Latest Urology research

Top 10 this week

Week of 1 November 2026

1. 1

   Durvalumab, Tremelimumab, and Enfortumab Vedotin in Muscle-Invasive Bladder Cancer

   The New England journal of medicine · Q1 journal · RCT · Evidence level 1 (High) · 24 October 2026

   In a phase 3 trial of patients unable or unwilling to receive cisplatin, perioperative durvalumab plus enfortumab vedotin increased 2-year event-free survival to 63.5%, versus 45.1% with surgery alone, and also improved overall survival. Adding tremelimumab also improved event-free survival versus surgery, but the regimens were not compared directly; severe adverse events were common, especially with tremelimumab.

2. 2

   Neoadjuvant Therapy in Patients with Upper Tract Urothelial Cancer: An Updated Systematic Review and Meta-analysis

   European urology oncology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 26 October 2026

   In a meta-analysis of 2,384 patients, neoadjuvant chemotherapy before surgery was associated with a 44% lower risk of death overall than surgery alone; 11% had no cancer found in the surgical specimen. Most evidence came from retrospective studies, so randomized trials are needed to determine whether chemotherapy itself drives the survival difference.

3. 3

   Talazoparib plus enzalutamide versus placebo plus enzalutamide in metastatic androgen pathway modulator-resistant (castration-resistant) prostate cancer (TALAPRO-2): a biomarker analysis of circulating tumour DNA and cells for prognosis and molecular profiling

   The Lancet. Oncology · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

   In this exploratory analysis of 805 men, circulating tumor DNA and tumor tissue tests agreed on whether cancers had relevant DNA-repair gene alterations in 84% of patients evaluable by both tests. Detectable blood tumor DNA and circulating tumor cell counts also tracked with shorter progression-free survival, while declines were linked to better outcomes; whether these markers can guide treatment choices remains unknown.

4. 4

   Active Surveillance in Low- and Intermediate-Risk Prostate Cancer: Comparative Oncologic Safety, Patient Selection, and Predictors of Treatment Conversion in the Era of Multiparametric MRI: A Systematic Review and Meta-Analysis

   Cancers · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 19 October 2026

   A meta-analysis of 46,318 patients found 98.9% prostate cancer-specific survival and 96.2% metastasis-free survival at 10 years with active surveillance, with outcomes reported as comparable to immediate treatment. Serial MRI had a 93.4% negative predictive value, leaving a 6.6% risk of missed high-grade disease; cribriform growth strongly predicted progression, underscoring the need for careful patient selection.

5. 5

   Immersive Virtual Reality for Pain and Anxiety Reduction During Transrectal Ultrasound-Guided Prostate Biopsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

   Journal of clinical medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 20 October 2026

   Across four randomized trials involving 454 patients, immersive virtual reality did not significantly reduce pain or anxiety during transrectal ultrasound-guided prostate biopsy. The pooled results were highly inconsistent and unstable, although no major device-related harms were reported; evidence is too uncertain to support routine use and larger standardized trials are needed.

6. 6

   Micro-ultrasound experience and clinically significant prostate cancer detection: a center-level analysis of the optimum randomized trial

   Prostate cancer and prostatic diseases · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

   In the OPTIMUM trial analysis, adding center-level measures of operator experience did not improve models' ability to identify clinically significant prostate cancer; both models had an area under the curve of 0.803. All participating operators met a proficiency threshold, so the findings suggest limited learning-curve effects in this setting, not that experience is irrelevant for less-trained operators.

7. 7

   Economic Evaluation of Surgical Management for Urolithiasis: A Systematic Review of Comparative Cost Analyses from EAU endourology

   European urology focus · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 26 October 2026

   Across 18 studies, shock wave lithotripsy generally cost less upfront, but repeat procedures could make it more expensive over time. Ureteroscopy appeared to offer better long-term value for smaller stones, while percutaneous surgery was more cost-effective for larger stones in some settings. Wide differences in study methods and follow-up mean these comparisons cannot yet support firm recommendations for every patient.

8. 8

   Controlled postoperative red wine intake versus abstinence in habitual wine drinkers undergoing elective urological surgery (WISE): a translational randomized controlled trial assessing quality of life, surgical outcomes and complications

   World journal of urology · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

   In a randomized trial of habitual wine drinkers, two glasses of red wine daily after elective urologic surgery did not improve mental health scores at 30 days compared with abstinence. Complications, hospital stay and blood markers also showed no meaningful differences; the small, single-center study offers no support for starting or encouraging alcohol use after surgery.

9. 9

   Electroacupuncture for Mild-to-Moderate Stress Urinary Incontinence in Women: A Systematic Review

   Neurourology and urodynamics · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 30 October 2026

   A review of 10 Chinese trials found electroacupuncture was associated with less urine leakage and better symptom scores than sham treatment, medication, or pelvic floor training, with reported longer-term benefits. But only two trials had low risk of bias, and small samples and limited geographic scope leave its superiority over other treatments uncertain.

10. 10

    Laparoscopic Burch Colposuspension Versus Transobturator Tape for the Treatment of Stress Urinary Incontinence in Egyptian Women: A 12-Month Randomized Controlled Trial

    Neurourology and urodynamics · Q1 journal · RCT · Evidence level 1 (High) · 11 August 2026

    Laparoscopic Burch vs TOT for stress urinary incontinence – RCT

Paper of the day, last two weeks

• Postresection Urinary Tumor DNA Refines Residual Disease Assessment and Recurrence Risk Stratification in Non-Muscle-Invasive Bladder Cancer

  JCO precision oncology · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 4 November 2026

  Among 161 patients undergoing repeat bladder tumor resection, 35% had residual tumor. Adding a urine tumor DNA test substantially improved identification of residual disease and improved recurrence risk estimates beyond established clinical tools; a negative result also flagged many patients selected for repeat surgery as lower-yield, though about 1 in 10 still had tumor. Whether test-guided surgery or surveillance improves outcomes remains untested.

• Suction versus traditional ureteral access sheaths in retrograde intrarenal surgery: an updated systematic review and meta-analysis of stone-free rates and complications

  World journal of urology · Q1 journal · SR of cohorts · Evidence level 2 (Moderate) · 5 November 2026

  Across 29 studies involving 5,604 adults, suction sheaths were linked to about half as many residual stone fragments and 57% fewer fevers than traditional sheaths; sepsis was also less common. Most evidence was low certainty, and septic shock was rare, so the findings do not establish a shock benefit or confirm whether flexible-tip sheaths work better.

• One-year Outcomes of Female Artificial Urinary Sphincter Implantation in Europe: The VENUS Registry

  European urology focus · Q1 journal · Unclassified · Evidence level 5 (Expert Opinion) · 2 November 2026

  In this prospective registry across 19 European centers, more than 80% of women with severe stress incontinence from sphincter weakness were continent one year after artificial urinary sphincter implantation, defined as using no pad or just one security pad. Short-term device outcomes and complications were described as acceptable and manageable, but longer follow-up and comparisons with other treatments are needed.

• Retrograde intrarenal surgery (RIRS) with Holmium: YAG laser and Magneto technology versus Thulium Fiber Laser: it's time to compare

  World journal of urology · Q1 journal · Unclassified · Evidence level 5 (Expert Opinion) · 31 October 2026

  In a four-center comparison of 424 patients undergoing kidney stone surgery, the Magneto-modulated holmium laser group had a 94% stone-free rate, compared with 83% for the thulium fiber laser group. Magneto also used less energy and had higher ablation efficiency, while procedure times and complication rates were similar; whether the stone-free advantage holds in other settings remains unknown.

• The impact of 5-alpha reductase inhibitors on multiparametric MRI diagnostic performance and prostate-specific antigen density triage: A systematic review

  BJUI compass · Q1 journal · SR of cohorts · Evidence level 2 (Moderate) · 30 October 2026

  Across seven observational studies, MRI sensitivity for clinically significant prostate cancer was 93.8% in men taking 5-alpha reductase inhibitors, close to 96.1% in other men. A prostate-specific antigen density cutoff avoided biopsy in more men taking the drugs, with similar missed-cancer rates, but one lesion-level study found weaker detection in the prostate's peripheral zone; prospective validation is needed.

• Postinduction Urine Tumor DNA Is Predictive for Response to Maintenance Intravesical Therapy in Non-muscle-invasive Bladder Cancer

  European urology oncology · Q1 journal · Cohort · Evidence level 3 (Low) · 31 October 2026

  Prospective bladder cancer study informs maintenance therapy and de-escalation

• Role of [18F]F-Fluciclovine PET/CT in Patients with Biochemical Recurrence of Prostate Cancer and Negative PSMA PET Results: A Single-Center Study

  Journal of nuclear medicine : official publication, Society of Nuclear Medicine · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 29 October 2026

  In this prospective study of 50 patients with recurrent prostate cancer despite negative prostate-specific membrane antigen imaging, fluciclovine PET/CT found disease in 28; intended treatment plans changed for 71%. Detection rose with prostate-specific antigen levels, but the study was small and only 14 patients had a reference standard, so how reliably findings guide care remains uncertain.

• External Validation of MRI-Based Prostate Cancer Risk Calculators in a Contemporary Pre-Biopsy mpMRI Cohort

  Journal of clinical medicine · Q1 journal · Retrospective cohort · Evidence level 4 (Very Low) · 20 October 2026

  External validation of pre-biopsy prostate cancer risk calculators

• Neoadjuvant nivolumab plus gemcitabine-cisplatin followed by postsurgical adjuvant nivolumab versus neoadjuvant gemcitabine-cisplatin in patients with muscle-invasive bladder cancer: final results from the phase III CA017-078 trial

  Annals of oncology : official journal of the European Society for Medical Oncology · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 31 December 2026

  In this phase III trial, adding nivolumab before and after surgery raised the rate of no detectable cancer at surgery from 29.6% to 39.1%, but did not improve event-free survival after a median 54.5 months of follow-up. Severe treatment-related side effects were similar in both groups; whether circulating tumor DNA can help identify patients at higher risk remains an exploratory question.

• Can We Omit Systematic Biopsies in Men with a Positive MRI During Repeat Biopsies for Active Surveillance for Prostate Cancer? Results from the PRIAS Study

  European urology open science · Q1 journal · Unclassified · Evidence level 5 (Expert Opinion) · 13 October 2026

  Active surveillance biopsy strategy for prostate cancer

Evidence summaries in Urology

• Nephrolithiasis
• Benign Prostatic Hyperplasia
• Male Infertility