Arab Journal of Urology最新文献

{"title":"Efficacy of hyaluronic acid local injection in treatment of lifelong premature ejaculation: A new protocol.","authors":"Mahmoud Farag, Islam Nouh, Helmy Eldib","doi":"10.1080/20905998.2025.2457922","DOIUrl":"10.1080/20905998.2025.2457922","url":null,"abstract":"<p><strong>Aim: </strong>To discuss a new protocol of hyaluronic acid (HA) injection in terms of safety, efficacy and long-term benefits.</p><p><strong>Methods: </strong>In all, 80 patients, 29-54 years old, with refractory premature ejaculation were included. All patients were given three sessions of HA injection, each session 2 weeks apart. Follow-up of intravaginal ejaculatory latency time (IELT) and glans circumference was done at 3, 6 and 12 months after the last session. Post-procedural complications were recorded.</p><p><strong>Results: </strong>IELT highly significantly increased (<i>P</i>-value <0.001) after HA gel injection from baseline, 94.40 ± 5.645 sec at repeated measures, IELT measures after 3-, 6- and 12-month post-injection were 201.175 ± 2.765 s, 197.731 ± 2.539 s and 196.6 ± 3.224 s, respectively, with significant increase from pre-injection baseline one and with a significant yet minimal drop of 12-month versus 3 and 6 months measures. Maximum glans circumference was highly significantly increased (<i>P</i>-value <0.001) after HA gel injection from baseline, 96.072 ± 0.929 mm, at repeated measures after 3-, 6- and 12-month post-injection were 107.762 ± 1.548 mm, 111.582 ± 1.522 mm and 110.677 ± 1.552 mm, respectively, with significant increase from pre-injection baseline one and with a significant yet minimal drop of 12-month versus 6 months measure. 3.8% of patients suffered from ecchymosis, 1.3% had bullae formation at site of injection. All patients suffered from pain at site of injection.</p><p><strong>Conclusion: </strong>Our new protocol of HA injection proved both safe and efficacious with long-term benefits in terms of IELT and glans circumference decreasing the future need for repeated injections of HA.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"287-293"},"PeriodicalIF":1.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors of venous thromboembolism following radical nephrectomy: A meta-analysis of observational studies.","authors":"Yuan Li, Chiming Gu, Siyi Li, Franky Leung Chan, Shusheng Wang","doi":"10.1080/20905998.2025.2457923","DOIUrl":"10.1080/20905998.2025.2457923","url":null,"abstract":"<p><strong>Background: </strong>A meta-analysis was conducted to evaluate the incidence of venous thromboembolism (VTE) following radical nephrectomy and to examine the related risk factors.</p><p><strong>Methods: </strong>We conducted a comprehensive search for primary research articles from the inception of the databases up to October, 2024 across several databases, including MEDLINE, Embase, and the Cochrane Library. We employed random effects models to determine multivariate adjusted odds ratios (ORs) along with their corresponding 95% confidence intervals (CIs).</p><p><strong>Results: </strong>In total, 11 studies including 140,795 patients who underwent radical nephrectomy met inclusion criteria. The results showed that postoperative VTE incidence was 1.01% (95% CI = 1.01-1.02; <i>p</i> < 0.001) within 30 days. Moreover, diabetes, open nephrectomy, and history of VTE were related to higher odds of VTE through regression analysis. Analyses of sensitivity and meta-regression demonstrated the robustness of the study's findings.</p><p><strong>Conclusions: </strong>The overall incidence of VTE after radical nephrectomy is 1%, occurring approximately one month after surgery, and may be related to factors such as open surgery, diabetes and history of VTE. This reminds urologists that more aggressive thromboprophylaxis may be required for these patients.</p><p><strong>Prospero registration number: </strong>CRD42023439919.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"307-314"},"PeriodicalIF":1.2,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inception of novel equations for estimation of differential renal function changes after successful pyeloplasty in children.","authors":"Mustafa Abo Yaman, Osama El Gamal, Samir El Gamal, Mohemed Almaadawy, Salah Nagla","doi":"10.1080/20905998.2025.2453961","DOIUrl":"10.1080/20905998.2025.2453961","url":null,"abstract":"<p><strong>Introduction: </strong>Ureteropelvic junction obstruction is the most common cause of pediatric hydronephrosis. Anderson Hynes dismembered pyeloplasty as the standard surgical treatment in such cases.</p><p><strong>Purpose: </strong>To evaluate and detect factors that affect renal function changes (improvement) after successful pyeloplasty using Tc-99 m Diethylenetriaminepentaacetic (DTPA) renography in children and to predict renal scan changes after successful pyeloplasty.</p><p><strong>Methods: </strong>This retrospective study was conducted on children ≤ 18 years of age who underwent successful pyeloplasty from May 2018 to May 2022. Pelvic-abdominal ultrasonography and radioisotope scan Tc-99 m DTPA were performed in all patients.</p><p><strong>Results: </strong>Postoperative group showed a significant increase in renal parenchyma thickness, split renal function, and glomerular filtration rate with a decreased renal pelvis anteroposterior diameter (<i>p</i> < 0.05). There was a significant correlation between each postoperative decrease in the anteroposterior diameter of the renal pelvis and the postoperative increase in parenchyma thickness with the postoperative increase in split renal function. The equation used to detect postoperative split renal function and glomerular filtration rate had a high detection rate.</p><p><strong>Conclusions: </strong>Pyeloplasty resulted in significant improvements in hydronephrosis, and renal parenchymal changes in association with renal pelvis diameter can predict Postoperative increase in split renal function and glomerular filtration rate.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"301-306"},"PeriodicalIF":1.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penile shear-wave elastography predicts the outcome of botulinum neurotoxin (Botox) in the management of non-responders to phosphodiesterase-5-inhibitors: A pilot study.","authors":"Mohamed Wael Ragab, Khaled Ahmed Shawky, Ahmed Zein Eldin Fathy Bendary, Abo-Almagd Mohamed Albohy","doi":"10.1080/20905998.2025.2451488","DOIUrl":"10.1080/20905998.2025.2451488","url":null,"abstract":"<p><strong>Objective: </strong>Botulinum neurotoxin (BoNT) was introduced as a minimally invasive treatment option for erectile dysfunction (ED). However, there is no proven method that predicts improvement after BoNT injection. Shear wave elastography is an emerging imaging modality that evaluates tissue stiffness. This study aims to assess the reliability of SWE in predicting BoNT response in patients with ED and phosphodiesterase 5 inhibitors (PDE-5i) non-responders.</p><p><strong>Methods: </strong>This study comprised 20 men presenting with ED and PDE-5i non-responders. Mean tissue stiffness values (TSVs) were measured by SWE, international index of erectile function (IIEF-5), erection hardness score (EHS), sexual encounter profile questions 2 and 3 (SEP-2 and SEP-3), and global assessment questionnaire (GAQ) were evaluated before and after 100 IU of BoNT injection by 6 and 12 weeks.</p><p><strong>Results: </strong>In comparison with baseline, there was a significant improvement in IIEF-5 and EHS scores after BoNT injection at 6- and 12 weeks (<i>p</i> < 0.001). Similar improvements were observed in SEP-2&3 (<i>p</i> < 0001 & <i>p</i> = 0.001, respectively) and GAQ-1&2 (<i>p</i> = 0.008 & <i>p</i> = 0.006, respectively). We found that mean SWE in a penile flaccid state can predict failure of clinically significant improvement after BoNT injection using a cutoff point of 12.7 kPa (sensitivity = 100%, specificity = 54%, AUC = 0.86, <i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>This finding could be applied to avoid unnecessary BoNT injections in men with ED and PDE-5i non-responders.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"281-286"},"PeriodicalIF":1.2,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluoxetine, a selective serotonin reuptake inhibitor, versus desmopressin in primary monosymptomatic nocturnal enuresis: A randomised controlled trial.","authors":"Abdelwahab Hashem, Hesham Torad, Ahmed Mohamed Soleiman, Hesham Abdel-Azim El-Helaly","doi":"10.1080/20905998.2024.2448386","DOIUrl":"10.1080/20905998.2024.2448386","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of fluoxetine 20 mg, a selective serotonin reuptake inhibitor, versus the standard treatment, desmopressin 0.2 mg, in primary monosymptomatic nocturnal enuresis (PMNE) treatment.</p><p><strong>Patients and methods: </strong>This was a single-blinded randomized controlled clinical trial. Children ≥7 years old on urotherapy and who still had severe PMNE were screened for eligibility. Children were maintained on 20 mg of fluoxetine or desmopressin 0.2 mg orally once daily for 3 months. The primary outcome for this trial was to assess the efficacy of both drugs as quantified by the change from baseline in the frequency of nocturnal enuresis at three months. The secondary endpoints were treatment-related side effects and nighttime arousal.</p><p><strong>Results: </strong>The baseline parameters were comparable between both groups. The response to treatment at 1 month as non-responders (NR), partial responders (PR), and complete responders (CR) was 69%, 24.1%, and 6.9% versus 57.1%, 32.1%, and 10.7% in fluoxetine and desmopressin groups, respectively (<i>p</i> = 0.65). At the third month, the NR, PR, and CR were 69%, 31%, and 0% versus 57.1%, 32.1%, and 10.7% in fluoxetine and desmopressin groups, respectively (<i>p</i> = 0.18). Nighttime arousal was better in the fluoxetine group (41.4%) versus 14.3% in the desmopressin group, <i>p</i> = 0.02, at the first month, and it decreased to 31% in the fluoxetine group versus 14.3% in the desmopressin group, <i>p</i> = 0.13, at the third month.</p><p><strong>Conclusion: </strong>Fluoxetine 20 mg, a selective serotonin reuptake inhibitor, is non-inferior to desmopressin 0.2 mg for the management of PMNE. Fluoxetine improves nighttime arousal significantly at the first month. This improvement becomes insignificant at the third month.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"294-300"},"PeriodicalIF":1.2,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Male accessory gland infection (MAGI): Over-diagnosed or under treated in infertile men?","authors":"Sulagna Dutta, Fahmi Bahar, Aldo E Calogero, Rupin Shah, Ashok Agarwal","doi":"10.1080/20905998.2024.2445332","DOIUrl":"10.1080/20905998.2024.2445332","url":null,"abstract":"<p><p>Male accessory gland infection (MAGI) is a significant yet often under-recognized contributor to male infertility. This review article provides a comprehensive synopsis of MAGI, distinguishing it from male genital tract infection (MGTI) and emphasizing the challenges posed by asymptomatic cases. It concisely presents the pathophysiology of MAGI, highlighting the inflammatory response characterized by leukocyte infiltration, elevated pro-inflammatory cytokines, and increased production of reactive oxygen species, which collectively impair sperm quality and fertilizing capability. The article discusses the complexities in diagnosis due to the overlap with benign conditions and presents emerging diagnostic markers. It also critically reviews the controversies surrounding the over-diagnosis and under-treatment of MAGI, emphasizing the need for improved diagnostic accuracy to encourage appropriate treatment. Current therapeutic strategies are explored, revealing variable efficacy and the importance of personalized approaches. This review aims to provide a clear understanding of the clinical implications of MAGI and to guide accurate diagnosis and effective treatment, ensuring better fertility outcomes for affected patients.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 3","pages":"201-209"},"PeriodicalIF":1.2,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing VIRADS score for image-guided assessment of muscle invasiveness in bladder cancer pre-TURBT: An updated meta-analysis.","authors":"Ahmad R Al-Qudimat, Doaa Sabir, Muna Elamin, Mica Ching, Seif B Altahtamouni, Kalpana Singh, Ibrahim A Khalil, Khalid Alrumaihi","doi":"10.1080/20905998.2024.2442256","DOIUrl":"10.1080/20905998.2024.2442256","url":null,"abstract":"<p><strong>Background: </strong>Bladder urothelial carcinoma is the most prevalent malignancy of the urinary system worldwide. Accurate staging of bladder cancer, particularly distinguishing between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC), is essential for determining appropriate treatment. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy, sensitivity, and specificity of the vesical imaging-reporting and data system (VI-RADS) scoring system using multiparametric MRI in differentiating NMIBC from MIBC.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines. Comprehensive searches were performed in PubMed, Web of Science, Embase, and Cochrane databases up to December 2023. Studies that evaluated the diagnostic accuracy of the VI-RADS scoring system using multiparametric magnetic resonance imaging (MRI) to distinguish between NMIBC and MIBC were included. Data from eligible studies were extracted to calculate pooled sensitivity and specificity, and heterogeneity was assessed using meta-regression and subgroup analyses by using STATA V17.0.</p><p><strong>Results: </strong>A total of 31 studies, comprising 3,798 bladder cancer patients, were included in the meta-analysis. The pooled sensitivity and specificity for predicting MIBC using a VI-RADS cutoff score of ≥ 3 was 89%, with moderate heterogeneity observed across studies. Subgroup analysis revealed variations in diagnostic performance based on geographic location (North America, Europe, and Asia), MRI technical parameters, and study design. Studies utilizing 3.0 Tesla MRI scanners and those involving multiple radiologists demonstrated higher diagnostic accuracy.</p><p><strong>Conclusion: </strong>The VI-RADS system demonstrates high diagnostic accuracy in distinguishing between NMIBC and MIBC, with a cutoff score of ≥ 3 yielding optimal sensitivity and specificity. Its integration into clinical practice has the potential to reduce the need for invasive procedures, improve staging accuracy, and expedite treatment decisions. Future research should focus on standardizing MRI protocols and further validating these findings across diverse clinical settings to enhance the utility of VI-RADS in bladder cancer management.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 2","pages":"97-108"},"PeriodicalIF":1.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of smartphone technology for capturing videos and images of semen analysis samples: A cross-sectional study.","authors":"Anju Khairwa, Pratibha Gautum, Richa Gupta","doi":"10.1080/20905998.2024.2441109","DOIUrl":"10.1080/20905998.2024.2441109","url":null,"abstract":"<p><strong>Background: </strong>Semen analysis is an essential indicator of male infertility potential. The study aims to assess the diagnostic accuracy of smartphones compared to manual microscopy for semen analysis.</p><p><strong>Method: </strong>It is a cross-sectional analytical study with investigator blinding. Data were collected from August to September 2023. Pictures of semen analysis were captured through light microscopy and stored in a coded format on a smartphone. Later, the results of both methods were compared.</p><p><strong>Results: </strong>A total of 50 adequate semen samples were included. The age of enrolled males was Mean±SD 29.4 ± 5.9 years. The sensitivity and specificity were 100% (95% CI 83.9%-100%) and (95% CI 88.1%-100%), respectively, for smartphones compared to light microscopy for total sperm counts. The positive predictive value (PPV) and negative predictive value (NPV) were both 100%, with (95% CI 83.9%-100%) and (95% CI 88.1%-100%), respectively. Sensitivity, specificity, PPV, and NPV for total sperm motility were 97.9%, 100%, 100%, and 66%, respectively. For normal morphology sperm, the sensitivity, specificity, PPV, and NPV of smartphones were 72.7%, 82.1%, 53.3%, and 91.4%, respectively, and for abnormal morphology sperm, they were 100%, 98%, 50%, and 100%, respectively. Smartphones exhibited a sensitivity of 98%, specificity of 100%, PPV of 100%, and NPV of 50% for assessing sperm vitality. The diagnostic agreement between smartphones and light microscopy was very good (κ value -0.6-1) for the detection of total count, vitality, and total motility of sperm.</p><p><strong>Conclusion: </strong>Smartphone technology demonstrates high sensitivity and specificity for semen analysis compared to manual microscopy. It also shows excellent agreement with manual microscopy for most parameters in semen analysis. We recommend smartphone reporting for semen analysis in remote areas and poor resource settings.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"266-272"},"PeriodicalIF":1.2,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in urology: Revolutionizing diagnostics and treatment planning.","authors":"Kirolos Eskandar","doi":"10.1080/20905998.2024.2443334","DOIUrl":"10.1080/20905998.2024.2443334","url":null,"abstract":"<p><p>Artificial Intelligence (AI) is rapidly transforming the field of urology, offering unprecedented advancements in diagnostics and treatment planning. This review explores the integration of AI across various urological practices, highlighting its impact on improving diagnostic accuracy, optimizing treatment strategies, and enhancing patient monitoring. We examine the role of AI in imaging, pathology, and personalized medicine, as well as its contributions to robotic-assisted surgeries and remote patient care. The article also addresses the ethical and legal challenges posed by AI, including issues of data privacy, algorithmic bias, and regulatory oversight. Despite these challenges, the potential of AI to revolutionize urology is immense, promising more precise, efficient, and patient-centered care. As AI technologies continue to evolve, their integration into urology will likely lead to significant improvements in patient outcomes and the overall quality of care.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 4","pages":"341-347"},"PeriodicalIF":1.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted partial nephrectomy in complex renal tumors using the Versius platform: An initial but promising experience.","authors":"Mahmoud A Abdelhakim, Mohamed Abdelwahab","doi":"10.1080/20905998.2024.2442268","DOIUrl":"10.1080/20905998.2024.2442268","url":null,"abstract":"<p><strong>Background and objectives: </strong>The widespread utilization of robotic surgeries in urology encouraged several teams to explore the option of performing robot-assisted partial nephrectomy (RAPN), taking advantage of its magnified stereoscopic vision and the articulating instruments that facilitate tumor resection and the reconstructive steps of hemostasis and renorrhaphy. The implementation of the CMR Versius system in RAPN, especially in complex masses, has not been explored yet. Herein, we present our initial experience in performing RAPN in complex renal masses using this novel platform.</p><p><strong>Methods: </strong>Between July 2022 and November 2023, thirty patients who had complex renal masses and were candidates for RAPN were enrolled in this study. Tumor complexity was assessed using the preoperative aspects of the dimension used for anatomic (PADUA) nephrometry scores. Perioperative data were prospectively collected and analyzed. 'TRIFECTA' was defined as free surgical margins, warm ischemia time (WIT)< 30 minutes, and no major complications (>Clavien-Dindo II).</p><p><strong>Results: </strong>All cases were successfully completed with no conversion to radical, open, or laparoscopic surgery. The median PADUA score was 9.5 (8-11). The mean docking time, console time, and total operative time were 9.17 ± 0.91, 149 ± 14.27, and 177.17 ± 29.53 minutes, respectively. The mean WIT was 26.67 ± 3.66 minutes. Surgical margins were free in all cases. TRIFECTA was fulfilled in 25/30 patients (83.33%). Five patients (16.66%) did not fulfill TRIFECTA; two patients had prolonged WIT > 30 minutes, two had prolonged WIT with prolonged urine leakage necessitating DJ stent insertion, and the fifth patient had only prolonged urine leakage and DJ insertion. None of the patients developed tumor recurrence or acute kidney injury during follow-up.</p><p><strong>Conclusion: </strong>Performing RAPN with the CMR Versius platform is a feasible option in complex renal masses with slightly increased but accepted WIT and total operative time. It should be wisely restricted to well-experienced teams.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"23 2","pages":"145-151"},"PeriodicalIF":1.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}