Central European Journal of Urology最新文献

{"title":"Beyond conventional forceps: suction biopsy and cryobiopsy in upper tract urothelial tumors.","authors":"Bartosz Dybowski","doi":"10.5173/ceju.2026.001E","DOIUrl":"10.5173/ceju.2026.001E","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"73-74"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350973","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":"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":1.7,"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":"Differences in pentafecta outcome between on-clamp and off-clamp robotic partial nephrectomy.","authors":"Nicolò Fiorello, Gregorio Romei, Giulia Tornabene, Francesco Gregori, Erika Massai, Francesco De Vita, Carlo Alberto Sepich","doi":"10.5173/ceju.2025.0220","DOIUrl":"10.5173/ceju.2025.0220","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic partial nephrectomy (RAPN) can be considered the gold standard for the treatment of localized renal tumors (cT1-T2a). The on-clamp approach is considered safer for complex tumors, but the off-clamp approach is constantly growing, offering advantages for renal function.</p><p><strong>Material and methods: </strong>We enrolled 517 patients underwent RAPN between 1/2020 and 12/2023 and we divided in two groups: A (on-clamp) and B (off-clamp). We analyzed the individual parameters of the pentafecta outcomes, so absence of complications, negative surgical margins (PSMs), and warm ischemia period shorter than 25' or zero ischemia, >90% preservation of estimated glomerular filtration rate (eGFR) and no stage progression of chronic kidney disease (CKD) at 1-year follow-up, and finally the overall results.</p><p><strong>Results: </strong>The duration of surgery was significantly longer in group A (120' vs 90') (p <0.001). The median value for duration of warm ischemia was 16 minutes. Postoperative complications occurred in 22 cases (4.2%). Although the frequency of anemia was higher in Group B, in relation to the total number of procedures, no statistically significant difference was found (p = 0.36), neither for PSMs rate (p = 0.73). The achievement of pentafecta outcomes in group A and B was 79.7% and 91.2%, respectively (p ≤0.001). In patients who have undergone ischemia, the duration of clamping is correlated with the increase in postoperative creatinine (p <0.001).</p><p><strong>Conclusions: </strong>Off-clamp approaches show better results in pentafecta outcomes and to reduce the risk of increased creatinine in the post-operative course, although they require greater surgical skill but offer shorter execution times.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"84-89"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350892","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":"Impact of prior shock wave lithotripsy on outcomes of retrograde intrarenal surgery for 1-2 cm lower pole kidney stones: a comparative analysis by the EAU-YAU Endourology & Urolithiasis Working Group.","authors":"Rifat Burak Ergül, Yasin Yitgin, T Emre Şener, Arman Tsaturyan, Francesco Esperto, Begona Ballesta Martinez, Ali Talyshinskii, Victoria Jahrreiss, Lazaros Tzelves, Emine Yitgin, Tzevat Tefik, Amelia Pietropaolo","doi":"10.5173/ceju.2025.0188","DOIUrl":"10.5173/ceju.2025.0188","url":null,"abstract":"<p><strong>Introduction: </strong>The study compared the outcomes of retrograde intrarenal surgery (RIRS) performed as a second-line treatment following failed extracorporeal shock wave lithotripsy (SWL) with those of primary RIRS in patients with 1-2 cm lower pole kidney stones.</p><p><strong>Material and methods: </strong>A total of 83 patients who underwent RIRS for 1-2 cm lower pole renal calculi between February 2019 and September 2024 were retrospectively analyzed in this single-center study. Patients were divided into two groups: those who underwent RIRS after failed SWL (n = 43) and those who underwent primary RIRS (n = 40). Preoperative demographics, stone characteristics, operative parameters, and postoperative outcomes were compared. Statistical analyses were performed using R software.</p><p><strong>Results: </strong>There were no significant differences between the groups in terms of age, gender, body mass index, stone size, laterality, density, or Ito scores. The failed SWL group had significantly longer operative time (60 [55-75] vs 55 [40-66] min, p = 0.041), RIRS time (45 [37.5-55] vs 40 [30-46] min, p = 0.043), and fluoroscopy time (4 [3-7] vs 2 [2-4] s, p = 0.001). The stone-free rate was lower in the failed SWL group (79% vs 92%), but the difference was not statistically significant (p = 0.153). Postoperative urinary tract infections and complication rates were similar between groups (p >0.05).</p><p><strong>Conclusions: </strong>RIRS remains an effective and safe option for managing lower pole kidney stones after failed SWL. However, previous SWL may increase procedural complexity, as reflected by longer operative and fluoroscopy times. Given the retrospective single-center design and limited sample size, the study's findings should be considered exploratory and interpreted with appropriate caution pending validation in larger, multicenter cohorts.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"171-177"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350960","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":"Augmented reality-assisted rectum-free transperineal prostate biopsy: a next-generation image-guided technique.","authors":"Abdulrahman Al-Bayati, Nicolas A Soputro, Karim Daher, Mohamad Watfa, Salim K Younis, Ruben Olivares, Jihad Kaouk, Zeyad R Schwen","doi":"10.5173/ceju.2025.0312","DOIUrl":"https://doi.org/10.5173/ceju.2025.0312","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"206"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350955","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":"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":1.7,"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}

{"title":"YouTube and TikTok as patient resources: assessment of online video content on extracorporeal shock wave lithotripsy.","authors":"Ayberk Iplikci, Kenan Toprak, Ozgur Arikan, Asif Yildirim","doi":"10.5173/ceju.2025.0306","DOIUrl":"10.5173/ceju.2025.0306","url":null,"abstract":"<p><strong>Introduction: </strong>Our objective was to determine the content, reliability, and quality of YouTube and TikTok videos related to extracorporeal shock wave lithotripsy (SWL).</p><p><strong>Material and methods: </strong>The key word \"shock wave lithotripsy\" was searched on YouTube and TikTok in July 2025 and the first 100 videos on both platforms were watched. Video characteristics were documented, and each video was independently evaluated by two urologists using a custom-designed comprehensiveness scale, along with the modified DISCERN and Global Quality Scale (GQS).</p><p><strong>Results: </strong>Sixty-five YouTube and 23 TikTok videos met the inclusion criteria. While YouTube videos were longer in duration (p <0.001), TikTok videos achieved a significantly greater median view count (p = 0.048). YouTube videos demonstrated significantly higher scores on the comprehensiveness scale, modified DISCERN, and GQS compared to TikTok videos, respectively (p = 0.001, p <0.001, p = 0.002). Most narrators were urologists (54.5%), and their videos scored significantly higher GQS compared to others (p = 0.001). Comprehensiveness scale modified DISCERN and GQS scores were significantly positively correlated with duration of video (p <0.001). The scales demonstrated positive intercorrelations among themselves (p <0.001).</p><p><strong>Conclusions: </strong>YouTube videos about SWL were of higher quality, reliability, and comprehensiveness than TikTok videos, although TikTok content attracted more viewers. The results emphasize that popularity does not equate to accuracy and underscore the importance of increasing the availability of high-quality, expert-led educational content across social media platforms.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"178-184"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350883","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":"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":1.7,"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":"Single-port transvesical enucleation of a 903-ml prostate: technical adaptations for giant prostatic hyperplasia.","authors":"Salim K Younis, Lin Wang, Karim Daher, Mahmoud Abou Zeinab, Abdulrahman Al-Bayati, Nicolas A Soputro, Mohamad Watfa, Samarpit Rai, Rui M Bernardino, Riccardo Autorino, Jihad Kaouk","doi":"10.5173/ceju.2026.0026","DOIUrl":"10.5173/ceju.2026.0026","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"207-208"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350939","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":"Does body mass index affect the proper pre-operative grade and stage assessment in patients with prostate cancer undergoing radical prostatectomy?","authors":"Julia Drewa, Jan Adamowicz, Kajetan Juszczak","doi":"10.5173/ceju.2025.0298","DOIUrl":"10.5173/ceju.2025.0298","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate pre-operative assessment of prostate cancer (PCa) grade and stage is critical for determining the optimal treatment strategy and predicting oncological outcomes. Body mass index (BMI) may affect the diagnostic accuracy of pre-operative evaluations.Aim of the study is to investigate whether BMI affects the accuracy of pre-operative grade and stage assessment in patients PCa who undergo robotic-assisted radical prostatectomy (RARP).</p><p><strong>Material and methods: </strong>This retrospective study analyzed 338 patients with PCa who underwent RARP, assessing concordance between preoperative and postoperative tumor grade (ISUP, Gleason) and stage (TNM) across BMI categories. Correlations between BMI and histopathological parameters were examined, and potential risk factors for underestimation in preoperative evaluation were identified.</p><p><strong>Results: </strong>The median age and BMI of the cohort was 67 years. The median BMI was 27.4 with 49.7% overweight and 25.6% obese. Upstaging occurred in 56.4% of cases, with concordance in 34.9% and overestimation in 8.7%. Underestimation rates increased progressively with BMI - 51.8% (normal weight), 54.5% (overweight), and 65.4% (obese). Similarly, ISUP grade concordance declined with higher BMI, from 48.7% in normal-weight to 31.2-33.8% in obese patients, paralleled by higher underestimation (34-36% vs 49-54%). Gleason score concordance also fell with increasing BMI, while underestimation rose accordingly. Although BMI correlated weakly with most postoperative pathological parameters, higher BMI was significantly associated with underestimation of grade and stage. Metabolic comorbidities (particularly hypertension and diabetes) further amplified this trend.</p><p><strong>Conclusions: </strong>Elevated BMI is associated with a progressively increased risk of underestimating PCa grade and stage during preoperative assessment. The reduced concordance across TNM staging, ISUP grading, and Gleason scoring is observed in obese patient with PCa. Due to the risk of underestimating PCa, patients in this group should be very cautiously selected for active surveillance.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"79 2","pages":"118-125"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350882","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}