Asian Journal of Urology最新文献

{"title":"A novel single-port robotic system in urology: A prospective multicenter single-arm clinical trial evaluating feasibility and efficacy of first 50 cases","authors":"Zheng Wang ,&nbsp;Chao Zhang ,&nbsp;Taile Jing ,&nbsp;Yong Wei ,&nbsp;Chengwu Xiao ,&nbsp;Yang Wang ,&nbsp;Yu Fang ,&nbsp;Xiaofeng Wu ,&nbsp;Shouyan Tang ,&nbsp;Hong Xu ,&nbsp;Yi Liu ,&nbsp;Bo Yang ,&nbsp;Shuo Wang ,&nbsp;Bin Xu ,&nbsp;Qingyi Zhu ,&nbsp;Dan Xia ,&nbsp;Zhenjie Wu ,&nbsp;Xiaofeng Gao ,&nbsp;Linhui Wang","doi":"10.1016/j.ajur.2024.07.002","DOIUrl":"10.1016/j.ajur.2024.07.002","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.</div></div><div><h3>Methods</h3><div>In this prospective, multicenter clinical trial, we examined the effectiveness of the SHURUI single-port robotic surgical system in urological interventions. The first 50 patients from four centers in China underwent single-port surgeries including partial nephrectomy, radical prostatectomy, partial adrenalectomy, and pyeloureteroplasty, exclusively by the SHURUI single-port robotic surgical system. The study's primary endpoints focused on the success of surgeries, defined as no deviations from planned procedures, no need for more than one port, and no re-operations within 24 h after surgery. Secondary endpoints encompassed a range of surgical metrics, functional outcomes, and patient demographic data. Clinical assessments were conducted before surgery, before discharge, and 1 month after discharge.</div></div><div><h3>Results</h3><div>The surgical procedures were executed successfully without requiring intraoperative conversions or transfusions. Both estimated blood loss and operation durations were maintained within satisfactory limits. For each type of surgery, the mean console times and estimated blood loss were 179.8 (standard deviation [SD] 39.4) min and 125.6 (SD 126.0) mL for radical prostatectomy, 126.7 (SD 47.8) min and 39.2 (SD 54.4) mL for partial nephrectomy, 112.6 (SD 37.4) min and 20.0 (SD 13.2) mL for partial adrenalectomy, and 148.0 (SD 18.2) min and 18.0 (SD 17.9) mL for pyeloureteroplasty, respectively. Across the cohort, 17 patients experienced a total of 25 adverse events, while 10 postoperative complications, all rated as Clavien-Dindo grade I, were encountered by eight patients. All patients had shown recovery or improvement from these events before the end of this trial.</div></div><div><h3>Conclusion</h3><div>The SHURUI single-port robotic surgical system demonstrated feasibility and safety in the performance of major urological surgeries. These initial findings highlight the system's potential, though further research and longer follow-up are required to assess long-term outcomes.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 152-161"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical applications of artificial intelligence in robotic urologic surgery","authors":"Shady Saikali,&nbsp;Runzhuo Ma,&nbsp;Vipul Patel,&nbsp;Andrew Hung","doi":"10.1016/j.ajur.2024.06.005","DOIUrl":"10.1016/j.ajur.2024.06.005","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 139-142"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing efficacy and safety of monotherapy and combination therapy with tadalafil, tamsulosin, and silodosin for distal ureteral stones: A systematic review and meta-analysis","authors":"Sholeh Ebrahimpour ,&nbsp;Mona Kargar ,&nbsp;Mohadeseh Balvardi ,&nbsp;Ozra Tabatabaei-Malazy ,&nbsp;Pardis Asadi ,&nbsp;Mehdi Mohammadi","doi":"10.1016/j.ajur.2024.05.003","DOIUrl":"10.1016/j.ajur.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>Medical expulsive therapy (MET) is a suitable option for facilitating stone expulsion in patients with distal ureteral stones. This meta-analysis was conducted to compare efficacy and safety of monotherapy and combination therapy with tamsulosin, silodosin, and tadalafil on stone expulsion rate (SER) and stone expulsion time (SET), as well as their comparative safety, numbers of colic pain episodes, and need for analgesics.</div></div><div><h3>Methods</h3><div>Randomized controlled trials were retrieved by searching PubMed, Scopus, and Web of Science up to November 27, 2023. Hand-searching was also conducted in Google Scholar to find additional records. Papers in English that compared the safety and efficacy of at least two of the above agents in adults with distal ureteral stones ≤10 mm were included.</div></div><div><h3>Results</h3><div>In total, 27 studies were identified (six studies through database searches and 21 through checking reference lists and hand-searching in Google Scholar). More than half of them (<em>n</em>=15, 56%) were conducted in India. The SER significantly improved with silodosin compared with tamsulosin (odds ratio [OR] 2.24, <em>p</em>&lt;0.001), whereas the difference in SET was non-significant. Tadalafil achieved a significantly higher SER compared with tamsulosin (OR 1.42, <em>p</em>=0.042) without any difference in SET. Subgroup analysis of 5- and 10-mg doses of tadalafil showed no significant difference in SER or SET. We found no significant difference in need for analgesics (mean difference [MD −53.73, <em>p</em>=0.2) or the mean number of colic episodes (MD −0.42, <em>p</em>=0.060) between tadalafil and tamsulosin. SER or SET was not significantly different between silodosin and tadalafil. Tadalafil plus tamsulosin led to a significantly higher SER (OR 1.87, <em>p</em>&lt;0.001) and SET (MD −2.99, <em>p</em>=0.002) compared with tamsulosin, without any significant difference in adverse effects.</div></div><div><h3>Conclusion</h3><div>Compared with tamsulosin, SER significantly improved with silodosin, tadalafil, and the combination of tadalafil plus tamsulosin. Meanwhile, the difference in SET was only significant between tadalafil plus tamsulosin versus tamsulosin. It appears that tadalafil and silodosin have similar efficacy in SET and SER. All medical expulsive therapies had comparable safety.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 189-203"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single bladder instillation of gemcitabine versus mitomycin C after minimally invasive radical nephroureterectomy: A propensity-score match analysis from the ROBUUST 2.0 collaborative group","authors":"Eugenio Bologna ,&nbsp;Zhenjie Wu ,&nbsp;Antonio Franco ,&nbsp;Firas Abdollah ,&nbsp;Marco Finati ,&nbsp;Giuseppe Simone ,&nbsp;Gabriele Tuderti ,&nbsp;Leslie Claire Licari ,&nbsp;Andres F. Correa ,&nbsp;Randall Lee ,&nbsp;Ottavio De Cobelli ,&nbsp;Matteo Ferro ,&nbsp;Francesco Porpiglia ,&nbsp;Daniele Amparore ,&nbsp;Enrico Checcucci ,&nbsp;Antonio Tufano ,&nbsp;Sisto Perdonà ,&nbsp;Raj Bhanvadia ,&nbsp;Vitaly Margulis ,&nbsp;Stephan Brönimann ,&nbsp;Riccardo Autorino","doi":"10.1016/j.ajur.2024.10.006","DOIUrl":"10.1016/j.ajur.2024.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>Radical nephroureterectomy (RNU) is considered the standard of care for patients with high-risk upper tract urothelial carcinoma. Current literature reveals a deficit in direct comparative studies evaluating the efficacy of different chemotherapeutic agents administered in single postoperative instillation following RNU. The primary aim of this study was to compare the bladder recurrence (BR) rates between patients receiving a single instillation of mitomycin C (MMC) versus gemcitabine (Gem) after RNU.</div></div><div><h3>Methods</h3><div>The ROBUUST (ROBotic surgery for Upper tract Urothelial cancer STudy) 2.0 is an international, multicenter registry that aggregates data on patients who have undergone curative surgery for upper tract urothelial carcinoma across participating centers from January 2015 to December 2022. Data including primary baseline variables of the patients, characteristics of the tumors, surgical management, and definitive histopathological characterizations were collected and stratified based on the type of postoperative bladder instillation: MMC (the MMC group) and Gem (the Gem group). We selected variables correlated with our primary outcome to conduct a propensity-score match analysis.</div></div><div><h3>Results</h3><div>One hundred patients in the MMC group were matched 1:1 with 100 patients in the Gem group. At 36 months of follow-up, 30 patients in the MMC group and 39 patients in the Gem group experienced BR, representing recurrence rates of 30% and 39%, respectively (<em>p</em>=0.2). The Cox proportional hazards model comparing BR between the groups revealed a hazard ratio of 1.58 (95% confidence interval: 0.98–2.55) with a non-statistically significant increased risk of BR in the Gem group compared with the MMC group (<em>p</em>=0.059).</div></div><div><h3>Conclusion</h3><div>A single perioperative instillation of Gem or MMC seems to offer similar efficacy in reducing the risk of BR in patients undergoing RNU. Further research, ideally within the framework of prospective studies, is warranted to elucidate the optimal chemotherapeutic approach in this setting.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 250-257"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New surgical robotic platforms in China and their applications in urologic surgeries","authors":"Hongkai Wang,&nbsp;Dingwei Ye","doi":"10.1016/j.ajur.2025.01.001","DOIUrl":"10.1016/j.ajur.2025.01.001","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 134-138"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel ejaculation-sparing surgical technique in the patient with primary bladder neck obstruction: Results of a single-arm cohort","authors":"Marco Dellabella,&nbsp;Luca Gasparri,&nbsp;Antonio Vinci,&nbsp;Massimo Maurici,&nbsp;Redi Claudini,&nbsp;Alessandro Branchi,&nbsp;Michele Pucci,&nbsp;Edoardo Agostini","doi":"10.1016/j.ajur.2024.09.004","DOIUrl":"10.1016/j.ajur.2024.09.004","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 278-280"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotics, artificial intelligence, telepresence, and telesurgery: The future of urology","authors":"Vipul Patel,&nbsp;Shady Saikali,&nbsp;Marcio Covas Moschovas","doi":"10.1016/j.ajur.2025.03.001","DOIUrl":"10.1016/j.ajur.2025.03.001","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 131-133"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decade's experience of robotic buccal ureteroplasty for post-ureteroscopic laser lithotripsy-induced strictures—Should this be the new standard?","authors":"Deerush Kannan Sakthivel ,&nbsp;Pratik Taur ,&nbsp;Rajesh Paul ,&nbsp;Pravin Meenashi Sundaram ,&nbsp;Deepak Raghavan","doi":"10.1016/j.ajur.2024.03.003","DOIUrl":"10.1016/j.ajur.2024.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>To present the surgical technique of robotic buccal ureteroplasty for strictures after laser lithotripsy and its outcomes.</div></div><div><h3>Methods</h3><div>This was a retrospective study conducted at the Department of Urology, Apollo Hospitals, Chennai, India from October 2012 to October 2022. Indications for surgery included worsening hydronephrosis, declining renal function, and recurrent urinary tract infections with obstruction. Apart from liberal exposure of the stricture, we stress upon use of indocyanine green to assess vascularity and quilting of the graft to bare area of the psoas muscle to increase graft vascularity.</div></div><div><h3>Results</h3><div>Among the 15 patients, ureteropelvic junction strictures were observed in eight (53%), while five (33%) had proximal ureteric strictures, and two (13%) had mid-ureteral strictures. Notably, eight of the 15 patients (53%) had previous unsuccessful double-J stenting. The median stricture length was 3.5 (range: 2.0–5.0) cm, with a mean operative time of 167 (range: 126–214) min and estimated blood loss of 60 (range: 40–100) mL. After a median follow-up of 12 (range: 4–32) months, 13 out of the 15 patients (87%) showed significant improvement in their follow-up functional scans.</div></div><div><h3>Conclusion</h3><div>Robotic buccal ureteroplasty is a very effective technique for the management of laser-induced ureteral strictures with good long-term results and minimal morbidity. The results are comparable irrespective of previous failed stenting.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 258-261"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted partial nephrectomy for renal cell carcinoma: A narrative review of different clinical scenarios","authors":"Antonio Andrea Grosso ,&nbsp;Vincenzo Salamone ,&nbsp;Fabrizio Di Maida,&nbsp;Sofia Giudici,&nbsp;Anna Cadenar,&nbsp;Luca Lambertini,&nbsp;Francesco Lupo Conte,&nbsp;Mara Bacchiani,&nbsp;Luca Mazzola,&nbsp;Alfonso Crisci,&nbsp;Rino Oriti,&nbsp;Gianni Vittori,&nbsp;Riccardo Fantechi,&nbsp;Agostino Tuccio,&nbsp;Andrea Mari,&nbsp;Andrea Minervini","doi":"10.1016/j.ajur.2024.09.010","DOIUrl":"10.1016/j.ajur.2024.09.010","url":null,"abstract":"<div><h3>Objective</h3><div>Nowadays robot-assisted partial nephrectomy (RAPN) represents the standard of care for clinical T1 (cT1) renal masses, providing similar oncological outcomes when compared to open or laparoscopic PN with advantages in terms of functional outcomes and lower perioperative comorbidity, when compared to radical nephrectomy.</div></div><div><h3>Methods</h3><div>We performed an extensive literature review of studies regarding RAPN, its evolution, technical aspects and applications, and new technological tools using different combinations of Medical Subject Headings terms “RAPN”, “partial nephrectomy”, “robot-assisted”, “nephron-sparing surgery”, “renal cell carcinoma”, “complex renal masses”, “endophytic renal masses”, and “bilateral renal tumors”.</div></div><div><h3>Results</h3><div>A consistent body of evidence was selected, including original articles, systematic reviews, meta-analyses, and clinical trials having RAPN as the central focus in adult patients, with all its technical nuances. We started our narrative review with a background on PN and its evolution toward the robotic era with a special spotlight on the extending indications for PN in large and highly complex renal masses. Our review continued with an overview of nephron-sparing surgery in bilateral and recurrent masses. RAPN for bilateral synchronous renal masses represents a challenging scenario with no formal recommendations provided by international guidelines and controversial management and decision-making. Additionally, we reported evidence on redo RAPN which seems to be safe and effective. A final overview of the available technological tools, and in particular on three-dimensional reconstruction was provided.</div></div><div><h3>Conclusion</h3><div>RAPN has been established as the standard of care for cT1 renal masses with an expanding spectrum of applications in different scenarios, including large (cT2), highly complex, and bilateral renal masses, as well as the surgical treatment of local recurrences after nephron-sparing surgery with acknowledged advantages in terms of functional outcomes and perioperative risk profiles while maintaining similar oncological outcomes when compared to open or laparoscopic PN and radical treatment.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 210-216"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted laparoendoscopic single-site retroperitoneal nephroureterectomy with bladder cuff excision for upper tract urothelial carcinoma: Preliminary experience","authors":"Qianying Ji ,&nbsp;Jun Wang ,&nbsp;Tong Zhao ,&nbsp;Yetao Zhang ,&nbsp;Kai Li ,&nbsp;Yong Wei ,&nbsp;Qingyi Zhu","doi":"10.1016/j.ajur.2024.05.001","DOIUrl":"10.1016/j.ajur.2024.05.001","url":null,"abstract":"<div><h3>Objective</h3><div>To present a modified technique for robot-assisted laparoendoscopic single-site retroperitoneal nephroureterectomy (RLESS-RNU) with bladder cuff excision and evaluate its effectiveness as a minimally invasive approach for managing upper tract urothelial carcinoma (UTUC).</div></div><div><h3>Methods</h3><div>Fifteen patients who underwent RLESS-RNU for UTUC between April 2020 and June 2021 were reviewed at our medical institution (The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China), from our prospectively maintained institutional database. The da Vinci® Xi system (Intuitive Surgical, Sunnyvale, CA, USA) was utilized for surgical procedures in all patients. An in-depth analysis was conducted on their baseline demographic characteristics, pathological factors, and perioperative details. The complete surgical process and details are elaborated.</div></div><div><h3>Results</h3><div>The median age of 15 patients was 67 years. The final pathology demonstrated 47% (7/15) patients with pT1 or lower and 47% (7/15) with pT3; one patient could not undergo pathological staging because of preoperative chemotherapy. The perioperative outcomes revealed that the mean operative time was 185 (standard deviation [SD] 23.05) min. The mean times of the trocar placement for primary and second docking were 15.00 (SD 0.85) min and 8.00 (SD 0.52) min, respectively. The median estimated blood loss was 55 mL. The mean drainage tube duration and postoperative hospital stay were 7.50 days and 11.00 days, respectively. After a mean follow-up period of 24.20 months, the relapse-free survival rate was 87%. Two patients experienced disease progression: one patient exhibited multifocal evidence of non-muscle invasive bladder cancer, and the other patient developed systemic recurrence.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that the modified technique for RLESS-RNU is safe and satisfactory for UTUC.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 244-249"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}