28 January 2026, Volume 79 Issue 1
    

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  • Review
    Stamatios Katsimperis, Lazaros Tzelves, Ioannis Kyriazis, Panagiotis Neofytou, Sotirios Kapsalos-Dedes, Georgios Feretzakis, Andreas Skolarikos
    Archivos Españoles de Urología. 2026, 79(1): 1-12. https://doi.org/10.56434/j.arch.esp.urol.20267901.1
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    Background: Artificial intelligence (AI) and big data are transforming urological oncology by enhancing diagnostic precision, prognostic assessment and treatment personalisation for prostate, bladder and kidney cancer.

    Methods: We searched PubMed and MEDLINE up to September 2025 for English-language, peer-reviewed human studies using terms including “artificial intelligence”, “deep learning”, “radiomics”, “real-world evidence” and “urological oncology”.

    Results: AI-driven radiomics and deep learning models have demonstrated high accuracy in detecting and characterising urological malignancies by using magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET) and histopathology. In prostate, bladder and kidney cancers, AI-driven radiomics and deep learning models have demonstrated high diagnostic performance, with reported area under the curves (AUCs) typically ranging from 0.80 to 0.95 for lesion detection, staging and risk stratification. Sensitivities and specificities in cystoscopic image analysis often exceed 90%, but radiogenomic models for renal cancer achieve mutation prediction accuracies of 85%–95%.

    Conclusions: AI and big data are reshaping urological oncology by integrating diagnostic imaging, pathology and real-world practice. Their continued integration promises a precise, equitable and adaptive model of cancer care. Despite these robust results, most studies rely on retrospective or single-centre datasets with limited external validation, raising concerns about generalisability. Future progress will depend on multicentre standardisation, federated learning frameworks and incorporation of multimodal real-world data to facilitate clinically robust and implementable AI systems.

  • Article
    Sandra San Cayetano Talegón, Felix Campos-Juanatey, Paola Calleja Hermosa, Raquel Varea Malo, Jaime García Herrero, Marina Sánchez Gil, Gonzalo Azcárraga Aranegui, María Onrubia Pereira, Sergio Zubillaga Guerrero, Óscar Gorría Cardesa, Eva Mallén Mateo, Ignacio Puche Sanz, Balig Amir Nicolau, Eduardo Barroso Deyne, Ana Gutiérrez Aguilar, José Luis Gutiérrez Baños
    Archivos Españoles de Urología. 2026, 79(1): 13-20. https://doi.org/10.56434/j.arch.esp.urol.20267901.2
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    Background: Vesicourethral anastomotic stenosis (VUAS) is a rare but complex complication following radical prostatectomy (RP), with an incidence ranging from 0.5% to 33% depending on surgical approach, surgeon experience and prior radiotherapy. Risk factors include intraoperative bleeding, urinary leakage, infection and adjuvant treatments. Despite advances in minimally invasive and robotic surgery, VUAS remains a significant cause of morbidity, often compromising urinary function and quality of life. Our objective is to evaluate the surgical and functional outcomes of perineal vesicourethral re-anastomosis in patients with recurrent VUAS after radical prostatectomy.

    Methods: We retrospectively reviewed 12 patients with recurrent VUAS treated between 2017 and 2024 by a single surgeon, with a minimum follow-up period of 6 months. All had at least one failed endoscopic treatment and preoperative incontinence. Anatomic success was assessed by urethrogram or urethroscopy. Descriptive analysis was conducted on demographic, surgical and outcome data.

    Results: The mean patient age was 71 years, with a median interval of 42–4 months (interquartile range (IQR) 9.5–86.1) from RP to stenosis diagnosis. Minor postoperative complications (Clavien I–II) occurred in three patients. Anatomical success, defined as the atraumatic passage of a 16 Fr cystoscope and/or absence of radiological stenosis, was achieved in 83.3% of cases with a mean follow-up of 39.5 months (standard deviation (SD) 24.7). At follow-up, urinary incontinence persisted in the majority of patients, and seven underwent artificial urinary sphincter implantation with satisfactory functional outcomes. One patient developed a urosymphyseal fistula complicated with pubic osteitis, ultimately requiring cystectomy and pubectomy.

    Conclusions: Perineal vesicourethral re-anastomosis represents an effective salvage strategy for recurrent VUAS after RP, providing high rates of urethral patency. However, it carries a substantial risk of postoperative incontinence, frequently necessitating subsequent continence surgery. Management should be centralised in reconstructive referral centres to optimise anatomical and functional outcomes.

  • Article
    Ana Roche-Gomez, Cristina Julia Blázquez Gómez, Daniel Cabezalí Barbancho, Cristina Tordable Ojeda, Alejandra Licero Villanueva, Alvaro Castro Garrido, Mar Espino Hernández
    Archivos Españoles de Urología. 2026, 79(1): 21-30. https://doi.org/10.56434/j.arch.esp.urol.20267901.3
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    Background: Prune belly syndrome (PBS) is a rare congenital disorder defined by deficient abdominal musculature, urinary tract anomalies and cryptorchidism. Clinical presentation is variable, and extrarenal malformations are common.

    Materials and Methods: A retrospective descriptive study of seven patients diagnosed with PBS between 1990 and 2024 in a tertiary-care hospital was carried out. Clinical, biochemical, radiological, auxological and surgical data were reviewed.

    Results: All patients had megacystis and abdominal muscle hypoplasia. Megalourethra was observed in three (43%), cryptorchidism in six (86%), hydronephrosis in all cases and renal dysplasia in four (57%). Extrarenal anomalies included congenital heart disease in three patients (43%), musculoskeletal defects in three (43%) and other malformations in two (28%). Mean serum creatinine level was 0.83 mg/dL at birth and 1.30 mg/dL at the last follow-up. Two patients (28%) required clean intermittent catheterisation, and one (14%) underwent renal transplantation at 14 years. Surgical procedures included orchidopexy in five patients (71%), vesicostomy in four (57%) and Mitrofanoff appendicovesicostomy in one patient.

    Conclusions: PBS is a rare disorder with a heterogeneous clinical spectrum. This cohort revealed a high prevalence of cardiac anomalies. Renal dysplasia, recurrent urinary tract infections and delayed surgical intervention were associated with progressive renal impairment. Management in centres with multidisciplinary teams is essential.

  • Article
    Roberto Molina Escudero, Luís Crespo Martínez, Emilio Ripalda Ferreti, Manuel Álvarez Ardura, Ana Muñoz Rivas
    Archivos Españoles de Urología. 2026, 79(1): 31-35. https://doi.org/10.56434/j.arch.esp.urol.20267901.4
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    Introduction: The treatment for severe male stress urinary incontinence (SUI) following surgery refers to the implantation of an artificial urinary sphincter (AUS). Traditionally, the procedure requires two incisions: Perineal and inguinal.

    Objective: To present a series of patients treated with the Zephyr 375 AUS implanted via a single perineal incision.

    Materials and Methods: We report 14 male patients with SUI following transurethral resection of the prostate (1) and radical prostatectomy (13). Preoperative assessment included a pad test and cystoscopy. Under epidural anaesthesia, bulbar urethra was exposed through a vertical perineal incision via dissection and division of the bulbospongiosus muscle. After catheter removal, the cuff was placed around the urethra and tested to ensure appropriate pressure and then deactivated. The pump-reservoir was positioned by digitally creating a scrotal dartos pouch from the perineum and secured with a 3/0 Vicryl. The perineum was closed, and a urinary catheter was installed.

    Results: The mean age was 65 years (55–74), and the average operative time was 64 minutes (50–85). All patients were discharged the following day without a catheter. Each one of them can palpate the pump-reservoir in the scrotum. After activation, all patients achieved continence, with five requiring a safety pad. During follow-up, four patients required pressure adjustment due to diminished continence with desirable outcomes. Patient satisfaction was notably high.

    Conclusions: After a mean follow-up of 19 months, the Zephyr 375 AUS demonstrated good functional outcomes for the treatment of severe male SUI. The system allowed for effective pressure adjustments when efficacy diminished. Implantation via a single perineal approach simplifies the procedure and reduces morbidity associated with dual-incision techniques.

  • Article
    Qi Yang, Dewang Zhou, Aaron Beasley, Yujun Liu, Zeqin Yan, Hu Fang, Yuqing Li, Elin S. Gray
    Archivos Españoles de Urología. 2026, 79(1): 36-48. https://doi.org/10.56434/j.arch.esp.urol.20267901.5
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    Background: Bladder cancer (BC) represents the most prevalent malignancy within the urinary system. Mounting evidence underscores the critical involvement of ferroptosis in cancer pathogenesis; Consequently, this study delves into its molecular underpinnings and therapeutic potential specifically in BC.

    Methods: We analyzed gene expression profiles from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) repositories. Ferroptosis-related genes (FRGs) were selected from the FerrDb database. Utilizing systematic bioinformatics analyses, we identify differentially expressed and prognostic FRGs and construct an FRGs prognostic model. Combined with protein-protein interaction (PPI) analysis, solute carrier family 3 member 2 (SLC3A2) was selected for further study. Following targeted small interfering RNA (siRNA)-mediated knockdown of SLC3A2 in BC cell lines, we conducted comprehensive functional assays to evaluate its effect on malignant phenotypes, ferroptosis, and cisplatin sensitivity.

    Results: SLC3A2 expression was significantly elevated in BC cells (p < 0.001). Its knockdown inhibited the proliferation, migration, and invasion abilities and promoted erastin-induced ferroptosis, as evidenced by increased reactive oxygen species (ROS), lipid peroxidation, and iron accumulation (all p < 0.05). SLC3A2 depletion also enhanced cisplatin sensitivity.

    Conclusions: Collectively, these findings establish SLC3A2 as playing a vital oncogenic role in BC tumorigenesis and progression. Its function in inhibiting ferroptosis—especially during cisplatin-based chemotherapy—makes it a promising therapeutic target.

  • Article
    Muhammed Fatih Simsekoglu, Ahmet Vural, Feyyaz Irmak, Furkan Kuzucu, Ugur Aferin, Göktug Kalender, Sinharib Citgez, Cetin Demirdag
    Archivos Españoles de Urología. 2026, 79(1): 49-57. https://doi.org/10.56434/j.arch.esp.urol.20267901.6
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    Background: Retroperitoneal lymph node dissection (RPLND) is an effective treatment option for testicular cancer with retroperitoneal lymph node metastasis. The accurate prediction of surgical and oncological outcomes after RPLND is essential. In the present study, we aim to evaluate the effect of central sarcopenia on surgical and oncological outcomes in patients undergoing RPLND.

    Methods: This retrospective cohort study was approved by the institutional ethics committee. Patients diagnosed with metastatic testicular germ cell cancer treated with three or four cycles of bleomycin, etoposide and platinum chemotherapy followed by RPLND between 2010 and 2023 were enrolled. Demographic factors (age, gender, body mass index, comorbidities and cancer characteristics), RPLND pathology, postoperative complications and survival data were evaluated, and the relationship between the psoas lumbar vertebral index (PLVI) calculated from axial computed tomography images and clinical outcomes was examined.

    Results: The median follow-up duration for the 48 patients was 81.5 months (interquartile range (IQR): 32–150). The median age at RPLND was 26 years (IQR: 21–30). The median PLVI was 0.79 (IQR: 0.65–0.91), and low PLVI values were significantly associated with high postoperative complication rates (p = 0.013). Furthermore, low PLVI (p = 0.007) and large tumour size (p = 0.018) were independently associated with short metastasis-free survival (MFS).

    Conclusions: Low PLVI is significantly associated with short MFS and an increased risk of postoperative complications. In addition, large tumour size predicts short MFS, and the PLVI is a potentially valuable predictive marker for surgical and oncological outcomes for patients undergoing post-chemotherapy RPLND.

  • Article
    Hilmi Sarı, Serdar Celik, Kutsal Yorukoglu, Ilhan Celebi, Mehmet Ugur Mungan, Safiye Aktas
    Archivos Españoles de Urología. 2026, 79(1): 58-65. https://doi.org/10.56434/j.arch.esp.urol.20267901.7
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    Background: To evaluate the antineoplastic effects of Ankaferd Blood Stopper (ABS) compared with standard immunotherapeutic and chemotherapeutic agents in primary bladder cancer cell cultures.

    Methods: Tumour tissues taken from patients who underwent transurethral bladder tumour resection due to primary bladder tumour were grown in primary cell culture (PCC). Each patient was divided into six different groups. Ankaferd Blood Stopper, Bacillus Calmette-Guérin (BCG), gemcitabine (GCB), ABS + BCG and ABS + GCB combinations were applied to the groups. A 24-h viability assay was performed for all groups.

    Results: Amongst the 24 patients diagnosed with bladder cancer, 4 were excluded due to the detection of muscle invasive bladder cancer on pathological evaluation. Consequently, 20 patients with confirmed non-muscle invasive bladder cancer (NMIBC) were included in the study. Patients treated with BCG, ABS and GCB were compared with the control group, and the average cell viability rates were 39.20%, 32.30% and 42.00%, respectively (p < 0.001). Furthermore, combination treatments (ABS + BCG and ABS + GCB) resulted in significant reductions in viability (p < 0.001). Despite similarities in stages, histological types and grades, the viability outcomes following drug treatment varied.

    Conclusions: ABS negatively impacted the survival outcomes of bladder cancer cells. Upon examination of the results for each bladder tumour, despite identical stages and grades, the viability responses still varied. These findings support further investigation of personalised treatment and ABS as a potential adjunct in bladder cancer therapy.

  • Article
    Yigit Akin, Enis Mert Yorulmaz, Sacit Nuri Gorgel, Serkan Ozcan, Osman Kose, Erbay Tumer, Erhan Ates
    Archivos Españoles de Urología. 2026, 79(1): 66-72. https://doi.org/10.56434/j.arch.esp.urol.20267901.8
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    Background: Salvage cystectomy (SC) following failed bladder-preserving therapy shows an association with exceptionally high perioperative morbidity and mortality. Reliable preoperative biomarkers that can predict short-term outcomes are urgently needed. We investigated whether the systemic immune-inflammation index (SII) and De Ritis ratio (aspartate aminotransferase/alanine aminotransferase) can serve as predictors of 90-day postoperative survival following SC.

    Methods: Of the 139 patients with advanced bladder cancer (cT3b–cT4) who underwent cystectomy between 2010 and 2025 at a tertiary referral centre, we identified 70 individuals who underwent SC. We then aimed to create a matched control group from a pool of primary radical cystectomy (RC) patients. With the use of a nearest-neighbour matching approach based on age, sex and clinical stage, a suitable match was found for 69 of the 70 SC patients. Therefore, the final study cohort consisted of 70 SC patients and 69 primary RC patients. The groups were well-balanced for the matching variables. Preoperative clinical, pathological and laboratory variables—including SII and De Ritis ratio—were assessed. The primary endpoint was 90-day all-cause mortality, and statistical significance was defined as p < 0.05.

    Results: The 90-day mortality rate reached 49.6%. Nonsurvivors had significantly higher preoperative SII (979.9 vs. 521.5, p < 0.001) and De Ritis ratios (1.52 vs. 1.24, p < 0.001) compared with the survivors. Multivariate analyses confirmed SII (p < 0.001) and De Ritis ratio (p = 0.018) as independent predictors of early mortality. Receiver operating characteristic analysis demonstrated good discrimination with SII (area under the curve (AUC): 0.79) and De Ritis ratio (AUC: 0.68). The combined model demonstrated the highest predictive performance (AUC: 0.80; Sensitivity 69.6%; Specificity 80.0%).

    Conclusions: Elevated preoperative SII and De Ritis ratio can independently predict 90-day mortality following SC. Their combined use may improve prognostic accuracy and offer a cost-effective and readily available tool for preoperative risk stratification in this high-risk population.

  • Article
    Mustafa Aydın, Mustafa Koray Kırdağ, Lokman İrkılata, Mesut Berkan Duran, Uğur Öztürk, Mehmet Özen, Mücahit Uğur, Mustafa Kemal Atilla
    Archivos Españoles de Urología. 2026, 79(1): 73-79. https://doi.org/10.56434/j.arch.esp.urol.20267901.9
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    Objective: This study aims to evaluate the characteristics of patients with urinary stone disease before and during the pandemic and to assess the impact of the pandemic on diagnosis-to-treatment intervals and treatment outcomes.

    Materials and Methods: Medical records, laboratory values and radiological images of patients who underwent ureterolithotripsy, retrograde intrarenal surgery and percutaneous nephrolithotomy for ureteral and renal stones before and during the pandemic were retrospectively analysed. Pregnant women and patients under the age of 18 were excluded from the study. The patients’ demographic data, number of stones, stone size, stone location, hydronephrosis, impacted stones, creatinine levels, duration of surgery, stone-free rates, hospital stay, complication rates and diagnosis-to-treatment intervals before and during the pandemic were compared.

    Results: A total of 162 patients with ureteral stones and 129 patients with kidney stones were included in the study. During the pandemic, complication rates and diagnosis-to-treatment intervals were considerably higher in patients with kidney and ureteral stones. Furthermore, the presence of impacted stones for ureteral stones and the presence of hydronephrosis for kidney stones emerged as predictors of complications.

    Conclusions: During the pandemic, delays were observed in the diagnosis and treatment of patients with both renal and ureteral stones. This delay negatively affected the patients’ clinical characteristics at presentation (hydronephrosis) and surgical outcomes (complication rates). Therefore, patients with urolithiasis should be prioritised in exceptional situations, such as pandemics.

  • Article
    Turgay Kacan, Emre Uzun, Hasan Batuhan Arabaci, Huseyin Gultekin, Samet Senel
    Archivos Españoles de Urología. 2026, 79(1): 80-87. https://doi.org/10.56434/j.arch.esp.urol.20267901.10
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    Objectives: This study investigated whether the Naples prognostic score (NPS), derived from preoperative immunonutritional markers, can predict biochemical recurrence (BCR) amongst individuals with prostate cancer (PCa) treated surgically with robot-assisted laparoscopic radical prostatectomy (RALP).

    Methods: This study involved a retrospective review of information obtained from patients who underwent RALP for PCa between February 2019 and June 2023. The information included patients’ laboratory findings, biopsy results and postoperative pathological assessments. Participants were separated into BCR-positive and BCR-negative cohorts. Comparisons across these groups included preoperative laboratory measurements, NPS assessments and histopathological findings from biopsy and surgical specimens. Independent predictors of BCR were determined through Cox regression analysis.

    Results: This analysis comprised 321 individuals treated with RALP who had a minimum postoperative follow-up of one year for BCR assessment. Cox regression analysis revealed that high preoperative prostate-specific antigen (PSA) levels (hazard rate (HR) = 1.067; 95% confidence interval (CI) = 1.018–1.109; p < 0.001), postoperative specimen pathology >International Society of Urological Pathology (ISUP) 3 (HR = 2.459; 95% CI = 1.264–4.782; p = 0.008), positive surgical margins (HR = 2.625; 95% CI = 1.253–5.502; p = 0.011) and an NPS of 3 or 4 (HR = 2.692; 95% CI = 1.377–5.261; p = 0.004) were associated with an increased risk of BCR. The NPS-only Cox regression model demonstrated a moderate predictive ability with Harrell’s concordance index (C-index) of 0.654 (95% CI = 0.582–0.726), and the combined Cox regression model incorporating preoperative PSA levels, postoperative specimen pathology >ISUP 3, positive surgical margins and an NPS of 3 or 4 showed high discriminative performance with a C-index of 0.819 (95% CI = 0.761–0.877). Kaplan–Meier survival analysis revealed a statistically significant reduction in BCR-free survival amongst patients in the high-risk NPS group (57.9%) relative to those in the low-risk NPS group (81.2%) following RALP (log-rank test, p < 0.001).

    Conclusions: A high NPS was found to be associated with an increased risk of BCR in patients with localised PCa. These results suggest that pretreatment NPS may serve as a useful adjunctive prognostic marker. Nevertheless, additional well-designed prospective investigations are required to validate its applicability in clinical practice.

  • Article
    Zhenya Shen, Shaohui Zhang, Yang Gui, Yuhua Wang, Guoqiang Yu
    Archivos Españoles de Urología. 2026, 79(1): 88-97. https://doi.org/10.56434/j.arch.esp.urol.20267901.11
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    Background and Aims: To explore the factors influencing the clinical efficacy of emergency extracorporeal shock wave lithotripsy (ESWL) in patients with upper urinary tract calculi, construct a nomogram model for predicting stone expulsion outcomes and validate its performance.

    Methods: A retrospective analysis was conducted on the clinical data of 502 patients with upper urinary tract calculi who underwent emergency ESWL at The First Affiliated Hospital of Henan University of Science and Technology from January 2022 to December 2024. All patients were divided into the effective and ineffective groups based on the complete elimination of calculi within 4 weeks after surgery. Differences in general clinical data, urinalysis, liver and renal function indicators, calculus-related characteristics and treatment-related characteristics between the two groups were compared. Multivariate logistic regression was used to identify independent predictors of ESWL efficacy and construct a nomogram model. The model was evaluated using the receiver operating characteristic curve, calibration curve and decision curve analysis.

    Results: A total of 140 (27.9%) patients had ineffective treatment. Independent risk factors for failure included long emergency visit-to-ESWL time, high urinary white-blood-cell count, elevated serum creatinine/serum uric acid, large maximum stone diameter, high stone density and severe hydronephrosis; ESWL energy and the number of shocks were mediated associated factors; High estimated glomerular filtration rate and ureteral calculi were protective factors (all p < 0.05). The nomogram showed a good predictive performance (area under the curve = 0.862, 95% confidence interval: 0.793–0.931) with good calibration and net benefit.

    Conclusions: A validated nomogram based on independent predictors and mediated factors was constructed to provide a reliable tool for emergency ESWL decision-making.

  • Article
    Xiaoshan Li, Wei Liu, Shiping Wei, Wei Peng
    Archivos Españoles de Urología. 2026, 79(1): 98-104. https://doi.org/10.56434/j.arch.esp.urol.20267901.12
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    Objective: To investigate the risk factors of urinary tract infection (UTI) after the ureteroscopic treatment of renal calculi and analyse the correlation amongst serum inflammatory markers, perioperative factors and infection occurrence.

    Methods: A retrospective analysis was conducted on patients who underwent ureteroscopic lithotripsy and stone extraction at the authors’ hospital. On the basis of postoperative diagnostic criteria, patients were categorised into the infection (n = 60) and noninfection (n = 150) groups. The serum levels of C-reactive protein (CRP), procalcitonin (PCT), lipopolysaccharide (LPS), endotoxin (ET) and interleukin-8 (IL-8) were measured preoperatively and postoperatively in both groups. In addition, the maximum stone diameter, operative time and postoperative catheterisation duration were recorded. The correlations amongst serum markers, perioperative factors and UTI were analysed, and univariate and multivariate logistic regression analyses were performed to identify independent risk factors.

    Results: No significant differences in baseline characteristics or preoperative serum markers were found between the two groups (p > 0.05). The postoperative serum levels of CRP, PCT, LPS, ET and IL-8 were significantly higher in the infection group than in the noninfection group (p < 0.05). Maximum stone diameter did not differ significantly between groups (p > 0.05). However, operative time and postoperative catheterisation duration were markedly longer in the infection group (p < 0.05) than in the noninfection group. Postoperative UTI showed a positive correlation with CRP, PCT, LPS, ET, IL-8, operative time and catheterisation duration (p < 0.001). Multivariate logistic regression analysis identified PCT, IL-8 and postoperative catheterisation duration as independent risk factors for infection (p < 0.05). Although CRP, ET and operative time did not reach statistical significance, all had odds ratio >1, suggesting a potential association with increased infection risk.

    Conclusions: Postoperative UTI following ureteroscopic lithotripsy is closely associated with elevated serum inflammatory markers and perioperative factors. Increased PCT and IL-8 levels, as well as prolonged postoperative catheterisation, were identified as independent risk factors. Monitoring perioperative inflammatory indicators and optimising surgical and catheter management may reduce the incidence of postoperative UTI and provide a basis for individualised preventive strategies in clinical practice.

  • Article
    Shaohang Yang, Yangyang Lin, Zhile Chen
    Archivos Españoles de Urología. 2026, 79(1): 105-113. https://doi.org/10.56434/j.arch.esp.urol.20267901.13
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    Objective: Urinary tract infection (UTI) frequently occurs in patients with ureteral calculi and metabolic syndrome (MetS). Timely recognition of patients at elevated risk remains a clinical challenge. This study aimed to construct and internally validate a nomogram for assessing the risk of UTI in this population.

    Materials and Methods: We retrospectively reviewed the data of 254 patients diagnosed with ureteral calculi and MetS who were hospitalised between January 2022 and March 2025. Baseline patient characteristics, clinical parameters, laboratory test results and imaging findings were systematically collected. Factors showing significant differences (p < 0.05) between patients with and without UTI were examined for multicollinearity and then entered into a multivariable regression framework to determine independent predictors. A risk-prediction nomogram based on these key determinants was subsequently constructed. The model’s performance was assessed through the area under the receiver operating characteristic curve (AUC), calibration plot, Hosmer–Lemeshow goodness-of-fit test, Brier score and decision curve analysis (DCA). Internal validation was conducted using bootstrap resampling.

    Results: Multivariate analysis identified periureteral fat stranding, tissue rim sign, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and positive urine nitrite as independent predictors of UTI. The constructed nomogram exhibited robust discriminative ability (AUC = 0.783; 95% confidence interval (CI): 0.702–0.863) and satisfactory calibration (χ2 = 6.867, p = 0.551; Brier score = 0.118). Bootstrap validation confirmed model stability (AUC = 0.783). DCA indicated that the nomogram yielded a superior net clinical benefit compared with strategies of treating all or none with a probability threshold of 0.1–0.85.

    Conclusions: The proposed nomogram accurately predicts the risk of UTI in patients with ureteral calculi and MetS. The integration of imaging features, haematologic inflammatory markers and urinalysis results enables individualised risk assessment, facilitating the early detection of high-risk patients and informing timely preventive and therapeutic interventions.

  • Article
    Chaofei Zhao, Yue Li, Ao Wu, Dayong Jiang
    Archivos Españoles de Urología. 2026, 79(1): 114-124. https://doi.org/10.56434/j.arch.esp.urol.20267901.14
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    Objective: This study aimed to describe the aetiology and risk factors of urinary tract infection in patients with type 2 diabetes mellitus (T2DM).

    Methods: The clinical data of patients with T2DM treated in our hospital from January 2023 to January 2025 were retrospectively analysed. The patients were divided into the infection group and control group based on the occurrence of urinary tract infection (UTI). The incidence and risk factors of T2DM associated with UTI were analysed. Multivariate logistic regression analysis was conducted to establish a risk prediction model, and a receiver operating characteristic (ROC) curve was drawn. All patients were randomly divided into a training set and a validation set at a ratio of 7:3 to evaluate the stability of the prediction model.

    Results: This study comprised 269 patients with T2DM, of whom 50 had UTI, resulting in an incidence rate of 18.59%. Multivariate logistic regression analysis showed that the duration of diabetes and levels of glycosylated haemoglobin (HbA1c), sodium-dependent glucose transporter 2 (SGLT2) inhibitor and albumin (ALB) were independent risk factors for T2DM complicated by UTI (p < 0.05). The area under the ROC curve for the training set was 0.806 (95% CI 0.723–0.888), the specificity was 0.845 and the sensitivity was 0.833. In the validation set, the area under the ROC curve was 0.877 (95% CI 0.793–0.960), the specificity was 0.829 and the sensitivity was 0.882. The calibration curve indicated that the prediction curve fit well with the ideal curve (45-degree diagonal). This suggested a strong correlation between the predicted and actual probabilities, indicating a good model.

    Conclusions: Duration of diabetes and levels of HbA1c, SGLT2 inhibitor and ALB may be independent risk factors for UTI in patients with T2DM. These indicators should be monitored in clinical practice to prevent UTIs.

  • Article
    Yu Li, Wensheng Yue, Fang Yang, Xuebin Liu, Jiping Luo, Siyu Dan, Xiuli He, Ling He, Guihao Hu
    Archivos Españoles de Urología. 2026, 79(1): 125-133. https://doi.org/10.56434/j.arch.esp.urol.20267901.15
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    Background: Bone metastasis (BM) is a common complication associated with advanced prostate cancer (PCa). The multiparametric features of transrectal ultrasound (TRUS) in PCa patients with BM remain poorly characterized. This study examined the presence of TRUS in patients with BM and developed a clinical nomogram for risk assessment.

    Methods: From December 2021 to September 2023, 114 consecutive patients with pathologically confirmed PCa were enrolled in this study. Based on the bone scan results, the patients were classified into BM (n = 56) and non-BM (n = 58) groups. Clinical, baseline TRUS, and transrectal contrast-enhanced ultrasound (TR-CEUS) data were recorded. Predictors of BM were identified using univariate and multivariate logistic regression. A nomogram was developed and internally validated via bootstrap resampling (1000 repetitions). The performance of the model was assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).

    Results: The results of the multivariate analysis revealed three independent predictors of BM, which included elevated total prostate-specific antigen (T-PSA) (odds ratio (OR) = 4.745, 95% CI: 2.177–10.344, p = 0.018), higher Gleason score (GS) (OR = 1.844, 95% CI: 1.144–2.970, p = 0.012), and TR-CEUS wash-in presence (OR = 3.268, 95% CI: 1.014–10.538, p = 0.047). The nomogram that incorporated these predictors showed strong discrimination, with an area under the curve (AUC) of 0.899 (95% CI: 0.841–0.96) in the development cohort and 0.859 (95% CI: 0.765–0.968) upon internal validation. Calibration was satisfactory, and the model offered significant net clinical benefits.

    Conclusions: We found that TR-CEUS wash-in is an independent predictor of BM in PCa patients. Based on the clinical parameters T-PSA, GS, and TR-CEUS, a nomogram might provide a clinical reference for accurately assessing BM.

    Clinical Trial Registration: This study was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn) (Registration No. ChiCTR 2400082813).

  • Article
    Shuwen Yu, Fengling Yin, Yihui Fan, Qiuchan Qu
    Archivos Españoles de Urología. 2026, 79(1): 134-144. https://doi.org/10.56434/j.arch.esp.urol.20267901.16
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    Objective: This study aims to analyse factors influencing maternal postpartum stress urinary incontinence (SUI) and construct a prediction model using a nomogram.

    Methods: A retrospective analysis of clinical data was conducted on 500 women who delivered at our hospital between June 2021 and June 2024, of whom 147 developed postpartum SUI. The participants were randomly assigned to the modelling (n = 354) or validation groups (n = 146) in a 7:3 ratio. The modelling group was further subdivided on the basis of postpartum SUI occurrence: SUI (n = 106) and non-SUI groups (n = 248). Relevant factors were identified through logistic regression analysis, and a nomogram was constructed using R software. The nomogram was evaluated through receiver operating characteristic, calibration and decision curves.

    Results: Significant differences existed between the SUI and non-SUI groups in maternal educational attainment, newborn weight, current address, natural birth and gestation period (p < 0.05). Educational attainment (junior high school and below), increase in newborn weight, rural residence, natural birth and parity (≥2) were identified as risk factors for postpartum SUI (p < 0.05). The nomogram showed good predictive performance with area under the curve (AUC) values of 0.778 and 0.754 for the modelling and validation groups, respectively (p < 0.05).

    Conclusions: Maternal educational attainment, newborn weight, current address, natural birth and gestation period are risk factors for postpartum SUI. Based on these factors, the proposed nomogram model is a potentially reliable tool for predicting postpartum SUI risk.

  • Case Report
    Javier Arredondo Montero
    Archivos Españoles de Urología. 2026, 79(1): 145-149. https://doi.org/10.56434/j.arch.esp.urol.20267901.17
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    Selective preservation of the testicular lymphatics is the most effective among the strategies for preventing postoperative hydrocele after laparoscopic Palomo varicocelectomy (LPV). Classical methods employ intraoperative dyes, such as isosulfan blue, instead of indocyanine green (ICG), which enables clearer and real-time lymphatic mapping through near-infrared imaging after intratesticular injection. ICG facilitates the precise identification and preservation of lymphatic vessels and reduces hydrocele risk. Notably, LPV is traditionally performed with three trocars, but this technical note describes a two-port ICG-assisted modification based on an illustrative case and discusses its practical implications, highlighting its potential as a tool for advancing single-incision laparoscopic surgery.

  • Letter
    Huahui Li, Hongchen Zhou, Xingli Xu, Lei Wang
    Archivos Españoles de Urología. 2026, 79(1): 150-151. https://doi.org/10.56434/j.arch.esp.urol.20267901.18
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