Asian Journal of Urology最新文献

{"title":"Central role of imaging in a case with renal aggressive angiomyxoma","authors":"Mohsen Ayati, Mohsen Shiraghaee, Mohammad Reza Nowroozi, Erfan Amini, Nasser Rakhshani, Laleh Sharifi","doi":"10.1016/j.ajur.2025.03.009","DOIUrl":"10.1016/j.ajur.2025.03.009","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 374-375"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a retrograde resection technique in robot-assisted laparoscopic nephron-sparing surgery for large complex renal tumors","authors":"Jinhuan Wei, Junjie Cen, Xu Chen, Jun Lu, Wei Chen, Junhang Luo","doi":"10.1016/j.ajur.2025.08.004","DOIUrl":"10.1016/j.ajur.2025.08.004","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 371-373"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient versus inpatient flexible ureteroscopy with flexible and navigable suction access sheath: A multicenter comparative analysis of perioperative outcomes from the flexible and navigable access sheath collaborative study group","authors":"Carlo Giulioni,&nbsp;Daniele Castellani,&nbsp;Federico Falsetti,&nbsp;Arman Tsaturyan,&nbsp;Nariman Gadzhiev,&nbsp;Marek Zawadzki,&nbsp;Kremena Petkova,&nbsp;Kemal Sarica,&nbsp;Steffi Kar Kei Yuen,&nbsp;Anil Shrestha,&nbsp;Pablo Contreras,&nbsp;Sundaram Palaniappan,&nbsp;Tsung Wen Chong,&nbsp;Angelo Cafarelli,&nbsp;Wei Zhu,&nbsp;Guohua Zeng,&nbsp;Yi Quan Tan,&nbsp;Jia-Lun Kwok,&nbsp;Amelia Pietropaolo,&nbsp;Thomas Herrmann,&nbsp;Vineet Gauhar","doi":"10.1016/j.ajur.2025.06.004","DOIUrl":"10.1016/j.ajur.2025.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical effectiveness and safety of outpatient versus inpatient flexible ureterorenoscopy (FURS) using the flexible and navigable suction access sheath (FANS).</div></div><div><h3>Methods</h3><div>Conducted across 25 global centers between July 2023 and March 2024, this study included patients undergoing retrograde intrarenal surgery stratified by surgical setting. All patients were counseled for FURS with FANS as an outpatient procedure unless otherwise planned earlier. The primary outcome was stone-free rate defined as zero residual fragments or a single fragment of ≤2 mm on a 30-day non-contrast CT scan. The secondary outcome was complication rates. Outpatient status applied to any patient observed for less than 24 h postoperatively. No fixed criteria were assigned for outpatient care.</div></div><div><h3>Results</h3><div>Seven hundred and four patients were included, with 356 undergoing outpatient surgery and 348 receiving inpatient care. Operative, lasing, and ureteroscope times were significantly shorter in the outpatient group (<em>p</em>&lt;0.001 in all three), despite the larger stone burden in the outpatient group. A significantly higher number of patients had intraoperative residual fragments in the inpatient group. The outpatient group achieved a significantly higher 100% stone-free rate (67% <em>vs.</em> 53%, <em>p</em>&lt;0.001). A significantly greater proportion of the outpatient cohort underwent placement of an overnight ureteral catheter (<em>p</em>&lt;0.001), which was subsequently removed at discharge, whereas the majority of the inpatient group received a double-J stent (<em>p</em>&lt;0.001). Reintervention and intraoperative complication rates were comparable between groups. Postoperative complications were fewer in outpatient patients: fever (0.84% <em>vs.</em> 3.2%, <em>p</em>=0.02). The multivariate analysis identified postoperative double-J stent positioning as the factor associated with lower odds of having postoperative fever requiring antibiotics (odds ratio 0.282, 95% confidence interval 0.109–0.729, <em>p</em>=0.009).</div></div><div><h3>Conclusion</h3><div>Outpatient FURS with FANS demonstrates excellent outcomes, with a low rate of minor complications. These findings support the broader adoption of outpatient RIRS in patients with kidney stones and normal renal anatomy, provided that patient selection and intraoperative planning are appropriately optimized.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 295-304"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery of urinary continence after neoadjuvant hormonal therapy plus radical prostatectomy: A multicenter retro-prospective cohort study with propensity score matching","authors":"Zhongqing Zhang,&nbsp;Jiaxi Mi,&nbsp;Tong Lu,&nbsp;Yuwen Wang,&nbsp;Yu Chen,&nbsp;Shujun Liu,&nbsp;Jiajun Qian,&nbsp;Shun Zhang,&nbsp;Xuefeng Qiu,&nbsp;Yao Fu,&nbsp;Linfeng Xu,&nbsp;Shaohao Chen,&nbsp;Jianhao Wu,&nbsp;Yun Jin,&nbsp;Hongqian Guo,&nbsp;Weidong Gan,&nbsp;Junlong Zhuang","doi":"10.1016/j.ajur.2025.10.004","DOIUrl":"10.1016/j.ajur.2025.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the impact of neoadjuvant hormonal therapy (NHT) combined with robotic-assisted radical prostatectomy (RARP) on postoperative urinary continence (UC) recovery compared with RARP alone in patients with localized prostate cancer.</div></div><div><h3>Methods</h3><div>A multicenter retro-prospective cohort study was conducted involving 2453 patients treated between November 2018 and November 2023 at four tertiary hospitals in China. After applying exclusion criteria, 1927 patients who completed 1-year follow-up were included (760 NHT plus RARP and 1167 RARP alone). Propensity score matching (1:1) was performed based on age, prostate volume, body mass index, preoperative prostate-specific antigen level, surgical approach, and pT stage, resulting in 249 matched pairs. UC was defined as using no pad or one safety pad per day and assessed via standardized questionnaires during follow-up visits.</div></div><div><h3>Results</h3><div>The NHT group demonstrated significantly better UC recovery compared with the control group (<em>p</em>&lt;0.001). The median time to UC recovery was 8 (interquartile range: 3–24) weeks for the NHT group and 16 (interquartile range: 4–34) weeks for the control group. Short-term continence rates (range: 2–12 weeks) were significantly higher in the NHT group (42% <em>vs.</em> 24%, <em>p</em>&lt;0.001). Multivariate Cox regression analysis identified NHT (hazard ratio 1.273, 95% confidence interval 1.063–1.525, <em>p</em>=0.009) and age (hazard ratio 0.968, 95% confidence interval 0.955–0.980, <em>p</em>&lt;0.001) as independent predictors of UC recovery.</div></div><div><h3>Conclusion</h3><div>Preoperative NHT was associated with significantly improved postoperative UC recovery after RARP, including faster recovery time and higher short-term continence rates. These findings suggest that NHT may provide functional benefits beyond its established oncological effects in prostate cancer treatment.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 343-353"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From molecules to the clinic—pathophysiology of sodium-glucose cotransporter 2 inhibitors and their emerging role in urology: A comprehensive review from the European Association of Urology Section of Endourology","authors":"Ali Talyshinskii,&nbsp;Vineet Gauhar,&nbsp;Steffi Kar Kei Yuen,&nbsp;Selcuk Güven,&nbsp;Theodoros Tokas,&nbsp;Arman Tsaturyan,&nbsp;Dmitry Enikeev,&nbsp;Bhaskar Somani","doi":"10.1016/j.ajur.2025.11.004","DOIUrl":"10.1016/j.ajur.2025.11.004","url":null,"abstract":"<div><h3>Objective</h3><div>This review aims to comprehensively evaluate the mechanisms of action of sodium-glucose cotransporter 2 inhibitors (SGLT2is), with a specific focus on their relevance to urological practice, including both potential benefits and risks.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in February 2025 using PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar. Studies addressing the pharmacodynamics of flozins, their systemic effects, and genitourinary outcomes were included. Data were organized into mechanistic themes: tubular glucose and sodium transport, organ protection, antioxidative signaling, and potential anticancer activity. Urological effects were analyzed separately for non-oncological and oncological domains, and adverse outcomes were summarized.</div></div><div><h3>Results</h3><div>SGLT2is exert beneficial effects beyond glycemic control, including reduced intraglomerular pressure, improved endothelial function, antioxidative and anti-inflammatory activities, and modulation of cellular metabolism and proliferation. These effects translate to potential benefits in erectile dysfunction, nephrolithiasis, benign prostatic hyperplasia, and possibly genitourinary malignancies. However, flozins are associated with risks including genital mycotic infections, euglycemic ketoacidosis, and, in rare cases, severe urinary tract infections. Conflicting data exist regarding the actual risk of UTIs, with recent evidence suggesting a lower or neutral risk when used appropriately.</div></div><div><h3>Conclusion</h3><div>Flozins represent a promising therapeutic class with multifaceted benefits that extend into the field of urology. However, individualized risk assessment remains essential, and further urology-focused clinical research is needed to clarify their full utility and safety in this domain.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 251-260"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor heterogeneity in metastatic prostate cancer: Limitations on the efficacy of prostate-specific membrane antigen radioligand therapy","authors":"Giordano Savelli,&nbsp;Marco Galelli,&nbsp;Claudio Bnà,&nbsp;Alberto Zaniboni","doi":"10.1016/j.ajur.2025.04.006","DOIUrl":"10.1016/j.ajur.2025.04.006","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 376-378"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Between a stone and a hard place—Mortality from conservative management of kidney stone disease: Systematic review of the literature from the European Association of Urology Section of Endourology","authors":"Sohani N. Dassanayake,&nbsp;Nicholas L. Harrison,&nbsp;Robert Geraghty,&nbsp;Patrick Juliebø-Jones,&nbsp;Lazaros Tzelves,&nbsp;Niall F. Davis,&nbsp;Begoña Ballesta Martínez,&nbsp;Bhaskar K. Somani","doi":"10.1016/j.ajur.2026.01.002","DOIUrl":"10.1016/j.ajur.2026.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to provide information on the factors associated with mortality in conservative management of kidney stone disease (KSD). Secondary aims were to identify important risk factors and highlight key learning points to reduce mortality from conservatively managed KSD.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted in Embase, MEDLINE, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature, in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, from the inception of the databases to 1 March 2025 (PROSPERO registration number: CRD420251013472). The Population, Intervention, Comparison, Outcome framework was used to define eligibility criteria, with the population comprising patients with KSD managed without procedural intervention, with mortality as the outcome. English-language articles involving adult or paediatric patients were included. Data extracted included demographics, comorbidities, stone characteristics, reasons for conservative management, complications, causes of death, and authors’ learning points.</div></div><div><h3>Results</h3><div>A total of 1301 articles were identified. After screening, 12 articles were eligible for analysis, which reported on 313 562 patients from 1955 to 2023. In 11 studies, a total of 119 deaths were recorded following conservative management, and an additional study of 147 600 conservatively managed cases reported a mortality rate of 1.7%. There were 38 deaths with reported causes, with renal failure being the most common, followed by sepsis and cardiac events. Key recommendations from the studies included prompt renal decompression in infected cases (as those without decompression had more than twice the mortality risk), surgical intervention for staghorn calculi, active stone removal in high-risk patients after thorough assessment, and prophylactic antibiotic use to reduce infection-related mortality.</div></div><div><h3>Conclusion</h3><div>Renal failure appears to be a significant contributor to mortality in patients with conservatively managed KSD. Decisions regarding conservative management should be guided by the presence of infection, stone type, and the degree of renal impairment at presentation, as some cases may require timely renal decompression.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 273-284"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rock-on or crumble: Do kidney stones pass the test of time? A European Association of Urology Section of Endourology study","authors":"Michaël M.E.L. Henderickx,&nbsp;Simone J.M. Stoots,&nbsp;Richard M. van den Elzen,&nbsp;Michel Daudon,&nbsp;Maurits C.F.J. de Rotte,&nbsp;Harrie P. Beerlage,&nbsp;Daniel Martijn de Bruin,&nbsp;Wendy P.J. den Elzen,&nbsp;Guido M. Kamphuis","doi":"10.1016/j.ajur.2025.07.004","DOIUrl":"10.1016/j.ajur.2025.07.004","url":null,"abstract":"<div><h3>Objective</h3><div>Kidney stone disease is a relapsing disease and preventive measures are therefore of great importance. A cornerstone for adequate treatment and prevention of kidney stone recurrence is stone analysis. This pilot study aimed to evaluate whether time and different <em>ex vivo</em> environments, such as liquid media or light exposure, influence the morpho-constitutional aspects of kidney stones and whether these changes influence the outcome of X-ray diffraction (XRD) or morphoconstitutional assessment (MCA) for stone analysis.</div></div><div><h3>Methods</h3><div>Ninety-two stone fragments from 23 kidney stone patients were allocated to four groups (Group A, direct stone analysis; Group B, dry non-transparent environment; Group C, dry transparent environment; Group D, wet non-transparent environment). Fragments from Groups B, C, and D were photographed on postoperative day (POD) 0 and POD 84 and sent for stone analysis afterwards. The objective change in appearance was assessed through the mean Euclidean distance in the Commission Internationale de l'Éclairage <em>L</em>^∗<em>a</em>^∗<em>b</em>^∗ (CIELAB) color space. The agreement of XRD and MCA between POD 0 and POD 84 was evaluated. Spearman's rank correlation coefficient was calculated to assess the correlation between the objective changes in appearance and the diagnostic accuracy for XRD and MCA.</div></div><div><h3>Results</h3><div>Overall, the mean Euclidean distance was 5.52 between POD 0 and POD 84. XRD had an agreement between POD 0 and POD 84 of 98%. MCA had an agreement of 92%. The objective changes in appearance between POD 0 and POD 84 did not correlate with the diagnostic accuracy of XRD or MCA.</div></div><div><h3>Conclusion</h3><div>The appearance of kidney stones alters over time and in different <em>ex vivo</em> environments but does not change the diagnostic accuracy of XRD or MCA.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 305-312"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should we choose suction mini-percutaneous nephrolithotomy or flexible ureteroscopy with flexible and navigable suction ureteral access sheath in patients aged 65 years and older? An International Alliance of Urolithiasis and European Association of Urology Section of Endourology collaboration","authors":"Chu Ann Chai,&nbsp;Steffi Kar Kei Yuen,&nbsp;Bhaskar Kumar Somani,&nbsp;Guohua Zeng,&nbsp;Wei Zhu,&nbsp;Deepak Ragoori,&nbsp;Khi Yung Fong,&nbsp;Vigen Malkhasyan,&nbsp;Nariman Gadzhiev,&nbsp;Arman Tsaturyan,&nbsp;Jia-Lun Kwok,&nbsp;Mohamed Elshazly,&nbsp;Tzevat Tefik,&nbsp;Luis Rico,&nbsp;Kremena Petkova,&nbsp;Yadgar Abduljabbar Shwani,&nbsp;Mahmoud Laymon,&nbsp;Mohamed Amine Lakmichi,&nbsp;Jaisukh Kalathia,&nbsp;Takaaki Inoue,&nbsp;Vineet Gauhar","doi":"10.1016/j.ajur.2025.10.003","DOIUrl":"10.1016/j.ajur.2025.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to conduct a multicenter, prospective cohort study comparing the outcomes of suction mini-percutaneous nephrolithotomy (SM-PCNL) and flexible ureteroscopy (FURS) with a flexible and navigable suction ureteral access sheath (FANS) in patients aged ≥65 years.</div></div><div><h3>Methods</h3><div>A total of 340 patients were enrolled from global registries, of whom 130 underwent FURS with a FANS and 210 underwent SM-PCNL. Baseline, operative, and perioperative data were collected, and patients were followed for 30 days. The primary outcome was the stone-free rate (SFR) assessed by non-contrast CT at 30 days, with secondary outcomes including complications and reinterventions. Predictors of complete stone clearance were evaluated using multivariable logistic regression.</div></div><div><h3>Results</h3><div>Both techniques demonstrated high overall SFRs at 30 days (94% for the SM-PCNL group <em>vs</em>. 98% for FURS with a FANS), with SM-PCNL achieving superior complete SFR (80% <em>vs</em>. 55%, <em>p</em>&lt;0.001). However, FURS with a FANS was associated with a lower median postoperative pain score, a shorter median postoperative hospital stay, and no bleeding-related complications. Multivariable analysis identified SM-PCNL as a positive independent predictor of complete stone clearance. No sepsis occurred in either group, reinforcing the safety of suction-enhanced approaches.</div></div><div><h3>Conclusion</h3><div>These real-world data suggest both methods are effective in elderly stone formers, with FURS combined with a FANS favored for lower morbidity rates and SM-PCNL shown to have higher efficacy for complex stones. Treatment should be individualized based on stone complexity, patient factors, and surgeon expertise.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 323-331"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of virtual reality in enhancing informed consent for shockwave lithotripsy: A mixed-methods study of physician and patient perspectives","authors":"Bhaskar K. Somani,&nbsp;Phoebe C.J. Reynolds","doi":"10.1016/j.ajur.2025.11.003","DOIUrl":"10.1016/j.ajur.2025.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>The integration of immersive technologies such as virtual reality (VR) in healthcare is gaining momentum, particularly in patient education and the informed consent process. Traditional patient information leaflets often fail to meet the needs of diverse populations due to literacy barriers and a lack of visual engagement. This study aimed to evaluate the impact of a VR platform (Surgassists®) on patient understanding, anxiety, and satisfaction during the consent process for shockwave lithotripsy (SWL), alongside surgeon perspectives on VR's feasibility and utility.</div></div><div><h3>Methods</h3><div>A mixed-methods, cross-sectional study was conducted between August 2024 and July 2025. One hundred patients undergoing SWL at the University Hospital Southampton NHS Foundation Trust were recruited to evaluate VR-enhanced consent using pre- and post-intervention questionnaires, including understanding, visual analogue scale pain scores, and the State-Trait Anxiety Inventory scores. Simultaneously, a structured electronic survey was distributed to 50 urologists across Europe, assessing familiarity, current use, and perceptions regarding VR in surgical consent.</div></div><div><h3>Results</h3><div>Patients demonstrated significantly improved understanding (mean score increased from 2.60 to 3.72, <em>p</em>&lt;0.001), reduced anxiety (<em>p</em>=0.004), and high overall satisfaction, with 81% expressing strong approval of VR for future use. Among surgeons, 94% expressed willingness to use VR, with 86% viewing it as a positive advancement in surgical communication. While most were unconcerned about medicolegal issues, concerns about cost, consultation time, and workflow integration were noted.</div></div><div><h3>Conclusion</h3><div>VR significantly enhances patient education and emotional preparedness for SWL, with strong surgeon support for future adoption. Addressing logistical and cost-related concerns will be key to broader clinical integration. VR holds considerable promise in modernising and standardising the consent process across surgical specialties.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"13 3","pages":"Pages 332-338"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}