Journal of endourology最新文献

{"title":"Factors Influencing Postoperative Adherence after Pediatric Kidney Stone Surgery in Alabama (USA): A Single-Institution Retrospective Analysis.","authors":"Brenton T Bicknell, Joseph J Crivelli, Timothy Boswell, John Galloway, David Kitchens, David Joseph, Stacy Tanaka, Greg Tasian, Ching Man Carmen Tong","doi":"10.1177/08927790251376636","DOIUrl":"https://doi.org/10.1177/08927790251376636","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Pediatric kidney stone disease is on the rise, and high recurrence rates necessitate consistent postoperative follow-up. Identifying social determinants of health is a key step in understanding the factors that influence adherence to follow-up after operation. This study examines socioeconomic associations with adherence after kidney stone procedure in children and evaluates whether enrollment in a multi-center clinical incentivized trial was associated with adherence. We hypothesize that those who lived farther from our hospital, lived in areas of higher deprivation, or were not enrolled in the trial were less likely to follow-up. <b><i>Methods:</i></b> We conducted a retrospective review of patients under 18 years old who underwent kidney stone operation from August 2019 to July 2023. Demographics, medical history, Area Deprivation Index (ADI) scores, and surgical details were analyzed. The primary outcome was follow-up clinic attendance within 16 weeks postoperation. ADI was calculated using patient home address to rank against other neighborhoods in the United States. Higher ADI score indicates more socioeconomic disadvantage. Variables were analyzed using chi-square tests for categorical variables and independent <i>t</i>-tests for continuous variables. <b><i>Results:</i></b> A total of 120 patients were identified: predominantly female (75/120, 62.5%), White (102/120, 85.0%), with median age of 15.7 years (interquartile range 11.5-17.2). Median travel distance to hospital was 51.0 miles. Of the 120 patients, 66 (55.0%) followed up within 16 weeks. Adherence was higher among patients with private insurance (<i>p</i> = 0.03) and lower ADI scores (less neighborhood-level deprivation) (<i>p</i> < 0.01). Prior surgical stone removal was also associated with lower adherence (<i>p</i> < 0.01). Enrollment in a clinical trial did not significantly impact imaging adherence (<i>p</i> = 0.98). <b><i>Conclusion:</i></b> Private insurance and lower ADI scores were associated with improved follow-up adherence, emphasizing the association of socioeconomic factors with adherence after kidney stone procedure. Clinical trial enrollment did not affect follow-up adherence, suggesting a need for targeted strategies to support high-risk pediatric patients.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033456","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":"Mini-Percutaneous Nephrolithotomy Less Injurious to the Kidney?","authors":"Juan Serna, Raymond Khargi, Kavita Gupta, Christopher Connors, Susan Gong, Anna Ricapito, Blair Gallante, Manishkumar Patel, Seunghee Kim-Schulze, William Atallah, Natasha Kyprianou, Mantu Gupta","doi":"10.1177/08927790251372581","DOIUrl":"10.1177/08927790251372581","url":null,"abstract":"<p><p><b><i>Background and Objectives:</i></b> Percutaneous nephrolithotomy (PCNL) technique trends have shifted toward smaller caliber access sheaths, leading to a varied array of miniPCNL (mPCNL) systems. Urinary biomarkers have been validated as noninvasive direct markers of renal cellular injury. Our objective was to assess changes in biomarkers levels in the perioperative setting, comparing mPCNL suction (s-mPCNL), non-suction (ns-mPCNL), and standard PCNL (sPCNL) systems. <b><i>Patients and Methods:</i></b> PCNL systems used were as follows: s-mPCNL single-step dilator (ClearPetra™, 18F), ns-mPCNL metallic dilator and sheath (Storz MIP-M, 17.5F), and sPCNL with balloon dilation (Nephromax, 24F). Urine samples were collected at three time points: preoperatively (V1), 1 hour postoperatively (V2), and 10 days postoperatively (V3). Samples were analyzed using enzyme-linked immunofluorescent assay for key biomarkers-kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and β2-microglobulin (β2M)-normalized to urine creatinine. The primary outcome was changes in urinary biomarkers. <b><i>Results:</i></b> Twenty patients were randomized into two groups: s-mPCNL and ns-mPCNL, and 10 patients were assigned to the sPCNL cohort. The mean differences and percent change in biomarker levels at different time intervals were calculated as follows: early injury (V1-V2), recovery (V2-V3), and long-term injury (V1-V3). There was a statistically significant rise in NGAL levels for both ns-mPCNL and s-mPCNL in the early injury interval (2.377; <i>p</i> = 0.004, 2.606; <i>p</i> < 0.001, respectively), and a subsequent fall in levels during the recovery interval for sPCNL, ns-mPCNL, and s-mPCNL (-4.720; <i>p</i> = 0.026, -2.427; <i>p</i> = 0.014, -3.141; <i>p</i> = 0.018, respectively). There was no statistically significant difference in all three biomarkers for all forms of PCNL in the long-term injury interval. <b><i>Conclusion:</i></b> There is a sharp rise in urinary biomarkers in the immediate postoperative setting, likely because of early tubular injury, more notable in ns-mPCNL systems that utilize metal sheaths. However, this is a transient effect that normalizes days later irrespective of the sheath size used during the PCNL.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956489","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":"Extracorporeal Shockwave Lithotripsy Still Alive for Pediatric Ureteral Stones ≤1.0 cm².","authors":"Sinharib Çitgez, Elif Altınay Kırlı, Muhammet Demirbilek, Feyyaz Irmak, Engin Dereköylü, Bülent Önal","doi":"10.1177/08927790251372163","DOIUrl":"10.1177/08927790251372163","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> This retrospective study compares extracorporeal shockwave lithotripsy (SWL) and ureteroscopy (URS) in pediatric ureteral stones ≤1.0 cm², aiming to determine the optimal treatment based on clinical outcomes. <b><i>Patients and Methods:</i></b> The study included patients with ureteral stones ≤1.0 cm² eligible for SWL or URS. Treatment choices were made based on family decisions. SWL was performed under sedation, with 180° rotation for distal stones, whereas URS was conducted under general anesthesia using semirigid/flexible ureteroscopes with Ho:YAG laser lithotripsy. Complications were classified using Satava and Clavien criteria, respectively. <b><i>Results:</i></b> A total of 230 children (median age:7 y/o, interquartile range 4-12) underwent SWL (<i>n</i> = 129, 56%) or URS (<i>n</i> = 101, 44%)for ureteral stones ≤1.0 cm². The groups were comparable in terms of demographic characteristics. SWL and URS had comparable stone-free rates (85% <i>vs</i> 80, <i>p</i> = 0.276), and there was no difference according to the location. However, URS had a higher overall complication rate (16% <i>vs</i> 4%, <i>p</i> = 0.005). Complication rates were significantly higher for distal stones treated with URS (<i>p</i> = 0.009), whereas stone-free rates were similar between proximal (<i>p</i> = 0.821) and distal stones (<i>p</i> = 0.332). Logistic regression analysis revealed that female gender and stone burden were significant factors in achieving overall stone-free status. When stone-free outcomes were evaluated based on stone location, female gender and a history of previous minimally invasive stone intervention were also found to be influential predictors. <b><i>Conclusion:</i></b> These findings indicate that SWL and URS provide comparable efficacy in stone clearance, but URS is associated with a higher complication rate, particularly for distal ureteral stones. Additionally, our data suggest that SWL remains a preferable first-line option, particularly for stones ≤1.0 cm², whereas URS might be reserved for cases with larger stone burdens or prior treatment failures.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956528","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":"Outcome and Impact of Diagnostic Ureteroscopy in Clinically Suspected Upper Urinary Tract Carcinoma <i>in Situ</i>.","authors":"Satoshi Katayama, Katsumi Sasaki, Norihiro Kusumi, Osamu Fujita, Kyohei Kurose, Takaharu Ichikawa, Tadasu Takenaka, Hideaki Hashimoto, Tetsuya Nakada, Ryoji Arata, Katsutoshi Uematsu, Yasuo Yamamoto, Yoshitsugu Nasu, Masaya Tsugawa, Takashi Yoshida, Takanori Sekito, Kasumi Yoshinaga, Tomoaki Yamanoi, Tatsushi Kawada, Yusuke Tominaga, Takuya Sadahira, Takehiro Iwata, Shingo Nishimura, Kensuke Bekku, Kohei Edamura, Tomoko Kobayashi, Yasuyuki Kobayashi, Toyohiko Watanabe, Motoo Araki","doi":"10.1177/08927790251374291","DOIUrl":"https://doi.org/10.1177/08927790251374291","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> To clarify disease behavior and oncological outcomes as well as the need for ureteroscopy (URS) implementation in patients with clinically suspected upper tract carcinoma <i>in situ</i> (UT-CIS). <b><i>Patients and Methods:</i></b> In this multi-institutional study, we retrospectively analyzed patients who met three criteria for clinically suspected UT-CIS between 2008 and 2018: positive high-grade cytology from the upper tract, absence of a solid upper tract lesion on imaging, and negative bladder biopsy. Patients who underwent URS were compared with those who did not. Kaplan-Meier curve was used to assess the natural history of treated UT-CIS and the prognostic impact of URS. <b><i>Results:</i></b> In total, 48 patients with clinically suspected UT-CIS were analyzed, of whom 27 (57%) had a previous history of urothelial carcinoma. Of 28 (58%) patients who underwent URS, pathologically confirmed UT-CIS and UT-non-CIS were detected in 7 (25%) and 6 (21%), respectively. As initial treatment, 23 (48%) patients received upper tract bacillus Calmette-Guérin, while 21 (44%) underwent radical nephroureterectomy (RNU). During a median follow-up of 44.8 months, the most common site that suffered recurrence and progression was the bladder (40% and 17%), followed by the affected (15% and 6%) and contralateral (8% and 4%) upper tract, respectively. Three-year overall, cancer-specific, upper tract-specific, progression-free (PFS), and recurrence-free survival estimates were 88.2%, 94.8%, 100%, 80.8%, and 52.4%, respectively. Survival outcomes were comparable regardless of URS implementation, with the exception of PFS. However, URS implementation resulted in an earlier transition to surgical intervention in 11% and avoided unnecessary RNU in 11%. <b><i>Conclusions:</i></b> UT-CIS is a pan-urothelial disease and frequently shows metachronous recurrence and progression in any part of the urinary tract, necessitating long-term, meticulous follow-up. Despite the lack of a statistical difference between patients with and without URS, we found that a non-negligible number of patients benefited from URS implementation.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956502","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":"Ultrasound-Only-Guided <i>vs</i> Fluoroscopy-Guided Mini-Percutaneous Nephrolithotomy in Children: A Randomized Comparative Trial.","authors":"Ahmad A Elderwy, Ahmed A Shahat, Ayman A Elqady, Islam F Abdelkawi, Ahmed S Safwat, Hassan A Abolella, Guohua Zeng, M A Abdelaziz, Ahmad Elbadry I Abonnoor","doi":"10.1177/08927790251372540","DOIUrl":"https://doi.org/10.1177/08927790251372540","url":null,"abstract":"<p><p><b><i>Background and objective:</i></b> Avoidance of ionizing radiation during management of pediatric urolithiasis is imperative. Objectives are to evaluate feasibility of ultrasound-only-guided mini-percutaneous nephrolithotomy (PNL) in children and to compare it with fluoroscopic guidance. <b><i>Methods:</i></b> Randomized comparative trial (NCT03250559) including 60 renal units with stones >1 cm in 57 children ≤14 years. Exclusion criteria were anomalous kidney and Guy's stone score IV. Mini-PNL was either ultrasound or fluoroscopy guided (30 cases each). The two groups were compared regarding operative details and postoperative outcomes. Stone clearance was evaluated by computed tomography 2 weeks postoperatively and on last follow-up. Follow-up period ranged 1.17-3.42 years. <b><i>Results:</i></b> In ultrasound group, fluoroscopy was needed in one case during access and in three cases for detection of residuals. In fluoroscopy group, ultrasound was needed in two cases to manage fluid collection. Fluoroscopy group had significantly fewer dilated tracts (<i>p</i> = 0.021), fewer supra-costal tracts (<i>p</i> = 0.002), lower calyceal approach (<i>p</i> < 0.001), more nephrostomy tubes (<i>p</i> = 0.008), and shorter hospital stay (<i>p</i> = 0.010). The two groups were comparable regarding other operative details, stone clearance and complications. On last follow-up, stone-free rate was 86.2% in ultrasound group and 93.3% in fluoroscopy group. After exclusion of Guy's III cases, these rates increased to 96% and 96.6%, respectively. <b><i>Conclusions:</i></b> Ultrasound-only-guided mini-PNL in children is feasible. In comparison with fluoroscopic guidance, it leads to more dilated tracts, higher calyceal approaches, less nephrostomy tubes, and longer hospital stay. However, it yields comparable outcomes regarding access time, complications, and stone clearance, especially for Guy's I/II cases.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956504","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":"Endoscopic Evaluation of Ureteral Stone Impaction Highlights Significant Variability in Definitions Between Endourologists.","authors":"Jared S Winoker, Brendan Yi, Robert Chang, Raymond Khargi, Jonathan Khusid, William Atallah, Mantu Gupta, Dima Raskolnikov, Alexander Small, Charan Mohan, Gregory Mullen, Sarah Razavi, Tareq Aro, Christopher Hartman, David Hoenig, Zeph Okeke, Arthur Smith, Arun Rai","doi":"10.1177/08927790251362867","DOIUrl":"10.1177/08927790251362867","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Previous studies attempting to predict impaction on CT have relied on various criteria without a gold standard for comparison. Intraoperative single-surgeon estimations of impaction have been unvalidated and subjective. This study aimed to investigate surgeon perspectives and variability in estimating ureteral stone impaction based on a curated ureteroscopy video catalog. <b><i>Methods:</i></b> A catalog of 35 primary ureteroscopy cases was distributed to a group of fellowship-trained endourologists. All videos featured visual inspection of tissue around the stone, attempted passage of a guidewire adjacent to the stone, and an attempt to dislodge the stone with gentle nudging of the scope. Participants independently rated impaction on two different scales: continuous (0-9) and categorical (none/mild/moderate/severe). After a first pass, participants rated the videos in a new, random order. Inter- and intrarater agreement across both rating systems was evaluated. <b><i>Results:</i></b> In total, 35 videos were evaluated by 13 endourologists. Overall, 13/35 videos had strong agreement (>70%) on the degree of impaction (6 none, 7 severe), and only 2 of these had 100% agreement (1 none, 1 severe). Continuous scale ratings mirrored the categorical ratings for the none and severe impaction cases. There were no cases with consensus agreement of mild or moderate impaction. More than one-third (12/35) of videos had at least one vote for each of the four severity categories, indicating stark disagreement between surgeons on what constitutes impaction. <b><i>Conclusions:</i></b> There is significant variability among endourologists regarding the definition and severity of stone impaction. When strong agreement occurs, it is when a stone is deemed to be severely impacted or not impacted. Further work is needed to create a standardized definition of impaction based on objective endoscopic criteria. A tripartite classification system may be the most appropriate manner of grouping ureteral stones based on impaction.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"948-952"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715084","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-2024-0718-OR.R1.","authors":"Joel Gelman","doi":"10.1089/end.2025.0332","DOIUrl":"10.1089/end.2025.0332","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"975-976"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584041","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":"Transurethral Cystolithotripsy <i>vs</i> Percutaneous Cystolithotomy for Bladder Stones in Children: A Systematic Review and Meta-Analysis Comparing Clinical Outcomes and Complications.","authors":"Xingming Zhao, Qiang Guo, Sheng Ren, Yuting Song, Chengyong Li, Jingqi Wang","doi":"10.1089/end.2024.0677","DOIUrl":"10.1089/end.2024.0677","url":null,"abstract":"<p><p><b><i>Background:</i></b> The minimally invasive treatment of bladder stones (BS) in children has been demonstrated to be safe and effective by both transurethral cystolithotripsy (TUCL) and percutaneous cystolithotomy (PCCL). The surgical outcomes and potential complications associated with these two treatments remain uncertain. We conducted a meta-analysis to compare TUCL and PCCL in pediatric BS with a focus on long-term stone-free rates (SFR), postoperative complications, and cost-effectiveness. <b><i>Materials and Methods:</i></b> PubMed, Embase, Cochrane Library, and Web of Science were last searched on September 12, 2023. Included studies should evaluate at least one of the following outcomes: SFR, operation time, hospital stay, and complications. The quality assessment of the studies was performed using the Cochrane tools and Newcastle-Ottawa Scale system. <b><i>Results:</i></b> A total of 397 patients from 7 studies met the inclusion criteria, of which 202 patients underwent TUCL and 195 patients underwent PCCL. The results showed that the PCCL group had shorter operative time (<i>p</i> < 0.00001) and longer hospitalization days (<i>p</i> < 0.00001) than the TUCL group, and other perioperative prognostic differences were not statistically significant. <b><i>Conclusion:</i></b> TUCL and PCCL are effective and safe for the treatment of BS in children. Multicenter, large-patient series, and prospective studies are needed to determine the critical value of stone size for selecting the surgical approach.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"960-967"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006791","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":"Changes in Kidney Volume after Robot-Assisted Partial Nephrectomy and Impact on Postoperative Renal Function.","authors":"Asuka Sano, Takayuki Sugiyama, Yuto Matsushita, Hiromitsu Watanabe, Keita Tamura, Daisuke Motoyama, Atsushi Otsuka, Hideaki Miyake","doi":"10.1089/end.2024.0244","DOIUrl":"10.1089/end.2024.0244","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The objectives of this study were to measure the changes in kidney volume after robot-assisted partial nephrectomy (RAPN) and examine the impact on the postoperative renal function. <b><i>Methods:</i></b> This study included 58 patients undergoing RAPN at our institution between July 2017 and November 2019. Kidney volume was measured with Synapse VINCENTv3.1 (Fujifilm Medical Co., Tokyo, Japan) based on the findings on contrast-enhanced CT before and after RAPN. <b><i>Results:</i></b> At 1 week post-RAPN, kidney volumes on the operated side, contralateral side, and overall were significantly larger compared with preoperative measurements (110.6%, <i>p</i> < 0.001; 113.2%, <i>p</i> < 0.001; 112.1%, <i>p</i> < 0.001, respectively). By 1 year postoperation, the operated-side and total kidney volumes had significantly decreased compared with the preoperative levels (83.2%, <i>p</i> < 0.001; 92.7%, <i>p</i> < 0.001), whereas the contralateral kidney volume showed a slight but significant increase (102.1%, <i>p</i> = 0.027). In addition, the estimated glomerular filtration rate (eGFR) decreased by 12.8% at 1 year after RAPN compared with the preoperative value. Multivariate analysis revealed that age, warm ischemia time, and changes in total kidney volume at 1 year had independent impacts on changes in eGFR. Furthermore, only changes in kidney volume on the operated and contralateral sides were shown to be independently associated with changes in total kidney volume 1 year after RAPN. A higher R.E.N.A.L. nephrometry score, L score, and a smaller preoperative total kidney volume were identified as independent predictors of contralateral renal enlargement 1 year after RAPN. <b><i>Conclusions:</i></b> This study confirmed the occurrence of compensatory hypertrophy of the contralateral kidney after RAPN. This phenomenon associated with a higher R.E.N.A.L. nephrometry score, L score, and a smaller preoperative total kidney volume.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"897-904"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248192","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":"Perioperative and Short-Term Functional Outcomes of Robot-Assisted Radical Prostatectomy with the Dexter Robotic System.","authors":"Humphrey Robin, Guillaume Hugues, Théo Fontanier, Nadia Ali Benali, Aurélien Forgues, Damien Emeriau, Hubert Mignot, Damien Thillou","doi":"10.1089/end.2024.0763","DOIUrl":"10.1089/end.2024.0763","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Previous data have demonstrated the feasibility of robot-assisted radical prostatectomy (RARP) performed with the Dexter robotic system. This study aimed to assess the early functional and oncological outcomes of RARP performed at our center using Dexter. <b><i>Methods:</i></b> Forty-seven consecutive patients underwent RARP ± lymph node dissection at our institution between April 2022 and May 2023. Prospectively collected medical records from routine care were retrospectively analyzed. RARP was performed using a standard transperitoneal anterior approach with the Dexter system. We assessed intraoperative safety and performance outcomes, as well as postoperative safety, early oncological outcomes, and functional recovery at 3 months of follow-up. <b><i>Results:</i></b> All procedures were successfully completed, without any intraprocedural complications, conversions to open surgery, or major technical failures. The median operative time was 198 minutes (interquartile range [IQR]: 163-232), and the median length of stay was 2 days (IQR: 2-3). Positive surgical margins were observed in 8/47 cases (17%). Two patients (4%) had rising prostate-specific antigen levels during follow-up. Urinary continence was achieved for 94% of patients at 3 months postoperatively and 52% had recovered sexual function. The study's limitation includes its retrospective design and the varying levels of robotic expertise among surgeons transitioning to the Dexter system. <b><i>Conclusion:</i></b> This study highlights the oncological safety and encouraging functional outcomes of RARP performed with the Dexter system.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"905-910"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584078","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}