ESPU Meeting on Wednesday 17, June 2026, 16:50 - 17:50
16:50 - 16:54
S04-1 (BSP)
Chandramouli GOSWAMI and Minu BAJPAI
All India Institute of Medical Sciences, New Delhi, Pediatric Surgery, New Delhi, INDIA
PURPOSE
Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) contribute substantially to childhood chronic kidney disease (CKD), often progressing silently due to compensatory nephron hypertrophy. Early detection of subtle tubular stress—before irreversible nephron loss—remains a critical gap in pediatric nephrology. Nano-biosensing offer unprecedented sensitivity for early biomarker detection. NGAL, TFF-3 and Cystatin-C are validated early markers of tubular injury, but current assays lack point-of-care precision at ultra-low concentrations. The study aimed to design, develop and validate a multimodal nano-impedance biosensor capable of ultra-sensitive electrical and optical detection of NGAL, TFF-3 and Cystatin-C in pediatric CAKUT.
MATERIAL AND METHODS
A hybrid nanocomposite was engineered using Ni-porphyrin nanosheets, Au@Si core-shell nanoparticles, and a peptide-bond-based antibody-immobilization strategy (APTES-EDC/NHS). Ni-TPP sheets were synthesized via hydrothermal reaction; Au-Si nanostructures were obtained using a modified Stöber reduction. The composite architecture enhanced electrochemical charge transfer and optical quenching. Clinical samples included children with CAKUT (PUJO, PUV, VUR) and age-matched controls. All subjects underwent standardized clinical workup including GFR, DMSA and RDS assessment. Electrochemical output was quantified using cyclic voltammetry (CV) and differential pulse voltammetry (DPV), while optical detection was performed using fluorescence quenching on the immobilized nanocomposite.
RESULTS
Among 20 CAKUT patients and 20 controls, urinary biomarkers were markedly higher in CAKUT (NGAL: 180 vs 12 ng/mL; TFF-3: 140 vs 18 ng/mL; Cystatin-C: 380 vs 25 ng/mL). DPV showed reduced current after antigen binding, and CV demonstrated clear concentration-dependent shifts. Strong ELISA correlations were observed (NGAL r=0.91, TFF-3 r=0.87, Cystatin-C r=0.89) with LODs of 5-10, 10-20 and 20-50 ng/mL respectively. Optical quenching showed excellent linearity (R²: 0.98-0.93). Diagnostic performance was high, with ROC-AUCs of 0.96 (NGAL), 0.93 (TFF-3) and 0.91 (Cystatin-C), and sensitivities of 95-88% and specificities of 90-82%.
CONCLUSIONS
This study demonstrates the feasibility of a biologically-inspired multimodal nano-biosensor capable of ultra-sensitive detection of early urinary biomarkers in CAKUT. The integrated electrical-optical platform represents a promising step toward rapid, point-of-care pediatric nephrology diagnostics and may enable earlier intervention in the CKD life-course trajectory.
16:54 - 16:58
S04-2 (BSP)
Jupiter SIBARANI
UNIVERSITAS PADJADJARAN, Urology, Bandung, INDONESIA
PURPOSE
Prolonged obstruction in UPJO would lead to kidney damage. It is important to find a non-invasive biomarker for early detection of renal damage so we can initiate an operative treatment for UPJO as early as possible. Cytochrome c is best known as an indicator of cell death burden in any organ or tissue. It is released during mitochondrial damage that is associated with the processing of apoptosis. In the molecular mechanism of apoptosis, cysteinyl aspartate-specific proteinases (caspases) have a key role. The objective of this study is to evaluate the role of urinary cytochrome c and caspase-3 as a novel biomarker of early kidney damage in an UPJO model of Wistar rats.
MATERIAL AND METHODS
We conducted an experimental randomize control trial on Wistar rats. Twenty-five male Wistar rats were separated into 3 groups. Group I consists of 5 rats without any treatment or model, group II consists of 5 rats (sham group), and group III consists of 15 rats with the unilateral partial ureteropelvic junction obstruction model. After 4, 15, and 21 days of observation, the urine was collected be analyzed for the level of cytochrome c and caspase-3, and then rats were sacrificed to count the remain glomerular number in the kidney under light microscope.
RESULTS
Cytochrome c and caspase-3 concentrations were increased significantly in the UPJO group compared to the control group and sham group. The normal glomerular count decreased as the cytochrome c concentration and caspase-3 concentration increased. There was a significant relationship between the decrease in glomerulus count with the increase in the concentration of cytochrome c and caspase-3 in the UPJO group.
CONCLUSIONS
Increased urinary caspase-3 and cytochrome c in UPJO condition could be a promising biomarker for establishing the diagnosis of early kidney damage and justify early surgical correction in UPJO.
16:58 - 17:02
S04-3 (BSP)
Pooja SINGH 1, Sampreeti MUKHERJEE 1, Himalaya KUMAR 1, Kalpana LUTHRA 2, Ajay VERMA 1, Sandeep AGARWALA 3 and Sachit ANAND 1
1) All India Institute of Medical Sciences, Department of Pediatric Surgery, New Delhi, INDIA - 2) All India Institute of Medical Sciences, Department of Biochemistry, New Delhi, INDIA - 3) All India Institute of Medical Sciences, New Delhi, Department of Pediatric Surgery, New Delhi, INDIA
PURPOSE
This study investigates how Vitamin D-binding protein (VDBP) gene polymorphisms and Vitamin D (vitD) levels influence the disease phenotype and UTI risk in children with congenital anomalies of the kidney and urinary tract (CAKUT).
MATERIAL AND METHODS
102 children with CAKUT and 204 controls were enrolled. Two GC polymorphisms (rs4588 & rs7041) were genotyped using PCR-RFLP and validated by Sanger sequencing. Serum vitD levels were measured using chemiluminescence immunoassay. CAKUT patients were prospectively followed to document UTI occurrence. Associations between GC genotypes, vitD status, and CAKUT or its different phenotypes (PUV, PUJO, VUR) were analyzed statistically. The effect of GC genotypes and vitD on UTI risk in CAKUT was assessed. All regression analyses were adjusted for age, sex, season, and ethnicity.
RESULTS
GC rs7041, rs4588, or diplotypes frequency did not differ significantly between CAKUT vs. controls. However, rs4588 C allele and GC 1F were significantly associated with obstructive CAKUT (p<0.05). Adjusted mean serum VitD levels were higher in CAKUT compared to controls (18.35 vs 15.25 ng/mL; p<0.05). Genotype-stratified analysis showed that CAKUT patients carrying GC 1S/1S, rs7041 GG, or rs4588 CC genotypes had higher VitD levels than controls (p<0.05). VitD status had no significant association with UTI occurrence or the number of UTIs during follow-up in CAKUT. Among GC genotypes, rs7041 GG was significantly associated with the occurrence of UTI in CAKUT children [hazard ratio 2.45; 95%CI: 1.03-5.85; p<0.05].
CONCLUSIONS
GC polymorphisms were not associated with overall CAKUT risk but showed distinct phenotype-specific associations. Higher vitD levels in CAKUT, particularly in specific GC genotypes, may reflect VDBP-related differences in binding affinity affecting total vs. free vitD. The association of rs7041 GG with UTI occurrence indicates immunological functions of VDBP. Larger studies are warranted to validate these observations.
17:12 - 17:16
S04-4 (BSP)
Sang Hoon SONG 1, Sang Min LEE 1, Junghoon LEE 1, Hwan Yeul YU 2, Jisun LIM 3, Seungun LEE 4 and Dong-Myung SHIN 5
1) Asan Medical Center, University of Ulsan College of Medicine, Department of Urology, Seoul, REPUBLIC OF KOREA - 2) UroGyn Efficacy Evaluation Center, Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, REPUBLIC OF KOREA - 3) Cell Therapy Lab, PHARMICELL, Seoul, Korea., Seoul, REPUBLIC OF KOREA - 4) Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea., Department of Cell and Genetic Engineering, Brain Korea 21 project,, Seoul, REPUBLIC OF KOREA - 5) Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea., Department of Cell and Genetic Engineering, Brain Korea 21 project, Seoul, REPUBLIC OF KOREA
PURPOSE
In an obstructive nephropathy animal model, we aimed to evaluate the efficacy of a multifunctional, primed mesenchymal stem cell (MP-MSC) transplantation and to analyze biological changes associated with MP-MSC treatment to elucidate its mechanism of action.
MATERIAL AND METHODS
A unilateral ureteral obstruction (UUO) model was established in Sprague-Dawley rats using a 0.45 mm stainless steel wire fixed with 8-0 nylon sutures. Sham controls underwent the same procedure without obstruction. Two weeks later, Naïve-MSCs or MP-MSCs (1×10⁶ cells/200 μL) were administered via tail vein, with PBS injected in sham and UUO groups. After one week, kidneys were harvested for histological analysis, and blood and 24-hour urine samples were collected. Kidney tissues were stained with H&E, Masson's Trichrome, and Sirius Red to assess injury and fibrosis. Urinary KIM-1 and NGAL, serum creatinine and BUN were measured to evaluate renal injury and function.
RESULTS
MP-MSC treatment significantly reduced relative kidney weight compared to the UUO group, indicating attenuation of kidney hypertrophy. Histological analysis revealed that MP-MSC restored glomerular counts and markedly reduced collagen deposition, as shown by H&E, Masson's Trichrome, and Sirius Red staining, compared to Naïve-MSC and UUO groups. Furthermore, urinary KIM-1 and NGAL levels were significantly lower in the MP-MSC group, suggesting improved renal tubular protection. Serum BUN and creatinine levels remained stable across all groups. Overall, MP-MSC demonstrated superior therapeutic efficacy in reducing fibrosis and improving renal injury compared to Naïve-MSC in UUO rats.
CONCLUSIONS
MP-MSC treatment effectively attenuates renal fibrosis, preserves glomerular structure, and improves renal function in a UUO model. These findings suggest that MP-MSC has superior therapeutic potential over conventional MSCs and may serve as a promising cell-based therapy for obstructive nephropathy.
17:16 - 17:20
S04-5 (BSP)
Nao IGUCHI 1, Ali TEIMOURI 1, Anna MALYKHINA 1, Duncan WILCOX 2 and Nicholas COST 2
1) University of Colorado SOM, Surgery, Aurora, USA - 2) Children's Hospital Colorado, Surgery, Aurora, USA
PURPOSE
This study aimed to evaluate whether systemic doxorubicin (DOX) exposure during childhood causes persistent lower urinary tract (LUT) dysfunction and to explore sex-specific differences using a juvenile murine model. DOX, a widely used pediatric chemotherapeutic, is known for late cardiac and skeletal muscle toxicity, yet its long-term impact on LUT function remains unclear despite clinical reports of increased LUT symptoms among survivors.
MATERIAL AND METHODS
Juvenile male and female mice received weekly systemic DOX (3 mg/kg) or saline (control) for six cycles and were assessed at 1 and 3 months post-treatment. Assessments included body and bladder weights, cystometry, histology, transcriptomic analysis and in vitro detrusor contractility.
RESULTS
DOX-treated mice showed persistent growth suppression in both sexes (p< 0.005). Bladder weight and histology were largely preserved; however, functional and physiological alterations were sex-divergent. At 1 month, females exhibited reduced bladder capacity (−16%), and markedly diminished contractile responses to electric field stimulation, carbachol, and purinergic agonists by up to 40% (p< 0.05) ex vivo. These deficits persisted at 3 months. These results indicate that DOX induced persistent, generalized detrusor weakness in females. In contrast, males demonstrated increased peak intravesical pressure (+22%) and non-voiding contractions (+150%) contractions, suggesting bladder overactivity with no significant impairment in bladder strip contractility. Molecular profiling revealed female-specific downregulation of the T-type calcium channel gene Cacna1g and upregulation of the two-pore domain potassium channel gene Kcnk2, suggesting altered excitability and contractile signaling. No comparable transcriptional shifts were detected in males.
CONCLUSIONS
Childhood DOX exposure induces long-lasting, sex-specific LUT dysfunction. Females appear prone to detrusor weakness, while males show signs of bladder hyperactivity. The female-specific decline of Cacna1g and induction of Kcnk2 implicates ion channel remodeling as a mechanistic contributor to impaired bladder contractility. Our preliminary clinical data from a cohort of female breast cancer patients in the All of Us Research Program showed increased odds of LUT dysfunction with DOX exposure (OR = 2.74; p < 0.001), supporting the translational relevance of these findings. Together, these results highlight the need for sex-aware surveillance and suggest calcium and potassium channel pathways as potential therapeutic targets to mitigate LUT complications in cancer survivors.
17:27 - 17:31
S04-6 (BSP)
Mingming YU 1, Yiqing LYU 2, Yichen HUANG 2, Yu DING 2 and Fang CHEN 2
1) Shanghai Children's Hospital, Urology, Shanghai, CHINA - 2) Children's Hospital of Shanghai, Department of Urology, Shanghai, CHINA
PURPOSE
Urethral reconstruction is frequently complicated by impaired healing, fibrosis, and stricture formation, necessitating innovative strategies to enhance tissue repair. Here, we developed a wearable low-intensity pulsed ultrasound (LIPUS) device tailored for penile anatomy to address post-surgical complications.
MATERIAL AND METHODS
A flexible and biocompatible LIPUS device adapted to penile anatomy was developed, which contains adjustable transducer arrays. A rabbit model of full-thickness urethral reconstruction was established, with LIPUS treatment group and control group set up. Local LIPUS stimulation was applied postoperatively. Histological examination, multi-omics analysis, and single-cell RNA sequencing were used to evaluate indicators such as angiogenesis and fibrosis, and to explore the related pathways and cellular effects.
RESULTS
The device features a flexible, biocompatible patch with adjustable transducer arrays, enabling conformal application and localized stimulation. In a rabbit model of full-thickness urethral reconstruction, LIPUS treatment significantly enhanced angiogenesis, reduced fibrosis, and improved collagen composition. Multi-omics analyses revealed upregulation of growth factors (GFs) and activation of HIF-1 and PI3K-Akt pathways. Single-cell RNA sequencing identified a mechanoresponsive FGF10+ fibroblast subpopulation that mediated pro-regenerative signaling via FGF10-FGFR2 interactions with mural cells. Further analyses demonstrated that LIPUS promoted fibroblast differentiation through activating Wnt pathway, driving phenotypic transitions critical for tissue remodeling.
CONCLUSIONS
This study establishes a non-invasive, patient-friendly therapeutic approach for urethral repair and elucidates mechanobiological mechanisms underlying ultrasound-mediated regeneration, offering translational potential for improving surgical outcomes in urology.
17:31 - 17:35
S04-7 (BSP)
David KEENE 1, Ahmed HASSAN 1, Nikolai JUUL 2, Tamas CSERNI 3, William COWEY 4, John STONE 4, James FILDES 4 and Magdalena FOSSUM 5
1) Royal Manchester Children's Hospital, Paediatric Urology, Manchester, UNITED KINGDOM - 2) Copenhagan University Hospital, Division of Paediatric Surgery, Copenhagen, DENMARK - 3) Royal Manchester Children's Hospital, Department of Paediatric Urology, Manchester, UNITED KINGDOM - 4) Pebble Institute, Pebble Biotechnology Laboratories, Manchester, UNITED KINGDOM - 5) Copenhagen and Karolinska Institutet, Department of Women's and Children's Health, Stockholm, SWEDEN
PURPOSE
Use of decellularized tissue in paediatric surgery has been described, however graft contracture remains an issue despite omental pre-vascularisation (Keene et al. PSI 2024;40(1):308). We aimed to assess a new technique to pre-vascularisation the inside and outside of the porcine acellular bladder matrix (PABM) prior to use in bladder augmentation.
MATERIAL AND METHODS
Four large white domestic pigs underwent hemicystectomy and bladder augmentation using PABM prepared using dynamic detergent–enzymatic treatment (Garriboli et al,PSI 2022;38:665–67). Bladder detrusor muscle micrografts were added to the PABM (Juul et al.Sci.Rep 2023;13:15584).
Three stages were performed each 8-10 weeks apart:
Stage 1 – Prevascularisation; In both groups PABM was sutured around a tissue expanding device, sutured in the pelvis next to the hemicystectomised bladder. 2 pigs (Group A) had omentum wrapped externally, 2 pigs had combined peritoneal flaps internally and omentum wrapped externally (Group B). Bladder detrusor muscle micrografts were added to the outside of the bladder prior to wrapping in omentum.
Stage 2 – Augmentation and bladder augmentation performed using the pre-vascularized PABM.
Stage 3 –Euthanasia; Analysis of the neo-bladders macroscopically for size, laser speckle for blood flow and histologically.
RESULTS
Group A had complications (animal 1 had abdominal wall herniation therefore sacrificed early at 15 weeks, animal 2 passed the majority of the PABM patch urethrally).
Group B bladder patches were well vascularised at stage 2 but dusky in group A.
At stage 3 graft shrinkage was observed in group A, whereas bladder patch sizes were well maintained in group B. Histology showed the Group B grafts resembled phenotypic full walled bladder with positive staining for cytokeratin and smooth muscle actin.
Table 1: comparison of 2 groups
|
Parameter |
Group A (Omental) |
Group B (Combined) |
|
Identity porcine subjects |
1,2 |
3,4 |
|
Prevascularisation |
Omentum (outside) |
Omentum (outside) |
|
Complications |
Abdominal wall herniation, early sacrifice week 3 (1) |
None |
|
Laser speckle stage 3 |
Poor vascularity |
Good vascularity |
|
Macroscopic size(cm2) |
15/30 |
60/100 |
|
Histology H&E |
Inflammatory cells |
Phenotypically resembled normal bladder wall |
|
Immunostains |
No positive staining |
CK & SMA positive staining |
CONCLUSIONS
Pre-vascularization with both omental wrap externally and peritoneal flap internally allows large PABM patches to integrate, develop a urothelial lining with smooth muscle in the matrix. This technique is promising reducing complications and graft contracture and merits further study to demonstrate reproducibility.
17:35 - 17:39
S04-8 (BSP)
Zhongzhong CHEN 1, Yijing CHEN 2, Jielong HUANG 2, Yingliu LUO 3, Can AN 2, Cheng SU 4 and Lingqian WU 3
1) Guangzhou Women and Children's Medical Center, Department of Urology, Shanghai, CHINA - 2) Guangzhou Women and Children's Medical Center, Guangzhou, CHINA - 3) Central South University, School of Life Sciences, Changsha, CHINA - 4) The First Affiliated Hospital of Guangxi Medical University, Department of Pediatric Surgery, Nanning, CHINA
PURPOSE
Hypospadias displays marked clinical heterogeneity and variable surgical outcomes. Although Sex Development (DSD) targeted gene panels have advanced our understanding of masculinization, their diagnostic yield remains low (~5.5%), and the genetic determinants of phenotypic heterogeneity remain poorly defined. We hypothesized that differential perturbation of androgen receptor (AR)–regulated subnetworks contributes to this variability.
MATERIAL AND METHODS
We performed whole‑exome sequencing in 100 unrelated patients with hypospadias spanning variable clinical outcomes. Variants in DSD‑targeted genes were annotated and grouped by predicted effect size, including LoF (frameshift, splice-site variant, start-loss, or stop-loss variants), and missense. The Missense variants were considered damaging only if predicted deleterious by both SIFT and PolyPhen‑2. Integrated with reported data, associations between gene‑/effect‑specific variant burden and anatomical subtype were tested, comparing posterior versus non‑posterior (anterior/midshaft) hypospadias.
RESULTS
AR, NR5A1 and SRD5A2 emerged as mutational hotspots in hypospadias. Among the DSD‑targeted genes, variants with larger effect size (LoF and damaging missense) in AR and NR5A1 were enriched in posterior hypospadias (p < 0.05), whereas protein‑altering variants in SRD5A2 and HSD17B3 was enriched in both posterior and non‑posterior hypospadias (p < 0.05). Network mapping indicated that both posterior and non‑posterior forms converge on an AR‑centric regulatory framework, but engage distinct AR‑regulated subnetworks, receptor/co‑regulator signaling versus steroidogenesis, thereby driving phenotypic divergence.
CONCLUSIONS
These data support hypospadias as an AR dosage‑dependent, network‑driven condition. Partitioning genetic risk across AR‑regulated subnetworks explains key aspects of clinical heterogeneity and refines the current genetic etiology, laying the groundwork for molecular stratification and tailored management.