{"title":"Letter to the Editor on \"Clinical outcome of BCG treatment for patients with urothelial carcinoma of the prostatic urethra: implications for early cystectomy\".","authors":"Kemal Demirhan","doi":"10.1007/s00345-025-05482-y","DOIUrl":"https://doi.org/10.1007/s00345-025-05482-y","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"156"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597959","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 association between obstructive sleep apnea and nocturnal enuresis in children: current advances and research trends.","authors":"Zhaokai Zhou, Zhan Wang, Fu Peng, Shuang Chen, Shuai Yang, Zhengrui Li, Yudi Xu, Hongzhuo Qin, Jiaojiao Wang, Qiong Lu, Ran Xu","doi":"10.1007/s00345-025-05541-4","DOIUrl":"https://doi.org/10.1007/s00345-025-05541-4","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) and nocturnal enuresis (NE) represent two clinically prevalent pediatric disorders that frequently present as comorbidities. OSA, characterized by recurrent upper airway collapse during sleep, and NE, defined as involuntary voiding during sleep, collectively contribute to psychosocial distress in children. Emerging evidence suggests that OSA in children can cause NE through multiple mechanisms, though the pathophysiological interplay involving altered arousal thresholds and hormonal dysregulation remains incompletely elucidated. Herein, we summarized the relationship between OSA and NE and identified mainstream research directions and recent hotspots in the relationship between OSA and NA in children and informed further research.</p><p><strong>Materials and methods: </strong>This review searched for original publications on the relationship between OSA and NE in children in the Web of Science Core Collection from 1981 to 2025. Research trends, countries, institutions, journals, authors, highly cited publications, and keywords were analyzed using bibliometrics. Co-citation networks were mapped using VOSviewer, and research hotspots and trends were analyzed using CiteSpace.</p><p><strong>Results: </strong>A total of 147 publications were included. The number of publications and related research interest in the relationship between OSA and NE in children has increased globally year after year. Sleep monitoring and multidisciplinary collaboration may be the next hotspot in this field. The occurrence of NE shows a positive correlation with the prevalence of OSA, and children with NE frequently exhibit comorbid sleep-disordered breathing. Adenotonsillectomy has been demonstrated to have therapeutic efficacy as a primary intervention for children with concurrent OSA and NE.</p><p><strong>Conclusions: </strong>The co-morbid association between NE and OSA may have significant adverse effects on the psychophysical health of children. Adenotonsillectomy shows potential for treating children with co-morbid OSA and NE. However, systematic multidisciplinary clinical evaluation remains critical in this patient population. Furthermore, this review will help researchers to identify the mainstream research directions and latest hotspots in the field of the relationship between OSA and NE.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"158"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597966","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}
Andreas Karlsson Rosenblad, Bassam Mazin Hashim, Per Lindblad, Börje Ljungberg
{"title":"Reply to the letter to the editor about \"recurrences after nephron-sparing treatments of renal cell carcinoma: a competing risk analysis\" by Lundgren and Radros.","authors":"Andreas Karlsson Rosenblad, Bassam Mazin Hashim, Per Lindblad, Börje Ljungberg","doi":"10.1007/s00345-025-05526-3","DOIUrl":"https://doi.org/10.1007/s00345-025-05526-3","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"157"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597964","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}
Gaoshen Mi, Yucheng Ma, Linhu Liu, Banghua Liao, Kunjie Wang
{"title":"Optimal energy source selection strategies for en bloc resection in non-muscle invasive bladder cancer: a systematic review and network meta-analysis.","authors":"Gaoshen Mi, Yucheng Ma, Linhu Liu, Banghua Liao, Kunjie Wang","doi":"10.1007/s00345-025-05513-8","DOIUrl":"https://doi.org/10.1007/s00345-025-05513-8","url":null,"abstract":"<p><strong>Objective: </strong>This research aimed to identify the most effective energy source for en bloc resection of non-muscle-invasive bladder cancer (NMIBC) by a systematic review and network meta-analysis of randomized controlled trials (RCTs) and observational studies. We assessed and contrasted the effectiveness and safety of various energy modalities used in en bloc resection (ERBT) with those employed in conventional transurethral resection of bladder tumor (cTURBT).</p><p><strong>Methods: </strong>A thorough search was conducted in PubMed, EMBASE, Cochrane, and Web of Science (WOS) to discover relevant articles published till August 29, 2024. Research comparing en bloc resection using various energy sources (such as hybrid knife, holmium laser, thulium laser, green-light laser, monopolar, and bipolar devices) to conventional transurethral resection of bladder tumor (cTURBT) was included. A network meta-analysis was performed using Stata/MP 18.0. Standardized mean differences (SMD) were computed for continuous outcomes, whilst relative risks (RR) were used for dichotomous outcomes. Nine clinical outcomes were assessed: duration of surgery, length of hospital stay, catheterization duration, irrigation duration, volume of intraoperative blood transfusion, 12-month recurrence rate, bladder perforation rate, incidence of obturator nerve reflex, and presence of detrusor muscle in the resected specimen. (PROSPERO ID: CRD42024623881).</p><p><strong>Results: </strong>The study included 37 research, including 8 randomized controlled trials (RCTs) and 29 high-quality non-randomized controlled trials (NRCTs), with a total of 4973 patients involved. The network meta-analysis revealed that ERBT was much better than cTURBT in the majority of outcomes. Hybrid knife and laser technologies (holmium, thulium, and green-light lasers) shown superior efficacy regarding decreased surgical length, diminished 12-month recurrence rates, and fewer problems. Hybridknife proved to be the most advantageous energy source for various results, while cTURBT consistently exhibited the least effective performance across all metrics.</p><p><strong>Conclusion: </strong>En bloc resection surpasses traditional TURBT in the management of NMIBC, with various energy modalities exhibiting distinct benefits. Among the assessed energy sources, laser technologies and hybrid knives regularly surpassed monopolar and bipolar devices. These findings provide critical direction for urologists in selecting the most suitable energy source for en bloc resection in NMIBC, emphasizing the need for individualized decision-making based on the patient's distinct variables and tumor attributes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"155"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587482","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 and safety of disitamab vedotin in combination with immune checkpoint inhibitors in patients with locally advanced or metastatic urothelial carcinoma.","authors":"Ji-Ming Yao, Jia-Lei Zhong, Qiang Zhou, Ju Guo","doi":"10.1007/s00345-025-05544-1","DOIUrl":"https://doi.org/10.1007/s00345-025-05544-1","url":null,"abstract":"<p><strong>Introduction: </strong>Disitamab Vedotin (DV, RC48, or RC48-ADC) is a novel humanized antibody-drug conjugate (ADC), which is based on human epidermal growth factor receptor 2 antibody (anti-HER2, or hertuzumab) coupled with monomethyl auristatin E (MMAE). This study aims to evaluate the efficacy and safety of RC48-ADC in combination with programmed cell death protein 1 (PD-1) inhibitors for treatment of locally advanced or metastatic urothelial carcinoma (la/mUC) patients.</p><p><strong>Patients and methods: </strong>This is a retrospective and real-world investigation originated from an enrollment of locally advanced or mUC patients underwent treatments with RC48-ADC in combination with PD-1 inhibitors in two hospitals, between August 2022 and July 2024. The overall objective response rate (ORR), disease control rate (DCR), median overall survival (mOS), median Progression Free Survival (mPFS) and safety were assessed.</p><p><strong>Results: </strong>Totally 51 locally advanced or mUC patients were included in this study, with the following background: age range (39-86 years old), gender (39 (76.5%) male, 12 (23.5%) female). Treatment outcomes included complete remission (27.5%), partial remission (33.3%), stable disease (13.7%), and disease progression (25.5%), yielding an ORR of 61% (95% CI:47-73%) and DCR of 75% (95% CI:61-84%). Until July 2024, the median overall survival (mOS) for all patients was not reached, the median progression-free survival (mPFS) for all patients was 9 months (95% CI:5.8-12.1).Treatment-related adverse events occurred in all patients and the most common side effects were anorexia, asthenia, rash, and pruritus. These adverse symptoms were readily manageable and could be relieved by symptomatic treatment.</p><p><strong>Conclusion: </strong>RC48-ADC in combination with PD-1 immunotherapy has promising efficacy and manageable safety for locally advanced or mUC patients in real-world settings.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"154"},"PeriodicalIF":2.8,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587480","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}
Daniel R Hanna, Michael L Creswell, Russell S Terry, Lucas B Vergamini, Mihaela Sardiu, Holly E Du, Amber K McMahon, Wilson R Molina, Bristol B Whiles
{"title":"Bing chat for kidney stone management questions based on the AUA guidelines: a comparison of chatbot conversation style modes.","authors":"Daniel R Hanna, Michael L Creswell, Russell S Terry, Lucas B Vergamini, Mihaela Sardiu, Holly E Du, Amber K McMahon, Wilson R Molina, Bristol B Whiles","doi":"10.1007/s00345-025-05533-4","DOIUrl":"https://doi.org/10.1007/s00345-025-05533-4","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial intelligence (AI) technology will inevitably permeate healthcare. Bing Chat is an AI chatbot with different conservation styles. We evaluated each of these response mode answers regarding management of nephrolithiasis.</p><p><strong>Methods: </strong>A total of 20 questions were created based on the AUA Surgical Management of Stones guidelines. Bing Chat's responses were evaluated across Precise, Balanced, and Creative conversation style chat modes by three physicians using the Brief DISCERN tool. Consensus scoring was employed to assess appropriateness, guideline adherence, empathy, recommendation for physician consultation, and inability to answer the inquiry. Responses were also assessed for their directness and the presence of superfluous information. Chat modes were compared using descriptive statistics as well as ANOVA, Chi-Squared tests, and Fisher exact tests.</p><p><strong>Results: </strong>The median Brief DISCERN Score in Precise, Balanced, and Creative modes were: 22, 21, and 21, respectively. There was no significant difference in Brief DISCERN scores between the three chat modes (p = 0.68). Guideline adherence by chatbot conversation style was similar (p = 0.37), as was response appropriateness (p = 0.62), directly answering the question asked (p = 0.26) and providing a recommendation to consult with a healthcare provider (p = 0.07). Creative and balanced modes outperformed precise mode when evaluating response empathy. Creative mode was more likely to include superfluous information and less likely to answer the question.</p><p><strong>Conclusion: </strong>In its current iteration, Bing Chat provides low quality urologic healthcare information for nephrolithiasis queries, regardless of the conversation style utilized.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"151"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568252","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}
A Tozsin, A Aydin, S Silay, A E Demet, T Knoll, T Herrmann, M De Bruin, P Dasgupta, J Rassweiler, Selcuk Guven, K Ahmed
{"title":"Environmental sustainability in urologic practices: a systematic review.","authors":"A Tozsin, A Aydin, S Silay, A E Demet, T Knoll, T Herrmann, M De Bruin, P Dasgupta, J Rassweiler, Selcuk Guven, K Ahmed","doi":"10.1007/s00345-025-05522-7","DOIUrl":"10.1007/s00345-025-05522-7","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this systematic review is to assess the environmental impact of urologic procedures and equipment (P), specifically comparing emissions and waste generation between single-use and reusable devices (I and C), while also exploring strategies for emission reduction and providing relevant recommendations for sustainable practices in urology.</p><p><strong>Methods: </strong>The review registered to PROSPERO (ID: CRD42024576865) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search was conducted to identify studies addressing sustainability, carbon footprint, and environmental impact in urology. A total of 7714 records were initially identified, of which ten met the inclusion criteria. Study quality was assessed using the QUADAS scoring system to evaluate risk of bias and applicability concerns.</p><p><strong>Results: </strong>Ten studies met the inclusion criteria, focusing on the environmental impacts of urologic devices and procedures (O). Single-use cystoscopes demonstrated lower carbon dioxide (CO<sub>2</sub>) emissions per procedure (2.41 kg) compared to their reusable counterparts (4.23 kg) but produced more waste (622 g). Reusable cystoscopes, while having a lower cumulative waste per-use, increased emissions due to energy-intensive reprocessing. For ureteroscopes, single-use devices generated less CO<sub>2</sub> but significantly more solid waste. TURBT procedures had a high carbon footprint (131.8 kg CO<sub>2</sub> per procedure), largely from single-use items and sterilization. Robotic prostatectomy produced a lower carbon footprint (47,313 g CO<sub>2</sub>) than laparoscopic methods, emphasizing the potential for energy-efficient techniques to reduce emissions in urology.</p><p><strong>Conclusion: </strong>A hybrid approach in urology, focusing on improving sterilization processes and developing eco-friendly single-use alternatives, may provide a balanced approach toward sustainability.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"152"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574017","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}
Loris Cacciatore, Antonio Minore, Lilla Bonanno, Pierangelo Contessa, Francesco Esperto, Antonio Rosario Iannello, Rocco Papalia
{"title":"Is flexible navigable suction ureteral access sheath (FANS) safer and more efficient than conventional sheaths? Italian multicentric experience.","authors":"Loris Cacciatore, Antonio Minore, Lilla Bonanno, Pierangelo Contessa, Francesco Esperto, Antonio Rosario Iannello, Rocco Papalia","doi":"10.1007/s00345-025-05520-9","DOIUrl":"https://doi.org/10.1007/s00345-025-05520-9","url":null,"abstract":"<p><strong>Background and objective: </strong>The flexible and navigable suction ureteral access sheath (FANS) with continuous flow lithotripsy may improve stone-free rates (SFR) in ureterorenolithotripsy procedures, reducing operative time and the need for fragment extraction. This study aimed to compare the safety and efficacy of FANS versus conventional sheaths in patients undergoing retrograde intrarenal surgery (RIRS) for renal stones.</p><p><strong>Methods: </strong>From January to September 2024, patients undergoing RIRS with high-power pulsed lasers (60 W Ho:YAG or 100 W pTm:YAG) were randomized to receive either a conventional sheath (Group 1) or FANS (Group 2). Data on baseline characteristics, operative details, and complications were collected. SFR, defined as the absence of fragments > 3 mm, was assessed with non-contrast CT scans one-month post-surgery. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>A total of 132 patients were enrolled (70 with conventional sheath, 62 with FANS). The FANS group had shorter operative times (55.25 vs. 61.36 min, p = 0.028), while laser time was similar between groups. Postoperative complications were lower in the FANS group. At one month, the FANS group had a higher SFR (95% vs. 67%, p < 0.005) and fewer re-interventions (p = 0.02).</p><p><strong>Conclusions: </strong>FANS significantly improves SFR without increasing postoperative complications postoperative complications or negatively affecting recovery, offering a promising alternative to conventional sheaths in ureterorenolithotripsy procedures. FANS improves kidney stone surgery outcomes, providing better stone removal, fewer complications, and faster recovery compared to the standard tool.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"153"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574067","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 graded detrusor preservation on continence in Retzius-Sparing Robotic-Assisted Prostatectomy.","authors":"Thekke Adiyat Kishore, Jeni Mathew, Venkata Bhargava Boppanna, Surgery Fellow, Sandeep Prabhakaran","doi":"10.1007/s00345-025-05523-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05523-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the influence of detrusor apron preservation on continence in Retzius-sparing Robotic assisted radical prostatectomy (RS-RARP).</p><p><strong>Materials and methods: </strong>A prospective study was carried out on patients who underwent RS-RARP at our institute from January 2019 to June 2022. We aimed to identify potential factors that could affect continence, including age, BMI, ISUP Grade Group, bladder neck sparing, fascial plane of dissection, and degree of preservation of the detrusor apron. The detrusor preservation was graded from 0 to 3, where grade 0 the detrusor apron is sacrificed and grade 3 it is complete preservation.</p><p><strong>Result: </strong>The study included 311 patients. There was a significant correlation between the degree of detrusor preservation and continence at three months, with significance escalating with greater detrusor preservation. The OR for grade 1, grade 2 and grade 3 stood at 3.84 (p = 0.026), 9.83 (p < 0.001) and 16.06 (p = 0.03) respectively. This correlation in the three groups at six months was 29.38 (p < 0.001), 26.57 (p < 0.001), and 17.29 (p = 0.005) respectively, showing an even stronger association with continence recovery. The OR for detrusor apron preservation at 12 months was 21.89 (p = 0.003), 14.21 (p = 0.006), and 6.31 (p = 0.105) respectively. We observed that the association between detrusor apron preservation persisted at 12 months, although the odds ratios (OR) were diminished compared to the six-month periods.</p><p><strong>Conclusion: </strong>The study emphasizes the critical role of the detrusor apron in achieving both early and superior continence rates. Sacrificing the detrusor apron was associated with delayed continence recovery and an increased incidence of incontinence. To achieve good continence with reduced incidence of margin positivity detrusor can be preserved in a graded manner.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"150"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568273","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}
Randi M Pose, S Knipper, B Beyer, L Hohenhorst, A Haese, H Heinzer, G Salomon, T Steuber, L Budäus, D Tilki, H Isbarn, T Maurer, P Tennstedt, M Graefen, U Michl
{"title":"Impact of peritoneal bladder flap in robot-assisted radical prostatectomy patients on lymphoceles: a prospective randomised trial.","authors":"Randi M Pose, S Knipper, B Beyer, L Hohenhorst, A Haese, H Heinzer, G Salomon, T Steuber, L Budäus, D Tilki, H Isbarn, T Maurer, P Tennstedt, M Graefen, U Michl","doi":"10.1007/s00345-025-05518-3","DOIUrl":"https://doi.org/10.1007/s00345-025-05518-3","url":null,"abstract":"<p><strong>Objective: </strong>To test the impact of fixing a peritoneal flap of the bladder to the plexus Santorini as final step of robot-assisted radical prostatectomy (RARP) to reduce the incidence of symptomatic lymphoceles and postoperative complications.</p><p><strong>Patients and methods: </strong>A two-armed prospective randomised, controlled, single-centre trial on 1080 patients with prostate cancer who underwent RARP with bilateral pelvic lymph node dissection was carried out. Patients in the intervention arm received fixation of the peritoneal flap of the bladder to the plexus Santorini at the end of surgery (Michl-technique, MT); in the control group, surgery was performed without this modification. The primary endpoint was the rate of lymphoceles requiring intervention. Secondary endpoints were total lymphocele rate, other complications ≥ grade IIIa according to Clavien-Dindo and continence rates within one year after RARP.</p><p><strong>Results: </strong>Overall, between June 2017 and October 2019, 531 patients were randomised to the MT and 549 to the control arm. There were no differences in both arms with respect to age at surgery, PSA, BMI, prostate volume, surgical time, blood loss, and time to removal of the catheter. Overall, in median 14 lymph nodes were dissected and 337 (32%) patients had a lymphocele. There was no statistically significant difference in lymphoceles requiring intervention (7.2% in MT-group versus 8.8% in control group, p = 0.4). There was no difference in continence rates and other complications between the two groups after one-year-follow-up.</p><p><strong>Conclusions: </strong>There was no significant reduction in symptomatic lymphoceles observed when using the Michl-technique. Lymphoceles remain a significant complication post lymph node dissection in RARP patients.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"148"},"PeriodicalIF":2.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568278","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}