World Journal of Urology最新文献

{"title":"Evaluation of ureteral injury using the PULS grading system in patients undergoing semi-rigid and flexible ureteroscopy.","authors":"Alper Şimşek, Mesut Berkan Duran, Mustafa Aydın, Hakan Yıldız, Reha Ordulu, Lokman İrkilata, Mustafa Koray Kırdağ, Uğur Öztürk, Emrah Küçük, Mustafa Kemal Atilla","doi":"10.1007/s00345-025-05461-3","DOIUrl":"https://doi.org/10.1007/s00345-025-05461-3","url":null,"abstract":"<p><strong>Purpose: </strong>Ureteroscopy is one of the main diagnostic and treatment approaches for the upper urinary system luminal pathologies today. In recent years complication rates have decreased significantly. Standardizing ureteral damage after ureteroscopic interventions is of great importance for the management of complications. This study aimed to prospectively evaluate ureteral damage and factors affecting it in patients who underwent retrograde intrarenal surgery (RIRS) with ureteral access sheath (UAS), RIRS without UAS, and stone treatment with semi-rigid ureteroscope.</p><p><strong>Methods: </strong>In this study, we included patients who underwent endoscopic surgery for ureter or kidney stones in our clinic. The ureteral pathologies of 202 patients who underwent RIRS with UAS, RIRS without the use of UAS, and semi-rigid ureteroscopy were prospectively evaluated using the Post-Ureteroscopic Lesion Scale (PULS).</p><p><strong>Results: </strong>75.7% of the lesions were PULS grade 1, 15.3% were grade 2. Lesions were most commonly located in the lower ureter during semi-rigid ureteroscopy, in the middle ureter during RIRS without a sheath, and in the upper ureter during RIRS with a sheath (p = 0.003). PULS 1 lesions (55.6%) were more commonly observed in the lower ureter, and PULS 2 lesions (41.9%) were also predominantly located in the lower ureter compared to other parts of the ureter.</p><p><strong>Conclusion: </strong>It should be kept in mind that ureteral damage may occur after the ureteroscopy procedure. The degree and localization of the ureteral lesion may vary depending on the procedure to be chosen. Evaluating ureteral damage using the PULS scoring system is important for patient management.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"176"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658898","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: \"impact of positive surgical margin location after radical prostatectomy: a network meta-analysis\".","authors":"Yalong Zhang, Kangyu Wang, Li Yang","doi":"10.1007/s00345-025-05547-y","DOIUrl":"https://doi.org/10.1007/s00345-025-05547-y","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"175"},"PeriodicalIF":2.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651058","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 of the advanced lung cancer inflammation index with prognosis in patients receiving radical nephroureterectomy.","authors":"Sunbin Dong","doi":"10.1007/s00345-025-05548-x","DOIUrl":"https://doi.org/10.1007/s00345-025-05548-x","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"173"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630867","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":"Exploring the application of FANS-UAS in pediatric kidney stone treatment.","authors":"Biao Jiang, Jiansheng Xiao","doi":"10.1007/s00345-025-05554-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05554-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"171"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630863","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":"Novel computed tomography characteristics of dust as well as tiny and small fragments in laser lithotripsy.","authors":"Naoto Tanaka, Akash Chitrakar, Satoshi Kitamura, Daiki Katsura, Fukashi Yamamichi, Yasuhiro Kaku, Yosuke Fukiishi, Masaichiro Fujita, Takaaki Inoue","doi":"10.1007/s00345-025-05550-3","DOIUrl":"https://doi.org/10.1007/s00345-025-05550-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the appearance of dust and stone fragments in the upper urinary tract after retrograde intrarenal surgery (RIRS) on computed tomography (CT) imaging.</p><p><strong>Methods: </strong>Human renal stones were implanted into porcine kidneys to assess the characteristics of dust and small fragments on CT imaging. Stone samples were classified as small fragments (2.00-2.36 mm), tiny fragments (1.00-1.40 mm) or dust (≤ 250 μm). Each group was divided into multiple 0.25-g dry weight samples. Twenty-four samples were placed in the upper poles of porcine kidneys with a ureteroscope and characterized using CT. The reconstructed images were evaluated with volume analyzer software to determine stone volume, maximum and mean attenuation values, and standard deviation of the stone attenuation value.</p><p><strong>Results: </strong>The mean stone volume decreased with increasing stone size (p < 0.001). The mean attenuation value (depicted in Hounsfield units [HU]) significantly increased with increasing stone size: dust (309.9), tiny fragments (401.2), and small fragments (474.5). The maximum attenuation value (HU) of small fragments (1430.0) was significantly greater than those of tiny fragments (1126.3) and dust (1039.8). As the stone size decreased from the small fragment size to the dust size, the standard deviation of the stone attenuation value significantly decreased.</p><p><strong>Conclusion: </strong>As the stone size approaches the that of dust particles, the mean and maximum attenuation values decrease and become more homogeneous. CT and volume analyzer software can be used to distinguish dust from small fragments and assess small residual stones after RIRS.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"174"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634797","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 \"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":"Ruohui Huang, Liqin Gu","doi":"10.1007/s00345-025-05527-2","DOIUrl":"https://doi.org/10.1007/s00345-025-05527-2","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"172"},"PeriodicalIF":2.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630864","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 long-term impact of single intraoperative instillation of pirarubicin after radical nephroureterectomy on local and systemic cancer control: a prospective, multicenter, randomized trial.","authors":"Toru Suzuki, Akihiro Kanematsu, Shiro Tanaka, Sojun Kanamaru, Toshinari Yamasaki, Mutsushi Kawakita, Shingo Yamamoto","doi":"10.1007/s00345-025-05557-w","DOIUrl":"https://doi.org/10.1007/s00345-025-05557-w","url":null,"abstract":"<p><strong>Purpose: </strong>Although the preventive effect against intravesical recurrence (IVR) has been established for single instillation of chemotherapy during or after radical surgery of upper urinary tract urothelial carcinoma (UTUC), there has been no research on the long-term outcome. This study aims to investigate the IVR and long-term survival outcome of a single intraoperative instillation of pirarubicin during radical nephroureterectomy (RNU).</p><p><strong>Methods: </strong>In this prospective, multicenter, randomized trial, 97 patients undergoing RNU between August 2012 and January 2019 were randomly assigned either to receive a single intraoperative pirarubicin instillation or to serve as the controls.</p><p><strong>Results: </strong>A total of 80 patients were analyzed, including 42 in the pirarubicin group and 38 in the control group. The median follow-up period was 58.5 months and 62 months in the pirarubicin and the control groups, respectively. In patients who did not experience IVR, the median follow-up period was 59 months and 61 months in the pirarubicin and the control groups, respectively. There was no significant difference in OS between the two groups, although the IVR rate was significantly lower in pirarubicin group (p = 0.044). Multivariable analyses revealed that the pirarubicin instillation was the only independent factor for IVR.</p><p><strong>Conclusions: </strong>The present trial demonstrated that a single intraoperative instillation of pirarubicin resulted in a significant and long-term reduction of IVR, although there was no significant difference in OS.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"168"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626328","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":"Assessing peri-operative antibiotic administration practices amongst urologic surgeons performing holmium laser enucleation of the prostate worldwide.","authors":"Seyed Mohammad Mohaghegh Poor, Hafsa Asif, Darion Denis-Diaz, Eric Riedinger, Tasha Posid, Maxwell Newton, Michael Sourial, Mark Assmus, Amy Krambeck, Bodo Knudsen, Matthew Lee","doi":"10.1007/s00345-025-05535-2","DOIUrl":"10.1007/s00345-025-05535-2","url":null,"abstract":"<p><strong>Purpose: </strong>Holmium Laser Enucleation of the Prostate (HoLEP) is a size-independent surgical treatment for benign prostatic hypertrophy. There is currently a lack of data on peri-operative antibiotic prescribing patterns for HoLEP and, thus, no consensus on optimal practices. This study aims to assess peri-operative antibiotic prescribing practices for HoLEP.</p><p><strong>Methods: </strong>Members of the Endourological Society (EUS) were invited by e-mail to complete a REDCap survey. The survey inquired about surgeons' practice setting, training, surgical volume, antibiotic prescribing practices and explored different factors that might affect antibiotic choice and duration. A p-value of < 0.05 was determined to be statistically significant.</p><p><strong>Results: </strong>A total of 70 Urologists (66 male, 4 female) reported that they performed an average of 108 HoLEPs per year with a mean clinical experience of 11 years. In the case of a negative pre-operative urine culture with a patient who is not catheterized/intermittently self-catheterizing (C/ISC), 96% of urologists would only give a single peri-operative dose of antibiotic. If the patient is C/ISC then 49% of Urologists would give more than a single dose of peri-operative antibiotic when the urine culture is negative. If the pre-operative urine culture is negative, 39% of surgeons would prescribe post-operative antibiotics even when the patient is not C/ISC and this increased to 64% if the patient is C/ISC. The most common factors urologists considered when prescribing antibiotic prophylaxis/therapy were positive urine culture, catheterization status, and a history of recurrent UTIs. Non-academic urologists administered post-operative prophylaxis more often (p < 0.05) and urologists with more experience treated a positive urine culture for a shorter period.</p><p><strong>Conclusion: </strong>There is significant variability for peri-operative antibiotic prescribing practices prior to HoLEP. In general, more antibiotics are prescribed if the patient has a history of C/ISC or infection. Further clinical studies are needed to identify optimal antibiotic prescribing protocols prior to HoLEP.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"169"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626286","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":"Comments on \"Deciphering RCC immunotherapy outcomes: insights from a Japanese multi-institutional study on the CANLPH score's impact\".","authors":"Yangbiao Chen, Tingting Chen, Liangchen Qu","doi":"10.1007/s00345-025-05546-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05546-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"170"},"PeriodicalIF":2.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626324","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":"Querying the capability of the post-HoLEP endoscopic aspect of the membranous urethral mucosa in predicting urinary incontinence: a prospective AI-based analysis.","authors":"Tomer Mendelson, Ziv Savin, Ron Marom, Yotam Veredgorn, Omri Schwarztuch Gildor, Tomer Bashi, Karin Lifshitz, Adi Kidron, Amichay Nevo, Ofer Yossepowitch, Mario Sofer","doi":"10.1007/s00345-025-05555-y","DOIUrl":"https://doi.org/10.1007/s00345-025-05555-y","url":null,"abstract":"<p><strong>Introduction: </strong>Transient stress urinary incontinence (SUI) after holmium laser enucleation of prostate (HoLEP) is commonly linked to intraoperative injury of the external urethral sphincter (EUS). We assessed the reliability of the post-HoLEP endoscopic appearance of the membranous urethra mucosa (MUM) in predicting post-HoLEP continence.</p><p><strong>Methods: </strong>Forty HoLEPs were prospectively recorded by an artificial intelligence video platform capable of segmenting clips by surgical steps. The final clip was assessed for postoperative MUM integrity by 2 experts in HoLEP and 2 residents, all blinded to the clinical outcome. Their findings were scored as no injury, anterior injury, and lateral injury, and the results underwent statistical analyses.</p><p><strong>Results: </strong>The referent rating was 72% for no injury, 23% for anterior injury, and 5% for lateral injury. The overall inter-observer agreement was K = 0.26, the inter-experts' agreement was K = 0.12, and the inter-residents' agreement was K = 0.38, reflecting low inter-observer reliability. The postoperative rate of SUI, defined as any drop on a pad, was 30% at 1 month and 12.5% at 3 months. There was no association between the MUM injury graded and SUI according to any of the evaluators (univariate analysis OR 0.83, 95%CI 0.17-3.89). A multivariate analysis controlling for age, prostate size, resectoscope size (22 vs. 26 FR), surgery time, and use of final fulguration showed no significantly independent predictor of post-HoLEP-related incontinence.</p><p><strong>Conclusion: </strong>The post-HoLEP endoscopic appearance of the MUM is apparently not a reliable marker of EUS injury. Further studies are needed to better understand the mechanism underlying post-HoLEP SUI.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"165"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617352","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}