International Urology and Nephrology最新文献

{"title":"The modified 5-item frailty index as a predictor of perioperative risk in patients undergoing percutaneous nephrolithotomy.","authors":"Kays Chaker, Yassine Ouanes, Mahdi Marrak, Nader Gharbia, Moez Rahoui, Boutheina Mosbahi, Mokhtar Bibi, Wassim Ben Chedly, Yassine Nouira","doi":"10.1007/s11255-024-04178-3","DOIUrl":"10.1007/s11255-024-04178-3","url":null,"abstract":"<p><strong>Introduction: </strong>The modified 5-item frailty index is a relatively new tool to assess the post-operative complication risks. In urology, there is limited literature on the impact of frailty on percutaneous nephrolithotomy (PCNL) outcomes. We aimed to compare the predictive value of the modified 5-item frailty index (mFI-5) to identify high risk patients prior to PCNL.</p><p><strong>Methods: </strong>A database of patients undergoing PCNL, between 2015 and 2022, was analyzed. Patient frailty was assessed using the mFI-5 index. The mFI-5 index was calculated based on the presence of the five co-morbidities: congestive heart failure within 30 days prior to surgery, diabetes mellitus, chronic obstructive pulmonary disease, partially dependent or totally dependent functional health status at time of surgery, and hypertension requiring medication. Patients were grouped as not frail (mFI-5 = 0), intermediate (mFI-5 = 1), and severely frail (mFI-5 ≥ 2). Primary outcomes were 30-day postoperative complications. Secondary outcomes were hospitalization: total hospital length of stay, reoperation, and unplanned readmission.</p><p><strong>Results: </strong>From a total of 320 PCNL patients included for analysis, 54.06% (n = 173) were not frail, 17.81% (n = 57) were intermediate, and 28.12% (n = 90) were severely frail. Frail patients were likely to be older (p = 0.002) and have a higher American Society of Anesthesiologists score (p = 0.001), chronic kidney disease (p < 0.001). Patients of intermediate or severe frailty were more likely to exhibit postoperative sepsis (p = 0.042), significant blood loss (p = 0.036) and require intensive care units admissions (p = 0.0015). Frail patients had a longer hospital length of stay (p < 0.001) and tended to require reoperation (p = 0.001), and unplanned readmission (p = 0.02).</p><p><strong>Conclusion: </strong>Frailty assessment appears useful in stratifying those at risk of extended hospitalization, septic and hemorrhagic complications, readmission, or reoperation after PCNL. Preoperative assessment of frailty phenotype may give insight into treatment decisions and assist surgeons in counselling patients on expected course and hospital stay following PCNL.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"93-97"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of low to moderate potency topical corticosteroids for phimosis resolution in children: results of a network meta-analysis.","authors":"Suresh Shanmugham, E Lyn Lee, Suresh Kumar, Mohammed Zuber, Nabeela Noreen, Frederick Charles Smales, Siew Mooi Ching, Sajesh K Veettil","doi":"10.1007/s11255-024-04184-5","DOIUrl":"10.1007/s11255-024-04184-5","url":null,"abstract":"<p><strong>Purpose: </strong>The use of topical corticosteroids (TCSs) has become an efficient, less-invasive treatment for phimosis. Whether any significant difference in efficacy exists between TCSs based on their potency is unclear.</p><p><strong>Methods: </strong>Electronic databases were searched up to March 2024 for randomised controlled trials (RCTs) comparing the use of any type or concentration of TCSs with placebo or no treatment in boys with any degree of physician diagnosed phimosis. A random-effects network meta-analysis (NMA) using a consistency model within a frequentist approach was employed. The primary outcome was partial or complete resolution of phimosis reported as a pooled risk ratio (RR) with 95% CI. Relative ranking was assessed with surface under the cumulative ranking curve (SUCRA) probabilities.</p><p><strong>Results: </strong>Seventeen RCTs, containing 2057 participants were identified. NMA suggested that, compared with control, the high (RR 3.19 (95% CI 1.42 to 7.16), moderate (RR 2.68 (95% CI 1.87 to 3.83) and low (RR 3.05 (95% CI 1.63 to 5.71) potency TCSs statistically significantly increased complete or partial clinical resolution of phimosis. The SUCRA plot revealed that high potency (SUCRA = 0.76) was ranked first followed by low and moderate TCSs. When we assessed comparative efficacy among TCSs based on potency, none of the classes were superior to others. The certainty of the evidence for an effect of moderate potent TCSs was that of moderate GRADE quality.</p><p><strong>Conclusion: </strong>Moderate to low potency TCSs are of comparable therapeutic effect in the treatment of phimosis to that of highly potent formulations. More high-quality RCTs are warranted.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"9-17"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common comorbidity indices fail to predict short-term postoperative outcomes following male urethroplasty.","authors":"Nikolas Moring, Michael K Tram, Paul J Feustel, Charles Welliver, Brian M Inouye","doi":"10.1007/s11255-024-04199-y","DOIUrl":"10.1007/s11255-024-04199-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether commonly used comorbidity indices [Charlson Comorbidity Index (CCI), Van Walraven Index (VWI), and modified frailty index (mFI)] predict postoperative readmissions and complications after urethroplasty.</p><p><strong>Methods: </strong>Patients undergoing urethroplasty for urethral stricture from the State Inpatient Database and State Ambulatory Surgery and Services Database for Florida (2010-2015) and California (2010-2011) were identified. We calculated CCI, VWI, and mFI scores for each patient. We extracted the following adverse outcomes: 30 day ER services, 30 day inpatient readmissions, and 90 day Clavien-Dindo III-V complications. We constructed receiver operating characteristic (ROC) curves and compared area under the curve (AUC), using the VWI as the reference index.</p><p><strong>Results: </strong>We identified 908 urethroplasty patients. Among these patients, 11.5% (n = 104) of patients had a complication, with 4.8% (n = 44) specifically having 30-day ER services, 6.2% (n = 56) having 30 day readmissions, and 9.0% (n = 82) having 90-day Clavien-Dindo III-V complications. ROC curves demonstrated poor predictive performances for all four indices as no index achieved an AUC > 0.70. The indices performed similarly poorly but the mFI-DX was particularly poor at predicting 90 day Clavien-Dindo III-V complications (AUC = 0.49; 95% CI 0.43-0.55; p < 0.01).</p><p><strong>Conclusions: </strong>The CCI, VWI, and mFI have poor ability to identify patients who had an adverse event after urethroplasty. Our results support the need for a urology-specific comorbidity index to better identify at-risk patients undergoing urethroplasty.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"127-134"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of dual renin-angiotensin system (RAS) blockade for non-elderly diabetic kidney disease patients with preserved eGFR.","authors":"Mei Mei, Jun Zeng, Li Fang, Sha Xiang, Haili Sun, Chaolin Wen, Liyin Chai, Xinqing Chen, Zhuhong Li, Ning Li, Bingbing Shen","doi":"10.1007/s11255-024-04156-9","DOIUrl":"10.1007/s11255-024-04156-9","url":null,"abstract":"<p><strong>Aim: </strong>Although sodium glucose cotransporter2 inhibitor (SGLT-2I) is widely used in clinical practice, sufficient renin-angiotensin system (RAS) inhibition remains the cornerstone of diabetic kidney disease (DKD) treatment. The aim of this single-center study was to evaluate the efficacy and safety of dual RAS blockade compared with angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB) monotherapy in non-elderly DKD patients with preserved eGFR (WHO Standard, < 60y).</p><p><strong>Methods: </strong>This single-center study was registered in Chinese Clinical Trial Registry (ChiCTR1900024752), and approved by the ethical committee (KY201994). In this study, we recruited non-elderly type 2 diabetes volunteers with initial diagnosis of DKD to receive dual RAS blockade or monotherapy. 150 non-elderly DKD patients with preserved eGFR were recruited. The patients were randomly divided into dual RAS blockade group and monotherapy group. The dual RAS blockade group treatment regimen was an 80 mg valsartan plus a 4 mg perindopril tert-butylamine per day. At the same time, monotherapy group patients who received the 8 mg perindopril tert-butylamine or 160 mg valsartan monotherapy. The clinical data of the three groups were compared at baseline and collected during the follow-up period of 12 months.</p><p><strong>Results: </strong>The baseline of patients who received dual RAS blockade was similar to that of monotherapy group. After 12 months of treatment, the median level of proteinuria in the dual RAS blockade group was significantly lower than that in the monotherapy group. There was no significant difference in the estimated glomerular filtration rate (eGFR) level, potassium, blood pressure and no serious adverse reactions.</p><p><strong>Conclusions: </strong>In non-elderly DKD patients with preserved eGFR, dual RAS blockade is superior to control proteinuria, and does not increase the probability of adverse reactions such as hyperkalemia, hypotension and acute kidney injury in 12 months.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"187-196"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibacterial and therapeutic effects of low energy shock waves on uropathogenic E. coli investigated by in vitro and in vivo cystitis rat model.","authors":"Zong-Sheng Wu, Cheng-Yen Kao, Hung-Jen Wang, Wei-Chia Lee, Hou Lun Luo, Chao-Cheng Huang, Yao-Chi Chuang","doi":"10.1007/s11255-024-04173-8","DOIUrl":"10.1007/s11255-024-04173-8","url":null,"abstract":"<p><strong>Aims: </strong>Low-energy shock waves (LESWs) are known to alter cell-membrane permeability. This study aimed to investigate the effect of LESWs on Escherichia coli and E. coli-induced cystitis in rats.</p><p><strong>Main methods: </strong>Standardized suspensions of E. coli ATCC25922 were treated with or without LESWs (100 or 300 pulses; 0.12 mJ/mm²; 2 pulses/s) followed by bacterial counting, an antibiotic sensitivity test, and gene ontology analysis and gene-set enrichment analysis. Intravesical administration of saline or E. coli (0.5 mL with 10⁸ CFU/mL) for 30 min was performed in female Sprague-Dawley rats. The rats were treated with or without LESWs (300 pulses; 0.12 mJ/mm²; 2 pulses/s) on days 4 and 5. The changes in inflammatory reactions, uroplakin IIIa staining, and correlation with urodynamic findings were assessed on day 8.</p><p><strong>Key findings: </strong>LESW treatment induced a decrease in CFU and the autoaggregation rate and increased the inhibition zone sizes in a cefazolin-sensitivity study. These changes were associated with gene expression in regulation of cellular membrane components, biofilm formation, and the ATP-binding cassette transporter pathway. E. coli induced bladder hyperactivity and an inflammatory reaction as well as decreased uroplakin IIIa staining; these effects were partially reversed by LESW treatment.</p><p><strong>Significance: </strong>The LESW antibacterial effect occurs by altering bacterial cell-membrane gene expression, enhancing antibiotic sensitivity, and inhibiting bladder inflammatory reaction and overactivity. These findings support the potential benefits of LESWs for treatment of recurrent or refractory bacterial cystitis.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"49-61"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in life expectancy of adrenocortical carcinoma patients vs. age‑ and sex-matched population controls.","authors":"Letizia Maria Ippolita Jannello, Andrea Baudo, Lukas Scheipner, Mario de Angelis, Carolin Siech, Francesco Di Bello, Jordan A Goyal, Kira Vitucci, Zhe Tian, Stefano Luzzago, Francesco A Mistretta, Matteo Ferro, Fred Saad, Felix K H Chun, Alberto Briganti, Luca Carmignani, Nicola Longo, Ottavio de Cobelli, Gennaro Musi, Pierre I Karakiewicz","doi":"10.1007/s11255-024-04180-9","DOIUrl":"10.1007/s11255-024-04180-9","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify to what extent the 5-year overall survival (OS) of adrenocortical carcinoma (ACC) patients differs from age- and sex-matched population-based controls, especially when stage is considered.</p><p><strong>Methods: </strong>We relied on the Surveillance, Epidemiology, and End Results database (2004-2020) to identify newly diagnosed (2004-2014) ACC patients. Subsequently, we compared OS between ACC patients relative to simulated age- and sex-matched controls (Monte Carlo simulation), according to Social Security Administration Life Tables (2004-2020).</p><p><strong>Results: </strong>Of all 742 ACC patients, 301 (41%) harbored localized stage, 173 (23%) locally advanced stage, and 268 (36%) metastatic stage. At 5-years follow-up, ACC patients' OS was 33%. After stratification for stage, the 5-years OS was 55 vs. 31 vs. 8% in localized, locally advanced, and metastatic stages, respectively. Conversely, after Monte Carlo simulation of age- and sex-matched controls, OS at five-years was 93% in the entire simulated cohort vs. 94% in the simulated localized cohort vs. 92 and 92% in locally advanced and metastatic stage, respectively. The resulting differences in OS between ACC patients and age- and sex-matched population-based controls were 60 vs. 39 vs. 61 vs. 84% respectively in the overall cohort vs. localized vs. locally advanced vs. metastatic stage.</p><p><strong>Conclusion: </strong>The most pronounced life expectancy detriment (84%) was recorded in metastatic ACC followed by locally advanced ACC patients (61%). Unfortunately, even in patients with localized ACC, life expectancy was 39% lower than that of the general population. Therefore, regardless of stage, ACC diagnosis results in a very pronounced detriment in life expectancy relative to the general population.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"107-113"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of SIRT1 in kidney diseases.","authors":"Wei Wang, Yuanyuan Hu, Ning Ding, Jiping Wei, Cairong Li","doi":"10.1007/s11255-024-04162-x","DOIUrl":"10.1007/s11255-024-04162-x","url":null,"abstract":"<p><p>SIRT1, a nicotinamide adenine dinucleotide (NAD +)-dependent class III histone deacetylase, exhibits a high level of expression within renal tissues. It has garnered considerable recognition for its pivotal role in modulating signaling pathways intricately linked with the aging process; however, it extends beyond this in the organism. The literature reports that SIRT1 regulates biological processes such as glucose metabolism, lipid metabolism, oxidative stress, inflammation, autophagy, endoplasmic reticulum stress, and apoptosis. Therefore, our study reviews the primary mechanisms by which SIRT1 induces kidney disease and the regulation of related signaling pathways in different models of renal disease. We also discuss commonly studied SIRT1-targeted interventional drugs reported in the literature, including inhibitors (e.g., Ex-527) and activators (e.g., resveratrol). This study aims to provide theoretical foundations and clinical insights for the development and screening of clinical drugs targeting SIRT1, aiming at enhanced scientific approaches for the prevention and treatment of kidney diseases.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"147-158"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of calcium oxalate stones and uric acid stones on male sexual function.","authors":"Jian Chen, Nannan Pang, Jianlin Lu, Guodao Liu, Shih-Pin Lee, Weiguo Wang","doi":"10.1007/s11255-024-04127-0","DOIUrl":"10.1007/s11255-024-04127-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study compared the effects of calcium oxalate stones and uric acid stones on male sexual function.</p><p><strong>Methods: </strong>We enrolled 100 patients with ureteral stones. According to the composition of the stones, they were divided into the calcium oxalate stone group and the uric acid stone group. All patients underwent ureteroscopic holmium laser lithotripsy. General data such as age, body mass index, course of disease, stone diameter, and degree of renal hydronephrosis were compared. Sperm parameters, including sperm density, sperm viability, and sperm deformity rate, as well as International Index of Erectile Function-5 questionnaire (IIEF-5) scores, and Quality of Life (QOL) scores, were measured and compared before and 6 weeks after the surgery.</p><p><strong>Results: </strong>There were no statistically significant differences in general data and sperm parameters between the two groups before the surgery (P > 0.05). However, there were significantly lower IIEF scores but significantly higher QOL scores in the uric acid stone group. In the calcium oxalate stone group, there were no statistically significant differences in sperm parameters, IIEF score, and QOL score before and after the surgery (P > 0.05). In the uric acid stone group, there were no statistically significant differences in sperm parameters before and after surgery (P > 0.05), whereas there were significantly higher IIEF scores but significantly lower QOL scores after the surgery (P < 0.05). The prevalence of erectile dysfunction (ED) in the uric acid stone group was 38.18% (21/55), which was significantly higher compared to 20.00% (9/45) in the calcium oxalate stone group (P < 0.05). The multivariate binary logistic regression analysis showed that the independent risk factor related to ED was uric acid stones (odds ratio: 2.637, 95% confidence interval 1.040-6.689, P = 0.041). No statistically significant differences were found in sperm parameters between patients with and without ED.</p><p><strong>Conclusion: </strong>Compared with the calcium oxalate stone group, patients with uric acid stones had a higher prevalence of ED and poorer sexual performance.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"19-25"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of intravesical chemohyperthermia with mitomycin in non-muscle-invasive bladder tumour patients who cannot tolerate BCG treatment or recur after treatment and refuse cystectomy.","authors":"Enes Malik Akdaş, Mustafa Melih Çulha, Engin Telli, Efe Bosnalı, Serdar Baykal, Enes Abdullah Baynal, Kerem Teke, Önder Kara","doi":"10.1007/s11255-024-04169-4","DOIUrl":"10.1007/s11255-024-04169-4","url":null,"abstract":"<p><strong>Purpose: </strong>Many patients receiving intravesical BCG treatment for non-muscle-invasive bladder cancer experience high recurrence rates despite initial adequate response. In this study, the effectiveness of intravesical chemohyperthermia (CHT) with mitomycin C (MMC) was evaluated in patients who developed relapse after intravesical BCG treatment or could not tolerate the treatment and could not undergo radical cystectomy for any reason.</p><p><strong>Materials and methods: </strong>59 patients who underwent complete bladder tumour resection, who had a T1 high-grade tumour and no variant histology was observed in the pathology, and who had previously received intravesical BCG treatment were included in the study. Adjuvant treatment with intravesical CHT-MMC was applied. As a treatment protocol, induction was applied once a week for 6 weeks, followed by maintenance treatment 6 times at 4-week intervals. Each treatment session, it involved bladder wall hyperthermia with a temperature of up to 42 ℃ ± 2 and intravesical administration of 20 mg/50 ml MMC solution twice at 30-min intervals.</p><p><strong>Results: </strong>Recurrence-free survival after warm mitomycin was 58.7 and 48%, respectively, at 24 months and 44 months, and progression-free survival was 72.6 and 66.2%, respectively. In the subgroup analysis performed according to the number of tumours at diagnosis (single, 2-5, more than 5), recurrence-free survival rates were 81.8%, 48.2% and 11%, respectively, during the median follow-up period of 44 months.</p><p><strong>Conclusions: </strong>Intravesical CHT-MMC can be considered as an alternative treatment in selected well-informed patients with non-muscle-invasive papillary urothelial carcinoma who are unresponsive to BCG or intolerant to BCG. Prospectively designed studies with larger number of patients are needed.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"63-69"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term efficacy and catheter choice in male varicocele embolization using NBCA-MS glue.","authors":"Ezio Lanza, Alessandra Mininni, Luigi Tomasino, Angela Ammirabile, Giuseppe Ferrillo, Silvio Romano, Dario Poretti, Marco Francone, Vittorio Pedicini","doi":"10.1007/s11255-024-04347-4","DOIUrl":"https://doi.org/10.1007/s11255-024-04347-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the long-term efficacy of n-butyl-2-cyanoacrylate-metacryloxysulpholane (NBCA-MS) for varicocele embolization (VE) without using a microcatheter.</p><p><strong>Methods: </strong>A retrospective study was conducted on male patients who underwent VE with NBCA-MS for grade III-IV varicocele between January 2016 and December 2022. Patients were categorized by the catheter type used. Telephone interviews assessed long-term effectiveness, focusing on relapse, re-treatment and spermiogram improvements.</p><p><strong>Results: </strong>Of 185 patients, 102 completed the phone interview (median age 25 years, median follow-up 4.1 years). Sixty-six procedures were performed with only an HH1 catheter (Group A, 65%), and 36 required an additional microcatheter (Group B, 35%), with Group A having a shorter median procedure time (30 vs. 36.5 min, p = 0.004). Long-term follow-up indicated a low recurrence rate (12%) and spermiogram improvement among a subset of patients (81%), with no significant difference in long-term efficacy between groups (relapse p = 0.244, re-treatment p = 1). Costs increased by 47-56% when adding a microcatheter plus a 0.018-inch guidewire.</p><p><strong>Conclusion: </strong>The study confirms the effectiveness and safety of VE with NBCA-MS, demonstrating low recurrence rates and improvements in groin discomfort and fertility outcomes. In most cases of varicocele embolization using NBCA-MS, microcatheters can be avoided, reducing procedural costs and duration without compromising long-term efficacy.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}