Central European Journal of Urology最新文献

{"title":"Prostate cancer: Improving lives by not \"overtreating\" patients.","authors":"Maciej Salagierski, Paula Szarek, Marta Tortyna, Róża Poźniak-Balicka","doi":"10.5173/ceju.2025.0318","DOIUrl":"https://doi.org/10.5173/ceju.2025.0318","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"13-14"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442767","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":"Retrospective analysis to evaluate Allium stents as an alternative method for the treatment of ureteral strictures.","authors":"Krzysztof Nowakowski, Agata Panfil, Agata Lurka, Piotr Matuszak, Grzegorz Prokopowicz, Andrzej Potyka","doi":"10.5173/ceju.2025.0155","DOIUrl":"https://doi.org/10.5173/ceju.2025.0155","url":null,"abstract":"<p><strong>Introduction: </strong>Allium metal ureteral stents have become an increasingly popular endoscopic treatment option for ureteral strictures. This study aimed to present the outcomes of Allium ureteral stents in the treatment of refractory ureteral strictures of different origin at a single center.</p><p><strong>Material and methods: </strong>The objective of our study is to present the retrospective analysis of patients treated with an Allium ureteral stent in our department and to evaluate its effectiveness. The success rate of treatment, postoperative resolution in hydronephrosis, symptom and complication rates were evaluated during the follow-up period. The study group consisted of 18 patients with unilateral or bilateral hydronephrosis due to the ureteral stricture of different etiologies.</p><p><strong>Results: </strong>The total percentage of regression of hydronephrosis was observed in 77.78% of cases. The median follow-up period was 575 days. The main causes of hydronephrosis were urolithiasis and its previous treatment, as well as neoplastic diseases of the abdomen and pelvis.</p><p><strong>Conclusions: </strong>The study found that the use of Allium ureteral stents can be an effective and helpful option in the treatment of ureteral strictures, especially in cases where primary treatment options are not suitable.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"53-58"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442786","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":"A decade of greener care: Environmental, economic, and operational impact of the virtual stone clinic in the United Kingdom.","authors":"Salma Khalifa, Amr Makia, Hasham Saleem, Tom Hughes, Mary Nada, Loretta Tear, Tanya Davis, Bhaskar K Somani","doi":"10.5173/ceju.2025.0194","DOIUrl":"https://doi.org/10.5173/ceju.2025.0194","url":null,"abstract":"<p><strong>Introduction: </strong>Outpatient care generates a significant environmental footprint through patient travel, energy use, and resource consumption. As the UK healthcare sector works toward Net Zero targets, sustainable redesign of routine services is essential. This study quantifies the environmental, economic, and operational benefits of the Virtual Stone Clinic (VSC), a telephone-based follow-up model for kidney stone disease (KSD).</p><p><strong>Material and methods: </strong>We conducted a prospective study of 854 patients managed in the VSC between March 2014 and December 2024. A total of 2,917 telephone consultations were delivered. Using postcode-based travel modelling and UK standard emission factors, we calculated reductions in travel distance, CO₂ emissions, fuel use, time burden, and cost compared with equivalent face-to-face (F2F) appointments. Clinic delivery costs were estimated using NHS Reference Costs.</p><p><strong>Results: </strong>The VSC avoided an estimated 27,138 km of patient travel, reducing CO₂ emissions by 4.04-4.42 tonnes. Patients saved over 560 hours of travel time and more than £2,000 in personal fuel costs. Clinic delivery costs were £201,273 lower than for equivalent F2F care, rising to over £204,000 when patient fuel savings were included.</p><p><strong>Conclusions: </strong>Over a decade, the VSC has delivered substantial environmental, economic, and time savings without compromising safety or access. This proven model offers a scalable approach to integrating environmental accountability into outpatient care, with clear potential for adoption across urology and other specialities in the UK and beyond.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"36-41"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442832","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":"Comparison of the effects of commonly used double-J stents on stone-free rates and ureteral stent-related symptoms after lithotripsy for upper urinary tract stones.","authors":"Peng Lei, Abulizi Simayi, Shuheng Wang, Bide Liu, Hongliang Jia, Peixin Zhang, Yibing Liu, Weili Du, Jiuzhi Li","doi":"10.5173/ceju.2024.0276","DOIUrl":"https://doi.org/10.5173/ceju.2024.0276","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence on the impact of different stent sizes on stone-free rate (SFR) and ureteral stent-related symptom questionnaire (USSQ) scores in endoscopic lithotripsy remains limited. This study aimed to evaluate the effects of 2 commonly used double-J stents of different diameters on these outcomes.</p><p><strong>Material and methods: </strong>We retrospectively reviewed 108 patients with upper urinary tract stones who underwent lithotripsy between January 2022 and December 2023. Patients were stratified into 4.7F and 6F groups based on stent diameter. Primary outcomes were SFR at 24 h and 30 days. USSQ scores and complications were compared between groups.</p><p><strong>Results: </strong>SFR was similar between groups at 24 h (52.5% vs 55.1%; p = 0.791) and 30 days (74.6% vs 77.6%; p = 0.719). USSQ scores were comparable (Urinary Symptoms: 29 vs 29, p = 0.473; Body Pain: 12 vs 12.5, p = 0.347; General Health: 13 vs 13, p = 0.706; Work Performance: 8 vs 8, p = 0.072; Sexual Matters: 4 vs 3, p = 0.242; Additional Problems: 12 vs 12, p = 0.485). More patients in the 4.7F group reported hematuria (83.1% vs 69.4%; p = 0.094) and changes in daily work activities. Many experienced body pain (76.9%) and absence of sexual activity (88.9%). No complications exceeded grade II.</p><p><strong>Conclusions: </strong>Both 4.7F and 6F stents showed similar efficacy and safety. Stent size did not significantly impact USSQ scores or SFR.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"23-29"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442792","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":"Evaluation of DeepSeek-R1 and ChatGPT-4o as educational sources for upper tract urothelial carcinoma.","authors":"Wojciech Krajewski, Jan Łaszkiewicz, Łukasz Biesiadecki, Wojciech Tomczak, Łukasz Nowak, Piotr Łaszkiewicz, Joanna Chorbińska, Francesco Del Giudice, Benjamin I Chung, Tomasz Szydełko","doi":"10.5173/ceju.2025.0238","DOIUrl":"https://doi.org/10.5173/ceju.2025.0238","url":null,"abstract":"<p><strong>Introduction: </strong>Upper tract urothelial carcinoma (UTUC) is associated with poor survival outcomes. Therefore, providing reliable information about UTUC is crucial. Recently, chatbots powered by large language models have become a widely used information source. Our aim was to evaluate and compare responses generated by ChatGPT-4o and DeepSeek-R1 to patient-important questions regarding UTUC.</p><p><strong>Material and methods: </strong>A set of 43 questions assigned into four categories (general information, symptoms and diagnosis, treatment, prognosis) was curated. Each question was entered into DeepSeek-R1 and ChatGPT-4o. Answers were rated by two urologists using a scale from 1 (completely incorrect) to 4 (fully correct). The median score was calculated for each question. Median scores ≥3 were considered accurate. The repeatability of responses was evaluated using cosine similarity. The number of words in responses was counted.</p><p><strong>Results: </strong>The median scores for DeepSeek-R1 and ChatGPT-4o were both 3.5. There was no statistically significant difference between the scores assigned to two chatbots for all questions (p = 0.35), nor for any particular category.DeepSeek-R1 and ChatGPT-4o provided satisfactory answers for 93% and 91% of the evaluated questions, respectively. No potentially dangerous information was found. Both models consistently generated responses with moderate-high similarity (cosine similarity >0.5), except in one query. Finally, DeepSeek-R1 provided significantly longer answers than ChatGPT-4o (p <0.001).</p><p><strong>Conclusions: </strong>Both DeepSeek-R1 and ChatGPT-4o predominantly provide satisfactory responses to patient-important questions about UTUC. Artificial intelligence chatbots demonstrate potential as the first-line information sources for patients but struggle with highly specialized inquiries and thus cannot replace expert medical advice.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442813","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":"Double-face buccal mucosa graft urethroplasty for obliterative urethral strictures of the fossa navicularis.","authors":"Leonidas Karapanos, Nicolas Fischer, Friederike Haas, Moritz Beck, Leonhard Gernhold, Tobias Kowalke, Daniel Porres","doi":"10.5173/ceju.2025.0181","DOIUrl":"https://doi.org/10.5173/ceju.2025.0181","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"66"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442788","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 effect of powerlifting on urinary incontinence in women.","authors":"Tanja Maria Heidorn, Zane Pilsetniece","doi":"10.5173/ceju.2025.0184","DOIUrl":"https://doi.org/10.5173/ceju.2025.0184","url":null,"abstract":"<p><strong>Introduction: </strong>Powerlifting is a strength sport that has recently gained popularity among women. It is associated with a high prevalence of stress urinary incontinence, which is known to negatively affect women's quality of life. Therefore, this study aimed to assess the effects of powerlifting on urinary incontinence not only during training but also in daily life. Furthermore, this study aimed to identify risk factors associated with stress urinary incontinence during powerlifting.</p><p><strong>Material and methods: </strong>This cross-sectional study used an anonymous 26-item online questionnaire. Participants were mainly recruited via social media. Responses from 1,072 female powerlifters were analyzed using SPSS.</p><p><strong>Results: </strong>After starting to perform powerlifting, women were 22.7 times more likely to experience stress urinary incontinence overall, 1.6 times more likely to experience stress urinary incontinence in daily life, and 5.2 times more likely to experience urgency urinary incontinence. Among those who experienced changes in the severity of symptoms in daily life after starting to perform powerlifting, a narrow majority indicated an improvement in symptoms. The lifetime prevalence of stress urinary incontinence during powerlifting was 67.3%, whereas the lifetime stress urinary incontinence prevalence in daily life was 31.7%. Risk factors for stress urinary incontinence during powerlifting were older age, years of powerlifting experience, vaginal birth, use of a lifting belt, deadlift stance, and one repetition maximum.</p><p><strong>Conclusions: </strong>While powerlifting appears to increase the risk of urinary incontinence in daily life, it also improves symptoms in some participants - likely those able to activate their pelvic floor during lifting.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"15-22"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442757","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":"Postoperative spindle cell nodule of the urethra and bladder in a 90-year-old male: A diagnostic challenge.","authors":"Ari Frajewicki, Ilan Klein, Boris Friedman, Edmond Sabo, Yoram Dekel","doi":"10.5173/ceju.2025.0305","DOIUrl":"https://doi.org/10.5173/ceju.2025.0305","url":null,"abstract":"<p><p>Postoperative spindle cell nodule is a rare benign reactive lesion of the genitourinary tract that can closely mimic malignant spindle cell neoplasms. We report a 90-year-old male with recurrent urethral obstructions and bladder lesions over four years following repeated instrumentation for urethral strictures. Multiple cystoscopies revealed recurrent masses (2-5 cm) throughout the urethra and urinary bladder. Initial biopsies were nondiagnostic. The final histopathological examination demonstrated fibrosis, edema, inflammation, and atypical spindle cells without mitosis or necrosis. Immunohistochemistry showed positivity only for Vimentin and p53, with all lineage-specific markers negative. In view of the clinical course and the pathological findings, postoperative spindle cell nodule was diagnosed. This case emphasizes the diagnostic challenge of distinguishing benign pseudosarcomatous reactive lesions from true malignancy in elderly patients with recurrent urinary tract masses following instrumentation.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"9-12"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442795","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":"Beyond <i>Candida</i>: A clinical insight into rare fungal pyelonephritis in urological practice.","authors":"Poorn Pandya, Rohan Valsangkar, Shirish Bhave, Bhalchandra Kashyapi","doi":"10.5173/ceju.2025.0255","DOIUrl":"https://doi.org/10.5173/ceju.2025.0255","url":null,"abstract":"<p><strong>Introduction: </strong>Non-<i>Candida</i> fungal infections of the urinary tract, such as <i>Aspergillus</i> and <i>Mucor</i>, though uncommon, pose significant diagnostic and therapeutic challenges. Their variable presentation, antifungal resistance, and frequent association with immunocompromised states or prior instrumentation necessitate a high index of suspicion. This study aims to describe the clinical profile, diagnostic approach, and management outcomes of non-<i>Candida</i> fungal pyelonephritis in urological practice.</p><p><strong>Material and methods: </strong>A retrospective observational analysis was conducted on four patients diagnosed with non-<i>Candida</i> fungal pyelonephritis at a tertiary urology centre between April 2024 and April 2025. Patients with urine cultures positive for fungi other than <i>Candida</i> were included. Data on clinical features, comorbidities, imaging findings, microbiology, intraoperative observations, treatment modalities, and outcomes were reviewed. Diagnosis was confirmed through culture and/or histopathology, and management was coordinated with infectious disease specialists.</p><p><strong>Results: </strong>Four patients (three males, one female; age 37-72 years) were identified - three with <i>Aspergillus</i> and one with <i>Mucor</i> infection. Diabetes mellitus was the predominant comorbidity (3/4), and two patients had a history of prior urological instrumentation. Presentations ranged from incidental findings to pyelonephritis with fever and flank pain. Individualized management included minimally invasive percutaneous nephrolithotomy, pyeloplasty, percutaneous nephrostomy insertion, or nephrectomy. All patients responded to therapy, with infection clearance and preserved or improved renal function on follow-up. No mortality was observed.</p><p><strong>Conclusions: </strong>Non-<i>Candida</i> fungal pyelonephritis, though rare, requires early diagnosis and individualized surgical and antifungal management. Multidisciplinary collaboration ensures favourable outcomes and renal preservation.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"67-71"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442799","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":"High-power holmium laser versus pulsed thulium laser for ureteroscopic lithotripsy: Results of a randomized prospective study.","authors":"José A Salvadó, José M Villena, Felipe Urrea, Pablo Marchant, Matías Larrañaga, José M Cabello, Pablo Marchetti","doi":"10.5173/ceju.2025.0044","DOIUrl":"https://doi.org/10.5173/ceju.2025.0044","url":null,"abstract":"<p><strong>Introduction: </strong>Current evidence indicates that the outcomes obtained with the holmium laser (Ho:YAG) and the thulium fiber laser (TFL) in the endoscopic treatment of upper urinary tract stones are at least equivalent. The recent introduction of the pulsed thulium laser (p-Tm:YAG) could result, due to its characteristics, in the ideal combination of its predecessors. The aim of this study was to compare the performance and outcomes between high-power Ho:YAG and p-Tm:YAG.</p><p><strong>Material and methods: </strong>This prospective randomized clinical study included patients with a single renal or ureteral stone, who underwent retrograde endoscopic surgery.</p><p><strong>Results: </strong>A total of 122 patients were recruited, of whom 66 (54%) received treatment with the p-Tm:YAG laser. The overall stone-free rate was 65.1% for p-Tm:YAG and 62.5% for Ho:YAG (p = 0.76). Specifically, for renal stones, the stone-free rates were 60.9% vs 48.4% (p = 0.28), respectively. The median energy used in the p-Tm:YAG group was 4.71 kJ compared to 5.31 kJ in the Ho:YAG group (p = 0.28). The postoperative requirement for a double-J catheter was higher in the Ho:YAG group (67.8% vs 50%; p = 0.04). The analysis showed no statistically significant difference in the energy required to treat 1 mm³ of stone (20 J/mm³ for p-Tm:YAG vs 22 J/mm³ for Ho:YAG; p = 0.48).</p><p><strong>Conclusions: </strong>Intracorporeal lithotripsy with p-Tm:YAG shows non-inferior results in terms of stone-free rates compared to high-power Ho:YAG. There is a trend in favor of p-Tm:YAG regarding the total energy required and a lower need for a subsequent double-J catheter, which should be corroborated by further studies in this field of urology.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"30-35"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442840","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}