The Canadian journal of urology最新文献

{"title":"Association of online health information exposure with disease awareness initial symptom severity in benign prostatic hyperplasia: a cross-sectional study.","authors":"Xiaoxiao Guo, Mingyu Chang, Gangyue Hao, Fengbo Zhang, Haoran Xia","doi":"10.32604/cju.2026.075599","DOIUrl":"10.32604/cju.2026.075599","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is prevalent among aging men. Whether exposure to internet-derived health information is associated with disease awareness and symptom burden at initial diagnosis remains unclear.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 400 newly diagnosed BPH outpatients. Participants were classified by prior exposure to internet-derived BPH content. BPH awareness and International Prostate Symptom Scores (IPSS) were compared using the Mann-Whitney U test and multivariate linear regression adjusted for age, education, and disposable income. Stratified analyses were performed according to educational attainment, disposable income, and content format.</p><p><strong>Results: </strong>Exposure to internet-derived BPH content was independently associated with higher awareness and lower IPSS. Compared with unexposed participants, exposed participants had higher awareness (median 1.5 vs. 0) and lower IPSS (median 7.0 vs. 10.5) (both p < 0.001). In multivariable models, being unexposed was associated with a 1.39-point lower awareness score and a 2.20-point higher IPSS (both p < 0.001). In stratified analyses, the associations remained significant across education and income strata. Among exposed participants, those accessing text-based or mixed-format content had higher awareness and lower IPSS than those exposed to videos only (both p < 0.001).</p><p><strong>Conclusions: </strong>This study shows that exposure to internet-derived health content is significantly associated with higher BPH awareness and a lower symptom burden at initial presentation. Text-based or mixed-format content may be more effective than video-only formats.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 3","pages":"573-582"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407718","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":"Study on automatic recognition of stone composition in intraoperative endoscopic images-a single center study.","authors":"Daxun Luo, Bixiao Wang, Haifeng Song, Chaoyue Ji, Weiguo Hu, Bo Xiao, Boxing Su, Yubao Liu, Jianxing Li","doi":"10.32604/cju.2026.076790","DOIUrl":"https://doi.org/10.32604/cju.2026.076790","url":null,"abstract":"<p><strong>Objectives: </strong>Urinary stone composition critically influences treatment selection and recurrence prevention, yet current intraoperative assessment remains imprecise. This study aims to achieve intraoperative prediction of stone composition by applying a deep convolutional neural network (CNN) to routinely captured endoscopic images.</p><p><strong>Methods: </strong>We retrospectively studied endoscopic images from stone-breaking surgeries in Beijing Tsinghua Changgung Hospital during 2022-12-2024-12. Images were captured before and after laser lithotripsy. Based on postoperative infrared spectroscopy, stones were divided into five categories. In total, 1780 images (1167 from RIRS, 613 from PCNL) were included and split into training and testing sets at an 8:2 ratio. Using ResNet-50 as the base model, only endoscopic digital images and stone classification data were input for minimal-supervision learning. After training, the model accuracy for each stone category surpassed 95%. The model was then tested on 20% of RIRS and RIRS+PCNL images, with 3D PCA and Grad-cam for visual analysis.</p><p><strong>Results: </strong>For the RIRS image test set: The precision was 93.8% for the calcium oxalate group (n = 147), 96.3% for the calcium oxalate mixed with a uric acid group (n = 30), 91.8% for the calcium oxalate mixed with carbonate apatite group (n = 106), 88.9% for the struvite mixed with calcium oxalate and carbonate apatite group (n = 16), and 100% for the stone free control group (n = 26) (Table 1). Total accuracy for CNN modeling is:94.16%, AUC:0.99, weighted F1-Score: 0.9353, weighted F1-score 95% CI: (0.9089, 0.9599), weighted Kappa: 0.9122, weighted Kappa 95% CI: (0.8523, 0.9569).For the RIRS+PCNL image test set: The precision was 94.9% for the calcium oxalate group (n = 195), 98.7% for the calcium oxalate mixed with a uric acid group (n = 80), 92.2% for the calcium oxalate mixed with carbonate apatite group (n = 111), 100% for the struvite mixed with calcium oxalate and carbonate apatite group (n = 29), and 93.8% for the stone free control group (n = 26) (Table 2).Total accuracy: 95.92%, AUC: 0.99, weighted F1-Score: 0.9508, weighted F1-score 95% CI: (0.9304, 0.9708) weighted Kappa: 0.9357, weighted Kappa 95% CI: (0.8907, 0.9678).The 3D PCA projection results are as follows: PC1: 0.2723 (27.23%), PC2: 0.1102 (11.02%), PC3: 0.0801 (8.01%), Cumulative: 46.26%.</p><p><strong>Conclusions: </strong>This study shows deep CNNs can identify renal stone compositions from intraoperative endoscopic images, differentiating pure and mixed components. This analysis is an alternative to traditional methods and has the potential to improve treatment effectiveness.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 3","pages":"623-634"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407699","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":"Innovations in the management of urethral stricture disease: emerging and regenerative strategies.","authors":"Nicola Fazaa, Kamil Malshy, Yuval Shafran, Ameer Nsair, Etan Eigner, Melissa Atallah, Shadie Badaan, Kirolos Meilika, Ariel Zisman","doi":"10.32604/cju.2026.076687","DOIUrl":"10.32604/cju.2026.076687","url":null,"abstract":"<p><p>Urethral stricture disease remains a challenging clinical entity within contemporary urology, requiring interventions that achieve sustained urethral patency while preserving functional outcomes. Established modalities such as urethral dilation, endoscopic urethrotomy, and urethroplasty using autologous grafts provide effective treatment for many patients. However, they are constrained by morbidity, graft contraction, and suboptimal success in complex or recurrent strictures. These inherent limitations have stimulated growing investigation of therapeutic strategies. Among device-based innovations, drug-coated balloon dilation, exemplified by the Optilume™, combines mechanical expansion with localized antiproliferative drug delivery and represents a significant evolution in endoscopic management. Pharmacologic adjuncts such as intralesional corticosteroids, mitomycin C, and hyaluronidase are already in clinical use to extend stricture-free intervals. Some emerging biologic strategies, including platelet-rich plasma, mesenchymal stem cells, and experimental inhibition of tyrosine kinase or YAP/TAZ signaling, represent prospective avenues for targeted antifibrotic therapy that remain largely in early translational stages. Parallel advances in regenerative medicine offer the potential for anatomically and functionally restorative repair. Bioengineered urethral grafts and 3D bio-printed constructs are designed to recapitulate native tissue architecture and support host cellular integration, providing patient-specific solutions that obviate the morbidity of autologous harvest. Preclinical and early clinical studies are reviewed with particular attention to scaffold composition, bioink formulation, and strategies to enhance vascularization and long-term functionality. This review aims to present these emerging approaches within the broader framework of contemporary urethral reconstruction, highlighting ongoing clinical trials and delineating the scientific, regulatory, and manufacturing challenges that must be addressed to facilitate their translation into routine clinical practice.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 3","pages":"515-526"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407711","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":"Comparison of endoscopic treatment for bladder neck contracture: a single centre study and review of literature.","authors":"Sofia Fontanet, Julio F Calderón-Cortéz, Edgar Suquilanda, Fernando Gaona, Alejandro García Navarro, Marta Piqueras","doi":"10.32604/cju.2026.074254","DOIUrl":"10.32604/cju.2026.074254","url":null,"abstract":"<p><strong>Objectives: </strong>Nowadays, bladder neck contracture treatment reported is both bladder neck incisions and resection. Also, different energies have been described. This study aimed to describe and compare surgical techniques and energy sources used in Hospital Universitari de Vic.</p><p><strong>Methods: </strong>retrospective study of patients with a diagnosis of bladder neck contracture that required endoscopic surgical treatment between 2000 and 2024. Preoperative, operative, and postoperative characteristics were analysed. At the end of follow-up, the patient's status was asymptomatic, under urethral dilatations, or with a permanent catheter.</p><p><strong>Results: </strong>60 patients were included. Mean age was 71.1 years (SD = 8.95). Previous urologic surgery was open radical prostatectomy (33.3%), laparoscopic radical prostatectomy (6.7%), transurethral resection of the prostate (31.7%), laser prostate vaporization (16.7%), open prostate adenomectomy (6.7%), and transurethral resection of bladder tumour (5.0%). Concomitant urethral stricture was detected in 21.3%. Bladder neck resection was used in 41.7% and bladder neck incisions at 12, 5, and 7 h in 58.3%. No significant difference in success rate was detected (p = 0.598). The instrument was monopolar loop (31.7%), Collins (41.7%), cold knife (11.7%), bipolar loop (8.3%), and Holmium laser (6.7%). In 13 patients, a second endoscopic management was performed, and 9 presented success. Median time follow-up was 63 months (IQR: 25-100). Patient's clinical situation was asymptomatic in 71.1%, periodic dilatations in 25% and a permanent catheter in 3.3%. The only risk factor detected for periodic dilatations was urethral stenosis.</p><p><strong>Conclusions: </strong>Endoscopic treatment presents a success rate of 71% at 5 years with no significant difference between bladder neck incisions or resection, nor between previous types of prostate surgery.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 3","pages":"537-544"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407727","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":"Optimizing postoperative pain relief with a novel technique: intraluminal lidocaine administration during retrograde intrarenal surgery.","authors":"Sezgin Yeni, Hakan Kilicarslan, Bertan Tanrıbuyurdu, Levent Turan, Hatice Ortac, Onur Kaygisiz","doi":"10.32604/cju.2026.072974","DOIUrl":"https://doi.org/10.32604/cju.2026.072974","url":null,"abstract":"<p><strong>Objectives: </strong>Retrograde intrarenal surgery (RIRS) has become an increasingly preferred minimally invasive option for the management of kidney stones. However, postoperative pain remains a major clinical concern that may adversely affect patient comfort and recovery. This study aimed to evaluate whether intraluminal administration of lidocaine at the end of RIRS could effectively reduce postoperative pain and analgesic requirements.</p><p><strong>Methods: </strong>A total of 61 patients who underwent RIRS between March and July 2024 were evaluated. Four patients were excluded due to residual stones, and five due to a history of cardiac arrhythmia, leaving 52 patients for analysis. Patients were divided into two groups according to the use of intraluminal lidocaine: Group L (Lidocaine Group, n = 27) received 100 mg of lidocaine prior to DJ stent placement, whereas Group C (Control Group, n = 25) did not. Demographic and stone-related parameters were recorded. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 1, 4, 8, 12, and 24 h, and postoperative analgesic use was documented.</p><p><strong>Results: </strong>No significant differences were observed between the groups regarding demographic characteristics, stone parameters, or preoperative pain scores. However, postoperative VAS scores were significantly lower in Group L at the 8th and 12th hours (p = 0.041 and p = 0.028, respectively). Moreover, total postoperative analgesic consumption was significantly lower in Group L (p = 0.027), supporting the analgesic efficacy of intraluminal lidocaine administration.</p><p><strong>Conclusion: </strong>Intraluminal lidocaine administration at the end of RIRS appears to be a safe, feasible, and effective method for reducing postoperative pain and minimizing analgesic requirements. These findings suggest that the technique may contribute to improved postoperative recovery, although larger multicenter studies are warranted to confirm its clinical value.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 3","pages":"635-642"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407694","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":"Application of the prior exposure maneuvers urethroplasty in complex posterior anastomotic urethroplasty.","authors":"Minkai Xie, Chong Liu, Ziwei Wei, Bin Xu","doi":"10.32604/cju.2026.073929","DOIUrl":"https://doi.org/10.32604/cju.2026.073929","url":null,"abstract":"<p><strong>Objectives: </strong>Current surgical interventions for pelvic fracture urethral injury (PFUI) are constrained by multiple limitations. This study aimed to introduce the prior exposure maneuvers urethroplasty (PEM-U) in complex posterior anastomotic urethroplasty for PFUI.</p><p><strong>Methods: </strong>From February 2018 to March 2023 at Shanghai Ninth People's Hospital, 78 patients with complex PFUI underwent transperineal anastomotic urethroplasty, 39 patients of whom underwent classic Webster urethral urethroplasty in which bodies splitting or an inferior pubectomy after transection of bulbar urethra (Group A), and the other 39 patients underwent improved urethral urethroplasty (Group B), in which using PEM-U (corporeal bodies splitting or an inferior pubectomy before transection of bulbar urethra). Postoperative evaluations were performed at 1, 3, 6, and 12 months after catheter removal. Success was defined as a urine flow rate ≥15 mL/s, no difficulty in urination, and no further intervention was required.</p><p><strong>Results: </strong>There was no statistical difference in the length of urethral defect between 39 patients (mean age 43.7 years) in Group A and 39 patients (mean age 41.3 years) in Group B. The average operation time of Group A was 115 min (range, 90-150 min), and that of Group B was 93 min (range, 85-115 min) (p = 0.012). The blood loss was 265 mL (range, 100-650 mL) in Group A and 214 mL (range, 90-350 mL) in Group B (p = 0.015). The success rate was 89.7% in the classical group and 92.3% in the improved group.</p><p><strong>Conclusion: </strong>The PEM-U was effective for treating complex PFUI cases, improving surgical efficacy, reducing the operation time, and the amount of blood loss.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 3","pages":"603-609"},"PeriodicalIF":0.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407746","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":"Ten Years of Progress in Advanced Prostate Cancer at the AUA.","authors":"Leonard G Gomella","doi":"10.32604/cju.2026.083134","DOIUrl":"https://doi.org/10.32604/cju.2026.083134","url":null,"abstract":"","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"233-234"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148020377","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":"Can AI and predictive models accurately predict stone-free status? a systematic review and meta-analysis.","authors":"Yahya Ghazwani, Mohammad Alghafees, Mishari Alshasha, Fahad Brayan, Abdulrahman Alsayyari, Ali Alyami","doi":"10.32604/cju.2026.077411","DOIUrl":"10.32604/cju.2026.077411","url":null,"abstract":"<p><strong>Objectives: </strong>The emergence of artificial intelligence (AI) and predictive modeling offers prospects for clinical, anatomical, and imaging factor combination, like radiomics, to help with stone-free status (SFS) estimation and peroperative decision-making. The goal of this study was, therefore, to define the present performance range, determine sources of heterogeneity, and determine methodological practices permitting reliable implementation by varied circumstances.</p><p><strong>Methods: </strong>We searched six bibliographic databases through 19 September 2025. Studies deriving or validating AI/predictive models for SFS after ureteroscopy were eligible. Independent dual screening, duplicate data extraction, and risk-of-bias consideration using QUADAS-AI were conducted.</p><p><strong>Results: </strong>Five retrospective cohorts were included. Modeling approaches encompassed multivariable logistic regression, regularized/radiomics pipelines, gradient boosting, and ensembles. SFS definitions ranged from <2 mm residual (day-1 to 3 months) to ≤5 mm residual (1 month), determined by plain radiography, ultrasound, and/or CT. The pooled ratio-scale effect for stone size per 1 mm increase was 1.26 (95% CI 0.91-1.76; τ² ≈ 0.055; Q = 18.52; I² = 94.6%; prediction interval 0.03-49.45). Hydronephrosis (moderate-severe vs. mild/none) showed a pooled RR 2.72 (95% CI 0.96-7.72; τ² ≈ 0.821; Q = 65.40; I² = 96.9%; prediction interval 0.03-249.87). As continuous contrasts, stone size was larger in the non-stone-free group (SMD 1.36, 95% CI 0.85-1.86; τ² ≈ 0.096; I² = 72.9%; prediction interval -3.77 to 6.48), and HU was higher (SMD 0.64, 95% CI 0.39-0.90; τ² ≈ 0; Q = 0.73; I² = 0%; prediction interval -0.99 to 2.27).</p><p><strong>Conclusions: </strong>Across studies evaluating AI and predictive models for ureteroscopy, discrimination was generally acceptable to excellent, and performance appeared highest in models integrating radiomics with anatomic/clinical descriptors. However, the degree of between-study heterogeneity (population mix, outcome definitions, imaging protocols, thresholds, and follow-up windows) was sufficiently large that pooled quantitative estimates should be considered clinically uninterpretable.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"291-308"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848874","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 nutritional-inflammatory index for early prediction of inpatient urinary tract infection risk after acute stroke in the elderly.","authors":"Shanhong Luo, Hongjuan Xu","doi":"10.32604/cju.2025.069884","DOIUrl":"10.32604/cju.2025.069884","url":null,"abstract":"<p><strong>Background: </strong>Early detection and timely treatment of urinary tract infections (UTIs) can prevent the aggravation of the inflammatory response following a stroke and enhance the recovery of neurological function. This study aimed to develop a simple scoring system by integrating nutritional and inflammatory markers to predict the occurrence of UTIs in patients with acute stroke.</p><p><strong>Methods: </strong>Reviews of 1011 patients with acute stroke were retrieved. The Geriatric Nutritional Risk Index (GNRI) and systemic inflammation response index (SIRI) were utilized to develop a composite score of nutritional-systemic inflammation response index (G-SIRI). The primary endpoint was the efficacy of predicting stroke-associated UTIs through an area under the curve (AUC) using receiver operating characteristic analysis. Secondary outcomes included the optimal cut-off value, hazard ratio (HR), in-hospital mortality, and length of hospital stay.</p><p><strong>Results: </strong>The composite scoring system of G-SIRI had a superior predictive accuracy for the occurrence of UTIs after acute stroke with a greater AUC of 0.850 (95% CI: 0.825-0.874) compared to either of isolated GNRI (0.782 [95% CI: 0.751-0.812]) or SIRI scores (0.796 [95% CI: 0.767-0.826]) (p < 0.001). A high-risk G-SIRI score was an independent predictor of stroke-associated UTI (HR = 2.192, 95% CI: 1.702-2.940) with a specificity of 0.784 and sensitivity of 0.899. A shorter survival time from post-stroke UTIs was observed in the high-risk G-SIRI cohort as opposed to the low-risk cohort (6.05 ± 1.14 vs. 3.22 ± 1.44 days, p < 0.001). The high-risk G-SIRI cohort showed significantly higher in-hospital mortality and longer length of hospital stays (all p < 0.05).</p><p><strong>Conclusions: </strong>The G-SIRI scoring system showed a superior efficacy in predicting stroke-associated UTIs as opposed to the individual GNRI or SIRI scores, which underscored the clinical utilization of integrating nutritional and inflammatory factors for UTI risk stratification among patients with acute stroke.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"417-426"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848197","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":"Pulsed solid-state thulium: YAG laser compared to holmium: YAG laser during mini-PCNL.","authors":"Benedikt Becker, Sophia Hook, Carla Dapper, Julius Bergmann, Christopher Netsch, Simon Filmar","doi":"10.32604/cju.2025.072386","DOIUrl":"10.32604/cju.2025.072386","url":null,"abstract":"<p><strong>Background: </strong>Holmium: yttrium-aluminum-garnet (Ho: YAG) laser technology has long been employed for urinary stone fragmentation; however, its limitations have prompted the exploration of alternative systems such as thulium lasers. This study aims to compare a novel pulsed solid-state Thulium: YAG (Tm: YAG) laser to the standard Ho: YAG laser in Mini-percutaneous nephrolithotomy (Mini-PCNL) lithotripsy for renal calculi.</p><p><strong>Methods: </strong>In total, 100 patients undergoing Mini-PCNL were enrolled in this clinical trial. Fifty patients treated with a holmium laser were selected from a retrospective database. These patients were compared to fifty patients who were prospectively enrolled and treated with a new thulium laser. Patient characteristics, stone parameters, operative details, and complications were recorded and analyzed statistically.</p><p><strong>Results: </strong>Both groups were comparable in demographics and stone characteristics. The Tm: YAG group demonstrated significantly shorter laser-on-time (7.20 vs. 10.46 min; p < 0.05) and operative time (32.6 vs. 41.2 min; p < 0.05) compared to the Ho: YAG group. There was no difference regarding stone-free rates (SFR) at 24 h, which were 90% in the Ho: YAG group and 92% in the Tm: YAG group (p > 0.999). Intraoperative complications did not significantly differ between groups.</p><p><strong>Conclusion: </strong>The novel pulsed solid-state Tm: YAG laser demonstrates advantages over the Ho: YAG laser in terms of laser-on-time and operation time, while showing comparable results for stone-free rate and complications. Further clinical trials are needed to compare Tm: YAG and Ho: YAG lasers in various contexts and to evaluate the Tm: YAG laser against the thulium fiber laser (TFL) for a comprehensive understanding of each technology's advantages.</p>","PeriodicalId":520500,"journal":{"name":"The Canadian journal of urology","volume":"33 2","pages":"271-279"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848843","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}