World Journal of Urology最新文献

{"title":"Vacuum-assisted dedusting lithotripsy: a retrospective comparative study in high-risk patients with positive preoperative urine cultures.","authors":"Junjie Liang, Zhonghua Shen, Linguo Xie, Chunpeng Li, Xingwang Qi, Chunyu Liu","doi":"10.1007/s00345-025-05510-x","DOIUrl":"https://doi.org/10.1007/s00345-025-05510-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the efficacy of vacuum-assisted dedusting lithotripsy (VADL), employing a flexible vacuum-assisted ureteral access sheath (FV-UAS), with traditional flexible ureteroscopic lithotripsy (fURL) for upper urinary tract stones in patients with positive urine cultures.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 421 patients treated with fURL between January 2022 and August 2024. Patients were divided into a traditional fURL group and a VADL group. Propensity score matching adjusted for baseline differences, with a 1:1 ratio applied to compare stone-free rates, operative durations, postoperative hospital stay durations, and postoperative infectious complications.</p><p><strong>Results: </strong>Among 114 well-matched patients in each group, no mortalities occurred. The VADL group demonstrated significantly lower incidences of postoperative systemic inflammatory response syndrome (SIRS) (7.0% vs. 15.8%, p = 0.037) and shorter hospital stays (2.0 [1.0, 2.0] vs. 1.0 [1.0, 2.0], p = 0.014). The stone-free rate was significantly higher in the VADL group (87.7% vs. 72.8%, p = 0.005). However, no significant differences were observed in postoperative fever incidence or operative duration (7.0% vs. 9.6%, p = 0.472; 55.5 [40.0, 75.0] vs. 60.0 [45.0, 75.0], p = 0.104).</p><p><strong>Conclusions: </strong>VADL significantly reduces postoperative infectious complications and enhances stone-free rates in patients with upper urinary tract stones and positive preoperative urine cultures undergoing ureteroscopic lithotripsy.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"128"},"PeriodicalIF":2.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442018","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":"Micro-costing analysis of Rezum™ therapy: comparing sedation and local anesthesia with the Schelin® catheter.","authors":"Yasmine Saibi, Thibaut Long-Depaquit, Marc Fourmarier, Alessandro Uleri, Jennifer Campagna, Cyrille Bastide, Florence Peyron, Michael Baboudjian","doi":"10.1007/s00345-025-05472-0","DOIUrl":"https://doi.org/10.1007/s00345-025-05472-0","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"124"},"PeriodicalIF":2.8,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426263","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":"Crossed paths: a systematic review unveiling patterns in crossed testicular ectopia.","authors":"Catherine Robey, Tanisha Martheswaran, Tijesunimi Oni, Jason Yang, David Heap, Victoria Maxon, Chad Crigger","doi":"10.1007/s00345-025-05471-1","DOIUrl":"https://doi.org/10.1007/s00345-025-05471-1","url":null,"abstract":"<p><strong>Purpose: </strong>Crossed Testicular Ectopia (CTE) is a rare congenital anomaly where both testes descend on one side of the body. Although previously believed to be exceedingly uncommon, the number of published cases has grown, suggesting it may be more prevalent than initially believed. CTE is associated with various abnormalities, of which the most cited anomaly is persistent mullerian duct syndrome (PMDS) which has its own implications regarding infertility. This systematic review aims to clarify the impact of CTE on fertility, histopathology, associated congenital abnormalities, and potential long-term outcomes.</p><p><strong>Methods: </strong>A systematic review of the literature was performed to identify relevant studies on CTE. Inclusion criteria covered case reports, case series, and meta-analyses with individual case data published in English. Two reviewers independently extracted data, including demographic details, diagnostic methods, histological findings, and fertility status. Data analysis was performed using JMP software.</p><p><strong>Results: </strong>We identified 417 cases of CTE, a significant increase from previous review. CTE was diagnosed preoperatively in only 42.6% of cases, with ultrasound and MRI achieving the highest diagnostic success rates. Histological abnormalities were common, observed in 66% of cases, including testicular dysgenesis, Leydig cell hyperplasia, and malignancy. Infertility was reported in 79.2% of patients, notably high even among those with unilateral undescended testes. Fusion anomalies involving the spermatic cord, vas deferens, or testes were documented in 9.5% of cases. PMDS was the most common associated anomaly, identified in 33.3% of cases, and appeared to reduce the likelihood of fusion anomalies.</p><p><strong>Conclusion: </strong>This review highlights CTE as a complex and potentially underdiagnosed condition with significant implications for fertility and cancer risk. Early diagnosis and intervention are essential to improving long-term outcomes, while future research should investigate the genetic factors underlying CTE and optimize diagnostic protocols.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"125"},"PeriodicalIF":2.8,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426224","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":"Optimizing AI-assisted communication in urology: potential and challenges.","authors":"Yuekun Fang, Shengyi Chen, Bin Cheng","doi":"10.1007/s00345-025-05508-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05508-5","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"122"},"PeriodicalIF":2.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415339","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":"IC/BPS is not associated with bladder cancer: a nationwide propensity score matched cohort study in Taiwan.","authors":"Ming-Huei Lee, Huei-Ching Wu, Wei-Chih Chen, Yung-Fu Chen","doi":"10.1007/s00345-025-05501-y","DOIUrl":"https://doi.org/10.1007/s00345-025-05501-y","url":null,"abstract":"<p><strong>Purpose: </strong>Previous studies have reported an increased risk of bladder cancer (BC) in IC/BPS patients. In this study, we re-examined the BC risk in a population based IC/BPS cohort to assess the potential detection bias caused by some IC/BPS patients diagnosed who might already have co-existing BC.</p><p><strong>Methods: </strong>We performed a retrospective cohort study based on a Research Database by extracting IC/BPS patients diagnosed within years 2002-2013. The patients in the study cohorts were identified based on at least 2 IC/BPS diagnoses and excluded patients with BC occurred before IC/BPS diagnosis. The primary outcome was BC events detected. Propensity scores (PSs) were calculated for matching IC/BPS cohort with non-IC/BPS cohort on a 1:1 basis. Cox proportional hazard regression analysis was then used to compare hazard ratios of BC development between 2 cohorts.</p><p><strong>Results: </strong>By excluding patients with BC diagnosed within 1 year after IC/BPS diagnosis, the study cohort was insignificantly different from the PS-matched control (Model 1, p = 0.219) but significantly different from the non-PS-matched control (Model 2, p < 0.001). However, when including patients with BC diagnosed within 1 year after IC/BPS diagnosis, the study cohort was significantly different from both PS-matched (Model 3, p = 0.002) and non-PS-matched (Model 4, p < 0.001) controls, indicating that excluding patients with BC diagnosed within 1 year after IC/BPS diagnosis and adopting PS matching method greatly reduce the BC detection bias.</p><p><strong>Conclusions: </strong>IC/BPS is not associated with BC. The detection bias of previous studies may result from inadequate recruitments of study cohorts or improper matching of control cohorts.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"123"},"PeriodicalIF":2.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426257","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":"Evaluating ChatGPT's role in urological counseling and clinical decision support.","authors":"Kamil Malshy, Jathin Bandari, Victor Kucherov, Jean V Joseph, Thomas Osinski","doi":"10.1007/s00345-025-05500-z","DOIUrl":"https://doi.org/10.1007/s00345-025-05500-z","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"121"},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415332","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":"Socioeconomic disparities in survival of patients with non-muscle invasive urothelial carcinoma.","authors":"Bohdan Baralo, Peter T Daniels, Cody A McIntire, Rajesh Thirumaran, John W Melson, Asit K Paul","doi":"10.1007/s00345-024-05422-2","DOIUrl":"10.1007/s00345-024-05422-2","url":null,"abstract":"<p><strong>Purpose: </strong>Limited data are available on the impact of socioeconomic disparities on the survival of patients with non-muscle invasive urothelial carcinoma (NMIBC).</p><p><strong>Methods: </strong>We analyzed the Surveillance, Epidemiology, and End Results database to review the effects of sex, race, location, and socioeconomic factors on the survival of patients with NMIBC. We calculated 5-year overall survival (OS) and cancer-specific survival (CSS) using the log-rank test. The impact of socioeconomic factors on OS and CSS was analyzed using the Cox proportional hazards model adjusted for clinical characteristics. Hazard ratios (HR) and survival rates were reported with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Analysis of 3831 patients showed that older age was associated with worse OS (HR 1.08 [1.08-1.09]) and CSS (HR 1.05 [1.04-1.06]). Women and men had similar OS (HR 0.91 [0.82-1.01]) and CSS (HR 1.12 [0.95-1.32]). Black patients had worse OS (HR 1.33 [1.08-1.62] and CSS [HR 1.54 [1.13-2.05]) than their White counterparts. Patients with an annual household income below $40,000 had worse outcomes compared to those with income above $70,000 for both OS (HR 1.79 [1.37-2.33]) and CSS (HR 1.924 [1.26-2.89]).</p><p><strong>Conclusions: </strong>There were no gender differences in survival outcomes of NMIBC. Older age, Black, American Indian/Alaskan Native, and patients with a household income below $40,000 appear to have worse survival. However, the area of residence did not seem to affect patient survival.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"120"},"PeriodicalIF":2.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400273","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":"Pulsed Thulium: YAG laser for the management of Urolothiasis: a systematic review from the EAU section of endourology.","authors":"Panagiotis Kallidonis, Theodoros Spinos, Selcuk Guven, Vasileios Tatanis, Angelis Peteinaris, Evangelos Liatsikos, Olivier Traxer, Bhaskar Somani","doi":"10.1007/s00345-025-05486-8","DOIUrl":"https://doi.org/10.1007/s00345-025-05486-8","url":null,"abstract":"<p><strong>Introduction: </strong>In an effort to address the limitations of current lasers, pulsed-waved Thulium: YAG laser devices were released. The purpose of this systematic review is to present all existing data, arising exclusively from human studies and clinical practice, regarding the endourological applications of the new pulsed-waved Thulium: YAG laser technology in stone disease management.</p><p><strong>Patients and methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, three databases (PubMed, Scopus and Cochrane) were thoroughly investigated from inception to 30 December 2024. The following search string was utilized: (pulsed OR hybrid) AND (thulium: YAG OR Tm: YAG).</p><p><strong>Results: </strong>In total eight studies satisfied all inclusion criteria and were finally included in the qualitative analysis. Six studies reported the use of the pulsed-waved Thulium: YAG laser during ureteroscopic lithotripsy (URSL) or retrograde intrarenal surgery (RIRS) and two studies reported its use during percutaneous nephrolithotomy (PCNL). In included studies, the lasing time ranged from 6.7 (2.7-13.9) to 36 (11-52) minutes. Stone-free rates (SFRs) ranged from 82 to 95%, while the Grade I-II and III-IV complications, based on the Clavien-Dindo Classification System, ranged from 3.3 to 30% and from 0 to 2%, respectively.</p><p><strong>Conclusion: </strong>The purely pulsed Thulio^® and hybrid RevoLix^® Thulium: YAG lasers demonstrate promising safety and efficacy for RIRS and PCNL, with high peak power enabling efficient stone disintegration and effective dusting. However, the evidence is limited by small sample sizes, heterogeneity, and a lack of high-quality comparative trials. Further robust studies are needed to confirm these findings and draw reliable conclusions.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"118"},"PeriodicalIF":2.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400359","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":"A prospective survey evaluating the visual quality of KARL STORZ fiberoptic, digital, and disposable flexible ureteroscopes.","authors":"Clarissa Wong, Perry Xu, Nicholas Dean, Mark Assmus, Alyssa McDonald, Deepak Agarwal, Sohrab Ali, Garen Abedi, Ezra Margolin, Robert Medairos, Charles Nottingham, Amy Krambeck","doi":"10.1007/s00345-025-05502-x","DOIUrl":"https://doi.org/10.1007/s00345-025-05502-x","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the visual quality amongst the disposable FLEX-XC1, digital FLEX-XC, and fiberoptic FLEX-X2S flexible ureteroscopes (FUS) and determine whether urologists can distinguish which FUS is in use.</p><p><strong>Methods: </strong>In this prospective survey, 6 patients were prospectively randomized to the disposable FLEX-XC1, digital FLEX-XC, and fiberoptic FLEX-X2S FUS for retrograde intrarenal surgery (RIRS) for nephrolithiasis. Each RIRS was performed by a single-surgeon and recorded. 9 fellowship-trained endourologists were blinded to which FUS was used. They were asked to view the recordings, answer which FUS was used, and fill out a 7-question survey grading parameters from 0 to 5. Statistical analysis was performed with SPSS. ANOVA with Tukey's posthoc analysis confirmed significance defined as p < 0.05.</p><p><strong>Results: </strong>78%, 89%, and 78% of endourologists correctly identified which FUS was used between the disposable FLEX-XC1, digital FLEX-XC, and fiberoptic FLEX-X2S FUS's respectively. The digital FUS outperformed the others in overall score (p < 0.001). The only visual parameter that was not statistically different amongst FUS's was Laser Activation Interference (p = 0.97). After Tukey's posthoc analysis, the digital FUS outperformed the fiberoptic scope in all parameters except LAI. The disposable FUS outperformed the fiberoptic scope in all parameters except for LAI, tissue interference (TI), and overall impression. The digital FUS was superior to the disposable FUS only in Visual quality (Color) and TI.</p><p><strong>Conclusions: </strong>The majority of fellowship-trained endourologists can distinguish which type of KARL STORZ FUS is in use. The KARL STORZ digital and disposable FUS's outperform the KARL STORZ fiberoptic FUS in nearly all visual parameters. The KARL STORZ disposable FUS is comparable to the KARL STORZ digital FUS except for Visual Quality (Color) and Tissue Interference.</p><p><strong>Clinical trial registration: </strong>This study was approved by the Northwestern Institutional Review Board and was assigned study ID STU00217933. It is also registered under NCT05646069, titled \"Evaluation of Novel Disposable Flexible Ureteroscope for the Treatment of Renal Calculi.\"</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"119"},"PeriodicalIF":2.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400356","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":"Which current chatbot is more competent in urological theoretical knowledge? A comparative analysis by the European board of urology in-service assessment.","authors":"Mehmet Fatih Şahin, Çağrı Doğan, Erdem Can Topkaç, Serkan Şeramet, Furkan Batuhan Tuncer, Cenk Murat Yazıcı","doi":"10.1007/s00345-025-05499-3","DOIUrl":"10.1007/s00345-025-05499-3","url":null,"abstract":"<p><strong>Introduction: </strong>The European Board of Urology (EBU) In-Service Assessment (ISA) test evaluates urologists' knowledge and interpretation. Artificial Intelligence (AI) chatbots are being used widely by physicians for theoretical information. This research compares five existing chatbots' test performances and questions' knowledge and interpretation.</p><p><strong>Materials and methods: </strong>GPT-4o, Copilot Pro, Gemini Advanced, Claude 3.5, and Sonar Huge chatbots solved 596 questions in 6 exams between 2017 and 2022. The questions were divided into two categories: questions that measure knowledge and require data interpretation. The chatbots' exam performances were compared.</p><p><strong>Results: </strong>Overall, all chatbots except Claude 3.5 passed the examinations with a percentage of 60% overall score. Copilot Pro scored best, and Claude 3.5's score difference was significant (71.6% vs. 56.2%, p = 0.001). When a total of 444 knowledge and 152 analysis questions were compared, Copilot Pro offered the greatest percentage of information, whereas Claude 3.5 provided the least (72.1% vs. 57.4%, p = 0.001). This was also true for analytical skills (70.4% vs. 52.6%, p = 0.019).</p><p><strong>Conclusions: </strong>Four out of five chatbots passed the exams, achieving scores exceeding 60%, while only one did not pass the EBU examination. Copilot Pro performed best in EBU ISA examinations, whereas Claude 3.5 performed worst. Chatbots scored worse on analysis than knowledge questions. Thus, although existing chatbots are successful in terms of theoretical knowledge, their competence in analyzing the questions is questionable.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"116"},"PeriodicalIF":2.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391795","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}