Pub Date : 2023-01-01Epub Date: 2023-11-08DOI: 10.5173/ceju.2023.132
Łukasz Białek, Mikołaj Frankiewicz, Jan Adamowicz, Felix Campos-Juanatey, Andrea Cocci, Guglielmo Mantica, Clemens M Rosenbaum, Wesley Verla, Marjan Waterloos, Malte W Vetterlein
Introduction: The artificial urethral sphincter (AUS) is the gold standard treatment in cases of moderate-to-severe stress urinary incontinence in males. Cuff erosions are one of the most important distant complications of AUS implantation. The optimal urethral management has still not been established.
Material and methods: Search terms related to 'urethral stricture', 'artificial urinary sphincter', and 'cuff erosion' were used in the PubMed database to identify relevant articles.
Results: In this mini review we identified 6 original articles that assessed the urethral management after AUS explantation due to cuff erosion and included urinary diversion by transurethral and/or suprapubic catheterization, urethrorrhaphy, and in situ urethroplasty. We summarized the results of different management methods and their efficacy in terms of preventing urethral stricture formation. We highlight the need for better-quality evidence on this topic.
Conclusions: The available data do not provide a clear answer to the question of optimal urethral management during AUS explantation. There is a great need to provide higher-quality evidence on this topic.
导言:人工尿道括约肌(AUS)是治疗男性中重度压力性尿失禁的金标准。袖带侵蚀是人工尿道括约肌植入术最重要的远期并发症之一。最佳尿道处理方法尚未确定:在 PubMed 数据库中使用与 "尿道狭窄"、"人工尿道括约肌 "和 "袖带侵蚀 "相关的关键词进行搜索,以确定相关文章:在这篇微型综述中,我们发现了 6 篇原创文章,这些文章评估了因袖带侵蚀而导致 AUS 剥离后的尿道处理方法,包括经尿道和/或耻骨上导尿术、尿道成形术和原位尿道成形术的尿流改道。我们总结了不同处理方法的结果及其在预防尿道狭窄形成方面的功效。我们强调在这一问题上需要更高质量的证据:结论:现有数据并不能明确回答 AUS 移植过程中的最佳尿道管理问题。我们亟需就这一问题提供更高质量的证据。
{"title":"Urethral management after artificial urinary sphincter explantation due to cuff erosion.","authors":"Łukasz Białek, Mikołaj Frankiewicz, Jan Adamowicz, Felix Campos-Juanatey, Andrea Cocci, Guglielmo Mantica, Clemens M Rosenbaum, Wesley Verla, Marjan Waterloos, Malte W Vetterlein","doi":"10.5173/ceju.2023.132","DOIUrl":"10.5173/ceju.2023.132","url":null,"abstract":"<p><strong>Introduction: </strong>The artificial urethral sphincter (AUS) is the gold standard treatment in cases of moderate-to-severe stress urinary incontinence in males. Cuff erosions are one of the most important distant complications of AUS implantation. The optimal urethral management has still not been established.</p><p><strong>Material and methods: </strong>Search terms related to 'urethral stricture', 'artificial urinary sphincter', and 'cuff erosion' were used in the PubMed database to identify relevant articles.</p><p><strong>Results: </strong>In this mini review we identified 6 original articles that assessed the urethral management after AUS explantation due to cuff erosion and included urinary diversion by transurethral and/or suprapubic catheterization, urethrorrhaphy, and <i>in situ</i> urethroplasty. We summarized the results of different management methods and their efficacy in terms of preventing urethral stricture formation. We highlight the need for better-quality evidence on this topic.</p><p><strong>Conclusions: </strong>The available data do not provide a clear answer to the question of optimal urethral management during AUS explantation. There is a great need to provide higher-quality evidence on this topic.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valentina Bernasconi, Marco Tozzi, Amelia Pietropaolo, Vincent De Coninck, Bhaskar K Somani, Thomas Tailly, Ewa Bres-Niewada, Ioannis Mykoniatis, Andrea Gregori, Michele Talso
Ureteral stents are useful devices in urological surgery. The main objective of a ureteric stent is to allow passage of urine and reduce early or late complications related to obstruction in the urinary tract. Despite their widespread use, there is a general lack of knowledge and awareness in stent composition and indication of application. We represented a synthesis of our extensive research over materials, coatings and shapes available on the market and then analyzed the main characteristics and peculiarities of ureteral stents. We have also focused our attention over the side effects and complication that must be considered when placing a ureteral stent. Encrustation, microbial colonization, stent-related symptoms and patient's history must always be evaluated when there is the need for a ureteral stent. The perfect stent should have many characteristics including easy insertion and removal, easy manipulation, resistance to encrustation and migration, lack of complications, biocompatibility, radio-opacity, biodurability, affordability (cost-effectiveness), tolerability and optimal flow characteristics. Nevertheless, further research and studies need to be done to provide more information about stent composition and efficacy in vivo. In this narrative review, we covered the basic information and main characteristics of ureteral stents, in order to help clinicians choose the appropriate device needed for a given situation.
{"title":"Comprehensive overview of ureteral stents based on clinical aspects, material and design.","authors":"Valentina Bernasconi, Marco Tozzi, Amelia Pietropaolo, Vincent De Coninck, Bhaskar K Somani, Thomas Tailly, Ewa Bres-Niewada, Ioannis Mykoniatis, Andrea Gregori, Michele Talso","doi":"10.5173/ceju.2023.218","DOIUrl":"https://doi.org/10.5173/ceju.2023.218","url":null,"abstract":"<p><p>Ureteral stents are useful devices in urological surgery. The main objective of a ureteric stent is to allow passage of urine and reduce early or late complications related to obstruction in the urinary tract. Despite their widespread use, there is a general lack of knowledge and awareness in stent composition and indication of application. We represented a synthesis of our extensive research over materials, coatings and shapes available on the market and then analyzed the main characteristics and peculiarities of ureteral stents. We have also focused our attention over the side effects and complication that must be considered when placing a ureteral stent. Encrustation, microbial colonization, stent-related symptoms and patient's history must always be evaluated when there is the need for a ureteral stent. The perfect stent should have many characteristics including easy insertion and removal, easy manipulation, resistance to encrustation and migration, lack of complications, biocompatibility, radio-opacity, biodurability, affordability (cost-effectiveness), tolerability and optimal flow characteristics. Nevertheless, further research and studies need to be done to provide more information about stent composition and efficacy in vivo. In this narrative review, we covered the basic information and main characteristics of ureteral stents, in order to help clinicians choose the appropriate device needed for a given situation.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/f3/CEJU-76-218.PMC10091895.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9309523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-11-13DOI: 10.5173/ceju.2023.74
Kristiana Gkeka, Evangelos N Symeonidis, Georgios Tsampoukas, Mohammad Moussa, Hussein Issa, Elena Kontogianni, Murtadha Almusafer, Antigoni Katsouri, Ioannis Mykoniatis, Fotios Dimitriadis, Athanasios Papatsoris, Noor Buchholz
Introduction: Recurrent miscarriage is defined as 2 or more failed clinical pregnancies, typically known as repeated pregnancy loss, occurring before 20 gestational weeks, and further categorized into primary and secondary types. It represents a common and distressing condition to deal with in the field of reproductive medicine, usually affecting <5% of couples, with up to 50% of cases lacking a clearly defined aetiology. The epidemiology also varies depending on maternal age. Remarkably, the situation significantly afflicts expecting parents, whereas maternal factors, such as age and previous pregnancy loss rate, are commonly reported as risk factors. Although previously underestimated, existing evidence suggests the male factor is a possible cause of recurrent pregnancy loss.
Material and methods: A non-systematic literature review was conducted in the PubMed and Scopus databases for articles written in English investigating the possible association of the male factor in recurrent pregnancy loss. The eligible studies were synthesized in a narrative review format upon discussion and consensus among the authors after being previously independently assessed and selected.
Results: Lifestyle, obesity, genetic predisposition, chromosomal anomalies, endocrine dysfunction, anatomical abnormalities, immunological factors, infections, and oxidative stress can result in poor embryo development and recurrent miscarriage. Although professional organizations currently recognize male gender as a possible risk factor, specific recommendations on the diagnostic and therapeutic field are still lacking, and the condition necessitates a high level of suspicion and case-by-case management.
Conclusions: In this review, we delve deeper into the contribution of the male factor in the concept of recurrent miscarriage.
{"title":"Recurrent miscarriage and male factor infertility: diagnostic and therapeutic implications. A narrative review.","authors":"Kristiana Gkeka, Evangelos N Symeonidis, Georgios Tsampoukas, Mohammad Moussa, Hussein Issa, Elena Kontogianni, Murtadha Almusafer, Antigoni Katsouri, Ioannis Mykoniatis, Fotios Dimitriadis, Athanasios Papatsoris, Noor Buchholz","doi":"10.5173/ceju.2023.74","DOIUrl":"10.5173/ceju.2023.74","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent miscarriage is defined as 2 or more failed clinical pregnancies, typically known as repeated pregnancy loss, occurring before 20 gestational weeks, and further categorized into primary and secondary types. It represents a common and distressing condition to deal with in the field of reproductive medicine, usually affecting <5% of couples, with up to 50% of cases lacking a clearly defined aetiology. The epidemiology also varies depending on maternal age. Remarkably, the situation significantly afflicts expecting parents, whereas maternal factors, such as age and previous pregnancy loss rate, are commonly reported as risk factors. Although previously underestimated, existing evidence suggests the male factor is a possible cause of recurrent pregnancy loss.</p><p><strong>Material and methods: </strong>A non-systematic literature review was conducted in the PubMed and Scopus databases for articles written in English investigating the possible association of the male factor in recurrent pregnancy loss. The eligible studies were synthesized in a narrative review format upon discussion and consensus among the authors after being previously independently assessed and selected.</p><p><strong>Results: </strong>Lifestyle, obesity, genetic predisposition, chromosomal anomalies, endocrine dysfunction, anatomical abnormalities, immunological factors, infections, and oxidative stress can result in poor embryo development and recurrent miscarriage. Although professional organizations currently recognize male gender as a possible risk factor, specific recommendations on the diagnostic and therapeutic field are still lacking, and the condition necessitates a high level of suspicion and case-by-case management.</p><p><strong>Conclusions: </strong>In this review, we delve deeper into the contribution of the male factor in the concept of recurrent miscarriage.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-11-13DOI: 10.5173/ceju.2023.193
Fabrizio Di Maida, Antonio Andrea Grosso, Anna Cadenar, Maria Lucia Gallo, Sofia Giudici, Daniele Paganelli, Laura Olivera, Andrea Mari, Lorenzo Masieri, Andrea Minervini
{"title":"Step-by-step robotic technique to manage an extensive retroperitoneal fibrosis.","authors":"Fabrizio Di Maida, Antonio Andrea Grosso, Anna Cadenar, Maria Lucia Gallo, Sofia Giudici, Daniele Paganelli, Laura Olivera, Andrea Mari, Lorenzo Masieri, Andrea Minervini","doi":"10.5173/ceju.2023.193","DOIUrl":"https://doi.org/10.5173/ceju.2023.193","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pathological report and prognostic meaning of Bosniak IV cysts: results from a contemporary cohort","authors":"","doi":"10.5173/ceju.2023.083r","DOIUrl":"https://doi.org/10.5173/ceju.2023.083r","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135550682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anil Erdik, Haci Ibrahim Cimen, Yavuz Tarik Atik, Deniz Gul, Osman Kose, Fikret Halis, Hasan Salih Saglam, Omer Faruk Ates
Introduction: This study aimed to determine whether sarcopenia is a predictor of overall survival (OS) and cancer-specific survival (CSS) in patients with bladder cancer (BC) undergoing radical cystectomy (RC).
Material and methods: Patients who underwent radical cystectomy for BC between September 2016 and June 2022 were retrospectively reviewed. Patients underwent digital computed tomography (CT) scans of the abdomen and pelvis. The skeletal muscle index (SMI) was used to assess sarcopenia using CT images. OS and CSS were estimated using Kaplan-Meier curves. Predictors of CSS and OS were analysed using univariate and multivariate Cox regression models.
Results: Of the 84 reviewed patients, 45 (53.6%) had sarcopenia. The median follow-up period for survivors was 70 months. Patients with sarcopenia were older and had a lower BMI, but other preoperative clinical and laboratory parameters were similar to those of patients without sarcopenia. During follow-up, 57 (67.9%) patients died, 39 (46.4%) due to BC. In addition, patients with sarcopenia had worse 5-year OS (24.4% vs 41.0%, p = 0.036) and CSS (35.6% vs 61.5%, p = 0.012) than non-sarcopenic patients. The findings indicate that sarcopenia is an independent predictor of increased CSS (HR, 2.841; p = 0.003) and overall mortality (HR, 2.465; p = 0.004) in multivariate analysis.
Conclusions: The results of this study support the view that sarcopenia is an important risk factor for predicting CSS and OS in BC patients undergoing RC.
本研究旨在确定肌肉减少症是否能预测膀胱癌(BC)根治性膀胱切除术(RC)患者的总生存期(OS)和癌症特异性生存期(CSS)。材料和方法:回顾性分析2016年9月至2022年6月期间接受BC根治性膀胱切除术的患者。患者接受了腹部和骨盆的数字计算机断层扫描(CT)。骨骼肌指数(SMI)用于评估CT图像中的肌肉减少症。使用Kaplan-Meier曲线估计OS和CSS。采用单因素和多因素Cox回归模型分析CSS和OS的预测因素。结果:84例患者中,45例(53.6%)出现肌肉减少症。幸存者的中位随访期为70个月。肌少症患者年龄较大,BMI较低,但其他术前临床和实验室参数与无肌少症患者相似。随访期间,57例(67.9%)患者死亡,39例(46.4%)死于BC。此外,肌少症患者的5年OS (24.4% vs 41.0%, p = 0.036)和CSS (35.6% vs 61.5%, p = 0.012)均低于非肌少症患者。研究结果表明,肌肉减少症是CSS升高的独立预测因子(HR, 2.841;p = 0.003)和总死亡率(HR, 2.465;P = 0.004)。结论:本研究结果支持了肌少症是预测接受RC的BC患者CSS和OS的重要危险因素的观点。
{"title":"Sarcopenia is an independent predictor of survival in patients undergoing radical cystectomy for bladder cancer: a single-centre, retrospective study.","authors":"Anil Erdik, Haci Ibrahim Cimen, Yavuz Tarik Atik, Deniz Gul, Osman Kose, Fikret Halis, Hasan Salih Saglam, Omer Faruk Ates","doi":"10.5173/ceju.2023.14","DOIUrl":"https://doi.org/10.5173/ceju.2023.14","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine whether sarcopenia is a predictor of overall survival (OS) and cancer-specific survival (CSS) in patients with bladder cancer (BC) undergoing radical cystectomy (RC).</p><p><strong>Material and methods: </strong>Patients who underwent radical cystectomy for BC between September 2016 and June 2022 were retrospectively reviewed. Patients underwent digital computed tomography (CT) scans of the abdomen and pelvis. The skeletal muscle index (SMI) was used to assess sarcopenia using CT images. OS and CSS were estimated using Kaplan-Meier curves. Predictors of CSS and OS were analysed using univariate and multivariate Cox regression models.</p><p><strong>Results: </strong>Of the 84 reviewed patients, 45 (53.6%) had sarcopenia. The median follow-up period for survivors was 70 months. Patients with sarcopenia were older and had a lower BMI, but other preoperative clinical and laboratory parameters were similar to those of patients without sarcopenia. During follow-up, 57 (67.9%) patients died, 39 (46.4%) due to BC. In addition, patients with sarcopenia had worse 5-year OS (24.4% vs 41.0%, p = 0.036) and CSS (35.6% vs 61.5%, p = 0.012) than non-sarcopenic patients. The findings indicate that sarcopenia is an independent predictor of increased CSS (HR, 2.841; p = 0.003) and overall mortality (HR, 2.465; p = 0.004) in multivariate analysis.</p><p><strong>Conclusions: </strong>The results of this study support the view that sarcopenia is an important risk factor for predicting CSS and OS in BC patients undergoing RC.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/ae/CEJU-76-14.PMC10357826.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9860921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-04-07DOI: 10.5173/ceju.2023.019
Guglielmo Mantica, Diego M Carrion, Karl H Pang, Taha Ucar, Stefano Parodi, Stefano Tappero, Lazaros Lazarou, Ioannis Glykas, Christos Zabaftis, Mario Lourenco, Daniel A González Padilla, Luis Enrique Ortega Polledo, Irene Paraboschi, Alfredo Berrettini, Carlo Terrone, Juan Gomez Rivas, Francesco Esperto
Introduction: At the end of their residency program, urology trainees should reach the minimum skills required to be able to work by themselves and within a team. To achieve this objective, it is fundamental that the training involves not only surgical activities, but also theoretical, academic, and relational ones. What is the perfect balance between these activities within the ideal urological training? This study aims to evaluate the concordance in different concepts of good urological training between different perspectives (trainees vs professors).
Material and methods: Between January and December 2020 the same survey was distributed via email to 967 urology trainees and urology tutors. The survey investigated 5 educational fields: theoretical, clinical, surgical, relational, and simulation. For each field, specific questions investigated the importance of different activities and the training outcomes considered fundamental to be reached by a resident. The questions were evaluated by responders through a Likert 10-point scale.
Results: The survey was completed by 155 trainees (58.9%, Group A) and 108 tutors (41.1%, Group B) from 26 different countries. Relative to the tutors, residents assigned statistically significantly lower scores to prostate biopsy (median score 9.11 vs 9.24), robotic simulator training (5.66 vs 5.93), on-call duties with consultants (6.85 vs 7.99), as well as all aspects of relational training (e.g., proper dialogue with colleagues: 7.95 vs 8.88). Conversely, residents assigned statistically significantly higher scores, albeit below sufficiency, to the performance of robotic prostatectomy as a first operator (4.45 vs 4.26). Finally, no discrepancies between residents' and tutors' scores were recorded regarding the remaining items of clinical training (e.g., urodynamics, outpatient clinic, ward duties) and surgical training (e.g., major open, laparoscopic and endoscopic surgical training; all p values >0.05).
Conclusions: There was partial concordance between trainees and tutors regarding the activities that should be implemented and the skills that should be achieved during a urological residency. The residents aimed for more surgical involvement, while the tutors and professors, although giving importance to surgical and theoretical training, considered clinical practice as the fundamental basis on which to train future urologists.
{"title":"The definition of ideal training of a urology resident from two different perspectives: trainees vs professors. Is there agreement in their idea of good training?","authors":"Guglielmo Mantica, Diego M Carrion, Karl H Pang, Taha Ucar, Stefano Parodi, Stefano Tappero, Lazaros Lazarou, Ioannis Glykas, Christos Zabaftis, Mario Lourenco, Daniel A González Padilla, Luis Enrique Ortega Polledo, Irene Paraboschi, Alfredo Berrettini, Carlo Terrone, Juan Gomez Rivas, Francesco Esperto","doi":"10.5173/ceju.2023.019","DOIUrl":"10.5173/ceju.2023.019","url":null,"abstract":"<p><strong>Introduction: </strong>At the end of their residency program, urology trainees should reach the minimum skills required to be able to work by themselves and within a team. To achieve this objective, it is fundamental that the training involves not only surgical activities, but also theoretical, academic, and relational ones. What is the perfect balance between these activities within the ideal urological training? This study aims to evaluate the concordance in different concepts of good urological training between different perspectives (trainees vs professors).</p><p><strong>Material and methods: </strong>Between January and December 2020 the same survey was distributed via email to 967 urology trainees and urology tutors. The survey investigated 5 educational fields: theoretical, clinical, surgical, relational, and simulation. For each field, specific questions investigated the importance of different activities and the training outcomes considered fundamental to be reached by a resident. The questions were evaluated by responders through a Likert 10-point scale.</p><p><strong>Results: </strong>The survey was completed by 155 trainees (58.9%, Group A) and 108 tutors (41.1%, Group B) from 26 different countries. Relative to the tutors, residents assigned statistically significantly lower scores to prostate biopsy (median score 9.11 vs 9.24), robotic simulator training (5.66 vs 5.93), on-call duties with consultants (6.85 vs 7.99), as well as all aspects of relational training (e.g., proper dialogue with colleagues: 7.95 vs 8.88). Conversely, residents assigned statistically significantly higher scores, albeit below sufficiency, to the performance of robotic prostatectomy as a first operator (4.45 vs 4.26). Finally, no discrepancies between residents' and tutors' scores were recorded regarding the remaining items of clinical training (e.g., urodynamics, outpatient clinic, ward duties) and surgical training (e.g., major open, laparoscopic and endoscopic surgical training; all p values >0.05).</p><p><strong>Conclusions: </strong>There was partial concordance between trainees and tutors regarding the activities that should be implemented and the skills that should be achieved during a urological residency. The residents aimed for more surgical involvement, while the tutors and professors, although giving importance to surgical and theoretical training, considered clinical practice as the fundamental basis on which to train future urologists.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/07/CEJU-76-19.PMC10357832.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9864206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-05-12DOI: 10.5173/ceju.2023.039
Fabio Zattoni, Giacomo Novara, Massimo Iafrate, Filippo Carletti, Giuseppe Reitano, Gianmarco Randazzo, Tommaso Ceccato, Giovanni Betto, Fabrizio Dal Moro
Introduction: The pre-treatment neutrophil-to-lymphocyte ratio (NLR) has been associated with adverse pathology or survival in a variety of malignancies, including urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC). Whether the prognostic value of NLR is retained, or even increased, when measured postoperatively remains to be studied. In this study, we evaluated the association of preoperative and postoperative NLR with oncological outcomes following RC.
Material and methods: The NLR was recorded in 132 consecutive patients with UCB treated with open RC: before surgery (NLR1), postoperatively within 2 days (NRL2), between 7 and 15 days after RC before discharge (NLR3), and a few days before recurrence or last available follow-up (NLR4).
Results: When assessed by multivariate analysis NLR1 remained independently associated with a significantly increased risk of extravesical disease (pT 3-4) (OR = 1.4, p <0.01) and lymphovascular invasion (LVI) (OR = 1.40, 95% CI 1.09-1.83, p <0.01). NLR4 was independently associated with a significantly increased risk of cancer-specific mortality (CSM) (HR = 1.14, 95%CI 1.03-1.24, p = 0.013). In a postoperative model, NLR3 was found to be an independent predictor of all-cause mortality (ACM) [HR = 1.11, 95% CI 1.02-1.21, p = 0.01]. NLR1 was associated with a significantly increased risk of recurrence in the univariable preoperative model [HR = 1.9, 95%CI 1.00-3.65, p = 0.05], while in the postoperative model NLR4 remained independently associated with a significantly increased risk of recurrence (HR = 1.13, 95%CI 1.04-1.23, p = 0.03).
Conclusions: In patients with UCB treated with RC, the NLR is associated with more advanced tumour stage, LVI, lymph node metastasis, and higher CSM. Furthermore, the variation of the NLR after surgery might play a role in predicting higher ACM and recurrence-free survival.
{"title":"Neutrophil-to-lymphocyte ratio as a prognostic factor for patients with urothelial carcinoma of the bladder following radical cystectomy.","authors":"Fabio Zattoni, Giacomo Novara, Massimo Iafrate, Filippo Carletti, Giuseppe Reitano, Gianmarco Randazzo, Tommaso Ceccato, Giovanni Betto, Fabrizio Dal Moro","doi":"10.5173/ceju.2023.039","DOIUrl":"10.5173/ceju.2023.039","url":null,"abstract":"<p><strong>Introduction: </strong>The pre-treatment neutrophil-to-lymphocyte ratio (NLR) has been associated with adverse pathology or survival in a variety of malignancies, including urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC). Whether the prognostic value of NLR is retained, or even increased, when measured postoperatively remains to be studied. In this study, we evaluated the association of preoperative and postoperative NLR with oncological outcomes following RC.</p><p><strong>Material and methods: </strong>The NLR was recorded in 132 consecutive patients with UCB treated with open RC: before surgery (NLR1), postoperatively within 2 days (NRL2), between 7 and 15 days after RC before discharge (NLR3), and a few days before recurrence or last available follow-up (NLR4).</p><p><strong>Results: </strong>When assessed by multivariate analysis NLR1 remained independently associated with a significantly increased risk of extravesical disease (pT 3-4) (OR = 1.4, p <0.01) and lymphovascular invasion (LVI) (OR = 1.40, 95% CI 1.09-1.83, p <0.01). NLR4 was independently associated with a significantly increased risk of cancer-specific mortality (CSM) (HR = 1.14, 95%CI 1.03-1.24, p = 0.013). In a postoperative model, NLR3 was found to be an independent predictor of all-cause mortality (ACM) [HR = 1.11, 95% CI 1.02-1.21, p = 0.01]. NLR1 was associated with a significantly increased risk of recurrence in the univariable preoperative model [HR = 1.9, 95%CI 1.00-3.65, p = 0.05], while in the postoperative model NLR4 remained independently associated with a significantly increased risk of recurrence (HR = 1.13, 95%CI 1.04-1.23, p = 0.03).</p><p><strong>Conclusions: </strong>In patients with UCB treated with RC, the NLR is associated with more advanced tumour stage, LVI, lymph node metastasis, and higher CSM. Furthermore, the variation of the NLR after surgery might play a role in predicting higher ACM and recurrence-free survival.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/f0/CEJU-76-39.PMC10357830.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrick Juliebø-Jones, Øyvind Ulvik, Mathias Sørstrand Æsøy, Peder Gjengstø, Christian Beisland, Bhaskar K Somani
Introduction: Urolithiasis is a recognised disease of prevalence, and although not common, fatal sequelae can occur. There are few studies with population-based data that provide an overview of the mortality burden associated with this condition. Our aim was to perform an update based on national data from England and Wales.
Material and methods: A search was performed of the database available through the Office of National Statistics (ONS), which collates relevant information from all death certificates in England and Wales. The cause of death is classified according to the conditions listed in the International Classification of Diseases, Tenth Revision (ICD-10). The codes N 20-23 were utilised. Data were collected on gender, location in the upper or lower urinary tract, and age.
Results: Over the 23-year period, 3717 deaths caused by urolithiasis were recorded. The male-to-female ratio was 1:1.4. However, this gender gap steadily closed over time. The mean number of deaths per year was 161 (range: 98-308 year), and this gradually increased over the study period. By 2021, urolithiasis accounted for 0.1% of deaths in England and Wales. Over half of the deaths (64.9%) were in persons aged ≥75 years, while the mortality rate in persons under 50 years old was less than 4%. 0.1% of the deaths occurred in children under 15 years of age, and these were all females.
Conclusions: The number of deaths caused by urolithiasis has increased in England and Wales. Although mortality is higher among females, this gender gap is narrowing.
{"title":"Mortality due to urolithiasis in England and Wales: updated findings from a national database over a 23-year period.","authors":"Patrick Juliebø-Jones, Øyvind Ulvik, Mathias Sørstrand Æsøy, Peder Gjengstø, Christian Beisland, Bhaskar K Somani","doi":"10.5173/ceju.2023.054","DOIUrl":"https://doi.org/10.5173/ceju.2023.054","url":null,"abstract":"<p><strong>Introduction: </strong>Urolithiasis is a recognised disease of prevalence, and although not common, fatal sequelae can occur. There are few studies with population-based data that provide an overview of the mortality burden associated with this condition. Our aim was to perform an update based on national data from England and Wales.</p><p><strong>Material and methods: </strong>A search was performed of the database available through the Office of National Statistics (ONS), which collates relevant information from all death certificates in England and Wales. The cause of death is classified according to the conditions listed in the International Classification of Diseases, Tenth Revision (ICD-10). The codes N 20-23 were utilised. Data were collected on gender, location in the upper or lower urinary tract, and age.</p><p><strong>Results: </strong>Over the 23-year period, 3717 deaths caused by urolithiasis were recorded. The male-to-female ratio was 1:1.4. However, this gender gap steadily closed over time. The mean number of deaths per year was 161 (range: 98-308 year), and this gradually increased over the study period. By 2021, urolithiasis accounted for 0.1% of deaths in England and Wales. Over half of the deaths (64.9%) were in persons aged ≥75 years, while the mortality rate in persons under 50 years old was less than 4%. 0.1% of the deaths occurred in children under 15 years of age, and these were all females.</p><p><strong>Conclusions: </strong>The number of deaths caused by urolithiasis has increased in England and Wales. Although mortality is higher among females, this gender gap is narrowing.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/cd/CEJU-76-54.PMC10357824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-11-27DOI: 10.5173/ceju.2023.004E
Bartosz Dybowski
{"title":"Local solutions to shorten treatment delays in bladder cancer. Results of a survey among CEJU authors.","authors":"Bartosz Dybowski","doi":"10.5173/ceju.2023.004E","DOIUrl":"10.5173/ceju.2023.004E","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}