Central European Journal of Urology最新文献

{"title":"Predictive factors for difficult ureter in primary kidney stone patients before retrograde intrarenal surgery.","authors":"Samet Senel, Emre Uzun, Kazim Ceviz, Hasan Batuhan Arabaci, Sedat Tastemur, Antonios Koudonas, Cuneyt Ozden","doi":"10.5173/ceju.2024.243","DOIUrl":"https://doi.org/10.5173/ceju.2024.243","url":null,"abstract":"<p><strong>Introduction: </strong>Ureter may be resistant to insertion of ureteral access sheath (UAS) and/or semi-rigid ureterorenoscope because of the narrow ureter, 'difficult ureter' especially in primary retrograde intrarenal surgery (RIRS) cases. We aimed to delineate the parameters that affect significantly the accessibility of the ipsilateral ureter of the stone-bearing patient side.</p><p><strong>Material and methods: </strong>The data of age, gender, body mass index, comorbidities, prior urinary tract infection, prior stone passage, stone burden, stone density, number of stones, stone localization, surgery side, the presence of hydronephrosis and need for double J (DJ) stent due to difficult ureter for all patients were reviewed. Difficult ureter was defined as the insertion inability of a semi-rigid ureterorenoscope or UAS into the ureter at the surgery side. All patients were divided into two groups as difficult ureter group and non-difficult ureter group.</p><p><strong>Results: </strong>A total of 454 patients who underwent RIRS for primary kidney stones were included. The incidence of difficult ureter was 7.5% (34/454). The patients in the difficult ureter group were younger. Female gender and prior urinary tract infection rates were higher in the difficult ureter group. Multivariate logistic regression analysis indicated that the factors significantly associated with higher odds of having a difficult ureter in primary RIRS patients were younger age (OR 1.040; 95% CI 1.010-1.070; p = 0.008), female gender (OR 2.859; 95% Cl 1.383-5.908; p = 0.005) and prior urinary tract infection (OR 3.327; 95% CI 1.230-8.999; p = 0.018).</p><p><strong>Conclusions: </strong>Difficult ureter was associated with younger age at the time of RIRS, female gender and the manifestation of urinary infections in the patient's medical history.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"280-285"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342541","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: Ioannis Tsikopoulos, Lazaros Lazarou, Lazaros Tzelves L et al. The effect of pelvic floor muscle training on urodynamic parameters in women with stress urinary incontinence. Cent European J Urol. 2023; 76 (4): 315-321.","authors":"Yasemin Yumusakhuylu, Cihat Kurt, Belgin Erhan","doi":"10.5173/ceju.2024.47","DOIUrl":"https://doi.org/10.5173/ceju.2024.47","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"278-279"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342544","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 impact of artificial intelligence in revolutionizing all aspects of urological care: a glimpse in the future.","authors":"Carlotta Nedbal, Ewa Bres-Niewada, Bartosz Dybowski, Bhaskar K Somani","doi":"10.5173/ceju.2023.255","DOIUrl":"https://doi.org/10.5173/ceju.2023.255","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"12-14"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847603","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 ureteral double J stent insertion on work performance in patients undergoing endoscopic stone treatment.","authors":"Muhammed Emin Polat, Mustafa Karaaslan, Mehmet Yilmaz, Erkan Olcucuoglu, Mehmet Emin Sirin","doi":"10.5173/ceju.2023.110","DOIUrl":"https://doi.org/10.5173/ceju.2023.110","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the developments in the material of the double J (DJ) stents and the production of thinner ones of desired sizes, patients continue to experience troublesome DJ stent-related symptoms in their lives. This study aimed to determine how DJ stenting affects patients' work performance after endoscopic stone surgery.</p><p><strong>Material and methods: </strong>A total of 107 patients underwent placement of a ureteral stent after ureterorenoscopy (URS)/retrograde intrarenal surgery (RIRS), and only active and full-time working patients were included. All patients were asked to complete the validated Turkish version of the work performance score (WPS) questionnaire in the Ureteral Stent Symptom Questionnaire (USSQ) the day before stent removal and again one month after stent removal.</p><p><strong>Results: </strong>Of the participants, 32.7% (n = 35) were female and 67.3% (n = 72) were male; the mean age was 41 (19-80) years. The workday loss had no statistically significant correlation with patient BMI, stone size, or stent indwelling time (p >0.005); however, a statistically significant negative correlation was detected with patient age (r = -0.335, p <0.001). The medians of WPSs with the stent and without the stent were 6 (3-15) and 3 (3-12), respectively (p <0.001).</p><p><strong>Conclusions: </strong>Although DJ catheterization is a crucial tool for urological practice, it may increase the social and economic burden of patients due to reduced work performance and lost workdays. Therefore, limiting the duration of the DJ stent's stay and providing treatments to minimize patient symptoms will positively impact their professional lives. It would be beneficial to avoid DJ stenting in routine practice unless medically necessary.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"117-121"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848039","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":"Retrograde intrarenal surgery using the ILY robotic flexible ureteroscope: a single centre experience.","authors":"Jan Łaszkiewicz, Wojciech Krajewski, Łukasz Nowak, Joanna Chorbińska, Francesco Del Giudice, Aleksandra Sójka, Małgorzata Mazur, Szymon Pisarski, Wojciech Tomczak, Bartosz Małkiewicz, Tomasz Szydełko","doi":"10.5173/ceju.2023.228","DOIUrl":"https://doi.org/10.5173/ceju.2023.228","url":null,"abstract":"<p><strong>Introduction: </strong>The ILY robotic flexible ureteroscope has been introduced in order to improve intraoperative ergonomics, reduce operator distance from radiation and shorten the learning curve. In this study we aimed to assess the clinical performance and feasibility of the ILY robot during retrograde intrarenal surgery (RIRS) and combined endoscopic procedures (miniECIRS).</p><p><strong>Material and methods: </strong>The RIRS procedures were performed using the ILY robotic arm in 57 adult patients (46 RIRS and 11 miniECIRS) from 2022 to 2023. All procedures were performed in the supine position. Pre-stenting was not the standard of care.</p><p><strong>Results: </strong>Turning on and calibration of the device took approximately 100 s. Average draping time was 93 s using original ILY drapes and 47 s using classic drapes designed for C-arm covering. Mean docking time was 73 s in procedures with ureteral access sheath (UAS) and 61 s in procedures without it. The undocking took less than 60 s in every case. Average procedure time was 63 min for RIRS and 55 min for miniECIRS. Endoscopically proven stone-free rate was achieved in 37 (80.4%) RIRS and 10 (90.9%) miniECIRS patients. A total of 17 (36.9%) RIRS and 8 (72.7%) miniECIRS procedures required conversion in order to perform basketing and stone fragments retrieval/transposition.</p><p><strong>Conclusions: </strong>The use of ILY robot during endourological procedures is feasible and urologists that are familiar with the device controller do not require extensive training. The time needed for device draping, docking and undocking was approximately 4 minutes. Moreover, use of the robot resulted in satisfactory stone-free rates.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"136-139"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848274","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":"Regional versus general anaesthesia in percutaneous nephrolithotomy: a systematic review and meta-analysis.","authors":"Mohammed Shahait, Tuan Thanh Nguyen, Nguyen Xuong Duong, Philip Mucksavage, Bhaskar K Somani","doi":"10.5173/ceju.2023.233","DOIUrl":"https://doi.org/10.5173/ceju.2023.233","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have compared the safety and effectiveness of general and regional anaesthesia in percutaneous nephrolithotomy (PCNL). This study aimed to compare the perioperative and postoperative outcomes of general anaesthesia and regional anaesthesia for patients undergoing PCNL.</p><p><strong>Material and methods: </strong>For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until March 2023. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines. The risk ratio (RR) and mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI).</p><p><strong>Results: </strong>The final cohort analysis, comprised 3871 cases of PCNL, (2154 regional anaesthesia and 1717 general anaesthesia). Compared to general anaesthesia, the regional anaesthesia group had a significantly shorter length of stay (MD = -0.34 days, 95% CI -0.56 to -0.12, p = 0.002), lower postoperative nausea and vomiting rates (RR = 0.16, 95% CI 0.03 to 0.80, p = 0.026), lower complications grade III-V rates (RR = 0.68, 95% CI 0.53 to 0.88, p = 0.004), and lower postoperative visual analogue pain score (VAS) at 1 hour (MD = -3.5, 95% CI -4.1 to -2.9, p <0.001). There were no significant differences in other outcomes between the two groups.</p><p><strong>Conclusions: </strong>Our results show that PCNL under regional anaesthesia is safe and feasible, with comparable results to those done under general anaesthesia. While patient selection is important, counselling and decision-making for these procedures must go hand in hand to achieve the best clinical outcome.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"140-151"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851513","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":"Extracorporeal shock wave lithotripsy, ureterolithotripsy, and percutaneous nephrolithotripsy challenges in managing spinal cord neuropathy patients. Lessons learned from a scoping review.","authors":"Daniele Castellani, Carlo Brocca, Demetra Fuligni, Carlo Giulioni, Angelo Antezza, Angelo Cormio, Arianna Rubino, Lucia Pitoni, Virgilio De Stefano, Giulio Milanese, Luigi Cormio, Bhaskar Kumar Somani, Vineet Gauhar, Andrea Benedetto Galosi","doi":"10.5173/ceju.2023.123","DOIUrl":"10.5173/ceju.2023.123","url":null,"abstract":"<p><strong>Introduction: </strong>We aim to review the outcomes of shock wave lithotripsy (SWL), ureteroscopy, and percutaneous nephrolithotripsy (PCNL) for renal and ureteral stones in spinal cord neuropathy patients (SNP).</p><p><strong>Material and methods: </strong>A literature search was performed on 8^th March 2023 using PubMed, EMBASE, and Google Scholar with no date limit. Preclinical/animal studies, reviews, letters to the editor, case reports, and meeting abstracts were excluded. Only English papers were accepted.</p><p><strong>Results: </strong>Thirty-five articles were accepted. Five studies focused on SWL, 17 on PCNL, and 6 on ureteroscopy. The remaining articles employed more than one procedure. Stone composition has shifted from struvite to the more common calcium phosphate. SWL showed a very poor stone-free rate (SFR) likely due to challenges in patient positioning, stone visualization, localization, and inability to pass fragments spontaneously. Flexible ureteroscopy and PCNL were associated with a high incidence of infectious complications, long hospital stays, high blood transfusion rate, and intensive care admissions. There were also cases of death. Both procedures were challenging due to genitourinary reconstruction, scoliosis and kyphosis, rib-cage deformity, lower limb contractures, and severe comorbidity which also affected anesthesia. SFR was lower than in non-neurological patients.</p><p><strong>Conclusions: </strong>SWL, ureterolithotripsy, and PCNL should be considered challenging procedures in SNP due to positioning issues, an increased risk of intra and peri-operative morbidity, and even mortality. Computed tomography should be recommended to assess residual fragments as it becomes imperative to minimize a re-intervention in SNP who should be preferably treated in referral centers.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"89-110"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847414","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":"Endoflex - the first portable virtual simulator for flexible ureterorenoscopy (fURS): pilot study.","authors":"Ali Talyshinskii, B M Zeeshan Hameed, Prajwal P Ravinder, Nithesh Naik, Kinju Adhikari, Ulanbek Zhanbyrbekuly, Bhaskar K Somani","doi":"10.5173/ceju.2024.34.R1","DOIUrl":"10.5173/ceju.2024.34.R1","url":null,"abstract":"<p><strong>Introduction: </strong>The market for virtual reality simulators designed to simulate retrograde intrarenal kidney stone (RIRS) surgery, utilising flexible ureteroscopes, is highly limited and dominated by a handful of simulators. The objective of our research is to carry out a pilot study and to provide a description of Endoflex, a transportable virtual flexible ureterorenoscopy simulator for kidney stone treatment.</p><p><strong>Material and methods: </strong>Seventeen novices were recruited, and each performed a virtual ureterorenoscopy with lithotripsy and lithoextraction. The cavity and location of the stone were determined randomly using the random.org portal. The same scenario was used after an educational week, to define changes in metrics. The time taken for the entire simulation, lasing time, fluoroscopic time, stone-free rate, novices' opinions regarding the usefulness of such a simulator in their training, and its impact on their motivation to continue learning endourological skills were evaluated. Three experienced endourologists were asked about the face and content validity.</p><p><strong>Results: </strong>There was a significant decrease in simulation time, activated laser time, and fluoroscopy time. The number of novices who fully cleared the pelvicalyceal system increased from 11 to 15 (out of 17). All participants found the Endoflex simulator to be useful for their education. The face and content validity estimated was 4 each for face and content validity.</p><p><strong>Conclusions: </strong>Endoflex is a promising VR-simulator that can be implemented in urological simulation-based training. However, further improvements are necessary for its full-fledged training of RIRS.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"486-493"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669075","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":"Thulium laser en bloc resection is a safe and efficacious alternative to conventional bipolar transurethral resection of bladder tumors.","authors":"Osama Zaytoun, Neeraja Tillu, Kaushik Kolanukuduru, Arjun Venkatesh, Manish Choudhary, Zachary Dovey, Tommasangelo Petitti, Maida Bada, Maurizio Buscarini","doi":"10.5173/ceju.2024.103.R1","DOIUrl":"10.5173/ceju.2024.103.R1","url":null,"abstract":"<p><strong>Introduction: </strong>Bipolar transurethral resection of bladder tumors (bTURBT) is the standard of care technique for the management of bladder tumors; however, new techniques such as thulium laser en bloc resection of bladder tumors (TmLRBT) have been introduced as alternatives to bTURBT. In this study, detrusor muscle acquisition, perioperative outcomes and survival outcomes after TmLRBT and bTURBT were prospectively compared in patients with primary bladder tumors (1-5 cm).</p><p><strong>Material and methods: </strong>This prospective interventional study, conducted over ten years, involved 542 patients under a single surgeon. Inclusion criteria were a single tumor of 1-5 cm. The primary endpoint was the presence or absence of detrusor muscle. Perioperative criteria included operative time, hospital stay length, catheterization duration, bladder perforations, readmissions, and complication incidence. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed using the Kaplan-Meier method with subgroup comparisons by the log-rank test.</p><p><strong>Results: </strong>Of 449 patients, 211 underwent TmLRBT and 238 underwent bTURBT. Detrusor muscle was present in 201 (95.2%) TmLRBT patients vs 154 (64.7%) bTURBT patients (p <0.001). Complications were less frequent in the TmLRBT group (p <0.05). Hemoglobin drop (p <0.001), hospital stay (p <0.001), catheterization duration (p <0.001), and operative time (p <0.001) were all significantly lower in the TmLRBT group. Kaplan-Meier analysis showed no significant differences in RFS (p = 0.255) and CSS (p = 0.258) between the groups.</p><p><strong>Conclusions: </strong>TmLRBT demonstrated significantly better detrusor muscle inclusion and perioperative outcomes compared to bTURBT.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"466-471"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669226","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":"Understanding the role of surveys in modern urology: an insight into survey trends over the decades.","authors":"Carlotta Nedbal, Steffi Kar Kei Yuen, Pietro Tramanzoli, Martina Maggi, Carlo Giulioni, Virgilio De Stefano, Rossella Nicoletti, Maria Pia Pavia, Giacomo Maria Pirola, Ee Jean Lim, Chu Ann Chai, Wei Zheng So, Andrea Benedetto Galosi, Bhaskar Kumar Somani, Daniele Castellani, Vineet Gauhar","doi":"10.5173/ceju.2024.89","DOIUrl":"10.5173/ceju.2024.89","url":null,"abstract":"<p><strong>Introduction: </strong>To provide a comprehensive review of survey trends in urology, aiming to provide insight into changes in publication in the new millennium. Surveys in healthcare allow for a better understanding of the knowledge, attitudes, and practice patterns as well as gaps in healthcare systems.</p><p><strong>Material and methods: </strong>A comprehensive review of all \"surveys in urology answered by urologists\" was performed through the PubMed and Scopus databases, according to the SPICE framework. Included surveys were divided according to the subject: \"Uro-oncology\", \"Urolithiasis\", \"Mental health\" \"Resident training\", and \"Miscellaneous\". Publications were then divided into 2 main periods: Period-1 (2000-2011) and Period-2 (2012-2023).</p><p><strong>Results: </strong>A total of 361 surveys have been published since 2000, with a significant overall increasing trend in the recent decade (p <0.001). A significantly increasing focus is seen for publications on resident training (n = 86; +660%; p = 0.003), mental health (n = 31; +650%; p = 0.001), urolithiasis (n = 40; +371%; p = 0.002), and uro-oncology (n = 94; +230%, p ≤0.001). In subanalysis, the largest increase in publications was noted for surveys on radical prostatectomy (+175%, p = 0.024), surgical treatment of urolithiasis (+320%, p = 0.040), quality of resident education (+483%, p <0.001), and personal satisfaction with resident training (+500%, p = 0.005).</p><p><strong>Conclusions: </strong>Over the decades, surveys have served as an effective interactive tool for urologists to engage and investigate different aspects of practice and training across sub-specialties. In modern times, better evaluation tools integrated with AI will provide a bigger platform for urologists to use surveys as part of their armamentarium to address and evaluate not only clinical practices but also emotional challenges, training needs, and inequalities that hinder progress in urology.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"547-565"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669227","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}