Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.12.012
Devin Boehm, Ziho Lee
{"title":"Reply to Editorial Comment on “Development of a Patient-reported Outcome Measure for Patients With Ureteral Stricture Disease”","authors":"Devin Boehm, Ziho Lee","doi":"10.1016/j.urology.2024.12.012","DOIUrl":"10.1016/j.urology.2024.12.012","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 281-282"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.11.035
Jill S. Patel, Joseph Y. Clark
{"title":"Editorial Comment on “Development of a Patient-reported Outcome Measure for Patients With Ureteral Stricture Disease”","authors":"Jill S. Patel, Joseph Y. Clark","doi":"10.1016/j.urology.2024.11.035","DOIUrl":"10.1016/j.urology.2024.11.035","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 279-280"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.11.022
Kristin Chrouser , Jessica Ameling , Jennifer Meddings
{"title":"Reply to Letter to the Editor on “Use of Catheterization Algorithms to Manage Acute Urinary Retention: What is the Evidence?”","authors":"Kristin Chrouser , Jessica Ameling , Jennifer Meddings","doi":"10.1016/j.urology.2024.11.022","DOIUrl":"10.1016/j.urology.2024.11.022","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Page 345"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.12.023
Reynaldo G. Gómez
{"title":"Reply to Editorial Comment on “Vessel Sparing Nontransecting Anastomotic Reconstruction of the Posterior Urethra: Single-center Experience With Long-term Follow-up”","authors":"Reynaldo G. Gómez","doi":"10.1016/j.urology.2024.12.023","DOIUrl":"10.1016/j.urology.2024.12.023","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 292-293"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.09.025
Eric Qualkenbush , Alan G. Perry , Neal Kumar , Colleen S. Thomas , Raymond W. Pak , Sij Hemal , Ram A. Pathak
Objective
To determine the utility of a virtual reality (VR) model constructed using patient-derived clinical imaging to improve patient understanding of localized prostate cancer (PCa) diagnosis and surgical plan.
Methods
Patients undergoing robotic radical prostatectomy were selected and demographic data recorded. Patients completed a questionnaire to assess baseline knowledge of their diagnosis after consultation and shared-decision making with their surgeon. A trained non-clinical staff member then guided the patient through a VR experience to view patient-specific anatomy in a 3-dimensional space. Patients then completed the same questionnaire, followed by an additional post-VR questionnaire evaluating patient satisfaction. Questions 1-7 (patient understanding of prostate cancer and treatment plan) and 11-17 (patient opinion of VR) used a standard Likert scale and Questions 8-10 were multiple choice with 1 correct answer.
Results
In total, 15 patients were included with an average age of 64.1 years. 6 of 7 questions showed an improvement after VR (P <.001). The percentage of correct responses on Questions 8-10 was higher after VR but not statistically significant (P >.13). Mean responses range from 4.3 to 4.8 (Likert scale, 1 through 5) for the post-VR questionnaire, with a mean total of 31.9 out of 35.
Conclusion
This small preliminary investigation of a novel technology to improve the patient experience showed potential as an adjunct to traditional patient counseling. However, due the small sample size and study design, further research is needed to determine the value VR adds to prostate cancer surgical counseling.
{"title":"Virtual Reality as an Adjunct to Traditional Patient Counseling in Patients With Newly Diagnosed Localized Prostate Cancer","authors":"Eric Qualkenbush , Alan G. Perry , Neal Kumar , Colleen S. Thomas , Raymond W. Pak , Sij Hemal , Ram A. Pathak","doi":"10.1016/j.urology.2024.09.025","DOIUrl":"10.1016/j.urology.2024.09.025","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the utility of a virtual reality (VR) model constructed using patient-derived clinical imaging to improve patient understanding of localized prostate cancer (PCa) diagnosis and surgical plan.</div></div><div><h3>Methods</h3><div>Patients undergoing robotic radical prostatectomy were selected and demographic data recorded. Patients completed a questionnaire to assess baseline knowledge of their diagnosis after consultation and shared-decision making with their surgeon. A trained non-clinical staff member then guided the patient through a VR experience to view patient-specific anatomy in a 3-dimensional space. Patients then completed the same questionnaire, followed by an additional post-VR questionnaire evaluating patient satisfaction. Questions 1-7 (patient understanding of prostate cancer and treatment plan) and 11-17 (patient opinion of VR) used a standard Likert scale and Questions 8-10 were multiple choice with 1 correct answer.</div></div><div><h3>Results</h3><div>In total, 15 patients were included with an average age of 64.1 years. 6 of 7 questions showed an improvement after VR (<em>P</em> <.001). The percentage of correct responses on Questions 8-10 was higher after VR but not statistically significant (<em>P</em> >.13). Mean responses range from 4.3 to 4.8 (Likert scale, 1 through 5) for the post-VR questionnaire, with a mean total of 31.9 out of 35.</div></div><div><h3>Conclusion</h3><div>This small preliminary investigation of a novel technology to improve the patient experience showed potential as an adjunct to traditional patient counseling. However, due the small sample size and study design, further research is needed to determine the value VR adds to prostate cancer surgical counseling.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.11.027
Erman Ceyhan , Mehmet Vehbi Kayra , Eylem Gul Ates , Yalcın Kizilkan , Mesut Altan , Omer Yildirim , Mehmet Hamza Gultekin , Nebil Akdogan , Eray Hasirci , Tufan Cicek , Iyimser Ure , Cem Sah , Aykut Baser , Umit Gul , Hamdi Ozkara , Kadir Emre Akkus , Tahsin Turunc , Andrology Working Group of the Society of Urological Surgery in Turkey
{"title":"Reply to Editorial Comment on “A Nomogram Predicting Testicular Sperm Extraction Success in Men With Non-Obstructive Azoospermia: A Multi-Center Study”","authors":"Erman Ceyhan , Mehmet Vehbi Kayra , Eylem Gul Ates , Yalcın Kizilkan , Mesut Altan , Omer Yildirim , Mehmet Hamza Gultekin , Nebil Akdogan , Eray Hasirci , Tufan Cicek , Iyimser Ure , Cem Sah , Aykut Baser , Umit Gul , Hamdi Ozkara , Kadir Emre Akkus , Tahsin Turunc , Andrology Working Group of the Society of Urological Surgery in Turkey","doi":"10.1016/j.urology.2024.11.027","DOIUrl":"10.1016/j.urology.2024.11.027","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 163-164"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.11.069
Rahul Janak Sinha
{"title":"Editorial Comment on “Integrating a Virtual Reality Mask in Functional Urological Surgeries Under Local Anaesthesia: A Prospective Cohort Study on Utility and Satisfaction”","authors":"Rahul Janak Sinha","doi":"10.1016/j.urology.2024.11.069","DOIUrl":"10.1016/j.urology.2024.11.069","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 100-101"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.10.003
Ryan J. Davis , Marissa Maas , David Ginsberg , Jay Simhan , Jeffrey Loh-Doyle
Objective
To assess risk of persistent opioid use and emergency department (ED) and office/outpatient visits following post-operative prescriptions of common opioids in patients following artificial urinary sphincter (AUS) implantation using a nationwide claims database.
Methods
The TriNetX US Collaborative Network, which encompasses over 115 million patients from 66 healthcare organizations was used to identify males who underwent first-time AUS placement between 2010-2024. Patients with history of opioid dependence/abuse, opioid use within 6 months prior to AUS placement, or surgery within 9 months post-operation were excluded. Patients were distributed into 2 cohorts: those who received opioids post-operatively or those that did not. Cohorts were propensity score matched on demographic characteristics, pain, mental health, and substance-related diagnoses. Primary outcome was risk of persistent opioid use 3-9 months post-operatively. Secondary outcomes included risk of ED or office/outpatient visit 30- and 90-days post-operatively.
Results
Each cohort contained 1036 patients following application of exclusion criteria and propensity score matching. Post-operative Oxycodone, Hydrocodone, or Codeine had a 3-fold increase in risk of persistent opioid use at 3-9 months (15.15% vs 4.92%, RR = 3.08, 95% CI = [2.27-4.17]). Risk of ED or office visits was not significantly lower in patients receiving these opioids.
Conclusion
Opioid prescriptions following AUS placement increase risk of persistent opioid use without lowering the risk of ED or outpatient visits. These findings highlight the necessity for opioid-sparing approaches to post-operative pain control following AUS placement.
目的利用全国性理赔数据库评估人工尿道括约肌（AUS）植入术后患者持续使用阿片类药物的风险以及术后开具常见阿片类药物处方后的急诊科（ED）和诊室/门诊就诊情况：方法：利用TriNetX美国协作网络（该网络涵盖66家医疗机构的1.15亿名患者）来识别2010-2024年间首次接受人工尿道括约肌置入术的男性患者。排除了有阿片类药物依赖/滥用史、在植入 AUS 前 6 个月内使用过阿片类药物或手术后 9 个月内接受过手术的患者。患者被分为两个组群：术后接受阿片类药物治疗的组群和未接受阿片类药物治疗的组群。两组患者在人口统计学特征、疼痛、心理健康和药物相关诊断方面进行了倾向性评分匹配。主要结果是术后 3-9 个月持续使用阿片类药物的风险。次要结果包括术后 30 天和 90 天的急诊室或诊室/门诊就诊风险：在应用排除标准和倾向评分匹配后，每个队列中有 1,036 名患者。术后使用羟考酮、氢可酮或可待因的患者在 3-9 个月内持续使用阿片类药物的风险增加了三倍（15.15% vs. 4.92%，RR=3.08，95% CI=[2.27-4.17]）。接受这些阿片类药物治疗的患者的急诊室或诊室就诊风险并没有明显降低：结论：放置 AUS 后开具阿片类药物处方会增加持续使用阿片类药物的风险，但不会降低急诊室或门诊就诊风险。这些发现凸显了在 AUS 置入术后使用阿片类药物控制疼痛的必要性。
{"title":"Persistent Opioid Use Following Artificial Urinary Sphincter Placement: A Large Claims Database Analysis","authors":"Ryan J. Davis , Marissa Maas , David Ginsberg , Jay Simhan , Jeffrey Loh-Doyle","doi":"10.1016/j.urology.2024.10.003","DOIUrl":"10.1016/j.urology.2024.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>To assess risk of persistent opioid use and emergency department (ED) and office/outpatient visits following post-operative prescriptions of common opioids in patients following artificial urinary sphincter (AUS) implantation using a nationwide claims database.</div></div><div><h3>Methods</h3><div>The TriNetX US Collaborative Network, which encompasses over 115 million patients from 66 healthcare organizations was used to identify males who underwent first-time AUS placement between 2010-2024. Patients with history of opioid dependence/abuse, opioid use within 6 months prior to AUS placement, or surgery within 9 months post-operation were excluded. Patients were distributed into 2 cohorts: those who received opioids post-operatively or those that did not. Cohorts were propensity score matched on demographic characteristics, pain, mental health, and substance-related diagnoses. Primary outcome was risk of persistent opioid use 3-9 months post-operatively. Secondary outcomes included risk of ED or office/outpatient visit 30- and 90-days post-operatively.</div></div><div><h3>Results</h3><div>Each cohort contained 1036 patients following application of exclusion criteria and propensity score matching. Post-operative Oxycodone, Hydrocodone, or Codeine had a 3-fold increase in risk of persistent opioid use at 3-9 months (15.15% vs 4.92%, RR<!--> <!-->=<!--> <!-->3.08, 95% CI<!--> <!-->=<!--> <!-->[2.27-4.17]). Risk of ED or office visits was not significantly lower in patients receiving these opioids.</div></div><div><h3>Conclusion</h3><div>Opioid prescriptions following AUS placement increase risk of persistent opioid use without lowering the risk of ED or outpatient visits. These findings highlight the necessity for opioid-sparing approaches to post-operative pain control following AUS placement.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 265-269"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.10.026
Enrico Checcucci , Matteo Bauckneht , Edoardo Cisero , Gabriele Volpi , Alessio Rizzo , Fabio Zattoni , Lorenzo Bianchi , Mario De Angelis , Danilo Cangemi , Joris Heetman , Andrea Farolfi , Federico Piramide , Sabrina De Cillis , Daniele Amparore , Stefano De Luca , Michele Di Dio , Fabrizio Dal Moro , Stefano Fanti , Riccardo Schiavina , Alberto Briganti , Francesco Porpiglia
Objective
To describe the initial experience with PSMA-PET/CT-guided biopsy in European referral centres.
Methods
This multicenter observational cohort study was endorsed by the Young Academic Urologist (YAU) Prostate Cancer Group of the EAU and conducted across 6 tertiary-level European centres. PSMA-guided biopsies were carried out in a cognitive/fusion manner for all the recruited patients with or without MRI-guided biopsies and/or standard biopsy (SB). PCa and clinical significant PCa (csPCA) detection rate (DR) at prostate biopsy was assessed. Uni- and multivariable models were employed to identify features related to csPCA.
Results
Overall, 72 patients were recruited. The topographic location of the dominant lesion depicted by PSMA PET/CT was significantly associated with the location of csPCa, especially in the biopsy naïve cohort. The DR for PCa and csPCa of PSMA-PET/CT-guided biopsies was significantly higher than SB (0.40 ± 0.43 vs 0.23 ± 0.29, and 0.36 ± 0.44 vs 0.21 ± 0.30, respectively, both P <.05) but did not surpass MRI-guided biopsies (0.40 ± 0.43 vs 0.47 ± 0.44, and 0.36 ± 0.44 vs 0.47 ± 0.34, respectively, both P >.05). PSMA-PET/CT-guided biopsy performed better in the biopsy naïve than in the repeated biopsy setting. A SUVmax cut-off value equal to 4.8 provided the best results for detecting csPCa.
Conclusion
Our real-world data illustrate the potentialities of PSMA-PET/CT-guided biopsy in diagnosing PCa. Specifically, in biopsy naïve patients with suspicion of high-risk disease, the use of PSMA-PET/CT-targeted biopsy can be considered. Additionally, in the context of repeated biopsies, a PSMA-PET/CT target biopsy might be advisable over the SB.
目的：描述欧洲转诊中心在PSMA-PET/CT引导下进行活检的初步经验：这项多中心观察性队列研究得到了欧洲泌尿外科联盟（EAU）青年泌尿外科医师（YAU）前列腺癌小组的认可，并在欧洲六家三级中心开展。所有入组患者均在认知/融合方式下进行了PSMA引导活检，无论是否进行了MRI引导活检和/或标准活检（SB）。评估了前列腺活检时的PCa和临床重大PCa（csPCA）检出率（DR）。采用单变量和多变量模型确定与csPCA相关的特征：结果：共招募了 72 名患者。PSMA PET/CT 显示的主要病变的地形位置与 csPCa 的位置显著相关，尤其是在活组织检查未获成功的人群中。PSMA-PET/CT引导活检的PCa和csPCa的DR明显高于SB（分别为0.40±0.43 vs. 0.23±0.29和0.36±0.44 vs. 0.21±0.30，均为P0.05）。PSMA-PET/CT引导活检在活检新手中的效果优于重复活检。SUVmax临界值为4.8时，csPCa的检测效果最佳：我们的实际数据说明了PSMA-PET/CT引导活检在诊断PCa方面的潜力。具体而言，对于怀疑患有高危疾病的活检不成熟患者，可以考虑使用 PSMA-PET/CT 靶向活检。此外，在反复活检的情况下，PSMA-PET/CT 靶向活检可能比 SB 更为可取。
{"title":"PSMA PET-targeted Biopsy for Prostate Cancer Diagnosis: Initial Experience From a Multicenter Cohort","authors":"Enrico Checcucci , Matteo Bauckneht , Edoardo Cisero , Gabriele Volpi , Alessio Rizzo , Fabio Zattoni , Lorenzo Bianchi , Mario De Angelis , Danilo Cangemi , Joris Heetman , Andrea Farolfi , Federico Piramide , Sabrina De Cillis , Daniele Amparore , Stefano De Luca , Michele Di Dio , Fabrizio Dal Moro , Stefano Fanti , Riccardo Schiavina , Alberto Briganti , Francesco Porpiglia","doi":"10.1016/j.urology.2024.10.026","DOIUrl":"10.1016/j.urology.2024.10.026","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the initial experience with PSMA-PET/CT-guided biopsy in European referral centres.</div></div><div><h3>Methods</h3><div>This multicenter observational cohort study was endorsed by the Young Academic Urologist (YAU) Prostate Cancer Group of the EAU and conducted across 6 tertiary-level European centres. PSMA-guided biopsies were carried out in a cognitive/fusion manner for all the recruited patients with or without MRI-guided biopsies and/or standard biopsy (SB). PCa and clinical significant PCa (csPCA) detection rate (DR) at prostate biopsy was assessed. Uni- and multivariable models were employed to identify features related to csPCA.</div></div><div><h3>Results</h3><div>Overall, 72 patients were recruited. The topographic location of the dominant lesion depicted by PSMA PET/CT was significantly associated with the location of csPCa, especially in the biopsy naïve cohort. The DR for PCa and csPCa of PSMA-PET/CT-guided biopsies was significantly higher than SB (0.40 ± 0.43 vs 0.23 ± 0.29, and 0.36 ± 0.44 vs 0.21 ± 0.30, respectively, both <em>P</em> <.05) but did not surpass MRI-guided biopsies (0.40 ± 0.43 vs 0.47 ± 0.44, and 0.36 ± 0.44 vs 0.47 ± 0.34, respectively, both <em>P</em> >.05). PSMA-PET/CT-guided biopsy performed better in the biopsy naïve than in the repeated biopsy setting. A SUVmax cut-off value equal to 4.8 provided the best results for detecting csPCa.</div></div><div><h3>Conclusion</h3><div>Our real-world data illustrate the potentialities of PSMA-PET/CT-guided biopsy in diagnosing PCa. Specifically, in biopsy naïve patients with suspicion of high-risk disease, the use of PSMA-PET/CT-targeted biopsy can be considered. Additionally, in the context of repeated biopsies, a PSMA-PET/CT target biopsy might be advisable over the SB.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 178-185"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.urology.2024.09.024
Yubao Liu , Haifeng Song , Bixiao Wang , Bo Xiao , Weiguo Hu , Yangyang Xu , Boxing Su , Xuesong Li , Jianxing Li
Objective
To evaluate the application of Mixed Reality technology in the planning of ultrasound-guided percutaneous nephrolithotomy (PCNL) for special types of complex upper urinary stones.
Methods
Clinical data of 15 patients with complex upper urinary stones undergoing ultrasound-guided PCNL were analyzed which included pelvic ectopic kidney, horseshoe kidney, spinal deformity, and transplant kidney. Based on preoperative computed tomography urography (CTU) data, digital 3-dimensional reconstruction is performed, and AI mixed reality is used to project 3-dimensional images in real space. This facilitates preoperative design and planning. The consistency rate of target calyx and channel numbers, stone-free rate, total operative time, percutaneous renal access establish time, decrease in hemoglobin level, surgical complications, and postoperative hospital stay are analyzed.
Results
All patients underwent preoperative planning using mixed reality and successfully completed PCNL. Based on the preoperative planning, we utilized S-PCNL alone or combined with Needle-perc or antegrade/retrograde flexible ureteroscopic surgery. The consistency rate between preoperative planning and intraoperative completion was 87.6%. The stone-free rate was 80%. The average time for establishing the main tract was 2.3 ± 0.3 minutes, and the average total operative time was 61.5 ± 12.2 minutes. The mean decrease in hemoglobin level was 9.6 ± 1.2 g/L, and the average postoperative hospital stay was 4.6 ± 0.5 days. There were no occurrences of Clavien-Dindo grade≥II complications.
Conclusion
Preoperative quantification and analysis of imaging data through mixed reality enable 3-dimensional visualization and facilitate surgical plans, and effectively avoid the risks of surrounding organ injury in these special urinary stones cases, make complex surgeries smoother and more controllable.
{"title":"Application of Mixed Reality Technology in the Planning of PCNL for Special Types of Complex Upper Urinary Stones: A Pilot Study","authors":"Yubao Liu , Haifeng Song , Bixiao Wang , Bo Xiao , Weiguo Hu , Yangyang Xu , Boxing Su , Xuesong Li , Jianxing Li","doi":"10.1016/j.urology.2024.09.024","DOIUrl":"10.1016/j.urology.2024.09.024","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the application of Mixed Reality technology in the planning of ultrasound-guided percutaneous nephrolithotomy (PCNL) for special types of complex upper urinary stones.</div></div><div><h3>Methods</h3><div>Clinical data of 15 patients with complex upper urinary stones undergoing ultrasound-guided PCNL were analyzed which included pelvic ectopic kidney, horseshoe kidney, spinal deformity, and transplant kidney. Based on preoperative computed tomography urography (CTU) data, digital 3-dimensional reconstruction is performed, and AI mixed reality is used to project 3-dimensional images in real space. This facilitates preoperative design and planning. The consistency rate of target calyx and channel numbers, stone-free rate, total operative time, percutaneous renal access establish time, decrease in hemoglobin level, surgical complications, and postoperative hospital stay are analyzed.</div></div><div><h3>Results</h3><div>All patients underwent preoperative planning using mixed reality and successfully completed PCNL. Based on the preoperative planning, we utilized S-PCNL alone or combined with Needle-perc or antegrade/retrograde flexible ureteroscopic surgery. The consistency rate between preoperative planning and intraoperative completion was 87.6%. The stone-free rate was 80%. The average time for establishing the main tract was 2.3 ± 0.3 minutes, and the average total operative time was 61.5 ± 12.2 minutes. The mean decrease in hemoglobin level was 9.6 ± 1.2<!--> <!-->g/L, and the average postoperative hospital stay was 4.6 ± 0.5 days. There were no occurrences of Clavien-Dindo grade≥II complications.</div></div><div><h3>Conclusion</h3><div>Preoperative quantification and analysis of imaging data through mixed reality enable 3-dimensional visualization and facilitate surgical plans, and effectively avoid the risks of surrounding organ injury in these special urinary stones cases, make complex surgeries smoother and more controllable.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 40-47"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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