BMC Urology最新文献

{"title":"An advantageous practical modification in mini-laparoscopic pyeloplasty for prepubertal children: Extracorporeal ureteral spatulation, suturing and stenting - EUSSS technique.","authors":"Ali Sezer, Bilge Turedi, Emre Bulbul","doi":"10.1186/s12894-024-01645-y","DOIUrl":"10.1186/s12894-024-01645-y","url":null,"abstract":"<p><strong>Background: </strong>Ureteral spatulation, the first ureteral suture, and double-J stenting may be challenging and time-consuming in laparoscopic pyeloplasty, especially in small children. We aimed to present our comparative results of the extracorporeal ureteral spatulation, suturing, and stenting (EUSSS) technique in mini-laparoscopic pyeloplasty (MLP) and the conventional intracorporeal technique in prepubertal children.</p><p><strong>Methods: </strong>The data of 46 prepubertal pediatric patients (< 12 years) who underwent laparoscopic pyeloplasty by a single surgeon between January 2021 and October 2023 were retrospectively reviewed. The patients were divided into two groups: who underwent EUSSS-MLP (Group-1, n = 26) and who underwent conventional intracorporeal pyeloplasty (Group-2, n = 20).</p><p><strong>Results: </strong>The mean age of all patients was 5.3 years (4.8 ± 2.8 years in Group-1 and 6.0 ± 2.1 years in Group-2 p = 0.126). The mean duration of ureteral preparation plus double-J stenting was 5.7 ± 1.6 min in Group-1 and 19.2 ± 4.1 min in Group-2 (p < 0.0001). The mean duration of surgery was statistically significantly higher in Group-2 (p = 0.034). There was no significant difference in terms of postoperative complications (p = 0.482). Laparoscopic pyeloplasty was successful in 42 (91.3%) patients, with no statistically significant difference between the two groups (Group-1: 24 (92.3%), Group-2:18 (90%), p = 0.783).</p><p><strong>Conclusion: </strong>Extracorporeal ureteral preparation and double-J stenting can be safely and effectively preferred in MLP for prepubertal children.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"251"},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615182","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":"Characteristics and outcomes in bladder Leiomyoma management: a systematic review of case reports and case series from the past 20 years.","authors":"Johannes Cansius Prihadi, Antoninus Hengky, Stevan Kristian Lionardi, Sean Peter Haruman","doi":"10.1186/s12894-024-01624-3","DOIUrl":"10.1186/s12894-024-01624-3","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder leiomyomas (LM) are uncommon, non-cancerous growths that originate from the smooth muscle cells of the bladder and constitute 0.5% of bladder tumor cases. This review aims to compile existing data and present a summary of bladder leiomyomas' characteristics, management, and related outcomes.</p><p><strong>Method: </strong>We conducted systematic review of studies that investigated bladder leiomyoma. Case studies or series describing individuals with bladder leiomyoma who underwent surgery and the outcomes were included. Four databases were used in our literature search, which was carried out until January 2024: PubMed, Proquest, EBSCOHost, and Google Scholar. We utilized MeSH terms such as \"leiomyoma,\" \"urinary bladder,\" and looked for synonyms of \"bladder leiomyoma\" in free text.</p><p><strong>Results: </strong>A total of 99 studies with 119 patients were included. Most reported bladder leiomyoma cases were female, accounting for 79.0% of all cases. While symptomatic patients primarily presented with lower urinary tract symptoms (LUTS) (59.7%), hematuria (24.4%), acute urine retention (11.8%), and about 16.8% of cases were incidentally detected. Storage-related symptoms were the most common LUTS (37.0%). Different diagnostic techniques were used, frequently combining CT (Computed Tomography), MRI (Magnetic Resonance Imaging), USG (Ultrasonography), and/or cystoscopy. Bladder leiomyomas were commonly found on the left lateral wall (26.9%) and the bladder neck (17.6%). In more than half of the cases (52.1%) the treatment techniques used were transurethral resection (TURBt/TUR). Fifteen out of 119 cases (12.6%) had recurrence or remain symptomatic. Symptomatic symptoms at first presentation and extended location are frequently found among recurrent or symptomatic cases after first management.</p><p><strong>Conclusion: </strong>Management of bladder leiomyoma should focus on the relief of symptoms and recurrence and be personalized based on the tumor characteristics, patient symptoms, and surgeon's expertise. Further investigation is necessary to fully understand the best course of treatment and long-term results for bladder leiomyomas. In particular, prospective trials with bigger participant pools and meticulously controlled factors should be the main emphasis of this research.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"252"},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615184","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":"Chronic renal impairment predicts oncological outcomes in UTUC patients undergoing RNU.","authors":"Chris Ho-Ming Wong, Kang Liu, Hongda Zhao, Kubilay Sabuncu, Rahim Horuz, Selami Albayrak, Maria Del Pilar, Laguna Pes, Jean de la Rosette, Jeremy Yuen-Chun Teoh","doi":"10.1186/s12894-024-01627-0","DOIUrl":"10.1186/s12894-024-01627-0","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the relationship between pre-existing renal impairment and oncological outcomes in upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy (RNU) using data from a multicentre international registry.</p><p><strong>Patients and methods: </strong>Data on non-metastatic UTUC patients who underwent RNU were obtained from the Clinical Research Office of the Endourology Society Urothelial Carcinomas of the Upper Tract (CROES-UTUC) Registry. Patients were categorised into normal pre-operative renal function and chronic renal impairment (CKD) groups, with CKD defined as an estimated glomerular filtration rate below 60 mL/kg/1.73 m². Kaplan-Meier survival analysis was employed to investigate disease-free survival (DFS) and overall survival (OS). Multivariable Cox regression analysis was conducted to identify confounding variables.</p><p><strong>Results: </strong>A total of 1393 patients diagnosed with UTUC who underwent RNU between 2014 and 2019 were analysed. 875 patients (62.4%) had normal renal function, whilst 528 patients (37.6%) had CKD prior to RNU. The two groups had similar proportions of bladder cancer history, comparable cardiovascular comorbidity, similar tumour stage, and comparable proportions receiving laparoscopic or robotic-assisted RNU. In multivariable cox regression analysis, CKD was found to be associated with inferior DFS (HR = 1.419; 95%CI = 1.060-1.898; p = 0.019). Upon multivariable analysis, pre-existing renal impairment and higher T stage (HR = 4.613; 95%CI = 1.829-4.712; p < 0.001) and the use of adjuvant chemotherapy (HR = 1.858; 95%CI = 1.229-2.807; p = 0.003) were also found to associate with worse DFS. Significant cardiovascular disease and higher T stage were associated with worse OS. Existing renal impairment at baseline did not have any significant associated with OS.</p><p><strong>Conclusion: </strong>In this multicentre registry, preoperative chronic renal impairment was identified as an independent predictor of inferior DFS in patients undergoing RNU for non-metastatic UTUC. Preoperative CKD could serve as a clinical predictor of poorer oncological outcomes.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"250"},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615187","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":"Comparative study in distal hypospadias repair: a meatal-based flaps technic vs. tubularized incised plate urethroplasty.","authors":"Sinan Kılıç, Mehmet Kaba, İlhan Gecit","doi":"10.1186/s12894-024-01603-8","DOIUrl":"10.1186/s12894-024-01603-8","url":null,"abstract":"<p><strong>Objectives: </strong>Hypospadias is the most common anomaly of the male genital system after undescended testis. More than 200 surgical repair techniques have been described for the treatment of hypospadias due to many different meatus localisations and other accompanying anomalies. Kutlay defined a new technique in 2010 with 10 patients with distal hypospadias patients. We compared this new technique with tubularized incised plate urethroplasty (TIP) which is one of the most frequently performed methods.</p><p><strong>Methods: </strong>148 patients with hypospadias who underwent surgery at the Urology and Pediatric Surgery Clinic during the period of January 2010 to December 2022 in the first and 2nd clinic, were retrospectively analyzed. The study focused on the remaining 83 patients with distal hypospadias for the purpose of comparison.</p><p><strong>Results: </strong>The mean age of group one was 10.0 (± 6.9, range 2-27), while for group two it was 10.8 (± 5.9, range 3-23). There was no statistically significant difference between the two groups in terms of anatomical position of the meatus, stricture and fistula complications (p > 0.5).</p><p><strong>Conclusion: </strong>The Kutlay technique has been described as an easy-to-learn and feasible method with reliable results. No significant difference in complications was observed in this study compared with TIP, which is known as the standard technique worldwide. We would like to suggest that the method be considered for further evaluation with larger patient groups and different techniques.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"249"},"PeriodicalIF":1.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615192","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":"Trends of prostate cancer treatment in Ehime Prefecture, Japan: analysis of a hospital-based cancer registry.","authors":"Katsuyoshi Hashine, Natsumi Yamashita, Norihiro Teramoto","doi":"10.1186/s12894-024-01646-x","DOIUrl":"10.1186/s12894-024-01646-x","url":null,"abstract":"<p><strong>Background: </strong>We previously conducted a retrospective Japanese cohort study of patients who underwent radical prostatectomy (RP) between January 2010 and December 2020 in Ehime Prefecture. This study revealed an increase in the number of RP, but other treatment trends remained unclear. In the current study, we examined prostate cancer treatment in Ehime Prefecture using the hospital-based cancer registry of all designated cancer care hospitals and community cancer care hospitals belonging to the Council of Ehime Cancer Care Hospitals.</p><p><strong>Methods: </strong>Trends of prostate cancer were compared by year according to stage and treatment using data from the hospital-based cancer registry between 2011 and 2020.</p><p><strong>Results: </strong>The number of patients with stage 1 disease increased over time, but the proportion of patients with stage 1 disease among all patients decreased from 65.2% in 2012 to 56.9% in 2020. The number of patients with stage 2 disease also increased, but the proportion of such patients among all patients remained constant. Meanwhile, the proportions of patients with stage 3 or 4 disease increased significantly over time, while that of patients undergoing RP increased from 29.2% in 2011 to 45.7% in 2020 (P < 0.001). The proportion of patients receiving radiotherapy (RT) decreased from 25.8% in 2011 to 17.2% in 2020. The use of hormone therapy (HT) remained unchanged, and the proportion of patients undergoing observation fell from 11.0% in 2011 to 7.0% in 2020. A higher proportion of patients with stage 3 cancer received HT, and RT was more frequently used in stage 3 cancer than in stage 1-2 cancer. The use of HT increased with age.</p><p><strong>Conclusions: </strong>The data highlighted differences in prostate cancer stages and treatment over time. This information could be shared with both urologists and radiologists to improve treatment.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"248"},"PeriodicalIF":1.7,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615197","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":"Outcomes of nephrostomy and double J stent in malignant ureteral obstruction in the Palestinian practice.","authors":"Elisa Ghannam, Helen Musleh, Tamara Ahmad, Mahmoud Mustafa, Razan Odeh, Ramzi Shawahna","doi":"10.1186/s12894-024-01640-3","DOIUrl":"10.1186/s12894-024-01640-3","url":null,"abstract":"<p><strong>Background: </strong>Malignant ureteral obstruction (MUO) is a serious health condition in which a malignant tumor compresses the ureter. The optimal decompressive intervention in MUO remains unclear. This study was conducted to assess and compare renal function, the occurrence of ureterohydronephrosis (UHN), intraoperative, and postoperative complications among patients with MUO who underwent double J stenting (DJS) and percutaneous nephrostomy (PCN) in the Palestinian practice.</p><p><strong>Methods: </strong>This study was conducted in retrospective design in one of the main tertiary care hospitals in the West Bank of Palestine. The data were collected from the electronic health information system of the hospital for the patients with MUO who received either DJS or PCN as a decompressive intervention from January 2018 to January 2024.</p><p><strong>Results: </strong>In this retrospective analysis, 62 patients who had stage 2 to stage 4 cancer and suffered MUO were included. The mean age of the patients was 60.8 ± 13.6 years. Of the patients, 40 (64.5%) were male and 22 (35.5%) were female. Of the patients, 26 (41.9%) had urinary bladder cancer. Of the patients, 23 (37.1%) had flank pain and 16 (25.8%) had lower urinary tract symptoms. Of the patients, 34 (54.8%) experienced bilateral UHN and 28 (45.2%) experienced unilateral UHN. In this study, 43 patients (69.4%) received PCN, and 19 (30.6%) received DJS as a decompressive intervention. Of the patients, 36 (58.1%) suffered postoperative complications. Stent migration/slip, UTIs, and urosepsis were the most commonly reported postoperative complications. There were no statistically significant differences in the occurrence of intraoperative complications, postoperative complications, time elapsed from receiving the decompression intervention to the diagnosis of complications, ICU admission, prognosis of UHN, serum creatinine, and serum BUN between both decompressive interventions.</p><p><strong>Conclusion: </strong>Despite improvements in renal functions, creatinine and BUN levels remained abnormal even after receiving a decompressive intervention. Postoperative complications were frequently reported among patients who received DJS or PCN as decompressive interventions. Larger prospective studies are still needed to determine the optimal interventions to improve outcomes, quality of life, and survival rates of patients with DJS or PCN.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"245"},"PeriodicalIF":16.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602227","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":"Correction: Cellular angiofibroma of the female pelvic cavity: a case report.","authors":"Li Chen, Gumuyang Zhang, Hao Sun","doi":"10.1186/s12894-024-01641-2","DOIUrl":"10.1186/s12894-024-01641-2","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"246"},"PeriodicalIF":16.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602199","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 prognostic value of visible hematuria is only significant in T1a renal cell carcinoma: a single-center retrospective study.","authors":"Yongjie Zhang, Xintao Li, Shidong Zuo, Xin Ma, Lijun Chen, Liulin Xiong","doi":"10.1186/s12894-024-01635-0","DOIUrl":"10.1186/s12894-024-01635-0","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the prognostic value of visible hematuria in T1a renal cell carcinoma (RCC).</p><p><strong>Materials and methods: </strong>In the RCC database of the Chinese People's Liberation Army General Hospital Department of Urology, we assembled the records of patients with unilateral RCC over 18 years of age diagnosed between 2008 and 2019. The clinical stage was cT1, and the tumors ranged in size from 0 to 7 cm. The primary treatments were partial nephrectomy (PN) or radical nephrectomy (RN). Logistic regression analysis, Cox regression, interaction analysis, and Kaplan-Meier survival analysis were used to study the correlation between visible hematuria and progression-free survival (PFS), and cancer-specific survival (CSS).</p><p><strong>Results: </strong>A total of 7,610 patients with cT1 RCC comprised the study population, including 505 RCC patients with visible hematuria. The average follow-up time was 64.6 months (range: 12-144 months). Visible hematuria was significantly associated with the prognosis (PFS, hazard ratio [HR] = 2.7, P < 0.001; CSS, HR = 4.2, P < 0.001) of T1a RCC, but was more significant for CSS in cases of a tumor size ≤ 2 cm (HR = 26.8, P = 0.026). This effect was not significant in T1b RCC (PFS, HR = 0.7, P = 0.153; CSS, HR = 1.1, P = 0.862). The interaction between visible hematuria and tumor size was significant (P = 0.001).</p><p><strong>Conclusions: </strong>This study showed that visible hematuria was an independent risk factor for PFS and CSS in T1a RCC. The predictive value of visible hematuria for CSS was more significant in RCCs ≤ 2 cm, but did not reach statistical significance in T1b RCC. T1a RCC patients with visible hematuria should be intensively monitored during follow-up.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"247"},"PeriodicalIF":16.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602287","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 relationship between map scores and complications after standard percutaneous nephrolithotomy.","authors":"Veli Mert Yazar, Osman Gercek, Kutay Topal, Kemal Ulusoy, Recep Uzun","doi":"10.1186/s12894-024-01639-w","DOIUrl":"10.1186/s12894-024-01639-w","url":null,"abstract":"<p><strong>Purpose: </strong>Upper urinary tract stones are a common condition in urology clinics. Percutaneous nephrolithotomy (PCNL) is an effective procedure frequently used for the treatment of stones larger than 2 cm. MAP scoring is used to predict oncological outcomes and intraoperative complications after partial nephrectomy by using the thickness and adhesion of perinephric adipose tissue. We examined the relationship between MAP score and clinical and demographic findings of the patients, especially postoperative Hgb drop and postoperative complications.</p><p><strong>Material-method: </strong>Patients were divided into 2 groups: Those with MAP score < 3 and ≥ 3. The impact of the MAP score on the demographic, clinical, and surgical parameters of the groups was assessed and analyzed. The relationship between MAP score and complications based on Clavien Dindo classification was also examined. The study investigated factors affecting the development of complications, the amount of bleeding, and the influence of MAP scores on these outcomes.</p><p><strong>Results: </strong>The Hgb drop was 2.56 ± 1.00 in the group with a MAP score ≥ 3 which was statistically significantly higher than the group with a MAP score < 3 (1.43 ± 1.21) (p < 0.001). The stone-free rate was 81.7% in the group with a MAP score < 3, which was statistically significantly higher than the group with a MAP score ≥ 3 (59.6%) (p = 0.012).</p><p><strong>Conclusion: </strong>As the MAP score of patients scheduled for standard PNL operation increased, there was a corresponding rise in Hgb drop, a decline in stone-free rates and an uptick in postoperative urinary complications of postoperative urinary infections.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"241"},"PeriodicalIF":1.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582320","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":"Comparison of the efficacy and safety of mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for the treatment of kidney stones in overweight or obese patients: a systematic review and meta-analysis.","authors":"Ming Qiu, Hongjin Shi, Fabin Yang, Pingchu Li, Shi Fu, Jiansong Wang, Haifeng Wang, Qiao Yang, Yigang Zuo, Bing Hai, Jinsong Zhang","doi":"10.1186/s12894-024-01588-4","DOIUrl":"10.1186/s12894-024-01588-4","url":null,"abstract":"<p><strong>Objective: </strong>To discuss the differences in the effectiveness and security of kidney stones in overweight or obese patients by mini percutaneous nephrolithotomy (MiniPCNL) and retrograde intrarenal surgery (RIRS).</p><p><strong>Materials and methods: </strong>We exhaustively searched numerous databases, including PubMed, Embase, Web of Science, Cochrane Library, and CNKI, covering all records from their initiation date until September 2023. This included controlled trials focusing on the use of MiniPCNL and RIRS in the treatment of kidney stones in overweight or obese patients. The gathered data was then analyzed using the Review Manager 5.4 software.</p><p><strong>Results: </strong>9 studies including 1122 patients were included. Meta-analysis showed that: The MiniPCNL group had higher overall complications, grade I complications, length of hospital stay(LOS), first stone-free rate (SFR), and final SFR in obese patients, with no significant difference between the two groups in terms of operative time(OT), hemoglobin drop, and grade II complication rate. There were more overall complications, grade I complications, final SFR, and LOS with MiniPCNL in patients with stones > 2 cm compared to no significant difference in grade II complications. MiniPCNL performed in the prone position had higher final SFR, less OT, hemoglobin drop, and no statistically significant difference in overall complications or LOS. Sheaths using > 14 F had higher overall complication rates, final SFR, and LOS, and no statistical differences in OT and first SFR between the two modalities. In the MiniPCNL subgroup aged ≤ 50 years, there were higher first SFR, final SFR, and shorter OT, and in the MiniPCNL subgroup aged > 50 years, there were more OT, LOS, and hemoglobin drop, with no statistical difference in overall complications between the two groups.</p><p><strong>Conclusion: </strong>Our study showed that MiniPCNL in obese patients had higher initial SFR and final SFR, fewer procedures, but more postoperative complications, LOS, and grade I complications compared with RIRS. Similar results were seen in patients in the prone position, with stones > 2 cm and age ≤ 50 years.</p><p><strong>Systematic review registration: </strong>[ https://www.crd.york.ac.uk/PROSPERO/ ], identifier PROSPERO (CRD42023467284).</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"243"},"PeriodicalIF":1.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582305","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}