Urology最新文献

{"title":"Editorial Comment on \"Effect of Age on Robotic-Assisted Radical Prostatectomy Outcomes: A Multi-center Analysis\".","authors":"Abhilash Moolupuri, John M Lacy","doi":"10.1016/j.urology.2025.05.061","DOIUrl":"10.1016/j.urology.2025.05.061","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Editorial Comment on \"A Predictive Model for the Risk of Procedural Failure in Retrograde Ureteral Stenting for Malignant Extrinsic Ureteral Obstruction\".","authors":"Shuhan Liu, Zongyao Hao","doi":"10.1016/j.urology.2025.05.065","DOIUrl":"10.1016/j.urology.2025.05.065","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Urology Resident Surgical Autonomy: What Do ACGME Chief Resident Case Logs Indicate?","authors":"Niccola B Lynch, Jonah Samuel, Zachary Corey, Prakash Gorroochurn, Gary E Lemack, Adam P Klausner, Akanksha Mehta, Mathew D Sorensen, Ryan Smith, Jill C Buckley, R Houston Thompson, Benjamin N Breyer, Eric M Wallen, Jay D Raman, Gregory A Joice, Gina M Badalato","doi":"10.1016/j.urology.2025.05.070","DOIUrl":"10.1016/j.urology.2025.05.070","url":null,"abstract":"<p><strong>Objective: </strong>To investigate urology resident surgical autonomy trends over time and according to procedure subtype using Accreditation Council for Graduate Medical Education (ACGME) case log data.</p><p><strong>Methods: </strong>A retrospective review of 364 chief urology resident ACGME case logs collected from 11 institutions spanning 2010-2021 was completed. Resident-defined role in cases as \"assistant,\" \"surgeon,\" or \"teaching surgeon\" were used as a metric of graded autonomy. An autonomy score was calculated. Analysis of variance (ANOVA) evaluated differences in autonomy between institutions, within institutions, and between procedure types. Generalized estimating equations assessed changes in autonomy over time.</p><p><strong>Results: </strong>Mean autonomy scores were significantly different between procedure categories, with general urology/endourology having the highest autonomy, reconstruction/pediatrics having the second highest autonomy, and oncology having the lowest autonomy (P <.05 across all comparators). Between institution variance in autonomy was significantly greater than within institution variance (0.09396 vs 0.01109, P <.0001). Globally, mean autonomy scores significantly decreased from 2010 to 2021 by a value of 0.007 per year (P <.001).</p><p><strong>Conclusion: </strong>Surgical autonomy, as extrapolated from self-reported urology chief resident ACGME case logs, varied according to procedure type, with general urology and endourology ranking highest and oncology ranking lowest. Overall, chief resident autonomy scores decreased significantly over time. If validated in a larger national cohort, these findings may have implications for contemporary urologic training in terms of resident confidence and self-sufficiency for independent practice.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment on \"The Statistical Fragility of Randomized Controlled Trials in Kidney Stone Management: An Analysis of AUA and EAU Guidelines\".","authors":"David F Friedlander","doi":"10.1016/j.urology.2025.05.066","DOIUrl":"10.1016/j.urology.2025.05.066","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment on \"Association Between Social Determinants of Health and Choice of Urinary Reconstruction in Children\".","authors":"Jeremy Wiygul","doi":"10.1016/j.urology.2025.05.068","DOIUrl":"10.1016/j.urology.2025.05.068","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review on the Learning Curve of Percutaneous Nephrolithotomy: Operative Time, Fluoroscopy Time, Stone-free Rate, Puncture Performance, Complications, and Safety Indicators.","authors":"Nathan Wirtzfeld, Etienne Xavier Keller, Jia-Lun Kwok, Nariman Gadzhiev, Arman Tsaturyan, Bhaskar Somani, Vincent De Coninck","doi":"10.1016/j.urology.2025.05.060","DOIUrl":"10.1016/j.urology.2025.05.060","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review the learning curve of percutaneous nephrolithotomy (PCNL) among urology trainees, focusing on the number of procedures required to achieve proficiency and key performance metrics.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the PRISMA and the EAU guidelines. PubMed/Medline, Scopus, and Embase were searched up to December 9, 2024, for studies on learning curves in urology trainees performing PCNL on adult humans. Outcomes included operative time, fluoroscopy time, stone-free rate, puncture time and success, complications, and safety indicators. The protocol was registered in PROSPERO (CRD42025633899).</p><p><strong>Results: </strong>Seventeen studies (2230 patients) were included from 807 records. Operative time plateaued after 40-50 cases. Fluoroscopy time improved with experience and plateaued after 30-115 cases, with faster learning in supine positioning. Puncture success neared 100% after 25-50 cases, and puncture time improved after 36 cases. Complication and retreatment rates declined over time, although plateau phases were rarely reported. Stone-free rates and patient safety indicators improvement inconsistently across studies. Considerable heterogeneity in outcome definitions and reporting methods precluded pooled analysis.</p><p><strong>Conclusion: </strong>Performance plateaus in PCNL are generally observed after 30-60 procedures, depending on surgical approach and stone complexity. Operative and fluoroscopy times, puncture success, and complication rates improved with experience. Stone-free and retreatment rates showed greater variability, with no clear patterns or plateaus. However, heterogeneity in reporting and outcome definitions currently limits inter-study comparisons and precludes meta-analysis. Standardized training and uniform evaluation methods are needed to better define surgical proficiency.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment on \"A Comparison of Preoperative Frailty Indices Correlation With Perioperative Risk for Patients Undergoing Sacrocolpopexy\".","authors":"Kellen Choi","doi":"10.1016/j.urology.2025.05.069","DOIUrl":"10.1016/j.urology.2025.05.069","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Editorial Comment on \"Assessment of Applicant and Program Director Attitudes Towards a Hybrid Approach to Urology Residency Interviews\".","authors":"Mitchell M Huang, Conor B Driscoll, Nicole Handa, Evan J Panken, Amanda X Vo, Nelson E Bennett","doi":"10.1016/j.urology.2025.05.064","DOIUrl":"10.1016/j.urology.2025.05.064","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Artificial Intelligence Based Augmented Reality Navigation in Minimally Invasive Partial Nephrectomy\".","authors":"Qi Guo","doi":"10.1016/j.urology.2025.05.067","DOIUrl":"10.1016/j.urology.2025.05.067","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment on \"Electronic Residency Application Service Application Fees in Surgical Subspecialties: A Barrier to a Diverse Healthcare Workforce?\"","authors":"Casey G Kowalik","doi":"10.1016/j.urology.2025.05.062","DOIUrl":"10.1016/j.urology.2025.05.062","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}