World Journal of Urology最新文献

{"title":"Does sheath size matter: benchtop comparison of flow and pressure across variety of continuous flow endoscopes.","authors":"Vishnuvardhan Ganesan, Michael Borofsky, Deepak Agarwal","doi":"10.1007/s00345-024-05270-0","DOIUrl":"https://doi.org/10.1007/s00345-024-05270-0","url":null,"abstract":"<p><strong>Introduction: </strong>Laser enucleation utilizes purpose-built endoscopes for laser stabilization and continuous flow. No evaluation has been done with respect to flow or intravesical pressure with these scopes. We sought to evaluate the effect different endoscopes and sheath sizes on irrigation outflow and intravesical pressure.</p><p><strong>Methods: </strong>Using a benchtop model using a silicone bladder model, five outer/inner sheath combinations were assessed: Storz 28/26Fr, Storz 26/26Fr, Wolf 26/24Fr, Wolf 26/22Fr, and Wolf 24/22Fr. A urodynamics pressure transducer was inserted alongside the scope for bladder pressure measurement and outflow from scope to drain was measured using uroflowmetry device. Four 1-minute trials were recorded for each sheath and the steady state flow and pressure was recorded.</p><p><strong>Results: </strong>The Storz 28 F outer sheath and 26 F inner sheath had the highest outflow (12.4 ± 0.5 mL/s, p < 0.01). The Wolf 24 F outer and 22 F inner had the lowest outflow (7.0 ± 0.0 mL/s, p < 0.01). The steady state bladder pressure was the lowest in the Storz 28/26 (1.5 ± 1.7 cm H2O, p < 0.01)) and the greatest in the Storz 26/26 (24.2 ± 1.9 cm H2O, p < 0.01).</p><p><strong>Conclusion: </strong>The Storz 28/26 combination had best outflow rate and lowest intravesical pressures in our benchtop study. Flow rates generally decreased with smaller sheath sizes and steady state bladder pressures increased as the difference between the outflow and inflow sheath size narrowed. These findings provide initial parameters that could guide sheath selection in future to optimize visualization and success of voiding trials.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"573"},"PeriodicalIF":2.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401493","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":"Preoperative multidisciplinary team meeting improves the incidence of positive margins in pathological T2 prostate cancer.","authors":"Kohei Kobatake, Keisuke Goto, Yukiko Honda, Miki Naito, Kenshiro Takemoto, Shunsuke Miyamoto, Yohei Sekino, Hiroyuki Kitano, Kenichiro Ikeda, Keisuke Hieda, Akihiro Goriki, Nobuyuki Hinata","doi":"10.1007/s00345-024-05261-1","DOIUrl":"10.1007/s00345-024-05261-1","url":null,"abstract":"<p><strong>Purpose: </strong>Positive surgical margins (PSM) after robot-assisted radical prostatectomy (RARP) for prostate cancer (PCa) can increase the risk of biochemical recurrence and PCa-specific mortality. We aimed to evaluate the impact of multidisciplinary team meetings (MDTM) on reducing the incidence of PSM following RARP.</p><p><strong>Methods: </strong>We retrospectively collected the clinical data of consecutive patients undergoing RARP at Hiroshima University between February 2017 and October 2023. The MDTM, comprising a radiologist, uropathologist, and urologist, reviewed the preoperative magnetic resonance imaging (MRI) and prostate biopsy results of each patient before RARP and considered the areas requiring attention during RARP. Surgeons were categorized as experienced or non-experienced based on the number of RARP procedures performed.</p><p><strong>Results: </strong>In the pT2 population, the PSM rate was significantly lower in cases evaluated using the MDTM than in those not (11.1% vs. 24.0%; p = 0.0067). Cox regression analysis identified that a PSA level > 7 ng/mL (hazard ratio 2.2799) and nerve-sparing procedures (hazard ratio 2.2619) were independent predictors of increased PSM risk while conducting an MDTM (hazard ratio 0.4773) was an independent predictor of reduced PSM risk in the pT2 population. In the pathological T3 population, there was no significant difference in PSM rates between cases evaluated and not evaluated at an MDTM. In cases evaluated at an MDTM, similar PSM rates were observed regardless of surgeon experience (10.4% for non-experienced and 11.9% for experienced surgeons; p = 0.9999).</p><p><strong>Conclusions: </strong>An MDTM can improve the PSM rate of pT2 PCa following RARP.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"571"},"PeriodicalIF":2.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393757","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":"Evaluating the efficacy and safety of Holmium laser enucleation of the prostate in patients with obstructive uropathy attributable to bladder outlet obstruction.","authors":"Ansh Bhatia, Joao G Porto, Renil S Titus, Jean C Daher, Theodora M Zavos, Diana M Lopategui, Robert Marcovich, Hemendra N Shah","doi":"10.1007/s00345-024-05278-6","DOIUrl":"https://doi.org/10.1007/s00345-024-05278-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate outcomes of Holmium laser enucleation of the prostate (HoLEP) in individuals presenting with obstructive-uropathy (OU) attributable to bladder outlet obstruction (BOO).</p><p><strong>Methods: </strong>We performed a retrospective review of patients who underwent HoLEP from August 2017 to January 2023 at our institution. We identified patients with preoperative OU defined by presence of chronic hydronephrosis suggestive of BOO and conducted a matched-pair analysis (1:2) with patients undergoing HoLEP without OU. Patients' demographic, perioperative and postoperative voiding parameters, serum creatinine level, and complications were analyzed up to one-year of follow-up.</p><p><strong>Results: </strong>Preoperative OU was present in 42 patients. Demographic and preoperative parameters were comparable except median preoperative creatinine (1.245 vs. 1.065 ng/ml, p < 0.001) and catheterization rates (76.2% vs. 25%, p < 0.001) were higher in the OU group. The mean duration of postoperative catheterization was longer in the OU group (3.83 vs. 2.26 days, p = 0.048). Two patients in the OU group developed postoperative acute kidney injury. There was no difference in the rate of postoperative complications, improvement in International Prostate Symptom Score and maximum urinary flow amongst both groups except a higher post-void residual volume at 3- and 12-months (p = 0.001 and p = 0.037, respectively) in OU patients. Patients noted significant improvement in serum creatinine level at 6-12 weeks postoperatively from peak baseline level (P = 0.002).</p><p><strong>Conclusion: </strong>HoLEP is effective and safe in patients with OU suggestive of BOO, though they are at higher risk of postoperative acute kidney injury.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"572"},"PeriodicalIF":2.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393754","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":"General anesthesia is associated with lower perioperative bleeding and better functional outcomes than spinal anesthesia for endoscopic enucleation of the prostate: a single-center experience.","authors":"Carlo Silvani, Gianpaolo Lucignani, Carolina Bebi, Matteo Turetti, Francesco Ripa, Stefano Paolo Zanetti, Elisa De Lorenzis, Giancarlo Albo, Fabrizio Longo, Franco Gadda, Emanuele Montanari, Luca Boeri","doi":"10.1007/s00345-024-05271-z","DOIUrl":"https://doi.org/10.1007/s00345-024-05271-z","url":null,"abstract":"<p><strong>Purpose: </strong>Holmium laser enucleation of the prostate (HoLEP) and bipolar transurethral enucleation of the prostate (B-TUEP) are safe and effective treatment options for benign prostatic hyperplasia (BPH). Spinal anesthesia (SA) is widely used for endoscopic enucleation of the prostate (EEP) in place of general anesthesia (GA). We aimed to assess the impact of GA vs. SA on blood loss, postoperative course and functional outcomes after HoLEP and B-TUEP.</p><p><strong>Methods: </strong>After propensity score matching, we analyzed data from 148 patients treated with EEP in our centre for symptomatic BPH. We recorded patient's characteristics, procedural data, type of anesthesia (SA vs. GA). Postoperatively we evaluated hemoglobin drop, catheterization time (CT), and length of hospital stay (LOS). Functional outcomes were evaluated with the International Prostate Symptoms Score (IPSS) at baseline and 3 months after surgery. Descriptive statistics and linear regression models tested the association between anesthesia type and EEP outcomes.</p><p><strong>Results: </strong>After matching groups were comparable in terms of pre- and intra-operative variables. Of all, 111 (75%) patients were treated under SA. Haemoglobin drop was lower in GA compared to SA group (1 vs. 1.4 g/dL, p < 0.01). CT was shorter in the GA group (1 vs. 2 days, p = 0.01). Postoperative IPSS score was lower in GA group (4 vs. 8, p = 0.04). Multivariable linear regression models revealed that prostate volume (p = 0.01) and SA vs. GA (p = 0.01) were associated with higher haemoglobin drop, after accounting for age and use of anticoagulants/antiplatelets. Similarly, SA vs. GA (p = 0.02) and postoperative complications occurrence (p < 0.001) were associated with a longer LOS, after accounting for age, prostate volume and use of anticoagulants/antiplatelets.</p><p><strong>Conclusion: </strong>EEP can be safely performed under both GA and SA. GA offers better outcomes in terms of perioperative bleeding and 3-month functional outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"569"},"PeriodicalIF":2.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393755","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":"Ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (UBo-HPN) with branch renal artery occlusion: a single arm trial.","authors":"Tianrun Ye, Xu Shi, Yang Yu, Gan Yu, Bin Xu, Zongbiao Zhang, Shen Wang, Zheng Liu, Ke Chen, Shaogang Wang, Heng Li","doi":"10.1007/s00345-024-05263-z","DOIUrl":"10.1007/s00345-024-05263-z","url":null,"abstract":"<p><strong>Background: </strong>One key focus of partial nephrectomy is preserving renal function. Segmental renal artery occlusion with microdissection at the renal hilum confines ischemia, effectively reducing warm ischemic injury. Ultrasound-Guided Renal Artery Balloon Catheter Occluded Hybrid Partial Nephrectomy (UBo-HPN) can achieve branch occlusion without the need for dissecting the renal hilum.</p><p><strong>Objective: </strong>To investigate the feasibility and safety of UBo-HPN of branch renal artery occlusion in the treatment of localized renal tumors.</p><p><strong>Subject and methods: </strong>A prospective single-arm analysis involving 20 patients with renal localized tumors underwent robot assisted UBo-HPN with branch renal artery occlusion from August 2021 to July 2023, with an average follow-up of 12 months.</p><p><strong>Results: </strong>All patient was successfully operated on without conversion to conventional arterial clamping or radical nephrectomy. One case (5%) of minor complication occurred in the whole cohort, which was bruising around the puncture site. The mean total operative time was 95.8 min, with a mean operative time of 21.25 min for vascular intervention. The mean warm ischemia time was 20.35 min, and the median estimated blood loss was 50 ml. The median eGFR preservation percentage at postoperative 48 h, 30 days, and the latest follow-up were 87.52%, 91.47%, and 92.2%, respectively. After a median follow-up of 10.2 (2.3-19.2) months, no patients had radiological tumor recurrence or died from tumor-related causes.</p><p><strong>Conclusions: </strong>UBo-HPN with renal artery branch occlusion emerges as an efficient alternative to partial nephrectomy (PN), which achieved branch artery occlusion without dissecting the renal hilum. Long-term follow-up is expected for functional outcomes.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"570"},"PeriodicalIF":2.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393758","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":"Intravenous indocyanine green to evaluate distal ureteral vascularity during robot-assisted radical cystectomy with intracorporeal urinary diversion.","authors":"Enric Carbonell, Alba Sierra, Clàudia Mercader, Mònica Peradejordi, Maria Muní, Alberto Tello, Héctor Alfambra, Carmen Martínez, Tarek Ajami, Laura Izquierdo, Antoni Vilaseca, María José Ribal, Antonio Alcaraz, Raúl Martos, Mireia Musquera","doi":"10.1007/s00345-024-05284-8","DOIUrl":"https://doi.org/10.1007/s00345-024-05284-8","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the present study is to assess the role of indocyanine green (ICG) to evaluate distal ureteral vascularity during robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion and its impact on the incidence of benign ureteroenteric strictures (UES).</p><p><strong>Methods: </strong>The study included patients who underwent RARC for bladder cancer between 2018 and 2023. All patients included underwent intracorporeal urinary diversion with ileal conduit or neobladder. Bricker technique was performed in all ureteroenteric anastomosis. ICG was employed during the study period to evaluate ureteral vascularity. We divided patients into 2 groups depending on the utilization of ICG during surgery and compared demographic, clinicopathological and perioperative outcomes, including benign UES rates.</p><p><strong>Results: </strong>We identified 221 patients that underwent RARC with intracorporeal urinary diversion. Ileal conduit was performed in 173 (78.3%) patients and neobladder in 48 (21.7%) cases. A total of 142 (64.3%) and 79 (35.7%) patients were in the non-ICG and ICG group, respectively. With a median follow-up of the entire cohort of 21.1 months, there were no differences in the rate of benign UES after RARC between the non-ICG and the ICG group (p = 0.901). In the non-ICG group, 26 (18.3%) patients developed benign UES and in the ICG group 15 (19.0%) patients. Most of the strictures appeared in the left ureter in both groups (80.8% non-ICG vs. 66.7% ICG, p = 0.599). Median time to stricture diagnosis was 4 months (IQR 3-7.25) for the non-ICG and 3 months (IQR 2-5) for the ICG group (p = 0.091). The ICG group had a slightly greater length of ureter resected compared with the non-ICG group (1.5 vs. 1.3 cm, p = 0.007).</p><p><strong>Conclusion: </strong>In our experience, choosing to use ICG intraoperatively to evaluate distal ureteral vascularity may not reduce the rate of benign UES after robot-assisted radical cystectomy with intracorporeal urinary diversion and Bricker ureteroileal anastomosis.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"568"},"PeriodicalIF":2.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393756","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":"Ejaculation preserving TURP (Ep-TURP): A viable alternative in sexually active males with BOO-a single centre prospective randomized study.","authors":"Arvind Ramachandran, Karthik M Chavannavar, Gayathri Thiruvengadam, Hariharasudhan Sekar, Sriram Krishnamoorthy","doi":"10.1007/s00345-024-05276-8","DOIUrl":"10.1007/s00345-024-05276-8","url":null,"abstract":"<p><strong>Introduction: </strong>Benign prostatic hyperplasia (BPH) is a common urological condition, particularly among middle-aged and elderly men. Trans urethral resection of prostate (TURP) has some drawbacks, particularly concerning ejaculatory function. Ejaculation preserving TURP (Ep-TURP) is one such technique that aims at preserving the tissues that are primarily responsible for antegrade ejaculation.</p><p><strong>Methods and material: </strong>In this prospective study, patients with bothersome LUTS were randomized into Ep-TURP and standard TURP groups. Supramontal tissue was preserved in Ep-TURP while standard TURP group had resection of the entire prostatic tissue up to the verumontanum. The outcomes with regard to IPSS, Qmax, IIEF(Q9), Ejaculation and PVR were studied. Ejaculation projection score was separately calculated and assessed.</p><p><strong>Results: </strong>About 60 patients were studied, with 30 in each group. At 6 months' follow-up, complication rates were the same in both groups. The IPSS, Qmax, IIEF were similar and comparable. There was no change in erection in all patients (P = 0.559). The ejaculation was well preserved in Ep-TURP (p<0.001). Ejaculation projection score was maintained at 3.77 in the Ep-TURP group while in the standard group it was 0 (P<0.001).</p><p><strong>Conclusions: </strong>Ep-TURP is a safe and a cost-effective method of preserving ejaculation in patients undergoing TURP. This procedure adds a better quality of life that greatly aids in enhancing the improving his psychological outlook towards life. Ep-TURP has now emerged as the standard procedure of choice in sexually active young males needing TURP, as the degree of ejaculation is largely well preserved in patients undergoing this procedure.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"567"},"PeriodicalIF":2.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393742","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 systematic review of robot-assisted simple prostatectomy outcomes by prostate volume.","authors":"Andrey Morozov, Svetlana Bogatova, Evgeny Bezrukov, Nirmish Singla, Jeremy Yuen-Chun Teoh, Leonid Spivak, Juan Gomes Rivas, Lukas Lusuardi, Vineet Gauhar, Bhaskar Somani, David Lifshitz, Jack Baniel, Thomas R W Herrmann, Dmitry Enikeev","doi":"10.1007/s00345-024-05264-y","DOIUrl":"10.1007/s00345-024-05264-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of our study is to assess the differences in functional outcomes during the perioperative and postoperative period after RASP depending on BPH volume.</p><p><strong>Methods: </strong>We searched 2 databases: MEDLINE (PubMed) and Google Scholar using the following search query: robot* AND \"simple prostatectomy\". The search strategy and review protocol are available at Prospero (CRD42024508071).</p><p><strong>Results: </strong>We included 25 articles published between 2008 and 2023. Preoperatively, patients with prostate size < 100 cm³ had more severe symptoms while postoperatively all of them had only mild lower urinary tract symptoms (LUTS). In larger BPH, two authors reported moderate LUTS after RASP: Fuschi [1] (mean IPSS 8.09 ± 2.41) and Stolzenburg [2] (mean IPSS 8 ± 2.7). Postoperative Qmax was also noticeably higher in smaller BPH (mean value range 28.5-55.5 ml/s) compared to larger BPH (mean Qmax 18-29.6 ml/s), although in both groups it was within the normal range. Postoperative post-void residual (PVR) was normal as well except in one study by Stolzenburg et al. [2]. Blood loss was comparable between the groups. The complications rate in general was low.</p><p><strong>Conclusion: </strong>RASP is effective in terms of subjective and objective urination indicators, and a safe procedure for BPH. In the lack of data on implementation of RASP in small prostate volumes, this procedure can be seen as an upper size «limitless» treatment alternative. Currently, comparative data regarding prostate volume is lacking, and future trials with subgroups analysis related to BPH volume might help to address this issue.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"565"},"PeriodicalIF":2.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393740","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":"Challenges in diagnosis and treatment of cystinuria patients with Urolithiasis: multicenter patient centered study.","authors":"Wissam Khalid Kamal, Mohammed Abuzenada, Raed A Azhar, Musab M Alghamdi, Hassan Aljifri, Yahya Ghazwani, Aiman Al Solumany, Abdulaziz Alamri, Saeed Bin Hamri, Ahmad Bugis, Abdulaziz Almanie, Yasser A Noureldin","doi":"10.1007/s00345-024-05244-2","DOIUrl":"10.1007/s00345-024-05244-2","url":null,"abstract":"<p><strong>Introduction and aim: </strong>Cystinuria represents a rare cause of urolithiasis, accounting for 1% of all cases. However, it poses unique challenges in diagnosis and management. This study aimed to examine the challenges of managing cystine stones from the perspective of cystinuria patients.</p><p><strong>Methods: </strong>Following ethical approval, we reviewed the medical records of cystine stone patients treated at four tertiary centers from 2016 to 2021 and surveyed them on their perceptions of cystinuria. It included questions about demographic characteristics, herbal treatments, pain management, online engagement, disease outcomes, and cystinuria-related fears.</p><p><strong>Results: </strong>The study included 28 adults with cystinuria nephrolithiasis, with a mean age of 30.5 years. Of these, 78.6% had consanguineous parents, and the first stone episode occurred at a mean of 14.82 years age. Family history of Cystinuria was encountered in 82.1%. Cystinuria was diagnosed after a mean of 6.43 years from the first stone episode, and stone analysis was performed in 22/28 after a mean of 3.86 years from the first stone episode. Only 17 patients (60.8%) underwent metabolic evaluation for kidney stones. Regarding non-surgical treatments, 13 (46.5%) patients received alkalinization medication, and only 10 (35.7%) were prescribed chelating agent therapy. Additionally, 50% of patients took herbal remedies.</p><p><strong>Conclusion: </strong>The diagnosis of cystinuria is often delayed, leading to a delay in receiving medical treatment (alkalinization and chelating agents) and poor health education and counseling. Thus, referring cystinuria patients to tertiary hospitals and providing a multidisciplinary approach might decrease the morbidity of the disease and enhance their well-being.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"566"},"PeriodicalIF":2.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393741","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":"Trends of European School of Urology (ESU) training and resident education: an overview of 2 decades of EAU education programme.","authors":"Bhaskar Somani, Juan Gomez-Rivas, Tiago Ribeiro de Oliveira, Domenico Veneziano, Ton Brouwers, Claudia Herrmann, Jacobijn Sedelaar-Maaskant, James N'Dow, Joan Palou, Nan Li, Carlotta Nedbal, Chandra Shekhar Biyani, Ben Van Cleynenbreugel, Evangelos Liatsikos","doi":"10.1007/s00345-024-05274-w","DOIUrl":"https://doi.org/10.1007/s00345-024-05274-w","url":null,"abstract":"<p><strong>Background: </strong>Over the last 2 decades, various education and training programmes have been launched by the European School of Urology (ESU) on behalf of the European Association of Urology (EAU) Education Office. These include e-learning platforms, in-person meetings, courses, podcasts, webinars, sub-specialisation meetings and the European Urology Resident Education Programme (EUREP), all of which aim to achieve standardisation in urological education (SISE) and training at the highest level.</p><p><strong>Methods: </strong>Data from the last 2 decades of all ESU activities were collected by the EAU/ESU office and analyzed for attendance, geographical, gender and age trends. Demographic data on registrations and attendances at EUREP were also monitored and analysed. A descriptive analysis of participation and trends is provided.</p><p><strong>Results: </strong>A total of 4750 participants have completed ESU courses (including guideline courses, specialization courses and webinar courses). Similarly, a total of 5958 trainees attended the EUREP from 2004 to 2022 of which the male: female ratio was 3.75:1. However, the proportion of females increased 3.5-fold from 10.7% in 2004 to 37.1% in 2022(p < 0.001). There is a growing interest in the meeting, with increasing registrations over this time (353 in 2004 to 599 in 2023, p < 0.001). The mean age of participants is constantly decreasing (32.6 years in 2004 to 31.54 in 2022), with a mean yearly decrease of -0.18% (p < 0.001).</p><p><strong>Conclusion: </strong>ESU courses have had increasing interest and participation from young urologists worldwide. During EUREP, while the trainee age has decreased, there has been a surge in the proportion of female trainees. ESU is providing all modes of education and training across the world with both virtual and in-person meetings and courses, which would help in the development and preparation of urologists of the future and provide the best patient care.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"564"},"PeriodicalIF":2.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381692","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}