Journal of endourology最新文献

{"title":"The Small Acute Ureteral Stone Protocol: Clinical Outcomes and Relapse Patterns.","authors":"Conrad Bayley, Patrick Albers, Nicholas Dean, Matthew Mancuso, Dariusz Bochinski, Tim Wollin, Shubha De, Ambikaipakan Senthilselvan, Trevor Schuler","doi":"10.1089/end.2024.0883","DOIUrl":"10.1089/end.2024.0883","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Nephrolithiasis affects approximately 10% of North Americans, placing a significant burden on health care systems. This study evaluates the effectiveness of a novel, virtual Small Acute Ureteral Stone (SAUS) protocol for managing ureteral stones ≤5 mm, aiming to optimize resource utilization and patient care. <b><i>Materials and Methods:</i></b> A retrospective review was conducted on 209 consecutive patients enrolled in the SAUS protocol from June 2018 to May 2019. The protocol included follow-up renal bladder ultrasound and nurse case manager telephone assessment. Patients were followed for a median of 5.4 years, with data collected on stone passage rates, interventions, and long-term outcomes. <b><i>Results:</i></b> The SAUS protocol successfully redirected 53% of patients from urgent clinic visits. Of these, 98% did not necessitate urologic intervention for their small ureteral stone. Overall, 77% of patients showed radiographical confirmation of stone passage, and 74% reported being symptom-free. Only 13% of all patients underwent intervention for their initial ureteral stone. Long-term follow-up revealed that after discharge from our protocol, 67% of patients did not re-present over 5 years, and 90% remained free from urologic intervention. The study's retrospective nature and reliance on electronic medical records may have introduced bias. Patient adherence to follow-up recommendations varied, potentially affecting outcome accuracy. <b><i>Conclusion:</i></b> The SAUS protocol demonstrates effectiveness in virtually managing small ureteral stones, reducing unnecessary clinic visits and interventions. The protocol's success suggests its potential for implementation in similar clinical scenarios, potentially reducing health care costs and improving patient care in urolithiasis management.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":"39 6","pages":"542-548"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475503","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 Comparative Study of Flexible Navigable Vacuum-Assisted Ureteral Access Sheath and Traditional Ureteral Access Sheath in Retrograde Intrarenal Surgery: Evaluating the Impact of Hydronephrosis on Stone-Free Rate and Complications.","authors":"Ozgur Arikan, Erhan Erdogan, Mehmet Erhan Aydin, Ferhat Yakup Suceken, Mehmet Uslu, Ayberk Iplikci, Emre Burak Sahinler, Cahit Sahin, Asif Yildirim, Kemal Sarica","doi":"10.1089/end.2024.0921","DOIUrl":"https://doi.org/10.1089/end.2024.0921","url":null,"abstract":"<p><p><b><i>Background:</i></b> Retrograde intrarenal surgery (RIRS) is a widely used minimally invasive technique for renal stone management. Recently, flexible navigable vacuum-assisted ureteral access sheaths (FV-UASs) have been introduced to enhance RIRS outcomes. This study aimed to evaluate the efficacy of FV-UAS compared with traditional UAS (T-UAS) in RIRS, with a specific focus on the impact of hydronephrosis. <b><i>Methods:</i></b> A retrospective multicenter study was conducted involving 207 patients undergoing RIRS for renal stones. Patients were divided into two groups based on the type of UAS used: FV-UAS (<i>n</i> = 105) or T-UAS (<i>n</i> = 102). Demographic data, stone characteristics, operative time, complications, and stone-free rates (SFRs) were analyzed. The degree of hydronephrosis was assessed using the Society of Fetal Urology grading system. <b><i>Results:</i></b> The FV-UAS group demonstrated significantly shorter operative times (median: 50 minutes <i>vs</i> 57.5 minutes, <i>p</i> = 0.039) and a higher SFR at 1-week postoperatively (47.6% <i>vs</i> 23.5%, <i>p</i> < 0.001) compared with the T-UAS group. However, there was no significant difference in SFR at 1 month (75.2% <i>vs</i> 68.6%, <i>p</i> = 0.290). Postoperative fever was significantly lower in the FV-UAS group (3.8% <i>vs</i> 18.6%, <i>p</i> = 0.001). Importantly, the degree of hydronephrosis did not significantly impact the outcomes that performed RIRS with FV-UAS. <b><i>Conclusion:</i></b> FV-UAS offers potential advantages over T-UAS in RIRS, including shorter operative times, improved early stone-free status, and reduced postoperative complications. Hydronephrosis did not appear to affect the efficacy of FV-UAS. These findings suggest that FV-UAS may be a valuable tool in optimizing RIRS outcomes.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187068","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":"Ureteral Stone Impaction with Its Possible Effects on the Outcomes of Endoscopic Management in Children: A Critical Evaluation with an Emphasis on Ureteral Wall Thickness.","authors":"Ali Sezer, Bilge Turedi, Emre Bulbul, Hikmet Yasar, Kemal Sarıca","doi":"10.1089/end.2024.0862","DOIUrl":"https://doi.org/10.1089/end.2024.0862","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Ureteral stone impaction can significantly affect the success of ureteroscopy (URS) in children. While the factors predicting impaction have been well studied in adults, data in children are limited. This study aimed to identify factors that predict ureteral stone impaction in children undergoing URS and to compare the success rates and complications based on the stone impaction status. <b><i>Patients and Methods:</i></b> Pediatric patients undergoing URS for ureteral stones were retrospectively reviewed. Impaction status of the stones was evaluated by radiological parameters and the children were divided into two groups based on the presence of stone impaction. Peri- and postoperative findings were comparatively evaluated in patients with or without stone impaction. <b><i>Results:</i></b> A total of 102 pediatric patients were included (40 with impacted stones, 62 with nonimpacted ureteral stones). The mean age was 9.3 ± 5.3 years. Univariate analysis showed significant differences between the groups in degree of hydronephrosis, presenting symptoms, stone density (HU), stone size, upper ureteral diameter, and that of ureteral wall thickness (UWT) (<i>p</i> = 0.004, <i>p</i> = 0.044, <i>p</i> = 0.033, <i>p</i> = 0.005, <i>p</i> = 0.012, <i>p</i> = 0.000, respectively). Multivariate analysis revealed UWT as the only independent predictor of stone impaction, with a cutoff value of 2.63 mm showing 83% sensitivity and 82% specificity (<i>p</i> = 0.000). The highest UWT value in the nonimpacted stone group was 3.1 mm. The mean operation time was found to be significantly longer in cases with impacted stones (<i>p</i> = 0.000). Kids with impacted stones had lower mean success rate (impacted = 70%, nonimpacted = 88.7%) and higher mean rate of complications, longer duration of DJ-stenting, more anesthesia sessions (<i>p</i> = 0.018, <i>p</i> = 0.019, <i>p</i> = 0.000 and <i>p</i> = 0.000, respectively). <b><i>Conclusions:</i></b> Similar to the adult cases, UWT could be used as a reliable parameter in predicting the impaction status of ureteral stones in pediatric patients. Impacted ureteral stones may reveal decreased success and higher complications rates during and after endoscopic stone surgery in these cases.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187069","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":"High-Power Lasers Induce Dose-Dependent Acute Kidney Injury.","authors":"Mantu Gupta, Kavita Gupta, Roman Shimonov, Raymond Khargi, Anna Ricapito, Blair Gallante, Christopher Connors, Dara Lundon, Manishkumar Patel, Seunghee Kim-Schulze, William Atallah, Natasha Kyprianou, Alan J Yaghoubian","doi":"10.1089/end.2025.0036","DOIUrl":"https://doi.org/10.1089/end.2025.0036","url":null,"abstract":"<p><p><b><i>Introduction and Objective:</i></b> High-powered lasers have been hypothesized to cause kidney injury; however, no human studies have confirmed or quantified this damage. Our objective was to identify and quantify damage and explore factors affecting degree of injury in patients undergoing retrograde intrarenal surgery (RIRS) with thulium fiber laser (TFL) and Holmium:YAG (Ho:YAG) lasers. <b><i>Methods:</i></b> Patients undergoing RIRS for unilateral nonobstructing renal stones were randomized to receive lithotripsy with either a 60 W SuperPulse TFL or 120 W pulse-modulated Ho:YAG laser. A control group of patients undergoing RIRS without laser use were used for comparison. Urine samples were collected at 3 time points as follows: preoperative, 1 hour postoperative, and 10 days postoperative. Samples were analyzed using ELISA for key biomarkers-kidney injury molecule-1, neutrophil gelatinase-associated lipocalin (NGAL), and β2-microglobulin-normalized to urine creatinine. Primary outcome was the extent of renal injury based on biomarker elevation. <b><i>Results:</i></b> Ninety-one patients with similar baseline patient and stone characteristics were randomized (46 TFL, 45 Ho:YAG). Both lasers led to significant biomarker elevation, which trended toward but did not reach baseline by postoperative day 10. The Ho:YAG laser resulted in a sustained increase in NGAL at 10 days. Multivariate analysis demonstrated that injury is dose dependent on total laser energy used (<i>p</i> < 0.001, <i>p</i> = 0.006) and worse in older patients (<i>p</i> = 0.009) and in those with metabolic syndrome (<i>p</i> = 0.002), with slower recovery in both these groups, but not with the type of laser used. Multiple levels of the nephron are involved. <b><i>Conclusions:</i></b> There is notable kidney injury induced by both SuperPulse TFL and pulse-modulated Ho:YAG lasers in a dose-dependent manner, but the 2 lasers do not differ in the degree of injury. Injury occurs at multiple levels. Age and metabolic syndrome affect the amount of injury and recovery from injury. Further studies evaluating factors that can mitigate damage from high-energy lasers are needed.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181803","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 Evolution of Percutaneous Nephrolithotripsy - An Overview from European Association of Urology Endourology Section.","authors":"Ali Talyshinskii, Lazaros Tzelves, Patrick Juliebø-Jones, B M Zeeshan Hameed, Yerzhan Sharapatov, Olivier Traxer, Bhaskar Kumar Somani","doi":"10.1089/end.2024.0910","DOIUrl":"https://doi.org/10.1089/end.2024.0910","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> While reviews and book chapters focus on certain aspects of evolution and perhaps key milestones, a comprehensive overview of the history and evolution of percutaneous nephrolithotomy (PCNL) is lacking. This review looks at different aspects of PCNL evolution with procedural and technological advancements, with specific aspects of history, positioning, imaging and puncture, tract dilation, miniaturization, and lithotripsy devices. <b><i>Material and Methods:</i></b> We conducted a thorough search in October 2024 across multiple databases, social media platforms, and Google with specific terms and Boolean operators to determine the main dates for the development of individual PCNL stages. To be more specific, the main focus was on identifying chronological events that led to the evolution of PCNL with respect to these six categories: (1) history of PCNL; (2) patient positioning; (3) imaging and puncture; (4) tract dilation; (5) nephroscope size; and (6) lithotripsy devices. <b><i>Results:</i></b> All six aspects that have been investigated have undergone significant changes, leading to the modernization of PCNL in the 21st century. There is a trend toward supine position, miniaturization of instruments, an increase in image quality, the active development of various imaging modalities, and the integration of various digital and prototyping technologies. There are tools to help with puncture and needle guidance, as well as the emergence of navigation and robotic systems. Tract dilation seems to move toward single-step approach rather than serial dilatation. Major discoveries in energy sources such as lasers have now been incorporated into lithotripsy for PCNL. <b><i>Conclusion:</i></b> The modernization of PCNL has been a result of multiple evolutions along its journey, from imaging advancements, lithotripsy devices, miniaturization, learning from cross-disciplinary techniques, and digital integration with the use of virtual and augmented reality. While the journey continues to evolve, we summarize the key milestones that have led to the current clinical standard of practice.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174113","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":"Effect of Pulse Modulation on Diode-Pumped Laser Lithotripsy.","authors":"Nitesh Katta, Katherine Sikorski, Joel M H Teichman, Thomas E Milner","doi":"10.1089/end.2024.0733","DOIUrl":"https://doi.org/10.1089/end.2024.0733","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> This study addresses pulse modulation for kidney stone lithotripsy using diode-pumped thulium yttrium aluminum garnet (Tm:YAG, λ = 2.02 µm) and thulium fiber lasers (TFLs, λ = 1.94 µm). Three research questions were investigated: (1) What are the effects of varying pulse duration and energy of the first pulse and varying the interpulse delay in a pulse modulation sequence to increase energy transfer across saline to a stone? (2) Does an optimal pulse modulation profile exist in a single-pulse sequence to provide highest percent radiant energy transfer? (3) Does a higher effective energy transfer to the stone using pulse modulation produce greater stone volumetric removal? <b><i>Materials and Methods:</i></b> We measured radiant energy transmission efficiency (RETE) and ablation volumes in phantom and human stones. RETE was utilized to compare the pulse energy transmission through air and saline media. We recorded fast camera traces and vapor bubble collapse pressures. Craters were created at fiber standoff distances (SDs) of 0.0 mm, 0.5 mm, and 1.0 mm, and volumes were measured using optical coherence tomography. <b><i>Results:</i></b> For Tm:YAG laser irradiation, dual-pulse mode significantly increased RETE by as much as 75% at 1 mm SD compared with single-pulse mode. With the Tm:YAG laser, an optimal \"dual-pulse\" modulation resulted in greater volumetric removal compared with a \"single-pulse\" across all stone cohorts (<i>p</i> < 0.05) except for calcium oxalate monohydrate stones (<i>p</i> = 0.38) at a 1 mm SD. TFL yielded similar results, but showed heterogeneity across stone compositions. <b><i>Conclusions:</i></b> Pulse-modulated diode-pumped Tm:YAG and TFL can deliver higher photon count through a saline layer if the first pulse is optimized. An optimal pulse modulation profile where the second pulse is synchronized with the vapor bubble dynamics of the first pulse results in the highest percent RETE and increased stone volumetric removal.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150580","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":"Safety and Efficacy of Fluoroscopy-Free Technique During Retrograde Intrarenal Surgery for Renal Stones: A Prospective, Randomized, Controlled, Noninferiority Trial.","authors":"Abul-Fotouh Ahmed, Ahmed ElShazly, Abdullah Daoud, Hassan Abdelazim, Mohammed AlGammal","doi":"10.1089/end.2025.0120","DOIUrl":"https://doi.org/10.1089/end.2025.0120","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Fluoroscopy-free (FF) retrograde intrarenal surgery (RIRS) presents a promising alternative to fluoroscopy-guided (FG) RIRS to reduce radiation exposure in endourology. This study aimed to assess the noninferiority of FF-RIRS compared with FG-RIRS regarding safety and efficacy. <b><i>Patients and Methods:</i></b> A prospective, randomized trial was conducted at a tertiary care center from November 2021 to June 2024. Adult patients with renal stones (10-30 mm) eligible for RIRS were randomized to either the FF-RIRS group (direct endoscopic visualization) or the FG-RIRS group. The primary endpoint was the stone-free rate (SFR), with secondary outcomes including stone size reduction, fluoroscopy use in FF-RIRS, operative time, hospital stay, reintervention, and complication rates. <b><i>Results:</i></b> The final analysis included 253 patients in the FF-RIRS group and 249 in the FG-RIRS group. The mean age was 41.3 ± 12.3 years, and the mean stone size was 16.5 ± 3.2 mm. In the FF-RIRS group, 214 procedures (84.6%) were performed without fluoroscopy, whereas 39 (15.4%) required fluoroscopy because of intraoperative challenges. Regression analysis identified multiple stones and congenital renal anomalies as predictors for fluoroscopy use. SFRs were comparable between groups (zero residual fragments [RF]: 54.9% vs. 51.0%, no RF >2 mm: 70.4% vs. 69.1%, no RF >4 mm: 79.4% vs. 82.3%) (<i>p</i> > 0.05). For SFR defined as no RF >4 mm, FF-RIRS demonstrated noninferiority with a -10% margin (p = 0.021). Furthermore, per-protocol analysis confirmed noninferiority (<i>p</i> = 0.002), with nearly equal SFRs (82.7% vs. 82.3%, <i>p</i> = 0.914). Stone size reduction, operative time, hospital stay, reintervention, and complication rates were similar between groups, with no serious adverse events. <b><i>Conclusions:</i></b> FF-RIRS is a safe and effective alternative to FG-RIRS for selected patients. Its safety and efficacy are noninferior to FG-RIRS in direct comparison. However, fluoroscopy should remain available as a backup, especially in complex cases, to ensure optimal outcomes and patient safety.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022056","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> Letter to the Editor for \"Trifecta of Same-Day Discharge after Single-Port Robotic-Assisted Simple Prostatectomy\".","authors":"Ranjana Sah, Shubham Kumar, Rachana Mehta, Amogh Verma","doi":"10.1089/end.2025.0229","DOIUrl":"https://doi.org/10.1089/end.2025.0229","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012189","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":"Effect of Using Automated Irrigation Systems on the Risk of Infectious Complications after Endoscopic Combined Intrarenal Surgery: A Retrospective Cohort Study.","authors":"Chatporn Boonyapalanant, Rei Unno, Kazumi Taguchi, Sousuke Niwa, Koei Tori, Yasuhito Sue, Takahiro Yanase, Masahiko Isogai, Ryosuke Chaya, Tomoki Okada, Kengo Kawase, Teruaki Sugino, Shuzo Hamamoto, Atsushi Okada, Takahiro Yasui","doi":"10.1089/end.2024.0758","DOIUrl":"https://doi.org/10.1089/end.2024.0758","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Endoscopic combined intrarenal surgery (ECIRS) is a treatment option for kidney stones comparable with other standard methods. One reported complication of ECIRS is infection associated with high intrarenal pressure (IRP), and the irrigation system is an important factor affecting the IRP. Therefore, this study aimed to compare the operative outcomes and infectious complications between manual and gravity irrigation and automated irrigation systems for ECIRS. <b><i>Materials and Methods:</i></b> This single-center, retrospective cohort study enrolled patients who underwent ECIRS between January 2016 and August 2021. We compared operative results and complications between the two irrigation systems, and a multivariate analysis was performed to identify the factors associated with each outcome. <b><i>Results:</i></b> A total of 294 patients were enrolled in this study. The operative time was significantly longer in the manual and gravity irrigation group than in the automated irrigation group (122 ± 45 <i>vs</i> 108 ± 37 minutes, <i>p</i> = 0.003). Postoperative fever occurred in 25% of the patients in the manual and gravity group compared with 10% in the automated group (<i>p</i> < 0.001). In multivariate analysis, the use of a manual and gravity irrigation system was a significant factor associated with postoperative fever (<i>p</i> = 0.001) and longer operative time (<i>p</i> < 0.001). <b><i>Conclusions:</i></b> Using an automated irrigation system for flexible ureteroscopy in ECIRS reduces the risk of postoperative fever and the operative time.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969512","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":"https://doi.org/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":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-12","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}