Archivio Italiano di Urologia e Andrologia最新文献

{"title":"Analysis of factors associated with length of stay in renal trauma patients: a single-centre retrospective study.","authors":"Paksi Satyagraha, Besut Daryanto, Bagas Wilianto, Fauzan Kurniawan Dhani","doi":"10.4081/aiua.2025.13939","DOIUrl":"10.4081/aiua.2025.13939","url":null,"abstract":"<p><strong>Background: </strong>Renal trauma represents a critical injury requiring precise management with the length of hospital stay (LOS) serving as a key metric for trauma care. Recognizing the factors contributing to extended LOS is essential for optimizing treatment strategies and enhancing patient outcomes. This study aims to analyse the risk factors influencing LOS in patients with renal trauma.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at Dr. Saiful Anwar General Hospital, Malang, analysing medical record data of renal trauma patients from 2013 to 2023. Collected variables included demographics, mechanism of injury, associated injuries, hemodynamic status upon admission, injury severity, haemoglobin levels, LOS, management approach, and mortality outcomes. Univariate and multivariate analyses were performed to assess the impact of each variable on LOS.</p><p><strong>Results: </strong>119 renal trauma patients were included. The average age was 40.1 ± 16.86 years, and 77.3% of the participants were male. The average LOS was 6.85 ± 3.85 days. Blunt renal trauma was the predominant mechanism, accounting for 95.8% of cases, while associated injuries were observed in 53.1% of patients. Upon hospital admission, 66.4% of cases presented with stable hemodynamic status, and non-operative management was employed in 92.4% of cases. Prolonged LOS was significantly associated with age, blunt trauma, associated injuries, hemodynamic instability, and low haemoglobin levels in both univariate and multivariate analyses.</p><p><strong>Conclusions: </strong>Age, mechanism of injury, associated injuries, hemodynamic status at admission, and haemoglobin levels significantly impact LOS in renal trauma patients. Identifying these factors may aid in improving patient management and reducing hospitalization duration.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13939"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477273","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":"Exploring the association between hemoglobin, hematocrit, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio with erectile dysfunction in chronic kidney disease patients undergoing hemodialysis: a cross-sectional study.","authors":"Anak Agung Ngurah Krisnanta Adnyana, I Wayan Suarsana, Anak Agung Patriana Puspaningrat, Ida Bagus Oka Widya Putra","doi":"10.4081/aiua.2025.13856","DOIUrl":"https://doi.org/10.4081/aiua.2025.13856","url":null,"abstract":"<p><p>Erectile dysfunction (ED) is one of the complications in male patients with end-stage chronic kidney disease (CKD). Renal replacement therapy may improve general conditions and thus improve erectile function. This study aims to determine changes in erectile dysfunction in end-stage CKD patients who underwent hemodialysis, focusing on changes in laboratory parameters. This cross-sectional study was conducted from March to April 2024 at the Hemodialysis Unit of Wangaya General Hospital. The subjects were male patients with end-stage chronic kidney disease (CKD) who were undergoing hemodialysis and met the specific inclusion and exclusion criteria. Erectile function was assessed using the International Index of Erectile Function (IIEF- 5) and the Erection Hardness Score (EHS). Laboratory parameters, including hemoglobin, hematocrit, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were recorded. Twenty-two subjects were included in this study. The prevalence of ED before starting hemodialysis and after a period of at least 3 months of hemodialysis was 28.3% and 86.4% respectively. A statistically significant difference was observed in the IIEF-5 scores of patients before and after hemodialysis (p=0.001). Significant differences were observed in the erection degree before and after hemodialysis based on IIEF-5 (p=0.001) and EHS (p=0.001). There was a significant correlation between erection degree assessed by IIEF-5 and hemoglobin, hematocrit, NLR and PLR; and erection degree assessed by EHS and hemoglobin, hematocrit, and PLR, (all p<0.05). In conclusion, there is a deterioration in erectile function in patients undergoing hemodialysis compared to their condition before hemodialysis. There was a significant correlation between hemoglobin, hematocrit, NLR, and PLR and erectile dysfunction.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"97 2","pages":"13856"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530338","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 changes of semen parameters of patients with clinical <h>versus</h> subclinical varicocele managed by laparoscopic varicocelectomy: observational study.","authors":"Tamer A Abouelgreed, Mohamed A Abdelaal, Mohamed A Amer, Hassan Mamdouh, Ahmed F El-Sherbiny, Emad Elrewiny, Ahmed E Elsaadany, Waleed A Mahmoud, Mohamed S Hasan, Mostafa T Eldestawy, Hazem B Zakaria, Shaimaa H Mohamed, Mosab F Alassal, Hany Elsegeay, Mohamed Y Elamir","doi":"10.4081/aiua.2025.13938","DOIUrl":"10.4081/aiua.2025.13938","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effectiveness of laparoscopic varicocelectomy in patients with clinical versus subclinical varicocele concerning preoperative and postoperative seminal parameters.</p><p><strong>Patients and methods: </strong>Between February 2021 and August 2024, a total of 162 patients diagnosed with varicocele (72 with subclinical and 90 with clinical presentation) seeking infertility advice (primary or secondary) at the author's institution underwent laparoscopic varicocelectomy and were enrolled in the study. All patients underwent history taking, clinical examination, semen analysis, and scrotal colour Doppler ultrasonography. Patients with recurrent varicocele, azoospermia, or infertility due to causes other than varicocele were excluded from the study. Semen analysis was conducted for all patients before laparoscopic varicocelectomy and 3 to 6 months after varicocelectomy.</p><p><strong>Results: </strong>Significant improvements in seminal parameters were observed in patients with clinical varicocele (p < 0.05). Bilateral and right-sided varicoceles were more prevalent in patients with subclinical varicocele. Additionally, the incidence of secondary infertility was higher in patients with subclinical varicocele compared to those with clinical varicocele (p<0.05).</p><p><strong>Conclusions: </strong>Our study indicates favourable outcomes of laparoscopic varicocelectomy in patients with clinical varicocele. Regarding the effects of varicocelectomy in patients with subclinical varicocele, we recommend avoiding varicocelectomy in subclinical group of patients unless no identifiable causes of semen abnormality.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"97 2","pages":"13938"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530340","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":"Does bilateral undescended testis have worst testicular function than unilateral cases? A meta-analysis of adult orchidopexy patients.","authors":"Anak Agung Ngurah Krisnanta Adnyana, Marshal Harvy Wicaksono Pantjoro, Gede Wirya Kusuma Duarsa","doi":"10.4081/aiua.2025.13918","DOIUrl":"10.4081/aiua.2025.13918","url":null,"abstract":"<p><strong>Introduction: </strong>Cryptorchidism, or undescended testis (UDT), is a congenital anomaly linked to an increased risk of infertility. The laterality of UDT, whether unilateral or bilateral, may influence post-orchidopexy outcomes. This meta-analysis compares testicular function and azoospermia rates between patients with bilateral and unilateral UDT post-orchiopexy.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was performed using PubMed, ScienceDirect, and Google Scholar databases up to March 2025. Statistical analyses were conducted using Review Manager (RevMan).</p><p><strong>Results: </strong>Ten eligible studies were included in the analysis, comprising 563 bilateral UDT post-orchidopexy and 1259 unilateral UDT post-orchidopexy cases. Populations post bilateral orchidopexy have significantly higher FSH level (MD: 3.77 UI/L [95% CI: 1.65 - 5.89]), significantly higher LH level (MD: 1.27 UI/L [95% CI: 0.27 - 2.26]), lower inhibin B level (MD: -44.86 pg/mL [95% CI: -69.58 - -20.15]), and higher frequency of azoospermia (OR 2.3 [95% CI: 1.57 - 3.37]) compared to unilateral UDT post orchidopexy.</p><p><strong>Conclusions: </strong>Bilateral UDT post-orchidopexy exhibits poorer testicular function with significantly higher FSH and LH levels, reduced inhibin B levels, and a greater incidence of azoospermia compared to unilateral UDT post-orchidopexy.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"97 2","pages":"13918"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530336","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":"PSMA PET/CT in the diagnosis of prostate cancer: why and when?","authors":"Pietro Pepe, Ludovica Pepe, Daniele Cignoli, Marco Roscigno","doi":"10.4081/aiua.2025.13746","DOIUrl":"10.4081/aiua.2025.13746","url":null,"abstract":"<p><p>Prostate-specific membrane antigen (PSMA) is expressed in most primitive and metastatic prostate cancer (PCa), and PSMA inhibitors conjugated with the radionuclides Gallium 68 (68Ga) and fluoride 18 (18F) have been evaluated to detect PCa; moreover, tumour uptake, which represents PSMA expression, is highly correlated with the aggressiveness of the primary prostatic tumour. PSMA positron emission tomography/computed tomography (PET/CT) demonstrated to be sensitive for the detection of primary prostatic lesions, regional lymphadenopathy and clinical metastases in case of biochemical recurrence. In this respect, PSMA PET/CT has been evaluated in men enrolled in clinical trials candidate to initial or repeat prostate biopsy especially in the presence of clinical high risk for PCa, Active Surveillance (AS) and/or in case of negative histology of Prostate Imaging Reporting and Data System (PI-RADS score) 4-5 targeted biopsy. Although many experimental studies reported a superimposable detection rate for PCa of PSMA PET/CT vs. mpMRI targeted biopsy, still today, the use of PSMA PET/CT is experimental and had some limitations: cost, availability, patient characteristics, local expertise and false negative rate. Although prospective and randomized studies are awaited, including a greater number of patients, PSMA PET/CT evaluation could be proposed in the presence of claustrophobia, cardiac pacemaker and severe obesity especially in men at high risk for PCa.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13746"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081351","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":"Extra-anatomical urinary diversion for malignant ureteric obstruction: our clinical experience.","authors":"Napoleon Moulavasilis, Konstantinos Douroumis, Konstantinos Kotrotsios, Periklis Anastasiou, Panagiotis Levis, Evangelos Fragkiadis, Ioannis Anastasiou","doi":"10.4081/aiua.2025.13869","DOIUrl":"10.4081/aiua.2025.13869","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Ureteral stenosis and upper urinary tract obstruction present significant clinical challenges, especially in cases involving complex, long strictures. Traditional management options like ureteral stents and percutaneous nephrostomy tubes often result in complications and diminished quality of life. Extra-anatomical urinary diversion (EAUD) offers an alternative approach, particularly for oncologic patients requiring palliative care.</p><p><strong>Materials and methods: </strong>From 2015 to 2019, eight patients with cancer-related ureteral strictures underwent EAUD. In all patients cancer-specific prognosis exceeded one year. The procedure was performed using a standard surgical technique.</p><p><strong>Results: </strong>The mean patient age was 62.5 years, ranging from 22 to 82 years. The mean follow-up duration was 62.8 months. Improvement in renal function was observed in some patients, while the early complication rate was 62.5%. Notable complications included infections and encrustation of the prosthesis. Two patients experienced multiple infections of the overlying skin and soft tissue necessitated the dislodgement of the prothesis after 38 and 101 months, respectively.</p><p><strong>Conclusions: </strong>Extra-anatomical stent placement constitutes a somewhat effective and safe option in the context of complex ureteral obstruction management in oncologic patients. The lack of external devices and its longer duration without the need for substitution compared with conventional double J stents can theoretically assure a better quality of life. However, a careful patient selection is needed in order to maximize the patients' benefit.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13869"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152281","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":"Is silodosin better than tadalafil as a medical expulsive therapy in lower ureter stones?","authors":"Mohab Alsaid Saad Abdalaziz, Yousif Ahmad Hanafi, Belal Mohamed Hamed, Omar Fayez Abbas, Khaled Omar Mahmoud Khader, Mohammad Kh Alzawahreh, Hesham Ghzayel, Rashed Yousef Al Sharqi, Zaid F Altawallbeh","doi":"10.4081/aiua.2025.13642","DOIUrl":"10.4081/aiua.2025.13642","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aims to compare the efficacy and safety of tadalafil and silodosin as medical expulsive therapy (MET) for lower ureteric stones below 10 mm. The study also assesses the incidence of adverse effects associated with each drug.</p><p><strong>Methods: </strong>A comprehensive search of electronic databases was conducted up to October, 2024. The study included randomized controlled trials (RCTs) and cohort studies that compared tadalafil and silodosin in patients with lower ureteric stones (5-10 mm). The primary outcomes assessed were stone expulsion time (SET), stone expulsion rate (SER), and adverse effects. Data were analyzed using a random-effects model for heterogeneity and a fixed-effect model for non-heterogeneity.</p><p><strong>Results: </strong>Eight studies involving 797 patients were included. The pooled analysis showed no significant difference in SET between tadalafil and silodosin (MD = 0.15, 95% CI [-0.28, 0.57], p=0.50), with significant heterogeneity. Similarly, the pooled analysis showed no significant difference in SER between the two drugs (RR = 0.92, 95% CI [0.80 to 1.05], p=0.22), with heterogeneity. However, after excluding one study, silodosin was favored over tadalafil for SER (RR 0.88, 95% CI [0.79 to 0.98], p=0.02). There were no significant differences in headache, backache, or dizziness. Silodosin was associated with a higher incidence of orthostatic hypotension, but this was resolved by excluding one study. A significant difference for abnormal ejaculation favored tadalafil (RR = 0.16, 95% CI [0.09 to 0.29], p=0.01).</p><p><strong>Conclusions: </strong>While the pooled results initially showed no significant difference in SET and SER, silodosin demonstrated a superior stone expulsion rate after adjusting for heterogeneity silodosin showed a trend towards shorter SET. However, silodosin was associated with a higher risk of orthostatic hypotension and abnormal ejaculation. Further high-quality RCTs with larger sample sizes are needed to confirm these findings.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13642"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057453","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":"A comparison of renal cell carcinoma with tumor thrombus across North America, Central/South America, and South Korea.","authors":"Maxwell Sandberg, Rachel Vancavage, Claudia Marie-Costa, Emily Ye, Mitchell Hayes, Justin Miller, Reuben Ben David, Kartik Patel, Kimberly Waggener, Brejjette Aljabi, SeokSoon Byun, Patricio García Marchiñena, Thiago Mourao, Charles Peyton, Reza Mehrazin, Philippe Spiess, Rafael Zanotti, Steven Chang, Stenio de Casio Zequi, Diego Abreu, Alejandro Rodriguez","doi":"10.4081/aiua.2025.13820","DOIUrl":"10.4081/aiua.2025.13820","url":null,"abstract":"<p><strong>Purpose: </strong>With multi-institutional collaboration, the purpose of this study was to analyze geographical differences of renal cell carcinoma with tumor thrombus between patients in North America, Central/South America, and South Korea.</p><p><strong>Materials and methods: </strong>Patients with renal cell carcinoma and a tumor thrombus who underwent nephrectomy plus thrombectomy were retrospectively analyzed. Patients were from North America, Central/South America, and South Korea. All comparisons were done based on the region where a patient had their surgery and follow-up. Chi-squared test, analysis of variance, Kaplan-Meier survival with log-rank test, and Cox regression analysis were used.</p><p><strong>Results: </strong>A total of 478 patients were included, 212 from North America, 209 from Central/South America, and 57 from South Korea. Of note, thrombus level was different using the Neves classification system between regions (p<0.001), with a greater thrombus level in Central/South America. Surgical approach differed, with laparoscopic cases done most often in Central/South America and robotic in North America (p<0.001). Tumor grade was lowest in South Korea (p<0.001) and stage (p<0.001) greatest in Central/South America. Overall survival was greater in South Korea compared to Central/South America (p=0.026). Cancer-specific survival was greater in South Korea relative to North America and Central/South America (p=0.026).</p><p><strong>Conclusions: </strong>Patients from North America, Central/South America, and South Korea diagnosed with renal cell carcinoma and tumor thrombus do not present the same and have different outcomes peri-/post-operatively. This includes important variables which have impacts on patient morbidity and mortality. Considering increased efforts on health equity in urology.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13820"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259107","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":"What is the diagnostic process experience of patients with genital Lichen? An Italian Survey.","authors":"Stefano Lauretti, Michele Rizzo, Lorena Di Marco, Luca Braulin, Enzo Maria F Palminteri, Marco Bitelli, Muriel Rouffaneau, Tommaso Cai, Giovanni Liguori, Alessandro Palmieri","doi":"10.4081/aiua.2025.13379","DOIUrl":"10.4081/aiua.2025.13379","url":null,"abstract":"<p><strong>Introduction: </strong>Genital Lichen Sclerosus (GLS) is a chronic inflammatory disease due to autoimmune events that occurs in anogenital region. It seems to affect mostly women but both the etiology and the prevalence of the disease are largely unknown. The aim of this cross-sectional study was to examine the real-world diagnostic and therapeutic experiences of patients with GLS, focusing on their perceptions and expectations regarding disease management.</p><p><strong>Methods: </strong>Utilizing Google Forms, we developed a questionnaire consisting of 10 items aimed at examining the diagnostic and therapeutic experiences of patients with GLS. This survey was distributed via email to all members of the Italian Association of Patients with Lichen Sclerosus (LISCLEA), which includes 564 female and 216 male members. The survey was accessible for a period of 48 hours in February 2020.</p><p><strong>Results: </strong>Of the 780 members surveyed, 280 (36.3% response rate) completed the questionnaire, comprising 226 females (80.7%), 53 males (18.9%), and 1 respondent (0.4%) who did not declared her/his gender identity. A significant 34% of respondents waited over five years for a correct diagnosis of GLS. Diagnostic challenges were frequently reported, with a majority (78%) believing that doctors' knowledge about LS is inadequate. Moreover, 63.9% expressed a need for better medical training concerning GLS, supported by calls for more research networks (42.5%) and specialized centers (26.1%). GLS had a severe impact on sexual health and relationships; 57.3% reported anxiety due to GLS, and 39% avoided intercourse because of symptoms like pain and discomfort. The majority (95%) received local treatments, while a small percentage (5%) underwent surgical interventions such as circumcision. The diagnostic and therapeutic process was perceived as difficult by most patients (82%).</p><p><strong>Conclusions: </strong>GLS profoundly affects patients' quality of life, causing significant anxiety, discomfort, and often hindering sexual activity. The study highlights the commonality of late diagnoses and the insufficient referral of patients to specialists, underscoring the need for greater awareness and expertise among healthcare providers. Enhancing doctor awareness and knowledge could facilitate earlier diagnosis and more effective management of GLS, thereby improving outcomes for those affected by this debilitating condition. This research advocates urgent enhancement in both medical education regarding GLS and the establishment of more specialized care pathways to better address the complexities of this disease.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13379"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101970","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":"Urine pH, citrate, and beyond: challenges of pharmaceutical stone management in daily urological practice.","authors":"Georgios Tsampoukas, Mohammad Ferdous Hossain, Antigoni Katsouri, Alisha Pati-Alam, Evangelos N Symeonidis, Mohammad Moussa, Murtadha Almusafer, Mohammed Alameedee, Athanasios Papatsoris","doi":"10.4081/aiua.2025.13798","DOIUrl":"10.4081/aiua.2025.13798","url":null,"abstract":"<p><p>Kidney stone disease, or nephrolithiasis, is a prevalent urological condition with variable pathogenesis. Among various factors, urine pH is not only considered to be a more influential factor in stone formation and can aid in the early diagnosis and management of specific stone types such as uric acid, cystine, calcium phosphate and struvite stones, but the role of urine pH in calcium oxalate stones, which comprise most cases, is more complex. Hypocitraturia in routine evaluation is another recognizable factor in lithogenesis, and administration of citrate, a widely used agent in the conservative management of stones. corrects hypocitraturia. Citrate also alkalizes the urine and can therefore be used to dissolve and prevent uric acid stones. However, citrate can induce the formation of insoluble calcium phosphate salts, such as brushite and hydroxyapatite, which can lead to mixed stones and the development of nephrocalcinosis. To address this complexity, innovative treatments that focus on a broader inhibition of lithogenesis with pH-modifying strategies may allow for more comprehensive management. In addition, modern technological tools such as pH meters and pH-tracking mobile applications can offer personalized treatment plans, potentially improving patient outcomes. The current lack of consensus on the standard and optimal management of pH measurement and modification underscores the need for further research and greater collaboration among experts. The development of evidence-based strategies will be essential to improve prevention and nephrolithiasis.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13798"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477274","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}