Central European Journal of Urology最新文献

{"title":"Hiatal expansion and pelvic organ prolapse - the association is not causation.","authors":"Peter Petros","doi":"10.5173/ceju.2023.272","DOIUrl":"https://doi.org/10.5173/ceju.2023.272","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"203-205"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342534","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":"Laparoscopic vs open transcapsular adenomectomy (Millin): a comparative study of perioperative outcomes and complications.","authors":"Gonçalo Mendes, Alexandra Rocha, Bernardo Lobão Teixeira, Mariana Madanelo, Sofia Mesquita, Miguel Monteiro, Avelino Fraga, Diogo Nunes-Carneiro, João Cabral, Frederico Teves","doi":"10.5173/ceju.2023.223","DOIUrl":"https://doi.org/10.5173/ceju.2023.223","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic adenomectomy for prostates larger than 80 mL is still a topic of debate. The purpose of this study is to evaluate the perioperative outcomes and complications between open Millin (OM) and laparoscopic Millin (LM) adenomectomy.</p><p><strong>Material and methods: </strong>Perioperative data and complications were retrospectively collected from patients submitted to Millin procedure from August 2019 to August 2022 in a tertiary centre, and OM and LM were compared. Complications were classified according to Clavien-Dindo classification.</p><p><strong>Results: </strong>A total of 205 patients were identified, 125 in the OM group and 80 in the LM group. Baseline characteristics were similar between the groups. Mean total blood loss (194 ±210 vs 477 ±389 mL, p <0.001), mean haemoglobin drop (1.40 ±1.16 vs 2.62 ±1.42 g/dL, p <0.001), duration of catheterisation (4.63 ±1.39 vs 5.37 ±1.99 days, p = 0.004), and hospital stay (4.59 ±1.72 vs 5.82 ±3.36 days, p = 0.003) were significantly lower in the laparoscopic group. The mean operative time was longer in the laparoscopic group (109.9 ±33.4 vs 68.7 ±18.0 min, p <0.001). The overall complication rate was significantly lower in the laparoscopic group (18.8% vs 36.8%; p = 0.012), and this difference was maintained only in Clavien-Dindo groups I (3.8% vs 13.6%; p = 0.018) and II (12.5% vs 21.6%; p = 0.049). Regarding individual complications, patients in the LM group had significantly less haematuria (1.3% vs 8.8%, p = 0.031), wound infections (0% vs 4.8%, p = 0.047), and blood transfusions (0% vs 6.4%, p = 0.024).</p><p><strong>Conclusions: </strong>Laparoscopic Miilin adenometomy is a safe technique, with less intraoperative blood loss, shorter length of hospital stay and catheterisation time, and fewer complications, including a lower transfusion rate, than its open counterpart.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"256-261"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342537","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":"Management of urethral complications after total phallic reconstruction: a single center experience.","authors":"Mohammed Abdel-Rassoul, Galal El Shorbagy, Sameh Kotb, Ahmed Alagha, Samih Zamel, Ahmed M Rammah","doi":"10.5173/ceju.2023.160","DOIUrl":"https://doi.org/10.5173/ceju.2023.160","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the outcomes of different urethroplasty procedures as well as two novel techniques, invented in our center, in management of urethral complications after total phallic reconstruction.</p><p><strong>Material and methods: </strong>Different urethroplasty procedures were conducted according to the urethral pathology for 36 cis-male patients with urethral complications after total phallic reconstruction including meatoplasty, visual internal urethrotomy, staged Johanson urethroplasty utilizing either buccal mucosal graft or skin graft (Tiersche-Duplay principle), non-transecting urethroplasty (Hieneke-Miiklulicz principle), excision and primary anastomosis, as well as two novel techniques: urethral closure under a suprapubic tunnel and abdominal pedicled skin flap urethroplasty. Each patient was routinely evaluated one month after surgery and every 3 months for 12 months, with clinical evaluation, uroflowmetry and post-void residual urine.</p><p><strong>Results: </strong>With a total of 41 procedures for the 36 patients, 32 patients (88.8 %) could eventually void while standing. The success rate was highest for staged Johanson urethroplasty using split thickness skin graft, staged abdominal pedicled skin flap and excision and primary anastomosis, respectively, while it was lowest for visual internal urethrotomy (0% success) and non-transecting anastomotic urethroplasty (50% success). For staged versus one-stage procedures prospective analysis, 17 out of 26 one-stage procedures (65.4%) succeeded while 13 out of 15 staged procedures (86.6%) succeeded.</p><p><strong>Conclusions: </strong>Urethral complications following phalloplasty require complex procedures demanding a high level of surgical expertise. Abdominal pedicled skin flap urethroplasty is a viable option for long and recalcitrant urethral strictures.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"310-319"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342539","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":"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":"Outcomes and predictors of clinically significant prostate cancer detection by transperineal computer fusion biopsy during active surveillance.","authors":"Tomasz Milecki, Wojciech Malewski, Anna Barnaś, Omar Tayara, Andrzej Antczak, Piotr Kryst, Łukasz Nyk","doi":"10.5173/ceju.2024.95.R1","DOIUrl":"10.5173/ceju.2024.95.R1","url":null,"abstract":"<p><strong>Introduction: </strong>Active surveillance (AS) is an option for management of low-risk and selected intermediate prostate cancer (PC) patients. Pathological progression confirmed on prostate biopsy (PB) is the most common reason for transitioning to radical treatment. The role and timing of repeat PB during AS is a topic of ongoing debate.The aim of the study was to determine the detection rate of clinically significant PC (csPC) during AS protocol by transperineal computer fusion PB in low-risk PC patients enrolled based on results of transrectal systematic PB, and to identify predictors that may impact csPC detection.</p><p><strong>Material and methods: </strong>The study involved 95 patients with low-risk PC enrolled in AS, who underwent confirmatory or follow-up PB, proceeded by mpMRI.</p><p><strong>Results: </strong>The reclassification rate to csPC was 38.9% and 43.9% for confirmatory and follow-up biopsies, respectively. Patients with csPC differed significantly from those without csPC in the following parameters: prostate-specific antigen (PSA) 10.5 ng/ml vs 7.3 ng/ml (p = 0.029), PSA density (PSAD) 0.27 ng/ml² vs 0.18 ng/ml² (p = 0.006), age - 68 years vs 66.5 years (p = 0.024), lesion size 16 mm vs 14 mm (p = 0.042), and PIRADS score (p = 0.004). Multivariable regression models showed that PIRADS score each one-category increase hazard ratio (HR) - 3.615 (1.599-8.172), PSAD >0.20 ng/ml²; HR - 2.760 (1.065-7.149) and age; HR - 1.085 (1.011-1.164) were independent factors increasing the probability of csPC detection in PB.</p><p><strong>Conclusions: </strong>Confirmatory and repeat transperineal PB detect a significant rate of csPC in low-risk PC patients on AS. Higher PIRADS score and PSAD >0.20 ng/ml² increase the csPC detection rates during AS and should prompt immediate PB.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"418-423"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669115","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}