Journal of endourology最新文献

{"title":"Trifecta of Same-Day Discharge after Single-Port Robotic-Assisted Simple Prostatectomy.","authors":"Hakan Bahadir Haberal, Luca Lambertini, Matteo Pacini, Giulio Avesani, Fabio Maria Valenzi, Muhannad Aljoulani, Ruben Calvo Sauer, Juan Ramon Torres-Anguiano, Simone Crivellaro","doi":"10.1089/end.2024.0930","DOIUrl":"https://doi.org/10.1089/end.2024.0930","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> There are numerous options available for the surgical treatment of benign prostate hyperplasia, and single-port robotic-assisted simple prostatectomy (SP-RASP) has emerged as a novel method in this field. In this study, we aim to define the trifecta of same-day discharge (SDD) and identify the factors associated with the trifecta of SDD following SP-RASP. <b><i>Materials and Methods:</i></b> Data from 95 patients who underwent SP-RASP between February 2020 and July 2024 at a single center by a single surgeon were evaluated. The trifecta of SDD was defined as a patient being discharged on the same day without experiencing any 90-day postoperative complications and no readmissions. The factors associated with predicting the trifecta of SDD were investigated. <b><i>Results:</i></b> A total of 95 SP-RASP cases were successfully performed without the need for conversion to alternative approaches, and 54 patients (56.8%) were included in the trifecta of the SDD-achieved group. The reasons for failure included 23 patients (24.2%) requiring postoperative hospitalization from the recovery area, 24 patients (25.3%) experiencing postoperative complications, and 2 patients (2.1%) needing readmission within 90 days after discharge. There was a 0% incidence of major postoperative complications (≥Clavien-Dindo grade 3). When comparing the groups, trifecta-achieved patients showed lower estimated blood loss, smaller specimen weight, lower percentage of adenoma removed, and a reduced rate of opioid prescriptions at discharge (<i>p</i> = 0.005, 0.033, 0.025, and 0.026, respectively). In the multivariate logistic regression analysis, specimen weight was the only factor significantly associated with trifecta following SP-RASP (<i>p</i> = 0.018). <b><i>Conclusion:</i></b> In our cohort, 56% of patients were classified within the trifecta group, with no major postoperative complications observed following SP-RASP. Specimen weight was the only independent predictor of trifecta achievement in these patients.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649133","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":"Enhanced Artificial Intelligence in Bladder Cancer Management: A Comparative Analysis and Optimization Study of Multiple Large Language Models.","authors":"Kun-Peng Li, Li Wang, Shun Wan, Chen-Yang Wang, Si-Yu Chen, Shan-Hui Liu, Li Yang","doi":"10.1089/end.2024.0860","DOIUrl":"https://doi.org/10.1089/end.2024.0860","url":null,"abstract":"<p><p><b><i>Background:</i></b> With the rapid advancement of artificial intelligence in health care, large language models (LLMs) demonstrate increasing potential in medical applications. However, their performance in specialized oncology remains limited. This study evaluates the performance of multiple leading LLMs in addressing clinical inquiries related to bladder cancer (BLCA) and demonstrates how strategic optimization can overcome these limitations. <b><i>Methods:</i></b> We developed a comprehensive set of 100 clinical questions based on established guidelines. These questions encompassed epidemiology, diagnosis, treatment, prognosis, and follow-up aspects of BLCA management. Six LLMs (Claude-3.5-Sonnet, ChatGPT-4.0, Grok-beta, Gemini-1.5-Pro, Mistral-Large-2, and GPT-3.5-Turbo) were tested through three independent trials. The responses were validated against current clinical guidelines and expert consensus. We implemented a two-phase training optimization process specifically for GPT-3.5-Turbo to enhance its performance. <b><i>Results:</i></b> In the initial evaluation, Claude-3.5-Sonnet demonstrated the highest accuracy (89.33% ± 1.53%), followed by ChatGPT-4 (85.67% ± 1.15%). Grok-beta achieved 84.33% ± 1.53% accuracy, whereas Gemini-1.5-Pro and Mistral-Large-2 showed similar performance (82.00% ± 1.00% and 81.00% ± 1.00%, respectively). GPT-3.5-Turbo demonstrated the lowest accuracy (74.33% ± 3.06%). After the first phase of training, GPT-3.5-Turbo's accuracy improved to 86.67% ± 1.89%. Following the second phase of optimization, the model achieved 100% accuracy. <b><i>Conclusion:</i></b> This study not only establishes the comparative performance of various LLMs in BLCA-related queries but also validates the potential for significant improvement through targeted training optimization. The successful enhancement of GPT-3.5-Turbo's performance suggests that strategic model refinement can overcome initial limitations and achieve optimal accuracy in specialized medical applications.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649127","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":"Drivers of Cost Variability of Ureteroscopy with Laser Lithotripsy at an Academic Institution.","authors":"Tyler Bergeron, Ilir Agalliu, Alexander C Small, Dima Raskolnikov","doi":"10.1089/end.2024.0801","DOIUrl":"https://doi.org/10.1089/end.2024.0801","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Ureteroscopy with laser lithotripsy (URS/LL) requires significant disposable equipment including wires, baskets, lasers, and stents. Surgeons choose this equipment based on preference, with higher- and lower-cost options available. We sought to explore factors that affect cost variability among urologists performing URS/LL within a single academic medical center. <b><i>Patients and Methods:</i></b> We retrospectively reviewed all patients who underwent URS/LL at our institution between September 2022 and June 2023. A weighted cost for each item's contribution to total cost was generated. Bivariate and then multivariate median regression models were generated to identify variables associated with higher total surgical cost. Statistical significance was considered <i>p</i> < 0.05. <b><i>Results:</i></b> A total of 311 patients underwent URS/LL during the study period with 14 different surgeons. The total median cost of disposable equipment for the entire cohort was $1488/operation. On multivariate regression, basket cost above the cohort median or specialized catheter cost above the cohort median was associated with increased total surgical cost (<i>p</i> < 0.001). Fellowship training in endourology was associated with a decreased cost of $90.40 per case (<i>p</i> < 0.05). <b><i>Conclusions:</i></b> There is significant variability in the cost of ureteroscopy, even at a single institution where all surgeons have access to identical supplies. Attention to specific categories of equipment, which appear to be associated with higher total cost, as well as the potential differences in technique between surgeons with varied training, may help to identify opportunities for institutional cost savings.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657354","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. Jason Lee, MD, MHPE, FRCSC.","authors":"","doi":"10.1089/end.2025.63321.spot","DOIUrl":"https://doi.org/10.1089/end.2025.63321.spot","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604935","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":"Comparison of Measurement Methods for Stone Volume Estimation: An <i>In Vitro</i> Study.","authors":"Felipe Pauchard, Frederic Panthier, Catalina Espinoza, Nataly Vejar, Eugenio Ventimiglia, Olivier Traxer","doi":"10.1089/end.2024.0524","DOIUrl":"https://doi.org/10.1089/end.2024.0524","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Urolithiasis guidelines still rely on the maximum stone diameter to propose treatment strategy, although this measure is known to have many pitfalls. Stone volume (SV) could represent a more accurate measurement, helping to plan the treatment or follow-up. Various methods to measure SV have been proposed. We aimed to compare different methods to estimate SV. <b><i>Methods:</i></b> Fifteen stones (human and artificial) were assessed. Real SV was measured using the water displacement method. Volume estimation included three diameter-based formulas (Ackerman, 4/3 Pi r³ and r³/2) and two 3D segmentation methods (Horos and Kidney Stone Calculator [KSC]). All measurements were done by a single operator. Spearman correlation test and comparative analyses were conducted between the real and the estimated SV. <b><i>Results:</i></b> Compared with real SVs, Ackerman and r³/2 formulas estimated volume accurately in 2/15 (13%) of stones each. No accurate measurement was reported using the sphere formula. KSC did estimate volume accurately in 4/15 (27%) stones compared with the reference SV; Horos did it in 7/15 (47%) stones. Both segmentation methods presented strong correlation coefficients (<i>r</i> = 0.9642 and 0.9659, <i>p</i> < 0.0001), while formula correlation was moderate (<i>r</i> = 0.7531, <i>p</i> < 0.0001). <b><i>Conclusion:</i></b> Formulas and segmentation methods for SV estimation resulted in divergent outcomes. Segmentation methods (Horos and KSC) presented higher accuracies in SV estimation, compared with real SV. Formulas were the least accurate.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605014","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 Outpatient Totally Tubeless Standard Percutaneous Nephrolithotomy Safe and Efficacious?","authors":"Kavita Gupta, Nir Tomer, Christopher Connors, Susan Gong, Raymond Khargi, Blair Gallante, William M Atallah, Mantu Gupta","doi":"10.1089/end.2024.0441","DOIUrl":"https://doi.org/10.1089/end.2024.0441","url":null,"abstract":"<p><p><b><i>Introduction and Objectives:</i></b> Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for large, complex intrarenal stones. Tubeless PCNL (t-PCNL) where no nephrostomy tube is placed and totally tubeless PCNL (tt-PCNL) in selected patients have been well described. There has been no study to our knowledge discharging patients the same day totally tubeless. In this study, we describe our experience with tt-PCNL on a totally outpatient basis-with the patient going home with absolutely no tube, catheter, or stent, evaluating its safety and efficacy vis-à-vis a comparison with outpatient t-PCNL patients discharged with an indwelling stent. <b><i>Methods:</i></b> We prospectively collected data from 130 consecutive patients scheduled for outpatient PCNL from August 2023 to January 2024. Demographics, stone characteristics, and intraoperative data were compared. Outcomes included postoperative (post-op) pain, stone-free rate (SFR), 30-day complications, and ED visits or readmissions. Categorical variables were compared using Chi-square or Fisher's exact tests and continuous variables via Mann-Whitney U tests. <b><i>Results:</i></b> After exclusions, 53 patients underwent tt-PCNL and 50 had t-PCNL. Demographics and stone burden did not differ between groups. No visceral or pleural injuries occurred in either group. Post-op transfusion rates, SFR, 30-day complications, ED visits, and readmissions were also comparable between the two groups. The mean operative (OR) time and incidence of Clavien-Dindo I complications were higher with t-PCNL with stent (80 minutes <i>vs</i> 58 minutes, <i>p</i> < 0.001,16% <i>vs</i> 3.8%, <i>p</i> = 0.048). Post-op pain scores and postanesthesia care unit stay times were similar. <b><i>Conclusions:</i></b> In this first ever comparison of outpatient t-PCNL to tt-PCNL, we found the same-day discharge of tt-PCNL patients to be safe and effective. Stent omission in our patients did not increase the risk of RF, ED visits, complications, or readmissions. A large, multicenter, randomized prospective controlled trial will help to confirm our findings.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584824","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":"Risk Factors for Conversion to Open Surgery in Laparoscopic Nephrectomy for Xanthogranulomatous Pyelonephritis: A Multicenter Study.","authors":"José Iván Robles-Torres, José Antonio Zapata-González, Marcos Andrés Sánchez-Rendón, Fred Alain Montelongo-Rodríguez, Jesús García-Saucedo, Santosh Kumar, Bhaskar K Somani, Vineet Gauhar, Adrián Gutiérrez-González","doi":"10.1089/end.2024.0814","DOIUrl":"https://doi.org/10.1089/end.2024.0814","url":null,"abstract":"<p><p><b><i>Introduction and Objective:</i></b> Xanthogranulomatous pyelonephritis (XGP) is an infrequent, but life-threatening, chronic granulomatous pyelonephritis. Surgical intervention can be challenging because of severe inflammation and often a fibrotic reaction that obliterates anatomical landmarks. In addition, a high rate of open conversion has been reported when performing a laparoscopic nephrectomy. The aim of this study is to determine the risk factors for open conversion in patients with histologically confirmed XGP who underwent laparoscopic nephrectomy. <b><i>Methods:</i></b> A multicenter retrospective study was performed, including patients who underwent laparoscopic nephrectomy between 2018 and 2022 with histopathologic diagnosis of XGP. Clinical and laboratory parameters at initial presentation were evaluated. Extension of XGP was recorded as per the Malek clinical-radiological classification. Characteristics of laparoscopic nephrectomy and perioperative outcomes were obtained. The primary outcome was conversion to open surgery. Secondary outcomes included major complications, evaluated by Clavien-Dindo ≥3, and organ injuries during the procedure. <b><i>Results:</i></b> A total of 49 patients from 5 centers were included, with a mean age of 46.5 ± 17.7 years. Conversion to open surgery was reported in 10 cases (20.4%). Major complications were reported in 13 cases (26.5%), and organ injuries were reported in 10 patients (20.4%). Colonic (3 cases, 6.1%) and pleura injuries (3 cases, 6.1%) were the most frequently affected organ. The presence of renal abscess (odds ratio [OR]: 3.174, <i>p</i> = 0.003) and paranephric extension of disease (Malek stage 3) (OR: 14, <i>p</i> = 0.016) were independent factors related to conversion to open surgery. <b><i>Conclusion:</i></b> Laparoscopic nephrectomy for XGP is a technically challenging procedure because of extensive chronic inflammation and fibrosis. The presence of renal abscess and Malek stage III are independent predictors of conversion to open. Despite these challenges, laparoscopic nephrectomy remains a viable and effective approach for managing XGP, with the potential for reduced recovery time and postoperative morbidity compared with open surgery.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597130","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":"Optimization of Cone Beam Computed Tomography Scan Protocols for the Intraoperative Detection of Residual Stones in Percutaneous Nephrolithotomy.","authors":"Riemer Adam Kingma, Nienke T L van Asten, Marcel J W Greuter, Igle J de Jong, Stijn Roemeling","doi":"10.1089/end.2024.0732","DOIUrl":"https://doi.org/10.1089/end.2024.0732","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The primary surgical treatment modality for large or complex renal stones is percutaneous nephrolithotomy (PCNL). Cone beam computed tomography (CBCT) allows for intraoperative imaging and can be used to enhance intraoperative assessment of a stone-free status during a PCNL procedure. However, scanning protocols have not yet been optimized for this purpose. The high degree of stone and patient characteristics require a tailored approach. This study aimed to select the most suitable CBCT protocols for imaging stone fragments intraoperatively during PCNL. <b><i>Methods:</i></b> A phantom insert with 100 calcifications varying in size and density was placed in an anthropomorphic abdominal phantom. Nine different CBCT protocols were used with varying dose and copper filter settings, and each scan was repeated five times with a small translation between each scan. Detectability of the calcifications was scored by visual assessment and visibility curves were generated for each protocol, depicting the minimum size and density at which calcifications were still detectable. Image noise and contrast-to-noise ratios (CNRs) were calculated for each protocol, as well as estimated effective patient doses per CBCT scan. <b><i>Results:</i></b> Calcification detectability and CNRs decreased with a decrease in radiation dose, whereas noise ratios increased. Three suitable scanning protocols were selected, a high-dose or soft-stone CBCT protocol resulting in an effective dose of 10.7 millisievert (mSv) per CBCT scan, a medium-dose CBCT protocol resulting in an effective dose of 4.6 mSv and a low-dose or hard-stone CBCT protocol resulting in an effective dose of 2.2 mSv. <b><i>Conclusion:</i></b> Radiation dose for intraoperative CBCT for imaging calcifications can effectively be lowered while maintaining calcification visibility, by implementing low-dose CT protocols with lowered dose settings and the application of a copper filter. The three proposed scanning protocols provide options to select a scan protocol based on stone type and patient characteristics.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572344","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":"Fluoroless Ureteroscopy Under Local Anesthetic Gel: Experience from a Canadian Tertiary Referral Center.","authors":"Tarek Benzouak, Ahmad Alshammari, Abdulmalik Addar, Fadl Hamouche, Abdullah Alahmari, Sébastien Belliveau, Michael Maalouf, Rakan Al Haidey, Sero Andonian, Nada Mohamed, Anne Yin, Nader Fahmy","doi":"10.1089/end.2024.0667","DOIUrl":"https://doi.org/10.1089/end.2024.0667","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Flexible ureteroscopy (URS) is the backbone of diagnosing upper urinary tract pathologies. Recent advancements in scope design have led to smaller, more maneuverable scopes with enhanced precision. The aim of this study was to assess feasibility of fluoroless URS under a local anesthetic (LA) gel. <b><i>Patients and Methods:</i></b> A prospective cohort study was performed at a Canadian tertiary care center. All patients booked for a diagnostic URS were included in this study. All patients were given intraurethral local lidocaine gel and instructed to signal if discomfort was encountered. Data collected include age, gender, indications of URS, history of URS, ureteral stenting, comorbidity index, and the use of a guidewire, as well as pain using a visual analog scale. <b><i>Results:</i></b> A total of 61 URSs using LA were performed on 38 patients. The majority of patients were men (68.9%). Indications for URS were to rule out upper tract urothelial cancer (47.5%), stricture (32.8%), or urolithiasis (19.7%). The average pain score, as rated by the visual analog scale, was 2.05 (standard deviation = 2.037). Only one patient did not want to continue his URS under LA. Guidewire use was associated with an average increase of 1.87 in pain score when compared with freehand URS (β = 1.869, standard error [SE] = 0.610, t = 3.063, <i>p</i> = 0.004, r_partial = 0.398). Male patients reported a 1.38 decrease in pain scores compared with female patients (β = -1.380, SE = 0.615, t = -2.244, <i>p</i> = 0.029, r_partial = -0.302). <b><i>Conclusions:</i></b> LA URS was well tolerated in our patient population. Randomized controlled trials on URS with LA vs general or spinal anesthesia are needed to broaden its use, increase accessibility, and improve health care resource utilization.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557036","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":"Classifying Renal Pyelocaliceal System: A Complete Literature Overview of All Existing Classification Approaches.","authors":"Ali Talyshinskii, Patrick Juliebø-Jones, B M Zeeshan Hameed, Lazaros Tzelves, Amelia Pietropaolo, Bhaskar Kumar Somani","doi":"10.1089/end.2024.0693","DOIUrl":"https://doi.org/10.1089/end.2024.0693","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Our comprehension of the actual diversity of kidney pyelocaliceal system (PCS) is lacking and many crucial features have been overlooked in the existing literature on this subject. The purpose of this review is to provide a concise summary of the current understanding of the structure of the pelvicalyceal system, considering both anatomical and surgical perspectives, as well as to highlight any limitations or inconsistencies in these approaches. <b><i>Material and Methods:</i></b> A full review of all the literature on the anatomical and surgical methods used to classify pelvicalyceal system was conducted in several databases in August 2024. This included all the articles that talked about classifications for the whole pelvicalyceal system, minor calyces, and morphometric measurements within the pelvicalyceal system. <b><i>Results:</i></b> Despite over a century of studying this anatomical zone and numerous approaches, some classifications still rely on pelvic branching or the division site related to the renal sinus. However, no single classification has incorporated both aspects. In addition, despite the consensus regarding the number of minor calyces, there are many approaches to determining their orientation. Finally, researchers have described a sufficient number of morphometric measurements within the pelvicalyceal system, considering their prognostic value before endourological interventions and their correlation with individual patterns of the structure of pelvicalyceal system. However, these measurements often lead to contradictions in interpreting the anatomical favorability of the same pelvicalyceal system using different approaches. <b><i>Conclusion:</i></b> Despite the numerous approaches to identify pelvicalyceal system from both morphological and surgical perspectives, there are significant gaps in our understanding of the real anatomy of the renal cavity that, even after more than a century, remain unanswered. There needs to be more correlation of anatomy with modern minimally invasive clinical interventions for stone disease.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556975","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}