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Grand RoundsWeekly Evidence Brief

Urology

Edition

30-Second Takeaway

  • AI prediction models for endourological stone outcomes show promise but require external validation before clinical use.
  • A disposable anal insert reduced weekly fecal incontinence episodes but did not meet the trial's primary severity endpoint.
  • Bowel management alone reduces daytime wet days in children with bladder and bowel dysfunction; urotherapy added no clear benefit.

Week ending May 2, 2026

Grand Rounds: Selected Recent Trials and Prognostic Studies Relevant to Urology Practice

Systematic review: AI prediction models for endourological stone procedures lack external validation

EUROPEAN UROLOGY FOCUSApr 30, 2026

This systematic review identified 25 studies of AI-labelled prediction models for outcomes after ureteroscopy, RIRS, or PCNL. Most studies reported discrimination but rarely reported calibration or formal clinical-utility assessment. Validation was predominantly internal; external or temporal validation and standardised outcomes were limited. The authors conclude these models show promise but are not ready for routine clinical decision support without further validation.

Randomized trial: single-use anal insert reduced FI episodes but missed primary St Mark's endpoint

JAMA NETWORK OPENApr 28, 2026

In this multicenter RCT (n=72), the insert did not significantly increase the proportion achieving ≥3-point St Mark's reduction versus usual care. The device reduced weekly FI episodes by about 3.09 episodes and increased the proportion with >50% episode reduction. Selected FI-specific quality-of-life domains (coping and depression) improved with the insert, while others did not. No serious adverse events occurred; device-related events were common but mild.

Randomized trial: audiovisual augmentation of virtual consent did not increase consent or comprehension

JAMA NETWORK OPENApr 30, 2026

In a four-arm randomized substudy (n=1535), adding physician, patient, or animated videos to text did not meaningfully change consent rates. Overall consent rate was 57.9%, and consent comprehension was high (about 86%) across all arms. Relative risks for consent versus text-only were close to 1 for all video modalities, indicating no clear benefit. Findings apply to virtual research consent in one academic health system and may not generalize to other settings.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Avoid deploying AI models without external calibration and clinical-utility data.
  • Consider the anal insert for selected FI patients as a symptom-reducing, low-risk option; discuss modest evidence.
  • In pediatric bladder–bowel dysfunction, prioritize constipation treatment first and monitor continence response.