Minerva Urology and Nephrology最新文献

{"title":"Environmental sustainability in urolithiasis care: a scoping review.","authors":"Muhidin H Ibrahim, Atinc Tozsin, Yuhong Yuan, Hakan Akdere, Cristian Fiori, Kamran Ahmed, Selcuk Guven","doi":"10.23736/S2724-6051.26.06800-X","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.06800-X","url":null,"abstract":"<p><strong>Background: </strong>Urolithiasis is climate-sensitive and increasingly prevalent, but the environmental impact of its care remains poorly defined. The aim of the study is to map existing evidence on the environmental footprint of urolithiasis care and identify gaps for future research.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with the PRISMA-ScR guidelines. PubMed, Ovid MEDLINE, and the Cochrane Library were searched to March 20^th, 2025. Studies were eligible if they provided quantitative estimates of the environmental footprint using life cycle assessment or clinical audit methodologies. Two reviewers screened and extracted data independently.</p><p><strong>Results: </strong>Six studies were included. Endoscopic analyses reported comparable footprints for single-use and reusable ureteroscopes, with emissions primarily from manufacturing in disposables and from sterilization in reusables. Imaging studies showed substantial variation across modalities, with ultrasound lowest, CT intermediate, and MRI highest. Surgical audits indicated that reusable drapes and gowns reduced emissions by nearly one-fifth, while cystoscopy drapes and irrigation fluid disposal represented additional hotspots.</p><p><strong>Conclusions: </strong>Evidence on the environmental impact of stone disease care is limited and fragmented. No studies addressed Percutaneous Nephrolithotomy, Extracorporeal Shock Wave Lithotripsy, or laser interventions. Patient-centered outcomes and system-level strategies remain underexplored. Standardized, multicenter life cycle assessments and evaluation of decarbonization strategies (including anesthetic choice, energy-efficient operating theatres, and pathway redesign) are priorities for guiding climate-smart stone care.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 3","pages":"335-342"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431499","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 modified Y-V plasty for bladder neck contracture: single-center comparative analysis.","authors":"Meng Liu, Jianwen Huang, Ranxing Yang, Song Li, Xiaoyong Hu, Jihong Wang, Ying Wang, Lujie Song, Qiang Fu","doi":"10.23736/S2724-6051.25.06283-4","DOIUrl":"10.23736/S2724-6051.25.06283-4","url":null,"abstract":"<p><strong>Background: </strong>Bladder neck contracture (BNC) is common complication following surgery for benign prostate hyperplasia (BPH). Bladder neck reconstruction such as Y-V plasty may be considered for treatment of refractory BNC. This study aimed to compare the outcomes of robot-assisted modified Y-V plasty (RAMYV) and traditional Y-V plasty (RAYV) for refractory. Additionally, it seeks to establish a potential predictive system for postoperative patient-reported outcomes (PROs).</p><p><strong>Methods: </strong>We retrospectively analyzed clinical data of all patients with refractory BNC who underwent robot-assisted Y-V plasty from October 2022 and January 2024. Follow-up assessments were conducted at 1, 3 and 6 months.</p><p><strong>Results: </strong>Forty-eight patients with refractory BNC were included. 20 patients underwent RAYV, while 28 patients underwent RAMYV. All patients were followed for a period of six months. All patients had patent repairs and were voiding per urethra. Significant improvements were noted in the maximum urinary flow rate (Qmax), residual urine, and IPSS scores in both groups at 1, 3, and 6 months postoperatively, compared to the preoperative state. However, no statistically significant difference was found between the two groups at 1 month postoperatively. At 3 months postoperatively, the RAMYV group exhibited superior outcomes in IPSS and USS-PROM compared to the RAYV group, with statistically significant differences. At 6 months, the RAMYV group also exhibited superior outcomes in QoL and OAB-V8 compared to the RAYV group. Age and corresponding baseline scores on various scales are important predictors of lower urinary tract symptoms (LUTSs) after surgery. Preoperative scores on scales emphasizing flow assessment, such as the IPSS and USS PROM, carry significant weight, whereas age is the most influential factor in assessing storage function. This was a retrospective study, data bias was inevitable.</p><p><strong>Conclusions: </strong>YV plasty has been identified as an effective option for treating refractory BNC. Compared to RAYV, RAMYV appears to have better efficacy for patient outcomes in our six-month follow-up. Baseline scores related to age and preoperative symptom scores may serve as potential predictive factors for postoperative outcomes.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"419-429"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796109","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":"Robotic intracorporeal modified Bordeaux versus Padua ileal bladder: head-to-head surgical technique, perioperative and functional outcomes.","authors":"Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Alfredo M Bove, Aldo Brassetti, Simone D'Annunzio, Mariaconsiglia Ferriero, Rocco S Flammia, Leonardo Misuraca, Flavia Proietti, Leslie Licari, Eugenio Bologna, Giuseppe Chiacchio, Salvatore Guaglianone, Costantino Leonardo, Giuseppe Simone","doi":"10.23736/S2724-6051.26.06906-5","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.06906-5","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (iUD) has facilitated the development of several orthotopic neobladder (ON) configurations. However, comparative evidence between iON types remains limited. This study aimed to provide a head-to-head comparison between modified Bordeaux Neobladder (mBN) and Padua Ileal Bladder (PIB) in terms of surgical technique, perioperative outcomes and functional results.</p><p><strong>Methods: </strong>We prospectively analyzed patients from an IRB-approved database undergoing RARC with totally iON reconstruction between January 2022 and July 2025. Eligible patients had muscle-invasive bladder cancer or BCG-refractory high-grade NMIBC and received either mBN or PIB reconstruction by a single experienced robotic surgical team. Outcomes included operative time, transfusion rates, perioperative and early postoperative complications, diversion-related morbidity and continence recovery assessed through 3-day voiding diaries. Continuous variables were compared with Student's t-test, while categorical variables with χ² Fisher's Exact Tests. Functional recovery was compared via Kaplan-Meier analyses and log-rank tests. A two-sided P value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Seventy-nine patients were included (38 mBN; 41 PIB). Baseline characteristics were comparable. Operative time (286±45 vs. 297±33 min; P=0.18), transfusion rates (11% vs. 17%; P=0.31) and hospital stay (7±7 vs. 6±3 days; P=0.41) showed no significant differences. Perioperative and 30-day complication rates were similar, as were 90-day outcomes. Uretero-ileal leakages (3% vs. 12%; P=0.12) and strictures (11% vs. 12%; P=1.00) occurred infrequently in both groups. Day- and night-time continence recovery and intermittent self-catheterization rates (8% vs. 15%; P=0.28) were comparable.</p><p><strong>Conclusions: </strong>In this single-center observational cohort, the modified Bordeaux Neobladder demonstrated perioperative and early functional outcomes comparable to those of the Padua Ileal Bladder after RARC with intracorporeal orthotopic diversion. These findings require confirmation in larger multicenter studies with longer follow-up and objective functional assessment.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 3","pages":"430-437"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431081","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 spotlight: where evidence ends and consensus begins for renal cell carcinoma. Insights from the Advanced Urologic Cancer Consensus Conference (AUC3) 2025.","authors":"Veronica Mollica, Emre Yekedüz, Daniele Amparore, Riccardo Campi","doi":"10.23736/S2724-6051.26.07065-5","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07065-5","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 3","pages":"308-315"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431496","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 concordance between ChatGPT-4 and EAU guidelines indications in bladder cancer management: a real-world study.","authors":"Mattia Lo Re, Anna Cadenar, Marta Pezzoli, Stefano Mancon, Elettra Fuligni, Luca Lambertini, Asia Carlino, Rossella Catanzaro, Michele DI Dio, Andrea Minervini, Andrea Cocci","doi":"10.23736/S2724-6051.26.06641-3","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.06641-3","url":null,"abstract":"<p><strong>Background: </strong>The integration of Artificial Intelligence (AI), particularly Large Language Models (LLMs) like ChatGPT, into healthcare is reshaping patient information-seeking behaviors. While prior studies have evaluated ChatGPT's performance across various urological domains, no research has yet addressed its ability to provide guideline-concordant recommendations for Bladder Cancer (BCa) management based on histopathological findings. This study aimed to evaluate the concordance between ChatGPT-4 and urologists' therapeutic recommendations for patients undergoing transurethral resection of bladder tumor (TURBT), using the European Association of Urology (EAU) guidelines as the reference.</p><p><strong>Methods: </strong>We retrospectively analyzed 219 consecutive patients who underwent TURBT for BCa at a tertiary referral center between January and June 2024. Data collected included demographics, oncological history, and histopathology reviewed according to WHO 2022 standards. Patients were risk-stratified using the 2021 EAU Non Muscle-Invasive Bladder Cancer (NMIBC) risk model. Two urologists independently defined treatment plans per 2024 EAU guidelines. ChatGPT-4 (accessed April 2025) was queried using histopathological reports and previous BCa history. Recommendations from ChatGPT and urologists were compared for agreement, evaluated using Cohen's Kappa coefficient.</p><p><strong>Results: </strong>Among the 219 patients (mean age 72.36 years, 78.5% male), 42.9% had de novo BCa, 6.8% underwent II look TURBT, and 50.2% had recurrence. Histopathology revealed 68.5% pure urothelial carcinoma and 53.8% high-grade tumors. NMIBC risk classification identified 5.5% low, 19.6% intermediate, 32.9% high, and 9.1% very-high risk cases. Overall agreement between urologist and ChatGPT recommendations was poor (Cohen's K=-0.06). Stratified analyses showed moderate agreement for first-time BCa (K=0.23) and very high agreement in muscle-invasive BCa (MIBC) cases (K=0.88). In contrast, recurrent cases and II look TURBT showed low to negative concordance (K=-0.24 and K=-0.6, respectively). ChatGPT displayed a notably conservative attitude towards recommending early radical cystectomy, aligning with guidelines in only 3 of 21 cases.</p><p><strong>Conclusions: </strong>Despite good readability and accessibility, ChatGPT-4's therapeutic recommendations based solely on histopathological reports lacked consistency with EAU guidelines, especially in complex scenarios such as recurrent disease or post-intravesical therapy management. Concordance was higher in straightforward cases like initial diagnosis or MIBC. These findings underscore the limitations of AI when clinical context is incomplete and highlight the irreplaceable role of clinician judgment. ChatGPT may serve as a supplementary tool for patient education but should not be used independently for clinical decision-making in BCa.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 3","pages":"411-418"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431465","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 Urological Age and Longevity Score: a step towards a targeted measure of biological aging.","authors":"Zeynep Akdagcik, Selcuk Guven, Evelyne Y Bischof, Atinc Tozsin, Mahmut Caliskan, Burak Akgul, Aly Abdel-Karim, Stefano Puliatti, Stefania Ferretti, Mehmet Balasar, Kultigin Turkmen, Cristian Fiori, Lutfi Tunc, Cathy Y Yuan, Jens Rassweiler, Giampaolo Bianchi, Thomas Herrmann, Kamran Ahmed","doi":"10.23736/S2724-6051.26.06865-5","DOIUrl":"10.23736/S2724-6051.26.06865-5","url":null,"abstract":"<p><strong>Background: </strong>Aging affects all organ systems, yet no standard method exists to quantify urological age. Renal function, prostate health, sexual function, fertility, and bladder control are central to men's health span, but their relationship with mental health and chronological aging remains poorly defined. The aim of this study was to develop the Urological Age and Longevity (UAL) framework, a consensus-driven composite index that quantifies urological biological age in men and explores its potential for guiding personalized strategies for healthy aging.</p><p><strong>Methods: </strong>The UAL model was constructed through a three-phase process combining literature evidence and expert consensus. First, a multidisciplinary group systematically reviewed aging and urology indices to identify relevant longevity domains. Second, the preliminary framework underwent content validation using qualitative and quantitative feedback from an expert panel. Third, each parameter was organized into consensus-defined risk tiers to create a personalized UAL score.</p><p><strong>Results: </strong>Ten domains central to urological aging, including functional measures, biochemical markers, hormonal profile, sexual functions, systemic correlates, mental health, environmental exposures, lifestyle habits, surgical history, and family history, were identified and validated. Each parameter was assigned consensus-defined tiers, generating a structured 0 to 20 scoring system that estimates urological biological age and supports individualized risk profiling.</p><p><strong>Conclusions: </strong>The UAL framework is the first organ-specific biological age model in urology. It enables assessment of genitourinary aging using routine clinical and lifestyle data, offering opportunities for targeted, modifiable interventions. Prospective validation studies are now warranted to confirm its predictive and clinical utility.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 3","pages":"389-399"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431413","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 reliable are the results of clinical studies reported in urology?","authors":"Giampaolo Bianchi, Natali Rodriguez Peñaranda, Stefano Puliatti","doi":"10.23736/S2724-6051.26.07093-X","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.07093-X","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 3","pages":"319-322"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430774","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":"Management of urinary fistula after partial nephrectomy using a Pleur-evac drainage system with ureteral catheter.","authors":"Miguel A Arrabal-Polo, Alberto Zambudio-Munuera, Miguel Arrabal-Martin","doi":"10.23736/S2724-6051.25.06669-8","DOIUrl":"10.23736/S2724-6051.25.06669-8","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"438-440"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460737","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":"Clinical and technical insights on KIM-1: what we need to know.","authors":"Daniela Arduini, Antonio Agostini, Chiara Ciccarese, Denis Occhipinti, Gloria Messina, Romina R Pedone, Giampaolo Tortora, Carmine Carbone, Roberto Iacovelli","doi":"10.23736/S2724-6051.25.06760-6","DOIUrl":"10.23736/S2724-6051.25.06760-6","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"440-441"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004533","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":"Comparison of Ho:YAG and pTm:YAG lasers in mini-percutaneous nephrolithotomy: safety, efficiency, and efficacy for lithotripsy.","authors":"Ahmet F Ozsoy, Abdulrahman Jafarov, Mehmet E Maras, Yusuf H Sahin, Atakan Atakli, Vineet Gauhar, Mehmet I Gokce","doi":"10.23736/S2724-6051.26.06979-X","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.06979-X","url":null,"abstract":"<p><strong>Background: </strong>While several in-vitro studies have compared the performance of Holmium:YAG and pulsed Thulium:YAG lasers, no studies to date have directly compared the performance of these lasers during mini- PCNL. Herein, we aimed to compare the clinical effectiveness and stone-free rates of Ho:YAG and pThulium:YAG lasers in patients undergoing mini-PCNL.</p><p><strong>Methods: </strong>This prospective, non-randomized study included 264 patients who underwent mini-PCNL: 170 patients in the Ho:YAG group and 94 patients in the pTm:YAG group. Demographic characteristics, stone-related variables, and intraoperative and postoperative parameters were systematically recorded.</p><p><strong>Results: </strong>Demographic characteristics and stone-related variables, including stone diameter, volume (mm³), and Hounsfield units, were similar between the groups; a significant difference was observed only in the GUYS score (P=0.013). Median total energy and energy consumption were significantly lower in the Ho:YAG group than in the pTm:YAG group (3954 J [1932-8630] vs. 9887 J [3961.25-21,972.75], and 1.52 J/mm³ [0.80-3.17] vs 5.03 J/mm³ [1.94-9.08], respectively; both P<0.001). Laser ablation efficiency was higher in the Ho:YAG group (0.66 mm³/J [0.31-1.24] vs. 0.20 mm³/J [0.11-0.51]; P<0.001), whereas laser efficacy was comparable between groups (61.15 vs. 55.92 mm³/min; P=0.738). Postoperative complication and stone-free rates were similar (P=0.468 and P=0.418, respectively).</p><p><strong>Conclusions: </strong>Ho:YAG was associated with lower total energy use and shorter lasing times than pTm:YAG in mini-PCNL. However, overall efficacy, stone-free rates, and safety outcomes in mini-PCNL were comparable between the two laser systems.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 3","pages":"400-410"},"PeriodicalIF":5.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431475","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}