International Braz J Urol最新文献_第2页

Safety, Complications, and Procedural Efficiency of Neonatal Circumcision Devices: A Network Meta-Analysis. 新生儿包皮环切装置的安全性、并发症和程序效率：一项网络荟萃分析。

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-07-01 DOI: 10.1590/S1677-5538.IBJU.2026.0167

Amani N Alansari, Mohammed A Mahmoud, Habib Ullah Joya, Hanan Youssif, Mousa M Ahmeda, Marwa Messaoud

{"title":"Safety, Complications, and Procedural Efficiency of Neonatal Circumcision Devices: A Network Meta-Analysis.","authors":"Amani N Alansari, Mohammed A Mahmoud, Habib Ullah Joya, Hanan Youssif, Mousa M Ahmeda, Marwa Messaoud","doi":"10.1590/S1677-5538.IBJU.2026.0167","DOIUrl":"10.1590/S1677-5538.IBJU.2026.0167","url":null,"abstract":"Purpose: This study aims to compare safety, complications, and procedural characteristics of commonly used circumcision devices in neonates and early infants.Methods: We searched PubMed, EMBASE, Web of Science, and SCOPUS through January 2026 for randomized controlled trials comparing infant circumcision devices (Plastibell™, Mogen™, ShangRing™, AccuCirc™) in infants ≤3 months. The primary outcome was total adverse events; secondary outcomes included bleeding, infection, redundant skin, adhesions, parental satisfaction, and procedure time. A random-effects network meta-analysis estimated relative effects with 95% confidence intervals (CI), using Gomco™ or Mogen™ as reference devices. Analyses were performed in R.Results: Ten trials including 3,984 infants from Africa, the Middle East, and the United States were analyzed. No device differed significantly from Gomco™ in total adverse events: Plastibell™ (risk ratios, [RR] 1.53, 95% CI 0.56-4.21), ShangRing™ (RR 2.70, 95% CI 0.31-23.66), Mogen™ (RR 3.83, 95% CI 0.97-15.17), and AccuCirc™ (RR 9.62, 95% CI 0.24-388.45). Plastibell™ was associated with a higher infection risk versus Gomco™ (RR 4.25, 95% CI 1.43-12.65). No significant differences were observed in bleeding, redundant skin, adhesions, or parental satisfaction. Mogen™ and ShangRing™ had shorter procedure times than Gomco™ (mean difference [MD] -3.29 minutes, 95% CI -4.82 to -1.76; MD -3.39 minutes, 95% CI -6.11 to -0.67).Conclusions: Neonatal circumcision devices demonstrate generally comparable safety profiles, though Plastibell™ carries elevated infection risk. Mogen™ and ShangRing™ offer procedural efficiency advantages. Device selection should prioritize provider expertise, infection control capabilities, and programmatic efficiency requirements alongside safety considerations.","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ureterovesical Junction and Waldeyer's Sheath: A Narrative Review Applied to Vesicoureteral Reflux. 输尿管膀胱结和瓦尔德耶氏鞘：膀胱输尿管反流的叙述回顾。

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-07-01 DOI: 10.1590/S1677-5538.IBJU.2026.9903

Luciano A Favorito, Ricardo C de Mattos

{"title":"Ureterovesical Junction and Waldeyer's Sheath: A Narrative Review Applied to Vesicoureteral Reflux.","authors":"Luciano A Favorito, Ricardo C de Mattos","doi":"10.1590/S1677-5538.IBJU.2026.9903","DOIUrl":"10.1590/S1677-5538.IBJU.2026.9903","url":null,"abstract":"The ureterovesical junction (UVJ) is a specialized anatomical and functional unit responsible for maintaining unidirectional urinary flow from the ureter into the bladder. Dysfunction at this junction may lead to vesicoureteral reflux (VUR), obstruction, recurrent infections, and potential renal damage. The aim of this review is to present a narrative overview of the historical evolution in the understanding of the UVJ and to summarize key surgical principles, techniques, and contemporary controversies in its management. A narrative analysis of historical anatomical literature, landmark surgical innovations, and contemporary management strategies for UVJ pathology was performed. Emphasis was placed on seminal contributors and the evolution of surgical techniques. Early anatomical descriptions established the importance of the intramural ureter and trigonal anatomy. With the advent of cystography, VUR became recognized as a major pediatric urologic condition. Despite technological advances, the fundamental surgical principles governing UVJ reconstruction remain unchanged: adequate submucosal tunnel length, preservation of vascularity, and tension-free reimplantation. Ongoing advances in minimally invasive surgery and biomaterials continue to refine management strategies.","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tubeless Retroperitoneal Robot-assisted Partial Nephrectomy: An Innovative Approach to Treat Early Renal Tumor. 无管腹膜后机器人辅助部分肾切除术：一种治疗早期肾肿瘤的创新方法。

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-07-01 DOI: 10.1590/S1677-5538.IBJU.2026.0042

Haitao Liang, Yixin Xu, Yulu Peng, Tingxuan Huang, Qiuyue Zheng, Xiangyun Yang, Yunlin Ye, Yanling Liu, Jie Zhou, Zhiling Zhang, Zhenhua Liu, Xia Zheng, Renchun Lai, Pei Dong

{"title":"Tubeless Retroperitoneal Robot-assisted Partial Nephrectomy: An Innovative Approach to Treat Early Renal Tumor.","authors":"Haitao Liang, Yixin Xu, Yulu Peng, Tingxuan Huang, Qiuyue Zheng, Xiangyun Yang, Yunlin Ye, Yanling Liu, Jie Zhou, Zhiling Zhang, Zhenhua Liu, Xia Zheng, Renchun Lai, Pei Dong","doi":"10.1590/S1677-5538.IBJU.2026.0042","DOIUrl":"10.1590/S1677-5538.IBJU.2026.0042","url":null,"abstract":"Purpose: Retroperitoneal robot-assisted partial nephrectomy (RRPN) has achieved widespread acceptance worldwide. However, the complications and discomfort associated with tubes cannot be overlooked. Consequently, we have initiated Tubeless RRPN (TLRRPN). This approach eliminates the need for tracheal intubation, central venous catheterization, urinary catheters, or abdominal drainage.Materials and methods: From 2024-07 to 2025-06, a total of 78 patients underwent RRPN at our center. Following a 1:1 propensity scores matching process, we compared 14 patients who underwent TLRRPN with 14 matched patients receiving Traditional RRPN (TRRPN). Anesthetic management and surgical procedures were systematically detailed, and perioperative outcomes were comprehensively assessed.Results: All 28 patients underwent successful R0 tumor resection, with no conversions or major complications reported in either group. Patients who received TLRRPN resumed oral intake and ambulation significantly earlier (1.03 hours vs. 22.20 hours and 1.03 hours vs. 30.55 hours, p <0.001), experienced a shorter postoperative hospital stay (26.00 hours vs. 91.43 hours, p < 0.001), and incurred lower overall costs. No anesthesia- or surgery-related complications were observed, and postoperative pain was significantly reduced in the TLRRPN group compared to the TRRPN group.Conclusions: TLRRPN is a safe, efficient, innovative, cost-effective, and selective surgical procedure. This operation fundamentally reduces the adverse effects associated with tubes in patients and significantly facilitates rapid recovery.","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Redefining Surgical Collaboration: The First Structured Transcontinental Robotic Tele-mentoring Experience Between Africa and South America. 重新定义外科合作：非洲和南美之间的第一个结构化的跨大陆机器人远程指导经验。

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-07-01 DOI: 10.1590/S1677-5538.IBJU.2026.0136

Marcio Covas Moschovas, Renan Desimon Cabral, Eduardo Parra-Davila, Vanessa Alvarenga-Bezerra, Antônio Rebello Horta Gorgen, Tiago Almeida Ramos, Pablo Wesz Nascimento, Guilherme Arend Pesce, Herber Sauer, Mirandolino Batista Mariano, Vipul Patel

引用次数: 0

Surgical Treatment of Adrenal Neuroblastoma in Children - A Narrative Review. 儿童肾上腺神经母细胞瘤的手术治疗综述。

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-07-01 DOI: 10.1590/S1677-5538.IBJU.2026.0168

Arovel Oliveira Moura, Francisca Norma Albuquerque Girão Gutierrez, Fádia Carvalho Pacheco, Ricardo Vianna de Carvalho, Ruy Garcia Marques

{"title":"Surgical Treatment of Adrenal Neuroblastoma in Children - A Narrative Review.","authors":"Arovel Oliveira Moura, Francisca Norma Albuquerque Girão Gutierrez, Fádia Carvalho Pacheco, Ricardo Vianna de Carvalho, Ruy Garcia Marques","doi":"10.1590/S1677-5538.IBJU.2026.0168","DOIUrl":"10.1590/S1677-5538.IBJU.2026.0168","url":null,"abstract":"Objective: To analyze the role of surgical treatment in pediatric adrenal neuroblastoma and the operative methods employed according to staging and risk stratification based on patient-related and tumor biological factors.Materials and methods: A narrative literature review was conducted through a structured search of the PubMed/MEDLINE, Scopus, and Web of Science databases. Studies published in English between 2020 and 2025 were included, while classical references were used to contextualize staging and risk stratification systems. Letters, editorials, case reports, and studies not providing specific insight into the topic were excluded.Results: Surgical treatment represents a key component in the management of pediatric adrenal neuroblastoma. Staging and risk stratification determine both the timing of surgery and its role in achieving local disease control. In low-risk neuroblastoma, surgery alone may be curative. In intermediate-risk patients, neoadjuvant chemotherapy precedes resection, reducing surgical complexity and facilitating tumor removal. In high-risk patients, tumor resection exceeding 90% may contribute to improved overall survival (OS). Image-Defined Risk Factors (IDRFs) are essential for staging and surgical planning, as they define the anatomical relationship between the tumor and adjacent vascular and organ structures. Surgical approaches include open surgery and minimally invasive surgery, the latter being appropriate in carefully selected cases.Conclusion: Surgical treatment remains fundamental in pediatric adrenal neuroblastoma, and operative strategies should be guided by clinical, biological, and radiologic parameters to achieve maximal oncologic safety.","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pain Perception During Transperineal and Transrectal Prostate Biopsy Under Local An-esthesia: a Prospective Analysis of a Multi-ethnic and Diverse Cohort. 局部麻醉下经会阴和经直肠前列腺活检的疼痛感知：一项多种族和多样化队列的前瞻性分析。

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-05-01 DOI: 10.1590/S1677-5538.IBJU.2025.0512

Kevin Joseph Chua, Lorenzo Storino Ramacciotti, Masatomo Kaneko, Yuta Inoue, Luis Medina Navarro, Jie Cai, Manju Aron, Pierre Halteh, Eric Kau, Anne Schuckman, Sij Hemal, Mihir Desai, Hooman Djaladat, Inderbir S Gill, Monish Aron, Andre Luis Abreu

{"title":"Pain Perception During Transperineal and Transrectal Prostate Biopsy Under Local An-esthesia: a Prospective Analysis of a Multi-ethnic and Diverse Cohort.","authors":"Kevin Joseph Chua, Lorenzo Storino Ramacciotti, Masatomo Kaneko, Yuta Inoue, Luis Medina Navarro, Jie Cai, Manju Aron, Pierre Halteh, Eric Kau, Anne Schuckman, Sij Hemal, Mihir Desai, Hooman Djaladat, Inderbir S Gill, Monish Aron, Andre Luis Abreu","doi":"10.1590/S1677-5538.IBJU.2025.0512","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0512","url":null,"abstract":"Purpose: To assess factors associated with patients' self-assessed pain scores during prostate biopsy (PBx) performed exclusively under local anesthesia (LA).Materials and methods: Consecutive patients who underwent MRI followed by a transperineal (TP) or transrectal (TR) PBx under LA were prospectively assessed. Race and ethnicity were self-reported according to NIH standards. Socioeconomic status was assessed using the Distressed Community Index (DCI). Pain was evaluated with a visual analog scale (0-10) after the procedure. Univariable and multivariable linear regression analyses were performed to correlate clinical parameters related to pain.Results: A total of 419 patients underwent TP (77%) or TR (23%) PBx. Overall, 14% of patients were Asian, 5% Black, 17% Latino, 12% Others, and 53% White. Of the cohort, 20% of Black and 27% of Latino patients were most distressed (DCI 80-100) compared with 4% of Asian, 9% of Other, and 5% of White patients (p<0.001). The median (IQR) self-assessed pain levels were higher for Black 5 (2-5) and Latino 4 (3-5) compared to Asian 3 (2-4), Other 3 (2-5), and White 3 (2-4) patients (p=0.01). On multivariable analysis, younger patients, Black or Latino patients, and the number of lesions on MRI were independent predictors for pain levels.Conclusions: PBx under LA alone are generally well tolerated; however, there is a subset of patients who experience more pain, including Black and Latino, younger patients, and those with more MRI suspicious lesions. Discussion of these pain risk factors is important for patients when choosing to have a biopsy performed under LA versus sedation.","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gonadotropin Stimulation Before Sperm Retrieval in Non-Obstructive Azoospermia: Myth, Magic, or Medicine? 非阻塞性无精子症患者取精前促性腺激素刺激：神话、魔法还是药物？

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-05-01 DOI: 10.1590/S1677-5538.IBJU.2026.9902

Marina C Viana, Arnold P P Achermann, Danilo L Andrade, Ricardo Miyaoka, Sandro C Esteves

引用次数: 0

Is there still a role for systematic biopsy after targeted biopsy for the detection of clini-cally significant prostate cancer in MRI suspicious lesions? 在MRI可疑病变中，在靶向活检后，系统活检是否仍有作用来检测具有临床意义的前列腺癌？

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-05-01 DOI: 10.1590/S1677-5538.IBJU.2025.0653

João M Pina, João Guerra, Miguel B Lança, João L Dias, Rita N Lucas, Luis C Pinheiro

{"title":"Is there still a role for systematic biopsy after targeted biopsy for the detection of clini-cally significant prostate cancer in MRI suspicious lesions?","authors":"João M Pina, João Guerra, Miguel B Lança, João L Dias, Rita N Lucas, Luis C Pinheiro","doi":"10.1590/S1677-5538.IBJU.2025.0653","DOIUrl":"10.1590/S1677-5538.IBJU.2025.0653","url":null,"abstract":"Purpose: The combination of systematic biopsy (SB) and MRI-targeted biopsy (TB) is the current approach for prostate cancer (PCa) diagnosis; however, the clinical benefit of including SB remains controversial. This study aimed to determine whether SB adds value beyond TB in detecting clinically significant prostate cancer (csPCa) in men with suspicious lesions.Materials and methods: Retrospective, single-center study conducted between January 2019 and September 2023. It enrolled men with suspicious lesions identified on multiparametric MRI (PI-RADS≥3) who had undergone combined biopsy (TB+SB). Sociodemographic and clinical data were secondarily collected. csPCa was defined when ISUP≥2.Results: This study included 997 men with a median age of 68 years, of whom 497 had a negative prior biopsy. The TB+SB approach identified 53.0% of PCa and 36.8% of csPCa cases. TB alone significantly outperformed SB in identifying csPCa, with detection rates of 34.8% vs. 10.3%, respectively, missing only 4.8% of PCa diagnosis-most of which were low-grade tumors. SB contributed marginally, identifying additional csPCa cases in 1.4% of patients. In patients with a prior negative biopsy, the addition of SB to TB only accounted for 12.5% of PCa diagnosis. Limitations include the study single-center design, restricting generalizability, and the lack of whole-mount prostatectomy for histological confirmation.Conclusions: In conclusion, SB adds limited diagnostic value, with TB alone being sufficient for detecting csPCa cases in patients with MRI-visible lesions. The results suggest that SB may be safely omitted in selected patients to reduce biopsy burden and lead to better clinical outcomes.","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":"52 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prostate Biopsy Once Again Is a Hot Topic in This Issue of the International Brazilian Journal of Urology. 前列腺活检再次成为本期国际巴西泌尿学杂志的热门话题。

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-05-01 DOI: 10.1590/S1677-5538.IBJU.2026.03.01

Luciano A Favorito

引用次数: 0

Editorial Comment: Maximal anatomic bladder neck preservation at the prostatic origin (MANO) in robotic radical prostatectomy: does prostate size matter? 编辑评论：机器人根治性前列腺切除术中最大解剖膀胱颈保留前列腺起源（MANO）：前列腺大小重要吗？

IF 4.3 3区医学

International Braz J Urol Pub Date : 2026-05-01 DOI: 10.1590/S1677-5538.IBJU.2026.9904

Luciano A Favorito

引用次数: 0