BMC Urology最新文献

{"title":"Enhancing pediatric robotic pyeloplasty with a no-touch urothelium approach: a case series.","authors":"Niklas Pakkasjärvi, Pyry Jaakkola, Liisi Ripatti, Seppo Taskinen","doi":"10.1186/s12894-025-01782-y","DOIUrl":"https://doi.org/10.1186/s12894-025-01782-y","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted laparoscopic surgery has advanced minimally invasive urology. However, the absence of haptic feedback may increase the risk of tissue trauma. This case series evaluates a no-touch technique in robotic-assisted pyeloplasty to minimize urothelial handling and assess its feasibility and short-term outcomes.</p><p><strong>Methods: </strong>This retrospective case series reviewed 20 pediatric patients with ureteropelvic junction obstruction treated with robotic-assisted pyeloplasty between 2019 and 2022. In 10 cases, a no-touch urothelium approach was applied to minimize direct tissue handling. Patient selection, surgical details, perioperative outcomes, and follow-up at 6 and 12 months were documented.</p><p><strong>Results: </strong>The no-touch approach was successfully implemented in all cases without intraoperative complications. Median console time was 98 min (IQR: 81-131). Postoperative outcomes were favorable, with significant improvement or resolution of hydronephrosis in all cases. No major complications occurred, and no anastomotic strictures were observed during follow-up.</p><p><strong>Conclusions: </strong>The no-touch technique in robotic-assisted pyeloplasty is a feasible approach that maintains surgical efficiency while minimizing direct urothelial handling. Further studies with larger sample sizes and longer follow-up are needed to validate its potential benefits.</p><p><strong>Trial registration: </strong>This study was approved by the Institutional Review Board of New Children's Hospital, Helsinki University Hospital (permit nr 5485), Finland.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"94"},"PeriodicalIF":1.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rolling stone: migration of an intrauterine device leading to bladder stone formation nine years after insertion: a case report.","authors":"Elie G Malki, Dina Sbeih, Peter Bael, Haitham Alsarabta, Ahmad Alzawahra","doi":"10.1186/s12894-025-01780-0","DOIUrl":"https://doi.org/10.1186/s12894-025-01780-0","url":null,"abstract":"<p><strong>Background: </strong>Intrauterine devices are safe, affordable, convenient, and the most common form of contraception used by females of childbearing age in Palestine. A rare complication of intrauterine devices is migration to nearby structures, rarely the urinary bladder, leading to bladder stone formation.</p><p><strong>Case presentation: </strong>A 34-year-old female patient presented due to repeated urinary tract infections and flank pain associated with lower urinary tract symptoms, including dysuria, frequency, and gross hematuria. Subsequent laboratory tests revealed a past medical history of iron-deficiency anemia. Urinalysis revealed hematuria and pyuria, and the urine culture confirmed colonization of Escherichia coli. Computed tomography revealed an irregularly shaped 5.5 cm hyperdense calculus in the urinary bladder. Open cystolithotomy was done to extract the calculus, which was later incidentally revealed to be encrusting a migrated intrauterine device.</p><p><strong>Conclusions: </strong>This case highlights the rare potential for intrauterine devices to migrate to the urinary bladder, leading to calculus formation, which, in this case, was discovered in this patient nine years post-insertion. The intrauterine device perforation into the urinary bladder was due to delayed inflammatory migration. This case underscores the critical need for both patient and physician education in low-resource settings on the warning signs of intrauterine device migration, including new-onset irritative lower urinary tract symptoms, hematuria, and missing intrauterine device threads, ensuring routine scheduled follow-ups, patient self-checks, and timely imaging can aid in early detection and prevent complications associated with intrauterine device migration.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"93"},"PeriodicalIF":1.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative outcomes using template mapping after radical cystectomy and extended lymph node dissection.","authors":"Salvador Jaime-Casas, Ahmad Imam, Daniel J Lama, Oluwatimilehin Okunowo, Clayton S Lau, Kevin G Chan, Bertram E Yuh","doi":"10.1186/s12894-025-01776-w","DOIUrl":"https://doi.org/10.1186/s12894-025-01776-w","url":null,"abstract":"<p><strong>Background: </strong>To evaluate oncologic and perioperative outcomes of extended pelvic lymph node dissection (PLND) during robot-assisted radical cystectomy (RARC) based on the location of lymph node positivity (LN⁺).</p><p><strong>Methods: </strong>We reviewed a tertiary center database of patients with bladder cancer who underwent extended PLND during RARC from 2004 to 2020. Patients were assigned to a standard (sPLN⁺) or extended (ePLN⁺) cohort based on LN⁺ location. ePLN⁺ patients were LN⁺ in one or more of the following: common iliac, presacral, aortic bifurcation, or paracaval packets. The Kaplan-Meier method estimated recurrence-free survival (RFS) and overall survival (OS). Perioperative 90-day complications were identified using the Clavien-Dindo system.</p><p><strong>Results: </strong>Ninety patients were included; 43 (48%) were sPLN^+, and 47 (52%) were ePLN⁺. The median follow-up for sPLN⁺ and ePLN⁺ patients was 14.9 and 20.0 months, respectively. ePLN⁺ patients were older than sPLN⁺ patients (median age 75 vs. 68 years, p = 0.019). There were more ≤ cT1 LN⁺ patients in the sPLN⁺ cohort compared to the ePLN⁺ cohort (26% vs. 9%, p = 0.037). We recorded no differences in 90-day mortality or in RFS or OS between baseline and 12-year follow-up between groups (all, p > 0.05). Overall, the grade II or higher complication rate was 71%, with similar rates for the sPLN⁺ and ePLN⁺ (77% vs. 66%, p = 0.26) cohorts.</p><p><strong>Conclusion: </strong>Location of LN⁺ does not affect oncologic outcomes in patients who underwent extended PLND. This underscores the lack of a notable therapeutic benefit beyond the standard dissection template.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"91"},"PeriodicalIF":1.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for the success of subureteric injection in renal transplant patients with vesicoureteral reflux.","authors":"Alkım Tolga Varol, Ahmet Ender Caylan, Murat Uçar","doi":"10.1186/s12894-025-01779-7","DOIUrl":"https://doi.org/10.1186/s12894-025-01779-7","url":null,"abstract":"<p><strong>Background: </strong>Predicting the success of endoscopic treatment of VUR in transplant patients may not only protect both the physician and the patient from unnecessary investigations and treatment but may also prolong the life of the graft by preventing possible loss of time.</p><p><strong>Methods: </strong>This retrospective study included 116 patients with vesicoureteral reflux following kidney transplantation between 2014-2022. Demographic data, preoperative and intraoperative clinical aspects, and postoperative 6^th-month success rates were evaluated.</p><p><strong>Results: </strong>The success rate of the injection treatment in the 6^th month was 41.4%. As the patient age decreased, the success rate of the injection decreased (p = 0.025). While no significant relationship was observed between the preoperative reflux grade, injected volume of the bulking agent, and success (p = 0.109 and 0.222, respectively), a significant decrease in success was observed with an increase in UDR (p < 0.001) in group comparison. Regression analyses demonstrated that pre-injection visual assessment and post-injection orifice mound view influenced the success rate (p < 0.001 and p < 0.001, respectively).</p><p><strong>Conclusions: </strong>Intraoperative visual assessment of the orifice is a reliable indicator for predicting the success of subureteric injection. It not only provides patients with trustworthy postoperative information but also saves clinicians time by anticipating the next surgical stage, ultimately contributing to the prolongation of graft life.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"92"},"PeriodicalIF":1.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectral CT findings of bladder urothelial carcinoma with gastric metastasis: a case report.","authors":"Gang Wang, Li-Li Wang, Dian-Dian Deng, Han-Xin Xu, Sheng-Hui Yu, Yu Wang","doi":"10.1186/s12894-025-01783-x","DOIUrl":"https://doi.org/10.1186/s12894-025-01783-x","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer is one of the most common cancers worldwide, and urothelial carcinoma is the most common form of bladder cancer. Gastric metastasis of urothelial carcinoma of the bladder is a rare condition. Cystoscopy plays an important role in the diagnosis of bladder cancer; however, it is an invasive procedure that may affect the patient's prognosis and does not allow for the observation of cancer infiltration and metastasis. Therefore, non-invasive imaging is increasingly becoming the most appropriate method for the diagnosis and follow-up of urothelial carcinoma.</p><p><strong>Case presentation: </strong>A 51-year-old female patient presented with pain in the lower abdomen and lower back for more than 2 months. This was a case of bladder urothelial carcinoma with gastric metastases, confirmed by pathology using dual-layer detector computed tomography (CT) spectral multiparametric imaging. The stage of the cancer was cT3N+M1b IVB, and the dimensions were 11.6 mm×42.2 mm×44.4 mm. The energy spectrum multiparameter image shows good consistency in the quantitative measurement of multiple nodules on the gastric wall and bladder wall masses (single energy 40 keV-CT value, iodine concentration, effective atomic number), and the spectral curve runs basically consistent. After 5 months of chemotherapy, the slope values of the spectral curve were 3.74 and 3.09 in the initial and follow-up spectral CT scans, respectively, reflecting the improvement of bladder wall lesions after treatment.</p><p><strong>Conclusions: </strong>The present case is a very rare case of bladder urothelial carcinoma with gastric metastasis. We applied multi-parameter quantitative indicators of spectral CT to more accurately show the homology characteristics of gastric metastasis and bladder cancer, and also reflected the different sources of cystic lesions in the left adnexal region from bladder cancer and gastric metastasis. Spectral CT has a promising application prospect in detecting the homology of different lesions and diagnosing urothelial gastric metastasis carcinoma.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"90"},"PeriodicalIF":1.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of intraoperative furosemide and dexamethasone on complications following mini-percutaneous nephrolithotripsy: a retrospective propensity score-matched cohort study.","authors":"Guilin Wang, Qihui Zheng, Wentao Ma, Enguang Yang, Suoshi Jing, Luyang Zhang, Qi Jin, Qiqi He, Xiaoran Li, Zhiping Wang","doi":"10.1186/s12894-025-01778-8","DOIUrl":"https://doi.org/10.1186/s12894-025-01778-8","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of intraoperative use of furosemide (FUR) in combination with dexamethasone (DEX) on postoperative complications following mini-percutaneous nephrolithotripsy (mini-PCNL).</p><p><strong>Patients and methods: </strong>The study was a retrospective cohort analysis of adult patients with kidney calculi treated with mini-PCNL. Exposure was the intravenous administration of FUR and DEX during mini-PCNL. The primary outcome was postoperative fever (≥ 38°C), whereas the secondary outcomes were other complications. Propensity score matching (PSM) was performed at a 1:1 ratio. Subgroup analyses and interaction tests were used to examine differences among different demographic groups.</p><p><strong>Results: </strong>The pre-matched and propensity score-matched cohorts included 237 and 166 patients, respectively. In the PSM cohort, postoperative fever (≥ 38°C) occurred in 8.4% (7/83) of the FUR + DEX group and 20.5% (17/83) of the control group. The combined use of FUR and DEX was associated with a lower postoperative fever (P = 0.027). There was no statistically significant difference between the FUR + DEX group and the control group for other complications, including SIRS, urosepsis, and pain-requiring opioids. SIRS occurred in 4.8% (4/83) of the FUR + DEX group versus 8.4% (7/83) in the control group, while urosepsis rates were 2.4% (2/83) versus 3.6% (3/83), respectively. Subgroup analysis showed a significant reduction in postoperative fever in patients with an operation time of ≥ 2 h in the FUR + DEX group, as indicated by the interaction test (P = 0.05).</p><p><strong>Conclusion: </strong>The intravenous combined use of FUR and DEX in mini-PCNL reduces postoperative fever (≥ 38°C), particularly benefiting patients with an operative time of ≥ 2 h.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"88"},"PeriodicalIF":1.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of bladder function in children with familial mediterranean fever and outcomes: A retrospective study.","authors":"Sevim Yener, Şeyma Türkmen, Mehmet Oğuzhan Ağaçli, Zekeriya Ilçe, Betül Sözeri","doi":"10.1186/s12894-025-01777-9","DOIUrl":"https://doi.org/10.1186/s12894-025-01777-9","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate bladder functions in patients diagnosed with familial Mediterranean fever but without urological complaints using non-invasive methods.</p><p><strong>Materials and methods: </strong>Patients aged between 6 and 17 years diagnosed with FMF were included in the study. Complete urinalysis, ultrasonography (renal parenchymal thickness, hydronephrosis, bladder wall thickness, postmicturition residual urine) were recorded for the patients. Uroflowmetry was performed for the patients.</p><p><strong>Results: </strong>A total of 51 patients were included in the study, 28 of whom were female (54.9%) and 23 were male (45.1%). The mean age of the patients was 11.8 (± 3.8) years. Hydronephrosis was detected in 3 patients (5.9%) in the ultrasonography. The mean bladder wall thickness measured was 1.14 (± 1.6) mm. Significant postmicturition residual urine (> 20 ml) was recorded in 15 patients. There was a statistically significant positive relationship between uroflowmetry bladder capacity (UFM-BV) values (p < 0.001). Normal Q max values were measured in 9 patients (17.6%).</p><p><strong>Conclusion: </strong>Considering the inflammatory effect of FMF, it is important to evaluate bladder function in asymptomatic patients with parameters measured by uroflowmetry to predict its long-term effects. Additionally, ultrasonographic measurement may be misleading in the evaluation of bladder capacity.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"89"},"PeriodicalIF":1.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring dysfunctional voiding in girls: a comprehensive literature review of assessment and management strategies.","authors":"Maryam Sadeghi, Iman Menbari Oskouie, Alvand Naserghandi, Alireza Arvin, Masoumeh Majidi Zolbin","doi":"10.1186/s12894-025-01772-0","DOIUrl":"https://doi.org/10.1186/s12894-025-01772-0","url":null,"abstract":"<p><p>Dysfunctional voiding (DV) is a multifactorial functional problem that refers to dysfunction during voiding. DV is clinically important because it increases the risk of urinary tract infections, mostly due to incomplete bladder emptying, and unfavorably affects renal function. Additionally, a child with DV may experience storage symptoms such as frequency and wetting, which can significantly impact the child's quality of life. There is also a correlation between DV with bowel dysfunction and behavioral disorders. Girls with external urethral meatus anomalies, like hypospadias and/or meatal web, are more prone to complications related to DV. Therefore, girls exhibiting DV symptoms should also be evaluated for meatus anomalies. These patients often contract their external urethral sphincter and pelvic floor musculature, leading to voiding problems. Successful treatment involves applying appropriate diagnostic approaches. In girls with DV, urotherapy and biofeedback are considered gold standard modalities for retraining pelvic floor muscle function synchronously and properly. Although new emerging techniques such as stem cell therapy could improve urinary incontinence in adults and animal models with damaged external urethral sphincters, there is currently a lack of evidence regarding its therapeutic potential for children with DV.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"87"},"PeriodicalIF":1.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced stone-free rates with suctioning ureteral access sheath vs. traditional sheath in retrograde intrarenal surgery: a systematic review and meta-analysis.","authors":"Felipe Giraldo Alvarez Gonçalves, Breno Cordeiro Porto, Bruno Damico Terada, João Victor Gruner Turco Spilborghs, Carlo Camargo Passerotti, Rodrigo A S Sardenberg, Jose Pinhata Otoch, Jose Arnaldo Shiomi Da Cruz","doi":"10.1186/s12894-025-01775-x","DOIUrl":"https://doi.org/10.1186/s12894-025-01775-x","url":null,"abstract":"<p><strong>Background: </strong>As a safe approach to the upper urinary tract, flexible ureteroscopic lithotripsy (fURL) is a widely accepted treatment for nephrolithiasis. Sometimes, this technique can rely on the natural expulsion of stones, increasing the risk of infections and stone recurrence. To mitigate these issues, some studies tried to use a suctioning ureteral access sheath (S-UAS).</p><p><strong>Methods: </strong>A systematic review was conducted across multiple databases for trials comparing S-UAS with traditional (T-UAS) in retrograde intrarenal surgery (RIRS). The primary endpoint was the stone-free rate (SFR), while adverse effects, operative time, fever rate, and hospital stay were analyzed as secondary outcomes.</p><p><strong>Results: </strong>We retrieved 8 articles, encompassing a total of 2,255 patients, with 978 in the S-UAS group and 1,247 in the T-UAS group. Our analysis revealed a higher SFR in the S-UAS group after 1 day, and also at later time points (one or three months) (OR 3.79; 95% CI 1.70-8.46; p = 0.001; I² = 89.2%) and (OR 1.98; 95% CI 1.52-2.59; p < 0.001; I² = 0%), respectively. Regarding surgical complications, we observed a lower incidence in the S-UAS group (OR 0.37; 95% CI 0.26-0.51; p < 0.001; I² = 0%), as well as a reduced fever rate (OR 0.34; 95% CI 0.24-0.48; p < 0.001; I² = 0%) and a shorter length of hospital stay (MD -0.11; 95% CI -0.16 to -0.05; p < 0.001; I² = 39.6%). No differences were found in the operative time between both approaches (MD -2.49; 95% CI -7.62-2.65; p < 0.343; I² = 88.3%).</p><p><strong>Conclusion: </strong>Our study suggests that using S-UAS in RIRS may enhance the SFR, and also reduce both complications and hospital stay.</p><p><strong>Trial registration: </strong>This systematic-review and meta-analysis was prospectively registered on PROSPERO under protocol CRD42024543084.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"86"},"PeriodicalIF":1.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stapled vs. manually sutured bowel anastomosis in robot-assisted radical cystectomy: a single-center retrospective analysis.","authors":"Thomas Hermans, Giel Schevenels, Steve Motmans, Thomas De Sutter, Yannic Raskin","doi":"10.1186/s12894-025-01763-1","DOIUrl":"https://doi.org/10.1186/s12894-025-01763-1","url":null,"abstract":"<p><strong>Background: </strong>Radical cystectomy is the primary treatment for muscle-invasive bladder cancer and certain cases of high-risk non-muscle-invasive disease. Robot-assisted cystectomy techniques (RARC) have emerged as a minimally invasive alternative to traditional open surgery, offering enhanced precision and potentially improved recovery. Bowel anastomosis remains a critical step in these procedures, with manually sutured anastomosis offering a cost-effective alternative to the standard stapled technique. However, concerns remain regarding its impact on surgical outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective study of 92 patients who underwent RARC in our hospital between March 2021 and November 2023. Bowel anastomosis was performed using either stapled (n = 33) or manually sutured techniques (n = 59). Key outcome parameters included gastro-intestinal (GI) complications, overall complications, operation duration, length of hospital stay, readmissions, and postoperative recovery metrics.</p><p><strong>Results: </strong>GI complications occurred in 23 patients (25%), with paralytic ileus being the most common (17%). The rates of GI complications were comparable between the manually sutured (27%) and stapled (21%) groups (p = 0.530, odds ratio 1.38). The mean operation duration was 300 min for the sutured group and 313 min for the stapled group (p = 0.124). The median hospital stay was similar at 8 days (p = 0.384) for both groups. Readmission rates were higher in the sutured group (25% vs. 6%, p = 0.022, odds ratio 5.28), but this was predominantly due to non-GI complications.</p><p><strong>Conclusion: </strong>This study indicates that outcomes are comparable between stapled and manually sutured bowel anastomosis in RARC, with no significant increase in overall complications, GI complications, operation duration or hospital stay if using a manually sutured anastomosis. Considering the low cost of manual suturing, this technique seems highly cost-effective and could be considered a viable alternative to existing stapling techniques.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"85"},"PeriodicalIF":1.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}