Journal of endourology最新文献

{"title":"Increased Risk of Kidney Stones in Transgender Women and Gender-Diverse Adults on Gender-Affirming Hormone Therapy: Insights from a Large Database Study.","authors":"Eve Frangopoulos, Ziv Savin, Kavita Gupta, Vinay Durbhakula, Blair Gallante, William M Atallah, Mantu Gupta","doi":"10.1177/08927790251363612","DOIUrl":"https://doi.org/10.1177/08927790251363612","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Transgender and gender-diverse (TGD) individuals represent a growing yet underrepresented group in medical literature. Estrogen and antiandrogens are essential in feminizing gender-affirming hormone therapy (f-GAHT) for individuals assigned male at birth (AMAB). This study examines f-GAHT effects on <i>de novo</i> nephrolithiasis risk in TGD individuals AMAB. <b><i>Methods:</i></b> This big data study utilizes medical records from the National Institutes of Health's <i>All of Us</i> database. The cohort includes patients AMAB who self-identified as non-binary, female, transgender women or had a relevant gender diagnosis. The cohort was divided into f-GAHT and non-f-GAHT groups. Cumulative incidence was calculated for each group. Participants were subdivided into estrogen-only f-GAHT (e-f-GAHT) and combined estrogen and antiandrogen f-GAHT (c-f-GAHT) groups. Univariate, unweighted multivariate, and weighted propensity score multivariate analyses were used to explore the association between nephrolithiasis and GAHT. <b><i>Results:</i></b> A total of 777 patients AMAB met our inclusion and exclusion criteria. The cumulative incidences of kidney stones were 10.3% and 4.8% in the f-GAHT and non-f-GAHT groups, respectively (<i>p</i> = 0.01). Kidney stone odds were 2.53 and 2.76 times greater in the unweighted and weighted regressions for f-GAHT compared with non-f-GAHT patients (<i>p</i> = 0.044 and <i>p</i> < 0.001, respectively). C-f-GAHT was associated with kidney stones in a weighted model (odds ratio [OR]: 2.63, 95% confidence interval [CI]: 1.44, 4.97, <i>p =</i> 0.002), whereas e-f-GAHT was not (OR = 1.88, 95% CI: 0.85, 4.32, <i>p</i> = 0.13). <b><i>Conclusions:</i></b> We observed a greater <i>de novo</i> incidence of nephrolithiasis among patients on f-GAHT. Antiandrogen therapy may work synergistically with estrogen to increase nephrolithiasis risk. Patients AMAB should be counseled about increased risk when starting f-GAHT, particularly if antiandrogens are included.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742245","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":"Single-Center Experience of Robot-Assisted Nephrectomy and Venous Tumor Thrombectomy: Indications, Surgical Strategies, and Long-Term Outcomes.","authors":"Qingbo Huang, Kan Liu, Cheng Peng, Zhi Li, Xinran Chen, Qilong Jiao, Qingjiang Xu, Jialong Song, Zhuo Jia, Liangyou Gu, Shichao Li, Guodong Zhao, Shuanglei Li, Haiyi Wang, Xiaohui Ding, Qiuyang Li, Feng Duan, Hauchun Khoo, Baojun Wang, Xu Zhang, Xin Ma","doi":"10.1177/08927790251363235","DOIUrl":"10.1177/08927790251363235","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> To introduce the indications and surgical strategies of robot-assisted nephrectomy and venous tumor thrombectomy (RA-N-VTT) and to assess the long-term outcomes in a high-volume, single-center setting. <b><i>Materials and Methods:</i></b> We retrospectively enrolled 309 patients with renal tumors and venous tumor thrombus who underwent a robotic procedure in our center between June 2013 and December 2023. To better define the indications and surgical strategies for RA-N-VTT, we proposed the Chinese People's Liberation Army General Hospital (PLAGH) classification system, incorporating three modifications to the Mayo Clinic classification system. Specifically, thrombus within the left renal vein was divided into levels 0a and 0b based on the landmark of superior mesenteric artery. Retrohepatic inferior vena cava thrombus was reclassified using the first and second portal hepatis as landmarks. In addition, level IV thrombus was subclassified into levels IVa and IVb, depending on whether it entered the atrium. Long-term perioperative surgical and survival outcomes were analyzed. <b><i>Results:</i></b> All operations were effectively completed, except for six patients converted to open procedure. There were significant differences in perioperative outcomes among patients with different PLAGH levels of thrombus (<i>p</i> < 0.001). With a median follow-up of 47.8 months, the median overall survival (OS) and progress-free survival of all patients were 75.4 and 44.7 months, respectively. Multivariable analysis identified that distant metastasis and tumor grade were independent risk factors for OS, as well as PLAGH classification (<i>p</i> < 0.05). <b><i>Conclusions:</i></b> Our results indicated that RA-N-VTT is safe and feasible. The PLAGH classification system effectively guides robotic surgical planning and provides acceptable surgical and survival outcomes in selected patients.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731590","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 \"Is Outpatient Totally Tubeless Standard Percutaneous Nephrolithotomy Safe and Efficacious?\"","authors":"Guglielmo Mantica, Francesco Chierigo","doi":"10.1177/08927790251363553","DOIUrl":"https://doi.org/10.1177/08927790251363553","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Outcomes of Robot-Assisted Partial Nephrectomy with MP1000 Surgical System <i>vs</i> da Vinci Xi Surgical System and Evaluation of the MP1000 Learning Curve.","authors":"Honglei Wang, Ziyu Dong, Radheshyam Gupta, Tao Xu, Jianzhang Li, Dexin Ding, Yangyang Xu, Lichen Teng, Pengyu Guo, Jinqiao Li, Yongliang Sun, Yuchen Bao, Ziqi Wang, Wanhai Xu","doi":"10.1089/end.2024.0870","DOIUrl":"https://doi.org/10.1089/end.2024.0870","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To compare the perioperative outcomes between the MP1000 and da Vinci Xi surgical systems in robot-assisted partial nephrectomy (RAPN) and examine the MP1000 learning curve. <b><i>Methods:</i></b> In this prospective single-center study, 90 patients undergoing RAPN were equally allocated to the MP1000 (<i>n</i> = 45) or da Vinci Xi (<i>n</i> = 45) groups. Perioperative outcomes were analyzed, and the learning curve was assessed for MP1000 group operative times. <b><i>Results:</i></b> All procedures were completed without positive surgical margins. Significant discrepancies were observed in operation time, docking time, and estimated blood loss (<i>p</i> < 0.05). Postoperative estimated glomerular filtration rate (day 2), length of stay, and complication rate showed no significant differences. The cumulative sum curve was best fit by the equation <math><mrow><mo> </mo><mi>y</mi><mo>=</mo><mo>-</mo><mn>0.0002</mn><mrow><msup><mrow><mi>x</mi></mrow><mn>4</mn></msup></mrow><mo>+</mo><mn>0.0568</mn><mrow><msup><mrow><mi>x</mi></mrow><mn>3</mn></msup></mrow><mo>-</mo><mn>3.6013</mn><mrow><msup><mrow><mi>x</mi></mrow><mn>2</mn></msup></mrow><mo>+</mo><mn>69.011</mn><mi>x</mi></mrow></math>, and <math><mrow><mrow><msup><mrow><mi>R</mi></mrow><mn>2</mn></msup></mrow><mo>=</mo><mn>0.8806</mn></mrow></math>, with peak at case 13, and is subsequently delineated into a learning group (1-13 cases) and a skilled group (14-45 cases). The two groups exhibited comparable baseline characteristics. <b><i>Conclusion:</i></b> The MP1000 system is effective for partial nephrectomies, with all cases completed effectively. Meanwhile, surgeons with prior experience using the da Vinci Xi system achieve proficiency with the MP1000 after 13 procedures.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718002","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> Reply to Letter to the Editor on \"Trifecta of Same-Day Discharge after Single-Port Robotic-Assisted Simple Prostatectomy\".","authors":"Hakan Bahadir Haberal, Luca Lambertini, Matteo Pacini, Giulio Avesani, Fabio Maria Valenzi, Muhannad Aljoulani, Ruben Calvo Sauer, Juan Ramon Torres-Anguiano, Simone Crivellaro","doi":"10.1177/08927790251363253","DOIUrl":"https://doi.org/10.1177/08927790251363253","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715083","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":"Illuminating Gaps in Laser Education in Urology Residency Programs.","authors":"Kyle R DeRoma, Raymond Lanzafame, Greg Adey, Lori B Lerner","doi":"10.1177/08927790251360267","DOIUrl":"https://doi.org/10.1177/08927790251360267","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Urologists utilize numerous laser technologies. The American Urological Association (AUA) has an online laser education module, but no standardized program curriculum is required. We sought to understand gaps in knowledge surrounding laser technologies in the AUA New England (NE) Section to inform decisions around the annual Residents Skills Course and overall resident education. <b><i>Methods:</i></b> An anonymous questionnaire assessing basic laser information and attitudes was created. All academic urology training programs in NE (<i>n</i> = 12) were invited. Responders were encouraged to give their best guess rather than confer or look up answers. <b><i>Results:</i></b> A total of 62% of residents (<i>n</i> = 72) and 62 attendings from the 12 NE programs participated. The most common laser technology uses were nephrolithiasis, urothelial cancer, prostate, strictures, and skin. Faculty varied as regards which diseases residents should apply lasers, be trained in, and show competence. Residents felt less confident in their baseline knowledge as compared with attendings, but most in both groups rated their knowledge lower after completing the questionnaire. Knowledge of the nominal optical hazard distance for each wavelength was negligible. Some respondents could not differentiate between laser wavelength, depth of penetration, Joules, Hertz, or Watts; and very few could explain the difference between standard holmium and Moses, and thulium (solid state) <i>vs</i> thulium fiber. <b><i>Conclusions:</i></b> Gaps in knowledge surrounding laser technologies are significant. Urologists acknowledge deficiencies, yet only 25% to 32% are very likely to seek information on their own. Standardized laser education that is frequently updated and delivered will improve overall knowledge and reduce the risk for patient harm.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini-Endoscopic Combined Intrarenal Surgery <i>vs</i> Percutaneous Nephrolithotomy in the Management of Complex Nephrolithiasis: A Randomized Controlled Trial.","authors":"Ahmed Mohamed Tawfeek, Ahmed Higazy, Moatazbellah Mohamed Elkenany, Khaled Taema, Hisham Arafa","doi":"10.1177/08927790251360265","DOIUrl":"https://doi.org/10.1177/08927790251360265","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate mini-endoscopic combined intrarenal surgery (mECIRS) <i>vs</i> percutaneous nephrolithotomy (PCNL) in managing complex renal stones. <b><i>Material and Methods:</i></b> A randomized controlled study was conducted at our tertiary center between July 2022 and July 2024, involving 100 patients with complex renal stones who were randomly allocated for PCNL or mECIRS. The stone burden was determined based on Guy's score using a non-contrast computed tomography of the urinary tract; patients with Guy's Stone Score of III or IV were included in our study. Our primary objective was to assess grade A single session stone-free rate (SS-SFR) in both procedures after 1 month, defined as no stone residual after a single session procedure. Secondary outcomes included grade A (≤2 mm residual), Grade C (2.1-4 mm residual), and overall SFRs, complication rates (per Clavien-Dindo classification), operative time, fluoroscopy time, hospital stay, and overall cost. <b><i>Results:</i></b> Patient and stone characteristics were similar in both groups. Grade A SS-SFR revealed a statistically significant difference in favor of the mECIRS group compared with the PCNL group (51% <i>vs</i> 32.6%, respectively, <i>p</i>-value = 0.0275). However, the final grade A SFR after auxiliary procedures was comparable (40.8% for the PCNL group compared with 51% for the ECIRS group, <i>p</i>-value = 0.557). The mECIRS showed a less operative and fluoroscopy time. The complication rate was 38.77% <i>vs</i> 14.28% in the PCNL and mECIRS, respectively, where it was higher in the former, with a statistically significant value (<i>p</i>-value = 0.006). The mECIRS group experienced shorter hospital stay and comparable cost-effectiveness. <b><i>Conclusion:</i></b> mECIRS is effective and safe in managing patients with complex renal stones in a single session with fewer comorbidities than standard PCNL. The study was registered at Clinicaltrial.gov with a registration number: NCT06085794.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667731","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> Beyond Diabetes Diagnosis: Does Perioperative Glycemic Control Predict Urosepsis Better?","authors":"Mi Zhou, Renjie Zhou, Xin Zhu","doi":"10.1177/08927790251360251","DOIUrl":"https://doi.org/10.1177/08927790251360251","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637123","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 Stents in the Management of Pediatric Urolithiasis: A Systematic Review.","authors":"Qibo Hu, Hongbo Liu, Kai Chen, Weifeng Yang, Wei Ru, Xiang Yan","doi":"10.1089/end.2024.0442","DOIUrl":"https://doi.org/10.1089/end.2024.0442","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Ureteral stents are extensively utilized in the treatment of urolithiasis. Given the anatomical and physiological differences between children and adults, the rational, effective, and safe application of ureteral stents in pediatric patients is a matter of significant clinical interest. This review summarizes the classification, application scenarios, and potential adverse effects of ureteral stents in pediatric urolithiasis, aiming to provide a reference for clinical decision-making related to ureteral stents in children with urinary tract stones. <b><i>Materials and Methods:</i></b> A systematic review was conducted by searching PubMed, Embase, and Cochrane with the keywords \"ureteral stent,\" \"urolithiasis,\" and \"pediatric\" up to June 4, 2024. The review exclusively included comparative trials. Information regarding patient medical records and treatment efficacy were meticulously extracted. <b><i>Results:</i></b> For uncomplicated cases, routine placement of ureteral stents before and after extracorporeal shock wave lithotripsy, ureteroscopic lithotripsy, percutaneous nephrolithotomy, and open stone surgery do not confer significant clinical benefits. Selective stent placement is recommended for complex cases with intraoperative ureteral injury, ureteral stricture, anatomical or functional solitary kidney, or renal impairment. Novel ureteral stents have shown promise in reducing stent-related complications, avoiding secondary anesthesia, and decreasing health care-related costs. <b><i>Conclusions:</i></b> Currently, there is no consensus on the indications for ureteral stent placement in children in clinical practice. Urologists should selectively place ureteral stents based on the medical center's conditions, the child's condition, and intraoperative findings. The future development direction of ureteral stents is to improve the postoperative quality of life of patients, reduce stent-related complications, and facilitate stent removal.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600640","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> Editorial Comment on MONARCH™ Robotic-Assisted Combined Mini-Percutaneous Nephrolithotomy and Flexible Ureteroscopic Lithotripsy: A Step-By-Step Guide.","authors":"Heather Benz, Jaime Connelly, Raymond Fryrear","doi":"10.1177/08927790251359653","DOIUrl":"https://doi.org/10.1177/08927790251359653","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608557","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}