Central European Journal of Urology最新文献

{"title":"Baseline characteristics and clinical outcomes of prostate cancer patients on delayed palliative management: a PIONEER analysis based on big data.","authors":"Lana Yh Lai, Vasileios Sakalis, Christos Chatzichristos, Irene de la Parra, Carl Steinbeisser, Asieh Golozar, Bertrand de Meulder, Ayman Hijazy, Robert Snijder, Qi Feng, Thomas Falconer, Philip Cornford, Anders Bjartell, Susan Evans-Axelsson, James N'Dow, Giorgio Gandaglia, Juan Gómez Rivas","doi":"10.5173/ceju.2024.83","DOIUrl":"10.5173/ceju.2024.83","url":null,"abstract":"<p><strong>Introduction: </strong>Delayed palliative management (DPM) is an alternative for prostate cancer (PCa) patients with poor performance status, or those who received radical treatment but progressed and no longer meet the criteria for curative treatment. PIONEER is a large network of federated data analytic platforms in PCa that aims to improve its care through the application of big data analytics. The objective of this study was to describe clinical baseline characteristics and outcomes of PCa patients receiving DPM using big data.</p><p><strong>Material and methods: </strong>Descriptive study of patients on DPM from four databases in PIONEER (Pharmetrics Plus, Optum Clinformatics, Marketscan and Columbia University Irving Medical Center (CUIMC)). Baseline characteristics, including comorbidities (hypertension, type 2 diabetes (T2DM), asthma/chronic obstructive pulmonary disease (COPD) and obesity), were stratified by age. Outcomes of interest were annual emergency department (ED) visits, hospitalization and symptomatic progression. Additional outcomes were time to death, hospitalization and time to symptomatic progression for CUIMC.</p><p><strong>Results: </strong>We included 13246 men with a median age of 68-75 and Charlson Comorbidity index of 6-8. The three most common comorbidities were hypertension (80-93% [>80 years] vs 69-80% [55-80 years] vs 59-64% [<55 years]), T2DM (29-41% [>80 years] vs 26-38% [55-80 years] vs 23-26% [<55 years] and asthma/COPD (28-37% [>80 years] vs 19-30% [55-80 years] vs 16-19% [<55 years]). ED visits and hospitalizations were highest in the first year of follow-up (19-33% and 21-48% respectively). The median time to death was 548 days (IQR 1265 days) and to symptomatic progression was 408 days (IQR 1125 days) in CUIMC.</p><p><strong>Conclusions: </strong>Men on DPM were in their mid-seventies, with the three most common comorbidities being hypertension, T2DM and asthma/COPD, regardless of age groups. This study reflects the potential of PIONEER as a federated network of databases that may be used to harness big data in PCa research.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"403-410"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669069","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":"Safety and efficacy of ureteroscopy and laser lithotripsy with a single-use 7.5Fr ureteroscope: a multicenter prospective pilot study.","authors":"Victoria Jahrreiss, Mahir Akram, Vincent De Coninck, Guido Kamphuis, Joyce Baard, Oriol Angerri, Esteban Emiliani, Sarah Schippers, Eva Van Bos, Kim Pauwaert, Thomas Tailly, Amelia Pietropaolo, Bhaskar Somani","doi":"10.5173/ceju.2024.85","DOIUrl":"10.5173/ceju.2024.85","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of kidney stone disease (KSD) has evolved significantly with the introduction of minimally invasive endourological techniques. Advancements in technology, particularly the transition from fibreoptic to digital and single use systems and the development of smaller-diameter instruments, has improved intraoperative view and efficacy in stone treatment. The miniaturization in single-use scopes represent a recent innovation, offering potential benefits, especially in challenging cases. However, there is limited evidence on their safety and clinical outcomes. This study aims to evaluate the efficacy and safety of stone treatment using a single-use 7.5 Fr flexible ureteroscope.</p><p><strong>Material and methods: </strong>Consecutive patients with urinary stones undergoing flexible ureteroscopy with a 7.5 Fr single-use flexible ureteroscope across five tertiary endourology centers were included. Data on patient demographics, stone characteristics, intra- and postoperative outcomes were prospectively collected and analyzed. Procedures were performed by experienced endourology surgeons following standard protocols.</p><p><strong>Results: </strong>50 patients with a mean age of 54.5 years (IQR: 25-65.8) and a male to female ratio of 34:16 underwent flexible ureteroscopy (FURS). Mean cumulative stone size was 18.9 mm (SD ±10.9 mm) with a mean stone volume of 2031.2 mm³ (SD ±2869.4 mm³) and mean Hounsfield units of 1087.4 (SD ±384.9). 36 (72%) had multiple stones and a bilateral FURS was performed in 9 cases (18%). 24 patients (48%) had a preoperative stent inserted. A ureteral access sheath was used in 22 (44%) cases and 46 (92%) patients had a postoperative stent inserted. The median operative time was 60min (IQR: 53-90), 32 patients (64%) were stone free after the first procedure (SFR for <2 cm and ≥2 cm stones was 85.2% and 36.2% respectively), perioperative and postoperative complications (Clavien ≤II) were observed in 3 patients (6%).</p><p><strong>Conclusions: </strong>This multicentric study demonstrates the safety and efficacy of using the 7.5Fr single-use flexible ureteroscope for urinary stone treatment. While the results are promising, larger studies are needed to validate these findings further.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"507-511"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669222","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":"Value of baseline PSA in predicting prostate cancer diagnosis and death. Spanish arm of the European Randomized Study of Screening for Prostate Cancer.","authors":"Alba María García-Cano-Fernández, Álvaro Páez Borda, Luis Llanes González, Marcos Luján Galán","doi":"10.5173/ceju.2024.31.R1","DOIUrl":"10.5173/ceju.2024.31.R1","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have suggested that prostate-specific antigen (PSA) in young men may predict the risk of developing prostate cancer (PC). Our aim is to study baseline PSA as a prognostic factor in the lifetime risk of developing PC, clinically significant PC (csPC), and metastatic PC (mPC), as well as to assess its impact on long-term mortality.</p><p><strong>Material and methods: </strong>This study was a retrospective analysis involving 2,415 men aged 45-70 years, all participants in the Spanish arm of the European Randomized Study of Screening for Prostate Cancer (ERSPC). These men underwent PSA testing, and prostate biopsies were performed if their PSA levels were ≥3 ng/ml. The follow-up period spanned from September 2, 1996, to February 11, 2021. Kaplan-Meier survival analysis was conducted to calculate the probability of prostate cancer diagnosis and death. The relationship between these probabilities and baseline PSA levels was assessed using the log-rank test.</p><p><strong>Results: </strong>After 25 years of follow-up, the probability of being free of a diagnosis of PC was 95.5%, 89.6%, 80.0%, and 69.4%; and of PC death: 99.6%, 99.6%, 98.9%, and 98.3% for the categories of PSA <1 ng/ml, 1-1.9 ng/ml, 2-2.9 ng/ml, and >3 ng/ml, respectively. There is an association between baseline PSA level and the probability of PC diagnosis (which is maintained in age stratification), csPC, mPC (p <0.001), and PC death (p = 0.047).</p><p><strong>Conclusions: </strong>There is a clear relationship between baseline PSA and the probability of detection of PC, csPC and mPC during follow-up, as well as PC death, in a cohort belonging to the Spanish branch of the ERSPC, with a median follow-up of more than 23 years. Baseline PSA level can be used to define the most appropriate PC screening interval for everyone.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"383-388"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669228","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":"Methodology and findings of randomized clinical trials on pharmacologic and non-pharmacologic interventions to treat renal colic pain – a review","authors":"","doi":"10.5173/ceju.2023.92","DOIUrl":"https://doi.org/10.5173/ceju.2023.92","url":null,"abstract":"Introduction Renal colic pain is considered one of the most excruciating pains ever experienced and ranks as one of the most common urological emergencies. Despite existing established recommendations, new therapies and their combinations are continuously being tested. The aim of this systematic review is to analyze and compare studies involving pharmacologic and non-pharmacologic interventions used in the treatment of renal colic pain. Material and methods This systematic review was conducted following the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Medline, Scopus, Cochrane Library, and Google Scholar were searched for relevant randomized controlled trials (RCTs) involving adult patients. The quality and results of the included studies were assessed and discussed. Results This review provides an extensive analysis of 71 identified RCTs. Opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and dipyrone/metamizole have demonstrated effectiveness as single medications. Some evidence points to opioids having a potential disadvantage compared to others when used as a first-line single medication. Among the 63 studies exploring pharmacological therapy, 51 reported opioids utilization for rescue therapy in significant proportion of patients. Promising combination therapies involve the administration of an NSAID alongside opioids, ketamine, desmopressin, steroids, or nitric oxide. Conversely, spasmolytics, magnesium, and lidocaine exhibited limited or no additional effect. Noteworthy methodological shortcomings encompass a low pain threshold during participant recruitment and the reliance on pain reduction rather than complete pain elimination as an endpoint. Conclusions Frequent use of opioids as rescue medications in RCTs undermine their conclusions on effectiness of other therapeutics. Combination therapies should be considered as first choice in renal colic pain management. RCTs should define success of therapy as achieving complete or near-complete pain relief rather than pain reduction.","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135602438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic simple prostatectomy vs HOLEP, a 'multi single-center' experiences comparison.","authors":"Alfredo Maria Bove,&nbsp;Aldo Brassetti,&nbsp;Mario Ochoa,&nbsp;Umberto Anceschi,&nbsp;Simone D'Annunzio,&nbsp;Marilia Ferriero,&nbsp;Gabriele Tuderti,&nbsp;Leonardo Misuraca,&nbsp;Riccardo Mastroianni,&nbsp;Silvia Cartolano,&nbsp;Giulia Torregiani,&nbsp;Riccardo Lombardo,&nbsp;Cosimo De Nunzio,&nbsp;Giuseppe Simone","doi":"10.5173/ceju.2023.204","DOIUrl":"10.5173/ceju.2023.204","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare peri-operative and mid-term outcomes of patients who underwent robot-assisted simple prostatectomy (RASP) vs holmium laser enucleation of the prostate (HOLEP). RASP and HOLEP are the treatments of choice for men with symptomatic benign prostatic obstruction (BPO) and a prostate ≥80 g, achieving comparable short and mid-term efficacy. No randomized controlled studies have proved the superiority of one technique over the other.</p><p><strong>Material and methods: </strong>The prospectively maintained databases of the participating institutions were queried for patients with a prostate volume (PV) ≥80 g, who underwent surgery for BPO between 2011 and 2021. The study population was divided into two subgroups based on surgical approach. Demographics, baseline characteristics, and 12 months outcomes were compared between groups: χ² and Student t-tests were used for categorical and continuous variables, respectively. The Trifecta composite outcome (post-operative Q-max >15 ml/sec, International Prostate Symptom Score (IPSS) <8 and absence of complications) was used to define surgical quality and the two groups were compared accordingly. Logistic regression analyses investigated predictors of Trifecta achievement.</p><p><strong>Results: </strong>We included 97 patients with comparable pre-operative features (all p >0.30): 43 underwent RASP, 54 HOLEP. Median PV was 102 g (IQR 89-120) and Q-max was 7.2 ml/s (IQR 5.4-9.0). The Trifecta rate was 43% overall, higher in the RASP subgroup (56% vs 33%; p = 0.02). The endoscopic approach was its only independent predictor (OR 0.5; 95% CI 0.28-0.88; p = 0.016).</p><p><strong>Conclusions: </strong>At univariable regression analysis, surgical approach was the only independent predictor of Trifecta achievement, which was significantly higher in the RASP group compared to HOLEP.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"76 2","pages":"128-134"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/a6/CEJU-76-204.PMC10357823.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9860923","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":"Oncologic outcomes of postoperative adjuvant versus salvage radiotherapy in prostate cancer.","authors":"Furkan Şendoğan,&nbsp;Turgay Turan,&nbsp;Ferhat Keser,&nbsp;Tayfun Hancilar,&nbsp;Gokhan Atis,&nbsp;Asif Yildirim","doi":"10.5173/ceju.2023.190","DOIUrl":"https://doi.org/10.5173/ceju.2023.190","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the long-term oncological results of patients with the diagnosis of prostate cancer who underwent open radical retropubic prostatectomy (RRP) and subsequent adjuvant (ART) or salvage radiotherapy (SRT).</p><p><strong>Material and methods: </strong>A total of 145 patients underwent open RRP for prostate cancer and subsequent ART or SRT postoperatively between 2010 and 2019. ART (n = 56) is defined as the group of patients with prostate-specific antigen (PSA) <0.2 ng/mL or with positive lymph nodes without PSA increase who received radiotherapy within the first 6 months of urinary continence. SRT (n = 89) is defined as the group of patients with PSA >0.2 ng/mL who received RT before PSA amounted to 0.5 ng/mL.</p><p><strong>Results: </strong>Statistically no significant difference was found between groups in terms of age, prostate volume, final pathology Gleason scores, lymphadenectomy, duration of androgen deprivation therapy (ADT), time to relapse after radiotherapy, development of biochemical recurrence and disease progression. Extraprostatic extension, seminal vesicle invasion and surgical margin positivity were significantly higher in the ART group. No difference was found between the groups in terms of biochemical recurrence-free survival, while cancer-specific survival and overall survival rates were significantly higher in the SRT group.</p><p><strong>Conclusions: </strong>It was found that cancer-specific and overall survival was better in the SRT group. It will be more appropriate to follow-up until the recurrence and then to perform SRT after the relapse in the postoperative period.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"76 2","pages":"109-115"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/55/CEJU-76-190.PMC10357821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9864198","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":"Predictors of trainees' proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series.","authors":"Umberto Anceschi,&nbsp;Michele Morelli,&nbsp;Rocco Simone Flammia,&nbsp;Aldo Brassetti,&nbsp;Paolo Dell'Oglio,&nbsp;Antonio Galfano,&nbsp;Stefano Tappero,&nbsp;Enrico Vecchio,&nbsp;Marco Martiriggiano,&nbsp;Lorenzo Giuseppe Luciani,&nbsp;Isabella Sperduti,&nbsp;Simone Albisinni,&nbsp;Gabriele Tuderti,&nbsp;Francesco Prata,&nbsp;Maria Consiglia Ferriero,&nbsp;Alfredo Maria Bove,&nbsp;Riccardo Mastroianni,&nbsp;Giuseppe Spadaro,&nbsp;Andrea Russo,&nbsp;Daniele Mattevi,&nbsp;Antonio Tufano,&nbsp;Costantino Leonardo,&nbsp;Riccardo Lombardo,&nbsp;Cosimo De Nunzio,&nbsp;Tommaso Cai,&nbsp;Thierry Quackels,&nbsp;Aldo Massimo Bocciardi,&nbsp;Giuseppe Simone","doi":"10.5173/ceju.2023.260","DOIUrl":"https://doi.org/10.5173/ceju.2023.260","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this series was to evaluate predictors of Proficiency score (PS) achievement on a multicentric series of robot-assisted radical prostatectomies (RARP) performed by trainee surgeons with two different surgical techniques at four tertiary-care centers.</p><p><strong>Material and methods: </strong>Four institutional datasets were merged and queried for RARPs performed by surgeons during their learning curve (LC) between 2010 and 2020 using two different approaches (Group A, Retzius-sparing RARP, n = 164; Group B, standard anterograde RARP, n = 79). Logistic regression analysis was performed to identify predictors of PS achievement for the overall trainee cohort. For all analyses, a two-sided p <0.05 was considered significant.</p><p><strong>Results: </strong>Group B showed significantly increased median operative time, positive surgical margins (PSM) status, increased number of nerve-sparing procedures, shorter LC time (each p <0.04). PS, continence status, potency, biochemical recurrence and 1-year trifecta rates were comparable between groups (each p >0.3). On multivariable analysis, time from LC starting ≥12 months (OR = 2.79; 95%IC [1.15-6.76]; p = 0.02) and a nerve-sparing intent (OR = 3.18; 95%IC [1.15-8.77]; p = 0.02) were independent predictors of PS score achievement (Table 3).</p><p><strong>Conclusions: </strong>Higher PS rates for RARP trainees may be expected after 12 months from LC beginning. Short-term training courses are unlikely to confer proper surgical training, while long-term structured training programs seem to be beneficial on perioperative outcomes.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"76 1","pages":"38-43"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0e/3a/CEJU-76-260.PMC10091888.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9309522","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":"Determination of optimal stent length: a survey of urologic surgeons.","authors":"Justin Kwong,&nbsp;R John D'A Honey,&nbsp;Jason Y Lee,&nbsp;Michael Ordon","doi":"10.5173/ceju.2023.83","DOIUrl":"https://doi.org/10.5173/ceju.2023.83","url":null,"abstract":"<p><strong>Introduction: </strong>Ureteral double-J stent length is an important factor affecting stent-related symptoms. Multiple techniques exist to determine ideal stent length for a given patient, however, little is known about what techniques urologists rely on. Our objective was to identify how urologists determine optimal stent length.</p><p><strong>Material and methods: </strong>An online survey was e-mailed in 2019 to all members of the Endourology Society. The survey sought to assess what methods are commonly used to determine choice of stent length, along with frequency of stent placement post ureteroscopy, duration of stenting, availability of different stent lengths and the use of stent tether.</p><p><strong>Results: </strong>301 urologists (15.1%) responded to our survey. Following ureteroscopy, 84.5% of respondents would stent at least 50% of the time. Following uncomplicated ureteroscopy, most respondents (52.0%) would leave a stent for 2-7 days. Patient height was most commonly ranked first as the method of choice in determining stent length (47.0%), followed by estimation based on experience only (20.6%) and intra-operative direct measurement of ureteric length (19.1%). Most respondents utilized multiple methods in determination of optimal stent length. Most respondents (66.5%) were interested in a simple intra-operative technique utilizing a special ureteral catheter that would help choose the most appropriate stent length.</p><p><strong>Conclusions: </strong>Post-ureteroscopy stent insertion is common and patient height is the most common method of choice used in determining optimal stent length. Most respondents were interested in using a simple, novel ureteral catheter device that would allow them to more accurately select optimal stent length.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"76 1","pages":"57-63"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/ee/CEJU-76-83.PMC10091891.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9309524","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 laser lithotripsy - do we treat or harm? Histological evaluation of temperature effects in an in vivo study with thulium fiber laser.","authors":"Angelis Peteinaris,&nbsp;Arman Tsaturyan,&nbsp;Vasiliki Bravou,&nbsp;Vasileios Tatanis,&nbsp;Gabriel Faria-Costa,&nbsp;Konstantinos Pagonis,&nbsp;Solon Faitatziadis,&nbsp;Athanasios Vagionis,&nbsp;Evangelos Liatsikos,&nbsp;Panagiotis Kallidonis","doi":"10.5173/ceju.2023.24","DOIUrl":"https://doi.org/10.5173/ceju.2023.24","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the possible histopathological alterations that occur in the kidneys due to a continuous temperature increase above 43°C for one hour of lithotripsy using a newly introduced thulium fiber laser (TFL).</p><p><strong>Material and methods: </strong>Two female pigs were used. After the insertion of a 9.5/11.5 ureteral access sheath, flexible ureteroscopy and laser lithotripsy for one hour were conducted. A TFL laser with a 200-μm fiber was used. The power setting used was 8 W (0.5 J × 16 Hz). A K-type thermocouple was inserted and fixed in the upper calyx of the right porcine kidney to record the temperature in the pelvicalyceal system during the laser activation. Second-look flexible nephroscopy followed by nephrectomy and pathohistological evaluation of the operated kidney was performed one week after the procedure in the first pig and 2 weeks after the surgery in the second pig.</p><p><strong>Results: </strong>Flexible nephroscopy did not reveal significant differences between the 2 porcine kidneys. Nevertheless, the histopathological report demonstrated severe alterations in the kidney of the first pig. Mild changes were reported in the kidney of the second pig. A significant improvement in inflammation and haemorrhagic lesions was demonstrated when comparing the 2 kidneys.</p><p><strong>Conclusions: </strong>The difference demonstrated between the 2 kidneys based on the histopathological report shows that the healing process is capable of improving severe to mild alterations within a one-week time frame. Two weeks after the surgery, only minor changes were observed, suggesting that even temperature increases above the threshold can be tolerated regarding renal damage.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"76 1","pages":"44-48"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/0e/CEJU-76-24.PMC10091897.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9316745","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":"A giant inguinoscrotal hernia containing urinary bladder repaired with use of robotic-assisted laparoscopy: a case report.","authors":"Piotr Kania,&nbsp;Paweł Marczuk,&nbsp;Jakub Biedrzycki","doi":"10.5173/ceju.2023.211","DOIUrl":"https://doi.org/10.5173/ceju.2023.211","url":null,"abstract":"<p><p>The aim of this report is to underline proper differential diagnosis of scrotal enlargement and to highlight feasibility of minimally invasive robotic-assisted treatment of giant urinary bladder containing inguinoscrotal hernia. A 48-year-old patient was referred to the outpatient urology clinic with diagnosis of hydrocele. During the diagnostic procedures, it was confirmed that the scrotal enlargement is a giant inguinal hernia containing most of the urinary bladder. Robotic-assisted laparoscopic transabdominal preperitoneal hernia repair (TAPP) has been performed. The patient remains asymptomatic after 18 months of observation. Minimally invasive repair should always be considered due to better perioperative and postoperative outcomes.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"76 1","pages":"64-67"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/8e/CEJU-76-211.PMC10091887.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9309521","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}