Minerva Urology and Nephrology最新文献

{"title":"Comparison between papillary and non-papillary access for percutaneous nephrolithotomy: a systematic review and meta-analysis.","authors":"Yuhan Xiao, Yuehua Wang, Wuran Wei","doi":"10.23736/S2724-6051.26.06955-7","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.06955-7","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous nephrolithotomy (PCNL) is first-line treatment for large or complex renal calculi. The traditional papillary access is considered safer, while non-papillary access may offer procedural advantages. This systematic review and meta-analysis aims to evaluate the efficacy and safety of papillary versus non-papillary approaches in PCNL for the management of kidney stones.</p><p><strong>Methods: </strong>Eligible studies were identified by searching the PubMed, Web of Science, Scopus, Embase, and the Cochrane Library databases for relevant reports published until November 2025. Outcome measures included stone-free rate (SFR), fluoroscopy time, operation time, blood loss, transfusion rates, change in serum creatinine, hospital stay, and complications. Risk ratio (RR), weighted mean difference (WMD) and standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models. Two reviewers independently assessed the quality of all included studies, and statistical analyses were performed using R software.</p><p><strong>Results: </strong>Eight studies involving 985 patients were included, three of which were randomized controlled trials. Post-PCNL SFR showed no significant difference between the papillary and non-papillary approach groups (fixed-effects model: RR=1.01, 95% CI: 0.94 to 1.07, P=0.858). Similarly, no statistically significant differences were found between the two groups in transfusion rates (RR=1.32; 95% CI: 0.75 to 2.30; P=0.336), blood loss (WMD=0.11; 95% CI: -0.22 to 0.44; P=0.519), fluoroscopy time (WMD=0.15; 95% CI: -0.07 to 0.38; P=0.185), hospital stay (WMD= -0.01; 95% CI: -0.15 to 0.13; P=0.911), or changes in serum creatinine (WMD=0.00; 95% CI: -0.05 to 0.05; P=0.893). Moreover, complication rates were comparable between papillary access and non-papillary access. Although operative time was slightly longer in the papillary group (SMD=0.16; 95% CI: 0.03 to 0.29; P=0.014), this difference was clinically insignificant.</p><p><strong>Conclusions: </strong>Both papillary and non-papillary access are suitable for most PCNL procedures, demonstrating comparable efficacy and safety. The optimal approach should be determined by patient anatomy and surgeon expertise.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186030","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":"Distal ureteral fibroepithelial polyp: endoscopic diagnosis and treatment with thulium fiber laser.","authors":"Ghali Belkahia, Fernando Cabrera Meirás, Nahuel Paesano, Gemma Duque Ruiz, Agustín Fraile Poblador, Vital Hevia Palacios, José M Pérez Ruiz, Clara Briand Barriga, Marco T Martínez Membreño, Javier Romero Otero","doi":"10.23736/S2724-6051.26.07155-7","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07155-7","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129100","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":"Intrarenal pressure in RIRS: from passive drainage to active control and real-time monitoring.","authors":"Andrea Li Puma, Elisa DE Lorenzis, Daniele Amparore, Ettore DI Trapani, Francesco Prata, Filippo Turri, Michele Talso","doi":"10.23736/S2724-6051.26.07138-7","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07138-7","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946224","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":"The butterfly position and the strategic role of patient positioning in contemporary endourology.","authors":"Alberto DE Gobbi, Arianna Pischetola, Francesco Esperto, G Roberto Lunardi, Alberto Testolina, Luigi Rizzolo, Matteo Vittori, Giuseppe Costa, Mario Fiorello","doi":"10.23736/S2724-6051.26.07011-4","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07011-4","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901364","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":"The silicon stethoscope: AI's role in bridging the urological communication gap.","authors":"Antonio A Grosso, Pieter DE Backer, Severin Rodler, Karl F Kowalewski, Ines Rivero Belenchon, Stefano Puliatti, Pietro Piazza, Luca Orecchia, Loic Baekelandt, Mark Taratkin, Mieszko Kozikowski, Stessy Kutchukian, Alessandro Veccia, Riccardo Lombardo, Enrico Checcucci","doi":"10.23736/S2724-6051.26.07174-0","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07174-0","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901301","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":"Challenges of UTUC with hydronephrosis: a trojan horse of diagnostic uncertainty and rare variants.","authors":"Francesco Esperto, Arianna Pischetola, Loris Cacciatore, Gianluigi Raso, Mariavittoria Vescovo, Roberto M Scarpa, Giuseppe Perrone, Rocco Papalia","doi":"10.23736/S2724-6051.26.07043-6","DOIUrl":"10.23736/S2724-6051.26.07043-6","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"467-469"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044668","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":"Darolutamide versus abiraterone acetate-based triplets in patients with hormone-sensitive prostate cancer: real-world, head-to-head comparison from the ARON-3 study.","authors":"Pasquale Rescigno, Tarek Taha, Maria J Fita, Diana Matthews, Kazutoshi Fujita, Cristian Lolli, Fabrizio DI Costanzo, Alvaro Juárez, Yüksel Ürün, Sati C Yazgan, Haoran Li, Gaetano Facchini, María N Quiroga, Enrico Sammarco, Martin Bögemann, Daniele Santini, Jalal Baranseh, Giandomenico Roviello, Ray M Kopp, Ondřej Fiala, Thomas Büttner, Francesco Carrozza, Jawaher Ansari, Deniz Tural, Vincenza Conteduca, Javier Molina-Cerrillo, Teresa Alonso-Gordoa, Maria T Bourlon, Georgia A Palacios, Federico Paolieri, Anca Zgura, Roberta DI Rocco, Leonardo G Lacerenza, Marc R Matrana, Angelo Martignetti, Francesco Massari, Andrey Soares, Fernando S Monteiro, Diogo A Bastos, Luke Gaughan, Mike Wenzel, Philipp Mandel, Giuseppe L Banna, Matteo Santoni","doi":"10.23736/S2724-6051.26.06453-0","DOIUrl":"10.23736/S2724-6051.26.06453-0","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic landscape of metastatic hormone-sensitive prostate cancer (mHSPC) has expanded significantly with triplet regimens, raising questions about their real-world applicability. This study evaluates the efficacy and safety of darolutamide- and abiraterone-based triplets using real-world data from the ARON-3 study.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 247 mHSPC patients treated with DARO+DOCE+ADT or ABI+DOCE+ADT across 37 institutions in 14 countries. Key outcomes included progression-free survival (PFS), overall survival (OS), PSA kinetics, and safety. A propensity score was estimated based on key clinical variables and included as a covariate in Cox regression models to adjust for baseline imbalances between treatment groups.</p><p><strong>Results: </strong>Data from 247 patients receiving triplet therapy were analyzed. The median OS for the entire cohort was not reached (NR). The median PFS was 24.8 months (95% CI: 18.7-33.6), with NR for DARO+DOCE+ADT and 21.5 months (95% CI: 13.1-25.2) for ABI+DOCE+ADT (P=0.007). In patients with visceral metastases, DARO+DOCE+ADT demonstrated superior outcomes, achieving higher OS rates at 6 months (97% vs. 83%, P=0.002) and 12 months (92% vs. 74%, P<0.001) compared to ABI+DOCE+ADT. The safety profiles of both regimens were comparable, although grade 3-4 fatigue was more frequently observed in the ABI+DOCE+ADT group. After adjusting for baseline imbalances through propensity score inclusion in multivariate models, the differences in OS (P=0.103) and PFS (P=0.135) between treatment groups did not reach statistical significance, although a numerical trend favoring DARO+DOCE+ADT was observed.</p><p><strong>Conclusions: </strong>Both regimens demonstrate efficacy, with DARO+DOCE+ADT offering superior outcomes in high-volume disease, especially visceral metastases. Nonetheless, the limited sample size and potential biases highlight the need for further follow-up and biomarker-driven studies in larger cohorts to refine treatment strategies.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"548-559"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303946","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":"Robot-assisted advancing spiral flap pyeloplasty for complex ureteropelvic junction obstruction and ureteral atresia: a preliminary experience in 27 patients.","authors":"Gong Cheng, Yuenan Liu, Qi Cao, Qingyang Lv, Min Chen, Xingyuan Xiao, Teng Hou, Bo Hai, Bing Li, Xiaoping Zhang, Xiaomin Han","doi":"10.23736/S2724-6051.26.07070-9","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07070-9","url":null,"abstract":"<p><strong>Background: </strong>Long-segment ureteropelvic junction obstruction (UPJO) (typically 12≥3 cm) and ureteral atresia present major reconstructive challenges due to fixed-length limitations of conventional flap techniques. This study evaluates the feasibility and safety of a robot-assisted advancing spiral flap pyeloplasty (RASFP) with dynamically adjustable flap design as a proof-of-concept for complex cases.</p><p><strong>Methods: </strong>A single-center retrospective study (August 2022-July 2025) included 27 patients with long-segment UPJO (median stricture length 3 cm) or ureteral atresia. All patients underwent RASFP using two intraoperatively tailored flap configurations (anterograde/retrograde) without pre-determined length constraints. Primary outcomes were feasibility and safety; secondary outcomes included functional, radiological, and clinical improvement.</p><p><strong>Results: </strong>All 27 procedures were completed robotically without conversion or major complications (Clavien-Dindo ≥II). The technique successfully managed all six ureteral atresia cases without grafts and bridged a 7-cm stricture. At median follow-up of 14 months, symptomatic relief was achieved in 88.9% of patients, and median hydronephrosis diameter decreased from 3.8 cm to 2.0 cm (P=0.01). Median eGFR increased by 1.6 mL/min. In complex cases (stricture ≥4 cm, atresia, or redo pyeloplasty, N.=16), clinical symptom relief was achieved in 87.5% (14/16) and radiological improvement in 81.3% (13/16). Postoperative CT urography in four patients confirmed obstruction relief in three.</p><p><strong>Conclusions: </strong>In this preliminary series, RASFP demonstrated acceptable safety and feasibility for carefully selected patients with complex UPJO and ureteral atresia who have a dilated renal pelvis. The technique may offer a potential tissue-sparing option for ultra-long strictures and atresia where conventional flaps may be inadequate. Comparative studies are needed to establish its relative efficacy.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 4","pages":"529-540"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118696","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":"External validation and comparison of nomograms for prediction of long-term disease recurrence and survival for bladder cancer patients who undergo radical cystectomy.","authors":"Rodrigue Benijts, Murat Akand, Mustafa Tipirdamaz, Jonas Mennes, Loïc Baekelandt, Wouter Everaerts, Maarten Albersen, Hein VAN Poppel, Steven Joniau, Frank VAN DER Aa","doi":"10.23736/S2724-6051.25.06600-5","DOIUrl":"10.23736/S2724-6051.25.06600-5","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare existing nomograms and identify which models best predict long-term survival outcomes, namely disease-free survival (DFS) or recurrence-free survival (RFS), and cancer-specific survival (CSS), in patients undergoing radical cystectomy (RC) for bladder cancer (BC).</p><p><strong>Methods: </strong>Six nomograms (three for DFS, three for CSS) were selected from 20 studies and evaluated using data from 730 RC patients treated at University Hospitals Leuven. Discriminatory performance was assessed using area under the curve (AUC) of receiver operating characteristics (ROC) curve, along with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. Calibration was analyzed using the Hosmer-Lemeshow (HL) test and calibration plots, while clinical utility was assessed through decision curve analysis (DCA). Statistical significance was set at P<0.05.</p><p><strong>Results: </strong>All nomograms effectively predicted 5-year DFS and CSS. The AUC values for DFS nomograms were 0.74 (95% Confidence interval [CI]: 0.70-0.78) for Simone et al., 0.74 (95% CI: 0.70-0.77) for Cicione et al., and 0.73 (95% CI: 0.69-0.77) for Karakiewicz et al. For CSS nomograms, the AUC values were 0.78 (95% CI: 0.74-0.82) for Simone et al., 0.78 (95% CI: 0.74-0.82) for Cicione et al., and 0.77 (95% CI: 0.74-0.81) for Shariat et al. Among DFS nomograms, Simone et al. showed the highest sensitivity (0.64, 95% CI: 0.58-0.69), while Karakiewicz et al. had the highest specificity (0.81, 95% CI: 0.78-0.88). Among CSS nomograms, sensitivity was highest for Shariat et al. (0.84, 95% CI: 0.81-0.88), while specificity was highest for Simone et al. (0.72, 95% CI: 0.67-0.78). Accuracy, PPV, NPV, and Brier scores were comparable across all DFS and CSS nomograms. The Cicione et al. nomogram demonstrated the best calibration for DFS, while the Simone et al. nomogram had the least systematic bias in absolute calibration. For CSS, all three nomograms exhibited similar discrimination and predictive accuracy, with the Cicione et al. and Shariat et al. models showing slightly better calibration than the Simone et al. nomogram. DCA confirmed the clinical usefulness of all DFS and CSS nomograms.</p><p><strong>Conclusions: </strong>All evaluated nomograms showed comparable accuracy in predicting 5-year DFS or CSS, supporting their use in clinical practice. Nonetheless, their limitations should be considered when applying them to individual patient-specific decision-making.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"560-573"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312351","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":"Enhancing ARPI therapy in HSPC: who, when and why?","authors":"Lorenzo Bianchi, Riccardo Scarlatti, Paolo Dell'oglio, Ugo Falagario, Giancarlo Marra, Fabio Zattoni, Savio D Pandolfo","doi":"10.23736/S2724-6051.26.07124-7","DOIUrl":"10.23736/S2724-6051.26.07124-7","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"470-473"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279978","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}