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Nomogram predicts bladder stone risk in BPH patients after prostate resection

Nomogram predicts bladder stone risk in BPH patients after prostate resection
Photo by Cht Gsml / Unsplash
Key Takeaway
Consider this internally validated nomogram for bladder stone risk stratification in BPH patients post-resection.

This retrospective cohort study (2023–2025) developed and validated a nomogram to predict bladder stone risk in 446 patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate. The model was trained on 70% of the sample and validated on the remaining 30%.

The nomogram demonstrated excellent discrimination, with an AUC of 0.865 in the training set and 0.882 in the validation set. Among the cohort, 106 patients had bladder stones and 340 did not. Calibration was good, with a Hosmer-Lemeshow test p > 0.05.

Safety and tolerability were not reported. Key limitations include the retrospective, single-center design and the use of only internal validation. The model's performance in external populations is unknown.

The nomogram may serve as a reliable tool for clinicians to guide personalized monitoring and prevention of bladder stones in BPH patients, but it does not establish causation. Practice relevance is limited to risk stratification within this specific cohort.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
PurposeThe aim of this study is to identify independent risk factors for bladder stones in patients with benign prostatic hyperplasia (BPH), and to develop and validate a nomogram prediction model for assessing the risk of bladder stones in this patient population.MethodsRetrospective analysis included 446 BPH patients (106 with bladder stones, 340 without) who underwent transurethral resection of the prostate (2023–2025). Univariate ROC (receiver operating characteristic), correlation analysis, LASSO regression, and multivariate logistic regression were used for variable screening and model construction. The cohort was split into training (70%) and validation (30%) sets. Model performance was evaluated via AUC (discrimination), calibration curves, Hosmer-Lemeshow test (calibration), and DCA (clinical utility).ResultsSeven independent risk factors were identified: age, IPSS (International Prostate Symptom Score), serum uric acid, IPP (intravesical prostatic protrusion), PUA (prostatic urethral angle), TPV (total prostate volume), and urinary red blood cell count. The nomogram showed excellent discrimination (AUC: 0.865 in training set, 0.882 in validation set), good calibration (p > 0.05), and robust clinical utility.ConclusionThe nomogram overcomes univariate and multicollinearity limitations, enabling precise individualized risk assessment of bladder stones in BPH patients. It serves as a reliable tool for clinicians to guide personalized monitoring and prevention, potentially reducing incidence and healthcare burdens.
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