Minerva Urology and Nephrology最新文献

{"title":"The Italian Society of Urology Statement on focal therapy for localized prostate cancer.","authors":"Giovanni Lughezzani, Antonio Celia, Vittorio Fasulo, Giancarlo Marra, Tommaso Silvestri, Gianni Vittori, Armando Stabile, Riccardo Mastroianni, Alessandro Branchi, Ugo Falagario, Giuseppe Simone, Pierluigi Bove, Valerio Iacovelli, Stefano DE Luca, Vincenzo Ficarra, Andrea Minervini, Andrea Salonia, Vincenzo Mirone, Giuseppe Carrieri, Nicolò M Buffi, Massimo Lazzeri","doi":"10.23736/S2724-6051.25.06851-X","DOIUrl":"10.23736/S2724-6051.25.06851-X","url":null,"abstract":"<p><p>Focal therapy (FT) represents a promising strategy for the management of localized prostate cancer (PCa). However, due to limited long-term evidence and the heterogeneity of prostate cancer, its use must be carefully considered, and patient selection must be stringent. A panel of urologists with expertise in PCa and FT was selected by the Italian Society of Urology (SIU - Società Italiana di Urologia) and proposed criteria to consider in FT for PCa, with the aim of supporting its use in clinical practice. The ideal candidate for FT is a patient with a unilateral, localized, multiparametric MRI-visible lesion, harboring intermediate-risk PCa (ISUP Grade Group 2) and a life expectancy greater than 10 years. The different energy sources used in FT (cryotherapy, high-intensity focused ultrasound, irreversible electroporation, and transperineal laser ablation) offer comparable oncological and functional outcomes. The choice of energy modality primarily depends on tumor location, physician expertise, and local availability of the technology. Different FT failure definitions exist. Standard follow-up should always include PSA monitoring and mpMRI. Follow-up biopsy should not be routinely performed in every patient except for centers starting a FT program. Per protocol biopsy should be considered depending on the risk of PCa treated with FT. The SIU position paper on FT aims to guide its use in clinical practice by providing recommendations to select, treat and follow-up patients.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 1","pages":"1-14"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203741","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":"Comment on: \"Evaluation of inflammatory markers in survival analysis of patients undergoing radical cystectomy using machine learning\".","authors":"Murat Akand, Selcuk Guven","doi":"10.23736/S2724-6051.25.06869-7","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06869-7","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 1","pages":"145-147"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203634","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":"En-bloc resection of bladder tumors with Cyber Ho generator with Magneto technology: report from the first 50 cases.","authors":"Davide Perri, Federica Mazzoleni, Giovannalberto Pini, Andrea Pacchetti, Tommaso Calcagnile, Eugenio Ventimiglia, Jean-Baptiste Roche, Giorgio Bozzini","doi":"10.23736/S2724-6051.25.06543-7","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06543-7","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 1","pages":"157-159"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203701","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":"Virtual hypnosis with HypnoVR system during prostate biopsy: a new tool to increase patients' comfort.","authors":"Enrico Checcucci, Gabriele Volpi, Saverio Liguori, Paolo Alessio, Michele Sica, Sabrina DE Cillis, Daniele Amparore, Liliana Davide, Patrizia Torrisi, Francesca Fidone, Francesco Porpiglia","doi":"10.23736/S2724-6051.25.06776-X","DOIUrl":"10.23736/S2724-6051.25.06776-X","url":null,"abstract":"<p><p>Prostate biopsy is often perceived as an invasive and painful procedure, frequently associated with significant emotional distress. Despite the use of local anesthesia, a considerable proportion of patients still report pain and anxiety. Hypnosis has been demonstrated to reduce procedural discomfort; however, its clinical use is limited by the requirement of trained professionals and time constraints. This preliminary study evaluates the feasibility and potential benefits of digital sedation using immersive virtual reality (VR) with the HypnoVR system in five patients undergoing prostate biopsy. Patients selected their preferred virtual environment and started wearing the device four minutes before the procedure. Anxiety and pain were assessed using Visual Analog Scales (VAS), and vital signs were monitored as physiological surrogates. Results revealed low pre-procedural anxiety (median 1/10 ±1) and moderate pain during (median 5.6/10 ±1.1) and immediately after biopsy (median 3/10 ±2.2), with no pain reported at 24 hours. All patients reported high satisfaction and no complications occurred. Transrectal biopsies were performed without anesthesia, while the transperineal ones were carried out using subcutaneous anesthesia only, with no significant differences in tolerability. Although limited by its small sample size, this initial experience supports the potential role of VR-based hypnosis as a non-pharmacological, patient-centered approach to enhance comfort and reduce invasiveness during prostate biopsy.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"15-20"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745715","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 ileal ureteral reconstruction for radiation-induced ureteral strictures in pelvic malignancy survivors: experience from a multi-institutional database.","authors":"Yishun Huang, Xiang Wang, Fangzhou Zhao, Guanpeng Han, Zhihua Li, Yiming Zhang, Xinfei Li, Jing Liu, Hongjian Zhu, Kunlin Yang, Kai Zhang, Liqun Zhou, Xuesong Li","doi":"10.23736/S2724-6051.25.06567-X","DOIUrl":"10.23736/S2724-6051.25.06567-X","url":null,"abstract":"<p><strong>Background: </strong>Chronic double-J stenting or nephrostomy dependence remains the default management for radiation-induced ureteral strictures (RIUS). This study aimed to evaluate the feasibility and clinical efficacy of robotic ileal ureter replacement (IUR) in managing RIUS with prior pelvic malignancy radiotherapy.</p><p><strong>Methods: </strong>In our prospective multi-institutional RECUTTER database, 35 patients with a diagnosis of RIUS underwent robotic IUR between March 2019 and April 2024. Unilateral and bilateral procedures were performed with or without augmentation ileocystoplasty. Baseline characteristics, perioperative, and follow-up results of the patients were collected. Postoperative complications were evaluated using the Clavien-Dindo (CD) Classification system.</p><p><strong>Results: </strong>All patients were female with a mean age of 49.46±8.25 year. Cervical carcinoma was the predominant primary malignancy for radiotherapy (85.7%). The median length of the ileal graft was 28 cm (range 15-45). The mean operative time was 331.6±112.3 min, and the median estimated blood loss was 50 mL (range 20-100). The mean postoperative hospitalization was 12.43±6.00 day. During the median follow-up of 20 months (range 12-74), 34 patients (97.1%) achieved clinical success. One case of surgical failure developed right ureteral restenosis post-bilateral IUR. Complications included short-term (20%: CD grade I 11.4%, grade II 8.6%) and long-term events (22.9%, all grade II). No grade ≥III complications occurred.</p><p><strong>Conclusions: </strong>Robotic IUR represents a feasible and effective option-for managing RIUS after pelvic malignancy radiotherapy, addressing surgical challenges posed by dense adhesions, retroperitoneal fibrosis, extensive bilateral strictures, and concurrent bladder contracture.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 1","pages":"78-89"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203734","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":"Contemporary methods for surgical margin assessment in radical prostatectomy: a systematic review and meta-analysis of diagnostic test accuracy.","authors":"Josep M Gaya, Wojciech Tomczak, Paolo Verri, Andrea Gallioli, Giulio Avesani, Francesco DI Bello, Laura Mas, Jorge Huguet, Wojciech Krajewski, Joan Palou, Alberto Breda","doi":"10.23736/S2724-6051.25.06642-X","DOIUrl":"10.23736/S2724-6051.25.06642-X","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical treatment of prostate cancer often leads to adverse outcomes such as erectile dysfunction and urinary incontinence. Nerve-sparing surgery aims to minimize these complications but may increase the risk of incomplete cancer removal. Intraoperative surgical margin assessment assists in balancing oncologic control with functional preservation. This systematic review and meta-analysis evaluated the technologies used for intraoperative margin assessment during radical prostatectomy.</p><p><strong>Evidence acquisition: </strong>A literature review was conducted in February 2025. All included studies involved patients with prostate cancer undergoing nerve-sparing radical prostatectomy in which intraoperative surgical margin assessment was performed. The primary outcome was the comparative diagnostic test accuracy of commercially available assessment methods.</p><p><strong>Evidence synthesis: </strong>A total of 47 studies were included in the qualitative synthesis, of which 24 were eligible for the meta-analysis of diagnostic test accuracy. These included 11 studies on intraoperative frozen section analysis, seven validating the NeuroSAFE protocol, and six evaluating fluorescence confocal microscopy. A key finding was the demonstration that fluorescence confocal microscopy is non-inferior to the NeuroSAFE protocol. However, limitations such as inconsistent data reporting substantially reduced the number of studies eligible for quantitative analysis.</p><p><strong>Conclusions: </strong>This study offers a comprehensive evaluation of intraoperative surgical margin assessment techniques employed during radical prostatectomy. Evidence from the NeuroSAFE randomized controlled trial confirms the clinical utility of this protocol, while our findings demonstrate that confocal microscopy provides comparable diagnostic performance. Collectively, these results support their broader clinical implementation. Nonetheless, definitive conclusions will require higher-quality evidence and standardized reporting in future research.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 1","pages":"26-39"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203617","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":"Balancing maternal and fetal safety in non-muscle-invasive bladder cancer: report of our experience.","authors":"Beatrice Crestani, Valeria Tamborrino, Riccardo Bertolo, Alessandro Antonelli, Simone Garzon, Mariachiara Bosco, Piercarlo Zorzato, Massimo P Franchi, Stefano Uccella","doi":"10.23736/S2724-6051.25.06842-9","DOIUrl":"https://doi.org/10.23736/S2724-6051.25.06842-9","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 1","pages":"155-157"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203667","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":"Comparative efficacy and safety of intelligent pressure-controlled versus flexible vacuum-assisted ureteral access sheath for 2-4 cm renal calculi.","authors":"Xin Huang, Leming Song, Xiaolin Deng, Hua Chen, Jiansheng Xiao, Jin Kuang, Zhiwen Wang, Xiaoling Deng, Qiliang Zhai","doi":"10.23736/S2724-6051.24.05814-2","DOIUrl":"10.23736/S2724-6051.24.05814-2","url":null,"abstract":"<p><strong>Background: </strong>Retrograde intrarenal surgery (RIRS) is being increasingly used to treat 2-4 cm renal stones, which can be attributed to advances in flexible ureteroscopes and ureteral access sheaths (UASs). Despite the improvement and application of flexible vacuum-assisted (FV) and intelligent pressure-controlled (IPC) UASs, no studies have compared their therapeutic efficacy and safety. Therefore, this study aimed to compare the therapeutic efficacy and safety of IPC-UAS and FV-UAS in RIRS 2-4 cm renal stones.</p><p><strong>Methods: </strong>We included 96 and 103 patients who underwent IPC-UAS and FV-UAS RIRS, respectively, for 2-4 cm renal stones. Stone-free rate (SFR), operative time, and complications were compared between the two groups.</p><p><strong>Results: </strong>The immediate SFR was 69.8% and 82.5% in the IPC-UAS and FV-UAS groups, respectively (P<0.05). There were no significant between-group differences in the 1-month SFR (84.4% vs. 84.5%, P>0.05). The IPC-UAS group had a shorter hospital stay (5.2±2.4 vs. 6.2±3.2 days, P=0.018) and lower cost (CNY13014.7±3240.7 vs. CNY14022.5±2301.6, P=0.012) than the FV-UAS group. There were no significant between-group differences in operative time or complications.</p><p><strong>Conclusions: </strong>Regarding RIRS for 2-4 cm renal stones, the IPC-UAS group can achieve a 1-month SFR similar to that of the FV-UAS group, with shorter hospitalization and lower cost. Additionally, the IPC-UAS is a promising device for efficient and safe RIRS, considering its intelligent pressure regulation. Our findings could inform optimal UAS selection for managing large renal calculi and demonstrate the utility of the novel IPC-UAS in improving outcomes of RIRS for 2-4 cm renal stones.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"136-144"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876739","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 role of artificial intelligence in predicting graft survival in kidney transplantation: a systematic review.","authors":"Francesco DI Bello, Andrea Gallioli, Alessio Pecoraro, Thomas Prudhomme, Alberto Piana, Beatriz Bañuelos Marco, Hakan B Haberal, Muhammet I Dönmez, Alicia Lopez-Abad, Donato Cannoletta, Stefano Mancon, Lluis Guirado, Carma Facundo, Andres K Kanashiro, Pavel Gavrilov, Oscar Rodriguez-Faba, Josep M Gaya, Alberto Breda, Angelo Territo","doi":"10.23736/S2724-6051.25.06559-0","DOIUrl":"10.23736/S2724-6051.25.06559-0","url":null,"abstract":"<p><strong>Introduction: </strong>Gradient-boosting (GB) algorithm is considered as the state-of-the-art algorithm for prediction of survival. The aim of the current study was consolidating the evidence on GB machine-learning (ML) model to predict graft survival (GS) after kidney transplant (KT).</p><p><strong>Evidence acquisition: </strong>A systematic search (PROSPERO: CRD42025645353) with a qualitative analysis was performed according to PRISMA statement. Study quality and risk of bias were evaluated using the Prediction-model Risk of Bias ASsessment Tool (PROBAST).</p><p><strong>Evidence synthesis: </strong>Overall, 15 studies involving 889,657 patients were included in the final analysis. Of those, 14,334 included GS information. According to ML algorithm, 12 (80.3%) studies relied on eXtremeGB, two (13.3%) on StochasticGB and one (6.4%) on lightGB. The model performance was evaluated with Area Under Curve (AUC) methodology in 12 (80%) of papers and ranged from 0.715 to 0.989. The Brier-score was evaluated in five (33.3%) papers and ranged from 0.020 to 0.14. The C-index and/or Accuracy were evaluated in three (20%) papers and ranged, in respectively, from 0.635 to 0.837, and from 0.81 to 0.979.</p><p><strong>Conclusions: </strong>The current systematic review showed a promising potential role of GB in the GS prediction after KT. However, ML models should be carefully interpreted before being used in clinical practice.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 1","pages":"53-62"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203795","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":"Trends for ejaculatory sparing and minimally invasive surgical treatments adoption for lower urinary tract symptoms related to BPH in Italy: screenshot from the Italian society of urology (SIU) benign research network.","authors":"Andrea Mari, Luca Cindolo, Cristian Fiori, Luca Lambertini, Silvia Secco, Giorgio I Russo, Francesco Sessa, Andrea Cocci, Giovanni Cochetti, Roberto Castellucci, Daniele Amparore, Daniele Castellani, Antonio Cicione, Cosimo DE Nunzio, Sebastiano Cimino, Antonio Galfano, Ettore Mearini, Andrea B Galosi, Sergio Serni, Francesco Porpiglia, Andrea Salonia, Vincenzo Ficarra, Giuseppe Carrieri, Vincenzo Mirone, Andrea Minervini","doi":"10.23736/S2724-6051.25.06569-3","DOIUrl":"10.23736/S2724-6051.25.06569-3","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgical treatments (MISTs) for benign prostatic hyperplasia (BPH) are increasingly adopted due to fewer complications and better preservation of ejaculatory function. However, real-world data on patient selection and clinical application in Italy remain scarce.</p><p><strong>Methods: </strong>Patients undergoing Aquablation, Rezum, iTIND, TPLA, or PUL from October 2022 to December 2024 were prospectively enrolled by 15 Italian centers in the SIU Research Network. Baseline clinical, anatomical, and functional data were collected via a secure digital platform. Data were recorded using standardized electronic case report forms, and patient-reported outcomes were gathered through validated questionnaires administered at baseline and during follow-up.</p><p><strong>Results: </strong>A total of 312 patients were enrolled: 30 (9.6%) Aquablation, 97 (31.1%) Rezum, 49 (15.7%) iTIND, 108 (34.6%) TPLA, and 28 (9.0%) PUL. iTIND patients were the youngest (median age 47, IQR 42-57), had the lowest prostate volume (30 mL, IQR 27.5-40), lowest comorbidity scores, and poorest Qmax (6.2 mL/s, IQR 5-8). Aquablation and TPLA were adopted for larger prostates (70 mL, IQR 50-80 and 67 mL, IQR 45-85, respectively). Median lobe was most frequent in Rezum (56.7%) patients. PUL patients had the lowest post-void residual (20 mL, IQR 5-60). Rezum and TPLA patients reported better ejaculatory function (P<0.02), while iTIND patients showed the highest dysfunction (P<0.05). Baseline QoL scores were comparable across groups.</p><p><strong>Conclusions: </strong>This interim analysis shows that MIST adoption in Italy is influenced by prostate size, age, comorbidities, and functional profiles. The findings describe baseline selection patterns only, with postoperative outcomes to be reported in future analyses.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 1","pages":"127-135"},"PeriodicalIF":5.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203754","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}