Urologia Internationalis最新文献

{"title":"Comprehensive Analysis of Surgically Treated Renal Tumor Characteristics in Turkey: A Nationwide Study.","authors":"Ahmet Burak Yilmaz, Tolga Karakan, Bugra Bilge Keseroglu","doi":"10.1159/000545292","DOIUrl":"10.1159/000545292","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the kidney tumor characteristics in surgically treated patients in Turkey.</p><p><strong>Methods: </strong>Patients who underwent surgical treatment for kidney tumors between January 2017 and December 2022 in Turkey were retrospectively reviewed through the Health Information Systems of the Ministry of Health. Patient's age, gender, comorbidities, surgical methods, and tumor characteristics were evaluated.</p><p><strong>Results: </strong>The most common subtype of RCC was clear cell RCC (ccRCC) in 4,892 patients (72%). Papillary RCC (pRCC) was less frequent in patients under 50, with its incidence increasing with age compared to other subtypes (p = 0.006). There was a significant relationship found between hypertension and pathological subtypes (p = 0.002), with pRCC and unclassified RCC contributing to this difference. Among RCC subtypes, as the ISUP/Fuhrman grade increased, the tumor stage also progressed (p < 0.001). Tumors in males and tumors in the left kidney were at more advanced cancer at the time of diagnosis (p < 0.001 and p = 0.006, respectively). In multivariate logistic regression analysis, advanced age (odds ratio [OR]: 1.007, 95% confidence interval [CI]: 1.001-1.014, p = 0.04), male gender (OR: 0.416, 95% CI: 0.350-0.493, p < 0.001), increased tumor size (OR: 1.117, 95% CI: 1.079-1.156, p < 0.001), and the presence of diabetes mellitus (OR: 1.222, 95% CI: 1.007-1.483, p = 0.042) were found to be independent risk factors for malignancy.</p><p><strong>Conclusions: </strong>Our study identifies key factors associated with surgically treated renal tumors in Turkey. While aligning with prior research, these findings highlight the need for detailed studies to clarify the impact of biological, demographic, and lifestyle factors on RCC risk and progression, enabling more accurate diagnosis and tailored treatment.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Vision Internal Urethrotomy in the Management of Bulbar Urethral Strictures: Long-Term Follow-Up and Factors Predicting Treatment Failure.","authors":"David Hernández-Hernández, María Yanira Ortega-González, Bárbara Padilla-Fernández, Irene Díaz-González, Julia Climent-González, Stephany Hess-Medler","doi":"10.1159/000543674","DOIUrl":"10.1159/000543674","url":null,"abstract":"<p><strong>Introduction: </strong>Evaluation of long-term results, risk factors for treatment failure, and complications in a contemporary cohort of patients with bulbar urethral strictures managed with direct vision internal urethrotomy (DVIU).</p><p><strong>Methods: </strong>We retrospectively reviewed 140 consecutive patients who underwent internal urethrotomy in a single institution between January 2012 and October 2020, with a minimum follow-up of 24 months. Most urethral strictures had an iatrogenic origin (89.3%), length under 2 cm (75%) and were located in the mid-bulbar urethra (56.4%). The main variable was treatment failure, defined as recurrent urethral stricture at the same location in urethrography or urethroscopy, or the need for dilation, internal urethrotomy or open urethral reconstruction. Secondary variables analyzed were length of stricture, suspected etiology, previous endoscopic procedures, hospital stay, days of catheterization, and postoperative complications such as infections or hematuria.</p><p><strong>Results: </strong>Treatment failure occurred in 61.4% of patients (104). Idiopathic strictures and those under 2 cm had better outcomes. Strictures longer than 2 cm and those with previous endoscopic procedures demonstrated a higher failure rate. More than 90% of recurrences occurred within the first 2 years of follow-up. Complications of DVIU were scarce with postoperative urinary tract infection/urosepsis in 5.7% and prolonged hematuria in 10%. The mean hospital stay was 2.9 days.</p><p><strong>Conclusion: </strong>DVIU is a safe and simple technique, with reasonable efficacy in primary cases of bulbar urethral strictures under 2 cm in length. Strictures longer than 2 cm or recurrent cases might be better approached through drug-coated balloon dilation or open urethral reconstruction. Follow-up after DVIU must be at least 24 months.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-6"},"PeriodicalIF":1.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mayo Adhesive Probability Score: A Reliable Predictor for Percutaneous Nephrolithotomy in Obese Patients?","authors":"Ali Ayranci, Ufuk Caglar, Huseyin Burak Yazili, Ufuk Can Aksu, Omer Sarilar, Faruk Ozgor","doi":"10.1159/000545180","DOIUrl":"10.1159/000545180","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluates the predictive value of the Mayo Adhesive Probability (MAP) score for surgical outcomes in obese patients undergoing miniaturised percutaneous nephrolithotomy (m-PCNL). The primary research question is whether the MAP score can predict intraoperative and postoperative complications in patients with a BMI greater than 30.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent m-PCNL at a tertiary care centre between August 2018 and August 2023. Patients with kidney stones larger than 2 cm and a BMI >30 were included. They were categorised based on MAP scores (<3 vs. ≥3). Data on operation time, fluoroscopy time, hospital stay, and complications were compared. Statistical analyses included t tests, chi-square tests, and logistic regression to assess risk factors for postoperative fever.</p><p><strong>Results: </strong>Among 87 patients, those with a MAP score ≥3 had a significantly higher rate of postoperative fever (17.1% vs. 3.8%, p = 0.035). There were no significant differences between groups in operation time, fluoroscopy time, hospital stay, or blood transfusion needs. Logistic regression showed that a higher MAP score (OR: 6.614, p = 0.045) and increased stone burden (OR: 1.003, p = 0.040) were significant predictors of postoperative fever.</p><p><strong>Conclusion: </strong>The MAP score is a significant predictor of postoperative fever in obese patients undergoing m-PCNL. Higher MAP scores are associated with a greater risk of fever, suggesting that careful monitoring and preventive measures are essential for patients with higher MAP scores. Further multicentre studies are needed to validate these findings and improve predictive accuracy.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-6"},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of 10-20 mm Renal Stones: Shock Wave Lithotripsy versus Flexible Ureteroscopy.","authors":"Erhan Erdoğan, Ahmet Fatih Kanberoğlu, Alper Aşık, Göksu Sarıca, Kemal Sarıca","doi":"10.1159/000545108","DOIUrl":"10.1159/000545108","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the efficacy and safety of shock wave lithotripsy (SWL) and flexible ureteroscopy (fURS) in treating unilateral moderate-sized (10-20 mm) kidney stones, with a focus on changes in quality of life (QoL).</p><p><strong>Methods: </strong>This study included 112 patients with unilateral radiopaque kidney stones. Patients were divided into two groups: SWL (n = 64) and fURS (n = 48). Treatment outcomes, including QoL changes, were evaluated comparatively between the groups.</p><p><strong>Results: </strong>Both groups were similar in terms of age, gender, stone size, and density. Short-term (4-week) stone-free rates (SFRs) were higher in the fURS group (79.17% vs. 51.56%, p = 0.003). However, at 3 months, there was no significant difference in SFRs (89.8% vs. 85.2%, p = 0.098). Pain levels, assessed using the Visual Analog Scale, showed no difference 1-h post-procedure (p = 0.338), but SWL had lower pain scores at 4 h (p = 0.002). QoL, assessed with the SF-36 questionnaire, indicated an advantage for SWL in energy/fatigue parameters (p = 0.017), with no significant differences in other domains. SWL was particularly beneficial for energy levels and emotional well-being.</p><p><strong>Conclusions: </strong>SWL's noninvasive nature, reduced pain levels, and advantages in specific QoL parameters make it an effective treatment option for medium-sized kidney stones. While fURS offers better short-term stone clearance, SWL demonstrates comparable long-term efficacy with added QoL benefits.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Radical Cystectomy with Orthotopic Neobladder Reconstruction in Patients Developing Bladder Cancer after Prior Radical Prostatectomy, Radiation Therapy, or BPH Surgery.","authors":"Nikolaos Pyrgidis, Yannic Volz, Sarah Takayama Fouladgar, Benedikt Ebner, Philipp Weinhold, Julian Marcon, Michael Chaloupka, Christian G Stief, Gerald Bastian Schulz, Patrick Keller","doi":"10.1159/000545103","DOIUrl":"10.1159/000545103","url":null,"abstract":"<p><strong>Introduction: </strong>Current evidence suggests that prior prostatic interventions, such as prostatectomy, radiation, or transurethral surgery, may increase the risk of incontinence in patients undergoing radical cystectomy (RC) with ileal orthotopic neobladder reconstruction. We aimed to evaluate the short- and long-term complications, functional outcomes of neobladder reconstruction in patients undergoing RC after prior prostatic procedures.</p><p><strong>Methods: </strong>We analyzed patients who underwent RC after prior prostatic intervention in our department from 2013 to 2022. A comparison was made between patients receiving neobladder reconstruction (ONB) versus ileal conduit, including propensity score matching for age and preoperative continence.</p><p><strong>Results: </strong>We included 79 patients who underwent RC for bladder cancer after prior prostatic intervention. Of them, 43 (54%) patients had previously undergone BPH surgery, 29 (37%) radical prostatectomy, and 7 (9%) prostate radiation therapy. An ileal conduit was performed in 62 (78%) cases. Patients presented similar baseline characteristics, perioperative complications, and quality of life after RC. Accordingly, after propensity-score-matching patients with ONB after prior prostatic intervention and patients who received ONB without prior prostatic intervention did not differ significantly in their baseline characteristics, perioperative complications, and quality of life. Overall, 24% of patients without prior intervention reported incontinence, compared to 53% with prior prostatic intervention.</p><p><strong>Conclusion: </strong>Neobladder reconstruction remains to be a feasible option in patients undergoing RC after prior prostatic intervention.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrimination of T-Stage Using Tumor Weight and Size: A Potential Approach to Guide Perioperative Decision-Making in Patients with Bladder Cancer.","authors":"Karl Tully, Henning Bahlburg, Moritz J Reike, Mirco Brehmer, Sebastian Berg, Peter Bach, Joachim Noldus, Florian Roghmann","doi":"10.1159/000543112","DOIUrl":"10.1159/000543112","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of the study were to examine the value of tumor size, weight, and density in predicting pathological tumor stage in patients with suspected bladder cancer (BCa), minimize inter-observer variability of estimated tumor size, and thus provide a more objective instrument to describe the extent of local tumor growth.</p><p><strong>Methods: </strong>An institutional dataset of 588 consecutive patients undergoing transurethral resection of bladder tumor (TUR-BT) for suspected BCa from 05/2016 to 09/2018 was used. Separate Mann-Whitney U tests examined differences in each unit between non-muscle-invasive BCa (NMIBC) and muscle-invasive BCa (MIBC) and between Ta/carcinoma in situ and T1 NMIBC. Intraoperative tumor size, weight, and respective density were calculated. We then calculated multivariable logistic regression models to examine each unit's predictive value and distinguish between endpoints.</p><p><strong>Results: </strong>Overall, 367 patients undergoing TUR-BT were diagnosed with BCa. In patients with MIBC (n = 73), the median size (p < 0.001) and weight (p < 0.001) were higher compared to NMIBC. In contrast, tumor density (p < 0.001) was lower. On multivariable analysis, increasing size and weight were associated with higher odds of T1 (size: odds ratio [OR] 2.50, 95% confidence interval [CI]: 1.87-3.35; weight: OR 1.65, 95% CI: 1.26-2.15) and muscle-invasive disease (size: OR 1.51, 95% CI: 1.29-1.78; weight: OR 1.09, 95% CI: 1.03-1.15). Meanwhile, an increasing density was associated with lower odds of both outcomes (T1: OR 0.96, 95% CI: 0.89-1.02; MIBC: OR 0.81, 95% CI: 0.69-0.96).</p><p><strong>Conclusion: </strong>In patients diagnosed with BCa, tumor size, and weight showed similar predictive power concerning T1 NMIBC and MIBC. Tumor density failed to predict the local tumor stage sufficiently. These results may lay the foundation for improving objective measurement of the local tumor burden in patients with BCa and may help guide further immediate treatment decisions.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"323-329"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship between Procalcitonin, Systemic Inflammatory Index, and C-Reactive Protein and Skin Reconstruction in Fournier's Gangrene Patients: A Retrospective Single-Center Study.","authors":"Salih Bürlukkara, Özer Baran","doi":"10.1159/000545013","DOIUrl":"10.1159/000545013","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to examine the relationship between skin reconstruction and systemic inflammatory index (SII), procalcitonin in Fournier's gangrene.</p><p><strong>Methods: </strong>Forty-seven male patients who underwent debridement and were diagnosed with Fournier's gangrene were included in this retrospective study. The patient groups were divided into two groups. Group 1 included 26 patients who required primary skin closure, and Group 2 included 21 patients who required skin grafts and flaps. Data regarding initial symptoms, physical examination findings, vital signs, and laboratory tests were collected through archive scanning. Patients with available data for the Fournier's gangrene severity index (FGSI), Uludağ's Fournier's gangrene severity index (UFGSI), procalcitonin, C-reactive protein (CRP), and SII calculations were included in the study.</p><p><strong>Results: </strong>A significant difference in vital signs was found between the groups. Fever, pulse and respiratory rate were significantly greater in Group 2 than in Group 1 (p = 0.747). There was no significant difference in body mass index (BMI) or duration of hospitalization (p = 0.983). The average procalcitonin level of the patients measured preoperatively was 1.01 in Group 1 and 2.30 in Group 2. In Group 1, the average CRP level was 111.90, the SII was 3,460.00; in Group 2, the CRP level was 165.00, the SII was 6,544.00, and this difference between the two groups was significant (p = 0.011-0.018).</p><p><strong>Conclusion: </strong>CRP, procalcitonin, and SII rates can be measured simply, easily applied, and can provide insight into predicting skin reconstruction.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"391-398"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiologic, Tomographic, and Infrared Spectroscopic Analysis of Double J Stent Encrustations.","authors":"Renato Pedro, Andre Rubez, Tamara Silva Cunha, Ivan Selegatto, Azal Neto, Ricardo Miyaoka, Kamran Hassan Bhatti, Renato Nardi Pedro","doi":"10.1159/000543443","DOIUrl":"10.1159/000543443","url":null,"abstract":"<p><strong>Introduction: </strong>Double J (DJ) stent is a common medical device, and it may become encrusted, causing significant concern. Understanding the composition and associated risk factors for encrusted stents is crucial for appropriate management.</p><p><strong>Objective: </strong>The aim of the study was to evaluate the types of DJ encrustation by infrared spectroscopy and correlate them with patient characteristics and computerized tomographic (CT) findings.</p><p><strong>Methods: </strong>All encrusted stents surgically removed over a 1-year period underwent infrared spectroscopy analysis, and types of encrustations were compared with the patient's demographic, clinical, and imaging features. For categorical variables, frequency tables were generated, and for comparing continuous measurements across multiple groups, the Kruskal-Wallis test was used, considering p < 0.05 as statistically significant.</p><p><strong>Results: </strong>Thirty-three patients were included; the mean age was 46 years, and the mean BMI was 32.9 ± 8.98 kg/m2. The average DJ indwelling time was 8.3 ± 7.78 months. Spectroscopic analysis: 34.3% struvite, 22.8% uric acid, 17.1% calcium oxalate, 11.4% ammonium urate, 5.7% brushite, 5.7% calcium oxalate dihydrate, and 2.9% protein. Lower urine pH was associated with uric acid encrustations (p = 0.017). Uric acid and urate encrustations presented significantly lower densities on CT readings (p = 0.043). Brushite prevalence was surprisingly high in our series, and therefore, it has to be considered for early DJ encrustation.</p><p><strong>Conclusion: </strong>The types of mineral deposits depicted in our study differed from the literature, where calcium oxalate is the most common; therefore, other compositions such as struvite and uric acid/ammonium urate should be considered. Urine pH demonstrated an association with uric acid and urate calcifications, which can be predicted by lower densities in CT readings.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"463-470"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refluxing versus Non-Refluxing Ureteric Implantation in Continent Cutaneous Urinary Diversion: A Propensity-Scored Comparison regarding Long-Term Renal, Metabolic, and Functional Outcomes of Patients with Ileocecal Pouch.","authors":"Marcel Schwinger, Anna Katharina Seitz, Hubert Kübler, Arkadius Kocot, Hubertus Riedmiller, Charis Kalogirou","doi":"10.1159/000540096","DOIUrl":"10.1159/000540096","url":null,"abstract":"<p><strong>Introduction: </strong>Studies comparing refluxing versus non-refluxing ureteric implantation in continent cutaneous urinary diversion (CCUD) are scarce and often characterized by heterogeneous study populations. This work therefore aimed at comparing both techniques regarding long-term outcomes in a propensity-scored approach.</p><p><strong>Methods: </strong>We identified n = 19 patients, totaling n = 38 renal units (RU), who underwent CCUD surgery at our hospital out of a pool of 120 patients. Of these 38 RU, 27 RU were implanted via refluxing ureteric implantation utilizing various procedures due to special intraoperative circumstances (short ureters, damage due to radiation). In terms of preoperative renal function, a comorbidity index (Age-Adjusted Charlson Comorbidity Index [ACCI]), and gender, we compared them to n = 38 patients with a total of 76 RU with non-refluxing ureteric implantation in all RU (1:2 matching). The mean follow-up was 56 (IQR: 23-112) months.</p><p><strong>Results: </strong>Long-term renal function was comparable in CCUD patients receiving refluxing versus non-refluxing ureteric implantation (estimated glomerular filtration rate: 63.11 mL/min vs. 71.7 mL/min, p = 0.22) with an average decline of 17.4 mL/min and 13.69 mL/min during the follow-up period, respectively. Also, the rate of new-onset chronic kidney disease (CKD) (both 15%, p = 1), the need for alkalizing medication, or the number of pyelonephritis episodes did not significantly differ between the groups. In Cox regression analysis, ACCI was the single most predictive parameter for the development of new-onset CKD (HR: 1.71 [1.10-2.66], p = 0.0167). None of the RU in the refluxing group needed revisional surgery concerning the ureterointestinal anastomosis, whereas 7 RU of the non-refluxing group did.</p><p><strong>Conclusions: </strong>Our study confirms that refluxing ureteric implantation in CCUDs is a valid and safe procedure regarding long-term renal, metabolic and functional outcomes. Our data also suggest that patients should be counseled according to their comorbidities regarding long-term renal function.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"45-51"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Pole Stones Are Associated with Low Stone-Free Rates in Retrograde Intrarenal Surgery: A Myth or Fact? - A Matched Case-Control Study from the RIRSearch Group.","authors":"Muhammed Fatih Simsekoglu, Oktay Özman, Hakan Cakir, Kerem Teke, Önder Çınar, Murat Akgül, Mustafa Bilal Tuna, Cem Başataç, Eyüp Burak Sancak, Duygu Sıddıkoğlu, Cenk Yazici, Barbaros Başeskioğlu, Haluk Akpinar, Bulent Onal","doi":"10.1159/000541253","DOIUrl":"10.1159/000541253","url":null,"abstract":"<p><strong>Introduction: </strong>There are conflicting results in the literature regarding the efficacy of retrograde intrarenal surgery (RIRS) in lower pole stones. This study aimed to evaluate RIRS outcomes in lower pole stones by forming matched case-control groups.</p><p><strong>Methods: </strong>The data of 491 patients who were diagnosed with kidney stones and underwent RIRS were retrospectively included in the study. A total of 209 patients with lower pole stones (Group 1) and 282 patients with pelvic stones (Group 2) were matched at a 1:1 ratio in terms of stone burden, stone density, preoperative double-J stenting status, and a previous history of shock wave lithotripsy, yielding 159 patients in each group. A computed tomography scan was performed to evaluate the stone-free status. The primary outcome was stone-free status 1 month after RIRS.</p><p><strong>Results: </strong>After case-control matching, the median age was 49 years (interquartile range [IQR]: 40-58) in Group 1 and 50 years (IQR: 35-60) in Group 2 (p = 0.388). The median stone burden values of Group 1 and Group 2 were 415.3 mm3 (IQR: 176.1-858.2) and 503.3 mm3 (IQR: 282.5-864), respectively (p = 0.100). After RIRS, stone-free status was achieved by 126 of the 159 (79.2%) in Group 1 and 133 of the 159 (83.6%) patients in Group 2 (p = 0.387). The groups were similar in terms of perioperative complications (4.4% in Group 1 and 3.8% in Group 2, p = 0.777), postoperative complications (13.8% in Group 1 and 10.3% in Group 2, p = 0.393), and median operation time (60 min in both, p = 0.230). A longer median fluoroscopy time was noted in Group 1 compared to Group 2 (26 s and 3 s, respectively, p = 0.013).</p><p><strong>Conclusions: </strong>Stone-free rates and complications were comparable between the patients with lower pole and pelvic stones after RIRS. However, lower pole stones are associated with longer fluoroscopy time. RIRS can be performed effectively for the treatment of lower pole stones.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"52-60"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}