Journal of endourology最新文献

{"title":"Still Using Only ChatGPT? The Comparison of Five Different Artificial Intelligence Chatbots' Answers to the Most Common Questions About Kidney Stones.","authors":"Mehmet Fatih Şahin, Erdem Can Topkaç, Çağrı Doğan, Serkan Şeramet, Rıdvan Özcan, Murat Akgül, Cenk Murat Yazıcı","doi":"10.1089/end.2024.0474","DOIUrl":"10.1089/end.2024.0474","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate and compare the quality and comprehensibility of answers produced by five distinct artificial intelligence (AI) chatbots-GPT-4, Claude, Mistral, Google PaLM, and Grok-in response to the most frequently searched questions about kidney stones (KS). <b><i>Materials and Methods:</i></b> Google Trends facilitated the identification of pertinent terms related to KS. Each AI chatbot was provided with a unique sequence of 25 commonly searched phrases as input. The responses were assessed using DISCERN, the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P), the Flesch-Kincaid Grade Level (FKGL), and the Flesch-Kincaid Reading Ease (FKRE) criteria. <b><i>Results:</i></b> The three most frequently searched terms were \"stone in kidney,\" \"kidney stone pain,\" and \"kidney pain.\" Nepal, India, and Trinidad and Tobago were the countries that performed the most searches in KS. None of the AI chatbots attained the requisite level of comprehensibility. Grok demonstrated the highest FKRE (55.6 ± 7.1) and lowest FKGL (10.0 ± 1.1) ratings (<i>p</i> = 0.001), whereas Claude outperformed the other chatbots in its DISCERN scores (47.6 ± 1.2) (<i>p</i> = 0.001). PEMAT-P understandability was the lowest in GPT-4 (53.2 ± 2.0), and actionability was the highest in Claude (61.8 ± 3.5) (<i>p</i> = 0.001). <b><i>Conclusion:</i></b> GPT-4 had the most complex language structure of the five chatbots, making it the most difficult to read and comprehend, whereas Grok was the simplest. Claude had the best KS text quality. Chatbot technology can improve healthcare material and make it easier to grasp.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"1172-1177"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107986","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":"First Worldwide Multicentric Series of Mini-Ecirs in Children: Outcomes from Two Tertiary Endourology Centers.","authors":"Yesica Quiroz, Stefania Ferretti, Davide Campobasso, Claudia Gatti, Francesca Caravaggi, Rocio Jiménez, Erika Llorens, Anna Bujons","doi":"10.1089/end.2024.0168","DOIUrl":"10.1089/end.2024.0168","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Endoscopic combined intrarenal surgery (ECIRS) is a combination of both retrograde and antegrade approaches for treatment of large or complex renal stones in one procedure, that are currently being treated with multiple tracts or sessions of percutaneous nephrolithotomy, increasing the complications. The aim of our study is to describe the clinical outcomes of Mini-ECIRS in a pediatric population. <b><i>Material and Methods:</i></b> A retrospective study was performed in pediatric patients with lithiasis disease treated with mini-ECIRS between 2006 and 2023 in 2 referral centers in Europe. Demographic data, clinical data, stone size and location, laser settings, intraoperative variables, stone-free rate (SFR) and complications were collected. Pearson's chi-squared test, Fisheŕs test and logistic regression, were performed. <b><i>Results:</i></b> A total of 32 mini-ECIRS were included. The mean age was 9,8 years, 56.3% girls. The mean size and volume of the stone were 21.5mm and 3298, 2mm³, 53.1% were multiple. Ureteral access sheath was used in 93.8% of the surgeries and only 37.5% had preoperative JJ stent. 53.1% of percutaneous access were with 14 Fr sheath. High power laser was the most frequent energy source for lithotripsy, including thulium fiber laser. The mean operative time was 166,6 minutes. There was one perforation of the collecting system that was managed with JJ stent and in the postoperative period 81.2% of the patients had no complications. Three presented fever, 1 developed urinary sepsis, and 1 required reintervention. The SFR was 75% and the size, volume, hardness, and complexity of the lithiasis, as well as the non-use of lithotripsy in the retrograde approach were statistically significant in decreasing the success of the surgery. <b><i>Conclusions:</i></b> ECIRS is a feasible, safe, and efficient procedure in children with complex renal lithiasis, decreasing the number of procedures needed for stone free. Multicenter studies are required to validate these results on a population scale.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"1141-1147"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975771","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":"Miniaturization: The Way to Go.","authors":"Pankaj N Maheshwari","doi":"10.1089/end.2023.0644","DOIUrl":"10.1089/end.2023.0644","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"e1234"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89718442","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":"Pharmacological Modulation of Intrarenal Pressure in a Porcine Model Using a Novel Isoprenaline-Eluting Guidewire.","authors":"Jeff John, Mark Wellman, Tracy Kellermann, Kamil Kopeć, Tomasz Ciach, Graham Fieggen, Lisa Kaestner, John Lazarus","doi":"10.1089/end.2024.0348","DOIUrl":"10.1089/end.2024.0348","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Several complications of retrograde intrarenal surgery have been attributed to inadvertent increases in intrarenal pressure. We recently described the development of an innovative isoprenaline-eluting guidewire (IsoWire). The objective of this study was to investigate the impact of this IsoWire on the intrarenal pressure and evaluate its safety. <b><i>Materials and Methods:</i></b> This study was performed in 17 renal units using a porcine model. As controls, the intrarenal pressure, heart rate, and mean arterial pressure were measured for a duration of six minutes with a standard guidewire placed in the renal pelvis. For the experiment, the conventional guidewire was substituted with the IsoWire and the same parameters were measured. Blood samples were taken at one-minute intervals to measure plasma isoprenaline levels. This procedure was repeated on the opposite side. <b><i>Results:</i></b> The mean intrarenal pressure reduction was 29% (95% CI: 13%-53%). The mean isoprenaline effect time was 174 seconds. No changes in heart rate (<i>p</i> = .908) or mean arterial pressure (<i>p</i> = .749) were recorded after IsoWire insertion. Plasma isoprenaline levels were below the quantitation threshold. Isoprenaline concentrations in the plasma were below the quantification threshold. Ureteroscopy revealed no ureteral lesions. <b><i>Conclusions:</i></b> The IsoWire demonstrated a safe and effective reduction of intrarenal pressure. Additional research is necessary to determine whether ureteral smooth muscle relaxation generated by isoprenaline facilitates easier insertion of a ureteral access sheath, decreases the incidence of ureteral access sheath related ureteral lesions, or even encourage the practice of sheathless retrograde intrarenal surgery.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"1185-1191"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603732","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":"Construction of a Risk Prediction Model for Ureteral Stricture after Ureteroscopic Holmium Laser Lithotripsy.","authors":"Ping Li, Kangning Wang, Lin Luo, Qingzhi Xie, Yunchou Wu, Qiuling Liao","doi":"10.1089/end.2023.0638","DOIUrl":"10.1089/end.2023.0638","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> To analyze the influencing factors of ureteral stenosis after ureteroscopic holmium laser lithotripsy. <b><i>Methods:</i></b> The clinical data of 427 patients treated with ureteroscopic holmium laser lithotripsy were selected, and the patients were divided into two groups based on the presence or absence of ureteral stenosis after the operation. Univariate and multivariate logistic regression were used to analyze the independent risk factors for postoperative ureteral stenosis, and R software and regression coefficients were used to construct a predictive model. <b><i>Results:</i></b> After a 1-year follow-up of 427 patients, 28 patients (6.56%) developed ureteral stenosis; univariate analysis showed that the occurrence of ureteral stenosis after subureteral holmium laser lithotripsy was related to stone diameter, stone incarceration, degree of hydronephrosis, holmium laser injury of mucosa, and operation time (<i>p</i> < 0.05); further logistic regression analysis showed that a large stone diameter, stone incarceration, and moderate to severe hydronephrosis were independent risk factors for ureteral stenosis after ureteroscopic holmium laser lithotripsy (<i>p</i> < 0.05); According to H-L deviation degree and area under receiver operating characteristic curve test, the results show that the model has high accuracy (<i>χ</i>² = 2.475, <i>p</i> = 0.613) and differentiation (0.875 [95% confidence interval or CI: 0.817-0.919]), and the external verification of the nomogram prediction model was carried out by the verification group. The results showed that the prediction probability of the calibration curve was close to the actual probability and had a good consistency (area under the curve: 0.873 [95 CI: 0.822-0.914]). <b><i>Conclusion:</i></b> The established nomogram model exhibits high accuracy and discriminative ability. It can effectively identify high-risk groups, enabling timely prevention of ureteral stenosis and minimizing the risk of postoperative ureteral stenosis.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"1178-1184"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288967","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":"Renal Access in Pediatric Supine Miniaturized Percutaneous Nephrolithotomy: Comparative Evaluation of Ultrasound-Fluoroscopy Combined and Biplanar (0°-90°) Fluoroscopic Techniques.","authors":"Ali Sezer, Bilge Türedi, Onur Kucuktopcu, Mustafa Bilal Hamarat, Burak Yilmaz, Rasim Güzel, Kemal Sarica","doi":"10.1089/end.2024.0181","DOIUrl":"10.1089/end.2024.0181","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Ultrasound (US)-guided puncture has the benefits of avoiding radiation and limiting the risk of visceral injury. We aimed to evaluate the results of two different renal access techniques during pediatric supine mini percutaneous nephrolithotomy (smPCNL) in a comparative manner. <b><i>Patients and Methods:</i></b> Data obtained from pediatric patients undergoing smPCNL by single surgeon between September 2021 and 2023 were reviewed retrospectively. Children were divided into two groups namely; biplanar 0°-90° fluoroscopy (Group-F) and US-fluoroscopy combined (Group-C). In all cases, preoperative, operative, and postoperative findings were recorded. Success was defined as the determination of either no (complete stone-free status) or < 4 mm residual fragments (CIRF) on US and X-ray (postoperative 3rd month) images. Complications were evaluated according to modified Clavien-Dindo classification. <b><i>Results:</i></b> Data of 54 patients with a mean age of 8.6 years (Group-F = 30, Group-C = 24) are reviewed. In addition to the similar success rates in both groups (Group-F = 86.7% Group-C = 87.5% <i>p</i> = 0.928), similar minor complications were noted in the majority of the cases. No child required transfusion and/or angioembolization. Although the fluoroscopy and operation time were lower in Group-C, the difference was not statistically significant. <b><i>Conclusion:</i></b> US-fluoroscopy combined access technique can be applied with similar success and complication rates in pediatric smPCNL. Ultimately, as experience is gained, this technique may lower radiation exposure, although this was not observed in the current study.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"1134-1140"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603734","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>Comment on:</i> \"Initial Postoperative Prostate Specific Antigen and PSA Velocity Are Important Indicators of Underlying Malignancy After Simple Prostatectomy\" by Livingston <i>et al.</i>","authors":"Diana M Lopategui, Joao G Porto, Ansh Bhatia, Renil Titus, Robert Marcovich, Hemendra N Shah","doi":"10.1089/end.2024.0111","DOIUrl":"10.1089/end.2024.0111","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"e1235-e1236"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305860","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":"Beyond ChatGPT: It Is Time to Focus More on Specialized Medical LLMs.","authors":"Shuo Wang","doi":"10.1089/end.2024.0374","DOIUrl":"10.1089/end.2024.0374","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"e1244-e1245"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237127","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":"Unveiling the Crystal Clear: Cone Beam Computed Tomography's Role in Enhancing PCNL Outcomes and the Path Forward.","authors":"Fu-Xiang Lin, Yi Yu, Zhan-Ping Xu","doi":"10.1089/end.2024.0235","DOIUrl":"10.1089/end.2024.0235","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"e1239-e1240"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237273","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":"Reply Letter to Dr Victor DR et al. on: Preoperative α1-Blockers Impact on Outcomes of Patients Undergoing Ureteroscopy with Ureteral Access Sheaths: A Systematic Review and Meta-Analysis.","authors":"Guglielmo Mantica, Giovanni Drocchi, Carlo Terrone","doi":"10.1089/end.2024.0455","DOIUrl":"10.1089/end.2024.0455","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"e1243"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603735","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}