Minerva Urology and Nephrology最新文献

{"title":"Comparison of efficacy and safety of fluoroscopy-free and conventional retrograde ureteroscopy for urolithiasis: a systematic review and metanalysis of randomized controlled trials.","authors":"Luiz G Serrão Gimenez, Diogo Souto Santana, Guilherme M Maia Lopes, Rafael Baldissera Cardoso, Breno Cordeiro Porto, Carlo Camargo Passerotti, Rodrigo A da Silva Sardenberg, Jose Pinhata Otoch, Jose A Shiomi DA Cruz","doi":"10.23736/S2724-6051.25.06087-2","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06087-2","url":null,"abstract":"<p><strong>Introduction: </strong>Urolithiasis is a highly prevalent condition and its definitive treatment with endourological procedures exposes patients and medical staff to ionizing radiation. The efficacy and safety of fluoroscopy-free ureteroscopy (FF-URS) over conventional ureteroscopy (CV-URS) are controversial.</p><p><strong>Evidence acquisition: </strong>We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) data comparing FF-URS to CV-URS in patients undergoing treatment for ureteral or kidney stones.</p><p><strong>Evidence synthesis: </strong>Eight randomized controlled trials (RCTs) were included in the meta-analysis, comprising 873 patients. Of these, 440 (50.4%) patients underwent FF-URS. The meta-analysis revealed no statistically significant difference in stone-free rate (SFR) between the two groups (RR=0.99; 95% CI 0.94-1.04; P=0.65; I²=0%). Similarly, there was no difference in the overall complication rates (8.4% vs. 9.7%; RR 0.87; 95% CI 0.57-1.31; P=0.50; I²=0%), Clavien-Dindo I/II (RR=0.68; 95% CI 0.42, 1.10; P=0.12; I²=0%) and operative time (MD 1.58 min; 95% CI -0.02-3.18; P=0.05; I²=16%). Clavien-Dindo III occurred only in one patient (0.2%) in the FF-URS group.</p><p><strong>Conclusions: </strong>FF-URS is effective and safe compared to CV-URS and can reduce radiation exposure for both patients and medical staff without compromising treatment outcomes.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755870","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":"Cyber Ho generator with Magneto technology: the first experience of a new concept of hybrid HoLEP.","authors":"Davide Perri, Umberto Besana, Federica Mazzoleni, Matteo Maltagliati, Andrea Pacchetti, Tommaso Calcagnile, Giorgio Bozzini","doi":"10.23736/S2724-6051.25.06384-0","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06384-0","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651941","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":"Effectiveness of patient education on adherence to treatment regimen and quality of life in hemodialysis patients: a systematic review and meta-analysis.","authors":"Bushra Sultan, Erika S Froelicher","doi":"10.23736/S2724-6051.24.05718-5","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05718-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Hemodialysis constitutes a protracted therapeutic intervention for renal failure, characterized by symptoms that exert a considerable toll on quality of life owing to their intensity and frequent recurrence. Patient education and engagement has been shown to enhance adherence, thereby improving treatment effectiveness and quality of life. The objective of this systematic review was to assess the effectiveness of patient education on improving adherence to treatment and enhancing quality of life among individuals undergoing hemodialysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Evidence acquisition: &lt;/strong&gt;The systematic review and meta-analysis followed PRISMA's Preferred Reporting Item for Systematic Review and Meta-Analysis guidelines. The studies were evaluated utilizing the Joanna Briggs Institute methodology. The search utilized several databases including PubMed, CINAHL, Ovid, Wiley Online Library, Springer Link, and Google Scholar. Studies that specifically examined treatment adherence encompassing aspect such as fluid restriction, dietary modification, medication usage, electrolyte balance, and interdialytic weight management) as well as those assessing quality of life were included in this review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Evidence synthesis: &lt;/strong&gt;A total of 15 studies met the inclusion criteria. The studies explored adherence to various facets of treatment including fluids and electrolytes management (potassium, phosphate, creatinine level), medication usage (compliance with prescribe medication), dietary practices (adaptation according to disease and hemodialysis requirement), interdialytic weight management, and quality of life. Seven of these studies focus on investigating the quality of life, while the remaining eight examined specific components of treatment adherence. Due to the variation in methods, the results are described narratively. A quantitative synthesis was conducted using Revman 5.0 to assess the impact of educational intervention. This meta-analysis evaluated the pooled effects of adherence to fluids, electrolytes (creatinine), diet, and quality of life. A significant improvement is shown in fluid adherence (MD=35.18, 95% CI: 22.35, 48.0) (overall effect Z=5.38, P&lt;0.0001), dietary modification (MD=37.50, 95% CI: 24.65, 50.35) (Overall effect Z=5.72, P=0.0001), and quality of life (MD=8.50, 95% CI: 4.50, 12.50, (overall effect Z=4.17, P=0.0001). However, no significant effect is observed on the creatinine level (MD=-0.50, 95% CI: -1.38, 0.38) (Z=1.12, P=0.026). The observed level of heterogeneity ranged from low to moderate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Hemodialysis impacts various aspects of patients' lives. This systematic review shows that nursing education and behavior monitoring in patients undergoing hemodialysis contributes to improving their adherence to treatment and quality of life. The evaluated pooled effect and mean difference in meta-analysis findings shows that the educational interventions improv","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574672","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":"Different clusters in patients with lupus podocytopathy identified by clinical-pathological characteristics.","authors":"Savino Sciascia, Grazia D Bonelli, Marta Calatroni, Vincenzo L'imperio, Roberta Fenoglio, Lorenza M Argolini, Camillo Carrara, Nicola Lepori, Francesco Reggiani, Alessandra Bortoluzzi, Fausta Catapano, Mariele Gatto, Chiara Tani, Elisa Longhitano, Maurizio Garozzo, Barbara Trezzi, Emanuele Conte, Domenico Santoro, Maria Gerosa, Marta Mosca, Renato A Sinico, Gabriella Moroni, Dario Roccatello","doi":"10.23736/S2724-6051.25.06306-2","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06306-2","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574671","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":"A comparison on the efficiency and safety between two morcellators for laser enucleation of the prostate: Piranha versus Cyber Blade. A randomized controlled trial.","authors":"Davide Perri, Federica Mazzoleni, Jean-Baptiste Roche, Javier Romero-Otero, Andrea Pacchetti, Flavio C Mattuzzi, Thomas Knoll, Evangelos Liatsikos, Panagiotis Kallidonis, Antonio L Pastore, Alexander Govorov, Giorgio Bozzini","doi":"10.23736/S2724-6051.25.06051-3","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06051-3","url":null,"abstract":"<p><strong>Background: </strong>We performed a comparison between the Wolf^® Piranha^™ and the Quanta System^® Cyber Blade^™ morcellators for the Thulium laser enucleation of the prostate (ThuLEP).</p><p><strong>Methods: </strong>Overall, 205 patients underwent ThuLEP in three urologic departments (Como, Bordeaux, Madrid). Patients were randomized to Piranha morcellator with disposable blades (100 cases, Group A) or Cyber Blade morcellator (105 cases, Group B). Morcellation efficiency was related to prostate volume (PV) using the cut-off of 100 mL. Complication rate and device malfunctions were reported. The chi-square test was used for the comparison of the study groups. All statistical tests were two-sided with a level of significance at P<0.05.</p><p><strong>Results: </strong>Mean PV was 82.5 vs. 91.9 mL (P=0.21) in Group A vs. B. Mean morcellation time was 9.7 vs. 10.1 min in Group A vs. B when PV was ≤100 mL (P=0.34), it was significantly lower in Group B when PV was >100 mL (12.7 vs. 10.1 min, P=0.04). Similarly, morcellation efficiency was comparable when PV was ≤100 mL (8.5 vs. 9.1 g/min, P=0.08), while it was significantly higher with the Cyber Blade when PV was >100 mL (10.0 vs. 12.3 g/min, P=0.04). Bladder injury occurred in three and two cases in Group A and B. Complication rate was comparable.</p><p><strong>Conclusions: </strong>Piranha and Cyber Blade morcellators showed a comparable efficacy when PV was ≤100 mL, while efficacy was significantly higher with the Cyber Blade when PV was >100 ml. Both instruments are safe and reliable according to the risk of bladder injury and the occurrence of mechanical problems.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469968","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 \"gender-gap\" problem of artificial urinary sphincter: the future is robotic.","authors":"Maria Lucia Gallo, Sabrina DE Cillis, Riccardo Lombardo, Véronique Phé, Vincenzo Li Marzi, Cosimo DE Nunzio, Alessandro Giammò","doi":"10.23736/S2724-6051.25.06298-6","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06298-6","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469978","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":"Prospective and multicenter validation of the BETTY score for predicting perioperative outcomes after elective urological surgery.","authors":"Alessandro Uleri, Michael Baboudjian, Gilles Pasticier, Victor Basset, Guillaume Cordier, Bernard Malavaud, Pourya Pashootan, Jean-Baptiste Beauval, Guillaume Ploussard","doi":"10.23736/S2724-6051.25.06041-0","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06041-0","url":null,"abstract":"<p><p>Postoperative complications remain a significant challenge in surgical care. This study assessed the ability of the BETTY score, a novel user-friendly scoring system, to predict postoperative outcomes in a large multicenter cohort of urological surgeries. We conducted a post-hoc analysis of a prospective, nonrandomized multicenter trial including 415 patients undergoing elective urological surgeries in six French hospitals. The BETTY score, part of a smartphone app, incorporates pre- and intraoperative data to classify patients into risk categories. We evaluated multiple endpoints, including 90-day postoperative overall and major complications, length of stay, prolonged care after discharge, unplanned readmission, reoperation, and days alive and out of hospital. Of the 415 patients, 22% experienced postoperative complications, with 3.9% major complications. Unplanned readmissions, prolonged care after discharge, and reoperation occurred in 8%, 20%, and 2.4% of cases, respectively. We found significant correlations between the BETTY score and all endpoints analyzed. In multivariate analysis, the BETTY score was significantly associated with all postoperative events studied. These findings demonstrate the reliability of the BETTY score in predicting various postoperative outcomes in urological surgery patients, especially for patients undergoing major surgeries. This tool may help optimize perioperative care and improve patient outcomes, potentially contributing to more personalized surgical care.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392515","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":"Current management of patients affected by benign prostatic hyperplasia: a multi-institutional study from a contemporary large Italian cohort.","authors":"Chiara Re, Mattia Longoni, Giuseppe Rosiello, Enrico Finazzi Agrò, Paolo Gontero, Francesco S Grossi, Vincenzo Mirone, Carmelo Morana, Richard Naspro, Francesco Montorsi","doi":"10.23736/S2724-6051.24.05957-3","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05957-3","url":null,"abstract":"<p><strong>Background: </strong>Despite a large amount of literature focused on pharmacologic and surgical therapy for benign prostate hyperplasia (BPH), little is known about clinical presentation and management of outpatient clinic patients. We aimed to conduct a tailored analysis of BPH-affected patients, comparing men with known BPH versus newly diagnosed. The analysis was made through International Prostate Symptom Score (IPSS) and BPH Impact index (BII).</p><p><strong>Methods: </strong>\"Intensive prostate benefit\" project working group designed a questionnaire prospectively administered by urologists to patients affected by lower urinary tract symptoms (LUTS) related to BPH.</p><p><strong>Results: </strong>Overall, 3198 (64%) patients were previously diagnosed with BPH versus 1800 (36%) received a first diagnosis. Patients previously diagnosed with BPH were older (median 69 vs. 66 years) and more comorbid (P<0.001). Moreover, median IPSS score was higher in these patients (16 vs. 14), who also experienced a higher rate of severe symptoms (32.0% vs 21.5%, P<0.0001). At BII, concerns for one's health and time lost due to urinary problems were higher in patients previously diagnosed with BPH (P<0.0001). In these patients, a BPH-specific therapy was already established (88.5% vs. 75.1%) and a higher rate of therapy adherence (55.0% vs. 27.0%, P<0.0001) was observed. Roughly 90% of patients already taking BPH therapy changed their therapy after urological examination. In these patients, supplements/phytotherapeutics, alpha blockers, 5-alfa-reductase inhibitors, were prescribed in 32.8%, 37.4%, 17.4%, respectively.</p><p><strong>Conclusions: </strong>Patients with prior BPH diagnosis have severe LUTS that worsen over time, affecting quality of life despite treatment. LUTS management in primary care is crucial, emphasizing counseling for a healthy lifestyle, cardiovascular risk control, and medication adherence.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257207","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":"Erectile dysfunction and obstructive sleep apnea syndrome: a post-hoc evaluation of Italian survey results.","authors":"Francesco DI Bello, Gianluigi Califano, Claudia Collà Ruvolo, Simone Morra, Agostino Fraia, Edoardo Mocini, Benedetta Muzii, Luigi Napolitano, Massimiliano Creta, Giovanni Salzano, Luigi A Vaira, Francesco Mangiapia, Nelson M Maldonato, Elena Cantone, Nicola Longo","doi":"10.23736/S2724-6051.24.05925-1","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.05925-1","url":null,"abstract":"<p><strong>Background: </strong>The aim of the current study was to identify predictors of erectile dysfunction (ED) and obstructive sleep apnea syndrome (OSAS) in male participants at Italian web-survey.</p><p><strong>Methods: </strong>A cross-sectional web-based survey was administered via Google Forms between July 17 and October 31, 2022, among Italian participants. The erectile function and the excessive daytime sleepiness were measured through the International Index of Erectile Function - 5 (IIEF5) and Epworth Sleepiness Scale (ESS), respectively. Two separate and independent multivariable logistic regression models (mLRMs) were fitted to predict ED and OSAS, respectively, in men answering to the survey.</p><p><strong>Results: </strong>A total of 238 patients were identified. Of those, 58 (24%) reported to be affected by OSAS disease. Higher proportion of mild (21 vs. 6%), mild-to-moderate (9 vs. 5%), and severe (16 vs. 7%) ED were recorded in OSAS vs. non-OSAS patients (P<0.001). In mLRMs predicting ED (IIEF5≤7), age (OR: 1.04, 95% confidence interval [CI]: 1.01-1.06; P=0.002), and IPSS total score (OR:1.08, 95% CI: 1.02-1.15; P=0.006) were independent predictors. In mLRMs predicting OSAS, age (OR: 1.08, 95% CI: 1.05-1.12; P<0.001), Body Mass Index (BMI; OR: 1.12, 95% CI: 1.05-1.21; P<0.001), and ESS score (OR:1.14, 95% CI: 1.05-1.24; P=0.001) were independent predictors. In the subgroup analyses predicting severe ED, ESS and age or BMI or IPSS resulted as independent predictors (OR from 0.7 to 0.8; all P<0.05).</p><p><strong>Conclusions: </strong>The ESS score independently predicted severe ED in males. As a result, the OSAS disease should be explored in patients who harbored severe ED to address those patients for a prompt ear, nose and throat evaluation.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190311","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 future of BPH treatment: is a new paradigm at our doorstep?","authors":"Paolo Geretto, Sabrina DE Cillis, Mikolaj Przydacz","doi":"10.23736/S2724-6051.24.06294-3","DOIUrl":"https://doi.org/10.23736/S2724-6051.24.06294-3","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190469","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}