Central European Journal of Urology最新文献

{"title":"Worldwide trends of practice and intervention in Paediatric Endourology: Comparison of European versus Non-European responses","authors":"","doi":"10.5173/ceju.2023.79","DOIUrl":"https://doi.org/10.5173/ceju.2023.79","url":null,"abstract":"Introduction The area of paediatric endourology is unique and is recognised to be challenging, and it requires a certain level of focused training and expertise. Our aim was to conduct a worldwide survey in order to gain an overview regarding the current practice patterns for minimally invasive treatments of paediatric upper urinary tract stone patients. Material and methods The survey was distributed between December 2021 and April 2022 through urology sections and societies in United Kingdom, Latin America and Asia. The survey was made up of 20 questions and it was distributed online using the free online Google Forms (TM). Results 221 urologists answered the survey with 56 responses each from India, South America and UK and 53 responses from the rest of Europe (15 countries). In total, 163 responders (73.7%) managed paediatric stone patients in their daily practice. Of the responders, 60.2% were adult urologists and 39.8% were paediatric urologists. 12.9% adult urologists and 20.4% paediatric urologists run independent clinics while some run combined adult and paediatric clinics sometimes with the support of the nephrologists. Only 33.9% urologists offered all surgical treatments [extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureteroscopy (URS) and retrograde intrarenal surgery (RIRS)]. Conclusions Treatment of paediatric stones can vary according to country and legislations. Based on the results of this survey, minimally invasive methods such as URS and mini PCNL seem to have become more popular. In most institutions a collaboration exists between adult and paediatric urologists, which is the key for a tailored decision making, counselling and treatment success.","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135550684","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":"Off-clamp robotic-assisted partial nephrectomy: surgical experience from a single centre.","authors":"Matteo Zanoni,&nbsp;Fabio Grizzi,&nbsp;Paolo Vota,&nbsp;Giovanni Toia,&nbsp;Cinzia Mazzieri,&nbsp;Maria Chiara Clementi,&nbsp;Edoardo Beatrici,&nbsp;Gianluigi Taverna","doi":"10.5173/ceju.2023.261","DOIUrl":"https://doi.org/10.5173/ceju.2023.261","url":null,"abstract":"<p><strong>Introduction: </strong>Robot-assisted partial nephrectomy (RAPN) is a minimally invasive treatment for localized renal tumours, which can sometimes result in extended warm ischaemic time and serious complications. This study reports on surgical outcomes including feasibility, positive margins, and complications during and after surgery.</p><p><strong>Material and methods: </strong>From January 2011 to November 2022, a single centre performed off-clamp sutureless RAPN on 287 patients. The study recorded preoperative patient characteristics, estimated glomerular filtration rate, and tumour features according to the preoperative aspects and dimensions used for an anatomical (PADUA) classification, and utilized the RENAL nephrometry scoring system. Intraoperative details and complications were documented. Postoperative complications within 30 days were classified according to the Clavien-Dindo system. Follow-up appointments were scheduled at 1, 3, and 6 months in the first year, followed by subsequent appointments every 6 months, and then annually.</p><p><strong>Results: </strong>The study included 145 males and 142 females, with a mean age of 58.9 years and a mean body mass index of 26.7 kg/m². The mean PADUA score was 8.3, the average console time was 83 minutes, and the estimated blood loss was 280 mL. The average hospital stay was 3 days, and no intraoperative complications were observed. However, 4 patients (1.4%) experienced post-operative haemorrhage that required laparotomy (Clavien-Dindo stage IIIB), and 4 patients (1.4%) had positive surgical margins.</p><p><strong>Conclusions: </strong>Off-clamp selective arterial clamping during minimally invasive partial nephrectomy is a safe and feasible approach for small renal tumours. Further randomized prospective studies are required to confirm if RAPN without clamping offers any renal functional benefits and reduces perioperative bleeding complications.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"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/4f/bb/CEJU-76-261.PMC10357834.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9860920","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 radical nephrectomy in Trendelenburg position - technical modifications for a pelvic kidney.","authors":"Andreia Cardoso,&nbsp;Sara Anacleto,&nbsp;Catarina Laranjo Tinoco,&nbsp;Ana Sofia Araújo,&nbsp;Nuno Morais,&nbsp;Emanuel Carvalho-Dias","doi":"10.5173/ceju.2022.237","DOIUrl":"https://doi.org/10.5173/ceju.2022.237","url":null,"abstract":"14.6 g/dl to 11.9 g/dl. The histopathologic examination revealed an 808 g surgical specimen, 8.8*8.0*6.5 cm kidney, with 7.0*6.0*4.5 cm clear cell RCC, in the middle and infe - rior pole, G3 pT3aNxR0, with focal invasion of hilar and perirenal fat. There was also vascular invasion. In conclusion, this was a challenging but success - ful surgery, using only standard laparoscopic mate-rial. Robot-assistance or CT-scan 3D reconstruction might have been helpful, if available, but we showed these are not essential","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"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/94/5f/CEJU-76-237.PMC10091892.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9309936","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":"Endourological treatment of uretero-enteric benign stricture after radical cystectomy and kidney transplant.","authors":"Angelo Territo,&nbsp;Paolo Verri,&nbsp;Alessandro Uleri,&nbsp;Pietro Diana,&nbsp;Andrea Gallioli,&nbsp;Michael Baboudjian,&nbsp;Josep Maria Gaya,&nbsp;Francesco Sanguedolce,&nbsp;Julia Aumatell,&nbsp;Giuseppe Basile,&nbsp;Alejandra Bravo,&nbsp;Joan Palou,&nbsp;Alberto Breda","doi":"10.5173/ceju.2022.238","DOIUrl":"https://doi.org/10.5173/ceju.2022.238","url":null,"abstract":"Endourological treatment of uretero-enteric benign stricture after radical cystectomy and kidney transplant. Cent European","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"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/3e/7b/CEJU-76-238.PMC10091890.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9309937","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 antithrombotic therapy on the time of detection of bladder cancer.","authors":"Dora Jakus,&nbsp;Marijan Šitum,&nbsp;Petra Čepin,&nbsp;Ivana Vrhovac,&nbsp;Josip Anđelo Borovac","doi":"10.5173/ceju.2022.193","DOIUrl":"https://doi.org/10.5173/ceju.2022.193","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this article was to investigate the impact of chronic antithrombotic therapy (AT) use on the time of detection of bladder cancer, assuming that patients taking AT experience episodes of macroscopic hematuria earlier, and therefore have a more favorable histopathological grade and stage, as well as a smaller number and size of tumors compared to patients not taking AT.</p><p><strong>Material and methods: </strong>A retrospective, cross-sectional study was conducted, including 247 patients who underwent bladder cancer surgery for the first time at our institution during the three-year period (2019-2021) and who experienced macroscopic hematuria.</p><p><strong>Results: </strong>A lower frequency of high-grade bladder cancer (40.6% vs 60.1%, P = 0.006), T2 stage (7.2% vs 20.2%, P = 0.014), and a lower frequency of tumors larger than 3.5 cm (29% vs 57.9%, P <0.001) were found in patients using AT compared to patients not using them. The patients using AT had a smaller mean tumor size (2.98 vs 4.51 cm, P <0.001). A multivariable regression analysis, adjusted for age, sex, and number of comorbidities, showed a lower probability of having a high-grade cancer (OR 0.393, 95% CI 0.195-0.792, P = 0.009), T2 stage (OR 0.276, 95% CI 0.090-0.849, P = 0.025), and tumors larger than 3.5 cm (OR 0.261, 95% CI 0.125-0.542, P <0.001) in patients using AT.</p><p><strong>Conclusions: </strong>More favorable histopathological grades, stages, and smaller tumor sizes were found in patients with bladder cancer who experienced macroscopic hematuria and were using AT compared to patients not taking AT.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"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/84/6d/CEJU-76-193.PMC10091894.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9316748","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":"Treatment of 2-4 cm kidney stones: multicentre experience. Comparison of safety, efficacy, and costs of percutaneous nephrolithotomy and retrograde intrarenal surgery.","authors":"Nicolò Fiorello,&nbsp;Andrea Di Benedetto,&nbsp;Andrea Mogorovich,&nbsp;Daniele Summonti,&nbsp;Massimo Aquilini,&nbsp;Giuseppe Silvestri,&nbsp;Chiara Gilli,&nbsp;Gregorio Romei,&nbsp;Michele Santarsieri,&nbsp;Francesca Manassero,&nbsp;Giorgio Pomara,&nbsp;Sandro Benvenuti,&nbsp;Carlo Alberto Sepich","doi":"10.5173/ceju.2023.119","DOIUrl":"10.5173/ceju.2023.119","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study is to compare the safety and efficacy, through the stone-free rate (SFR), as well as the costs, between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), for 2-4 cm kidney stones.</p><p><strong>Material and methods: </strong>We analysed the data relating to RIRS and PCNL performed in 3 reference centres for kidney stones, in the period between 1/2019 and 12/2021. The total number of procedures was 130 (63 RIRS and 67 PCNL). We defined SFR as the absence of lithiasic fragments or stones <3 mm. Results were compared between 2 groups depending on the stone size: 2-3 cm stones (group 1) and >3 cm stones (group 2).</p><p><strong>Results: </strong>The duration of RIRS was 90 minutes for group 1 and 115 minutes for group 2, and for PCNL it was 135 minutes for group 1 and 145 minutes for group 2. RIRS had shorter duration with a significant difference in group 1 (p = 0.000014). SFR for RIRS was 78% for group 1 and 21% for group 2, and for PCNL it was 92% for group 1 and 81% for group 2. Therefore, there is a statistically significant difference, which is more evident for 3 cm and multiple stones (p = 0.0057 for group 1, p = 0.000146 for group 2). The difference in costs was estimated by calculating the expected costs for a single surgical procedure and the estimated cost per day for ordinary hospitalization.</p><p><strong>Conclusions: </strong>2-4 cm stones can be safely treated with both RIRS and PCNL, but RIRS should not be chosen as an option for stones >3 cm, except in selected cases. PCNL remains the gold standard for the treatment of complex stones, especially for stones >3 cm. Risk of postoperative complications is higher in PCNL, even if this difference is not great. The costs associated with RIRS, even when recalculating with the need for new treatments, remain cheaper.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"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/ca/a7/CEJU-76-119.PMC10357833.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9864203","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":"Temperature effect of Moses™ 2.0 during flexible ureteroscopy: an <i>in vitro</i> assessment.","authors":"José M Villena, Vicente Elorrieta, José A Salvadó","doi":"10.5173/ceju.2023.127","DOIUrl":"10.5173/ceju.2023.127","url":null,"abstract":"<p><strong>Introduction: </strong>One of the main issues related to the use of high-power lasers is the associated rise in temperature. The aim of this study was to characterize temperature variations with activation of the Moses™ 2.0 laser.</p><p><strong>Material and methods: </strong>An in vitro experimental study was designed using a high-fidelity uretero-nephroscope simulation model to assess changes in temperature during intracorporeal laser lithotripsy. Renal and ureteral temperature records were obtained from the treatment of BegoStones positioned in the renal pelvis. Different laser settings over three time periods and two possible irrigation flow speeds were evaluated. We considered 43°C as the threshold since it is associated with denaturation of proteins. The Wilcoxon-Mann-Whitney test was used to assess quantitative variables and the Kruskal-Wallis test for categorical variables.</p><p><strong>Results: </strong>The highest increase in intrarenal temperature was reached with 30 seconds of laser activation at a laser setting of 0.5 J/100 Hz (50 W) and a flow of 10 mL/min. Only 15 seconds of activation was sufficient for most settings to exceed 43°C. The ureteral temperature did not increase significantly, regardless of the combination of laser setting, time, or irrigation flow, except when 30 W was used for a 30 second period. Multivariate analysis showed that an irrigation flow of 20 mL/min produced an intrarenal temperature decrease of 4.7-9.2°C (p <0.001).</p><p><strong>Conclusions: </strong>Use of high-power lasers, both for the ureter and kidney, should involve consideration of temperature increases evidenced in this study, due to the potential biological risk entailed.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477176","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":"Guillain-Barré Syndrome following intravesical Bacillus Calmette-Guérin therapy for bladder cancer: a rare and intriguing case report.","authors":"Vincent Khor, Omar Fahmy, Christopher Kheng Siang Lee, Mohd Ghani Khairul-Asri","doi":"10.5173/ceju.2023.91","DOIUrl":"10.5173/ceju.2023.91","url":null,"abstract":"<p><p>Intravesical Bacillus Calmette-Guérin (BCG) therapy is a standard treatment for non-muscle invasive bladder cancer, but some patients experience side effects that lead to treatment discontinuation. Local side effects are typically mild, while systemic side effects can be severe and life-threatening. BCG therapy has immunotherapy effects on bladder cancer, but the mechanism is not fully understood. Due to its effect on the immune system, patients may also develop rare autoimmune complications, such as neuropathy. This case report suggests a potential association between BCG therapy and Guillain-Barré Syndrome (GBS), as a patient developed GBS after receiving intravesical BCG therapy for invasive bladder cancer.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10789272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478284","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":"Patient perception and barriers with fluid hydration: A prospective face-to-face interview and counselling from a university hospital stone clinic","authors":"","doi":"10.5173/ceju.2023.105","DOIUrl":"https://doi.org/10.5173/ceju.2023.105","url":null,"abstract":"Introduction Kidney stone disease (KSD) has a lifetime prevalence of up to 14% in the United Kingdom. Primary and secondary prevention of KSD via dietary intervention is a low-cost public health intervention and remains the best preventative strategy against urolithiasis. Material and methods This prospective study was conducted on kidney stone patients attending a stone clinic at our tertiary endourology centre. Patients were taken through a questionnaire, which was completed in the clinic by a trained specialist endourology nurse. Results A total of 259 patients completed the questionnaire. 141 (54.4%) had an active stone during the clinic visit with the remaining 118 (45.6%) with a history of stone treatment. Regarding barriers to fluid intake, 43 (16.6%) patients did not have a habit of drinking water or felt too bloated, 36 (13.9%) did not like the taste, 17 (6.6%) were not thirsty, 10 (3.9%) of patients were too busy. Of those who answered, 108 (46.8%) patients did not believe there was a link between fluid intake and stone formation. A belief of a link between fluid intake and stone formation significantly predicted fluid intake (p = 0.024) with people who did believe in this drinking less water. Conclusions There are numerous perceived barriers to adequate fluid intake, with almost half of all patients not believing that there is a link between fluid intake and stone formation. This misunderstanding may predict a lower fluid intake. More attention should therefore be focussed on patient education and primary prevention aspects to avoid kidney stone recurrence.","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135550679","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":"The Role of Primary Nocturnal Enuresis in the Aetiology of Overactive Bladder Syndrome","authors":"","doi":"10.5173/ceju.2023.56","DOIUrl":"https://doi.org/10.5173/ceju.2023.56","url":null,"abstract":"Introduction The aim of this study was to investigate the effect of nocturnal enuresis (NE) in childhood on the development and course of overactive bladder (OAB) in adulthood. Material and methods Between January and September 2021, data from patients who visited the Urology Outpatient Clinic with OAB symptoms were collected. Patients with a history of diabetes mellitus, neurological diseases, bladder outlet obstruction, active urinary system infection, or previous medical treatment for OAB and those who did not agree to join the study were excluded. Patients with a diagnosis of NE in childhood were classified as group 1, and patients without a diagnosis of NE were classified as group 2. Demographic data were recorded. Frequency of incontinence, and the number of daytime voids and nocturia were evaluated according to a three-day voiding diary. In addition, the maximum urinary flow ratio (Qmax), bladder wall thickness, and postvoid residual volume were determined using uroflowmetry and pelvic ultrasound. Results After applying the inclusion/exclusion criteria, the mean age of the study group of 103 patients, consisting of 34 women and 69 men, was 32.85 ±11.20 years (18–65), and the mean BMI of both groups was 26.62 ±3.34 (19.49–39.18). Sixty-five of 103 patients (63.1%) had a history of childhood NE diagnosis. Patients in the group with a history of NE were younger than those without a history of NE. Conclusions The earlier onset and more intense course of OAB symptoms in patients diagnosed with NE in childhood suggests that NE may be a triggering factor in the aetiology of OAB.","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135550685","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}