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RADA16 as a novel hemostatic and regenerative agent in urology: European Association of Urology endourology up-to-date overview.

PURPOSE OF REVIEW: Self-assembling peptide (SAP) hydrogels represent a novel class of synthetic biomaterials with growing relevance in surgery. Among them, the ion-complementary peptide RADA16 has gained attention as an athermal, transparent, and biocompatible hemostatic agent. While its use is increasingly reported in multiple surgical specialties, evidence specific to urology remains fragmented. This review aims to summarize the physicochemical properties, mechanisms of action, and current clinical evidence for RADA16-based hydrogels, with a particular focus on urological applications. RECENT FINDINGS: RADA16 rapidly self-assembles into a transparent, extracellular-matrix-like nanofibrillar hydrogel upon exposure to physiological fluids, providing effective local hemostasis without reliance on the coagulation cascade. Preclinical and clinical data from other surgical fields demonstrate rapid bleeding control, favorable safety, and potential regenerative effects. Emerging urological evidence suggests that RADA16 is effective in managing hemorrhagic cystitis, radiation-induced hematuria, and bleeding during prostate surgery, including robot-assisted radical prostatectomy and benign prostate surgery. Beyond hemostasis, RADA16 may support wound healing and promotion of re-epithelialization. However, the current evidence base is limited by small sample sizes, lack of comparative studies, heterogeneous methodologies, and short follow-up. SUMMARY: RADA16-based hydrogels represent a promising adjunctive hemostatic option in urology, offering technical advantages such as transparency, absence of thermal injury, minimal swelling, and applicability in confined or high-risk settings. Robust prospective, comparative, and cost-effectiveness studies are required to define its definitive role in routine urological practice.

Humans

Elevated circulating IL-8 correlates with poor prognosis in urological cancers: a meta-analysis and bioinformatic validation.

BACKGROUND: Interleukin-8 (IL-8) is a key cytokine that has been implicated in multiple aspects of cancer progression and therapeutic resistance. Elevated levels of circulating IL-8 (cIL-8) have been implicated in adverse clinical outcomes among patients with urological cancers. However, definitive evidence consolidating these observations remains lacking. The present study aims to synthesize the existing research findings to provide a comprehensive, evidence-based reference for clinical practice. METHODS: A systematic literature search was conducted to identify relevant studies that reported on the prognostic impact of cIL-8 levels in urological cancer patients. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were extracted and pooled to estimate the overall effect. Furthermore, Kaplan-Meier's survival analyses were conducted using RNA-seq data from The Cancer Genome Atlas (TCGA) through the Gene Expression Profiling Interactive Analysis 2 (GEPIA 2) online tool to validate the observed associations. RESULTS: A total of 19 cohorts encompassing 2740 patients from 12 studies were included in the meta-analysis. The findings revealed that elevated cIL-8 levels were significantly associated with inferior OS (HR: 1.86; 95% confidence intervals (CI): 1.72-2.02) and PFS (HR: 1.59; 95%CI: 1.25-2.03) in patients with urological cancers. The consistency and validity of these results were further supported by survival analyses performed using the GEPIA 2 tool. CONCLUSIONS: This study, which is the first meta-analysis to systematically examine the prognostic significance of cIL-8 in urological cancers, supported by bioinformatics validation, confirms that elevated cIL-8 levels serve as a potential biomarker for predicting adverse outcomes. Our findings underscore the importance of targeting IL-8 as a therapeutic strategy to overcome treatment resistance and improve outcomes for urological cancer patients. Further research into IL-8-targeted therapies and their integration into clinical practice is urgently needed to enhance the treatment landscape for urological cancers.

Humans

An introductory practical guide to secondary data analysis in pediatric urology.

INTRODUCTION: Secondary data analysis (SDA) has become an increasingly important approach in pediatric urology, enabling the study of long-term outcomes, care variation, and disparities in populations with chronic or congenital urologic conditions. With the growing availability of large datasets, a structured approach to designing and conducting SDA studies is increasingly relevant. OBJECTIVES: To provide an introductory, practical guide to SDA in pediatric urology by (1) summarizing commonly used data sources with representative studies, (2) outlining a stepwise approach to designing and executing SDA studies, and (3) highlighting key methodological considerations, limitations, and opportunities for future work. STUDY DESIGN: Narrative review of existing literature and commonly used datasets relevant to pediatric urology, including administrative claims, hospital encounter databases, clinical registries, electronic health record networks, and population-based surveys. RESULTS: Data sources differ in scope, clinical granularity, longitudinal follow-up, and representativeness, and each is suited to specific research questions. We present a practical workflow for SDA, including dataset selection, cohort definition, and analytic planning. Linkage across datasets can provide a more comprehensive view of care patterns and outcomes, although feasibility is influenced by legal, technical, and data-quality constraints. DISCUSSION: SDA enables population-level analyses and the study of rare conditions that are challenging to evaluate through single-center or prospective designs. However, careful cohort definition, feasibility assessment, and awareness of data limitations are essential to ensure validity and interpretability. CONCLUSION: SDA provides a scalable, cost-efficient framework for generating meaningful evidence in pediatric urology. Continued efforts to harmonize data elements, improve linkage infrastructure, and support cross-institution collaboration will enhance the quality and impact of future research. This article provides a practical framework and examples to support the design and execution of SDA studies.

Humans

Healthcare transition readiness in an adolescent and young adult urologic population: The ADHERENT study.

INTRODUCTION: There is a paucity of research regarding transition to adult services within pediatric and adolescent urology. Several recent articles have discussed the barriers in transitioning urologic patients from pediatric to adult health care, but empiric data that may drive intervention are lacking. This study proposes to begin to address this gap in literature and to provide information that may lead to improved understanding of how best to support transition in urologic care. OBJECTIVES: 1) to identify modifiable and non-modifiable factors related to transition readiness as measured by Transition Readiness Assessment Questionnaire (TRAQ) scores in a congenital urologic population and 2) to evaluate the relationships between TRAQ scores (a validated questionnaire measuring transition readiness) and scores measuring anxiety levels related to transition (using an adapted, non-validated questionnaire). STUDY DESIGN: This is a cross-sectional study of adolescent and young adult patients with complex congenital urologic diagnoses. Subjects were electronically administered the validated TRAQ and a study-developed ADHERENT survey, which assesses anxiety and worry surrounding transition. Regression models for the outcomes of the TRAQ and ADHERENT scales were developed to assess multivariable associations with variables of clinical importance. RESULTS: The youngest subgroup (14-17 years of age) compared to the oldest subgroup (21-25 years of age) had significantly lower TRAQ scores [regression estimate = 12.3 (95 % CI: 2.9, 21.7), p = 0.010]. Additionally, single participants versus those in a stable relationship had significantly lower TRAQ scores [estimate = 8.7 (95 % CI: 1.9, 15.4), p = 0.012]. The Spearman correlation coefficient between TRAQ and ADHERENT scores was 0.52 (p = <0.001), indicating a positive, moderate relationship between the two measures, suggesting more readiness correlated with less anxiety. DISCUSSION: This study found that age, higher education, and stable relationship status were associated with higher measures of transition readiness. There was a correlation found between more transition readiness and less anxiety surrounding transition. This finding can be used to inform future research and emphasizes the need for multidisciplinary support throughout the transition process. CONCLUSION: Early discussion of transition of care and education around transition readiness are not the only solution to improving transition success. The second phase of ADHERENT seeks to understand the patient experience and to include adolescents and young adults in shaping effective healthcare transition strategies.

Humans

Role of lncRNA PVT1 in the progression of urological cancers: Novel insights into signaling pathways and clinical opportunities.

Urologic malignancies, encompassing cancers of the kidney, bladder, and prostate, represent approximately 25&#xa0;% of all cancer cases. Recent advances have enhanced our understanding of PVT1's crucial functions. Long noncoding RNAs influence both the onset and development of cancer, as well as epigenetic alterations. Recent findings have focused on PVT1's mechanism of action across several malignancies, particularly urologic cancers. Understanding the various functions of PVT1 linked to cancer is necessary for the development of cancer detection and treatment when PVT1 is dysregulated. Furthermore, recent advancements in genomic and epigenetic research have elucidated the complex regulatory networks that control PVT1 expression. Comprehending the intricate role of PVT1 Understanding the complex function of PVT1 in urologic cancers has substantial clinical implications. Here, we summarize some of the most recent findings about the carcinogenic effects of PVT1 signaling pathways and the possible treatment strategies for urological malignancies that target these pathways.

Humans

Urological complications of renal transplantation can be prevented or controlled.

Our incidence of urological complications in 860 consecutive renal transplants in 3.4 per cent. A further reduction in incidence is demonstrated in the most recent 250 transplants of this series. Urological complications have been kept to a minimum by strict adherence to certain principles in donor nephrectomy, management of multiple and small arteries, and the technique of graft implantation. When urological complications were suspected early and judicious use of 131I hippurate scintiphotographic techniques has proved to be the most helpful method to evaluate patients. If a urological complication did occur prompt recognition and treatment were responsible for a high rate of graft salvage, low incidence of sepsis and absence of patient mortality.

Follow-Up Studies

Urologic complications in renal transplantation.

The current overall reported incidence of major urologic complications following renal transplantation is 5 per cent. The presence of such a complication increases the likelihood of patient mortality by a factor of three. Standard utilization of postoperative radionuclide scanning is very useful in early diagnosis. Vesical fistulas generally result from improper bladder closure. The incidence of bladder complications increases with secondary and tertiary grafts. Ureteral complications result when the blood supply of the ureter is impaired. These include fistula formation, necrosis, and obstruction. Immediate surgical correction is indicated in almost all serious urologic complications following transplantation; otherwise there is marked increase in morbidity and mortality. Complications appearing early in the postoperative period carry a poor prognosis for both graft and recipient survival. The presence of urinary tract infection early in the postoperative period also correlates negatively with graft survival. The presence of multiple renal arteries in the donor has been associated with an increased rate of urologic complications. Ureteral fistulas can be avoided by meticulous dissection of the donor at the time or organ harvesting. Great care must be taken to preserve the arterial and venous blood supply to the ureter by avoiding any dissection into the renal hilum. Aberrant renal arteries must be preserved or repaired if damaged. Ureteroneocystostomy is the preferred method for re-establishing urinary tract continuity following transplantation. The immediate surgical correction of urologic complications is mandatory, and the techniques involved are highly specialized and must be individualized with each patient.

Erectile Dysfunction

Urological septicemia. A retrospective study.

In order to investigate the clinical course and outcome of septicemia in urological patients, data were collected retrospectively from all patients admitted to a specialized urological department, in whom positive blood cultures were drawn. During a 5-year period 91 patients were registered with urosepsis corresponding to an incidence of 1.2%. In non-iatrogenic urosepsis due to ureteral obstruction women dominated over men, however, in iatrogenic disease--after investigative manoeuvres as well as after surgery--men by large dominated the material. Gram-negative bacteria were responsible for almost 75% of the septicemias and for 99% of the cases where septic shock was present. Where a urinary infection was demonstrated prior to septicemia (45%- identical bacteria were subsequently found in the blood, whether the focus had been successfully treated or not. Septic shock developed in 20 of the patients of whom 3 died. This overall mortality of 3% occurred only in patients with comcomitant serious disease. In general the course of septicemia was benign and the complication rate low. It is concluded that in urological patients septicemia is a less serious problem than in gastroenterological patients. The possible explanation for this is discussed in relation to the more discrete diagnostic and therapeutical procedures in the urological clinic.

Adult

[Cystoscopy and its importance in urology].

From the enumeration of modern endoscopic methods for diagnosis and treatment of urological disease, the characteristics of their value and their importance for modern urology becomes evident that by means of these methods, the basis of which was created 100 years ago with the introduction of the cystoscopy, examination and treatment became possible in all regions of the urinary tracts. Based on cystoscopy a subspeciality in urology developed, which might be called endoscopic surgery in urology. The endoscopic treatment methods are relatively atraumatic and loaded with a more insignificant complication rate than the open operative interventions. However, they demand an exact knowledge of the indications and contraindications. By the great possibilities which nowadays open the modern methods of endoscopic diagnostics and therapy we are indebted to their inventors still 100 years after the detection of the cystoscope, among the inventors German researchers and masters play an important role.

Color

Urologic complications after operations for anorectal cancer, with an evaluation of preoperative intravenous pyelography.

Urologic complications arose in 23.7 per cent of 569 patients who underwent abdominoperineal or low anterior resection for anorectal cancer. No radomization of the two operations was attempted, low anterior resection being performed whenever resection 5 cm below the tumor was possible. Complications were more frequent after abdominoperineal resection and in men. Preoperative intravenous pyelography was performed in the cases of 541 of the patients, including 60 who underwent palliative colostomy. The pyelograms of 30 per cent of these patients were abnormal. The abnormalities were anatomic variations of the urinary tract in 25 per cent and urologic diseases in 75 per cent. None of the postoperative urologic complications was related to an abnormal preoperative pyelogram. No relation was found between the radicality of abdominoperineal and low anterior resection and the pyelographic signs of tumor involvement.

Anus Neoplasms

Comparison of quality of life in children with posterior urethral valves, isolated hydronephrosis and minor urologic conditions.

OBJECTIVE: To compare the quality of life (QoL) and family impact scores of children with posterior urethral valves (PUV), isolated hydronephrosis (HN), and those with minor urologic conditions, referred to here as minor urologic controls (MUC). METHODS: From December 2022 to April 2025, the PedsQL Inventory and Family Impact Module (FIM) questionnaires were distributed to patients in dedicated PUV, HN, and community-based urology clinics. Higher scores indicate better QoL. Children &#x2265;8 years self-completed the questionnaires, while parents served as proxies for younger children. PUV patients were compared to HN patients and MUC. RESULTS: A total of 331 patients were included (124 PUV, 101 HN, and 106 MUC). The median age differed across groups, with HN patients being the youngest (median: 7 months), followed by MUC patients (median: 36 months) and PUV patients (median: 79.5 months). Overall, PUV patients scored similarly to HN patients and MUC in QoL and FIM scores. When stratified by age, however, PUV patients <2 years old had lower median scores in total QoL, psychosocial, and family functioning domains compared to other groups. CONCLUSION: Overall, PUV was not associated with lower QoL or family impact scores compared to comparator groups in this tertiary-care cohort; however, lower scores were observed among younger children with PUV, likely reflecting parent-perceived burden early in the disease course. This highlights the importance of age-tailored support and close monitoring, particularly for younger children and families navigating early post-diagnosis care.

Humans

Urological injuries associated with pelvic trauma.

We reviewed 100 consecutive cases of pelvic fractures at our hospital to establish the relationship between bone injuries and urological lesions. There were 11 major urological injuries found: 6 patients had bladder laceration, 4 had rupture of the membranous urethra and 1 had a ureteral injury. Emphasis is placed on the physiopathology of the urological injuries.

Adolescent

Urological complications in 119 consecutive renal transplants.

One hundred and nine patients undergoing 119 transplants have been followed up from 8 months to 9 years. Urological complications occurred in 16 transplants, an incidence of 13.4%. Ureteroneocystostomy was performed primarily in all cases; in 98 by the conventional Politano-Leadbetter technique with 9 (9.2%) urological complications and in 32 by an extravesical technique with 7 (21.8%) urological complications. One patient died as a result of ureteric obstruction, without operation. In 3 patients with lower ureteric obstruction, transurethral ureteric meatotomy was successful in 2 cases and resulted in no change in renal function in the third. Two patients with urinary fistulae were managed successfully by continuous drainage with indwelling urethral catheters. The remaining 10 patients required 12 open surgical procedures for relief of ureteric obstruction, with improvement in function in 7 patients.

Follow-Up Studies

[Clinical and urological after care in gynecologic neoplasms].

Patients after operative and/or radiological therapy for cervical cancer should have gynecological follow-up examinations every two months in the first year. In cases of urological complications after irradiation therapy, radionephrography, infusion urogram, blood count, cystoscopy, and cystometry should also be carried out after two months. Depending on the clinical picture, radionephrography, blood count and urinalysis are to be repeated in regular intervals. After lymphography with positive findings, x-ray controls are necessary after two and four months. In cases of increasing hydronephrosis and hydroureter due to fibrostenosis of the ureter plastic surgery is recommended. Most urological complications are to be expected after radical operation and postoperative irradiation. In patients with endometrial uterine cancer, metastases mostly occur paraurethrally and in the lungs. Chest x-ray is to be taken every six months. Suspicious paraurethral hardening is cytologically diagnosed by needle biopsy. In ovarian carcinoma stage III and IV repeated x-ray controls of the lungs during longterm polychemotherapy are advisable. Prior to second look operations after combined treatment a second look laparoscopy is particularly important. Urological complications are more frequent after therapy of cervical cancer while ovarian carcinoma is more likely to develop complications of the small bowel.

Adult

[Urological treatments before and after kidney transplantations].

The repair of pre-existing bladder sphincter lesions in patients excluded from kidney transplant programs, and the recovery of grafts threatened by ureteral complications, are favourable influences in establishing equilibrium between dialysis and transplantation. In a series of 74 kidney transplants, two patients were able to receive grafts: one after the reconstruction of an ileal tube and the other after bladder diverticulectomy and resection of the bladder neck. Two other grafts, complicated by ureteral necrosis, were able to be conserved following a uretero-ureterostomy in the first case, and a psoic bladder in the second. These repair operations are discussed from three points of view: incidence, procedures, and complications. Advances made in transplanting kidneys encourage its use in patients who were previously excluded from receiving transplants because of bladder sphincter lesions. These lesions can be the cause of a renal insufficiency, or those associated with the original kidney disease. This group of patients represents 3 to 5% of the population of patients on permanent dialysis who respond to the other criteria for inclusion in the lists of potential receivers of kidney transplants: some of them could benefit from the graft if their lesions were treated by the standard urological methods. Furthermore, 5 to 8% of those with kidney transplants could lose the grafted kidney, which is immunologically tolerated, because of urological complications. As with patients in the first category, they also could obtain benefit from repair procedures on the urinary tract. A total of 74 kidney grafts were performed in the Sheba medical Center between March 1971 and July 1977: two patients were able to benefit from preventive urological procedures before transplantation: two others with grafts developed ureteral complications and were benefited by therapeutic procedures rarely used in kidney transplantation cases.

Adult

Evaluation of research needs in nephrology in urology. Obstructive and neuromuscular disorders affecting the urinary system.

Obstructive and neuromuscular disorders are common problems of the urinary tract. They cause considerable morbidity and some mortality. In all problem areas research efforts have been and continue to be limited. The principal reason for the lack of research efforts in these areas is the lack of trained established investigators interested in the problems of the urinary tract. Unfortunately, most basic scientists with the research and investigative background to solve many of these problems see them as mundane and not worthy of investigation. In addition, these same basic scientists are out of touch with clinical urologic diseases and probably do not appreciate the magnitude of the problems. In our opinion the solution is 2-fold: to train qualified investigators in urology and nephrology, and to interest, educate and collaborate with the basic scientists about these clinical problems of the urinary tract.

Action Potentials