International Braz J Urol最新文献

{"title":"Asymptomatic Leukocytospermia and Assisted Reproductive Technology Outcomes: Reason for concern?","authors":"Marie-Christin Reich, Natalie Heide, Peter Corrêa Humaidan, Sandro C Esteves","doi":"10.1590/S1677-5538.IBJU.2025.0166","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0166","url":null,"abstract":"<p><p>Leukocytospermia, defined as ≥1×10⁶ white blood cells (WBC)/ml of semen, is a condition frequently observed in infertile men. While symptomatic leukocytospermia is often associated with genital tract infections and managed accordingly, the clinical significance of asymptomatic leukocytospermia remains uncertain-particularly in the setting of Assisted Reproductive Technology (ART). Seminal leukocytes, primarily neutrophils, play a physiological role in immune surveillance and tissue homeostasis. However, when excessively activated, they may generate high levels of reactive oxygen species (ROS), contributing to oxidative stress, sperm dysfunction, and DNA damage. This narrative review critically examines whether asymptomatic leukocytospermia adversely affects ART outcomes, including fertilization, embryo development, clinical pregnancy, and live birth rates. A synthesis of current evidence-including meta-analyses and large retrospective studies-suggests that asymptomatic leukocytospermia does not negatively impact these outcomes. Moreover, standard sperm preparation techniques and the widespread use of ICSI appear to neutralize any potential deleterious effects from seminal leukocytes. Given the absence of compelling evidence supporting its harmful impact on ART success, routine treatment of asymptomatic leukocytospermia-particularly with empiric antibiotics-is not recommended. Such interventions may disturb the natural immune balance, promote antibiotic resistance, and increase healthcare burdens without demonstrable benefit. Nonetheless, selective treatment may be justified in specific scenarios, such as recurrent implantation failure or early pregnancy loss. Further research is warranted to standardize leukocyte detection methods and to clarify the role of adjunctive therapies. Until more definitive data emerge, an individualized, evidence-based approach remains the most appropriate strategy for managing asymptomatic leukocytospermia in infertile men pursuing ART.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053498","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}

{"title":"International Brazilian of Urology is the Seventh Biggest Impact Factor (4.5) Among Urology and Andrology Journals in the World.","authors":"Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2025.05.01","DOIUrl":"10.1590/S1677-5538.IBJU.2025.05.01","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627538","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}

{"title":"Male Infertility: Diagnostic Approach - A Committee Opinion.","authors":"Sandro C Esteves, Marina C Viana, Augusto B Reis, Filipe Tenório Lira, Thiago Afonso Teixeira, João Paulo Camarço, Matheus Gröner, Antônio José T Paula, Alberto C Stein, Maria Gabriela F Mulato, Jorge Hallak, Renato Fraietta","doi":"10.1590/S1677-5538.IBJU.2025.0223","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0223","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003054","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}

{"title":"New Evidence on an Old Question: a Meta-Analysis of Wallace versus Bricker Anastomoses.","authors":"Francisco Jazon de Araújo, Frank Robisom Costa de Sousa, Camille Rodrigues Aggensteiner, Gabriel Bruno Jácome de Melo, Pedro Aquiles Souza das Chagas, Thomas Silva de Queiroz, Rafael Paiva Arruda, Francisco Eugênio Vasconcelos, Paulo Silveira Campos Soares, Cristiano Araújo Costa, João Pompeu Frota Magalhães, Bárbara Vieira Lima Aguiar Melão","doi":"10.1590/S1677-5538.IBJU.2025.0100","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0100","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis compares the efficacy and safety of the Bricker and Wallace techniques, focusing on updating previously unassessed clinical outcomes to inform surgical decision-making.</p><p><strong>Material and methods: </strong>A systematic review and meta-analysis followed PRISMA and Cochrane guidelines, with the protocol in PROSPERO (CRD42024621076). Searches in MEDLINE/PubMed, EMBASE, and Cochrane Library included Randomized Clinical Trials and cohort studies comparing both anastomosis techniques. Analyses used Odds Ratio (OR) and mean differences with a random-effects model.</p><p><strong>Results: </strong>Fourteen studies with 1,903 patients (980 Bricker; 923 Wallace) were included. No significant difference was found in overall stricture rates. However, the Bricker technique had more unilateral strictures (OR 0.47; 95% CI 0.30-0.75; p < 0.01), while the Wallace technique had lower stricture rates in patients who underwent ileal-conduit urinary diversion (OR 0.35; 95% CI 0.19-0.64; p < 0.001), and patients without prior radiotherapy (OR 0.29; 95% CI 0.14-0.61; p < 0.001). Wallace also presented reduced hydronephrosis (OR 0.37; 95% CI 0.17-0.79; p < 0.05). No significant differences were observed in patients undergoing neobladder diversion or those with bladder cancer.</p><p><strong>Conclusion: </strong>No difference in main analyses of stricture rates was found, supporting that technique choice should rely on surgeon preference and expertise. Therefore, beyond surgeon preference, the choice of technique should consider the patient's history of radiotherapy, and the type of urinary diversion planned, aiming to optimize postoperative outcomes and minimize the risk of specific complications.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310679","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}

{"title":"Integrating Clinical Insights and Methodological Refinement: Addressing Key Limitations and Future Directions in Imaging Biomarkers.","authors":"Yuekun Fang, Shengyi Chen, Bin Cheng","doi":"10.1590/S1677-5538.IBJU.2025.0253","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0253","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 5","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152682","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}

{"title":"Enhancing Robotic Surgery Training and Reducing Remote Complications with Telesurgery Technology.","authors":"Marcio Covas Moschovas, Shady Saikali, Travis Rogers, Mischa Dohler, Michael Mcdonald, Ela Patel, Jeffrey Marquinez, Ahmed Gamal, Jeffery Magnuson, Vipul Patel","doi":"10.1590/S1677-5538.IBJU.2025.0082","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0082","url":null,"abstract":"<p><strong>Introduction: </strong>The 2001 Lindbergh operation provided evidence for the feasibility of transatlantic telesurgery.(1-3) However, technological and economic challenges have limited the implementation of this technique.(4-6) This video illustrates details of a telesurgery connection over a 13,000 km distance between Orlando (USA) and Shanghai (China). Surgeons at both locations operated simultaneously on the same animals using telesurgery consoles (MicroPort® MedBot™) for teleproctoring, allowing for a robust evaluation of connectivity and robotic system performance across vast distances.</p><p><strong>Methods: </strong>On July 23rd and 24th, 2024, we conducted a prospective telesurgery study using live animal models (porcine) connecting Orlando to Shanghai. We reproduced a real-life telesurgery scenario where both ends of the connection had control over the robot. Four surgeons were in Orlando and one in Shanghai. We illustrated the communication between surgeons and highlighted the potential of telesurgery to improve outcomes and teaching robotic surgery.</p><p><strong>Results: </strong>Connectivity and robotic technology performed optimally for several hours without troubleshooting or malfunctions. Median delay was 139 milliseconds (137-216) on the first day and 139 milliseconds (137-185) on the second day. The surgeons were able to switch the console control multiple times during the procedures. They could communicate, discuss cases in real-time, and seamlessly transfer control in critical steps of the surgery.</p><p><strong>Conclusions: </strong>This video underscores the practical potential of Telesurgery use in teleproctoring, particularly when an experienced remote surgeon steps in to assist another surgeon during complex or challenging procedures. It highlights Telesurgery's potential for training and improving outcomes in robotic surgery.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659413","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}

{"title":"First Step to Equity and Organization in Waiting Lines for Stone Surgery. Translation of Prioritization Scores.","authors":"Guilherme Gentile, Fabio Carvalho Vicentini, Erik Montagna, Daniel Pérez-Fentes, Guilherme Pimenta Roncete, Artur Henrique Brito, Fabio Miranda Torricelli, Alexandre Danilovic, Carlos Alfredo Batagello, Eduardo Mazzucchi, William Carlos Nahas","doi":"10.1590/S1677-5538.IBJU.2025.0039","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0039","url":null,"abstract":"<p><strong>Purpose: </strong>The use of patient prioritization tools is one of several methods to enhance the management of waiting times for elective surgeries. Developing these tools specifically for urinary stones in the Brazilian context may enhance queue management and increase patient satisfaction. This study aims to adapt two previously published scores, the WCWL (Western Canada Waiting List - general criteria) and the SCQ-score (specific to urinary stone criteria), into Brazilian Portuguese.</p><p><strong>Materials and methods: </strong>Our study adhered to established protocols for the cross-cultural adaptation and translation of health-related questionnaires. The process for translating both original scores involved four steps: initial translation, back-translation, committee review, and pre-testing. The translations were conducted by professionals proficient in the relevant languages. The pre-test phase engaged eight endourologists who applied the translated versions of the scores to twelve hypothetical patient cases.</p><p><strong>Results: </strong>Our study successfully produced Brazilian Portuguese versions of the SCQ and WCWL scores. During the pre-testing, these scores were found to be quick to perform (with an average completion time of 1 minute and 35 seconds) and were deemed easy to understand and use by the endourologists. However, there was a concern regarding the practical utility and interpretability of the WCWL score due to its more generalized criteria.</p><p><strong>Conclusion: </strong>We successfully developed the Brazilian Portuguese version of the Western Canada Waiting List and SCQ-score. This development will allow further studies to evaluate the impact of their use within the Brazilian healthcare environment.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043954","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}

{"title":"Efficacy of Alpha Lipoic Acid Supplementation in Sperm Parameters: A Systematic Review and Meta-Analysis of Randomized Trials.","authors":"Iago Zang Pires, Marília Oberto da Silva Gobbo, Renan Yuji Ura Sudo, Tanize Louize Milbradt, Nilson Marquardt, Gustavo Franco Carvalhal, Carlos Teodosio Da Ros","doi":"10.1590/S1677-5538.IBJU.2024.0614","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0614","url":null,"abstract":"<p><strong>Introduction: </strong>Male factors contribute to 30 to 50% of infertility in couples. Treatment options for male infertility are limited, so antioxidant supplementation for idiopathic male infertility is currently being studied. Alpha lipoic acid (ALA) has a high antioxidant capacity and the potential to penetrate tissues, cells, and organelles, including mitochondria, due to its water and lipid solubility properties. The recent inclusion of randomized trials in the literature has required a new systematic review and meta-analysis to evaluate the efficacy of alpha lipoic acid in sperm parameter changes.</p><p><strong>Purpose: </strong>We aimed to perform a systematic review and meta-analysis of the currently available randomized trials comparing the effects of ALA supplementation versus placebo on sperm function in infertile male patients.</p><p><strong>Material and methods: </strong>Pubmed, Embase, Cochrane Library, and Scopus databases were searched from inception to June 2024. A random-effects model was employed to compute mean differences and risk ratios for continuous and binary endpoints. Heterogeneity was evaluated through the prediction interval. A sensitivity analysis was conducted by systematically excluding one study at a time and recalculating the pooled effect. All statistical analysis was conducted using R software 4.4.1. The certainty of evidence was evaluated with the GRADE approach. Results were reported following the PRISMA statement guidelines. This study was registered in PROSPERO.</p><p><strong>Results: </strong>Five randomized trials comprising 250 patients with a mean age of 28 to 40 years were included in this analysis. Over a mean follow-up time of 3 months, ALA was associated with a reduced proportion of abnormal sperm morphology (MD -0.89; 95% CI -1.48 to -0.29; p=0.003), increased total motility (MD 13.49; 95% CI 3.52 to 23.46; p=0.008), and increased sperm progressive motility (MD 12.43; 95% CI 2.89 to 21.97; p=0.01). Additionally, ALA was associated with a higher pregnancy rate in two individual studies reporting the outcome, however, no significance was found in our pooled analysis (RR 2.28; 95% CI 0.66 to 7.85; p=0.1). Finally, ALA did not change ejaculation volume (MD 0.14; 95% CI -0.54 to 0.83; p=0.6), sperm concentration (MD 11.99; 95% CI -0.67 to 24.66; p=0.06), live sperm (MD 4.42; 95% CI -3.17 to 12.02; p=0.2), or total antioxidant capacity (MD 0.43; 95% CI -0.02 to 0.87; p=0.06). No adverse events were reported.</p><p><strong>Conclusion: </strong>In this meta-analysis, ALA was associated with a favorable change in sperm quality. However, there were no effects on pregnancy rates. ALA should be considered for patients with idiopathic infertility.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062920","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}

{"title":"Clinical Outcomes and Cost-effectiveness between the Sentire® and da Vinci® systems in Robot-assisted Radical Prostatectomy.","authors":"Run-da Jiao, Zheng Wang, Xian-Gui Kong, Shou-Yan Tang, Dan Xia, Zhen-Jie Wu, Jian-Chao Liu, Li-Hua Liu","doi":"10.1590/S1677-5538.IBJU.2024.0706","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0706","url":null,"abstract":"<p><strong>Objective: </strong>Robotic surgery has enhanced minimally invasive procedures with greater precision and control, but high costs have limited its widespread adoption. The Sentire® surgical system is hypothesized to achieve clinical outcomes comparable to those of the da Vinci® system while demonstrating superior cost-effectiveness in robot-assisted radical prostatectomy (RARP) procedures. This study aimed to compare RARP outcomes using Sentire® and da Vinci® ®, focusing on clinical efficacy and economic impact.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted at three high-volume urology centers in China, including 22 patients who underwent RARP with the Sentire® system and 287 patients who underwent RARP with the da Vinci® system. After 1:3 propensity score matching (PSM), 66 patients were successfully matched in the control group. Perioperative outcomes and cost metrics were assessed. Key measures included operative and console times, docking time, blood loss, recovery, positive surgical margins, surgeon evaluations of performance and comfort, and cost-effectiveness.</p><p><strong>Results: </strong>The Sentire® group had a longer median operative time (143 vs. 112 minutes, p=0.024), while console time (85 vs. 76 minutes, p=0.323) and docking time (9.0 vs. 6.0 minutes, p=0.279) were comparable. Blood loss was also similar between the groups (p=0.093). Positive surgical margin rates were 22.7% for Sentire® and 20.0% for da Vinci® (p=1.000), and no significant differences were observed in pathological ISUP grades or prostate volumes (p=0.327 and p=0.856, respectively). At 1-year follow-up, PSA recurrence was observed in 3 patients in the Sentire® group (4.5%) and 4 in the control group (6.1%) (p=0.625), with similar median PSA levels (0.012 vs. 0.014 ng/mL, p=0.410). Urinary continence rates were also comparable at 1, 3, and 12 months (all p > 0.05). Cost-effectiveness analysis revealed lower total and direct costs in the Sentire® group, including surgery expenses ($8,750 vs. $10,500, p=0.021), although differences in consumable and indirect costs were not statistically significant. Surgeon satisfaction scores for performance and comfort were slightly better for Sentire® but did not reach statistical significance (p > 0.05).</p><p><strong>Conclusion: </strong>This study demonstrates that the Sentire® system is well-suited for urological surgeries, offering comparable clinical outcomes and shorter hospital stays while improving cost-effectiveness compared to the da Vinci® system.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736261","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}

{"title":"Iatrogenic Ureteropelvic Junction Disruption from Lumbar Spinal Fusion Surgery: Early Repair using The SP Robotic System.","authors":"Arianna Biasatti, Leslie C Licari, Eugenio Bologna, Angelo Orsini, Matthew C Pearson, Riccardo Autorino","doi":"10.1590/S1677-5538.IBJU.2024.0690","DOIUrl":"10.1590/S1677-5538.IBJU.2024.0690","url":null,"abstract":"<p><strong>Introduction: </strong>Severe iatrogenic ureteral injuries are uncommon but challenging clinical scenarios, mostly related to abdominal and gynecological surgery (1) but lately also to spinal surgery (2). Prompt management is mandatory to avoid impaired outcomes (3). Moreover, a minimally invasive approach is desirable to minimize surgical morbidity and expedite recovery (4). Single Port robotic surgery is being implemented for a variety of indications, including ureteral surgery (5, 6).</p><p><strong>Materials and methods: </strong>We present the case of a 48-year-old, who underwent lumbar spinal fusion surgery and 3 days after discharge was readmitted presenting abdominal pain. A CT scan revealed a large abdominal fluid collection and consequently a percutaneous drain was placed. A subsequent CT-urogram revealed a right ureteral injury at level of the ureteropelvic junction (UPJ). A percutaneous nephrostomy was inserted after unsuccessful retrograde and anterograde stent placement attempts. The patient underwent SP robotic early repair of the ureter 3 weeks after spinal surgery.</p><p><strong>Results: </strong>SP robotic ureteral injury repair with transperitoneal approach was performed. The surgery was well tolerated without intraoperative complications, patient was discharged on post-operative day 2. Right percutaneous nephrostomy was removed after 2 weeks and ureteral stent after 4. At 6-months follow-up the patient was asymptomatic and CT-urogram confirmed symmetric contrast excretion without hydroureteronephrosis or contrast leakage.</p><p><strong>Conclusion: </strong>SP robotic repair of the UPJ injury is safe and feasible. This procedure provides the benefits of minimally invasive surgery, and it should be considered as a valid alternative to traditional multiport robotic approach.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"51 4","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257258","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}