Minerva Urology and Nephrology最新文献

{"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}

{"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":"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}

{"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; I²=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; I²=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; I²=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":"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}

{"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}

{"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}

{"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}

{"title":"Robot-assisted artificial urinary sphincter revision in \"non-neurogenic\" stress urinary incontinence in female patients: surgical technique and outcomes.","authors":"Mariela Corrales, Paolo Geretto, Martina Moriconi, Maria L Gallo, Sabrina DE Cillis, Veronique Phé","doi":"10.23736/S2724-6051.25.06123-3","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06123-3","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted artificial urinary sphincter (AUS) implantation is a suitable option for the treatment of severe stress urinary incontinence (SUI) in female patients. However, to the best of our knowledge, any report of robotic AUS revision in case of recurrent SUI is available. The present study aims to provide the outcomes of a cohort of female patients subjected to robot-assisted AUS revision at a single tertiary referral center and to describe the surgical technique.</p><p><strong>Methods: </strong>The main surgical steps are the following: through robotic technique, the AUS reservoir and urethral cuff are found by following the connection tubes. The reservoir and the activating pump are then removed, and the urethral cuff is opened. A measuring tape is used to obtain the correct size of the bladder neck and to choose the correct new cuff, which is then placed. The reservoir is replaced, and the connection tubes are exteriorized. Finally, a subcutaneous passage towards the right labia majora is obtained and the connections are closed. The outcomes of a retrospective cohort of female patients subjected to robotic AUS revision according to the described technique are also provided.</p><p><strong>Results: </strong>Four patients were included. The median age was 63 (51-76 years); the median time to revision was 12 years (5-16 years). Median operative time was 160.5 (130-185 minutes). The reason for the AUS revision was a mechanical failure of the device in all cases. Any intra-operative or severe postoperative complication (Clavien-Dindo ≥3) was observed. After AUS activation at 4 weeks, all patients were dry.</p><p><strong>Conclusions: </strong>Robotic AUS revision in female patients is a feasible and safe technique and can give excellent functional outcomes.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 3","pages":"408-412"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318687","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 Renal Cancer SPOTLIGHT: the promise of molecular imaging to decrypt the renal tumors histological spectrum.","authors":"Savio D Pandolfo, Riccardo Bertolo, Stijn Muselaers, Selcuk Erdem, Michele Marchioni, Riccardo Campi, Daniele Amparore","doi":"10.23736/S2724-6051.25.06499-7","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06499-7","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 3","pages":"413-416"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318694","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 renal cancer SPOTLIGHT: the understated challenge of tumor rupture during robotic partial nephrectomy.","authors":"Riccardo Bertolo, Riccardo Campi, Daniele Amparore","doi":"10.23736/S2724-6051.25.06509-7","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06509-7","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"77 3","pages":"417-421"},"PeriodicalIF":4.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318695","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}