Lasers for benign prostatic hyperplasia (hybrid, blue diode, TFL, Moses). Which one to choose?
Purpose of review
To present the evidence of latest developments of lasers for the surgical treatment of benign prostatic hyperplasia (BPH). We focused on recent advancements in Ho:YAG laser such as Moses technology, the Thulium Fiber Laser (TFL), the blue diode laser, and hybrid laser.
Recent findings
Laser enucleation of prostate techniques using either Ho:YAG laser with the Moses technology and Moses 2.0, or TFL seem efficient and safe compared with the standard enucleation using Ho:YAG laser. Only in vitro studies evaluated the blue diode laser and hybrid laser (combination of a continuous wave TFL and blue ...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research
Trends in outpatient versus inpatient urologic surgery at a university academic medical center
Purpose of review
To analyze trends in outpatient and inpatient urologic surgeries at a large university academic medical center and test the hypothesis that the proportion of outpatient surgeries has been increasing as compared to inpatient surgeries in urology.
Recent findings
We analyzed a total of 33,054 claims for urologic surgeries at a large university academic medical center from 2010 to 2020, of which 23.2% met inpatient criteria (n = 7695), whereas 76.7% were outpatient (n = 25,359). Although outpatient claims increased yearly by an average of 24%, inpatient claims increased yearly by an averag...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research
Prevalence and trends of urolithiasis among adults
Purpose of review
The purpose of this article is to review and synthesize the current literature on the epidemiology of urolithiasis.
Recent findings
The global patterns of urolithiasis are changing, as the prevalence of urolithiasis appears to be increasing across the world. Geographical variation in the prevalence of urolithiasis is noted across countries and within each country. Although urolithiasis is more common among men and white race, recent data suggests a more prominent rise in the prevalence among women and African Americans. Yet, no conclusive explanations for these phenomena are reported so far.
...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Jodi Antonelli and Evangelos Liatsikos Source Type: research
Paediatric stone management: innovations and standards
Purpose of review
The aim of this study was to discuss current trends and recent developments in the surgical management of paediatric urolithiasis.
Recent findings
Medical expulsive therapy (MET) is considered as an option for the treatment of children with ureter stones. Extracorporeal shockwave lithotripsy (SWL) remains as a first option for majority of kidney stones and upper ureter stones. Advances in endourology have led to increased adoption of retrograde intrarenal surgeries (RIRS) and percutaneous nephrolithotomy (PCNL/mini-PCNL/ultra-mini-PCNL/micro-PCNL).
Summary
Management of paediatric stone ...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Jodi Antonelli and Evangelos Liatsikos Source Type: research
Advances in ureteral stent technology
Purpose of review
Ureteral stents are an invaluable tool for urologists but suffer from several drawbacks, including: limited durability due to stent encrustation, significant morbidity from bothersome urinary symptoms, pain and infection, risk of the forgotten stent and costly removal. This review highlights key advances in ureteral stent technology that seek to address these issues.
Recent findings
Over the past 2 years clinical trials have brought ureteral stent technology aimed to reduce stent-associated morbidity closer to clinical application. Stent material and changes to stent design show promise in impr...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Jodi Antonelli and Evangelos Liatsikos Source Type: research
The future of laser technology in kidney stones
Purpose of review
The aim of this study was to present the recent and promising innovations of the new laser technologies used for the treatment of renal stones.
Recent findings
Taking advantage of pulse modulation, new technologies such as the Moses effect, the Virtual basket and the Vapor tunnel have been introduced. These technologies seem to improve lithotripsy efficacy by reducing retropulsion and increasing the stone ablation rate.
High-power laser lithotripsy has arisen in everyday clinical practice in some centres. The combination of equal efficacy and safety levels compared with the low-power laser l...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Jodi Antonelli and Evangelos Liatsikos Source Type: research
Lithotripsy devices for percutaneous nephrolithotomy (PNL) – new developments
Purpose of review
Percutaneous nephrolithotomy (PNL) is the mainstay of surgery for renal calculi>2 cm or complex multiple calculi and is a technique that has been around since 1976. We review recent literature surrounding novel lithotripsy devices and technology used in PNL.
Recent findings
At present, the Holmium:yttrium-aluminum-garnet (Ho:YAG) laser is widely accepted as the gold standard laser lithotripsy for PNL. SwissLithoClast Trilogy offers a range of probes with a trifecta of electromagnetic, ultrasonic energy with surgeon-controlled suction. The Olympus Shockpulse-SE is a similar lithotripter that r...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Jodi Antonelli and Evangelos Liatsikos Source Type: research
Imaging in stone diagnosis and surgical planning
Purpose of Review
Radiological imaging techniques and applications are constantly advancing. This review will examine modern imaging techniques in the diagnosis of urolithiasis and applications for surgical planning.
Recent Findings
The diagnosis of urolithiasis may be done via plain film X-ray, ultrasound (US), or contrast tomography (CT) scan. US should be applied in the workup of flank pain in emergency rooms and may reduce unnecessary radiation exposure. Low dose and ultra-low-dose CT remain the diagnostic standard for most populations but remain underutilized. Single and dual-energy CT provide three-dimensi...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Jodi Antonelli and Evangelos Liatsikos Source Type: research
Electromagnetic-guided puncture: a tool or a tale?
Purpose of review
The puncture technique and site of the puncture can impact the clinical outcome and the development of postoperative adverse events following percutaneous nephrolithotomy (PCNL). The aim of the current review was to discuss the available puncture guidance approaches and outline the potential role of the recently introduced electromagnetic-guided method.
Recent findings
The puncture and PCNL tract establishment is usually performed using fluoroscopic or ultrasound guidance or a combination of two approaches. Electromagnetic-guided puncture is one of the most recent advancements of technology. Th...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Jodi Antonelli and Evangelos Liatsikos Source Type: research
Artificial intelligence in endourology: emerging technology for individualized care
Purpose of review
Artificial intelligence in medicine has allowed for efficient processing of large datasets to perform cognitive tasks that facilitate clinical decision-making, and it is an emerging area of research. This review aims to highlight the most pertinent and recent research in artificial intelligence in endourology, where it has been used to optimize stone diagnosis, support decision-making regarding management, predict stone recurrence, and provide new tools for bioinformatics research within endourology.
Recent findings
Artificial neural networks (ANN) and machine learning approaches have demonstra...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Jodi Antonelli and Evangelos Liatsikos Source Type: research
Metabolic evaluation: is there really a future?
Purpose of review
To confirm the need for a metabolic evaluation in stone formers based on the latest information published in the last 24 months and in the current 2022 American and European urological guidelines.
Recent findings
Recent studies suggest that urolithiasis prevalence has been increasing since 1990. Along with it, metabolic abnormalities that contribute to the development of kidney stones are also increasing, such as hyperuricosuria, hyperoxaluria, hypocitraturia, hypomagnesuria, hypocalciuria, hypophosphaturia, and hyperuricemia. Those abnormalities can only be detected through a metabolic evaluat...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Jodi Antonelli and Evangelos Liatsikos Source Type: research
Decoding germ cell tumours for clinicians
Purpose of review
Germ-cell tumours of the testis affect predominantly younger males aged between 15 and 40 years, with nearly 74,500 new cases estimated globally in 2020. Their rarity and the complex morphology, mean that, in nonexpert hands, there is a significant risk of misdiagnosis of both type and staging of these neoplasms.
Recent findings
There have been significant changes in the 2016 WHO classification of Testicular tumours that need to be understood by both pathologists and clinicians for streamlining management. Standardised structured reporting guidelines and discussion at the multidisciplinary-te...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: URO PATHOLOGY: Edited by Eva M. Compérat Source Type: research
Basal cell carcinoma of the prostate: a case report responding to the FGFR inhibitor pemigatinib and literature review
We describe the diagnostic process, including the uropathological and DNA-sequencing results, which allowed us to start an experimental treatment with pemigatinib. BCC of the prostate is associated with an aggressive biological and clinical behavior, such as recurrence and metastasis. Several immunohistochemical stainings are available to differentiate BCC from adenocarcinoma of the prostate. Based on pathology and results from next-generation sequencing (NGS), patients can be offered targeted therapies.
Summary
With the aid of histological work-up and immunostaining, prostatic BCC can be accurately diagnosed. Our p...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: URO PATHOLOGY: Edited by Eva M. Compérat Source Type: research
Nonmuscle-invasive bladder cancer, old problems, new insights
Purpose of review
Nonmuscle-invasive bladder cancer (NMIBC) is the most frequent bladder cancer and represents around 75% of bladder cancers. This review will discuss known challenges and recent advances in staging, grading and treatment stratification based on pathology.
Recent findings
Pathological staging and grading in NMIBC remains challenging and different techniques exist. Substaging has been shown to be of prognostic relevance and to help predict treatment response in patients receiving Bacillus Calmette-Guérin (BCG) therapy, which is the treatment of choice for high-grade NMIBC. Recent advances in mole...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: URO PATHOLOGY: Edited by Eva M. Compérat Source Type: research
Papillary renal cell carcinoma: current and controversial issues
Purpose of the review
Papillary renal cell carcinoma (pRCC) is the second most frequent renal cancer subtype and represents 15–20% of all RCC. Classification of pRCC is changing because novel tumour entities have been discovered in the last years. In this review, we summarise recent studies relevant for the understanding of the molecular complexity and the broader differential diagnosis of pRCC.
Recent findings
It has been 25 years ago, that pRCC was morphologically subdivided into type 1 and type 2. Recently described tumour entities in the 2022 WHO classification challenged this concept and allow a new vie...
Source: Current Opinion in Urology - June 29, 2022 Category: Urology & Nephrology Tags: URO PATHOLOGY: Edited by Eva M. Compérat Source Type: research
