Alberto Ragusa, Francesco Prata, Andrea Iannuzzi, Francesco Tedesco, Matteo Pira, Angelo Civitella, Loris Cacciatore, Giovanni Muto, Roberto Scarpa, Rocco Papalia
{"title":"Robot-assisted pyeloplasty with the New Hugo™ RAS: step-by-step surgical settings and technique.","authors":"Alberto Ragusa, Francesco Prata, Andrea Iannuzzi, Francesco Tedesco, Matteo Pira, Angelo Civitella, Loris Cacciatore, Giovanni Muto, Roberto Scarpa, Rocco Papalia","doi":"10.23736/S2724-6051.25.06067-7","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06067-7","url":null,"abstract":"<p><strong>Background: </strong>We present our step-by-step experience regarding the feasibility and surgical setup for a case series of robotic pyeloplasty using the new Hugo<sup>™</sup> RAS System.</p><p><strong>Methods: </strong>Five consecutives robotic pyeloplasties have been performed, through a trans-peritoneal route. Three robotic ports were placed under direct vision, including an optical 11-mm robotic trocar, and two 8-mm operative robotic ports. Two laparoscopic ports for bed-assistant were placed between robotic ports and below the camera port to avoid clashes. Only three arm carts were used and located behind the back of the patient to leave more working space to the bed-assistant space and avoid internal or external clashes between robotic arms. After docking and paracolic gutter incision, kidney lower pole identification, UPJ stenosis excision, and spatulation of the ureter with double J ureteral catheter placement were key steps of our procedure.</p><p><strong>Results: </strong>Median Docking and Console time were 4 minutes (IQR: 4-5) and 115 minutes (IQR:105-120), respectively. No intraoperative complications occurred. No additional ports placement was necessary. No robotic instrument clashed, nor clashes between the robotic arms and the bed-assistant were observed. Estimated blood loss was negligible. The patients were discharged on postoperative day 3 after bladder catheter and abdominal drain removal. No complications were recorded within the first 30 postoperative days. Finally, a median follow-up of 4 (IQR: 3-8) reported satisfactory outcomes.</p><p><strong>Conclusions: </strong>In the setting of robotic pyeloplasty, this novel platform showed a user-friendly docking system, providing satisfactory perioperative outcomes with a simple three-arms configuration.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stavros Gravas, Georgios Chasiotis, Mauro Gacci, Gokhan Calik, Andrea Liaci, Athanasios Dellis, Petros Sountoulides, M Pilar Laguna, Jean DE LA Rosette
{"title":"The feasibility and acceptability of a (mobile) application for men with lower urinary tract symptoms: a pilot study.","authors":"Stavros Gravas, Georgios Chasiotis, Mauro Gacci, Gokhan Calik, Andrea Liaci, Athanasios Dellis, Petros Sountoulides, M Pilar Laguna, Jean DE LA Rosette","doi":"10.23736/S2724-6051.25.06352-9","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06352-9","url":null,"abstract":"<p><strong>Background: </strong>The growing use of smartphones offers a key opportunity to monitor BPO/LUTS through well-designed medical apps. The primary objective of the study was to assess the feasibility and acceptability of a mobile app (MyBPHCare) for men with lower urinary tract symptoms (LUTS). Secondary objectives included medical adherence using electronic reminders and compliance of treatment with current guidelines.</p><p><strong>Methods: </strong>This was an observational cohort pilot study conducted in Greece, Türkiye, and Italy. Patients with LUTS, treatment-naïve or under treatment, older than 40 years were eligible. Patients received standard care according to physician's practice and duration of follow-up was 6 months. Standard questionnaires, diagnostic tools, medication, and follow-up visits were employed. Feasibility, acceptance, and satisfaction were assessed using a standardized, translated and validated app rating user questionnaire (uMARS). Patients' adherence to treatment and physicians' with guidelines were also recorded.</p><p><strong>Results: </strong>From a total of 157 patients, 68.15% filled in the uMARS questionnaire. All uMARS mean scores ranged between \"Acceptable\" and \"Good\": App Quality (3.43), Engagement (3.21), Functionality (3.47), Aesthetics (3.37), and Information (3.68). 96.3% of the participants would recommend using the app. Recorded adherence to medication was 47.85%, while a discrepancy between guidelines and real-life practice was found.</p><p><strong>Conclusions: </strong>MyBPHCare app is a possibly feasible application for virtually monitoring men with LUTS with good acceptance from the patients.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khaled M Zeinelabden, Elsayed A Elsayed, Mohamed Aziz, Hussein Mamdoh
{"title":"Assessment of efficacy of mirabegron, solifenacin, tadalafil 5 mg and combination therapy in female patients with overactive bladder: a double blinded multicenter prospective placebo-controlled trial.","authors":"Khaled M Zeinelabden, Elsayed A Elsayed, Mohamed Aziz, Hussein Mamdoh","doi":"10.23736/S2724-6051.25.06129-4","DOIUrl":"10.23736/S2724-6051.25.06129-4","url":null,"abstract":"<p><strong>Background: </strong>This study assess the efficacy of mirabegron, solifenacin, tadalafil 5 mg, and tadalafil 5 mg combination with solifenacin and mirabegron in the treatment of female patients with overactive bladder (OAB), comparing these to a placebo in a double-blinded, prospective, randomized, placebo-controlled trial.</p><p><strong>Methods: </strong>A total of 483 female patients diagnosed with OAB and confirmed detrusor overactivity were recruited from three university hospitals (Tanta, Kafrelsheikh, and Menoufia) between January and July 2024. Participants were randomly assigned to one of six groups: tadalafil 5 mg (Group I), solifenacin 5 mg (Group II), mirabegron 50 mg (Group III), mirabegron 50 mg + tadalafil 5 mg (Group IV), solifenacin 5 mg + tadalafil 5 mg (Group V), or placebo (Group VI). Assessments were performed at baseline, 1, 2, and 3 months.</p><p><strong>Results: </strong>At 3 months, the combination therapies (Groups IV and V) demonstrated significantly greater improvements in OABSS compared to mono-therapy groups (Groups I, II, III) and placebo (Group VI). Group V (tadalafil 5 mg + solifenacin) achieved the greatest symptom reduction, comparable with Group IV (tadalafil 5 mg + mirabegron). Urodynamic improvements were also notable in the combination therapy groups, with significant increases in bladder capacity and compliance, and reduction in detrusor contractions compared to placebo. With the exception of high post voiding residual was high with solifenacin monotherapy Adverse effects were similar across groups, with no significant differences in overall incidence.</p><p><strong>Conclusions: </strong>The novel combination therapies of tadalafil 5mg with solifenacin or mirabegron are more effective in reducing OAB symptoms and improving urodynamic parameters compared to single-agent therapies and placebo. These findings suggest that combination therapy is alternative pathway which can enhance outcomes for female patients with OAB. Further research is warranted to validate these results and explore long-term efficacy and safety.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"383-395"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alessio Pecoraro, Angelo Territo, Andrea Gallioli, Giuseppe Basile, Joris Vangeneugden, Begoña Etcheverry, Mireia Musquera, Byron Lopez DE Mesa Rodriguez, Thomas Prudhomme, Jeremy Mercier, Milla Ortved, Philip Zeuschner, Alessandro Volpe, Rodrigo Garcia-Baquero, Burak Kocak, Mirza Idu, Michael Stockle, Malene Rohrsted, Albdullah E Canda, Andreas Røder, Antonio Alcaraz, Nicolas Doumerc, Francesc Vigues, Karel Decaestecker, Lorenzo Masieri, Sergio Serni, Alberto Breda, Riccardo Campi
{"title":"Robot-assisted kidney transplantation using right- vs. left-sided grafts from living donors: a prospective multicenter study from the ERUS-RAKT working group.","authors":"Alessio Pecoraro, Angelo Territo, Andrea Gallioli, Giuseppe Basile, Joris Vangeneugden, Begoña Etcheverry, Mireia Musquera, Byron Lopez DE Mesa Rodriguez, Thomas Prudhomme, Jeremy Mercier, Milla Ortved, Philip Zeuschner, Alessandro Volpe, Rodrigo Garcia-Baquero, Burak Kocak, Mirza Idu, Michael Stockle, Malene Rohrsted, Albdullah E Canda, Andreas Røder, Antonio Alcaraz, Nicolas Doumerc, Francesc Vigues, Karel Decaestecker, Lorenzo Masieri, Sergio Serni, Alberto Breda, Riccardo Campi","doi":"10.23736/S2724-6051.25.06279-2","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06279-2","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation using right-sided graft (RSG) is technically challenging and may be associated with increased risk of complications and/or suboptimal graft function. Our study aims to compare perioperative and functional outcomes of robot-assisted kidney transplantation (RAKT) using RSG vs. left-sided graft (LSG).</p><p><strong>Methods: </strong>The multi-institutional, prospectively collected EAU Robotic Urology Section (ERUS)-RAKT database was queried to select consecutive patients undergoing RAKT from living donors between 7/2015 and 11/2023. Intraoperative outcomes and early (30 days) postoperative complications and functional results were the main study end-points. Dialysis-free survival was explored as a secondary outcome.</p><p><strong>Results: </strong>Overall, 624 RAKTs were included, of which 526 (84%) using LSGs and 98 (16%) using RSGs. Preoperative characteristics did not significantly differ between the RSG and LSG groups. The median console time did not differ between the two groups while the use of RSGs was associated with a longer median rewarming time (46 vs. 43 min). No difference in intraoperative adverse events and postoperative high-grade complications between the two groups were reported (4% vs. 5.4%, P=0.4). At multivariable analysis, kidney side did not predict high-grade complications; the only significant factor predicting this outcome was the Centre's experience in RAKT (measured by the case number). RAKT achieved similar dialysis-free survival rates using LSGs and RSGs.</p><p><strong>Conclusions: </strong>In experienced centers, RAKT using RSG from living donors is safe and achieves favorable perioperative and mid-term functional outcomes. While larger studies with longer follow-up are needed to confirm our findings, our study can influence the practice of living donor nephrectomy if RAKT is available.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 3","pages":"320-329"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicolas A Soputro, Carter D Mikesell, Salim K Younis, Samarpit Rai, Lin Wang, Adriana M Pedraza, Jihad Kaouk
{"title":"The anesthesia impact of regionalized insufflation with transvesical single port robot-assisted radical prostatectomy.","authors":"Nicolas A Soputro, Carter D Mikesell, Salim K Younis, Samarpit Rai, Lin Wang, Adriana M Pedraza, Jihad Kaouk","doi":"10.23736/S2724-6051.25.06307-4","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06307-4","url":null,"abstract":"<p><strong>Background: </strong>To evaluate for any differences between the intraoperative oxygenation and ventilation outcomes between single port (SP) extraperitoneal (EP) and transvesical (TV) robot-assisted radical prostatectomy (RARP) with the standard multi-port (MP) transperitoneal (TP) approach.</p><p><strong>Methods: </strong>A retrospective review was performed on the prospectively maintained, IRB-approved database to identify 962 consecutive patients who underwent MP TP, SP EP, and SP TV RARP between 2015 and 2024. A 1:1 propensity-matched analysis was completed based on the patient's age, Body Mass Index (BMI), as well as comorbidities based on the Charlson Comorbidity Index (CCI) and American Society of Anesthesiologists' (ASA) physical status classification score. Intraoperative anesthesia parameters collected included the lowest recorded oxygen saturation (SpO<inf>2</inf>), highest end-tidal carbon dioxide (ETCO<inf>2</inf>), highest respiratory rate (RR), the highest positive end-expiratory pressure (PEEP) setting, as well as the total intraoperative doses of propofol, rocuronium, and fentanyl.</p><p><strong>Results: </strong>Based on our propensity-matched analysis, 603 patients were included, which comprised 201 cases of MP TP, SP EP, and SP TV RARP, respectively. Our cohort had a median age of 63.5 years (IQR 58.5-68.1 years), a median BMI of 28.4 kg/m<sup>2</sup> (IQR 25.9-31.7 kg/m<sup>2</sup>), a median CCI of 4 (IQR 3-5), and a median ASA Score of 3 (IQR 2-3). All procedures were completed without any conversion, intraoperative complications, or need for blood transfusion. Notably, the SP TV RARP was associated with significant improvements in both SpO<inf>2</inf> and ETCO<inf>2</inf> (median lowest SpO<inf>2</inf>, MP TP 95% vs. SP EP 96% vs. SP TV 98%, P<0.001; median highest ETCO<inf>2</inf>, MP TP 45 vs. SP EP 42 vs. SP TV 40 mmHg, P<0.001). Compared to MP-RARP, the SP technique was associated with a significantly decreased use of intraoperative fentanyl (median, MP TP 200 vs. SP EP 175 vs. SP TV 150 mcg, P<0.001) yet without any statistically significant differences between the SP EP and SP TV approaches (P=0.223).</p><p><strong>Conclusions: </strong>Herein, we demonstrated the benefits of pneumovesicum with the regionalized SP TV approach in improving intraoperative oxygenation, ventilation, as well as perioperative analgesia requirements, especially when compared to the standard TP MP-RARP. These resulting improvements hold promise for further enhancements in perioperative outcomes and patient safety, especially in patients with pre-existing cardiopulmonary comorbidities.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 3","pages":"330-337"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Breno C Porto, Bruno D Terada, Felipe G Gonçalves, Nathalie C Hobaica, Carlo C Passerotti, Everson L Artifon, Alfredo L Jacomo, Jose P Otoch, Jose A Shiomi DA Cruz
{"title":"Thiazide diuretics for preventing calcium oxalate recurrent kidney stones: an updated systematic review, meta-analysis and trial sequential analysis of randomized controlled trials.","authors":"Breno C Porto, Bruno D Terada, Felipe G Gonçalves, Nathalie C Hobaica, Carlo C Passerotti, Everson L Artifon, Alfredo L Jacomo, Jose P Otoch, Jose A Shiomi DA Cruz","doi":"10.23736/S2724-6051.25.05903-8","DOIUrl":"10.23736/S2724-6051.25.05903-8","url":null,"abstract":"<p><strong>Introduction: </strong>Nephrolithiasis, a prominent urological condition, necessitates effective management. Thiazide diuretics play a crucial role in preventing recurrence, supported by a prior meta-analysis. Guidelines further endorse thiazides for nephrolithiasis in hypercalciuria cases. Despite this knowledge, uncertainties persist in optimizing thiazide prescriptions for hypercalciuric patients. The intent of this study is to offer a comprehensive update on nephrolithiasis management, evaluating thiazide diuretics' role using insights from recent RCTs and trial sequential analysis.</p><p><strong>Evidence acquisition: </strong>A systematic search was conducted in MEDLINE, Embase, Scopus, Cochrane, Web of Science and Google Scholar. We included only RCTs studies that compared thiazides diuretics and placebo for managing recurrence of nephrolithiasis in patients with hypercalciuria. Our primary outcome of interest was the rate of recurrence of calculi. Secondary outcomes included the 24-hour calciuria and the 24-hour citraturia.</p><p><strong>Evidence synthesis: </strong>We retrieved 10 articles, encompassing 650 patients in the intervention group and 672 patients in the placebo group. Overall, our findings favor thiazide diuretics, through recurrence rate in patients that received thiazides (RR 0.63; 95% CI 0.49, 0.83; P=0.0007; I<sup>2</sup>=65%). Also, when analyzing the urinary parameters, there was a lower prevalence of 24-hour calciuria in those patients who underwent treatment with thiazides (MD -40.59; 95% CI -76.39, -4.79; P=0.03; I<sup>2</sup>=84%), while no difference was found regarding the 24-hour citraturia between groups (MD -29.70; 95% CI -83.02, 23.63; P=0.28; I<sup>2</sup>=59%).</p><p><strong>Conclusions: </strong>This comprehensive systematic review, meta-analysis and trial sequential analysis confirms that thiazide diuretics significantly mitigates the risk of nephrolithiasis in patients with hypercalciuria.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 3","pages":"298-307"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Transrectal vs. transperineal: still on the fence.","authors":"Alessandro Guercio, Riccardo Lombardo, Ferdinando Fusco, Elisa Mancini, Cosimo DE Nunzio","doi":"10.23736/S2724-6051.25.06521-8","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06521-8","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 3","pages":"428-431"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angelo Mottaran, Federico Piramide, Paolo Dell'oglio, Carlo A Bravi, Marco Paciotti, Gabriele Source, Edward Lambert, Christoph Wurnschimmel, Mike Wenzel, Nikolaos Liakos, Filippo Turri, Ruben DE Groote, Iulia Andras
{"title":"Transforming hostile abdomen management: the rise of single-port for retroperitoneal robot-assisted partial nephrectomy.","authors":"Angelo Mottaran, Federico Piramide, Paolo Dell'oglio, Carlo A Bravi, Marco Paciotti, Gabriele Source, Edward Lambert, Christoph Wurnschimmel, Mike Wenzel, Nikolaos Liakos, Filippo Turri, Ruben DE Groote, Iulia Andras","doi":"10.23736/S2724-6051.25.06549-8","DOIUrl":"10.23736/S2724-6051.25.06549-8","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 3","pages":"438-440"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matteo Ferro, Octavian S Tataru, Giuseppe Fallara, Cristian Fiori, Matteo Manfredi, Francesco Claps, Rodolfo Hurle, Nicolò M Buffi, Giovanni Lughezzani, Massimo Lazzeri, Achille Aveta, Savio D Pandolfo, Biagio Barone, Felice Crocetto, Pasquale Ditonno, Giuseppe Lucarelli, Francesco Lasorsa, Giuseppe Carrieri, Gian M Busetto, Ugo G Falagario, Francesco Del Giudice, Martina Maggi, Francesco Cantiello, Marco Borghesi, Carlo Terrone, Pierluigi Bove, Alessandro Antonelli, Alessandro Veccia, Andrea Mari, Stefano Luzzago, Raul Gherasim, Ciprian Todea-Moga, Andrea Minervini, Gennaro Musi, Francesco A Mistretta, Roberto Bianchi, Marco Tozzi, Francesco Soria, Paolo Gontero, Michele Marchioni, Letizia M Janello, Daniela Terracciano, Giorgio I Russo, Luigi Schips, Sisto Perdonà, Riccardo Autorino, Michele Catellani, Chiara Sighinolfi, Emanuele Montanari, Savino M DI Stasi, Francesco Porpiglia, Bernardo Rocco, Ottavio de Cobelli, Roberto Contieri
{"title":"Assessing the influence of smoking on inflammatory markers in bacillus Calmette Guérin response among bladder cancer patients: a novel machine-learning approach.","authors":"Matteo Ferro, Octavian S Tataru, Giuseppe Fallara, Cristian Fiori, Matteo Manfredi, Francesco Claps, Rodolfo Hurle, Nicolò M Buffi, Giovanni Lughezzani, Massimo Lazzeri, Achille Aveta, Savio D Pandolfo, Biagio Barone, Felice Crocetto, Pasquale Ditonno, Giuseppe Lucarelli, Francesco Lasorsa, Giuseppe Carrieri, Gian M Busetto, Ugo G Falagario, Francesco Del Giudice, Martina Maggi, Francesco Cantiello, Marco Borghesi, Carlo Terrone, Pierluigi Bove, Alessandro Antonelli, Alessandro Veccia, Andrea Mari, Stefano Luzzago, Raul Gherasim, Ciprian Todea-Moga, Andrea Minervini, Gennaro Musi, Francesco A Mistretta, Roberto Bianchi, Marco Tozzi, Francesco Soria, Paolo Gontero, Michele Marchioni, Letizia M Janello, Daniela Terracciano, Giorgio I Russo, Luigi Schips, Sisto Perdonà, Riccardo Autorino, Michele Catellani, Chiara Sighinolfi, Emanuele Montanari, Savino M DI Stasi, Francesco Porpiglia, Bernardo Rocco, Ottavio de Cobelli, Roberto Contieri","doi":"10.23736/S2724-6051.24.05876-2","DOIUrl":"10.23736/S2724-6051.24.05876-2","url":null,"abstract":"<p><strong>Background: </strong>Approximately 70% of bladder cancer is diagnosed as non-muscle invasive (NMIBC) and inflammation is known to impact the oncological outcomes. Adjuvant intravesical BCG in intermediate/high risk can lower recurrence and progression. The efficacy of intravesical BCG can be impacted by smoking effects on systemic inflammation.</p><p><strong>Methods: </strong>Our retrospective, multicenter study with data from 1.313 NMIBC patients aimed to assess the impact of smoking and the systemic inflammatory status on BCG response in T1G3 bladder cancer, using a machine-learning CART based algorithm.</p><p><strong>Results: </strong>In a median of 50-month follow-up (IQR 41-75), 344 patients experienced progression to muscle invasive or metastatic disease and 65 died due to bladder cancer. A CART algorithm has been employed to stratify patients in three prognostic clusters using smoking status, LMR (lymphocytes to monocytes ratio), NLR (neutrophil-to-lymphocyte ratio) and PLR (platelet-to-lymphocyte ratio) as variables. Cox regression models revealed a 1.5-fold (HR 1.66, 95%, CI 1.20-2.29, P=0.002) and three-fold (HR 2.99, 95% CI 2.08-4.30, P<0.001) risk of progression, in intermediate and high risk NMIBC respectively, compared to the low-risk group. The model's concordance index was 0.66.</p><p><strong>Conclusions: </strong>Our study provides an insight into the influence of smoking on inflammatory markers and BCG response in NMIBC patients. Our machine-learning approach provides clinicians a valuable tool for risk stratification, treatment, and decision-making. Future research in larger prospective cohorts is required for validating these findings.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"338-346"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marco Amato, Natali Rodriguez Peñaranda, Stefano Puliatti, Stefania Ferretti, Cristian Fiori, Thomas Tailly, Anthony G Gallagher, Ben VAN Cleynenbreugel
{"title":"How are outpatient cystoscopies conducted in your department? A European survey.","authors":"Marco Amato, Natali Rodriguez Peñaranda, Stefano Puliatti, Stefania Ferretti, Cristian Fiori, Thomas Tailly, Anthony G Gallagher, Ben VAN Cleynenbreugel","doi":"10.23736/S2724-6051.25.06534-6","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06534-6","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 3","pages":"281-284"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}