Current Opinion in Urology最新文献_第4页

Safety and efficacy of laser lithotripsy for treatment of bladder calculi: evidence from a systematic literature review. 激光碎石治疗膀胱结石的安全性和有效性：来自系统文献综述的证据。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-07-01 Epub Date: 2024-11-13 DOI: 10.1097/MOU.0000000000001250

Mahir Akram, Clara Cerrato, Dmitry Enikeev, Theodoros Tokas, Bhaskar K Somani

{"title":"Safety and efficacy of laser lithotripsy for treatment of bladder calculi: evidence from a systematic literature review.","authors":"Mahir Akram, Clara Cerrato, Dmitry Enikeev, Theodoros Tokas, Bhaskar K Somani","doi":"10.1097/MOU.0000000000001250","DOIUrl":"10.1097/MOU.0000000000001250","url":null,"abstract":"Purpose of review: Bladder stones account for 5% of all urinary tract calculi. Contributing factors include bladder outflow obstruction, infections, foreign bodies, or neurogenic voiding dysfunction. This necessitates an effective treatment modality, and with advances in medical technology, minimally invasive techniques using lasers are being widely adopted. This systematic review aims to assess the efficacy and safety of laser lithotripsy for treating bladder stones.Recent findings: A thorough literature review (PROSPERO: CRD 42024551910) was conducted using appropriate search terms up to March 2024. Only original studies written in English, with at least 10 patients with bladder stones treated with laser, were considered with inclusion. A total of 8 studies (411 patients) were identified on screening with a mean age of 59.6 ± 8.5 years and a male: female ratio of 326 : 14. These reviews covered a geographical area of Asia, Europe, and the USA. The mean stone size was 3.7 ± 0.7 cm, and an overall stone-free rate (SFR) postlaser lithotripsy was 96%. Mean operation time was calculated to be 76.36 ± 47.10 min and an overall complication rate of 16.5% ( n = 68), with the most common being haematuria ( n = 22), followed by UTI ( n = 18), incontinence ( n = 8), urosepsis ( n = 6), clot retention ( n = 4), mucosal injury ( n = 3) and urinary retention ( n = 3). All complications were minor and there were no Clavien >II complications.Summary: Laser lithotripsy for bladder stone achieves an excellent success rate in the form of SFR, combined with a low risk of major complications, and allows concomitant treatment of enlarged prostate, and should be considered in all patients.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"331-337"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Differences in lasers and laser technologies: what does a clinician need to know? 激光和激光技术的差异：临床医生需要知道什么？

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-07-01 Epub Date: 2025-01-20 DOI: 10.1097/MOU.0000000000001264

Andrey Morozov, Vladislav Skossyrskiy, Diana Babaevskaya, Vineet Gauhar, Dmitry Enikeev

{"title":"Differences in lasers and laser technologies: what does a clinician need to know?","authors":"Andrey Morozov, Vladislav Skossyrskiy, Diana Babaevskaya, Vineet Gauhar, Dmitry Enikeev","doi":"10.1097/MOU.0000000000001264","DOIUrl":"10.1097/MOU.0000000000001264","url":null,"abstract":"Purpose of review: This review focuses on recent advancements in laser technologies used in urology, particularly in enucleation, vaporization, lithotripsy, and focal laser ablation (FLA). The growing use of the thulium fiber laser (TFL) and the development of pulsed thulium lasers (p-Tm:YAG) highlight the relevance of this review, as these innovations aim to improve precision and outcomes in urological procedures.Recent findings: Recent studies have shown the advantages of TFL in achieving precise tissue ablation, reduced retropulsion offered by the Moses technology in holmium lasers, and the potential of pulsed thulium lasers for more precise control of the effects on tissues. Additionally, FLA is gaining traction for its ability to treat localized prostate cancer with minimal collateral damage. These technologies not only optimize procedural accuracy but also reduce complications, making them safer for high-risk patients, including those receiving anticoagulants.Summary: The advancements in laser technology, including TFL, Moses technology, and pulsed thulium lasers, are improving outcomes in urological surgeries by increasing precision, reducing operative time, and minimizing complications. FLA represents a promising alternative for minimally invasive cancer treatments. Ongoing research should focus on optimizing laser parameters and exploring broader clinical applications.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"354-359"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Small tools, big impact and redefining endourology: the paradigm shift of ureteroscopy for large stones and percutaneous nephrolithotomy for small stones - a literature review. 小工具，大影响，重新定义泌尿道学：输尿管镜治疗大结石和经皮肾镜治疗小结石的模式转变-文献综述。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-07-01 Epub Date: 2025-04-03 DOI: 10.1097/MOU.0000000000001283

Maria Florencia Frascheri, Pablo Contreras, Dmitry Enikeev, Arman Tsaturyan, Giorgio Bozzini, Bhaskar K Somani

{"title":"Small tools, big impact and redefining endourology: the paradigm shift of ureteroscopy for large stones and percutaneous nephrolithotomy for small stones - a literature review.","authors":"Maria Florencia Frascheri, Pablo Contreras, Dmitry Enikeev, Arman Tsaturyan, Giorgio Bozzini, Bhaskar K Somani","doi":"10.1097/MOU.0000000000001283","DOIUrl":"10.1097/MOU.0000000000001283","url":null,"abstract":"Purpose of review: We aim to review the evolving paradigm in endourology, where technology has led us to manage small stones with ureteroscopy (URS) and large stones with miniaturized percutaneous nephrolithotomy (mPCNL) techniques. We analyse recent literature, their findings, emerging trends and newer technologies that are helping redefine modern day endourology in pushing these boundaries.Recent findings: A significant trend is the use of smaller devices to treat larger stones via ureteroscopy, and to treat smaller stones via percutaneous nephrolithotomy (PCNL). Improved laser technologies, smaller single use ureteroscopes and nephroscopes, suction access sheaths, all play a key role in this.The use of suction sheaths and vacuum assisted devices allows to control intrarenal pressure and help in reducing infectious and other complications whilst improving the stone-free rate (SFR). The treatment choice often depends on surgical expertise and available resources, guided by anatomical factors, stone composition and patient-specific considerations.Summary: The management of kidney stone disease has undergone a paradigm shift. While ureteroscopy is being done for larger renal stones, miniaturised PCNL is being done for small stones. This has been driven by a surge in technology, but a tailored and patient-centred approach is needed, and must be helped by guidelines and a multidisciplinary approach.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"347-353"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immunotherapy toxicities in genito-urinary cancers: insights and challenges for clinicians. 生殖-泌尿系统癌症的免疫治疗毒性：临床医生的见解和挑战。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-07-01 Epub Date: 2025-05-02 DOI: 10.1097/MOU.0000000000001295

Chiara Mercinelli, Chiara Carli, Rosanna Di Vita, Maria Oliveri, Luca Galli, Andrea Necchi

{"title":"Immunotherapy toxicities in genito-urinary cancers: insights and challenges for clinicians.","authors":"Chiara Mercinelli, Chiara Carli, Rosanna Di Vita, Maria Oliveri, Luca Galli, Andrea Necchi","doi":"10.1097/MOU.0000000000001295","DOIUrl":"10.1097/MOU.0000000000001295","url":null,"abstract":"Purpose of review: The advent of immunotherapy has completely transformed cancer treatment, particularly in genitourinary malignancies, where immune checkpoint inhibitors (ICIs) are now a cornerstone in bladder and kidney cancer management. However, their use introduces a distinct spectrum of immune-related adverse events (irAEs), necessitating a thorough understanding of their incidence, mechanisms, and management. This review explores the safety profile of ICIs in genitourinary cancers, addressing their impact in both localized and metastatic settings.Recent findings: Recent studies highlight the diverse nature of irAEs, which can affect multiple organ systems with varying severity. While ICIs have demonstrated durable responses, their toxicity profile differs significantly from conventional therapies, requiring vigilant monitoring and prompt intervention. Notably, combination therapies, such as PD-1/PD-L1 inhibitors with CTLA-4 blockade or chemotherapy, may increase the risk of severe irAEs. Emerging data suggest that preexisting autoimmune conditions and specific patient subgroups may be more susceptible to toxicity, emphasizing the need for individualized risk assessment.Summary: This review highlights the need for continuous monitoring, effective management strategies, and further research to better understand the mechanisms of irAEs and improve the well tolerated use of immunotherapy in genitourinary cancers. Clinicians should be aware of the incidence of immunotherapy-related adverse events in order to early identify them.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"461-466"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetics of male infertility. 男性不育的遗传学。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-07-01 Epub Date: 2025-04-03 DOI: 10.1097/MOU.0000000000001287

Christian Corsini, Edoardo Pozzi, Andrea Salonia

{"title":"Genetics of male infertility.","authors":"Christian Corsini, Edoardo Pozzi, Andrea Salonia","doi":"10.1097/MOU.0000000000001287","DOIUrl":"10.1097/MOU.0000000000001287","url":null,"abstract":"Purpose of review: The aim of this study was to outline the role of genetic abnormalities, including chromosomal anomalies, single-gene mutations, epigenetic changes, and mitochondrial DNA (mtDNA) defects, in male factor infertility.Recent findings: Recent advances in genetic research have brought incredible new perspectives to understanding male infertility, thanks in large part to next-generation sequencing. Chromosomal abnormalities like Klinefelter syndrome and Y chromosome microdeletions remain key contributors, with new insights into their variable presentations and impact on sperm retrieval. Advanced discoveries in genes such as CFTR and ADGRG2 have reframed our approach to conditions like CBAVD, while epigenetic disruptions and mitochondrial DNA mutations are revealing previously unrecognized mechanisms behind impaired spermatogenesis and sperm motility. Rare copy number variations and genetic syndromes like Kallmann and Noonan further underscore the complex interplay between systemic disorders and male fertility.Summary: The field of genetic infertility is rapidly evolving, offering new insights into the molecular mechanisms behind impaired spermatogenesis and fertility. These findings highlight the importance of integrating genetic testing into infertility evaluations to guide personalized management strategies.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"489-496"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-effectiveness of serum, urine, and tissue-based prostate cancer biomarkers. 基于血清、尿液和组织的前列腺癌生物标志物的成本效益。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-07-01 Epub Date: 2025-04-25 DOI: 10.1097/MOU.0000000000001293

Veerain K Gupta, Brian D Cortese, Ruchika Talwar

{"title":"Cost-effectiveness of serum, urine, and tissue-based prostate cancer biomarkers.","authors":"Veerain K Gupta, Brian D Cortese, Ruchika Talwar","doi":"10.1097/MOU.0000000000001293","DOIUrl":"10.1097/MOU.0000000000001293","url":null,"abstract":"Purpose of review: Prostate cancer remains a leading malignancy among men in the United States. While prostate-specific antigen (PSA) screening improves early detection, it also leads to over-diagnosis and over-treatment. Biomarkers offer a promising solution for risk stratification and guiding treatment decisions. This review examines the cost-effectiveness of serum, urine, and tissue-based biomarkers to assess their impact on healthcare expenditures and clinical decision-making.Recent findings: Serum-based biomarkers like 4Kscore and PHI reduce unnecessary biopsies and healthcare costs. Urine-based biomarkers, including SelectMDx and ExoDx Prostate IntelliScore (EPI), have shown potential to optimize prostate cancer detection while being more cost-effective than some serum-based alternatives. Tissue-based biomarkers, such as OncotypeDx and Decipher, help in treatment selection, though their economic impact varies. Economic analyses suggest that biomarkers can enhance clinical decision-making while reducing healthcare expenditures, but real-world validation remains limited.Summary: Prostate cancer biomarkers improve risk stratification and may lower healthcare costs. However, variations in cost-effectiveness, reimbursement policies, and guideline recommendations limit widespread adoption. Prospective studies are needed to validate real-world cost savings and refine biomarker integration into clinical practice. Addressing financial and policy challenges is essential to ensure equitable access and maximize their impact on prostate cancer management.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"412-417"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blood- and urine-based biomarkers for the detection of clinically significant prostate cancer: a contemporary review. 基于血液和尿液的生物标志物检测临床意义重大的前列腺癌：当代回顾。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-06-27 DOI: 10.1097/MOU.0000000000001308

Keavash D Assani, Janene M Pierce, Lan Anh Galloway, Jeffrey J Tosoian

{"title":"Blood- and urine-based biomarkers for the detection of clinically significant prostate cancer: a contemporary review.","authors":"Keavash D Assani, Janene M Pierce, Lan Anh Galloway, Jeffrey J Tosoian","doi":"10.1097/MOU.0000000000001308","DOIUrl":"https://doi.org/10.1097/MOU.0000000000001308","url":null,"abstract":"Purpose of review: Prostate cancer (PCa) is the most common malignancy in men. While prostate-specific antigen (PSA) screening aids early detection, its low specificity leads to unnecessary biopsies and overdiagnosis of low-grade cancers. Blood- and urine-based biomarkers are proposed by clinical guidelines to better identify patients with elevated PSA that can safely avoid more intensive testing (e.g. imaging, biopsy). The current article aims to provide clinicians and researchers with a contemporary assessment of prostate cancer biomarker tests.Recent findings: This review focused on prebiopsy blood- and urine-based biomarker tests that are commercially-available and included in clinical guidelines. A systematic search identified 955 studies, of which 14 were published in the past 18 months (July 2023-January 2025) and reported performance metrics for clinically significant PCa (csPCa, defined as grade group ≥2). The literature revealed that blood- [Prostate Health Index (PHI), 4Kscore, and IsoPSA] and urine-based tests [SelectMDx, ExoDx IntelliScore (EPI), and MyProstateScore (MPS, MPS2)] maintained high sensitivity for csPCa while significantly reducing unnecessary biopsies performed relative to PSA-based testing. Furthermore, available data suggest that biomarkers can inform the need for biopsy in patients with equivocal (PI-RADS 3) mpMRI.Summary: Commercially-available, noninvasive biomarker tests consistently outperformed PSA and PSA-based risk calculators for detection of csPCa. Clinical use of these tests appears to substantially reduce the proportion of unnecessary biopsies performed, while maintaining detection of the vast majority of significant cancers.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Flexible versus rigid ureteroscopy in the management of proximal ureteric calculi: a systematic review and meta-analysis from EAU Endourology comparing perioperative outcomes and complication rates. 柔性输尿管镜与刚性输尿管镜在输尿管近端结石治疗中的应用：一项来自EAU Endourology的系统综述和荟萃分析，比较围手术期结果和并发症发生率。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-06-24 DOI: 10.1097/MOU.0000000000001311

Orla Cullivan, Sorcha O'Meara, Cian M Hehir, Rob Geraghty, Olivier Traxer, Bhaskar Somani, Niall F Davis

{"title":"Flexible versus rigid ureteroscopy in the management of proximal ureteric calculi: a systematic review and meta-analysis from EAU Endourology comparing perioperative outcomes and complication rates.","authors":"Orla Cullivan, Sorcha O'Meara, Cian M Hehir, Rob Geraghty, Olivier Traxer, Bhaskar Somani, Niall F Davis","doi":"10.1097/MOU.0000000000001311","DOIUrl":"https://doi.org/10.1097/MOU.0000000000001311","url":null,"abstract":"Purpose of review: Urolithiasis is a common condition, with an increasing prevalence. Rigid ureteroscopy (rURS) and flexible ureteroscopy (fURS) are two management approaches for proximal ureteric calculi. The aim of this systematic review and meta-analysis was to compare perioperative outcomes in rURS versus fURS in the management of proximal ureteric calculi.Recent findings: This systematic review was conducted according to PRISMA guidelines. Systematic search of online databases was performed in November 2024. A combination of MeSH and free text terms were applied. Primary outcome was stone free status. Secondary outcomes included operative time, complication rates, and hospital stay. Six studies met inclusion criteria, in which a total of 1085 patients underwent ureteroscopy (fURS, n = 537 versus rURS, n = 548). Five studies were retrospective comparative, one was prospective randomized comparative. FURS use was associated with significantly superior stone free rates (92%) when compared with rURS (84.5%) (P < 0.001). Secondary outcomes of complication rates (P = 0.17), length of stay (P = 0.39), and operative time (P = 0.08) did not reach statistical significance.Summary: Both rURS and fURS have acceptable stone clearance and complication rates for managing proximal ureteric calculi. Regarding stone clearance, fURS is superior to rURS, both interventions are comparable with regards to complications, operative time, and hospital stay.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adjuvant radiotherapy following radical cystectomy in patients with muscle-invasive bladder cancer: a narrative review. 肌肉浸润性膀胱癌根治性膀胱切除术后的辅助放疗：一个叙述性的回顾。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-06-23 DOI: 10.1097/MOU.0000000000001310

Agata Suleja, Ekaterina Laukhtina, Angelo Cormio, Marcin Miszczyk, Shahrokh F Shariat

{"title":"Adjuvant radiotherapy following radical cystectomy in patients with muscle-invasive bladder cancer: a narrative review.","authors":"Agata Suleja, Ekaterina Laukhtina, Angelo Cormio, Marcin Miszczyk, Shahrokh F Shariat","doi":"10.1097/MOU.0000000000001310","DOIUrl":"https://doi.org/10.1097/MOU.0000000000001310","url":null,"abstract":"Purpose of review: This review aims to synthesize emerging evidence on the role of adjuvant radiotherapy (RT) following radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC).Recent findings: A randomized trial comparing adjuvant chemoradiotherapy to chemotherapy alone in 125 MIBC patients demonstrated a significant improvement in 2-year local recurrence free survival (LRFS) (96% vs. 69%; P < 0.01). Three studies have evaluated adjuvant RT alone. A single-arm study reported a 5-year local control rate of 79% among 72 patients, with 17% experiencing serious gastrointestinal (GI) adverse events (AEs). A randomized controlled trial (RCT) involving 122 patients found improved 3-year LRFS in the RT arm (81% vs. 71% at three years; P = 0.046), with low rate of severe GI AEs (3%); however, the survival difference was not statistically significant. Another RCT with 153 patients showed similar rates of acute severe AEs between RT and observation groups (1.6% vs. 4.2%; P = 0.34). Key limitations across studies include heterogeneity in design, lack of statistical power to detect survival differences, limited patient-reported outcome data, and absence of direct comparisons with immune checkpoint inhibitors - the current standard of care in the adjuvant setting.Summary: Modern adjuvant RT appears to be associated with acceptable toxicity, likely due to improved delivery techniques. Although data suggest a benefit in local-regional control, an overall survival advantage has not been demonstrated. Adjuvant RT may be considered in selected high-risk patients, particularly in settings where access to salvage therapies or immunotherapy is limited.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bladder diverticula management - conservative and surgical outcomes: a narrative review from EAU endourology. 膀胱憩室治疗-保守和手术结果：来自EAU泌尿外科的叙述回顾。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-06-13 DOI: 10.1097/MOU.0000000000001307

Davide Perri, Jean-Baptiste Roche, Bogdan Petrut, Giorgio Bozzini

{"title":"Bladder diverticula management - conservative and surgical outcomes: a narrative review from EAU endourology.","authors":"Davide Perri, Jean-Baptiste Roche, Bogdan Petrut, Giorgio Bozzini","doi":"10.1097/MOU.0000000000001307","DOIUrl":"https://doi.org/10.1097/MOU.0000000000001307","url":null,"abstract":"Purpose of review: Standardized treatment of bladder diverticula is not defined. The majority of evidence comes from single-centre case series and high-quality studies are lacking.Recent findings: Surgery is the preferred option to treat a symptomatic bladder diverticulum. Robot-assisted surgery has progressively replaced open approach, either with an extravesical or transvesical or transdiverticular technique, with favourable outcomes. Endoscopic treatment may represent a valid alternative mainly in old and frail patients. In case of intradiverticular tumour, some concerns arise on the optimal management between transurethral resection, partial and radical cystectomy. Pathological evaluation may underestimate the oncological status given the lack of muscular layer in the diverticular wall.Summary: Surgical diverticulectomy is considered the reference option for symptomatic diverticula. Robotics should be the preferred approach whenever available. Whatever the technique used (extravesical, transvesical, transdiverticular), good outcomes have been reported. Alternatively, endoscopic incision of diverticular neck and fulguration of the mucosa may be considered for selected patients. The relationship between bladder diverticula and bladder cancer is unclear and the choice between transurethral resection, partial or radical cystectomy should be based on multiple factors, starting from tumour stage and grade. However, evidence comes mainly from limited, heterogeneous case-series. Further studies are needed to properly assess the management of these patients.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0