World Journal of Urology最新文献

{"title":"Is the ablation stone efficacy and efficiency better with a flexible and navigable suction ureteric access sheath?","authors":"Luis Rico, Victoria Diaz-Zorita, Leandro Blas, Lorena Banda Ramos, Pablo Sabeh, Pablo Contreras","doi":"10.1007/s00345-025-05610-8","DOIUrl":"https://doi.org/10.1007/s00345-025-05610-8","url":null,"abstract":"<p><strong>Objective: </strong>To compare the ablation efficacy and efficiency of flexible and navigable suction ureteric access sheath (FANS) and conventional ureteral access sheath (c-UAS) in retrograde intrarenal surgery (RIRS) for kidney stones treatment.</p><p><strong>Materials and methods: </strong>A retrospective study of 96 patients who underwent RIRS using thulium fiber laser was performed. We divided the patients into Group 1: FANS and Group 2: c-UAS. We assessed the lithotripsy efficiency (mm³/Joules), ablation efficacy (mm³/min), and laser energy consumption (Joules/mm³). The stone-free rate (SFR) was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4-weeks after the procedure.</p><p><strong>Results: </strong>Both groups presented comparable stone volume (mm³) and stone density. RIRS with FANS presented a significantly lower surgical time and laser energy consumption (10.9 vs. 12.1 Joules/mm³, p < 0.001). In addition, FANS presented higher ablation efficiency (0.22 vs. 0.09 mm³/Joules, p < 0.001) and ablation efficacy (26.1 vs. 19.9 mm³/min, p < 0.001). SFR was significantly higher in the FANS group (93.7% vs. 75%, p < 0.001).</p><p><strong>Conclusion: </strong>Compared to c-UAS, RIRS with FANS was associated with decreased total operative time and laser energy consumption and presented a significantly higher ablation efficacy and efficiency. Additionally, SFR was significantly higher in the FANS group.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"219"},"PeriodicalIF":2.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to comments.","authors":"Selcuk Guven, Kamran Ahmed, Atinc Tozsin, Thomas Herrmann","doi":"10.1007/s00345-025-05612-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05612-6","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"218"},"PeriodicalIF":2.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of transcutaneous electrical tibial nerve stimulation in lower urinary tract dysfunction secondary to a parkinsonian syndrome: Uroparktens-a multicenter randomized placebo-controlled study.","authors":"Evelyne Castel-Lacanal, Benoit Peyronnet, Gilles Karsenty, Catherine-Marie Loche, Véronique Phé, Emmanuel Chartier-Kastler, Jean-Nicolas Cornu, Xavier Biardeau, Alexia Even, Pierre Denys, Amandine Guinet-Lacoste, Alain Ruffion, Stéphane Bart, Emilie Berard, Xavier Gamé","doi":"10.1007/s00345-025-05597-2","DOIUrl":"https://doi.org/10.1007/s00345-025-05597-2","url":null,"abstract":"<p><strong>Purpose: </strong>Lower urinary tract dysfunction (LUTD) is common in parkinsonian syndromes (PS) and requires special treatment due to limitations in the use of certain drugs and the progression of the disease. Tibial nerve stimulation by transcutaneous electrical nerve stimulation (TENS) is a simple, well-tolerated treatment with proven effectiveness in LUTD. The aim of our study was to evaluate the efficacy on urinary symptoms in patients with a parkinsonian syndrome.</p><p><strong>Method: </strong>A prospective, double-blind, multicenter, randomized study to compare the effects of TENS 20 min a day for 3 months with sham stimulation using the 3-month Patient Global Impression of Improvement (PGI-I) score in adults with PS and LUTD for whom conventional treatments had failed. The secondary endpoints studied were 3-month changes in PGI-S (Severity), Urinary Symptom Profile (USP), Qualiveen questionnaire, voiding diary (VD), post-void residue and the rate of complications.</p><p><strong>Results: </strong>Between 2015 and 2020, 100 patients with a mean age of 68.6 ± 8.4 years were randomized and included in the intention to treat analysis population (ITT). Among them were 71 men and 85 patients with idiopathic Parkinson's disease. Initially, the PGI-S was moderate to severe (score of 3-4) in 80 patients: 38 (83%) in the TENS group and 42 (82%) in the sham group. After 3 months of treatment, 68 patients felt an improvement (PGI-I 1-3): 30 (64%) in the TENS group and 38 (72%) in the sham-stimulation group (p = 0.399). There was no statistically significant difference between the 2 groups regardless of the endpoint considered.</p><p><strong>Conclusion: </strong>The effect of tibial neuromodulation by TENS on urinary disorders in patients with parkinsonian syndrome after 3 months of stimulation was not significantly different from the placebo effect obtained with sham stimulation.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"214"},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve on prostate fusion biopsies: key insights.","authors":"Mélanie Leprêtre, Iyad Chaoui, Franck Bruyère, Ali Bourgi","doi":"10.1007/s00345-025-05609-1","DOIUrl":"https://doi.org/10.1007/s00345-025-05609-1","url":null,"abstract":"<p><strong>Purpose: </strong>MRI-guided prostate biopsies offering improved accuracy in detecting clinically significant cancer. Image fusion (IF) techniques have shown promise, but their adoption requires overcoming a learning curve. This study evaluates the impact of operator experience on prostate biopsy outcomes using the HITACHI ultrasound system.</p><p><strong>Methods: </strong>This study was conducted from September 2016 to March 2020, including 148 patients undergoing mpMRI and targeted biopsies. The patients were grouped into Early (first 50 cases), Intermediate (cases 51-100), and Late (cases 101-148) phases, based on operator experience. Biopsy outcomes, including cancer detection rates, procedure times, and false-negative rates, were analyzed across these phases.</p><p><strong>Results: </strong>A significant learning curve was observed. In the Early phase, the detection rate for clinically significant cancers was 12%, increasing to 18% in the Intermediate phase and 25% in the Late phase. The overall positivity rate rose from 30 to 45%, while procedure times decreased from 45 to 30 min. Sensitivity for detecting clinically significant cancer improved from 60 to 85%, showing enhanced accuracy with operator experience.</p><p><strong>Conclusion: </strong>Operator experience plays a crucial role in improving prostate biopsy outcomes using IF techniques. As proficiency increased, both cancer detection rates and procedural efficiency improved. These findings emphasize the need for adequate training and experience to optimize results and ensure the full benefits of fusion biopsy technologies in prostate cancer diagnosis.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"215"},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of bladder spasm during catheter-indwelling in discharged patients after robot-assisted laparoscopic radical prostatectomy.","authors":"Jiahui Niu, Lu Cao, Yongbing Cheng, Xiaoyu Lyu, Shun Zhang, Hongqian Guo, Xuefeng Qiu","doi":"10.1007/s00345-025-05515-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05515-6","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative bladder spasm is a prevalent complication during the indwelling catheter period after radical prostatectomy (RP), affecting patient recovery and quality of life. This study aimed to identify preoperative patient characteristics that predict bladder spasm during the catheter-indwelling period in discharged patients following RP.</p><p><strong>Methods: </strong>A retrospective analysis of 126 patients with localized prostate cancer who underwent RP by a single surgeon between February 2023 and February 2024 was conducted. Preoperative clinical characteristics and pathologic data were collected. The presence of bladder spasm and related symptoms postoperatively was assessed until catheter removal. Univariate and multivariate logistic regression analyses were performed to identify independent predictors for bladder spasm and its manifestations.</p><p><strong>Results: </strong>Of the 126 eligible patients, 58 (46.0%) experienced bladder spasm. Higher International Prostate Symptom Score (IPSS) (P = 0.009) and lower educational levels, particularly primary school (P = 0.002) and junior high school (P = 0.044), were significantly associated with bladder spasm in multivariate analyses. Additionally, anxiety was related to a higher odds ratio of catheter-related bladder discomfort (CRBD) (P = 0.016).</p><p><strong>Conclusion: </strong>Preoperative factors, particularly higher IPSS, lower educational level, and preoperative anxiety, are significant predictors of bladder spasm and related symptoms following RP. These results highlight the importance of preoperative factors in prediction postoperative complications, informing personalized perioperative care and may assist in the development of targeted interventions to improve patient outcomes and potentially reduce postoperative complications.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"216"},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of star-like mapping incision on vesicourethral anastomotic stenosis after radical prostatectomy and cystectomy.","authors":"Abbas Basiri, Seyedhossein Rabani, Mohammadamin Omrani","doi":"10.1007/s00345-025-05607-3","DOIUrl":"https://doi.org/10.1007/s00345-025-05607-3","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy of star-like internal urethrotomy on vesicourethral anastomotic stenosis (VUAS) and its impact on voiding and continence outcomes.</p><p><strong>Methods: </strong>This observational study was conducted in two tertiary referral hospitals. 31 patients confirmed with VUAS after radical prostatectomy or cystectomy were included. A novel Star-like Incision Urethrotomy procedure focused on a shallow incision on scar tissue all around the anastomotic site was performed. The primary outcome was the procedure's impact on urinary voiding and continence, assessed using the International Prostate Symptom Score (IPSS) and the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF).</p><p><strong>Results: </strong>Participants had a mean age of 68.32 years, 27 (87%) with a history of radical prostatectomy and 4 (13%) with a history of radical cystectomy, who presented to our clinic with urinary obstructive symptoms. We performed Star-like incision on the anastomotic site using a ureteral catheter as a guide. During patient follow-up, significant improvements were observed in urinary flow and continence. At one month postoperatively, the mean IPSS score decreased from 26.58 to 13.39, and the ICIQ-SF score initially increased from 4.48 to 6.87 at first and then reduced to about 4. These improvements were sustained throughout the six regular follow-ups, with an IPSS score of 12.8 and an ICIQ-SF score of 3.6. Besides these improvements, 5 (16%) patients required repeated urethrotomy due to recurrence of stenosis.</p><p><strong>Conclusion: </strong>Endoscopic treatment with Star-like incision for VUAS has promising outcomes compared to other endoscopic treatments.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"217"},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacotherapy for overactive bladder syndrome and the risk of incident dementia.","authors":"David Sheyn, Jennifer Murphy, Abhimanyu Mahajan, C Emi Bretschneider, Lindsay Scott, Stephen Rhodes, Adonis Hijaz, Ankita Gupta","doi":"10.1007/s00345-025-05595-4","DOIUrl":"https://doi.org/10.1007/s00345-025-05595-4","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the risk of incident dementia in patients prescribed either an anticholinergic medication or mirabegron.</p><p><strong>Materials and methods: </strong>This was a retrospective cohort study of patients treated for OAB with pharmacotherapy between the years 2012 and 2023, using data from the TrinetX Research Collaborative Network. Patients who were diagnosed with OAB who were prescribed Mirabegron, Oxybutynin, Tolterodine, Darifenacin, Trospium, Fesoterodine, or Solifenacin after 1/1/2012 were identified. Anticholinergic medications were stratified into high-risk (Oxybutynin, Tolterodine, and Solifenacin) and low-risk (Darifenacin, Trospium and Fesoterodine) Patients with OAB who were not prescribed medications were included as a control group. The primary outcome was incidence of dementia occurring after initiation of pharmacotherapy or entry into the study (for the control group). Using Cox proportional hazard analyses, and adjusting for age and sex and adjusting for Elixhauser comorbidity index, anticholinergic burden score, and the average treatment effect, the risk of each medication on incident dementia was determined.</p><p><strong>Results: </strong>A total of 941,402 met inclusion for the final analysis, with 83,550 prescribed any medication. With an average follow-up time of 4.3 years, the only medication not found to be associated with an increased risk of dementia in any group was fesoterodine, while mirabegron was found to have a significant association with dementia across all age groups for both sexes.</p><p><strong>Conclusions: </strong>Most anticholinergic medications and mirabegron are associated with an increased risk of dementia compared to untreated controls with OAB, while fesoterodine was not found to be associated with an increased risk in any group.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"212"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes of Subsymphyseal Urethral Reconstruction (SURE) in isolated female epispadias: evaluation of continence scoring.","authors":"Mamta Sengar, Sauradeep Dey, Chhabi Ranu Gupta, Ashvin Damdoo, Niyaz Ahmed Khan","doi":"10.1007/s00345-025-05598-1","DOIUrl":"https://doi.org/10.1007/s00345-025-05598-1","url":null,"abstract":"<p><strong>Objective: </strong>To assess the long-term urinary continence of patients operated for isolated female epispadias using novel approach of distal urethral lengthening along with the incorporation of deeper periurethral muscles over the native urethra. Occurrence of UTI and stress incontinence too were assessed as secondary outcomes.</p><p><strong>Methodology: </strong>All girls diagnosed with isolated female epispadias, who underwent epispadias repair, and completed follow-up period of minimum 2 years, were included in this study. Their long-term continence was assessed using a validated questionnaire. The study group patients underwent distal urethroplasty using hairless skin of mons along with incorporation of deep periurethral tissue. Bladder neck reconstruction was added in initial patients with minor variant (type 2 of Davis classification) and in patient with cleft extending till bladder neck (type 3 of Davis classification). Five of the patients with type 2 defects were managed only with urethroplasty.</p><p><strong>Results: </strong>At a mean follow up of 7.4years all patients with type 2 epispadias (Davis classification) are continent and void on desire. None of them are having UTI or stress incontinence. Patient with type 3 epispadias is incontinent with dry interval of less than 30 min and awaiting augmentation cystoplasty.</p><p><strong>Conclusion: </strong>Simple urethral reconstruction with inclusion of hairless skin over mons and deeper peri-urethral soft tissue might be sufficient to restore sphincteric function in minor variants of isolated female epispadias. More extensive procedures may be reserved for the most severe cases.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"213"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for future research on single-use ureteroscopes in retrograde intrarenal surgery.","authors":"Yaping Ding","doi":"10.1007/s00345-025-05591-8","DOIUrl":"https://doi.org/10.1007/s00345-025-05591-8","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"207"},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relocation of big stone fragments with direct-in scope suction.","authors":"Arman Tsaturyan, Eugenio Ventimiglia, Arkadya Musayelyan, Hayk Grigoryan, Marat Harutyunyan, Gagik Amirjanyan, Armen Muradyan, Marine Khaskhazyan, Angelis Peteinaris, Vasileios Tatanis, Evangelos Liatsikos, Panagiotis Kallidonis, Francesco Esperto, Patrick Juliebø-Jones, Lazaros Tzelves, Ali Talyshinskii, Bhaskar Somani, Amelia Pietropaolo","doi":"10.1007/s00345-025-05594-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05594-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effectiveness of DISS feature of novel 7.5Fr and 9.2Fr single-use flexible digital ureteroscopes to relocate and evacuate stone fragments (2-5 mm in diameter) without any accessory instruments.</p><p><strong>Methods: </strong>An ex-vivo experimental study on porcine kidney and ureter was performed. Natural calcium oxalate dihydrate stone fragments sized 2-5 mm placed in the upper, middle and lower calyces were used. For each stone in each location 5 attempts were performed. The attempt was defined as successful if stone evacuation was reported while withdrawing the scope through the 12/14Fr UAS. The time collapsing the collecting system was also reported.</p><p><strong>Results: </strong>The time needed to collapse the porcine pelvi-calyceal system (PCS) was 4-5 s for 9.2Fr and 5-6 s for 7.5Fr scope. Evacuation of 2 mm stone fragments occurred in all trials both with 9.2Fr and 7.5Fr scopes. In case of 3 mm stone, evacuation of stone fragments was observed in 3 out of 5 and 1 out of 5 attempts in upper calyx, 5 out of 5 and 3 out of 5 in the middle calyx and 2 out of 5 and 0 out 5 in lower calyx using 7.5Fr and 9.2Fr scope, respectively.</p><p><strong>Conclusion: </strong>The DISS feature of the novel 7.5Fr and 9.2Fr single-use digital flexible ureteroscope can be potentially used not only to aspirate dust but also to relocate and evacuate larger stone fragments up to 4 mm in diameter using only suction. The speed of collapse of the PCS seems to be one of the main predictors of success.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"210"},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}