Central European Journal of Urology最新文献

{"title":"Regulatory T cells in non-muscle invasive bladder cancer: Immune modulators, prognostic markers, and therapeutic targets.","authors":"Dimitrios Diamantidis, Georgios Tsakaldimis, Stilianos Giannakopoulos, Alexandra Giatromanolaki, Evangelia Deligeorgiou, Stavros Lailisidis, Christos Kalaitzis","doi":"10.5173/ceju.2025.0036","DOIUrl":"10.5173/ceju.2025.0036","url":null,"abstract":"<p><strong>Introduction: </strong>Non-muscle invasive bladder cancer (NMIBC) is characterized by a high recurrence rate and variable response to intravesical Bacillus Calmette-Guérin (BCG) therapy. Regulatory T cells (Tregs), a specialized subset of CD4+ T lymphocytes expressing FOXP3, play a crucial role in shaping the tumor immune microenvironment by suppressing anti-tumor immune responses. Their presence in NMIBC has been associated with both immune evasion and, paradoxically, potential protective effects under specific conditions.This review examines the role of Tregs in NMIBC, focusing on their impact on the tumor microenvironment, prognosis, and therapeutic potential.</p><p><strong>Material and methods: </strong>A literature review was conducted using PubMed to analyze studies on Tregs in NMIBC, including their immunosuppressive mechanisms and therapeutic targeting strategies.</p><p><strong>Results: </strong>Tregs suppress anti-tumor immunity through cytokine secretion (interleukin-10, tumor growth factor β), metabolic adaptations, and inhibition of CD8+ T cells. High FOXP3+ Treg levels are associated with increased recurrence and progression, particularly post-BCG. PD-L1+ Tregs contribute to BCG resistance, making them a potential target for immune checkpoint inhibitors and combination therapies.</p><p><strong>Conclusions: </strong>Tregs are key modulators of NMIBC progression and treatment response. Targeting their suppressive functions may enhance immunotherapy outcomes and improve patient prognosis.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 4","pages":"462-469"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269807","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":"Predicting extracorporeal shock wave lithotripsy success with a machine learning nomogram: A pilot study.","authors":"Jan Svihra, Peter Svihra, Igor Sopilko","doi":"10.5173/ceju.2025.0104","DOIUrl":"10.5173/ceju.2025.0104","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this pilot study was to develop and validate a machine learning (ML)-based clinical nomogram to predict the success rate of extracorporeal shock wave lithotripsy (ESWL) for kidney stones, optimizing patient selection and treatment outcomes.</p><p><strong>Material and methods: </strong>A retrospective analysis of ESWL data in all nephrolithiasis patients was performed from January 2018 to September 2022. Age, gender, stone size, stone area, stone location inside the kidney, stone density, skin-to-stone distance (SSD), stent presence, hydronephrosis presence, complications, and number of ESWL procedures were analysed. Inclusion criteria were a single kidney stone, stone size 5 mm to 20 mm, stone density less than average 1000 HU according to a native CT scan, and an adult patient. Statistical analysis was performed using the T test, mean, and standard deviation, and the calculations were processed using IBM SPSS Statistics for Macintosh, Version 25.0 with statistically significant values indicated by p <0.05. Python programming language was used to test machine learning models based on the previous study data. The scikit-learn library was used as a source of different ML models.</p><p><strong>Results: </strong>102 patients fulfilled inclusion and exclusion criteria. There were 70 male and 32 female patients. The mean age was 54.1 ±13.2 years, mean stone size 9.1 ±3.1 mm, stone area 47.3 ±30.8 mm² and SSD 8.4 ±1.8 cm. Patients were divided into two groups. The first group consisted of patients who achieved an SFR ≤3 mm after single ESWL procedure (group ESWL 1^st, n = 42), the second group were patients who needed more than one ESWL procedure to achieve the SFR (group ESWL n^th, n = 60). Statistically significant predictors of single-treatment success were stone size (7.9 ±2.2 mm vs 10.0 ±3.4 mm, p <0.001), stone area (34.1 ±19.4 mm² vs 56.6 ±33.9 mm², p <0.001), and SSD (7.2 ±1.3 cm vs 9.3 ±1.7 cm, p <0.001). The Linear Discriminant Analysis model (LDA) achieved a mean predictive accuracy of ~70%. The final nomogram identified the highest probability of single-treatment ESWL success for SSD ≤8 cm and stone area ≤60 mm², in all locations except for stones in the lower kidney pole.</p><p><strong>Conclusions: </strong>Using machine learning we have introduced the nomogram predicting single treatment success rate of an ESWL procedure. The application of this ML-nomogram in clinical practice enables the nomogram to continuously improve and refine its outputs as new data become available.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 4","pages":"540-545"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269769","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 of Rezum water vapor therapy for benign prostate obstruction with 1-year follow-up: Largest real-world data from Turkey.","authors":"Basri Cakiroglu, İsmail Cenk Acar, Bekir Sami Uyanık","doi":"10.5173/ceju.2024.0224","DOIUrl":"10.5173/ceju.2024.0224","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to retrospectively assess the safety and efficacy of Rezum, a promising minimally invasive treatment method for BPH, in patients treated at our clinic.</p><p><strong>Material and methods: </strong>From January 1, 2022, to December 31, 2022, a cohort of 71 patients presenting with moderate to severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) were enrolled in the study. These individuals opted for Rezum therapy as their treatment approach. Primary outcome measures included the International Prostate Symptom Score (IPSS), maximum flow rate (Q_max), post-void residual volume (PVR), Quality of Life (QoL), prostate volume (PV), prostate-specific antigen (PSA), and the International Index of Erectile Function (IIEF) questionnaire.</p><p><strong>Results: </strong>The median age of the 71 patients was 62.1 ±9.3 years, with a median PV of 60.4 ±16.6 ml. Preoperatively, IPSS was 21.9 ±5.2, Q_max was 9.67 ±3.2, QoL was 3.35 ±0.61, IIEF-5 was 23.9 ±5.4, total PSA was 2.43 ±1.27 ng/ml, and PVR was 177.4 ±216.5 ml. At the 3-month follow-up, IPSS improved to 10.1 ±5.6, Q_max to 24.5 ±3.7, QoL to 1.2±0.51, IIEF-5 to 24.5 ±5.4, total PSA to 1.8 ±0.9 ng/ml, and PVR remained at 177.4 ±216.5 ml. At the 12-month follow-up, IPSS was 6.0 ±3.1, Q_max was 18.12 ±3.7, QoL was 1.2 ±0.51, IIEF-5 was 24.5 ±5.4, total PSA was 1.8 ±0.9 ng/ml, and PVR was 24.9 ±25.2 ml.</p><p><strong>Conclusions: </strong>Rezum therapy is a safe, effective, and minimally invasive option for the treatment of men with moderate to severe lower urinary tract symptoms (LUTS).</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 2","pages":"144-150"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ureteral stents with extraction strings - a review on infection risk and prevention.","authors":"Patryk Osiński, Jakub Bartłomiej Kawecki, Martyna Zofia Stachoń, Izabela Teresa Zawadzka, Ewa Bres-Niewada, Bartosz Dybowski","doi":"10.5173/ceju.2024.0222","DOIUrl":"https://doi.org/10.5173/ceju.2024.0222","url":null,"abstract":"<p><strong>Introduction: </strong>This review aims to determine whether the use of ureteral stents with extraction strings in adult patients undergoing upper urinary tract endoscopic procedures results in a higher incidence of urinary tract infections (UTIs) compared to stents without strings.</p><p><strong>Material and methods: </strong>A systematic literature search was conducted using PubMed, Scopus, and Google Scholar. Studies evaluating differences in UTI rates among adult patients with ureteral stents with or without extraction strings were included. Data on UTI rates, antibiotic prophylaxis protocols, and stent dwell time were extracted.</p><p><strong>Results: </strong>The review included 11 trials published between 2015 and 2023. One multicenter retrospective study involving 4,392 patients reported a significantly higher UTI rate in patients with extraction strings (2.1% vs 1.1%, p = 0.006). In the remaining 10 studies, including four randomized controlled trials, the differences were not statistically significant. Antibiotic prophylaxis was described in five studies. In two studies, a single perioperative antibiotic dose was administered, with a total UTI rate of 6.8% (28/410). In contrast, three studies using prolonged prophylactic antibiotic regimens reported a total UTI rate of 3.2% (13/403). The impact of stent dwell time on UTI risk could not be determined. The risk of bias was high in 10 studies and moderate in one retrospective study.</p><p><strong>Conclusions: </strong>Based on low-quality evidence, the difference in UTI risk between ureteral stents with and without extraction strings appears to be minimal and statistically insignificant. Well-designed studies with standardized methodologies are needed to clarify these findings.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"94-99"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of pre-stenting on flexible and navigable suction (FANS) access sheath outcomes. Results of a prospective multicentre study by the EAU Section of Endourology and the global FANS collaborative group.","authors":"Victoria Jahrreiss, Vineet Gauhar, Olivier Traxer, Khi Yung Fong, Saeed Bin Hamri, Karl Tan, Vigen Malkhasyan, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Steffi Yuen, Vikram Sridharan, Daniele Castellani, Mehmet Ilker Gökce, Nariman Gadzhiev, Deepak Ragoori, Boyke Soebhali, Chu Ann Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Tzevat Tefik, Anil Shrestha, Marek Zawadzki, Mohamed Amine Lakmichi, Christian Seitz, Bhaskar K Somani","doi":"10.5173/ceju.2024.0197","DOIUrl":"https://doi.org/10.5173/ceju.2024.0197","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-stenting remains a subject of debate, and its influence on FANS assisted ureteroscopy is unclear. The global FANS collaborative group aims to address the influence of pre-stenting on FANS-assisted ureterorenoscopy (URS).</p><p><strong>Material and methods: </strong>This prospective multicentre study assesses the outcomes of 394 patients undergoing FANS-assisted ureteroscopy for renal stones. Patients were stratified into a non-pre-stented (group 1, n = 163) and pre-stented group (group 2, n = 231). Data on demographics, stone characteristics, operative parameters, and postoperative 30-day outcomes were analysed. Statistical analyses, including multivariate regression, were performed for stone-free rates (SFR) and complications. SFR was defined by bone window on non-contrast computed tomography (CT).</p><p><strong>Results: </strong>Pre-stented patients had a higher prevalence of positive urine culture treated with preoperative antibiotics (23.8% vs 12.3%, p = 0.006). Larger stone volumes were noted (1,306 mm³ vs 1,200 mm³, p = 0.027) in group 1. Postoperative complications were minor. Sepsis was not reported in either group. Group 1 had a higher incidence of low-grade Traxer grade 1 ureteric injuries (4.3% vs 0.4%, p = 0.021). FANS resulted in high overall SFRs of 97.5% and 97.0% in groups 1 and group 2. Multivariate analysis showed no statistical difference in SFR between the groups (63.2% vs 53.2%, p = 0.063). Only thulium fibre laser (TFL) and stone volume were significant predictors of residual fragments (RF).</p><p><strong>Conclusions: </strong>Pre-stenting for FANS is not mandatory irrespective of stone location and volume. The use of TFL and stone volume significantly influenced SFR, while FANS itself proved highly effective in achieving high SFR.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 1","pages":"85-93"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12073519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between erectile dysfunction and blood urea nitrogen/creatinine and blood urea nitrogen/albumin ratios: A case-control study.","authors":"Ahmet Yuce, Ahmet Anil Acet, Erdal Benli, Abdullah Cirakoglu, Ayhan Arslan","doi":"10.5173/ceju.2024.0220","DOIUrl":"10.5173/ceju.2024.0220","url":null,"abstract":"<p><strong>Introduction: </strong>Blood urea nitrogen (BUN)/creatinine (Cr) and BUN/albumin ratios are used in the evaluation of many diseases that can be associated with ED. The aim of this study was to examine the relationship between ED and BUN/Cr and BUN/albumin ratios and compare them to healthy peers.</p><p><strong>Material and methods: </strong>Total of 1,664 patients diagnosed with ED between January 2020 and August 2024 were accessed and retrospectively examined. Six hundred and seventy-two male patients with IIEF-5 score below 22 and complaining of ED were included in the study. Ninety-six patients without ED complaints were selected as the control group. Control and ED groups were compared in terms of BUN/Cr and BUN/Albumin ratio values and other biochemical and hormonal parameters.</p><p><strong>Results: </strong>BUN/Cr value was calculated as 27.63 ±12.3 in the ED group and 17.52 ±5.1 in the control group (p <0.001). The AUC value of this ratio was calculated as 0.745 and its sensitivity was found to be 32% and specificity was found to be 98%. BUN/albumin ratio was calculated as 6.03 ±5.8 in the ED group and 3.54 ±1.2 in the control group (p <0.001). The AUC value of this ratio was found to be 0.718, its sensitivity was 43% and its specificity was 98%. The BUN/Cr ratio of all ED subgroups was significantly higher than control group, and BUN/albumin value was significantly higher in mild, moderate and severe groups.</p><p><strong>Conclusions: </strong>In this study, it was calculated that the risk of ED was higher in patients with BUN/Cr ratio >33.92 and BUN/albumin ratio >5.80, and both values had high specificity.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 3","pages":"422-428"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12663802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647440","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 clinical utility of urolithiasis morphology assessment for perioperative stone composition determination.","authors":"Wojciech Tomczak, Katarzyna Grunwald, Klaudia Molik, Joanna Chorbińska, Łukasz Nowak, Jan Łaszkiewicz, Patryk Patrzałek, Mikołaj Przydacz, Magdalena Krajewska, Bartosz Małkiewicz, Tomasz Szydełko, Wojciech Krajewski","doi":"10.5173/ceju.2025.0162","DOIUrl":"10.5173/ceju.2025.0162","url":null,"abstract":"<p><strong>Introduction: </strong>Urolithiasis is a highly prevalent disease influenced by a wide range of factors multifactorial etiology results in the formation of urinary stones with diverse mineral compositions. Accurate identification of stone constituents is crucial for effective prevention of recurrence. Gold-standard methods for stone analysis are not always readily available in clinical practice. To address this, Daudon proposed a morphological classification system aimed at identifying stone types based on their surface characteristics. However, existing literature reports suboptimal accuracy of this method, largely due to technical limitations of endoscopic equipment. The primary objective of this study was to evaluate the reliability of morphological assessment in predicting stone mineral composition. Secondary aims included the identification of factors contributing to the consistently poor accuracy reported in previous studies.</p><p><strong>Material and methods: </strong>An online quiz consisting of 20 single-choice questions was developed, each accompanied by a high-resolution image of a urinary stone and five predefined answer options. The reference stone composition for each image was determined using Fourier-transform infrared spectroscopy. Participants' performance was evaluated based on the percentage of correct responses per individual and per question. The results of specialists and residents were compared using the two-proportion Z-test, with statistical significance set at p <0.05.</p><p><strong>Results: </strong>A total of 779 responses were collected, with an overall accuracy rate of 33.7%. The most commonly selected answers were respectively oxalates, phosphates, uric acid, cystine, and infectious stones. Subgroup analysis revealed accuracy rates of 36% among attending physicians and 32% among residents, with no statistically significant difference. Notably, two participants achieved a perfect score (100%), supporting the internal validity of the test.</p><p><strong>Conclusions: </strong>Detailed analysis revealed a wide distribution of scores, ranging from participants with only one correct response to those who completed the quiz with full accuracy. These results suggest that the consistently low diagnostic accuracy reported in the literature is more likely due to limited familiarity and lack of experience with the morphological classification, rather than inherent shortcomings of the system itself. The findings highlight the need for comprehensive endourology training programs focused on improving stone morphology recognition skills.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 3","pages":"401-405"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12663811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647477","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":"Measurement and comparison of intrarenal pressures during retrograde intrarenal surgery using novel flexible ureteroscopes with integrated direct in-scope suction: An experimental <i>ex vivo</i> study.","authors":"Arman Tsaturyan, Begoña Ballesta Martinez, Laurian Dragos, Hakob Sargsyan, Arthur Grabsky, Armen Muradyan, Sergey Fanarjyan, Artak Madatyan, Eugenio Ventimiglia, Angelis Peteinaris, Evangelos Liatsikos, Panagiotis Kallidonis, Steffi Kar Kei Yuen, Vineet Gauhar, Olivier Traxer, Bhaskar Somani, Amelia Pietropaolo","doi":"10.5173/ceju.2025.0092","DOIUrl":"10.5173/ceju.2025.0092","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the intrarenal pressure parameters of the 9.2 Fr (5.1 Fr working channel) and 7.5 Fr (3.6 Fr working channel) flexible ureteroscopes with direct-in-scope suction (DISS) in an <i>ex vivo</i> experimental setting.</p><p><strong>Material and methods: </strong>We performed an experimental study using an <i>ex vivo</i> porcine model using two DISS single-use digital videoureteroscopes: a 7.5 Fr PU3033AH and 9.2 Fr PU400A (Pusen, Zhuhai, China). Intrarenal pressures (IRPs) were measured with an automated irrigation pump set at 40, 60, 80, 100 mmHg, manual hand pumping and gravity fed-irrigation, with suction applied continuously and intermittently at 3-second intervals.</p><p><strong>Results: </strong>Higher IRPs were documented when the 9.2 Fr flexible ureteroscope was used compared to the 7.5 Fr scope, regardless of the irrigation setup. The highest IRP (45 mmHg) was documented with the 9.2 Fr scope, using manual pump irrigation and intermittent pumping with no suction. In contrast, the lowest IRP was reported with the 7.5 Fr scope and the automated pump at 40 mmHg. The pressure difference following 1second of suctioning was more pronounced with 9.2 Fr compared to 7.5 Fr. The 9.2 Fr ureteroscope with the 5.1 Fr working channel resulted in significantly shorter time to regain the initial IRP.</p><p><strong>Conclusions: </strong>For the first time in experimental studies we noted that irrigation through a wider 5.1 Fr working channel raises the baseline IRP faster than the classic 3.6 Fr working channel. Although these findings should be further investigated in a clinical setting, they should be taken into consideration to select the optimal strategy, to keep IRP at safe levels, and avoid complications.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 3","pages":"394-400"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12663809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted artificial urinary sphincter implant complicated by ureteric obstruction.","authors":"Tim Brits, Sam Tilborghs, Cindy Mai, Stefan de Wachter","doi":"10.5173/ceju.2025.0088","DOIUrl":"10.5173/ceju.2025.0088","url":null,"abstract":"<p><p>Robotic-assisted surgery is gaining popularity for the implantation of artificial urinary sphincters (AUS) in female patients. We present a case of a 76-year-old woman with refractory stress urinary incontinence. She underwent an uncomplicated robotic-assisted AUS implant. Post activation of the system, she experienced right-sided flank pain and developed urosepsis shortly thereafter. On imaging with an activated system, grade 3 hydro-ureteronephrosis (HUN) was seen. Robotic-assisted revision showed a right-sided ectopic ureter draining towards the bladder neck, which was compressed on activation of the system. A new cuff was successfully placed distal to the orifice with complete continence 3 months after the procedure.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 3","pages":"419-421"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12663803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647507","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 laser enucleation of the prostate: Learning curve analysis and comparison with TURP.","authors":"Tarik Emre Sener, Turker Altuntas, Yasir Sahak, Kader Ada Dogan, Omer Faruk Asker, Yusuf Senoglu, Haydar Kamil Cam","doi":"10.5173/ceju.2025.0071","DOIUrl":"10.5173/ceju.2025.0071","url":null,"abstract":"<p><strong>Introduction: </strong>Benign prostatic obstruction (BPO) is a prevalent cause of lower urinary tract symptoms (LUTS), traditionally managed with transurethral resection of the prostate (TURP). However, advances in technology, particularly holmium laser enucleation of the prostate (HoLEP), offer an alternative approach. Our aim was to compare the outcomes of HoLEP, during both the surgeon's learning and expert phases, to TURP, assessing perioperative safety, efficacy, and functional recovery.</p><p><strong>Material and methods: </strong>This prospective study included 200 men with BPO-related LUTS, divided into three groups: group 1: TURP (n = 100), group 2: HoLEP during the learning curve (n = 50), and group 3: post-learning curve (n = 50). Outcomes analyzed included learning curve analysis, IPSS, QoL, Q_max, PVR, surgical efficiency, and complication rates. Postoperative outcomes were assessed at 1 and 6 months.</p><p><strong>Results: </strong>The HoLEP learning curve reached a plateau around case 30, and improved after case 50. Group 3 demonstrated significantly better outcomes in surgical efficiency and functional recovery compared to groups 1 and 2. Enucleation efficiency in group 3 was higher, and the operative time was shorter. Postoperatively, the Q_max, IPSS and PVR improved significantly across all groups but were highest in group 3, followed by group 2 and group 1. Regarding safety, group 3 had the lowest complication rates, with significantly less frequent postoperative bleeding. Catheter removal time was slightly shorter in group 2 compared to both groups 1 and 3.</p><p><strong>Conclusions: </strong>HoLEP, especially after overcoming the learning curve, provides better perioperative safety, greater efficiency, and improved functional outcomes compared to TURP, making it a highly effective treatment.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"78 4","pages":"511-521"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269782","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}