Urology Annals最新文献

{"title":"Evaluation of holmium laser enucleation of the prostate and bipolar transurethral resection of the prostate in relation to benign prostatic hyperplasia treatment.","authors":"Ahsan Ahmad, Nikhil Ranjan, Kumar Dheeraj, Gaurav Babelay","doi":"10.4103/ua.ua_55_25","DOIUrl":"10.4103/ua.ua_55_25","url":null,"abstract":"<p><strong>Background: </strong>A common disorder in men that has been linked to the natural aging process is benign prostatic hyperplasia (BPH). In men aged 70 and older, the frequency is approximately 40%.</p><p><strong>Aims: </strong>In this study, we compared the results of bipolar transurethral resection of the prostate (TURP) with our experience using holmium laser enucleation of the prostate (HoLEP).</p><p><strong>Settings and design: </strong>The research was prospective and randomized. It was conducted from April 2024 to January 2025 to treat BPH.</p><p><strong>Methodology: </strong>Fifty participants in total had taken part in the study. Patients were randomized using the odd-even method into two groups; Group A was administered with HoLEP, and Group B with bipolar TURP. Both groups were distributed equally, with 25 patients in each.</p><p><strong>Statistical analysis: </strong>For statistical analysis, an independent <i>t</i>-test was employed. Any <i>P</i> value below 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Operative time was 70.74 ± 16.54 min in Group A, whereas 52.46 ± 12.24 min in Group B. The operative time and capsular perforation were found to be statistically significant between the groups with a <i>P</i> < 0.001 and 0.04, respectively. The International Prostate Symptom Score scores were 5.65 ± 2.23 in Group A and 5.43 ± 2.02 in Group B, respectively. Qmax was found to be 20.32 ± 8.7 in Group A, while 18.66 ± 5.45 in Group B.</p><p><strong>Conclusion: </strong>In the study, both HoLEP and TURP tend to be equally effective in terms of symptomatic relief. A steep learning curve has been seen along with less morbidity, which is associated with HoLEP.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 1","pages":"83-87"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202949","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":"Early or late intervention of upper urinary tract stone disease: What dictates it?","authors":"Murat Tuğrul Eren, Hakan Özveri","doi":"10.4103/ua.ua_58_25","DOIUrl":"10.4103/ua.ua_58_25","url":null,"abstract":"<p><strong>Objective: </strong>Urolithiasis is a multifactorial disease that causes symptomatology and needs to be managed depending on various clinical parameters. In this study, we aimed to investigate clinical factors for early operation in patients with uncomplicated symptomatic urolithiasis.</p><p><strong>Materials and methods: </strong>Medical records of 148 patients who underwent ureterorenoscopic lithotripsy (URS) within 6 weeks of diagnosis of urolithiasis were retrospectively reviewed. The patients were divided into two groups: those operated early (≤3 days, <i>n</i> = 80) and those operated late (≥4 days, <i>n</i> = 68). Data, including age, sex, body mass index, degree of pain assessed with Visual Analog Scale (VAS), radiological and laboratory examinations at the time of admission, along with perioperative surgical data, were recorded.</p><p><strong>Results: </strong>110 (74.3%) males and 38 (25.7%) females with a median age of 38 years were operated on for uncomplicated ureteral stones. Median time from diagnosis to ureteroscopic intervention was 3 days. Among clinical factors, only the number of readmissions to the emergency room, the mean white blood cell count, the level of microscopic hematuria, and VAS scores of pain at the initial diagnosis were significantly higher in the early operated group (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>Pain is a major clinical factor resulting in earlier URS in uncomplicated upper urinary tract stone disease. First admission to the emergency room due to renal colic with multiple readmissions after diagnosis, high level of microscopic hematuria, and white blood cell counts appear to be significant pain-related factors for earlier operation.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 1","pages":"88-94"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202968","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":"A comparative analysis of clinicopathological characteristics and surgical outcomes in adults with renal masses.","authors":"Siddharta Saxena, Vikas Kumar Panwar, Ankur Mittal, Mohammed Taher Mujahid, Mehul Agarwal","doi":"10.4103/ua.ua_54_25","DOIUrl":"10.4103/ua.ua_54_25","url":null,"abstract":"<p><strong>Background: </strong>The management of renal masses varies significantly across age groups, necessitating a comprehensive understanding of age-related clinicopathological characteristics. This study evaluates these characteristics and surgical outcomes in patients aged ≤45 years versus >45 years.</p><p><strong>Aim: </strong>The aim of the study was to evaluate the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR), patient age, tumor-node-metastasis (TNM) stage, and long-term survival in renal cell carcinoma (RCC), and to assess whether NLR can improve risk stratification beyond conventional clinicopathologic factors.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 199 patients with renal space-occupying lesions was conducted between January 2018 and December 2024. Patients were stratified by age (≤45 years: <i>n</i> = 64; >45 years: <i>n</i> = 135). Demographics, clinical presentations, histopathology, surgical approaches, and perioperative parameters were analyzed using appropriate statistical methods.</p><p><strong>Results: </strong>Older patients more frequently experienced flank pain (76.4% vs. 58.1%) and hematuria (50.3% vs. 34.4%), and had higher nodal (N1: 9 vs. 1) and metastatic (M1: 28 vs. 2) disease rates compared to those ≤45 years. Clear-cell RCC remained most common (43.2% across groups). Postoperative creatinine rose significantly in all nephrectomy types, whereas hemoglobin changes were similar by age. Preoperative NLR increased with pT stage (<i>P</i> < 0.001), was higher in node-positive (<i>P</i> = 0.030) and metastatic (<i>P</i> < 0.001) cases, underscoring its independent prognostic value across age strata.</p><p><strong>Conclusions: </strong>Age significantly influences the clinical presentation and disease stage of renal masses. Histologic subtypes were similar across ages, but older patients consistently had more advanced disease. Moreover, elevated preoperative NLR was strongly linked to higher TNM stage, underscoring its value in RCC risk stratification.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 1","pages":"41-49"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202887","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":"Walk-in ureteroscopy and laser management service for urolithiasis in patients with renal colic: Lessons focusing on gains and challenges.","authors":"Shahad Mohamed Elhadi, Soha Nabi, Jose Antonio Campos Sanudo, Ghulam Nabi","doi":"10.4103/ua.ua_56_25","DOIUrl":"10.4103/ua.ua_56_25","url":null,"abstract":"<p><strong>Introduction: </strong>We conceptualized a modified care pathway for renal colic management with the intention of expediting their treatment. This proof-of-concept study aimed at assessment of walk-in ureteroscopy outcomes in comparison to conservative treatment of urolithiasis with renal colic.</p><p><strong>Patients and methods: </strong>Forty-two patients (32 in walk-in ureteroscopy group and 10 in the conservative group) with a mean age of 37 ± 10.2 years were confirmed to have ureteric/renal stones as the cause of renal colic using non-contrast computed tomography (CT) scan. Walk-in ureteroscopy and laser fragmentation procedures were offered to all. Those opting for the procedure underwent ureteroscopy and laser fragmentation. They were discharged immediately after the procedures and followed up in the clinic, including removal of stents. Patients with sepsis were excluded. Stone, free rate, and re-admission, including complications, were assessed and analyzed.</p><p><strong>Results: </strong>The mean time from CT detection to ureteroscopic laser fragmentation was 6 ± 3.4 h. All patients resumed work in 2-3 weeks and reported no further admission to hospital for stone-related events. 30 patients were stone free at a follow-up imaging at 6 weeks. One patient had a small residual stone fragment (<2 mm) located in the inferior calyx and required no further intervention. In contrast, 4 patients in the control group required at least two admissions each in emergency departments and continued to be off work for more than 3 weeks. Overall, 8 patients in the control group eventually required interventions in other hospitals, and two continued to have stones and managed pain conservatively with analgesics.</p><p><strong>Conclusions: </strong>In a modified pathway for renal colic management, walk-in ureteroscopy is feasible and safe. The procedure is associated with a very high stone-free rate and with early return to work and reduced re-admissions in comparison to the conservative management option. The study and its conclusions are limited by sample size and generalizability, as the procedures were carried out by experienced staff. Lack of randomization raises the possibility of selection bias as patients self-selected their treatment groups. Finally, the brief follow-up duration might not adequately reflect long-term results like recurrence or late complications.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 1","pages":"50-55"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202897","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":"Awareness of benign prostatic hyperplasia among males in the Riyadh region, KSA.","authors":"Mohammed Salman Alkhaldi, Abdulrahman S Binsaleh, Ahmed O Alghamdi, Bandar Hather A Alharthy, Abdulaziz Nasser Alkudam, Faisal R Alanazi, Talal K Aldawsari, Mahmood Ahmad H Alqunais, Mohammed H Karrar Alsharif, Ali Hassan A Ali, Mosab A A Alzubier","doi":"10.4103/ua.ua_65_25","DOIUrl":"10.4103/ua.ua_65_25","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is a prevalent urological condition characterized by nonneoplastic enlargement of the prostate gland, leading to lower urinary tract symptoms such as nocturia, urine retention, and secondary urinary infections.</p><p><strong>Methodology: </strong>This cross-sectional study evaluates BPH awareness, risk factors, and management among males ≥19 years in Riyadh, using a validated questionnaire (<i>n</i> = 398). Data were collected using a structured questionnaire distributed to 398 participants.</p><p><strong>Results: </strong>The results reveal a significant lack of awareness, with 61.3% of participants showing poor knowledge about BPH, its symptoms, and available treatments. Notably, the internet and social media were the primary information sources, overshadowing healthcare providers. Despite the low awareness, 76.6% of participants expressed interest in learning more about BPH, highlighting an opportunity for targeted educational programs.</p><p><strong>Conclusions: </strong>The study shows an urgent need for public health interventions to improve awareness, promote early detection, and address modifiable lifestyle risk factors to enhance the quality of life in affected populations. Targeted interventions leveraging social media and healthcare providers are urgently needed to address gaps in awareness and screening.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 1","pages":"68-74"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202899","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":"Perioperative outcomes of laparoscopic donor nephrectomy: A single-center experience.","authors":"John Kim, Emily Zhang, Deron Britt, Jennifer Tang, Ibrahim Ebeido, Evan Fang, Amanda Paynter, Shahid Lambe","doi":"10.4103/ua.ua_17_25","DOIUrl":"10.4103/ua.ua_17_25","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic donor nephrectomy (LDN) remains the gold standard for living kidney donation. There is controversy over the optimal method for controlling the renal vessels. In this study, we assessed the outcomes of LDN and compared postoperative outcomes based on donor demographics and method of vascular control.</p><p><strong>Materials and methods: </strong>We conducted a retrospective single-center review examining all adult patients who underwent LDN from 2017 to 2022. The outcomes collected included transfusion rate, estimated blood loss (EBL), reintervention rate, and overall 30-day complication rate. We also analyzed intra- and postoperative variables, including operative duration, conversion to open, method of vascular control, change in renal function, and length of stay.</p><p><strong>Results: </strong>168 patients were included, with the majority (81%) of patients undergoing left LDN. The median EBL was 100 mL (interquartile range 100-200 mL). Only two patients (1%) experienced hemorrhagic complications, though none was a result of clip or staple malfunction. The most common methods of arterial control were staples and clips (69%) and clips alone (28%), and the use of staples and clips was associated with longer operative duration. However, there were no significant differences in EBL, length of stay, or complication rate between groups. No patients required surgical reintervention for any reason, and there were no postoperative deaths.</p><p><strong>Conclusion: </strong>At our center, LDN was associated with low rates of hemorrhagic complications. There was no association between the method used to control the renal artery and perioperative outcomes or complication rates. Our data suggest that LDN is a safe procedure with low complication rates.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"18 1","pages":"18-24"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202982","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":"Frailty scoring systems in urological surgery: Current status and future perspectives.","authors":"Patrick Juliebø-Jones, Arman Tsaturyan, Esteban Emiliani, Ali Talyshinskii, Bhaskar K Somani, Wissam Khalid Kamal, Christian Arvei Moen, Eugenio Ventimiglia, Lazaros Tzelves, Christian Beisland","doi":"10.4103/ua.ua_45_25","DOIUrl":"10.4103/ua.ua_45_25","url":null,"abstract":"<p><p>Frailty refers to a state of increased vulnerability and is recognised to be multifactorial. It is associated with a higher likelihood for functional dependency and a reduced life expectancy. In the surgical setting, frailty has attracted increased attention in regard to how it can impact post-operative outcomes. Many research groups have explored ways to translate frailty into a clinical marker and represent it as a quantifiable measurement. To this end, there now exist a plethora of tools (over 50 tools) available that have been applied in a clinical and/or research setting across nearly all medical and surgical specialities. However, the large number of tools can make it challenging for clinicians to know which one to adopt. This article provides an overview of the commonly used tools in urological surgery. Most tools have been studied in the context of urological cancer surgery and consistently show that frailty is associated with poorer outcomes. Of note, none of the systems described were developed exclusively for purely urological studies. Many of the abovementioned systems require a face-to-face assessment and therefore preclude retrospective data collection. Frail patients may not therefore be eligible on account of either one of these and it may account for why research in this field is lacking. Important outcomes such as the discharge location and how ADLs have changed are also challenging to collect retrospectively. Further research should focus on developing a frailty scoring system that is customised for urological surgeries.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"17 4","pages":"218-222"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507435","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":"Role, effectiveness, cost efficiency, sustainability, and outcomes of using telemedicine in endourology: A systematic review of literature.","authors":"Amr Makia, Salma Khalifa, Bhaskar K Somani","doi":"10.4103/ua.ua_49_25","DOIUrl":"10.4103/ua.ua_49_25","url":null,"abstract":"<p><p>The role of telemedicine (TM) in endourology has expanded significantly over the past decade, demonstrating benefits for both patient satisfaction and healthcare efficiency. We wanted to look at the role and effectiveness of using these technological innovations in endourology. A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework and Population, Intervention, Comparison, and Outcome statement. Search was done for all English language articles, over several databases, from inception to Aug 2024. The inclusion criteria focused on studies involving patients with kidney stone disease and reporting outcomes related to healthcare delivery, cost savings, and environmental sustainability (green credentials). A total of 933 articles were initially identified and after screening of titles, abstracts, and full texts, 10 articles were finally included. Of these articles, 8 showed a cost-saving and 9 showed a greener credential of using TM. All included studies showed a positive impact of TM in terms of reduced time to access urology services, enhanced acute and follow-up efficiency, time to decision-making or treatment, patient satisfaction, and safety. Most studies showed more than one clinical and/or organizational benefit in the patient pathway. Our review shows that TM in endourology demonstrates multiple benefits, including cost savings, environmental sustainability, and improved healthcare delivery. The included studies highlight enhanced access to services, faster decision-making, and high patient satisfaction and safety. Given the pressures on the National Health Service and existing waiting times, more should be done to adapt and adopt this technological revolution.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"17 4","pages":"210-217"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507433","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":"Trifecta outcomes to assess the feasibility of local anesthesia for benign prostate hyperplasia minimally invasive surgical treatments.","authors":"Alberto Olivero, Sinan Khadhouri, Erika Palagonia, Paolo Dell'Oglio, Stefano Tappero, Barend Dreyer, Aldo Massimo Bocciardi, Alberto Caviglia, Antonio Galfano, Feras Al Jaafari, Bhaskar K Somani, Amelia Pietropaolo, Silvia Secco","doi":"10.4103/ua.ua_41_25","DOIUrl":"10.4103/ua.ua_41_25","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgical treatments (MISTs) are many promising approaches for the management of benign prostate hyperplasia (BPH) that might be performed under local anesthesia (LA) and have same-day discharge. To address the feasibility and efficacy of LA for BPH-MIST, a specific trifecta was conceptualized and tested: (1) no intraoperative complications, (2) reduced intraoperative pain, and (3) same-day discharge.</p><p><strong>Materials and methods: </strong>We prospectively collected data from patients who underwent Rezum, Urolift, and iTIND treatments from January 01, 2023, to February 28, 2024, on an international database. All the patients received a local administration of two anesthetic gels in the urethra before the procedure; selected patients, in addition, received a transperineal anesthetic injection in the periprostatic space or transurethrally with a Schelin Catheter (SC) injection directly in the prostatic lobes. Reduced intraoperative pain was defined as <5 on the visual analogue scale (VAS range: 0-10).</p><p><strong>Results: </strong>Overall, 156 patients were included in the study. Median age was 63.5 (interquartile range [IQR]: 56-70) years. Eleven patients (7.0%) had diabetes, and 29 (18.6%) received anticoagulant medication. Ten patients (6.4%) had indwelling catheters. The median prostate size was 45 ml (IQR: 34-60). Forty-eight patients underwent Urolift (30.8%), 70 (44.8%) Rezum, and 38 (24.4%) iTIND. The transperineal block and the SC were used in 21 patients (13.5%) and 32 (20.5%) patients, respectively, with 103 (66%) patients receiving only the anesthetic gels in the urethra. Performing MIST in pure LA achieved the trifecta outcome in 122 patients (78.2%). Six patients (3.8%) had intraoperative complications. One hundred and thirty patients (83.3%) experienced reduced intraoperative pain (<5 on VAS). One hundred and 47 (94.2%) patients were discharged on the same day of the procedure.</p><p><strong>Conclusions: </strong>LA for MIST in BPH is feasible, with excellent success rates and reduced pain, as trifecta outcomes were achieved.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"17 4","pages":"233-238"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507450","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":"Changes in estimated glomerular filtration rate after percutaneous nephrolithotomy in patients with stage 2-4 chronic kidney disease.","authors":"Amr H Abou Faddan, Mohamed Abdelghany, Adel Kurkar, Ahmed M Moeen, Mohammed A Gadalla","doi":"10.4103/ua.ua_92_25","DOIUrl":"10.4103/ua.ua_92_25","url":null,"abstract":"<p><strong>Background and objective: </strong>Percutaneous nephrolithotomy (PCNL) is the gold standard technique used for the treatment of large renal stones ≥ 2 cm. However, in patients with chronic kidney disease (CKD), the effect of PCNL remains underreported. We aimed to prospectively evaluate the changes in estimated glomerular filtration rate (eGFR) after PCNL in patients with stage 2-4 CKD.</p><p><strong>Subjects and methods: </strong>This prospective study included patients with stage 2-4 CKD who underwent PCNL in the period from December 2020 to December 2023. eGFR was measured using the Cockroft-Gault formula preoperatively and 3 months postoperatively. Patients were classified as either improved/stable or deteriorated. Perioperative complications and stone-free rate (SFR) were also evaluated.</p><p><strong>Results: </strong>The study included 50 patients (male/female = 33/17) with CKD who underwent PCNL. The mean operative time was 84.8 ± 27.4 min. A total number of 49 complications were reported in 21 patients. At a follow-up of 3 months, eGFR was improved/stable in 40 (80%) patients, and it deteriorated in 10 (20%) patients. The SFR was 76% at 3 months postoperatively. Factors that significantly affected the eGFR were bleeding, access number, incidence of perioperative complications, stone burden, and operative time.</p><p><strong>Conclusions: </strong>PCNL is an effective and safe treatment option for patients with stage 2-4 CKD with renal stones ≥2 cm. It is advisable to avoid long operative time, excessive bleeding, and multiple accesses as possible in these patients to minimize the risk of renal function deterioration.</p>","PeriodicalId":23633,"journal":{"name":"Urology Annals","volume":"17 4","pages":"250-256"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507382","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}