Journal of endourology最新文献

{"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":"968-974"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","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":"Is Totally Tubeless Percutaneous Nephrolithotomy a Safe and Efficacious Option for Caliceal Diverticular Calculi?","authors":"Susan Gong, Kavita Gupta, Christopher Connors, Ziv Savin, Vinay Durbhakula, Blair Gallante, William M Atallah, Mantu Gupta","doi":"10.1089/end.2024.0783","DOIUrl":"10.1089/end.2024.0783","url":null,"abstract":"<p><p><b><i>Introduction and Objectives:</i></b> Percutaneous nephrolithotomy (PCNL) is a common treatment for caliceal diverticular calculi and provides excellent stone-free outcomes. Because of a concern for urinary stasis in the setting of a dilated nephrostomy tract, an indwelling ureteral stent and/or nephrostomy tube (NT) was traditionally left in the collecting system. The rationale for investigating totally tubeless PCNL (tt-PCNL) for the treatment of caliceal diverticula was to determine whether the advantages attributed to tt-PCNL for normal collecting system stones, such as shorter hospital stay and reduced morbidity, would extend to PCNL of caliceal diverticula. We describe our experience with tt-PCNL for caliceal diverticula, where patients typically go home the same day without any tube. <b><i>Methods:</i></b> We identified 42 patients (21 tt-PCNL, 21 PCNL with a NT and/or stent [t-PCNL]) with caliceal diverticular calculi undergoing PCNL from 2013 to 2024 in our prospectively maintained PCNL database. Demographics, stone characteristics, and intraoperative data were compared. Outcomes included final stone-free rate (SFR) using the absolute (0 mm) and relative (≤2 mm, 2.1-4 mm) fragment cutoffs, diverticular cavity resolution, 30-day complications, emergency department (ED) visits, readmissions, and phone calls. Categorical variables were compared using Chi-square or Fisher's exact tests and continuous variables with Mann-Whitney <i>U</i> tests. <b><i>Results:</i></b> Demographics and stone characteristics were similar between groups. SFRs were 94% for tt-PCNL and 90% for t-PCNL (<i>p</i> = 0.910) using CT-based criteria, with effective diverticular resolution in 90% and 100% of cases, respectively (<i>p</i> = 0.480). Complications, all Clavien-Dindo grade 1, occurred in four tt-PCNL patients and in one t-PCNL patient (<i>p</i> = 0.343). There were no statistically significant differences in readmission rates, 30-day complication and ED visit rates, or in the incidence of phone calls within 7 days. tt-PCNL patients were discharged same day, whereas t-PCNL required overnight observation. <b><i>Conclusions:</i></b> tt-PCNL is a safe effective option for caliceal diverticular stones, offering similar SFRs and safety outcomes compared with t-PCNL, but with shorter hospital stays.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"880-887"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553650","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":"Randomized Controlled Trial of Nonsteroidal Anti-Inflammatory Drugs as a Safe and Effective Alternative to Opioids for Pain Relief Following Percutaneous Nephrolithotomy.","authors":"Ziv Savin, Kavita Gupta, Eve Frangopoulos, Vinay Durbhakula, Asher Mandel, Christopher Connors, Anna Ricapito, Raymond Khargi, Alan J Yaghoubian, Blair Gallante, William M Atallah, Mantu Gupta","doi":"10.1089/end.2025.0090","DOIUrl":"10.1089/end.2025.0090","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> This randomized controlled trial aims to demonstrate the noninferiority of nonsteroidal anti-inflammatory drugs (NSAIDs) compared with narcotics for postoperative pain management after percutaneous nephrolithotomy (PCNL), in an era where opioids are commonly utilized. <b><i>Methods:</i></b> After institutional review board approval, 85 patients scheduled for PCNL at our institution between May 2023 and January 2025 were consented and randomized to receive either oxycodone (OXY) or ketorolac (KET) for postoperative pain management at home. Inclusion criteria were unilateral, single-access standard PCNL, whereas exclusion criteria included abnormal anatomy, contraindications to KET/OXY, and preexisting stents or nephrostomy tubes. The primary outcome was the Visual Analog Scale (VAS) pain score from postoperative days (PODs) 1-5. Secondary outcomes were recorded on POD 10 office visit and included VAS score, Patient-Reported Outcomes Measurement Information System questionnaire, pill count, office phone calls because of pain, and drug-related adverse events. Complication outcomes were also included as secondary. <b><i>Results:</i></b> The cohort had median age of 65 years (interquartile range [IQR]: 49-70), stone burden of 975 mm³ (IQR: 558-2356), STONE score of 6 (IQR: 5-7), and operative time of 66 minutes (IQR: 53-90). Baseline characteristics, including clinical, stone, and intraoperative variables, were comparable between groups. Maximum and average VAS pain scores over PODs 1-5 were similar across both treatment groups (<i>p</i> = 0.18 and <i>p</i> = 0.17, respectively). Patients in the OXY group consumed fewer pills over the 10-day period (median of 6.5 <i>vs</i> 12, <i>p</i> < 0.01). All other secondary outcomes were not different between the groups. <b><i>Conclusion:</i></b> NSAIDs provide comparable postoperative pain relief to opioids following PCNL, with minimal side effects, making them a viable option for patients without contraindications. Our study is the first level 1 evidence on this topic.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"888-896"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584079","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 Step Toward Modernization of Urologic Training: Incorporation of a Novel Surgical Intelligence Platform for Robotic Prostatectomy Video Review.","authors":"Grant M Henning, Bridget L Findlay, Tal Cohen, Matthew T McLeay, Spyridon P Basourakos, Aaron M Potretzke, Kevin Koo, Stephen A Boorjian, Matthew K Tollefson, Brian J Linder, Abhinav Khanna, Boyd R Viers","doi":"10.1177/08927790251371728","DOIUrl":"https://doi.org/10.1177/08927790251371728","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Surgical video review can be used in urologic training, yet significant barriers to the implementation of video review programs exist, and formal assessment of usage and utility for trainees is limited. Here, we evaluate a novel video review platform to describe patterns of use and determine perceived utility. <b><i>Materials and Methods:</i></b> We analyzed learning points entered by trainees during video review of radical prostatectomy cases using our surgical intelligence-enabled Film Room platform between September 2023 and July 2024. Learning point content was categorized according to surgical coaching domains as technical, cognitive, nontechnical, or descriptive. Entries were compared by surgical step and level of training. Anonymous surveys were distributed to trainees to determine perceived utility and reveal patterns of video review. <b><i>Results:</i></b> Thirteen trainees entered 480 unique learning points across all radical prostatectomy steps and spanning surgical coaching domains during the study period. Learning points varied by training level, with junior trainees entering points more often than senior trainees for Retzius-space dissection (<i>N</i> = 73 <i>vs</i> 17, <i>p</i> < 0.01) and seminal vesicle and posterior dissection (<i>N</i> = 58 <i>vs</i> 27, <i>p</i> < 0.01). Trainees used video review in preparation for both upcoming cases and performance analysis. Ninety-four percent of survey respondents reported they either agreed or strongly agreed that video review helped them develop surgical skills. <b><i>Conclusions:</i></b> We found usage across training levels and high perceived utility of our Film Room platform for video review of robotic prostatectomy. Implementation of video review platforms holds promise to augment existing urologic training and should be explored further.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956509","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":"ArtiSential® Clip Applier Use in Robotic Urologic Surgery: Initial Experience and Outcomes.","authors":"Shirin Razdan, Ali Fathollahi, Sanjay Razdan","doi":"10.1177/08927790251372155","DOIUrl":"https://doi.org/10.1177/08927790251372155","url":null,"abstract":"<p><p><b><i>Objective:</i></b> The ArtiSential® clip applier (LivsMed®, San Diego, CA, USA) is a new double-jointed laparoscopic clip applier with 90° wrist articulation. We sought to explore the feasibility of the new clip applier in robotic urologic surgery and compare it with the standard Weck® laparoscopic Hem-o-lok® clip applier. <b><i>Materials and Methods:</i></b> A retrospective review of 100 consecutive robotic urologic surgeries completed using the new clip applier by two surgeons was conducted from August 2024 to January 2025. The surgeries performed were robotic radical prostatectomy (RALP), robotic radical nephrectomy (RARN), and robotic partial nephrectomy (RAPN). Clips were applied during pelvic lymph node dissection in RALP, during ureteral transection in RARN, and during renorrhaphy in RAPN. Both ArtiSential (Group 1) and Hem-o-lok (Group 2) clips were applied during similar portions of the cases, with the latter group acting as a control. The number of successfully deployed clips (no misfires) was recorded and compared between groups. Subjective surgeon and bedside assistant approval was assessed using a dichotomous scale of yes/no for correct clip application. Cognitive load for the bedside assistant using the ArtiSential clip applier was measured using the NASA task load index (TLX). <b><i>Results:</i></b> A total of 340 clips in Group 1 and 360 clips in Group 2 were used. The percent of successful deployments of clips in Group 1 was 97.1% (330/340), while in Group 2 it was 94.4% (340/360) (<i>p</i> < 0.05). Subjective bedside assistant assessment of clip application was 91.2% accuracy in Group 1 (301/330 clips) and 87.6% accuracy in Group 2 (298/340 clips). Subjective surgeon assessment of clip application was 89.1% in Group 1 (294/330 clips) and 83.2% in Group 2 (283/340 clips). The mean NASA-TLX was significantly higher in Group 1 compared with Group 2. There was one reported lymphocele in Group 2. <b><i>Conclusions:</i></b> The ArtiSential clip applier is a double-jointed, multi-articulating laparoscopic clip applier that allows for improved accuracy of clip application when compared to standard Weck Hem-o-lok clip appliers in pelvic and retroperitoneal robotic urologic surgery.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956576","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":"Minimally Invasive Treatments for Posterior Urethral Stenosis.","authors":"Chandler N Hudson, Tiffany Damm, M Francesca Monn","doi":"10.1177/08927790251371037","DOIUrl":"https://doi.org/10.1177/08927790251371037","url":null,"abstract":"<p><p>The objective of this study was to summarize and review literature on treatment methods for stenoses of the posterior urethra. Stenosis of the posterior urethra, particularly of a bladder neck stenosis (BNS) or vesicourethral anastomotic stenosis (VUAS), presents significant clinical challenges, in part owing to the heterogeneity of the patient population and additionally secondary to morbidity of historic definitive treatments. Traditionally, this disease process has been preferentially managed with endoscopic interventions in the form of direct vision internal urethrotomy or dilation, with or without injectables, with variable success rates ranging from 40.0% to 72.0%; however, 90.0% of patients require repeat intervention within the first 2 years. Definitive treatments were often more challenging, requiring joint abdominoperineal approaches, and thus less utilized outside of academic centers with reconstructive urologists. Recent advancements in the endoscopic management of posterior urethral stenosis are synthesized in this review, specifically in populations at increased risk, including those with radiation therapy, transurethral prostate resections, or radical prostatectomy. Herein, a literature review of publications from 2014 to 2024 highlights key endoscopic techniques such as drug-coated balloon dilation and transurethral mucosal realignment aimed at treating BNS and VUAS. These novel techniques demonstrate short-term success rates approaching 85.0% to 90.0%, which represents a significant improvement in success compared with traditional endoscopic therapies. Overall, the current review emphasizes the evolution of minimally invasive treatment options for posterior urethral stenosis, focusing specifically on BNS and VUAS, demonstrating the evolution of the scope of minimally invasive techniques and improved patient outcomes.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956553","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 Between Bedside and Traditional Operative Placement of Ureteral Stent for Acute Obstructive Pyelonephritis: A Retrospective Cohort Study.","authors":"Suvig Dua, Maximilian Fidel, Ryan Ramjiawan, Ken Xing, Gregory Hosier, Premal Patel, David Chung","doi":"10.1177/08927790251370366","DOIUrl":"https://doi.org/10.1177/08927790251370366","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Previous studies have demonstrated the feasibility of bedside placement of ureteral stents in cases of acute ureteral obstruction. However, there is a lack of evidence comparing its efficacy to traditional stent placement in the operating room with fluoroscopy. We compared the clinical outcomes of bedside ureteral stent placement with the current standard of care. <b><i>Methods:</i></b> A retrospective cohort study included patients with acute obstructive pyelonephritis from July 2023 to July 2024. Exclusion criteria included patients not requiring hospital admission, absence of obstructing ureteral calculi, and absence of sepsis criteria. Baseline demographics, including the degree of sepsis and stone characteristics, were measured. Outcomes included time to decompression, successful stent placement, and hospital duration. <b><i>Results:</i></b> A total of 55 patients were included, of which 17 underwent bedside ureteral stenting and underwent operative stent placement. No significant differences were found in baseline demographics, sepsis criteria measures, stone characteristics, or degree of hydronephrosis between the groups. Patients in the bedside group had reduced time to stenting (216.0, Q1-Q3: 4.5-408.5 minutes <i>vs</i> 319.0, Q1-Q3: 174-792 minutes, <i>p</i> = 0.040) and achieved higher rates of urine aspirate retrieval (100% <i>vs</i> 76%, <i>p</i> = 0.028) compared with the operating theater group. There were no statistically significant differences in the stent success rates (100% <i>vs</i> 95%, <i>p</i> = 0.344) or complication rates (0% <i>vs</i> 3%, <i>p</i> = 0.500) between the two groups. <b><i>Conclusions:</i></b> Bedside stent placement offers faster source control and reliable urine aspirate retrieval while maintaining comparable success and complication rates to stenting in the operating theater for patients with obstructive pyelonephritis.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956555","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":"<i>Letter:</i> Comment on \"The Feasibility and Safety of the Glean Urodynamics System: The Modern Urodynamics System Efficacy Study\".","authors":"Wajid Memon, Rachana Mehta, Ranjana Sah","doi":"10.1177/08927790251370363","DOIUrl":"https://doi.org/10.1177/08927790251370363","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855402","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":"Management of Renal Transplant Ureteral Strictures: Versatility of a Robotic-Assisted Approach.","authors":"Hafiz Umair Siddiqui, Dylan Isaacson, Khaled Refaai, Yi-Chia Lin, Krishnamurthi Venkatesh, Alvin Wee, Mohamed Eltemamy","doi":"10.1089/end.2025.0308","DOIUrl":"https://doi.org/10.1089/end.2025.0308","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Ureteral stricture after renal transplantation has a reported incidence of 1.4%-4.7%. This is classically repaired using an open surgical approach. The objective of this case series is to demonstrate the feasibility and effectiveness of robot-assisted repair for ureteral stricture following kidney transplantation. <b><i>Methods:</i></b> Between November 2021 and May 2024, 10 patients underwent robot-assisted repair. Nephrostomy tubes were placed in all patients prior to the robotic repair. Patients were positioned supine with Trendelenburg tilt, and robotic ports were arranged in a W configuration. Indocyanine green was administered through the nephrostomy tube. If necessary, the pre-stented native ureter was identified and dissected. The reconstructive technique was tailored to the location and length of the stricture. Ureteral stents were placed for 4-6 weeks. <b><i>Results:</i></b> Patient demographics transplant characteristics, and details of stricture repair techniques along with associated outcomes were analyzed. Strictures were located at the ureterovesical anastomosis in eight patients, at the ureteropelvic junction in one patient, and at multiple sites in one patient. Repair techniques included ureteroneocystostomy (five patients) and Boari flap reconstruction (two patients). The native ureter was used in three patients (two ureteroureterostomies and one ureteropyelostomy). A bladder hitch was performed in two patients. Median operative time was 255.5 minutes, blood loss was 62 mL, and the hospital stay was 2 days. Postoperative complications occurred in two patients, and five patients required readmission within 30 days. At 3-month follow-up, all patients had excellent renal allograft function (median serum creatinine = 1.63 mg/dL) and were nephrostomy tube- and stent-free. <b><i>Conclusions:</i></b> Robotic repair of ureteral stricture following kidney transplantation is a safe, minimally invasive approach with reduced postoperative pain and shorter hospital stays. This approach should be considered the primary treatment option for renal transplant ureteral strictures and included within the renal transplant surgeons' repertoire of procedures.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775484","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":"Unplanned Health Care Utilization after Ureteroscopy with Ureteral Stenting: Results from the Study to Enhance Understanding of Stent-Associated Symptoms Cohort.","authors":"Brett A Johnson, Jonathan D Harper, Yu-Lun Liu, Hussein R Al-Khalidi, Hal D Kominsky, Rebecca D McCune, Alana C Desai, Ziya Kirkali, Charles D Scales, Naim M Maalouf","doi":"10.1089/end.2024.0805","DOIUrl":"10.1089/end.2024.0805","url":null,"abstract":"<p><p><b><i>Background:</i></b> Urinary stone disease (USD) often necessitates ureteroscopy with ureteral stenting. We assessed the frequency and risk factors associated with unplanned health care utilization related to ureteroscopy with ureteral stenting within 30 postoperative days, using data from the STudy to Enhance uNderstanding of sTent-associated Symptoms (STENTS), a prospective multicenter observational cohort study. <b><i>Methods:</i></b> Demographic, medical, surgical, and postoperative data were collected prospectively across four clinical centers for participants undergoing ureteroscopy for USD. Any utilization of health care (urgent care/emergency room or in-person clinical encounter) within 30 days was assessed for potential relationship to the stone procedure. We used univariable and multivariable logistic regression models to evaluate the associations between potential prespecified covariates and the primary outcome of unplanned encounter (UE). <b><i>Results:</i></b> A total of 484 participants (451 adults) underwent ureteroscopy (424 unilateral and 60 bilateral). Mean age was 49 years, and 47% were female. All postoperative clinical encounters within 30 days were reviewed to determine if they were unplanned and surgery related. Overall, 49 of the participants (10%) had at least one UE within 30 days, and 24/49 (49%) were an emergency room visit and/or hospitalization. Age, race, sex, and previous stone history were not statistically associated with a UE. Participants with a chronic pain condition were three times more likely to have a UE. Surgical duration, use of a ureteral access sheath, stent diameter, or irrigation method did not differ between the groups in a multivariable logistic model. <b><i>Conclusions:</i></b> The prevalence of unplanned health care utilization related to ureteroscopy and stenting for USD in our cohort was 10%. The presence of a chronic pain condition was an independent predictor of a UE. These findings may help identify patients at higher risk of utilizing health care resources following USD surgery and could enable proactive targeted interventions.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"788-793"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}