Urinary Biomarkers: Is the Era of Exclusive Follow-Up Cystoscopy Coming to an End? A Mini-Review of Emerging Molecular Diagnostics and Risk-Stratified Surveillance
Published on: 8th April, 2026
Bladder cancer is among the most costly malignancies to treat, primarily due to the high rate of recurrence for Non-Muscle-Invasive Bladder Cancer (NMIBC) and the subsequent necessity for lifelong cystoscopic surveillance. Although cystoscopy is widely regarded as the gold standard, it is an invasive procedure that can be costly and is associated with patient discomfort and anxiety. In recent years, a novel generation of urinary biomarkers (comprising genomic, epigenomic, and proteomic assays) has emerged, exhibiting diagnostic capabilities that increasingly challenge the prevailing role of cystoscopy in surveillance protocols. This mini-review examines the landscape of FDA-approved and emerging urinary biomarkers, compares their diagnostic accuracy, evaluates the first randomized controlled trials supporting biomarker-guided surveillance, and proposes a risk-stratified algorithm for the future integration of urinary biomarkers into clinical practice.
Not Every Bladder Mass Is Malignant: A Case of Inverted Urothelial Papilloma in a Young Adult
Published on: 30th March, 2026
Inverted Urothelial Papilloma (IUP) is an unusual variety of urothelial tumors that typically occurs in adults, with a predominance in males. The definitive diagnosis of IUP relies on histopathological examination, as the clinical presentation and endoscopic appearance are non-specific. The recommended treatment for IUP includes the complete transurethral resection, with some controversy regarding the need for cystoscopic follow-up. In this case, we present an atypical instance of IUP in a 21-year-old male patient, diagnosed with gross hematuria and irritative lower urinary tract symptoms. A clinical assessment revealed a 3.0 × 2.6 cm intravesical mass. The definitive diagnosis was confirmed histopathologically and further substantiated by immunohistochemistry, which demonstrated low expression of p53 and Ki-67, effectively ruling out malignancy. This case underscores the diagnostic challenges posed by bladder masses in young adults, emphasizing the necessity of integrating morphological and immunohistochemical findings to prevent overdiagnosis of urothelial carcinoma. The paper focuses on the diagnostic approach and management of this rare condition in the young male population.
Bilateral Severe Encrustation of Long-Term Indwelling Double-J Stents in a Young Non-Lithiasic Patient
Published on: 16th March, 2026
Ureteral double-J stents are a commonly used device in urological practice to allow urinary drainage, avoid ureteral obstruction processes, and protect the upper urinary tract after surgical procedures. However, long indwelling time may give rise to numerous complications, such as infection, migration, and fragmentation of the stent, especially encrustation. Encrustation of stents is a well-known complication that has been closely related to the time active of the stent and can cause significant morbidity if not timely addressed. In severe cases, abundant mineral deposition can result in the development of large calculi encasing the stent and rarely progress to staghorn stones. These cases may pose challenges in terms of the extraction of the stent and may result in complex endourological intervention. The encrustation likelihood is substantially higher if stents are left forgotten or remain in place longer than the advised period. Most patients with heavily encrusted stents have symptoms including flank pain, urinary tract infection, hematuria, or obstructive uropathy, but can present without any symptoms, and this can delay the diagnosis.
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