Journal of endourology最新文献

{"title":"Segmental Resection with Ureteral Reimplantation <i>vs</i> Radical Nephroureterectomy with Bladder Cuff Removal for Urothelial Carcinoma of Distal Ureter: A Propensity Score Matching Study in a Large Chinese Center.","authors":"Bao Guan, Yiwei Huang, Guoli Wang, Huifeng Zhang, Zihao Tao, Qi Tang, Chunru Xu, Qian Yang, Hanzhen Ren, Yicong Du, Chao Cao, Kaishun Luo, Kai Zhang, Liqun Zhou, Xuesong Li","doi":"10.1089/end.2024.0654","DOIUrl":"https://doi.org/10.1089/end.2024.0654","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> We aim to compare the clinical outcomes of radical nephroureterectomy with bladder cuff removal (RNU) and segmental resection with ureteral reimplantation (RR) in Chinese patients with distal ureteral urothelial carcinoma. <b><i>Materials and Methods:</i></b> A retrospective analysis of medical records was performed for 922 patients found to have distal ureteral cancer, defined as below the level of the iliac vessels, with 747 patients who underwent RNU and 175 who underwent RR included in the final analysis. The primary endpoints included clinical outcomes and changes in the estimated glomerular filtration rate (eGFR). Survival analysis was conducted using the Kaplan-Meier method, and propensity score matching (PSM) was utilized to mitigate selection bias between the two surgical approaches. <b><i>Results:</i></b> After PSM, the Kaplan-Meier survival curves demonstrated significant associations between surgical approach and both local recurrence-free survival (LRFS) and bladder recurrence-free survival (BRFS), but no significant differences were found in cancer-specific survival (CSS) and overall survival (OS). There were no significant differences in metastasis-free survival and contralateral recurrence-free survival between the two groups. Multivariate Cox regression analysis identified RR as an independent predictor of poorer outcomes for LRFS and BRFS. In addition, a significant increase in eGFR was observed following RR, whereas a significant decrease was noted after RNU. <b><i>Conclusion:</i></b> RR is associated with equivalent CSS and OS compared with RNU, even in the context of high-risk distal ureteral cancer, and results in improved postoperative eGFR, whereas the potential of RR to increase the risk of local tumor recurrence and intravesical recurrence requires clinical consideration.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"The Safety and Feasibility of Ambulatory Minimally Invasive Partial Nephrectomy: A Systematic Review and Meta-Analysis\".","authors":"Shubham Kumar, Ahmad Neyazi, Rachana Mehta, Ranjana Sah","doi":"10.1089/end.2024.0923","DOIUrl":"https://doi.org/10.1089/end.2024.0923","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Office-Based Endoscopic Urological Procedures Under Local Anesthesia: Prospective Evaluation of Feasibility, Pain, and Patient Preference.","authors":"Anna Ricapito, Kavita Gupta, Raymond Khargi, Alan J Yaghoubian, William M Atallah, Mantu Gupta","doi":"10.1089/end.2024.0080","DOIUrl":"https://doi.org/10.1089/end.2024.0080","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Several diagnostic and therapeutic endoscopic urological procedures, such as stent placement, ureteroscopy, and bladder stone lithotripsy, can be performed in a hospital, an ambulatory surgery center, in the office with IV sedation, or in the office using only topical anesthesia. The potential benefits of performing procedures in the office setting using topical anesthesia include efficiency and cost reduction. The potential harms are failure to achieve the desired outcome and patient pain. The purpose of our study was to assess the feasibility, safety, pain tolerance, and cost-effectiveness of advanced office endourological procedures. <b><i>Methods:</i></b> All patients from September 2022 to July 2023 undergoing certain office-based endoscopic procedures under topical anesthesia, including ureteral stent placement for obstruction, ureteral stent exchange, ureteroscopy with laser lithotripsy, ureteroscopy with tumor ablation, laser ablation of multifocal bladder tumors, laser lithotripsy of bladder stones, nephrostomy tube exchange, and ureteral catheterization for chemotherapy instillation or retrograde ureteropyelography, were prospectively enrolled and evaluated. At the end of every procedure, visual analog scale (VAS) score and procedure location preference were assessed. Complications and facility costs were also assessed. <b><i>Results:</i></b> A total of 80 endoscopic procedures were performed, including 11 bladder procedures, 9 ureteroscopies, and 60 stent and nephrostomy procedures. The mean VAS pain score for bladder procedures was 2.4, ureteroscopy procedures 3.9, and stent and nephrostomy procedures 3.3. Patients undergoing bladder and stent/nephrostomy procedures unanimously expressed a preference for the in-office setting. The office setting was also largely preferred in the ureteroscopy procedure cohort (77.8%). There were eight postprocedure calls and two ED visits. One complication and one failed stent placement occurred. Procedure cost savings ranged from $5,309 to $6,009. <b><i>Conclusions:</i></b> Performing certain endoscopic urological procedures in an office setting with only the use of topical anesthesia is feasible, safe, well tolerated, and cost-effective when compared with performing these procedures in the operating room or with general anesthesia.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr. Michael A. Palese, MD.","authors":"","doi":"10.1089/end.2025.21556.spot","DOIUrl":"https://doi.org/10.1089/end.2025.21556.spot","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter to the Editor:</i> Reply to \"The Impact of External Sphincter Grading after Early Apical Release Holmium Laser Enucleation of the Prostate on Postoperative Stress Urinary Incontinence\".","authors":"Mohamed Omar","doi":"10.1089/end.2024.0878","DOIUrl":"https://doi.org/10.1089/end.2024.0878","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-Assisted Radical Prostatectomy Using the KangDuo Surgical Robot-1500: A Prospective, Multicenter, Single-Arm Clinical Study.","authors":"Silu Chen, Shubo Fan, Jie Dong, Xu Chen, Zhihua Li, Yi Xie, Bing Wang, Kunlin Yang, Qi Tang, Han Hao, Yaming Gu, Zheng Zhang, Kai Zhang, Zhigang Ji, Liqun Zhou, Weifeng Xu, Cheng Shen, Xuesong Li","doi":"10.1089/end.2024.0586","DOIUrl":"https://doi.org/10.1089/end.2024.0586","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The KangDuo Surgical Robot-1500 (KD-SR-1500) is a newly developed surgical robot. We aim to evaluate the feasibility and efficiency of the KD-SR-1500 system for robot-assisted radical prostatectomy (RARP). <b><i>Materials and Methods:</i></b> This prospective, multicenter, single-arm clinical study was conducted among 18-75-year-old patients with suspected T1-2N0M0 prostate cancer scheduled for RARP. The perioperative and follow-up data were prospectively recorded. Early oncologic outcomes were assessed according to surgical margin status and prostate-specific antigen (PSA) at 6 weeks after surgery. Continence was defined as no more than one pad daily. Ergonomics were assessed with the National Aeronautics and Space Administration task load index (NASA-TLX). Perioperative complications were recorded according to the Clavien-Dindo classification. <b><i>Results:</i></b> A total of 31 patients were involved in the trial. One patient with severe abdominal adhesion withdrew from the trial. All surgeries were performed successfully without any conversion or secondary surgery due to surgical complications. The median docking time and console time were 3.8 (3.3-5.2) and 104.6 (80.0-145.6) minutes, with a median estimated blood loss of 50 (20-100) mL. Positive surgical margin was observed in 6 (20%) patients. One (3.4%) patient experienced PSA persistence at 6 weeks after surgery. The urinary continence rate was 75.9% (22/29) at 4 weeks after catheter removal. There were no major complications (grade ≥ III) or equipment-related adverse events. The mean NASA-TLX score was 23.9 ± 11.7. <b><i>Conclusions:</i></b> The KD-SR-1500 is feasible and effective for the management of T1-T2 prostate cancer.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transperineal MR Fusion Laser Ablation of Prostate Cancer in Office Setting: 1 Year Efficacy and Safety Outcomes in Intermediate-Risk Patients.","authors":"Giuseppe Maiolino, Alberto Lopez-Prieto, Gloria Egui-Benatuil, Ariel M Kaufman, Edward L Gheiler, Fernando J Bianco","doi":"10.1089/end.2024.0776","DOIUrl":"https://doi.org/10.1089/end.2024.0776","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Focal therapy (FT) is an emerging option for intermediate-risk prostate cancer (IR-PCa). Transperineal MRI fusion laser ablation of PCa (TPFLA) is a novel FT technique with limited data reported. We conducted a phase I clinical trial evaluating the safety, feasibility, and 1-year oncologic results for patients with IR-PCa treated with TPFLA in an office setting. <b><i>Materials and Methods:</i></b> NCT05241236 aimed to evaluate TPFLA for the International Society of Urological Pathology-grade 2 (ISUP-2) tumors. All procedures were performed in the office using MR/US fusion imaging. The diode interstitial laser system fibers were applied through the perineum using local anesthesia. The primary outcome was safety and tolerability. Pain scores were recorded using analog scales. Thirty-day adverse events and 1-year prostate biopsy oncologic outcomes were noted. Functional outcomes at 3 months and 1 year were compared with baseline as well. <b><i>Results:</i></b> Thirty patients accrued had TPFLA safely in the office with no complications. TPFLA median pain score was 1. At 30 days, one man required a transurethral resection of the prostate (TURP). There were no imaging demonstrable cancers at 3 months and a significant improvement in urinary function (<i>p</i> = 0.001) was noted and sustained for the year. No patient experienced urinary incontinence. No changes in sexual function were observed (<i>p</i> = 0.7). At 1 year, 25/30 (83%) had no clinically significant cancer. However, 14 had PCa, in 5 (17%) solely in treated areas, all ISUP-1. Seven had PCa outside the treated areas. Two had infield and outfield recurrences, both were ISUP 2. At study closure, 16 patients were free from PCa, 3 were on active surveillance, 9 were treated focally with cryoablation, and 2 were converted to radical surgical procedure. <b><i>Conclusions:</i></b> TPFLA appears to be a safe and an effective focal therapy for IR-PCa, offering a potential alternative to more radical treatments with a minimal periprocedural impact. Longer follow-up and larger studies are needed to confirm these results.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of Noncontrast-Enhanced Vessel Wall MRI in Longitudinal Venous System Invasion Before Robot-Assisted Radical Nephrectomy.","authors":"Ying Cui, Yang Jiang, Yufei Zhao, Lin Fu, Jingyue Dai, Xin-Gui Peng","doi":"10.1089/end.2024.0568","DOIUrl":"https://doi.org/10.1089/end.2024.0568","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> To explore the value of vessel wall MRI (VW-MRI) in the preoperative assessment of T3 renal-cell carcinoma (RCC) with varying degrees of longitudinal venous system invasion. <b><i>Materials and Methods:</i></b> Patients with RCC with pathological T3 stage between January 2016 and December 2023 were included in this retrospective study. All the patients underwent contrast-enhanced CT (CECT), conventional MRI (con-MRI) or VW-MRI. Images were independently and blindly evaluated at 4-week intervals by three readers. The pathological features reported in the pathological report, combined with clinical data, were used as the reference standards. The incremental value was calculated using net reclassification improvement (NRI) and integrated discrimination improvement. <b><i>Results:</i></b> Eighty-two T3 RCC patients (median age, 65 years) were enrolled. The accuracy of T staging in CECT (<i>n</i> = 59), con-MRI (<i>n</i> = 49), and VW-MRI (<i>n</i> = 30) was 69.5%, 71.4%, and 93.3%, respectively. VW-MRI had a statistically incremental value for CECT in the preoperative evaluation of T3a-c stages (T3a: NRI = 0.066, <i>p</i> = 0.04. T3b: NRI = 0.085, <i>p</i> = 0.02. T3c: NRI = 0.178, <i>P</i> = 0.02), especially in renal pelvicaliceal invasion (NRI = 0.154, <i>p</i> = 0.04) and vena cava wall invasion (NRI = 0.263, <i>p</i> = 0.01). Besides, statistically significant preoperative incremental effects were obtained in the assessment of T3a-c stages (T3a: NRI = 0.264, <i>p</i> = 0.01. T3b: NRI = 0.373, <i>p</i> = 0.03. T3c: NRI = 0.202, <i>p</i> = 0.045), renal vein invasion (NRI = 0.630, <i>p</i> = 0.03), and vena cava wall invasion (NRI = 0.185, <i>p</i> = 0.02) when added VW-MRI into con-MRI. VW-MRI changed 24% (4/27) of the previous CECT and con-MRI-based surgical plan. <b><i>Conclusion:</i></b> VW-MRI added a preoperative value for evaluating T stage of T3 RCC, especially in the evaluation of renal vein invasion and vena cava wall invasion.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ejaculation-Preserving Transurethral Resection of the Prostate: A Randomized Controlled Trial.","authors":"A M Tawfeek, Ahmed Radwan, M Esmat, Abdelrahman Mohamed Ismail, Karim Omar ElSaeed, Ahmed Higazy","doi":"10.1089/end.2024.0460","DOIUrl":"https://doi.org/10.1089/end.2024.0460","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate the efficacy of preserving urethral mucosa around verumontanum in all directions and at the prostatic apex on antegrade ejaculation preservation and early postoperative continence in patients undergoing transurethral resection of the prostate (TURP). <b><i>Materials and Methods:</i></b> A randomized controlled trial was conducted in our tertiary center on patients scheduled for TURP. Patients were randomly allocated into two equal groups. Group A represented the control group who underwent conventional TURP, while Group B represented the ejaculation-sparing TURP. Patients were followed up for 3 months postoperatively to evaluate the voiding parameters and the preservation of antegrade ejaculation. <b><i>Results:</i></b> A total of 106 patients were evaluated in our study. Both groups were comparable regarding improvement in voiding parameters. Antegrade ejaculation was preserved in 44 patients (83%) of Group B compared with 10 patients (18.9%) in Group A with a highly statistically significant difference (<i>p</i> < 0.001). Early postoperative urge urinary incontinence was lower in group B (5.7%) compared with (20.8%) in group A, with a statistically significant difference (<i>p</i> = 0.02). Other perioperative parameters were compared between both groups. <b><i>Conclusion:</i></b> The ejaculation-sparing technique adopted in our study showed a promising result for preserving antegrade ejaculation following TURP with a success rate of 83%. Additionally, there was a lower incidence of early postoperative urge urinary incontinence.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital Outcomes after Robotic <i>Vs</i> Open Radical Nephroureterectomy.","authors":"Francesco Di Bello, Natali Rodriguez Peñaranda, Andrea Marmiroli, Mattia Longoni, Fabian Falkenbach, Quynh Chi Le, Zhe Tian, Jordan A Goyal, Claudia Collà Ruvolo, Gianluigi Califano, Massimiliano Creta, Fred Saad, Shahrokh F Shariat, Stefano Puliatti, Ottavio De Cobelli, Alberto Briganti, Markus Graefen, Felix H K Chun, Nicola Longo, Pierre I Karakiewicz","doi":"10.1089/end.2024.0730","DOIUrl":"https://doi.org/10.1089/end.2024.0730","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To test whether the contemporary robot-assisted nephroureterectomy (RNU) is associated with more favorable in-hospital outcomes than historical RNU, relative to the same endpoints in open NU (ONU). <b><i>Methods:</i></b> Within the National Inpatient Sample (2008-2019), we identified RNU and ONU patients. Multivariable logistic and Poisson regression models were fitted. <b><i>Results:</i></b> Of 8032 NU patients, historical (2008-2013) <i>vs</i> contemporary (2014-2019) proportions were 776 (41%) <i>vs</i> 1104 (59%) for RNU and 3719 (60%) <i>vs</i> 2433 (40%) for ONU. The rates of RNU have increased over time (2008-2019; Δ absolute: +18%; <i>p</i> < 0.001). Contemporary RNU patients exhibited significantly better in-hospital outcomes in 6 of 12 comparisons <i>vs</i> historical that ranged from -54% for genitourinary complications to -12% for median length of stay (LOS). Contemporary ONU patients also exhibited significantly better in-hospital outcomes in 11 of 12 comparisons <i>vs</i> historical that ranged from -67% for blood transfusions to -26% for gastrointestinal complications. When historical RNU was compared with historical ONU, RNU in-hospital outcomes were better in 7 of 12 comparisons that ranged from -61% for median LOS to -16% for postoperative complications. Conversely, when contemporary RNU was compared with contemporary ONU, RNU in-hospital outcomes were only better in 2 of 12 comparisons: -25% cardiac complications and -13% for median LOS. <b><i>Conclusion:</i></b> The magnitude of in-hospital outcomes categories improvement between historical <i>vs</i> contemporary was two-fold more pronounced in ONU (11 improved categories) than in RNU (6 improved categories). Few outcome benefits remained (two categories only) when contemporary RNU was compared with contemporary ONU.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}