Therapeutic Advances in Urology最新文献

{"title":"The role of 'artificial intelligence, machine learning, virtual reality, and radiomics' in PCNL: a review of publication trends over the last 30 years.","authors":"Carlotta Nedbal,&nbsp;Clara Cerrato,&nbsp;Victoria Jahrreiss,&nbsp;Daniele Castellani,&nbsp;Amelia Pietropaolo,&nbsp;Andrea Benedetto Galosi,&nbsp;Bhaskar Kumar Somani","doi":"10.1177/17562872231196676","DOIUrl":"https://doi.org/10.1177/17562872231196676","url":null,"abstract":"<p><strong>Introduction: </strong>We wanted to analyze the trend of publications in a period of 30 years from 1994 to 2023, on the application of 'artificial intelligence (AI), machine learning (ML), virtual reality (VR), and radiomics in percutaneous nephrolithotomy (PCNL)'. We conducted this study by looking at published papers associated with AI and PCNL procedures, including simulation training, with preoperative and intraoperative applications.</p><p><strong>Materials and methods: </strong>Although MeSH terms research on the PubMed database, we performed a comprehensive review of the literature from 1994 to 2023 for all published papers on 'AI, ML, VR, and radiomics' in 'PCNL', with papers in all languages included. Papers were divided into three 10-year periods: Period 1 (1994-2003), Period 2 (2004-2013), and Period 3 (2014-2023).</p><p><strong>Results: </strong>Over a 30-year timeframe, 143 papers have been published on the subject with 116 (81%) published in the last decade, with a relative increase from Period 2 to Period 3 of +427% (<i>p</i> = 0.0027). There was a gradual increase in areas such as automated diagnosis of larger stones, automated intraoperative needle targeting, and VR simulators in surgical planning and training. This increase was most marked in Period 3 with automated targeting with 52 papers (45%), followed by the application of AI, ML, and radiomics in predicting operative outcomes (22%, <i>n</i> = 26) and VR for simulation (18%, <i>n</i> = 21). Papers on technological innovations in PCNL (<i>n</i> = 9), intelligent construction of personalized protocols (<i>n</i> = 6), and automated diagnosis (<i>n</i> = 2) accounted for 15% of publications. A rise in automated targeting for PCNL and PCNL training between Period 2 and Period 3 was +247% (<i>p</i> = 0.0055) and +200% (<i>p</i> = 0.0161), respectively.</p><p><strong>Conclusion: </strong>An interest in the application of AI in PCNL procedures has increased in the last 30 years, and a steep rise has been witnessed in the last 10 years. As new technologies are developed, their application in devices for training and automated systems for precise renal puncture and outcome prediction seems to play a leading role in modern-day AI-based publication trends on PCNL.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/03/10.1177_17562872231196676.PMC10492475.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiparametric ultrasound of prostate: role in prostate cancer diagnosis.","authors":"Masatomo Kaneko, Maria Sarah L Lenon, Lorenzo Storino Ramacciotti, Luis G Medina, Aref S Sayegh, Anibal La Riva, Laura C Perez, Alireza Ghoreifi, Maria Lizana, Donya S Jadvar, Amir H Lebastchi, Giovanni E Cacciamani, Andre Luis Abreu","doi":"10.1177/17562872221145625","DOIUrl":"10.1177/17562872221145625","url":null,"abstract":"<p><p>Recent advances in ultrasonography (US) technology established modalities, such as Doppler-US, HistoScanning, contrast-enhanced ultrasonography (CEUS), elastography, and micro-ultrasound. The early results of these US modalities have been promising, although there are limitations including the need for specialized equipment, inconsistent results, lack of standardizations, and external validation. In this review, we identified studies evaluating multiparametric ultrasonography (mpUS), the combination of multiple US modalities, for prostate cancer (PCa) diagnosis. In the past 5 years, a growing number of studies have shown that use of mpUS resulted in high PCa and clinically significant prostate cancer (CSPCa) detection performance using radical prostatectomy histology as the reference standard. Recent studies have demonstrated the role mpUS in improving detection of CSPCa and guidance for prostate biopsy and therapy. Furthermore, some aspects including lower costs, real-time imaging, applicability for some patients who have contraindication for magnetic resonance imaging (MRI) and availability in the office setting are clear advantages of mpUS. Interobserver agreement of mpUS was overall low; however, this limitation can be improved using standardized and objective evaluation systems such as the machine learning model. Whether mpUS outperforms MRI is unclear. Multicenter randomized controlled trials directly comparing mpUS and multiparametric MRI are warranted.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/f3/10.1177_17562872221145625.PMC9806443.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10119015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current role of neuromodulation in bladder pain syndrome/interstitial cystitis.","authors":"Bárbara Padilla-Fernández,&nbsp;David Hernández-Hernández,&nbsp;David M Castro-Díaz","doi":"10.1177/17562872221135941","DOIUrl":"https://doi.org/10.1177/17562872221135941","url":null,"abstract":"<p><p>Neuromodulation is recommended by major international guidelines as a fourth-line treatment in bladder pain syndrome/interstitial cystitis (BPS/IC) patients after failure of behavioural, oral and intravesical pharmacological treatments, including hydrodistension. A non-systematic review of studies identified by electronic search of MEDLINE was performed with no time limitation. A narrative synthesis of the existing evidence regarding the results of sacral, tibial and pudendal nerve stimulation in the management of BPS/IC was developed. Neuromodulation in pelvic chronic pain disorders, including BPS/IC, is a useful tool for refractory patients to conventional treatments. Sacral neuromodulation may be effective in patients with BPS without Hunner's lesions, and the effect seems to be maintained in the mid- and long-term. Posterior tibial nerve stimulation can be offered to patients with BPS/IC in the context of a multidisciplinary approach. When pudendal neuralgia is suspected, selective pudendal nerve stimulation has a high response rate. The aetiology of the pain can influence the outcomes in the mid- and long-term of the different neuromodulation approaches, thus careful diagnosis is recommended.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/6d/10.1177_17562872221135941.PMC9685149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40708366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative MELD score predicts mortality and adverse outcomes following radical cystectomy: analysis of American College of Surgeons National Surgical Quality Improvement Program.","authors":"Christian Habib Ayoub, Ali Dakroub, Jose M El-Asmar, Adel Hajj Ali, Hadi Beaini, Suhaib Abdulfattah, Albert El Hajj","doi":"10.1177/17562872221135944","DOIUrl":"10.1177/17562872221135944","url":null,"abstract":"<p><strong>Background: </strong>The model for end-stage liver disease (MELD) has been widely used to predict the mortality and morbidity of various surgical procedures.</p><p><strong>Objectives: </strong>We aimed to correlate a high preoperative MELD score with adverse 30-day postoperative complications following radical cystectomy.</p><p><strong>Design and methods: </strong>Patients who underwent elective, non-emergency radical cystectomy were identified from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2017. Patients were categorized according to a calculated MELD score. The primary outcomes of this study were 30-day postoperative mortality, morbidity, and length of hospital stay following radical cystectomy. For further sensitivity analysis, propensity score matching was used to yield a total of 1387 matched pairs and primary outcomes were also assessed in the matched cohort.</p><p><strong>Results: </strong>Compared with patients with a MELD < 10, those with MELD ⩾ 10 had significantly higher rates of mortality [odds ratio (OR) = 1.71, <i>p =</i> 0.004], major complications (OR = 1.42, <i>p <</i> 0.001), and prolonged hospital stay (OR = 1.29, <i>p <</i> 0.001) on multivariate analysis. Following risk-adjustment for race, propensity-matched groups revealed that patients with MELD score ⩾ 10 were significantly associated with higher mortality (OR = 1.85, <i>p =</i> 0.008), major complications (OR = 1.34, <i>p <</i> 0.001), yet similar length of hospital stay (OR = 1.17, <i>p =</i> 0.072).</p><p><strong>Conclusion: </strong>MELD score ⩾ 10 is associated with higher mortality and morbidity in patients undergoing radical cystectomy compared with lower MELD scores. Risk-stratification using MELD score may assist clinicians in identifying high-risk patients to provide adequate preoperative counseling, optimize perioperative conditions, and even consider nonsurgical alternatives.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/8f/10.1177_17562872221135944.PMC9669693.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40503687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging perioperative therapeutic approaches in muscle invasive bladder cancer.","authors":"Goutham Patil,&nbsp;Arnab Basu","doi":"10.1177/17562872221134389","DOIUrl":"https://doi.org/10.1177/17562872221134389","url":null,"abstract":"<p><p>Bladder cancer is a significant healthcare burden with more than 17,000 deaths in the United States in 2018. Patients who are diagnosed with muscle invasive bladder cancer (MIBC) have a high rate of micro-metastatic disease and have a much poorer prognosis compared with patients who have less advanced lesions. Historically, neoadjuvant administration of cisplatin-based therapy followed by surgery has been the mainstay of treatment. Unfortunately, of patients who come in with initially diagnosed MIBC, more than 50% are ineligible for traditional cisplatin-based therapy. Today, new modalities of treatment such as immune checkpoint inhibitors are beginning to radically improve outcomes in this population. The addition of immune checkpoint therapy to traditional chemotherapy appears to augment pathologic complete response rates in the bladder during surgery. Immunotherapy combinations also provide novel trimodality approaches with excellent outcomes in those pursuing non-surgical management. Pure immunotherapy approaches appear promising in the neoadjuvant and adjuvant setting, and the immune checkpoint inhibitor nivolumab is now approved in the adjuvant setting for high-risk patients. Antibody drug conjugates, such as enfortumab vedotin, and targeted therapies, such as infigratinib, are in trials in the perioperative setting. This review article summarizes the current evidence and likely future developments for the management of muscle invasive bladder cancer in 2022 and beyond.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/df/10.1177_17562872221134389.PMC9619281.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40443696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Furosemide improves the stone clearance rate of extracorporeal shockwave lithotripsy for kidney stones but not ureteral stones: a systematic review and meta-analysis.","authors":"Feng Yao,&nbsp;Ke Li,&nbsp;ShiQuan Huang,&nbsp;XueSong Cheng,&nbsp;XiaoLiang Jiang","doi":"10.1177/17562872221128473","DOIUrl":"https://doi.org/10.1177/17562872221128473","url":null,"abstract":"<p><strong>Introduction: </strong>We conducted a meta-analysis (MA) to investigate the effects of furosemide on the prognosis of extracorporeal shockwave lithotripsy (SWL) therapy to remove renal (RS) and ureteric stones (US).</p><p><strong>Methods: </strong>We screened scientific databases including PubMed, Clinicalkey, Google Scholar, Medline, Embase, and Cochrane, from the date of establishment until March 2022, to search for randomized controlled trials evaluating SWL, in combination with furosemide (experimental group) or with SWL alone (control group), in treating RS or US. Our search terms included furosemide, extracorporeal SWL, and urolithiasis. For this MA, we employed the Cochrane Collaboration's RevMan version 5.3.0.</p><p><strong>Results: </strong>Six trials, involving 1344 participants, with RS (<i>n</i> = 1097) and/or US (<i>n</i> = 247), met our predefined criteria. This included 137 proximal ureteral stones (PUSs), 35 mid-ureteral stones (MUS), and 75 distal ureteral stones (DUS). In case of RS, the experimental group exhibited significantly enhanced clearance, relative to controls (risk ratio [RR] = 1.16, 95% confidence interval [CI] = 1.07-1.25, <i>p</i> = 0.0002), yet there was no obvious difference in the PUS, MUS, and DUS (RR = 1.14, 95% CI = 0.97-1.33, <i>p</i> = 0.10; odds ratio [OR] = 1.26, 95% CI = 1.40-3.95, <i>p</i> = 0.69; RR = 1.21, 95% CI = 0.99-1.49, <i>p</i> = 0.06). There was also no marked difference between fragmentations in either group. Only reports of SWL treatment of RS provided adequate data on shocks, sessions, and complications for our analysis. Unfortunately, there was no significant alteration between the two groups.</p><p><strong>Conclusion: </strong>According to our analysis, furosemide strongly accelerates the clearance rate of SWL-treated RS. However, it does not enhance the fragmentation rate. Given this evidence, we propose that furosemide does not significantly improve the efficacy of SWL therapy in removing US.</p><p><strong>Registration: </strong>Our work is registered with PROSPERO (CRD42020204780).</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/ae/10.1177_17562872221128473.PMC9577065.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40649430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of artificial intelligence in prostate cancer detection on imaging.","authors":"Indrani Bhattacharya, Yash S Khandwala, Sulaiman Vesal, Wei Shao, Qianye Yang, Simon J C Soerensen, Richard E Fan, Pejman Ghanouni, Christian A Kunder, James D Brooks, Yipeng Hu, Mirabela Rusu, Geoffrey A Sonn","doi":"10.1177/17562872221128791","DOIUrl":"10.1177/17562872221128791","url":null,"abstract":"<p><p>A multitude of studies have explored the role of artificial intelligence (AI) in providing diagnostic support to radiologists, pathologists, and urologists in prostate cancer detection, risk-stratification, and management. This review provides a comprehensive overview of relevant literature regarding the use of AI models in (1) detecting prostate cancer on radiology images (magnetic resonance and ultrasound imaging), (2) detecting prostate cancer on histopathology images of prostate biopsy tissue, and (3) assisting in supporting tasks for prostate cancer detection (prostate gland segmentation, MRI-histopathology registration, MRI-ultrasound registration). We discuss both the potential of these AI models to assist in the clinical workflow of prostate cancer diagnosis, as well as the current limitations including variability in training data sets, algorithms, and evaluation criteria. We also discuss ongoing challenges and what is needed to bridge the gap between academic research on AI for prostate cancer and commercial solutions that improve routine clinical care.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/74/10.1177_17562872221128791.PMC9554123.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33545252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimuscarinics for neurogenic overactive bladder in multiple sclerosis: real-life data.","authors":"Elena Andretta,&nbsp;Enrico Finazzi Agrò,&nbsp;Massimiliano Calabrese,&nbsp;Luca Orecchia,&nbsp;Antonietta Furlan,&nbsp;Cristina Zuliani","doi":"10.1177/17562872221122484","DOIUrl":"https://doi.org/10.1177/17562872221122484","url":null,"abstract":"<p><strong>Background: </strong>Antimuscarinics (AMs) represent the mainstay of treatment for storage lower urinary tract symptoms (LUTS) but few data are available on their impact in multiple sclerosis (MS) patients.</p><p><strong>Objective: </strong>To assess effectiveness and tolerability of AMs in MS patients with neurogenic detrusor overactivity (NDO).</p><p><strong>Methods: </strong>Sixty consecutive outpatients, who started treatment with AMs at one centre, were recruited. The primary endpoint was change in Patient's Perception of Intensity of Urgency Scale (PPIUS) at 6 months; secondary endpoints were post-void residual urine (PVR) and pads used daily. Incidence and severity of adverse events (AEs) were recorded.</p><p><strong>Results: </strong>Significant reduction (<i>p</i> < 0.001) of mean PPIUS and pads use were detected, as well as a significant increase (<i>p</i> < 0.001) of PVR (143 ± 42 ml).AEs, recorded in 53% of patients, were frequently multiple and caused suspension of AM in 10% of cases, mainly for xerostomia, which has been the commonest AE (26.6%). Neurological AEs appeared in 11.7% of subjects, mostly with oxybutynin. Worsening/onset of voiding LUTS, reported by 8.3% of MS, resulted to be the unique AE correlated to AM dosage.</p><p><strong>Conclusion: </strong>This study suggests that AMs are effective in MS patients, but their use should be tailored on every patient as even low dosages can be poorly tolerated. AEs, including neurological ones, are common.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/1e/10.1177_17562872221122484.PMC9510970.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40382614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiogenomics influence on the future of prostate cancer risk stratification.","authors":"Vinayak Banerjee,&nbsp;Shu Wang,&nbsp;Max Drescher,&nbsp;Ryan Russell,&nbsp;M Minhaj Siddiqui","doi":"10.1177/17562872221125317","DOIUrl":"https://doi.org/10.1177/17562872221125317","url":null,"abstract":"<p><p>In an era of powerful computing tools, radiogenomics provides a personalized, precise approach to the detection and diagnosis in patients with prostate cancer (PCa). Radiomics data are obtained through artificial intelligence (AI) and neural networks that analyze imaging, usually MRI, to assess statistical, geometrical, and textural features of images to provide quantitative data of shape, heterogeneity, and intensity of tumors. Genomics involves assessing the genomic markers that are present from tumor biopsies. In this article, we separately investigate the current landscape of radiomics and genomics within the realm of PCa and discuss the integration and validity of both into radiogenomics using the data from three papers on the topic. We also conducted a clinical trials search using the NIH's database, where we found two relevant actively recruiting studies. Although there is more research needed to be done on radiogenomics to fully adopt it as a viable diagnosis tool, its potential by providing personalized data regarding each tumor cannot be overlooked as it may be the future of PCa risk-stratification techniques.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/c6/10.1177_17562872221125317.PMC9490455.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ureteroscopy for stone disease in the paediatric population: lessons learned and outcomes in a Nordic setting.","authors":"Patrick Juliebø-Jones,&nbsp;Mathias Sørstrand Æsøy,&nbsp;Peder Gjengstø,&nbsp;Christian Beisland,&nbsp;Øyvind Ulvik","doi":"10.1177/17562872221118727","DOIUrl":"https://doi.org/10.1177/17562872221118727","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric stone disease is rare in the Nordic communities. Still, the condition can require surgical intervention in the form of ureteroscopy (URS). Here, we report outcomes achieved at a regional (tertiary) centre.</p><p><strong>Patients and methods: </strong>Retrospective analysis was performed of consecutive patients (<18 years of age) undergoing URS for stone disease between 2010 and 2021. Outcomes of interest included stone-free rate (SFR) determined using a definition of no residual fragments ⩾ 3 mm on imaging and complications classified according to Clavien-Dindo system.</p><p><strong>Results: </strong>In total, 23 patients underwent 47 URS procedures for a total of 31 stone episodes. Mean age was 9 (range 1-17) years and male-to-female ratio was 6:17. Overall, 35% had at least one medical comorbidity. Ultrasound determined preoperative stone status in 87%. Mean largest index and cumulative stone sizes were 9 (range 3-40) and 12 (range 3-40) mm, respectively. Overall, 32% had multiple stones. Lower pole was the commonest stone location (39%). No patients underwent elective pre-operative stenting. Ureteral access sheaths were not used in any cases. Access to upper urinary tract at first procedure was successful in 94%. Initial and final SFR was 61% and 90%, respectively. No intra-operative complications were recorded. Overall post-operative complication rate was 17.5%. Urinary tract infection (CD II) was the commonest adverse event (12.5%).</p><p><strong>Conclusion: </strong>Paediatric URS can be delivered in the setting of a regional centre without compromising outcomes. This includes when carried out by adult endourologists, without routine pre-stenting and omitting use of ureteric access sheath.</p>","PeriodicalId":23010,"journal":{"name":"Therapeutic Advances in Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/2a/10.1177_17562872221118727.PMC9403456.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33442551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}