Urinary microbiota signatures associated with different types of urinary diversion: a comparative study

2bRAD-M Reveals the Characteristics of Urinary Microbiota in Overweight Patients with Urinary Tract Stones

Background: Urinary tract stone (UTS) is a common disease significantly impacting human health. Obesity influences stone formation and increases UTS incidence, yet the differences in the urinary microbiota and pathways between overweight and healthy-weight UTS patients remain unclear. Methods: In this study, 16 patients were analyzed: 8 overweight and 8 healthy-weight UTS patients. Bladder urine samples were collected during surgery, and DNA was extracted for microbial analysis using 2bRAD markers. Microbial diversity and KEGG pathway differences were studied. Results: The results showed that overweight UTS patients had a significantly higher urinary microbial diversity than healthy-weight patients. The analysis identified differences in microbiota at various taxonomic levels. LEfSe analysis revealed Sphingomonas_paucimobilis as abundant in overweight patients, while Bifidobacterium_piotii dominated in healthy-weight patients. Key species, including Ralstonia_sp000620465, Sphingomonas_paucimobilis, and Campylobacter_D_coli, were identified. KEGG analysis highlighted enriched pathways in overweight UTS patients, including the porphyrin and chlorophyll metabolism, fatty acid metabolism, amino acid degradation, and renin-angiotensin and mineral absorption pathways. Conclusions: This study is the first to use 2bRAD-M microbiome analysis to compare the urinary microbiota between overweight and healthy-weight UTS patients. It identified significant microbiota and pathway differences, suggesting a link between microbiota imbalance, obesity, and stone formation. These findings provide potential targets for further research on obesity-related stone susceptibility mechanisms.

Comparative outcomes of internal, external, and no stent in ureteroileal anastomosis for ileal orthotopic neobladder reconstruction

Background

Ureteral stents, including internal stents and stentless techniques, are commonly employed in urological procedures such as urinary stone management and deformity correction. However, their use in radical cystectomy for bladder cancer remains relatively limited. This study aimed to compare the efficacy of internal stent, external stent, and no-stent treatments for ureteroileal anastomosis in laparoscopic radical cystectomy (LRC) combined with ileal orthotopic neobladder (IONB). The goal was to compare postoperative outcomes and complications to identify the optimal stent choice.

Methods

A retrospective analysis was conducted on 51 patients who underwent LRC with IONB between April 2013 and December 2023. Patients were divided into three groups: internal stent (Group A), external stent (Group B), and no stent (Group C). Baseline characteristics, perioperative data, and postoperative complications were compared across three groups.

Results

Among the 51 patients (42 males, 9 females; median age: 62 years), internal stents were used in 18 (35.3%, Group A), external stents in 20 (39.2%, Group B), and no stents in 13 (25.5%, Group C) patients. Group A demonstrated significantly shorter hospital stays compared to Groups B and C (P=0.02). Abnormal renal function occurred less frequently in Group A (16.7%) and Group B (15.0%) than in Group C (53.8%, P=0.04). Early postoperative hydronephrosis was significantly different among the three groups (Group A: 5.6%, Group B: 5.0%, Group C: 38.5%; P=0.02). Ureteroileal anastomotic stricture (UIAS) was observed less frequently in Group A (0%) than in Group B (12.5%) and Group C (20.0%, P=0.01). No significant differences were found in other perioperative characteristics or complications.

Conclusions

Internal stents reduce early postoperative complications, including hydronephrosis and renal dysfunction, while lowering the risk of late UIAS. Internal stent use is a safe and effective option that promotes faster recovery and better postoperative outcomes.