Urologia Journal最新文献

{"title":"Sheathless RIRS in the era of slim and single use flexible ureteroscopy (ssFURS): Prospective analysis of clinical outcome.","authors":"Faris Abushamma, Rola Abu Alwafa, Sa'ed H Zyoud","doi":"10.1177/03915603241282734","DOIUrl":"10.1177/03915603241282734","url":null,"abstract":"<p><strong>Introducation: </strong>the purpose is to assess the feasibility of sheathless and time-limited retrograde intrarenal surgery (RIRS) using slim and single use flexible ureteroscopy (ssFURS) in view of the stone-free rate (SFR), complication rate and upfront ureteral stenting.</p><p><strong>Methods: </strong>A prospective, cross-sectional study of patients who underwent RIRS for kidney stones between December 2021 and December 2023 at our tertiary urology center was performed. Patient demographics, clinical presentations and stone characteristics were calculated. The SFR and complication rate were included.</p><p><strong>Results: </strong>Hundred and eighteen patients were included. The median age was 48 (35.7-60.0) years. Diabetes mellitus (DM) was present in 32 patients (27.1%). The median length of the kidney stones was 1.15 (range [0.4-3.0]), and the median width was 1 (range [0.05-3.7]). The pelvi-ureteric junction (PUJ) represented 75 (63.6%) patients. The lower pole stone (LP) consisted of 27 (22.9%) patients. Thirty-seven (31.4%) of the patients had multiple kidney stones. An overall complete SFR after the first session was observed for 94 (79.7%) patients. The second session of complete SFR was observed in 15 patients (12.7%). A median stone length of 1 (0.8-1.5) cm and a median stone width of 0.95 (0.7-1.3) cm were both significantly associated with a complete SFR after the first session (<i>p</i> < 0.001). A single kidney stone in 69 (73.4%) patients was significantly more strongly associated with a complete SFR after the first session than was multiple kidney stones in 25 (26.6%) patients (<i>p</i> = 0.027). Upfront stenting was performed in 74 patients (62.7%). The complete SFR after the first session was significantly greater in patients who underwent upfront stenting (65; 69.1%) than in those who underwent primary ssFURS (29; 30.9%, <i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>Sheathless and time-limited RIRS using ssFURS is a feasible and successful procedure with low complication rate.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"81-88"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354787","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":"Much ado about nothing? Assessing the actual benefits of proton beam therapy for prostate cancer.","authors":"Mario Terlizzi, Alberto Bossi","doi":"10.1177/03915603241283296","DOIUrl":"10.1177/03915603241283296","url":null,"abstract":"<p><p>We are discussing and commenting on the paper by Yu et al. titled \"Updated Analysis of Comparative Toxicity of Proton and Photon Radiation for Prostate Cancer,\" published in the <i>Journal of Clinical Oncology</i> in June 2024.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"65-66"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475998","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":"Randomised controlled trial comparing safety and efficacy of Urolift to monopolar TURP.","authors":"Mostafa Sheba, Farouk El Gamal, Mohamed Abd El Wahed, Sameh Kotb, Alaa Meshref, Hussien Aly Hussein, Amr Mostafa Zahran","doi":"10.1177/03915603241277905","DOIUrl":"10.1177/03915603241277905","url":null,"abstract":"<p><strong>Objectives: </strong>Benign Prostatic Hyperplasia (BPH) is the most common cause of the Lower Urinary Tract Symptoms (LUTS) in ageing men. TURP is still the gold-standard procedure for the treatment of LUTS-BPH, however new minimally invasive modalities like Urolift procedure has been introduced.</p><p><strong>Methods: </strong>Patients with prostate size up to 100 g were offered both treatment modalities. Hundred patients were included in the study, 100 in TURP group (group A) and 100 in Urolift group (group B). International Prostate Symptom Score (IPSS) was used at initial contact and for evaluation of response to treatment. Group A underwent TURP under regional anaesthetic, while group B underwent Urolift under sedation.</p><p><strong>Results: </strong>The mean age in both groups was 66.4 years. The IPSS score improvement among both groups is attached in the diagram. Group B patients had less hospital stay, better erectile and ejaculatory function compared to group B, and no stress incontinence was detected in group B while 6.7% of the patients in group A suffered some stress incontinence.</p><p><strong>Conclusion: </strong>Urolift has the benefit of preserving the ejaculatory function and less complications. Nevertheless, it has size limitations and the IPSS score improvement is less satisfactory when compared to TURP.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"59-64"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296606","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":"Epididymal sonographic findings in infertile males with isolated asthenozoospermia and their correlation with seminal plasma l-carnitine: An observational study.","authors":"Ahmed Mahmoud ElShibany, Emad Abd El Raheem Taha, Dalia Tarek Kamal, Sameh Fayek GamalEl Din, Yasser Mohamed Abo El Yamen, Hosam A Hasan, Abdel Rahman Bakry","doi":"10.1177/03915603241273886","DOIUrl":"10.1177/03915603241273886","url":null,"abstract":"<p><strong>Objectives: </strong>The present study aimed to show epididymal sonographic findings in infertile males with isolated asthenozoospermia as well as their correlation with seminal plasma l-carnitine.</p><p><strong>Methods: </strong>Eighty married men were recruited in the study. Fifty infertile men with isolated asthenozoospermia and 30 fertile controls with normal semen parameters were included. Semen analysis was done with estimation of seminal plasma l-carnitine level. Scrotal ultrasonography was used as the diagnostic method for assessing epididymal morphology.</p><p><strong>Results: </strong>Epididymal heterogeneous echogenicity was significantly higher in the infertile group compared to the controls. Whereas homogeneous epididymal echotexture and seminal plasma l-carnitine levels were significantly higher in the controls compared to the infertile patients. Interestingly, it was observed that within each group, seminal l-carnitine and sperm total motility were significantly higher in those with homogeneous rather than heterogeneous epididymal echotexture.</p><p><strong>Conclusions: </strong>Our study demonstrated a significant association between epididymal echo-texture, seminal plasma l-carnitine and sperm motility. Thus, we recommend performing epididymal sonographic evaluation as one of the basic investigations for infertile men.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"126-133"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296602","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":"Current role of focal therapy in prostate cancer.","authors":"Sara Tamburini, Lorenzo Bianchi, Pietro Piazza, Angelo Mottaran, Amelio Ercolino, Valeria Rotaru, Valerio Pirelli, Massimiliano Presutti, Matteo Droghetti, Riccardo Schiavina, Eugenio Brunocilla","doi":"10.1177/03915603241258713","DOIUrl":"10.1177/03915603241258713","url":null,"abstract":"<p><strong>Background: </strong>Thanks to the improved accuracy of multiparametric Magnetic Resonance Imaging (mpMRI) to detect and localize the dominant index lesion on prostate cancer (PCa), the concept of minimally invasive focal treatments (FT) has gained popularity. Nevertheless, although high-quality evidence that FT has favorable functional outcomes, definitive proof of its oncological effectiveness compared to standard treatments remains underreported.</p><p><strong>Objective: </strong>This study aims to explore the efficacy, safety, oncologic and functional outcomes of different type of FT for PCa.</p><p><strong>Evidence acquisition: </strong>A non-systematic literature review was conducted by searching on PubMed \"prostate cancer\" AND \"focal treatment\" OR \"HIFU\" OR \"irreversible electroporation\" OR \"cryoablation\" OR \"focal laser ablation.\" Overall, 22 articles published in English literature from 2018 to 2023 describing FT techniques for PCa were included.</p><p><strong>Evidence synthesis: </strong>Related to the field ablated, focal therapies include hemiablation (half gland), focal ablation (zonal-base) or targeted therapy (lesion-based). FT modalities can be categorized in thermal and non-thermal energy: thermal energy techniques include high-intensity focused ultrasound (HIFU), cryotherapy, radiofrequency ablation (RFA), and focal laser ablation (FLA). Focal brachytherapy, irreversible electroporation (IRE), and vascular-targeted photodynamic therapy (VTP) are classified as non-thermal ablation. Each focal ablative treatments could be promising alternative to conventional radical therapies to treat PCa in term of mid-term oncologic and functional outcomes, however, limited data are available in comparison with standardized radical treatments. HIFU and Cryo are the most studied techniques and seem to be superior to radical treatments in term of functional outcomes despite associated with higher recurrence and retreatment rate.</p><p><strong>Conclusions: </strong>Current evidences of oncologic and functional outcomes of FT are based mainly on retrospective, non-comparative and single center studies. Thus, none of the focal therapies available should be considered safe alternative to standardized treatments in routine practice and should be offered only for well selected PCa patients with low or at least favorable-intermediate risk disease, unfit for radical options.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"67-74"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629229","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 prognostic value of cystography-measured bladder capacity on very early continence rates after radical prostatectomy.","authors":"Stankovic Mladen, Schumacher Bastian","doi":"10.1177/03915603241293839","DOIUrl":"10.1177/03915603241293839","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the utility and reliability of cost-effective cystography-measured bladder capacity as a prognostic tool for predicting very early continence recovery following radical prostatectomy. Additionally, the study aims to discuss the clinical implications of the findings, including their potential impact on patient management, postoperative rehabilitation strategies, and the development of personalized care pathways for prostate cancer patients.</p><p><strong>Methods: </strong>In this prospective monocentric study, we analyzed 223 patients who underwent either robot assisted radical prostatectomy (RARP) or open radical prostatectomy (ORP) between January 2022 and January 2024. Postoperative cystography was routinely performed 5 days after robot-assisted radical prostatectomy and 7 days after open radical prostatectomy. Very early continence rates were determined using a standardized pad-test conducted on the first day following catheter removal. The bladder capacity during cystography was measured and documented for every patient. The correlation between the rate of continence recovery and the bladder capacity was then assessed. To determine other predictive factors for recovery of continence, several parameters were analyzed using multivariate logistic regression analysis, including age, prostate volume, nerve-sparing technique and surgical procedure.</p><p><strong>Results: </strong>Urinary continence rates at day 1 after catheter removal were 73.5% for patients who underwent RARP and 72.6% for patients who underwent ORP. A strong prognostic value of cystography-measured bladder capacity on very early continence rates was reported (<i>p</i> < 0.001), with a cut-off value calculated to be 140 ml of bladder capacity. After adjusting for additional variables such as age, surgical procedure, prostate volume and nerve-sparing technique, multivariate linear model analysis still found a strong correlation between cystography-measured bladder capacity and very early continence rates (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The cystography-measured bladder capacity may be a good predictor of the recovery of post-prostatectomy urinary continence.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"148-153"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629253","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":"En-bloc resection of non-muscle invasive urinary bladder tumors using low power Holmium laser-A new promise.","authors":"Sunirmal Choudhury, Shahbaaz Ahmed, Surajit Sasmal, Prakhar Patel","doi":"10.1177/03915603241277914","DOIUrl":"10.1177/03915603241277914","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary bladder tumors are one of the most common urological malignancies. Traditionally, it has been initially managed with conventional trans-urethral resection of urinary bladder tumors (cTURBT) which has certain drawbacks and complications. Efforts have been made to find newer methods for management. In this study, we have used low power Holmium laser en-bloc resection and have assessed its safety, efficacy and feasibility.</p><p><strong>Materials and methods: </strong>Forty patients have been included in this prospective observational study who underwent low power Holmium laser en-bloc resection of urinary bladder tumor after taking Institutional ethical committee clearance and informed consent from all the patients. Intra-operative and post-operative data were collected.</p><p><strong>Results: </strong>The average tumor size was 21.68 ± 9.55 mm. Out of those, 65% of the patients had a tumor less than 3 cm in size. Fourteen patients (35%) had tumors at multiple sites. The average duration of resection per tumor was 24.84 ± 6.83 min. None of the cases required conversion to cTURBT. There was no obturator reflex or urinary bladder perforation in any of the cases. Detrusor muscle was present in the histopathology reports of 92.5% patients. The average duration of catheterization was 1.82 ± 0.61 days.</p><p><strong>Conclusion: </strong>For NMIBC's, low power Holmium laser en-bloc resection is a safe procedure with minimum risk of complications. High rate of detrusor-positive specimens indicates its efficacy and feasibility.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"39-43"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126826","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":"Exploring the landscape of urinary tract melanomas: A review for pathologists and clinicians.","authors":"Elisabetta Maffei, Antonio D'Antonio, Maria Addesso, Savio Domenico Pandolfo, Paolo Verze, Alessandro Caputo","doi":"10.1177/03915603241263215","DOIUrl":"10.1177/03915603241263215","url":null,"abstract":"<p><p>Melanomas originating within the urinary tract represent a rare and clinically challenging subset of malignancies. Despite extensive research on cutaneous melanomas, urinary tract melanomas remain relatively unexplored, presenting diagnostic dilemmas and limited treatment consensus. In this comprehensive review, we synthesize current knowledge on the epidemiology, risk factors, clinical presentation, histopathological characteristics, and treatment strategies specific to this disease. Enhancing clinical awareness, refining diagnostic approaches, and exploring novel therapeutic interventions hold promise for improving outcomes in this challenging malignancy subset.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"5-13"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752888","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":"Predictors of urethral stricture recurrence following internal urethrotomy: A systematic review.","authors":"David Endo, Jaime Robayo, Herney Andrés García-Perdomo","doi":"10.1177/03915603241292191","DOIUrl":"10.1177/03915603241292191","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the factors associated with urethral stricture recurrence in patients undergoing internal urethrotomy by direct vision.</p><p><strong>Methods: </strong>A systematic review was performed in MEDLINE (Ovid), EMBASE, LILACS, and central databases. Clinical, quasi-experimental, cohort, case-control, and cross-sectional trials were included.</p><p><strong>Results: </strong>The search strategy found 402 studies, and 6 were finally included. All of them were clinical trials. A total of 1723 patients diagnosed with urethral stricture undergoing internal urethrotomy were included. The primary associated factor was the association between the length of stricture and recurrence. Other factors described were post-RTU as etiology, previous interventions for urethral stricture management, and previous Qmax on uroflowmetry less than 5 ml/s.</p><p><strong>Conclusion: </strong>The length of urethral stricture was identified as the leading association with stricture recurrence following internal urethrotomy. Other associated factors were post-URT as etiology, previous interventions for managing stricture, and Qmax less than 5 ml/s. However, studies with better methodology are required.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"32-38"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508970","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":"Investigating the association between blue light cystoscopy utilization and social determinants of health.","authors":"Vikas Bhatt, Kamil Malshy, Alexander Homer, Borivoj Golijanin, Dragan Golijanin","doi":"10.1177/03915603241282407","DOIUrl":"10.1177/03915603241282407","url":null,"abstract":"<p><strong>Introduction: </strong>Blue light cystoscopy (BLC) improves bladder cancer (BCa) detection. No studies have evaluated socioeconomic inequity in the utilization of BLC.</p><p><strong>Methods: </strong>An institutional bladder tumor (TURBT) database (2016-2023) was retrospectively reviewed and BLC and white light cystoscopy (WLC) recipients were compared. Demographic and insurance data were collected. Socioeconomic Status (SES) was determined using a validated national and Rhode Island Area Deprivation Index (ADI).</p><p><strong>Results: </strong>2122 Rhode Island patients underwent TURBT and 32.23% had BLC. BLC recipients were younger (mean age 71.5 vs 73.8 years, <i>p</i> < 0.001), more likely married (69.6% vs 57.2%, <i>p</i> < 0.001), more likely English speakers (93.3% vs 91.9%, <i>p</i> = 0.015), and more likely to have private insurance (34.2% vs 27%, <i>p</i> = 0.001). BLC recipients had less socioeconomic disadvantage (<i>p</i> < 0.001): lower mean National (36.2 vs 38.7) and State (4.8 vs 5.2) ADI.</p><p><strong>Conclusion: </strong>SES is associated with BLC utilization, which may negatively influence BCa outcomes.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"44-50"},"PeriodicalIF":0.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296604","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}