World Journal of Urology最新文献

{"title":"Transurethral resection of the prostate across continents: a meta-analysis evaluating quality of gold standard in the twenty-first century.","authors":"Joao G Porto, Ansh M Bhatia, Abhishek Bhat, Maria Camila Suarez Arbelaez, Ruben Blachman-Braun, Khushi Shah, Ankur Malpani, Diana Lopategui, Thomas R W Herrmann, Robert Marcovich, Hemendra N Shah","doi":"10.1007/s00345-024-05439-7","DOIUrl":"10.1007/s00345-024-05439-7","url":null,"abstract":"<p><strong>Purpose: </strong>To compare outcomes of transurethral resection of the prostate (TURP) across different regions worldwide over the past two decades.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomized clinical trials indexed to PubMed that assessed TURP. A total of 102 studies with 8,454 patients were included and grouped by continents: Europe, Asia, Africa, and Others (North America, South America, and Australia). International Prostate Symptom Score (IPSS), peak flow (Qmax), postvoid residual urine (PVR), PSA levels, prostate volume, and Sexual Health Inventory for Men scores (at 3, 12, and 36 months) were assessed, along with postoperative complications. Heterogeneity across studies was classified as low (I² < 25%), moderate (I² = 25-75%), or high (I² > 75%).</p><p><strong>Results: </strong>TURP consistently exhibited significant enhancements in IPSS, Qmax, and PVR across various regions. Notably, PVR demonstrated high heterogeneity (I²=100%). TURP presented low complication rates with TURP syndrome (2%), bleeding (8%), and blood transfusion (6%). However, significant heterogeneity was observed, particularly for clot evacuation (I² = 87%), irritative symptoms (I² = 96%), and incontinence (I² = 84%). The retreatment rates at 1 and 3 years were 5% and 7%, respectively, with significant differences across regions.</p><p><strong>Conclusion: </strong>Global outcomes of TURP lack a discernible trend. The substantial heterogeneity observed among continents suggests a lack of standardization. Nevertheless, uniform symptomatic improvements among patients still support TURP as the gold-standard surgical treatment for benign prostatic hyperplasia, despite variations in its results worldwide.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"85"},"PeriodicalIF":2.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042506","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":"Constructive feedback on the efficacy of tip-flexible suction access sheath in ureteroscopic lithotripsy for unilateral upper urinary tract calculi.","authors":"Miaolin Zeng, Jiansheng Xiao","doi":"10.1007/s00345-025-05446-2","DOIUrl":"https://doi.org/10.1007/s00345-025-05446-2","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"82"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012943","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":"Comment on \"Physician vs. AI-generated messages in urology: evaluation of accuracy, completeness, and preference by patients and physicians\".","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1007/s00345-025-05448-0","DOIUrl":"https://doi.org/10.1007/s00345-025-05448-0","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"83"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012935","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: \"Environmental impact of current endoscopic technology in urological procedures: a systematic review on reusable vs. disposable scopes\".","authors":"Marlene Thöne, Steffen Rausch","doi":"10.1007/s00345-025-05454-2","DOIUrl":"10.1007/s00345-025-05454-2","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"84"},"PeriodicalIF":2.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012947","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":"Feasibility of robot-assisted system for navigated needle positioning in the PCNL procedure in vitro.","authors":"Jianpo Zhai, Yong Zhang, Hai Wang, Guizhong Li, Libo Man","doi":"10.1007/s00345-025-05450-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05450-6","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to explore the feasibility of using the TianJi Robot system for navigated needle positioning in the PCNL procedure in vitro.</p><p><strong>Methods: </strong>A pig kidney with a segment of ureter was selected as the in vitro organ model. Iodine contrast agent was infused into the renal pelvis to dilate the renal pelvis and calyx to establish the in vitro hydronephrosis model. Fluoroscopic images were obtained using a 3D C-arm and transferred to the robotic workstation. Three-dimensional reconstructed images were generated and displayed on the monitor screen. The surgeon planned the optimal puncture trajectory on the workstation. After that, the robotic arm was instructed to move to the surgical field. The guiding cannula was placed onto the robotic arm and brought close to the skin. The needle was placed along the guiding cannula. An 18G needle was inserted manually. Finally, a second CBCT scan was performed to validate the needle's location.</p><p><strong>Results: </strong>Three hydronephrosis models were used in the study, and a total of seven target calyces were planned. six target calyces were successfully punctured in one attempt, with a single-puncture success rate of 87.5%.</p><p><strong>Conclusions: </strong>A high single-puncture success rate is achieved using the TianJi Robot system for navigated needle positioning in the PCNL procedure in vitro, marking an innovative step forward in urological interventions.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"81"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012945","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":"A comparison on safety and efficacy between 24 Fr versus 18 Fr pneumatic balloon dilators for percutaneous treatment of renal stones between 10 and 20 mm: results from a contemporary cohort.","authors":"Davide Perri, Umberto Besana, Matteo Maltagliati, Andrea Pacchetti, Tommaso Calcagnile, Antonio Luigi Pastore, Javier Romero-Otero, Salvatore Micali, Alexander Govorov, Bhaskar Somani, Evangelos Liatsikos, Thomas Knoll, Bernardo Rocco, Giorgio Bozzini","doi":"10.1007/s00345-025-05445-3","DOIUrl":"10.1007/s00345-025-05445-3","url":null,"abstract":"<p><strong>Purpose: </strong>To assess differences in safety and efficacy between 24 and 18 Fr pneumatic balloon dilators for percutaneous nephrolithotripsy (PCNL) of renal stones between 10 and 20 mm.</p><p><strong>Methods: </strong>Patients were randomized to dilatation with a 24 Fr (Group A) versus 18 Fr (Group B) Ultraxx pneumatic dilator (Cook Medical^®). In all procedures percutaneous puncture was performed under ultrasound guidance. In both groups the Holmium: YAG Cyber Ho laser generator was used (Quanta System^®). Stone-free rate (SFR) and postoperative complications were assessed.</p><p><strong>Results: </strong>42 and 44 patients were assigned to Groups A and B, respectively. Preoperative features were comparable. Mean stone size was 17.8 vs. 16.6 mm in Group A vs. B (p = 0.21). SFR was 95.2% in Group A and 95.4% in Group B (p = 0.19). Postoperative gross haematuria was observed in 5 vs. 2 cases in Group A vs. B (p = 0.04). Mean haemoglobin drop at first postoperative day (POD) was higher in Group A (2.4 vs. 1.1 mg/dl, p = 0.04), while comparable at third POD. Blood transfusion was required in 2 cases in Group A and 1 case in Group B. No patients required embolization. No significant difference was observed in terms of postoperative pain and urinary infection.</p><p><strong>Conclusions: </strong>24 and 18 Fr pneumatic dilators are both effective to access renal cavity during PCNL for the treatment of renal stones between 10 and 20 mm. Gross haematuria rate and mean haemoglobin decrease at first POD were significantly higher with 24 Fr dilator, but with no differences in the need for blood transfusions and renal embolization.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"79"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012933","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":"Grip strength, a predictor of stress urinary incontinence after endoscopic enucleation of the prostate for benign prostate hyperplasia.","authors":"Hong-Chen Song, Meng-Hua Wu, Dong Han, Jia-Xin Liu, Zi-Bing Cao, Yuan Du, Ming-Jun Shi, Jian Song, Xuan-Hao Li","doi":"10.1007/s00345-024-05431-1","DOIUrl":"https://doi.org/10.1007/s00345-024-05431-1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between the grip strength (GS) and stress urinary incontinence (SUI) after endoscopic enucleation of the prostate (EEP).</p><p><strong>Methods: </strong>We retrospectively collected 87 patients who underwent EEP at our center from January to December 2023. The associations between GS and post-surgical SUI at immediate, 1, 4, 12 and 24 weeks were analyzed. The cohort was then divided into the SUI and non-SUI group based on the presence of the SUI at 4-week postoperatively.</p><p><strong>Results: </strong>Of overall 87 patients, 49 (56.3%), 40 (46.0%), 33 (37.9%), 20 (23.0%), and 9 (10.3%) patients presented SUI at immediate, 1, 4, 12 and 24 weeks postoperatively. Significant negative correlations were consistently observed between the GS and SUI till 12 weeks postoperatively, with patients requiring more daily pads presenting lower GS. Compared to the non-SUI group, the SUI group had significantly higher average age (76.0 ± 8.4 vs. 70.1 ± 6.3, P = 0.001), BMI (25.1 ± 2.9 vs. 23.8 ± 2.9, P = 0.040), rates of PKEP (90.9% vs. 72.2%, P = 0.037), CSEA (69.7% vs. 42.6%, P = 0.014) and III/IV ASA score (33.3% vs. 14.8%, P = 0.043), but lower GS (26.2 ± 8.2 vs. 33.3 ± 6.5 kg, P < 0.001). Multivariate analyses identified BMI and GS as independent risk factors for post-operative SUI.</p><p><strong>Conclusions: </strong>The GS was found to be negatively correlated with post-operative SUI within 12 weeks after EEP and was an independent predictor of SUI at 4 weeks postoperatively.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"80"},"PeriodicalIF":2.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012946","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":"Tunica vaginalis or dartos as second layer coverage for distal and mid-shaft penile hypospadias, quo vadis?","authors":"Mohamed Ramez, Abdelwahab Hashem, Mahmoud Bazeed, Mohamed S Dawaba, Tamer E Helmy","doi":"10.1007/s00345-024-05419-x","DOIUrl":"10.1007/s00345-024-05419-x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare between the dartos and tunica vaginalis flaps as covering layers in denovo distal or mid-shaft penile hypospadias underwent tubularized incised plate (TIP) repair.</p><p><strong>Methods: </strong>This is a single-center, randomized trial was for denovo distal or mid-shaft penile hypospadias. Children with history of orchiectomy, orchiopexy and inguinal hernia repair were excluded. Eighty-eight patients were divided into two groups: the first used dartos flap (DF), while the second used tunica vaginalis flap (TVF). The primary outcome was to assess the incidence of urethrocutaneous fistula. The secondary outcome was to assess cosmetic outcome using paediatric penile perception score (PPPS) and hypospadias objective scoring evaluation (HOSE).</p><p><strong>Results: </strong>Baseline demographic and clinical characteristics showed no statistically significant. Median operative time (IQR) was 100 (90, 120) and 145 (140, 150) minutes in in DF and TVF Groups, respectively (p < 0.001). Urethrocutaneous Fistula was detected in 9 (20.9%) in DF group and 2 (4.9%) in TVF group (p 0.029). Meatal stenosis occurred in 3 (7%) in DF group and 2 (4.9%) in TVF group. Penile torque was diagnosed in one (2.4%) in TVF group. There was no significant difference in total PPPS score (p = 0.076), however, there was a significant difference in total HOSE score in the favour to TVF group (p = 0.024). At 12 months, testicular ascent occurred in 0% and 3 (7.3%) in DF and TVF groups, respectively (p = 0.071).</p><p><strong>Conclusion: </strong>Compared to dartos flap, tunica vaginalis flap significantly helps in reduction of fistula rate. However, it has significant more operative time.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"78"},"PeriodicalIF":2.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012873","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":"Real time monitoring of intrarenal pressures while using the flexible and navigable suction ureteral access sheath.","authors":"Kelven Weijing Chen, Kyo Chul Koo, Tianshuang Zhong, Runhan Ren, Victor Kf Wong, Saud Almousa, Max Levitt, Abbas Guennoun, Ben H Chew, Naeem Bhojani","doi":"10.1007/s00345-025-05444-4","DOIUrl":"https://doi.org/10.1007/s00345-025-05444-4","url":null,"abstract":"<p><strong>Purpose: </strong>To report on in-vivo intrarenal pressure (IRP) during flexible ureteroscopy for treatment of kidney stones while using the novel flexible and navigable suction ureteral access sheath (FANS).</p><p><strong>Methods: </strong>A retrospective observational analysis was performed for 25 patients undergoing routine flexible ureteroscopy for treatment of renal stones between February 2024 and June 2024 from two centres in Canada. The LithoVue Elite™ ureteroscope (Boston Scientific Corp., Marlborough, MA, USA) with pressure sensing capability was used together with the Clearpetra^® Ureteral Access Sheath System (Well Lead Medical Co. Ltd., Guangzhou, China) for all cases. Irrigation was via a pressure bag set at 250mmHg where possible and the access sheath was connected to wall suction at 200mmHg. Median and maximum IRP, as well as the distribution of cumulative procedure times according to various IRP ranges were analyzed.</p><p><strong>Results: </strong>The median age of the patients was 56 years, with a median BMI of 26.7 kg/m². The median (Interquartile range {IQR}) IRP for all the cases was 22.0 (15.0-36.5) mmHg, with a median (IQR) procedure time of 35.9 (16.4-54.8) minutes. The IRP remained below 40mmHg in 76.2% of the total time in all procedures, and was below 60mmHg in 94.1% of the time. Significant variables associated with lower IRP were having a prior endourological procedure, pre-stenting, larger ureteral access sheath size and use of pre-operative alpha blocker. Age, BMI and total stone volume did not significantly affect IRP.</p><p><strong>Conclusions: </strong>Low intrarenal pressures can be achieved with the use of FANS, even with higher irrigation pressures. Alpha blocker use, larger sheath size, prior endourological procedures and pre-stenting are all associated with lower IRP.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"76"},"PeriodicalIF":2.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012871","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":"Efficacy of urethral suspension-assisted urethral anastomosis as a treatment for complex long-segment posterior urethral stricture.","authors":"Ying Wang, Meng Liu, Chongrui Jin, Lujie Song, Ranxing Yang, Qiang Fu","doi":"10.1007/s00345-025-05442-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05442-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the clinical effects of urethral suspension-assisted urethral anastomosis on complex long-segment posterior urethral stricture and describe the technical aspects of this procedure.</p><p><strong>Materials and methods: </strong>The clinical data for 24 patients who underwent urethral suspension-assisted urethral anastomosis for complex long-segment posterior urethral stricture between March 2021 and March 2024 were retrospectively analyzed. The surgical procedure comprises the following four steps: creation of an inverted Y-shaped incision in the perineum; mobilization of the urethra up to the penile-scrotal junction followed by dissection and separation of the septum of the corpus cavernosum; separation of the inferior pubic symphysis, excising a portion of the inferior pubic symphysis bone tissue and thoroughly clearing the scar tissue surrounding the proximal urethra; and suturing and suspension of the proximal urethra and surrounding tissues at the 2, 5, 7, and 10 o'clock positions, ensuring complete exposure of the proximal urethral mucosa and tension-free anastomosis between the proximal and distal urethra.</p><p><strong>Results: </strong>The mean patient age was 46.7 years (range 27-64) and the median urethral stricture length was 5.1 cm. The urethral catheter was removed 4 weeks postoperatively. The median follow-up duration was 13.6 months (4-32). Urinary flow remained unobstructed in 22 patients (91.7%), with an average maximum flow rate of 24.5 ml/s (15.3-36.2). Urethral stricture recurred post-surgery in two patients, one of whom underwent successful repair with the same surgical procedure while the other achieved successful voiding after urethrotomy.</p><p><strong>Conclusions: </strong>Urethral suspension-assisted urethral anastomosis is an effective treatment for complex long-segment posterior urethral stricture. This technique allows for optimal exposure of the proximal urethral mucosa, reduces the distance between the proximal and distal urethra, simplifies surgical procedures, enables tension-free anastomosis between the proximal and distal urethra, and has a high success rate.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"77"},"PeriodicalIF":2.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012944","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}