Minerva Urology and Nephrology最新文献

{"title":"Can all surgical trainees be trained to proficiency for a robotic urethro-vesical anastomotic task using a chicken model? A prospective, randomized trial.","authors":"Stefano Puliatti, Marco Amato, Marco Ticonosco, Rui Farinha, Ruben De Groote, Laura Langhendries, Maxime Lassel, Ahmed Eissa, Ben VAN Cleynenbreugel, Elio Mazzone, Stefania Ferretti, Salvatore Micali, Giampaolo Bianchi, Alexandre Mottrie, Anthony G Gallagher","doi":"10.23736/S2724-6051.25.06367-0","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06367-0","url":null,"abstract":"<p><strong>Background: </strong>Proficiency based progression (PBP) is a very effective method of training and has been adopted by the European Robotic Surgical Section (ERUS) for robotic skills training. No study has addressed whether all learners can be trained to the proficiency benchmark. In this study, we evaluated: 1) if all trainees reached a quantitatively defined proficiency benchmark for a robotic suturing and knot tying anastomosis task; and 2) the number of training trials required.</p><p><strong>Methods: </strong>In a multi-center, prospective, randomized, study, 48 participants were randomized to: 1) a PBP group that received e-learning on the ORSI chicken anastomosis task with the requirement to reach the proficiency benchmark before starting practical training; 2) e-learning group, received the exact same curriculum as group 1, but with no proficiency requirement on the e-learning; 3) traditional group received the exact same curriculum in face-to-face lectures; 4) the apprenticeship group received a conventional preparation.</p><p><strong>Results: </strong>All participants, except five in group 4, demonstrated the proficiency benchmark. Group 1 took ~6 trials (~3 hours); group 2 required 14% longer, group 3, 103% (P<0.001) and in group 4, 58% of trainees demonstrated the benchmark but took 162% (P<0.001) longer. This was a small-scale but robust study with substantial effect sizes.</p><p><strong>Conclusions: </strong>All PBP trainees demonstrated the proficiency benchmark in comparison to 58% of conventional trained group. As adherence to the PBP methodology decreased, the efficiency of proficiency demonstration significantly reduced.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994908","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":"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":"https://doi.org/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":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-23","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}

{"title":"From laparoscopic to robot-assisted extravesical ureteral reimplantation: evolution of a new standard treatment for pediatric vesicoureteral reflux.","authors":"Ciro Esposito, Lorenzo Masieri, Mariapina Cerulo, Fulvia Del Conte, Francesco Tedesco, Vincenzo Coppola, Annalisa Chiodi, Claudia DI Mento, Marco Chiarenza, Giorgia Esposito, Leonardo Continisio, Marco Castagnetti, Maria Escolino","doi":"10.23736/S2724-6051.25.06127-0","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06127-0","url":null,"abstract":"<p><strong>Background: </strong>This paper aimed to compare laparoscopic (LEVUR) vs. robot-assisted (REVUR) Lich Gregoir extravesical ureteral reimplantation (UR) in children with vesicoureteral reflux (VUR).</p><p><strong>Methods: </strong>The charts of all patients with moderate to high-grade VUR (3 to 5), who received LEVUR or REVUR over a 10-year period (2014-2024), were retrospectively reviewed.</p><p><strong>Results: </strong>Seventy-six patients (40 girls and 36 boys), with median age of 5.7 years (range 2-11) and moderate to high-grade VUR, were enrolled. VUR was unilateral in 55/76 (72.3%) and bilateral in 21/76 (27.7%). Patients were grouped according to the MIS approach and pathology side. The median operative time (OT) of unilateral non-dismembered UR was similar in LEVUR (65 min) and REVUR (50 min) (P=0.56). REVUR was faster than LEVUR in unilateral dismembered (90 vs. 120 min) (P=0.001) and bilateral UR (105 vs. 160 min) (P=0.001). The radiographic VUR resolution rate was similar between REVUR and LEVUR (97.8% vs. 96.7%) (P=0.89). Two patients (2.6%) reported low-grade persistent reflux without need for additional treatments. Mild bladder dysfunction developed in 2/21 (9.5%) undergoing bilateral UR (Clavien-Dindo 2).</p><p><strong>Conclusions: </strong>REVUR is technically easier, faster and provides better ergonomics compared to LEVUR. The postoperative outcomes are excellent in both techniques, with success rates higher than 95%. Complications developed after bilateral reimplantation in patients who had previous history of bladder dysfunction. Given the robot availability, we believe that the best indication for LEVUR remains unilateral reflux without need for ureteral tapering. In unilateral refluxing megaureter, para-ureteral diverticulum or bilateral cases, REVUR represents the best choice.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058222","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":"Partial penectomy with glans reconstruction: technical modification.","authors":"Guglielmo Mantica, Benedetta Col, Federica Balzarini, Giorgia Granelli, Tommaso Saccucci, Carlo Terrone","doi":"10.23736/S2724-6051.25.06466-3","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06466-3","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052772","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":"Awareness and use of generative AI-powered tools: results of one-year follow-up prospective cross-sectional global survey.","authors":"Francesco Cei, Conner Ganjavi, Ethan Layne, Tesniem Hussari, Rafael R Gevorkyan, Michael Eppler, Pietro Piazza, Severin Rodler, Enrico Checcucci, Juan Gomez Rivas, Karl F Kowalewski, Ines Rivero Belenchón, Stefano Puliatti, Mark Taratkin, Alessandro Veccia, Loïc Baekelandt, Pieter DE Backer, Jeremy Teoh, Bhaskar Somani, Marcelo Wroclawski, Andre DE Castro Abreu, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Francesco Porpiglia, Declan Murphy, David Canes, Inderbir Gill, Giovanni E Cacciamani","doi":"10.23736/S2724-6051.25.06133-6","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06133-6","url":null,"abstract":"<p><strong>Background: </strong>Generative AI (GenAI) frameworks, such as generative pre-trained transformer (GPTs) and large language models (LLMs), promise to transform clinical and research practices. Informed human opinion is key to guiding appropriate technological development and task refinement. Detailed data on how GPTs/LLMs powered-Chatbots usage, perceived risks and benefits among physicians has evolved over time and their impact on clinical and academic activities remain unclear. The aim of this study is to assess how the use of GPTs/LLMs chatbots by professionals working in urology has changed over time in the setting of academic and clinical activities.</p><p><strong>Methods: </strong>A one-year follow-up prospective cross-sectional survey was conducted among urology professionals. Results were reported highlighting the differences in baseline characteristics of participants and their responses between the initial release (April 20^th, 2023 and May 5^th, 2023) and re-deployment of the survey 12 months after chi square and t-test were used to compare categorical and continuous variables.</p><p><strong>Results: </strong>A total of 129 participants completed the second survey. Eighty-six percent of participants reported having used any GPTs/LLMs chatbot for academic tasks, a significant increase from the previous survey (52.4%; P<0.001). When asked if they were using GPTs/LLMs chatbots more in academic settings compared to one year prior, 70.1% of participants answered affirmatively. Participants, when asked about the use of GPT/LLMs in particular clinical tasks after one year, reported less frequent use for deciding treatment options (18.6% vs. 31.0%; P=0.03) and patient follow-up care (10.1% vs. 21.4%; P=0.02). When participants were asked if they were using LLM chatbots more in clinical settings compared to one year before, 35.6% answered affirmatively.</p><p><strong>Conclusions: </strong>GPTs/LLMs have a consolidated role in academic tasks, with increasing usage, while some resistance to their use in clinical practice remains. These results are relevant for driving the human-centered development of GenAI technology.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063265","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":"Acute kidney injury following retrograde intrarenal surgery (RIRS) with flexible and navigable suction ureteral access sheath (FANS): results from a prospective multicenter study.","authors":"Luigi Candela, Vineet Gauhar, Bhaskar Somani, Khi Y Fong, Satyndrea Persaud, Daniele Castellani, Nariman Gadzhiev, Vigen Malkhasyan, Chu A Chai, Boyke Soebhali, Mohammed Elshazly, Yiloren Tanidir, Karl M Tan, Saeed Bin Hamri, Steffi Yuen, Tzevat Tefik, Olivier Traxer","doi":"10.23736/S2724-6051.25.06274-3","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06274-3","url":null,"abstract":"<p><strong>Background: </strong>Flexible and navigable suction ureteral access sheaths (FANS) have proven to be effective in reducing operative time and infectious complications and in increasing stone-free rate during retrograde intrarenal surgery (RIRS). FANS may reduce intrarenal pressure, thus reducing parenchymal renal damage. The aim of the present study was to assess acute kidney injury (AKI) rate following RIRS with FANS.</p><p><strong>Methods: </strong>This was a prospective multicenter study. Patients were enrolled between August 2023 and March 2024. Inclusion criteria were: patients aged ≥18 years with normal urinary anatomy who successfully underwent RIRS using FANS for renal stones. Complete baseline and perioperative data were collected. AKI was assessed at postoperative day 1 or 2 according to the KDIGO criteria. Intra and early postoperative complications, readmissions, and reinterventions up to 30 days post-surgery were documented. Univariable logistic regression (UVA) analysis was performed to identify predictors of AKI.</p><p><strong>Results: </strong>Two hundred an ten patients were eligible for analysis. The median stone volume was 1320 mm³. Median preoperative serum creatinine and eGFR were 0.94 mg/dL and 84 mL/min, respectively. The commonest FANS size used was 11-13 Ch (47%). A disposable scope was used in 55%, and TFL in 53% of surgeries. Median total laser time, ureteroscopy time, and operative times were 16.5, 31, and 49 minutes, respectively. At the end of the surgery, a double-J ureteral stent was placed in 84% of patients. AKI occurred in 13 (6.2%) patients. All cases were stage 1 AKI. At UVA, none of the preoperative or intraoperative variables were statistically associated with the occurrence of AKI (all P>0.05).</p><p><strong>Conclusions: </strong>AKI following RIRS with FANS is a not neglectable event and endourologist should be aware of this eventuality. However, all AKI episodes were mild. This study findings should be validated with a randomized controlled trial comparing outcomes of RIRS with and without FANS.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060455","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":"Organ-sparing robotic-assisted radical cystectomy in men: description of technique and outcomes.","authors":"Lazaros Tzelves, Elizabeth Day, Amit Bhudia, Mark Markov, Osama Al-Bermani, Joanna Olphert, Zafer Tandogdu, Ashwin Sridhar, John Kelly, Anthony Ta","doi":"10.23736/S2724-6051.25.06170-1","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06170-1","url":null,"abstract":"<p><strong>Background: </strong>Organ sparing radical cystoprostatectomy in males is being considered with skepticism due to fear of compromising oncological safety; however, sacrifice of erectile nerves can lead to quality of life deterioration due to erectile dysfunction.</p><p><strong>Methods: </strong>Data from men with muscle-invasive bladder cancer (MIBC) who were potent and wish to preserve potency were collected prospectively. Both nerve-sparing and capsule-sparing approach (with or without seminal vesicle preservation) was performed in a high-volume center. Baseline characteristics, oncological and sexual outcomes were collected. International Index for Erectile Function-5 (IIEF-5) was used both preoperatively and at last follow-up. Potency was defined as a score ≥3 in question 2.</p><p><strong>Results: </strong>Twenty-five patients were included in capsule-sparing and 15 in nerve-sparing group. Patients in the former group were younger (55 vs. 66 years old) but no other significant difference in baseline characteristics was noted. Perioperative outcomes were similar among groups, whilst no difference was found regarding overall survival, recurrence rate, incidental prostate cancer and positive surgical margins. Postoperative IIEF-5 score was higher in capsule-sparing group (14 vs. 7, P=0.016) and more patients were potent (18 vs. 3, P=0.004). In regression analysis, the only significant predictor of potency was capsule-sparing surgery (odds ratio: 8.58, 95% CI: 1.30-81.5, P=0.034).</p><p><strong>Conclusions: </strong>Capsule-sparing and nerve-sparing approaches during robotic radical cystectomy are feasible techniques among carefully selected patients, with improved sexual and non-inferior oncological outcomes compared with standard approach.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813055","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":"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":"256-261"},"PeriodicalIF":4.9,"publicationDate":"2025-04-01","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":"Radical cystectomy for bladder cancer in solid organ transplant recipients.","authors":"Elena Tonin, Lorenzo Bianchi, Angelo Mottaran, Stephan Brönimann, Florian Berndl, Stefano Biolcati, Matteo Droghetti, Francesco Chessa, Benjamin Pradere, Eva Comperat, Riccardo Schiavina, Eugenio Brunocilla, Shahrokh F Shariat, David D'Andrea","doi":"10.23736/S2724-6051.25.06130-0","DOIUrl":"10.23736/S2724-6051.25.06130-0","url":null,"abstract":"<p><strong>Background: </strong>Solid organ transplant recipients (SOTRs) face higher cancer risk because of immunosuppressive therapy used to prevent organ rejection. We hypothesized that SOTRs treated with radical cystectomy (RC) and pelvic lymph-node dissection (PLND) for bladder cancer (UBC) might have worse survival outcomes compared to non-SOTRs. This study aims to assess survival outcomes of SOTRs treated with RC and PLND for UBC compared to non-SOTRs.</p><p><strong>Methods: </strong>A retrospective analysis of 645 patients treated with RC and PLND for UBC, originating from our multicenter cooperation program (2002-2022), stratified in two groups according to previous solid organ transplantation. Co-primary endpoints were OS and CSS, assessed using mixed-effects Cox-analysis. Secondary endpoints included postoperative complications, readmission-rates, operation time, estimated blood loss and length of stay.</p><p><strong>Results: </strong>Of the 361 patients analyzed (median follow-up: 17 months), 23 were SOTRs. SOTRs exhibited lower 12-month (70% vs. 80%) and 24-month (36% vs. 68%) OS-rates compared to non-SOTRs (P=0.011). Corresponding CSS-rates were also lower for SOTRs at 12 (81% vs. 85%) and 24 months (55% vs. 76%) (P=0.016). Multivariable Cox-regression identified a prior solid organ transplant (OR:5.2; P=0.002), higher pathologic-stage (OR:3.8; P=0.03 for pT2, OR:3.6; P=0.04 for pT3, OR:4.5; P=0.03 for pT4), and administration of \"any systemic treatment\" (OR:0.3; P=0.001) as OS predictors. For CSS, predictors were a prior solid organ transplant (OR:3.0; P=0.03), higher pathologic-stage (OR:9.8; P=0.04 for pT3, OR:13; P=0.02 for pT4), and administration of \"any systemic treatment\" (OR:0.4; P=0.03).</p><p><strong>Conclusions: </strong>Solid organ transplant recipients undergoing RC and PLND for urinary UBC have worse survival outcomes compared to non-SOTRs. Our findings may impact patient counseling, follow-up, and planning future clinical trials.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 2","pages":"202-208"},"PeriodicalIF":4.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039386","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":"Cardiovascular events after kidney cancer surgery: insights from a comprehensive national database.","authors":"Francesco Lasorsa, Angelo Orsini, Gabriele Bignante, Arianna Biasatti, Luca Lambertini, Michele Marchioni, Matteo Pacini, Kyle A Dymanus, Francesco Del Giudice, Rocco Damiano, Savio D Pandolfo, Cristian Fiori, Srinivas Vourganti, Edward E Cherullo, Pasquale Ditonno, Giuseppe Lucarelli, Riccardo Autorino","doi":"10.23736/S2724-6051.25.06097-5","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06097-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to compare the occurrence of major cardiovascular events (MCEs) after partial nephrectomy (PN) and radical nephrectomy (RN), and to identify risk factors for their development, including the impact of social determinants of health (SDOH).</p><p><strong>Methods: </strong>We used the PearlDiver™ Mariner database (Pearl-Diver Technologies, Colorado Springs, CO, USA) for this analysis. At 1- and 5-year after surgery, the following MCEs were described by using proper ICD-9/10 diagnostic codes: myocardial infarction, cerebrovascular diseases, congestive heart failure, and peripheral vascular diseases. Risk factors for overall risk of MCEs within 5 years after surgery were assessed using multivariable logistic regression analysis.</p><p><strong>Results: </strong>A total of 44,455 and 46,295 patients underwent PN and RN, respectively. Statistically significant differences were reported with RN group being characterized by higher rates per each of these events. At a multivariable analysis, RN was associated with a significantly greater likelihood of MCEs (OR 1.51, 95% CI 1.46-1.56, P=0.001), so as age at surgery, male gender, preoperative diabetes mellitus, hypertension and dyslipidemia, tobacco use, history of myocardial infarction and congestive heart failure, presence of SDOH and end-stage renal disease. Our study acknowledges limitations including potential misclassification and lack of detailed clinical data in the PearlDiver Mariner database.</p><p><strong>Conclusions: </strong>Kidney cancer surgery is associated with a non-negligible risk of MCEs. Even after taking into consideration comorbidities and history of cardiovascular diseases, RN continues to independently increase the risk of MCEs. Moreover, social disparities, as measured by the SDOH, play a crucial role in risk of MCEs in patients undergoing surgery for kidney cancer.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 2","pages":"233-238"},"PeriodicalIF":4.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017586","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}