World Journal of Urology最新文献

{"title":"Effect of ureteral rest on surgical outcomes in adults with ureteral stricture undergoing reconstruction: a propensity score matching study.","authors":"Yuancheng Zhou, Shuaishuai Chai, Kangxiang Xu, Chaoqi Liang, Xingyuan Xiao, Xiaomin Han, Bing Li","doi":"10.1007/s00345-025-05577-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05577-6","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of ureteral rest on outcomes of ureteral reconstruction (UR) and analyse the risk factors for postoperative recurrence of ureteral stricture.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with ureteral strictures who underwent ureteral rest or did not undergo ureteral rest prior to UR using propensity score matching (PSM). Furthermore, univariate, and multivariate regression models were used to analyse the risk factors for the recurrence of ureteral stricture.</p><p><strong>Results: </strong>A total of 261 patients were grouped according to whether they underwent ureteral rest. After PSM, two groups of 82 patients were selected for the comparative study. The ureteral rest group had a higher surgical success rate (96.34% vs 86.59%; P = 0.025) and a lower proportion of patients with estimated blood loss (EBL) > 100 ml (9.76% vs 23.17%; P = 0.021). Subgroup analysis showed that the patients with the history of ureteroscopy in ureteral rest group had a lower proportion of patients with EBL > 100 ml (6.98% vs 22.22%, P = 0.044) and higher surgical success rate (100.00% vs 86.67%, P = 0.040) compared to those with no ureteral rest. Multivariate logistic regression identified high BMI (OR = 1.19, P = 0.018), no ureteral rest (OR = 3.90, P = 0.019), a history of UR (OR = 4.59, P = 0.012), and American Society of Anesthesiologists (ASA) grade III (OR = 3.56, P = 0.031) as independent risk factors for stricture recurrence.</p><p><strong>Conclusion: </strong>Preoperative ureteral rest facilitates stricture maturation, improving surgical success rate and reducing blood loss, particularly in patients with prior ureteral surgery. Furthermore, high BMI, no ureteral rest, history of UR, and ASA grade III are independent risk factors for stricture recurrence. Therefore, ureteral rest is recommended to enhance surgical outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"186"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732011","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":"Targeted and regional biopsy in prostate cancer: first real-world data.","authors":"Thibaut Long-Depaquit, Renaud Corral, Alessandro Uleri, Arthur Peyrottes, Jennifer Campagna, Harry Toledano, Cyrille Bastide, Michael Baboudjian","doi":"10.1007/s00345-025-05585-6","DOIUrl":"https://doi.org/10.1007/s00345-025-05585-6","url":null,"abstract":"<p><strong>Introduction: </strong>MRI-targeted biopsies enhance prostate cancer (PCa) diagnostics, but systematic distant biopsies increase overdiagnosis and overtreatment. Regional biopsies may optimize diagnostic efficiency.</p><p><strong>Methods: </strong>This prospective single-center study included biopsy-naïve patients undergoing transperineal MRI-guided biopsies with cognitive fusion and regional sampling.</p><p><strong>Results: </strong>Among 50 patients, 66% had clinically significant PCa, 16% insignificant PCa, and 18% no cancer. No re-biopsies were needed for non-cancerous cases. Of 12 patients undergoing nerve-sparing radical prostatectomy, 25% had a bilateral disease, with two positive margins.</p><p><strong>Conclusion: </strong>This novel biopsy template may help reduce unnecessary sampling and associated risks. Larger comparative studies are needed to confirm these findings.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"187"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732014","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":"Safety analysis of ureterolysis for ureteric obstruction secondary to retroperitoneal fibrosis.","authors":"James Ross, Maya Morcos, Neal E Rowe","doi":"10.1007/s00345-025-05576-7","DOIUrl":"https://doi.org/10.1007/s00345-025-05576-7","url":null,"abstract":"<p><strong>Purpose: </strong>Ureterolysis is an uncommonly performed surgery for management of retroperitoneal fibrosis. This study sought to utilize a large, multi-centered database to assess the short-term post-operative outcomes of patients undergoing ureterolysis surgery for retroperitoneal fibrosis.</p><p><strong>Methods: </strong>Using the American College of Surgeons National Quality Improvement Program database, a retrospective review was conducted on patients who underwent ureterolysis for retroperitoneal fibrosis between January 1st, 2006, and December 31st, 2016. Patients who underwent ureterolysis for retroperitoneal fibrosis as a principle operative procedure by a urologist were included. Complications within 30 days of surgery were captured and organized based on the Clavien-Dindo classification system. The prevalence of secondary reconstructive urologic procedures performed at the time of ureterolysis (ureteroureterostomy, ureteroneocystostomy, and ureteroneocystostomy with psoas hitch/bladder flap) was determined.</p><p><strong>Results: </strong>One hundred patients (51 male, 49 female) were included in the cohort, with a mean age of 57 (IQR 43 and 66, respectively). Of these, six underwent a secondary urological procedure at the time of ureterolysis (1 ureteroureterostomy, 2 ureteoneocystostomy, and 3 ureteroneocystostomy with psoas hitch/bladder flap). The overall complication rate was 12%. Of the patients affected, 92% experienced only Clavien grade I or II complications (wound or urinary infection). Only one patient required return to the operating room (Clavien III) and there were no high-grade complications (Grade IV or V).</p><p><strong>Conclusion: </strong>Ureterolysis for retroperitoneal fibrosis is an uncommonly performed surgery with generally low incidence of post-operative complications. Ureterolysis may represent a safe treatment option for ureteric obstruction secondary to retroperitoneal fibrosis.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"189"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721288","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":"Distribution characteristics of staghorn calculi bacteria and metabolic differences in patients of different genders.","authors":"Zhibin Zheng, Weiguo Hu, Xijie Ding, Jian Li, Shaobo Zhou, Zhichao Chi, Wenjie Bai, Hongmei Jiang, Jianxing Li, Guojun Chen","doi":"10.1007/s00345-025-05569-6","DOIUrl":"10.1007/s00345-025-05569-6","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to examine the distribution patterns of bacteria and to elucidate the distinctions in stone composition and metabolism.</p><p><strong>Methods: </strong>A review of 205 cases of staghorn stones treated at Beijing Tsinghua Changgung Hospital from January 2016 to June 2024 was conducted. Data on preoperative mid-course urine culture, blood biochemistry, 24-hour urine and postoperative stone composition were collected. Stones with > 50% mixed stone components or single components were defined as main stone components. According to the main components, patients with staghorn calculi were divided into infectious and non-infectious stone groups, and the distribution of bacteria among different stone groups was analyzed. The metabolic differences between patients with staghorn calculi of different genders were analyzed according to the results of blood biochemistry and 24-hour urine metabolism.</p><p><strong>Results: </strong>The study population consisted of 88 males and 117 females with an average age of 53 ± 12 years. The most common components were magnesium ammonium phosphate hexahydrate and carbonated apatite (40%). The prevalence of calcium oxalate stones (16.6%) and uric acid stones (9.3%) was significantly higher in males (P < 0.05), while infectious stones (42.9%) were more prevalent in females (P < 0.05). The detection rate of Proteus mirabilis was more prevalent in the infectious stone group (26.2%), whereas the detection rate of Ureaplasma urealyticum (9%) and Enterococcus faecalis (6.9%) were more prevalent in non-infectious stone group (P<0.05). The levels of serum uric acid, serum creatinine, urinary calcium, urinary sodium, urinary phosphorus, urinary chloride and urinary uric acid were found to be significantly higher in males than in females (P < 0.05).</p><p><strong>Conclusion: </strong>The biochemical metabolism of patients with staghorn stones exhibits gender-specific differences, with a notable discrepancy in the distribution of bacteria. It is therefore necessary to refine the biochemical metabolic indicators and mid-stream urine culture tests.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"185"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701343","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":"Does intraoperative surgeon reported stone free status (IO-SFS) correlate with CT based post operative stone free status (PO-SFS) in flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS) in real-world practice? A prospective global FANS collaborative study group initiative with the section of EAU endourology.","authors":"Vineet Gauhar, Olivier Traxer, Steffi Kar Kei Yuen, Daniele Castellani, Guohua Zeng, Khi Yung Fong, Zhu Wei, Deepak Reddy Ragoori, Mohamed Elshazly, Kremena Petkova, Wissam Kamal, Nariman Gadzhiev, Mehmet Ilker Gokce, Mohamed Amine Lakmichi, Chaeeun Lee, Albert El Hajj, Marek Zawadzki, Luis Rico, Pablo Contreras, Tzevat Tefik, Chu Ann Chai, Petrisor Geavlete, Kemal Sarica, Jia-Lun Kwok, Bhaskar Kumar Somani, Ee Jean Lim","doi":"10.1007/s00345-025-05570-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05570-z","url":null,"abstract":"<p><strong>Background: </strong>Flexible and navigable suction ureteral access sheath (FANS) has been proven to improve stone-free rate (SFR) and many studies report high intraoperative 100% stone-free status (IO-SFS) and postoperative 100% stone-free status (PO-SFS). The reliability of IO-SFS vis-à-vis image-proven PO-SFS needs to be evaluated as it has implications on perioperative management.</p><p><strong>Methods: </strong>Our prospective, multicenter study enrolled 704 adult patients from 21 centers who underwent FURS with FANS between August 2023 and October 2024. IO-SFS was categorized into three groups: (1) 100% SFR (no dust or fragments), (2) only dust remaining, and (3) both dust and fragments remaining. PO-SFS was assessed via 2 mm non-contrast computed tomography (NCCT) at 30 days and categorized into four grades: Grade A (100% stone-free), Grade B (single ≤ 2 mm residual fragment), Grade C (single 2.1-4 mm), and Grade D (multiple or any > 4 mm). Primary outcome was correlation between intraoperative and postoperative 100% SFS. Secondary outcomes included perioperative complications, reintervention rates, and predictors of residual fragments and perioperative complications.</p><p><strong>Results: </strong>IO-SFS reported 100% SFR in 395 cases. Postoperative NCCT confirmed a significantly higher SFS (Grade A + B) in this group (99%) compared to 95.8% in the dust only group and 61.1% in the dust and fragments group (p < 0.001). Positive predictive value (PPV) of intraoperative 100% SFR was 99% with post-op NCCT, while negative predictive value (NPV) was only 12.3%. Secondary outcome analysis showed higher stone volumes, lower pole locations, and use of high-power holmium lasers were associated with increased 2-4 mm residual fragments (OR 6.53, p = 0.047). In the 100% SFR group, the use of 12/14 Fr UAS and disposable scopes was significantly higher, with a preferred strategy combining fragmentation, dusting, and aspiration. No cases of sepsis or significant postoperative bleeding were reported due to the use of FANS, with fewer patients requiring post-operative stenting.</p><p><strong>Conclusion: </strong>This study provides robust evidence that surgeon-reported 100% IO-SFS is highly predictive of NCCT-proven postoperative stone-free outcomes, with a PPV of 99%. However, intraoperative detection of residual fragments is less reliable in predicting persistent stone burden, as only 40% of these patients eventually achieved SFS on NCCT. Standardized imaging protocols remain necessary to optimize postoperative management and patient counseling, while avoid unnecessary re-intervention.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"184"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677351","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":"Comparison of extended and standard lymph node dissection in radical cystectomy for urothelial bladder cancer: a systematic review and meta-analysis.","authors":"Aleksander Ślusarczyk, Pietro Scilipoti, Gautier Marcq, Benjamin Pradere, Roberto Contieri, Wojciech Krajewski, Ekaterina Laukthina, Francesco Del Giudice, Mattia Longoni, Andrea Gallioli, Yasmin Abu-Ghanem, Muhammed Shamin Khan, Francesco Soria, Simone Albisinni, Morgan Rouprêt, Piotr Radziszewski, Francesco Montorsi, Alberto Briganti, Marco Moschini","doi":"10.1007/s00345-025-05549-w","DOIUrl":"https://doi.org/10.1007/s00345-025-05549-w","url":null,"abstract":"<p><strong>Purpose: </strong>Lymph node dissection (LND) is an essential part of radical cystectomy (RC) performed with curative intent for invasive urothelial bladder cancer (UBC). This meta-analysis synthesizes evidence from randomized controlled trials (RCTs) comparing outcomes of extended and standard LND during RC.</p><p><strong>Methods: </strong>Systematic searches of PubMed, Scopus, and Web of Science, conducted on November 10, 2024, identified RCTs that compared outcomes of standard (removal of pelvic lymph nodes [LNs]) versus extended LND (removal of pelvic and retroperitoneal LNs) during RC. Intention-to-treat populations were analyzed. Primary outcomes were recurrence-free (RFS) and overall survival (OS).</p><p><strong>Results: </strong>Two RCTs involved 993 patients, among whom 490 were randomized to extended and 503 to standard LND. We did not find evidence that RFS (hazard ratio [HR] 1.01, 95% confidence interval [CI] 0.83-1.24) and OS (HR 0.98, 95% CI 0.81-1.19) differed between patients undergoing extended and standard LND. The risk of local recurrence did not differ between extended and standard LND (relative risk [RR] 1.17, 95% CI 0.80-1.72). The risk of major complications (grade > 3) was higher for the extended template (RR 1.22, 95% CI 1.05-1.41), as was the 90-day postoperative mortality (RR 1.93, 95% CI 1.01-3.69). The limited number of studies and sample size constitute major limitations.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates that extended LND was not associated with improved RFS or OS compared to standard LND, but was linked to increased morbidity. Therefore, pelvic lymphadenectomy up to the common iliac bifurcation should remain the standard of care during RC.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"181"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671180","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 \"Clinical study of UMP and RIRS in 1.0-2.0 cm diameter renal/upper ureteral calculi\".","authors":"Jianghua Yang, Ming Jin, Xiaoxing Liao","doi":"10.1007/s00345-025-05542-3","DOIUrl":"https://doi.org/10.1007/s00345-025-05542-3","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"183"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671181","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":"Sacrospinous fixation versus uterosacral ligament suspension in managing apical prolapse.","authors":"Jodie McDonald, Omar Salehi, Niranjan Sathianathen, Caroline Dowling, Sandra Elmer","doi":"10.1007/s00345-025-05563-y","DOIUrl":"https://doi.org/10.1007/s00345-025-05563-y","url":null,"abstract":"<p><strong>Purpose: </strong>To compare and assess the safety of two mesh-free surgical techniques in managing apical pelvic organ prolapse (POP); robot assisted/laparoscopic uterosacral ligament suspension (USLS) and vaginal sacrospinous ligament fixation (SSLF).</p><p><strong>Methods: </strong>We performed a retrospective review of 116 women with apical POP who underwent USLS (n = 61) or SSLF (n = 55) by a single surgeon. Demographic data including age, parity, previous POP surgery was recorded. A pre-operative pelvic floor questionnaire was used to identify prevalence of bladder, bowel and vaginal symptoms. POP Quantification system (POP-Q) scores were recorded at surgery and at post-operative reviews. The absolute change in POP-Q scores were recorded as objective measures of pelvic floor support. Other post-operative metrics used include the presence of vaginal bulge, need for repeat POP surgery (re-operation) and subjective improvement in symptoms based on a patient-reported outcome measures survey. Post-operative adverse events were recorded using the Clavien-Dindo grading scale. Multivariable logistical regression analysis was performed to predict factors for failure, re-operation and adverse events.</p><p><strong>Results: </strong>Baseline demographics were similar. Mean post-operative follow-up time was 24 months (USLS) and 18.5 months (SSLF). The difference in post-operative C point was not significant (USLS: median - 8 (IQR 2), SSLF: median - 7 cm (IQR 2)). Procedure success rates (post-operative C point < 0) were not different (USLS 90.2%, SSLF 92.5%). Re-operation rates for apical recurrence were similar between groups (SSLF 1.9%, USLS 6.6%). Univariate analysis for re-operation found that age, parity, and surgery type were not predictors of re-operation. The most common post-operative adverse event was urinary tract infection (USLS 10.2%, SSLF 10.5%).</p><p><strong>Conclusion: </strong>Robot assisted/laparoscopic uterosacral ligament suspension and vaginal sacrospinous ligament fixation are safe and effective mesh-free techniques for management of apical pelvic organ prolapse based on objective improvements in POP-Q score and patient-reported outcome measures.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"182"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671183","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":"Exime prostatic stent in acute and chronic urinary retention.","authors":"Thibaut Long Depaquit, Michael Baboudjian, Alessandro Uleri, William Berchiche, Frederic Arroua, Arthur Peyrottes, Christophe Eghazarian, Marc Fourmarier","doi":"10.1007/s00345-025-05470-2","DOIUrl":"https://doi.org/10.1007/s00345-025-05470-2","url":null,"abstract":"<p><strong>Purpose: </strong>The Exime prostatic stent, a silicone-based device designed for temporary urinary retention management, offers an alternative to indwelling urethral catheters (IUCs), allowing spontaneous voiding. This study aimed to compare the efficacy and safety of the Exime device with IUCs in patients with urinary retention due to benign prostatic obstruction (BPO).</p><p><strong>Methods: </strong>This retrospective study included 43 patients from 2020 to 2024 with failed trial without catheter (TWOC) following acute urinary retention (AUR) secondary to BPO, prostate volume ≤ 120 mL, and intravesical prostatic protrusion < 5 mm. The stent was inserted under local anesthesia as an outpatient procedure.</p><p><strong>Primary endpoint: </strong>effectiveness in restoring urinary flow. Secondary endpoints: complications, patient preferences, and comparisons with IUCs.</p><p><strong>Results: </strong>Median patient age was 86 years (IQR 78-90); median prostate volume was 45 mL (IQR 40-61). The stent was successfully inserted in 42 patients (98%), with all achieving spontaneous voiding. Median post-void residual volume was 45 mL (IQR 38-73), and 70% retained the stent for ≥ 4 weeks. Complications included obstruction (14%), infection (9%), and migration (7%). Compared to IUCs, the Exime stent reduced symptomatic urinary tract infections (9% vs. 40%, p = 0.03), bladder spasms (16% vs. 84%, p < 0.001), and urinary leakage (0% vs. 30%, p < 0.001). Patients reported lower pain (VAS 2 vs. 8, p < 0.001) and higher satisfaction (VAS 8 vs. 1, p < 0.001).</p><p><strong>Conclusion: </strong>The Exime stent effectively managed urinary retention with fewer complications and higher patient satisfaction compared to IUCs.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"179"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664562","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":"Tauber's antegrade sclerotherapy for the treatment of varicocele in children and adolescents. Does the pubertal stage matter?","authors":"Carlotta Plessi, Nino Guarino, Gabriele Vasta, Vito Briganti, Guido Fiocca","doi":"10.1007/s00345-025-05564-x","DOIUrl":"10.1007/s00345-025-05564-x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the results of Tauber's antegrade sclerotherapy at different pubertal stages and, notably, to evaluate its feasibility in pre-pubertal age.</p><p><strong>Methods: </strong>We retrospectively reviewed the clinical records of patients that underwent antegrade sclerotherapy at our centre between 2005 and 2019. We divided our population into groups based on pubertal stage according to Tanner's classification. Pre-operative, intra-operative and post-operative data were collected. Finally, we assessed the association between Tanner's stage at surgery, operative characteristics, short-term complications and long-term outcomes.</p><p><strong>Results: </strong>513 patients were included in our study. Median age was 13 years (range 9-17). 467 (91%) underwent the procedure under local anaesthesia or with mild sedation. Median operative time was 23 min. In 7 cases (1%) conversion was necessary due to intraoperative complications. In 31 cases (6%) we observed minor post-operative complications. Recurrence rate was 3%. Data analyses revealed that there were statistically significant differences among different Tanner's pubertal stages at the intervention in terms of type of anaesthesia (p = 0.009). No difference was found in terms of operative time (p = 0.214), conversion's rate (p = 0.406), postoperative complications (p = 0.159), and clinical outcomes at 1 month (p = 0.916), 6 month (p = 0.112) and at final follow up (p = 0.312).</p><p><strong>Conclusion: </strong>Tauber's antegrade sclerotherapy is a reliable technique in the treatment of paediatric and adolescent varicocele, regardless of patients' pubertal stage. Although prepubertal patients may need more general anaesthesia, the procedure maintains similar efficacy and complication rates across all age groups.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"180"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664628","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}