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Predictive value of Bladder EpiCheck® in detecting residual tumor before second TUR for non-muscle-invasive bladder cancer.
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-27 DOI: 10.1007/s00345-025-05453-3
Serhat Süzan, İsmail Ulus, İbrahim Hacıbey, Ahmet Yaser Müslümanoğlu

Purpose: As Bladder EpiCheck® (BE) is a promising urinary biomarker for diagnosis and follow up of non-muscle-invasive bladder cancer (NMIBC), there are no studies evaluated this tool for second transurethral resection (TUR) indication. We aim to evaluate the performance of BE in predicting residual tumor before second TUR in NMIBC and its effects on clinical decision making.

Methods: A total of 50 patients who were diagnosed with NMIBC and indicated for a second TUR were included in the study prospectively. The urine sample taken one day before the second TUR operation was evaluated with BE and the results were compared with second TUR pathologies.

Results: The mean age was 65.3 and 45 of the patients were male. Specificity and negative predictive value of BE in primary tumor stage Ta were 100% and 87.5% while in primary tumor stage T1 were 71.4% and 68.2%, respectively. The specificity and negative predictive value of BE were 77.8% and 75%, respectively, in patients with high grade primary tumor. When all NMIBC were evaluated, the specificity and negative predictive value of BE were found to be 78.6% and 73.3% for second TUR, respectively. As an independent predictor of residual tumor in this group, positivity rates of BE were higher in T1 (p < 0.037) and high grade (p < 0.002) tumors.

Conclusions: BE may be useful in detecting residual tumor before second TUR and benefit in clinical decision making with high specificity and negative predictive value. These results encourage the use of BE to reduce number of unnecessary second TUR procedures. It may improve cost effectivity and quality of life as high numbered studies are needed to support these views and to incorporate BE into clinical practice.

{"title":"Predictive value of Bladder EpiCheck<sup>®</sup> in detecting residual tumor before second TUR for non-muscle-invasive bladder cancer.","authors":"Serhat Süzan, İsmail Ulus, İbrahim Hacıbey, Ahmet Yaser Müslümanoğlu","doi":"10.1007/s00345-025-05453-3","DOIUrl":"https://doi.org/10.1007/s00345-025-05453-3","url":null,"abstract":"<p><strong>Purpose: </strong>As Bladder EpiCheck<sup>®</sup> (BE) is a promising urinary biomarker for diagnosis and follow up of non-muscle-invasive bladder cancer (NMIBC), there are no studies evaluated this tool for second transurethral resection (TUR) indication. We aim to evaluate the performance of BE in predicting residual tumor before second TUR in NMIBC and its effects on clinical decision making.</p><p><strong>Methods: </strong>A total of 50 patients who were diagnosed with NMIBC and indicated for a second TUR were included in the study prospectively. The urine sample taken one day before the second TUR operation was evaluated with BE and the results were compared with second TUR pathologies.</p><p><strong>Results: </strong>The mean age was 65.3 and 45 of the patients were male. Specificity and negative predictive value of BE in primary tumor stage Ta were 100% and 87.5% while in primary tumor stage T1 were 71.4% and 68.2%, respectively. The specificity and negative predictive value of BE were 77.8% and 75%, respectively, in patients with high grade primary tumor. When all NMIBC were evaluated, the specificity and negative predictive value of BE were found to be 78.6% and 73.3% for second TUR, respectively. As an independent predictor of residual tumor in this group, positivity rates of BE were higher in T1 (p < 0.037) and high grade (p < 0.002) tumors.</p><p><strong>Conclusions: </strong>BE may be useful in detecting residual tumor before second TUR and benefit in clinical decision making with high specificity and negative predictive value. These results encourage the use of BE to reduce number of unnecessary second TUR procedures. It may improve cost effectivity and quality of life as high numbered studies are needed to support these views and to incorporate BE into clinical practice.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"89"},"PeriodicalIF":2.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048033","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
Chatbot's performance in answering medical questions: the effects of prompt design, customization settings, and session context.
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-27 DOI: 10.1007/s00345-025-05449-z
Mehmet Ezer
{"title":"Chatbot's performance in answering medical questions: the effects of prompt design, customization settings, and session context.","authors":"Mehmet Ezer","doi":"10.1007/s00345-025-05449-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05449-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"88"},"PeriodicalIF":2.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048030","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
New evidence for content validity of the German version of the Acute Cystitis Symptom Score: cognitive interview study among patients and experts. 德国版急性膀胱炎症状评分内容有效性的新证据:对患者和专家的认知访谈研究。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-25 DOI: 10.1007/s00345-024-05406-2
Sophie Nestler, Christian Apfelbacher, Ebru Özkan, Kurt Naber, Katharina Piontek

Purpose: The Acute Cystitis Symptom Score (ACSS) is a clinically validated instrument to assess symptoms and quality of life in women with uncomplicated urinary tract infections (uUTIs). A previous study examining the content validity of the German version of the ACSS has shown some methodological limitations when rated against the criteria for content validity of the COnsensus-based Standards for the Selection of Health Measurement INstruments (COSMIN) initiative. Extending the existing evidence, the present study aimed to assess the content validity of the German version of the ACSS according to the criteria of the COSMIN methodology.

Methods: In individual cognitive interviews following a structured, standardized interview guide, women with a history of uUTI and experts from different medical fields rated the instructions, items, response options and recall period of the ACSS in terms of relevance, comprehensiveness and comprehensibility. Additionally, the Content Validity Index (CVI) was calculated based on expert assessments to quantify content validity.

Results: A total of 14 patients and 14 experts participated in two rounds of interviews. The overall relevance and comprehensiveness of the instrument were rated as appropriate. Modifications focused on improving comprehensibility. Ten items underwent minor modifications or were given examples to enhance comprehensibility. The scales of five items were linguistically revised. Confirming good content validity, CVI was 0.97.

Conclusions: Comprehensive qualitative assessments support content validity of the ACSS for evaluating symptoms and quality of life in women with uUTIs. Minor modifications addressed comprehensibility. Psychometric validation of the revised ACSS is recommended.

{"title":"New evidence for content validity of the German version of the Acute Cystitis Symptom Score: cognitive interview study among patients and experts.","authors":"Sophie Nestler, Christian Apfelbacher, Ebru Özkan, Kurt Naber, Katharina Piontek","doi":"10.1007/s00345-024-05406-2","DOIUrl":"10.1007/s00345-024-05406-2","url":null,"abstract":"<p><strong>Purpose: </strong>The Acute Cystitis Symptom Score (ACSS) is a clinically validated instrument to assess symptoms and quality of life in women with uncomplicated urinary tract infections (uUTIs). A previous study examining the content validity of the German version of the ACSS has shown some methodological limitations when rated against the criteria for content validity of the COnsensus-based Standards for the Selection of Health Measurement INstruments (COSMIN) initiative. Extending the existing evidence, the present study aimed to assess the content validity of the German version of the ACSS according to the criteria of the COSMIN methodology.</p><p><strong>Methods: </strong>In individual cognitive interviews following a structured, standardized interview guide, women with a history of uUTI and experts from different medical fields rated the instructions, items, response options and recall period of the ACSS in terms of relevance, comprehensiveness and comprehensibility. Additionally, the Content Validity Index (CVI) was calculated based on expert assessments to quantify content validity.</p><p><strong>Results: </strong>A total of 14 patients and 14 experts participated in two rounds of interviews. The overall relevance and comprehensiveness of the instrument were rated as appropriate. Modifications focused on improving comprehensibility. Ten items underwent minor modifications or were given examples to enhance comprehensibility. The scales of five items were linguistically revised. Confirming good content validity, CVI was 0.97.</p><p><strong>Conclusions: </strong>Comprehensive qualitative assessments support content validity of the ACSS for evaluating symptoms and quality of life in women with uUTIs. Minor modifications addressed comprehensibility. Psychometric validation of the revised ACSS is recommended.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"86"},"PeriodicalIF":2.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transurethral resection of the prostate across continents: a meta-analysis evaluating quality of gold standard in the twenty-first century.
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-24 DOI: 10.1007/s00345-024-05439-7
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: To compare outcomes of transurethral resection of the prostate (TURP) across different regions worldwide over the past two decades.

Methods: A systematic review and meta-analysis of randomized clinical trials indexed to PubMed that assessed TURP. A total of 102 studies with 8,454 patients were included and grouped by continents: Europe, Asia, Africa, and Others (North America, South America, and Australia). International Prostate Symptom Score (IPSS), peak flow (Qmax), postvoid residual urine (PVR), PSA levels, prostate volume, and Sexual Health Inventory for Men scores (at 3, 12, and 36 months) were assessed, along with postoperative complications. Heterogeneity across studies was classified as low (I2 < 25%), moderate (I2 = 25-75%), or high (I2 > 75%).

Results: TURP consistently exhibited significant enhancements in IPSS, Qmax, and PVR across various regions. Notably, PVR demonstrated high heterogeneity (I²=100%). TURP presented low complication rates with TURP syndrome (2%), bleeding (8%), and blood transfusion (6%). However, significant heterogeneity was observed, particularly for clot evacuation (I2 = 87%), irritative symptoms (I2 = 96%), and incontinence (I2 = 84%). The retreatment rates at 1 and 3 years were 5% and 7%, respectively, with significant differences across regions.

Conclusion: Global outcomes of TURP lack a discernible trend. The substantial heterogeneity observed among continents suggests a lack of standardization. Nevertheless, uniform symptomatic improvements among patients still support TURP as the gold-standard surgical treatment for benign prostatic hyperplasia, despite variations in its results worldwide.

{"title":"Transurethral resection of the prostate across continents: a meta-analysis evaluating quality of gold standard in the twenty-first century.","authors":"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","doi":"10.1007/s00345-024-05439-7","DOIUrl":"10.1007/s00345-024-05439-7","url":null,"abstract":"<p><strong>Purpose: </strong>To compare outcomes of transurethral resection of the prostate (TURP) across different regions worldwide over the past two decades.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized clinical trials indexed to PubMed that assessed TURP. A total of 102 studies with 8,454 patients were included and grouped by continents: Europe, Asia, Africa, and Others (North America, South America, and Australia). International Prostate Symptom Score (IPSS), peak flow (Qmax), postvoid residual urine (PVR), PSA levels, prostate volume, and Sexual Health Inventory for Men scores (at 3, 12, and 36 months) were assessed, along with postoperative complications. Heterogeneity across studies was classified as low (I<sup>2</sup> < 25%), moderate (I<sup>2</sup> = 25-75%), or high (I<sup>2</sup> > 75%).</p><p><strong>Results: </strong>TURP consistently exhibited significant enhancements in IPSS, Qmax, and PVR across various regions. Notably, PVR demonstrated high heterogeneity (I²=100%). TURP presented low complication rates with TURP syndrome (2%), bleeding (8%), and blood transfusion (6%). However, significant heterogeneity was observed, particularly for clot evacuation (I<sup>2</sup> = 87%), irritative symptoms (I<sup>2</sup> = 96%), and incontinence (I<sup>2</sup> = 84%). The retreatment rates at 1 and 3 years were 5% and 7%, respectively, with significant differences across regions.</p><p><strong>Conclusion: </strong>Global outcomes of TURP lack a discernible trend. The substantial heterogeneity observed among continents suggests a lack of standardization. Nevertheless, uniform symptomatic improvements among patients still support TURP as the gold-standard surgical treatment for benign prostatic hyperplasia, despite variations in its results worldwide.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"85"},"PeriodicalIF":2.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Constructive feedback on the efficacy of tip-flexible suction access sheath in ureteroscopic lithotripsy for unilateral upper urinary tract calculi. 输尿管镜下单侧上尿路结石取石术中尖端柔性吸引通路鞘疗效的建设性反馈。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-22 DOI: 10.1007/s00345-025-05446-2
Miaolin Zeng, Jiansheng Xiao
{"title":"Constructive feedback on the efficacy of tip-flexible suction access sheath in ureteroscopic lithotripsy for unilateral upper urinary tract calculi.","authors":"Miaolin Zeng, Jiansheng Xiao","doi":"10.1007/s00345-025-05446-2","DOIUrl":"https://doi.org/10.1007/s00345-025-05446-2","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"82"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012943","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
Comment on "Physician vs. AI-generated messages in urology: evaluation of accuracy, completeness, and preference by patients and physicians". 评论“泌尿科医生与人工智能生成的信息:患者和医生对准确性、完整性和偏好的评估”。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-22 DOI: 10.1007/s00345-025-05448-0
Amnuay Kleebayoon, Viroj Wiwanitkit
{"title":"Comment on \"Physician vs. AI-generated messages in urology: evaluation of accuracy, completeness, and preference by patients and physicians\".","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1007/s00345-025-05448-0","DOIUrl":"https://doi.org/10.1007/s00345-025-05448-0","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"83"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012935","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
Letter to the Editor: "Environmental impact of current endoscopic technology in urological procedures: a systematic review on reusable vs. disposable scopes". 致编辑的信:“泌尿外科手术中当前内窥镜技术对环境的影响:对可重复使用与一次性内窥镜的系统回顾”。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-22 DOI: 10.1007/s00345-025-05454-2
Marlene Thöne, Steffen Rausch
{"title":"Letter to the Editor: \"Environmental impact of current endoscopic technology in urological procedures: a systematic review on reusable vs. disposable scopes\".","authors":"Marlene Thöne, Steffen Rausch","doi":"10.1007/s00345-025-05454-2","DOIUrl":"10.1007/s00345-025-05454-2","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"84"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility of robot-assisted system for navigated needle positioning in the PCNL procedure in vitro. 机器人辅助导航针定位系统在体外PCNL手术中的可行性。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-20 DOI: 10.1007/s00345-025-05450-6
Jianpo Zhai, Yong Zhang, Hai Wang, Guizhong Li, Libo Man

Purpose: The objective of this study was to explore the feasibility of using the TianJi Robot system for navigated needle positioning in the PCNL procedure in vitro.

Methods: A pig kidney with a segment of ureter was selected as the in vitro organ model. Iodine contrast agent was infused into the renal pelvis to dilate the renal pelvis and calyx to establish the in vitro hydronephrosis model. Fluoroscopic images were obtained using a 3D C-arm and transferred to the robotic workstation. Three-dimensional reconstructed images were generated and displayed on the monitor screen. The surgeon planned the optimal puncture trajectory on the workstation. After that, the robotic arm was instructed to move to the surgical field. The guiding cannula was placed onto the robotic arm and brought close to the skin. The needle was placed along the guiding cannula. An 18G needle was inserted manually. Finally, a second CBCT scan was performed to validate the needle's location.

Results: Three hydronephrosis models were used in the study, and a total of seven target calyces were planned. six target calyces were successfully punctured in one attempt, with a single-puncture success rate of 87.5%.

Conclusions: A high single-puncture success rate is achieved using the TianJi Robot system for navigated needle positioning in the PCNL procedure in vitro, marking an innovative step forward in urological interventions.

目的:探讨在体外PCNL手术中使用天际机器人系统进行导航定位的可行性。方法:以猪肾和一段输尿管作为体外器官模型。通过向肾盂内灌注碘造影剂扩张肾盂和肾盏,建立离体肾积水模型。使用3D c型臂获得透视图像并传输到机器人工作站。生成三维重建图像并显示在监视器屏幕上。外科医生在工作站上规划了最佳穿刺轨迹。之后,机器人手臂被指示移动到手术区域。引导套管被放置在机械臂上,靠近皮肤。针沿着引导套管放置。手工插入18G针头。最后,进行第二次CBCT扫描以验证针头的位置。结果:本研究采用3种肾积水模型,共规划7个靶肾盏。一次成功穿刺6个靶萼,单次穿刺成功率为87.5%。结论:在体外PCNL手术中,使用“天际机器人”导航定位系统实现了较高的单次穿刺成功率,标志着泌尿外科干预迈出了创新的一步。
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引用次数: 0
A comparison on safety and efficacy between 24 Fr versus 18 Fr pneumatic balloon dilators for percutaneous treatment of renal stones between 10 and 20 mm: results from a contemporary cohort. 24 Fr与18 Fr气囊扩张器用于10 - 20毫米肾结石经皮治疗的安全性和有效性比较:来自当代队列的结果。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-20 DOI: 10.1007/s00345-025-05445-3
Davide Perri, Umberto Besana, Matteo Maltagliati, Andrea Pacchetti, Tommaso Calcagnile, Antonio Luigi Pastore, Javier Romero-Otero, Salvatore Micali, Alexander Govorov, Bhaskar Somani, Evangelos Liatsikos, Thomas Knoll, Bernardo Rocco, Giorgio Bozzini

Purpose: To assess differences in safety and efficacy between 24 and 18 Fr pneumatic balloon dilators for percutaneous nephrolithotripsy (PCNL) of renal stones between 10 and 20 mm.

Methods: Patients were randomized to dilatation with a 24 Fr (Group A) versus 18 Fr (Group B) Ultraxx pneumatic dilator (Cook Medical®). In all procedures percutaneous puncture was performed under ultrasound guidance. In both groups the Holmium: YAG Cyber Ho laser generator was used (Quanta System®). Stone-free rate (SFR) and postoperative complications were assessed.

Results: 42 and 44 patients were assigned to Groups A and B, respectively. Preoperative features were comparable. Mean stone size was 17.8 vs. 16.6 mm in Group A vs. B (p = 0.21). SFR was 95.2% in Group A and 95.4% in Group B (p = 0.19). Postoperative gross haematuria was observed in 5 vs. 2 cases in Group A vs. B (p = 0.04). Mean haemoglobin drop at first postoperative day (POD) was higher in Group A (2.4 vs. 1.1 mg/dl, p = 0.04), while comparable at third POD. Blood transfusion was required in 2 cases in Group A and 1 case in Group B. No patients required embolization. No significant difference was observed in terms of postoperative pain and urinary infection.

Conclusions: 24 and 18 Fr pneumatic dilators are both effective to access renal cavity during PCNL for the treatment of renal stones between 10 and 20 mm. Gross haematuria rate and mean haemoglobin decrease at first POD were significantly higher with 24 Fr dilator, but with no differences in the need for blood transfusions and renal embolization.

目的:评价24和18fr气球囊扩张器用于10 - 20mm肾结石经皮肾镜碎石术(PCNL)的安全性和有效性差异。方法:患者随机分为24fr (a组)和18fr (B组)Ultraxx气球囊扩张器(Cook Medical®)。所有手术均在超声引导下经皮穿刺。两组均使用Holmium: YAG Cyber Ho激光发生器(Quanta System®)。评估无结石率(SFR)及术后并发症。结果:A组42例,B组44例。术前特征具有可比性。A组和B组的平均结石大小分别为17.8和16.6 mm (p = 0.21)。A组SFR为95.2%,B组为95.4% (p = 0.19)。A组术后总血尿5例,B组2例(p = 0.04)。A组术后第一天平均血红蛋白下降(POD)较高(2.4 vs 1.1 mg/dl, p = 0.04),而第三天的POD相当。A组2例需要输血,b组1例需要栓塞。两组术后疼痛和尿路感染无明显差异。结论:在PCNL术中,24fr和18fr气动扩张器均可有效进入肾腔,用于治疗10 ~ 20mm肾结石。总血尿率和首次POD时平均血红蛋白下降明显高于24fr扩张器,但在输血和肾栓塞的需要方面没有差异。
{"title":"A comparison on safety and efficacy between 24 Fr versus 18 Fr pneumatic balloon dilators for percutaneous treatment of renal stones between 10 and 20 mm: results from a contemporary cohort.","authors":"Davide Perri, Umberto Besana, Matteo Maltagliati, Andrea Pacchetti, Tommaso Calcagnile, Antonio Luigi Pastore, Javier Romero-Otero, Salvatore Micali, Alexander Govorov, Bhaskar Somani, Evangelos Liatsikos, Thomas Knoll, Bernardo Rocco, Giorgio Bozzini","doi":"10.1007/s00345-025-05445-3","DOIUrl":"10.1007/s00345-025-05445-3","url":null,"abstract":"<p><strong>Purpose: </strong>To assess differences in safety and efficacy between 24 and 18 Fr pneumatic balloon dilators for percutaneous nephrolithotripsy (PCNL) of renal stones between 10 and 20 mm.</p><p><strong>Methods: </strong>Patients were randomized to dilatation with a 24 Fr (Group A) versus 18 Fr (Group B) Ultraxx pneumatic dilator (Cook Medical<sup>®</sup>). In all procedures percutaneous puncture was performed under ultrasound guidance. In both groups the Holmium: YAG Cyber Ho laser generator was used (Quanta System<sup>®</sup>). Stone-free rate (SFR) and postoperative complications were assessed.</p><p><strong>Results: </strong>42 and 44 patients were assigned to Groups A and B, respectively. Preoperative features were comparable. Mean stone size was 17.8 vs. 16.6 mm in Group A vs. B (p = 0.21). SFR was 95.2% in Group A and 95.4% in Group B (p = 0.19). Postoperative gross haematuria was observed in 5 vs. 2 cases in Group A vs. B (p = 0.04). Mean haemoglobin drop at first postoperative day (POD) was higher in Group A (2.4 vs. 1.1 mg/dl, p = 0.04), while comparable at third POD. Blood transfusion was required in 2 cases in Group A and 1 case in Group B. No patients required embolization. No significant difference was observed in terms of postoperative pain and urinary infection.</p><p><strong>Conclusions: </strong>24 and 18 Fr pneumatic dilators are both effective to access renal cavity during PCNL for the treatment of renal stones between 10 and 20 mm. Gross haematuria rate and mean haemoglobin decrease at first POD were significantly higher with 24 Fr dilator, but with no differences in the need for blood transfusions and renal embolization.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"79"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012933","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
Grip strength, a predictor of stress urinary incontinence after endoscopic enucleation of the prostate for benign prostate hyperplasia. 握力,在内镜下前列腺摘除良性前列腺增生后应激性尿失禁的预测因子。
IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2025-01-20 DOI: 10.1007/s00345-024-05431-1
Hong-Chen Song, Meng-Hua Wu, Dong Han, Jia-Xin Liu, Zi-Bing Cao, Yuan Du, Ming-Jun Shi, Jian Song, Xuan-Hao Li

Objective: To investigate the relationship between the grip strength (GS) and stress urinary incontinence (SUI) after endoscopic enucleation of the prostate (EEP).

Methods: We retrospectively collected 87 patients who underwent EEP at our center from January to December 2023. The associations between GS and post-surgical SUI at immediate, 1, 4, 12 and 24 weeks were analyzed. The cohort was then divided into the SUI and non-SUI group based on the presence of the SUI at 4-week postoperatively.

Results: Of overall 87 patients, 49 (56.3%), 40 (46.0%), 33 (37.9%), 20 (23.0%), and 9 (10.3%) patients presented SUI at immediate, 1, 4, 12 and 24 weeks postoperatively. Significant negative correlations were consistently observed between the GS and SUI till 12 weeks postoperatively, with patients requiring more daily pads presenting lower GS. Compared to the non-SUI group, the SUI group had significantly higher average age (76.0 ± 8.4 vs. 70.1 ± 6.3, P = 0.001), BMI (25.1 ± 2.9 vs. 23.8 ± 2.9, P = 0.040), rates of PKEP (90.9% vs. 72.2%, P = 0.037), CSEA (69.7% vs. 42.6%, P = 0.014) and III/IV ASA score (33.3% vs. 14.8%, P = 0.043), but lower GS (26.2 ± 8.2 vs. 33.3 ± 6.5 kg, P < 0.001). Multivariate analyses identified BMI and GS as independent risk factors for post-operative SUI.

Conclusions: The GS was found to be negatively correlated with post-operative SUI within 12 weeks after EEP and was an independent predictor of SUI at 4 weeks postoperatively.

目的:探讨内镜下前列腺摘除术(EEP)后握力(GS)与压力性尿失禁(SUI)的关系。方法:回顾性收集2023年1月至12月在我中心行脑电图治疗的87例患者。分析即刻、1周、4周、12周和24周GS与术后SUI的关系。然后根据术后4周SUI的存在将队列分为SUI组和非SUI组。结果:87例患者中,分别有49例(56.3%)、40例(46.0%)、33例(37.9%)、20例(23.0%)和9例(10.3%)在术后即刻、1周、4周、12周和24周出现SUI。直到术后12周,GS和SUI之间一直观察到显著的负相关,每天需要更多垫子的患者表现出较低的GS。与非SUI组相比,SUI组患者的平均年龄(76.0±8.4比70.1±6.3,P = 0.001)、BMI(25.1±2.9比23.8±2.9,P = 0.040)、PKEP发生率(90.9%比72.2%,P = 0.037)、CSEA(69.7%比42.6%,P = 0.014)、III/IV ASA评分(33.3%比14.8%,P = 0.043)显著高于SUI组(26.2±8.2比33.3±6.5 kg, P = 0.043)。发现脑电图后12周内GS与术后SUI呈负相关,是术后4周SUI的独立预测因子。
{"title":"Grip strength, a predictor of stress urinary incontinence after endoscopic enucleation of the prostate for benign prostate hyperplasia.","authors":"Hong-Chen Song, Meng-Hua Wu, Dong Han, Jia-Xin Liu, Zi-Bing Cao, Yuan Du, Ming-Jun Shi, Jian Song, Xuan-Hao Li","doi":"10.1007/s00345-024-05431-1","DOIUrl":"https://doi.org/10.1007/s00345-024-05431-1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between the grip strength (GS) and stress urinary incontinence (SUI) after endoscopic enucleation of the prostate (EEP).</p><p><strong>Methods: </strong>We retrospectively collected 87 patients who underwent EEP at our center from January to December 2023. The associations between GS and post-surgical SUI at immediate, 1, 4, 12 and 24 weeks were analyzed. The cohort was then divided into the SUI and non-SUI group based on the presence of the SUI at 4-week postoperatively.</p><p><strong>Results: </strong>Of overall 87 patients, 49 (56.3%), 40 (46.0%), 33 (37.9%), 20 (23.0%), and 9 (10.3%) patients presented SUI at immediate, 1, 4, 12 and 24 weeks postoperatively. Significant negative correlations were consistently observed between the GS and SUI till 12 weeks postoperatively, with patients requiring more daily pads presenting lower GS. Compared to the non-SUI group, the SUI group had significantly higher average age (76.0 ± 8.4 vs. 70.1 ± 6.3, P = 0.001), BMI (25.1 ± 2.9 vs. 23.8 ± 2.9, P = 0.040), rates of PKEP (90.9% vs. 72.2%, P = 0.037), CSEA (69.7% vs. 42.6%, P = 0.014) and III/IV ASA score (33.3% vs. 14.8%, P = 0.043), but lower GS (26.2 ± 8.2 vs. 33.3 ± 6.5 kg, P < 0.001). Multivariate analyses identified BMI and GS as independent risk factors for post-operative SUI.</p><p><strong>Conclusions: </strong>The GS was found to be negatively correlated with post-operative SUI within 12 weeks after EEP and was an independent predictor of SUI at 4 weeks postoperatively.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"80"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012946","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
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World Journal of Urology
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