Archivio Italiano di Urologia e Andrologia最新文献

{"title":"Management of urinary stones: state of the art and future perspectives by experts in stone disease.","authors":"Athanasios Papatsoris, Alberto Budia Alba, Juan Antonio Galán Llopis, Murtadha Al Musafer, Mohammed Alameedee, Hammad Ather, Juan Pablo Caballero-Romeu, Antònia Costa-Bauzá, Athanasios Dellis, Mohamed El Howairis, Giovanni Gambaro, Bogdan Geavlete, Adam Halinski, Bernhard Hess, Syed Jaffry, Dirk Kok, Hichem Kouicem, Luis Llanes, Juan M Lopez Martinez, Elenko Popov, Allen Rodgers, Federico Soria, Kyriaki Stamatelou, Alberto Trinchieri, Christian Tuerk","doi":"10.4081/aiua.2024.12703","DOIUrl":"10.4081/aiua.2024.12703","url":null,"abstract":"<p><strong>Aim: </strong>To present state of the art on the management of urinary stones from a panel of globally recognized urolithiasis experts who met during the Experts in Stone Disease Congress in Valencia in January 2024. Options of treatment: The surgical treatment modalities of renal and ureteral stones are well defined by the guidelines of international societies, although for some index cases more alternative options are possible. For 1.5 cm renal stones, both m-PCNL and RIRS have proven to be valid treatment alternatives with comparable stone-free rates. The m-PCNL has proven to be more cost effective and requires a shorter operative time, while the RIRS has demonstrated lower morbidity in terms of blood loss and shorter recovery times. SWL has proven to be less effective at least for lower calyceal stones but has the highest safety profile. For a 6mm obstructing stone of the pelviureteric junction (PUJ) stone, SWL should be the first choice for a stone less than 1 cm, due to less invasiveness and lower risk of complications although it has a lower stone free-rate. RIRS has advantages in certain conditions such as anticoagulant treatment, obesity, or body deformity. Technical issues of the surgical procedures for stone removal: In patients receiving antithrombotic therapy, SWL, PCN and open surgery are at elevated risk of hemorrhage or perinephric hematoma. URS, is associated with less morbidity in these cases. An individualized combined evaluation of risks of bleeding and thromboembolism should determine the perioperative thromboprophylactic strategy. Pre-interventional urine culture and antibiotic therapy are mandatory although UTI treatment is becoming more challenging due to increasing resistance to routinely applied antibiotics. The use of an intrarenal urine culture and stone culture is recommended to adapt antibiotic therapy in case of postoperative infectious complications. Measurements of temperature and pressure during RIRS are vital for ensuring patient safety and optimizing surgical outcomes although techniques of measurements and methods for data analysis are still to be refined. Ureteral stents were improved by the development of new biomaterials, new coatings, and new stent designs. Topics of current research are the development of drug eluting and bioresorbable stents. Complications of endoscopic treatment: PCNL is considered the most invasive surgical option. Fever and sepsis were observed in 11 and 0.5% and need for transfusion and embolization for bleeding in 7 and 0.4%. Major complications, as colonic, splenic, liver, gall bladder and bowel injuries are quite rare but are associated with significant morbidity. Ureteroscopy causes less complications, although some of them can be severe. They depend on high pressure in the urinary tract (sepsis or renal bleeding) or application of excessive force to the urinary tract (ureteral avulsion or stricture). Diagnostic work up:  Genetic testing consents the diagnosis of monog","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 2","pages":"12703"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pentoxifylline treatment as a safe method for selecting viable testicular spermatozoa before cryopreservation of a small numbers of spermatozoa in azoospermia individuals.","authors":"Keivan Lorian, Serajoddin Vahidi, Fatemeh Dehghanpour, Fatemeh Anbari, Azam Agha-Rahimi","doi":"10.4081/aiua.2024.12525","DOIUrl":"https://doi.org/10.4081/aiua.2024.12525","url":null,"abstract":"<p><strong>Background: </strong>Single sperm cryopreservation (SSC) is a specific technique especially used in individuals with small numbers of sperm who suffered from non-obstructive azoospermia (NOA). Testicular specimens possess poor motility and low population of viable spermatozoa. Therefore, sperm selection methods such as applying pentoxifylline (PTX) may improve motility in these cases. The main aim of this study was to evaluate the protective effects of PTX on testicular spermatozoa before and after performing SSC.</p><p><strong>Methods: </strong>Thirty testicular samples were obtained from men with azoospermia. This study was conducted in two phases. Phase 1 evaluated the effect of PTX for sperm selection before SSC. Twenty testicular samples were divided to two experimental groups: SSC without (I) and with PTX treatment (II). For PTX treatment spermatozoa were incubated with PTX at 37°C for 30 min and only motile spermatozoa were selected for SSC. In phase 2, ten testicular samples were cryopreserved with SSC and warming procedure was carried out in droplet with and without PTX. Motility and viability rates, morphology by motile sperm organelle morphology examination (MSOME), DNA fragmentation by sperm chromatin dispersion test (SCD) and mitochondrial membrane potential (MMP) were evaluated.</p><p><strong>Results: </strong>In phase 1, post warm motility rate was higher in PTX exposed group compared to the unexposed group (25.6 ± 8.13 vs. 0.85 ± 2.1) (p > 0.00). Recovery rate, viability and morphology were not significantly different between groups. DNA integrity and MMP were also similar between both groups. In phase 2 although motility increased in PTX group compared to without PTX group (29.30 ± 12.73 vs. 1.90 ± 2.64) (p > 0.00), the viability rate was not different (70.40 ± 12.12 vs. 65.30 ± 11.87). All above mentioned parameters were similar between the two SSC groups.</p><p><strong>Conclusions: </strong>Supplementation of testicular spermatozoa with PTX before cryopreservation increases motility and did not have adverse effects on viability, morphology, DNA integrity and MMP. PTX could be used as sperm selection method before single sperm cryopreservation, but PTX could not maintain motile the most of viable testicular sperms.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"96 2","pages":"12525"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of immunotherapy in urological cancers.","authors":"Efe Bosnali, Enes Malik Akdas, Engin Telli, Kerem Teke, Onder Kara","doi":"10.4081/aiua.2024.12307","DOIUrl":"10.4081/aiua.2024.12307","url":null,"abstract":"<p><p>Immunotherapy is defined as a therapeutic approach that targets or manipulates the immune system. A deeper understanding of the cellular and molecular composition of the tumour environment, as well as the mechanisms controlling the immune system, has made possible the development and clinical investigation of many innovative cancer therapies. Historically, immunotherapy has played an essential role in treating urologic malignancies, while in the modern era, the development of immune checkpoint inhibitors (ICIs) has been critical to urology. Urothelial carcinoma is a common type of cancer in the genitourinary system, and treatment strategies in this area are constantly evolving. Intravesical and systemic immunotherapeutic agents have begun to be used increasingly frequently in treating urothelial carcinoma. These agents increase the anti-tumour response by affecting the body's defence mechanisms. Immunotherapeutic agents used in urothelial carcinoma include various options such as BCG, interferon, anti-PD-1 (pembrolizumab, nivolumab) and anti-PD-L1 (atezolizumab, avelumab, durvalumab). Renal cell carcinoma (RCC) has been known for many years as a tumour with unique sensitivity to immunotherapies. The recent emergence of ICIs that block PD-1/PD-L1 (pembrolizumab, nivolumab, atezolizumab) or CTLA4 (ipilimumab) signalling pathways has reestablished systemic immunotherapy as central to the treatment of advanced RCC. In light of randomized clinical trials conducted with increasing interest in the application of immunotherapies in the adjuvant setting, combination therapies (nivolumab/ipilimumab, nivolumab/cabozantinib, pembrolizumab/ axitinib, pembrolizumab/lenvantinib) have become the standard first-line treatment of metastatic RCC. Prostate cancer is in the immunologically \"cold\" tumour category; on the contrary, in recent years, immunotherapeutic agents have come to the fore as an essential area in the treatment of this disease. Especially in the treatment of castration-resistant prostate cancer, immunotherapeutic agents constitute an alternative treatment method besides androgen deprivation therapy and chemotherapy. Ipilimumab, nivolumab, pembrolizumab, atezolizumab, and Sipuleucel T (Vaccine-based) are promising alternative treatment options. Considering ongoing randomized clinical trials, immunotherapeutic agents promise to transform the uro-oncology field significantly. In this review, we aimed to summarize the role of immunotherapy in urothelial, renal and prostate cancer in the light of randomized clinical trials.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"12307"},"PeriodicalIF":1.4,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric renal transplantation: a single center experience.","authors":"Shakhawan Hama Amin Said, Saiwan Hayas Agha, Goran Fryad Abdulla, Mzhda Sahib Jaafar, Rawa Bapir, Nali H Hama, Ismaeel Aghaways, Aso Omer Rashid, Berun A Abdalla, Fahmi H Kakamad","doi":"10.4081/aiua.2024.12389","DOIUrl":"10.4081/aiua.2024.12389","url":null,"abstract":"<p><strong>Introduction: </strong>The rising prevalence of global end-stage renal disease (ESRD) is a significant health concern, especially among children. Although renal replacement therapy is available, children with ESRD are at an increased risk of mortality. Kidney transplantation is the preferred modality of treatment and surpasses renal replacement therapy in terms of survival. However, pediatric renal transplantation could prove difficult due to factors like smaller recipients and donor-recipient mismatches leading to higher complications.</p><p><strong>Materials and methods: </strong>A retrospective single-group case series study was conducted on children with ESRD who were planned to undergo kidney transplantation from living donors between 2015 and 2021. The data was collected from two centers in the city of Sulaymaniyah.</p><p><strong>Results: </strong>The study comprised a predominantly male patient population, with a total of 39 individuals (n = 39) and 13 female patients. The donors were mostly males between 25-40 years old. The majority of participants were 15-18 years old. In majority of the patients Thymoglobulin was the immunosuppressive agent used in induction. The most common etiology for renal failure was reflux nephropathy and artery anastomosis was performed to the external iliac artery in the majority of patients. Only 9 patients had complications following the transplantation and 3 patients had an episode of acute rejection.</p><p><strong>Conclusions: </strong>Renal transplantation is the preferred treatment of renal failure in pediatric patients in the city of Sulaymaniyah. The most common etiology for pediatric renal failure was reflux nephropathy which was different from the findings of North American Pediatric Renal Trials and Collaborative Studies.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"12389"},"PeriodicalIF":1.4,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated to hemoglobin decrease after percutaneous nephrolithotomy: a retrospective study.","authors":"Syarif Syarif, Abdul Azis, Saidah Rahmat A, Ahmad Taufik Fadillah Zainal, Ade Nusraya","doi":"10.4081/aiua.2024.12382","DOIUrl":"10.4081/aiua.2024.12382","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine the preoperative and perioperative risk parameters associated with a decrease in hemoglobin (Hb) in patients undergoing percutaneous nephrolithotomy (PCNL).</p><p><strong>Methods: </strong>We collected prospective data of consecutive patients who underwent PCNL from January 2018 to December 2022. The median decrease in post-operative hemoglobin levels compared to pre-operative was found to be 1.5 g/dl. This value was the cut-off value that divided the sample into two groups. Group 1 has a decrease in Hb levels that is higher or equal to the cutoff, group 2 has a decrease in Hb levels that is lower than the cut-off. All preoperative, stone characteristics and perioperative factors were recorded.</p><p><strong>Results: </strong>A total of 273 patients were included in the study, 141 in Group 1 and 132 in Group 2. The mean age of Group 1 was significantly higher (55.48 ± 8.73 vs 45.9 ± 10.75 years, p < 0.05). The mean bleeding of Group 1 was significantly higher (285.85 ± 113.68 vs 135 ± 77.54 ml, p < 0.05). There was a significant difference in mean operation time between groups (86.35 ± 32.05 vs 64.89 ± 27.83 min, p < 0.05). Multivariate analysis showed that the variables age, comorbid diabetes mellitus, intraoperative bleeding amount, and operation time had a significant relationship with Hb reduction in patients undergoing PCNL (p < 0.05).</p><p><strong>Conclusions: </strong>Older age, comorbid diabetes mellitus, large amounts of intraoperative bleeding, and longer operating time are factors associated with PCNL-related postoperative hemoglobin decrease.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"12382"},"PeriodicalIF":1.4,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted laparoscopic pyeloplasty for the treatment of ureteropelvic junction obstruction - How should success be determined?","authors":"Marie Lien, Mathias Sørstrand Æsøy, Karin Hjelle, Bjarte Almås, Patrick Juliebø-Jones, Øyvind Ulvik","doi":"10.4081/aiua.2024.12431","DOIUrl":"10.4081/aiua.2024.12431","url":null,"abstract":"<p><strong>Background: </strong>Ureteropelvic junction obstruction (UPJO) is characterised by stenosis of the ureteral lumen at the level of the renal pelvis and proximal ureter. At Haukeland University Hospital, robotic-assisted laparoscopic pyeloplasty (RLP) for UPJO has been performed since 2014. The aim of this study was to evaluate the results of the treatment and consider what determines treatment success.</p><p><strong>Materials and methods: </strong>Retrospective review was performed of consecutive patients undergoing RLP between 2014-2022. Outcomes of interest included symptom relief, complication rates and renographic findings at follow-up. Treatment success was defined in terms of symptom improvement and/or improvement as well as relief of obstruction on renography.</p><p><strong>Results: </strong>In total, 95 RLPs were performed in 54 women and 41 men, with a mean age of 40 years (IQR: 21-58). Flank pain was the most frequent presenting complaint (n = 81, 85%) followed by infection (n = 33, 35%). More than one indication for surgery was present in 1/3 of the patients. Urodynamic relevant obstruction on renography was found in 62 patients (65%) preoperatively. Mean operative time was 123 minutes (range 60-270). Two patients experienced minor intraoperative complications. At three months follow-up, 91% of patients had symptom relief, and no obstruction on renography was recorded in 64%. There was no significant association between improvement in symptoms and renography findings at follow-up, p = 1.</p><p><strong>Conclusions: </strong>RLP can deliver a high success rate in terms of symptom relief and few complications. There was no association between renography findings and symptom relief at follow-up. Success after surgery should be determined by symptom relief rather than renography findings.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"12431"},"PeriodicalIF":1.4,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic renal scans as a modality for follow-up of flexible ureteroscopy.","authors":"Murad Asali, Osman Hallak","doi":"10.4081/aiua.2024.12393","DOIUrl":"10.4081/aiua.2024.12393","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether dynamic renal scans - DTPA or MAG3 - routinely performed after flexible ureteroscopies (f-URS) could detect the development of an obstruction and thus promote prompt early intervention for kidney preservation.</p><p><strong>Patients and methods: </strong>In this retrospective study, with all the data recorded prospectively between April 2010 and October 2023, 250 renal units in 242 patients with upper urinary tract stones (UUTS) who underwent ureterorenoscopy by one surgeon in the same medical center were evaluated. Stone-free rate (SFR) was defined as no residual fragments at all using an intraoperative \"triple test\". The following characteristics were examined: gender, BMI, age, Hounsfield unit, stone diameter, laterality, renal/ureteral stones, stone-free rate, and auxiliary procedures per renal unit. The Clavien-Dindo classification was used to report complications. Renal units with residual stones were scheduled for a 2nd f-URS. Post- flexible ureteroscopy ureteral obstruction and renal function were detected using renal scan DTPA or MAG-3. The primary outcome was renal/ ureteral obstruction.</p><p><strong>Results: </strong>The mean patient age was 53 years. The mean stone size was 12.3 mm. Stones in renal pelvis, upper, middle and lower calyces were treated in 9.2% (23), 27.6% (69), and 30.8% (77) of cases, respectively; 44% (110) ureteral stones were also treated. The single- and second-session SFRs were 94.8% and 99.7%, respectively. A third auxiliary procedure was needed in one renal unit (0.4%). The mean number of procedures per renal unit was 1.06 (264/250). Ureteral double-J stents were inserted in 53.6% (134) of the cases. In 37 (14.8%) cases, a stent was placed before surgery. Post-operative complications were minor, with readmission and pain control needed in only two patients (0.8%). No avulsion or perforation of the ureters was observed. In six patients with t1/2 between 10-20 minutes, a second renal scan revealed spontaneous improvement and no obstruction in five patients. One patient with large stones and a history of prior ureteroscopy developed a ureteral stricture (0.4%) and needed treatment with laser endoureterotomy.</p><p><strong>Conclusions: </strong>Post-flexible ureteroscopy obstruction due to ureteral stricture is very rare. A routine renal scan post-operatively may be used in potentially high-risk patients.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"12393"},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostatic artery embolization for intractable hematuria in patients with unregulated coagulation parameters: three case reports.","authors":"Manuel Belmonte, Abdulghani Khogeer, Ghizlane Moussaoui, Rafael Melo, Louis-Martin Boucher, Tatiana Villalpando-Cabrera, Serge Carrier, Mélanie Aubé-Peterkin","doi":"10.4081/aiua.2024.12306","DOIUrl":"10.4081/aiua.2024.12306","url":null,"abstract":"<p><strong>Introduction: </strong>Benign prostatic hyperplasia is a prevalent disease that could be responsible of severe intractable hematuria requiring invasive surgical management.</p><p><strong>Case presentation: </strong>We report three high-risk cases presented with intractable hematuria of prostatic origin with high medical co-morbidities treated safely and effectively by prostatic artery embolization with favorable outcomes.</p><p><strong>Conclusions: </strong>In non-surgical, anticoagulated patients, prostatic artery embolization represents a safe and effective intervention for the treatment of intractable hematuria related to benign prostatic hyperplasia.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"12306"},"PeriodicalIF":1.4,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel emerging therapy for erectile dysfunction: efficacy and safety of flat magnetic stimulation.","authors":"Daniel Galimberti, Agustina Vila Echague, Ery A Ko, Laura Pieri, Alessandra Comito, Irene Fusco, Tiziano Zingoni","doi":"10.4081/aiua.2024.12506","DOIUrl":"10.4081/aiua.2024.12506","url":null,"abstract":"<p><strong>Background: </strong>The erectile dysfunction (ED), which is the inability to achieve and/or sustain a penile erection sufficient to result in a satisfying sexual performance, represents a very common complaint. for men over forty years old. The aim of the study was to evaluate if Flat Magnetic Stimulation (FMS) technology could help individuals with symptomatic erectile dysfunction.</p><p><strong>Methods: </strong>Twenty patients with erectile dysfunction, underwent eight sessions of about 30 minutes each in a twice a week frequency with the study device. During treatments, every potential side effect was assessed. The International Index of Erectile Function (IIEF) was compiled by all patients at the beginning, after the eighth treatment and at 1 month from the end of the last treatment. The questionnaire scores were presented as median values along with the interquartile range (IQR) and we set the significance threshold at 0.01.</p><p><strong>Results: </strong>After the treatment and at 1-month follow-up, the increase in questionnaire scores was statistically significant compared to the baseline, thus supporting the clinical usefulness of this treatment. In particular, the result of the study indicates a statistically significant difference between IIEF score before treatment (Median = 34) and IIEF score after the end of treatment (Median = 45) and between IIEF score before treatment and IIEF score at 1-month follow-up (Median = 54).</p><p><strong>Conclusions: </strong>The study findings showed that FMS represents a promising treatment option to individuals affected by symptomatic erectile dysfunction.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"12506"},"PeriodicalIF":1.4,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of two percutaneous nephrolithotomy methods for the treatment of pediatric kidney stones: mini-percutaneous nephrolithotomy and standard percutaneous nephrolithotomy.","authors":"Kadir Karkin, Mubariz Aydamirov, Buğra Aksay, Eyüp Kaplan, Güçlü Gürlen, Adem Altunkol, Ferhat Ortaoğlu, Ömer Faruk Akgün, Ediz Vuruşkan, Zafer Gökhan Gürbüz","doi":"10.4081/aiua.2024.12369","DOIUrl":"10.4081/aiua.2024.12369","url":null,"abstract":"<p><strong>Objective: </strong>In this study, the aim was to compare the results of mini and standard percutaneous nephrolithotomy (PCNL) for the treatment of pediatric kidney stones.</p><p><strong>Materials and methods: </strong>Data for 128 patients < 18 years of age who underwent mini and standard PCNL due to pediatric kidney stones were retrospectively examined. Patients were divided into two groups: mini-PCNL (16-20 Fr) and standard PCNL (26 Fr). Surgery time, number of punctures to the pelvicalyceal system, hospital stay, postoperative hemoglobin drop, complications and stone-free status (SFR) were compared between the groups. Additional surgical intervention (double-J stent, ureterorenoscopy, secondary PCNL) performed after the surgery was recorded. The absence of residual stones or < 3 mm residual stones on kidney, ureter and bladder radiography (KUB) and ultrasonography (USG) performed in the third postoperative month were accepted as success criteria.</p><p><strong>Results: </strong>There were 32 (43.8%) patients in the mini-PCNL group and 41 (56.2%) patients in the standard PCNL group. The mean age was 9.3 ± 4.1 years in the mini-PCNL group and 10.1 ± 5.4 years in the standard PCNL group. Mean stone size in the mini-PCNL group was 2.1 ± 1.2; while for standard PCNL it was 2.3 ± 1.4. The mean surgery time was statistically significantly higher in the mini-PCNL group (p = 0.005). There was no difference between the groups in terms of intraoperative double J stent use, postoperative complications and SFR. A double J stent was inserted in two patients in the mini-PCNL group and in one patient in the standard PCNL group due to urine leakage from the nephrostomy tract in the postoperative period. Although the postoperative hemoglobin drop was found to be significantly higher in standard PCNL (p = 0.001), hematuria and blood transfusion rates were low in both groups. Mean hospital stay was shorter in the mini-PCNL group compared to standard PCNL (3.6 ± 1.2 days vs. 2.5 ± 1.1; p = 0.018).</p><p><strong>Conclusions: </strong>Although mini-PCNL has longer surgery time compared to standard PCNL, it should be preferred for the treatment of pediatric kidney stones due to advantages such as similar success and complication rates to standard PCNL, short hospital stay and less postoperative hemoglobin drop.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"12369"},"PeriodicalIF":1.4,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}