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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。
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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。
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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
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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
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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":null,"pages":null},"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
Could transperineal interstitial laser ablation of the prostate be the right option for highly-comorbid patients with lower urinary tract symptoms due to benign prostatic obstruction? A preliminary single-center experience focusing on functional and safety outcomes. 经会阴前列腺间质激光消融术能否成为因良性前列腺梗阻而出现下尿路症状的高合并症患者的正确选择?以功能性和安全性结果为重点的初步单中心经验。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-01 Epub Date: 2023-12-13 DOI: 10.23736/S2724-6051.23.05479-4
Paolo Polverino, Mattia Lo Re, Marco Saladino, Alessio Pecoraro, Luisa Moscardi, Anna Rivetti, Giulio R Resta, Marta Pezzoli, Andrea Romano, Bhaskar K Somani, Giampaolo Siena, Andrea Cocci, Mauro Gacci, Andrea Minervini, Sergio Serni, Riccardo Campi, Francesco Sessa

In this paper, we aimed to highlight functional and safety outcomes of highly-comorbid patients undergoing transperineal laser ablation (TPLA) of prostate at a referral academic center. Patients undergoing TPLA from April 2021 and February 2023 with moderate to severe lower urinary tract symptoms (LUTS), prostate volume ranging from 30 to 100 mL, and an American Society of Anesthesiologists (ASA) Score ≥3 were included. All patients were evaluated as unfit for standard surgery. Procedures were performed in an outpatient setting using local anesthesia. Failure after the procedure was defined as the shift to other ultra-minimally invasive surgical treatment or the need for long-term indwelling catheter replacement. Overall, 23 patients were enrolled with a median age of 76 years. Median ASA Score and Charlson Comorbidity Index were 3 and 5, respectively. Of these, 11 (48%) were under antiplatelets, 4 (17%) under new oral anticoagulants (NOACs) and 3 (13%) under warfarin. Six (26%) patients had an indwelling catheter preoperatively. Median prostate volume was 42 mL. Median follow-up was 12 months. No Clavien-Dindo Grade ≥2 complications were recorded. Four/six (66%) patients with an indwelling catheter before TPLA achieved spontaneous micturition. Treatment failure occurred in 2 (8.5%) patients. Of the remaining 21 patients, 12/21 (57%) patients reported an improvement in International Prostate Symptoms Score (IPSS) symptoms class (i.e., severe to moderate, moderate to mild, etc.); all patients whose IPSS symptoms class remained stable (N.=8 [38%]) had a significant improvement of the IPSS score as compared to the preoperative period, while 1 (4.5%) patient reported worsening of LUTS. In conclusion, TPLA appears to be a safe and feasible ultra-minimally-invasive option for LUTS due to benign prostatic obstruction (BPO) in patients with significant comorbidities at high-risk for standard surgical options.

本文旨在强调在一家转诊学术中心接受经会阴前列腺激光消融术(TPLA)的高合并症患者的功能和安全结果。2021年4月至2023年2月期间接受经会阴前列腺激光消融术的患者均伴有中度至重度下尿路症状(LUTS),前列腺体积在30至100毫升之间,美国麻醉医师协会(ASA)评分≥3分。所有患者均被评估为不适合接受标准手术。手术在门诊进行,采用局部麻醉。术后失败的定义是转向其他超微创手术治疗或需要长期更换留置导管。共有 23 名患者入选,中位年龄为 76 岁。ASA评分和Charlson合并症指数中位数分别为3和5。其中,11 人(48%)服用抗血小板药物,4 人(17%)服用新型口服抗凝药(NOACs),3 人(13%)服用华法林。6名(26%)患者术前留置了导尿管。前列腺体积中位数为 42 毫升。中位随访时间为 12 个月。无克拉维恩-丁多≥2级并发症记录。4/6(66%)名在 TPLA 术前留置导尿管的患者实现了自主排尿。2例(8.5%)患者治疗失败。在剩余的 21 例患者中,12/21(57%)例患者的国际前列腺症状评分(IPSS)症状分级(即重度至中度、中度至轻度等)有所改善;所有 IPSS 症状分级保持稳定的患者(8 例 [38%])的 IPSS 评分与术前相比均有显著改善,而 1 例(4.5%)患者的 LUTS 有所恶化。总之,TPLA似乎是治疗良性前列腺梗阻(BPO)引起的LUTS的一种安全可行的超微创方法,适用于有严重合并症且标准手术方案风险较高的患者。
{"title":"Could transperineal interstitial laser ablation of the prostate be the right option for highly-comorbid patients with lower urinary tract symptoms due to benign prostatic obstruction? A preliminary single-center experience focusing on functional and safety outcomes.","authors":"Paolo Polverino, Mattia Lo Re, Marco Saladino, Alessio Pecoraro, Luisa Moscardi, Anna Rivetti, Giulio R Resta, Marta Pezzoli, Andrea Romano, Bhaskar K Somani, Giampaolo Siena, Andrea Cocci, Mauro Gacci, Andrea Minervini, Sergio Serni, Riccardo Campi, Francesco Sessa","doi":"10.23736/S2724-6051.23.05479-4","DOIUrl":"10.23736/S2724-6051.23.05479-4","url":null,"abstract":"<p><p>In this paper, we aimed to highlight functional and safety outcomes of highly-comorbid patients undergoing transperineal laser ablation (TPLA) of prostate at a referral academic center. Patients undergoing TPLA from April 2021 and February 2023 with moderate to severe lower urinary tract symptoms (LUTS), prostate volume ranging from 30 to 100 mL, and an American Society of Anesthesiologists (ASA) Score ≥3 were included. All patients were evaluated as unfit for standard surgery. Procedures were performed in an outpatient setting using local anesthesia. Failure after the procedure was defined as the shift to other ultra-minimally invasive surgical treatment or the need for long-term indwelling catheter replacement. Overall, 23 patients were enrolled with a median age of 76 years. Median ASA Score and Charlson Comorbidity Index were 3 and 5, respectively. Of these, 11 (48%) were under antiplatelets, 4 (17%) under new oral anticoagulants (NOACs) and 3 (13%) under warfarin. Six (26%) patients had an indwelling catheter preoperatively. Median prostate volume was 42 mL. Median follow-up was 12 months. No Clavien-Dindo Grade ≥2 complications were recorded. Four/six (66%) patients with an indwelling catheter before TPLA achieved spontaneous micturition. Treatment failure occurred in 2 (8.5%) patients. Of the remaining 21 patients, 12/21 (57%) patients reported an improvement in International Prostate Symptoms Score (IPSS) symptoms class (i.e., severe to moderate, moderate to mild, etc.); all patients whose IPSS symptoms class remained stable (N.=8 [38%]) had a significant improvement of the IPSS score as compared to the preoperative period, while 1 (4.5%) patient reported worsening of LUTS. In conclusion, TPLA appears to be a safe and feasible ultra-minimally-invasive option for LUTS due to benign prostatic obstruction (BPO) in patients with significant comorbidities at high-risk for standard surgical options.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138800110","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
Comparison of tolerance and efficacy of JJ and pigtail suture stents in acute ureteral obstruction. 比较 JJ 和辫子缝合支架在急性输尿管梗阻中的耐受性和疗效。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-01 DOI: 10.23736/S2724-6051.24.05958-5
Michal Fedorko, Viktor Adedokun, Tomas Adamkovic, Michal Majesky
{"title":"Comparison of tolerance and efficacy of JJ and pigtail suture stents in acute ureteral obstruction.","authors":"Michal Fedorko, Viktor Adedokun, Tomas Adamkovic, Michal Majesky","doi":"10.23736/S2724-6051.24.05958-5","DOIUrl":"10.23736/S2724-6051.24.05958-5","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472573","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
Transforming UTUC diagnostics: the potential of bladder Epicheck® in clinical practice. UTUC诊断的变革:膀胱Epicheck®在临床实践中的潜力。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI: 10.23736/S2724-6051.24.06059-2
Loic Baekelandt, Murat Akand, Thomas VAN DEN Broeck, Thomas Gevaert, Steven Joniau
{"title":"Transforming UTUC diagnostics: the potential of bladder Epicheck® in clinical practice.","authors":"Loic Baekelandt, Murat Akand, Thomas VAN DEN Broeck, Thomas Gevaert, Steven Joniau","doi":"10.23736/S2724-6051.24.06059-2","DOIUrl":"10.23736/S2724-6051.24.06059-2","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876712","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
Operative outcomes 24 hours after retrograde intrarenal surgery for solitary renal calculi using a flexible and navigable suction ureteral access sheath. A prospective global multicenter study by the European Association of Urology Section on Urolithiasis. 使用灵活、可导航的抽吸输尿管入路鞘进行逆行肾内手术治疗单发肾结石后 24 小时的手术效果。欧洲泌尿外科协会泌尿系结石分会的一项前瞻性全球多中心研究。
IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-01 DOI: 10.23736/S2724-6051.24.05961-5
Vineet Gauhar, Olivier Traxer, Daniele Castellani, Khi Y Fong, Saeed Bin Hamri, Mehmet I Gökce, Nariman Gadzhiev, Mariela Corrales, Vigen Malkhasyan, Deepak Ragoori, Boyke Soebhali, Karl Tan, Chu A Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Tzevat Tefik, Anil Shrestha, Ben H Chew, Mohamed A Lakmichi, Andrea B Galosi, Heng C Tiong, Christian Seitz, Bhaskar K Somani

Background: Suction techniques showed potential to improve outcomes of retrograde intra-renal surgery (RIRS). We assessed the 24-hour stone-free rate (SFR) and complications after RIRS using flexible and navigable suction ureteral access sheaths (FANS-UAS).

Methods: Sixteen centers prospectively contributed to data (August 2023-October 2023). Inclusion criteria: age ≥18 years, single renal stone, pre and 24-hour post-RIRS CT scan. Exclusion criteria were: ureteral stone, anomalous kidney, multiple stones. SFR was divided into: 1) grade A - no fragments; 2) grade B - fragments ≤2 mm; 3) grade C - fragments 2.1-4 mm; and 4) grade D - fragments >4 mm. A multivariable logistic regression analysis model was performed to assess factors associated with the odds of having grade A stone-free status. Data are expressed as median (interquartile range), absolute numbers and frequencies, odds ratio (OR), and 95% confidence interval (CI).

Results: One hundred forty-two patients with a median age of 52 years (40-61) were enrolled. 61.3% were males. Median stone volume was 1165 mm3 (656-1936). Median operative time was 48.5 (36.25-71.75) min. Transient fever (37°C-37.5°C) occurred in 10 (7%) patients. No sepsis case occurred. 96.5% of patients were stone-free (Grade A+B). Grade A SFR was 52.8%. All patients were discharged within 48 hours. Bone window (OR 3.156 95% CI 1.177-9.130, P=0.027) was the only factor significantly associated with higher odds of 100% SFR, while stone volume (OR 0.999, 95% CI 0.999-1.000, P=0.007) was significantly associated with lower odds.

Conclusions: Imaging and clinical evidence demonstrate excellent perioperative outcomes just 24 hours post RIRS with FANS-UAS. The technique demonstrates a good safety profile, ability for immediate high SFR, and a low rate of infective complications.

背景:抽吸技术显示出改善逆行肾内手术(RIRS)结果的潜力。我们评估了使用柔性可导航抽吸输尿管通道鞘(FANS-UAS)进行逆行肾内手术后的24小时无结石率(SFR)和并发症:16个中心提供了前瞻性数据(2023年8月至2023年10月)。纳入标准:年龄≥18 岁,单发肾结石,RIRS 前后 24 小时 CT 扫描。排除标准:输尿管结石、肾脏异常、多发性结石。SFR分为1)A级--无碎石;2)B级--碎石≤2毫米;3)C级--碎石2.1-4毫米;4)D级--碎石>4毫米。采用多变量逻辑回归分析模型评估与 A 级无结石状态几率相关的因素。数据以中位数(四分位间距)、绝对数和频率、几率比(OR)和 95% 置信区间(CI)表示:142 名患者的中位年龄为 52 岁(40-61 岁),61.3% 为男性。61.3%为男性。结石体积中位数为 1165 立方毫米(656-1936)。手术时间中位数为 48.5 (36.25-71.75) 分钟。10例(7%)患者出现短暂发热(37°C-37.5°C)。无败血症病例。96.5%的患者无结石(A+B级)。A 级 SFR 为 52.8%。所有患者均在 48 小时内出院。骨窗(OR 3.156 95% CI 1.177-9.130,P=0.027)是唯一与100% SFR几率较高显著相关的因素,而结石体积(OR 0.999,95% CI 0.999-1.000,P=0.007)与较低几率显著相关:成像和临床证据表明,使用 FANS-UAS 进行 RIRS 术后 24 小时即可获得极佳的围手术期效果。结论:影像学和临床证据表明,使用 FANS-UAS 进行 RIRS 术后 24 小时就能获得极佳的围手术期效果。该技术具有良好的安全性、立即获得高 SFR 的能力以及较低的感染并发症发生率。
{"title":"Operative outcomes 24 hours after retrograde intrarenal surgery for solitary renal calculi using a flexible and navigable suction ureteral access sheath. A prospective global multicenter study by the European Association of Urology Section on Urolithiasis.","authors":"Vineet Gauhar, Olivier Traxer, Daniele Castellani, Khi Y Fong, Saeed Bin Hamri, Mehmet I Gökce, Nariman Gadzhiev, Mariela Corrales, Vigen Malkhasyan, Deepak Ragoori, Boyke Soebhali, Karl Tan, Chu A Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Tzevat Tefik, Anil Shrestha, Ben H Chew, Mohamed A Lakmichi, Andrea B Galosi, Heng C Tiong, Christian Seitz, Bhaskar K Somani","doi":"10.23736/S2724-6051.24.05961-5","DOIUrl":"10.23736/S2724-6051.24.05961-5","url":null,"abstract":"<p><strong>Background: </strong>Suction techniques showed potential to improve outcomes of retrograde intra-renal surgery (RIRS). We assessed the 24-hour stone-free rate (SFR) and complications after RIRS using flexible and navigable suction ureteral access sheaths (FANS-UAS).</p><p><strong>Methods: </strong>Sixteen centers prospectively contributed to data (August 2023-October 2023). Inclusion criteria: age ≥18 years, single renal stone, pre and 24-hour post-RIRS CT scan. Exclusion criteria were: ureteral stone, anomalous kidney, multiple stones. SFR was divided into: 1) grade A - no fragments; 2) grade B - fragments ≤2 mm; 3) grade C - fragments 2.1-4 mm; and 4) grade D - fragments >4 mm. A multivariable logistic regression analysis model was performed to assess factors associated with the odds of having grade A stone-free status. Data are expressed as median (interquartile range), absolute numbers and frequencies, odds ratio (OR), and 95% confidence interval (CI).</p><p><strong>Results: </strong>One hundred forty-two patients with a median age of 52 years (40-61) were enrolled. 61.3% were males. Median stone volume was 1165 mm<sup>3</sup> (656-1936). Median operative time was 48.5 (36.25-71.75) min. Transient fever (37°C-37.5°C) occurred in 10 (7%) patients. No sepsis case occurred. 96.5% of patients were stone-free (Grade A+B). Grade A SFR was 52.8%. All patients were discharged within 48 hours. Bone window (OR 3.156 95% CI 1.177-9.130, P=0.027) was the only factor significantly associated with higher odds of 100% SFR, while stone volume (OR 0.999, 95% CI 0.999-1.000, P=0.007) was significantly associated with lower odds.</p><p><strong>Conclusions: </strong>Imaging and clinical evidence demonstrate excellent perioperative outcomes just 24 hours post RIRS with FANS-UAS. The technique demonstrates a good safety profile, ability for immediate high SFR, and a low rate of infective complications.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332209","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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