Translational andrology and urology最新文献

{"title":"Video discharge instructions increase patient understanding for office-based procedures: a randomized controlled study.","authors":"Jenna Bates Maffei, Jeffrey J Song, Gal Saffati, Mohit Khera","doi":"10.21037/tau-24-501","DOIUrl":"https://doi.org/10.21037/tau-24-501","url":null,"abstract":"<p><strong>Background: </strong>Health literacy significantly influences healthcare outcomes, with poor literacy leading to worse quality of life, increased mortality, and higher readmission rates. Recent efforts to improve post-encounter education include structured teach-back methods, patient preference assessments, and standardized discharge instructions. Studies in emergency departments have shown that incorporating video discharge instructions enhances patient understanding and retention of care information. To address the gap in urology, this study aims to evaluate patient comprehension and satisfaction with video discharge instructions following clinic-based vasectomy procedures.</p><p><strong>Methods: </strong>We performed an Institutional Review Board approved (#H-51614) unblinded randomized controlled study with written consent from each participant. All men undergoing vasectomy from August to September 2022 in our outpatient clinic were included in our study. Patients were randomized to receive either video or written discharge instructions. A standardized questionnaire was administered containing objective comprehension questions regarding the discharge instructions they received. Patients were also queried on their preference of discharge instruction format and subjective Likert-scale of information usefulness and format understandability.</p><p><strong>Results: </strong>Each cohort contained 11 men. There was no difference in age or educational level between the groups (P=0.91, 0.38, respectively). The video cohort exhibited increased comprehension scores (P<0.001). There was no difference between cohorts in ratings of information helpfulness and instruction understandability (P=0.48, 0.06, respectively). Approximately 73% of men in the video group preferred to receive both video and written instructions while 73% patients in the written cohort preferred to receive only written instructions (P<0.001).</p><p><strong>Conclusions: </strong>Use of video discharge instructions significantly improved objective comprehension with similar perceptions of information helpfulness and understandability. Patients who received video discharge instructions were more likely to prefer receiving both written and video instructions than those who received written instructions. Overall, these findings support the utility of video discharge instructions in a urologic setting.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"678-684"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video platforms and sexual healthcare in China: assessment of content on premature ejaculation.","authors":"Hao-Yang Lu, Rong-Hao Zhang, Xi Wen, Yi Wang, Ke-Qiu Wu, Zhong-Lai Li, Du Geon Moon, Wei-Fan Jiang","doi":"10.21037/tau-2025-104","DOIUrl":"https://doi.org/10.21037/tau-2025-104","url":null,"abstract":"<p><strong>Background: </strong>Premature ejaculation (PE) is among the most commonly reported types of sexual dysfunction both globally and in China. Despite the growing popularity of online healthcare services and the greater availability of information in mainland China, there is a pressing need to assess the quality and reliability of PE-related content available online and address the potential impact of online misinformation. Thus, in this study, we assessed the quality of information regarding PE videos on the top video websites in China.</p><p><strong>Methods: </strong>The top 10 video platforms in mainland China were searched using PE-related keywords for videos published as of July 2023. All available videos were examined for eligibility and reliability, and two reviewers independently evaluated the videos using Global Quality Score (GQS) scores for quality and DISCERN tools for their content reliability. All data were analyzed with SPSS software (IBM Corp.).</p><p><strong>Results: </strong>Information on sexual medicine content related to PE was found to be available on just seven of the websites examined. From the 1,468 videos initially retrieved, 582 met the inclusion criteria. Of these, 319 videos (54.81%) were deemed reliable, while 263 (45.19%) were classified as unreliable. The agreement between the two urologists reviewing the videos and the intraclass correlation coefficient (ICC) were deemed acceptable. There were significant differences in the quality, reliability, source, presentation format, and themes of the videos.</p><p><strong>Conclusions: </strong>The quality of resources on Chinese video platforms varies widely. Users seeking PE-related information should carefully select the appropriate platforms and opt for higher-quality videos. The existing participation of professional medical personnel was seen as insufficient, and joint efforts are needed to implement content review and the establishment of an evaluation framework.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"729-739"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The underappreciated underactive bladder.","authors":"Basil Razi, Kevin Zhuo, Dane Cole-Clark, Amanda Chung","doi":"10.21037/tau-2025-61","DOIUrl":"https://doi.org/10.21037/tau-2025-61","url":null,"abstract":"<p><p>Slow urinary flow is a common lower urinary tract symptom (LUTS) that frequently prompts men to consult their primary care physician. While bladder outlet obstruction (BOO) is well recognised, underactive bladder (UAB) remains underappreciate despite its significant impact on quality of life. This review highlights the pathophysiology, clinical features, and diagnostic challenges and approach to UAB in men. Improving recognition of UAB as a distinct condition separate from other LUTS aetiologies, it can facilitate earlier diagnosis and management. Slow urinary flow is highly prevalent, particularly in an ageing population. UAB is characterised by impaired detrusor muscle activity, leading to slow urinary flow, hesitancy, straining and incomplete bladder emptying. The overlap in symptoms with BOO often leads to misdiagnosis, delaying appropriate intervention. UAB has multiple underlying causes including, neurogenic, myogenic, iatrogenic and idiopathic factors. Diagnosis is further complicated by the limited availability of urodynamic studies, the gold standard for assessing detrusor underactivity. Current management options remain limited with no definitive treatments. Current strategies focus on behavioural modifications, pelvic floor exercises, timed voiding, sacral neuromodulation and intermittent catheterisation. Increased awareness of UAB among primary care physicians and urologists is essential for timely diagnosis and intervention. Recognition of UAB as a distinct clinical entity will lead to a reduction in potential complications and significant improvement in the quality of life of affected men.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"841-847"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of split-dose cisplatin-based neoadjuvant chemotherapy followed by robotic-assisted radical cystectomy for muscle invasive bladder cancer.","authors":"Keita Nakane, Ayaka Okamoto, Hiroki Kato, Hiroki Hoshino, Teppei Nishiwaki, Torai Enomoto, Masayuki Tomioka, Tomoki Taniguchi, Makoto Kawase, Kota Kawase, Daiki Kato, Koji Iinuma, Yuki Tobisawa, Takuya Koie","doi":"10.21037/tau-2024-662","DOIUrl":"https://doi.org/10.21037/tau-2024-662","url":null,"abstract":"<p><strong>Background: </strong>Although cisplatin is essential for neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC), good renal function is a prerequisite for those patients receiving NAC. However, patients with normal renal function may experience nephrotoxicity after cisplatin administration. We investigated the safety and efficacy of a split-dose regimen of gemcitabine and cisplatin (split-dose GC) in MIBC patients with normal renal function.</p><p><strong>Methods: </strong>This retrospective study included 45 patients with MIBC who received standard GC, split-dose GC, or gemcitabine and carboplatin (GCarbo) as a NAC and subsequently underwent robot-assisted radical cystectomy. The efficacy and safety of two cycles split-dose GC were compared with those of other regimens.</p><p><strong>Results: </strong>Among the 45 patients with MIBC, 14 received standard GC, 14 received split-dose GC, and 17 received GCarbo. Pathological complete response rates were 28.6%, 21.4%, and 29.4% for surgical specimens obtained post-treatment with standard GC, split-dose GC, and GCarbo, respectively (P=0.86). Renal function after NAC was significantly lower in the standard- and split-dose GC groups than in the GCarbo group (P<0.001).</p><p><strong>Conclusions: </strong>Although the split-dose GC regimen showed a significant reduction compared to pre-treatment renal function, the pathological response rate and incidence of adverse events were similar to those of the other two regimens.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"589-601"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of differentially expressed genes and proteins in donor arterial plaque on renal function recovery following allogeneic kidney transplantation.","authors":"Zijian Tian, Yongbin Tang, Jinfu Wang, Zhipeng Zhang, Lingfeng Meng, Hong Zhang, Yaqun Zhang","doi":"10.21037/tau-2024-736","DOIUrl":"https://doi.org/10.21037/tau-2024-736","url":null,"abstract":"<p><strong>Background: </strong>Donor kidney arteriosclerotic plaque is a risk factor for renal allograft functional injury. The aim of this study was to screen, identify, and verify differentially expressed genes (DEGs) and proteins in arteriosclerotic plaques and analyze their correlation with renal transplant function recovery.</p><p><strong>Methods: </strong>This study included 82 deceased donor allogeneic kidney transplant recipients and analyzed 20 eligible donor arterial plaque specimens. Patients were divided into \"no or mild\" and \"moderate or severe\" donor arteriosclerotic plaque groups. The latter group was further divided into impaired and normal kidney function groups. Correlations between target DEGs and proteins and transplanted kidney function recovery were determined using immunofluorescence assay, polymerase chain reaction (PCR), and western blotting.</p><p><strong>Results: </strong>We identified 40 intersecting DEGs. Matrix metallopeptidase 12 (<i>MMP12</i>) and aquaporin 9 (<i>AQP9</i>) were identified as target DEGs, with their expression found to be higher in the \"moderate or severe\" group compared with that in the \"no or mild\" group. Additionally, <i>MMP12</i> and <i>AQP9</i> expression was higher in the impaired group than it was in the normal kidney function group. <i>MMP12</i> and <i>AQP9</i> are associated with transplanted kidney function recovery.</p><p><strong>Conclusions: </strong>Our study contributes valuable information to the development of clinical strategies for kidney transplant maintenance.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"637-650"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized prostate biopsy protocols: enhancing cancer detection through tailored approaches-a narrative review.","authors":"Shanqi Guo, Xingkang Jiang","doi":"10.21037/tau-24-619","DOIUrl":"https://doi.org/10.21037/tau-24-619","url":null,"abstract":"<p><strong>Background and objective: </strong>Traditionally, patients with positive magnetic resonance imaging (MRI) results [i.e., Prostate Imaging-Reporting and Data System (PI-RADS) ≥3] would have to undergo both targeted and systematic biopsies. The 2024 European Urology Association guidelines now recommend incorporating perilesional sampling with targeted biopsy; however, these recommendations have not yet been widely adopted. This review aims to examine recent advancements in personalized prostate biopsy techniques to enhance cancer detection through tailored approaches.</p><p><strong>Methods: </strong>We conducted a narrative review to highlight recent advancements in personalized prostate biopsy techniques, emphasizing the roles of serum prostate-specific antigen (PSA) levels, prostate volume (PV), PSA density (PSAD), region of interest (ROI), and PI-RADS scores.</p><p><strong>Key content and findings: </strong>This review discusses personalized prostate biopsy protocols, integrating PSA levels, PV, PSAD, and PI-RADS scores. Tumor localization can be refined using transrectal or transperineal approaches. For patients with lower PSA levels (4-19.99 ng/mL), smaller PSAD (<0.1 ng/mL/cc), or PI-RADS 3 lesions, a targeted plus systematic biopsy or regional saturation biopsy may be appropriate. For those with medium PSA levels (20-50 ng/mL), PSAD (0.1-0.2 ng/mL/cc), or PI-RADS 4 lesions, regional saturation biopsy is preferred. Targeted biopsy is recommended for higher PSA levels (>50 ng/mL), PSAD (>0.2 ng/mL/cc), or PI-RADS 5 lesions. Variability in cut-off values across studies precludes meta-analysis, limiting our work to a systematic review.</p><p><strong>Conclusions: </strong>Personalized prostate biopsy protocols considering PSA levels, PV, PSAD, ROI, and PI-RADS scores can improve prostate cancer detection accuracy. Further research and clinical validation are needed to optimize these personalized methods.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"831-840"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is early-life obesity associated with kidney cancer in adulthood?-insights from genetic studies.","authors":"Song Yang, Xinmiao Ni, Jun Jian, Lei Wang, Zhiyuan Chen, Xiuheng Liu","doi":"10.21037/tau-24-521","DOIUrl":"https://doi.org/10.21037/tau-24-521","url":null,"abstract":"<p><strong>Background: </strong>Adult obesity increases the risk of kidney cancer (KIC), yet the link between early body size traits and KIC remains uncertain. This study aimed to investigate the causal relationship between early body size characteristics and KIC, including its subtypes, using Mendelian randomization (MR).</p><p><strong>Methods: </strong>We utilized data from public genome-wide association study (GWAS) databases on birth weight and body mass index (BMI) across childhood, adolescence, and adulthood as exposure variables, and KIC and its subtypes as outcome variables. A two-way two-sample MR analysis was performed to explore these associations, with the inverse variance weighted (IVW) method as the primary analytical approach and sensitivity analyses to assess result stability.</p><p><strong>Results: </strong>IVW analysis revealed significant associations between childhood obesity [odds ratio (OR) =1.08, 95% confidence interval (CI): 1.04-1.14, P<0.001], childhood BMI (OR =1.23, 95% CI: 1.07-1.42, P=0.003), adolescent BMI (OR =1.22, 95% CI: 1.07-1.40, P=0.003), and adult BMI (OR =1.75, 95% CI: 1.41-2.17, P<0.001) with increased risk of KIC. Similar associations were observed for clear cell renal cell carcinoma (ccRCC), with childhood obesity (OR =1.09, 95% CI: 1.02-1.15, P=0.007), childhood BMI (OR =1.33, 95% CI: 1.14-1.55, P<0.001), adolescent BMI (OR =1.24, 95% CI: 1.04-1.47, P=0.01), and adult BMI (OR =1.97, 95% CI: 1.51-2.57, P<0.001) significantly linked to higher ccRCC risk. No evidence of reverse causation was found.</p><p><strong>Conclusions: </strong>This study provides MR evidence supporting a causal association between early-life obesity and KIC. Our findings suggest that reducing obesity in early life may have a potential positive impact on the prevention of KIC.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"519-528"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking and analysis of benign prostatic hyperplasia and prostate cancer burden globally: 1990-2021 epidemiological trends.","authors":"Qizhou Mo, Fengyi Wang, Haiqi Liang, Yujian Li, Min Qin, Jiwen Cheng","doi":"10.21037/tau-2025-12","DOIUrl":"https://doi.org/10.21037/tau-2025-12","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are prevalent prostate conditions in middle-aged and elderly men, yet comprehensive and current epidemiological data remain scarce. This study aimed to comprehensively evaluate the global burdens of BPH and PCa from 1990 to 2021.</p><p><strong>Methods: </strong>We analyzed data on BPH and PCa from the Global Burden of Disease 2021 database, including incidence, disability-adjusted life-years (DALYs), mortality, and attributable risk factors. Estimated annual percentage changes (EAPC) were calculated to assess trends in age-standardized incidence rates (ASIR), age-standardized DALY rates (ASDR), and age-standardized mortality rates (ASMR). We also examined correlations between the burden of these conditions and socio-demographic indices (SDI).</p><p><strong>Results: </strong>From 1990 to 2021, the incidence of BPH and PCa increased by 115.23% and 161.66%, respectively. Over the 32-year period, PCa showed a decreasing trend in ASMR and ASDR (EAPC =-0.68 and -0.83, respectively), with no significant change in ASIR. BPH burdens were highest in Eastern Europe and Asia, while PCa burdens were concentrated in high-income North America and Australasia. The highest incidence rates for BPH were in the 65-69 age group, and for PCa in those aged 85 years and older. Smoking-related DALYs and mortality among PCa patients decreased annually across all age groups throughout the study period.</p><p><strong>Conclusions: </strong>BPH and PCa continue to pose significant global health challenges due to their increasing absolute burden. Although the relative burden of BPH remains stable and PCa shows a declining trend, strategic resource allocation based on regional epidemiological features and geographical distributions is crucial.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"764-778"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seminal plasma PGK2 serves as a predictive biomarker for post-varicocelectomy sperm motility improvement in varicocele subjects.","authors":"Cheng Yang, Jianxiong Li, Shenghao Wu, Cundong Liu, Ranran Zhou, Shan-Chao Zhao","doi":"10.21037/tau-24-629","DOIUrl":"10.21037/tau-24-629","url":null,"abstract":"<p><strong>Background: </strong>Not all varicocele (VC) patients experience improvements in semen quality after undergoing varicocelectomy. This study aims to investigate whether phosphoglycerate kinase 2 (PGK2) protein in seminal plasma could serve as a predictive biomarker for the enhancement of sperm motility post-varicocelectomy.</p><p><strong>Methods: </strong>Sixty patients diagnosed with VC-associated asthenospermia and who underwent varicocelectomy at the Third Affiliated Hospital of Southern Medical University were included in this study. Semen samples from 33 healthy donors were also collected. Hematological and semen analysis parameters were assessed at baseline and at the 6-month postoperative follow-up. The concentration of PGK2 in seminal plasma was determined using enzyme-linked immunosorbent assay (ELISA). Additionally, eleven machine learning algorithms were employed to develop a model to evaluate the effectiveness of varicocelectomy based on PGK2 concentration, hematological parameters, and semen quality indicators.</p><p><strong>Results: </strong>The levels of PGK2 in seminal plasma were significantly lower in VC patients compared to healthy donors (P<0.001). Increased levels of PGK2 were observed in the VC subjects after the varicocelectomy (P<0.001). PGK2 concentration was found to be a significant indicator [area under curve (AUC) =0.735, 95% confidence interval (CI): 0.601-0.860] and an independent predictor (P=0.003, P=0.049) of the success of varicocelectomy. The linear discriminant analysis (LDA) model demonstrated strong classification ability for assessing varicocelectomy outcomes in both the training (AUC =1.000, 95% CI: 1.000-1.000) and testing (AUC =0.804, 95% CI: 0.619-0.963) groups.</p><p><strong>Conclusions: </strong>PGK2 in seminal plasma shows promise as a potential biomarker for predicting improved sperm motility following varicocelectomy, thus aiding in clinical decision-making regarding therapeutic approaches.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"335-350"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status study of clinical application of ureteral access sheath in urology: a narrative review.","authors":"Changxiang Shu, Jun Liu","doi":"10.21037/tau-24-557","DOIUrl":"10.21037/tau-24-557","url":null,"abstract":"<p><strong>Background and objective: </strong>As one of the effective minimally invasive methods for upper urinary tract stone treatment, ureteroscopic lithotripsy has gradually become the mainstream surgical approach. The routine use of ureteral access sheaths (UAS) during ureteroscopic lithotripsy has plenty of advantages. Although many concerns have emerged in the clinical practice of the UAS, the clinically improved devices have addressed these issues. This article reviews the advantages, existing issues, and current improvements of UAS in clinical practice, aiming to provide references for better clinical application and further improvements of UAS.</p><p><strong>Methods: </strong>We searched in PubMed database using the terms: \"ureteral access sheath\", \"ureteroscopic lithotripsy\" or \"flexible ureteroscope\". Articles were independently evaluated for inclusion based on predetermined criteria.</p><p><strong>Key content and findings: </strong>The routine use of UAS during ureteroscopic lithotripsy facilitates the entry and exit of the ureteroscope, improves intraoperative visibility, and reduces postoperative complications. However, concerns over ureteral wall injury, difficulty in controlling renal pelvic pressure, lack of reduction in operation time, failure to increase stone free rates, and controversies regarding the ratios of endoscope-sheath diameter have limited the clinical application of UAS. The emergence of clinically improved devices such as intelligent pressure controlled, tip bendable, and rigid ureteroscope aided UAS has addressed these issues, laying a foundation for their further clinical application.</p><p><strong>Conclusions: </strong>The clinical improvement of the UAS can serve as a bridge for the widespread usage of the ureteroscopic lithotripsy. In the future, we anticipate more innovative advancements in UAS, making their clinical use even more practical and convenient.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 2","pages":"441-453"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}