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Robot-assisted retroperitoneoscopic kidney surgery with Versius®. 使用 Versius® 的机器人辅助腹膜后内镜肾脏手术。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-11-21 DOI: 10.23736/S2724-6051.24.06122-6
Fabrizio Dal Moro, Simonetta Fracalanza, Fabio Zattoni, Giacomo Novara, Mario Gardi
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引用次数: 0
Modified robot-assisted laparoscopic dismembered pyeloplasty for adult patients with horseshoe kidney: techniques and medium-term outcomes. 改良机器人辅助腹腔镜肢解肾盂成形术治疗成年马蹄肾患者:技术和中期疗效。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-11-21 DOI: 10.23736/S2724-6051.24.06024-5
Zhenyu Li, Silu Chen, Yicong DU, Zhihua Li, Shubo Fan, Shengwei Xiong, Xiang Wang, Xinfei Li, Liqun Zhou, Kunlin Yang, Xuesong Li

Background: The aim of this study was to report our technique and medium-term outcomes of modified robot-assisted laparoscopic dismembered pyeloplasty (RALDP) in the Lithotomy Trendelenburg position for treating adult ureteropelvic junction obstruction (UPJO) with horseshoe kidney (HSK).

Methods: Between March 2021 and March 2023, 11 adult patients with UPJO and HSK underwent modified RALDP in the lithotomy Trendelenburg position. Patient demographic characteristics, perioperative parameters, and follow-up outcomes were collected prospectively and analyzed. A detailed description of the technique and medium-term outcomes were reported.

Results: The median (range) age was 33 (23-50) years. The mean preoperative serum creatinine and preoperative estimated glomerular filtration rate (eGFR) were 74.72±16.20 μmol/L and 100.4±16.5 mL/min/1.73 m2, respectively. One patient (9.1%) required an additional right pyelolithotomy. The mean operative duration was 208±70 min. The median (range) estimated blood loss was 20 (20-100) mL. The median (range) drainage-tube removal time was 3 (2-4) days postoperatively. The median (range) postoperative hospitalization period was 5 (3-6) days. No open conversions or intraoperative complications occurred. Postoperative urinary tract infections (Clavien-Dindo grade II) occurred in two patients, managed with oral antibiotics. The median (range) follow-up of 25 (12-36) months achieved an overall success rate of 100%. The mean postoperative serum creatinine and postoperative eGFR were 74.96±17.43 μmol/L and 98.14±18.39 mL/min/1.73 m2, respectively.

Conclusions: Our medium-term outcomes indicate that the modified RALDP in the Lithotomy Trendelenburg position was safe and feasible for adult HSK patients. Further prospective studies of larger sample sizes and randomized controlled trials are warranted.

背景:本研究旨在报告我们采用改良的机器人辅助腹腔镜膀胱肾盂成形术(RALDP)在体位切开取石法(Lithotomy Trendelenburg)下治疗成人输尿管盆腔交界处梗阻(UPJO)合并马蹄肾(HSK)的技术和中期疗效:方法:2021年3月至2023年3月期间,11名UPJO和HSK成人患者接受了改良的RALDP术,取平卧位(Lithotomy Trendelenburg position)。对患者的人口统计学特征、围手术期参数和随访结果进行了前瞻性收集和分析。报告对技术和中期结果进行了详细描述:中位(范围)年龄为 33(23-50)岁。术前平均血清肌酐和术前估计肾小球滤过率(eGFR)分别为 74.72±16.20 μmol/L 和 100.4±16.5 mL/min/1.73 m2。一名患者(9.1%)需要进行额外的右肾盂切开术。平均手术时间为 208±70 分钟。估计失血量的中位数(范围)为 20(20-100)毫升。术后拔除引流管时间的中位数(范围)为 3(2-4)天。术后住院时间的中位数(范围)为 5(3-6)天。没有发生开放性转流或术中并发症。两名患者发生了术后尿路感染(Clavien-Dindo II 级),经口服抗生素治疗后好转。中位(范围)随访时间为 25(12-36)个月,总体成功率为 100%。术后平均血清肌酐和术后 eGFR 分别为 74.96±17.43 μmol/L 和 98.14±18.39 mL/min/1.73 m2:我们的中期研究结果表明,对成年 HSK 患者而言,采用立位 Trendelenburg 体位的改良 RALDP 是安全可行的。有必要进一步开展样本量更大的前瞻性研究和随机对照试验。
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引用次数: 0
Partial penectomy with reconstruction using a split-thickness skin graft: a multicenter experience. 阴茎部分切除术并使用分层厚皮移植进行重建:多中心经验。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-11-21 DOI: 10.23736/S2724-6051.24.05924-X
Mateusz Czajkowski, Bartosz Małkiewicz, Katarzyna Czajkowska, Piotr M Wierzbicki, Adrian Poterek, Roman Sosnowski, Małgorzata Sokołowska-Wojdyło, Tomasz Szydełko, Marzena Kogut-Wierzbicka, Marcin Matuszewski

Background: Penile cancer is a relatively rare neoplasm in developed countries, with the majority of newly diagnosed cases presenting as organ-confined, with a 5-year survival rate of 90%. Therefore, it is crucial to consider the impact of penile tumor resection on sexual and urinary function. Regrettably, the literature is devoid of comprehensive, step-by-step video instructions for the surgical procedure of partial penectomy with reconstruction using a split-thickness skin graft (0.3 mm). This study aimed to demonstrate a step-by-step video of the partial penectomy technique with reconstruction using a split-thickness skin graft and to present the outcomes of this procedure.

Methods: This multicenter study was initiated in April 2019 and completed in February 2023, enrolling 54 male patients who underwent partial penectomy and reconstruction using a split-thickness skin graft (0.3 mm). The study collected data on the local recurrence rates, overall survival, sexual and voiding functions and complications.

Results: The average patient age was 61.26 years old (range: 26-82 years). Following penile-sparing surgery, a substantial proportion of patients exhibited favorable results. Among the 54 patients, 37 (68.5%) were classified as sexually active and 50 (92.6%) demonstrated good voiding function. Excellent cosmetic outcomes were achieved in 52 patients (96.3%), and the average size of the negative resection margins was 4.75±4.162 mm (range: 0.5 to 20 mm). Notably, no positive margins were observed. Patient outcomes depend on the tumor stage and histologic grade rather than the size of the surgical margin.

Conclusions: Partial penectomy with reconstruction using a split-thickness skin graft has excellent oncological, functional, and cosmetic outcomes.

背景:在发达国家,阴茎癌是一种相对罕见的肿瘤,大多数新确诊病例表现为器官封闭,5 年生存率为 90%。因此,考虑阴茎肿瘤切除术对性功能和排尿功能的影响至关重要。遗憾的是,文献中没有关于阴茎部分切除并使用分层厚度皮肤移植(0.3 毫米)进行重建的手术过程的全面、分步骤视频指导。本研究旨在通过视频逐步演示阴茎部分切除术并使用分层厚度植皮进行重建的技术,并介绍该手术的结果:这项多中心研究于2019年4月启动,2023年2月完成,共纳入54名男性患者,他们接受了阴茎部分切除术,并使用分层厚度植皮(0.3毫米)进行了重建。研究收集了有关局部复发率、总生存率、性功能和排尿功能以及并发症的数据:患者平均年龄为 61.26 岁(26-82 岁)。阴茎保留手术后,相当一部分患者取得了良好的效果。在 54 名患者中,37 人(68.5%)性生活活跃,50 人(92.6%)排尿功能良好。52名患者(96.3%)获得了良好的美容效果,阴性切除边缘的平均大小为4.75±4.162毫米(范围:0.5至20毫米)。值得注意的是,没有观察到阳性边缘。患者的预后取决于肿瘤分期和组织学分级,而不是手术切缘的大小:结论:阴茎部分切除术并使用分层厚皮移植进行重建,在肿瘤、功能和美容方面都有很好的效果。
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引用次数: 0
The association between MET c.3328G>A p.Val1110Ile mutation and renal cell carcinomas in a specific population: data on histology, focality, onset and the need for surgery from a monocentric study. 特定人群中 MET c.3328G>A p.Val1110Ile 突变与肾细胞癌之间的关联:一项单中心研究中有关组织学、病灶、发病和手术需求的数据。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-11-07 DOI: 10.23736/S2724-6051.24.05998-6
Angelo Porreca, Stefania Zovato, Marco Rinaldi, Luca DI Gianfrancesco, Isabella Mammi, Filippo Marino, Gianluca Giannarini, Alessandro Crestani
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引用次数: 0
Validation of lymphovascular invasion as a predictor of lymph-node invasion in squamous cell carcinoma of the penis. 将淋巴管侵犯作为阴茎鳞状细胞癌淋巴结侵犯的预测指标进行验证。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-11-04 DOI: 10.23736/S2724-6051.24.05938-X
Letizia M Jannello, Mario DE Angelis, Carolin Siech, Francesco DI Bello, Natali Rodriguez Peñaranda, Zhe Tian, Jordan A Goyal, Stefano Luzzago, Francesco A Mistretta, Marco Tozzi, Fred Saad, Felix K Chun, Alberto Briganti, Stefano Puliatti, Nicola Longo, Ottavio DE Cobelli, Gennaro Musi, Pierre I Karakiewicz

Background: The aim of this study was to validate lymphovascular invasion (LVI) as a predictor of lymph-node invasion (LNI) in squamous cell carcinoma of the penis (SCCP).

Methods: Within the Surveillance, Epidemiology, and End Results database (2010-2020), we identified SCCP patients who underwent lymphadenectomy with known LVI status. Univariable logistic regression models (LRMs) addressed LNI. Harrell's concordance index (c-index) quantified accuracy after 2000 bootstrap resamples for internal validation. Multivariable LRMs included the most informative, statistically significant predictors. Subgroup analyses were repeated in organ-confined (T1b-T2) and non-organ confined (T3-T4) stages.

Results: Of 586 SCCP patients, 219 (37%) had LVI. LVI was associated with higher rate of LNI (66 vs. 43%; P<0.001). Positive predictive value of LVI was 66 vs. 57% for negative predictive value. In multivariable LRMs, LVI independently predicted LNI (Odds ratio [OR]: 2.41; P<0.001). Bootstrap-adjusted c-index of multivariable model was 0.570 without LVI vs. 0.639 with LVI. In subgroup analyses, LVI independently predicted LNI in organ-confined (OR: 2.23; P<0.001) and in non-organ confined stages (OR: 3.10; P<0.001). In subgroup analyses, addition of LVI increased c-index from 0.530 to 0.595 in organ-confined and from 0.599 to 0.682 in non-organ confined.

Conclusions: The current study validates LVI as an independent predictor of LNI in SCCP. LVI increases the accuracy of LNI predictions in the overall cohort as well as in organ-confined and non-organ confined stages. However, stage and grade even with the added consideration of LVI are not accurate enough to provide LNI prediction in individual patients.

背景:本研究旨在验证淋巴管侵犯(LVI)可作为阴茎鳞状细胞癌(SCCP)淋巴结侵犯(LNI)的预测指标:在监测、流行病学和最终结果数据库(2010-2020 年)中,我们确定了接受淋巴结切除术且已知 LVI 状态的 SCCP 患者。单变量逻辑回归模型(LRM)处理 LNI。经过 2000 次引导重采样进行内部验证后,哈雷尔一致性指数(c-index)对准确性进行了量化。多变量 LRM 包括信息量最大、统计意义最显著的预测因子。在器官局限期(T1b-T2)和非器官局限期(T3-T4)重复进行了亚组分析:在 586 名 SCCP 患者中,219 人(37%)患有 LVI。LVI与较高的LNI率相关(66%对43%;PC结论:本研究证实 LVI 是 SCCP LNI 的独立预测指标。LVI 提高了整体队列以及器官局限期和非器官局限期 LNI 预测的准确性。但是,即使考虑到 LVI,分期和分级也不足以准确预测单个患者的 LNI。
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引用次数: 0
Water vapor thermal therapy (Rezūm System) in patients with large prostates: results from a prospective comparative study. 前列腺肥大患者的水蒸气热疗(Rezūm 系统):一项前瞻性比较研究的结果。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-11-04 DOI: 10.23736/S2724-6051.24.05883-X
Raffaele Balsamo, Simone Tammaro, Massimiliano Trivellato, Felice Crocetto, Biagio Barone, Ferdinando Fusco, Davide Arcaniolo, Celeste Manfredi, Luca Cindolo, Raffaele Ranavolo, Francesco Uricchio

Background: Rezūm is a novel minimally invasive surgical technique (MIST) useful for BPH patients with medium-sized prostate (30-80 cm3) refractory to medical treatment. The aim of this study was to evaluate the efficacy and safety of Rezūm as a treatment option in large-sized prostates (>80 cm3).

Methods: We performed a prospective, comparative, single-center study from June 2022 to June 2023, including consecutive patients undergoing surgery with the Rezūm System. Enrolled men were classified into two subgroups based on prostate size: medium prostate (MP) (30-80 cm3) and large prostate (LP) (≥80 cm3). Inclusion criteria included an International Prostate Symptom Score (IPSS) Total score of ≥ 8 points. International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), post-void residual (PVR), and International Index of Erectile Function 5-item version (IIEF-5) were collected at baseline and at three, six, and 12 months post-procedure. Ejaculation presence was assessed at 3 months. Post-operative complications were described using the Clavien-Dindo (CD) classification. The primary outcome was the IPSS-Total score, with intraoperative and postoperative CD grade ≥III complications as secondary outcomes.

Results: One hundred and twenty-one patients (PV 78.2±32.1 mL) were included in the study, 51 large prostate (LP) and 70 medium prostate (MP). The IPSS-Total score and Qmax showed a statistically significant (P<0.0001) improvement at 3, 6, and 12 months respectively. PVR decreased at 3, 6, and 12 months; however, only at 3 months this variation was statistically significant (P<0.0001). At 3-month follow-up, anejaculation was detected in (3; 5.8% and 1; 1.4%) patients in LP and MP group respectively (P=0.86). IIEF-5 significantly improved 3 months after surgery in the LP subgroup (P<0.0001).

Conclusions: Rezūm water vapor therapy appears to be effective for treating BPH in larger prostates. Additionally, it demonstrates a low risk of impairing sexual function, indicating a favorable safety profile.

背景:Rezūm是一种新型微创外科技术(MIST),适用于药物治疗难治的中等尺寸前列腺(30-80 cm3)良性前列腺增生症患者。本研究的目的是评估 Rezūm 作为大型前列腺(大于 80 立方厘米)治疗方案的有效性和安全性:方法:我们在 2022 年 6 月至 2023 年 6 月期间进行了一项前瞻性、比较性、单中心研究,包括使用 Rezūm 系统进行手术的连续患者。入组男性根据前列腺大小分为两个亚组:中型前列腺(MP)(30-80 cm3)和大型前列腺(LP)(≥80 cm3)。纳入标准包括国际前列腺症状评分(IPSS)总分≥ 8 分。在基线、术后 3 个月、6 个月和 12 个月收集国际前列腺症状评分 (IPSS)、最大尿流率 (Qmax)、排尿后残余物 (PVR) 和国际勃起功能指数 5 项版 (IIEF-5)。在 3 个月时评估是否存在射精。术后并发症采用克拉维恩-丁多(Clavien-Dindo,CD)分类法进行描述。主要结果是IPSS-总分,次要结果是术中和术后CD≥III级并发症:研究共纳入121例患者(PV 78.2±32.1 mL),其中51例为大型前列腺(LP),70例为中型前列腺(MP)。IPSS-总分和 Qmax 显示出显著的统计学意义(PConclusions:Rezūm水蒸气疗法似乎能有效治疗较大前列腺的良性前列腺增生症。此外,该疗法损害性功能的风险较低,表明其安全性良好。
{"title":"Water vapor thermal therapy (Rezūm System) in patients with large prostates: results from a prospective comparative study.","authors":"Raffaele Balsamo, Simone Tammaro, Massimiliano Trivellato, Felice Crocetto, Biagio Barone, Ferdinando Fusco, Davide Arcaniolo, Celeste Manfredi, Luca Cindolo, Raffaele Ranavolo, Francesco Uricchio","doi":"10.23736/S2724-6051.24.05883-X","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05883-X","url":null,"abstract":"<p><strong>Background: </strong>Rezūm is a novel minimally invasive surgical technique (MIST) useful for BPH patients with medium-sized prostate (30-80 cm<sup>3</sup>) refractory to medical treatment. The aim of this study was to evaluate the efficacy and safety of Rezūm as a treatment option in large-sized prostates (>80 cm<sup>3</sup>).</p><p><strong>Methods: </strong>We performed a prospective, comparative, single-center study from June 2022 to June 2023, including consecutive patients undergoing surgery with the Rezūm System. Enrolled men were classified into two subgroups based on prostate size: medium prostate (MP) (30-80 cm<sup>3</sup>) and large prostate (LP) (≥80 cm<sup>3</sup>). Inclusion criteria included an International Prostate Symptom Score (IPSS) Total score of ≥ 8 points. International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), post-void residual (PVR), and International Index of Erectile Function 5-item version (IIEF-5) were collected at baseline and at three, six, and 12 months post-procedure. Ejaculation presence was assessed at 3 months. Post-operative complications were described using the Clavien-Dindo (CD) classification. The primary outcome was the IPSS-Total score, with intraoperative and postoperative CD grade ≥III complications as secondary outcomes.</p><p><strong>Results: </strong>One hundred and twenty-one patients (PV 78.2±32.1 mL) were included in the study, 51 large prostate (LP) and 70 medium prostate (MP). The IPSS-Total score and Q<inf>max</inf> showed a statistically significant (P<0.0001) improvement at 3, 6, and 12 months respectively. PVR decreased at 3, 6, and 12 months; however, only at 3 months this variation was statistically significant (P<0.0001). At 3-month follow-up, anejaculation was detected in (3; 5.8% and 1; 1.4%) patients in LP and MP group respectively (P=0.86). IIEF-5 significantly improved 3 months after surgery in the LP subgroup (P<0.0001).</p><p><strong>Conclusions: </strong>Rezūm water vapor therapy appears to be effective for treating BPH in larger prostates. Additionally, it demonstrates a low risk of impairing sexual function, indicating a favorable safety profile.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570175","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
Augmentation cystoplasty in children with neuropathic bladder: long-term outcomes after 30 years experience. 神经性膀胱患儿的膀胱成形术:30 年后的长期疗效。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-11-04 DOI: 10.23736/S2724-6051.24.05919-6
Carlos Delgado-Miguel, Virginia Amesty, Susana Rivas, Roberto Lobato, María J Martínez-Urrutia, Pedro López-Pereira

Background: Augmentation cystoplasty (AC) is a useful alternative for the treatment of neuropathic bladder, although there are few studies reporting long-term results. We assess our experience over the last 30-years.

Methods: A retrospective study was conducted in patients with neuropathic bladder in whom AC was performed in our institution between 1990-2020. Demographic variables, pre- and post- AC urodynamic studies, long-term outcomes and postoperative complications were collected.

Results: Eighty-six patients (43 males and 43 females) underwent AC surgery with a median age of 12.8 years (interquartile range 9.6-15.1). Bladder augmentation was performed with ileum in 49 cases (57%), sigma in 32 cases (37.2%) and ureter in 5 cases (5.8%). In 27 patients an artificial urinary sphincter (AUS) was placed at the same intervention. The mean preoperative bladder capacity was 117 mL (SD 40), which was increased to 430 mL (SD 64) one year after surgery, this difference being statistically significant (P<0.001). Median follow-up was 24.5 years (interquartile range 17.5-26). Vesico-ureteral reflux improved after AC in 78.9% with no other surgical interventions. Seven mechanical complications associated with AUS were reported. Bladder lithiasis was reported in 9 patients. No bladder perforations were described. One patient developed bladder squamous cell carcinoma 16 years after AC, requiring radical cystectomy and Hautmann neobladder.

Conclusions: Long-term results of this study demonstrate that AC is an effective surgical treatment in patients with neuropathic bladder patients without proper response to medical treatment. The risk of developing complications long after bladder augmentation makes close clinical follow-up of these patients essential.

背景:增强膀胱成形术(AC)是治疗神经性膀胱的一种有效替代方法,但报告长期效果的研究很少。我们对过去 30 年的经验进行了评估:方法:我们对 1990-2020 年间在本院接受膀胱成形术的神经性膀胱患者进行了一项回顾性研究。收集了人口统计学变量、膀胱刺激术前和术后尿动力学检查、长期疗效和术后并发症:86名患者(43男43女)接受了膀胱刺激术,中位年龄为12.8岁(四分位距为9.6-15.1)。49例(57%)患者使用回肠进行膀胱增容,32例(37.2%)使用西格玛,5例(5.8%)使用输尿管。27例患者在同一手术中植入了人工尿道括约肌(AUS)。术前平均膀胱容量为 117 毫升(标清 40),术后一年增加到 430 毫升(标清 64),这一差异具有统计学意义(PConclusions:这项研究的长期结果表明,对于药物治疗无效的神经性膀胱患者,AC 是一种有效的手术治疗方法。膀胱增容术后长期存在并发症风险,因此对这些患者进行密切的临床随访至关重要。
{"title":"Augmentation cystoplasty in children with neuropathic bladder: long-term outcomes after 30 years experience.","authors":"Carlos Delgado-Miguel, Virginia Amesty, Susana Rivas, Roberto Lobato, María J Martínez-Urrutia, Pedro López-Pereira","doi":"10.23736/S2724-6051.24.05919-6","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05919-6","url":null,"abstract":"<p><strong>Background: </strong>Augmentation cystoplasty (AC) is a useful alternative for the treatment of neuropathic bladder, although there are few studies reporting long-term results. We assess our experience over the last 30-years.</p><p><strong>Methods: </strong>A retrospective study was conducted in patients with neuropathic bladder in whom AC was performed in our institution between 1990-2020. Demographic variables, pre- and post- AC urodynamic studies, long-term outcomes and postoperative complications were collected.</p><p><strong>Results: </strong>Eighty-six patients (43 males and 43 females) underwent AC surgery with a median age of 12.8 years (interquartile range 9.6-15.1). Bladder augmentation was performed with ileum in 49 cases (57%), sigma in 32 cases (37.2%) and ureter in 5 cases (5.8%). In 27 patients an artificial urinary sphincter (AUS) was placed at the same intervention. The mean preoperative bladder capacity was 117 mL (SD 40), which was increased to 430 mL (SD 64) one year after surgery, this difference being statistically significant (P<0.001). Median follow-up was 24.5 years (interquartile range 17.5-26). Vesico-ureteral reflux improved after AC in 78.9% with no other surgical interventions. Seven mechanical complications associated with AUS were reported. Bladder lithiasis was reported in 9 patients. No bladder perforations were described. One patient developed bladder squamous cell carcinoma 16 years after AC, requiring radical cystectomy and Hautmann neobladder.</p><p><strong>Conclusions: </strong>Long-term results of this study demonstrate that AC is an effective surgical treatment in patients with neuropathic bladder patients without proper response to medical treatment. The risk of developing complications long after bladder augmentation makes close clinical follow-up of these patients essential.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570170","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
Intraoperative complications during radical cystectomy: a detailed analysis of intraoperative vascular injuries. 根治性膀胱切除术的术中并发症:术中血管损伤的详细分析。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-11-04 DOI: 10.23736/S2724-6051.24.06030-0
Kaushik P Kolanukuduru, Neeraja Tillu, Arjun Venkatesh, Osama Zaytoun, Maurizio Buscarini
{"title":"Intraoperative complications during radical cystectomy: a detailed analysis of intraoperative vascular injuries.","authors":"Kaushik P Kolanukuduru, Neeraja Tillu, Arjun Venkatesh, Osama Zaytoun, Maurizio Buscarini","doi":"10.23736/S2724-6051.24.06030-0","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.06030-0","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570172","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
Early prostatic artery control (EPAC) during robot-assisted radical prostatectomy: a new surgical technique aiming to improve early potency recovery. 机器人辅助根治性前列腺切除术中的早期前列腺动脉控制(EPAC):一种旨在改善早期效力恢复的新手术技术。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-17 DOI: 10.23736/S2724-6051.24.05997-4
Francesco Porpiglia, Daniele Amparore, Federico Piramide, Sabrina DE Cillis, Alberto Piana, Enrico Checcucci, Matteo Manfredi, Cristian Fiori
{"title":"Early prostatic artery control (EPAC) during robot-assisted radical prostatectomy: a new surgical technique aiming to improve early potency recovery.","authors":"Francesco Porpiglia, Daniele Amparore, Federico Piramide, Sabrina DE Cillis, Alberto Piana, Enrico Checcucci, Matteo Manfredi, Cristian Fiori","doi":"10.23736/S2724-6051.24.05997-4","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05997-4","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480568","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
Robot-assisted T-plasty for recalcitrant bladder neck stenosis: description of technique and initial results. 机器人辅助 T 形成形术治疗顽固性膀胱颈狭窄:技术描述和初步结果。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-09 DOI: 10.23736/S2724-6051.24.05872-5
Nicolaas Lumen, Zeyu Wang, Mieke Waterschoot, Thomas Tailly, Beatrice Turchi, Wesley Verla

Background: The aim of this study was to describe the technique and initial outcomes of robot-assisted T-plasty for recalcitrant bladder neck stenosis.

Methods: Patients who underwent robot-assisted T-plasty for recalcitrant bladder neck stenosis in a single center were included. Presence of bladder neck stenosis was preoperatively confirmed by the combination of retrograde urethrography with voiding cysto-urethrography and flexible urethroscopy. Follow-up visits were performed with history taking, uroflowmetry and echographic residual urine measurement. Complications were graded according to the Clavien-Dindo classification. Patients without urinary symptoms and with a maximum uroflow of no less than 15mL/s were considered as successfully treated. Otherwise, cystoscopy would be performed, and recurrence was defined as the inability to pass a 14 French cystoscope through the bladder neck.

Results: Since 2018, seven patients were treated. The etiologies were transurethral resection of the prostate and simple prostatectomy in respectively 6 patients and 1 patient. Cystoscopy was able to diagnose bladder neck stenosis in all cases whereas urethrography was equivocal in 3 out of 7 cases. Median (range) age at surgery was 60 (54-75) years, and median number of prior endoscopic treatment for bladder neck stenosis was 3 (1-16). The median operative time was 123 (110-159) minutes. No intraoperative complications were reported. Three patients suffered a grade 2 complication. After a median follow-up of 27 (4-74) months, the recurrence-free rate was 100% with no evidence of de-novo incontinence or erectile dysfunction.

Conclusions: In our series, robot-assisted T-plasty suggests positive and safe outcomes in treating recalcitrant bladder neck stenosis with a good patency rate and low incontinence rate. Additionally, cystoscopy is reliable in the diagnosis of patients with inconclusive urethrography results.

背景:本研究旨在描述机器人辅助膀胱颈狭窄T成形术的技术和初步结果:本研究旨在描述机器人辅助T成形术治疗顽固性膀胱颈狭窄的技术和初步疗效:方法:纳入在一个中心接受机器人辅助 T 形成形术治疗顽固性膀胱颈狭窄的患者。术前通过逆行尿道造影、排尿膀胱造影和柔性尿道镜检查确认是否存在膀胱颈狭窄。随访包括病史采集、尿流率测定和超声残余尿测定。并发症根据克拉维恩-丁多分类法进行分级。无排尿症状且最大尿流不低于 15 毫升/秒的患者被视为治疗成功。否则将进行膀胱镜检查,复发的定义是无法将14法分膀胱镜通过膀胱颈:自 2018 年以来,共有 7 名患者接受了治疗。病因分别为经尿道前列腺切除术和单纯前列腺切除术的患者分别为 6 人和 1 人。膀胱镜检查能够诊断出所有病例的膀胱颈狭窄,而尿道造影在 7 例病例中有 3 例诊断不明确。手术时的中位年龄(范围)为60(54-75)岁,之前接受过膀胱颈狭窄内镜治疗的中位数为3(1-16)次。手术时间中位数为123(110-159)分钟。无术中并发症报告。三名患者出现了二级并发症。中位随访27(4-74)个月后,无复发率为100%,且无证据显示再次出现尿失禁或勃起功能障碍:在我们的系列研究中,机器人辅助 T 形成形术在治疗顽固性膀胱颈狭窄方面具有积极而安全的效果,通畅率高,尿失禁率低。此外,对于尿道造影结果不确定的患者,膀胱镜检查也是可靠的诊断方法。
{"title":"Robot-assisted T-plasty for recalcitrant bladder neck stenosis: description of technique and initial results.","authors":"Nicolaas Lumen, Zeyu Wang, Mieke Waterschoot, Thomas Tailly, Beatrice Turchi, Wesley Verla","doi":"10.23736/S2724-6051.24.05872-5","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05872-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to describe the technique and initial outcomes of robot-assisted T-plasty for recalcitrant bladder neck stenosis.</p><p><strong>Methods: </strong>Patients who underwent robot-assisted T-plasty for recalcitrant bladder neck stenosis in a single center were included. Presence of bladder neck stenosis was preoperatively confirmed by the combination of retrograde urethrography with voiding cysto-urethrography and flexible urethroscopy. Follow-up visits were performed with history taking, uroflowmetry and echographic residual urine measurement. Complications were graded according to the Clavien-Dindo classification. Patients without urinary symptoms and with a maximum uroflow of no less than 15mL/s were considered as successfully treated. Otherwise, cystoscopy would be performed, and recurrence was defined as the inability to pass a 14 French cystoscope through the bladder neck.</p><p><strong>Results: </strong>Since 2018, seven patients were treated. The etiologies were transurethral resection of the prostate and simple prostatectomy in respectively 6 patients and 1 patient. Cystoscopy was able to diagnose bladder neck stenosis in all cases whereas urethrography was equivocal in 3 out of 7 cases. Median (range) age at surgery was 60 (54-75) years, and median number of prior endoscopic treatment for bladder neck stenosis was 3 (1-16). The median operative time was 123 (110-159) minutes. No intraoperative complications were reported. Three patients suffered a grade 2 complication. After a median follow-up of 27 (4-74) months, the recurrence-free rate was 100% with no evidence of de-novo incontinence or erectile dysfunction.</p><p><strong>Conclusions: </strong>In our series, robot-assisted T-plasty suggests positive and safe outcomes in treating recalcitrant bladder neck stenosis with a good patency rate and low incontinence rate. Additionally, cystoscopy is reliable in the diagnosis of patients with inconclusive urethrography results.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395209","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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Minerva Urology and Nephrology
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