International Braz J Urol最新文献

{"title":"New perspectives of robotic surgery are the topic highligheted in International Brazilian Journal of Urology.","authors":"Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2023.06.01","DOIUrl":"10.1590/S1677-5538.IBJU.2023.06.01","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414949","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":"Urological impact of race-free estimated glomerular filtration rate equations.","authors":"Natália Dalsenter Avilez, José Ignacio Nolazco, Steven Lee Chang, Leonardo O Reis","doi":"10.1590/S1677-5538.IBJU.2023.9913","DOIUrl":"10.1590/S1677-5538.IBJU.2023.9913","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414966","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":"Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder.","authors":"Carlos Magno Paiva da Silva, Mônica Maria de Almeida Vasconcelos, Eleonora Moreira Lima, José de Bessa, Otávio Augusto Fonseca Reis, Maria Francisca Tereza Freire Filgueiras, Roberta Vasconcellos Menezes de Azevedo, José Murillo Bastos, Eduardo Araújo Oliveira, Flávia Cristina de Carvalho Mrad","doi":"10.1590/S1677-5538.IBJU.2023.0311","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0311","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze the diagnostic accuracy of dynamic and static ultrasound (DSUS) in detecting vesicoureteral reflux (VUR) and renal scarring in a cohort of children with neurogenic bladder (NB).</p><p><strong>Materials and methods: </strong>A retrospective, longitudinal, observational study was conducted using the Reporting Diagnostic Accuracy Studies guideline. The DSUS (index test) data were compared with voiding cystourethrography (VCUG) and renal scintigraphy 99mTc-dimercaptosuccinic (reference tests). Overall performance for predicting VUR and renal scarring was assessed using renal pelvic diameter (RPD)/distal ureteral diameter and renal parenchymal thinning on DSUS, respectively.</p><p><strong>Results: </strong>A total of 107 patients (66 girls, median age 9.6 years) participated. Seventeen patients (15.9%) presented VUR, eight bilateral. For overall reflux grade, the AUC was 0.624 for RPD and 0.630 for distal ureteral diameter. The diagnostic performance for detecting high-grade VUR was slightly better for DSUS parameters. The AUC was 0.666 for RPD and 0.691 for distal ureteral diameter. The cut-offs of 5 mm for RPD and 6.5 mm for distal ureteral diameter presented the best diagnostic odds ratio (DOR) to identify high-grade VUR. The increase of RPD during detrusor contractions showed an accuracy of 89.2%. The thinness of renal parenchyma presented an accuracy of 88% for renal scarring.</p><p><strong>Conclusion: </strong>DSUS predicts VUR and renal scarring in children with NB with fair to good accuracy, and all measurements exhibited a high negative predictive value (NPV). The increase in RPD during voiding or detrusor contractions proved to be the most accurate parameter for indicating the presence of VUR in this study.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10084102","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":"En Bloc Resection of Bladder Tumors (ERBT) using different lasers - Hybrid and Holmium Laser.","authors":"Alexandre Iscaife, Moises Rodríguez Socarras, Luis Llanes González, Juan Gómez Rivas, Maykon William Aparecido Pires Pereira, Katia Ramos Moreira Leite, Willian Carlos Nahas, Fernando Gomez Sancha","doi":"10.1590/S1677-5538.IBJU.2023.0231","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0231","url":null,"abstract":"<p><strong>Introduction: </strong>The En-bloc Resection of Bladder Tumors (ERBT) is a method that offers more benefits compared to the traditional Transurethral Resection of Bladder Tumor (TURBT) (1, 2). Recent studies have shown that ERBT offers better pathological analysis and oncological outcomes (3-6). Thulium and holmium are the most frequently used lasers for this procedure, with the hybrid laser being a new addition that combines thulium and diode to improve hemostatic properties (5, 7-9).</p><p><strong>Objective: </strong>This report aims to discuss the use of two types of lasers, hybrid and holmium, for ERBT.</p><p><strong>Material and methods: </strong>Two case studies were conducted. The first case featured a 68-year-old male with two tumors measuring 1.5cm and 2cm. The hybrid laser was used for the procedure. The second case involved a 70-year-old female with a 5cm tumor on the posterior bladder wall, and holmium laser was used with morcellation of the tumor. The quality of histopathological analysis was evaluated. The perioperative data and the entire procedure of the two cases were documented in a step-by-step video.</p><p><strong>Results: </strong>Both lasers demonstrated excellent results without technical difficulties. There was no bleeding, and both patients were discharged with one day of hospitalization. The detrusor muscle was present without artifacts, and the morcellation did not affect the analysis. The first case showed a pT1G3, and the second case showed a pT2 urothelial carcinoma. The hybrid laser exhibited superior hemostatic capacity compared to the holmium laser.</p><p><strong>Conclusion: </strong>ERBT can use hybrid or holmium lasers without affecting histopathological analysis, even with morcellation.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10074111","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":"Tamsulosin vs. Tadalafil as medical expulsive therapy for distal ureteral stones: a systematic review and meta-analysis.","authors":"Mikhael Belkovsky, Giulia Veneziani Zogaib, Carlo Camargo Passerotti, Everson Luiz de Almeida Artifon, José Pinhata Otoch, José Arnaldo Shiomi da Cruz","doi":"10.1590/S1677-5538.IBJU.2023.0345","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0345","url":null,"abstract":"<p><strong>Purpose: </strong>Medical expulsive therapy (MET) is recommended for distal ureteral stones from 5 to 10 mm. The best drug for MET is still uncertain. In this review, we aim to compare the effectiveness of tadalafil and tamsulosin for distal ureteral stones from 5 to 10 mm in terms of stone expulsion rate (SER), stone expulsion time (SET) and the side effect profile.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was conducted on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scopus and Web of Science, from inception until April 2023. Only randomized controlled trials were included in the analysis.</p><p><strong>Results: </strong>Eleven publications with 1,330 patients were included. We observed that tadalafil has a higher SER (OR 0.55, CI 95% 0.38;0.80, p=0.02, I2=52%) and the same efficacy in SET (MD 1.07, CI 95% -0.25; 2.39, p=0.11, I2=84%). No differences were found when comparing side effects as headache, backache, dizziness, and orthostatic hypotension.</p><p><strong>Conclusion: </strong>Tadalafil has a higher stone expulsion rate than tamsulosin as a medical expulsive therapy for patients with distal stones from 5 to 10 mm without differences in side effects.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414952","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":"Abdominal testicular vessel distribution in human fetuses - basis for fowler-Stephens surgery.","authors":"Tatiana C Benzi, Carla M Gallo, Anneliese Fortuna, Waldemar S Costa, Francisco J B Sampaio, Luciano A Favorito","doi":"10.1590/S1677-5538.IBJU.2023.9909","DOIUrl":"10.1590/S1677-5538.IBJU.2023.9909","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the histology and distribution of abdominal testicular vessels in human fetuses Patients and Methods: We studied 19 fetuses (34 testes) ranging in age from 12 to 19 weeks post-conception. The fetuses were evaluated regarding crown-rump length (CRL), total length (TL) and body weight immediately before dissection. Each testis was dissected and embedded in paraffin, from which 5 μm thick sections were obtained and stained with Masson's trichrome and Anti-CD31 antibody to quantify the vessels. The stereological analysis was carried out with the Image Pro and Image J programs, using a grid to determine volumetric densities (Vv). Means were statistically compared using the unpaired T-test (p<0.05).</p><p><strong>Results: </strong>The fetuses presented mean weight of 222.5g, mean CRL of 15.3 cm and mean TL of 23.2 cm. All testes were in the abdominal position. The mean percentage of vessels (Vv) in the upper portion of the testis was 7.6% (4.6 to 15%) and in the lower portion the mean was 5.11% (2.3 to 9.8%), with a significant difference (p=0.0001). In the analysis between the upper portion of the right and left testes (p=0.99) and in the analysis of the lower portion of the right and left testes (p=0.83), we did not observe significant differences.</p><p><strong>Conclusion: </strong>The upper portion of the abdominal testis in human fetuses had a higher concentration of vessels than the lower portion. These results suggest that manipulation of the lower end of the testis during Fowler-Stephens surgery should be avoided in order to preserve the collateral circulation.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9667859","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":"Robot-assisted radical cystectomy and ileal conduit with Hugo^TM RAS system: feasibility, setting and perioperative outcomes.","authors":"Josep Maria Gaya, Alessandro Uleri, Isabel Sanz, Giuseppe Basile, Paolo Verri, Pedro Hernandez, Angelo Territo, Oscar Rodríguez Faba, Andrea Gallioli, Alberto Breda, Joan Palou","doi":"10.1590/S1677-5538.IBJU.2023.0349","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0349","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic approach has shown its feasibility and safety with respect to open approach for radical cystectomy (1). The performances of HugoTM RAS system (Medtronic, Minneapolis, USA) have been demonstrated in several clinical scenarios (2-5). We report the feasibility and surgical settings of the first series of robot-assisted radical cystectomy (RARC) with intracorporeal ileal-conduit performed with HugoTM RAS system.</p><p><strong>Methods: </strong>Two patients were submitted to RARC with ileal conduit at our institution. The trocar placement scheme and the operating room setting with docking angles of the four arms were already described (6). A 12-mm and a 5-mm trocar for the assistant were placed. In both cases, an ileal-conduit with a Wallace type-1 uretero-enteric derivation was performed intra-corporeally.</p><p><strong>Results: </strong>The first patient was a 71-year-old male with a very-high risk non-muscle invasive bladder cancer(BC), and the second patient was a 64-year-old male with a diagnosis of T2 high-grade BC. Operative times were 360 and 420 minutes with a docking time of 12 and 9 minutes, respectively. No intraoperative complications occurred. The estimated blood loss was 200ml and 400ml, respectively. The second patient developed an ileus on postoperative day 4 (Clavien-Dindo grade 2). No positive surgical margins were recorded. No recurrence nor progression occurred during follow-up.</p><p><strong>Conclusion: </strong>RARC with intracorporeal ileal conduit urinary diversion is feasible with HugoTM RAS system. We provided insight into the surgical setting using this novel robotic platform to help new adopters to face this challenging procedure. These findings may help a wider distribution of robotic programs for BC treatment.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10074110","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":"Editorial Comment: Management of sphincter insufficiency in patients with neurogenic bladder and bladder augmentation.","authors":"Andrés G Alfieri, Marcio A Averbeck","doi":"10.1590/S1677-5538.IBJU.2023.06.03","DOIUrl":"10.1590/S1677-5538.IBJU.2023.06.03","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414947","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":"Technology description, initial experience and first impression of HUGO™ RAS robot platform in urologic procedures in Brazil.","authors":"Arie Carneiro, Guilherme Miranda Andrade","doi":"10.1590/S1677-5538.IBJU.2023.9910","DOIUrl":"10.1590/S1677-5538.IBJU.2023.9910","url":null,"abstract":"","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414965","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":"Modified biplanar (0-90°) endoscopic-guided puncture technique for percutaneous nephrolithtomy: refinement with endoscopic combined intrarrenal surgery to reduce fluoroscopy and operative time.","authors":"Giovanni Scala Marchini, Fábio Sepúlveda Lima, Marcelo Esteves Chaves Campos, Marcus Vinícius Osorio Maroccolo, Ernesto Reggio, Eduardo Mazzucchi, William Carlos Nahas, Luiz Sérgio Santos, Thiago Hota","doi":"10.1590/S1677-5538.IBJU.2023.0346","DOIUrl":"10.1590/S1677-5538.IBJU.2023.0346","url":null,"abstract":"<p><strong>Introduction: </strong>We aim to publish our innovative modified biplanar 0-90 endoscopic guided puncture technique for percutaneous nephrolithotomy in supine recorded with a GoPro® camera for standardization of the technique. It solves drawbacks of the fluoroscopic technique, i.e., in kidneys with complex anatomy, it may be challenging to distinguish calyces as they are often superposed, and it does not allow for all benefits of a combined endoscopic approach (1, 2). Our technique shortens puncture and fluoroscopic time and is easy to teach and reproduce.</p><p><strong>Methods: </strong>A 77-year-old female patient had previous double J insertion due to an obstructing stone in the right distal ureter. She managed to pass the distal stone but remained with the double J and a 20mm stone (1300HU) in the right renal pelvis. The shared decision was for the actual standard of care (3, 4) endoscopic combined intrarenal surgery (ECIRS). The MiniECIRS started with flexible ureteroscopy and a posterior calix which gave direct access to the stone was chosen. The tip of the flexible scope was used to mark point A with the C-arm in the 0-degree position and line B in the 90-degree position. Puncture was fast and the MiniECIRS was uneventful with a single mid-pole access guided by the flexible scope. The surgeon had a Full-HD GoPro® camera mounted on his head, controlled by the surgical staff. All essential surgical steps were recorded.</p><p><strong>Results: </strong>The quality of the recorded movie was graded as excellent, and the camera did not cause any discomfort to the surgeon. Operative and X-Ray time were 120minutes and 2minutes (7.64mGy). Hemoglobin drop was 0.8g/dL. The post-operative day-1 computed tomography scan was stone-free. The patient was discharged 24h after surgery. Kidney stent was left with a string and removed after 5days. The patient remained asymptomatic and metabolic evaluation revealed a calcium oxalate stone, low urinary volume and hypocitraturia which were treated with potassium citrate and hydration.</p><p><strong>Conclusion: </strong>The Modified Biplanar (0-90 degree) Endoscopic-Guided Puncture Technique for Percutaneous Nephrolithotomy joins the reproducibility of the same technique under fluoroscopy with advantages regarding safety and efficiency of ECIRS.</p>","PeriodicalId":49283,"journal":{"name":"International Braz J Urol","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10075685","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}