Pub Date : 2025-04-01DOI: 10.1016/j.ajur.2025.01.001
Hongkai Wang, Dingwei Ye
{"title":"New surgical robotic platforms in China and their applications in urologic surgeries","authors":"Hongkai Wang, Dingwei Ye","doi":"10.1016/j.ajur.2025.01.001","DOIUrl":"10.1016/j.ajur.2025.01.001","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 134-138"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Robotics, artificial intelligence, telepresence, and telesurgery: The future of urology","authors":"Vipul Patel, Shady Saikali, Marcio Covas Moschovas","doi":"10.1016/j.ajur.2025.03.001","DOIUrl":"10.1016/j.ajur.2025.03.001","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 131-133"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To present the surgical technique of robotic buccal ureteroplasty for strictures after laser lithotripsy and its outcomes.
Methods
This was a retrospective study conducted at the Department of Urology, Apollo Hospitals, Chennai, India from October 2012 to October 2022. Indications for surgery included worsening hydronephrosis, declining renal function, and recurrent urinary tract infections with obstruction. Apart from liberal exposure of the stricture, we stress upon use of indocyanine green to assess vascularity and quilting of the graft to bare area of the psoas muscle to increase graft vascularity.
Results
Among the 15 patients, ureteropelvic junction strictures were observed in eight (53%), while five (33%) had proximal ureteric strictures, and two (13%) had mid-ureteral strictures. Notably, eight of the 15 patients (53%) had previous unsuccessful double-J stenting. The median stricture length was 3.5 (range: 2.0–5.0) cm, with a mean operative time of 167 (range: 126–214) min and estimated blood loss of 60 (range: 40–100) mL. After a median follow-up of 12 (range: 4–32) months, 13 out of the 15 patients (87%) showed significant improvement in their follow-up functional scans.
Conclusion
Robotic buccal ureteroplasty is a very effective technique for the management of laser-induced ureteral strictures with good long-term results and minimal morbidity. The results are comparable irrespective of previous failed stenting.
{"title":"A decade's experience of robotic buccal ureteroplasty for post-ureteroscopic laser lithotripsy-induced strictures—Should this be the new standard?","authors":"Deerush Kannan Sakthivel , Pratik Taur , Rajesh Paul , Pravin Meenashi Sundaram , Deepak Raghavan","doi":"10.1016/j.ajur.2024.03.003","DOIUrl":"10.1016/j.ajur.2024.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>To present the surgical technique of robotic buccal ureteroplasty for strictures after laser lithotripsy and its outcomes.</div></div><div><h3>Methods</h3><div>This was a retrospective study conducted at the Department of Urology, Apollo Hospitals, Chennai, India from October 2012 to October 2022. Indications for surgery included worsening hydronephrosis, declining renal function, and recurrent urinary tract infections with obstruction. Apart from liberal exposure of the stricture, we stress upon use of indocyanine green to assess vascularity and quilting of the graft to bare area of the psoas muscle to increase graft vascularity.</div></div><div><h3>Results</h3><div>Among the 15 patients, ureteropelvic junction strictures were observed in eight (53%), while five (33%) had proximal ureteric strictures, and two (13%) had mid-ureteral strictures. Notably, eight of the 15 patients (53%) had previous unsuccessful double-J stenting. The median stricture length was 3.5 (range: 2.0–5.0) cm, with a mean operative time of 167 (range: 126–214) min and estimated blood loss of 60 (range: 40–100) mL. After a median follow-up of 12 (range: 4–32) months, 13 out of the 15 patients (87%) showed significant improvement in their follow-up functional scans.</div></div><div><h3>Conclusion</h3><div>Robotic buccal ureteroplasty is a very effective technique for the management of laser-induced ureteral strictures with good long-term results and minimal morbidity. The results are comparable irrespective of previous failed stenting.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 258-261"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.ajur.2024.05.001
Qianying Ji , Jun Wang , Tong Zhao , Yetao Zhang , Kai Li , Yong Wei , Qingyi Zhu
Objective
To present a modified technique for robot-assisted laparoendoscopic single-site retroperitoneal nephroureterectomy (RLESS-RNU) with bladder cuff excision and evaluate its effectiveness as a minimally invasive approach for managing upper tract urothelial carcinoma (UTUC).
Methods
Fifteen patients who underwent RLESS-RNU for UTUC between April 2020 and June 2021 were reviewed at our medical institution (The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China), from our prospectively maintained institutional database. The da Vinci® Xi system (Intuitive Surgical, Sunnyvale, CA, USA) was utilized for surgical procedures in all patients. An in-depth analysis was conducted on their baseline demographic characteristics, pathological factors, and perioperative details. The complete surgical process and details are elaborated.
Results
The median age of 15 patients was 67 years. The final pathology demonstrated 47% (7/15) patients with pT1 or lower and 47% (7/15) with pT3; one patient could not undergo pathological staging because of preoperative chemotherapy. The perioperative outcomes revealed that the mean operative time was 185 (standard deviation [SD] 23.05) min. The mean times of the trocar placement for primary and second docking were 15.00 (SD 0.85) min and 8.00 (SD 0.52) min, respectively. The median estimated blood loss was 55 mL. The mean drainage tube duration and postoperative hospital stay were 7.50 days and 11.00 days, respectively. After a mean follow-up period of 24.20 months, the relapse-free survival rate was 87%. Two patients experienced disease progression: one patient exhibited multifocal evidence of non-muscle invasive bladder cancer, and the other patient developed systemic recurrence.
Conclusion
This study demonstrates that the modified technique for RLESS-RNU is safe and satisfactory for UTUC.
{"title":"Robot-assisted laparoendoscopic single-site retroperitoneal nephroureterectomy with bladder cuff excision for upper tract urothelial carcinoma: Preliminary experience","authors":"Qianying Ji , Jun Wang , Tong Zhao , Yetao Zhang , Kai Li , Yong Wei , Qingyi Zhu","doi":"10.1016/j.ajur.2024.05.001","DOIUrl":"10.1016/j.ajur.2024.05.001","url":null,"abstract":"<div><h3>Objective</h3><div>To present a modified technique for robot-assisted laparoendoscopic single-site retroperitoneal nephroureterectomy (RLESS-RNU) with bladder cuff excision and evaluate its effectiveness as a minimally invasive approach for managing upper tract urothelial carcinoma (UTUC).</div></div><div><h3>Methods</h3><div>Fifteen patients who underwent RLESS-RNU for UTUC between April 2020 and June 2021 were reviewed at our medical institution (The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China), from our prospectively maintained institutional database. The da Vinci® Xi system (Intuitive Surgical, Sunnyvale, CA, USA) was utilized for surgical procedures in all patients. An in-depth analysis was conducted on their baseline demographic characteristics, pathological factors, and perioperative details. The complete surgical process and details are elaborated.</div></div><div><h3>Results</h3><div>The median age of 15 patients was 67 years. The final pathology demonstrated 47% (7/15) patients with pT1 or lower and 47% (7/15) with pT3; one patient could not undergo pathological staging because of preoperative chemotherapy. The perioperative outcomes revealed that the mean operative time was 185 (standard deviation [SD] 23.05) min. The mean times of the trocar placement for primary and second docking were 15.00 (SD 0.85) min and 8.00 (SD 0.52) min, respectively. The median estimated blood loss was 55 mL. The mean drainage tube duration and postoperative hospital stay were 7.50 days and 11.00 days, respectively. After a mean follow-up period of 24.20 months, the relapse-free survival rate was 87%. Two patients experienced disease progression: one patient exhibited multifocal evidence of non-muscle invasive bladder cancer, and the other patient developed systemic recurrence.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that the modified technique for RLESS-RNU is safe and satisfactory for UTUC.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 244-249"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.ajur.2024.09.010
Antonio Andrea Grosso , Vincenzo Salamone , Fabrizio Di Maida, Sofia Giudici, Anna Cadenar, Luca Lambertini, Francesco Lupo Conte, Mara Bacchiani, Luca Mazzola, Alfonso Crisci, Rino Oriti, Gianni Vittori, Riccardo Fantechi, Agostino Tuccio, Andrea Mari, Andrea Minervini
Objective
Nowadays robot-assisted partial nephrectomy (RAPN) represents the standard of care for clinical T1 (cT1) renal masses, providing similar oncological outcomes when compared to open or laparoscopic PN with advantages in terms of functional outcomes and lower perioperative comorbidity, when compared to radical nephrectomy.
Methods
We performed an extensive literature review of studies regarding RAPN, its evolution, technical aspects and applications, and new technological tools using different combinations of Medical Subject Headings terms “RAPN”, “partial nephrectomy”, “robot-assisted”, “nephron-sparing surgery”, “renal cell carcinoma”, “complex renal masses”, “endophytic renal masses”, and “bilateral renal tumors”.
Results
A consistent body of evidence was selected, including original articles, systematic reviews, meta-analyses, and clinical trials having RAPN as the central focus in adult patients, with all its technical nuances. We started our narrative review with a background on PN and its evolution toward the robotic era with a special spotlight on the extending indications for PN in large and highly complex renal masses. Our review continued with an overview of nephron-sparing surgery in bilateral and recurrent masses. RAPN for bilateral synchronous renal masses represents a challenging scenario with no formal recommendations provided by international guidelines and controversial management and decision-making. Additionally, we reported evidence on redo RAPN which seems to be safe and effective. A final overview of the available technological tools, and in particular on three-dimensional reconstruction was provided.
Conclusion
RAPN has been established as the standard of care for cT1 renal masses with an expanding spectrum of applications in different scenarios, including large (cT2), highly complex, and bilateral renal masses, as well as the surgical treatment of local recurrences after nephron-sparing surgery with acknowledged advantages in terms of functional outcomes and perioperative risk profiles while maintaining similar oncological outcomes when compared to open or laparoscopic PN and radical treatment.
{"title":"Robot-assisted partial nephrectomy for renal cell carcinoma: A narrative review of different clinical scenarios","authors":"Antonio Andrea Grosso , Vincenzo Salamone , Fabrizio Di Maida, Sofia Giudici, Anna Cadenar, Luca Lambertini, Francesco Lupo Conte, Mara Bacchiani, Luca Mazzola, Alfonso Crisci, Rino Oriti, Gianni Vittori, Riccardo Fantechi, Agostino Tuccio, Andrea Mari, Andrea Minervini","doi":"10.1016/j.ajur.2024.09.010","DOIUrl":"10.1016/j.ajur.2024.09.010","url":null,"abstract":"<div><h3>Objective</h3><div>Nowadays robot-assisted partial nephrectomy (RAPN) represents the standard of care for clinical T1 (cT1) renal masses, providing similar oncological outcomes when compared to open or laparoscopic PN with advantages in terms of functional outcomes and lower perioperative comorbidity, when compared to radical nephrectomy.</div></div><div><h3>Methods</h3><div>We performed an extensive literature review of studies regarding RAPN, its evolution, technical aspects and applications, and new technological tools using different combinations of Medical Subject Headings terms “RAPN”, “partial nephrectomy”, “robot-assisted”, “nephron-sparing surgery”, “renal cell carcinoma”, “complex renal masses”, “endophytic renal masses”, and “bilateral renal tumors”.</div></div><div><h3>Results</h3><div>A consistent body of evidence was selected, including original articles, systematic reviews, meta-analyses, and clinical trials having RAPN as the central focus in adult patients, with all its technical nuances. We started our narrative review with a background on PN and its evolution toward the robotic era with a special spotlight on the extending indications for PN in large and highly complex renal masses. Our review continued with an overview of nephron-sparing surgery in bilateral and recurrent masses. RAPN for bilateral synchronous renal masses represents a challenging scenario with no formal recommendations provided by international guidelines and controversial management and decision-making. Additionally, we reported evidence on redo RAPN which seems to be safe and effective. A final overview of the available technological tools, and in particular on three-dimensional reconstruction was provided.</div></div><div><h3>Conclusion</h3><div>RAPN has been established as the standard of care for cT1 renal masses with an expanding spectrum of applications in different scenarios, including large (cT2), highly complex, and bilateral renal masses, as well as the surgical treatment of local recurrences after nephron-sparing surgery with acknowledged advantages in terms of functional outcomes and perioperative risk profiles while maintaining similar oncological outcomes when compared to open or laparoscopic PN and radical treatment.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 210-216"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.04.002
Kiron Krishnaprasad, Ravi Teja Pathi, Mustafa Nazar
Objective
The use of lasers has been an important part of urology in the treatment of stone and prostate disease. The thermal effects of lasers in lithotripsy have been a subject of debate over the years. The objective of this review was to assess the current state of knowledge available on the thermal effects of lasers in lithotripsy, as well as explore any new areas where studies are needed.
Methods
In August 2022, a keyword search on Google Scholar, PubMed, and Scopus for all papers containing the phrases “thermal effects” AND “laser” AND “lithotripsy” AND “urology” was done followed by citation jumping to other studies pertaining to the topic and 35 relevant papers were included in our study. The data from relevant papers were segregated into five groups according to the factor studied and type of study, and tables were created for a comparison of data.
Results
Temperature above the threshold of 43 °C was reached only when the power was >40 W and when there was adequate irrigation (at least 15–30 mL/min). Shorter lasing time divided by lithotripsy time or operator duty cycles less than 70% also resulted in a smaller temperature rise.
Conclusion
At least eight factors modify the thermal effects of lasers, and most importantly, the use of chilled irrigation at higher perfusion rates, lower power settings of <40 W, and with a shorter operator duty cycle will help to prevent thermal injuries from occurring. Stones impacted in the ureter or pelvi-ureteric junction further increase the probability of thermal injuries during laser firing.
{"title":"Factors affecting the thermal effects of lasers in lithotripsy: A literature review","authors":"Kiron Krishnaprasad, Ravi Teja Pathi, Mustafa Nazar","doi":"10.1016/j.ajur.2024.04.002","DOIUrl":"10.1016/j.ajur.2024.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>The use of lasers has been an important part of urology in the treatment of stone and prostate disease. The thermal effects of lasers in lithotripsy have been a subject of debate over the years. The objective of this review was to assess the current state of knowledge available on the thermal effects of lasers in lithotripsy, as well as explore any new areas where studies are needed.</div></div><div><h3>Methods</h3><div>In August 2022, a keyword search on Google Scholar, PubMed, and Scopus for all papers containing the phrases “thermal effects” AND “laser” AND “lithotripsy” AND “urology” was done followed by citation jumping to other studies pertaining to the topic and 35 relevant papers were included in our study. The data from relevant papers were segregated into five groups according to the factor studied and type of study, and tables were created for a comparison of data.</div></div><div><h3>Results</h3><div>Temperature above the threshold of 43 °C was reached only when the power was >40 W and when there was adequate irrigation (at least 15–30 mL/min). Shorter lasing time divided by lithotripsy time or operator duty cycles less than 70% also resulted in a smaller temperature rise.</div></div><div><h3>Conclusion</h3><div>At least eight factors modify the thermal effects of lasers, and most importantly, the use of chilled irrigation at higher perfusion rates, lower power settings of <40 W, and with a shorter operator duty cycle will help to prevent thermal injuries from occurring. Stones impacted in the ureter or pelvi-ureteric junction further increase the probability of thermal injuries during laser firing.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 23-32"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.04.001
Wissam Khalid Kamal , Musab M. Alghamdi , Raed A. Azhar , Ahmad Bugis , Mohammed Abuzenada , Majed Alharthi , Saeed Bin Hamri , Yahya Ghazwani , Yasser A. Noureldin , Hassan Aljifri , Abdulaziz Alamri , Hatem Hamed Althubiany , Mansour Alnazari , Badr Alharbi , Abdulrahman Al Own , Mohanad Jebril Bosily , Mohammed Almansour , Abdullah Alfakhri , Ibrahim Alowidah , Ali Abdel Raheem
Objective
To assess the effect of upper urinary tract (UUT) urolithiasis on urology services in a region with a high prevalence of the condition, and analyze the trends in endourological procedures for treating UUT urolithiasis and the cost of treatments in 11 hospitals over the last 6 years.
Methods
Using the hospital surgery statistics database, data were gathered from the urology departments of 11 hospitals in Saudi Arabia. The analysis focused on the trends, distribution, and annual cost of endourological procedures for UUT urolithiasis from January 2017 to December 2022.
Results
Out of the total surgery performed (54 711), over half (31 039, 57%) were related to UUT urolithiasis. Extracorporeal shock wave lithotripsy (ESWL) was the most performed procedure among stone-related procedures, accounting for 38% of all procedures. Double-J stent insertion, flexible ureteroscopy (URS), semi-rigid URS, percutaneous nephrolithotomy, and pyelo- and uretero-lithotomy accounted for 25%, 19%, 14%, 3.8%, and 0.35%, respectively. Notably, the number of stone-related UUT procedures in 2022 increased by 35% (from 4671 to 6283) compared to 2017. In the year 2022 compared to 2017, there was a statistically significant increase in the rate of all stone-related UUT procedures (p<0.001), except for ESWL and pyelo- and uretero-lithotomy. The rates of ESWL procedures reduced from 21% in 2017 to 13% in 2022 (p<0.001). Overall, the total cost of treatments has been estimated to be about 192.1 million SAR from 2017 to 2022 with an increase by 107% (47.7 million SAR in 2022 vs. 23.0 million SAR in 2017).
Conclusion
Our research findings suggest that urolithiasis poses a significant burden, accounting for over half of all urological surgery performed at the participating centers. Furthermore, there has been a 35% rise in stone-related UUT procedures over the past 6 years. Percutaneous nephrolithotomy, flexible URS, and semi-rigid URS have experienced significant increase in usage. Furthermore, in 2022 the cost of urolithiasis treatments has been more than doubled compared to 2017.
{"title":"The impact of urolithiasis on urology services in a high-prevalence region: A multicenter study","authors":"Wissam Khalid Kamal , Musab M. Alghamdi , Raed A. Azhar , Ahmad Bugis , Mohammed Abuzenada , Majed Alharthi , Saeed Bin Hamri , Yahya Ghazwani , Yasser A. Noureldin , Hassan Aljifri , Abdulaziz Alamri , Hatem Hamed Althubiany , Mansour Alnazari , Badr Alharbi , Abdulrahman Al Own , Mohanad Jebril Bosily , Mohammed Almansour , Abdullah Alfakhri , Ibrahim Alowidah , Ali Abdel Raheem","doi":"10.1016/j.ajur.2024.04.001","DOIUrl":"10.1016/j.ajur.2024.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effect of upper urinary tract (UUT) urolithiasis on urology services in a region with a high prevalence of the condition, and analyze the trends in endourological procedures for treating UUT urolithiasis and the cost of treatments in 11 hospitals over the last 6 years.</div></div><div><h3>Methods</h3><div>Using the hospital surgery statistics database, data were gathered from the urology departments of 11 hospitals in Saudi Arabia. The analysis focused on the trends, distribution, and annual cost of endourological procedures for UUT urolithiasis from January 2017 to December 2022.</div></div><div><h3>Results</h3><div>Out of the total surgery performed (54 711), over half (31 039, 57%) were related to UUT urolithiasis. Extracorporeal shock wave lithotripsy (ESWL) was the most performed procedure among stone-related procedures, accounting for 38% of all procedures. Double-J stent insertion, flexible ureteroscopy (URS), semi-rigid URS, percutaneous nephrolithotomy, and pyelo- and uretero-lithotomy accounted for 25%, 19%, 14%, 3.8%, and 0.35%, respectively. Notably, the number of stone-related UUT procedures in 2022 increased by 35% (from 4671 to 6283) compared to 2017. In the year 2022 compared to 2017, there was a statistically significant increase in the rate of all stone-related UUT procedures (<em>p</em><0.001), except for ESWL and pyelo- and uretero-lithotomy. The rates of ESWL procedures reduced from 21% in 2017 to 13% in 2022 (<em>p</em><0.001). Overall, the total cost of treatments has been estimated to be about 192.1 million SAR from 2017 to 2022 with an increase by 107% (47.7 million SAR in 2022 <em>vs.</em> 23.0 million SAR in 2017).</div></div><div><h3>Conclusion</h3><div>Our research findings suggest that urolithiasis poses a significant burden, accounting for over half of all urological surgery performed at the participating centers. Furthermore, there has been a 35% rise in stone-related UUT procedures over the past 6 years. Percutaneous nephrolithotomy, flexible URS, and semi-rigid URS have experienced significant increase in usage. Furthermore, in 2022 the cost of urolithiasis treatments has been more than doubled compared to 2017.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 59-65"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.07.004
Abbas Basiri , Azin Tahvildari , Mohammad Naji, Pardis Ziaeefar, Amir H. Kashi
Objective
The national lifetime prevalence of urolithiasis is estimated at 6.6% in Iran. However, reports on the composition of kidney stones have been based on imprecise methods like the chemical analysis. No prior large-scale study has reported the composition of kidney stones based on the gold-standard methods (X-ray diffraction or infrared spectroscopy) in Iran. This study aimed to provide the composition of kidney stones based on Fourier transform infrared spectroscopy.
Methods
This is a cross-sectional study assessing urinary stone composition from various cities in Iran at a referral center using infrared spectroscopy from February 2019 to March 2023.
Results
This study determined the stone composition of 1092 patients from 10 cities in Iran. Overall, the majority of stones were composed of calcium oxalate (n=498; 45.6%) and uric acid (UA, n=488; 44.7%) followed by cystine (n=49; 4.5%) and struvite (n=28; 2.6%). Stone composition in Shiraz and Isfahan was roughly similar with a higher percentage of UA stones (53.4% and 53.6%, respectively) while the capital city of Iran (Tehran) had less frequent UA stones (39.9%) with a higher percentage of calcium oxalate stones. The percentage of UA stones increased with age as it was 11.1% in children, 42.7% in adults, and 83.3% in geriatric patients (p<0.001). About 29.6% of cystine stones were observed in children.
Conclusion
The most frequent stone composition among kidney stones in Iran was calcium oxalate and UA stones. This relative frequency of UA stones is considerably higher than many international reports from neighboring as well as distant countries. More cystine stones were observed in children and women. Geriatric patients’ stones were mostly composed of UA.
{"title":"Determination of the kidney stone composition using infrared spectroscopy in Iran at a national referral center during 2019–2023","authors":"Abbas Basiri , Azin Tahvildari , Mohammad Naji, Pardis Ziaeefar, Amir H. Kashi","doi":"10.1016/j.ajur.2024.07.004","DOIUrl":"10.1016/j.ajur.2024.07.004","url":null,"abstract":"<div><h3>Objective</h3><div>The national lifetime prevalence of urolithiasis is estimated at 6.6% in Iran. However, reports on the composition of kidney stones have been based on imprecise methods like the chemical analysis. No prior large-scale study has reported the composition of kidney stones based on the gold-standard methods (X-ray diffraction or infrared spectroscopy) in Iran. This study aimed to provide the composition of kidney stones based on Fourier transform infrared spectroscopy.</div></div><div><h3>Methods</h3><div>This is a cross-sectional study assessing urinary stone composition from various cities in Iran at a referral center using infrared spectroscopy from February 2019 to March 2023.</div></div><div><h3>Results</h3><div>This study determined the stone composition of 1092 patients from 10 cities in Iran. Overall, the majority of stones were composed of calcium oxalate (<em>n</em>=498; 45.6%) and uric acid (UA, <em>n</em>=488; 44.7%) followed by cystine (<em>n</em>=49; 4.5%) and struvite (<em>n</em>=28; 2.6%). Stone composition in Shiraz and Isfahan was roughly similar with a higher percentage of UA stones (53.4% and 53.6%, respectively) while the capital city of Iran (Tehran) had less frequent UA stones (39.9%) with a higher percentage of calcium oxalate stones. The percentage of UA stones increased with age as it was 11.1% in children, 42.7% in adults, and 83.3% in geriatric patients (<em>p</em><0.001). About 29.6% of cystine stones were observed in children.</div></div><div><h3>Conclusion</h3><div>The most frequent stone composition among kidney stones in Iran was calcium oxalate and UA stones. This relative frequency of UA stones is considerably higher than many international reports from neighboring as well as distant countries. More cystine stones were observed in children and women. Geriatric patients’ stones were mostly composed of UA.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 72-78"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ajur.2024.04.007
Zhipeng Zhang , Deyi Luo , Zhong Chen , Peng Zhang , Ganping Zhong , Keji Xie , Zhuoqun Xu , Xudong Li , Jianye Wang , Yingfan Yang , Farid Abdul Hadi , Arianne Schild
Objective
To assess efficacy and safety of mirabegron 25 mg/day and 50 mg/day for overactive bladder in Chinese participants.
Methods
Participants of ≥18 years with overactive bladder symptoms lasting for ≥12 weeks, a mean of ≥8 micturitions per 24 h, and a mean of at least one episode of Grade 3 or 4 urgency or urge incontinence per 24 h based on the Patient Perception of Intensity of Urgency Scale over a 3-day micturition diary period were randomized 2:1 to open-label treatment with oral mirabegron 50 mg or 25 mg once daily for 12 weeks (15 sites in China, January 2021–March 2022). A dose escalation from 25 mg/day to 50 mg/day was permitted at weeks 4 and 8 according to the investigators' discretion. The primary efficacy endpoint was the change from baseline to Week 12 in the mean number of micturitions per 24 h in those randomized to mirabegron 50 mg/day. Secondary efficacy endpoints were the change in mean number of micturitions at weeks 4 and 8 in the mirabegron 50 mg/day group and weeks 4, 8, and 12 in the mirabegron 25 mg/day group, change from baseline to weeks 4, 8, and 12 in Grade 3 or 4 urgency episodes on the Patient Perception of Intensity of Urgency Scale, episodes of daytime incontinence, nighttime incontinence, and urgency incontinence, and Overactive Bladder Symptom Score for mirabegron 50 mg/day and 25 mg/day groups.
Results
Statistically significant reduction (p<0.001) from baseline to Week 12 was observed in mean micturitions per 24 h for participants randomized to mirabegron 50 mg/day: mean±standard error: 11.71±0.43 at baseline, 7.80±0.24 at Week 12; adjusted mean change: −3.73 (95% confidence interval −4.30 to −3.16). Both doses showed statistically significant improvement in secondary efficacy endpoints at weeks 4, 8, and 12 versus baseline. Safety was consistent with mirabegron's known safety profile.
Conclusion
The results support a mirabegron dosage of 50 mg/day for the treatment of OAB in China.
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