Journal of endourology最新文献

{"title":"The Impact of Timing of Definitive Intervention for Patients with Acute Renal Colic: A Population-Based Study.","authors":"Michael Ordon, Sarah Bota, Yuguang Kang, Blayne Welk","doi":"10.1089/end.2024.0657","DOIUrl":"https://doi.org/10.1089/end.2024.0657","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To determine the impact of early intervention (EI) <i>vs</i> delayed intervention/expectant management for patients presenting to the emergency department (ED) with renal colic. <b><i>Methods:</i></b> We conducted a population-based cohort study in Ontario, Canada, utilizing linked administrative health data. Patients presenting to an ED with renal colic between April 1, 2010, and June 30, 2020, were included. Patients were divided into two groups. The EI group underwent shockwave lithotripsy, ureteroscopy, or percutaneous nephrolithotomy within 2 weeks of presentation. The delayed intervention/expectant management (non-EI) group represented all other patients, including those who did not receive intervention. Patients were followed forward in time for 3 months in the EI group and for 4 weeks postintervention or 3 months (whichever was longer) in the non-EI group, to assess for our outcomes. The outcomes included additional ED visits, hospitalizations, or imaging studies, stent/nephrostomy insertion, and urologist/primary care visits. These outcomes were compared across the two groups using a propensity score-matched generalized linear model with generalized estimating equations. <b><i>Results:</i></b> There were 397,185 index renal colic events (after propensity score matching EI = 27,741, non-EI = 80,230). The EI group had a lower risk for additional ED visits (relative risk (RR): 0.70, 95% confidence interval (CI): 0.68-0.72, <i>p</i> < 0.001) and hospital admissions (RR: 0.52, 95% CI: 0.50-0.55, <i>p</i> < 0.001) compared with the non-EI group. Similarly, the EI group had a lower risk for stent (RR: 0.62, 95% CI: 0.54-0.71, <i>p</i> < 0.001) or nephrostomy insertion (RR: 0.49, 95% CI: 0.42-0.57, <i>p</i> < 0.001), however, there was no difference for additional imaging. The EI group had a slightly increased risk for urologist/primary care visit (RR: 1.02, 95% CI: 1.02-1.03, <i>p</i> < 0.001). In the non-EI group, 17.31% underwent eventual intervention. <b><i>Conclusion:</i></b> Our study demonstrated a benefit to EI for those presenting with renal colic to the ED, but potentially with the risk of exposing some patients to unneeded treatment. These findings could influence practice patterns and guideline recommendations.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199317","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 Drug-Coated Balloon Treatment for Urethral Stricture Disease: Three-Year Results from the ROBUST III Study.","authors":"Pooja Srikanth, Jessica DeLong, Ramon Virasoro, Sean P Elliott","doi":"10.1089/end.2024.0718","DOIUrl":"10.1089/end.2024.0718","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The goal of this study is to report the updated 3-year safety and efficacy outcomes of the intervention arm of the ROBUST III randomized controlled trial, comparing the Optilume® drug-coated balloon (DCB) with standard endoscopic management of recurrent male anterior urethral stricture. <b><i>Methods:</i></b> Eligible patients included adult men with recurrent anterior urethral stricture ≤3 cm in length and ≤12 Fr in diameter, International Prostate Symptom Score (IPSS) ≥11, and peak flow rate (Qmax) <15 mL/s. Patients were randomized to treatment with the Optilume DCB or standard-of-care endoscopic management. Primary endpoints evaluated over the 3-year follow-up period included freedom from reintervention and alterations in IPSS, Qmax, and postvoid residual (PVR). The primary safety endpoint was freedom from serious procedure- or device-related adverse events (AEs). <b><i>Results:</i></b> Descriptive statistics of the intervention cohort have been published previously. The treatment arm maintained a high percentage of patients free from repeat intervention (71%), nearly equal to the 2-year results and three times higher than that observed in the control group at the 1-year mark. Clinically significant subgroups, including those with history of repeat endoscopic dilations (≥5 prior dilations) and longer stricture lengths (≥2 cm), did not demonstrate any significant differences in observed metrics, including IPSS score, Qmax, or PVR. In the crossover cohort of patients who experienced treatment failure with standard endoscopic management and opted for DCB treatment, the Kaplan-Meier curve for freedom from reintervention closely resembles that of the original DCB cohort. Treatment-related AEs were rare and generally self-limited (hematuria, dysuria, and urinary tract infection). <b><i>Conclusion:</i></b> The Optilume DCB continues to achieve significant improvements in symptoms and reintervention rates through 3 years posttreatment and represents a viable endoscopic alternative with durable results and a low-risk safety profile for the management of recurrent anterior urethral strictures ≤3 cm in length.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974193","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":"Development of an Alginate Gel Composite with Antibacterial Properties Capable of Binding Calcium-Based Residual Stone Fragments in Endoscopic Stone Surgery.","authors":"Won Hoon Song, Seung Soo Lee, Jong Kil Nam, Sung-Woo Park","doi":"10.1089/end.2024.0765","DOIUrl":"10.1089/end.2024.0765","url":null,"abstract":"<p><p><b><i>Background:</i></b> Complete removal of urinary stones remains a challenge, as residual fragments can contribute to recurrence and postoperative urinary tract infections. This study presents an initial laboratory investigation into the development of an alginate gel composite designed to bind calcium-based stone remnants and exhibit antibacterial properties. <b><i>Methods:</i></b> To evaluate gel formation, calcium oxalate powder reagent and sodium alginate (SA) powder reagent were mixed in a Becker glass and stirred on a hot plate. Stones from 17 patients who underwent stone surgery were crushed, and gel formation was confirmed using the same experimental conditions with SA powder reagent. A gel composite material containing silver nitrate and vancomycin was prepared, and antibacterial activity against <i>Staphylococcus aureus</i> and <i>Escherichia coli</i> was tested over a 5-minute period. A mixture of 0.5 g alginic acid and 0.05 g calcium oxalate monohydrate powder reagent with 50 mL distilled water formed a gel after 30 minutes. <b><i>Results:</i></b> Sandy stones composed of calcium oxalate formed a better gel composite when mixed with SA than those composed of uric acid. In the antibacterial test of the alginate gel composite containing silver nitrate and vancomycin against <i>S. aureus</i> and <i>E. coli</i>, the number of live bacteria in the control and alginate gel composite was 3.5 × 10³ and <10, respectively. <b><i>Conclusion:</i></b> This study represents a preliminary laboratory investigation into the development of an alginate gel composite for potential use in urinary stone management. Further preclinical studies are necessary to evaluate its efficacy and safety before clinical translation.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"585-593"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803203","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":"The Feasibility and Safety of the Glean Urodynamics System: The Modern Urodynamics System Efficacy Study.","authors":"Jason Kim, Keith Xavier, Tracy Cannon-Smith, Taylor Vaughan, Sreenivas Vemulapalli, Hanson Zhao, Arshia Aalami-Harandi, Nemi Shah","doi":"10.1089/end.2025.0270","DOIUrl":"10.1089/end.2025.0270","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Urodynamics is used to diagnose lower urinary tract dysfunction; however, conventional urodynamics results often poorly correlate to patient symptoms because of the nonphysiological nature of the test. The Glean^TM Urodynamics System is a novel, wireless, catheter-free ambulatory urodynamics system that allows clinicians to study lower urinary tract dysfunction in a more physiological manner. The objective of this study was to evaluate the feasibility, efficacy, and safety of the Glean Urodynamics System for use in clinic. <b><i>Materials and Methods:</i></b> This prospective, single-arm, multicenter interventional trial enrolled adults with lower urinary tract dysfunction. Participants underwent conventional urodynamics per standard of care followed by ambulatory urodynamics using the intravesical Glean bladder sensor. After the removal of the Glean sensor, participants completed comfort and preference questionnaires. Participants were followed up within 7-14 days to assess the incidence of adverse events. <b><i>Results:</i></b> Thirty-eight participants were enrolled. Glean sensor insertion was attempted in 33 participants and successful in 32 (97.0%). The median sensor insertion time was 33.62 seconds (range: 12.32-256). The Glean Urodynamics System recorded vesical pressure, and all 32 participants were able to void with the sensor indwelling. Median sensor removal time was 5.71 seconds (range: 0.79-22.15). There were 14 adverse events in 12 participants, of which 7 events (in 7 participants) were attributed to the Glean Urodynamics System. There were no serious adverse events. Overall participant feedback on the Glean Urodynamics System was positive, and clinicians reported it was easy to use. <b><i>Conclusions:</i></b> The Glean Urodynamics System is a feasible, efficacious, safe, and well-tolerated device that enables ambulatory urodynamics with physiological bladder filling and without catheters impeding lower urinary tract function.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"625-634"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996993","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":"Hazem Elmansy, MD.","authors":"","doi":"10.1089/end.2025.98711.spot","DOIUrl":"10.1089/end.2025.98711.spot","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"517"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078297","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":"The Most Accurate Technique and Formulation for Prostate Volume Estimation: A Comparative Analysis of Transrectal Ultrasonography, Magnetic Resonance Imaging, and Three-Dimensional Segmentation.","authors":"Sinharib Citgez, Kadir C Sahin, Göktuğ Kalender, Mehmet H Gultekin, Ugurcan Sayili, İpek Sertbudak, Iclal Gurses, Hamdi Ozkara","doi":"10.1089/end.2024.0839","DOIUrl":"10.1089/end.2024.0839","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Prostate volume estimation is of great importance for patient evaluation in a urologist's clinical practice. The accuracy and superiority of the techniques used in volume calculation have always been the subject of debate. Therefore, we conducted a comparative analysis between the volumes derived from transrectal ultrasonography (TRUS), multiparametric prostate magnetic resonance imaging (MpMRI), and three-dimensional (3D)-constructed MpMRI images of patients, who underwent retropubic radical prostatectomy at our institution. <b><i>Methods:</i></b> The data of patients with preoperative TRUS and MpMRI who underwent radical prostatectomy (Rp) in our clinic between August 2021 and February 2023 were retrospectively reviewed. The prostatectomy specimens were taken to the pathology department without exposure to any fixative and measured with the water displacement method. All axial T2-weighted sequences were segmented by a single surgeon using 3D Slicer (v. 5.6.2) software, and all measurements were compared with the specimen volume measured at the pathology laboratory. <b><i>Results:</i></b> A total of 150 patients were included in this study. The median prostate volumes estimated by TRUS-ellipsoid, TRUS-bullet, MpMRI, and 3D segmentation were 43.45 cc (min.-max.: 15.1-122.6), 54.32 cc (min.-max.: 18.9-153.3), 44.05 cc (min.-max.: 15.4-128.9), and 43.11 cc (min.-max.: 14.3-110.6), respectively. The median Rp specimen volume measurement in the pathology department was 42 cc (min.-max.: 12-114). When the measurement techniques were compared between each other, it has been shown that the statistically significant difference was caused by TRUS-bullet measurement. No statistically significant difference between the other three measurement techniques as well as between them and the specimen volume measurements were detected. <b><i>Conclusion:</i></b> Consistent with the findings of previous studies, MpMRI has provided estimations closer to pathology measurements and 3D segmentation allows even more precise measurements. However, considering accessibility, reproducibility, time efficiency, and cost, TRUS-based measurements can be safely used in clinical practice, especially using the ellipsoid formula.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"601-607"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784386","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":"The Association of Perioperative Glycated Hemoglobin (Hemoglobin A1C) and the Risk of Sepsis after Ureteroscopy with Laser Lithotripsy.","authors":"Richard Berman, Justin Lee, Adithya Balasubramanian, Ojas Shah","doi":"10.1089/end.2024.0710","DOIUrl":"10.1089/end.2024.0710","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Elevated glycated hemoglobin A1c (HbA1c) has not been specifically evaluated as a risk factor for urosepsis after kidney stone procedures. Moreover, there are no current guidelines for perioperative HbA1c optimization, nor recommendations for the optimal timing to treat non-urgent kidney stones in the setting of poor glycemic control. We evaluated the association between perioperative HbA1c levels and sepsis risk after ureteroscopy with lithotripsy. <b><i>Methods:</i></b> Patients undergoing ureteroscopy with lithotripsy from January 2020 to June 2023 at a tertiary center were retrospectively reviewed. Postoperative sepsis was defined as Systemic Inflammatory Response Syndrome scores ≥2 within 30 days after ureteroscopy. The risk of sepsis at various HbA1c thresholds was evaluated via multivariate logistic regression. <b><i>Results:</i></b> A total of 1454 patients underwent ureteroscopy with lithotripsy, and 319 patients had HbA1c collected within 90 days of their procedures. The mean preoperative Charlson Comorbidity Index (CCI) score was 3.22 (±2.77). An increased risk of sepsis was observed among patients with HbA1c levels between 8.0% and 9.9% (odds ratio [OR] 4.42, <i>p</i> = 0.025) and ≥10% (OR 8.17, <i>p</i> = 0.003). Positive preoperative urine culture despite treatment (OR 4.53, <i>p</i> < 0.001) and higher CCI (OR 1.17, <i>p</i> = 0.045) were also associated with increased odds of sepsis. <b><i>Conclusion:</i></b> The odds of sepsis after ureteroscopy with lithotripsy follow a dose-response relationship with elevated perioperative HbA1c. These data underscore the clinical utility of incorporating HbA1c into preprocedural optimization and may justify certain patients to delay elective ureteroscopy to improve glycemic control before endourologic intervention.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"549-555"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995684","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":"Sustained-Release Rapamycin-Eluting Cobalt-Based Alloy Stent Ameliorates Ureteral Stricture in Mini-Pigs by Regulating TGF-β1/Smad3/mTOR/4EBP1/eIF4E Signaling Pathways.","authors":"Zhiwei Chen, Wei Zhao, Teng Zhang, Tengzhou Ren, Jie Chen, Lang Tian, Sheng Lu, Jie Wu, Yan Wang","doi":"10.1089/end.2024.0458","DOIUrl":"10.1089/end.2024.0458","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> To assess the feasibility and efficacy of sustained-release rapamycin-eluting metal stent in the repair of thermal injury-induced ureteral stricture in mini-pigs and explore its underlying mechanisms. <b><i>Materials and Methods:</i></b> A total of 18 female mini-pigs were used in this study. At 1 month after effective establishment of ureteral stricture model, they were randomly divided into normal control, model, bare-metal stent, and rapamycin-eluting stent groups. Before and at 4 weeks after stent placement, all animals underwent retrograde ureterography and single-photon emission computed tomography. Histologic examination was performed to assess the histomorphologic changes of the ureteral tissues. Real-time quantitative polymerase chain reaction and Western blot analysis were used to evaluate the expression levels of pro-fibrotic factors, transforming growth factor-beta1 (TGF-β1) and Smad3, as well as mammalian target of rapamycin (mTOR) downstream effectors, 4E binding protein 1 (4EBP1) and eukaryotic initiation factor 4E (eIF4E), in the ureteral stricture tissues. <b><i>Results:</i></b> Four weeks after stent placement, ureteral stricture was significantly ameliorated, and the glomerular filtration rate was significantly improved in the rapamycin-eluting stent group than the model and bare-metal stent groups (all <i>p</i> < 0.05). Pathologic examinations revealed obviously reduced fibroblasts and collagen fibers in the submucosa of the rapamycin-eluting stent group. The mRNA and protein expression levels of TGF-β1, Smad3, 4EBP1, and eIF4E were significantly decreased in the rapamycin-eluting stent group than the model and bare-metal stent groups (<i>p</i> < 0.05), whereas no significant difference was found between the model and bare-metal stent groups, indicating that rapamycin-eluting stent can inhibit fibroblast proliferation and attenuate fibrosis in the ureteral tissues. <b><i>Conclusion:</i></b> Sustained-release rapamycin-eluting stent can effectively ameliorate thermal injury-induced ureteral stricture in mini-pigs. The mechanism may be related to the role of rapamycin in inhibiting TGF-β1 and Smad3 expression, promoting the ureteral tissue remodeling through blocking mTOR, and suppressing 4EBP1 and eIF4E expression in the ureteral tissues. Sustained-release rapamycin-eluting stent deserves further investigation as a potentially effective means of treating iatrogenic ureteral strictures.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"570-584"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408557","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":"Robotic Approach to Surgery for Pheochromocytoma in Children: A Case Series.","authors":"Chinny Catherine, Ashitosh Pokharkar, Deepak K Kandpal, Priyank Yadav, Aditya Musham, Sujit K Chowdhary","doi":"10.1089/end.2024.0205","DOIUrl":"10.1089/end.2024.0205","url":null,"abstract":"<p><p>Pheochromocytoma is a rare disease in children with incidence of reported as 1 in 10 million children. There are few reported series with clinical follow-up published in literature from the Indian subcontinent; none has reported minimally invasive operation for pheochromocytoma and long-term outcome. These children present with symptoms secondary to increased catecholamine secretion from the adrenal pheochromocytes, of which hypertension is the most common and can be life threatening. Although hypertension in children is almost always secondary to a hidden disease, children with pheochromocytoma may be treated for a while before diagnosis is established. Surgical excision of the tumor is the treatment. Preoperative assessment can be challenging as 10% of the cases may be syndromic with bilateral tumors and associated with multiple endocrine neoplasia. The preoperative stabilization of the child with alpha antagonists, fluid replacement, and beta-blockers are the mainstay of preoperative preparation. Intraoperative disasters are well known in the absence of adequate preparation. Conventional procedure has been the standard surgical approach. Minimally invasive surgery (MIS) in children for pheochromocytoma is evolving. We report a series of five children treated over 5 years by the minimally invasive approach with follow-up details for this period. This study confirms the efficacy of MIS approach in treatment of pheochromocytoma and its ability to produce reliable results in the long term.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"556-563"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999637","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":"Characteristic Findings in Aborted Robot-Assisted Radical Prostatectomies.","authors":"Kathryn E Fink, Austin Drysch, Nicole Handa, Mitchell Huang, Sai Kumar, Yutai Li, Chalairat Suk-Ouichai, Kent T Perry, Ridwan Alam, Hiten D Patel, Anugayathri Jawahar, Ashley E Ross","doi":"10.1089/end.2025.0003","DOIUrl":"10.1089/end.2025.0003","url":null,"abstract":"<p><p><b><i>Background:</i></b> In rare instances, patients deemed operative candidates for robot-assisted radical prostatectomy (RARP) have their procedure aborted intraoperatively. Understanding the incidence and factors associated with aborted RARP cases can improve preoperative counseling and intraoperative decision-making. We performed a retrospective analysis of RARP cases performed by high-volume surgeons across our multihospital medical system to characterize the incidence and causes of aborted procedures. <b><i>Methods:</i></b> We queried the Northwestern Electronic Data Warehouse from January 2018 to June 2024 for patients who underwent RARP performed by high-volume surgeons. Aborted procedures were defined as those terminated after anesthesia but before completion. Comparative statistics were used to evaluate clinical, radiologic, and pathologic characteristics between aborted and completed cases. Imaging features of propensity-matched patients with completed or aborted procedures were also analyzed. <b><i>Results:</i></b> Among 3316 RARPs performed by 10 high-volume surgeons, 26 cases (0.7%) were aborted. The leading causes were pelvic lipomatosis (35%), adhesions (27%), and cardiorespiratory events (12%). Higher body mass index (BMI) was significantly associated with aborted operation (30.7 <i>vs</i> 27.8, <i>p</i> = 0.015). Although prior abdominal operations were more frequent in the aborted group (7.7% <i>vs</i> 2.6%), this was not statistically significant (<i>p</i> = 0.2). Perioperative complications occurred in 12% of aborted cases. Four cases were reattempted, with three completed effectively. The apparent diffusion coefficient of perivesical pelvic fat was higher in aborted cases but not statistically significant (<i>p</i> = 0.13). <b><i>Conclusions:</i></b> The incidence of aborted RARP among experienced surgeons is low, accounting for less than 1% of all cases. Pelvic lipomatosis was the most common reason for an aborted procedure and may be recognized preoperatively on imaging. Higher BMI was associated with a significantly higher risk for aborted procedure. When counseling patients, this information could be used to set expectations for the risk of an aborted procedure.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"564-569"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811660","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}