Urologia Journal最新文献

{"title":"Adult male circumcision with a circular stapler: Is this the new standard?","authors":"Luciano Ola, Federica Pini, Giovanni Busacca, Ettore Dalmasso, Juliette Meziere, Filippo Poletti, Paola Irene Ornaghi, Roberta Aimar, Daniele Dutto, Ivano Morra","doi":"10.1177/03915603261447737","DOIUrl":"https://doi.org/10.1177/03915603261447737","url":null,"abstract":"<p><strong>Introduction: </strong>Circumcision is a simple procedure, but it is not free from complications. New methods have recently been developed, including the circular stapler CircumCYS^®.</p><p><strong>Material and methods: </strong>This a retrospective analysis of our institutional series of 80 consecutive procedures. The stapler consists of a inner bell (in six different sizes), that it is designed to protect the gland, a pistol with a trigger, a circular scalpel and a stapler for the suture. The circumference of the penile shaft is measured at the level of the balano-preputial fold with the provided device. No antibiotic prophylaxis was necessary. A Dorsal Penile Nerve Block (DPNB) were performed by the urologist. Data were collected from medical records 14 days and 1 month after the surgery. Complication rate and Visual Analog Scale were investigated.</p><p><strong>Results: </strong>Eighty patients were treated between August 2023 and January 2024. The average operating time was 10 min (ds 6). Postoperatively we observed three scar edemas and two minor bleedings. The most common complication was the incarceration of the metal stitches within the scar (five cases). The average time for the stitches to fall out was 24.9 days (ds 3.9). Pain was consistently well-controlled (Visual Analog Scale 2/10 one hour post-surgery - ds 0.8).</p><p><strong>Conclusion: </strong>CircumCYS^® is a reliable, safe and easy-to-use tool. The technique is very fast and this allows the execution of many circumcisions in a single session. The learning curve appears minimal.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261447737"},"PeriodicalIF":0.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing forgotten double J stents: Lessons learned from a tertiary care center.","authors":"Devashish Kaushal, Viswas Raghavendra Marathi, Kumar Madhavan, Amrut Phonde, Shushant Shandilya","doi":"10.1177/03915603261447148","DOIUrl":"https://doi.org/10.1177/03915603261447148","url":null,"abstract":"<p><strong>Introduction: </strong>Double-J (DJ) stents find extensive use in Endourology. Nevertheless, occurrence of forgotten stents is not uncommon. This retrospective study details our encounters in handling forgotten stents and outlines the measures we have implemented to mitigate morbidity associated with DJ stents.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of hospital records of cases with Forgotten DJ stents from Jan 2021 to Jan 2025. The details reviewed included age, sex, indication for stenting, duration of the indwelling stent, presenting complaints, management, and complications.</p><p><strong>Results: </strong>Of the total of 35 patients, the mean patient age was 46.8 years (14-70 years). The male-to-female ratio was 4:3 (20 males and 15 females). The mean indwelling time was 35.8 months. Flank pain was the commonest symptom (72.7%), followed by storage lower urinary tract symptoms (54.5%) and dysuria (50%). Complicated stents were noted in 17 patients (48.5%), whereas uncomplicated stents were noted in 18 patients (51.5%). All 18 \"uncomplicated\" stents could be removed cystoscopically, while complicated stents were removed by the combination of endourological techniques mainly, while two patients underwent laparoscopic nephrectomy in which one of them needed open cystolithotomy also.</p><p><strong>Conclusion: </strong>The issue of forgotten DJ stents remains a prevalent problem in developing countries, causing significant morbidity and financial burdens for patients. Stent registers and electronic stent extraction reminders helps us to minimize the incidence of forgotten stents.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261447148"},"PeriodicalIF":0.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of AI in prostate cancer care: Assessing the role of chatbots versus urologists in patient communication and empathy.","authors":"Loris Cacciatore, Antonio Minore, Pierangelo Contessa, Gianluigi Raso, Antonio Rosario Iannello, Rocco Papalia, Francesco Esperto","doi":"10.1177/03915603261446425","DOIUrl":"https://doi.org/10.1177/03915603261446425","url":null,"abstract":"<p><strong>Objective: </strong>To date, the integration of artificial intelligence (AI) in healthcare has expanded rapidly, offering new tools for patient education and communication. In prostate cancer (PCa), where information needs are high and emotionally sensitive, AI-driven chatbots (CB) may enhance patient engagement. This study aims to compare the performance and perceived quality of responses from CB versus urologists (URO) to common PCa-related inquiries.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 20 frequently asked PCa general questions. Responses were generated by two AI-based CB and four certified URO in a simulated clinical messaging setting, without direct patient interaction. Expert reviewers first assessed each response for medical accuracy and completeness. Then, five blinded non-medical evaluators rated the responses using Likert scales to evaluate completeness (1-5), empathy (using a five-item adaptation of the Jefferson Scale), and overall preference.</p><p><strong>Results: </strong>A total of 600 responses were evaluated. Accuracy and completeness scores were comparable between CB and URO responses, according to experts' evaluations (<i>p</i> = 0.45 and <i>p</i> = 0.12). However, CB responses scored significantly higher in completeness and empathy (both <i>p</i> < 0.001) for non-medical evaluators. Moreover, a statistically significant preference for overall CB-generated responses over those from urologists, was demonstrated (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>While CB responses were as accurate as those from URO, they outperformed in completeness and empathy. These results suggest that AI-based CB could serve as effective tools in enhancing patient communication and satisfaction and may be a valuable complement to urologist-led care in clinical practice.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261446425"},"PeriodicalIF":0.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creatinine and hemoglobin/creatinine ratio as predictors of 12-month recurrence after direct visual internal urethrotomy for short-segment (<2 cm) bulbar urethral strictures.","authors":"Rıdvan Kayar, Kemal Kayar, Haşim Çaçan, Emre Tokuc, Metin İshak Öztürk","doi":"10.1177/03915603261447735","DOIUrl":"https://doi.org/10.1177/03915603261447735","url":null,"abstract":"<p><strong>Background: </strong>Urethral stricture (US) disease frequently recurs after direct visual internal urethrotomy (DVIU). This study investigated the prognostic value of serum creatinine, estimated glomerular filtration rate (eGFR), and the hemoglobin/creatinine (Hgb/Cre) ratio for predicting 12-month recurrence in short-segment bulbar US.</p><p><strong>Methods: </strong>A retrospective cohort of 237 patients undergoing DVIU for isolated bulbar US <2 cm between 2012 and 2024 was analyzed. Demographics, comorbidities, laboratory parameters, and uroflowmetry were recorded. Renal function markers (creatinine, eGFR) and Hgb/Cre ratio were evaluated using receiver operating characteristic (ROC) analysis, Kaplan-Meier survival curves, and multivariable logistic regression.</p><p><strong>Results: </strong>Recurrence occurred in 103 patients (43.5%) within 12 months (median: 6 months). Patients with recurrence had higher creatinine (1.10 vs 0.99 mg/dL, <i>p</i> < 0.001), lower eGFR (74.0 vs 88.0 mL/min/1.73 m², <i>p</i> < 0.001), and lower Hgb/Cre ratios (12.13 vs 14.28, <i>p</i> = 0.002). Endoscopic surgery-related etiology was strongly associated with recurrence (70.8% vs 47.0%, <i>p</i> = 0.001), whereas age, hemoglobin, Qmax, and PVR showed no significant relationship. In multivariable models, elevated creatinine (OR 3.47, 95% CI 1.82-6.60), reduced Hgb/Cre ratio (OR 0.90, 95% CI 0.85-0.95), and lower eGFR (OR 0.975, 95% CI 0.964-0.987) independently predicted recurrence. Kaplan-Meier analysis demonstrated significantly higher recurrence in patients with creatinine ⩾ 1.02 mg/dL, eGFR ⩽ 80.5 mL/min/1.73 m², and Hgb/Cre ratio ⩽ 13.26.</p><p><strong>Conclusions: </strong>Elevated serum creatinine, reduced eGFR, and a lower Hgb/Cre ratio are independent predictors of 12-month recurrence following DVIU for short-segment bulbar US. Demographic and uroflowmetric parameters showed limited predictive value, whereas iatrogenic etiology markedly increased recurrence risk. Incorporating renal function markers into risk stratification may guide patient selection and support timely consideration of urethroplasty or drug-coated balloon dilatation (Optilume) in high-risk individuals. Prospective multicenter studies are warranted.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603261447735"},"PeriodicalIF":0.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rezum therapy for management of frail patients with catheter dependent urinary retention due to benign prostate hyperplasia: A 1 year follow up study.","authors":"Ahmed Issam Ali, Waseem Tayeb, Suhail A Kalantan, Abdelsalam Abdelfadel, Amr Talaat Azzam, Turky Almouhissen, Basem Othman, Abdullah Albkri, Abdulaziz Mohammed Bakhsh, Adel Moalwi, Ali Abdullah Alqahtani, Mohammed Kasem, Abdulrahim A Mirza, Ali Hassan","doi":"10.1177/03915603251398255","DOIUrl":"10.1177/03915603251398255","url":null,"abstract":"<p><strong>Purpose: </strong>This study presents a 1-year follow-up for fragile patients with catheter-dependent urinary retention related to benign prostatic hyperplasia (BPH) treated with Rezum therapy.</p><p><strong>Materials and methods: </strong>All patients participating in this study exhibited catheter-dependent urine retention attributable to benign prostatic hyperplasia, with a mean prostate volume of 65 ± 13.1 ml. The study only included fragile patients with a PRISMA-7 questionnaire score of ⩾3. The study excluded patients with bladder or prostate cancer, ongoing urinary tract inflammation, a history of pelvic irradiation or prostate surgery, neurogenic bladder or urethral stricture. The treatment was carried out under local anesthesia, with the possibility of sedation. Patients were asked to follow up after 1, 2, 9, and 12 months of surgery. Clinical assessments included the IPSS score, bladder scans to determine pre- and post-voiding bladder volume, and an evaluation of the requirement for re-catheterization.</p><p><strong>Results: </strong>Eighty fragile patients with PRISMA-7 score ⩾3 underwent Rezum treatment for urinary retention due to BPH. Patients were monitored for 1 year after the procedure. Patients' IPSS improved from 14 to 9.5 (<i>p</i> = 0.02), while post-void residual urine decreased from 50 mL to 12 mL (<i>p</i> < 0.001). Prostate volume reduced from 60.5 mL to 40.9 mL (<i>p</i> = 0.0003) and PSA levels also dropped, from 3.5 mg/dl to 2.3 ng/ml (<i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>This study demonstrates that Rezum therapy is a feasible treatment option for frail patients with PRISMA-7 questionnaire score of ⩾3, presented with catheter dependent urinary retention. There were reported positive post-operative outcomes and an improvement in IPSS scores up to one year after surgery.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"192-199"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sperm DNA fragmentation and its association with semen parameters in male infertility: A cross-sectional study.","authors":"Ali Safa, Nicolas Medawar, Georges Abi Tayeh, Aline Khazzaka, Elie Nemer, Chady Waked","doi":"10.1177/03915603251395513","DOIUrl":"10.1177/03915603251395513","url":null,"abstract":"<p><p>Infertility has become a major concern over the past decades. While semen analysis is the standard initial test performed to assess male infertility, it offers limited insight due to its variability. Recently, new diagnostic tools, such as sperm DNA fragmentation (SDF), have been identified as key factors in reproductive failure. Although semen parameters are well-studied, the link between these parameters and SDF remains unclear. In addition, lifestyle factors like age, obesity, and tobacco use, known to affect fertility, have yet to be definitively linked to SDF. This study aims to explore the relationship between semen parameters and demographic factors with SDF rates in a population of Lebanese males. A total of 86 men were included in our study. Neither abnormal semen analysis-defined as the presence of at least one of the following: oligospermia, asthenospermia, and teratospermia-or each of the following semen analysis parameters: pH, vitality, leucocytospermia, oligospermia, asthenospermia, and teratospermia have been associated with high rates of SDF. Additionally, no statistically significant association was found with factors of demographic data. Our study highlights the importance of considering sperm DNA fragmentation (SDF) as an independent factor when semen analysis alone does not fully explain infertility.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"256-260"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-assisted uroflowmetry and automated evaluation of lower urinary system symptoms.","authors":"Hakan Şığva, Arif Mehmet Duran, Berat Deniz, Kadir Körpe, Mehmet Sevim","doi":"10.1177/03915603251406813","DOIUrl":"10.1177/03915603251406813","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop and validate an AI-assisted framework for the automated evaluation of uroflowmetry data in patients presenting with lower urinary tract symptoms. The primary goal was to overcome the limitations of traditional manual interpretations by leveraging advanced machine learning techniques to achieve higher diagnostic accuracy, objectivity, and clinical applicability in urological assessments.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted using a large, de-identified dataset comprising uroflowmetry recordings, patient-reported symptom scores, and comprehensive demographic data. The data underwent rigorous preprocessing-including noise reduction, baseline correction, normalization, and feature extraction-with key parameters such as peak flow rate, voided volume, average flow rate, and voiding time being analyzed. Multiple machine learning models-including a deep neural network, support vector machine, and random forest classifier-were developed and validated through cross-validation and extensive statistical testing. Performance metrics such as accuracy, sensitivity, specificity, and area under the ROC curve (AUC-ROC) were calculated, while multivariate regression analyses were performed to explore the relationships between uroflowmetry parameters and symptom severity.</p><p><strong>Results: </strong>The AI framework, particularly the deep neural network model, exhibited outstanding diagnostic performance with an accuracy of 92.5%, sensitivity of 90.0%, specificity of 94.0%, and an AUC-ROC of 0.96. Statistical analyses demonstrated significant correlations between key uroflowmetry parameters and clinical symptoms, with lower peak flow rates showing a strong association with increased symptom severity (<i>p</i> < 0.001). These findings confirm that the integration of multi-dimensional data through AI significantly enhances the objectivity and precision of urinary function evaluation compared to conventional methods.</p><p><strong>Conclusion: </strong>The study successfully established an AI-assisted diagnostic framework that markedly improves the automated evaluation of uroflowmetry data and lower urinary tract symptoms. This innovative approach offers a robust alternative to traditional diagnostic practices by reducing subjectivity and enhancing diagnostic accuracy, thereby paving the way for more personalized and effective management of urinary disorders.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"275-284"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition to targeted transperineal prostate biopsies does not impact progression to curative treatment for patients initially entered into active surveillance.","authors":"Alfred Honore, Christian Arvei Moen, Lars Anders Rokne Reisæter, Karsten Gravdal, Patrick Juliebø-Jones, Christian Beisland","doi":"10.1177/03915603251395510","DOIUrl":"10.1177/03915603251395510","url":null,"abstract":"<p><strong>Background: </strong>Concerns over infection have driven a shift from transrectal to transperineal prostate biopsy, while pre-biopsy MRI has promoted a move from systematic to targeted sampling. These changes may impact patient selection, treatment planning, and risk stratification in active surveillance.</p><p><strong>Objective: </strong>To compare active surveillance outcomes of patients diagnosed primarily by targeted transperineal (tTP) biopsy versus standard transrectal (sTR) biopsy.</p><p><strong>Design, setting and participants: </strong>Prospectively collected data of men who underwent prostate biopsy between January 2018 and May 2022 who were included into active surveillance in our institution.</p><p><strong>Outcome measurements and statistical analysis: </strong>Comparison of patient characteristics, clinical and radiological features, positive and total number of biopsies, biopsy Gleason grade group (GG) at inclusion using simple descriptive statistics, groups compared using Wilcoxon rank sum test; Fisher's exact test; Pearson's Chi-squared test. Time to transition to curative treatment was calculated using the Kaplan-Meier plot.</p><p><strong>Results: </strong>There were 112 and 167 patients in the tTP and sTR groups, respectively. No significant differences in age, BMI, ECOG, Charlson Comorbidity Index, PSA, radiological T-stage or GG at inclusion was seen. Number of positive biopsy cores were unchanged between tTP and sTR at 2 (1-3) (median (IQR); <i>p</i> = 0.2), while total cores were reduced significantly to 3 (3-5) from 12 (8-12) (<i>p</i> < 0.001), respectively. Overall, there was no difference in progression from surveillance to active treatment (<i>p</i> = 0.084), but when separated by biopsy type and GG, there was a significantly higher rate of transitioning to curative treatment after 1 year in the sTR group with GG2+ at inclusion (<i>p</i> < 0.0001), compared to the other three.</p><p><strong>Conclusion: </strong>Using targeted transperineal biopsy of the index lesion(s) alone does not lead to increased treatment of patients included in active surveillance.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"185-191"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of anterior urethral strictures based on histopathology and its correlation with outcome after urethroplasty.","authors":"Goyal Prashasya, Govind Sharma, Shivam Priyadarshi","doi":"10.1177/03915603251388207","DOIUrl":"10.1177/03915603251388207","url":null,"abstract":"<p><strong>Background: </strong>Anterior urethral strictures significantly impact urinary function and quality of life, often requiring surgical intervention. This study evaluates the histopathological characteristics of strictures and their correlation with urethroplasty outcomes.</p><p><strong>Methods: </strong>A prospective study was conducted on 65 male patients (aged 20-60) diagnosed with anterior urethral strictures at SMS Medical College. Exclusion criteria included posterior urethral distraction defects and prior surgical interventions. Biopsies from stricture sites were analyzed for lichen sclerosus (LS) and inflammation. Urethroplasty techniques included dorsal augmentation, ventral onlay buccal mucosal graft, Asopa's dorsal inlay, and staged urethroplasty. Statistical analysis was performed using the chi-square test, independent <i>t</i>-test, and ANOVA, with a significance threshold of <i>p</i> < 0.05.</p><p><strong>Results: </strong>The majority of strictures were idiopathic (46.1%), followed by LS (26.1%) and iatrogenic causes (21.5%). LS was significantly associated with poorer surgical outcomes (<i>p</i> = 0.032). Severe inflammation within the stricture segment correlated with unsuccessful urethroplasty outcomes (<i>p</i> = 0.027), whereas inflammation in proximal or distal segments showed no impact. Stricture length > 8 cm also exhibited higher failure rates. The most common postoperative complication was wound infection (13.8%).</p><p><strong>Conclusion: </strong>LS and severe inflammation are key predictors of unsuccessful urethroplasty outcomes. Histopathological evaluation should be integrated into preoperative assessment to optimize surgical planning and reduce recurrence rates. Future studies with larger cohorts and extended follow-ups are warranted to validate these findings.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"265-269"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailoring robotic-assisted partial nephrectomy: Should a retro- or transperitoneal approach be adapted based on tumor location, rather than surgeon's preference?","authors":"Valeria Feliciangeli, Nunzia Abbate, Luca Orecchia, Giuseppe Farullo, Anastasios Asimakopoulos, Enrico Finazzi Agrò, Simone Albisinni","doi":"10.1177/03915603251407024","DOIUrl":"10.1177/03915603251407024","url":null,"abstract":"<p><p>Robotic-Assisted Partial Nephrectomy (RAPN) can be performed via a transperitoneal (t-RAPN) or retroperitoneal (r-RAPN) approach. Despite the retroperitoneal route being potentially more suitable for posterior renal tumors, most surgeons prefer the transperitoneal access due to greater familiarity. This study evaluated perioperative and functional outcomes of r-RAPN versus t-RAPN for posterior renal masses performed by a surgeon without prior retroperitoneal experience. We retrospectively analyzed patients undergoing RAPN for posterior renal tumors between September 2023 and April 2025. Patient and tumor characteristics, operative time (OT), warm ischemia time (WIT), ΔeGFR, length of stay (LOS), complications, and Trifecta rate were compared. Trifecta was defined as WIT < 25 min, negative margins, and absence of Clavien-Dindo ⩾ III complications. Twenty patients were included: eight underwent t-RAPN and 12 r-RAPN. Baseline features were comparable. r-RAPN showed significantly shorter OT (125 ± 29 min vs 168 ± 37 min, <i>p</i> = 0.01), time on console (72 min vs 110 min, <i>p</i> = 0.01), and WIT (12 min vs 18 min, <i>p</i> = 0.048). Trifecta was achieved in all cases. Multivariate analysis identified surgical approach as the only independent predictor of console time (<i>p</i> = 0.024), with r-RAPN reducing it by 39 min. In conclusion, r-RAPN is feasible and safe even without prior retroperitoneal experience, offering comparable outcomes to t-RAPN with shorter operative times.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"164-169"},"PeriodicalIF":0.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}