Central European Journal of Urology最新文献

{"title":"Comparative efficacy and safety of silodosin and tadalafil combination or monotherapy for treating lower urinary tract symptoms due to benign prostatic obstruction: A systematic review and meta-analysis.","authors":"Abdul Azis, Syarif Syarif, Moh Anfasa Giffari Makkaraka, Ahmad Taufik Fadillah Zainal, Saidah Rahmat, Muhammad Fakhri","doi":"10.5173/ceju.2024.0219","DOIUrl":"10.5173/ceju.2024.0219","url":null,"abstract":"<p><strong>Introduction: </strong>Over the last few years, trends in managing benign prostatic hyperplasia (BPH) have improved, advancing from reliance on surgery to satisfactory medical therapies. However, the efficacy and safety of combination therapies, including silodosin and tadalafil, are not well established compared to monotherapy for treating lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO).</p><p><strong>Material and methods: </strong>A systematic search was conducted in PubMed, ScienceDirect, Cochrane Library, and Scopus up to April 1, 2024. The quality of the studies was assessed using The Cochrane Risk of Bias (RoB) Tools 2 and Risk of Bias in Non-randomized Studies of Exposures (ROBINS-E). Meta-analysis was conducted using RevMan 5.4.</p><p><strong>Results: </strong>A total of 1,300 records were screened, resulting in 7 final studies. Our meta-analyses showed that international prostate symptom score (IPSS), maximum urine flow rate (Q_max), and post-void residual volume (PVR) led to considerably greater improvements with the combination of silodosin and tadalafil compared to using either as monotherapy. However, combination therapy notably exhibited higher rates of adverse events (AE). On the other hand, as monotherapy, silodosin demonstrated a statistically significant improvement in Q_max (p = 0.006) and PVR (p = 0.02) over tadalafil but with higher rates of total AE, discontinuation, and risk of retrograde ejaculation.</p><p><strong>Conclusions: </strong>Silodosin and tadalafil are effective for treating LUTS in men due to BPO, especially when used in combination. However, with concerns about safety, tadalafil as monotherapy offers an advantage for patients with fertility desires due to its favorable side effect profile.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"165-176"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944450","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":"Relocation and evacuation of stone fragments using 7.5 Fr flexible ureteroscope with direct-in-scope suction: an experimental study.","authors":"Arman Tsaturyan, Hakob Sargsyan, Gagik Amirjanyan, Armen Muradyan, Tarik Emre Sener, Eugenio Ventimiglia, Angelis Peteinaris, Evangelos Liatsikos, Panagiotis Kallidonis, Lazaros Tselves, Marco Lattarulo, Pier Paolo Prontera, Steffi Kar Kei Yuen, Vineet Gauhar, Olivier Traxer, Bhaskar Somani, Amelia Pietropaolo","doi":"10.5173/ceju.2024.0269","DOIUrl":"10.5173/ceju.2024.0269","url":null,"abstract":"<p><strong>Introduction: </strong>Aim of the study was to evaluate and illustratively depict the aspiration properties of a single-use 7.5 Fr flexible ureteroscope with direct-in-scope suction (DISS) in a specifically designed <i>in vitro</i> setting.</p><p><strong>Material and methods: </strong>An experimental <i>in vitro</i> study using a 6.5 size sterile glove, natural stone fragments and part of a porcine ureter was performed. A single use 7.5 Fr digital flexible ureteroscope with integrated direct-in-scope suction (PU3033AH, Zhuhai Pusheng Medical Technology Co., Ltd., Zhuhai China) was used for all trials. Five stone fragments ranging from 3 to 5 mm in maximal diameter were used. For each stone, three trials were performed; stones placed in the upper, middle and lower calyx. The experimental trial was defined as partially successful if stone relocation using suction (SRS) was present and successful when subsequent evacuation was reported.</p><p><strong>Results: </strong>Relocation of stone fragments (partial success) was observed for all stones in different locations. Easy evacuation of the 3 mm stone fragment occurred from all calyces. Complete success was also reported for all 4 mm stones. Complete success was documented with the 5 mm stone positioned in the upper and middle calyces, whereas evacuation of the stone from the lower calyx was not achieved after 5 attempts.</p><p><strong>Conclusions: </strong>With the 7.5 Fr Pusen DISS integrated scope, stone fragments 3-5 mm in all calyces were successfully relocated. Whilst evacuation from any calyx was successfully done in 3-4 mm fragments, this was only possible for 5 mm fragments located in upper calyx or interpolar region. The lower pole and greater fragment size need further evaluation for optimal management by DISS.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"200-205"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944568","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":"Outcomes of ureteroscopy and laser lithotripsy with and without ureteral access sheaths for the treatment of renal calculi: A systematic review and meta-analysis.","authors":"James Connor, Steven Anderson, Niall F Davis","doi":"10.5173/ceju.2024.0196","DOIUrl":"10.5173/ceju.2024.0196","url":null,"abstract":"<p><strong>Introduction: </strong>The use of ureteral access sheaths (UASs) is an issue of contention among urologists, with their efficacy unclear in retrograde intrarenal surgery (RIRS). Therefore, we performed a systematic review and meta-analysis to assess RIRS with laser lithotripsy for the treatment of urolithiasis with and without the use of UASs.</p><p><strong>Material and methods: </strong>A systematic literature search was conducted in July 2023 using MEDLINE, EMBASE and the Cochrane library. The quality of the included studies was assessed using the Newcastle-Ottowa scale and Cochrane collaboration risk of bias tool. The primary outcome measures were stone-free rate (SFR), and post-operative complications. Secondary outcomes were operative time (OT), hospital length of stay (LOS) and ureteral injury rate. Effect sizes were calculated by pooled risk ratios (RRs) and mean differences (MDs) with confidence intervals (CIs).</p><p><strong>Results: </strong>In total, 16 studies met the inclusion criteria. There were 3,123 participants who had RIRS with a UAS and 1,478 without. Pooled analysis revealed no significant difference between groups in SFR (RR = 1.03, 95% CI: 0.99-1.07), complication rate (RR = 1.31, 95% CI: 1.00-1.73), ureteral injuries (RR = 1.13, 95% CI: 0.77-1.65) or LOS (MD = -0.01, 95% CI: from -0.08 to 0.11). OT was significantly longer in the UAS group (MD = 0.35, 95% CI: 0.01-0.7).</p><p><strong>Conclusions: </strong>The results of this meta-analysis demonstrate that the use of UASs during RIRS does not improve post-operative outcomes and is associated with a longer OT. While there are still times where the use of UASs may be beneficial, their routine use for patients undergoing RIRS is not currently indicated.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"228-236"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944492","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":"Investigation of irrigation fluid temperature variations caused by thulium fiber laser with various settings and comparison with Ho:YAG laser: An <i>in vitro</i> experimental study.","authors":"Mohammed Obaidat, Arman Tsaturyan, Vasileios Tatanis, Angelis Peteinaris, Ergina Farsari, Solon Faitatziadis, Konstantinos Pagonis, Athanasios Vagionis, Evangelos Liatsikos, Panagiotis Kallidonis","doi":"10.5173/ceju.2024.0165","DOIUrl":"10.5173/ceju.2024.0165","url":null,"abstract":"<p><strong>Introduction: </strong>Our experimental <i>in vitro</i> study aimed to evaluate the impact of four power settings with different energy and frequency combinations on the irrigation fluid temperature using the thulium fiber laser (TFL). In addition, we aimed to identify the differences between the Ho: YAG laser and TFL by direct comparison of the same power settings.</p><p><strong>Material and methods: </strong>All measurements were performed with a fluid volume fixed at 10 ml and an outflow rate at 10 ml/min. The laser was fired continuously for 30 seconds with total power settings of 10 W, 20 W, 40 W, and 60 W with different power settings (energy × frequency) and various pulse combinations using TFL and Ho: YAG laser (Quanta System, Samarate, Italy).</p><p><strong>Results: </strong>Higher temperatures were recorded when the power was increased from 10 W, 20 W, 40 W, to 60 W. The temperature exceeded the threshold of 43°C when power settings of ≥40 W were applied regardless of frequency (15-120 Hz) and energy (0.5-4 J). Similar temperature increase patterns were reported with different peak power settings. No major differences were found when the same power settings were applied using TFL and Ho: YAG lasers.</p><p><strong>Conclusions: </strong>Based on our results temperatures >43°C were recorded for power settings ≥40 W after continuous laser firing of 30 seconds using TFL. Modifying the frequency and energy settings, as well as firing with Ho:YAG laser under the same power setting did not affect the patterns of temperature increase. Generally, the TFL shows more regular thermal behavior in comparison with the Ho:YAG laser.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"184-191"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944550","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":"Differential prognostic impact of favourable prostate cancer pathology risk score patterns predicted by Briganti's 2012 nomogram across EAU risk groups: Analysis of 757 cases treated with robotic surgery.","authors":"Antonio Benito Porcaro, Sonia Costantino, Francesca Montanaro, Alberto Baielli, Francesco Artoni, Emanuele Serafin, Luca Roggero, Claudio Brancelli, Andrea Franceschini, Alessandro Princiotta, Michele Boldini, Lorenzo Treccani, Lorenzo De Bon, Alberto Bianchi, Alessandro Veccia, Riccardo Rizzetto, Matteo Brunelli, Vincenzo De Marco, Salvatore Siracusano, Maria Angela Cerruto, Riccardo Giuseppe Bertolo, Alessandro Antonelli","doi":"10.5173/ceju.2024.0170","DOIUrl":"10.5173/ceju.2024.0170","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the prognostic impact of favourable prostate cancer (PCa) pathology patterns through Briganti's 2012 nomogram and beyond EAU risk classes in patients treated with robotic surgery.</p><p><strong>Material and methods: </strong>We analysed 757 patients from January 2013 to December 2021 with favourable pathology features (ISUP 1-3, pT2/pT3a, and pN0/x) and available follow-up. Pathologic features were scored from zero (ISUP 1 + pT2) to three (ISUP 3 + pT3a). Associations with Briganti's 2012 nomogram by EAU risk class were evaluated to determine the prognostic impact on PCa progression, defined as biochemical persistence/recurrence or loco-regional/metastatic recurrence.</p><p><strong>Results: </strong>Favourable pathology risk scores were most commonly grades one (49%) and two (30.95%), followed by zero (15.2%) and three (4.9%). After adjusting for EAU prognostic groups, higher nomogram scores were associated with increased risk scores of two and three. PCa progression occurred in 12.7% of cases after a mean follow-up of 92.1 months. Patients with recurrence had a worse prognosis as risk scores increased from one to three, even after adjustment for Briganti's 2012 nomogram by EAU class.</p><p><strong>Conclusions: </strong>Favourable pathology risk scores, grouped by Briganti's 2012 and EAU nomograms, impact prognosis. As scores increase, the likelihood of disease progression rises, potentially influencing treatment strategies.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"109-115"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944580","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 pyeloplasty with direct pyelo-ureteral anastomosis for retrocaval ureter.","authors":"Angelo Mottaran, Pietro Piazza, Riccardo Scarlatti, Massimiliano Presutti, Marco Salvador, Matteo Droghetti, Lorenzo Bianchi, Riccardo Schiavina, Eugenio Brunocilla","doi":"10.5173/ceju.2024.0258","DOIUrl":"10.5173/ceju.2024.0258","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"250-251"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944571","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":"Modified posterior reconstruction and vesicourethral anastomosis in robot-assisted radical prostatectomy and its impact on anastomosis stricture rate and clips migration.","authors":"Piotr Kania, Markijan Kubis, Jakub Biedrzycki, Paweł Marczuk","doi":"10.5173/ceju.2024.0239","DOIUrl":"10.5173/ceju.2024.0239","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"252-253"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944528","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":"The potential of gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography as a main diagnostic tool in prostate cancer staging.","authors":"Oleksii Pisotskyi, Piotr Petrasz, Piotr Zorga, Marcin Gałęski, Paweł Szponar, Krzysztof Koper, Katarzyna Brzeźniakiewicz-Janus, Tomasz Drewa, Krzysztof Kaczmarek, Michał Cezary Czarnogórski, Jan Adamowicz","doi":"10.5173/ceju.2025.0014","DOIUrl":"https://doi.org/10.5173/ceju.2025.0014","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer (PC) remains a significant global health burden, necessitating accurate staging for optimal treatment planning. Conventional imaging methods, including multiparametric magnetic resonance imaging (mpMRI), computed tomography (CT), and bone scintigraphy (BS), exhibit limitations in sensitivity and specificity. Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (⁶⁸Ga PSMA-PET/CT) has emerged as a promising alternative, with potential advantages in staging accuracy.</p><p><strong>Material and methods: </strong>A comprehensive review of current literature was conducted to assess the role of ⁶⁸Ga PSMA-PET/CT in primary PC staging. The diagnostic performance of PSMA-PET/CT was compared with conventional imaging techniques in detecting locoregional and distant metastases. Studies evaluating sensitivity, specificity, and clinical utility in treatment decision-making were analyzed.</p><p><strong>Results: </strong>⁶⁸Ga PSMA-PET/CT demonstrated superior sensitivity and specificity in detecting lymph node and distant metastases compared to conventional imaging. It enables earlier and more precise disease staging, potentially reducing the need for multiple imaging modalities. Emerging evidence suggests its role in guiding therapeutic strategies, particularly in high-risk and recurrent PC cases. Despite its advantages, limitations such as accessibility, cost, and occasional false-negative findings must be considered.</p><p><strong>Conclusions: </strong>⁶⁸Ga PSMA-PET/CT represents a transformative diagnostic tool for PC staging, offering enhanced accuracy compared to traditional imaging. Its integration into clinical practice could streamline diagnostic pathways, improve treatment selection, and potentially optimize patient outcomes. Further research and cost-effectiveness analyses are needed to establish its widespread implementation.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"52-60"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075880","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":"Role of gabapentin in the management of neurogenic overactive bladders: A systematic review.","authors":"Roshan Chanchlani, Ketan Mehra, Pramod K Sharma, Sudarsan Agarwal, Amit Gupta, Reyaz Ahmad, Rakesh Mishra, Amit Agarwal, Suresh Kumar Thanneeru","doi":"10.5173/ceju.2024.0125","DOIUrl":"https://doi.org/10.5173/ceju.2024.0125","url":null,"abstract":"<p><strong>Introduction: </strong>Neurogenic lower urinary tract dysfunction is typically managed through a step-up approach, beginning with anticholinergic medications, progressing to Botulinum toxin injections, and surgical interventions. Gabapentin offers a less invasive option, either as an adjunct to anticholinergics or as a standalone therapy. This systematic review examines gabapentin's efficacy and safety in treating neurogenic overactive bladders (NOAB) in both paediatric and adult populations.To determine gabapentin's effect on reducing bladder pressure, increasing bladder capacity, and alleviating incontinence symptoms in NOAB patients.</p><p><strong>Material and methods: </strong>A systematic search was conducted on PubMed, Scopus, ScienceDirect, and Cochrane to identify studies on gabapentin for NOAB. Articles were sorted according to PRISMA guidelines, and the risk of bias was assessed using the JBI clinical appraisal tool. Data from the selected articles were synthesized qualitatively.</p><p><strong>Results: </strong>Of the 116 identified articles, 6 were selected. Two focused on paediatric patients with neural tube defects, while four studies involved adults with conditions like spinal trauma, Parkinson's disease, and multiple sclerosis. Urodynamic parameters improved in four studies, whether gabapentin was used alone or as an adjunct. All 6 studies reported significant improvements and minimal side effects.</p><p><strong>Conclusions: </strong>While limitations in dosages and study durations hinder a definitive endorsement of gabapentin, the overall positive response across studies suggests its potential efficacy in managing NOAB. Further high-quality randomized controlled trials comparing gabapentin with other treatments and exploring factors related to non-responsiveness are warranted for conclusive insights.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"61-69"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075912","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":"Re: Kaczmarek K, Jankowska M, Kalembkiewicz J, et al. Assessment of the incidence and risk factors of postoperative urosepsis in patients undergoing ureteroscopic lithotripsy. Cent European J Urol. 2024; 77: 122-128.","authors":"Akif Erbin, Bilal Kaya, Halil Lutfi Canat","doi":"10.5173/ceju.2024.0257","DOIUrl":"https://doi.org/10.5173/ceju.2024.0257","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"100-101"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076300","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}