Central European Journal of Urology最新文献

{"title":"Heavy as a rock or light as dust: a comparison between the perceived workload for extracorporeal shockwave lithotripsy, ureterorenoscopy and percutaneous nephrolithotomy.","authors":"Michaël Mel Henderickx, Nora Hendriks, A Carolien Bouma-Houwert, Joyce Baard, Guido M Kamphuis, Hugo W Schuil, Harrie P Beerlage, D Martijn de Bruin","doi":"10.5173/ceju.2023.214","DOIUrl":"https://doi.org/10.5173/ceju.2023.214","url":null,"abstract":"<p><strong>Introduction: </strong>There are three common treatment options for kidney stones: extracorporeal shockwave lithotripsy (ESWL), ureterorenoscopy (URS) and percutaneous nephrolithotomy (PNL). The choice of treatment is based on stone- and patient-related characteristics. However, some stones are eligible for several approaches and the decision is made based on patient and urologist's preferences. This study evaluates which approach has the highest workload.</p><p><strong>Material and methods: </strong>Between March and August 2022, five members of the Amsterdam Endourology Research Group collected data from 22 ESWL, 31 URS and 22 PNL procedures. After each procedure, the SURG-TLX questionnaire was completed by the surgeon to evaluate workload. Six dimensions were scored for each procedure, including: mental demands, physical demands, temporal demands, task complexity, situational stress, and distractions. The total workload, and the median for each dimension, was calculated and compared for the three treatments.</p><p><strong>Results: </strong>ESWL scored significantly lower than URS for mental demands, physical demands, temporal demands, situational stress, distraction and total workload. However, task complexity did not differ significantly between the two techniques. Compared with PNL, ESWL scored significantly lower for all dimensions. Finally, PNL received significantly higher scores for mental demands, physical demands, temporal demands, situational stress, distractions and total workload than URS. Only task complexity showed no significant difference between both groups.</p><p><strong>Conclusions: </strong>Urologists perceive the highest workload during PNL, followed by URS and finally ESWL. A follow-up study is needed to identify stressors that increase perceived workload with the purpose to address these variables and as final objective to improve urologists' workload, patient safety and treatment outcomes.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"129-135"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860041","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":"Efficacy of combination therapy tadalafil plus tamsulosin in ureteral stents-related symptoms relief.","authors":"Ihor Komisarenko, Oleg Banyra, Oleg Nikitin, Yaroslav Klymenko, Mykola Chaplia, Andrii Borzhievskyy","doi":"10.5173/ceju.2023.66","DOIUrl":"https://doi.org/10.5173/ceju.2023.66","url":null,"abstract":"<p><strong>Introduction: </strong>Ureteral stents-related symptoms (USRs) are the common complications of ureteral stenting. Tamsulosin a selective alpha-1 blocker and Tadalafil a PDE-5 inhibitor are one of drugs have been used for USRs relief. In this study we aimed to evaluate the effectiveness and safety of combination therapy Tamsulosin+Tadalafil for treating USRs comparing it with the efficacy of either Tamsulosin or Tadalafil monotherapies.</p><p><strong>Material and methods: </strong>279 patients with indwelled unilateral ureteral stents were randomized to Tamsulosin 0.4 mg + Tadalafil 5 mg once a day (Group 1, n = 67), Tamsulosin 0.4 mg once a day (Group 2, n = 71), Tadalafil 5 mg once a day (Group 3, n = 69) and Placebo once a day (Group 4, n = 72). USRs severity was registered and calculated by using the Ureteral Symptoms Score Questionnaire (USSQ) at the 14^th day of treatment. Side-effects and total analgesic use were recorded and compared.</p><p><strong>Results: </strong>At the endpoint in patients with unilateral ureteral stents the combination therapy Tamsulosin + Tadalafil led to statistically lower intensity of urinary symptoms comparing with Tamsulosin (15.2 ±4.3 vs 21.8±3.6, p = 0.0003) or Tadalafil (15.2 ±4.3 vs 20.6 ±2.8, p = 0.0004) monotherapy. All groups of treatment demonstrated significant relief of USRs comparing with Placebo mostly beneficial in the combined therapy group. Body pain and analgesic need in Group 1 was lower than in Groups 2, 3 or 4. Side-effects were registered rarely without statistical differences in frequency between groups.</p><p><strong>Conclusions: </strong>Combination therapy with Tamsulosin + Tadalafil is an effective and safe option that achieves the statistically more significant relief of USRs comparing with Tadalafil or Tamsulosin monotherapies.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"111-116"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874503","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 isothermic irrigation fluid on ureteroscopic lithotripsy outcomes.","authors":"Yavuz Karaca, Orhun Sinanoglu, Fatih Ustun, Emre Burak Sahinler, Cahit Sahin, Kemal Sarica","doi":"10.5173/ceju.2024.0053.R2","DOIUrl":"https://doi.org/10.5173/ceju.2024.0053.R2","url":null,"abstract":"<p><strong>Introduction: </strong>Ureteroscopic lithotripsy is amongst the most performed surgeries in urology practice. To achieve better results and lower complications, several approaches have been proposed. Using isothermic irrigation fluid in ureteroscopy is a novel method.The aim of this study was to show the advantages of body temperature irrigation fluid in ureteroscopy compared to room temperature fluid.</p><p><strong>Material and methods: </strong>A total of 94 patients with a single ureteral stone scheduled for semirigid ureteroscopy were enrolled into this study. Patients were randomised into 2 groups: group 1, ureteroscopy with room temperature (20-22°C) irrigation fluid and group 2, ureteroscopy with body temperature (37°C) irrigation fluid. Patient characteristics, stone characteristics (stone side, stone location, stone burden, Hounsfield unit), operation outcomes (operation time, ureteral JJ stenting, complications, stone free rate after 4 weeks, auxiliary intervention, Visual Analogue Scale) were analysed.</p><p><strong>Results: </strong>There was no statistically significant difference between two groups regarding patient and stone characteristics. Operation time was found to be shorter in group 2 compared to group 1 (p = 0.02). Post-operative pain was also less common in group 2 compared to group 1 (p <0.001). Complication rates were 17% in group 1 and 8% in group 2 but no statistically significant difference was found.</p><p><strong>Conclusions: </strong>Isothermic irrigation fluid in ureteroscopy is beneficial because: it facilitates easier ureteral access by decreasing ureteral spasms, shortens operation times, lowers post-operative pain and lowers the complications rates. This method can be used in semirigid ureteroscopy because it is an easily applicable method with no known associated complications.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 4","pages":"674-679"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976062","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":"Exploring the enigma of not macroscopically detectable urothelial carcinoma: A scoping review on the definition, prevalence, diagnosis, and management of positive urinary cytology with absent macroscopic disease.","authors":"Jacopo Durante, Francesca Manassero, Paola Gattuso, Salvatore Fiorenzo, Gaetano Corvino, Michele Santarsieri, Fiorini Girolamo, Riccardo Pagni, Maurizio Simone, Giorgio Pomara","doi":"10.5173/ceju.2024.0112","DOIUrl":"https://doi.org/10.5173/ceju.2024.0112","url":null,"abstract":"<p><strong>Introduction: </strong>There is a significant gap in the literature for cases of positive urinary cytology in the absence of macroscopically detectable disease for urothelial carcinoma. This condition, which we might define as not macroscopically detectable urothelial carcinoma (NMDUC), may be relatively rare but presents significant challenges in management and patient information. This review aims to search the literature for information useful for managing this condition.</p><p><strong>Material and methods: </strong>We structured the review as a scoping review given the desire to have a qualitative definition of NMDUC, without restrictions on study design or demographic characteristics. The review was structured around 5 domains: definition, diagnostic criteria, population, management, and time of disease progression. The review was conducted following the PRISMA for Scoping Reviews (PRISMA-ScR) guidelines.</p><p><strong>Results: </strong>We found a total of 411 studies and selected 16 for inclusion in the review. Notably, no studies adequately addressed the definition of NMDUC directly. Our findings highlight the diagnostic challenges posed by NMDUC, especially the reliability of positive urinary cytology. The literature indicates a significant gap in the standardisation of diagnostic criteria and management for NMDUC.</p><p><strong>Conclusions: </strong>NMDUC represents a critical area of urological research requiring further investigation and clearer diagnostic guidelines. We propose the initiation of an international registry to better understand the prevalence, impact, and progression of NMDUC, aiming to standardise the definition and enhance management strategies. This work lays the groundwork for future research that could lead to significant improvements in the diagnosis and treatment of this challenging condition.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 4","pages":"618-624"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969027","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":"Optimizing functional outcomes in prostate cancer: a new perspective on early artificial urinary sphincter implantation before salvage radiotherapy in prostate cancer treatment.","authors":"Mikołaj Frankiewicz, Katarzyna Matuszewska, Rafał Dziadziuszko, Marcin Matuszewski","doi":"10.5173/ceju.2024.0181","DOIUrl":"https://doi.org/10.5173/ceju.2024.0181","url":null,"abstract":"<p><strong>Introduction: </strong>Stress urinary incontinence is a significant adverse effect following radical prostatectomy for prostate cancer. Various factors, including surgical technique and patient characteristics, influence the incidence of incontinence. Early artificial urinary sphincter implantation prior to salvage radiotherapy may improve functional outcomes and quality of life for these patients. The objective of our study is to address the current gap in research regarding the effects of radiotherapy on tissues surrounding the artificial urethral sphincter, particularly when the artificial urethral sphincter (AUS) is implanted before, rather than after, radiotherapy.</p><p><strong>Material and methods: </strong>This pilot study analysed the impact of early AUS implantation in 2 prostate cancer patients who underwent radical prostatectomy (RP) and subsequently received salvage radiotherapy (SRT) due to biochemical recurrence. Radiation dose distribution and functional outcomes, including continence rates and complications, were evaluated.</p><p><strong>Results: </strong>Both patients experienced significant improvements in continence post-AUS implantation, using fewer pads daily. However, a slight deterioration in AUS effectiveness was observed post-radiotherapy, with an increase in pad usage. Radiation doses at the cuff site were relatively low, but mild tissue reactions were noted.</p><p><strong>Conclusions: </strong>Early AUS implantation before SRT shows promise in enhancing urinary continence and overall quality of life in prostate cancer patients. Despite mild complications, the approach appears feasible and beneficial. Further studies are needed to confirm these findings and optimise treatment sequencing.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 4","pages":"661-667"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965739","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: Senel S, Uzun E, Ceviz K, et al. Predictive factors for difficult ureter in patients undergoing retrograde intrarenal surgery. Cent European J Urol. 2024; 77: 280-285.","authors":"Guglielmo Mantica, Rosario Leonardi, Alessandro Calarco","doi":"10.5173/ceju.2024.128","DOIUrl":"10.5173/ceju.2024.128","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"518-519"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669214","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":"Magnetic resonance vasography using paramagnetic contrast agent - a case report.","authors":"Franciszek Rzymkowski, Michał Kozub, Patryk Sulmiński, Jan Karol Wolski, Magdalena Zagrodzka","doi":"10.5173/ceju.2024.117","DOIUrl":"10.5173/ceju.2024.117","url":null,"abstract":"<p><p>Azoospermia is recognised in 10-15% of men diagnosed due to infertility. Obstructive azoospermia occurs in 20-40% in this group of patients and it is characterised by normal FSH values, testes of normal size, and epididymal enlargement. Obstructive azoospermia is a common cause of male infertility. Several imaging techniques are used to assess the patency of the seminal tract, including the following: scrotal ultrasound, transrectal ultrasound (TRUS), and scrotal magnetic resonance imaging (MRI), with vasography being considered a gold standard. However, each of these methods has its limitations, and no single test can provide a comprehensive diagnosis. This article describes an attempt to combine high-resolution multiplanar MRI with functional evaluation of the patency of the seminal tract of classical vasography. A detailed description of the level of spermatic duct obstruction may help decide whether the condition qualifies for surgical treatment.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"566-569"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669104","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":"Breakage and detachment of the rigid cystoscope's distal tip: an unusual case of urological instrument malfunction.","authors":"Evangelos N Symeonidis, Asterios Symeonidis, Anastasios Anastasiadis, Aris Kaltsas, Georgios Tsampoukas, Ioannis Mykoniatis, Dimitrios Memmos, Chrysovalantis Toutziaris, Fotios Dimitriadis, Ioannis Vakalopoulos, Georgios Dimitriadis","doi":"10.5173/ceju.2024.20","DOIUrl":"https://doi.org/10.5173/ceju.2024.20","url":null,"abstract":"<p><p>Herein, we describe an unusual case of cystoscope damage during a planned laser cystolithotripsy in a 65-year-old male with a previous history of radical prostatectomy for prostate cancer and subsequent serial urethral dilations for bladder neck contracture. Upon crossing the penile urethra without exerting significant pressure, we noticed the cystoscope's distal metallic tip detachment. Therefore, we re-introduced another 22Fr cystoscope and removed the broken part with alligator forceps. Fortunately, no urethral injury or associated complications were noticed on gently re-entering the bladder. Hence, we managed to complete the endoscopic laser cystolithotripsy shortly thereafter. Review of the relevant literature revealed three similar cases. All related to the same manufacturer. Urologists should not lose sight of the fact that such an unexpected instance may tremendously impact the procedure's success, requiring vigilance and adherence to safety protocols.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"334-338"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342529","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":"Traditional and innovative interventions in the management of enuresis.","authors":"Pietro Ferrara, Ignazio Cammisa, Margherita Zona, Antonio Gatto, Roberto Sacco, Alberto Verrotti Di Pianella","doi":"10.5173/ceju.2023.183","DOIUrl":"10.5173/ceju.2023.183","url":null,"abstract":"<p><strong>Introduction: </strong>Enuresis (NE) is a socially stigmatising and stressful condition affecting children's and parent's quality of life. The aim of this review was to evaluate and summarize the current knowledge about the pharmacological and non-pharmacological traditional and innovative treatments in children with NE.</p><p><strong>Material and methods: </strong>We examined the following bibliographic electronic databases: PubMed and the Cochrane Library, from January 2000 until July 2023. The search was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) (8) and was limited to English-language papers that focused on enuresis in patients under 18 years old. Each paper that met the eligibility criteria was reviewed and analyzed in full text by three authors and any discrepancies among them were solved by debate. Due to the heterogeneity of the articles examined, we focused on a qualitative analysis.</p><p><strong>Results: </strong>Overall, we identified 560 records through database searching. As first step, we excluded 46 articles in non-English language, 6 records whose related articles were not available, 8 articles concerning ongoing trials and 210 duplicated papers. As second step, we eliminated 215 records by evaluating only title and abstract because they did not match the inclusive criteria we mentioned before. Of the remaining 75 studies, we excluded 34 through a further discussion among authors upon the reliability of data. Thus, 41 selected articles were included in the review.</p><p><strong>Conclusions: </strong>Multiple treatment approaches, both pharmacological and non pharmacological, have been established and validated to reduce signs and symptoms of NE and improve quality of life and the social and emotional discomfort experienced by children. The aim of pediatrician is to identify the right therapy protocol for very single child, evaluating the best approach for him and the family.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"42-57"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874504","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":"Changes in the quality of life of a population of Polish men undergoing radical prostatectomy: a 12-month longitudinal observational study.","authors":"Tomasz Jurys, Andrzej Kupilas, Maciej Szczębara, Agata Witosińska-Walica, Martyna Suchojad, Andrzej Paradysz, Bartłomiej Burzyński","doi":"10.5173/ceju.2024.23.R1","DOIUrl":"10.5173/ceju.2024.23.R1","url":null,"abstract":"<p><strong>Introduction: </strong>In the literature on cancer treatment, there is growing interest in quality of life (QoL). Improvement in QoL is coming to be regarded as a key consideration in maintaining standards of care. The choice of medical intervention should be based not only on a patient's physical health, test results, and the stage of the disease, but also on their emotional and psychosocial condition.</p><p><strong>Material and methods: </strong>The study included a group of 72 men with prostate cancer scheduled for radical prostatectomy (RP). QoL was assessed using standardised and validated questionnaires. The survey was conducted before surgery and then after 3, 6, 9, and 12 months.</p><p><strong>Results: </strong>Analysis of changes in QoL 3 months after surgery showed a significant decrease in all symptomatic and functional domains, the largest decrease being observed in social functioning. One year after surgery, most scores had returned to their preoperative level, with the exception of those for social functioning, symptoms of pain, insomnia, and financial difficulties. It was noted that preoperative urinary symptom scale scores were significantly lower than those obtained one year after RP, the largest difference being apparent in the first months after surgery. It was also found that the number of people using incontinence precautions significantly increased 3 months after surgery and continued to do so.</p><p><strong>Conclusions: </strong>The greatest deterioration of QoL occurs in the first months after surgery and mainly affects social, emotional, and sexual functioning, as well as symptoms related to incontinence and fatigue.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"375-382"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669070","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}