Top 5 benign urology headlines you missed in August 2025

The month of August contained a plethora of noteworthy research and expert perspective across benign conditions in urology. This included an exclusive case report of a single-stage transvaginal repair of erosion of ring pessary with bladder rupture and complete eversion, a report on vaginal estrogen tablets and recurrent ischemic stroke, a recap of studies comparing surgical procedures for pediatric kidney stones, and more.

Here, we collect 5 key articles and videos in the field of benign urology from August 2025. Click the headlines to access the full article/video.

1. Erosion of ring pessary with bladder rupture and complete eversion: A report of successful single-stage transvaginal repair

In this case report, E. Mackenzie Gibbs, MD, and Charles Lloyd Secrest, MD, outline what they write is the first documented instance of complete bladder eversion and prolapse due to ring pessary erosion, successfully repaired in a single-stage transvaginal procedure.

“Major complications of ring pessaries are rare but present considerable challenges to surgeons and patients when they do occur. We present favorable outcomes associated with a severe ring pessary erosion and bladder rupture using a single-stage transvaginal approach,” write Gibbs and Secrest.

2. Vaginal estrogen tablets not linked with increased risk of recurrent ischemic stroke

A Danish nationwide nested case-control study published in Stroke found that use of vaginal estradiol tablets was not associated with an increased risk of recurrent ischemic stroke in postmenopausal women with prior stroke. Among more than 34,000 women, current, recent, and past use of vaginal estradiol showed no significant difference in recurrent stroke risk compared with nonuse, regardless of dose or cumulative exposure. Investigators emphasize that the therapy may improve quality of life for symptomatic women without increasing cerebrovascular risk.

3. PKIDS studies compare outcomes between surgical procedures for pediatric kidney stones

Investigators for the Pediatric KIDney Stone (PKIDS) trial, the largest comparative effectiveness study of pediatric stone surgery, reported primary outcomes in JAMA Network Open. In one study, percutaneous nephrolithotomy (PCNL) and ureteroscopy achieved similar overall stone clearance, but PCNL provided superior clearance for stones larger than 15 mm and was associated with better short-term patient-reported outcomes, including less pain and fewer urinary symptoms. A second study found no significant difference in stone clearance between ureteroscopy and shockwave lithotripsy, though shockwave patients reported faster recovery, less pain, and reduced school and work disruption. Together, these findings challenge the dominance of ureteroscopy in pediatric practice and suggest opportunities to tailor treatment based on stone size and patient-centered outcomes.

4. Robert Jansen, MD, on rethinking testosterone management

In this video, Robert Jansen, MD, a urologist with Atlantic Urology Specialists in South Carolina, discusses the evolving role of urologists in managing men’s hormonal health, particularly in relation to testosterone therapy. He emphasizes a major shift in understanding testosterone’s broader impact—not just on sexual function but also on prostate cancer, longevity, cardiovascular health, and overall well-being. Jansen highlights that testosterone deficiency is also associated with reduced muscle mass, lower grip strength, and increased fall risk in older men, all of which impact longevity and quality of life.

5. Pearls & Perspectives: Treating Male Pelvic Floor Dysfunction, with Adam Gvili, PT, DPT

In this episode of Pearls & Perspectives, Amy Pearlman, MD, speaks with Adam Gvili, PT, DPT, a pelvic floor physical therapist and founder of Pelvis NYC, about his personal and professional journey in treating male pelvic floor dysfunction.

A major theme of the discussion is the disconnect between urologists and pelvic floor therapists. Both agree that collaboration is essential: urologists should rule out infection, strictures, or anatomic abnormalities, whereas physical therapists help address musculoskeletal and functional issues. Gvili emphasizes that many patients feel dismissed or “gaslit” when their symptoms don’t show up on standard tests, which underscores the need for compassionate listening and validation.