Asian Journal of Urology最新文献

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Comparing efficacy and safety of monotherapy and combination therapy with tadalafil, tamsulosin, and silodosin for distal ureteral stones: A systematic review and meta-analysis 比较他达拉非、坦索罗辛和西洛多辛治疗输尿管远端结石的单药和联合治疗的疗效和安全性:一项系统综述和荟萃分析
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-04-01 DOI: 10.1016/j.ajur.2024.05.003
Sholeh Ebrahimpour , Mona Kargar , Mohadeseh Balvardi , Ozra Tabatabaei-Malazy , Pardis Asadi , Mehdi Mohammadi
{"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}
引用次数: 0
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 微创根治性肾输尿管切除术后单膀胱滴注吉西他滨与丝裂霉素C:来自robust2.0协作组的倾向评分匹配分析
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-04-01 DOI: 10.1016/j.ajur.2024.10.006
Eugenio Bologna , Zhenjie Wu , Antonio Franco , Firas Abdollah , Marco Finati , Giuseppe Simone , Gabriele Tuderti , Leslie Claire Licari , Andres F. Correa , Randall Lee , Ottavio De Cobelli , Matteo Ferro , Francesco Porpiglia , Daniele Amparore , Enrico Checcucci , Antonio Tufano , Sisto Perdonà , Raj Bhanvadia , Vitaly Margulis , Stephan Brönimann , Riccardo Autorino
{"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}
引用次数: 0
New surgical robotic platforms in China and their applications in urologic surgeries 中国新型手术机器人平台及其在泌尿外科手术中的应用
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-04-01 DOI: 10.1016/j.ajur.2025.01.001
Hongkai Wang, Dingwei Ye
{"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}
引用次数: 0
A novel ejaculation-sparing surgical technique in the patient with primary bladder neck obstruction: Results of a single-arm cohort 原发性膀胱颈梗阻患者一种新颖的免射精手术技术:单臂队列研究结果
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-04-01 DOI: 10.1016/j.ajur.2024.09.004
Marco Dellabella, Luca Gasparri, Antonio Vinci, Massimo Maurici, Redi Claudini, Alessandro Branchi, Michele Pucci, Edoardo Agostini
{"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}
引用次数: 0
Robotics, artificial intelligence, telepresence, and telesurgery: The future of urology 机器人、人工智能、远程呈现和远程手术:泌尿外科的未来
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-04-01 DOI: 10.1016/j.ajur.2025.03.001
Vipul Patel, Shady Saikali, Marcio Covas Moschovas
{"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}
引用次数: 0
A decade's experience of robotic buccal ureteroplasty for post-ureteroscopic laser lithotripsy-induced strictures—Should this be the new standard? 输尿管镜后激光碎石致狭窄的机器人颊输尿管成形术的十年经验——这应该成为新的标准吗?
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-04-01 DOI: 10.1016/j.ajur.2024.03.003
Deerush Kannan Sakthivel , Pratik Taur , Rajesh Paul , Pravin Meenashi Sundaram , Deepak Raghavan
{"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}
引用次数: 0
Robot-assisted laparoendoscopic single-site retroperitoneal nephroureterectomy with bladder cuff excision for upper tract urothelial carcinoma: Preliminary experience 机器人辅助腹腔内镜单部位后腹膜肾切除术和膀胱袖带切除术治疗上尿路上皮癌:初步经验
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-04-01 DOI: 10.1016/j.ajur.2024.05.001
Qianying Ji , Jun Wang , Tong Zhao , Yetao Zhang , Kai Li , Yong Wei , Qingyi Zhu
{"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}
引用次数: 0
Robot-assisted partial nephrectomy for renal cell carcinoma: A narrative review of different clinical scenarios 机器人辅助部分肾切除术治疗肾细胞癌:不同临床情况的叙述回顾
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-04-01 DOI: 10.1016/j.ajur.2024.09.010
Antonio Andrea Grosso , Vincenzo Salamone , Fabrizio Di Maida, Sofia Giudici, Anna Cadenar, Luca Lambertini, Francesco Lupo Conte, Mara Bacchiani, Luca Mazzola, Alfonso Crisci, Rino Oriti, Gianni Vittori, Riccardo Fantechi, Agostino Tuccio, Andrea Mari, Andrea Minervini
{"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}
引用次数: 0
Factors affecting the thermal effects of lasers in lithotripsy: A literature review 影响激光碎石热效应的因素--文献综述
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-01-01 DOI: 10.1016/j.ajur.2024.04.002
Kiron Krishnaprasad, Ravi Teja Pathi, Mustafa Nazar
{"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}
引用次数: 0
The impact of urolithiasis on urology services in a high-prevalence region: A multicenter study 尿石症对高发地区泌尿科服务的影响:一项多中心研究
IF 2.4 3区 医学
Asian Journal of Urology Pub Date : 2025-01-01 DOI: 10.1016/j.ajur.2024.04.001
Wissam Khalid Kamal , Musab M. Alghamdi , Raed A. Azhar , Ahmad Bugis , Mohammed Abuzenada , Majed Alharthi , Saeed Bin Hamri , Yahya Ghazwani , Yasser A. Noureldin , Hassan Aljifri , Abdulaziz Alamri , Hatem Hamed Althubiany , Mansour Alnazari , Badr Alharbi , Abdulrahman Al Own , Mohanad Jebril Bosily , Mohammed Almansour , Abdullah Alfakhri , Ibrahim Alowidah , Ali Abdel Raheem
{"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}
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