Journal of endourology最新文献

{"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}

{"title":"Incidence of Incisional Hernias after Single-Port Versus Multi-Port Robotic Radical Prostatectomy.","authors":"J Corbin Norton, Tyler Compher, Luke Shumaker, Zachary Burns, Jeffrey W Nix, Abhishek D Parmar, Soroush Rais-Bahrami","doi":"10.1089/end.2024.0367","DOIUrl":"10.1089/end.2024.0367","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> To determine if single-port robotic-assisted radical prostatectomy (SP-RARP) has higher rates of incisional hernias when compared with multi-port robotic-assisted radical prostatectomies (MP-RARP). <b><i>Materials and Methods:</i></b> A retrospective, single-institution review of all consecutive robotic prostatectomy cases between January 2017 and December 2022. Analyzed multi-port and single-port robotic prostatectomies performed by two high-volume surgeons. Measured primary outcome for the development of incisional hernias, as defined by computed tomography imaging and clinical documentation. Multivariable logistic regression was used to determine the effect of the single-port approach on incisional hernia outcomes. <b><i>Results:</i></b> A total of 493 patients were included in the study (320 SP-RARPs and 173 MP-RARPs). The overall incisional hernia rate was 8.5% (SP-RARP 8.1% <i>vs</i> MP-RARP 9.2%, <i>p</i> = 0.669). A median follow-up time was 16.6 months and a median time from procedure to hernia diagnosis was 7.4 months. SP-RARP had shorter OR time than the MP-RARP (236 minutes <i>vs</i> 276 minutes, <i>p</i> < 0.001). Patients who developed hernias had higher body mass index (BMIs) than those who did not (30.7 <i>vs</i> 29, <i>p</i> = 0.009). Multivariable logistic regression analysis revealed that patients with higher BMI (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.14) and a history of prior operation (OR 2.23, 95% CI 1.71-4.29) were more likely to develop incisional hernias. Cox regression analysis accounting for the difference in follow-up period demonstrated that SP-RARP 3.4× more likely to develop incisional hernias than MP-RARP (hazard ratio 3.38, 95% CI 1.50-7.58). <b><i>Conclusions:</i></b> Patients with higher BMIs and prior history of abdominal surgeries are at increased risk of developing postoperative incisional hernias. SP-RARP procedures confer a higher risk of postoperative incisional hernias.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"2-9"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750931","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":"Impact of Patient Factors on Robotic-Assisted Partial Nephrectomy Operating Room Times: The Case for Fixed Operating Room Time as a Viable Efficiency Target.","authors":"Neda Qosja, Laura E Geldmaker, Christopher H Hasse, Vartika Tiwari, Taylor R Fuqua, Daniela A Haehn, Colleen S Thomas, Alex Hochwald, David D Thiel","doi":"10.1089/end.2024.0330","DOIUrl":"https://doi.org/10.1089/end.2024.0330","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> To analyze the association of patient characteristics on operating room (OR) times for robotic-assisted partial nephrectomies (RAPNs). <b><i>Methods:</i></b> In total, 248 consecutive RAPNs were performed by a single surgeon from October 2018 to August 2022. Data were collected on the following patient factors: sex, age, race, weight, body mass index (BMI), diabetes, hypertension (HTN), tumor side, tumor mass, and American Society of Anesthesiologists (ASA) score. Total fixed OR times were evaluated as the sum of in-room time to anesthesia-release time (IRAT), anesthesia-release time to cut time (ARCT), close time to wheels out time (CTWO), and in-room time to cut time (IRAT + ARCT). Total variable OR times were defined as cut time to close time (CTCT). Total operative time was defined as wheels into wheel out (WIWO). <b><i>Results:</i></b> Median OR time was 265 minutes (interquartile range [IQR]: 247-298 minutes) for WIWO, 191 minutes (IQR: 170-225 minutes) for CTCT, and 75 minutes (IQR: 68-83 minutes) for total fixed time. There was a significant increase in WIWO with the following patient variables: male sex (18.0 minutes, 95% confidence interval [CI]: 6.3-29.7 minutes), weight (5.6 minutes, 95% CI: 2.8-8.4 minutes), BMI (14.3 minutes, 95% CI: 4.2-24.4 minutes), HTN (15.1 minutes, 95% CI: 3.7-26.5 minutes), pathology tumor size (cm) (6.4 minutes, 95% CI: 2.2-10.6 minutes), and ASA score (13.8 minutes, 95% CI: 3.1-24.4 minutes). Sex, age, BMI, weight, HTN, and pathology tumor size significantly impacted CTCT (<i>P</i> < 0.05). Total fixed OR time was only affected by ASA score (<i>P</i> = 0.02). <b><i>Conclusions:</i></b> Patient variables significantly affect total OR time and variable OR time. These variables do not impact total fixed OR times, confirming fixed OR time as a viable OR efficiency point.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894885","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}