Journal of Endourology

OBJECTIVE: We aim to report the learning curve and experience performing holmium laser enucleation of the prostate (HOLEP) from a resident standpoint trained at a tertiary high-volume center. METHODS: An electronic survey was distributed to ten surveyees that included recently graduated chief residents trained at Indiana University in the last 3 years i.e. between 2020-2022 with a 100% response rate. The questionnaire focused on HOLEP training experience based on a recently established mentorship curriculum in training the residents through each individual step of the surgery...

The multidisciplinary nature of artificial intelligence (AI) has allowed for rapid growth of its application in medical imaging. Artificial intelligence algorithms can augment various imaging modalities such as X-rays, CT, and MRI to improve image quality and generate high-resolution three-dimensional images. AI reconstruction of three-dimensional models of patient anatomy from CT or MRI scans can better enable urologists to visualize structures and accurately plan surgical approaches. AI can also be optimized to create virtual reality simulations of surgical procedures based on patient-specific data, giving urologists more hands-on experience and preparation...

Introduction: The use of a ureteral access sheath (UAS) during ureteroscopy (URS) has been associated with the risk for ureteral injuries. Preoperative administration of α1-blockers presents a potential mitigator of such lesions by inducing ureteral relaxation, which may also contribute to improving other surgical outcomes. Methods: A comprehensive literature search was conducted across MEDLINE, Embase, and Cochrane databases for studies comparing preoperative α1-blockers administration vs its non-use in adult patients without pre-stenting undergoing URS...

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No abstract text is available yet for this article.

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Objectives: The absence of predictive markers for kidney stone recurrence poses a challenge for the clinical management of stone disease. The unpredictability of stone events is also a significant limitation for clinical trials, where many patients must be enrolled to obtain sufficient stone events for analysis. In this study, we sought to use machine learning methods to identify a novel algorithm to predict stone recurrence. Subjects/Patients and Methods: Patients enrolled in the Registry for Stones of the Kidney and Ureter (ReSKU), a registry of nephrolithiasis patients collected between 2015-2020, with at least one prospectively collected 24-hour urine test (Litholink 24-hour urine test; Labcorp) were included in the training set...

This research presents our application of artificial intelligence (AI) in predicting urolithiasis risk. Previous applications, including AI for stone disease, have focused on stone composition and aiding diagnostic imaging. AI applications centered around patient-specific characteristics, lifestyle considerations, and diet have been limited. Our study comprised a robust sample size of 976 Chilean participants, with meticulously analyzed demographic, lifestyle, and health data through a comprehensive questionnaire...

Background: Among emerging AI technologies, Chat-Generative Pre-Trained Transformer (ChatGPT) emerges as a notable language model, uniquely developed through artificial intelligence research. Its proven versatility across various domains, from language translation to healthcare data processing, underscores its promise within medical documentation, diagnostics, research, and education. The current comprehensive review aimed to investigate the utility of ChatGPT in urology education and practice and to highlight its potential limitations...

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OBJECTIVE: To compare the efficacy and postoperative infection rate of super mini percutaneous nephrolithotomy(SMP) and flexible ureteroscopic lithotripsy(FURL) in patients with diabetic nephrolithiasis, and to explore the risk factors associated with postoperative infection following these two procedures. METHODS: The medical history and surgery details of 252 patients with diabetic nephrolithiasis who underwent lithotripsy in our hospital between January 2018 and May 2023, including 144 SMP and 108 FURL, were reviewed and compared...

INTRODUCTION: Diffusion of Innovation Theory explains how ideas or products gain momentum and diffuse (or spread) through specific populations or social systems over time. The theory analyzes primary influencers of the spread of new ideas, including the innovation itself, communication channels, time, and social systems. METHODS: The current study reviewed published medical literature to identify studies and applications of artificial intelligence (AI) in endourology and utilized E...

BACKGROUND: We detail our approach and experience with a hybrid version of the endopelvic hood-sparing robotic-assisted radical prostatectomy (RARP) using the da Vinci robotic platform (Intuitive Surgical, Sunnyvale, CA). MATERIALS AND METHODS: We retrospectively reviewed the records of 200 patients who underwent RARP by a single surgeon. Patients were propensity-matched into three cohorts depending on biopsy and prostatectomy Gleason Grade Groups: traditional retropubic (RP) (n=80), retzius-sparing (RS) (n=40), and hood-sparing (HS) (n=80)...

PURPOSE: An investigation of various convolutional neural network (CNN)-based deep learning algorithms was conducted to select the appropriate artificial intelligence (AI) model for calculating the diagnostic performance of bladder tumor classification on cystoscopy images, with the performance of the selected model to be compared against that of medical students and urologists. METHODS: A total of 3,731 cystoscopic images that contained 2,191 tumor images were obtained from 543 bladder tumor cases and 219 normal cases were evaluated...

In early 2020 as the SARS-Cov-2 (COVID-19) pandemic progressed, many institutions limited non-urgent surgery. This coincided with a decade-long increase in percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS) and decrease in shock wave lithotripsy (SWL) for surgical management of urolithiasis. Herein, we evaluate temporal stone surgery rates and surgeon volumes in the Medicare population and suggest how COVID-19 contributed to them. Retrospective analysis was conducted using the "Medicare Physician & Other Practitioners" database containing data from January 2013-December 2021...

Introduction NGS is a new molecular technique for identifying microorganisms. Treating bacteriuria in patients undergoing stone removal procedures is important for preventing postoperative UTI. The objective of this study is to assess the usefulness of preoperative urine NGS testing by comparing NGS with standard urine culture in predicting postoperative UTI after URSL and PCNL. Materials and methods This prospective study was conducted from February 16th, 2022, to January 11th, 2024. Sixty subjects who underwent URSL or PCNL were included...

Introduction and Objective: Kidney-sparing surgery (KSS) for upper tract urothelial cancer (UTUC) has gained increasing interest recently. However, there is limited contemporary data regarding the role of KSS in ureteral urothelial carcinoma. Therefore, we investigated the survival outcomes of ureteral urothelial carcinoma after KSS from a large, prospective international UTUC registry. Methods: The Clinical Research Office of the Endourology Society-Urothelial Carcinomas of the Upper Tract (CROES-UTUC) Registry included patients with UTUC who received KSS or radical nephroureterectomy (RNU) between 2014 and 2019...

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While ChatGPT has gained popularity in various domains, it may not be the ideal focus for medical professionals due to its reliance on language pattern prediction rather than direct fact retrieval, potentially leading to inaccurate outputs. We emphasize the limitations of ChatGPT's training data, which mainly come from non-specialized sources and may result in misleading answers in highly specialized medical domains. We advocate for a shift towards specialized medical large language models (LLMs) that are trained using authoritative medical databases, supplemented by human validation, to ensure accuracy and completeness of data...

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