Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic granulomatous infection of renal parenchyma. XGP is often associated with long-term urinary tract obstruction due to stones and infection. We aimed to analyze the clinical, laboratory, and microbial culture profiles from bladder and kidney urine of patients who were diagnosed with XGP. Databases of patients with histopathological diagnosis of XGP from 10 centers across 5 countries were retrospectively reviewed between 2018 and 2022. Patients with incomplete medical records were excluded. A total of 365 patients were included. There were 228 (62.5%) women. The mean age was 45 ± 14.4 years. The most common comorbidity was chronic kidney disease (71%). Multiple stones were present in 34.5% of cases. Bladder urine culture results were positive in 53.2% of cases. Kidney urine culture was positive in 81.9% of patients. Sepsis and septic shock were present in 13.4% and 6.6% of patients, respectively. Three deaths were reported. Escherichia coli was the most common isolated pathogen in both urine (28.4%) and kidney cultures (42.4%), followed by Proteus mirabilis in bladder urine cultures (6.3%) and Klebsiella pneumoniae (7.6%) in kidney cultures. Extended-spectrum beta-lactamases producing bacteria were reported in 6% of the bladder urine cultures. On multivariable analysis, urosepsis, recurrent urinary tract infections, increased creatinine, and disease extension to perirenal and pararenal space were independent factors associated with positive bladder urine cultures. On multivariable analysis, only the presence of anemia was significantly more frequent in patients with positive kidney cultures. Our results can help urologists counsel XGP patients undergoing nephrectomy.

Background: Overactive bladder (OAB) is a common condition characterised by urgency, frequency and nocturia, with a substantial effect in quality of life. Home-based posterior tibial nerve stimulation (PTNS) using the TENSI+ device represents a non-invasive alternative to conventional therapies. This study aimed to evaluate the short-term clinical effectiveness, feasibility and safety of home-based transcutaneous PTNS (T-PTNS) in patients with OAB and detrusor overactivity (DO). Methods: A prospective, single-arm study was conducted in Barcelona (September 2024–October 2025). Adults with OAB, defined in accordance with the International Continence Society criteria and urodynamic DO or cystometric capacity < 250 mL, received T-PTNS (10 Hz, 200 µs, individualised sensory threshold; 20 min/day, 5 days/week for 12 weeks). Outcomes included OAB-V8, OAB-V3, ICIQ-SF, Bladder Control Self-Assessment Questionnaire (BCSAQ) and safety and adherence. Logistic regression was used to identify predictors of early discontinuation. Results: Thirty-one patients were enrolled (mean age 70.5 ± 18.2 years; 58.1% women), and 71% completed the protocol. Significant improvements were observed from baseline to week 12 in OAB-V8 (24.0 → 13.1; p < 0.001), OAB-V3 (8.7 → 4.7; p < 0.001), ICIQ-SF (10.7 → 6.4; p = 0.019), BCSAQ-Symptoms (7.5 → 4.3; p < 0.001) and BCSAQ-Bother (8.1 → 5.0; p = 0.005). Clinical benefits were evident by week 4 and consolidated by week 12, with a consistent effect across sex subgroups. No device-related adverse events were reported. Early discontinuation was associated with baseline ICIQ-SF ≥ 12, BCSAQ ≥ 20 and cystometric capacity < 200 mL. Conclusions: Home-based T-PTNS with the TENSI+ device resulted in significant short-term improvements in urgency, frequency and incontinence, with excellent safety and good adherence. Benefits emerged within 4 weeks, and they were sustained through 12 weeks, supporting TENSI+ as a feasible ambulatory neuromodulation option for selected patients with OAB. Larger randomised trials are warranted to confirm long-term efficacy and cost-effectiveness.

RESÚMEN La nefrolitotomía percutánea (NLPC) es el tratamiento de elección para litos coraliformes y cálculos renales grandes (mayores de 2 cm). El acceso renal percutáneo se puede lograr ya sea guiado por ultrasonido o fluoroscopia. El método de elección depende de la formación y las preferencias personales. El ultrasonido tiene varias fortalezas como herramienta de intervención y ofrece varias ventajas sobre la fluoroscopía: es fácilmente disponible, portátil, relativamente barato así como la reducción de la exposición a la radiación. Si bien existe una curva de aprendizaje para dominar estas técnicas, su adopción puede conducir a una menor exposición a la radiación para los pacientes, urólogos y proveedores de servicios de salud auxiliares al realizar la nefrolitotomia percutánea. Objetivos Describir la técnica quirúrgica, así como las características clínicas de los pacientes sometidos Nefrolitotomía Percutánea con acceso renal guiado por USG en el Hospital Regional De Alta Especialidad de la Península de Yucatán en el periodo enero 2019 a enero del 2021. Material y método Se realizó un estudio observacional, retrospectivo, descriptivo, de los expedientes clínicos de un total de 22 pacientes con diagnóstico litiasis renal corroborado por estudio de tomografía, sometidos a NLPC con punción guiada por ultrasonido. Resultados Se realizaron un total de 22 NLPC con acceso renal guiado por ultrasonido en un periodo de un año (enero 2019 a enero 2020). El 72.7% de los pacientes fueron del sexo femenino y 27.3% del sexo masculino. El 50% (11) tenían obesidad. El 68.2% (15) pertenecían a la clasificación de riesgo anestésico ASA 2, el 22.7% (5) ASA 3 y 9.1% (2) ASA 1. Dentro de las características del lito de acuerdo a la clasificación de GUY Stone Score, el 40.9% (9) contaban con un GUY III y el 27.3% (6) contaban con un GUY IV. Dentro de las características quirúrgicas: el tracto fue realizado en el 45.5% por un fellow de endourología en el (10) 22.7%, (5) por R5, 9.1% (2) por R4 y 22.7% por médico adscrito de endourología. En cuanto al número de punciones, el 45.5% (10) solamente requirieron una punción. 5 pacientes 2 punciones, 5 pacientes 3 punciones, 1 paciente 4 punciones y 1 paciente más 5 punciones; En el 95.5% (21) el tracto fue exitoso, únicamente en un paciente el tracto fue fallido. La punción se realizó en posición de Valdivia/Galdakao en el 90.0% (20) y en posición prono en el 9.1% (2). El número de tractos realizados fue unitracto en el 95.5% (21). Conclusiones El acceso guiado por ultrasonido para la nefrolitotomía percutánea (NLPC) es una técnica segura, efectiva, libre de radiación y de bajo costo que puede ser utilizada en cualquier hospital. Esta técnica requiere de entrenamiento estructurado el cual debe comenzar desde la residencia.