Minerva Urology and Nephrology最新文献

{"title":"Laparoscopy: is there still a place in 2026?","authors":"Sara Riolo, Antonio Celia","doi":"10.23736/S2724-6051.26.07164-8","DOIUrl":"10.23736/S2724-6051.26.07164-8","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"618-620"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400053","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":"YAU-RCC insights from EAU 2026: at the dawn of integrated personalized care of renal cell carcinoma.","authors":"Carlotta Palumbo, Michele Nicolazzini, Alexandru Turcan, Riccardo Campi, Daniele Amparore, Carmen Mir","doi":"10.23736/S2724-6051.26.07216-2","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07216-2","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 4","pages":"453-456"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118392","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":"Survival outcomes after cytoreductive nephrectomy with tumor thrombectomy: results from the Intercontinental Collaboration on Renal Cell Carcinoma.","authors":"Maxwell Sandberg, Gregory Russell, Phillip Krol, Mitchell Hayes, Seok-Soon Byun, Oscar Rodriguez Faba, Patricio Garcia Marchinena, Alberto Jurado, Gaetano Ciancio, Charles C Peyton, Philippe E Spiess, Reza Mehrazin, Soroush Rais-Bahrami, Diego Abreu, Stenio DE Cassio Zequi, Alejandro R Rodriguez","doi":"10.23736/S2724-6051.26.06854-0","DOIUrl":"10.23736/S2724-6051.26.06854-0","url":null,"abstract":"<p><strong>Background: </strong>Outcomes of cytoreductive nephrectomy with tumor thrombectomy are poorly characterized in the literature. The objective of this study was to report survival in patients with metastatic renal cell carcinoma with tumor thrombus who underwent cytoreductive nephrectomy with tumor thrombectomy.</p><p><strong>Methods: </strong>This was a retrospective, multi-institutional study. To be included, patients required an imaging confirmed diagnosis of metastatic renal cell carcinoma with a tumor thrombus on either computerized tomography and/or magnetic resonance imaging and underwent cytoreductive nephrectomy with tumor thrombectomy. Tumor thrombus was graded using the Mayo Clinic classification system. Overall survival, cancer-specific survival, and progression-free survival were evaluated. Cox proportional hazards regression and competing risks regression was used to assess the significance of demographic variables, treatment characteristics, and location of metastases on survival time-to-event measures within five years of surgery.</p><p><strong>Results: </strong>Overall, 131 patients were included. Median number of metastatic sites at the time of cytoreductive nephrectomy was one. Fifty-six (44%) patients had a level I thrombus, 31 (24%) had a level II, 20 (16%) had a level III, and 20 (16%) had a level IV thrombus. Median overall survival was 1.7 years, cancer-specific survival was 2.2 years, and progression-free survival was 1.1 years. Systemic symptoms at diagnosis, larger preoperative tumor size, and adrenal metastases conferred a greater hazard of death (P<0.05). Brain metastasis conferred a greater hazard of cancer-specific death (P<0.05).</p><p><strong>Conclusions: </strong>Identification of patients most likely to benefit from cytoreductive nephrectomy with tumor thrombectomy remains elusive. Multiple patient specific factors could aid in prediction of survival postoperatively.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"510-518"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976114","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":"Simultaneous surgery for NMIBC and BOO: evaluating surgical safety to oncological benefit.","authors":"Osman Ermiş, Halil Ç Aybal, Cathy Y Yuan, Atinç Tozsin, Cristian Fiori, Thomas Herrmann, Abdullatif Aydin, Kamran Ahmed, Selçuk Güven","doi":"10.23736/S2724-6051.26.07091-6","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07091-6","url":null,"abstract":"<p><strong>Background: </strong>Current evidence demonstrates that simultaneous surgical management of bladder cancer (BCa) and bladder outlet obstruction (BOO) is oncologically safe, despite well-known concerns. This systematic review and meta-analysis primarily evaluates oncological outcomes of concurrent transurethral resection of bladder tumor (TURBT) and BOO surgery compared to TURBT alone or staged treatments; perioperative safety is descriptively summarized.</p><p><strong>Methods: </strong>A systematic search of PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials was conducted from January 2000 to March 2026. Included were NMIBC and BOO surgical studies comparing simultaneous versus staged/control management. Pooled RR and HR were estimated using a random-effects model. Methodological quality was assessed using RoB 2 and ROBINS-I. Publication bias was assessed using funnel plots and Egger's weighted regression test.</p><p><strong>Results: </strong>Ten studies involved 1401 patients. Compared to the control group, simultaneous surgery was significantly associated with a reduced bladder tumor recurrence risk (pooled RR: 0.80; 95% CI: 0.70-0.91; P=0.001), with low heterogeneity (I²=7%). There were no significant differences in disease progression to stage ≥T2 (RR: 0.74; P=0.22), site-specific recurrence in the bladder neck and prostatic fossa (RR: 0.75; P=0.45). Time-to-recurrence analysis demonstrated similar oncological timeframes for both methods (pooled HR: 1.22; P=0.13). Cohorts are mostly retrospective, randomized controlled trials are limited, and surgical methods vary.</p><p><strong>Conclusions: </strong>Our analysis demonstrates that simultaneous surgery is not only oncologically safe but also appears to be associated with a lower risk of recurrence. Reducing obstruction may improve bladder dynamics and lower urothelial exposure to urine carcinogens, suggesting that, alongside its established surgical safety, this approach should also be considered for its potential oncological benefits.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 4","pages":"484-497"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118362","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":"Multicentric screening for Fabry disease in patients with kidney replacement therapy in the Italian Region of Veneto.","authors":"Gianni Carraro, Rime Khalf, Martina Cacciapuoti, Lucia F Stefanelli, Francesca K Martino, Federico Nalesso, Lorenzo A Calò","doi":"10.23736/S2724-6051.26.07089-8","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07089-8","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 4","pages":"624-626"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118638","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":"Importance of time to nephrectomy in localized renal cell cancer according to histological subtype.","authors":"Maximilian Filzmayer, Federico Polverino, Michele Petix, Leonardo Quarta, Filippo Orlandi, Jordan A Goyal, Nicola Longo, Gennaro Musi, Alberto Briganti, Salvatore Micali, Shahrokh F Shariat, Clara Humke, Miriam I Traumann, Mike Wenzel, Fred Saad, Felix K Chun, Pierre I Karakiewicz","doi":"10.23736/S2724-6051.26.06951-X","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.06951-X","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to test the effect of time to nephrectomy (TTN) >3 months on cancer-specific mortality (CSM) in localized renal cell carcinoma (RCC) according to histological subtype (clear-cell, papillary and chromophobe RCC).</p><p><strong>Methods: </strong>Within the Surveillance, Epidemiology and End Results database (SEER; 2004-2020) we identified 18,056 T1b-2 N0 M0 RCC patients treated with nephrectomy. After propensity score matching (PSM), multivariable competing risks regression (CRR) models addressing CSM were fitted.</p><p><strong>Results: </strong>TTN >3 months was recorded in 2194 (15.8%) of 13,879 clear cell, in 576 (21.7%) of 2656 papillary, and in 217 (14.8%) of 1521 chromophobe RCC patients. The proportion of TTN >3 months increased significantly over time in all three histological subtypes (all P<0.01). After PSM, 60-month CSM rates for TTN >3 vs. ≤3 months were 8.2 vs. 5.9% in clear-cell RCC, which resulted in 1.36-fold higher CSM in multivariable CRR (P<0.001). Conversely, TTN >3 vs. ≤3 months was not related to absolute or relative CSM differences in papillary (5.5 vs. 5.2%, HR: 1.17, P=0.4) and chromophobe RCC (2.3 vs. 2.8%, HR: 0.84, P=0.7).</p><p><strong>Conclusions: </strong>The proportions of TTN >3 months increased over time across all histological subtypes. However, only in clear-cell RCC, TTN >3 months was associated with higher CSM rates. In consequence, TTN >3 months should be avoided in clear-cell RCC or in all nephrectomy candidates if histological subtype is unknown. Broader use of renal mass biopsy for preoperative distinction of RCC subtypes may help prioritize surgical timing when triage or postponement is necessary.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 4","pages":"519-528"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118686","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":"Multicentric evaluation of a lateral-based anterior vaginal wall flap for female urethral stricture repair.","authors":"Pau Sarrio-Sanz, Luis Gómez-Perez, Ana-Isabel López López, Laura Martinez-Cayuelas, Lidia Verdú Verdú, Carla Pérez Tomás, Manuel-Angel Ortiz Gorraiz, Jesús Romero Maroto","doi":"10.23736/S2724-6051.25.06533-4","DOIUrl":"10.23736/S2724-6051.25.06533-4","url":null,"abstract":"<p><strong>Background: </strong>Female urethral stricture (FUS) is an uncommon pathology. Success of the different treatments has not been compared and the published series have low sample size and short follow-up, so the evidence is not enough to support one technique over another. Treatment options include urethral dilatation and urethroplasty. Urethroplasty techniques include vaginal flap and graft urethroplasty. The objective is to evaluate the efficacy and safety of the lateral-based anterior vaginal wall flap for the treatment of FUS, and to describe our experience in etiology, diagnosis and treatment.</p><p><strong>Methods: </strong>A retrospective study for women treated with the referred technique at three University hospitals between 1999 and 2023. Surgery was considered successful when there was resolution of voiding symptoms, absence of recurrent urinary tract infections, absence of postvoid residual and >50% increase of peak urinary flow (Qmax). Subjective response was assessed with PGI-I questionnaire.</p><p><strong>Results: </strong>Twenty-four patients were included. The mean age was 53.5 years (31-82) and follow-up was 9.5 years (2-21.8). The long-term success rate was 95.8% (N.=23). Peak flow improved from 7.5 to 17.5 mL/s (P=0.001)) and post-void residual urine decreases from 65 to 9 mL (P=0.006). Four patients (16.6%) had Clavien-Dindo I complications and no long-term complications. No de novo urinary incontinence was observed. The main limitations are the retrospective design and the relatively low number of patients.</p><p><strong>Conclusions: </strong>Treatment of female urethral stricture by lateral-based vaginal wall flap has proven to be safe, with high short- and long-term efficacy.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"541-547"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470319","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":"PSMA expression: enhancing prostate cancer diagnosis at the biopsy stage.","authors":"Rosario Leonardi, Massimiliano Mazza, Fabio Nicolini, Patricia Borges DE Souza, Antonio Lupo, Michele DI Dio, Alessandro Calarco, Guglielmo Mantica, Francesca Ambrosini, Francesco Pegreffi, Giovanni Paganelli, Maurizio Puccetti, Sara Bravaccini","doi":"10.23736/S2724-6051.26.07028-X","DOIUrl":"10.23736/S2724-6051.26.07028-X","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"461-463"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400041","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":"Outcomes and safety of ureterorenoscopy with pulsed thulium:YAG laser for urolithiasis: the largest prospective single-center series.","authors":"Francesco Esperto, Arianna Pischetola, Antonio Minore, Loris Cacciatore, Antonio Testa, Annamaria Salerno, Rocco Papalia, Roberto M Scarpa","doi":"10.23736/S2724-6051.26.07189-2","DOIUrl":"10.23736/S2724-6051.26.07189-2","url":null,"abstract":"<p><strong>Background: </strong>Laser lithotripsy is central to the endoscopic management of renal and ureteral stones. Thulium:YAG (Tm:YAG) laser has emerged as a promising platform, although clinical evidence on its safety, effectiveness, and real-world performance remains limited. The aim of this article is to evaluate the clinical performance, effectiveness, and safety of Tm:YAG laser lithotripsy in patients undergoing URS/ULT or RIRS at a high-volume center.</p><p><strong>Methods: </strong>Patients undergoing URS/ULT or RIRS for urolithiasis with the Tm:YAG laser were prospectively enrolled at a single high-volume institution between December 2023 and February 2026. Demographic, clinical, radiological, intraoperative, and postoperative variables were collected. Continuous variables were reported as mean and standard deviation or median with interquartile range, as appropriate. Mann-Whitney U Tests assessed associations between perioperative variables and postoperative outcomes in the overall cohort and separately in renal and ureteral stone cohorts. Stone-free rate (SFR) and clinically significant stone-free rate (CSSFR; residual fragments ≤3 mm) were evaluated on 4-week follow-up imaging. Complications were classified according to the Clavien-Dindo system.</p><p><strong>Results: </strong>Median stone diameter was 10.65 mm (IQR 7.3-16), median stone volume was 623 mm³ (IQR 203-2142), and median stone density was 1183 HU (IQR 867-1445). Mean operative time was 65.3±43.2 minutes, median laser activation time was 21.1 minutes (IQR 13.6-36.8), and median total laser energy was 8.2 kJ (IQR 2.4-23.1). At 4 weeks, overall SFR was 85.6%, including 80.5% in the renal cohort and 92.1% in the ureteral cohort; CSSFR was 89.8%. Postoperative complications occurred in 27 patients (6.3%), with no Clavien-Dindo grade ≥III events. Failure to achieve SFR or CSSFR was associated with greater stone burden, higher stone density, longer operative and laser activation times, higher total laser energy, and lower ablation speed.</p><p><strong>Conclusions: </strong>In this prospective high-volume single-center cohort, Tm:YAG laser lithotripsy demonstrated favorable efficacy and safety for renal and ureteral stones, supporting its feasibility for URS/ULT and RIRS. Comparative studies are needed to define its role among established laser technologies.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"603-615"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674708","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":"How to use artificial intelligence for complex medical decisions in uro-oncology?. Considerations from the YAU-Urotechnology and Digital Health Working Group.","authors":"Antonio A Grosso, Pieter DE Backer, Karl F Kowalwski, Ines Rivero Belenchon, Stefano Puliatti, Pietro Piazza, Loic Baekelandt, Mark Taratkin, Mieszko Kozikowski, Stessy Kutchukian, Alessandro Veccia, Riccardo Lombardo, Enrico Checcucci, Severin Rodler","doi":"10.23736/S2724-6051.26.07062-X","DOIUrl":"10.23736/S2724-6051.26.07062-X","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"464-466"},"PeriodicalIF":5.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943757","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}