Background/Objectives: Double-J stents (DJS) cause clinically significant lower urinary tract symptoms (LUTS) in 58–80% of patients following ureteroscopy (URS). The distal vesical coil is regarded as the primary anatomical source of trigonal irritation and detrusor instability. The single-J stent (SJS) eliminates this element while preserving the proximal renal pigtail for anti-migration anchorage. This study aimed to evaluate the safety and patient-reported symptom outcomes of a modified SJS compared with standard DJS following elective URS for ureteric stone disease. Methods: A prospective, single-arm, within-patient feasibility study was conducted in 28 adults undergoing elective URS at Austin Health, Melbourne, Australia (Human Research Ethics Committee (HREC)/25658/Austin-2025; NCT07535580). A modified SJS was fashioned from a commercially available 7Fr Bander™ ureteral diversion stent (Cook Medical, G14780) by trimming the shaft to 28 cm and affixing a 7 cm Prolene retrieval suture (Ethicon NW807) to the blunt distal end. The primary outcome was a cystoscopically confirmed SJS migration rate at removal (pre-specified feasibility threshold ≤5%). Secondary outcomes included change in Ureteral Stent Discomfort Test (USDT) total and domain scores (paired analysis, n = 24), adverse events, and patient preference. Results: The clinically significant migration rate was 0% (0/28); 27/28 stent tips were freely floating within the bladder, with one asymptomatic tip at the ureteric orifice at the scheduled removal visit. Mean total USDT score decreased from 39.92 ± 2.00 (DJS) to 30.42 ± 1.73 (SJS)—a mean absolute reduction of 9.50 points (23.8%; p < 0.001), a magnitude consistent with clinically relevant change, although a USDT-specific minimum clinically important difference has not been independently validated. All six USDT domains improved significantly (all p ≤ 0.014). No adverse events were recorded. All 28 patients (100%) reported they would choose the SJS again. Conclusions: The modified SJS demonstrated a favourable safety profile and was associated with lower patient-reported symptom scores than the preceding DJS across all USDT domains in this uncontrolled within-patient comparison. Because stent design, stone burden, and dwell time differed between the two assessment phases, these differences should be regarded as hypothesis-generating and provide a feasibility basis for a prospective randomised controlled trial evaluating the SJS following URS.

Objectives: To assess the clinical validity of Cxbladder Triage Plus (Pacific Edge Ltd., Dunedin, New Zealand), a non‐invasive urinary biomarker assay, for urothelial carcinoma (UC) risk stratification compared with standard‐of‐care evaluation (cystoscopy) in patients presenting with visible or non‐visible haematuria (VH or NVH) in routine practice in Australia. Patients and Methods: A multicentre, prospective, observational study (AUSSIE; Australian and New Zealand Clinical Trial Registry identifier: ACTRN12622001127796) enrolled adults (aged ≥18 years) presenting with VH or NVH, no UC history and a cystoscopy referral between September 2023 and August 2025 across four Australian clinical sites. Midstream urine samples were tested with Cxbladder Triage Plus prior to cystoscopy. The primary outcome was diagnostic performance of Cxbladder Triage Plus (sensitivity, specificity, positive predictive value [PPV], negative PV [NPV], and test‐negative rate [TNR]) vs white light cystoscopy and histopathological UC confirmation. Results: Of 691 patients with evaluable samples (424 with VH, 267 with NVH), 54 (7.8%) had histopathology‐confirmed tumours (44 with VH, 10 with NVH). Compared with cystoscopy, Cxbladder Triage Plus had sensitivity of 89%, specificity 79%, PPV 27%, NPV 99%, and TNR 74%. Six tumours were not detected (five low‐grade Ta, one T3b urachal adenocarcinoma). Compared with 2025 American Urological Association risk stratification criteria, Cxbladder Triage Plus provided a 3.3‐fold increase in PPV. Conclusion: These findings provide clinical validation of Cxbladder Triage Plus for UC risk stratification in Australian patients presenting with VH or NVH in routine clinical practice.

Background/Objectives: Double-J (DJ) ureteral stents are prone to luminal occlusion, which causes renal dysfunction and complicates exchange. Risk stratification in chronically stent-dependent patients is poorly defined, and the management of confirmed occlusion is not standardised. We aimed to identify independent risk factors for DJ stent occlusion in a chronically stent-dependent population and to evaluate stent-type substitution at first confirmed occlusion. Methods: We conducted a single-centre retrospective cohort study at a tertiary urology service in Melbourne, Australia (January 2023 to December 2025). Patients requiring three or more sequential DJ replacements were eligible. Mechanical occlusion was defined as inability to pass a guidewire through the stent lumen at fluoroscopic exchange, an objective intraoperative surrogate; clinical failure events (nephrostomy conversion, septic admission, or acute kidney injury requiring intervention) were recorded separately. Midstream urine culture and pre-exchange renal ultrasound were obtained at each visit. Cox proportional hazards modelling with robust patient-level clustering was performed. Results: We analysed 125 ureters (97 patients) over a mean follow-up of 20.6 months. Occlusion occurred in 55 ureters (44.0%). Four predictors were robust to Bonferroni correction: indwelling urethral catheter (hazard ratio [HR] 4.62), urinary stone disease versus malignant disease (HR 4.02), retroperitoneal fibrosis versus malignant disease (HR 3.24), and bacteriuria at exchange (HR 2.76). Two further associations, Eastern Cooperative Oncology Group (ECOG) performance status 2 to 4 (HR 2.31) and prior pyelonephritis (HR 1.89), did not survive correction and are exploratory. After stent-type substitution at first occlusion, 43 of 55 ureters (78.2%) had no further occlusion without interval shortening. Summer accounted for 45.1% of events (p < 0.001). Conclusions: In chronically stent-dependent patients, several factors were independently associated with DJ stent occlusion, four of them robust to multiple-comparison correction. Stent-type substitution was associated with occlusion-free outcomes in most cases without interval shortening; because the analysis was uncontrolled and regression to the mean cannot be excluded, this observation is hypothesis-generating. All hazard estimates are exploratory in view of an events-per-variable ratio below ten and a survivor-selected cohort, and apply only to patients with established chronic stent dependency. Prospective randomised evaluation is warranted.