BLAST—bladder lithiasis assessment of surgical treatment in real-world practice. A global prospective multicentre registry by EAU Endourology

PURPOSE: This registry aimed to establish a comprehensive global database to characterise contemporary real-world surgical approaches to bladder stones and to describe postoperative stone-free rate (SFR) and complications according to the surgical treatment route. METHODS: The BLAST (Bladder Lithiasis Assessment of Surgical Treatment) registry prospectively enrolled 805 patients across 31 centres in 16 countries between May 2025 and February 2026. Patients underwent transurethral intervention (TI, n = 741), percutaneous suprapubic (PSI, n = 39), or open surgery (OI, n = 25). Postoperative SFR was graded using cross-sectional computer tomography, or ultrasonography, X-ray, or flexible cystoscopy, as Grade A (100% complete clearance), Grade B (single residual fragment), Grade C (multiple residual fragments). Perioperative complications were classified by the Clavien-Dindo criteria. RESULTS: The cohort was predominantly male across all groups. TI patients were older (median 66 vs 60 and 59 years; p = 0.023) and presented with smaller stones (median 2.1 vs 3.0 cm in both other groups; p < 0.001). A history of urinary tract reconstruction was markedly more prevalent in the PSI cohort (23.1% vs 3.5% and 4.0%; p < 0.001). Median hospital stay was significantly shorter following TI (2 vs 3 days; p < 0.001), accompanied by a shorter duration of catheterisation (p < 0.001). Early complications within 48 h were most frequent after OI (48.0% vs 18.6% and 17.9%; p = 0.001), although major complications (Clavien-Dindo ≥ 3) remained rare and comparable across all modalities. No mortality was recorded. Grade A SFR was achieved in 95.5% of TI, 84.6% of PSI, and 100% of OI (p = 0.001). Reintervention for residual fragments was required significantly more often following PSI (10.3% vs 1.3% and 0%; p < 0.001). CONCLUSION: Transurethral cystolithotripsy was the predominant approach in this real-world international cohort and was associated with high stone clearance and shorter postoperative recovery. Percutaneous and open approaches were selectively used in patients with larger stone burdens, complex anatomy, prior urinary tract reconstruction, or specific urethral limitations. These findings describe contemporary treatment patterns and observed outcomes rather than comparative treatment effectiveness.

Authors

Institutions

Publication Details

Journal
World Journal of Urology
Published
2026-10-13
DOI
https://doi.org/10.1007/s00345-026-06813-3
Primary Topic
Kidney Stones and Urolithiasis Treatments
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

BLAST—bladder lithiasis assessment of surgical treatment in real-world practice. A global prospective multicentre registry by EAU Endourology

Angelo Cormio, Steffi Kar Kei Yuen, Benedikt Becker, 黄云腾 et al.
World Journal of Urology
Kidney Stones and Urolithiasis Treatments
article

BLAST—bladder lithiasis assessment of surgical treatment in real-world practice. A global prospective multicentre registry by EAU Endourology

Angelo Cormio, Steffi Kar Kei Yuen, Benedikt Becker, 黄云腾, Thiago Hota, A. Sierra, Khi Yung Fong, Mallikarjuna Chiruvella, Ender Cem Bulut, Daniele Castellani, Chawla Arun, Theodoros Tokas, Amish Mehta, Yasser Gamil Elnagar, Thomas Herrmann, Zijie Chai, Ng Chi-Fai, Nariman Gadzhiev, Azizbek Shomarufov, Bhaskar Somani, Bohan Wang, Alexey Martov, Tianyu Li, Zelimkhan Tokhtiev, Abdul Haseeb, Luca Boeri, Lazaros Tzelves, Yash Pamecha, Lin Xiong, Deepak Ragoori, Vineet Gauhar, Amelia Pietropaolo, Lim Tze Ying Benjamin, William Lay Keat Ong, Gunal Ozgur, Sohani Dassanayake, Giorgio Mazzon, Jaisukh Kalathia
article en

Abstract

PURPOSE: This registry aimed to establish a comprehensive global database to characterise contemporary real-world surgical approaches to bladder stones and to describe postoperative stone-free rate (SFR) and complications according to the surgical treatment route. METHODS: The BLAST (Bladder Lithiasis Assessment of Surgical Treatment) registry prospectively enrolled 805 patients across 31 centres in 16 countries between May 2025 and February 2026. Patients underwent transurethral intervention (TI, n = 741), percutaneous suprapubic (PSI, n = 39), or open surgery (OI, n = 25). Postoperative SFR was graded using cross-sectional computer tomography, or ultrasonography, X-ray, or flexible cystoscopy, as Grade A (100% complete clearance), Grade B (single residual fragment), Grade C (multiple residual fragments). Perioperative complications were classified by the Clavien-Dindo criteria. RESULTS: The cohort was predominantly male across all groups. TI patients were older (median 66 vs 60 and 59 years; p = 0.023) and presented with smaller stones (median 2.1 vs 3.0 cm in both other groups; p < 0.001). A history of urinary tract reconstruction was markedly more prevalent in the PSI cohort (23.1% vs 3.5% and 4.0%; p < 0.001). Median hospital stay was significantly shorter following TI (2 vs 3 days; p < 0.001), accompanied by a shorter duration of catheterisation (p < 0.001). Early complications within 48 h were most frequent after OI (48.0% vs 18.6% and 17.9%; p = 0.001), although major complications (Clavien-Dindo ≥ 3) remained rare and comparable across all modalities. No mortality was recorded. Grade A SFR was achieved in 95.5% of TI, 84.6% of PSI, and 100% of OI (p = 0.001). Reintervention for residual fragments was required significantly more often following PSI (10.3% vs 1.3% and 0%; p < 0.001). CONCLUSION: Transurethral cystolithotripsy was the predominant approach in this real-world international cohort and was associated with high stone clearance and shorter postoperative recovery. Percutaneous and open approaches were selectively used in patients with larger stone burdens, complex anatomy, prior urinary tract reconstruction, or specific urethral limitations. These findings describe contemporary treatment patterns and observed outcomes rather than comparative treatment effectiveness.

World Journal of UrologyVol. 44(1)
University of Foggia (IT), University College Hospital (GB), University of Crete (GR), St Petersburg University (RU), Chinese University of Hong Kong (HK), National and Kapodistrian University of Athens (GR), Singapore General Hospital (SG), European Association of Urology (NL), Hayatabad Medical Complex (PK), XinHua Hospital (CN), Ng Teng Fong General Hospital (SG), University Hospital Southampton NHS Foundation Trust (GB), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Ospedali Riuniti di Foggia (IT), Central Asian University (UZ), First Affiliated Hospital of Guangzhou Medical University (CN), Azienda Ospedaliero Universitaria Ospedali Riuniti (IT), Marmara Üniversitesi Eğitim ve Araştırma Hastanesi (TR), Hospital Nossa Senhora das Graças (BR), University Hospital Schleswig-Holstein (DE), Hospital Clínic de Barcelona (ES), Gujarat Kidney Foundation (IN), First Affiliated Hospital of GuangXi Medical University (CN), LUM Jean Monnet University (IT), University Hospital of Heraklion (GR), University of Hong Kong - Shenzhen Hospital (CN), Ospedale Generale Regionale Francesco Miulli (IT), State Scientific Center of the Russian Federation - Federal Medical Biophysical Center named after A.I. Burnazyan (RU), Hospital Sultanah Bahiyah (MY), Asklepios Klinik Barmbek (DE), Second Affiliated Hospital of Zhejiang University (CN), Sengkang General Hospital (SG), Tashkent Pediatric Medical Institute (UZ), Kantonsspital Frauenfeld (CH), University College London (GB), Westminster International University in Tashkent (UZ), Federal Medical-Biological Agency (RU), Universitat de Barcelona (ES), Marmara University (TR), Kasturba Medical College, Manipal (IN), Aswan University (EG), University of Hong Kong (HK), Guangzhou Medical University (CN), Gazi University (TR)
Openalex Percentile: Top 14%
Kidney Stones and Urolithiasis Treatments
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.