Urolithiasis is a common and recurrent urinary tract disorder in which stone size, composition, location, anatomy, and patient factors influence the choice and success of treatment. Although shock wave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL) provide effective treatment for many patients, residual fragments, difficult calyceal access, repeated procedures, tissue trauma, and procedure-specific risks remain relevant clinical challenges. These limitations have encouraged investigation of miniature, wirelessly controlled systems that could reach confined regions of the urinary tract and perform localized diagnostic or therapeutic tasks. This review examines magnetically actuated microrobots and related magnetic microdevices for kidney stone navigation, detection, fragmentation, dissolution, and fragment retrieval. Particular attention is given to rotational, oscillatory, and gradient-driven actuation; magnetic materials and biocompatible coatings; integration with ultrasound, magnetic resonance imaging, and other sensing approaches; and hybrid magnetic-acoustic or drug-delivery platforms. Rather than treating all microrobotic studies as equivalent, the review distinguishes direct urolithiasis evidence from evidence transferred from other biomedical applications. The available evidence remains predominantly preclinical. Demonstrations include urinary-tract phantoms, microfluidic models, ex vivo experiments, and selected animal studies, while human clinical trials of magnetically actuated microrobots for kidney stone diagnosis or treatment have not been established in the literature reviewed here. Accordingly, the principal value of these systems at present is technological feasibility rather than demonstrated clinical superiority. Key barriers include real-time localization, magnetic-force attenuation with depth, safe deployment and retrieval, obstruction or urothelial injury, material fate, manufacturing reproducibility, regulatory classification, and cost-effectiveness. Future clinical claims should therefore be considered prospective and conditional on rigorous validation.

The prospective, cross-sectional study was conducted at the Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, from February to July 2022 to compare outcomes related to Clean Intermittent Self Catheterisation via the urethral route and Mitrofanoff stoma. A total of 114 patients were divided into two urethral Clean Intermittent Self-Catheterisation Group A and Mitrofanoff Clean Intermittent Self-Catheterisation Group B. Quality of life, frequency, pain and difficulty associated with Clean Intermittent Self-Catheterisation were assessed using validated 12-item Medical Outcomes Study Short Form questionnaire. Data was analysed using SPSS 27. Group A had a mean age of 35.82±14.68 years, while Group B had a mean age of 29.03±14.42 years. Group B had a higher daily catheterisation frequency (5.85±2.03) than Group A (4.12±1.31) (p=0.001). No significant differences were observed in catheter size, difficulty, discomfort or quality of life outcomes between the groups. The study demonstrated that both Clean Intermittent Self Catheterisation methods were feasible and well-accepted by the patients.

Background. Renal biopsy is widely performed worldwide, but reported bleeding risks vary due to differences in technique, devices, operators, and patient populations. This study aimed to define the bleeding risk associated with current spring-loaded biopsy guns in a South-Asian population, identify relevant risk factors, and quantify the additional cost and hospital stay from bleeding complications. Methodology. In this six-month prospective observational cohort study, all adult patients undergoing kidney biopsy at a tertiary hospital were enrolled. Demographic, clinical, radiological, procedural, and histopathological data were collected. Bleeding was defined as gross haematuria, perinephric hematoma, hemoglobin drop, transfusion requirement, or need for intervention. Factors associated with bleeding were evaluated using univariate analysis and multivariate logistic regression. Results. Among 980 patients, overall bleeding incidence was 4.9%, with 1.6% clinically significant events. On univariate analysis, higher creatinine, urea, dialysis dependence, and ischemic heart disease were associated with bleeding, whereas diabetes mellitus was associated with lower bleeding risk. On multivariate analysis, ischemic heart disease remained independently associated with bleeding, while diabetes mellitus remained associated with lower bleeding risk. Histopathological chronicity, including glomerulosclerosis and interstitial fibrosis, was also associated with clinically significant bleeding events (requiring transfusion or intervention). Conclusions. Bleeding after kidney biopsy was infrequent in this cohort. Ischemic heart disease and histopathological chronicity were associated with increased bleeding risk, while procedural and operator-related factors were not significantly associated in this cohort, although these findings should be interpreted cautiously. Bleeding was associated with increased hospital stay and healthcare costs.

Objective. To evaluate the acute cross-shift changes in renal function and occupational risk factors associated with environmental nephropathy among rural workers in the Colombian Caribbean. Material and Method. An observational, cross-sectional analytical study was conducted with a community-based sample of 78 active rural workers (48 agricultural and 30 construction workers). Variables analyzed included sociodemographic characteristics, toxic habits, agrochemical exposure, fluid intake, and clinical parameters. Blood and urine samples were collected pre- and post-shift. A multivariable linear regression model was constructed to identify independent predictors of the acute cross-shift decline in estimated glomerular filtration rate (ΔeGFR). Results. The cohort was highly exposed to adverse occupational conditions, including prolonged workdays (69% worked > 48 hours per week) and insufficient hydration (79% consumed < 3 liters of fluid daily). Post-shift analysis revealed significant acute physiological stress, including a significant decline in overall eGFR (p < 0.001) and acute increases in urinary specific gravity, incident proteinuria (p=0.008), and leukocyturia (p<0.001). Notably, incident hematuria increased significantly across the workday exclusively among agricultural workers (21% to 40%, p = 0.02). Multivariable analysis identified occupational exposure to herbicides (β = -16, p = 0.014) and active smoking status (β = -12, p = 0.016) as the strongest independent predictors of acute cross-shift renal function loss. Conclusion. Workers under adverse environmental conditions in the Colombian Caribbean experience severe acute cross-shift declines in renal function and markers of acute tubular injury, driven by heavy labor, heat stress, and herbicide exposure.

The emergence of zoonotic diseases highlights the need for continuous surveillance of wildlife, particularly bats, known as natural reservoirs of several pathogens. This study aimed to investigate the presence of coronaviruses (CoV) and Leptospira spp. in non-hematophagous bats from the northwestern region of São Paulo State, Brazil, between 2019 and 2024. Samples of intestine and kidney from 98 specimens from 18 species belonging to three families (Molossidae, Phyllostomidae, and Vespertilionidae) were collected in 8 municipalities of the Araçatuba Intermediate Geographic Region. Coronaviruses detection was performed by pan-CoV nested RT-PCR, targeting fragments of 602 and 440 bp of the RNA-dependent RNA polymerase (RdRp) gene. Investigation of Leptospira spp. was conducted by real-time PCR, aiming the amplification of a fragment of 331 bp of the 16 S rRNA gene. The analyses yielded no amplification in any of the intestinal and renal samples. Due to geographic bias and the underrepresentation of phyllostomids - a central taxon in CoV epidemiology in Brazil -, the lack of detection reflects sampling limitations rather than the real absence of these pathogens in the local fauna. Continuous surveillance, integrated with comprehensive and standardized sampling in this under-studied region, remains essential for the early detection of emerging zoonotic pathogens and for characterizing local host-pathogen ecology.

This study aims to evaluate the association between the geriatric nutritional risk index (GNRI) and urinary incontinence (UI). This cross-sectional study utilized data derived from 9 cycles (2001-2018) of the National Health and Nutrition Examination Survey. Weighted multivariable logistic regression models were employed to assess the connection between GNRI and UI [stress UI (SUI), urgency UI (UUI), and mixed UI (MUI)]. Smooth curve fitting was conducted to explore the linear association between GNRI and UI. Subgroup analysis was used to assess the robustness of the relationship between GNRI and UI across various stratifications. In the current study, a total of 11,324 participants older than 60 years were enrolled, with 32.2% experiencing SUI, 36.5% complaining of UUI, and 17.8% having MUI. In the multivariable logistic regression, GNRI was negatively associated with 3 types of UI with full adjustment (SUI: odds ratio [OR] = 0.986, 95% confidence interval [CI]: 0.974-0.999; UUI: OR = 0.972, 95% CI: 0.961-0.983; MUI: OR = 0.972, 95% CI: 0.957-0.987, all P < .05). After categorizing GNRI into quartiles, a significant negative relationship between GNRI and UI was stable, particularly evident in the highest GNRI group when compared to the lowest GNRI quartile (SUI: OR = 0.797, 95% CI: 0.672-0.945; UUI: OR = 0.722, 95% CI: 0.615-0.848; MUI: OR = 0.674, 95% CI: 0.538-0.845, all P for trend < .05). Additionally, the smooth curves fitting revealed a negative linear connection between GNRI and UI. Moreover, the negative association between GNRI and SUI, as well as MUI, was more significant in men than in women (P for interaction < .05). In conclusion, GNRI was inversely associated with the prevalence of UI. The association between GNRI and SUI, as well as MUI, was stronger in males compared to females. Further research is needed to confirm causality and explore potential mechanisms.

While toxic heavy metals have been linked to sleep disorders, the role of less-studied metals remains unclear. We aimed to explore the associations of 8 urinary metals with trouble sleeping and to identify potential gender-specific patterns. This study included 10,012 adults from the National Health and Nutrition Examination Survey 2005-2018. Urinary concentrations of tungsten, arsenic, thallium, cesium, antimony, molybdenum, cobalt, and cadmium were measured. Trouble sleeping was self-reported. We employed weighted logistic regression, restricted cubic spline models, and weighted quantile sum regression to evaluate single and mixed-metal effects. Among participants, 50.2% were male and 25.3% reported trouble sleeping. Higher urinary tungsten levels were associated with increased likelihood of trouble sleeping in males (odds ratios: 1.28-1.30). Arsenic, thallium, and cesium showed inverse associations, with notable gender differences. Weighted quantile sum analysis supported the positive association of tungsten and the inverse associations of arsenic and cesium. No significant associations were found for antimony, molybdenum, cobalt, or cadmium. Urinary tungsten is cross-sectionally associated with trouble sleeping in males, while arsenic, thallium, and cesium show inverse associations, with gender-specific patterns. Further research using validated tools is warranted to validate these associations, elucidate the underlying biological mechanisms, and highlight the significance of assessing combined metal exposures in relation to sleep health.

Many varied presentations of genitourinary tuberculosis (GUTB) such as recurrent urinary tract infection, sterile pyuria (pus cells in urine despite a negative routine bacterial culture) with/without haematuria, irritating voiding symptoms, infertility, hydronephrosis and renal failure had been published in the literature. Tuberculous epididymo-orchitis (inflammation of the epididymis and testis) is an underreported and rare form of GUTB. Non-specific symptoms of epididymal tuberculosis (TB) are difficult to differentiate from cysts, tumours and other infections. Bilateral epididymal involvement with testicular lesion increases the suspicion of tubercular aetiology. Tuberculous epididymo-orchitis in late stages may present with non-functioning kidney and thimble bladder (a severely contracted, small-capacity bladder due to chronic inflammation) and infertility. Timely diagnosis and treatment will prevent late sequelae of the disease. Here, we present three cases of GUTB in young males: two cases of isolated tuberculous epididymo-orchitis (cases 1 and 3) and one case of complicated drug-resistant genitourinary tuberculosis (case 2). These rare cases were managed successfully with diagnostic and therapeutic challenges.