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A randomized controlled trial comparing efficacy, safety, and patient-reported outcomes of electroconductive and electrohydraulic extracorporeal shockwave lithotripsy. 一项随机对照试验,比较导电和电液体外冲击波碎石的疗效、安全性和患者报告的结果。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-20 DOI: 10.1177/03915603251390743
Hyeji Park, Christine Joy Castillo, Sung Yong Cho

Objectives: To evaluate the efficacy, safety, and patient-reported outcomes, including satisfaction and pain level, of electroconductive (EC) and electrohydraulic (EH) extracorporeal shock wave lithotripsy (ESWL) for the treatment of ureter and kidney stones in a randomized controlled trial.

Materials and methods: A total of 56 patients were randomly allocated to the EC or EH groups. Patient and stone characteristics and treatment outcomes were compared.

Results: The stone-free rates were not different between the groups. The EH group achieved the same stone-free rates as the EC group with less energy use. Pain scores were higher in the EH group (mean 4.76 ± 3.53) than in the EC group (mean 3.04 ± 2.84), with borderline significance (p = 0.063). Satisfaction scores and radiation exposure were significantly lower in the EH group than in the EC group, regardless of the stone location. Univariate and multivariate analyses identified the total number of shocks and stone location as significant predictors of stone-free status.

Conclusions: EC and EH lithotripters demonstrated comparable efficacy and complication rates across different stone locations. While the EC group showed lower pain scores and higher satisfaction, these outcomes required greater energy use and resulted in higher radiation exposure. Patient satisfaction and pain level, as patient-reported outcomes, may be considered as additional measures alongside safety and efficacy in the evaluation of ESWL modalities.

目的:在一项随机对照试验中,评价导电(EC)和电液(EH)体外冲击波碎石(ESWL)治疗输尿管结石和肾结石的疗效、安全性和患者报告的结果,包括满意度和疼痛水平。材料和方法:56例患者随机分为EC组和EH组。比较患者和结石特征及治疗结果。结果:两组间无明显差异。EH组达到了与EC组相同的无石率,但能源消耗更少。EH组疼痛评分(平均4.76±3.53)高于EC组(平均3.04±2.84),差异有统计学意义(p = 0.063)。无论结石的位置如何,EH组的满意度评分和辐射暴露明显低于EC组。单变量和多变量分析确定了冲击总数和结石位置是无结石状态的重要预测因子。结论:EC碎石机和EH碎石机在不同结石部位的疗效和并发症发生率相当。虽然EC组表现出较低的疼痛评分和较高的满意度,但这些结果需要更多的能量使用,并导致更高的辐射暴露。患者满意度和疼痛程度,作为患者报告的结果,可以被认为是评估ESWL方式安全性和有效性的附加措施。
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引用次数: 0
Evaluation of anterior urethral strictures based on histopathology and its correlation with outcome after urethroplasty. 基于组织病理学评价前尿道狭窄及其与尿道成形术后预后的关系。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-11 DOI: 10.1177/03915603251388207
Goyal Prashasya, Govind Sharma, Shivam Priyadarshi

Background: Anterior urethral strictures significantly impact urinary function and quality of life, often requiring surgical intervention. This study evaluates the histopathological characteristics of strictures and their correlation with urethroplasty outcomes.

Methods: A prospective study was conducted on 65 male patients (aged 20-60) diagnosed with anterior urethral strictures at SMS Medical College. Exclusion criteria included posterior urethral distraction defects and prior surgical interventions. Biopsies from stricture sites were analyzed for lichen sclerosus (LS) and inflammation. Urethroplasty techniques included dorsal augmentation, ventral onlay buccal mucosal graft, Asopa's dorsal inlay, and staged urethroplasty. Statistical analysis was performed using the chi-square test, independent t-test, and ANOVA, with a significance threshold of p < 0.05.

Results: The majority of strictures were idiopathic (46.1%), followed by LS (26.1%) and iatrogenic causes (21.5%). LS was significantly associated with poorer surgical outcomes (p = 0.032). Severe inflammation within the stricture segment correlated with unsuccessful urethroplasty outcomes (p = 0.027), whereas inflammation in proximal or distal segments showed no impact. Stricture length > 8 cm also exhibited higher failure rates. The most common postoperative complication was wound infection (13.8%).

Conclusion: LS and severe inflammation are key predictors of unsuccessful urethroplasty outcomes. Histopathological evaluation should be integrated into preoperative assessment to optimize surgical planning and reduce recurrence rates. Future studies with larger cohorts and extended follow-ups are warranted to validate these findings.

背景:前尿道狭窄严重影响泌尿功能和生活质量,通常需要手术干预。本研究评估狭窄的组织病理学特征及其与尿道成形术结果的关系。方法:对北京医科大学前尿道狭窄男性患者65例(20 ~ 60岁)进行前瞻性研究。排除标准包括后尿道牵张缺陷和既往手术干预。从狭窄部位活检分析硬化地衣(LS)和炎症。尿道成形术包括背侧增强术、腹侧颊粘膜移植术、Asopa背侧嵌体术和分期尿道成形术。采用卡方检验、独立t检验和方差分析进行统计学分析,显著性阈值为p。结果:大多数狭窄为特发性(46.1%),其次是LS(26.1%)和医源性(21.5%)。LS与较差的手术结果显著相关(p = 0.032)。狭窄节段的严重炎症与尿道成形术失败相关(p = 0.027),而近端或远端节段的炎症没有影响。结构长度bbbb8 cm也表现出较高的失效率。最常见的术后并发症是伤口感染(13.8%)。结论:LS和严重炎症是尿道成形术失败的关键预测因素。术前评估应结合组织病理学评估,以优化手术计划,降低复发率。未来的研究需要更大的队列和更长的随访来验证这些发现。
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引用次数: 0
A randomized study comparing outcomes of intravesical Gemcitabine, Mitomycin C (as hyperthermic intravesical chemotherapy-HIVEC) and Bacillus-Calmette Guerin in intermediate and high-risk non-muscle invasive bladder cancer. 一项比较膀胱内注射吉西他滨、丝裂霉素C(作为膀胱内热化疗- hivec)和卡介苗治疗中高风险非肌肉浸润性膀胱癌疗效的随机研究。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-11 DOI: 10.1177/03915603251388204
Shreyas Nellamkuziyil Michael, Arun Makkar, Supreeth Nagaraju, Rajeev Sood, Hemant Kumar Goel, Umesh Sharma, Anurag Singla, Shivaprasad Sahoo

Introduction: Intravesical therapy following transurethral resection of bladder tumor (TURBT) remains the standard of care for non-muscle invasive bladder cancer (NMIBC). However, the global shortage of Bacillus Calmette-Guérin (BCG) and its notable side effect profile have driven interest in alternative agents such as gemcitabine and hyperthermic intravesical chemotherapy (HIVEC), both of which have shown promising results.

Materials and methods: A total of 100 consenting patients with intermediate- and high-risk NMIBC, as per EAU 2020 risk stratification, were enrolled at a single institution between January 2021 and July 2022. Patients were electronically randomized in a 2:1:1 ratio into three groups: gemcitabine (n = 50), HIVEC (n = 25), and BCG (n = 25). Follow-up included cystoscopy and urine cytology every 3 months. Adverse events were assessed and graded using the Modified Clavien-Dindo Classification System.

Results: At 12 months, recurrence-free survival (RFS) was 94% in the gemcitabine group, 84% in the HIVEC group, and 92% in the BCG group (p = 0.675, intention-to-treat analysis). No cases of grade or stage progression were observed. Most recurrences (88.9%) occurred in the high-risk subgroup. Treatment-related side effects were significantly more frequent in the BCG group, while gemcitabine was the most well-tolerated during both induction and maintenance phases. The most common adverse events included lower urinary tract symptoms (LUTS), dysuria, and urinary tract infections (UTIs).

Conclusion: Preliminary findings indicate that intravesical gemcitabine is non-inferior to BCG and HIVEC in terms of short-term efficacy, with a significantly better safety and tolerability profile. These results position gemcitabine as a viable alternative in the management of NMIBC. However, the study's limited sample size and short follow-up period necessitate larger, long-term studies to validate these outcomes.

经尿道膀胱肿瘤切除术(turt)后膀胱内治疗仍然是非肌肉浸润性膀胱癌(NMIBC)的标准治疗方法。然而,卡介苗(BCG)的全球短缺及其显著的副作用促使人们对吉西他滨和膀胱内热化疗(HIVEC)等替代药物产生了兴趣,这两种药物都显示出有希望的结果。材料和方法:在2021年1月至2022年7月期间,根据EAU 2020风险分层,共有100名同意的中高风险NMIBC患者在单一机构入组。患者按2:1:1的比例电子随机分为三组:吉西他滨(n = 50), HIVEC (n = 25)和BCG (n = 25)。随访包括每3个月一次膀胱镜检查和尿细胞学检查。使用改良的Clavien-Dindo分类系统对不良事件进行评估和分级。结果:12个月时,吉西他滨组的无复发生存率(RFS)为94%,HIVEC组为84%,BCG组为92% (p = 0.675,意向治疗分析)。没有观察到分级或分期进展的病例。大多数复发(88.9%)发生在高危亚组。治疗相关的副作用在卡介苗组明显更频繁,而吉西他滨在诱导和维持阶段都是耐受性最好的。最常见的不良事件包括下尿路症状(LUTS)、排尿困难和尿路感染(uti)。结论:初步结果表明,膀胱内注射吉西他滨的短期疗效不逊于卡介苗和HIVEC,且安全性和耐受性明显更好。这些结果表明吉西他滨是治疗NMIBC的可行选择。然而,该研究样本量有限,随访时间短,需要更大规模的长期研究来验证这些结果。
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引用次数: 0
Role of ultrasound elastography versus ultrasound guided biopsy in detection of cancer prostate. 超声弹性成像与超声引导活检在前列腺癌检测中的作用。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-11 DOI: 10.1177/03915603251387890
Ali Ahmed Remah, Maha Mohamed Abdel Raouf, Ahmed Mohamed Ghandour, Shaimaa El Metwally El Diasty, Mohamed Ahmed Ateya

Introduction: Elastography, introduced in the early 1990s, is a high-performing diagnostic tool that enhances conventional B-mode ultrasonography. This study assessed the diagnostic potential of ultrasound (US) elastography for early prostate cancer, using histopathology as the reference. It aimed to evaluate elastography's ability to differentiate benign from malignant prostate lesions and measure its sensitivity and specificity.

Method: From June 2020 to November 2022, 22 men with prostate lesions were enrolled in a prospective study. These patients, referred from the urology outpatient clinic, had a median prostate-specific antigen of 30.6 ng/mL and a median prostate volume of 65 mL. Strain stiffness was calculated for each lesion and subsequently compared with the corresponding histopathological diagnoses.

Results: A stiffness threshold between 35 and 37 kPa demonstrated the optimal discriminatory capacity between benign and malignant lesions, yielding a sensitivity of 83.3%, a specificity of 70%, a positive predictive value of 76.9%, a negative predictive value of 77.7%, and an overall accuracy of 77.2%.

Conclusion: Elastography is an effective diagnostic tool that enhances B-mode ultrasound specificity for prostate cancer detection. It improves differentiation between benign and malignant lesions and increases the accuracy of prostate biopsy outcomes.

简介:弹性成像技术于20世纪90年代初推出,是一种高性能的诊断工具,可以增强传统的b超检查。本研究以组织病理学为参考,评估超声弹性成像(US)对早期前列腺癌的诊断潜力。目的是评估弹性成像区分前列腺良性和恶性病变的能力,并测量其敏感性和特异性。方法:从2020年6月到2022年11月,22名患有前列腺病变的男性被纳入前瞻性研究。这些患者来自泌尿科门诊,前列腺特异性抗原中位数为30.6 ng/mL,前列腺体积中位数为65 mL。计算每个病变的应变刚度,随后与相应的组织病理学诊断进行比较。结果:刚度阈值在35 ~ 37 kPa之间是良恶性病变的最佳区分能力,敏感性为83.3%,特异性为70%,阳性预测值为76.9%,阴性预测值为77.7%,总体准确率为77.2%。结论:弹性成像是一种有效的诊断工具,可提高b超诊断前列腺癌的特异性。它提高了良性和恶性病变的区分,提高了前列腺活检结果的准确性。
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引用次数: 0
Success and challenges of ESWL for managing distal ureteric stones of 5-15 mm size. 体外冲击波碎石治疗输尿管远端5- 15mm结石的成功与挑战。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-10 DOI: 10.1177/03915603251387892
Navdeep Garg, Sanjeev Jaiswal, Sudeep Singh, Nachiket Vyas, Shivam Priyadarshi

Introduction: Extracorporeal shock wave lithotripsy (ESWL) is widely recognized as a safe, non-invasive treatment with minimal side effects. This procedure does not require anesthesia, making it an effective option for lower ureteral stones. This study aimed to assess the effectiveness of ESWL in treating distal ureteral stones ranging from 5 to 15 mm in size and to identify factors influencing the treatment outcomes.

Methodology: This was a prospective hospital-based analytical cross-sectional study conducted in the Department of Urology, tertiary care facility, Jaipur. Data collection for the study was started in September 2023 and completed in November 2024. A total of sixty one patients diagnosed with distal ureteral stones and undergoing ESWL treatments were enrolled in this study. The data was analyzed using SPSS 25.0 version.

Results: The average age of the participants was 49.52 ± 10.99 years, with approximately two-thirds being male. The mean stone size was 9.93 ± 2.95 mm, and the average stone density was 765.10 ± 205.88 HU. The overall success rate of the procedure was 85.2% (n = 52/61). Treatment success was significantly associated with age, stone size, and BMI (p < 0.05), but not with the patient's sex or stone laterality (p > 0.05). In the multivariate analysis, the patient's BMI was identified as the only significant predictor of treatment success.

Conclusion: ESWL is a successful, non-invasive, and practical therapeutic option for lower ureteric calculi with no significant side effects. It is an effective procedure for small size ureteric calculi up to 15 mm size, ESWL could therefore be used as the main form of treatment.

体外冲击波碎石术(ESWL)被广泛认为是一种安全、无创、副作用小的治疗方法。该手术不需要麻醉,使其成为输尿管下段结石的有效选择。本研究旨在评估ESWL治疗输尿管远端5 - 15mm结石的有效性,并确定影响治疗结果的因素。方法:这是一项前瞻性的基于医院的横断面分析研究,在斋浦尔三级医疗机构泌尿科进行。该研究的数据收集于2023年9月开始,并于2024年11月完成。本研究共纳入61例诊断为输尿管远端结石并接受ESWL治疗的患者。采用SPSS 25.0版本对数据进行分析。结果:参与者的平均年龄为49.52±10.99岁,约三分之二为男性。平均结石大小为9.93±2.95 mm,平均结石密度为765.10±205.88 HU。手术总成功率为85.2% (n = 52/61)。治疗成功与年龄、结石大小和BMI显著相关(p < 0.05)。在多变量分析中,患者的BMI被确定为治疗成功的唯一重要预测因子。结论:体外冲击波碎石治疗输尿管下段结石是一种成功、无创、实用的治疗方法,且无明显副作用。对于小于15mm的输尿管结石,ESWL是一种有效的治疗方法,因此ESWL可以作为主要的治疗方式。
{"title":"Success and challenges of ESWL for managing distal ureteric stones of 5-15 mm size.","authors":"Navdeep Garg, Sanjeev Jaiswal, Sudeep Singh, Nachiket Vyas, Shivam Priyadarshi","doi":"10.1177/03915603251387892","DOIUrl":"https://doi.org/10.1177/03915603251387892","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal shock wave lithotripsy (ESWL) is widely recognized as a safe, non-invasive treatment with minimal side effects. This procedure does not require anesthesia, making it an effective option for lower ureteral stones. This study aimed to assess the effectiveness of ESWL in treating distal ureteral stones ranging from 5 to 15 mm in size and to identify factors influencing the treatment outcomes.</p><p><strong>Methodology: </strong>This was a prospective hospital-based analytical cross-sectional study conducted in the Department of Urology, tertiary care facility, Jaipur. Data collection for the study was started in September 2023 and completed in November 2024. A total of sixty one patients diagnosed with distal ureteral stones and undergoing ESWL treatments were enrolled in this study. The data was analyzed using SPSS 25.0 version.</p><p><strong>Results: </strong>The average age of the participants was 49.52 ± 10.99 years, with approximately two-thirds being male. The mean stone size was 9.93 ± 2.95 mm, and the average stone density was 765.10 ± 205.88 HU. The overall success rate of the procedure was 85.2% (<i>n</i> = 52/61). Treatment success was significantly associated with age, stone size, and BMI (<i>p</i> < 0.05), but not with the patient's sex or stone laterality (<i>p</i> > 0.05). In the multivariate analysis, the patient's BMI was identified as the only significant predictor of treatment success.</p><p><strong>Conclusion: </strong>ESWL is a successful, non-invasive, and practical therapeutic option for lower ureteric calculi with no significant side effects. It is an effective procedure for small size ureteric calculi up to 15 mm size, ESWL could therefore be used as the main form of treatment.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251387892"},"PeriodicalIF":0.7,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of surgical versus conservative treatment in ureteropelvic junction obstruction: A systematic review of non-randomized trials. 输尿管盂连接处梗阻手术与保守治疗的比较:一项非随机试验的系统综述。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-10 DOI: 10.1177/03915603251384442
Despoina Samourkasidou, Despoina Tramma, Nikolaos Gkiourtzis, Vaia Dokousli, Thomas Karagiannis, Michalis Aivaliotis

Ureteropelvic junction obstruction (UPJO) is a major cause of obstructive uropathy in pediatric patients. However, the optimal management remains controversial. We aimed to summarize the evidence comparing surgical versus conservative treatment. We searched MEDLINE/PubMed (2016 to 31 October 2024) and the Cochrane Central Register of Controlled Trials (CENTRAL) on 31 October 2024. The primary outcome was split renal function (SRF). Results were summarized in a structured table. Study quality was assessed using the ROBINS-I tool and the level of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. Our search resulted in 2.251 reports. We included two non-randomized interventional studies with 136 patients. One study reported no statistically significant difference in SRF between the study groups after 1 year of follow up, while the second study reported higher SRF in surgical group 6 months postoperatively. The studies were judged to have a serious risk of bias, and the quality of evidence was rated as very low. The paucity of eligible data precluded the performance of a meta-analysis. Our findings could not support clinical recommendations. This study highlights the lack of high-quality evidence that will come from large, prospective, well-designed trials comparing surgical intervention to updated conservative treatment options.

肾盂输尿管交界处梗阻(UPJO)是小儿患者梗阻性尿病的主要原因。然而,最优管理仍然存在争议。我们的目的是总结比较手术和保守治疗的证据。我们检索了MEDLINE/PubMed(2016年至2024年10月31日)和Cochrane Central Register of Controlled Trials (Central)(2024年10月31日)。主要终点是肾功能分裂(SRF)。结果汇总在一个结构化的表格中。使用ROBINS-I工具评估研究质量,使用分级建议评估、发展和评估(GRADE)工作组评估证据水平。我们的搜索结果是2.251份报告。我们纳入了两项非随机介入研究,共136例患者。一项研究报告随访1年后两组间SRF无统计学差异,而另一项研究报告手术组术后6个月SRF较高。这些研究被认为有严重的偏倚风险,证据质量被评为非常低。合格数据的缺乏妨碍了meta分析的进行。我们的研究结果不能支持临床建议。这项研究强调了缺乏高质量的证据,这些证据将来自大型的、前瞻性的、精心设计的比较手术干预和最新保守治疗方案的试验。
{"title":"Comparison of surgical versus conservative treatment in ureteropelvic junction obstruction: A systematic review of non-randomized trials.","authors":"Despoina Samourkasidou, Despoina Tramma, Nikolaos Gkiourtzis, Vaia Dokousli, Thomas Karagiannis, Michalis Aivaliotis","doi":"10.1177/03915603251384442","DOIUrl":"https://doi.org/10.1177/03915603251384442","url":null,"abstract":"<p><p>Ureteropelvic junction obstruction (UPJO) is a major cause of obstructive uropathy in pediatric patients. However, the optimal management remains controversial. We aimed to summarize the evidence comparing surgical versus conservative treatment. We searched MEDLINE/PubMed (2016 to 31 October 2024) and the Cochrane Central Register of Controlled Trials (CENTRAL) on 31 October 2024. The primary outcome was split renal function (SRF). Results were summarized in a structured table. Study quality was assessed using the ROBINS-I tool and the level of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. Our search resulted in 2.251 reports. We included two non-randomized interventional studies with 136 patients. One study reported no statistically significant difference in SRF between the study groups after 1 year of follow up, while the second study reported higher SRF in surgical group 6 months postoperatively. The studies were judged to have a serious risk of bias, and the quality of evidence was rated as very low. The paucity of eligible data precluded the performance of a meta-analysis. Our findings could not support clinical recommendations. This study highlights the lack of high-quality evidence that will come from large, prospective, well-designed trials comparing surgical intervention to updated conservative treatment options.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251384442"},"PeriodicalIF":0.7,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of personalized Three-dimensional printed model prior to Percutaneous nephrolithotomy on Patients' satisfaction and understanding: A randomized clinical study. 经皮肾镜取石术前个性化三维打印模型对患者满意度和理解的影响:一项随机临床研究。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-04 DOI: 10.1177/03915603251389518
Seyed Reza Hosseini, Alireza Pakdel, Ehsan Zemanati Yar, Hossein Chivaee, Fardin Asgari, Amirreza Shamshirgaran, Farshid Alaeddini, Leonardo Oliveira Reis, Seyed Mohammad Kazem Aghamir

Background: Percutaneous nephrolithotomy (PCNL) is a crucial treatment for large renal stones and has a high success rate. Patients require comprehensive information about the procedure to make informed decisions. Effective communication between patients and physicians is essential for treatment adherence and postoperative recovery. Utilizing three-dimensional (3D) models has been shown to improve comprehension of complication and increasing confidence in both treatments and surgeons.

Method: This study involved 40 individuals planned for PCNL surgery, aged 18 to 80, confirmed through computed tomography (CT) scans. They were divided randomly into 2D and 3D groups. The 3D group received detailed information using patient-specific 3D printed kidney models, while the 2D group received education based on conventional 2D CT scan. After the educational session, participants completed a survey to assess their comprehension. Following surgery, participants rated their satisfaction on scale of 1-10. This study aimed to compare the effectiveness of 3D models in patient comprehension and satisfaction in PCNL surgery.

Result: The analysis was performed on 40 individuals (23 males, 17 females). Each group comprises 20 participants, with similar demographic and stone feature characteristics. Participant ages ranged from 32 to 66 years with a mean (SD) of 50.0 (8.52) and no significant age or gender differences were seen between the groups. Patients in the 3D group showed significantly higher comprehension in various aspects and satisfaction levels (p-values<0.05).

Conclusion: Incorporating personalized 3D printed models in PCNL surgery has been shown to enhance the patients' comprehension of renal stone features and PCNL procedure. It also increases postoperative satisfaction.

背景:经皮肾镜取石术(PCNL)是治疗大肾结石的重要方法,成功率高。患者需要全面了解手术过程,以便做出明智的决定。患者和医生之间的有效沟通对于治疗依从性和术后恢复至关重要。利用三维(3D)模型已被证明可以提高对并发症的理解,并增加对治疗和外科医生的信心。方法:本研究纳入40例计划行PCNL手术的患者,年龄18 ~ 80岁,通过计算机断层扫描(CT)确认。他们被随机分为二维组和三维组。3D组通过患者特异性3D打印肾脏模型获得详细信息,而2D组根据常规2D CT扫描接受教育。在教育课程结束后,参与者完成了一项调查,以评估他们的理解能力。手术后,参与者对自己的满意度进行了1-10的评分。本研究旨在比较三维模型在PCNL手术患者理解和满意度方面的有效性。结果:共对40例个体进行分析,其中男性23例,女性17例。每组由20名参与者组成,具有相似的人口统计学和石材特征。参与者年龄从32岁到66岁不等,平均(SD)为50.0(8.52),各组之间没有明显的年龄或性别差异。结论:在PCNL手术中应用个性化3D打印模型可以增强患者对肾结石特征和PCNL手术的理解。它还提高了术后满意度。
{"title":"Impact of personalized Three-dimensional printed model prior to Percutaneous nephrolithotomy on Patients' satisfaction and understanding: A randomized clinical study.","authors":"Seyed Reza Hosseini, Alireza Pakdel, Ehsan Zemanati Yar, Hossein Chivaee, Fardin Asgari, Amirreza Shamshirgaran, Farshid Alaeddini, Leonardo Oliveira Reis, Seyed Mohammad Kazem Aghamir","doi":"10.1177/03915603251389518","DOIUrl":"https://doi.org/10.1177/03915603251389518","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous nephrolithotomy (PCNL) is a crucial treatment for large renal stones and has a high success rate. Patients require comprehensive information about the procedure to make informed decisions. Effective communication between patients and physicians is essential for treatment adherence and postoperative recovery. Utilizing three-dimensional (3D) models has been shown to improve comprehension of complication and increasing confidence in both treatments and surgeons.</p><p><strong>Method: </strong>This study involved 40 individuals planned for PCNL surgery, aged 18 to 80, confirmed through computed tomography (CT) scans. They were divided randomly into 2D and 3D groups. The 3D group received detailed information using patient-specific 3D printed kidney models, while the 2D group received education based on conventional 2D CT scan. After the educational session, participants completed a survey to assess their comprehension. Following surgery, participants rated their satisfaction on scale of 1-10. This study aimed to compare the effectiveness of 3D models in patient comprehension and satisfaction in PCNL surgery.</p><p><strong>Result: </strong>The analysis was performed on 40 individuals (23 males, 17 females). Each group comprises 20 participants, with similar demographic and stone feature characteristics. Participant ages ranged from 32 to 66 years with a mean (SD) of 50.0 (8.52) and no significant age or gender differences were seen between the groups. Patients in the 3D group showed significantly higher comprehension in various aspects and satisfaction levels (<i>p</i>-values<0.05).</p><p><strong>Conclusion: </strong>Incorporating personalized 3D printed models in PCNL surgery has been shown to enhance the patients' comprehension of renal stone features and PCNL procedure. It also increases postoperative satisfaction.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251389518"},"PeriodicalIF":0.7,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of long-term survival for muscle-invasive bladder cancer patients who underwent bladder preservation therapy and radical cystectomy: A systematic review and meta-analysis. 肌肉浸润性膀胱癌患者膀胱保留治疗和根治性膀胱切除术的长期生存率比较:一项系统回顾和荟萃分析
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-01 Epub Date: 2025-06-26 DOI: 10.1177/03915603251347444
Syah Mirsya Warli, Bungaran Sihombing, Dhirajaya Dharma Kadar, Ginanda Putra Siregar, Fauriski Febrian Prapiska, Lidya Imelda Laksmi, Bayu Hernawan Rahmat Muharia

Objective/purpose: This study aims to compare BPT and RC for long-term survival and quality of life outcomes in MIBC patients.

Materials and methods: The study conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, with search strategy across databases (PubMed, Scopus, Cochrane Library, EMBASE, and MEDLINE) used relevant keywords. RCTs, observational studies, and simulation studies were included. Each included study was evaluated with the Newcastle-Ottawa Scale (NOS) for observational studies and the Jadad score for randomized controlled trials (RCTs). Disagreements between reviewers were resolved by consensus, and inter-rater agreement was assessed using Cohen's Kappa statistic. The meta-analysis was performed with Review Manager (RevMan), v5.4.

Results: Seven studies (six retrospective cohorts, one RCT) met the inclusion criteria with a total of 25,212 patients. Analysis of four studies evaluating the comparison of BPT and RC showed no statistically significant differences in overall survival rates between the two therapies (HR = 1.14, 95%CI: 0.99-1.31, p = 0.07, I2 = 0%). Subgroup analysis results showed significant differences in overall mortality (HR = 1.16, 95%CI: 0.94-1.42, p = 0.17, I2 = 9%) and bladder cancer-specific mortality (HR = 1.11, 95%CI: 0.89-1.39, p = 0.34, I2 = 0%) between the two treatment approaches.

Conclusion: Compared to RC, BPT generally demonstrated similar results in terms of survival, local recurrence-free survival, and disease-free survival. Treatment decisions should be individualized, considering patient preferences, tumor characteristics, and available resources.

目的/目的:本研究旨在比较BPT和RC对MIBC患者长期生存和生活质量的影响。材料和方法:本研究基于系统评价和荟萃分析首选报告项目(PRISMA) 2020,使用相关关键词在数据库(PubMed、Scopus、Cochrane Library、EMBASE和MEDLINE)中进行搜索。包括随机对照试验、观察性研究和模拟研究。观察性研究采用纽卡斯尔-渥太华量表(NOS),随机对照试验采用Jadad评分(rct)。审稿人之间的分歧通过共识来解决,审稿人之间的一致性使用Cohen的Kappa统计来评估。meta分析使用Review Manager (RevMan), v5.4进行。结果:7项研究(6个回顾性队列,1个随机对照试验)符合纳入标准,共纳入25212例患者。4项评价BPT与RC比较的研究分析显示,两种治疗的总生存率无统计学差异(HR = 1.14, 95%CI: 0.99-1.31, p = 0.07, I2 = 0%)。亚组分析结果显示,两种治疗方法的总死亡率(HR = 1.16, 95%CI: 0.94-1.42, p = 0.17, I2 = 9%)和膀胱癌特异性死亡率(HR = 1.11, 95%CI: 0.89-1.39, p = 0.34, I2 = 0%)存在显著差异。结论:与RC相比,BPT在生存、局部无复发生存和无病生存方面普遍表现出相似的结果。治疗决定应个体化,考虑患者偏好、肿瘤特征和可用资源。
{"title":"Comparison of long-term survival for muscle-invasive bladder cancer patients who underwent bladder preservation therapy and radical cystectomy: A systematic review and meta-analysis.","authors":"Syah Mirsya Warli, Bungaran Sihombing, Dhirajaya Dharma Kadar, Ginanda Putra Siregar, Fauriski Febrian Prapiska, Lidya Imelda Laksmi, Bayu Hernawan Rahmat Muharia","doi":"10.1177/03915603251347444","DOIUrl":"10.1177/03915603251347444","url":null,"abstract":"<p><strong>Objective/purpose: </strong>This study aims to compare BPT and RC for long-term survival and quality of life outcomes in MIBC patients.</p><p><strong>Materials and methods: </strong>The study conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, with search strategy across databases (PubMed, Scopus, Cochrane Library, EMBASE, and MEDLINE) used relevant keywords. RCTs, observational studies, and simulation studies were included. Each included study was evaluated with the Newcastle-Ottawa Scale (NOS) for observational studies and the Jadad score for randomized controlled trials (RCTs). Disagreements between reviewers were resolved by consensus, and inter-rater agreement was assessed using Cohen's Kappa statistic. The meta-analysis was performed with Review Manager (RevMan), v5.4.</p><p><strong>Results: </strong>Seven studies (six retrospective cohorts, one RCT) met the inclusion criteria with a total of 25,212 patients. Analysis of four studies evaluating the comparison of BPT and RC showed no statistically significant differences in overall survival rates between the two therapies (HR = 1.14, 95%CI: 0.99-1.31, <i>p</i> = 0.07, <i>I</i><sup>2</sup> = 0%). Subgroup analysis results showed significant differences in overall mortality (HR = 1.16, 95%CI: 0.94-1.42, <i>p</i> = 0.17, <i>I</i><sup>2</sup> = 9%) and bladder cancer-specific mortality (HR = 1.11, 95%CI: 0.89-1.39, <i>p</i> = 0.34, <i>I</i><sup>2</sup> = 0%) between the two treatment approaches.</p><p><strong>Conclusion: </strong>Compared to RC, BPT generally demonstrated similar results in terms of survival, local recurrence-free survival, and disease-free survival. Treatment decisions should be individualized, considering patient preferences, tumor characteristics, and available resources.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"585-594"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Application of CPB in surgery for extended tumor thrombosis of inferior vena cava and right atrium. CPB在下腔静脉及右心房扩展性肿瘤血栓形成手术中的应用。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-01 Epub Date: 2025-05-17 DOI: 10.1177/03915603251338717
Mingchen Shao, Roman N Komarov, Leonid M Rapoport, Dmitry O Korolev, Ilya Vasalatii

Objective: To research the best time to provide cardiopulmonary bypass (CPB) and the best way to do it when treating an extensive tumor thrombosis of the inferior vena cava vein (IVC).

Results: The operating times in groups A and B were (376.7 ± 91.2) and (373.1 ± 80.7) minutes, respectively, with no statistically significant difference (t = 0.716, p > 0.05); intraoperative bleeding was (1916.7 ± 925.1) ml and (2600 ± 3756.3) ml, (t = -0.601, p < 0.05), and hospitalization was (32.3 ± 16.0) and (34.0 ± 8.0) days, with statistically significant differences (p < 0.05).

Conclusion: The CPB approach has the advantages of less intraoperative blood loss, faster surgical procedures, and fewer hospitalizations.

目的:探讨下腔静脉(IVC)广泛肿瘤血栓形成的最佳时机及最佳方法。结果:A、B组手术时间分别为(376.7±91.2)、(373.1±80.7)min,差异无统计学意义(t = 0.716, p < 0.05);术中出血量分别为(1916.7±925.1)ml和(2600±3756.3)ml, (t = -0.601, p) p结论:CPB入路术中出血量少,手术速度快,住院次数少。
{"title":"Application of CPB in surgery for extended tumor thrombosis of inferior vena cava and right atrium.","authors":"Mingchen Shao, Roman N Komarov, Leonid M Rapoport, Dmitry O Korolev, Ilya Vasalatii","doi":"10.1177/03915603251338717","DOIUrl":"10.1177/03915603251338717","url":null,"abstract":"<p><strong>Objective: </strong>To research the best time to provide cardiopulmonary bypass (CPB) and the best way to do it when treating an extensive tumor thrombosis of the inferior vena cava vein (IVC).</p><p><strong>Results: </strong>The operating times in groups A and B were (376.7 ± 91.2) and (373.1 ± 80.7) minutes, respectively, with no statistically significant difference (<i>t</i> = 0.716, <i>p</i> > 0.05); intraoperative bleeding was (1916.7 ± 925.1) ml and (2600 ± 3756.3) ml, (<i>t</i> = -0.601, <i>p</i> < 0.05), and hospitalization was (32.3 ± 16.0) and (34.0 ± 8.0) days, with statistically significant differences (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The CPB approach has the advantages of less intraoperative blood loss, faster surgical procedures, and fewer hospitalizations.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"559-563"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bugs and babies: How gut microbiota affect infertility? A narrative Review. 细菌和婴儿:肠道微生物群如何影响不孕症?叙述性评论。
IF 0.7 Q4 UROLOGY & NEPHROLOGY Pub Date : 2025-11-01 Epub Date: 2025-08-14 DOI: 10.1177/03915603251358953
Omnia Azmy Nabeh, Rahma Menshawey, Esraa Menshawey, Elsayed S Moubarak

Infertility is a disease of the reproductive system which is defined as the inability to conceive after more than 12 months of unprotected intercourse. It affects millions of people and has far-reaching impacts on quality of life, sexual dysfunction, marital impact, and societal implications. Despite advancements in understanding infertility, the cause of infertility in around 28% of cases remains unclear. This review addresses the pivotal relation between Gut microbiota (GM) and infertility. GM is now believed to interplay with the human body at different levels and is essential for our well-being. The abnormal translocation of GM to the systemic circulation, known as dysbiosis triggers an over-stimulated immune response associated with a marked increase in pro-inflammatory cytokines. This inflammatory situation may disrupt the hypothalamic-pituitary-gonadal axis and lead to disseminated inflammation ending in adhesions and obstructive lesions of the reproductive tract. Dysbiosis can also predispose individuals to obesity and insulin resistance, where both are risk factors for diabetes, hypertension, polycystic ovary syndrome (PCOS), impaired spermatogenesis, erectile dysfunction, and infertility. GM has an inevitable role in the pharmacokinetics of many drugs and can regulate the expression of many cytochrome P450 enzymes and several transporters. Further research is needed to validate the possible implication of GM in the pathophysiology of infertility, the efficacy of infertility medications, and the potential of GM-based therapies to treat infertile couples.

不孕症是一种生殖系统疾病,其定义是在无保护的性交超过12个月后无法怀孕。它影响着数百万人,并对生活质量、性功能障碍、婚姻影响和社会影响产生深远影响。尽管对不孕症的了解有所进展,但约28%的不孕症病例的病因仍不清楚。本文综述了肠道微生物群(GM)与不孕症之间的关键关系。转基因现在被认为在不同程度上与人体相互作用,对我们的健康至关重要。GM的异常易位到体循环,被称为生态失调,引发过度刺激的免疫反应,与促炎细胞因子的显着增加有关。这种炎症情况可能破坏下丘脑-垂体-性腺轴,导致弥散性炎症,最终导致生殖道粘连和梗阻性病变。生态失调还会使个体易患肥胖和胰岛素抵抗,这两者都是糖尿病、高血压、多囊卵巢综合征(PCOS)、精子发生受损、勃起功能障碍和不孕症的危险因素。GM在许多药物的药代动力学中具有不可避免的作用,可以调节许多细胞色素P450酶和几种转运体的表达。需要进一步的研究来验证转基因在不孕症病理生理中的可能意义,不孕症药物的疗效,以及基于转基因的治疗不孕症夫妇的潜力。
{"title":"Bugs and babies: How gut microbiota affect infertility? A narrative Review.","authors":"Omnia Azmy Nabeh, Rahma Menshawey, Esraa Menshawey, Elsayed S Moubarak","doi":"10.1177/03915603251358953","DOIUrl":"10.1177/03915603251358953","url":null,"abstract":"<p><p>Infertility is a disease of the reproductive system which is defined as the inability to conceive after more than 12 months of unprotected intercourse. It affects millions of people and has far-reaching impacts on quality of life, sexual dysfunction, marital impact, and societal implications. Despite advancements in understanding infertility, the cause of infertility in around 28% of cases remains unclear. This review addresses the pivotal relation between Gut microbiota (GM) and infertility. GM is now believed to interplay with the human body at different levels and is essential for our well-being. The abnormal translocation of GM to the systemic circulation, known as dysbiosis triggers an over-stimulated immune response associated with a marked increase in pro-inflammatory cytokines. This inflammatory situation may disrupt the hypothalamic-pituitary-gonadal axis and lead to disseminated inflammation ending in adhesions and obstructive lesions of the reproductive tract. Dysbiosis can also predispose individuals to obesity and insulin resistance, where both are risk factors for diabetes, hypertension, polycystic ovary syndrome (PCOS), impaired spermatogenesis, erectile dysfunction, and infertility. GM has an inevitable role in the pharmacokinetics of many drugs and can regulate the expression of many cytochrome P450 enzymes and several transporters. Further research is needed to validate the possible implication of GM in the pathophysiology of infertility, the efficacy of infertility medications, and the potential of GM-based therapies to treat infertile couples.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"571-584"},"PeriodicalIF":0.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Urologia Journal
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