Central European Journal of Urology最新文献

{"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}

{"title":"Renal and ureteral temperatures changes during ureteroscopic pulsed thulium: YAG laser lithotripsy: an <i>in vitro</i> analysis.","authors":"Felipe Urrea, José M Villena, Matias Larrañaga, José Antonio Salvadó","doi":"10.5173/ceju.2024.0177","DOIUrl":"https://doi.org/10.5173/ceju.2024.0177","url":null,"abstract":"<p><strong>Introduction: </strong>Promising studies have shown a high stone-free rate achieved with the pulsed solid-state thulium YAG laser. However, studies on its safety concerning temperature effects during activation remain limited. The aim of this study was to characterize temperature variations during laser activation.</p><p><strong>Material and methods: </strong>This <i>in vitro</i> experimental study utilized a high-fidelity uretero-renal simulation model to assess temperature changes during intracorporeal laser lithotripsy. Temperatures reached after laser activation at 15, 20, and 30 seconds were recorded. The flow rates used were 10 ml/min and 20 ml/min. The maximum allowed temperature was set at 43°C, given its association with thermal tissue damage. A linear logistic regression model was used to analyze variations and project temperature behavior over time.</p><p><strong>Results: </strong>In the renal model, temperature increases were correlated with the applied energy. With a 10 ml/min flow rate, no laser configuration exceeded 43°C at 15 seconds; at 20 seconds, only the 30 W (2.5 J/20 Hz) configuration exceeded this temperature. By 30 seconds, all 30 W configurations exceeded 43°C, except for 0.4 J/75 Hz. With a 20 ml/min flow rate, no laser configuration exceeded 43°C. The 20 ml/min flow rate decreased renal temperature by 1.96°C (p = 0.01). In the ureteral model, the temperature increase was not proportional to the applied energy, but in no scenario the temperatures reach the 43°C.</p><p><strong>Conclusions: </strong>The temperature variations observed in this study with the use of the pulsed solid-state thulium YAG laser should be considered to avoid potential renal and ureteral thermal damage.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"70-76"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076303","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":"Ureteral stents with extraction strings - a review on infection risk and prevention.","authors":"Patryk Osiński, Jakub Bartłomiej Kawecki, Martyna Zofia Stachoń, Izabela Teresa Zawadzka, Ewa Bres-Niewada, Bartosz Dybowski","doi":"10.5173/ceju.2024.0222","DOIUrl":"https://doi.org/10.5173/ceju.2024.0222","url":null,"abstract":"<p><strong>Introduction: </strong>This review aims to determine whether the use of ureteral stents with extraction strings in adult patients undergoing upper urinary tract endoscopic procedures results in a higher incidence of urinary tract infections (UTIs) compared to stents without strings.</p><p><strong>Material and methods: </strong>A systematic literature search was conducted using PubMed, Scopus, and Google Scholar. Studies evaluating differences in UTI rates among adult patients with ureteral stents with or without extraction strings were included. Data on UTI rates, antibiotic prophylaxis protocols, and stent dwell time were extracted.</p><p><strong>Results: </strong>The review included 11 trials published between 2015 and 2023. One multicenter retrospective study involving 4,392 patients reported a significantly higher UTI rate in patients with extraction strings (2.1% vs 1.1%, p = 0.006). In the remaining 10 studies, including four randomized controlled trials, the differences were not statistically significant. Antibiotic prophylaxis was described in five studies. In two studies, a single perioperative antibiotic dose was administered, with a total UTI rate of 6.8% (28/410). In contrast, three studies using prolonged prophylactic antibiotic regimens reported a total UTI rate of 3.2% (13/403). The impact of stent dwell time on UTI risk could not be determined. The risk of bias was high in 10 studies and moderate in one retrospective study.</p><p><strong>Conclusions: </strong>Based on low-quality evidence, the difference in UTI risk between ureteral stents with and without extraction strings appears to be minimal and statistically insignificant. Well-designed studies with standardized methodologies are needed to clarify these findings.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"94-99"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076223","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":"Influence of pre-stenting on flexible and navigable suction (FANS) access sheath outcomes. Results of a prospective multicentre study by the EAU Section of Endourology and the global FANS collaborative group.","authors":"Victoria Jahrreiss, Vineet Gauhar, Olivier Traxer, Khi Yung Fong, Saeed Bin Hamri, Karl Tan, Vigen Malkhasyan, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Steffi Yuen, Vikram Sridharan, Daniele Castellani, Mehmet Ilker Gökce, Nariman Gadzhiev, Deepak Ragoori, Boyke Soebhali, Chu Ann Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Tzevat Tefik, Anil Shrestha, Marek Zawadzki, Mohamed Amine Lakmichi, Christian Seitz, Bhaskar K Somani","doi":"10.5173/ceju.2024.0197","DOIUrl":"https://doi.org/10.5173/ceju.2024.0197","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-stenting remains a subject of debate, and its influence on FANS assisted ureteroscopy is unclear. The global FANS collaborative group aims to address the influence of pre-stenting on FANS-assisted ureterorenoscopy (URS).</p><p><strong>Material and methods: </strong>This prospective multicentre study assesses the outcomes of 394 patients undergoing FANS-assisted ureteroscopy for renal stones. Patients were stratified into a non-pre-stented (group 1, n = 163) and pre-stented group (group 2, n = 231). Data on demographics, stone characteristics, operative parameters, and postoperative 30-day outcomes were analysed. Statistical analyses, including multivariate regression, were performed for stone-free rates (SFR) and complications. SFR was defined by bone window on non-contrast computed tomography (CT).</p><p><strong>Results: </strong>Pre-stented patients had a higher prevalence of positive urine culture treated with preoperative antibiotics (23.8% vs 12.3%, p = 0.006). Larger stone volumes were noted (1,306 mm³ vs 1,200 mm³, p = 0.027) in group 1. Postoperative complications were minor. Sepsis was not reported in either group. Group 1 had a higher incidence of low-grade Traxer grade 1 ureteric injuries (4.3% vs 0.4%, p = 0.021). FANS resulted in high overall SFRs of 97.5% and 97.0% in groups 1 and group 2. Multivariate analysis showed no statistical difference in SFR between the groups (63.2% vs 53.2%, p = 0.063). Only thulium fibre laser (TFL) and stone volume were significant predictors of residual fragments (RF).</p><p><strong>Conclusions: </strong>Pre-stenting for FANS is not mandatory irrespective of stone location and volume. The use of TFL and stone volume significantly influenced SFR, while FANS itself proved highly effective in achieving high SFR.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"85-93"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076292","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":"Robotic retrocaval ureter repair.","authors":"Maxwell Sandberg, Randall Bissette, Ashok Hemal","doi":"10.5173/ceju.2024.0251","DOIUrl":"https://doi.org/10.5173/ceju.2024.0251","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"102"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074959","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":"Cancer stem cells and their role in metastasis.","authors":"Michał C Czarnogórski, Aleksandra Czernicka, Krzysztof Koper, Piotr Petrasz, Marta Pokrywczyńska, Kajetan Juszczak, Filip Kowalski, Tomasz Drewa, Jan Adamowicz","doi":"10.5173/ceju.2024.0144","DOIUrl":"https://doi.org/10.5173/ceju.2024.0144","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer, next to cardiovascular diseases, remains the primary concern of modern medicine in developed countries. Despite the unprecedented progress in targeted therapies and personalised medicine, including immunotherapy and gene therapy, we are still unable to efficiently treat many malignancies. One of the major obstacles to treating cancer is its ability to metastasise. Hence, a better understanding of cancer biology with emphasis on the metastasis formation may hold the key to further ameliorating cancer treatment. Nowadays, there is a growing body of evidence for the common denominator of neoplasia, which seems to be universal - cancer stem cells which are being found in a growing number of cancers.</p><p><strong>Material and methods: </strong>We conducted a Web of Science and Medline database search using the terms \"cancer stem cells\", \"carcinogenesis\", and \"stem cells\" in conjunction with \"metastasis\", without setting time limits.</p><p><strong>Results: </strong>The existence of cancer stem cells was proven both in animal models and in humans. We know beyond doubt that cancer stem cells may be found in bladder cancer, breast cancer, and colon cancer, among others. The cancer stem cells in the aforementioned cancers may initiate tumour formation <i>ex vivo</i> and thus theoretically lead to tumour recurrence. Their role in the formation of metastases, however, is still under investigation.</p><p><strong>Conclusions: </strong>Although their exact role is yet to be identified, it is now obvious that cancer stem cells give rise to primary mass in solid tumours and differentiated cancer cells in leukaemias. However, the role of cancer stem cells in metastasis is still obscure.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"40-51"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076286","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":"Discrepancies in volume: impact of Artemis segmented magnetic resonance imaging, ultrasound, and ExactVu measurements on prostate specific antigen density and National Comprehensive Cancer Network risk stratification.","authors":"Maximilian J Rabil, Lindsey T Webb, Gabriela M Diaz, Soum D Lokeshwar, Ankur U Choksi, Preston C Sprenkle","doi":"10.5173/ceju.2024.0249","DOIUrl":"https://doi.org/10.5173/ceju.2024.0249","url":null,"abstract":"<p><strong>Introduction: </strong>The combination of magnetic resonance imaging (MRI) and ultrasound (US) allows for better lesion targeting and diagnostic probability compared to random prostate biopsies. The Artemis Fusion Biopsy system and ExactVu micro-US technology capitalize on this advantage and provide higher-resolution imaging of the prostate during biopsy. Their accuracy in measuring prostate volume and resulting implications on prostate specific antigen (PSA) density and risk stratification, however, has not been evaluated. We hypothesized that PSA densities as measured by these modalities will demonstrate clinically insignificant differences compared to standard measurement.</p><p><strong>Material and methods: </strong>We retrospectively reviewed all prostate fusion biopsy cases performed at our health system with Artemis or ExactVu systems from April 2021 to July 2023 and compared the PSA density calculated from the volume obtained with these systems to standard measurement with ellipsoid calculation from MRI. Change in National Comprehensive Cancer Network (NCCN) prostate cancer risk stratification was analyzed for each system.</p><p><strong>Results: </strong>Artemis MRI segmentation (0.179 ng/ml, p = 0.04) and US (0.181 ng/ml, p = 0.067) underestimated and ExactVu micro-US (0.247 ng/ml, p <0.001) overestimated PSA density. Risk stratification changed in 1.2% of Artemis MRI segmentation cases, 1.6% of Artemis US cases, and 1.2% of ExactVu micro-US cases.</p><p><strong>Conclusions: </strong>Despite differences in PSA density, choice of fusion biopsy system has minimal clinical impact on risk stratification and any of these studied systems may be used without fear of misrepresenting a patient's disease state.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"1-4"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076289","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 prospective comparative study between retrograde intrarenal surgery vs supine mini percutaneous nephrolithotomy for single upper ureteric stones >10 mm.","authors":"Nitesh Kumar, Bhaskar K Somani","doi":"10.5173/ceju.2024.0205","DOIUrl":"https://doi.org/10.5173/ceju.2024.0205","url":null,"abstract":"<p><strong>Introduction: </strong>To compare retrograde intrarenal surgery (RIRS) and supine mini percutaneous nephrolithotomy (smPCNL) in the management of upper ureteric stones larger than 10 mm.</p><p><strong>Material and methods: </strong>Patients with upper ureteric stones (above L4 vertebra transverse process) larger than 10 mm at Ford Hospital and Research Centre between January 2023 and June 2024 were included in the study and were operated with either RIRS (group A) or smPCNL (group B) based on the informed consent and patients' decision. Patient demographics, stone parameters, intraoperative variables, postoperative outcomes, stone-free rates (SFR) and complications were recorded, and the two groups were compared.</p><p><strong>Results: </strong>Over 18 months, 140 patients (70 in each group) were available for comparison. Both the groups were comparable in terms of patient's demographics and the stone parameters. For RIRS and smPCNL, the mean stone size was 13.87 ±3.69 and 14.21 ±3.47 mm (p = 0.329), mean operative duration was 42.52 ±28.37 and 30.69 ±18.55 minutes (p = 0.0001), mean drop in haemoglobin at 24 hours was 0.44 ±0.96 and 0.69 ±0.92 g/dl (p = 0.364) and postoperative hospital stay was 0.92 ±0.68 and 1.13 ±0.76 days, respectively.The SFR (at 3 months post-surgery) were 94.2% for RIRS and 98.57% for smPCNL (p = 0.084) and complications rate (Clavien-Dindo ≥II) was 2.88% for both groups. Primary access was not possible in 30% of patients in RIRS leading to staged intervention.</p><p><strong>Conclusions: </strong>RIRS and smPCNL are safe and effective surgical alternatives for managing upper ureteric stones larger than 10 mm. smPCNL offers a single stage solution and equivalent results with RIRS for the large upper ureteric stones.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"77-84"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076284","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}