like peptide-1 receptor agonist versus other anti-diabetic agents on patients with prostate cancer undergoing androgen-deprivation therapy]]></title>
        <pubdate>2026-08-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sheng-Chi Huang</author><author>Wan-Yu Cheng</author><author>Cheng-You Hou</author><author>Jheng-Yan Wu</author><author>Chih-Cheng Lai</author><author>Wen-Hsin Tseng</author>
        <description><![CDATA[Patients with prostate cancer (PCa) undergoing androgen deprivation therapy (ADT) frequently develop cardiometabolic complications, particularly those with type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) provide cardiovascular and renal benefits in diabetic populations, but comparative evidence with other glucose-lowering therapies in men receiving ADT remains limited. We conducted a retrospective cohort study using the TriNetX network. Adults with T2D and PCa undergoing ADT who received GLP-1RA, dipeptidyl peptidase-4 inhibitors (DPP-4is), or sodium–glucose cotransporter-2 inhibitors (SGLT2is) between January 2005 and December 2025 were included. Propensity score matching generated balanced cohorts for two comparisons: GLP-1RA versus DPP-4i and GLP-1RA versus SGLT2i. The primary outcome was all-cause mortality; secondary outcomes were major adverse cardiovascular events (MACEs), major adverse kidney events (MAKEs), and thrombotic events. After matching, 659 patients per group were included in the GLP-1RA versus DPP-4i comparison and 1,009 per group in the GLP-1RA versus SGLT2i comparison. Compared with DPP-4i, GLP-1RA use was associated with lower all-cause mortality (HR, 0.60; 95% CI, 0.46–0.79), MAKEs (HR, 0.63; 95% CI, 0.48–0.81), and thrombotic events (HR, 0.53; 95% CI, 0.32–0.89), whereas MACEs were similar (HR, 0.87; 95% CI, 0.63–1.12). Compared with SGLT2i, GLP-1RA use was associated with lower all-cause mortality (HR, 0.76; 95% CI, 0.59–0.99), whereas no significant differences were observed for MACEs, MAKEs, or thrombotic events. These neutral findings should be interpreted cautiously because the limited number of events may have reduced statistical power to detect modest between-group differences. In conclusion, among men with PCa receiving ADT and comorbid T2D, GLP-1RA use was associated with lower all-cause mortality than both DPP-4i and SGLT2i, with additional reductions in kidney and thrombotic events versus DPP-4i. GLP-1RAs may represent a favorable therapeutic option in this metabolically and vascularly vulnerable population. Prospective studies are warranted to confirm these associations and clarify the underlying mechanisms.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1931923</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1931923</link>
        <title><![CDATA[Artificial intelligence and machine learning in neurogenic tract dysfunction and spinal cord injury: current status, emerging technologies, and ethical perspectives]]></title>
        <pubdate>2026-08-07T00:00:00Z</pubdate>
        <category>Perspective</category>
        <author>Patrick M. F. Levien</author><author>Jürgen Pannek</author>
        <description><![CDATA[Artificial intelligence (AI) and machine learning are increasingly applied across urology, with particular promise for the management of neurogenic lower urinary tract dysfunction (NLUTD) in individuals with spinal cord injury (SCI). There is also particular promise in the management of NLUTD, a complex, lifelong condition affecting individuals with SCI and also occurring in the context of multiple sclerosis, Parkinson’s disease, and other neurological disorders. This article provides a comprehensive analysis of AI’s current and emerging role in neuro-urology, with dedicated focus on the specific challenges and opportunities presented by NLUTD and SCI. We review the epidemiological and clinical burden of neurogenic bladder dysfunction. We further examine AI applications in uro-oncology, functional urology, digital pathology, and robotic surgery, integrating these with the specialized perspective of neuro-urology. The particular vulnerability of individuals with SCI to algorithmic bias, access inequity, and assistive technology dependency is critically discussed. We identified five key domains where AI may transform care for patients with NLUTD: automated urodynamic interpretation including detection of detrusor overactivity and detrusor-sphincter dyssynergia, predictive risk stratification for renal deterioration, closed-loop neuromodulation, remote digital monitoring, and AI-assisted rehabilitation support. Alongside the substantial opportunities, we articulate the ethical, moral, and societal responsibilities that accompany AI integration in this population, emphasizing that patients with SCI and NLUTD deserve not merely inclusion in AI development but active partnership as co-designers of the technologies that will shape their lives.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1865760</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1865760</link>
        <title><![CDATA[Efficacy and safety of an implantable tibial neuromodulation system for overactive bladder with urgency urinary incontinence: an open-label, single arm trial]]></title>
        <pubdate>2026-07-15T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Fuyuan Zheng</author><author>Yongjun Guan</author><author>Weilin Fang</author><author>Tingting Lv</author><author>Jin Huang</author><author>Xin Song</author><author>Jianwei Lv</author>
        <description><![CDATA[PurposeThis study aimed to evaluate the safety and efficacy of a domestically developed implantable tibial neuromodulation system (iTNS) in the treatment of overactive bladder (OAB) in patients with urgency urinary incontinence (UUI).MethodsA prospective single-center open-label trial was conducted. A total of 10 participants underwent iTNS device implantation, followed by device activation at 2–4 weeks post-implantation. Follow-up evaluations were performed at 1, 3, and 6 months post-implantation, including 3-day bladder diaries, validated questionnaires, and symptom satisfaction surveys. The primary endpoint was a ≥50% reduction in UUI episodes per day at 6 months.ResultsAt 6 months, the iTNS system achieved a 90% response rate (9/10 patients), among whom 40% (4/10) attained ≥3 consecutive dry days. A delayed therapeutic onset was observed: a significant reduction in UUI episodes emerged at 3 months (from 3.235 to 0.766 episodes per day) and 6 months (from 3.235 to 0.632 episodes per day). Quality of life was significantly improved at 6 months, as indicated by the changes in validated questionnaires (OAB-Q: 69.5 ± 11.76 to 44.4 ± 12.06; OABSS: 9 ± 1.155 to 6.2 ± 2.394). Additionally, 80% of patients reported satisfaction with their symptoms at the 6-month endpoint.ConclusionsThe domestically developed iTNS system is safe and effective for the treatment of UUI in patients with OAB. It exhibits a strong ability to significantly reduce or completely resolve UUI symptoms, with a favorable safety profile.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1878604</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1878604</link>
        <title><![CDATA[Predictors of recurrence after vesicovaginal fistula repair: a systematic review of surgical and patient-related factors]]></title>
        <pubdate>2026-06-23T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Mohammad Shazib Faridi</author><author>Lubna Inam</author><author>Vyomesh Rastogi</author>
        <description><![CDATA[BackgroundRepair of vesicovaginal fistula (VVF) is highly effective, with primary success rates of 80-95%; however, recurrence is reported in 10-30% of cases. Factors influencing recurrence include fistula size and tissue characteristics.MethodsThis systematic review identifies predictive factors for VVF recurrence by reviewing 21 studies published between 1994 and 2025 that met PRISMA criteria, and by analyzing the surgical outcomes from PubMed/MEDLINE data for various etiologies of VVF. Eligible studies reporting predictors of VVF repair were assessed for bias using the modified Newcastle-Ottawa Scale.ResultsThe following factors were consistently identified as predictors of VVF recurrence: fistula size greater than 2-3cm (odds ratio [OR]: 1.0-6.0), severe peri-fistula fibrosis (OR: 2.7 to 12.0), involvement of the urethra and/or bladder neck (OR: 0.4 to 9.0) and multiple fistulas (OR: 4.0 to 8.0). The following protective factors were identified: early intervention, surgery performed in a specialist center, and the use of interposition flaps. The Goh and Panzi classifications assist in the predictive risk stratification of patients. Most studies had a low to moderate risk of bias. Due to the heterogeneous nature of the studies, there was considerable variation in study design, etiology, and surgical technique; therefore, narrative synthesis rather than meta-analysis was performed. In most cases, secondary VVF repair has been documented to improve surgical outcomes; however, results for previously failed repairs remain contradictory.ConclusionUsing validated predictive factors for preoperative risk stratification may improve global VVF surgical outcomes. Closing the gap in surgical outcomes between regions and optimizing surgical techniques will require further prospective research and the development of predictive models.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1865730</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1865730</link>
        <title><![CDATA[Durable disease control after multimodal therapy and platinum-based chemotherapy rechallenge in advanced clear cell adenocarcinoma of the urethra with lymph node metastases: a case report]]></title>
        <pubdate>2026-06-22T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Akihiro Maeda</author><author>Shohei Tobu</author><author>Shuhei Kusano</author><author>Maki Kawasaki</author><author>Hiroaki Kakinoki</author><author>Mitsuru Noguchi</author>
        <description><![CDATA[BackgroundClear cell adenocarcinoma of the urethra (CCAU) is an extremely rare subtype of primary urethral carcinoma. Owing to its low incidence, the optimal treatment strategy for advanced or metastatic disease remains unclear. We report a case of advanced CCAU with lymph node metastases that achieved long-term disease control following multimodal therapy.Case presentationA 60-year-old woman presented with urinary retention and was diagnosed with primary urethral clear cell adenocarcinoma (cT4N2M0) with pelvic lymph node metastases. Neoadjuvant gemcitabine plus cisplatin (GC) chemotherapy achieved a partial response and was followed by robot-assisted radical cystourethrectomy combined with hysterectomy, vaginectomy, and pelvic lymph node dissection. Pathological examination revealed ypT4N2M0 disease with negative surgical margins. Adjuvant nivolumab was initiated but was discontinued because of immune-related hypothyroidism and nodal recurrence. Comprehensive genomic profiling demonstrated microsatellite stability, a low tumor mutational burden (1 mutation/Mb), and MET and MYC amplifications. As no actionable alterations were identified, GC chemotherapy was reintroduced and again achieved a partial response. The patient remains progression-free 32 months after diagnosis.ConclusionsThis case suggests that multimodal treatment combining radical surgery and platinum-based chemotherapy may contribute to durable disease control in selected patients with advanced CCAU and lymph node metastasis. Although genomic profiling did not directly guide therapy in this case, molecular characterization may provide a basis for future individualized treatment strategies for this rare malignancy.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1822923</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1822923</link>
        <title><![CDATA[The effects of locally administered aminophylline in patients undergoing ureteroscopic lithotripsy: a systematic review with exploratory meta-analysis]]></title>
        <pubdate>2026-06-17T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Mansour Alnazari</author><author>Ahmad Badawi</author><author>Osama Alamri</author><author>Abdullah Alsehli</author><author>Omar Alamri</author><author>Mohammed Alhusayni</author><author>Abdullah Alghamdi</author><author>Amr Mahran</author>
        <description><![CDATA[PurposeAminophylline, a methylxanthine derivative, acts as a smooth muscle relaxant through non-competitive inhibition of phosphodiesterase. It has been suggested to facilitate ureteroscopic lithotripsy by relaxing ureteral smooth muscle. The aim of this systematic review is to assess the available evidence on locally administered aminophylline in patients undergoing ureteroscopic lithotripsy and, where feasible, to perform an exploratory meta-analysis to estimate pooled effects.MethodsA systematic search was conducted through November 2025. Three randomized controlled trials (RCTs) met the inclusion criteria. The primary outcome was residual stone proportions (derived from the stone-free rate). Secondary outcomes included operative time, postoperative ureteral stenting, and auxiliary procedures. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB-2) tool. This review was registered with PROSPERO (CRD420251229352).ResultsThree RCTs enrolling 310 patients (155 receiving aminophylline and 155 receiving placebo) were included. Local aminophylline was associated with significantly fewer residual stones (RR 0.3; 95% CI: 0.13, 0.69; p = 0.025; I² = 0%) and fewer auxiliary procedures (RR 0.15; 95% CI: 0.06, 0.38; p <0.001; I² = 0%). Reductions in operative time and postoperative ureteral stenting were observed in the primary analysis; however, these did not remain statistically significant after applying the Hartung–Knapp–Sidik–Jonkman (HKSJ) correction.ConclusionThis exploratory meta-analysis provides preliminary evidence that locally administered aminophylline may reduce residual stone fragments and auxiliary procedures during ureteroscopic lithotripsy. Reductions in operative time and ureteral stenting did not retain statistical significance in sensitivity analyses and should be considered hypothesis-generating. These findings should be interpreted with caution, given the low certainty of the evidence. Adequately powered randomized trials are required to validate these results.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251229352.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1799957</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1799957</link>
        <title><![CDATA[Investigation of bioimpedance as a method for wearable noninvasive bladder volume measurements in individuals with spinal cord injury or disease: protocol of a feasibility study]]></title>
        <pubdate>2026-06-11T00:00:00Z</pubdate>
        <category>Study Protocol</category>
        <author>Judith Jantine Willemijn van Beek</author><author>Kanika Dheman</author><author>Sabrina Amrein</author><author>Michele Magno</author><author>Diego Paez-Granados</author><author>Jürgen Pannek</author><author>Jörg Krebs</author>
        <description><![CDATA[IntroductionNeurogenic lower urinary tract dysfunction (NLUTD) is a frequent consequence of spinal cord injury or disease (SCI/D). It can lead to impaired bladder emptying, urinary incontinence, and recurrent urinary tract infections. For those unable to empty their bladder effectively, intermittent catheterization (IC) is the recommended first-line management. Clinical guidelines advise catheterization four to six times daily to prevent bladder overdistension (i.e., bladder volume > 500 ml), yet fixed schedules are often impractical due to fluctuating daily factors. Personalized scheduling is particularly challenging for individuals with SCI/D who lack bladder sensation. Consequently, a noninvasive and unobtrusive method for bladder volume monitoring is needed. Electrical bioimpedance (BI) is a promising solution, as it measures the impedimetric response of tissue to an applied electrical signal and should detect changes related to bladder filling. This may enable continuous, dynamic volume estimation and support individualized bladder management.Methods and analysisThis multi-center observational feasibility study evaluates a BI sensor for noninvasive bladder volume monitoring across three phases. Phase 1 assesses feasibility in individuals without SCI/D. Phase 2 includes individuals with chronic SCI/D and NLUTD to determine the difference between BI-derived bladder volume and the clinical gold standard (bladder volume determined by catheterization). Effects of abdominal adiposity and muscle activity on BI-signals will also be analyzed. Phase 3 examines the usability of a BI-based wearable during six hours of real-life use in wheelchair users reliant on intermittent catheterization. Sixty participants will be enrolled across all phases. The primary outcome is the difference in bladder volume (mL) between BI measurements and catheterized volumes in individuals with SCI/D. Secondary outcomes include physiological and motion parameters possibly affecting BI measurements. Analyses will be descriptive, focusing on signal quality, feasibility, and measurement agreement.DiscussionThis multi-phase feasibility study evaluates whether a BI sensor can measure bladder volume in individuals with SCI/D and NLUTD noninvasively and continuously. By validating BI in controlled and real-life settings, the study aims to determine its feasibility and potential as an alternative to current bladder volume assessment methods.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1835856</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1835856</link>
        <title><![CDATA[The role of leptin in reproductive dysfunction in patients with varicocele: a systematic review and meta-analysis]]></title>
        <pubdate>2026-06-05T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Yan Zhang</author><author>Yangming Li</author><author>Xiaodan Du</author><author>Ye Dong</author><author>Honglong Jia</author><author>Jian Qiu</author><author>Bin He</author><author>Shengzhuo Liu</author><author>Sikui Shen</author><author>Yuchun Zhu</author>
        <description><![CDATA[BackgroundThe mechanism of leptin’s role in female infertility has been demonstrated, however, the relationship between it and infertile patients with varicocele has yet to be determined. This study aimed to evaluate role of leptin in reproductive dysfunction in patients with varicocele.MethodsA computerized literature search was independently conducted by two researchers in PubMed, EMBASE, Web of Science, ScienceDirect, and Cochrane Library up to July 2025. The search terms were as follows: ‘leptin’, ‘varicocele’ and ‘infertility’. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The meta-analysis was performed using Review Manager version 5.1 and R version 4.0.5.Results36 studies were retrieved and 5 studies were included for meta-analysis. We found that the expression of leptin in seminal plasma in infertile patients with varicocele were significantly higher than controls (SMD, 2.72; 95%CI, 1.05-4.39; I2 = 96%, p=0.001). In contrast, the serum leptin levels did not show statistically significant differences (SMD, 1.26; 95%CI -0.73-3.26; I2 = 96%, p=0.21) between patients and controls. Seminal plasma leptin levels had a moderate negative correlation with sperm concentration (r=-0.54; 95%CI, -0.77 - -0.19; p<0.01). Additionally, seminal plasma leptin levels had a strong negative correlation with sperm progressive motility (r=-0.71; 95%CI, -0.93 - -0.09; p<0.01).ConclusionsThe expression of leptin in seminal plasma was significantly higher in infertile patients with varicocele. Seminal plasma leptin levels had a negative correlation with sperm concentration and progressive motility. Leptin in seminal plasma seemed to have a negative effect on the reproductive function of patients with varicocele.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1816956</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1816956</link>
        <title><![CDATA[Hysterectomy and the risk of urinary incontinence: a systematic review and meta-analysis]]></title>
        <pubdate>2026-06-04T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Liping Wang</author><author>Leilei Gao</author><author>Xuechai Bai</author><author>Juan Gu</author>
        <description><![CDATA[ObjectTo evaluate the association between hysterectomy and the risk of developing urinary incontinence (UI) based on observational studies.MethodsWe conducted a systematic search of PubMed, Embase, and Cochrane Library for observational studies from inception to December 14, 2025, using medical subject headings (MeSH) and keywords. The risk of bias and the quality of evidence were assessed using the Newcastle-Ottawa Scale (NOS), the Agency for Healthcare Research and Quality (AHRQ) criteria, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, respectively. To derive overall summary estimates of odds ratios (OR), a random-effects meta-analysis was performed, complemented by subgroup analyses to explore potential effect modifiers. And the presence of publication bias was evaluated through funnel plots and Egger’s regression test.ResultsThis meta-analysis is registered with PROSPERO (CRD42024587774) and follows PRISMA guidelines, including 12 studies with a cumulative total of 146,759 individuals who underwent hysterectomy. The pooled analysis revealed a significant association between hysterectomy and an increased risk of UI, yielding an OR of 1.31, (95% CI: 1.03-1.66, I2 = 88.5%, P = 0.029). Subgroup analyses showed that the risk of UI was notably higher among patients who underwent abdominal hysterectomy (OR = 1.21, 95% CI: 1.10-1.34, I2 = 0.0%, P = 0.000). Furthermore, it was observed that the incidence of UI was particularly elevated in studies conducted in Asia, while no significant association was reported for regions such as Europe and North America.ConclusionHysterectomy is associated with an increased risk of urinary incontinence, based on synthesized evidence from observational studies.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024587774.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1801127</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1801127</link>
        <title><![CDATA[Comparative outcomes of focal HIFU versus active surveillance in low- and intermediate-risk localized prostate cancer: a 75-month retrospective cohort study]]></title>
        <pubdate>2026-06-02T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mohammad Jaabou</author><author>Maurizio Buscarini</author><author>Osama Zaytoun</author><author>Zachary Dovey</author><author>Brooke Hildebrand</author><author>Modassar Awan</author><author>Maida Bada</author><author>Mohammad Al Ogaili</author><author>Ahmad Rabie</author>
        <description><![CDATA[ObjectiveFocal high-intensity focused ultrasound (HIFU) is a minimally invasive treatment for localized prostate cancer. Its comparative effectiveness against active surveillance (AS) remains underexplored in patients eligible for either strategy.MethodsThis retrospective cohort study analyzed 635 men with localized prostate cancer treated between 2018 and 2023: 303 received focal HIFU and 332 underwent AS. Only low-risk and favorable intermediate-risk patients per NCCN guidelines were included (PSA <20 ng/mL, stage ≤T2b, ISUP ≤2, <50% positive cores). Multiparametric MRI and targeted biopsies confirmed eligibility. Outcomes included progression to clinically significant prostate cancer (csPC: ISUP ≥3 or ISUP 2 with PIRADS ≥4), radical treatment-free survival, PSA kinetics, and functional outcomes (IPSS, IIEF-5, continence).ResultsBaseline characteristics were comparable. At 12 months, csPC-free survival was higher with HIFU in intermediate-risk patients (95.8% vs. 84.0%, p=0.0018) and low-risk patients (97.6% vs. 88.3%, p=0.0035). At a median follow-up of 75 months, HIFU maintained superior csPC-free rates in both risk groups. Radical treatment-free survival was similar in both low and intermediate risk group 76% vs 77.1% and 83.2% vs 80.3% respectively, time to radical treatment was significantly longer in the HIFU group. PSA reductions at 3 and 6 months were greater with HIFU. Functional outcomes, including erectile function, continence, and urinary symptoms, were comparable between groups.ConclusionsFocal HIFU offers better short-term oncological control and delays the need for radical treatment compared to AS, with similar preservation of urinary and sexual function. These results support its use in selected patients seeking a balance between cancer control and quality of life.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1818561</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1818561</link>
        <title><![CDATA[Current views on sustainability in urology: findings from the North Central Section of American Urological Association membership survey]]></title>
        <pubdate>2026-06-01T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Chloe Shi</author><author>Susanna Wang</author><author>Ryan Steinberg</author><author>John O. DeLancy</author><author>Keow Goh</author><author>Sarah Adelstein</author><author>Pankaj Dangle</author><author>Frank C. Lin</author><author>Adam Miller</author><author>Matthew Gettman</author>
        <description><![CDATA[ObjectiveThe United Nations defines sustainability as meeting needs of the present without compromising future generations. While often equated to “saving the planet”, sustainability is a diverse topic. Healthcare generates >5% of CO2 emissions worldwide, yet sustainability efforts in urology are limited. The North Central Section of the American Urological Association (NCSAUA) recently convened a Sustainability Task Force to address this topic. This study queried members on sustainability in urologic practice.MethodsFollowing literature review on sustainability in surgery/urology, a 19-item anonymous REDCap survey was developed and distributed via email to NCSAUA members (N = 1607). The survey assessed current best practice, institutional/personal sustainability, and demographics. Responses were compiled and summarized using descriptive statistics.ResultsSurvey response rate was 4.9% (79/1607). Respondents were most commonly from metropolitan areas (82%), male (71%), and in practice for 5–14 years (29%). Sustainability topics were prioritized as: (1) financial, (2) future workforce, (3) environmental. Over half (56%) reported no institutional sustainability programs or were unaware of them. Instrument (67%), computer (68%), and paper (65%) recycling were supported by a majority of respondents. However, only 28% and 29% of respondents reported current institutional use of instrument and computer recycling, respectively. Telemedicine was infrequent, with most urologists (58%) conducting 0-5% of visits virtually.ConclusionsCurrent institutional and urologic practice emphasis on sustainability is low. Respondents ranked highest sustainability priorities as financial and future workforce. Efforts to address environmental sustainability were also supported, namely reduction of disposables and waste. The findings support the development of targeted programs to advance sustainability priorities widely.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1829407</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1829407</link>
        <title><![CDATA[Next-generation imaging in prostate cancer]]></title>
        <pubdate>2026-05-29T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Ahmed Rabie</author><author>Maurizio Buscarini</author><author>Osama Zaytoun</author>
        <description><![CDATA[BackgroundEarly detection of clinically significant prostate cancer (csPCa) remains a major challenge in urologic oncology. Although prostate-specific antigen (PSA) screening and systematic transrectal ultrasound– guided biopsy has historically been the main diagnostic approaches, these strategies are associated with both overdiagnosis of indolent disease and underdetection of clinically significant tumors. Recent advances in imaging technologies—including multiparametric magnetic resonance imaging (mpMRI), high-resolution micro-ultrasound (MUS), and prostate-specific membrane antigen positron emission tomography (PSMA PET)—have significantly improved the diagnostic pathway for prostate cancer. In parallel, artificial intelligence (AI)–based algorithms have emerged as promising tools for enhancing image interpretation and reducing diagnostic variability.ObjectiveThis review aims to summarize current evidence regarding the diagnostic performance of micro- ultrasound, mpMRI, and PSMA PET in prostate cancer detection and to explore the potential role of artificial intelligence in integrating these imaging modalities to improve diagnostic accuracy.MethodsA systematic literature search was performed using PubMed and MEDLINE databases for articles published between January 2013 and December 2024. The following search strategy was employed using combinations of MeSH terms and keywords: (‘prostate cancer’ OR ‘prostate neoplasm’ OR ‘prostatic carcinoma’) AND (‘micro-ultrasound’ OR ‘high-resolution micro-ultrasound’ OR ‘micro-US’ OR ‘PRI-MUS’ OR ‘ExactVu’) OR (‘multiparametric MRI’ OR ‘mpMRI’ OR ‘multi-parametric magnetic resonance imaging’ OR ‘PI-RADS’) OR (‘PSMA PET’ OR ‘prostate-specific membrane antigen’ OR ‘68Ga-PSMA’ OR ‘18F-DCFPyL’ OR ‘PSMA-11’) OR (‘artificial intelligence’ OR ‘machine learning’ OR ‘deep learning’ OR ‘radiomics’ OR ‘neural network’). Only English-language, peer-reviewed original research articles, systematic reviews, meta-analyses, and major consensus guidelines were included. Case reports, editorials, conference abstracts, and non-peer-reviewed publications were excluded. Two authors (A.R. and O.Z.) independently screened titles and abstracts for relevance. Full texts of potentially eligible articles were retrieved and assessed against predefined inclusion criteria: (1) evaluation of mpMRI, micro-ultrasound, or PSMA PET for prostate cancer detection, localization, or staging; (2) reported diagnostic accuracy metrics (sensitivity, specificity, AUC) or biopsy outcomes; (3) sample size ≥20 patients for original studies. Disagreements were resolved by consensus with a third author (M.B.). Reference lists of included articles were hand-searched for additional relevant studies. A narrative synthesis was conducted due to heterogeneity in study designs, populations, and outcome measures.ResultsMultiparametric MRI has become a cornerstone in prostate cancer diagnosis due to its high sensitivity for detecting clinically significant diseases and its role in guiding targeted biopsies. Micro-ultrasound, offering substantially higher spatial resolution than conventional ultrasound, has demonstrated promising diagnostic performance and may represent a cost-effective alternative or complement to in review mpMRI. Meanwhile, PSMA PET imaging has shown high sensitivity for identifying both intraprostatic lesions and metastatic disease. Emerging evidence suggests that combining these imaging modalities may significantly enhance detection rates. Furthermore, artificial intelligence techniques—including machine learning and deep learning algorithms—have shown potential in improving lesion detection, segmentation, and risk stratification in prostate imaging.ConclusionThe integration of multimodal imaging approaches with artificial intelligence represents a promising investigational strategy that may, following prospective validation, improve prostate cancer detection and characterization. Future prospective studies are needed to validate these technologies and define their optimal role in clinical practice.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1845544</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1845544</link>
        <title><![CDATA[Urodynamic characteristics of different types of detrusor overactivity in patients with benign prostatic obstruction]]></title>
        <pubdate>2026-05-22T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xiao Zeng</author><author>Bo Huang</author><author>Hong Shen</author><author>De-yi Luo</author><author>Tao Jin</author>
        <description><![CDATA[BackgroundThis study aimed to investigate whether the presence or the absence of detrusor overactivity (DO) in patients with urodynamic-confirmed benign prostatic obstruction (BPO) leads to alterations in urodynamic parameters.MethodsThis study is a retrospective analysis of patients with urodynamic-confirmed BPO [Bladder Outlet Obstruction Index (BOOI) >40]. Patients with a clinical diagnosis of benign prostatic hyperplasia (BPH) or benign prostatic enlargement (BPE) were initially screened, but only those with BOOI > 40 were included. Based on the presence or absence of DO during urodynamics, patients were categorized into two groups: BPO with DO and BPO without DO. Subsequently, the BPO with DO group was further stratified according to DO subtype into BPO with terminal DO (TDO) and BPO with phasic DO (PDO). Differences in the urodynamic parameters and the DO-related indices among these groups were then evaluated. In addition, correlations between the DO-related indicators and the urodynamic parameters within each DO subtype were further examined.ResultsThere were 75 patients assigned to the BPO with DO group and 71 to the BPO without DO group. There was a statistically significant difference in the maximum cystometric capacity (MCC) and bladder compliance (BC) between the BPO with DO group and the BPO without DO group: 259.05 ± 44.54 vs. 273.13 ± 36.69 (p = 0.04) and 158.71 ± 83.86 vs. 210.95 ± 82.58 (p < 0.001), respectively. The BPO with PDO group comprised 38 patients, while the BPO with TDO cohort included 37 patients. There exists a statistically significant difference between MCC and BC: 291.50 (248.75–301.75) vs. 250.00 (210.00–296.00) (p = 0.02) and 184.00 (150.50–286.75) vs. 103.00 (85.00–141.50) (p < 0.001), respectively. Univariate regression analysis revealed a statistically significant negative correlation between the maximum contraction amplitude of DO and BC exclusively within the BPO with TDO cohort (rs = −0.34, p = 0.03). Multivariable analysis confirmed this independent correlation (β = −0.33, 95%CI = −0.59 to −0.07, p < 0.05). Age was identified as an independent risk factor for DO (OR = 1.19, p < 0.001) and first desire to void (FD) as an independent protective factor (OR = 0.98, p < 0.001).ConclusionThis preliminary study indicates that DO is associated with storage-phase urodynamic alterations in BPO patients, with no notable association with the voiding phase parameters. Multivariable analysis identified age as an independent risk factor for DO and FD as an independent protective factor. TDO is associated with more pronounced storage-phase changes than PDO. In the TDO subgroup, the correlation between BC and DO contraction amplitude was independent of age. However, several other comparisons remain unadjusted; therefore, these findings are exploratory. Future prospective studies with larger samples and age-adjusted designs are needed.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1854503</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1854503</link>
        <title><![CDATA[Case Report: Low-frequency tibial nerve stimulation: demonstrating a novel therapeutic option for Fowler’s syndrome through a pilot case series]]></title>
        <pubdate>2026-05-20T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Aidan McConnell-Trevillion</author><author>Ingrid Hoeritzauer</author><author>Helen Simpson</author><author>Jalesh N. Panicker</author><author>Jon Stone</author><author>Dani Coombe</author><author>Kianoush Nazarpour</author>
        <description><![CDATA[Fowler’s Syndrome is a critically under-researched area of Women’s Urological health. The condition, which causes severe urinary retention in the absence of any obvious obstructive pathology, lacks any non-invasive options for treatment. Transcutaneous Tibial Nerve Stimulation (TTNS) is an established treatment strategy for disorders of incontinence that is non-invasive, safe, and efficacious. Computer based modelling and preliminary animal experimentation indicates that ultra-low frequency TTNS (1–2 Hz) may induce an excitatory effect on bladder function that is of particular therapeutic relevance to Fowler’s Syndrome. Therefore, the present case series describes a three-armed randomised-control (crossover) pilot study conducted from a biomechanical perspective in a population suffering from Fowler’s Syndrome. The study aimed to address the question of if the novel application of low-frequency TTNS could ameliorate the symptoms of Fowler’s Syndrome. Patients (N = 6) were administered either ultra-low frequency TTNS (1 Hz) or placebo. The objective outcome measure of the study was the change in voiding efficiency in response to intervention. 50% (N = 3) participants displayed a positive response to treatment, with a median increase in Voiding Efficiency of 6.3 to 12.6% across test conditions. Two participants displayed a negative response to the intervention, (median −3.6 to −20.9%) which may have been due to placebo effects but should be considered in future. The study indicated that TTNS may be capable of ameliorating the symptoms of Fowler’s Syndrome, to a significant degree in one case. The work provides a foundation for future clinical research. The authors hope that should the results be confirmed by further clinical study they will have considerable impact on patient care.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1806726</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1806726</link>
        <title><![CDATA[Optimal artificial urine formulations for in vitro urolithiasis models]]></title>
        <pubdate>2026-05-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Deok Hyun Han</author><author>Jae Hoon Chung</author>
        <description><![CDATA[PurposeTo develop and characterize standardized in vitro artificial urine (AU) models for three major stone-forming environments—calcium oxalate (CaOx), uric acid (UA), and infection-related struvite—and to identify assay operating conditions that maximize stent-associated surface deposition while limiting excessive bulk precipitation.Materials and methodsHomemade AU models were formulated from a physiologic base composition and modified to create disease-specific lithogenic conditions. The CaOx model used sodium oxalate fixed at 80 mg/L with stepwise calcium chloride escalation to 600%. The UA model was tested at uric acid concentrations of 500–1000 mg/L under acidic pH. The bacterial infection model was tested as two independent live-bacterial arms preset at bulk pH 6.5 or 9.0 before immersion to capture urease-driven alkalinization and surface colonization, and a non-bacterial ammonia-alkalinized control was also evaluated. Stents of three commercial types were immersed for 48 h under CDC biofilm-reactor conditions, and surface deposition was quantified as weight change per unit length (mg/mm).ResultsIn the CaOx model, surface-associated weight gain increased with calcium concentration up to 200% (0.98 g/L) but declined at higher levels owing to competing bulk precipitation. The UA model produced minimal deposition, with maximal weight gain at 600 mg/L. In the bacterial infection assay, weight gain was numerically highest in the arm preset at bulk pH 6.5 before immersion and remained substantial in the arm preset at pH 9.0, whereas the non-bacterial alkalinization model resulted in negligible deposits.ConclusionsThese stone type–specific AU models provide defined, lab-preparable lithogenic screening conditions. Within this 48-h reactor assay, CaCl2 200% + oxalate 80 mg/L, uric acid 600 mg/L, and the bacterial infection model initiated at preset bulk pH 6.5 yielded the highest observed stent-associated deposition. The platform may serve as an accelerated screening tool for evaluating stent materials, coatings, and anti-encrustation strategies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1704853</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1704853</link>
        <title><![CDATA[Determinants of pediatric urolithiasis hospitalizations in endemic and non-endemic regions of Mexico]]></title>
        <pubdate>2026-05-05T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xally Camila Cahuantzi-Flores</author><author>Daniel Flores-Ocotzi</author><author>Juan Pablo Flores-Tapia</author><author>Rosa Esther Moo-Puc</author><author>Edgar Villarreal-Jimenez</author><author>Antonio Esqueda-Mendoza</author><author>Salvador Gomez-Carro</author><author>Nina Mendez-Dominguez</author>
        <description><![CDATA[BackgroundUrolithiasis in pediatric populations is increasing worldwide, with environmental and social determinants playing key roles. In Mexico, Yucatan is an endemic area for urolithiasis in adults. However, pediatric data are scarce.ObjectiveThis study aimed to describe the clinical and ecological characteristics of pediatric urolithiasis hospitalizations in endemic (Yucatan) and non-endemic areas of Mexico.MethodsWe conducted a retrospective, cross-sectional analysis of national hospital discharge records (2018–2024) for patients <18 years with ICD-10 codes N20.0, N20.1, N20.9, N21.0, and N21.1. The sociodemographic and clinical variables were compared between Yucatan and other states. Non-parametric regression models were used to examine the associations between ecological indicators and hospitalization rates.ResultsA total of 2,238 hospitalizations were identified, with a national rate of 3.28 per 10,000 versus 28.03 in Yucatan. Patients in Yucatan were younger (mean = 111 vs. 128 months, p < 0.001) and more likely to self-report as indigenous (4.9% vs. 2.3%, p = 0.01). The majority of admissions originated from the emergency department (76% vs. 64%, p < 0.001). In the adjusted models, poverty was positively associated with hospitalization rates (β = 0.06, p = 0.032), while water hardness and marginalization lost significance.ConclusionPediatric urolithiasis in Yucatan is associated with younger age, indigenous status, and higher hospitalization rates, highlighting the combined role of environmental and socioeconomic factors. Poverty emerged as a key determinant, underscoring the need for targeted preventive strategies, improved access to safe hydration, and culturally sensitive interventions in vulnerable populations.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1767585</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1767585</link>
        <title><![CDATA[Case Report: Till death - or the urologist - do us part: management of penile wedding-ring incarceration]]></title>
        <pubdate>2026-04-29T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Jaisukh Kalathia</author><author>Bharti Talreja</author><author>Kaushal Patel</author><author>Arvind Valiya</author><author>Giriraj Vala</author><author>Ayush Khetarpal</author>
        <description><![CDATA[Penile strangulation is a rare urological emergency that can rapidly progress to vascular compromise and irreversible tissue damage. Metallic constricting devices pose the greatest challenge due to their rigidity and resistance to conventional removal techniques. We report the case of an adult male who developed progressive penile swelling and pain after self-application of a metallic wedding ring during an episode of emotional distress, necessitating mechanical sectioning with a tungsten-carbide orthopaedic cutter under continuous protective shielding for safe removal.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fruro.2026.1768406</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fruro.2026.1768406</link>
        <title><![CDATA[Case report: Pleasure gone wrong”: a case of endoscopic removal of an extra-long urethral electric cable self-inserted for sexual gratification]]></title>
        <pubdate>2026-04-23T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Jaisukh Kalathia</author><author>Bharti Talreja</author>
        <description><![CDATA[Foreign bodies in lower urinary tract, once regarded as rare, are now increasingly recognized and demand urgent urological intervention. Spectrum of self-inserted urethral objects is remarkably wide, ranging from household items to sharp instruments and cables, with motivations spanning sexual-gratification, autoerotic experimentation and psychiatric illnesses. Clinical presentation varies from acute pain, retention, or haematuria to chronic recurrent infections and unexplained voiding symptoms. We present a case of a 49-year-old male who self-inserted an electric cable, which was successfully retrieved intact through endoscopic intervention within six hours of insertion. This case highlights early recognition, minimally invasive retrieval, and attention to underlying behavioural and psychological risk factors to prevent recurrence.]]></description>
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