Journal of endourology最新文献

{"title":"Efficacy and Safety of Two Different Approaches in the Drainage of the Upper Urinary Tract in \"Acute Obstructive Uropathy\": A Critical Evaluation.","authors":"Ferhat Yakup Suçeken, Murat Beyatlı, Samet Güngör, Hakan Karaca, Eyüp Veli Küçük, Kemal Sarıca","doi":"10.1089/end.2024.0242","DOIUrl":"10.1089/end.2024.0242","url":null,"abstract":"<p><p><b><i>Aim:</i></b> To compare the results of retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) procedures for decompression in patients with acute obstructive pyelonephritis. <b><i>Patients and Methods:</i></b> Medical records of patients undergoing PCN or RUS for emergency urinary diversion because of obstructive pyelonephritis were evaluated retrospectively. Patients with urinary tract obstruction and concurrent fever (≥38°C), pyuria, and costovertebral angle tenderness were included and divided into two groups based on the type of emergency urinary drainage applied (PCN in Group 1) and (RUS in Group 2). Apart from the demographic data and Charlson Comorbidity Index, laboratory and radiologic examination outcomes were well evaluated. <b><i>Results:</i></b> A total of 155 patients including 73 patients (47.1%) undergoing PCN (Group 1) and 82 patients (52.9%) undergoing RUS (Group 2). Although no significant difference was found regarding the demographic characteristics, the operation time, as well as fluoroscopy time, was significantly shorter in Group 1 cases when compared with those in Group 2 (<i>p</i> < 0.0001). The success rate was similar between the two groups, and there was also a significant difference regarding the complication rates in both groups of cases (5.5% <i>vs</i> 7.3%). <b><i>Conclusions:</i></b> Our findings showed that despite similar efficacy and success rates noted between PCN and RUS applications in the emergency drainage of cases presenting with obstructive pyelonephritis, PCN application was found to be advantageous because of shorter operation and fluoroscopy durations. More importantly, this approach was associated with a significantly less need for intensive care during the postoperative period.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"84-89"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801070","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":"Comparing Thulium Fiber Versus High-Power Holmium Laser Lithotripsy Combined with the Flexible and Navigable Suction Access Sheath in Flexible Ureteroscopy for Kidney Stone Disease: A Propensity Score Matched Analysis by the Global FANS Collaborative Group.","authors":"Vineet Gauhar, Olivier Traxer, Khi Yung Fong, Christian Sietz, Ben Hall Chew, Saeed Bin Hamri, Mehmet Ilker Gökce, Nariman Gadzhiev, Steffi Kar Kei Yuen, Vigen Malkhasyan, Deepak Ragoori, Yiloren Tanidir, Bhaskar Kumar Somani, Daniele Castellani","doi":"10.1089/end.2024.0653","DOIUrl":"10.1089/end.2024.0653","url":null,"abstract":"<p><p><b><i>Objective:</i></b> We aim to evaluate stone-free rate (SFR) and complications after flexible ureteroscopy (F-URS) for kidney stones, using a flexible and navigable suction ureteral access sheath (FANS), comparing thulium fiber laser (TFL) and high-power holmium:yttrium-aluminum-garnet laser (HPHL). <b><i>Methods:</i></b> Data from adults who underwent F-URS in 15 centers were prospectively analyzed (August 2023-January 2024). Exclusion criteria were ureteral stones, concomitant bilateral procedures, and renal abnormalities. One-to-one propensity score matching for age, gender, stone location, stone volume, and Hounsfield unit was performed. SFR was assessed using computed tomography scan within 30 days and defined as zero fragments. Data are presented as median (25th-75th quartiles). Multivariable logistic regression was performed to evaluate predictors of SFR. <b><i>Results:</i></b> Of included patients, HPHL was used in 114 patients and TFL in 181 patients. After matching, 96 patients from each group with similar baseline characteristics were included. There was no difference between the groups regarding the use of disposable scopes, lithotripsy mode, and ureteroscopy, lasing and total surgical time. There was no case of sepsis, and blood transfusion was necessary for only one patient in the HPHL group. The incidence of transient fever was similar (3.4% in HPHL <i>vs</i> 3.8% in TFL group). Postoperative day 1 loin pain did not differ significantly. Postoperative stay did not differ significantly [1 [0, 2] in HPHL <i>vs</i> 1 [0, 1] days in TFL group, <i>p</i> = 0.12]. Thirty-day SFR was similar (52.1% for HL <i>vs</i> 64.6% for TFL group, <i>p</i> = 0.11). At multivariable analysis, the use of TFL (odds ratio 1.95, 95% confidence interval 1.01-3.82) was significantly associated with higher odds of being stone-free. <b><i>Conclusions:</i></b> Both lasers are safe and efficacious and can be suitably used for F-URS with FANS with high SFR and minimal complications.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"42-49"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828830","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":"Aquablation or Anatomic Endoscopic Enucleation of Prostate?","authors":"Pankaj N Maheshwari, Hussain G Kolsawala","doi":"10.1089/end.2024.0855","DOIUrl":"https://doi.org/10.1089/end.2024.0855","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":"39 1","pages":"56"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006430","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":"Editorial Comment on END-2024-0601-OR.R1.","authors":"James E Lingeman","doi":"10.1089/end.2024.0841","DOIUrl":"10.1089/end.2024.0841","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"64"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882080","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":"A Prospective, Randomized, Noninferiority Study to Evaluate the Safety and Effectiveness of Steerable Ureteroscopic Renal Evacuation Compared with Standard Ureteroscopy: 30-Day Results of the ASPIRE Study.","authors":"Brian R Matlaga, Thomas J Mueller, Brett Johnson, Jay Page, J Stuart Wolf, Glenn M Preminger, Loren Jones, Ilya Sobol, Karen Stern, David Cuellar, Kaitlan Cobb, Robert Barsky, Robert Medairos, Charles Marguet, Naren Nimmagadda, Mark White, Michael Levin, Thomas Chi","doi":"10.1089/end.2024.0602","DOIUrl":"10.1089/end.2024.0602","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> We report the first multicenter, prospective, randomized noninferiority controlled trial of steerable ureteroscopic renal evacuation (SURE) for nephrolithiasis treatment. <b><i>Materials and Methods:</i></b> Candidates for laser lithotripsy ≥18 years with ≥1 renal stone ≥7 mm and 7-20 mm stone burden were randomized 1:1 SURE <i>vs</i> ureteroscopy (URS). SURE was performed using the CVAC Aspiration System, a novel steerable irrigation-aspiration catheter. The primary efficacy end point was noninferiority in stone-free rate (SFR) based on zero residual fragments (RFs) 30 days postprocedure on noncontrast computed tomography. Secondary end points were superiority tests, stone clearance (percent stone volume reduction), residual stone volume (RSV), SFR (no RF >2 mm), and SFR (no RF >4 mm) 30 days postprocedure. <b><i>Results:</i></b> Of the subjects, 123 were randomized and 101 qualified for efficacy analysis (SURE 46 <i>vs</i> URS 55). Despite randomization, baseline URS stone volume was higher (SURE 485.0 ± 432.5 mm³ <i>vs</i> URS 713.3 ± 558.5 mm³). The primary noninferiority end point was achieved (SURE SFR 48% <i>vs</i> URS SFR 49%, <i>p</i> = 0.027, -1.3% [90% confidence interval; -18%, 15%]). Stone clearance was significantly higher for SURE <i>vs</i> URS subjects (SURE 96.9 ± 5.6% <i>vs</i> URS 92.9 ± 11.6%, <i>p</i> = 0.036); RSV was significantly lower (SURE 14.3 ± 3 0.9 mm³ <i>vs</i> URS 70.2 ± 144.9 mm³, <i>p</i> = 0.012). SURE stone clearance and RSV were independent of baseline stone volume, but for URS degraded with increasing baseline stone volume. Safety was comparable between groups. <b><i>Conclusions:</i></b> SFR for SURE subjects was noninferior compared with URS subjects; stone clearance and RSV were significantly better with SURE, independent of baseline stone volume.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"10-18"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854192","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. Jennifer Bjazevic.","authors":"","doi":"10.1089/end.2024.57896.spot","DOIUrl":"10.1089/end.2024.57896.spot","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"1"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915098","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":"Predictors of Persistent Residual Stones After Second Look Percutaneous Nephrolithotomy.","authors":"Jessica C Dai, Hersh Trivedi, Vineeth Kommidi, Jodi A Antonelli, Margaret S Pearle, Brett A Johnson","doi":"10.1089/end.2024.0610","DOIUrl":"10.1089/end.2024.0610","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Second look flexible nephroscopy (SLFN) is often offered after percutaneous nephrolithotomy (PCNL). However, even after SLFN, residual fragments (RFs) occasionally persist. We sought to determine the incidence of persistent RFs in patients who undergo SLFN for RFs after PCNL and to identify parameters predictive of persistent RFs. <b><i>Methods:</i></b> We identified all patients at our institution with RFs on post-PCNL computed tomography (CT) that underwent SLFN between 1/2016 and 5/2020. Patient demographics, stone characteristics, and perioperative parameters were analyzed for each study patient. Post-SLFN fragments were identified on either follow-up kidney, ureter, and bladder radiograph or CT imaging obtained within 3 months of PCNL. Multivariable logistic regression analyses (MVA) was performed to identify predictors of persistent fragments. <b><i>Results:</i></b> A total of 201 renal units met the inclusion criteria. The median size of the largest RF at the time of SLFN was 5 mm (IQR 2-8) and the median cumulative RF stone size was 8 mm (IQR 5-14). The final stone-free rate of patients with RFs on initial PCNL who then underwent SLFN was 60.7% (<i>n</i> = 122). The median cumulative RF stone size and the median size of the largest RF post SLFN was 6.5 mm (IQR 4-12) and 5 mm (IQR 3-8), respectively. On MVA, bilateral preoperative stones and greater RF stone burden at time of SLFN were independent predictors of radiographically detected post-SLFN fragments. <b><i>Conclusions:</i></b> Among patients who underwent SLFN for RFs after PCNL, 60% were rendered stone-free. Patients with bilateral stones prior to PCNL and greater RF stone burden at time of SLFN are more likely to have persistent fragments, despite attempts at aggressive stone removal during both the initial PCNL and subsequent SLFN. The risk of adverse stone events from such fragments is unknown and may be lower because of their inaccessibility.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"26-33"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780173","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":"Is Treating Bladder Outlet Really Needed when Removing Bladder Stones: Outcomes of Bladder Stones Removal Without Concomitant BPO Surgery.","authors":"Ziv Savin, Linda Dayan Rahmani, Eve Frangopoulos, Kavita Gupta, Vinay Durbhakula, Blair Gallante, William M Atallah, Mantu Gupta","doi":"10.1089/end.2024.0682","DOIUrl":"10.1089/end.2024.0682","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> While surgical intervention for benign prostatic obstruction (BPO) is traditionally recommended alongside bladder stone removal in males, recent studies have questioned the necessity of this approach. This study aims to evaluate the long-term outcomes of bladder stone removal without concomitant BPO surgery. <b><i>Methods:</i></b> We conducted a retrospective analysis of males with BPO who underwent bladder stone removal without concomitant BPO surgery in our institution between 2017 and 2024. Clinical and functional variables were collected, and our primary endpoint during the study period was future BPO surgery (BPO surgery-free survival). Secondary outcomes included BPO-related complications, medical therapy burden, and significant increase in post-void residual (PVR). Kaplan-Meier curves, receiver operating characteristic curves, and Cox regression models were used to analyze the results and identify predictors for future BPO surgery. <b><i>Results:</i></b> Our cohort consisted of 63 patients with median follow-up of 34 months. During the study period, 13 patients (22%) underwent BPO surgery. The 1-year, 3-year, and 5-year BPO surgery-free survival rates were 90%, 78%, and 78%, respectively. Prostate volume >100 cc and PVR >93 mL were the most significant predictors of future BPO surgery, increasing the likelihood by nearly fourfold. In the absence of concomitant BPO surgery, 94% of patients managed their BPO with medication, and 57% experienced BPO-related adverse outcomes. <b><i>Conclusion:</i></b> Bladder stone removal without concomitant BPO surgery offers a high likelihood of avoiding future BPO surgery in the intermediate-term. However, careful patient selection and management of BPO-related risks are crucial. Prostate volume and PVR should be considered in the shared decision-making process.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"65-70"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716365","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":"Assessment of Ablation Rates with Artificial Urinary Stones Appropriate for Simulation Training.","authors":"Begoña Ballesta Martinez, Vasileios Tatanis, Angelis Peteinaris, Theodoros Spinos, Bhaskar Somani, Domenico Veneziano, Evangelos Liatsikos, Panagiotis Kallidonis","doi":"10.1089/end.2024.0561","DOIUrl":"10.1089/end.2024.0561","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Artificial urinary calculi are an essential tool for research and training in endourology. The goal of the study was to evaluate different types of artificial stones and how they behave to laser treatment, to finally determine which is the optimal one for training purposes. <b><i>Materials and Methods:</i></b> The stones were produced with a mix of Bego Stone powder and water, at mixing rates of 15:03, 15:04, and 15:06. They were evaluated in an <i>in vitro</i> experimental setting using the Quanta Cyber 150 W high-power laser lithotripter. Dusting was set to 0.5 J × 20 Hz = 10 W and fragmentation was set to 0.8 J × 8 Hz = 6.4 W. Stone weights were assessed in dry and wet conditions. <b><i>Results:</i></b> The ablation rates in the dusting modality were similar for the three stone types tested. In the fragmentation mode, the mean ablation rate for 15:04 artificial stones was greater than those of 15:03 and 15:06 stones. Overall, the mean weight difference between the wet and dry stones was 0.03 g. Consequently, within the stone types tested, 15:04 artificial are probably the most convenient ones for training purposes because they get disintegrated similarly to 15:03 and 15:06 Bego Stones on a dusting setting, and ablation is faster on a fragmentation setting. <b><i>Conclusions:</i></b> The 15:04 Bego Stones may be considered as the optimal option for use in simulation training models of the endourological education programs.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"73-78"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716362","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":"Acknowledgment of Reviewers 2024.","authors":"","doi":"10.1089/end.2024.50030.revack","DOIUrl":"https://doi.org/10.1089/end.2024.50030.revack","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":"39 1","pages":"90-92"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006369","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}