World Journal of Urology最新文献

{"title":"\"Development and validation towards a Nomogram to predict acute kidney Injury following PCNL\".","authors":"Abhishek Goli, Kasi Viswanath Gali, Arun Chawla, Sunil Pillai Bhaskara, Padmaraj Hegde, Ankit Agarwal, Email Id, Jean de la Rosette, Pilar Laguna, Bhaskar Somani","doi":"10.1007/s00345-025-05511-w","DOIUrl":"10.1007/s00345-025-05511-w","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the occurrence, risk factors, and outcomes of post PCNL (Percutaneous Nephrolithotomy) Acute Kidney Injury (AKI), with a secondary goal of developing a nomogram for post-PCNL AKI prediction.</p><p><strong>Methods: </strong>A prospective observational study was conducted enrolling 333 patients who underwent PCNL between February 2022 and February 2023. Patient demographics, comorbidities, perioperative lab parameters, stone characteristics, intraoperative details, and postoperative AKI were assessed. Logistic regression analyses were employed to construct a nomogram for predicting post-PCNL AKI.</p><p><strong>Results: </strong>40 patients (12.4%) experienced postoperative AKI, with recovery observed in all cases during the 3-month follow-up. Female gender (p = 0.002), hypertension(p = 0.022), higher serum uric acid levels(p = 0.003), staghorn calculi(p = 0.001), higher Hounsfield Units(p = 0.013), bilateral PCNL(p < 0.001), larger tract size(p = 0.017), longer operative time(p < 0.001), greater stone volume(p = 0.025), higher baseline serum creatinine levels(p < 0.001), higher postoperative total leukocyte count(p = 0.005), and postoperative fever(p < 0.001) were significantly associated with the AKI group. Regression analysis identified female gender (OR = 0.26, p = 0.035), higher serum uric acid levels(OR = 1.62, p = 0.013), bilateral PCNL(OR = 12.55, p < 0.001), longer operation time(OR = 1.02, p = 0.047), and larger stone volume(OR = 1.12, p = 0.015) as independent risk factors for postoperative AKI. The internally validated nomogram(n = 70) for predicting AKI demonstrated excellent diagnostic performance, with an area under the ROC curve of 0.984(95% CI, p < 0.001).</p><p><strong>Conclusion: </strong>AKI occurs in approximately 12% of patients undergoing PCNL. We identified several significant predictors of post-PCNL AKI, including female gender, hypertension, hyperuricemia, higher Hounsfield units, larger stone volume, bilateral PCNL, larger access tract size, and longer operative time. Awareness of these factors is crucial for optimizing management and improving patient outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"136"},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483586","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":"Deciphering RCC immunotherapy outcomes: insights from a Japanese multi-institutional study on the CANLPH score's impact.","authors":"Tatsuo Fukushima, Takuya Tsujino, Moritoshi Sakamoto, Kiyoshi Takahara, Kazumasa Komura, Takafumi Yanagisawa, Keiichiro Mori, Wataru Fukuokaya, Fumihiko Urabe, Takahiro Adachi, Yosuke Hirasawa, Masanobu Saruta, Atsuhiko Yoshizawa, Shingo Toyoda, Tatsushi Kawada, Satoshi Katayama, Kengo Iwatsuki, Ko Nakamura, Kyosuke Nishio, Kazuki Nishimura, Keita Nakamori, Tomohisa Matsunaga, Ryoichi Maenosono, Taizo Uchimoto, Tomoaki Takai, Takeshi Hashimoto, Teruo Inamoto, Kazutoshi Fujita, Motoo Araki, Takahiro Kimura, Yoshio Ohno, Ryoichi Shiroki, Haruhito Azuma","doi":"10.1007/s00345-025-05507-6","DOIUrl":"10.1007/s00345-025-05507-6","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to determine the utility of the CANLPH score as a predictive biomarker for patients with advanced and metastatic renal cell carcinoma (a/mRCC). By validating its prognostic value, this study aims to contribute to more personalized treatment strategies for a/mRCC.</p><p><strong>Methods: </strong>In a multicenter retrospective study by the JK-FOOT consortium, we analyzed data from 309 a/mRCC patients undergoing ICI-based therapy. The CANLPH score-a composite marker of C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), and platelet to hemoglobin ratio (PHR)-for its prognostic accuracy in predicting cancer-specific survival (CSS). Advanced statistical methods, including receiver operating characteristic (ROC) curve analysis, Cox proportional-hazard regression, and Harrell's concordance index (C-index), were employed to assess its predictive capacity against established factors.</p><p><strong>Results: </strong>The median follow-up period was 17 months, revealing two-year and five-year overall survival rates of 76.8% and 62.4%, respectively, with CSS rates at 78.3% and 66.2%. The CANLPH score well stratified survival outcomes of ICI-based treatment for RCC patients (HR 5.71; P < 0.0001). C-index analysis demonstrated that the CANLPH score had the highest predictive potency for CSS among models, including IMDC score. Multivariate analysis confirmed the CANLPH score (HR, 5.59; P = 0.0007) and Karnofsky performance status (HR, 2.59; P = 0.0032) as independent prognostic factors for CSS.</p><p><strong>Conclusions: </strong>The CANLPH score emerges as a critical tool in the a/mRCC therapeutic landscape, enabling precise prediction of patient outcomes with ICI-based therapies. Limitations include the retrospective design and the single national cohort. Prospective validation studies are warranted.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"135"},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483623","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":"Comparing the tissue properties of human buccal mucosa and penile skin flap: insights for urethral graft substitution.","authors":"Yilong Guo, Ning Ma, Mengtong Wang, Sen Chen, Pingping Liu, Zhe Yang, Yangqun Li","doi":"10.1007/s00345-025-05519-2","DOIUrl":"https://doi.org/10.1007/s00345-025-05519-2","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the histological features, biomechanical properties, water permeability, and osmotic stress responses of human buccal mucosa and penile skin flaps to evaluate their suitability as urethral graft substitutes.</p><p><strong>Methods: </strong>Buccal mucosa (n = 53) and penile skin flap (n = 59) were prepared for histological assessment of tissue structural characteristics and vascular patterns using H&E staining and immunofluorescence. Biomechanical properties were evaluated through mechanical testing, water permeability through deuterium oxide diffusion assays, and osmotic stress responses under hypo-, iso-, and hypertonic conditions.</p><p><strong>Results: </strong>H&E staining revealed that the buccal mucosa epithelium was significantly thicker (628.8 ± 213.3 μm) than that of the penile skin flap (148.2 ± 62.1 μm; p < 0.05). Mechanical testing demonstrated that the buccal mucosa had significantly higher elastic modulus and tensile strength and lower tensile strain compared with penile skin flap (p < 0.05). Water permeability testing revealed that the cumulative diffusion of deuterium oxide (D₂O) through the buccal mucosa was consistently higher at all time points compared to the penile skin flap (p < 0.05). In the Hypo group, the ratio of variation in epithelial thickness was significantly higher in the penile skin flap compared to the buccal mucosa. No statistical differences in the ratio of epithelial thickness variation were observed under Iso (p = 0.43) and Hyper (p = 0.07) conditions. The primary limitation of this study is the relatively small sample size. Additionally, the in vitro model lacks the ability to fully replicate the urethral microenvironment, where multiple interacting factors influence graft survival.</p><p><strong>Conclusion: </strong>This study presents the first comprehensive comparison of the tissue properties of buccal mucosa and penile skin flaps. Our findings provide valuable insights for surgical decision-making, postoperative management, personalized treatment strategies, and the advancement of bioengineered urethral substitutes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"137"},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483588","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":"Cavernous tissue preservation technique versus conventional technique during penile prosthesis implantation: a prospective comparative study.","authors":"Mohamed Abdelrahman Alhefnawy, Hazem Abdelsabour Deif, Ahmed Farag Wahsh, Mohamed Gamal Ahmed, Ahmed Mohammed El-Taher, Gamal Abdelmalek Morsy, Alaa Rafaat Mahmoud, Helmy Ahmed Eldib","doi":"10.1007/s00345-025-05476-w","DOIUrl":"10.1007/s00345-025-05476-w","url":null,"abstract":"<p><strong>Background: </strong>Few prospective studies in literature with long postoperative follow-up compared between cavernous tissue sparing and conventional penile prosthesis implantation techniques.</p><p><strong>Aim: </strong>To compare between cavernous tissue sparing and conventional penile prosthesis implantation techniques in terms of patient and partner satisfaction and perioperative outcomes.</p><p><strong>Methods: </strong>In All, 60 Patients with severe erectile dysfunction were randomized into 2 equal groups; patients undergoing conventional malleable penile prosthesis implantation, and patients undergoing the cavernous tissue-sparing technique. Postoperatively, prosthesis function and patient satisfaction were assessed at 6 weeks after surgery and then 3-6 and 12 months using EDITS and QoLSPP questionnaires. Patients were asked about residual penile tumescence. Perioperative data were recorded.</p><p><strong>Results: </strong>Modified EDITS questionnaire after 3,6, and 12 months was 76.9 ± 18, 79 ± 17 and 82.3 ± 16 respectively. As QOLSPP questionnaire, 46 (73.8%) subjects were highly satisfied, 25 patients (83.3%) in cavernous tissue sparing and 21 patients (70.00%) in Conventional group. While 14 (26.2%) were less satisfied, 5 patients (16.7%) Cavernous tissue sparing and 9 patients (30.00%) in Conventional group. In the cavernous tissue-sparing group, 26 of 30 patients (86.6%) reported having a significantly higher incidence of residual penile tumescence versus 2 of 30 patients (6.6%) in the conventional surgery group (P < .001). The age of highly satisfied subjects was significantly lower than those less satisfied (p = 0.025), while the BMI of highly satisfied subjects was significantly lower than those less satisfied (p = 0.001).</p><p><strong>Conclusion: </strong>There is a significantly higher incidence of residual penile tumescence in Cavernous tissue sparing group. Many factors affect male satisfaction rates after PPI as age, and BMI.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"138"},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493733","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":"Impact of positive surgical margin location after radical prostatectomy: a network meta-analysis.","authors":"Athul John, Thomas Milton, Aashray Gupta, Mau T Nguyen, Brandon Stretton, Joseph Hewitt, James Virgin, Joshua Kovoor, Rick Catterwell, Luke Selth, Michael O Callaghan","doi":"10.1007/s00345-025-05479-7","DOIUrl":"10.1007/s00345-025-05479-7","url":null,"abstract":"<p><strong>Objective: </strong>To perform a network meta-analysis comparing the impact of different positive surgical margin locations (Comparisons and intervention) on biochemical recurrence (Outcome) in patients undergoing radical prostatectomy (Population).</p><p><strong>Methods: </strong>According to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a protocol was registered (PROSPERO: CRD42022119025) and a search across four databases was conducted (the MEDLINE, Scopus, Embase and Cochrane). The primary outcome was biochemical recurrence (BCR). A network meta-analysis was conducted. Further subgroup analysis was performed to evaluate studies exploring robot-assisted radical prostatectomy (RALP).</p><p><strong>Results: </strong>Our search yielded 1249 unique results; 22 studies were analysed. Anterior margins had the highest risk of BCR (HR 2.46, 95%CI 1.67-3.61, I² = 76%) followed by posterior (HR 2.29, 95%CI 1.43-3.66, I² = 0%), bladder base (HR 2.06, 95%CI 1.61-2.64, I² = 69%), apical (HR 1.88, 95%CI 1.51-2.35, I² = 59%), and posterolateral margins (HR 1.70, 95%CI 1.14-2.25, I² = 60%). Given significant heterogeneity, subgroup analysis was performed. In the RALP subgroup, anterior margins also demonstrated the highest recurrence risk (HR 3.74, 95%CI 2.47-5.66, I² = 0%), followed by apical (HR 2.43, 95%CI 1.97-8.00, I² = 0%), posterior (HR 2.23, 95%CI 1.47-3.38), base (HR 1.65, 95%CI 1.29-2.11, I² = 0%), and posterolateral margin (HR 1.54, 95%CI 1.07-2.22).</p><p><strong>Conclusions: </strong>The risk of BCR after radical prostatectomy varies by PSM location, with the highest recurrence risk observed at anterior margins.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"134"},"PeriodicalIF":2.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477070","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":"Association between the use of proton pump inhibitors and serum PSA levels in the general U.S. population.","authors":"Fabio Bioletto, Giorgio Calleris, Luigi Simone Aversa, Marco Oderda, Giancarlo Marra, Mirko Parasiliti-Caprino, Iacopo Gesmundo, Riccarda Granata, Paolo Gontero, Ezio Ghigo","doi":"10.1007/s00345-025-05469-9","DOIUrl":"10.1007/s00345-025-05469-9","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are widely prescribed drugs that have been associated with increased prostate cancer (PCa) cell proliferation in vitro and worse oncological outcomes in vivo. However, data on their influence on PSA levels in the general population are lacking.</p><p><strong>Methods: </strong>We extracted individual participant data from the 2001-2010 cycles of the National Health and Nutrition Examination Survey (NHANES), in which PSA levels were measured in all male participants aged 40 years or older. The association of PPI use with total PSA levels and free/total PSA ratio was evaluated through multivariable linear regression analyses, adjusted for potential confounders.</p><p><strong>Results: </strong>A total of 7366 subjects were included (median age: 53 years; median serum PSA: 0.9 ng/mL), of whom 746 were receiving PPI treatment at the time of the study. After adjustment for potential confounders, ongoing PPI use was associated with lower total PSA levels (-0.24 ng/mL, 95%CI: [-0.37,-0.11], p < 0.001), while no significant association with free/total PSA ratio was found (p = 0.881). A significant effect modification was observed according to age, with the association being limited to older participants (≥ 60 years) at stratified analyses.</p><p><strong>Conclusions: </strong>Contrary to the available data in the context of PCa, we found no evidence of increased PSA levels in PPI users with no prostate malignancy. Instead, PPI use was associated with a decrease of total PSA in older adults. This adds knowledge on how PPIs may influence PSA in population-based screening programs.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"133"},"PeriodicalIF":2.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469226","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":"The advanced lung cancer inflammation index as a useful prognostic indicator for patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma.","authors":"Tomoya Hatayama, Keisuke Goto, Yuki Kohada, Kensuke Nishida, Takeshi Ueno, Tomoki Furutani, Kunihiro Hashimoto, Kenshiro Takemoto, Miki Naito, Shunsuke Miyamoto, Kohei Kobatake, Yohei Sekino, Hiroyuki Kitano, Akihiro Goriki, Keisuke Hieda, Nobuyuki Hinata","doi":"10.1007/s00345-025-05505-8","DOIUrl":"10.1007/s00345-025-05505-8","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate the ability of the advanced lung cancer inflammation index (ALI) to predict the prognosis of patients who underwent radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). We also aimed to compare the ALI with other inflammatory or nutritional indices as prognostic indicators.</p><p><strong>Methods: </strong>We retrospectively evaluated patients who underwent RNU for UTUC at multiple centers between January 2010 and April 2024. We calculated the ALI before RNU and divided the patients into the low ALI and high ALI groups. We used 1:1 propensity score matching (PSM) to adjust the clinicopathological differences between two groups. We compared the overall survival (OS) and recurrence-free survival (RFS) of the low and high ALI groups using the Kaplan-Meier method. Furthermore, we assessed the ALI as a predictor of OS and RFS using a multivariate Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>Of 488 patients (48.3% low ALI group), 160 patients from each group were matched. The Kaplan-Meier analysis revealed that the OS (p = 0.009) and RFS (p = 0.006) of the low ALI group were significantly shorter than those of the high ALI group. According to a multivariate analysis that included clinicopathological prognostic indicators, a low ALI was an independent predictor of poor OS (p = 0.014) and RFS (p = 0.038). Furthermore, according to the multivariate analysis including other inflammatory or nutritional indices, the ALI was an independent predictor of poor OS (p = 0.024) and RFS (p = 0.044).</p><p><strong>Conclusions: </strong>The ALI was a significantly useful prognostic predictors of patients with UTUC who underwent RNU.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"132"},"PeriodicalIF":2.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459629","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":"Is it necessary for patients with a positive urine culture to achieve a negative result after antimicrobial treatment before undergoing percutaneous nephrolithotomy?","authors":"Junhao Zheng, Qixian Guo, Gaoyuanzhi Yue, Shangwen Dou, Xueqing Zeng, Tao He, Fuyang Lin, Renfei Liu, Qiansheng Zhang, Zijie Mai, Yongda Liu","doi":"10.1007/s00345-025-05484-w","DOIUrl":"https://doi.org/10.1007/s00345-025-05484-w","url":null,"abstract":"<p><strong>Objective: </strong>There is ongoing debate regarding whether patients with a positive urine culture (UC) need to wait for the culture to turn negative following antimicrobial treatment before undergoing percutaneous nephrolithotomy (PCNL). This study aimed to evaluate the necessity of achieving a negative UC before PCNL and its association with postoperative systemic inflammatory response syndrome (SIRS) and sepsis.</p><p><strong>Methods: </strong>This prospective study included 147 patients with positive UCs who underwent PCNL at The First Affiliated Hospital of Guangzhou Medical University from March 2021 to April 2024. Patients were treated with sensitive antibiotics for 5-7 days based on the susceptibility results of their initial UC. Follow-up UCs were performed on day 3 after starting antibiotics and immediately before surgery. The relationship between UC results and postoperative infectious complications, including SIRS and sepsis, was analyzed. Multivariable analysis was conducted to identify independent risk factors.occurrence of postoperative infectious complications, including SIRS and sepsis, was analyzed. Multivariable analysis was used to identify independent risk factors.</p><p><strong>Results: </strong>Among the 147 patients, 133 (90·5%) had a negative urine culture on day 3 of treatment, while 14 remained positive. Preoperatively, 136 patients (92·5%) had negative UCs. Univariate analysis showed no significant differences in the incidence of postoperative systemic inflammatory response syndrome (SIRS) and sepsis between the UC-negative and UC-positive groups on day 3 and preoperatively (p > 0·05). Multivariable analysis identified stone burden (OR 1·01, 95% CI 1·01-1·01, p = 0·009), multiple access tracts (OR 2·64, 95% CI 1·08 - 6·45, p = 0·034), and positive stone cultures (OR 5·03, 95% CI 1·84 - 13·74, p = 0·002) as independent risk factors for postoperative SIRS. Bacterial variations were observed in follow-up UCs from 8 patients, but these did not impact postoperative complications.</p><p><strong>Conclusion: </strong>Achieving a negative UC before PCNL is not a necessary condition. Patients with positive UCs can safely undergo surgery after 5 days or more of sensitive antibiotic treatment without the need for a negative UC result. Positive stone cultures are valuable predictors of postoperative SIRS, supporting the routine collection of stone culture specimens.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"131"},"PeriodicalIF":2.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459701","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 incidence and classification of intraoperative adverse events in urological surgery: a systematic review.","authors":"Gernot Ortner, Charalampos Mavridis, Athanasios Bouchalakis, Maria Chrisoula Nakou, Yuhong Yuan, Udo Nagele, Charalampos Mamoulakis, Thomas R W Herrmann, Chandra Shekhar Biyani, Theodoros Tokas, Mithun Kailavasan","doi":"10.1007/s00345-025-05509-4","DOIUrl":"https://doi.org/10.1007/s00345-025-05509-4","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a systematic review (SR) to examine the application of classification systems (CS) used to report intraoperative adverse events (iAEs) in urological surgery and to evaluate the crude incidence and type of iAEs.</p><p><strong>Materials and methods: </strong>This review was published via PROSPERO (CRD42024549954) and conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). MEDLINE, Embase, and the Cochrane CENTRAL were searched using a predefined PICO framework: (P) patients with benign and malignant urological diseases, (I) all types of urological surgery, (C) none/any, (O) intraoperative complications classified with grading systems. Retrospective and prospective studies published between January 2019 and June 2024 were included.</p><p><strong>Results: </strong>The search yielded 1,570 abstracts, 1,043 full-text articles were assessed for eligibility, of which 325 studies reported iAEs (54 used iAE-CS, 64 used Clavien-Dindo Classification and 207 used free-text descriptions). Of the 54 studies (15,298 patients) that used an iAE-CS, the three most used systems were the EAUiaiC (54%), SATAVA (26%), and the modified SATAVA (7%). The overall incidence of iAE was 14% (2,153/15,225 patients). On a study level, the crude incidence of iAE was between 0 and 100% (median 7%, IQR: 3-13%). The misapplication of the Clavien-Dindo system to describe iAEs was high (n = 64 studies).</p><p><strong>Conclusions: </strong>The use of iAE-CS is scarce, and there is a lack of universal consensus on a CS to describe iAEs. iAE are poorly reported in urological studies. Urologists should report all perioperative complications to improve transparency and surgical and hospital processes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"129"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450177","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":"Comparative analysis of trifecta and pentafecta outcomes in T1a and T1b renal tumors following robotic partial nephrectomy: a retrospective study.","authors":"Rakesh Sharma, S Lohith, Amaresh Mohan, Bhasker Reddy, Rohit Singh, Manoj Kharadae, Vivek Meyyappan, Srikanth Srirama","doi":"10.1007/s00345-025-05497-5","DOIUrl":"https://doi.org/10.1007/s00345-025-05497-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to conduct a comparative analysis of Trifecta and Pentafecta outcomes between T1a and T1b renal tumors in patients undergoing robotic partial nephrectomy (RAPN). We explore the influence of clinical factors, including the RENAL nephrometry score components, on these outcomes.</p><p><strong>Methods: </strong>A retrospective single centre study was conducted on 133 patients who underwent RAPN for T1a (n = 51) and T1b (n = 82) renal tumors between 2017 and 2023. We assessed Trifecta and Pentafecta outcomes, and statistical comparisons were made. Univariate and multivariate analyses were conducted to evaluate the impact of tumor size and RENAL components on these outcomes.</p><p><strong>Results: </strong>Trifecta was achieved in 84.3% of T1a tumors and 85.36% of T1b tumors (p = 0.86). Pentafecta outcomes were achieved in 60.8% of T1a and 41.46% of T1b tumors (p = 0.34). Warm ischemia time was significantly longer in T1b tumors (p = 0.037). In the univariate analysis, warm ischemia time and tumor size were significant predictors of Trifecta and Pentafecta outcomes, respectively. Nearness to the collecting system was also a significant factor in univariate analysis (p = 0.045). Other clinical factors such as exophytic/endophytic properties and location relative to polar lines did not significantly impact outcomes.</p><p><strong>Conclusion: </strong>RAPN is equally effective for T1a and T1b renal tumors, providing comparable Trifecta and Pentafecta outcomes. Warm ischemia time, tumor size, and nearness to the collecting system are important factors influencing these outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"130"},"PeriodicalIF":2.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459698","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}