World Journal of Urology最新文献

{"title":"The utility of flexible and navigable suction access sheath (FANS) in patients undergoing same session flexible ureteroscopy for bilateral renal calculi: a global prospective multicenter analysis by EAU endourology.","authors":"Vineet Gauhar, Bhaskar Somani, Daniele Castellani, Khi Yung Fong, Nariman Gadzhiev, Satyendra Persaud, Saeed Bin Hamri, Chu Ann Chai, Azimdjon Tursunkulov, Yiloren Tanidir, Boyke Soebhali, Anil Shrestha, Deepak Ragoori, Mohamed Elshazly, Mehmet Ilker Gokce, Vigen Malkhasyan, Yasser Farahat, Thomas Herrmann, Olivier Traxer, Steffi Kar Kei Yuen","doi":"10.1007/s00345-025-05477-9","DOIUrl":"10.1007/s00345-025-05477-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the 30-day stone-free rate and peri-operative outcomes of flexible ureteroscopy (FURS) with flexible and navigable suction ureteral access sheaths (FANS) in adults undergoing same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS).</p><p><strong>Methods: </strong>Prospectively data of 115 adult patients with bilateral kidney stone disease undergoing SSB-RIRS across 14 global centers between July 2023 and March 2024 were analyzed. Patient demographics, stone characteristics and operative outcomes were recorded. A low-dose non contrast CT scan was performed at 30 days to assess the stone-free rate and clinical outcomes.</p><p><strong>Results: </strong>Overall bilateral zero residual fragment(ZRF) was 42.6%; unilateral ZRF was 75.7%. Only two patients were noted to have residual fragments > 4 mm. 1.7% experienced Traxer-Thomas grade 1 ureteric injury which was managed with a ureteral stent for four weeks. No pelvicalyceal injury occured. Postoperative mean loin pain score was 1.7 ± 1.0. None had sepsis nor required blood transfusion. 4.3% required readmission within 30 days of surgery. Multivariate analysis indicated longer total operation time correlated with lower odds of achieving a 100% bilateral stone-free (ZRF) (OR 0.978, 95%CI = 0.959-0.994, p = 0.013).</p><p><strong>Conclusion: </strong>To our knowledge, this is the first multicenter study demonstrating the use of FANS in SSB-RIRS can achieve bilateral ZRF with low complication and re-intervention rates. However, prolonged surgical time may negatively impact outcomes. The indications of bilateral renal stones management with FURS can be expanded in appropriate chosen patients.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"142"},"PeriodicalIF":2.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524516","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":"Management of patients with mesh perforation into viscus following pelvic mesh surgery.","authors":"Yu Hwee Tan, Krishanthy Thayalan, Hannah Krause, Vivien Wong, Judith Goh","doi":"10.1007/s00345-025-05512-9","DOIUrl":"10.1007/s00345-025-05512-9","url":null,"abstract":"<p><strong>Purpose: </strong>Pelvic mesh has been used for the treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Between 3 and 20% suffer complications with debilitating long-term outcomes. Uncommon complications include mesh perforation into viscus however there is minimal published data regarding outcomes following surgical management.</p><p><strong>Methods: </strong>A retrospective observational study of patients with diagnosis of mesh in viscus at three tertiary urogynaecology units was performed to report on clinical outcomes following surgical management.</p><p><strong>Results: </strong>Fifty-eight patients were diagnosed with mesh in viscus following cystourethroscopy and thorough examination of vagina/rectum. Mesh involved included mid-urethral slings-retropubic (36.9%), transobturator (18.5%), single incision slings (10.8%); transvaginal POP mesh (15.4%); sacrocolpopexy (13.8%); uncertain type (4.6%). Viscus involved included bladder (39.7%), urethra (50%), bladder and urethra (3.4%), and rectum (6.9%). Main presenting symptoms included mixed urinary incontinence (UI) (75.9%), recurrent urinary tract infections (rUTIs) (48.3%) and rectal/pelvic pain (56.9%). Fifty-one patients underwent mesh excision and viscus repair, with successful repair in all (100%). 48% had complete mesh excision. Mean follow up was 9.5 months (range 0.5-96 months). Post-operatively, there was a statistically significant reduction in rUTIs (p = 0.0004) as well as pain (p = 0.000005). None had recurrent mesh erosion, lower genitourinary tract fistula or wound breakdown.</p><p><strong>Conclusions: </strong>All patients required thorough examination and cystourethroscopy for diagnosis. Surgical management of mesh in viscus appears to have low morbidity and is shown to reduce symptoms of rUTIs and pain as well as risk of recurrent mesh erosion and fistulae.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"143"},"PeriodicalIF":2.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524514","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":"Development and evaluation of USCnet: an AI-based model for preoperative prediction of infectious and non-infectious urolithiasis.","authors":"Jiexin Pan, Haodong Chen, Chen Huang, Ziji Liang, Chen Fan, Wei Zhao, Yongquan Zhang, Xiang Wan, Changmiao Wang, Rong Hu, Li Zhang, Yi Jiang, Yiwen Liang, Xingzhi Li","doi":"10.1007/s00345-025-05492-w","DOIUrl":"https://doi.org/10.1007/s00345-025-05492-w","url":null,"abstract":"<p><strong>Background: </strong>Urolithiasis, a prevalent condition characterized by a high rate of incidence and recurrence, necessitates accurate preoperative diagnostic methods to determine stone composition for effective clinical management. Current diagnostic practices, reliant on postoperative specimen analysis, often fail to facilitate timely and precise therapeutic decisions, leading to suboptimal clinical outcomes. This study introduces an artificial intelligence model developed to predict infectious and non-infectious urolithiasis preoperatively using clinical data and CT imaging.</p><p><strong>Methods: </strong>Data from December 2014 to November 2021 involving 642 patients undergoing surgical treatment for urolithiasis were used to train and validate the model. The model integrates Visual and Textual Transformation (VTT) and Multimodal-Segmentation Attention Fusion (MSAF) modules to enhance the diagnostic process.</p><p><strong>Results: </strong>The model demonstrated superior accuracy and reliability in differentiating between infectious and non-infectious urolithiasis compared to traditional diagnostic methods. It achieved a classification accuracy of 79.66%, Area Under Curve of 86.74%, significantly outperforming conventional ResNet architectures and similar models. The inclusion of clinical parameters substantially improved the model's predictive capabilities.</p><p><strong>Conclusions: </strong>Our model provides an efficient tool for the preoperative identification of urolithiasis type, supporting clinical decisions regarding surgical planning and postoperative care. Its ability to process and analyze complex clinical and imaging data preoperatively positions it as a valuable adjunct in urological practice, particularly in settings with limited access to specialized medical resources.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"141"},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516803","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":"Application trends and research hotspots of endoscopic enucleation of the prostate: a bibliometric and visualization analysis.","authors":"Xiao-Da Lan, Zhuo-Yang Yu, Rui Jiang, Zhi-Cun Li, Lei Yang, Kai Zhang, Yi-Sen Meng, Qian Zhang","doi":"10.1007/s00345-024-05379-2","DOIUrl":"https://doi.org/10.1007/s00345-024-05379-2","url":null,"abstract":"<p><strong>Purpose: </strong>Endoscopic enucleation of the prostate (EEP) is a preferred treatment for benign prostatic hyperplasia (BPH). This bibliometric analysis aims to analyze the application trends and research hotspots of EEP.</p><p><strong>Methods: </strong>We conducted a bibliometric analysis of publications indexed in the Web of Science Core Collection from 1989 to 2023. The techniques examined include holmium laser enucleation (HoLEP), thulium laser enucleation (ThuLEP/ThuFLEP), bipolar/monopolar transurethral enucleation (b-TUEP/m-TUEP), GreenLight laser enucleation (GreenLEP), and diode laser enucleation (DiLEP). We utilized VOSviewer, CiteSpace, and the R package 'bibliometrix' for the analysis.</p><p><strong>Results: </strong>A total of 739 English-language studies were analyzed, revealing a steady increase in EEP-related publications. HoLEP was the most extensively studied technique, followed by ThuLEP and b-TUEP, while ThuFLEP gaining emerging interest. There has been a notable lack of high-quality randomized controlled trials (RCTs) for GreenLEP, DiLEP and m-TUEP. China, the United States, and Germany led in publication volume and collaboration networks. Key contributors in the field were identified, with recent research focusing on topics like postoperative transient urinary incontinence (TUI) and the role of robot-assisted simple prostatectomy (RASP) in comparison to EEP.</p><p><strong>Conclusions: </strong>EEP is gaining widespread clinical acceptance for BPH treatment. Future research should focus on addressing the gap in high-quality RCTs, especially for underexplored techniques like GreenLEP, DiLEP and m-TUEP, and explore strategies to reduce postoperative TUI. Prospective comparisons between RASP and EEP will be crucial for optimizing surgical approaches in BPH management.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"140"},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504642","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":"Impact of advanced lithotripter technology on SWL success: ınsights from Modulith SLK ınline outcomes.","authors":"Erhan Erdoğan, Gamze Şimşek, Alper Aşık, Göksu Sarıca, Kemal Sarıca","doi":"10.1007/s00345-025-05517-4","DOIUrl":"10.1007/s00345-025-05517-4","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to evaluate the success rate of Shock Wave Lithotripsy (SWL) in treating kidney stones using the Modulith SLK Inline lithotripter, with a focus on the importance of device efficacy as emphasized in EAU guidelines.</p><p><strong>Patients and methods: </strong>This retrospective single-center study was conducted between June 2023 and June 2024. Inclusion criteria were adult patients (> 18 years) with radiologically confirmed renal stones smaller than 15 mm in diameter. Exclusion criteria included patients with solitary kidneys, significant renal functional deterioration, skeletal deformities, active urinary tract infections, pregnancy, or coagulopathies. Treatment outcomes were collected and analyzed in detail, considering patients' demographic characteristics (age, gender) and stone parameters (size, location, and hardness [Hounsfield Unit, HU]). The SWL procedures were performed using the Modulith SLK Inline lithotripter (Storz Medical, Switzerland). The success of SWL was defined as achieving complete stone clearance or the presence of clinically insignificant residual fragments (CIRF) (< 4 mm). This study seeks to provide detailed insights into the optimal use cases of SWL as a non-invasive yet effective treatment option for smaller, more manageable stones.</p><p><strong>Results: </strong>The mean age of the 208 patients included in the study was 42.2 ± 12.7 years (18-75), with a male-to-female ratio of 1.9:1. The mean stone size across all patients was 10.3 mm, and the average HU value was 874.0 ± 283.2. Patients who achieved a completely stone-free status had significantly lower HU values (p = 0.049). The overall success rate of SWL was 78.8%, with 164 patients achieving complete stone clearance. When cases with clinically insignificant residual fragments (CIRF, < 4 mm) were included as successful outcomes, the overall success rate increased to 92.3%. This distinction highlights the inclusion of patients with small residual fragments that are deemed clinically irrelevant in the adjusted success rate. In cases with successful outcomes, the mean stone size was 10.3 mm, whereas it was 12.5 mm in patients with residual fragments or treatment failure. A statistically significant relationship was identified between stone size and treatment success rates (p < 0.001). In contrast, stone localization did not have a significant impact on SWL success rates (p = 0.377).</p><p><strong>Conclusions: </strong>SWL has demonstrated its effectiveness in kidney stone treatment with a 78.8% complete stone-free rate using the Modulith SLK Inline lithotripter. Higher success rates were achieved with smaller stones (< 15 mm) and lower HU values. These findings support the significance of advanced lithotripter technology in establishing SWL as a valuable non-invasive option for stones under 15 mm.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"139"},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493737","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":"\"Development and validation towards a Nomogram to predict acute kidney Injury following PCNL\".","authors":"Abhishek Goli, Kasi Viswanath Gali, Arun Chawla, Sunil Pillai Bhaskara, Padmaraj Hegde, Ankit Agarwal, Email Id, Jean de la Rosette, Pilar Laguna, Bhaskar Somani","doi":"10.1007/s00345-025-05511-w","DOIUrl":"10.1007/s00345-025-05511-w","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the occurrence, risk factors, and outcomes of post PCNL (Percutaneous Nephrolithotomy) Acute Kidney Injury (AKI), with a secondary goal of developing a nomogram for post-PCNL AKI prediction.</p><p><strong>Methods: </strong>A prospective observational study was conducted enrolling 333 patients who underwent PCNL between February 2022 and February 2023. Patient demographics, comorbidities, perioperative lab parameters, stone characteristics, intraoperative details, and postoperative AKI were assessed. Logistic regression analyses were employed to construct a nomogram for predicting post-PCNL AKI.</p><p><strong>Results: </strong>40 patients (12.4%) experienced postoperative AKI, with recovery observed in all cases during the 3-month follow-up. Female gender (p = 0.002), hypertension(p = 0.022), higher serum uric acid levels(p = 0.003), staghorn calculi(p = 0.001), higher Hounsfield Units(p = 0.013), bilateral PCNL(p < 0.001), larger tract size(p = 0.017), longer operative time(p < 0.001), greater stone volume(p = 0.025), higher baseline serum creatinine levels(p < 0.001), higher postoperative total leukocyte count(p = 0.005), and postoperative fever(p < 0.001) were significantly associated with the AKI group. Regression analysis identified female gender (OR = 0.26, p = 0.035), higher serum uric acid levels(OR = 1.62, p = 0.013), bilateral PCNL(OR = 12.55, p < 0.001), longer operation time(OR = 1.02, p = 0.047), and larger stone volume(OR = 1.12, p = 0.015) as independent risk factors for postoperative AKI. The internally validated nomogram(n = 70) for predicting AKI demonstrated excellent diagnostic performance, with an area under the ROC curve of 0.984(95% CI, p < 0.001).</p><p><strong>Conclusion: </strong>AKI occurs in approximately 12% of patients undergoing PCNL. We identified several significant predictors of post-PCNL AKI, including female gender, hypertension, hyperuricemia, higher Hounsfield units, larger stone volume, bilateral PCNL, larger access tract size, and longer operative time. Awareness of these factors is crucial for optimizing management and improving patient outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"136"},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483586","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":"Deciphering RCC immunotherapy outcomes: insights from a Japanese multi-institutional study on the CANLPH score's impact.","authors":"Tatsuo Fukushima, Takuya Tsujino, Moritoshi Sakamoto, Kiyoshi Takahara, Kazumasa Komura, Takafumi Yanagisawa, Keiichiro Mori, Wataru Fukuokaya, Fumihiko Urabe, Takahiro Adachi, Yosuke Hirasawa, Masanobu Saruta, Atsuhiko Yoshizawa, Shingo Toyoda, Tatsushi Kawada, Satoshi Katayama, Kengo Iwatsuki, Ko Nakamura, Kyosuke Nishio, Kazuki Nishimura, Keita Nakamori, Tomohisa Matsunaga, Ryoichi Maenosono, Taizo Uchimoto, Tomoaki Takai, Takeshi Hashimoto, Teruo Inamoto, Kazutoshi Fujita, Motoo Araki, Takahiro Kimura, Yoshio Ohno, Ryoichi Shiroki, Haruhito Azuma","doi":"10.1007/s00345-025-05507-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05507-6","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to determine the utility of the CANLPH score as a predictive biomarker for patients with advanced and metastatic renal cell carcinoma (a/mRCC). By validating its prognostic value, this study aims to contribute to more personalized treatment strategies for a/mRCC.</p><p><strong>Methods: </strong>In a multicenter retrospective study by the JK-FOOT consortium, we analyzed data from 309 a/mRCC patients undergoing ICI-based therapy. The CANLPH score-a composite marker of C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), and platelet to hemoglobin ratio (PHR)-for its prognostic accuracy in predicting cancer-specific survival (CSS). Advanced statistical methods, including receiver operating characteristic (ROC) curve analysis, Cox proportional-hazard regression, and Harrell's concordance index (C-index), were employed to assess its predictive capacity against established factors.</p><p><strong>Results: </strong>The median follow-up period was 17 months, revealing two-year and five-year overall survival rates of 76.8% and 62.4%, respectively, with CSS rates at 78.3% and 66.2%. The CANLPH score well stratified survival outcomes of ICI-based treatment for RCC patients (HR 5.71; P < 0.0001). C-index analysis demonstrated that the CANLPH score had the highest predictive potency for CSS among models, including IMDC score. Multivariate analysis confirmed the CANLPH score (HR, 5.59; P = 0.0007) and Karnofsky performance status (HR, 2.59; P = 0.0032) as independent prognostic factors for CSS.</p><p><strong>Conclusions: </strong>The CANLPH score emerges as a critical tool in the a/mRCC therapeutic landscape, enabling precise prediction of patient outcomes with ICI-based therapies. Limitations include the retrospective design and the single national cohort. Prospective validation studies are warranted.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"135"},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483623","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":"Comparing the tissue properties of human buccal mucosa and penile skin flap: insights for urethral graft substitution.","authors":"Yilong Guo, Ning Ma, Mengtong Wang, Sen Chen, Pingping Liu, Zhe Yang, Yangqun Li","doi":"10.1007/s00345-025-05519-2","DOIUrl":"https://doi.org/10.1007/s00345-025-05519-2","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the histological features, biomechanical properties, water permeability, and osmotic stress responses of human buccal mucosa and penile skin flaps to evaluate their suitability as urethral graft substitutes.</p><p><strong>Methods: </strong>Buccal mucosa (n = 53) and penile skin flap (n = 59) were prepared for histological assessment of tissue structural characteristics and vascular patterns using H&E staining and immunofluorescence. Biomechanical properties were evaluated through mechanical testing, water permeability through deuterium oxide diffusion assays, and osmotic stress responses under hypo-, iso-, and hypertonic conditions.</p><p><strong>Results: </strong>H&E staining revealed that the buccal mucosa epithelium was significantly thicker (628.8 ± 213.3 μm) than that of the penile skin flap (148.2 ± 62.1 μm; p < 0.05). Mechanical testing demonstrated that the buccal mucosa had significantly higher elastic modulus and tensile strength and lower tensile strain compared with penile skin flap (p < 0.05). Water permeability testing revealed that the cumulative diffusion of deuterium oxide (D₂O) through the buccal mucosa was consistently higher at all time points compared to the penile skin flap (p < 0.05). In the Hypo group, the ratio of variation in epithelial thickness was significantly higher in the penile skin flap compared to the buccal mucosa. No statistical differences in the ratio of epithelial thickness variation were observed under Iso (p = 0.43) and Hyper (p = 0.07) conditions. The primary limitation of this study is the relatively small sample size. Additionally, the in vitro model lacks the ability to fully replicate the urethral microenvironment, where multiple interacting factors influence graft survival.</p><p><strong>Conclusion: </strong>This study presents the first comprehensive comparison of the tissue properties of buccal mucosa and penile skin flaps. Our findings provide valuable insights for surgical decision-making, postoperative management, personalized treatment strategies, and the advancement of bioengineered urethral substitutes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"137"},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483588","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":"Cavernous tissue preservation technique versus conventional technique during penile prosthesis implantation: a prospective comparative study.","authors":"Mohamed Abdelrahman Alhefnawy, Hazem Abdelsabour Deif, Ahmed Farag Wahsh, Mohamed Gamal Ahmed, Ahmed Mohammed El-Taher, Gamal Abdelmalek Morsy, Alaa Rafaat Mahmoud, Helmy Ahmed Eldib","doi":"10.1007/s00345-025-05476-w","DOIUrl":"10.1007/s00345-025-05476-w","url":null,"abstract":"<p><strong>Background: </strong>Few prospective studies in literature with long postoperative follow-up compared between cavernous tissue sparing and conventional penile prosthesis implantation techniques.</p><p><strong>Aim: </strong>To compare between cavernous tissue sparing and conventional penile prosthesis implantation techniques in terms of patient and partner satisfaction and perioperative outcomes.</p><p><strong>Methods: </strong>In All, 60 Patients with severe erectile dysfunction were randomized into 2 equal groups; patients undergoing conventional malleable penile prosthesis implantation, and patients undergoing the cavernous tissue-sparing technique. Postoperatively, prosthesis function and patient satisfaction were assessed at 6 weeks after surgery and then 3-6 and 12 months using EDITS and QoLSPP questionnaires. Patients were asked about residual penile tumescence. Perioperative data were recorded.</p><p><strong>Results: </strong>Modified EDITS questionnaire after 3,6, and 12 months was 76.9 ± 18, 79 ± 17 and 82.3 ± 16 respectively. As QOLSPP questionnaire, 46 (73.8%) subjects were highly satisfied, 25 patients (83.3%) in cavernous tissue sparing and 21 patients (70.00%) in Conventional group. While 14 (26.2%) were less satisfied, 5 patients (16.7%) Cavernous tissue sparing and 9 patients (30.00%) in Conventional group. In the cavernous tissue-sparing group, 26 of 30 patients (86.6%) reported having a significantly higher incidence of residual penile tumescence versus 2 of 30 patients (6.6%) in the conventional surgery group (P < .001). The age of highly satisfied subjects was significantly lower than those less satisfied (p = 0.025), while the BMI of highly satisfied subjects was significantly lower than those less satisfied (p = 0.001).</p><p><strong>Conclusion: </strong>There is a significantly higher incidence of residual penile tumescence in Cavernous tissue sparing group. Many factors affect male satisfaction rates after PPI as age, and BMI.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"138"},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493733","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":"Impact of positive surgical margin location after radical prostatectomy: a network meta-analysis.","authors":"Athul John, Thomas Milton, Aashray Gupta, Mau T Nguyen, Brandon Stretton, Joseph Hewitt, James Virgin, Joshua Kovoor, Rick Catterwell, Luke Selth, Michael O Callaghan","doi":"10.1007/s00345-025-05479-7","DOIUrl":"10.1007/s00345-025-05479-7","url":null,"abstract":"<p><strong>Objective: </strong>To perform a network meta-analysis comparing the impact of different positive surgical margin locations (Comparisons and intervention) on biochemical recurrence (Outcome) in patients undergoing radical prostatectomy (Population).</p><p><strong>Methods: </strong>According to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a protocol was registered (PROSPERO: CRD42022119025) and a search across four databases was conducted (the MEDLINE, Scopus, Embase and Cochrane). The primary outcome was biochemical recurrence (BCR). A network meta-analysis was conducted. Further subgroup analysis was performed to evaluate studies exploring robot-assisted radical prostatectomy (RALP).</p><p><strong>Results: </strong>Our search yielded 1249 unique results; 22 studies were analysed. Anterior margins had the highest risk of BCR (HR 2.46, 95%CI 1.67-3.61, I² = 76%) followed by posterior (HR 2.29, 95%CI 1.43-3.66, I² = 0%), bladder base (HR 2.06, 95%CI 1.61-2.64, I² = 69%), apical (HR 1.88, 95%CI 1.51-2.35, I² = 59%), and posterolateral margins (HR 1.70, 95%CI 1.14-2.25, I² = 60%). Given significant heterogeneity, subgroup analysis was performed. In the RALP subgroup, anterior margins also demonstrated the highest recurrence risk (HR 3.74, 95%CI 2.47-5.66, I² = 0%), followed by apical (HR 2.43, 95%CI 1.97-8.00, I² = 0%), posterior (HR 2.23, 95%CI 1.47-3.38), base (HR 1.65, 95%CI 1.29-2.11, I² = 0%), and posterolateral margin (HR 1.54, 95%CI 1.07-2.22).</p><p><strong>Conclusions: </strong>The risk of BCR after radical prostatectomy varies by PSM location, with the highest recurrence risk observed at anterior margins.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"134"},"PeriodicalIF":2.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477070","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}