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":"10.5173/ceju.2025.0318","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 1","pages":"13-14"},"PeriodicalIF":1.7,"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":"The comparison of synchronous bilateral and unilateral percutaneous nephrolithotomy: Meta-analysis.","authors":"Jan Svihra, Igor Sopilko, Timea Blichova, Robert Dusenka, Jan Svihra","doi":"10.5173/ceju.2025.0246","DOIUrl":"10.5173/ceju.2025.0246","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this meta-analysis was to evaluate the efficacy and safety of synchronous bilateral PCNL (B-PCNL) compared with staged unilateral PCNL (U-PCNL) in patients with bilateral kidney stones.</p><p><strong>Material and methods: </strong>This analysis was conducted in accordance with the PRISMA guidelines and was registered with PROSPERO (CRD420251036639). The study population comprised adult patients (≥18 years) diagnosed with bilateral nephrolithiasis and treated using B-PCNL or U-PCNL. The primary outcomes were stone-free rate (SFR) and complication rates (Clavien-Dindo). A literature search was performed using the PubMed, Web of Science, and Scopus databases for studies published between 1996 and 2024. Meta-analysis was performed using a random-effects model. Statistical analyses were conducted using IBM SPSS Statistics (Version 29), and a p-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Seven studies met the final inclusion criteria, with 5 retrospective cohort studies, 1 prospective cohort study, and 1 prospective randomized controlled trial. Egger's regression test (intercept = -0.61, p = 0.76) and Begg's rank correlation test (τ = 0.00, p = 1.00) revealed no significant evidence of publication bias. The overall log odds ratio for achieving SFR favoured the U-PCNL group, with an estimated log OR = -0.38 (95% CI: from -0.87 to 0.10; p = 0.12), although this difference did not reach statistical significance. There was no statistically significant difference for high-grade complications; the log odds ratio was 0.03 (95% CI: from -0.57 to 0.63, p = 0.91).</p><p><strong>Conclusions: </strong>Based on low-certainty evidence, synchronous B-PCNL may be considered a selective option at experienced centres.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"185-191"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350949","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":"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":1.7,"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":"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":1.7,"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":"Holmium versus bipolar en bloc transurethral resection of urinary bladder tumors: a randomized controlled trial.","authors":"Ahmed Higazy, Ahmed Lotfy, A M Tawfeek, Ayman Ali, Ahmed Radwan","doi":"10.5173/ceju.2025.0268","DOIUrl":"10.5173/ceju.2025.0268","url":null,"abstract":"<p><strong>Introduction: </strong>The study evaluated the safety, efficacy, and pathological outcomes of holmium laser en bloc resection of bladder tumor (HoL-ERBT) vs bipolar en bloc resection of bladder tumor (Bp-ERBT).</p><p><strong>Material and methods: </strong>Adult patients with bladder masses less than 5 cm with no signs of extravesical extension on preoperative imaging were included in our study and were randomly allocated to two equal groups representing HoL-ERBT and Bp-ERBT. The primary outcome was the conversion rate of the surgical technique in each group to either conventional resection or using another energy source. Secondary outcomes were perioperative complications and pathological evaluation outcomes in each group.</p><p><strong>Results: </strong>Ninety-four patients were finally evaluated in our study. Demographic data and tumor characteristics were comparable between the two groups. The surgical conversion rate was higher in the Bp-ERBT group (9 cases) compared to the HoL-ERBT group (4 cases) (p = 0.038). No obturator nerve reflex was observed in the HoL-ERBT group compared to 8 cases in the Bp-ERBT group. Perioperative complications were comparable between the two groups. Pathological assessment revealed better T1 substaging and fewer thermal artifacts in the HoL-ERBT group (p-value 0.011 and 0.027, respectively).</p><p><strong>Conclusions: </strong>Both holmium laser and bipolar energy sources are safe and effective in en bloc bladder tumor resection. HoL-ERBT showed a superior safety profile with no occurrence of ONR and a lower conversion rate, and offers an enhanced tumor pathological assessment regarding T1 substaging and the artifact score.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"111-117"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350914","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":"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":1.7,"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":"Re: Salvadó JA, Villena JM, Urrea F, et al. High-power holmium laser versus pulsed thulium laser for ureteroscopic lithotripsy: Results of a randomized prospective study. Cent European J Urol. 2026; 79: 30-35.","authors":"Marie Chicaud, Pietro Scilipoti, Olivier Traxer, Frederic Panthier","doi":"10.5173/ceju.2026.0054","DOIUrl":"10.5173/ceju.2026.0054","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"192-194"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350878","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 role of supramontanal preservation in ejaculation-sparing after transurethral resection of the prostate: A systematic review and meta-analysis.","authors":"Niwanda Yogiswara, Fikri Rizaldi, Mohammad Ayodhia Soebadi","doi":"10.5173/ceju.2025.0175","DOIUrl":"10.5173/ceju.2025.0175","url":null,"abstract":"<p><strong>Introduction: </strong>Transurethral resection of the prostate (TURP) is widely recognized as the gold standard surgical treatment for benign prostatic enlargement (BPE). However, despite its effectiveness, TURP is associated with male sexual dysfunction, with up to 70% of patients developing retrograde ejaculation. Recent evidence suggests that preserving supramontanal tissue around the verumontanum may preserve sexual outcomes. This study aims to assess the efficacy of supramontanal-sparing TURP as an ejaculation sparing approach in sexually active males with BPE through a systematic review and meta-analysis.</p><p><strong>Material and methods: </strong>The present review was performed using a systematic search, registered in PROSPERO (CRD42024614954), and followed PRISMA guideline. Sexual function and voiding outcomes were measured, including symptom scores, maximum flow rate (Q_max), and post-void residual (PVR). The results were presented as risk ratios (RRs) and mean differences (MDs), with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Six studies involving 540 patients, supramontanal-sparing TURP was compared to conventional TURP. The supramontanal-sparing TURP significantly reduced retrograde ejaculation (RR = 0.26, 95% CI: 0.14-0.46, p <0.01) and preserved semen volume better (MD = 1.04 ml, 95% CI: 0.36-1.73, p <0.01). Both techniques showed comparable outcomes in voiding function, including postoperative maximum flow rate, IPSS scores, and post-void residual volume (p = 0.49, p = 0.97, and p = 0.82, respectively).</p><p><strong>Conclusions: </strong>The supramontanal-sparing TURP technique demonstrated lower rates of retrograde ejaculation, while achieving similar voiding outcomes compared to standard TURP. These findings highlight the potential for preserving antegrade ejaculation after TURP when using the supramontanal-sparing technique.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"161-170"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350930","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 complications following simple cystectomy for radiation-induced bladder dysfunction compared to radical cystectomy: A matched cohort study.","authors":"Paweł Lipowski, Adam Ostrowski, Jan Adamowicz, Anastazja Zaigrajewa, Przemysław Jasiewicz, Filip Kowalski, Tomasz Drewa, Kajetan Juszczak","doi":"10.5173/ceju.2025.0163","DOIUrl":"10.5173/ceju.2025.0163","url":null,"abstract":"<p><strong>Introduction: </strong>Simple cystectomy (SC) for radiation-induced bladder dysfunction (RIBD) is occasionally performed, yet data regarding perioperative outcomes are limited. This study aimed to compare perioperative complications following SC for RIBD with radical cystectomy (RC) for bladder cancer.</p><p><strong>Material and methods: </strong>We conducted a retrospective single-center analysis of patients who underwent laparoscopic cystectomy with ureterocutaneostomy between 2016 and 2024. Propensity score matching (PSM) was applied separately for cT1-cT2 stage tumors, cT3-cT4 stage tumors, and for SC group vesicoenteric fistula patients. Outcomes were assessed using the Clavien-Dindo (CD) classification at 30 and 90 days.</p><p><strong>Results: </strong>In total, 257 patients were included in the study: 25 SC for RIBD and 232 RC for BC. Prior to matching, SC patients had significantly higher rates of CD grade ≥3 complications at 30 days (44% vs 22.4%, p <0.001), higher reoperation rates (47.8% vs 11.6%, p <0.001), and prolonged hospital stays (15 vs 9 days, p = 0.002). After matching, SC patients continued to demonstrate more severe complications, especially compared to cT1-T2 RC patients (CD ≥3 complications: 47.1% vs 11.8%, p = 0.057; reoperations: 56.2% vs 5.9%, p = 0.002). In patients with vesicoenteric fistula after matching, CD complication rates at 30 days did not differ significantly between groups (p = 0.130), 90-day complication rates were comparable (p = 0.968), and reoperations occurred significantly more often in the SC group (61.5% vs 6.7%; p = 0.004). Study limitations include the retrospective single-center design, small SC group size and urinary diversion type.</p><p><strong>Conclusions: </strong>Due to high morbidity, non-oncological cystectomy for RIBD should be limited to selected cases and managed in experienced, multidisciplinary centers. Urinary diversion without cystectomy may be a safer alternative.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"90-102"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350876","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":"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":1.7,"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}