Archivio Italiano di Urologia e Andrologia最新文献

{"title":"Laparoscopic radical prostatectomy with the simultaneous implant of a penile prosthesis: ten years follow up.","authors":"Nicola Mondaini, Andrea Abramo, Caterina Romeo, Fabio Crocerossa, Francesco Cantiello, Rocco Damiano, Riccardo Bartoletti","doi":"10.4081/aiua.2025.13541","DOIUrl":"10.4081/aiua.2025.13541","url":null,"abstract":"<p><strong>Introduction: </strong>Even today, despite technological evolution, erectile dysfunction remains the most feared complication after radical prostatectomy surgery expecially for patients who report pre-existent refractory erectile dysfunction (ED) and patients in whom there is a high risk of extracapsular disease, such as any cT2c or cT3, who undergo non-nerve sparing radical prostatectomy (RP). To overcome this issue, Khoudary et al. performed the first simultaneous placement of a penile prosthesis during open RP in 1997, aiming at an early return to sexual function without any impact on oncological outcomes and without significant adverse effects. Ten years ago we performed laparoscopic extraperitoneal RP and simultaneous penile prosthesis implantation (PPI) on ten patients in order to preserve the full length of the penis and to improve their satisfaction and quality of life (QoL) increasing the chances of ED resolution.</p><p><strong>Objectives: </strong>Aim of this study is to illustrate the ten years follow up of this case series which has no terms of comparison in the world. Oncological and functional results were analyzed.</p><p><strong>Materials and methods: </strong>In 2013 10 patients underwent simultaneous PPI (with an AMS InhibiZone prosthesis). Patients were evaluated by means of urological visits, questionnaires, and objective measurements before surgery, at discharge from the hospital, on postoperative days 21 to 28, each 3 months for the first year, and each year thereafter. The main outcome measures were biochemical recurrence-free rate, penile length and quality of life.</p><p><strong>Results: </strong>Eight patients with mean age 71 (range 66-75) were reached at the 10-year follow-up; one patient died of acute infarction 10 years after surgery and another one died of disease 7 years after surgery. Partners had, currently, mean age 60 (range 37-71). Mean preoperative PSA was 9.3 (6.3-13.7) and mean PSA at 10 years was 0.08 (range 0.01-1.2). International index erectile function IIEF before surgery was 11 (range 9-14) and 23 (range 22-25) at 10 years. Partner satisfaction rating increased from 7 (post-surgical) to 8 at 10 years. Penis length was unchanged after 10 years: mean intraoperative length was 9 cm (range 8.5-9.5) and mean length at 10 years was 8.8 cm (range 8-9.5).</p><p><strong>Conclusions: </strong>In our cases, laparoscopic radical prostatectomy with the simultaneous implant of a penile prosthesis demonstrate to be an interesting option to offer to selected and highly motivated patients. Outcomes like preservation of the penis length, resuming of normal sexual activity 21 days after surgery, partner satisfaction and oncological safety at 10-year follow-up make it a valid surgical technique to be proposed in clinical practice if performed by an experienced team in prosthetic surgery.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13541"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450047","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":"Sperm DNA fragmentation: focusing treatment on seminal transport fluid beyond sperm production.","authors":"Moises Abraham Adel Domínguez, Walter D Cardona Maya, Andrés Mora Topete","doi":"10.4081/aiua.2025.13128","DOIUrl":"10.4081/aiua.2025.13128","url":null,"abstract":"<p><strong>Aim: </strong>To determine the effects of oral antibiotics and anti-inflammatory agents on semen parameters and the sperm DNA fragmentation index (DFI).</p><p><strong>Methods: </strong>Ninety-eight men with infertility diagnosis were included. The participants submitted two semen samples, before and at least two months after treatment. Macroscopic and microscopic semen parameters were evaluated following the World Health Organization (WHO) guidelines. In addition, the sperm DFI was evaluated using the sperm chromatin dispersion (SCD) technique. Subsequently, a treatment regimen was administered, including daily oral doses of ciprofloxacin (1000 mg) and doxycycline (100 mg) for 21 and 10 days, respectively. In addition, non-steroidal anti-inflammatory drugs (15 mg of meloxicam) were used for 10 days. After treatment, the same parameters were re-evaluated for new semen samples taken under the same initial conditions.</p><p><strong>Results: </strong>After treatment, significant increases in pH, sperm count, total concentration, and normal sperm morphology were observed, but no significant differences were found in the seminal volume parameter or progressive motility. After treatment, a significant decrease in the concentration of immature cells was observed, and although not statistically significant, a reduction in the concentration of leucocytes was observed. After treatment, the mean sperm DFI significantly decreased from 28.24± 2.39% to 16.2±7.1%.</p><p><strong>Conclusions: </strong>Treatment with antibiotics and anti-inflammatories significantly reduced the sperm DFI and improved semen quality.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13128"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068738","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 effect of hyperbaric oxygen therapy on hypospadias reconstruction: a preliminary randomized controlled trial study of VEGF levels and HOPE score analysis.","authors":"Mendy Hatibie Oley, Maximillian Christian Oley, Ari Astram Adhiatma Iskandar, Chaula Luthfia Sukasah, Indri Aulia, Fima Lanra Fredrik G Langi, Harsali Fransicus Lampus, Irawan Sukarno, Vania Sukarno, Muhammad Faruk","doi":"10.4081/aiua.2025.13342","DOIUrl":"10.4081/aiua.2025.13342","url":null,"abstract":"<p><strong>Introduction: </strong>Hypospadias is a congenital abnormality of the urethral meatus in males. Hypospadias can be corrected by two-stage urethroplasty. Hyperbaric oxygen therapy (HBOT) can accelerate wound healing after surgery by increasing oxygenation, angiogenesis, and collagen synthesis. This study aimed to measure the effectivity of HBOT based on serum vascular endothelial growth factor (VEGF) level and Hypospadias Objective Penile Evaluation (HOPE) score in hypospadias reconstruction patients.</p><p><strong>Methods: </strong>This was a randomized controlled trial study. Hypospadias reconstruction was performed using the Sidik-Chaula and Manset Flap techniques. Each HBOT session ranged from 30-60 minutes, administered at 1-3 atm. Twenty subjects were divided into two groups: the HBOT and control groups. VEGF serum levels were measured 1 hour after the operation and 1 hour after every HBOT session. The HOPE score was assessed at the bedside by the attending physician, consisting of six items: the position of the meatus, the shape of the meatus, the shape of the glans, the shape of the penile skin, and the shape of the penile axis, including penile torsion and penile curvature. The data were analyzed with SPSS version 28, using the Shapiro-Wilk and independent t-test methods.</p><p><strong>Results: </strong>There was a trend of increasing VEGF levels as the number of HBOT sessions increased, with significant increase found in patients who underwent three (p=0.038), four (p=0.002), and five (p=0.008) HBOT sessions. We found a significant increase in the total HOPE score (p=0.028) and penile torsion score (p=0.006) in the HBOT group.</p><p><strong>Conclusions: </strong>HBOT can accelerate wound healing after urethroplasty. Three or more HBOT sessions are recommended after the repair of hypospadias.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13342"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674749","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":"Predictive role of lactylation-related gene signature in the prognosis and immunotherapy response in bladder cancer.","authors":"Guoyuan Liu, Ting Hong, Xinyu Liu, Xuanhao Lin, Peixiu Yao, Xifeng Chen, Yonghai Zhang, Kemal Sarica, Xuwei Hong","doi":"10.4081/aiua.2025.13516","DOIUrl":"10.4081/aiua.2025.13516","url":null,"abstract":"<p><strong>Objective: </strong>Lactylation is a type of chemical modification involving the introduction of lactyl groups to a molecule which can affect the interactions between tumor cells and their microenvironment. This study aims to evaluate the possible role of lactylation-related gene signature in the prediction of both prognosis and immunotherapy response in bladder cancer (BLCA).</p><p><strong>Methods: </strong>Lactylation-related genes were obtained from the published work and two subtypes (cluster A and B) were identified through unsupervised clustering. The differences including clinical features, differentially expressed genes (DEGs), pathways, and immune cell infiltration between these two clusters were thoroughly examined.</p><p><strong>Results: </strong>By utilizing the DEGs between the two clusters, a lactylation score was identified to predict the overall survival status and the response of BLCA patients receiving immunotherapy. Our results demonstrated that patients with a high lactylation score tended to have a worse survival period and increased immune cell infiltration level. Further analysis showed that high lactylation score may be associated with higher sensitivity to immune checkpoint inhibitor (ICI) treatment which is crucial in the identification of the suitable candidates for ICI therapy.</p><p><strong>Conclusions: </strong>Our results emphasize the possible predictive role of lactylation-related gene signature both in the survival rates of BLCA and its implications for treatment strategies.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13516"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450005","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":"Editorial comment on \"Urogenital and extra genital mutilation in gender-affirming surgery: are we violating <i>primum non nocere</i>?\"","authors":"Tommaso Cai, Alessandro Palmieri","doi":"10.4081/aiua.2025.13709","DOIUrl":"10.4081/aiua.2025.13709","url":null,"abstract":"<p><p>In the Archivio Italiano di Urologia e Andrologia, Zeki Bayraktar presented the results of a review of all published research on the quality of life, satisfaction, patient-reported outcomes, and short- and long-term problems of patients who had gender-affirming surgery (GAS)...</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13709"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674747","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":"Unlocking the potential of antioxidant supplementation with n-acetylcysteine to improve seminal parameters and analysis of its safety: a systematic review and meta-analysis of randomized controlled trials.","authors":"Syarif Syarif, Moh Anfasa Giffari Makkaraka, Ahmad Taufik Fadillah Zainal, Ponco Birowo, Widi Atmoko","doi":"10.4081/aiua.2025.13750","DOIUrl":"10.4081/aiua.2025.13750","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>N-acetyl-cysteine (NAC) is one of the oldest and most powerful antioxidants used to treat various diseases. It plays an important role in protecting cells against oxidative damage and has the potential to improve seminal parameters in male with infertility. This systematic review and meta-analysis aim to comprehensively evaluate the efficacy and safety profile of antioxidant supplementation with NAC in male with infertility or impaired semen parameters.</p><p><strong>Materials and methods: </strong>This systematic review and meta-analysis adhered to Cochrane Handbook guidelines. A literature search across PubMed, ScienceDirect, Cochrane Library and Scopus on February 21, 2024 of studies evaluating NAC supplementation for male infertility or impaired semen parameters was conducted. Study quality was assessed using Revised Cochrane's risk of bias (RoB 2.0) and RevMan 5.4 was used for meta-analysis.</p><p><strong>Results: </strong>Search yielded 1.106 articles and 5 studies were included in this meta-analysis. Our study showed that patients who received NAC had statistically significant results in improving sperm volume [MD: 0.69 (0.26-1.12), P = 0.002], sperm concentration [MD: 4.43 1.50-7.36), P = 0.003], sperm total motility [MD: 9.69 (6.61-12.77), P < 0.00001], and normal sperm morphology [MD: 1.36 (0.70-2.03), P < 0.0001] compared to control. Additionally, patients given NAC had no reported side effects based on our included studies.</p><p><strong>Conclusions: </strong>We found NAC supplementation significantly improves seminal parameters and has a favorable safety profile. These findings highlight the potential role of NAC as a safe supplementation for male with infertility or in male with impaired semen parameters.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13750"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693996","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 comprehensive systematic review of studies on the potential of A49T and V89L polymorphism in SRD5AR2 as high susceptibility gene association with benign prostate hyperplasia and prostate cancer.","authors":"Revina Maharani, Hotma Lestari, Putra Mahakarya Dewa, Dewangga Yudisthira, Nasim Amar, Besut Daryanto","doi":"10.4081/aiua.2025.13318","DOIUrl":"10.4081/aiua.2025.13318","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Being the most common disease in aged men, the etiology of benign prostatic hyperplasia (BPH) is not fully defined. Recent studies have reported that the association between BPH and metabolic genes is still inconsistent. A gene connected with BPH is SRD5AR2, whose polymorphisms, A49T and V89L, have distinct enzyme activity. This systematic review examines SRD5AR2 polymorphisms within two alleles (A49T and V89L), assessing their roles as prognostic indicators of malignancy, and response to medication.</p><p><strong>Materials and methods: </strong>We conducted a search on six different databases, including PubMed, Scopus, Wiley, ProQuest, Cochrane Central, and Science Direct using as string of keywords (BPH) AND [(rs523349) OR (V89L)] AND [(rs9282858) OR (A49T)]. We finally selected seven articles to be extracted. Quality appraisal of clinical trials was evaluated using the Joanna Briggs Institute Approach for systematic reviews.</p><p><strong>Results: </strong>We sorted nine clinical studies from various countries examining SRDA52 polymorphism and its association of BPH and prostate cancer. About V89L we found that the \"LL\" genotype, indicating reduced 5α-reductase activity, is linked to a lower BPH risk, while the \"VV\" genotype may slightly increase BPH risk. About A49T, compared to \"AA\" genotype, \"AT\" tends to be associated to higher risk in developing prostate cancer. A49T polymorphism does not show any effect on medical treatment while V89L showed a protective effect on the clinical progression of BPH when treated with 5a-reductase inhibitors, aadrenergic receptor antagonists, and alpha blockers.</p><p><strong>Conclusions: </strong>SRD5A2 polymorphisms could be a good indicator for prognostic malignancy and a potential tool for personalized medicine of BPH. The findings strongly support the recommendation for further study about SRD5AR2 to enhance its use for screening and prevention and to optimize the medical treatment of BPH.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13318"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450686","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":"Treatment with perilesional injections of pentoxifylline in patients with Peyronie's disease improves the therapeutic effect of oral and topical antioxidant therapy.","authors":"Gianni Paulis, Andrea Paulis, Giovanni De Giorgio","doi":"10.4081/aiua.2025.13525","DOIUrl":"10.4081/aiua.2025.13525","url":null,"abstract":"<p><p>To the Editor, We conducted a retrospective study to demonstrate that it is possible to achieve better therapeutic outcomes through combining perilesional injections of pentoxifylline (PTX) with oral antioxidants and the local application of a cream containing antioxidants and a gel containing diclofenac in patients with Peyronie's disease (PD)...</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13525"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391808","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 impact of inflammation on prostate tumor dynamics: a pathological perspective on prostate cancer and benign prostatic hyperplasia.","authors":"Syakri Syahrir, Muhammad Asykar Palinrungi, Mochammad Hatta, Khoirul Kholis, Syarif Syarif, Abdul Azis, Muhammad Faruk","doi":"10.4081/aiua.2025.13353","DOIUrl":"10.4081/aiua.2025.13353","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic inflammation is associated to the pathogenesis of prostate cancer (PCa) and benign prostatic hyperplasia (BPH). This study evaluated the correlation between inflammatory markers fibroblast growth factor-2 (FGF2), interleukin (IL)-8, and IL-6 in PCa and BPH tissues to understand their involvement in disease progression.</p><p><strong>Methods: </strong>A cross-sectional investigation was carried out, examining prostate specimens from 62 male patients diagnosed with PCA or BPH. Specimens were taken via transurethral resection of the prostate (TURP) and stained with hematoxylin and eosin to look for inflammatory infiltrates and aggressiveness. The levels of FGF2, IL-8, and IL-6 were evaluated using ELISA. Chi-square and logistic regression tests were used in the statistical analysis.</p><p><strong>Results: </strong>High-grade inflammation was found in all BPH cases (100%), but not in PCa cases. In BPH tissues, elevated levels of IL-8 and IL-6 had a significant correlation with high-grade inflammation (p < 0.05). On the other hand, PCa tissues had considerably greater FGF2 levels than benign tissues (p < 0.05). Elevated FGF2 levels and the lack of high-grade inflammation in PCa tissues point to different pathogenic processes in PCa and BPH.</p><p><strong>Conclusions: </strong>This study emphasizes the importance of chronic inflammation in BPH development, with IL-8 and IL-6 playing essential roles. The results imply that treating BPH by focusing on IL-8 and IL-6 may be beneficial. Increased levels of FGF2 in PCa tissues suggest that this protein may be used as a biomarker and therapeutic target for PCa. These findings highlight the importance of targeting both inflammatory and growth factor pathways for treating prostatic disorders.</p>","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":" ","pages":"13353"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693991","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":"Comparative evaluation of the efficacy and safety of antegrade minimally percutaneous nephrolithotomy and retrograde intrarenal surgery in the treatment of upper ureteral impacted stones: a retrospective cohort study.","authors":"Kequan Cheng, Xuwei Hong, Gang Wang, Zepai Chi, Kemal Sarica, Guoyuan Liu, Yonghai Zhang","doi":"10.4081/aiua.2025.13336","DOIUrl":"10.4081/aiua.2025.13336","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) vs minimally invasive percutaneous nephrolithotomy (mPCNL) in the minimal invasive management of impacted upper ureteral stones along with the evaluation of predictive radiological parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;A retrospective analysis was done in 124 patients, undergoing RIRS (n:61) and mPCNL (n:63) for the management of impacted upper ureteral stones. Both operative (success and complication rates, operative time, postoperative hospital stay) and radiological (ureteral wall thickness, UWT), stone volume (SV), and stone density (Hounsfield unit, HU) factors were all evaluated and recorded. Comparative evaluation of stone free status in both groups was done following 72 hours and 4-weeks after the procedures to calculate the primary stone-free as well as final stone clearance rates. Additionally, the outcomes of RIRS group were categorized based on the intraoperative findings (presence or absence of stone encasement by a polyp) and preoperative radiological parameters. All data were well analyzed for statistical significance. A significance level of p&lt;0.05 was considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline patient and stone related characteristics were similar in two groups. The success rates after a single session for RIRS and mPCNL were 73.77% and 93.65%, respectively (p=0.003), indicating a significantly higher success rate for mPCNL. However the final stone clearance rates were 96.72% and 100.00%, respectively (p=0.147), with no significant difference observed among the groups. The RIRS group demonstrated higher rate of need for auxiliary treatments (p&lt;0.001), shorter hospital stay (p&lt;0.001) and lower incidence of bleeding (p&lt;0.001). Radiological evaluation showed no significant differences in stone volume, HU and UWT values between patients with and without residual stones after RIRS (Pstone volume = 0.151, PHU = 0.451, PUWT = 0.083). Similarly, no significant differences were observed with respect to these values also in mPCNL patients, (Pstone volume = 0.532, PHU = 0.455, PUWT = 0.658). However, a significant difference has been noted regarding the mean value of UWT between the stones surrounded by a polypoid alterations and the ones without such changes with values 5.23 ± 0.65 mm, to 4.10 ± 0.82 mm, respectively (p=0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our results demonstrated that antegrade mPCNL achieves faster stone clearance and a lower re-treatment rate without serious complications in impacted upper ureteric stones. However, RIRS could be a valuable and safe alternative with comparable success rates particularly in cases with contraindications to or unwillingness for mPCNL. Preoperative assessment of ureteral wall thickness (UWT) value may be a good predictor for the possible tissue changes in ureteral wall at stone site to guide the decision making of the most app","PeriodicalId":46900,"journal":{"name":"Archivio Italiano di Urologia e Andrologia","volume":"97 1","pages":"13336"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754727","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}