Urologia Journal最新文献

{"title":"Is there a correlation between urodynamics findings and clinical outcomes in females with idiopathic overactive bladder syndrome (OAB).","authors":"Faris Abushamma, Mais Bishara, Mhmod Holy, Sandy Obeidat, Mobarak Egbaria, Rola Abu Alwafa, Amir Aghbar, Hashim Hashim","doi":"10.1177/03915603251318870","DOIUrl":"10.1177/03915603251318870","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the intricate relationship between urodynamic findings and clinical symptoms in females with overactive bladder (OAB).</p><p><strong>Methods: </strong>A retrospective cohort study, conducted at a tertiary university hospital, included female patients with positive detrusor overactivity (DO) OAB between November 2020 and November 2023. Patient demographics, OAB symptoms, and responses to anticholinergic treatment were recorded. Different Urodynamic features were analyzed.</p><p><strong>Results: </strong>A total of 92 female patients with positive detrusor overactivity (DO) and overactive bladder (OAB) were included. The median age was 49 years (IQR: 30.75-61.75). Among them, 16 (17.4%) were diabetic, 18 (19.6%) had hypertension, and 69 (75%) were regular coffee drinkers. Over half of the participants, 56 (60.9%), were overweight (BMI 25-29.9). The prevalence of key symptoms included frequency in 54 (58.7%), urgency in 73 (79.3%), urgency incontinence in 33 (35.9%), and nocturia in 44 (47.8%). Frequency of urination was more common among non-diabetic patients (41/54, 75.9%; <i>p</i> = 0.04), and urgency was significantly associated with non-smoking status (51/73, 69.9%; <i>p</i> = 0.025). Most patients (84, 91.3%) had phasic DO, with a median maximum detrusor pressure (Pdet DO) of 30 cmH₂O (IQR: 20.0-53.0) and a median cystometric capacity of 385.5 mL (IQR: 296.25-443.75). Frequency was significantly associated with higher maximum Pdet DO pressure (<i>p</i> = 0.049). In terms of treatment response, 81 patients (88.0%) demonstrated a good response to anticholinergic therapy. Non-responders had significantly higher maximum Pdet DO pressure (median 59.0 cmH₂O, IQR: 30.0-66.0) compared to responders (median 30.0 cmH₂O, IQR: 19.5-47.0; <i>p</i> = 0.013).</p><p><strong>Conclusion: </strong>The amplitude of DO in female with idiopathic OAB is theoretically and clinically correlated to symptomatology and response to anticholinergic treatment.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"529-535"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391919","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":"Endovideosurgical methods for treatment of local prostate cancer: Comparative functional and oncological results.","authors":"Chernov Yaroslav, Chinenov Denis, Kurbanov Asadulla, Kovalevskii Anatoliy, Yurkanova Darina, Votyakov Artem, Rapoport Leonid, Korolev Dmitry, Shpot Evgeniy","doi":"10.1177/03915603251318868","DOIUrl":"10.1177/03915603251318868","url":null,"abstract":"<p><strong>Introduction: </strong>Currently, robot-assisted radical prostatectomy (RARP), extraperitoneal radical prostatectomy (ERPE), and laparoscopic radical prostatectomy (LRP) are frequently used for the treatment of localized prostate cancer.</p><p><strong>Materials and methods: </strong>The study included 2,290 patients with localized prostate cancer. All patients underwent radical prostatectomy (RPE) performed by a single surgeon using different surgical approaches: robot-assisted (RARP, <i>n</i> = 888), laparoscopic (LRP, <i>n</i> = 965), and extraperitoneal (ERPE, <i>n</i> = 437). Oncological outcomes were assessed based on postoperative PSA levels. Functional status was assessed using the following questionnaires: IIEF-5, ICIQ-SF, DRIP-test, and 24-h pad test.</p><p><strong>Results: </strong>In the NS group (LRP and RARP access), the operative time was (200.0 [180.0; 225.0] vs 180.0 [135.0; 230.0] min; <i>p</i> < 0.0001), and the volume of blood loss was (300.0 [200.0; 350.0] vs. 200.0 [150.0; 250.0]). According to the ICIQ-SF test, the presence of patients with symptoms of severe to moderate urinary incontinence (ICIQ-SF scale) in the early postoperative period (mean 9.0 [4.0; 14.0] for RARP vs 11.0 [5.0; 16.0] for LRP and 12.0 [11.0; 14.0] for ERPE, <i>p</i> < 0.0001) contrasted with the results 12 months after surgery, where only patients with mild to moderate urinary incontinence remained (mean 1.0 [0.0; 5.0] for RARP, 4.0 [2.0; 7.0] for LRP, and 5.0 [3.0; 8.0] for ERPE, <i>p</i> < 0.0001).Postoperative erectile function results were evaluated at 12, 24, and 36 months. In all three groups without the NS technique, all patients had significant erectile dysfunction (<i>p</i> < 0.0001). In contrast, at a median follow-up of 12 months, the postoperative questionnaire results for RARP using the NS technique averaged 14.0 [10.0; 18.0], and for LRP 9.0 [6.0; 11.0] (<i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Robot-assisted radical prostatectomy is the preferred method as it provides better functional outcomes. The use of the nerve-sparing technique significantly improved outcomes in terms of urinary continence and also resulted in fewer patients requiring urological pads.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"415-423"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664786","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":"Zinner syndrome: Clinical insights from Western Norway.","authors":"Emanuel Bjurulf, Lars A R Reisæter, Hemamaalini Rajkumar, Adeel Asghar Chaudhury, Alfred Honoré, Florin Hopland-Nechita, Christian Arvei Moen, Julie Nøss Haugland, Ravi Rawal, Ingunn Roth, Anh Khoi Vo, Christian Beisland, Patrick Juliebø-Jones","doi":"10.1177/03915603251335609","DOIUrl":"10.1177/03915603251335609","url":null,"abstract":"<p><strong>Introduction: </strong>Zinner syndrome (ZS) is characterised by unilateral renal agenesis, ipsilateral seminal vesicle cyst and obstruction of the ejaculatory duct. Although rare, urologists may encounter it at some point in their clinical practice. The literature is largely limited to case reports, and the condition is poorly understood. Our objective was to report on cases of ZS that have been managed at two centres in order to gain further clinical insights on this condition.</p><p><strong>Methods: </strong>A retrospective review was conducted on ZS cases presenting at two centres in Western Norway between January 2021 and June 2024. Data were collected on demographic details, symptomatology, imaging findings, management and fertility outcomes.</p><p><strong>Results: </strong>Six cases were identified that met the full triad for ZS, with ages ranging from 18 to 70 years. Five patients were symptomatic at presentation, reporting issues such as anejaculation and testicular pain during sexual activity. Two cases presented as emergencies, one with acute urinary retention and the other with severe pelvic pain. Half of the patients were successfully managed with a conservative approach. Two-thirds had children, either through natural conception or assisted reproductive methods, while the remaining patients underwent sperm cryopreservation.</p><p><strong>Conclusion: </strong>ZS presents with a wide range of symptoms and at varying ages. Not all symptomatic cases require surgical intervention, and management should be individualised. In select cases, a conservative approach can feasible.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"377-382"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001053","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":"Predictive factors for functional improvement and assessment of outcomes in CKD patients after PCNL.","authors":"Shivcharan Navriya, Vikram Singh, Kartik Sharma, Deepak Prakash Bhirud, Mahendra Singh, Gautam Ram Choudhary, Arjun Singh Sandhu","doi":"10.1177/03915603251317042","DOIUrl":"10.1177/03915603251317042","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with urinary stone disease may present with CKD. The incidence of developing end stage renal disease (ESRD) in patients with renal calculi is 0.2%-3.2%. In the present study we aim to discuss outcomes of PCNL in CKD patients.</p><p><strong>Materials and methods: </strong>This was a prospective observational study done, from January 2023 to March 2024. Data of 96 CKD patients with renal stones who underwent standard PCNL were recorded. Patients were followed up with urinalysis, serum creatinine and ultrasound KUB. Preoperative eGFR were compared with eGFR 36 months follow up. Patients were divided into two groups. Group 1- improved and group 2- stable or worsened disease since the final follow up visit.</p><p><strong>Observations and results: </strong>After PCNL renal function improvement was seen in 52 (54%) patients that is, Group I & in 44 (46%) patients it was stable or declined that is, Group II. In Group I, mean preoperative eGFR was 41.13 ± 14.23 ml/min/m² which improved to 46.91 ± 12.14. In Group II mean preoperative eGFR was 37.14 ± 12.32 which declined to 33.17 ± 12.57. The statistically significant factor decreasing the efficacy of PCNL in CKD patients were presence of co morbidities (Hypertension, DM; <i>p</i> = 0.007), staghorn stones (<i>p</i> = 0.001), history of previous renal surgery (<i>p</i> = 0.001), operation time > 100 min (<i>p</i> < 0.0001), post PCNL stone free status(<i>p</i> < 0.0001), and Complications(<i>p</i> = 0.03). After 6 months follow up 8 patients in Group I shifted from CKD stage 4 to CKD stage 3 and four patients in group II shifted from CKD stage 3 to CKD stage 4.</p><p><strong>Conclusion: </strong>Factors like presence of comorbidities, staghorn calculus, previous surgery operative time and post operative complications affects improvement of renal function in CKD patients after stone clearance.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"432-438"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383318","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":"Harnessing radiomics and nutritional metrics to predict long-term survival in Fournier's gangrene patients.","authors":"Kamil Malshy, Stephen Schmit, Borivoj Golijanin, Benjamin Ahn, John Morgan, Amir Farah, Kennon Miller, Dragan Golijanin, Madeline Cancian","doi":"10.1177/03915603251318502","DOIUrl":"10.1177/03915603251318502","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association of traditional and novel nutritional measurements with survival in Fournier's gangrene (FG) patients.</p><p><strong>Methods: </strong>We reviewed records of FG patients from our tertiary center (Jan 2013-Jan 2022). Radiomic sarcopenia parameters (Psoas Muscle Area [PMA], Roundness, Solidity, and calculated PMA-Index) were measured from admission CT scans at the L3 level using ImageJ software. We assessed sarcopenia's impact on survival through three analyses: Model 1 used a PMI below the sex-adjusted median; Models 2 and 3 used published cutoffs. Kaplan-Meier curves were used to compare survival between sarcopenic and non-sarcopenic patients. Multivariable Cox and logistic regression analyses adjusted for age and the Charlson Comorbidity Index (CCI) to assess mortality risk.</p><p><strong>Results: </strong>Of 130 men and 31 women (82% white), 60 patients (37.3%) had died after a median follow-up of 2.2 years (IQR 0.9-4.4). Survival rates were 94% at 30 days, 92% at 90 days, 80% at 1 year, 77% at 2 years, and 56% at 5 years. Non-survivors were older (median age 63 vs 55.1 years, <i>p</i> < 0.001) and had higher median CCI (4.8 vs 3; <i>p</i> < 0.001).In Model 1, sarcopenic patients had a non-significant increased mortality risk with hazard ratio (HR 1.47, 95% CI 0.82-2.64, <i>p</i> = 0.196). Models 2 and 3 showed similar results (HR 1.41, 95% CI 0.70-2.84, <i>p</i> = 0.325; HR 1.35, 95% CI 0.70-2.61, <i>p</i> = 0.364). None of the models were significant when adjusting for CCI and age. Survivors had better traditional metabolic profiles, including higher albumin (3.1vs 2.7 g/dL), hemoglobin (12.4vs 11.4 g/dL), and lower creatinine (1.39 vs 2.1 mg/dL); however, none of these were significant when adjusting for age and CCI.</p><p><strong>Conclusions: </strong>Despite a mild trend, none of the sarcopenia models were able to predict long-term mortality in FG patients in our cohort. This well-known, cost-effective nutritional predictor still requires further research to optimize its utilization in the FG patient population.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"484-492"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433697","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":"Prediction of operation time in percutaneous nephrolithotomy (PCNL) patients: A machine learning approach.","authors":"Owais Ghammaz, Rami Alazab, Nabil Ardah, Mohammed Jalal Akel, Bashar Tayyem, Nazih Alhirtani, Abdallah Bakeer, Bader Al-Deen Anabtawi, Eyas Amaierh, Azhar Al-Alwani","doi":"10.1177/03915603251338720","DOIUrl":"10.1177/03915603251338720","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the factors influencing the length of percutaneous nephrolithotomy (PCNL) procedures and identify predictive variables for operation time using machine learning models.</p><p><strong>Materials and methods: </strong>A retrospective, observational cohort study was conducted at King Abdullah University Hospital, including 352 patients who underwent PCNL between January 2017 and September 2023. Data on preoperative and postoperative variables were collected from electronic health records. Four machine learning algorithms (Random Forest Classifier, AdaBoost Classifier, eXtreme Gradient Boosting Classifier, Logistic Regression) were employed to predict operation time, with features standardized using the StandardScaler module and Synthetic Minority Over-sampling Technique (SMOTE) used to address data imbalance. The dataset was split into training (80%) and testing (20%) sets. Model performance was evaluated using ROC curves, AUC scores, accuracy, precision, recall, and F1-score.</p><p><strong>Results: </strong>Stone burden, gender, and hydronephrosis were significantly associated with longer operation times. Machine learning analysis identified stone-free status, stone burden, and gender as key predictors, with the eXtreme Gradient Boosting Classifier achieving the highest AUC (0.789). Patients with non-stone-free status had longer operation times (<i>p</i> < 0.001). Stone burden and specific stone locations also significantly impacted procedure duration.</p><p><strong>Conclusion: </strong>Stone-free status followed by stone burden and gender are critical predictors of PCNL operation time. Achieving stone-free status significantly reduces procedure duration. Machine learning models, particularly eXtreme Gradient Boosting, provide valuable predictive insights, aiding in surgical planning and optimizing patient outcomes.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"470-478"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086708","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":"Outcomes and predictive factors of recurrence after endoscopic management of male bulbar urethral stricture at a Tertiary Care Centre.","authors":"Om Kumar Yadav, Jaydeep Jain, Shiv Charan Navriya, Deepak Prakash Bhirud, Mahendra Singh, Gautam Ram Choudhary, Arjun Singh Sandhu","doi":"10.1177/03915603251351068","DOIUrl":"https://doi.org/10.1177/03915603251351068","url":null,"abstract":"<p><strong>Introduction: </strong>Male urethral stricture is a common clinical condition in urology with significant socioeconomic impacts and is associated with high recurrence rates.Visual internal urethrotomy (VIU) is a widely used endoscopic treatment for short-segment urethral strictures (<2 cm). The aim of this study was to evaluate the stricture-free rates and analyze the predictive factors for recurrence after VIU, following both initial and repeated urethrotomies, with 12 months of follow-up.</p><p><strong>Methods: </strong>This retrospective study included male patients who underwent VIU for urethral stricture disease between January 2021 and July 2023. Statistical analysis was performed using MedCalc software (version 22.00). Univariate analyses were conducted using the Chi-square test for categorical variables and the <i>t</i>-test for continuous variables.</p><p><strong>Results: </strong>A total of 132 patients with a mean age of 39.8 years were included in the study, with a follow-up duration of 12 months. The mean stricture length was 12 mm, and the most common site of stricture was the bulbar urethra. The stricture-free rate following the first VIU was 59.7%, with a mean time to recurrence of 6.7 months. After the second VIU, the stricture-free rate decreased to 45.5%, with a mean time to recurrence of 5.2 months. The cumulative stricture-free rate at 12 months (following both first and second VIU) was 80.3%, with a mean time to recurrence of 7.9 months (range: 4-11 months). Patients who experienced recurrence after the second VIU underwent definitive urethroplasty. Intraoperative factors significantly influenced the outcomes of VIU, including stricture length (<2 cm vs >2 cm, <i>p</i> = 0.045), health of the urethral mucosa (healthy vs unhealthy, <i>p</i> = 0.250), presence of spongiofibrosis (present vs absent, <i>p</i> = 0.07), and stricture location (mid-bulbar urethral stricture in 74 patients [56.09%], penobulbar/distal bulbar urethral stricture in 50 patients [37.8%], and bulbomembranous/proximal bulbar urethral stricture in eight patients [6.09%]).</p><p><strong>Conclusions: </strong>Although VIU is a relatively simple procedure, it yields acceptable outcomes in carefully selected patients. Stricture length and the presence of spongiofibrosis had a statistically significant impact on outcomes. Other independent predictive factors for failure of VIU included older age, obesity, and mucosal health.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251351068"},"PeriodicalIF":0.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754428","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":"Effectiveness and safety of intermittent catheterisation for the management of acute urinary retention: A prospective, randomised, multicentre, controlled study.","authors":"Vigen Malkhasyan, Sergey Kotov, Ibragim Mamaev, Sergey Belomytcev, Roman Perov, Sergey Pulbere, Alexey Volnukhin, Bagrat Grigoryan, Dmitry Pushkar","doi":"10.1177/03915603251355815","DOIUrl":"https://doi.org/10.1177/03915603251355815","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the efficacy and safety of clean intermittent catheterisation (CIC) in the management of acute urinary retention (AUR) and identify factors those affect the likelihood of recovery of spontaneous urination and the development of adverse events.</p><p><strong>Materials and methods: </strong>A prospective multicentre comparative randomised study included 129 patients hospitalised in urological hospitals with AUR due to benign prostatic hyperplasia. Patients were randomised into two groups. In group I, the classical tactics of TWOC (drainage of the bladder with a urethral Foley catheter for 3 days) were used, whereas in group II, patients underwent CIC for 3 days. A comparative assessment of the effectiveness of intermittent catheterisation was carried out and compared to the classical tactics of TWOC (trial without catheter/attempt without catheter).</p><p><strong>Results: </strong>Normal voiding was restored in 25 (35.7%) patients in group I and 26 (44%) patients in group II. The point estimate of the probability of urination recovery on the third day of therapy in group II was 1.5 times higher than that in group I. The difference between these estimates was not statistically significant. In group II, 1 (3.8%) patient recovered spontaneous urination within 1 day, 12 (46.2%) within 2 days, and 13 (50%) by the end of 3 days. On the seventh day, AUR recurred in three (2.3%) patients: two (2.8%) in group I and one (1.7%) in group II. Statistically significant relationships were found between the probability of developing gross haematuria and patient age, as well as between possible urethrorrhagia and a history of AUR, between age and the use of α1-blockers at the time of AUR.</p><p><strong>Conclusion: </strong>Intermittent catheterisation is an effective treatment for AUR. Its main advantages include the possibility of outpatient management, earlier recovery of spontaneous urination and significantly less severe catheter-associated lower urinary tract symptoms.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251355815"},"PeriodicalIF":0.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660419","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":"Urology in the digital age: The power of telemedicine.","authors":"Giuseppe Lorusso, Simone Assumma, Filippo Gavi, Enrico Panio, Filippo Turri, Daniele Fettucciari, Domenico Sanesi, Or Schubert, Martina Bracco, Pierluigi Russo, Mauro Ragonese, Nazario Foschi, Riccardo Bientinesi, Emilio Sacco, Bernardo Rocco, Maria Chiara Sighinolfi","doi":"10.1177/03915603251356555","DOIUrl":"10.1177/03915603251356555","url":null,"abstract":"<p><p>Telemedicine and telesurgery emerged as transformative innovations in urology. These approaches overcome challenges such as geographic barriers, resource limitations, and increasing demand for specialized care. Telemedicine is applied across the surgical continuum, including preoperative, perioperative, and postoperative phases. Telesurgery during the perioperative phase achieves outcomes comparable to onsite guidance, while postoperative teleconsultations are well-accepted by patients, offering results equivalent to face-to-face visits. Benefits include fewer patient visits, reduced infection risks, enhanced convenience, and economic advantages. The advent of ultrabroadband 5G has significantly expanded telemedicine's scope, enabling real-time remote consultations and advanced telesurgical procedures. Robotic systems such as Toumai, Hinotori, Edge, KangDuo, and Microport Medbot demonstrate promising applications in urological surgery. Despite these advancements, telemedicine faces challenges, including data security, adherence to professional guidelines, and physician adaptability. Legal and ethical issues such as informed consent, patient privacy, licensing, and electronic documentation highlight the need for standardized frameworks. This review analyzes the current state of telemedicine and telesurgery in urology, emphasizing their benefits, challenges, and potential to transform patient care and improve outcomes.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251356555"},"PeriodicalIF":0.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643573","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":"An Effective Classification System for the Treatment of Encrusted Ureteral Stents.","authors":"María E Garza-Montúfar, Hid F Cordero-Franco, Carlos M García-Pérez, Juan H Díaz-García, Brissia Lazalde","doi":"10.1177/03915603251351767","DOIUrl":"https://doi.org/10.1177/03915603251351767","url":null,"abstract":"<p><strong>Background: </strong>We created a classification system for encrusted ureteral stents (ES) (<b>G</b>rading system for <b>A</b>dditional lithiasis and u<b>R</b>eteral <b>S</b>tent c<b>A</b>lcification -GARSA-, I-III grades), we demonstrate its utility for predicting the surgical outcome and the need of complex surgery.</p><p><strong>Methods: </strong>Retrospective review of patients with ES; clinico-demographics, additional lithiasis (AL), stent calcification characteristics, surgeries performed, complications and stone free rate were collected. Chi-square was used to compare the categorical variables and Kruskal-Wallis test for the comparison > 2 numerical groups; a <i>p</i>-value < .05 was considered significant.</p><p><strong>Results: </strong>We included 190 ES; 163 (85.8%) stents underwent one-time surgical removal. Most Grade I catheters were removed in a single surgery, without invasive/multimodal therapy; Grade II-III catheters required multimodal and invasive therapies. The presence of AL in kidney increased the number of surgical interventions performed in Grade I/II catheters (<i>p</i> < 0.05) and the likelihood of requiring multimodal (Grade I: 90%, Grade II: 83.3%, Grade III: 100%) or invasive surgery (Grade I: 38.1%, Grade II 58.3%, Grade III 90.9%) to achieve successful treatment.</p><p><strong>Conclusions: </strong>Incorporating both the calcified stent characteristics and the presence of AL, GARSA score can be used to determine the selection of the optimal surgical approach for patients with encrusted stents.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603251351767"},"PeriodicalIF":0.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601720","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}