Nicolò Fiorello, Alessandro Zucchi, Francesco Gregori, Gregorio Romei, Salvatore Fiorenzo, Andrea Di Benedetto, Riccardo Bossa, Andrea Mogorovich, Daniele Summonti, Sandro Benvenuti, Antonio Luigi Pastore, Carlo Alberto Sepich
{"title":"Urinary Leakage after Robot-Assisted Radical Prostatectomy: Is Always Predictive of Functional Results?","authors":"Nicolò Fiorello, Alessandro Zucchi, Francesco Gregori, Gregorio Romei, Salvatore Fiorenzo, Andrea Di Benedetto, Riccardo Bossa, Andrea Mogorovich, Daniele Summonti, Sandro Benvenuti, Antonio Luigi Pastore, Carlo Alberto Sepich","doi":"10.1159/000541409","DOIUrl":"10.1159/000541409","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to evaluate if and when the presence of radiological urinary leakages of vesico-urethral anastomosis, after robotic radical prostatectomy, could provoke urethral strictures or affect continence recovery.</p><p><strong>Methods: </strong>We enrolled 216 patients, undergoing robot-assisted radical prostatectomy between January 2020 and December 2022 in three high-volume referenced centres for robotic surgery. Before removal of the bladder catheter, all patients underwent a cystourethrography in which the presence/absence of leakage was assessed at level of vesico-urethral anastomosis. Based on degree of severity of urinary leakage on cystourethrography, patients were classified as no leakage or grade 0, grade 1 with transversal diameter ≤1 cm, and grade 2 with transversal diameter ≥1 cm. At follow-up, urethral stenosis formation and urinary continence recovery were assessed; furthermore, post-operative 12-month functional outcome was determined using EORTC-QLQ-PR25 questionnaire.</p><p><strong>Results: </strong>Radiological urinary leakage was found in 30 patients with grade 1 and 33 patients with grade 2, for a total of 63 patients. Only 1 patient (1.5%), grade 2 urinary leakage, developed significant urethral stricture and required endoscopic urethrotomy after 6 months. Analysing the differences in those who removed the bladder catheter after 7-9 days and those who kept it longer, we found no statistically significant differences regarding recovery of continence (p = 0.23) or about urinary symptoms (p = 0.94).</p><p><strong>Conclusions: </strong>RARP remains gold-standard approach for treatment of localized prostate cancer and the superiority of this technique is safe in preventing urethral strictures and continence recovery, even in presence of significant anastomotic urinary leakage.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"68-73"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296565","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}
Yushan Yang, Sonja Holbach, Maximilian Haas, Simon Udo Engelmann, Christopher Gossler, Roman Mayr, Maximilian Burger, Johannes Breyer, Michael Gierth
{"title":"Does Time Matter in Early Radical Cystectomy? Comparing Outcome, Clinical, and Pathological Characteristics of Immediate versus Deferred Radical Cystectomy.","authors":"Yushan Yang, Sonja Holbach, Maximilian Haas, Simon Udo Engelmann, Christopher Gossler, Roman Mayr, Maximilian Burger, Johannes Breyer, Michael Gierth","doi":"10.1159/000543235","DOIUrl":"10.1159/000543235","url":null,"abstract":"<p><strong>Introduction: </strong>Early radical cystectomy (eRC) can be performed for high or very high risk non-muscle-invasive bladder cancer (NMIBC). Whether immediate eRC is beneficial is still unclear. The objective of this study was to compare outcomes between immediate eRC, delayed eRC, and radical cystectomy (RC) at the diagnosis of muscle-invasive bladder cancer (MIBC).</p><p><strong>Methods: </strong>The single-center cohort consisting of patients with RC between 2008 and 2020 was divided into 4 populations: patients who received immediate eRC within 3 months of diagnosis of NMIBC (IEC), patients who received eRC at recurrence of NMIBC (REC), patients who underwent RC after primary diagnosis of MIBC (primMIBC), and patients with the initial diagnosis of NMIBC who received RC after progression to MIBC (progMIBC).</p><p><strong>Results: </strong>Among the 463 patients included, 39 had IEC, 58 had REC, 314 had primMIBC, and 53 had progMIBC. No statistically significant differences for OS, CSS, and RFS between the two groups receiving eRC were found. Patients with pT1 tumors (p = 0.003) and tumor size ≥3 cm (p = 0.012) were more likely to receive immediate RC.</p><p><strong>Conclusion: </strong>Immediate and delayed eRC show comparable survival outcomes. The present study emphasizes the need for accurate risk stratification of patients with NMIBC to identify the most advantageous therapy for individual patients.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"315-322"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883079","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}
Christian Guido Ruf, Johanna Hochmuth-Tisch, Andrea Salzbrunn, Cord Matthies, Tim Cordes, Kathrein von Kopylow, Christian Wülfing, Uwe Pichlmeier, Armin Soave, Klaus-Peter Dieckmann
{"title":"Pre-Orchiectomy Semen Analysis in Patients with Testicular Germ Cell Tumours and Comparison with Healthy Men and with Patients with Other Malignancies.","authors":"Christian Guido Ruf, Johanna Hochmuth-Tisch, Andrea Salzbrunn, Cord Matthies, Tim Cordes, Kathrein von Kopylow, Christian Wülfing, Uwe Pichlmeier, Armin Soave, Klaus-Peter Dieckmann","doi":"10.1159/000543360","DOIUrl":"10.1159/000543360","url":null,"abstract":"<p><strong>Introduction: </strong>Subfertility is a well-known aftermath of treatment of testicular germ cell tumours (GCTs). Growing evidence suggests reduced semen quality also before therapy. The present study aimed to evaluate pre-orchiectomy semen parameters in GCT patients and to compare the results with controls.</p><p><strong>Methods: </strong>GCT patients providing semen for cryopreservation before orchiectomy during 2012-2023 were retrospectively enrolled (TT cohort). Controls consisted of healthy volunteers for sperm donation (HD), and of patients with other malignancies (OMs). The following parameters were recorded in each participant: ejaculate volume (EV; ml), total sperm count in ejaculate (TSC), and proportion of progressive motility (PM) (%). Descriptive statistical methods were used to compare the 3 populations with each other.</p><p><strong>Results: </strong>A total of 664 subjects were included, thereof 163 TT, 289 HD, and 212 OM. Median EV was 3.0 mL, 3.5 mL, and 3.4 mL; median TSC was 56.9 × 106, 207 × 106, and 152 × 106; median PM was 40%, 40.2%, and 43% in TT, HD, and OM, respectively. TSC, EV, and several secondary parameters of semen quality observed in TT were significantly worse than those in the two control cohorts. HD and OM were within normal limits with regard to TSC and PM and were different in only a few secondary parameters.</p><p><strong>Conclusion: </strong>This study confirmed significantly lower pre-orchiectomy semen quality in GCT patients in comparison to healthy males and to patients with OM. Subfertility is an intrinsic feature of GCT preceding treatment that needs to be considered by care-givers.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"346-354"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410802","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":"Clinical Features and Outcomes of Congenital Anterior Urethrocutaneous Fistula: A Case Series Study.","authors":"Bin Zhang, Haijun Zhong, Hongquan Geng, Bin Zhang","doi":"10.1159/000545206","DOIUrl":"10.1159/000545206","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the clinical features and prognosis of congenital anterior urethrocutaneous fistula (CAUF) patients.</p><p><strong>Methods: </strong>This is a retrospective chart review of patients diagnosed with CAUF and underwent surgical repair by the author between October 2017 and December 2021 that was performed at a single tertiary care institution. The medical records of CAUF patients were reviewed to evaluate their clinical characteristics and outcomes.</p><p><strong>Results: </strong>11 patients with CAUF were included. The median age of the patients was 41 months (11-84 months). Subcoronal fistulas were observed in 1 patient, mid-penile shafts in 7 patients, proximal penile to subcoronal fistulas in 2 patients, and perineum to penile fistulas in 1 patient. Associated urinary system anomalies were found in 3 patients, and other anomalies were found in 2 patients. One-stage surgery was performed in 10 patients, and staged surgery was performed in 1 patient. There were no postoperative complications, and there was good voiding.</p><p><strong>Conclusion: </strong>Although CAUF often coexists with genitourinary or other deformities, it has a good prognosis following an appropriate surgical strategy for each patient.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"528-532"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606525","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}
Sebastian Lenart, Sebastian Lenart, Julia Dorfinger, Sebastian Graf, Florian Wimpissinger, Dennis Schallmayer, Livia Huber, Valentin Bachler, Lukas Lusuardi, Malavika Krishnakumar, Stephan Madersbacher, Michael Lotterstätter
{"title":"Fournier's Gangrene Leads to Lower Quality of Life and Self-Esteem.","authors":"Sebastian Lenart, Sebastian Lenart, Julia Dorfinger, Sebastian Graf, Florian Wimpissinger, Dennis Schallmayer, Livia Huber, Valentin Bachler, Lukas Lusuardi, Malavika Krishnakumar, Stephan Madersbacher, Michael Lotterstätter","doi":"10.1159/000543614","DOIUrl":"10.1159/000543614","url":null,"abstract":"<p><strong>Introduction: </strong>Fournier's gangrene (FG) is a life-threatening necrotizing infection of the perineal, genital, or perianal regions, often requiring extensive surgical intervention and prolonged recovery. Despite advances in acute management, the long-term impact of FG on patients' self-esteem and quality of life (QoL) remains underexplored.</p><p><strong>Methods: </strong>This retrospective study included 48 patients treated for FG at seven urological centres in Austria between 2017 and 2022. Several in-house data were collected and patients were contacted after a mean of 4.5 years to complete a questionnaire including the International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), Short Form (SF-12) QoL questionnaire, and the Rosenberg self-esteem scale (RSE).</p><p><strong>Results: </strong>The study recruited 48 patients with a median age of 64 years; 58.7% required intensive care unit stays due to infection (median duration, 6 days). The in-house mortality rate was 8.3%. Survivors (n = 44) had a median hospitalization of 16 days. They were contacted by mail, and 18 completed the questionnaire. There was a high prevalence of urinary symptoms and erectile dysfunction, wound pain, and impaired QoL. Severe erectile dysfunction (IIEF-5 score ≤7) was reported by 46.2%, and 38.9% reported Visual Analog Scale pain score ≥4. Impaired self-esteem (mean RSE score: 12.4) correlated with functional impairments, including urinary symptoms (IPSS ≥20 in 55.6%), erectile dysfunction, and wound-related pain. Physical and mental health were strongly associated with decreased self-esteem, with hypertension (61.1%) and alcohol abuse (16.7%) negatively impacting outcomes.</p><p><strong>Conclusion: </strong>FG negatively impacts patients' self-esteem and QoL, particularly in the presence of pre-existing risk factors. The findings highlight the importance of integrated rehabilitation approaches to mitigate long-term psychological and functional impairments.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"437-444"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012532","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":"Patient-Derived Bladder Cancer Organoids: Model Construction and Drug Sensitivity Testing.","authors":"Yong Zhang, Runze Liu, Yong Zhang, Zhongbao Zhou","doi":"10.1159/000543983","DOIUrl":"10.1159/000543983","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder urothelial carcinoma is highly heterogeneous and is prone to recurrence. There are many types of drugs for intravesical instillation, and there is an urgent need for reliable tumor models for individualized treatment strategies. Patient-derived organoids (PDOs) are efficient and accurate neotype tumor models that can compensate for the deficiencies of traditional tumor models.</p><p><strong>Methods: </strong>From September 2023 to February 2024, bladder cancer tissues were collected from surgical resections in the Department of Urology, Beijing Tiantan Hospital, Capital Medical University. We explored suitable culture systems and cultured primary tumor cells in Matrigel matrix gels. Hematoxylin and eosin (HE) staining and immunohistochemistry were performed for comparison with the original tumor tissue at the histological level for validation. Drug sensitivity tests were also conducted.</p><p><strong>Results: </strong>In this study, a culture system for PDOs was successfully established. HE staining and immunohistochemistry were used to morphologically verify the organ model. Drug sensitivity tests have clarified the value of PDOs as preclinical models of precision medicine.</p><p><strong>Conclusion: </strong>A bladder tumor PDO culture platform was initially established, which laid a foundation for the subsequent construction of the organoid bank, the study of bladder tumor progression mechanism, and research in precision medicine.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"478-486"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391862","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}
Lennert Eismann, Severin Rodler, Alexander Buchner, Frank Strittmatter, Abdulmajeed Alghamdi, Simon Lennartz, Jan-Peter Grunz, Raphaela Waidelich, Armin Becker, Philipp Weinhold, Alexander Kretschmer, Christian G Stief, Thilo Westhofen
{"title":"The Impact of Ureteral Access Sheaths on Radiation Exposure in the Ureterorenoscopic Treatment of Urolithiasis.","authors":"Lennert Eismann, Severin Rodler, Alexander Buchner, Frank Strittmatter, Abdulmajeed Alghamdi, Simon Lennartz, Jan-Peter Grunz, Raphaela Waidelich, Armin Becker, Philipp Weinhold, Alexander Kretschmer, Christian G Stief, Thilo Westhofen","doi":"10.1159/000542945","DOIUrl":"10.1159/000542945","url":null,"abstract":"<p><strong>Introduction: </strong>Ureteral access sheaths (UASs) are widely used in the endoscopic treatment of urolithiasis. In modern medicine, radiation exposure from diagnostics and therapy is increasing; however, the impact of UAS on procedure duration, fluoroscopy time, and radiation exposure is still uncertain.</p><p><strong>Methods: </strong>This retrospective study included 1,026 patients who received ureterorenoscopic treatment for nephrolithiasis between 2016 and 2018 at a large academic center. Patients were dichotomized according to the use of UAS, and propensity-score matching was performed based on age, BMI, and stone size. Patient demographics, stone size, radiographic density, perioperative complications, and postoperative outcome were assessed. Procedure time and radiation exposure, recorded as the fluoroscopy time and area dose product, were analyzed.</p><p><strong>Results: </strong>In total, 300 patients were successfully matched to the cohort with UAS (n = 150) and the cohort without UAS (n = 150). Patients' demographics were similar for age, gender, BMI, and ASA score (each p > 0.05). Median stone size was 8 mm and 7.5 mm in the cohort with and without UAS (p = 0.335). Procedure time showed no differences between the two cohorts (p = 0.749). Fluoroscopy time and area dose product were significantly lower in patients treated with the use of UAS (p = 0.004; p < 0.001).</p><p><strong>Conclusion: </strong>The use of a UAS does not prolong operation time in patients with an equivalent stone burden. In addition, the use of a UAS reduces fluoroscopy time and radiation exposure. In the future, to reduce radiation exposure to the patient and medical staff, the use of a UAS should also be considered for limited stone disease.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"330-336"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795235","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":"Assessment of Intrarenal Pressure through Dilatation State of the Renal Collecting System.","authors":"Yujun Chen, Heng Yang, Yue Yu, Haibo Xi, Gongxian Wang, Xiaochen Zhou","doi":"10.1159/000541637","DOIUrl":"10.1159/000541637","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to explore the relationship between the dilation states of the renal collecting system in flexible ureteroscopy (f-URS) view and intrarenal pressure (IRP).</p><p><strong>Methods: </strong>Fifteen porcine kidneys were randomly selected and numbered 1 through 15. Pressure transducers were inserted into the renal calyx via puncture and adjusted to a zero position. The distal end of the f-URS probe was placed within the renal pelvis. Perfusion rates of 50 mL/min, 80 mL/min, and 100 mL/min were utilized. We observed the relationship between the dilation state of the renal collecting system and changes in IRP. The state of complete dilation was defined as an unchanging spatial morphology of the renal collecting system as visualized during f-URS.</p><p><strong>Results: </strong>With irrigation rates of 50 mL/min, 80 mL/min, and 100 mL/min, IRP values at the moment of complete dilation of the renal collecting system ranged from 16 to 18 cm H2O, 16-19 cm H2O, and 16-19 cm H2O, respectively. Maximum IRPs ranged from 47 to 49 cm H2O, 82-85 cm H2O, and 97-100 cm H2O, respectively. Prior to complete dilation of the renal collecting system, IRP consistently remained below 20 cm H2O. However, following full dilation of the renal collecting system, IRP rose rapidly and rapidly surpassed 20 cm H2O. Despite sustained elevations in IRP following full dilation, no significant alterations in the renal collecting system dilated morphological were observed with f-URS.</p><p><strong>Conclusions: </strong>In vitro experiments indicate that when the renal collecting system is not fully dilated, the IRP is consistently less than 20 cm H2O. Evaluation of IRP being within a safe range can be determined by assessing the dilation status of the renal collecting system.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"151-157"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475895","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}
Yajie Li, Qifei Zhou, Weihao Li, Jiahui Cao, Kangjie An, Shuhui Liu, Yanping Ma, Bo Tao, Ning Wang, Yaodong Jia, Lihong Nie, Ruining Zhao
{"title":"The Application Value of 3D Model in Partial Nephrectomy of Varying Complexity.","authors":"Yajie Li, Qifei Zhou, Weihao Li, Jiahui Cao, Kangjie An, Shuhui Liu, Yanping Ma, Bo Tao, Ning Wang, Yaodong Jia, Lihong Nie, Ruining Zhao","doi":"10.1159/000542846","DOIUrl":"10.1159/000542846","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to explore the application value of three-dimensional (3D) model in partial nephrectomy across varying RENAL scores.</p><p><strong>Methods: </strong>A total of 126 patients were enrolled, divided into three groups: 25 cases in the 3D-partial nephrectomy (3D-PN), 86 cases in the 2D-partial nephrectomy (2D-PN), and 15 cases in the 3D-robot-assisted PN (3D-RAPN). Preoperative basic data were collected, including age, gender, neutrophil ratio, platelet count, blood glucose, GFR of the kidney, tumor diameter, tumor staging, RENAL score, Mayo Adhesive Probability (MAP) score, surgical time, warm ischemia time, intraoperative bleeding, postoperative drainage volume, postoperative hospital stay, change in creatinine level at 3 months postoperatively, and pathological results. Perioperative data between 3D-PN and 2D-PN, between the RENAL score 4-6 subgroup of 3D-PN and 2D-PN, between the RENAL score ≥7 subgroup of 3D-PN and 2D-PN, and between the 3D-PN and 3D-RAPN were compared. Statistical analysis was performed using SPSS version 26.0.</p><p><strong>Results: </strong>The 3D-PN showed statistically significant differences compared to the 2D-PN in warm ischemia time, intraoperative bleeding volume, postoperative drainage volume, and postoperative hospital stay (p < 0.05). In the RENAL score 4-6 subgroup, the 3D-PN showed statistically significant differences in intraoperative bleeding volume compared to the 2D-PN (p < 0.05). In the RENAL score ≥7 subgroup, the 3D-PN showed statistically significant differences compared to the 2D-PN in surgical time, warm ischemia time, postoperative drainage volume, and postoperative hospital stay (p < 0.05). There were statistically significant differences between the 3D-PN and the 3D-RAPN in warm ischemia time, intraoperative bleeding volume, and postoperative hospital stay (p < 0.05).</p><p><strong>Conclusion: </strong>Patients with RENAL score ≥7 benefit more from preoperative evaluation with 3D model. The combination of 3D model and RARP can further enhance the advantages and expand the convenience of surgery.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"251-259"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772718","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}
Marcel Schwinger, Johanna Wege, Oliver Hahn, Hubert Kübler, Vincent Scheper, Charis Kalogirou
{"title":"An Analysis of Renal and Surgical Outcomes of Patients with and without Preoperative Ureteral Stenting before Nephron-Sparing Surgery for Renal Malignancies of Higher Complexity by Using a Propensity Score-Based Approach.","authors":"Marcel Schwinger, Johanna Wege, Oliver Hahn, Hubert Kübler, Vincent Scheper, Charis Kalogirou","doi":"10.1159/000543073","DOIUrl":"10.1159/000543073","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to evaluate the impact of preoperative ureteral stenting on post-operative outcomes, especially the incidence of urinoma, in patients with complex renal tumours undergoing nephron-sparing surgery (NSS).</p><p><strong>Methods: </strong>A retrospective analysis of 35 patients received preoperative ureteral stenting prior to NSS for complex tumours at the University Hospital of Würzburg between 2002 and 2021. A control group of 115 patients was established through 1:3 propensity score matching based on age, gender, T-stage, and RENAL score. Clinical parameters, surgical outcomes, and complications were assessed, and statistical comparisons were performed using the unpaired Student's t test and chi-square test.</p><p><strong>Results: </strong>While both groups showed comparable tumour complexity (RENAL: 7 vs. 7, p = 0.58; PADUA: 9 vs. 8, p = 0.62), there were no significant differences in median hospital stay (12 vs. 11; p = 0.068), surgical time (183 vs. 190 min; p = 0.37), post-operative haemoglobin levels (11 g/dL vs. 11.1 day/dL; p = 0.9), and renal function (GFR 65 mL/min/m2 in both groups). Moreover complication severity during NSS, defined by Clavien-Dindo classification, was similar (none vs. grade I; p = 0.29). No significant difference in the rate of urinoma was observed (11% vs. 4%, p = 0.93).</p><p><strong>Conclusions: </strong>This study found no significant benefits of preoperative ipsilateral ureteral stenting on post-operative outcomes, particularly concerning the development of urinoma. Given these findings, preventive ureteral stenting is not recommended prior to partial kidney resection for complex renal tumours.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"278-284"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814235","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}