Urology Journal最新文献

{"title":"Effect of Monopolar Versus Bipolar Transurethral Resection of The Prostate on Erectile Function: A Randomized Controlled Trial with Phosphodiesterase-5 Inhibitors Users Subgroup Analysis.","authors":"Farbod Khorrami, Seyyed-Masoud Sadat, Mohammadreza Hajian, Farshad Gholipour","doi":"10.22037/uj.v22i.8234","DOIUrl":"https://doi.org/10.22037/uj.v22i.8234","url":null,"abstract":"<p><strong>Purpose: </strong>Men with lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH) often experience erectile dysfunction (ED). While transurethral resection of the prostate (TURP) can improve ED, new-onset ED remains a concern. This study compares monopolar (M-TURP) and bipolar (B-TURP) techniques, with a subgroup analysis based on phosphodiesterase-5 inhibitor (PDE5i) use.</p><p><strong>Materials and methods: </strong>This randomized clinical trial included candidates for TURP who were over 50 years old. Patients were divided into M-TURP and B-TURP groups. Erectile function was assessed using the International Index of Erectile Function-15 (IIEF-15) at baseline, six weeks, and six months post-surgery.</p><p><strong>Results: </strong>A total of 205 patients were analyzed (102 in the M-TURP group and 103 in the B-TURP group). Both groups showed no significant differences in baseline characteristics, perioperative findings, or surgical complications. IIEF-15 scores were comparable between groups at all time points. In the PDE5i user subgroup, M-TURP showed a slight short-term decline in erectile function and total scores at 6 weeks, but both groups demonstrated no significant long-term changes in ED at 6 months.</p><p><strong>Conclusion: </strong>While no significant difference was observed in the impact of M-TURP and B-TURP on erectile function during medium-term follow-up, patients with a history of PDE5i usage may experience fewer adverse effects on their erectile function from B-TURP during the short-term follow-up.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008481","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 Impact of Adjuvant Drug Therapy on Overall Survival in Patients with Clear Cell Renal Cell Carcinoma: A Systematic Review and Meta-Analysis.","authors":"Dong Lan, Jianhui Du, Wenqiang Yuan, Qiao Ying, Guohua Huang, Jianhua Lan","doi":"10.22037/uj.v22i.8540","DOIUrl":"https://doi.org/10.22037/uj.v22i.8540","url":null,"abstract":"<p><p>Purpose Clear cell renal cell carcinoma (ccRCC), the dominant subtype of renal malignancy, has a rising global incidence and mortality. While surgery is the standard of care for localized cases, adjuvant therapy aims to improve outcomes in high-risk postoperative patients. To quantify the clinical value of adjuvant pharmacotherapy, this systematic review and meta-analysis assesses its effect on overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) in patients with ccRCC. Materials and Methods A comprehensive search of the Web of Science, Embase, Cochrane Library, and PubMed databases was conducted for articles published up to October 2024. The search used the English keywords \"clear cell renal cell carcinoma,\" \"adjuvant drug therapy,\" and \"randomized controlled trials,\" combined with a free-word search. Randomized controlled trials (RCTs) assessing the effectiveness of at least one adjuvant drug therapy in patients with ccRCC were included. Results The meta-analysis showed that adjuvant drug therapy did not result in a statistically significant improvement for OS or PFS compared to the control group. There was also no statistically significant difference in DFS (P > 0.05). This systematic review provides evidence on the impact of adjuvant targeted therapy on OS, DFS, and PFS for patients with clear cell renal cell carcinoma. Conclusion This study summarizes the effects of adjuvant drug therapy on OS, PFS, and DFS in ccRCC patients. The evidence from this meta-analysis can inform clinical decision-making, support risk-stratification strategies, and encourage the integration of OS-driven endpoints in future trial designs, thereby providing valuable data for the treatment of ccRCC.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008469","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":"Update on Suprapubic Cystostomy Diversion vs. Primary Realignment for the Management of Blunt Posterior Urethral Injuries: A Systematic Review and Meta-Analysis.","authors":"Jian-Hua Wen, Shao-Jun Jiang","doi":"10.22037/uj.v22i.8061","DOIUrl":"10.22037/uj.v22i.8061","url":null,"abstract":"<p><strong>Purpose: </strong>This paper reviewed studies comparing the effectiveness of primary urethral realignment (PUR) and suprapubic cystostomy diversion (SCD) in the early treatment of blunt posterior urethral injuries (PUI).</p><p><strong>Materials and methods: </strong>We conducted a systematic review of original studies that directly compared the incidence of urethral strictures (US), urinary incontinence (UI), and erectile dysfunction (ED) in patients receiving primary management for pelvic fracture posterior urethral injuries with PUR versus SCD. We used Review Manager 5.3 for statistical analysis.</p><p><strong>Results: </strong>The initial search yielded 205 articles, and 14 met the inclusion criteria for the final systematic review. Meta-analysis showed that PUR was significantly more effective than SCD in reducing the proportion of US in the 365 and 335 cases of PUR and SCD, respectively (OR 0.09, 95% CI 0.04-0.22, p < 0.0001). However, there was no significant difference between PUR and SCD in the incidence of UI (OR 0.60, 95% CI 0.33-1.11) or ED (OR 0.70, 95% CI 0.45-1.11).</p><p><strong>Conclusion: </strong>PUR is more effective than SCD in reducing the incidence of US in patients with pelvic fracture posterior urethral injuries. However, there was no significant difference between PUR and SCD in the incidence of UI or ED.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"169-175"},"PeriodicalIF":0.9,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970931","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":"Effect of Spinal and General Anesthesia on Postoperative Pain and Satisfaction in Ureteroscopic Lithotripsy (URSL).","authors":"Ali Tavoosian, Amirreza Shamshirgaran, Seyed Reza Hosseini, Farshid Alaedini, Seyed Mohammad Kazem Aghamir","doi":"10.22037/uj.v22i.8405","DOIUrl":"https://doi.org/10.22037/uj.v22i.8405","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare general anesthesia (GA) with spinal anesthesia (SA) regarding postoperative pain and satisfaction after Ureteroscopic Lithotripsy (URSL) Materials and Methods: Two hundred twenty-nine patients were analyzed in the study. Patients were assigned to two groups - \"SA\" and \"GA.\" Demographic data, stone characteristics, operation time, and frequency of opioid analgesic use during the admission period were collected from the hospital medical records. Visual Analogue Scale (VAS) score at 6 hours and 24 hours after URSL were recorded. Complications according to the Clavien-Dindo classification and the experience of headaches after surgery (Yes/No) were documented after one month. Participants and surgeons were asked to rate their satisfaction on a scale of 1 to 10.</p><p><strong>Results: </strong>Of 237 eligible patients, 229 completed the study. The incidence of headaches and VAS score (at 6h and 24h) were significantly higher in the SA group (P < 0.001). The satisfaction of patients and surgeons in the GA group was significantly higher (P < 0.001). Multivariate analysis showed that female gender is associated with lower opioid analgesic use during the admission period (OR = 0.47) and surgery time correlated with frequency of opioid use and headache (OR = 1.12 and OR= 1.11 respectively).</p><p><strong>Conclusion: </strong>Our findings revealed that GA has a better effect on postoperative pain control after URSL surgery and is associated with higher satisfaction levels for both surgeons and patients.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668577","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":"Evaluation of the Effectiveness of Dynamic Neuromuscular Stabilization Training in Children Diagnosed with Lower Urinary Tract Dysfunction and Comparison with EMG Biofeedback Treatment: A Pilot Study.","authors":"Emine Nacar, Sinem Suner Keklik, Ahmet Taner Elmas","doi":"10.22037/uj.v22i.8348","DOIUrl":"https://doi.org/10.22037/uj.v22i.8348","url":null,"abstract":"<p><strong>Purpose: </strong>This study was designed to evaluate effectiveness of dynamic neuromuscular stabilization (DNS) training in children with non-neurogenic lower urinary tract dysfunction (LUTD) and compare it with biofeedback (BF) treatment.</p><p><strong>Materials and methods: </strong>Total of 15 participants aged 6-15 years with non-neurogenic LUTD were divided into three groups: Group I, \"DNS exercise training\"; Group II, \"BF training\"; and Group III, \"DNS plus BF training.\" Participants' Dysfunctional Voiding and Incontinence Scoring System (DVISS) scores, uroflowmetry parameters, uroflow curve, post voiding residual (PVR) values, deep trunk muscle strength were evaluated at baseline and at 4, 8 and 12 weeks after treatment.</p><p><strong>Results: </strong>It was observed that total DVISS scores of individuals in Groups I and III significantly decreased after 12 weeks, while individuals in Group II showed significant decrease in total DVISS score after 4 and 8 weeks (P < .05). When examining changes in deep trunk muscle strength between groups at all time periods, it was determined that improvement in Groups I and III after 4 and 8 weeks was significantly greater than that in Group II (P < .05). In Group I, average flow rate value significantly increased after 4 weeks, while flow time value significantly decreased after 12 weeks (P < .05). When examining PVR values between groups, it was determined that there were statistically significant decreases in individuals in Group I after 12 weeks and in individuals in Group III after 8 weeks (P < .05).</p><p><strong>Conclusion: </strong>According to results, DNS and BF training are effective in improving symptoms in patients with non-neurogenic LUTD. However, groups in which DNS exercises were applied were superior in improving some parameters.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668580","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":"Effects of 6-Gingerol Supplementation in Cryopreservation on Human Sperm Parameters, DNA Fragmentation, and Apoptosis Incidence.","authors":"Shadi Zekri, Roya Bahiraei, Zeinab Ghezelayagh, Parvaneh Maghami, Abdolhossein Shahverdi, Marjan Sabbagian, Bita Ebrahimi","doi":"10.22037/uj.v22i.8352","DOIUrl":"https://doi.org/10.22037/uj.v22i.8352","url":null,"abstract":"<p><strong>Purpose: </strong>Sperm cryopreservation is a valuable method for fertility preservation in men who suffer from oligozoospermia and cancer. The increase of oxidative stress during this process negatively affects the sperm viability, membrane fluidity, and function. Supplementation of antioxidants to the cryopreservation medium can reduce these negative effects. This study investigated the effects of 6-Gingerol as a natural antioxidant during human sperm cryopreservation on different sperm parameters, DNA fragmentation, and apoptosis.</p><p><strong>Material & method: </strong>In this experimental study, semen samples were obtained from 42 normozoospermic men referred to the Royan Institute. The samples were randomly divided into Fresh, Control (cryopreservation), and Gingerol (cryopreservation with 6-Gingerol) groups. Sperm evaluations were conducted before and after cryopreservation. Sperm parameters, DNA fragmentation index (DFI), caspase-3 activity, reactive oxygen species (ROS) levels, malondialdehyde (MDA) concentration, and total antioxidant capacity (TAC) levels were assessed.</p><p><strong>Results: </strong>Use of 6-gingerol in the cryopreservation medium resulted in the recovery of a significantly higher viable sperm post-cryopreservation compared to the control group (64.1 ± 1.3 % vs 56.4 ± 1.3 %; P = 0.000). The ROS levels were significantly lower (P = 0.000), and percent sperm with intact membrane potential was significantly higher (P = 0.000) in the gingerol group (26.1 ± 0.1 RLU/s, 63.5 ± 1.4 %) compared to the control group (32.1 ± 0.7 RLU/s, 53.3 ± 1.5 %).  Active caspase-3 (P = 0.007) and DFI (P = 0.008) were non-significantly lower in the gingerol group (47.3 ± 3.6 %, 37.9 ± 1.3 %, respectively) compared to the control group (60.5 ± 3.6 %, 42.1 ± 0.1 %, respectively).</p><p><strong>Conclusion: </strong>Supplementing sperm cryopreservation medium with 6-Gingerol could improve sperm quality and function, and positively affect the degree of apoptosis incidence during sperm freezing.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668578","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":"Erectile Dysfunction and Ejaculatory Dysfunction in Covid-19 Recovered Patient: Temporary or Persistent?","authors":"Exsa Hadibrata, Sutyarso Sutyarso, Hendri Busman, Sumardi Sumardi","doi":"10.22037/uj.v21i.8113","DOIUrl":"10.22037/uj.v21i.8113","url":null,"abstract":"<p><strong>Purpose: </strong>Examine the prevalence of erectile dysfunction and ejaculatory dysfunction among COVID-19 recovered patients and whether this condition improved over time. The retrospective study of 50 male patients who have recovered from COVID-19 infection previously hospitalized in dr. H Abdul Moeloek General Hospital between March 2020 - March 2021.</p><p><strong>Materials and methods: </strong>All of these patients were evaluated in terms of erectile and ejaculation function via phone interview. The International Index of Erectile Function 5 (IIEF-5) and Male sexual health questionnaire ejaculatory dysfunction (MHSQ-EJD) were used to assess the erectile function and ejaculatory dysfunction. Statistical analysis was performed to evaluate whether there was a difference between IIEF-5 & MHSQ-EJD scores within 6 months, 6 to 12 months, and >24 months after COVID-19 infection.</p><p><strong>Results: </strong>The prevalence of ED was 70% and EJD was 2 % during 0-6 months after COVID-19 infection. Mean age and BMI were 50.4 ± 8.5 years and 23.6 ± 1.6 kg/m2 respectively. There are 26 patients (52%) had an educational background lower than bachelor's degree and 24 patients (48%) had an educational background of bachelor's degree or higher. It was reported that 4 patients (8%) had Diabetes Mellitus and 12 patients (24%) had Hypertension. Most were active smokers (74%) and 2 patients (4%) had reported as active alcohol drinkers. There was a statistically significant IIEF-5 scores difference between three periods of time (p <0,001).</p><p><strong>Conclusion: </strong>The prevalence of Erectile Dysfunction was high in COVID-19 recovered patients. There was a temporary erectile dysfunction and ejaculatory dysfunction among COVID-19 patients.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"102-105"},"PeriodicalIF":1.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915589","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 Impact of Plasmakinetic Resection and Conventional Transurethral Resection of the Prostate on Clinical Symptoms and Quality of Life in Patients with Benign Prostatic Hyperplasia: Retrospective Cohort Study.","authors":"Caoke Gong, Songnian Zou, Shouxi Cui","doi":"10.22037/uj.v22i.8330","DOIUrl":"10.22037/uj.v22i.8330","url":null,"abstract":"<p><strong>Purpose: </strong>Benign prostatic hyperplasia (BPH) is a condition commonly observed in elderly males, leading to lower urinary tract symptoms and potential complications. Surgical procedures primarily include transurethral resection of the prostate (TURP) and plasmakinetic resection, with their effectiveness under active research and clinical interest.</p><p><strong>Materials and methods: </strong>This retrospective cohort study compared the impacts of plasmakinetic resection and conventional TURP on clinical symptoms and quality of life in patients with benign prostatic hyperplasia. It encompassed surgical duration, postoperative complications, urodynamic parameters, quality of life scores, sexual function, and long-term outcomes.</p><p><strong>Results: </strong>Postoperative symptom improvements, including International Prostate Symptom Score (IPSS) and Quality of Life (QoL) score, were significantly higher in the plasmakinetic resection group (P = 0.033 and P = 0.003, respectively). Urodynamic parameters such as peak flow rate (P = 0.008), post-void residual volume (P = 0.044), and Qmax (P = 0.012) also showed significant improvements. Quality of life assessments, including (EuroQol-5 Dimensions)EQ-5D scores (P = 0.003), general health perception (P = 0.009), sexual function (P = 0.011), and overall satisfaction (P = 0.004) favored plasmakinetic resection. Plasmakinetic resection resulted in better outcomes for continence and sexual function. Long-term outcomes at 1 year post-operation, including IPSS scores (P = 0.006) and overall satisfaction (P = 0.002), were significantly better in the plasmakinetic resection group. No significant differences were observed in health care resource utilization.</p><p><strong>Conclusion: </strong>The study suggests that plasmakinetic resection offers advantages over conventional TURP in symptom relief, quality of life, continence, sexual function, and long-term results for patients with BPH.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":"22 2","pages":"106-113"},"PeriodicalIF":1.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587238","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":"Predictive Urodynamic Parameters for The Treatment Efficacy of Onabotulinum Toxin A in Neurogenic Lower Urinary Tract Dysfunction.","authors":"Muharrem Baturu, Ömer Bayrak, Yusuf Yaşar, Özlem Başgut, İlker Seçkiner","doi":"10.22037/uj.v22i.8289","DOIUrl":"10.22037/uj.v22i.8289","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate urodynamic parameters that may serve as predictors of treatment efficacy with Onabotulinumtoxin-A (onaBoNT-A) in patients with neurogenic lower urinary tract dysfunction (NLUTD).</p><p><strong>Materials and methods: </strong>Patients with NLUTD who received 200 IU onaBont-A injections were included in the study. Urodynamic parameters and the correlations between these parameters and treatment outcomes were analyzed. The primary endpoints were changes in the daily pad usage, and the secondary endpoint was to demonstrate the relationship between duration of treatment efficacy of onabotulinumtoxin-A with preoperative urodynamic parameters in patients with NLUTD.</p><p><strong>Results: </strong>The data of 74 patients were analyzed retrospectively, and 66 (89%) patients benefited from onaBoNT-A treatment. A negative correlation was observed between the number of pads changed per day and maximum cystometric capacity (MCC) (p = 0.024, r = -0.277). A positive correlation existed between the duration of treatment efficacy of onaBoNT-A and change in detrusor pressure during filling cystometry (ΔPdet) (p = 0.018, r = 0.291), whereas a negative correlation was noted with bladder compliance (p = 0.035, r = -0.260). Any additional indicator of its urodynamic efficacy showing a correlation with the number of pads changed per day has not been identified yet.</p><p><strong>Conclusion: </strong>OnaBoNT-A injections effectively manage NLUTD, with MCC being a potential predictor of treatment response. Other urodynamic parameters showed limited predictive value. Patients with lower MCC experienced greater improvements in reducing the number of pads used following treatment. High ΔPdet and low bladder compliance were associated with treatment benefits persisting for longer periods of time.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":"22 2","pages":"95-101"},"PeriodicalIF":1.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587234","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":"Laparoscopic Management of the Urinary Stones.","authors":"Hamid Pakmanesh","doi":"10.22037/uj.v22i.8456","DOIUrl":"10.22037/uj.v22i.8456","url":null,"abstract":"<p><p>Laparoscopic stone surgery was historically recommended only for cases involving concomitant ureteropelvic junction obstruction (UPJO), congenital abnormalities, or when other endourological procedures had failed as an alternative to open surgery. However, recent randomized clinical trials and meta-analyses involving patients with normal anatomy and large renal stones have shown that laparoscopic pyelolithotomy (LPL) has a higher success rate and lower complication rates compared to the gold standard, percutaneous nephrolithotomy (PCNL). Furthermore, stone recurrence appears to be lower following LPL compared to PCNL. Therefore, we suggest that current guidelines for stone treatment reconsider laparoscopy as an effective primary treatment for large kidney stones, rather than simply viewing it as an alternative option. Nonetheless, careful case selection and the surgeon's experience are critical for the success of this treatment.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":"22 2","pages":"58-67"},"PeriodicalIF":1.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587232","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}