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Risk factors for kidney cancer and socio-occupational category: significant impact of chlorinated solvents (UroCCR 111). 肾癌风险因素与社会职业类别:氯化溶剂的重大影响(UroCCR 111)。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-21 DOI: 10.1007/s00345-024-05356-9
Matthieu Ferragu, Jean-Christophe Bernhard, Alexis Fontenil, Julien Guillotreau, Frédéric Panthier, Nicolas Branger, Olivier Belas, Jean-Jacques Patard, François Audenet, Louis Surlemont, Richard Mallet, Thibaut Waeckel, Pierre Bigot

Introduction: The rising incidence of renal cell carcinoma (RCC) is a significant concern in cancer research. This study analyses the characteristics of RCC patients based on their socio-professional category and explores the role of chlorinated solvents as a risk factor.

Materials and methods: A multicentre, descriptive epidemiological study was conducted using the UroCCR database. All patients from participating centres who had been diagnosed with RCC between July 2021 and February 2023, as well as those seen for follow-up consultation during this period, were included. Patients were categorised into 5 socio-professional groups based on INSEE's Profession and Social Categories classification. The characteristics and risk factors of RCC for each group were compared. Binary logistic regression was used to study the exposure to chlorinated solvents and risk factors for clear cell RCC (ccRCC).

Results: A total of 1252 patients were included. Males made up 69.6% of the population. The median age was 64 years, and 87% of the patients had at least one RCC risk factor. ccRCC, papillary, and chromophobe types accounted for 78%, 14.9%, and 8.5% of the population, respectively. The median tumor size was 4.5 cm (SD = 3.3). Farmers had a higher prevalence of ccRCC (91.3%; p = 0.05) and larger tumors (median = 6 cm SD = 3.23; p = 0.038) than patients from other populations. Smoking and obesity rates were lower (10.1%; p < 0.001; 15.9%, p = 0.018, respectively), but exposure to chlorinated solvents was higher (50.7%; p < 0.001). Exposure to chlorinated solvents was independently associated with higher TNM stages (p = 0.044, OR = 1.41 CI (1.01; 1.96)). Obesity and exposure to chlorinated solvents were independent risk factors for ccRCC (p = 0.006, OR = 1.6 CI (1.1;2.2) and p = 0.028, OR = 1.6 CI (1.1;2.6), respectively).

Conclusion: This study shows the influence of socio-professional categories on exposure to RCC risk factors and tumor characteristics. In particular, farmers stood out from the rest of the study population. Their significant exposure to chlorinated solvents could be an interesting factor to investigate.

导言:肾细胞癌(RCC)发病率的上升是癌症研究中的一个重要问题。本研究根据社会职业类别分析了肾细胞癌患者的特征,并探讨了氯化溶剂作为风险因素的作用:利用 UroCCR 数据库开展了一项多中心、描述性流行病学研究。研究纳入了参与中心在 2021 年 7 月至 2023 年 2 月期间确诊为 RCC 的所有患者,以及在此期间复诊的患者。根据国家统计和经济研究所(INSEE)的职业和社会类别分类法,患者被分为5个社会职业组。比较了每个组别的 RCC 特征和风险因素。采用二元逻辑回归法研究接触氯化溶剂与透明细胞癌变(ccRCC)的风险因素:结果:共纳入了 1252 名患者。男性占总人数的 69.6%。ccRCC、乳头型和嗜铬型分别占总人数的78%、14.9%和8.5%。肿瘤大小的中位数为 4.5 厘米(SD = 3.3)。与其他人群的患者相比,农民患 ccRCC 的比例更高(91.3%;p = 0.05),肿瘤也更大(中位数 = 6 厘米,标度 = 3.23;p = 0.038)。吸烟率和肥胖率较低(10.1%;P 结论:该研究显示了社会因素对癌症患者的影响:本研究显示了社会职业类别对接触 RCC 风险因素和肿瘤特征的影响。其中,农民在研究人群中尤为突出。他们大量接触氯化溶剂可能是一个值得研究的因素。
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引用次数: 0
Correction: Role of neoadjuvant chemotherapy in patients with locally advanced and clinically positive nodes Upper Tract Urothelial Carcinoma treated with Nephroureterectomy: real-world data from the ROBUUST 2.0 Registry. 更正:新辅助化疗在接受肾切除术的局部晚期和临床结节阳性上尿路上皮癌患者中的作用:来自 ROBUUST 2.0 注册中心的真实数据。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-18 DOI: 10.1007/s00345-024-05350-1
Gabriele Tuderti, Riccardo Mastroianni, Flavia Proietti, Zhenjie Wu, Linhui Wang, Antonio Franco, Firas Abdollah, Marco Finati, Matteo Ferro, Marco Tozzi, Francesco Porpiglia, Enrico Checcucci, Raj Bhanvadia, Vitaly Margulis, Stephan Bronimann, Nirmish Singla, Kevin Hakimi, Ithaar H Derweesh, Andreas Correa, Emma Helstrom, Dinno F Mendiola, Mark L Gonzalgo, Reuben Ben David, Reza Mehrazin, Sol C Moon, Soroush Rais-Bahrami, Courtney Yong, Chandru P Sundaram, Antonio Tufano, Sisto Perdonà, Alireza Ghoreifi, Farshad S Moghaddam, Hooman Djaladat, Francesco Ditonno, Alessandro Antonelli, Riccardo Autorino, Giuseppe Simone
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引用次数: 0
Impact of the time interval between biopsy and radical prostatectomy on functional outcomes. 活组织检查和根治性前列腺切除术之间的时间间隔对功能性结果的影响。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-16 DOI: 10.1007/s00345-024-05324-3
Rosannis Brown, Burkhard Beyer, Sophie Knipper, Gisa Mehring, Lars Budäus, Pierre Tennstedt, Markus Graefen, Randi M Pose

Purpose: The aim of our study was to investigate the impact of the time interval between prostate biopsy and radical prostatectomy (RP) on postoperative urinary continence (UC)/erectile function (EF). From a clinical point of view, an interval of several weeks seems to facilitate surgical preparation.

Materials and methods: We retrospectively analyzed patients who underwent RP for localized prostate cancer (PCa) in a tertiary care center between 2011 and 2020. We evaluated the influence of the following variables on UC and EF 1 year after RP: time from biopsy to RP, age, BMI, pathological T-stage, EF and intraoperative nerve sparing (unilateral vs. bilateral). For this purpose, we performed linear regression analyses as well as manual grouping and cluster analyses to identify possible temporal cutoff ranges. The EPIC-26 and the IIEF questionnaires were used for the assessment of UC and EF.

Results: We identified 6202 consecutive patients who underwent RP. Neither manual grouping nor cluster analyses showed a significant difference in continence or potency after RP. According to linear regression models, only age was an independent predictor of incontinence (95%-CI 0.006-0.01), and EF before RP (95%-CI 0.22-0.26), age (95%-CI - 0.68 to - 0.5), BMI (95%-CI - 0.66 to - 0.29) and bilateral NS (95%-CI 5.5-2.1) had significant impacts on postoperative EF (all p < 0.001).

Conclusion: In the selected patient population, the time interval between prostate biopsy and RP did not seem to have an effect on postoperative functional outcomes (UC and EF).

目的:我们的研究旨在探讨前列腺活检与根治性前列腺切除术(RP)之间的时间间隔对术后尿失禁(UC)/勃起功能(EF)的影响。从临床角度来看,间隔数周似乎更有利于手术准备:我们对 2011 年至 2020 年间在一家三级医疗中心接受局部前列腺癌(PCa)RP 治疗的患者进行了回顾性分析。我们评估了以下变量对 RP 术后 1 年 UC 和 EF 的影响:从活检到 RP 的时间、年龄、体重指数、病理 T 分期、EF 和术中神经疏通(单侧与双侧)。为此,我们进行了线性回归分析以及人工分组和聚类分析,以确定可能的时间截断范围。EPIC-26 和 IIEF 问卷用于评估 UC 和 EF:我们确定了 6202 名连续接受 RP 的患者。人工分组和聚类分析均未显示 RP 术后尿失禁或尿失禁率存在显著差异。根据线性回归模型,只有年龄是尿失禁的独立预测因素(95%-CI 0.006-0.01),RP 前的 EF(95%-CI 0.22-0.26)、年龄(95%-CI - 0.68 至 - 0.5)、体重指数(95%-CI - 0.66 至 - 0.29)和双侧 NS(95%-CI 5.5-2.1)对术后 EF 有显著影响(均为 p):在选定的患者群体中,前列腺活检与前列腺癌根治术之间的时间间隔似乎对术后功能预后(UC 和 EF)没有影响。
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引用次数: 0
Evaluating transurethral resection of the prostate over twenty years: a systematic review and meta-analysis of randomized clinical trials. 二十年来经尿道前列腺切除术的评估:随机临床试验的系统回顾和荟萃分析。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-15 DOI: 10.1007/s00345-024-05332-3
Joao G Porto, Ansh M Bhatia, Abhishek Bhat, Maria Camila Suarez Arbelaez, Ruben Blachman-Braun, Khushi Shah, Ankur Malpani, Diana Lopategui, Thomas R W Herrmann, Robert Marcovich, Hemendra N Shah

Purpose: The goal of this systematic review is to assess the temporal changes in outcomes and complications of transurethral resection of the prostate (TURP) from 2000 to 2022.

Methods: We conducted a systematic review and meta-analysis of 103 randomized clinical trials from PubMed on TURP, involving 8521 patients. Studies were grouped by years: 2000-2004, 2005-2009, 2010-2014, and 2015-2022. We assessed International Prostate Symptom Score (IPSS), Peak Flow (Qmax), Post-void residue of urine (PVR), and post-operative complications. Heterogeneity was ranked as low (I2 < 25%), moderate (I2 = 25-75%), or high (I2 > 75%).

Results: TURP significantly improved IPSS, Qmax, and PVR, with the most recent studies showing superior results in IPSS and Qmax after 3 years compared to 2000-2004 studies. Heterogeneity in PVR was high (I2 = 100%). No negative impact on erectile function was observed. Complication rates included TURP syndrome (2%), bleeding (8%), and blood transfusion (6%), but elevated heterogeneity with difference between the groups was seen in clot evacuation (I2 = 83%) and urinary tract infections (I2 = 82%). Other complications were urinary retention (4%), incontinence (8%), urethral stricture (3%), bladder neck stenosis (2%).

Conclusion: In the last 20 years there has not been a clear trend in the results of TURP. The found heterogeneity may indicate a lack of standardization in TURP procedures. However, symptomatic improvement among patients is uniform, which supports this procedure as a historical benchmark surgical treatment for BPH.

目的:本系统综述旨在评估 2000 年至 2022 年期间经尿道前列腺切除术(TURP)的疗效和并发症的时间变化:我们对PubMed上的103项经尿道前列腺电切术随机临床试验进行了系统综述和荟萃分析,共涉及8521名患者。研究按年份分组:2000-2004 年、2005-2009 年、2010-2014 年和 2015-2022 年。我们评估了国际前列腺症状评分(IPSS)、峰值流量(Qmax)、排尿后残余物(PVR)和术后并发症。异质性分为低(I2 2 = 25-75%)或高(I2 > 75%):结果:TURP能明显改善IPSS、Qmax和PVR,与2000-2004年的研究相比,最近的研究显示3年后的IPSS和Qmax效果更好。PVR 的异质性很高(I2 = 100%)。未观察到对勃起功能的负面影响。并发症发生率包括 TURP 综合征(2%)、出血(8%)和输血(6%),但血块排出(I2 = 83%)和尿路感染(I2 = 82%)的异质性较高,组间存在差异。其他并发症包括尿潴留(4%)、尿失禁(8%)、尿道狭窄(3%)、膀胱颈狭窄(2%):结论:在过去的 20 年中,TURP 的结果并没有明显的变化趋势。结论:在过去的 20 年中,TURP 术的结果并没有明显的趋势,发现的异质性可能表明 TURP 术缺乏标准化。然而,患者症状的改善是一致的,这支持了该手术作为良性前列腺增生症手术治疗的历史基准。
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引用次数: 0
SWL for pediatric population. 针对儿科人群的 SWL。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-12 DOI: 10.1007/s00345-024-05249-x
Rasim Guzel, Kemal Sarica
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引用次数: 0
Pressure reduction and suction characteristics of the new digital single use flexible ureteroscope with suction: an in-vitro experimental study. 新型数字化一次性柔性输尿管吸引镜的减压和吸引特性:体外实验研究。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-12 DOI: 10.1007/s00345-024-05334-1
Begoña Ballesta Martinez, Laurian Dragos, Vasileios Tatanis, Bhaskar Somani, Pedro Campillo Martinez, Oriol Angerri, Angelis Peteinaris, Arman Tsaturyan, Andres Kanashiro, Marina Garces Valverde, Manuel Christian Garcia Serrano, Javier Lopez Vivo, Sergio Fumero Arteaga, Evangelos Liatsikos, Panagiotis Kallidonis

Purpose: To assess the time taken by the single use 7.5Fr suction flexible ureteroscope to reduce pressure under 40 mm Hg and to characterize the behavior of stones, fragments and dust during suction activation.

Methods: An in vitro setting was developed for this experiment. A saline-filled globe, with the 7.5Fr single-use suction flexible ureteroscope, PU3033AH (ZhuHai Pusen Medical Technology Co, Ltd, Guangdon, China), an automatic irrigation pump and a pressure monitoring set were used at four modalities; i) continuous suction, no irrigation inflow; ii) continuous suction, irrigation inflow on; iii) one-second rate intermittent suction, irrigation inflow on, and iv) half-second rate intermittent suction, irrigation inflow on. The behavior of calcium oxalate stones from 0.5 to 5 mm when being aspirated via the ureteroscope into a plastic container filled with saline was recorded.

Results: Suction with the PU3033AH worked properly with the inflow irritation on. The fastest strategy to lower the pressure was by continuously pressing the suction button with the irrigation inflow on. Overall, the median time to reach 40 mg was roughly 3.5 s. The PU3033AH could aspirate 0.5 mm stones. The suction mode on a continuous pattern allowed the relocation of stones ranging from 1 to 5 mm on an experimental setup with no obstacles.

Conclusion: The PU3033AH was efficient in lowering pressure in a closed cavity mimicking the renal pelvis. Likewise, stone fragments under one millimeter were aspirated by the device whereas stones from one to five mm could be displaced when activating suction in continuous mode on an experimental setup with no obstacles.

目的:评估一次性使用的 7.5Fr 抽吸柔性输尿管镜将压力降至 40 mm Hg 以下所需的时间,并确定结石、碎片和灰尘在抽吸过程中的行为特征:方法:为本实验开发了一种体外环境。方法:为该实验开发了一个体外环境。5Fr一次性使用抽吸柔性输尿管镜(PU3033AH,珠海普森医疗科技有限公司,中国广东)、自动灌洗泵和压力监测装置在四种模式下使用:i) 持续抽吸,无灌洗流入;ii) 持续抽吸,开启灌洗流入;iii) 一秒率间歇抽吸,开启灌洗流入;iv) 半秒率间歇抽吸,开启灌洗流入。记录通过输尿管镜将 0.5 至 5 毫米的草酸钙结石吸入装有生理盐水的塑料容器中时的表现:结果:使用 PU3033AH 抽吸结石时,在打开流入刺激的情况下工作正常。降低压力的最快方法是在灌流开启的情况下持续按压抽吸按钮。PU3033AH 可以吸出 0.5 毫米的结石。在没有障碍物的实验装置上,通过连续模式的抽吸,可以移除 1 至 5 毫米的结石:结论:PU3033AH 能在模拟肾盂的封闭腔体内有效降低压力。同样,该设备能吸出 1 毫米以下的结石碎片,而在无障碍实验装置上以连续模式启动抽吸时,可移除 1 至 5 毫米的结石。
{"title":"Pressure reduction and suction characteristics of the new digital single use flexible ureteroscope with suction: an in-vitro experimental study.","authors":"Begoña Ballesta Martinez, Laurian Dragos, Vasileios Tatanis, Bhaskar Somani, Pedro Campillo Martinez, Oriol Angerri, Angelis Peteinaris, Arman Tsaturyan, Andres Kanashiro, Marina Garces Valverde, Manuel Christian Garcia Serrano, Javier Lopez Vivo, Sergio Fumero Arteaga, Evangelos Liatsikos, Panagiotis Kallidonis","doi":"10.1007/s00345-024-05334-1","DOIUrl":"https://doi.org/10.1007/s00345-024-05334-1","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the time taken by the single use 7.5Fr suction flexible ureteroscope to reduce pressure under 40 mm Hg and to characterize the behavior of stones, fragments and dust during suction activation.</p><p><strong>Methods: </strong>An in vitro setting was developed for this experiment. A saline-filled globe, with the 7.5Fr single-use suction flexible ureteroscope, PU3033AH (ZhuHai Pusen Medical Technology Co, Ltd, Guangdon, China), an automatic irrigation pump and a pressure monitoring set were used at four modalities; i) continuous suction, no irrigation inflow; ii) continuous suction, irrigation inflow on; iii) one-second rate intermittent suction, irrigation inflow on, and iv) half-second rate intermittent suction, irrigation inflow on. The behavior of calcium oxalate stones from 0.5 to 5 mm when being aspirated via the ureteroscope into a plastic container filled with saline was recorded.</p><p><strong>Results: </strong>Suction with the PU3033AH worked properly with the inflow irritation on. The fastest strategy to lower the pressure was by continuously pressing the suction button with the irrigation inflow on. Overall, the median time to reach 40 mg was roughly 3.5 s. The PU3033AH could aspirate 0.5 mm stones. The suction mode on a continuous pattern allowed the relocation of stones ranging from 1 to 5 mm on an experimental setup with no obstacles.</p><p><strong>Conclusion: </strong>The PU3033AH was efficient in lowering pressure in a closed cavity mimicking the renal pelvis. Likewise, stone fragments under one millimeter were aspirated by the device whereas stones from one to five mm could be displaced when activating suction in continuous mode on an experimental setup with no obstacles.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"638"},"PeriodicalIF":2.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anticoagulation, photoselective vaporization of the prostate and safety : a propensity score-matched study. 抗凝、前列腺光选择性汽化与安全性:倾向评分匹配研究。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-11 DOI: 10.1007/s00345-024-05273-x
Hugo Jacquey, François Kleinclauss, Loïc Balssa, Guillaume Guichard, Alexandre Frontczak

Purpose: We compared surgical complications after laser prostatic photovaporization in anticoagulated versus non-anticoagulated patients.

Methods: A propensity score was calculated and patients were matched, to compare postoperative complications using the Clavien-Dindo classification between the anticoagulated and non-anticoagulated groups. We also identified factors associated with complications, and perform an analysis of secondary endpoint with categories of urological complications.

Results: We included all patients that benefited a photovaporization between 2013 and 2022, either 811 patients, reducing to 245 after propensity score matching for anticoagulation. After propensity score matching, there were no differences in baseline characteristics between groups. Ninety five patients (38%) were receiving anticoagulants; 162 (66%) had an ASA score ≥ 3. Among 86 patients (35%) who experienced complications within 3 months postoperatively, 92% had a Clavien Dindo score ≤ 2. By multivariate analysis, anticoagulation was not statistically significant, the only significant risk factor for complications was ASA score ≥ 3 (Odds ratio (OR) 2.2; 95% confidence interval (CI) [1.2-4.1]). Secondary endpoint analysis for hematuria found ASA score of 3 or higher and anticoagulant treatment statistically significant in univariate and multivariate analysis, with OR of 2.9 (95% CI [1.1-7.4]) and OR of 3.5 (95% CI [1.7-7.5]), respectively.

Conclusion: Green light laser photovaporization of the prostate demonstrates significant safety, even in frail patients on anticoagulant therapy.

目的:我们比较了抗凝与非抗凝患者激光前列腺光汽化术后的手术并发症:方法:计算倾向评分并对患者进行配对,采用 Clavien-Dindo 分类法比较抗凝组与非抗凝组的术后并发症。我们还确定了与并发症相关的因素,并根据泌尿系统并发症的类别对次要终点进行了分析:我们纳入了2013年至2022年期间接受光汽化治疗的所有患者,共有811名患者,经过抗凝倾向得分匹配后减少到245名。经过倾向得分匹配后,各组间的基线特征无差异。95名患者(38%)正在接受抗凝治疗;162名患者(66%)的ASA评分≥3。术后 3 个月内出现并发症的 86 名患者(35%)中,92% 的患者的 Clavien Dindo 评分≤2。通过多变量分析,抗凝在统计学上没有意义,唯一显著的并发症风险因素是 ASA 评分≥ 3(比值比 (OR) 2.2;95% 置信区间 (CI) [1.2-4.1])。血尿的次要终点分析发现,ASA评分3分或以上和抗凝治疗在单变量和多变量分析中具有统计学意义,OR值分别为2.9(95% CI [1.1-7.4])和3.5(95% CI [1.7-7.5]):结论:绿光激光前列腺光汽化术具有显著的安全性,即使是正在接受抗凝治疗的体弱患者也不例外。
{"title":"Anticoagulation, photoselective vaporization of the prostate and safety : a propensity score-matched study.","authors":"Hugo Jacquey, François Kleinclauss, Loïc Balssa, Guillaume Guichard, Alexandre Frontczak","doi":"10.1007/s00345-024-05273-x","DOIUrl":"https://doi.org/10.1007/s00345-024-05273-x","url":null,"abstract":"<p><strong>Purpose: </strong>We compared surgical complications after laser prostatic photovaporization in anticoagulated versus non-anticoagulated patients.</p><p><strong>Methods: </strong>A propensity score was calculated and patients were matched, to compare postoperative complications using the Clavien-Dindo classification between the anticoagulated and non-anticoagulated groups. We also identified factors associated with complications, and perform an analysis of secondary endpoint with categories of urological complications.</p><p><strong>Results: </strong>We included all patients that benefited a photovaporization between 2013 and 2022, either 811 patients, reducing to 245 after propensity score matching for anticoagulation. After propensity score matching, there were no differences in baseline characteristics between groups. Ninety five patients (38%) were receiving anticoagulants; 162 (66%) had an ASA score ≥ 3. Among 86 patients (35%) who experienced complications within 3 months postoperatively, 92% had a Clavien Dindo score ≤ 2. By multivariate analysis, anticoagulation was not statistically significant, the only significant risk factor for complications was ASA score ≥ 3 (Odds ratio (OR) 2.2; 95% confidence interval (CI) [1.2-4.1]). Secondary endpoint analysis for hematuria found ASA score of 3 or higher and anticoagulant treatment statistically significant in univariate and multivariate analysis, with OR of 2.9 (95% CI [1.1-7.4]) and OR of 3.5 (95% CI [1.7-7.5]), respectively.</p><p><strong>Conclusion: </strong>Green light laser photovaporization of the prostate demonstrates significant safety, even in frail patients on anticoagulant therapy.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"636"},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A systematic review on urolithiasis in children with neurological disorders. 关于神经系统疾病儿童尿路结石的系统性综述。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-10 DOI: 10.1007/s00345-024-05330-5
Atinc Tozsin, Hakan Akdere, Selcuk Guven, Kamran Ahmed

Purpose: Advancements in medical treatments and increased access to healthcare have significantly extended the life expectancy of children with neurological disorders. However, this has also led to a higher incidence of secondary health issues, such as nephrolithiasis. This review aims to analyze the risk factors, management, and treatment outcomes for stone disease in children with neurological disorders and focus on specific risk factors such as immobilization, urinary tract infections, and metabolic abnormalities to identify key points in the occurrence of nephrolithiasis.

Methods: A comprehensive literature search was conducted across two primary databases, PubMed and Ovid Medline, to identify studies on urolithiasis in children with neurological disorders. A total of 771 articles were initially identified. After removing four duplicate articles, 729 were excluded following title and abstract screening due to irrelevance. Thirty-eight articles were selected for full-text review, and after further exclusions, 11 articles were included in this review.

Results: The studies mainly consisted of small-scale, single-center investigations. Nephrolithiasis were reported in 5-54% of patients across the studies. The most commonly identified risk factors were immobilization, urinary tract infections (UTIs), and hypercalciuria. Treatment options for urinary stones included medical expulsive therapy (MET), extracorporeal shock wave lithotripsy (ESWL), endoscopic surgery (RIRS), and percutaneous nephrolithotomy (PCNL).

Conclusion: Key steps in managing these patients include monitoring bone mineral density, conducting a 24-h urine analysis to assess metabolic components (despite challenges in obtaining this), and encouraging physical activity as much as the patient's condition permits.

目的:医疗技术的进步和医疗服务的普及大大延长了神经系统疾病患儿的预期寿命。然而,这也导致肾结石等继发性健康问题的发病率上升。本综述旨在分析神经系统疾病患儿结石病的风险因素、管理和治疗结果,并重点关注固定、尿路感染和代谢异常等特定风险因素,以确定发生肾炎的关键点:在 PubMed 和 Ovid Medline 两个主要数据库中进行了全面的文献检索,以确定有关神经系统疾病患儿尿路结石的研究。最初共发现了 771 篇文章。在删除了 4 篇重复文章后,有 729 篇文章因不相关而在标题和摘要筛选后被排除。筛选出 38 篇文章进行全文审阅,进一步排除后,本综述纳入了 11 篇文章:这些研究主要是小规模的单中心调查。在所有研究中,5%-54%的患者患有肾结石。最常见的风险因素是固定不动、尿路感染(UTI)和高钙血症。尿路结石的治疗方法包括药物排石疗法(MET)、体外冲击波碎石疗法(ESWL)、内窥镜手术(RIRS)和经皮肾镜碎石术(PCNL):管理这些患者的关键步骤包括监测骨矿物质密度、进行 24 小时尿液分析以评估代谢成分(尽管在获取尿液分析方面存在挑战),以及在患者病情允许的情况下鼓励其进行体育锻炼。
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引用次数: 0
Reply to Wei Qi's letter to the editor about "Preoperative proteinuria correlates with renal function after partial nephrectomy for renal cell carcinoma". 回复 Wei Qi 就 "肾细胞癌肾部分切除术后术前蛋白尿与肾功能的相关性 "写给编辑的信。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-09 DOI: 10.1007/s00345-024-05305-6
Michele Nicolazzini, Carlotta Palumbo, Francesca Porté, Gianmarco Bondonno, Paolo De Angelis, Maria Teresa Del Galdo, Alessandro Volpe

In this Letter, we respond to Wei Qi's Letter to the editor regarding our paper, "Preoperative proteinuria correlates with renal function after partial nephrectomy for renal cell carcinoma" (World Journal of Urology, 2024), addressing the concerns raised with the aim of clarifying the potential benefits of our findings in clinical practice.

在这封信中,我们回应了 Wei Qi 就我们的论文《肾细胞癌肾部分切除术后术前蛋白尿与肾功能的相关性》(《世界泌尿外科杂志》,2024 年)写给编辑的信,解决了他提出的问题,目的是澄清我们的研究结果在临床实践中的潜在益处。
{"title":"Reply to Wei Qi's letter to the editor about \"Preoperative proteinuria correlates with renal function after partial nephrectomy for renal cell carcinoma\".","authors":"Michele Nicolazzini, Carlotta Palumbo, Francesca Porté, Gianmarco Bondonno, Paolo De Angelis, Maria Teresa Del Galdo, Alessandro Volpe","doi":"10.1007/s00345-024-05305-6","DOIUrl":"https://doi.org/10.1007/s00345-024-05305-6","url":null,"abstract":"<p><p>In this Letter, we respond to Wei Qi's Letter to the editor regarding our paper, \"Preoperative proteinuria correlates with renal function after partial nephrectomy for renal cell carcinoma\" (World Journal of Urology, 2024), addressing the concerns raised with the aim of clarifying the potential benefits of our findings in clinical practice.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"634"},"PeriodicalIF":2.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current era HOLEP with MOSES 2.0 technology compared to the gold standard TURP. 目前采用 MOSES 2.0 技术的 HOLEP 与黄金标准 TURP 的比较。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2024-11-08 DOI: 10.1007/s00345-024-05309-2
Jamie Michael, Perry Xu, Nick Dean, Meera Ganesh, Kyle Tsai, Nabila Khondakar, Aidan Raikar, Amy Krambeck

Purpose: Bipolar TURP is regarded as the gold standard for treatment of BPH. Historically, when compared to HOLEP, bTURP has been found to have shorter operative times and is considered more efficient. We sought to compare the efficiency, efficacy, and safety of current era HOLEP with MOSES 2.0 technology (MOLEP) and bTURP.

Methods: We performed a retrospective review of patients who underwent bTURP or MOLEP at our institution between 2018 and 2023. Preoperative, intraoperative, and postoperative characteristics were collected for analysis. Analysis was done with SPSS software with significance defined as p < 0.05.

Results: We identified 195 bTURPs and 918 MOLEPs performed at our institution. Men undergoing MOLEP had significantly higher pre-op prostate volume and resected weight (61 ml v 123 ml and 15 g v 70 g, p < 0.001, respectively) when compared to bTURP patients. MOLEP was completed in significantly less OR and procedure time compared to bTURP (66 min vs. 73 min, p < 0.001; 90 min vs. 111 min, p = 0.026, respectively). These results remained significant when controlling for age and prostate volume. At a mean follow up of 3.7 months, HOLEP patients were significantly more likely to be medication (0 vs. 35.84% p < 0.001) and catheter free post-operatively (0.95% vs. 5.68%, p < 0.001) compared to bTURP.

Conclusion: In our contemporary cohort, MOLEP is faster and more efficient than bTURP. These findings remained significant despite being performed on larger prostates and in patients more likely to be anticoagulated. Furthermore, MOLEP patients are more likely to remain catheter and medication free at follow-up when compared to bTURP.

目的:双极 TURP 被认为是治疗良性前列腺增生症的金标准。从历史上看,与 HOLEP 相比,双极 TURP 的手术时间更短,效率更高。我们试图比较目前的 HOLEP 与 MOSES 2.0 技术(MOLEP)和 bTURP 的效率、有效性和安全性:我们对 2018 年至 2023 年期间在本院接受 bTURP 或 MOLEP 的患者进行了回顾性审查。收集术前、术中和术后特征进行分析。使用 SPSS 软件进行分析,显著性定义为 p 结果:我们确定了在本院进行的 195 例 bTURP 和 918 例 MOLEP。接受 MOLEP 的男性术前前列腺体积和切除重量(61 毫升对 123 毫升,15 克对 70 克,P)明显更高:在我们的现代队列中,MOLEP 比 bTURP 更快、更有效。尽管对前列腺较大和更有可能接受抗凝治疗的患者进行了 MOLEP,但这些结果仍然很重要。此外,与 bTURP 相比,MOLEP 患者在随访时更有可能不使用导管和药物。
{"title":"Current era HOLEP with MOSES 2.0 technology compared to the gold standard TURP.","authors":"Jamie Michael, Perry Xu, Nick Dean, Meera Ganesh, Kyle Tsai, Nabila Khondakar, Aidan Raikar, Amy Krambeck","doi":"10.1007/s00345-024-05309-2","DOIUrl":"https://doi.org/10.1007/s00345-024-05309-2","url":null,"abstract":"<p><strong>Purpose: </strong>Bipolar TURP is regarded as the gold standard for treatment of BPH. Historically, when compared to HOLEP, bTURP has been found to have shorter operative times and is considered more efficient. We sought to compare the efficiency, efficacy, and safety of current era HOLEP with MOSES 2.0 technology (MOLEP) and bTURP.</p><p><strong>Methods: </strong>We performed a retrospective review of patients who underwent bTURP or MOLEP at our institution between 2018 and 2023. Preoperative, intraoperative, and postoperative characteristics were collected for analysis. Analysis was done with SPSS software with significance defined as p < 0.05.</p><p><strong>Results: </strong>We identified 195 bTURPs and 918 MOLEPs performed at our institution. Men undergoing MOLEP had significantly higher pre-op prostate volume and resected weight (61 ml v 123 ml and 15 g v 70 g, p < 0.001, respectively) when compared to bTURP patients. MOLEP was completed in significantly less OR and procedure time compared to bTURP (66 min vs. 73 min, p < 0.001; 90 min vs. 111 min, p = 0.026, respectively). These results remained significant when controlling for age and prostate volume. At a mean follow up of 3.7 months, HOLEP patients were significantly more likely to be medication (0 vs. 35.84% p < 0.001) and catheter free post-operatively (0.95% vs. 5.68%, p < 0.001) compared to bTURP.</p><p><strong>Conclusion: </strong>In our contemporary cohort, MOLEP is faster and more efficient than bTURP. These findings remained significant despite being performed on larger prostates and in patients more likely to be anticoagulated. Furthermore, MOLEP patients are more likely to remain catheter and medication free at follow-up when compared to bTURP.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"633"},"PeriodicalIF":2.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
World Journal of Urology
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