Evidence map›Paper›PMID 41375065›Full record

ReviewCancers2025

Rationale and Emerging Evidence on the Potential Role of HoLEP-Mediated Relief of Bladder Outlet Obstruction in NMIBC Outcomes Through Optimal Management of Chronic Urinary Retention.

Angelo Porreca, Filippo Marino, Davide De Marchi, Marco Giampaoli, Daniele D'Agostino, Francesca Simonetti, Mauro Ragonese, Antonio Amodeo, Paolo Corsi, Francesco Claps and 1 more

Abstract readReview
In one paragraph

Review in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Angelo PorrecaDepartment of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy.
Filippo MarinoDepartment of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy.ORCID 0000-0002-2908-6907
Davide De MarchiDepartment of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy.
Marco GiampaoliDepartment of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy.
Daniele D'AgostinoDepartment of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy.
Francesca SimonettiDepartment of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy.ORCID 0009-0006-8387-8290
Mauro RagoneseDepartment of Urology, Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, 00144 Rome, Italy.
Antonio AmodeoDepartment of Oncological Urology, Veneto Institute of Oncology (IOV)-IRCCS, 35128 Padua, Italy.ORCID 0009-0009-2730-0402
Paolo CorsiDepartment of Oncological Urology, Veneto Institute of Oncology (IOV)-IRCCS, 35128 Padua, Italy.
Francesco ClapsDepartment of Oncological Urology, Veneto Institute of Oncology (IOV)-IRCCS, 35128 Padua, Italy.
Luca Di GianfrancescoDepartment of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy.ORCID 0000-0002-0564-7415

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-muscle-invasive bladder cancer (NMIBC) represents approximately 70-75% of newly diagnosed bladder cancers and is characterized by high recurrence rates despite guideline-based management. Chronic urinary retention and bladder outlet obstruction (BOO) have been proposed as under-recognized modifiers of NMIBC outcomes through prolonged exposure to urinary carcinogens, inflammation, and altered intravesical pharmacokinetics. This narrative review qualitatively synthesizes biological and clinical evidence linking BOO-related dysfunction with NMIBC behavior and explores the emerging, but preliminary, role of Holmium Laser Enucleation of the Prostate (HoLEP) as a functional adjunct in selected patients.

methodsA narrative review was conducted according to SANRA guidelines. PubMed/MEDLINE, Embase, and Scopus were searched (January 2000-October 2025) using predefined terms for NMIBC, BOO, urinary retention, and HoLEP. Two reviewers independently screened records, with disagreements resolved by consensus. Sixty-one studies met inclusion criteria.

resultsElevated postvoid residual (PVR) (>80-100 mL) and moderate to severe lower urinary tract symptoms (LUTS) were consistently associated with higher NMIBC recurrence rates, independent of tumor stage and grade, in heterogeneous cohorts. Retention correlated with reduced efficacy of Bacillus Calmette-Guérin (BCG) and mitomycin C, likely via uneven drug distribution and a chronically inflamed urothelium. Mechanistic data support a plausible link between BOO-related inflammation, barrier dysfunction, and tumor biology, although direct biomarker correlations with PVR or pharmacokinetic studies are lacking. HoLEP provides durable relief of BOO, reduces PVR, and improves LUTS. Limited retrospective data suggest an association between HoLEP and lower recurrence, but these observations are confounded and should be viewed as hypothesis-generating.

conclusionsChronic urinary retention and BOO appear to be modifiable functional factors that may influence NMIBC recurrence and intravesical therapy performance. HoLEP is a promising option to optimize bladder emptying in carefully selected patients, but its oncologic impact remains unproven and should be considered hypothesis-generating pending prospective, risk-adjusted studies.

Indexed as

BCG therapybenign prostatic hyperplasia (BPH)bladder cancer recurrencebladder compliancebladder outlet obstruction (BOO)chronic urinary retentionfunctional urologyholmium laser enucleation of the prostate (HoLEP)intravesical therapylower urinary tract symptoms (LUTS)mitomycin Cnon-muscle-invasive bladder cancer (NMIBC)oncological outcomespostvoid residual (PVR)urodynamic dysfunction

Identifiers

PMID41375065
PMCPMC12691192

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.