Latest Urology research

Top 10 this week

Week of 20 September 2026

1. 1

   Clinical outcomes of selective dorsal cryoneurolysis in patients with lifelong premature ejaculation: a retrospective cohort of 108 men

   The journal of sexual medicine · Q1 journal · RCT · Evidence level 1 (High) · 14 September 2026

   In a retrospective series of 108 men with lifelong premature ejaculation, median intravaginal ejaculatory latency time rose from 54 seconds to 231 seconds and stayed elevated through 12 months, while patient-reported scores improved and no erectile dysfunction occurred. About one in ten men did not achieve a meaningful response, and the procedure's long-term comparative efficacy remains unproven.

2. 2

   Short-term home-based multimodal prehabilitation for perioperative functional recovery in prefrail and frail older men undergoing radical prostatectomy: a randomized controlled trial

   BMC geriatrics · Q1 journal · RCT · Evidence level 1 (High) · 24 July 2026

   Prehabilitation RCT improves functional capacity before RP

3. 3

   Randomized Trial of Percutaneous Versus Transcutaneous Tibial Nerve Stimulation in The Treatment of Refractory Overactive Bladder: Results From The TRANSPER Trial

   Neurourology and urodynamics · Q1 journal · RCT · Evidence level 1 (High) · 14 September 2026

   TTNS non‑inferior to PTNS for refractory OAB in RCT

4. 4

   Transabdominal lumbar approach (TALA) versus retroperitoneal approach for robot-assisted renal surgery: a prospective randomised controlled trial

   World journal of urology · Q1 journal · RCT · Evidence level 1 (High) · 15 September 2026

   In a prospective randomized trial of 40 patients, the new transabdominal lumbar (TALA) technique reached the renal artery in a median of 38 minutes versus 54 minutes with the standard retroperitoneal route, saving about 16 minutes. Peri-operative safety was similar, with three grade III-IV complications (7.5%) overall. The faster exposure may streamline robot-assisted nephrectomy, but larger studies are needed to confirm broader benefits.

5. 5

   Augmented reality in robotic urology: from 3D printed models to cognitive surgical systems. A systematic literature review

   Journal of robotic surgery · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 16 September 2026

   A systematic review of 38 studies found that adding AR guidance to robot-assisted radical prostatectomy can reduce the incidence of positive surgical margins and improve early continence and erectile function recovery. Similar benefits were reported for partial nephrectomy, where AR helped shorten warm-ischemia time and preserve more healthy kidney tissue. Larger randomized trials are needed before AR becomes routine in urologic surgery.

6. 6

   Prospective randomised double-blind trial: holmium laser lithotripsy with vs without Moses™ 2.0

   BJU international · Q1 journal · RCT · Evidence level 1 (High) · 13 September 2026

   Largest double‑blind trial of Moses 2.0 laser lithotripsy

7. 7

   Patient-clinician symptom agreement before and after radiotherapy for prostate cancer: results from the randomized HYPO-RT-PC study

   Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · Q1 journal · RCT · Evidence level 1 (High) · 13 September 2026

   In a sub-study of 1,180 men from the HYPO-RT-PC trial, patient-reported urinary and bowel symptoms were regularly rated lower by clinicians at baseline and up to four years post-treatment, while sexual function was over-reported. Correlations between the two assessments were weak to moderate, indicating poor agreement and supporting routine use of patient-reported outcomes for accurate symptom monitoring.

8. 8

   Radiation Therapy for Bladder Cancer: An ASTRO Clinical Practice Guideline

   Practical radiation oncology · Q1 journal · Guideline · Evidence level 1 (High) · 15 September 2026

   The ASTRO guideline recommends trimodal chemoradiation, with concurrent radiosensitizing agents, as an alternative to radical cystectomy for patients with cT2-4aN0M0 bladder cancer, especially when systemic therapy is added for higher-risk disease. It also advises postoperative radiation for ypT3-4 or node-positive cases and palliative bladder RT for symptomatic metastases, emphasizing multidisciplinary evaluation and modern image-guided techniques.

9. 9

   Time to subsequent therapy (TTST) as an endpoint in clinical studies: development of standardized documentation of subsequent therapy through systematic literature review, expert interviews, and Delphi survey

   Journal of cancer research and clinical oncology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 2 September 2026

   In a Delphi survey of 381 clinicians, patients and relatives, 81% affirmed that time to subsequent therapy (TTST) reflects outcomes important to patients across five tumor types. Researchers identified nine scenarios that justify TTST and created a detailed and short checklist to record reasons and effects of therapy changes, enabling standardized, patient-focused reporting.

10. 10

    Prognostic impact of diabetes or hypertension in smokers with CRPC receiving enzalutamide or abiraterone

    International journal of clinical oncology · Q1 journal · RCT · Evidence level 1 (High) · 19 September 2026

    In a retrospective analysis of 161 castration-resistant prostate cancer patients who smoked, those with diabetes or hypertension had significantly poorer prostate-cancer specific survival than those without these conditions, an effect seen only with enzalutamide and not abiraterone. Smoking status alone did not affect outcomes, highlighting the need to manage metabolic disease in this subgroup.

Paper of the day, last two weeks

• Does active surveillance prior to radical prostatectomy increase the risk of adverse pathological findings or postoperative prostate cancer treatment?

  World journal of urology · Q1 journal · Unclassified · Evidence level 5 (Expert Opinion) · 19 September 2026

  Active surveillance before RP leads to adverse pathology

• Assessment of Bone Metastases, Skeletal-Related Events and Bone-Targeting Agents in Patients With Metastatic Renal Cell Carcinoma Receiving First-Line Systemic Therapy (Meet-URO 33 Study Subanalysis)

  Clinical genitourinary cancer · Q1 journal · Cohort · Evidence level 3 (Low) · 25 August 2026

  In a multicenter study of 1,696 metastatic renal cell carcinoma patients, 31% had bone metastases, which were linked to a median overall survival of 27 months compared with 102 months for those without bone spread. Bone involvement also shortened progression-free survival and was associated with higher skeletal-related events, underscoring a persistent unmet need.

• Prostate and pelvic SABR with or without a focal boost: results from a multicenter phase II prospective clinical trial

  Clinical and translational radiation oncology · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 11 August 2026

  In a multicenter phase II trial of 76 high-risk prostate cancer patients, weekly 5-fraction SABR (25 Gy to nodes, 40 Gy to prostate, optional 50 Gy boost) produced acute grade 2+ GI and GU toxicities in 4% and 18% and late grade 2 toxicities in under 5%, with no grade 3+ events. Five-year biochemical failure was 10.5%, suggesting the regimen is safe and effective, though confirmatory randomized data are pending.

• Comparison of ultrasonic lithotripsy with Ho:YAG laser lithotripsy during percutaneous nephrolithotomy for 20-40 mm low-hardness renal calculi: a propensity score-matched study

  World journal of urology · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 17 September 2026

  Ultrasonic vs Ho:YAG lithotripsy during PCNL for 20‑40 mm stones

• An Updated Systematic Review, Meta-analysis, and Trial Sequential Analysis of Endoscopic Combined Intrarenal Surgery (ECIRS) versus Percutaneous Nephrolithotomy (PCNL) for Upper Urinary Tract Calculi

  European urology open science · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 7 September 2026

• The impact of prehabilitation on postoperative outcomes in patients undergoing radical prostatectomy for prostate cancer: a systematic review and meta-analysis

  Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 14 September 2026

  Systematic review shows prehabilitation reduces early incontinence

• Incidental bladder cancer detected by routine cystoscopy before robot-assisted radical prostatectomy: A multicenter retrospective study

  Urologic oncology · Q1 journal · Cohort · Evidence level 4 (Very Low) · 11 September 2026

  Incidental bladder cancer detected before RARP

• Association Between Castration-resistant Prostate Cancer Progression Patterns and Survival Outcomes in Metastatic Castration-sensitive Prostate Cancer: A Post Hoc Analysis of the TITAN Trial

  European urology focus · Q1 journal · Unclassified · Evidence level 5 (Expert Opinion) · 11 September 2026

  CRPC progression patterns affect survival in mCSPC

• Whole-pelvic Versus Prostate-only Radiotherapy in Clinically Node-negative High-Risk Localised Prostate Cancer: A Systematic Review and Meta-analysis with Reconstructed Individual-patient Data

  Clinical oncology (Royal College of Radiologists (Great Britain)) · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 22 August 2026

  A meta-analysis of five phase-III trials (5,172 men) found that elective whole-pelvic radiotherapy gave no overall-survival advantage compared with prostate-only treatment, and any apparent gains in biochemical or metastasis-free survival vanished when a single PSMA-staged trial was removed. The approach modestly raised late grade 2 or higher urinary and gastrointestinal side effects, leaving routine pelvic irradiation unsupported pending prospective validation.

• Impact of Gleason Grade at the Positive Surgical Margin on Biochemical Recurrence After Radical Prostatectomy in pT2N0 Prostate Cancer

  Clinical genitourinary cancer · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 11 August 2026

  In a cohort of 4,659 organ-confined prostate cancers, patients with a Gleason grade 4 positive surgical margin faced a 4-fold higher chance of biochemical recurrence, while grade 3 margins raised risk about threefold compared with negative margins. The margin grade improved predictive models, especially in lower-grade tumors, suggesting its use for tailored postoperative surveillance.

• PSMA-PET Tumor Volume Stratifies Nonmetastatic Castration-resistant Prostate Cancer

  European urology focus · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 9 September 2026

  In a registry of 514 men with nmCRPC, PSMA-PET identified metastases in two-thirds and defined a tumor-volume cutoff of 7.8 ml that split patients into low- and high-volume groups; the high-volume group faced about 2.5-fold higher mortality. These results suggest PSMA-PET volume should be added to risk models, but prospective validation is needed.

• Impact of Treatment Intensification with Abiraterone on Fracture-related Hospitalisation in Newly Diagnosed Prostate Cancer: A Secondary Analysis of Two Randomised Phase 3 Trials Within the STAMPEDE Trial Platform

  European urology · Q1 journal · RCT · Evidence level 1 (High) · 8 September 2026

  In men with metastatic disease, adding abiraterone (with prednisolone, with or without enzalutamide) reduced the five-year rate of fracture-related hospital stays from roughly 30% to 22% (or 38% to 28%). The benefit was not seen in non-metastatic patients, and the analysis may miss fractures that did not require hospital care.

• Association between smoking, tumor genetics, and outcomes in men with metastatic prostate cancer

  Prostate cancer and prostatic diseases · Q1 journal · Cohort · Evidence level 3 (Low) · 5 September 2026

  In a review of 2,353 men, those who smoked at diagnosis lived about 38 months shorter (median 100 vs 138 months) even after adjusting for disease stage. Smoking was linked to higher rates of SPOP, FGFR1, and ARID1A alterations, but not to neuroendocrine transformation. The findings suggest smoking worsens outcomes and may drive distinct genetic pathways, warranting further study on targeted interventions.

Evidence summaries in Urology

• Nephrolithiasis
• Male Infertility
• Benign Prostatic Hyperplasia