World Journal of Urology最新文献

{"title":"Predicting complications after laparoscopic surgery for ureteropelvic junction obstruction using machine learning models: a retrospective cohort study.","authors":"Xintao Zhang, Dong Sun, Yu Zhou, Qiongqian Xu, Xue Ren, Jichang Han, Chuncan Ma, Guohua Ma, Zhihao Sun, Yu Jia, Zhihang Zhou, Xiaoyang Liu, Qiangye Zhang, Aiwu Li","doi":"10.1007/s00345-025-05552-1","DOIUrl":"https://doi.org/10.1007/s00345-025-05552-1","url":null,"abstract":"<p><strong>Purposes: </strong>Postoperative complications in patients with ureteropelvic junction obstruction (UPJO) negatively impact surgical outcomes and may necessitate redo surgery. We aimed to predict the occurrence of postoperative complications in these patients using machine learning algorithms.</p><p><strong>Methods: </strong>Data of UPJO patients admitted to our hospital for surgical treatment from May 2014 to May 2023 were retrospectively analyzed. Risk factors were screened using multivariate logistic and Lasso regression. Logistic regression (LR), k-nearest neighbours (KNN), Support Vector Machine (SVM), Decision Tree (DT), Random Forest (RF), Extreme Gradient Boosting (XGB) and Neural Network (NN) were used to create a prediction model.</p><p><strong>Results: </strong>526 patients were included, with 97 complications (61 urinary tract infections [UTI] and 36 recurrences). Risk factors for postoperative complications of pyeloplasty were preoperative UTI (Pre-UTI), calculus, renal cortical thickness (RCT), collecting system, time of removal of DJ, removal of drainage, and white blood cell count (WBC). Factors associated with post-UTI were p-UTI, RCT, collecting system, time of removal of DJ, and WBC. Factors influencing postoperative recurrence were p-UTI, calculus, RCT, and drainage removal. Finally, LR was selected to develop the clinical prediction model for postoperative complications, UTIs, and recurrence (area under the curve: 0.929, 0.941, and 0.894, respectively). The present study is the first predictive model on total complications, UTI and recurrence after pyeloplasty and demonstrated strong predictive results. However, there are some limitations; this is a single-center study, and the model has not undergone external validation, which may affect the generalizability of our findings.</p><p><strong>Conclusion: </strong>UPJO postoperative complications, UTI, and recurrence can be predicted prior to surgery by machine learning.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"178"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658899","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":"Early angiography improves postoperative clinical outcomes compared to delayed angiography among patients with vascular pathologies following partial nephrectomy.","authors":"Rinat Lasmanovich, Husny Mahmud, Boris Khaitovich, Dorit E Zilberman, Barak Rosenzweig, Menachem Laufer, Orith Portnoy, Avi Epstein, Avinoah Irony, Zohar A Dotan","doi":"10.1007/s00345-025-05491-x","DOIUrl":"10.1007/s00345-025-05491-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess the evaluation, management, clinical outcomes and incidence of postoperative hematuria following partial nephrectomy (PNx) for renal tumors.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical charts of 936 adult patients who underwent PNx between 2008 and 2023. Patients presenting with hematuria during the first 6 months of surgery were included. Group 1, comprising patients who were treated with early angiography and selective embolization (n = 8), was compared to Group 2, patients who underwent imaging first (US or CTA), followed by angiography and selective embolization (n = 10, \"delayed\" angiography).</p><p><strong>Results: </strong>24 (2.6%) patients presented with hematuria, 18 (75%) required angiography-assisted intervention. Of those 18 patients, 17 (94.4%) were diagnosed with vascular pathologies; renal artery pseudoaneurysm (RAP) and arteriovenous fistula. Ultrasound (US) did not detect RAP in 33% of patients' initial evaluations (67% sensitivity). The median age was 67 years (IQR: 71.5-58.5 years), and the median time to hematuria was 11.5 days (IQR: 20.3- 7 days). The difference in the median interval time from presentation to embolization between Groups 1 and 2 was 20.2 h (CI 95%, p = 0.25). Group 1 had higher hemoglobin levels following therapy (p = 0.04), lower transfusion rates or antibiotic therapy (p = 0.02), shorter hospitalization stays (p = 0.03), and lower re-admission rates (p = 0.043) compared to Group 2.</p><p><strong>Conclusion: </strong>RAP is ubiquitous among patients presenting with hematuria following PNx. With hematuria presentation, the use of US should be limited. For cases where selective embolization is considered, angiography is sufficient to identify vascular pathologies, guiding therapeutic intervention. Management by early angiographic intervention is associated with better clinical outcomes compared to delayed angiography following confirmatory imaging.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"177"},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658896","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":"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}