World Journal of Urology最新文献

{"title":"Exploring the location patterns and clinical characteristics of isolated simple renal cysts: insights from a multicenter retrospective study.","authors":"Jianli Wang, Diansheng Cui, Yuancheng Zhou, Haibin Bao, Jiawei Chen, Dandan Liu, Changqi Deng, Hongjie Fan, Xiaomin Han, Lilong Liu","doi":"10.1007/s00345-025-05465-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05465-z","url":null,"abstract":"<p><strong>Objective: </strong>Surgical decisions for simple renal cysts (SRCs) depend on symptoms and compression of the renal collecting system. This study investigated the relationship between cyst location and patient clinical characteristics, offering insights into personalized management and surgical intervention.</p><p><strong>Methods: </strong>This study investigated hospitalized isolated SRCs patients, excluding those with renal cancer or unknown cyst sizes. Isolated SRCs were defined as a single large cyst in either kidney, accompanied by less than three additional cysts < 1 cm. Patients with two or more cysts ≥ 1 cm were excluded. Complete clinical data, including cyst location and compression effects, were required for inclusion. Ethical approval was obtained.</p><p><strong>Results: </strong>This study included 1,093 cases of isolated SRCs: extracalyceal cysts (780 patients), parapelvic cysts (158 patients), cysts above renal pelvis (78 patients), and cysts below renal pelvis (77 patients). Patients with parapelvic cysts had a greater incidence of symptoms (77.85% vs. 57.56%, 61.54%, 53.25%). Parapelvic cysts (72.15%) and cysts below the renal pelvis (88.31%) had a higher risk of collecting system compression risk than extracalyceal cysts (47.69%) and cysts above the renal pelvis (60.26%). The combined risk of hydronephrosis was higher in parapelvic cysts (46.03%) and cysts below the renal pelvis (44.44%) than in extracalyceal cysts (8.96%) and cysts above the renal pelvis (0.00%). Cox regression analysis revealed that cyst size at diagnosis (p < 0.001) and the presence of parapelvic cysts (p < 0.001) independently contributed to symptomatic risk. Cyst size at diagnosis (p < 0.001), parapelvic cysts (p < 0.001), and cysts below the renal pelvis (p < 0.001) were independent predictors of hydronephrosis in patients with SRCs.</p><p><strong>Conclusion: </strong>SRCs in different kidney locations have unique features, necessitating tailored management. Cysts size at diagnosis and the presence of parapelvic cysts independently contribute to the symptoms of patients with SRCs. Parapelvic cysts and cysts below the renal pelvis are independent risk factors for hydronephrosis and should be actively managed.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"105"},"PeriodicalIF":2.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256709","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":"Focal or diffuse bladder wall thickness on bladder computed tomography indicates more severe bladder wall inflammation in patients with interstitial cystitis.","authors":"Wan-Ru Yu, Yuan-Hong Jiang, Jia-Fong Jhang, Hann-Chorng Kuo","doi":"10.1007/s00345-025-05451-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05451-5","url":null,"abstract":"<p><strong>Purpose: </strong>The classification of different phenotypes of interstitial cystitis/ bladder pain syndrome (IC/BPS) provides different pathophysiology and associated treatment strategies. Most clinical studies have focused on bladder symptoms and cystoscopic findings. This study analyzed bladder wall thickness (BWT) and compared bladder conditions, urinary biomarkers, and histopathology among patients of IC/BPS with different BWT.</p><p><strong>Methods: </strong>A total of 182 patients with cystoscopy-proven IC/BPS underwent abdominal computed tomography (CT) before intervention. The BWT on CT was classified as smooth, focal thickness, and diffuse thickness. Clinical symptoms, urodynamic findings, cystoscopic characteristics, presence of Hunner's lesion, urinary biomarkers, and bladder histopathology were compared among the three subgroups.</p><p><strong>Results: </strong>Among the patients, 85 had smooth, 64 had focal, and 33 had diffuse BWT. There was a significant trend of patients with focal and diffuse BWT being significantly older with higher symptom scores, smaller bladder capacity, higher grade of glomerulations, and incidence of Hunner's IC. Pathological findings revealed that patients with diffused BWT, followed by those with focal thickness, had the greatest uroepithelial cell denudation and plasma cell infiltration. Patients with diffuse BWT has higher rate of inflammatory cell infiltration, nerve bundle hyperplasia, and granulation tissue. The urinary levels of tumor necrosis factor-alpha and oxidative stress biomarkers in IC/BPS patients with different BWT were significantly higher than those in the controls.</p><p><strong>Conclusion: </strong>BWT in CT scans can reflect chronic inflammation of the bladder wall in patients with IC/BPS, which is clinically relevant for the diagnosis and treatment of IC subtypes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"100"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190643","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 \"Acute and long-term toxicity in primary hypofractionated external photon radiation therapy in patients with localized prostate cancer\".","authors":"Gokul Sudhakaran","doi":"10.1007/s00345-025-05447-1","DOIUrl":"https://doi.org/10.1007/s00345-025-05447-1","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"102"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190640","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 tidal volume during mechanical ventilation affect pediatric retrograde intrarenal surgery outcomes?","authors":"Muzaffer Tansel Kılınç, Mehmet Serkan Özkent, Ömer Faruk Çavdar, Bilal Güneş, Atilla Erol, Mehmet Mesut Pişkin","doi":"10.1007/s00345-025-05480-0","DOIUrl":"https://doi.org/10.1007/s00345-025-05480-0","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to analyze the effect of tidal volume during mechanical ventilation (MV) on pediatric retrograde intrarenal surgery (RIRS) outcomes.</p><p><strong>Methods: </strong>The data of patients who underwent RIRS between January 2018 and January 2023 were retrospectively analyzed. Patients under the age of 18 who underwent RIRS and whose data were available were included in the study. Patients were divided into two groups, ≤ 7 ml/kg (Group 1) and > 7 ml/kg (Group 2), according to the tidal volume during MV. Demographic data, clinical characteristics, and perioperative and postoperative data of the patients were statistically compared in both groups.</p><p><strong>Results: </strong>A total of 83 patients were enrolled, with a mean age of 6.9 ± 4.5 (1-17) years and a mean stone size of 11.7 ± 5.4 (5-33) mm. There were 31 patients in Group 1 and 52 patients in Group 2. The demographic data and clinical characteristics of the patients in both groups were comparable. There was no statistically significant difference between the two groups regarding stone-related (side, size, density, number, and location) and surgical (access sheath and basket use, operation time, fluoroscopy time, or postoperative stenting rates, complication rates) parameters. In the first month, the stone-free rate was higher in Group 1 than in Group 2 (90.3% vs. 71.1%, p = 0.03). No high-grade or anesthesia-related complications were observed in any of the patients.</p><p><strong>Conclusion: </strong>Reducing tidal volume in pediatric RIRS may improve the stone-free rate by facilitating laser targeting and increasing operative field stability and surgical comfort.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"103"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190586","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":"RE: The long-term learning curve of holmium laser enucleation of the prostate (HoLEP) in the en-bloc technique: a single surgeon series of 500 consecutive cases.","authors":"Francesco Montorsi, Paolo Capogrosso, Federico Dehò, Andrea Salonia","doi":"10.1007/s00345-025-05458-y","DOIUrl":"https://doi.org/10.1007/s00345-025-05458-y","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"101"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190652","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":"Clinical effectiveness and safety of tislelizumab plus TKI as first-line therapy in patients with metastatic renal cell carcinoma (mRCC): a single-center retrospective study.","authors":"Xi Zhong, Tingxuan Huang, Yulu Peng, Wensu Wei, Zhiling Zhang, Hui Han, Pei Dong","doi":"10.1007/s00345-025-05443-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05443-5","url":null,"abstract":"<p><strong>Purpose: </strong>The therapeutic efficacy of metastatic renal cell carcinoma (mRCC) has been significantly enhanced with the advent of immune checkpoint inhibitors (ICIs). However, there are limited data on the efficacy of Tislelizumab in patients with mRCC. This study aimed to assess the effectiveness and safety of Tislelizumab plus tyrosine kinase inhibitor (TKI) for patients with mRCC.</p><p><strong>Methods: </strong>Demographic and clinicopathological data of mRCC patients treated with first-line TKI monotherapy or Tislelizumab plus TKI therapy between March 2019 to February 2023 were collected. Outcome measures included the objective response rate (ORR), median progression-free survival (mPFS). Patient baseline characteristics and adverse events (AEs) were documented.</p><p><strong>Results: </strong>Totally 136 patients were included in the analysis, with a median age of 57 years. Of the patients, 72.1% were male, 78.8% with intermediate/poor-risk disease. For the overall population, the combination group (n = 61) exhibited a longer PFS compared to the TKI monotherapy group (n = 75) (mPFS (95% CI): 15.9 (10.9-20.9) vs. 6.2 (5.4-6.9) months, P < 0.001) and improved ORR (44.3% vs. 18.7%, P = 0.001). In the non-clear cell RCC (nccRCC) subgroup (n = 39), the combination group (n = 20) showed improved PFS (mPFS (95% CI): 11.9 (0.6-23.3) vs. 4.6 (3.4-5.9) months, P < 0.001) and ORR (40.0% vs. 10.5%, P = 0.006) compared to the TKI monotherapy group (n = 19). The incidence of grade three or higher treatment-related AEs are comparable between the groups (47.54% vs. 40.00%).</p><p><strong>Conclusion: </strong>Our data demonstrated the promising efficacy and safety profile of Tislelizumab plus TKI as first-line treatment for both ccRCC and nccRCC.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"99"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190639","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 role of anterior fibromuscular stroma in continence: a response to Barlas et al.","authors":"Kuo-Jen Lin, I-Hung Shao, Yu-Hsiang Lin","doi":"10.1007/s00345-025-05462-2","DOIUrl":"https://doi.org/10.1007/s00345-025-05462-2","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"104"},"PeriodicalIF":2.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190654","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 for the article \"Long-term perioperative antibiotic prophylaxis after urethral reconstruction does not improve clinical outcomes and increases incidence of MDR organisms\".","authors":"Yangbiao Chen, Tingting Chen, Liangchen Qu","doi":"10.1007/s00345-025-05456-0","DOIUrl":"https://doi.org/10.1007/s00345-025-05456-0","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"98"},"PeriodicalIF":2.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123774","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":"Local clinical practice patterns in urolithiasis guidelines: a critical evaluation from Turkey.","authors":"Kemal Sarica, Rasim Güzel, Zeki Bayraktar, Salih Yildirim, Hikmet Yasar, Göksu Sarica, Cahit Sahın","doi":"10.1007/s00345-025-05490-y","DOIUrl":"10.1007/s00345-025-05490-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the current clinical practice patterns regarding the utilization of \"Urolithiasis Guidelines\" in Turkey and to identify critical factors influencing their application by urologists.</p><p><strong>Methods: </strong>The study targeted practicing urologists in Turkey, primarily those involved in the management of urolithiasis, to assess their perspectives and experiences regarding the clinical application of established guidelines. A total of 415 urology specialists were invited to participate in a survey-based study conducted via Google Forms. Participation was voluntary, and 65.08% of the invited urologists completed the survey.</p><p><strong>Results: </strong>Among the respondents, 84.7% reported utilizing the available guidelines in their routine clinical practice, with varying frequencies of reference. The primary motivations for guideline use were the prevention of potential complications and the avoidance of legal risks, as indicated by 90.5% of respondents. While 56.9% of participants adhered to the guidelines as a clinically standardized practice, 41.6% reported applying the recommendations on a case-by-case basis. Notably, 41.0% of respondents emphasized the need for locally adapted versions of guideline texts. Additionally, nearly half of the participants reported receiving no formal education or training on the significance, content, and practical application of these guidelines. Furthermore, 12.7% expressed skepticism about the evidence-based foundation of the guidelines, questioning whether the recommendations were derived from rigorously conducted studies.</p><p><strong>Conclusion: </strong>The available urolithiasis guidelines are recognized as valuable resources offering key recommendations for the effective and safe management of urolithiasis. However, findings from this survey highlight significant variability in clinical practice patterns due to local conditions and the individual experience and attitudes of practicing urologists. The application of guideline recommendations is further influenced by perceptions regarding their development, content, and practicality. Insights gathered from this study may contribute to improving the preparation, dissemination, and implementation of urolithiasis guidelines, particularly in adapting them to local clinical settings.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"97"},"PeriodicalIF":2.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081265","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":"Long-term effects of superselective renal artery embolization on renal function after percutaneous nephrolithotomy.","authors":"Zhican He, Yong Li, Shike Zhang, Hongcan Yang, Zhen Li, Liang Han, Yuhao Zhou, Peng Xu, Tao Zeng, Steffi Kar Kei Yuen, Guohua Zeng, Wenqi Wu","doi":"10.1007/s00345-025-05468-w","DOIUrl":"https://doi.org/10.1007/s00345-025-05468-w","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the long-term impact of superselective renal artery embolization (SRAE) on renal function in cases of severe post-percutaneous nephrolithotomy (PCNL) haemorrhage, and to identify the factors associated with the long-term outcome of renal function.</p><p><strong>Methods: </strong>Patients treated with SRAE for post-PCNL hemorrhage between September 2016 and September 2021 were included. Patients' demographic and clinical data were recorded. Multiple linear regression and logistic regression were used to identify the factors related to the percentages of estimated glomerular filtration rate (eGFR) change and the risk factors of worsening renal function (WRF), respectively.</p><p><strong>Result: </strong>A total of 80 patients were included. There was no significant change in eGFR before and after SRAE immediately within 1.45 ± 1.66 days (66.37 ± 28.45 vs. 63.86 ± 29.26 mL/min/1.73 m², p = 0.202). Patient's eGFR increased significantly from 66.37 ± 28.45 to 70.94 ± 30.48 mL/min/1.73 m² (p = 0.044) with a mean follow-up of 30.4 months after SRAE, especially in patients with compromised renal function before SRAE (β = 0.297, p = 0.039). However, BMI > 24 kg/m² was significantly associated with the decrease of eGFR (β = -0.343, p = 0.016). 12 (15.0%) patients developed WRF, logistic regression analysis showed that BMI > 24.0 kg/m² (OR = 4.144, p = 0.045) and atrophic renal cortex (OR = 4.180, p = 0.040) were independent risk factors of WRF.</p><p><strong>Conclusion: </strong>SRAE is an effective treatment for post-PCNL severe haemorrhage, and is not deleterious to long term renal function. Notably, BMI > 24.0 kg/m² and atrophic renal cortex were significant predictors of long-term WRF in SRAE patients.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"96"},"PeriodicalIF":2.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068301","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}