Asian Journal of Urology最新文献

{"title":"Factors affecting the thermal effects of lasers in lithotripsy: A literature review","authors":"Kiron Krishnaprasad,&nbsp;Ravi Teja Pathi,&nbsp;Mustafa Nazar","doi":"10.1016/j.ajur.2024.04.002","DOIUrl":"10.1016/j.ajur.2024.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>The use of lasers has been an important part of urology in the treatment of stone and prostate disease. The thermal effects of lasers in lithotripsy have been a subject of debate over the years. The objective of this review was to assess the current state of knowledge available on the thermal effects of lasers in lithotripsy, as well as explore any new areas where studies are needed.</div></div><div><h3>Methods</h3><div>In August 2022, a keyword search on Google Scholar, PubMed, and Scopus for all papers containing the phrases “thermal effects” AND “laser” AND “lithotripsy” AND “urology” was done followed by citation jumping to other studies pertaining to the topic and 35 relevant papers were included in our study. The data from relevant papers were segregated into five groups according to the factor studied and type of study, and tables were created for a comparison of data.</div></div><div><h3>Results</h3><div>Temperature above the threshold of 43 °C was reached only when the power was &gt;40 W and when there was adequate irrigation (at least 15–30 mL/min). Shorter lasing time divided by lithotripsy time or operator duty cycles less than 70% also resulted in a smaller temperature rise.</div></div><div><h3>Conclusion</h3><div>At least eight factors modify the thermal effects of lasers, and most importantly, the use of chilled irrigation at higher perfusion rates, lower power settings of &lt;40 W, and with a shorter operator duty cycle will help to prevent thermal injuries from occurring. Stones impacted in the ureter or pelvi-ureteric junction further increase the probability of thermal injuries during laser firing.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 23-32"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767845","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 impact of urolithiasis on urology services in a high-prevalence region: A multicenter study","authors":"Wissam Khalid Kamal ,&nbsp;Musab M. Alghamdi ,&nbsp;Raed A. Azhar ,&nbsp;Ahmad Bugis ,&nbsp;Mohammed Abuzenada ,&nbsp;Majed Alharthi ,&nbsp;Saeed Bin Hamri ,&nbsp;Yahya Ghazwani ,&nbsp;Yasser A. Noureldin ,&nbsp;Hassan Aljifri ,&nbsp;Abdulaziz Alamri ,&nbsp;Hatem Hamed Althubiany ,&nbsp;Mansour Alnazari ,&nbsp;Badr Alharbi ,&nbsp;Abdulrahman Al Own ,&nbsp;Mohanad Jebril Bosily ,&nbsp;Mohammed Almansour ,&nbsp;Abdullah Alfakhri ,&nbsp;Ibrahim Alowidah ,&nbsp;Ali Abdel Raheem","doi":"10.1016/j.ajur.2024.04.001","DOIUrl":"10.1016/j.ajur.2024.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effect of upper urinary tract (UUT) urolithiasis on urology services in a region with a high prevalence of the condition, and analyze the trends in endourological procedures for treating UUT urolithiasis and the cost of treatments in 11 hospitals over the last 6 years.</div></div><div><h3>Methods</h3><div>Using the hospital surgery statistics database, data were gathered from the urology departments of 11 hospitals in Saudi Arabia. The analysis focused on the trends, distribution, and annual cost of endourological procedures for UUT urolithiasis from January 2017 to December 2022.</div></div><div><h3>Results</h3><div>Out of the total surgery performed (54 711), over half (31 039, 57%) were related to UUT urolithiasis. Extracorporeal shock wave lithotripsy (ESWL) was the most performed procedure among stone-related procedures, accounting for 38% of all procedures. Double-J stent insertion, flexible ureteroscopy (URS), semi-rigid URS, percutaneous nephrolithotomy, and pyelo- and uretero-lithotomy accounted for 25%, 19%, 14%, 3.8%, and 0.35%, respectively. Notably, the number of stone-related UUT procedures in 2022 increased by 35% (from 4671 to 6283) compared to 2017. In the year 2022 compared to 2017, there was a statistically significant increase in the rate of all stone-related UUT procedures (<em>p</em>&lt;0.001), except for ESWL and pyelo- and uretero-lithotomy. The rates of ESWL procedures reduced from 21% in 2017 to 13% in 2022 (<em>p</em>&lt;0.001). Overall, the total cost of treatments has been estimated to be about 192.1 million SAR from 2017 to 2022 with an increase by 107% (47.7 million SAR in 2022 <em>vs.</em> 23.0 million SAR in 2017).</div></div><div><h3>Conclusion</h3><div>Our research findings suggest that urolithiasis poses a significant burden, accounting for over half of all urological surgery performed at the participating centers. Furthermore, there has been a 35% rise in stone-related UUT procedures over the past 6 years. Percutaneous nephrolithotomy, flexible URS, and semi-rigid URS have experienced significant increase in usage. Furthermore, in 2022 the cost of urolithiasis treatments has been more than doubled compared to 2017.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 59-65"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788065","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":"Determination of the kidney stone composition using infrared spectroscopy in Iran at a national referral center during 2019–2023","authors":"Abbas Basiri ,&nbsp;Azin Tahvildari ,&nbsp;Mohammad Naji,&nbsp;Pardis Ziaeefar,&nbsp;Amir H. Kashi","doi":"10.1016/j.ajur.2024.07.004","DOIUrl":"10.1016/j.ajur.2024.07.004","url":null,"abstract":"<div><h3>Objective</h3><div>The national lifetime prevalence of urolithiasis is estimated at 6.6% in Iran. However, reports on the composition of kidney stones have been based on imprecise methods like the chemical analysis. No prior large-scale study has reported the composition of kidney stones based on the gold-standard methods (X-ray diffraction or infrared spectroscopy) in Iran. This study aimed to provide the composition of kidney stones based on Fourier transform infrared spectroscopy.</div></div><div><h3>Methods</h3><div>This is a cross-sectional study assessing urinary stone composition from various cities in Iran at a referral center using infrared spectroscopy from February 2019 to March 2023.</div></div><div><h3>Results</h3><div>This study determined the stone composition of 1092 patients from 10 cities in Iran. Overall, the majority of stones were composed of calcium oxalate (<em>n</em>=498; 45.6%) and uric acid (UA, <em>n</em>=488; 44.7%) followed by cystine (<em>n</em>=49; 4.5%) and struvite (<em>n</em>=28; 2.6%). Stone composition in Shiraz and Isfahan was roughly similar with a higher percentage of UA stones (53.4% and 53.6%, respectively) while the capital city of Iran (Tehran) had less frequent UA stones (39.9%) with a higher percentage of calcium oxalate stones. The percentage of UA stones increased with age as it was 11.1% in children, 42.7% in adults, and 83.3% in geriatric patients (<em>p</em>&lt;0.001). About 29.6% of cystine stones were observed in children.</div></div><div><h3>Conclusion</h3><div>The most frequent stone composition among kidney stones in Iran was calcium oxalate and UA stones. This relative frequency of UA stones is considerably higher than many international reports from neighboring as well as distant countries. More cystine stones were observed in children and women. Geriatric patients’ stones were mostly composed of UA.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 72-78"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145905","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 diagnostic performance of indocyanine green for the sentinel node biopsy in prostate cancer: A systematic review and meta-analysis","authors":"Siyang Ma ,&nbsp;Jianxuan Sun ,&nbsp;Jinzhou Xu,&nbsp;Ye An,&nbsp;Mengyao Xu,&nbsp;Chenqian Liu,&nbsp;Sihan Zhang,&nbsp;Lintao Miao,&nbsp;Xingyu Zhong,&nbsp;Na Zeng,&nbsp;Haodong He,&nbsp;Shaogang Wang,&nbsp;Qidong Xia","doi":"10.1016/j.ajur.2024.07.001","DOIUrl":"10.1016/j.ajur.2024.07.001","url":null,"abstract":"<div><h3>Objective</h3><div>Almost 15% of prostate cancer (PCa) patients were found to have lymph node metastases (LNMs), which are associated with higher risk of biochemical recurrence. Using indocyanine green (ICG) for the sentinel node biopsy (SNB) before surgery was proposed to detect LNMs in PCa patients. However, its diagnostic performance still remains controversial. This study aimed to investigate the diagnostic performance of ICG for the SNB in PCa.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis has been reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The protocol has been registered in the International Prospective Register of Systematic Reviews database, and the register number is CRD42023421911. Four bibliographic databases were searched, <em>i.e.</em>, PubMed, EMBASE, Cochrane Library, and Web of Science, to retrieve articles studying the diagnostic performance of ICG for the SNB in PCa from the inception to Sep 9, 2023. We calculated the pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratios and their 95% confidence intervals (CIs). Subgroup analyses and meta-regression analyses were also conducted.</div></div><div><h3>Results</h3><div>A total of 17 articles from databases are enrolled in this study. Using lymph node-based data, our results showed that the pooled sensitivity and specificity of applying ICG alone in PCa were 71% (95% CI 52%–85%) and 68% (95% CI 64%–72%), respectively. The pooled sensitivity and specificity of applying ICG-technetium-99m-nanocolloid in PCa were 49% (95% CI 39%–59%) and 69% (95% CI 67%–71%), respectively.</div></div><div><h3>Conclusion</h3><div>The efficacy of using ICG or ICG-technetium-99m-nanocolloid for the SNB in PCa is relatively unsatisfactory. ICG cannot yet substitute extended pelvic lymph node dissection for detecting LNMs accurately. More research or novel tracers are needed to achieve the goal of precise surgery.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 1-14"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849878","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":"An open-label, randomized, post-authorization study of mirabegron in Chinese participants with overactive bladder","authors":"Zhipeng Zhang ,&nbsp;Deyi Luo ,&nbsp;Zhong Chen ,&nbsp;Peng Zhang ,&nbsp;Ganping Zhong ,&nbsp;Keji Xie ,&nbsp;Zhuoqun Xu ,&nbsp;Xudong Li ,&nbsp;Jianye Wang ,&nbsp;Yingfan Yang ,&nbsp;Farid Abdul Hadi ,&nbsp;Arianne Schild","doi":"10.1016/j.ajur.2024.04.007","DOIUrl":"10.1016/j.ajur.2024.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>To assess efficacy and safety of mirabegron 25 mg/day and 50 mg/day for overactive bladder in Chinese participants.</div></div><div><h3>Methods</h3><div>Participants of ≥18 years with overactive bladder symptoms lasting for ≥12 weeks, a mean of ≥8 micturitions per 24 h, and a mean of at least one episode of Grade 3 or 4 urgency or urge incontinence per 24 h based on the Patient Perception of Intensity of Urgency Scale over a 3-day micturition diary period were randomized 2:1 to open-label treatment with oral mirabegron 50 mg or 25 mg once daily for 12 weeks (15 sites in China, January 2021–March 2022). A dose escalation from 25 mg/day to 50 mg/day was permitted at weeks 4 and 8 according to the investigators' discretion. The primary efficacy endpoint was the change from baseline to Week 12 in the mean number of micturitions per 24 h in those randomized to mirabegron 50 mg/day. Secondary efficacy endpoints were the change in mean number of micturitions at weeks 4 and 8 in the mirabegron 50 mg/day group and weeks 4, 8, and 12 in the mirabegron 25 mg/day group, change from baseline to weeks 4, 8, and 12 in Grade 3 or 4 urgency episodes on the Patient Perception of Intensity of Urgency Scale, episodes of daytime incontinence, nighttime incontinence, and urgency incontinence, and Overactive Bladder Symptom Score for mirabegron 50 mg/day and 25 mg/day groups.</div></div><div><h3>Results</h3><div>Statistically significant reduction (<em>p</em>&lt;0.001) from baseline to Week 12 was observed in mean micturitions per 24 h for participants randomized to mirabegron 50 mg/day: mean±standard error: 11.71±0.43 at baseline, 7.80±0.24 at Week 12; adjusted mean change: −3.73 (95% confidence interval −4.30 to −3.16). Both doses showed statistically significant improvement in secondary efficacy endpoints at weeks 4, 8, and 12 versus baseline. Safety was consistent with mirabegron's known safety profile.</div></div><div><h3>Conclusion</h3><div>The results support a mirabegron dosage of 50 mg/day for the treatment of OAB in China.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 79-86"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852305","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 prognostic value of the 8th American Joint Committee on cancer anatomic and prognostic stage groups for penile cancer: A multicenter collaboration study","authors":"Xueying Li ,&nbsp;Yepeng Guo ,&nbsp;Antonio Augusto Ornellas ,&nbsp;Jiun-Hung Geng ,&nbsp;Yonghong Li ,&nbsp;Wayne Lam ,&nbsp;Yabing Cao ,&nbsp;Zhuowei Liu ,&nbsp;Hui Han ,&nbsp;Fangjian Zhou ,&nbsp;Zaishang Li","doi":"10.1016/j.ajur.2024.10.001","DOIUrl":"10.1016/j.ajur.2024.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to investigate the value of the 8th American Joint Committee on Cancer (AJCC) anatomic and prognostic stage groups for penile cancer patients and explore whether there is room for improvement.</div></div><div><h3>Methods</h3><div>The clinical and histopathologic data from 16 centers between January 2000 and December 2021 were assessed according to the 8th AJCC anatomic and prognostic stage groups. Kaplan–Meier plots were used to estimate the disease-specific survival (DSS) of the patients. The accuracy of the staging systems was investigated using the Harrell's concordance index (C-index).</div></div><div><h3>Results</h3><div>According to the 8th AJCC anatomic and prognostic stage groups, the 5-year DSS rates for patients with stages 0is/a, I, IIA, IIB, IIIA, IIIB, and IV disease were 100%, 99%, 86%, 81%, 66%, 34%, and 23%, respectively (<em>p</em>_0is/a–I=0.8, <em>p</em>_I–IIA&lt;0.001, <em>p</em>_IIA–IIB=0.5, <em>p</em>_IIB–IIIA&lt;0.001, <em>p</em>_IIIA–IIIB&lt;0.001, <em>p</em>_IIIB–IV=0.004, and <em>p</em>_Total&lt;0.001). According to the modified model 1 system, the 5-year DSS rates without survivorship overlap for patients with stages 0is/a, I, II, IIIA, IIIB, and IV disease were 100%, 99%, 88%, 66%, 34%, and 23%, respectively (<em>p</em>_0is/a–I=0.8, <em>p</em>_I–II&lt;0.001, <em>p</em>_II–IIIA=0.002, <em>p</em>_IIIA–IIIB&lt;0.001, <em>p</em>_IIIB–IV=0.004, and <em>p</em>_Total&lt;0.001). Similarly, according to the modified model 2 system, the 5-year DSS rates without survivorship overlap for patients with stages 0is/a, I, II, IIIA, IIIB, and IV disease were 100%, 99%, 86%, 66%, 34%, and 23%, respectively (<em>p</em>_0is/a–I=0.8, <em>p</em>_I–II&lt;0.001, <em>p</em>_II–IIIA=0.008, <em>p</em>_IIIA–IIIB&lt;0.001, <em>p</em>_IIIB–IV=0.004, and <em>p</em>_Total&lt;0.001). The C-index scores of the simple modified staging systems were not inferior to those of the AJCC anatomic and prognostic stage groups. These results were confirmed by the bootstrap internal validation.</div></div><div><h3>Conclusion</h3><div>There is still room for improvement about the 8th AJCC anatomic and prognostic stage groups. The improved models, which are more concise and convenient, have similar prediction accuracy.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 100-105"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145944","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":"An unusual case of blood dripping following robotic-assisted laparoscopic varicocelectomy","authors":"Ciro Esposito,&nbsp;Claudia Di Mento,&nbsp;Annalisa Chiodi,&nbsp;Giovanni Esposito,&nbsp;Luisa Florio,&nbsp;Maria Escolino","doi":"10.1016/j.ajur.2024.06.004","DOIUrl":"10.1016/j.ajur.2024.06.004","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 127-128"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145945","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":"Indocyanine green-guided robotic-assisted partial cystectomy","authors":"Zhipeng Yao,&nbsp;Heng Li,&nbsp;Shen Wang,&nbsp;Fan Li,&nbsp;Jia Hu,&nbsp;Zheng Liu","doi":"10.1016/j.ajur.2024.01.005","DOIUrl":"10.1016/j.ajur.2024.01.005","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 129-130"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636633","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":"Worldwide variations in the knowledge and use of fluoroscopy during percutaneous nephrolithotomy—should we do better? A survey by the European Association of Urology Section for Uro-Technology and the International Alliance of Urolithiasis","authors":"Otaš Durutovic ,&nbsp;Guohua Zeng ,&nbsp;Bhaskar Somani ,&nbsp;Simon Choong ,&nbsp;Giorgio Mazzon ,&nbsp;Di Gu ,&nbsp;Zeeshan Hameed ,&nbsp;TP Rajeev ,&nbsp;Bogomir Milojevic ,&nbsp;Davide Brusa ,&nbsp;Tiago Ribeiro Oliveira ,&nbsp;Sergio Pereira ,&nbsp;Nariman Gadzhiev ,&nbsp;Ali Serdar Gozen ,&nbsp;Evangelos Liatsikos ,&nbsp;Panagiotis Kallidonis ,&nbsp;Uros Bumbasirevic ,&nbsp;Andreas Skolarikos","doi":"10.1016/j.ajur.2024.02.004","DOIUrl":"10.1016/j.ajur.2024.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the level of knowledge among urologists of usage of fluoroscopy during percutaneous nephrolithotomy.</div></div><div><h3>Methods</h3><div>We conducted an anonymous internet-based survey addressed to the EAU Section of Uro-Technology and the International Alliance of Urolithiasis members with particular interest in the stone treatment at all levels of expertise. The final version of the questionnaire included 31 questions, evaluated the level of knowledge on X-ray utilization and exposure, and identified correlations between geographic areas, levels of seniority, surgical volumes, and awareness on radiation protection.</div></div><div><h3>Results</h3><div>In total, 586 respondents were included. Knowledge of fluoroscopy settings appeared low, particularly among trainees (up to 87.5% were uninformed, <em>p</em>=0.008). Precautions to reduce exposure appeared poorly followed as up to 25.4% of respondents used regularly continuous fluoroscopy, and up to 20.5% used regularly high-frequency setting and this trend was more obvious among senior specialists (6.2% of trainees used high-frequency settings <em>vs.</em> 21.3% of consultants, <em>p</em>&lt;0.05). Additionally, only 24.9% of respondents would provide X-ray protection to patients too.</div></div><div><h3>Conclusion</h3><div>Although high and routinary utilization of X-rays, the level of awareness and adhesion to “as low as reasonably achievable” principles among endourologists seems suboptimal in 65.0% of all respondents. Highest volume surgeons, inevitably at higher risk, do not seem to adopt more precautions. More efforts should be addressed to improve these results, reducing the risk related to excessive radiation exposure for both surgical staff and patients in order to minimize health related issues.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 51-58"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468859","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":"Ketamine-associated upper urinary tract dysfunction: What we know from current literature","authors":"Zhihuan Zheng ,&nbsp;Zhongyi Li ,&nbsp;Jiazhe Yuan ,&nbsp;Feng Han ,&nbsp;Li Huang ,&nbsp;Zhao Wang","doi":"10.1016/j.ajur.2024.05.004","DOIUrl":"10.1016/j.ajur.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>To review the current literature on ketamine-associated upper urinary tract (UUT) dysfunction and provide an overview of its pathogenesis and treatment principles.</div></div><div><h3>Methods</h3><div>A literature search was conducted using PubMed and Cochrane databases for relevant articles published in English between 2008 and 2023. Keywords used included “ketamine” and “upper urinary tract”.</div></div><div><h3>Results</h3><div>A total of 22 papers were included. Relatively few studies have focused on ketamine-associated UUT dysfunction. Exclusion criteria included lack of hydronephrosis, or pathological findings. After careful screening and exclusion, we finally adopted 11 of these papers and analyzed them. Ketamine-associated UUT dysfunction may be a concern in this field.</div></div><div><h3>Conclusion</h3><div>Ketamine abuse can lead to UUT impairment and dysfunction, with symptoms such as bladder dysfunction and contracted bladder with vesicoureteral reflux, direct damage and barrier dysfunction, inflammation, apoptosis, fibrosis and stricture, and papillary necrosis. Oxidative stress, autophagy, and microvascular injury are also potential pathogenic mechanisms. The detection of these symptoms largely depends on laboratory and imaging examinations. The treatment principles of ketamine-associated UUT dysfunction are protecting the UUT, improving bladder dysfunction, and resuming normal social life. More investigations are needed to clarify the mechanisms and shed light on the treatment of ketamine-associated UUT damage.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 1","pages":"Pages 33-42"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145356","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}