Evidence map›Paper›PMID 41941012›Full record

ArticleWorld journal of urology2026

Simultaneous outlet surgery for bladder stones and BPO: a scoping review from EAU endourology - challenging the traditional approach.

Enes Dogan, Selim Soytürk, Abdullah Altunhan, Naeem Bhojani, Bhaskar Kumar Somani, Kamran Ahmed, Thomas Rw Herrmann, Selcuk Guven

Abstract readScoping Review
In one paragraph

Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
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

8 authors.

Enes DoganDepartment of Urology, School of Medicine, Necmettin Erbakan University, Konya, Türkiye, Turkey. enesdogann99@gmail.com.
Selim SoytürkDepartment of Urology, School of Medicine, Necmettin Erbakan University, Konya, Türkiye, Turkey.
Abdullah AltunhanDepartment of Urology, School of Medicine, Necmettin Erbakan University, Konya, Türkiye, Turkey.
Naeem BhojaniDivision of Urology, Université de Montréal, Montréal, PQ, Canada.
Bhaskar Kumar SomaniDepartment of Urology, University Hospital, Southampton, UK.
Kamran AhmedSheikh Khalifa Medical City, Abu Dhabi, UAE.
Thomas Rw HerrmannDepartment of Urology, Spital Thurgau AG, Frauenfeld, Switzerland.
Selcuk GuvenDepartment of Urology, School of Medicine, Necmettin Erbakan University, Konya, Türkiye, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveManagement of bladder stones in men with benign prostatic obstruction (BPO) conventionally assumes simultaneous outlet surgery is universally required. This scoping review evaluates evidence comparing simultaneous and staged strategies to establish rationale for selective management.

methodsThe protocol was registered in the Open Science Framework (OSF: https://osf.io/egmz7 ). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, PubMed, the Cochrane Library, and Web of Science were systematically searched for studies published up to September 18, 2025, Studies reporting outcomes of stone removal with or without concurrent outlet surgery in patients with bladder stones and BPO were included. Outcomes included stone-free rate (SFR), recurrence, voiding parameters (IPSS, Qmax, PVR), complications, and reintervention.

resultsFifteen studies (six comparative) met criteria. Both approaches achieved high SFRs (> 90%). Recurrence was lower after combined procedures (≤ 5%) versus isolated stone removal (10–25%), diverging beyond 2–3 years; however, most men receiving stone removal alone did not require subsequent outlet surgery. Combined procedures produced greater LUTS improvement, particularly with prostate volumes > 100 mL or PVR > 90 mL. Early morbidity was higher with simultaneous surgery. No study incorporated urodynamic testing, limiting physiologic interpretation. Key functional domains (ejaculatory function, continence, patient-reported outcomes) and minimally invasive surgical therapies were rarely evaluated.

conclusionsAvailable evidence does not support routine simultaneous outlet surgery for all men with bladder stones. The presumed equivalence of stone presence with obstruction, and prostate size with surgical indication, lacks consistent validation. A selective strategy incorporating postoperative re-evaluation, risk stratification, and patient-centered priorities offers a more physiologic, evidence-aligned approach while avoiding overtreatment.

Indexed as

Prostatic HyperplasiaUrinary Bladder CalculiHumansMaleBenign Prostatic ObstructionBladder calculiCystolithotripsyLower Urinary Tract SymptomsRecurrence

Identifiers

PMID41941012
PMCPMC13053587

What OpenQuestion holds

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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.