Journal of Endourology

OBJECTIVE: To assess the outcomes of redo laparoscopic pyeloplasty (RLP) in pediatric patients with recurrent ureteropelvic junction obstruction (UPJO) in contrast to redo open pyeloplasty (ROP). Additionally, evaluate the feasibility and efficacy of RLP as a treatment modality for recurrent UPJO in children. MATERIALS AND METHODS: The data of 44 patients from March 2012 to March 2022 who underwent redo pyeloplasty were retrospectively reviewed. In Group RLP, the children underwent RLP, while ROP was attempted in Group ROP...

INTRODUCTION AND OBJECTIVE: Renal transplantation is the treatment for end stage renal disease that offers better quality of life and survival. Among the possible complications that might affect allografts, urolithiasis might have severe consequences, causing acute kidney injury(AKI) or septic events in immunocompromised patients. Allograft stones might be treated with percutaneous nephrolithotomy(PCNL). The aim of this Cochrane style review was to assess the safety and efficacy of PCNL in patients with renal transplant...

UNLABELLED:   Abstract Purpose: We herein describe the superficial preprostatic vein anatomy and determine its relationship with the accessory pudendal artery. MATERIALS AND METHODS: We reviewed 500 patients with localized prostate cancer who underwent conventional robot-assisted radical prostatectomy between April 2019 and March 2023 at our institution. Superficial preprostatic vein was defined as "any vein coming from the space between the puboprostatic ligaments and running within the retropubic adipose tissue anterior to the prostate toward the vesical venous plexus or pelvic side wall...

BACKGROUND: The diagnostic accuracy of cystoscopy varies according to the knowledge and experience of the performing physician. Here, we evaluated the difference in cystoscopic gaze location patterns between medical students and urologists and assessed the differences in their eye movements when simultaneously observing conventional cystoscopic images and images with lesions detected by artificial intelligence (AI). METHODOLOGY: Eye-tracking measurements were performed, and observation patterns of participants (24 medical students and 10 urologists) viewing images from routine cystoscopic videos were analyzed...

Introduction: Predicting postoperative incontinence beforehand is crucial for intensified and personalized rehabilitation after robot-assisted radical prostatectomy. Although nomograms exist, their retrospective limitations highlight artificial intelligence (AI)'s potential. This study seeks to develop a machine learning algorithm using robot-assisted radical prostatectomy (RARP) data to predict postoperative incontinence, advancing personalized care. Materials and Methods: In this propsective observational study, patients with localized prostate cancer undergoing RARP between April 2022 and January 2023 were assessed...

Background: A variety of surgical and nonsurgical management options for small renal masses (SRMs) now exist. Surgery in the form of partial nephrectomy (PN) has three different approaches. It is unclear which PN approach, if any, offers superior clinical outcomes. Aim: The aim of this study is to compare outcomes in patients with SRMs <4 cm undergoing PN through the open partial nephrectomy (OPN), laparoscopic partial nephrectomy (LPN), or robotic partial nephrectomy (RPN) approach and to establish the advantages and disadvantages of the various approaches...

Background The narrower focal zone (FZ) size of modern lithotripter was considered as one of the factors that resulted in suboptimal treatment result of shockwave lithotripsy (SWL). Therefore, we would like to investigate the efficacy and safety of standard narrow or extended (FZ) sizes in SWL for patients with renal stones. Material and Methods: In this prospective study conducted between April 2018 and October 2022, patients with renal stones were randomized to receive SWL with either standard or extended FZ...

Background: Distinguishing between organ-confined disease and extraprostatic extension (EPE) is crucial for the treatment of patients with prostate cancer. EPE is associated with an increased risk of biochemical recurrence, positive surgical margins, and metastatic disease. An MRI-based EPE scoring system was developed by Mehralivand in 2019; however, it has not been adopted in the Urology community. The purpose of this study is to evaluate the association of MRI-based EPE scoring with the pathologic EPE (pEPE) after radical prostatectomy...

Introduction: Renal colic is frequently treated with opioids; however, narcotic analgesic use can lead to dependence and abuse. We evaluated use trends of opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management of kidney stones in United States emergency departments (EDs) from 2015 to 2021. Methods: Kidney stone encounters were identified using National Hospital Ambulatory Medical Care Survey data. We applied a multistage survey weighting procedure to account for selection probability, nonresponse, and population weights...

OBJECTIVE: To compare outcomes in patients undergoing robotic-assisted radical cystectomy (RARC) with urinary diversion for bladder cancer with either the single-port (SP) or multi-port (MP) robotic platform. METHODS: All patients who underwent SP and MP RARC at our institution between January 2018 and January 2023 were retrospectively reviewed. Postoperative analgesia was administered by a department-wide narcotic stewardship protocol, and inpatient and outpatient narcotic use was tracked...

INTRODUCTION: Retrograde intrarenal surgery is associated with complications, many of which are related to the intrarenal pressure (IRP). We aim to describe the design of a novel isoprenaline-eluting guidewire ("IsoWire") and present the results from the first in vitro release studies and the first animal studies showing its effect on IRP. MATERIALS AND METHODS: The IsoWire comprises a nitinol core surrounded by a stainless-steel wire wound into a tight coil. The grooves created by this coil created a reservoir for adding a hydrogel coating into which isoprenaline, a beta-agonist, was loaded...

Purpose Robotic surgery using da Vinci surgical system has gained prominence in urology, emerging robotic platforms are expanding its applications and increasing affordability. We assess the feasibility and safety of a novel system, the Toumai® robotic system in various urological surgeries. Methods This prospective study was conducted at the first affiliated hospital of Zhengzhou university. Twenty consecutive patients underwent renal and prostatic surgery with the Toumai®. The study assessed technical feasibility (conversion rate) and safety (perioperative complications) of the procedures as primary outcomes...

PURPOSE: To review our experience with >100 patients with primary obstructive megaureter (POM) undergoing Endoscopic Balloon Dilatation (EBD) and a follow-up of up to 12 years, and determine potential risk factors for failure. Our hypotheses were that EBD allows for long-term treatment in >80% of patients, and its effectiveness decreases in more severe cases. METHODS: Retrospective study of 123 consecutive patients (131 ureters) undergoing EBD from 2009 to 2021...

Introduction Artificial intelligence (AI) platforms such as ChatGPT and Bard are increasingly utilized to answer patient healthcare questions. We present the first study to blindly evaluate AI-generated responses to common endourology patient questions against official patient education materials. Methods 32 questions and answers spanning kidney stones, ureteral stents, BPH, and UTUC were extracted from official Urology Care Foundation (UCF) patient education documents. The same questions were input into ChatGPT 4...

UNLABELLED: Urothelial carcinoma (UC) affecting the urinary tract is recognized as one of the prevalent types of cancer, ranking fifth in terms of incidence. However, it is important to note that upper tract UC (UTUC), in comparison to bladder cancer (BC), is relatively uncommon and represents a minority of UC cases, accounting for approximately 5-10%. It is worth emphasizing that up to 60% of UTUC cases are invasive at the time of diagnosis, in contrast to 25% of BC cases. These statistics highlight the urgent need for well-designed, multi-disciplinary strategies to guide optimal management for this vulnerable patient population, aiming to control treatment variability and minimize the risks associated with under- and over-treatment...

INTRODUCTION: Retzius sparing prostatectomy was promoted with the early continence result. The long-term oncological outcome is still unknown. In this study, we aimed to compare the Intermediate-term oncologic outcomes of these two approaches in patient's cohort who was treated as part of a randomized controlled trial. METHODS: A total of 120 patients were previously randomized equally to receive retzius sparing (RS-RARP) versus standard robotic assisted laparoscopic radical prostatectomy (S-RARP) between January 2015 to April 2016...

BACKGROUND: Cone beam computed tomography (CBCT) enables intraoperative cross-sectional and three-dimensional imaging of the urinary tract. CBCT in a hybrid operating room can be used for intraoperative detection of residual stones and potential additional stone extraction at the end of percutaneous nephrolithotomy (PCNL). This study describes our initial experience with intraoperative CBCT during PCNL and analyzes its role in potentially improving its outcomes. METHODS: We conducted a single center retrospective cohort study at a tertiary referral hospital between 2018 and 2021...

Dear Editor: I would like to congratulate Dr. Soputro and collaborators for their fine article entitled "A Historical Perspective of the Evolution of Laparoscopic Surgeries" in the Journal of Endourology; Volume 36, Number 10, October 20221 and, in particular, thank them for mentioning us as authors of the first laparoscopic radical cystectomy, performed in 1993. However, it is notable that they fail to cite the first laparoscopic operative procedure in urology, i.e., the laparoscopic varicocelectomy published in 1988 and later in 1990 in the Journal of Endourology...

BACKGROUND: Following its introduction in 2018, the Single-Port (SP) robotic platform has been increasingly utilized for various approaches of robotic radical prostatectomy (RARP). Despite the demonstrable benefits in enhancing postoperative outcomes, there has been limited evidence on its perioperative morbidity, especially when compared to the gold-standard multi-port (MP). This study sought to compare the perioperative morbidity between SP and MP-RARP. METHODS: A retrospective review was performed on 911 patients who underwent RARP between January 2015 and May 2023...

Objective: The primary aim of the study was to explore intrarenal temperatures (IRTs) during flexible ureteroscopic laser lithotripsy (FURSL). The secondary aim was to investigate the correlation between temperatures and renal pelvis anteroposterior diameter (APD). Materials and Methods: From February 2023 to June 2023, 10 patients with an indwelling nephrostomy tube (NT) undergoing FURSL were enrolled in the study. Sheathless FURSL was performed using gravitational irrigation (23°C) at 60 cm. A sterile K-type thermocouple was inserted through the NT...