World Journal of Urology最新文献

{"title":"Laparoscopic sacrocolpopexy with mesh fixation: a randomized trial comparing synthetic cyanoacrylate glue to sutures.","authors":"Gery Lamblin, Graziella Moufawad, Cécile Becque, Chloé Miguet, Stéphanie Moret, Sophie Warembourg, Erdogan Nohuz, Charles-André Philip","doi":"10.1007/s00345-025-05885-x","DOIUrl":"https://doi.org/10.1007/s00345-025-05885-x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare laparoscopic sacrocolpopexy using synthetic glue for mesh fixation to laparoscopic suturing in the treatment of pelvic organ prolapse.</p><p><strong>Materials and methods: </strong>This prospective randomized controlled trial included 54 patients with stage III or IV pelvic organ prolapse who underwent surgical correction and were allocated to two groups: a glue group which underwent laparoscopic sacrocolpopexy using synthetic cyanoacrylate glue for mesh fixation and a sutures group which underwent the same procedure using suturing for mesh fixation. Operative time, success rate, and perioperative complications were compared between the two groups. Patients were followed up at 1, 12, and 24 months postoperatively.</p><p><strong>Results: </strong>The median operative time was 108.8 min [83.2-155.6] in the glue group and 111.4 min [90.2-186.2] in the sutures group, without significant difference between the groups. However, the time required for anterior mesh fixation was significantly lower in the glue group compared to the sutures group (4.6 min [0.5-29.6] vs. 25.4 min [1.7-44.7], p = 0.0001). The anatomical success rates ranged from 100 to 92.6% at 1 month postoperatively, and from 88.2 to 73.7% at 24 months in the glue and sutures groups, respectively, without statistically significant difference.</p><p><strong>Conclusions: </strong>The use of synthetic glue in laparoscopic sacrocolpopexy is a safe and effective alternative to suturing. However, larger studies with extended follow-up are required to further assess long-term efficacy and complication rates.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"598"},"PeriodicalIF":2.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239878","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":"Chronic prostatitis and male infertility: association mechanism and research progress.","authors":"Zhang Qinyu, Shi Jitao, Xuan Yang, Duan Yue, Zhang Hao","doi":"10.1007/s00345-025-05964-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05964-z","url":null,"abstract":"<p><strong>Objective: </strong>To systematically examine the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and male infertility, elucidate the pathophysiological mechanisms by which CP/CPPS impairs fertility, summarize current research advancements, and establish a foundation for targeted diagnosis and treatment strategies.</p><p><strong>Method: </strong>This study synthesizes clinical research, meta-analyses, and experimental model evidence to examine alterations in semen parameters (concentration, motility, morphology, DNA fragmentation rate) and seminal plasma biomarkers (PSA, cytokines, hormones). It explores the interactions across various systems, including neuro-immune-endocrine dysregulation, metabolic diseases, microcirculatory dysfunction, aberrant intestinal-prostate axis activity, and mitochondrial autophagy. The study assesses diagnostic frameworks such as NIH-CPSI and UPOINT, along with their therapeutic effectiveness.</p><p><strong>Results: </strong>CP/CPPS markedly decreased sperm concentration (SMD= - 14.12), forward motility (SMD= - 5.94), and normal morphology rate (SMD= - 8.26), while elevating DNA fragmentation rates (> 30%). Principal mechanisms comprise: (1) Pro-inflammatory cytokines (e.g., IL-6, TNF-α) impairing mitochondrial function and DNA integrity; (2) Neuroendocrine dysfunction inhibiting the hypothalamic-pituitary-testicular axis; (3) Metabolic syndrome comorbidity (OR = 2.10) inducing an energy crisis via mitochondrial dysfunction; (4) Gut microbiota dysbiosis diminishing anti-inflammatory short-chain fatty acids (SCFAs), intensifying systemic and reproductive tract inflammation; (5) Mitophagy impairments (e.g., PINK1 dysfunction) resulting in the accumulation of damaged sperm mitochondria. UPOINTs phenotype-guided multimodal therapy mitigates clinical symptoms, with 77.5% of patients attaining a reduction of at least 6 points in the NIH chronic prostatitis symptom index (NIH-CPSI) scores within 6 months.</p><p><strong>Conclusion: </strong>The intricate pathogenesis of male infertility in CP/CPPS encompasses a diverse array of pathways: inflammatory, autoimmune, neuroendocrine, metabolic, and mitochondrial. Future investigations should concentrate on the mechanisms of mitochondrial autophagy and the regulation of epigenetics. Clinical management may contemplate the implementation of multidisciplinary, collaborative, phenotype-oriented, comprehensive therapies to disrupt the \"chronic pain-inflammation-infertility\" vicious cycle and protect fertility health.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"599"},"PeriodicalIF":2.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239844","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":"¹⁸F-AlF-PSMA-HBED-CC as a novel tracer for the evaluation of prostate cancer patients with biochemical relapse: intraindividual comparison with ⁶⁸Ga-PSMA-HBED-CC.","authors":"Gerardo Gabriel Dos Santos Loureiro, Pablo Duarte Couto, Juan Pablo Gambini Gonzalez, Omar Alonso Nuñez","doi":"10.1007/s00345-025-05786-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05786-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To compare the diagnostic values of novel &lt;sup&gt;18&lt;/sup&gt;F-AlF-PSMA-11 versus &lt;sup&gt;68&lt;/sup&gt;Ga-PSMA-11 PET/CT has been consolidated as a clinically relevant technique for the evaluation of patients with prostate cancer, whereas 18F-AIF-PSMA-HBED-CC is a novel tracer produced in our center, with suitable radiochemical purity for clinical purposes and it is also cost-effective. The aim was to compare the diagnostic values of novel 18F-AlF-PSMA-11 versus 68Ga-PSMA-11 for the evaluation of prostate cancer patients with biochemical recurrence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;37 patients (median age: 67 ± 9.18, range: 53-85 years; median PSA level: 5.0 ± 7.48, range: 0.13-31.2 ng/mL) with biochemical recurrence after radical prostatectomy (76%) or radiotherapy (24%) underwent routine &lt;sup&gt;18&lt;/sup&gt;F-AlF-PSMA-11 and &lt;sup&gt;68&lt;/sup&gt;Ga-PSMA-11 64-slice PET/CT scans with time-of-flight correction. We measured the SUVmax in all coincident lesions. Histopathology, imaging, and/or clinical follow-up were considered as reference standard. Sensitivity, specificity, and predictive values were calculated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;&lt;sup&gt;18&lt;/sup&gt;F-AlF-PSMA-11 and &lt;sup&gt;68&lt;/sup&gt;Ga-PSMA-11 PET/CT demonstrated abnormal findings in 17 and 18 patients (46% and 49%), respectively. Detection rates for post-prostatectomy patients and for post-radiotherapy patients were 43% and 67% respectively. 76 suspicious lesions were detected by at least one radiopharmaceutical in bone (n = 35), lymph nodes (n = 33) and prostate gland (n = 8). A significant correlation was found between the SUVmax of both radiopharmaceuticals (r = 0.72, P = 0.02). We found a significantly higher SUVmax for &lt;sup&gt;68&lt;/sup&gt;Ga-PSMA-11 compared to &lt;sup&gt;18&lt;/sup&gt;F-AlF-PSMA-11 in lymph node and prostate: 8.1 (2.77-25.49) versus 7.7 (2.55-24.78) and 17.3 (5.1-47.12) versus 14.5 (4.69-38.63), median (range), for each tracer, respectively (P &lt; 0.001). &lt;sup&gt;18&lt;/sup&gt;F-AlF-PSMA-11 SUVmax was higher in bone foci compared to gallium (8.6 vs. 6.6; P &lt; 0.001). we found a significantly higher LBR for &lt;sup&gt;18&lt;/sup&gt;F-AlF-PSMA-11 in concordant bone lesions (P = 0.001) and for &lt;sup&gt;68&lt;/sup&gt;Ga-PSMA-11 in lymph node and prostate concordant lesions (P = 0.015 and 0.041, respectively). Detection rates for disease por PSA levels &lt; 1 and &gt; 1 ng/mL were 33% and 59% respectively. Additionally, detection rates for disease for PSA levels &lt; 1.77 and &gt; 1.77 ng/mL (median PSA of our sample) was 28% and 72%, respectively. Sensitivity, specificity, positive and negative predictive values were 0.50, 0.90, 0.94 and 0.45 for &lt;sup&gt;18&lt;/sup&gt;F-AlF-PSMA-11, and 0.63, 0.90, 0.94 and 0.47 for &lt;sup&gt;68&lt;/sup&gt;Ga-PSMA-11, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;&lt;sup&gt;18&lt;/sup&gt;F-AlF-PSMA-11 and &lt;sup&gt;68&lt;/sup&gt;Ga-PSMA-11 seems to have similar, complementary and clinically relevant diagnostic values for the detection of prostate cancer lesions in the biochemical recurrence scenario. More studies with a larger number of patie","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"597"},"PeriodicalIF":2.9,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233694","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":"Mini-PCNL using the new Cyber Ho with Magneto technology versus the standard Cyber Ho: are there any differences in the treatment of renal stones between 10 and 20 mm?","authors":"Davide Perri, Umberto Besana, Giovannalberto Pini, Matteo Maltagliati, Lorenzo Berti, Eugenio Ventimiglia, Ioannis Kartalas Goumas, Javier Romero-Otero, Giorgio Bozzini","doi":"10.1007/s00345-025-05980-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05980-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"590"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226022","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":"Does SUFU's best practice policy statement regarding antibiotic prophylaxis predict urinary tract infection after urodynamic study? : Evidence from a retrospective cohort.","authors":"Omri Schwarztuch Gildor, Elad Yosef, Netanel Levin, Anna Itshak, Rony Vainrib, Michael Vainrib","doi":"10.1007/s00345-025-05979-6","DOIUrl":"10.1007/s00345-025-05979-6","url":null,"abstract":"<p><strong>Purpose: </strong>To validate the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Best Practice Policy Statement (BPPS) risk factors (RFs) for predicting urinary-tract infection (UTI) after urodynamic study (UDS) and to identify possible RFs that could better guide antibiotic prophylaxis.</p><p><strong>Methods: </strong>A retrospective cohort study included all adults undergoing UDS at a single institution. Patients with asymptomatic bacteriuria received a 3-day antibiotic course, while those without bacteriuria received no prophylaxis. The primary endpoint was a culture-confirmed UTI within 7 days. Regression analysis was performed to check SUFU BPPS RFs as predictors for post-UDS UTI.</p><p><strong>Results: </strong>Among 1666 patients (median age 68 years; 42% female), UTI occurred in 31 (1.9%). Abnormal GU anatomy was found as a predictor for post-UDS UTI (OR = 3.26, p = 0.033). Other examined RFs were not found to predict post-UDS UTI. More concise variables were identified as statistically significant predictors: hydronephrosis (OR = 4.98, p = 0.004), elevated post-void residual (PVR) (OR = 2.80, p = 0.011), and NLUTD due to neurologic disease (OR = 2.27, p = 0.042). In multivariate analysis, elevated PVR and NLUTD caused by neurologic disease remained independent predictors.</p><p><strong>Conclusion: </strong>The current SUFU BPPS criteria exhibit limited accuracy for predicting post-UDS UTI. Our study emphasizes hydronephrosis, NLUTD caused by neurologic disease, and elevated PVR as predictors of post-UDS UTI. Updating prophylactic guidelines to incorporate these findings could enhance patient safety and antimicrobial stewardship without compromising infection control.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"596"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226059","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":"Effect of neoadjuvant chemotherapy on years of life lost in radical cystectomy-treated T2N0M0 bladder cancer patients.","authors":"Mattia Longoni, Fabian Falkenbach, Andrea Marmiroli, Quynh Chi Le, Michele Nicolazzini, Calogero Catanzaro, Federico Polverino, Jordan A Goyal, Markus Graefen, Matteo Ferro, Felix K H Chun, Alessandro Volpe, Riccardo Schiavina, Nicola Longo, Fred Saad, Shahrokh F Shariat, Leonardo Quarta, Marco Moschini, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Pierre I Karakiewicz","doi":"10.1007/s00345-025-05983-w","DOIUrl":"https://doi.org/10.1007/s00345-025-05983-w","url":null,"abstract":"<p><strong>Introduction: </strong>Neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) is standard of care for T2N0M0 urothelial carcinoma of urinary bladder (UCUB) patients. However, the effect of NAC on years of life lost (YLL) in RC-treated T2N0M0 patients has never been quantified.</p><p><strong>Methods: </strong>Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2021), T2N0M0 UCUB patients aged 40-75 years treated with RC, with or without NAC, were included. Relying on Social Security Administration (SSA) life tables, an age/sex-matched control (Monte Carlo simulation) was simulated for each patient. Kaplan-Meier method was used to calculate average YLL until the age of 75 years between SEER cases and SSA simulated controls.</p><p><strong>Results: </strong>Overall, 1511 (27.8%) T2N0M0 UCUB patients treated with RC + NAC and 3932 (72.2%) with RC alone were identified. Compared to simulated population controls, RC + NAC vs. RC alone patients exhibited 1.3 vs. 2.3 YLL. In sensitivity analyses according to age at diagnosis, the most pronounced YLL values were recorded in youngest patients (40-55 years): RC + NAC: 2.2 YLL vs. RC alone: 6.1 YLL. Intermediate YLL values were recorded in intermediate age patients (56-65 years): RC + NAC: 1.9 YLL vs. RC alone: 3.2 YLL. Finally, the least pronounced YLL values were recorded in oldest patients (66-75 years): RC + NAC: 0.4 YLL vs. RC alone: 0.7 YLL. Invariably, RC alone was associated with higher YLL values than RC + NAC.</p><p><strong>Conclusion: </strong>When YLL represented the endpoint, RC + NAC patients exhibited more favorable outcomes than RC alone patients. In both RC + NAC and RC alone groups maximal YLL applied to youngest individuals and decreased in proportion to increasing age.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"591"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225982","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":"Beyond the sheath: unmasking true predictors of Post-fURS fever through propensitymatched precision.","authors":"Peng Zhu, Xi Hua, Xiang Teng, Rong Wang","doi":"10.1007/s00345-025-05965-y","DOIUrl":"https://doi.org/10.1007/s00345-025-05965-y","url":null,"abstract":"<p><strong>Aim: </strong>Flexible ureteroscopy (fURS) is a prevalent minimally invasive treatment for upper urinary tract stones, but postoperative fever remains a considerable concern. The precise role of ureteral access sheath (UAS) utilization in influencing infectious complications following fURS continues to be debated. This study aimed to comprehensively evaluate the perioperative and postoperative outcomes of fURS, with a specific focus on the influence of UAS utilization. Furthermore, we sought to identify independent predictive factors for the development of postoperative fever after fURS, utilizing a propensity score-matched analysis to mitigate confounding variables and enhance the robustness of our findings.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 486 patients undergoing fURS, with propensity score matching (PSM) used to create balanced UAS (n = 150) and non-UAS (n = 150) groups. Perioperative outcomes and predictors of postoperative fever (defined as ≥ 37.5 °C within 48 h) were evaluated using univariate, multivariate logistic regression, and receiver operating characteristic (ROC) curve analyses.</p><p><strong>Results: </strong>Postoperative fever rates were comparable between UAS and non-UAS groups (12% vs. 9.3%, p = 0.454), although UAS use was associated with significantly longer hospital stays (median 5 vs. 4 days, p = 0.003). Independent predictors of postoperative fever included positive preoperative urine culture [adjusted odds ratio (aOR) 7.535, 95% CI 2.681-21.175, p < 0.001], elevated postoperative C-reactive protein (CRP) (aOR: 1.211, 95% CI 1.093-1.343, p < 0.001), and increased postoperative white blood cell (WBC) count (aOR: 1.200, 95% CI 1.012-1.424, p = 0.036). ROC analysis demonstrated high predictive accuracy for postoperative CRP (AUC: 0.943) and a combined prediction model (AUC: 0.951).</p><p><strong>Conclusions: </strong>Performing fURS without UAS did not significantly increase the risk of postoperative fever, supporting its safety in carefully selected cases. Monitoring preoperative urine culture results and postoperative CRP and WBC levels are critical for the early prediction and timely intervention of postoperative fever.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"595"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226036","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":"Risk stratification of high-risk muscle invasive upper urinary tract urothelial carcinoma: multi-institutional study.","authors":"Hao-Lun Luo, Hung-Lung Ke, Wei-Ming Li, Yao-Chou Tsai, Shu-Yu Wu, Shih-Hsiu Lo, Yi-Huei Chang, Chi-Ping Huang, Hung-Jen Wang","doi":"10.1007/s00345-025-05915-8","DOIUrl":"10.1007/s00345-025-05915-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze a large multi-institutional UTUC database to identify prognostic factors in patients with organ-confined and non-organ-confined disease, and to further stratify pT2 patients using a nomogram to identify high-risk subgroups who may benefit from adjuvant therapy.</p><p><strong>Methods: </strong>The records of patients diagnosed with UCTC who underwent nephroureterectomy from 1988 to 2022 at 15 hospitals in Taiwan were retrospectively reviewed. The outcomes evaluated were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and bladder recurrence-free survival (BRFS) after nephroureterectomy.</p><p><strong>Results: </strong>A total of 2635 patients were included: 1935 with organ-confined (pTis/pTa/pT1/pT2 stage) disease, and 700 with non-organ confined (pT3/pT4 stage) disease. Significant risk factors for poor survival in patients with organ-confined disease were age ≥ 70 years, ureter involvement, high pathological T stage (pT2), multiplicity, lymphovascular invasion, and eGFR ≤ 44 ml/min/1.73 m². In patients with non-organ-confined disease, risk factors included male sex, age ≥ 70 years, ureter involvement, high pathological T stage (pT4), multiplicity, eGFR ≤ 44 ml/min/1.73 m², tumor necrosis, variant UC cell type, and smoking. In patients with pT2 UTUC, those classified as high risk based on a nomogram-derived total score > 115 had significantly worse OS (P < 0.0001) and CSS (P = 0.025) compared to those with a score ≤ 115 (low risk).</p><p><strong>Conclusions: </strong>Patients with high-risk pT2 UTUC had significantly worse survival outcomes compared to those with low-risk pT2 UTUC. These findings suggest that further refinement of clinical trial designs is needed to better identify high-risk pT2 UTUC patients who may benefit from more aggressive treatment strategies, such as adjuvant therapy, while minimizing unnecessary systemic therapy in low-risk pT2 UTUC patients. Future studies should validate these findings and help establish the true value of systemic therapy for this patient population.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"594"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225979","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":"Robotic ureteral reconstruction for endometriosis-induced strictures: insights from a multi-institutional experience.","authors":"Matthew Lee, Sonam Saxena, Kelley Zhao, Cameron Dodd, Randall Lee, Michael Stifelman, Lee Zhao, Daniel D Eun","doi":"10.1007/s00345-025-05982-x","DOIUrl":"10.1007/s00345-025-05982-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate outcomes of robotic ureteral reconstruction (RUR) in female patients with ureteral strictures caused by peri-ureteral endometriosis lesions.</p><p><strong>Methods: </strong>We retrospectively reviewed our multi-institutional Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database to identify all consecutive patients undergoing RUR for surgical management of endometriosis-induced ureteral strictures between 2017 and 2022. Indications for surgery included female patients with radiographic evidence of ureteral strictures and/or decreasing renal function on renal scan. We performed a descriptives analysis of perioperative outcomes in patients who met inclusion criteria. Surgical success was defined as freedom from additional interventions for recurrent ureteral stenosis.</p><p><strong>Results: </strong>Overall, 19 patients met the inclusion criteria. Median age was 39 (IQR 30-43) years. Ureteral strictures were located in the middle ureter in 4 (21.1%) patients and in the distal ureter in 15 (78.9%) patients. Fourteen (73.6%) patients had a known preoperative diagnosis of endometriosis. RUR techniques included refluxing reimplantation (47.4%), side-to-side reimplantation (21.1%), ureteroureterostomy (21.1%), and buccal mucosa graft ureteroplasty (10.5%). There was one (5.3%) major postoperative complication (Clavien > 2) in which a patient developed an intrabdominal abscess requiring drainage by interventional radiology. Five (26.3%) patients were ultimately diagnosed postoperatively with endometriosis based on surgical pathology. At a median follow-up of 22.5 (IQR 11.7-41.5) months, 18 (94.7%) patients were surgically successful.</p><p><strong>Conclusion: </strong>Clinicians should maintain a high index of suspicion for endometriosis in premenopausal women with ureteral stricture disease. RUR techniques may be effective for the management of patients with ureteral strictures secondary to endometriosis.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"589"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226044","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":"Thulium fiber laser enucleation of the prostate (ThuFLEP) for the treatment of benign prostatic obstruction: a comparative study of men with prostate volumes ≥ 150 mL and < 150 mL.","authors":"Mehmet Yilmaz, Halil Cagri Aybal, Irfan Safak Barlas, Mehmet Duvarci, Zeynep Akdagcik, Selcuk Guven, Lutfi Tunc","doi":"10.1007/s00345-025-05985-8","DOIUrl":"https://doi.org/10.1007/s00345-025-05985-8","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate the outcomes of Thulium fiber laser enucleation of the prostate (ThuFLEP) in men with prostate volumes (PV) ≥ 150 mL and to compare them with those with PV < 150 mL.</p><p><strong>Methods: </strong>We retrospectively analyzed the patients who underwent ThuFLEP between December 2020 and June 2024 for benign prostatic obstruction (BPO). Patients were categorized into two groups according to prostate volume, with Group 1 including those with PV < 150 mL (n = 355) and Group 2 including those with PV ≥ 150 mL (n = 147). Perioperative and postoperative functional outcomes, as well as complications, were evaluated and compared.</p><p><strong>Results: </strong>Both groups demonstrated significant improvements in functional parameters (International Prostate Symptom Score-IPSS, maximal urinary flow rate-Qmax and postvoid residual urine volume-PVR) compared with baseline values at the 1, 6 and 12 months postoperatively. Postoperative IPSS, QoL scores, Qmax, PVR values, and rates of urge urinary incontinence (UUI) and stress urinary incontinence (SUI) were comparable between groups at all follow-up intervals (p > 0.05). No patient exhibited postoperative SUI or UUI at 6 and 12 months postoperatively. Complication rates were similar between groups, and no Grade ≥ 4 Clavien-Dindo complications occurred.</p><p><strong>Conclusion: </strong>ThuFLEP is a safe and effective LEP technique for very large prostates (≥ 150 mL). It yields significant improvements in postoperative functional outcomes with low perioperative complication rates, supporting its use as a minimally invasive alternative for BPO in routine endourology practice.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"592"},"PeriodicalIF":2.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226138","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}