World Journal of Urology最新文献

{"title":"Pathological assessment of morcellated tissue after ERBT: insights from a two-round Delphi survey.","authors":"Yossi Ventura, Andrey Morozov, Ronald Chan, Marcelo Combat Faria Tavares, Jeremy Yuen-Chun Teoh, Eva Compérat, Liang Cheng, Eddie Fridman, Julia Lerner, Ezra Baraban, Max Yakimov, Konstantin Lokshin, David Lifshitz, Shay Golan, Vineet Gauhar, Thomas R W Herrmann, Shahrokh Shariat, Dmitry Enikeev","doi":"10.1007/s00345-026-06451-9","DOIUrl":"https://doi.org/10.1007/s00345-026-06451-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the pathological adequacy of morcellated ERBT specimens using a two-round Delphi methodology and to establish expert consensus among leading pathologists worldwide.</p><p><strong>Methods: </strong>Core pathological parameters relevant for ERBT specimens were predefined, and representative high-quality digital slides of morcellated ERBT specimens were selected. These images were reviewed by an international panel of expert uropathologists with extensive experience in bladder cancer. A two-round Delphi survey was conducted, in which panelists rated the importance of predefined pathological parameters on a 5-point Likert scale. The items on which a consensus was not reached during the first round, were reviewed and rephrased for the second round involving the same responders. Consensus was defined as > 75% agreement among participants.</p><p><strong>Results: </strong>10 responders took part in the survey. During the initial Delphi round, agreement was achieved on six points, covering aspects such as tumor grading and staging (including lympho-vascular invasion, perineural invasion, detrusor muscle presence, grading adequacy, and histological classification). A broader statement also reached consensus, indicating that morcellation following ERBT provides specimen of appropriate quality. After revising the statements, the second round resulted in consensus on three more items: morcellated specimens allow for precise staging, evaluation of detrusor muscle invasion, and identification of carcinoma in situ.</p><p><strong>Conclusion: </strong>Tissue acquired after ERBT through morcellation permits dependable pathological evaluation, encompassing grading, staging, and identification of critical prognostic indicators such as carcinoma in situ, detrusor muscle, lymph vascular and perineural invasion. Morcellation is not perceived to compromise pathological evaluation based on expert consensus.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843638","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":"Preoperative urodynamics and the risk of overdiagnosis and overtreatment of occult urinary incontinence in continent women with advanced pelvic organ prolapse.","authors":"Susane Mei Hwang, Luis Gustavo Morato de Toledo, Silvia da Silva Carramão, Carolina Remesso Maximo de Jesus, Sarah Zanotto de Carvalho, Antonio Pedro Flores Auge","doi":"10.1007/s00345-026-06404-2","DOIUrl":"https://doi.org/10.1007/s00345-026-06404-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the impact of preoperative urodynamics (UDS) on the surgical treatment of pelvic organ prolapse (POP). It assessed whether UDS provided additional diagnoses, modified surgical planning, and influenced postoperative outcomes in continent women with advanced POP.</p><p><strong>Methods: </strong>This retrospective observational study included women with POP stages III-IV, without symptoms of stress urinary incontinence (SUI), who underwent surgical intervention between May 2015 and January 2020.</p><p><strong>Results: </strong>A total of 226 patients met the inclusion criteria, of whom 102 (45.1%) underwent UDS. Additional diagnoses were identified in 64/102 cases (62.6%), including 21 cases (20.6%) of occult SUI. Surgical planning was modified in 20/102 patients (19.6%), with 18 recommendations for sling placement and two contraindications. The overall rate of occult SUI was 28.8% (65/226). Among 182 patients continent on physical examination (PE), 68 (37.4%) underwent UDS. Postoperatively, the UDS group maintained more pronounced urge incontinence (p = 0.006) and storage symptoms (p < 0.001) compared to the PE group. No significant difference was observed in the incidence of de novo SUI between the UDS group 6/68 (8.8%) and the PE group 11/114 (9.6%) (p = 0.853), nor in the need of postoperative sling 4/68 (5.9%) and 5/114 (4.4%), respectively.</p><p><strong>Conclusions: </strong>Preoperative UDS in women with POP stages III - IV increases diagnostic yield, influences surgical planning, and raises the number of concomitant sling procedures. However, it does not alter postoperative outcomes in patients deemed continent on PE.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843643","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":"Letter to the editor: \"Clinical efficacy of ozone therapy in managing category IIIB chronic prostatitis: symptom improvement and antioxidant effects\".","authors":"Wei Xu, Liang Tang","doi":"10.1007/s00345-026-06456-4","DOIUrl":"https://doi.org/10.1007/s00345-026-06456-4","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843564","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 \"single-use ureteroscope era\": are we there yet?","authors":"Stessy Kutchukian, Olivier Traxer, Frederic Panthier","doi":"10.1007/s00345-026-06440-y","DOIUrl":"https://doi.org/10.1007/s00345-026-06440-y","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843641","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":"Prostate cancer therapeutic strategies decided based on in-bore MRI-targeted prostate biopsies alone, or in combination with TRUS-guided biopsies.","authors":"Alexandre Schull, Julie Gachet, Sebastian Tavolaro, Alexis Santy, Gregoire Bornet","doi":"10.1007/s00345-026-06434-w","DOIUrl":"https://doi.org/10.1007/s00345-026-06434-w","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose was to evaluate the concordance of prostate cancer therapeutic decisions based on in-bore MRI-targeted biopsies (MRI-TB) alone, with decisions based on combined in-bore MRI-TB and systematic US-guided biopsies.</p><p><strong>Methods: </strong>We included male biopsy-naïve patients, aged between 50 and ≤ 75 years, with PSA greater than 4 and/or a pathological digital rectal examination in this single-centre, exploratory, prospective, interventional study. All patients received T2-weighted MRI between November 2022 and May 2024, presenting a single lesion with a positive Prostate Imaging Reporting and Data System (PI-RADS) score ≥ 3. In-bore MRI-TB were carried out with the assistance of a Remote-Controlled Manipulator. A second operator (radiologist), blind to in-bore MRI-TB results, carried out systematic 12-core TRUS-guided biopsies.We evaluated concordance of therapeutic decisions decided in a multidisciplinary team meeting (MDT1) based on in-bore MRI-TB only, with decisions based on the combined biopsies (MDT2, blind to MDT1 decision). ISUP score and cancer detection concordance, and tolerance and acceptability of the procedures were evaluated.</p><p><strong>Results: </strong>Fifty patients were included, with average age 63.4 years (SD 6.9). Therapeutic strategies were aligned for 43 patients, with a weighted Cohen's Kappa of 0.81 [95%CI 0.67;0.95], within the very good range. ISUP score concordance was very good (0.82 [0.68;0.97]) and cancer detection concordance was strong (0.63 [0.38;0.89]). Pain was higher after TRUS-guided biopsies. Fourteen (28%) patients preferred in-bore MRI-TB and 7 (14%) preferred TRUS-guided and 29 (58.0%) had no preference. No infections were recorded.</p><p><strong>Conclusion: </strong>MRI-targeted biopsies reduce pain for patients. However, while there was excellent concordance between the two methods for therapeutic decisions and ISUP scores, the lower concordance for cancer detection means that systematic biopsies cannot yet be omitted for prostate cancer diagnosis.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843556","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":"Quantifying ergonomic challenges for urologists operating flexible ureteroscopes through artificial intelligence-based posture estimation.","authors":"Satoshi Kobayashi, Keiji Tsukino, Mikifumi Koura, Tokiyoshi Tanegashi, Shigehiro Tsukahara, Takashi Matsumoto, Masaki Shiota, Masatoshi Eto","doi":"10.1007/s00345-026-06444-8","DOIUrl":"https://doi.org/10.1007/s00345-026-06444-8","url":null,"abstract":"<p><strong>Purpose: </strong>The ergonomic challenges faced by surgeons during flexible ureteroscopy have yet to be thoroughly evaluated using objective methods. However, robot-assisted ureteroscopy has emerged as a promising treatment for urinary stones. The present study quantitatively assesses operative posture during transurethral ureteroscopy via an artificial intelligence-based posture estimation framework, and identifies kinematic differences associated with surgical expertise.</p><p><strong>Methods: </strong>Expert and novice urologists performed standardized flexible ureteroscopic tasks in a simulated transurethral ureteroscopy environment using kidney phantoms containing artificial stones. Upper-body movements were continuously video-recorded and joint coordinates of the shoulders, elbows, and wrists were extracted using an artificial intelligence-based pose estimation system. Kinematic parameters were quantitatively analyzed and compared between groups.</p><p><strong>Results: </strong>Experts completed observation of the entire renal pelvis significantly faster than novices (median 58 vs. 102 s, p < 0.001). Accumulated travel distance was markedly less in experts for the left shoulder (125 vs. 300 cm, p < 0.001), right elbow (324 vs. 1035 cm, p = 0.028), left elbow (349 vs. 772 cm, p = 0.019), and left wrist (729 vs. 3798 cm, p < 0.001). Experts had smaller movement areas at the left shoulder (6.29 vs. 40.5 cm², p < 0.001) and right elbow (17.3 vs. 281 cm², p = 0.040), and reduced movement ranges across multiple joints. Their angle fluctuation ranges were also narrower for the right shoulder (32.0 vs. 76.3°, p = 0.028) and left elbow (70.4 vs. 122.4°, p < 0.001).</p><p><strong>Conclusions: </strong>The artificial intelligence-based posture analysis objectively demonstrated ergonomic advantages associated with surgical expertise during flexible ureteroscopy and revealed persistent ergonomic risks to the wrist and elbow.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843607","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":"HALP score as a predictor of biochemical recurrence after robot-assisted laparoscopic prostatectomy for localized prostate cancer.","authors":"Emre Karabay","doi":"10.1007/s00345-026-06454-6","DOIUrl":"https://doi.org/10.1007/s00345-026-06454-6","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843632","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":"Safety and efficacy of percutaneous nephrolithotomy in elderly patients: a systematic review and meta-analysis by the EAU-YAU urolithiasis and EAU endourology sections.","authors":"Łukasz Nowak, Begoña Ballesta Martinez, Wojciech Krajewski, Bhaskar Somani, Amelia Pietropaolo, Wojciech Tomczak, Jan Łaszkiewicz, Matthias Boeykens, Thomas Tailly, Theodoros Spinos, Alberto Olivero, Arman Tsaturyan, Patrick JuliebØ-Jones, Senol Tonyali, Agata Góral, Paulina Biesiadecka, Adam Chełmoński, Bartosz Małkiewicz, Tomasz Szydełko","doi":"10.1007/s00345-026-06429-7","DOIUrl":"10.1007/s00345-026-06429-7","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate differences in safety and efficacy outcomes of PCNL between elderly and non-elderly patients, with special focus on commonly applied age cut-off values.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Comparative studies evaluating outcomes of PCNL in elderly versus non-elderly patients were identified through comprehensive searches of PubMed/MEDLINE, Embase, Web of Science, and the Cochrane Library up to February 2026. Primary outcomes included overall, minor, and major complications, as well as stone-free rate (SFR). Subgroup analyses were performed according to different age thresholds used to define elderly populations (60, 65, and 70 years).</p><p><strong>Results: </strong>Seventeen studies encompassing 45,603 patients, including 10,745 elderly individuals, were included. When pooled across all age definitions, rates of overall complications (OR 1.20, 95%CI 0.95-1.53) and major complications (OR 1.39, 95%CI 0.92-2.10) did not differ significantly between elderly and younger patients. Elderly patients demonstrated a significantly higher risk of postoperative sepsis (OR 3.94, 95%CI 1.83-8.47). SFR were comparable between groups. In subgroup analyses, studies applying a 70-year age cut-off demonstrated a significantly increased risk of overall complications (OR 1.26, 95% CI 1.03-1.55) and major complications (OR 1.95, 95% CI 1.15-3.31), whereas no significant differences were observed in studies using 60- or 65-year thresholds.</p><p><strong>Conclusions: </strong>PCNL can be performed safely in elderly patients, with SFR and complication profiles comparable to those observed in younger individuals when data across different elderly definitions are pooled. However, overall and major complications increases progressively with advancing age within the elderly population, especially among patients aged ≥ 70 years.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Face and content validation of laser enucleation of prostate simulation model: an EAU European School of Urology (ESU) Lower Urinary Tract Endoscopy Working Group study.","authors":"Tarik Emre Sener, Tiago Ribeiro de Oliveira, Engin Denizhan Demirkiran, Davide Perri, Sergio Pereira, Juan Pablo Caballero, Luis Osorio, Ioannis Goumas Kartalas, Marijn Goossens, Bernhard Schoensee, Laurian Dragos, Domenico Veneziano, Chandra Shekhar Biyani, Bhaskar Somani, Evangelos Liatsikos","doi":"10.1007/s00345-026-06428-8","DOIUrl":"10.1007/s00345-026-06428-8","url":null,"abstract":"<p><strong>Introduction: </strong>Laser enucleation of the prostate (LEP) has become a standard treatment for benign prostatic obstruction, yet its adoption is limited by a steep learning curve and a lack of validated training models. This study aimed to evaluate the face and content validity of a bench-top simulator specifically developed for LEP training within the framework of the European School of Urology (ESU) Lower Urinary Tract Endoscopy Working Group.</p><p><strong>Methods: </strong>Fourteen expert endourologists assessed the simulator during the European Urology Residents Education Programme (EUREP) 2025. Face and content validity were evaluated using 4-point Likert questionnaires, structured using the ESU validation framework. Descriptive statistics and content validity indices (I-CVI, S-CVI/Ave, S-CVI/UA) were calculated to assess agreement across anatomical, procedural, and educational domains.</p><p><strong>Results: </strong>Face validity scores were high across all items (mean 3.57-3.86; ≥90% agreement). The overall S-CVI/Ave was 0.85 and S-CVI/UA 0.47. Domain-specific analysis showed strong content validity for procedural steps (S-CVI/Ave = 0.89) and educational/global domains (0.95), moderate validity for essential anatomy (0.81), and lower ratings for intraoperative conditions (0.69), primarily due to the absence of bleeding simulation. When restricted to core domains (procedural + educational), S-CVI/Ave improved to 0.91.</p><p><strong>Conclusion: </strong>The simulator demonstrated strong face and content validity. Expert ratings indicated favorable perceptions of its realism, procedural similarity, and educational utility. These findings suggest that the simulator may be a useful component of a structured transurethral procedural training curriculum, although further construct validation is needed.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between urethral catheterization before TUR-P and postoperative stricture.","authors":"Miraç Ataman, Erdal Yılmaz, Mehmet Yufka, Emin Gürtan, Ercan Yuvanç","doi":"10.1007/s00345-026-06425-x","DOIUrl":"https://doi.org/10.1007/s00345-026-06425-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the relationship between the use of short-term preoperative urinary catheters and the development of postoperative urethral stricture in patients undergoing transurethral resection of the prostate (TUR-P) due to benign prostatic obstruction.</p><p><strong>Method: </strong>The records of 425 patients who underwent monopolar TUR-P between 2012 and 2025 were retrospectively reviewed. A total of 150 patients were included in the study according to the inclusion and exclusion criteria. Patients were divided into two groups based on preoperative urethral catheter use. The diagnosis of urethral stricture was confirmed by clinical findings, urethrography, and cystoscopy.</p><p><strong>Results: </strong>The overall urethral stricture rate was 8.7%. The stricture rate was 13.6% in the group without preoperative catheterization, compared with 2.9% in the group with catheterization (p = 0.020). No significant relationship was found between catheter duration and stricture development. An inverse relationship was observed between hypertension and stricture among comorbidities.</p><p><strong>Conclusion: </strong>Short-term preoperative urethral catheterization may be associated with a lower risk of postoperative urethral stricture after TUR-P. However, due to retrospective design of the study, causal inference cannot be established and prospective studies are needed.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843587","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}