The Ascent of Artificial Intelligence in Endourology: a Systematic Review Over the Last 2 Decades
AbstractPurpose of ReviewTo highlight and review the application of artificial intelligence (AI) in kidney stone disease (KSD) for diagnostics, predicting procedural outcomes, stone passage, and recurrence rates. The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist.Recent FindingsThis review discusses the newer advancements in AI-driven management strategies, which holds great promise to provide an essential step for personalized patient care and improved decision making. AI has been used in all areas of KSD including diagnosis, for predi...
Source: Current Urology Reports - October 9, 2021 Category: Urology & Nephrology Source Type: research

Gender Differences in Kidney Stone Disease (KSD): Findings from a Systematic Review
AbstractPurpose of ReviewThe prevalence of kidney stones is rising and historically carries a preponderance for males. However, recent evidence has questioned whether this gender gap is closing. The aim of this systematic review was to examine this further as well as evaluate possible underlying causes.Recent FindingsRecent evidence confirms the disparity in kidney stone disease between genders is closing. In the modern era, the rise in prevalence among females has been greater, especially in adolescence. Quality of life is also more adversely affected by kidney stone events among females who are also more likely to develo...
Source: Current Urology Reports - October 8, 2021 Category: Urology & Nephrology Source Type: research

Robotic-Assisted Partial Nephrectomy: Techniques to Improve Clinical Outcomes
AbstractPurpose of ReviewTo summarize current options available for robot-assisted partial nephrectomyRecent FindingsPartial nephrectomy (PN) is a standard treatment option for management of cT1 renal masses. It may be carried out by multiple approaches. Robot-assisted (RA) PN is one such option. The goal of treatment is both correct oncological (negative surgical margins) and functional (preservation of sufficient amount of renal parenchyma of the operated kidney) outcome. Appropriate outcomes depend on multiple factors. There are many, but among others tumor characteristics (size, location, i.e., tumor complexity), patie...
Source: Current Urology Reports - October 8, 2021 Category: Urology & Nephrology Source Type: research

Role of Intrarenal Pressure in Modern Day Endourology (Mini-PCNL and Flexible URS): a Systematic Review of Literature
AbstractPurpose of ReviewTo review the latest evidence about intrarenal pressures (IRPs) generated during flexible ureteroscopy (fURS) and mini percutaneous nephrolithotomy (mPCNL) and present tools and techniques to maintain decreased values.Recent FindingfURS and PCNL constitute the primary means of stone treatment. New flexible ureterorenoscopes with small diameter and miniaturized PCNL instruments achieve optimal stone-free rates (SFRs) while decreasing invasiveness and morbidity. Nevertheless, endourologists must remain cognizant regarding the dangers of increased IRPs to avoid complications. Current research presents...
Source: Current Urology Reports - October 8, 2021 Category: Urology & Nephrology Source Type: research

Role of Ureteroscopy in Treatment of Upper Tract Urothelial Carcinoma
AbstractPurpose of ReviewUpper tract urothelial carcinoma (UTUC) is uncommon accounting for less than 10% of all urothelial tumours. Ureteroscopic management (URS) is the first line treatment for low-risk disease and has been increasingly utilised due to technological advances and increasing surgical experience. This review looks at patient outcomes relating to URS, emerging technologies and the role of adjuvant intracavitary therapy in the management of UTUC.Recent FindingsURS has firmly established itself in the management algorithm for UTUC, and a good body of evidence supports its use for low-risk disease, wherein onco...
Source: Current Urology Reports - October 7, 2021 Category: Urology & Nephrology Source Type: research

Construction of a 3D Surgical Model for Minimally Invasive Partial Nephrectomy: the Urotrainer VK-1
AbstractPurpose of ReviewMinimally invasive partial nephrectomy (MIPN) is a very challenging technique and complications may occur during its learning curve. It is important to acquire surgical skills to minimize operative risks. Surgical skills may be acquired through simulation devices or mentoring by a mentor.Recent FindingsWe designed a 3D operable model with multiple and variant surgical scenarios in order to facilitate surgical training in MIPN. The model delivered a real-life feel and handle.SummaryTo our knowledge, this is the first minimally invasive partial nephrectomy simulator to encompass a series of scenarios...
Source: Current Urology Reports - October 2, 2021 Category: Urology & Nephrology Source Type: research

Integration of Robotics in Urology Residency Programs: an Unchecked Technological Revolution
AbstractPurpose of ReviewTo review the integration of robotics in urology residency programs and evaluate how it has impacted a graduates ’ level of surgical competence.Recent FindingsSurgical technique training has shown a dramatic shift towards robotics with the most profound occurring in oncology. However, integration of robotics is not uniform across programs nor even among residents themselves. Robotics require graduates to garner a broader skill set within the same prescribed training time. Unfortunately, in this modern era, graduates are feeling more ill-equipped to start independent practice and show an incre...
Source: Current Urology Reports - September 17, 2021 Category: Urology & Nephrology Source Type: research

Renal Tumor Biopsy: Rationale to Avoid Surgery in Small Renal Masses
AbstractPurpose of ReviewThe use of renal tumor biopsy (RTB) for small renal masses (SRMs) in daily practice, although safe and accurate, is unusual. Considering the large number of benign tumors in patients with renal masses    4 cm, cystic lesion, missing data). The remaining 182 with undetermined SRMs ≤ 4 cm underwent RTB under computed tomography guidance.Recent FindingsBiopsies were diagnostic in 154/182 (84.6%) cases. Of the non-diagnostic biopsies, 11 were diagnostic when repeated. When RTB was performed of all undetermined SRMs, active treatment (surgery or cryotherapy) was ...
Source: Current Urology Reports - September 6, 2021 Category: Urology & Nephrology Source Type: research

The Impact of the COVID-19 Pandemic on Urology Residents: a Narrative Review
AbstractPurpose of ReviewThe COVID-19 pandemic brought unprecedented challenges for urology resident education. In this review, we discuss the pandemic ’s impact on urology trainees and their education.Recent FindingsUrology trainees were often redeployed to frontline services in unfamiliar clinical settings. Residents often experienced increased levels of stress, anxiety, and depression. Many programs instituted virtual “check-ins” and formed liaisons with mental health services to foster cohesiveness. Urology trainees experienced the integration of telehealth into the clinical realm. Virtual surgery lec...
Source: Current Urology Reports - August 24, 2021 Category: Urology & Nephrology Source Type: research

Minimally Invasive Partial Nephrectomy: Are All Clamps Created Equal? An Ex Vivo Model Simulation of Vascular Clampage
We present an ex vivo experimental model, designed to demonstrate differences between the clamping devices.SummaryAll clamps proved to function properly without any leakage at 90 and 120  mmHg, respectively. Our study and the ex vivo model prove that all available clamps are equally efficient at physiologic pressures. (Source: Current Urology Reports)
Source: Current Urology Reports - August 24, 2021 Category: Urology & Nephrology Source Type: research

The Impact of the COVID-19 Pandemic on Urology Residents: a Narrative Review
AbstractPurpose of ReviewThe COVID-19 pandemic brought unprecedented challenges for urology resident education. In this review, we discuss the pandemic ’s impact on urology trainees and their education.Recent FindingsUrology trainees were often redeployed to frontline services in unfamiliar clinical settings. Residents often experienced increased levels of stress, anxiety, and depression. Many programs instituted virtual “check-ins” and formed liaisons with mental health services to foster cohesiveness. Urology trainees experienced the integration of telehealth into the clinical realm. Virtual surgery lec...
Source: Current Urology Reports - August 24, 2021 Category: Urology & Nephrology Source Type: research

Minimally Invasive Partial Nephrectomy: Are All Clamps Created Equal? An Ex Vivo Model Simulation of Vascular Clampage
We present an ex vivo experimental model, designed to demonstrate differences between the clamping devices.SummaryAll clamps proved to function properly without any leakage at 90 and 120  mmHg, respectively. Our study and the ex vivo model prove that all available clamps are equally efficient at physiologic pressures. (Source: Current Urology Reports)
Source: Current Urology Reports - August 24, 2021 Category: Urology & Nephrology Source Type: research

Office-Based Renal Tumor Biopsy: a Paradigm Change in the Management of a Small Renal Mass?
AbstractPurpose of ReviewThe goal of this paper is to evaluate the use of an office-based renal mass biopsy (RMB), whose feasibility could represent a paradigm shift in clinical practice.Recent FindingsDespite the earlier diagnosis of patients with renal masses, the lack of evidence showing a reduction in cancer-specific mortality warrants an examination in treatment practices. RMB is underutilized when compared to biopsy practice for all other neoplasms in every other solid organ (except testis), and the majority of RMB performed are outsourced to interventional radiologists. Performing an ultrasound-guided, office-based ...
Source: Current Urology Reports - August 6, 2021 Category: Urology & Nephrology Source Type: research

Correction to: Retroperitoneal Robot-Assisted Partial Nephrectomy (rRAPN): Surgical Technique and Review
A Correction to this paper has been published:https://doi.org/10.1007/s11934-021-01058-6 (Source: Current Urology Reports)
Source: Current Urology Reports - June 26, 2021 Category: Urology & Nephrology Source Type: research

Outcomes and Cost Evaluation Related to a Single-Use, Disposable Ureteric Stent Removal System: a Systematic Review of the Literature
AbstractPurpose of ReviewTo present the latest evidence related to the outcomes and cost of single-use, disposable ureteric stent removal system (Isiris).Recent FindingsOur review suggests that compared to a reusable flexible cystoscope (re-FC), a disposable flexible cystoscope (d-FC) with built-in grasper (Isiris) significantly reduced procedural time and provided a cost benefit when the latter was used in a ward or outpatient clinic-based setting. The use of d-FC also allowed endoscopy slots to be used for other urgent diagnostic procedures.SummaryDisposable FCs are effective and safe for ureteric stent removal. They off...
Source: Current Urology Reports - June 15, 2021 Category: Urology & Nephrology Source Type: research

How I Handle Retreatment of LUTS Following a Failed MIST
AbstractPurpose of ReviewThe goal of this paper is to review retreatment management after failed minimally invasive treatment (MIST) of various technologies.Recent FindingsA failed MIST can be defined by the return, persistence, or worsening of LUTS, as documented by symptom scores. Persistence, development, or recurrence of comorbidities such as recurrent urinary tract infection (UTI), retention, stones, hematuria, and incontinence can also signal a failed MIST.SummaryThe common etiology for MIST failure is the preoperative consequence of long-term bladder outlet obstruction (BOO) on the bladder function. Close monitoring...
Source: Current Urology Reports - June 11, 2021 Category: Urology & Nephrology Source Type: research

Robotic Repair of Ureteral Strictures: Techniques and Review
AbstractPurpose of ReviewTo provide an overview and description of the different surgical techniques for the robotic repair of ureteral strictures.Recent FindingsThe robotic repair of ureteral stenosis has emerged as a useful option for treating strictures unsuitable for endoscopic resolution with good results, lower morbidity, and faster recovery than open techniques. Depending on the stricture ’s length and location, the reconstructive options are reimplantation, psoas hitch, Boari flap, ureteroureterostomy, appendiceal onlay flap, buccal mucosa graft (BMG) ureteroplasty, ileal replacement, or renal autotransplanta...
Source: Current Urology Reports - June 9, 2021 Category: Urology & Nephrology Source Type: research

Improving Compliance with 24-H Urine Collections: Understanding Inadequacies in the Collection Process and Risk Factors for Poor Compliance
AbstractPurpose of ReviewThe purpose of this review paper is to describe the 24-h urine collection in terms of its utility, collection process, and common problems with its acquisition.Recent FindingsAlthough 24-h urine collections are standard of care for high-risk stone formers, several nuances in test acquisition including inaccurate urine collections 50% of the time and poor patient compliance limit its potential utility. Compliance in obtaining 24-h urine collections has been shown to be improved in patients who have not undergone surgical treatment of urinary calculi, patients with metabolic stone disease or family h...
Source: Current Urology Reports - June 4, 2021 Category: Urology & Nephrology Source Type: research

Management of Lower Urinary Tract Symptoms after Prostate Radiation
Discussion of the risks and management of post-RT LUTS should be included in the shared decision-making process when counseling patients on various treatment options for prostate cancer. Further studies evaluating treatments for storage and voidin g symptoms after RT are needed to help guide future care. (Source: Current Urology Reports)
Source: Current Urology Reports - May 27, 2021 Category: Urology & Nephrology Source Type: research

New Technologies for Kidney Surgery Planning 3D, Impression, Augmented Reality 3D, Reconstruction: Current Realities and Expectations
AbstractPurpose of reviewWe aim to summarize the current state of art about 3D applications in urology focusing on kidney surgeries. In addition we aim to provide a snapshot about future perspective of intraoperative applications of augmented reality (AR).Recent findingsA variety of applications in different fields have been proposed. Many applications concern current realities and 3D reconstruction, while some others are about future perspective. The majority of recent studies have focused their attention on preoperative surgical planning, patient education, surgical training, and AR.SummaryThe disposability of 3D models ...
Source: Current Urology Reports - May 25, 2021 Category: Urology & Nephrology Source Type: research

Optimal Surgical Outcome of Minimally Invasive Partial Nephrectomy (MIPN) Based on an Early Postoperative Estimated Glomerular Filtration Rate (eGFR)
AbstractPurpose of ReviewTo compare laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) performed in two European tertiary centers using the classic optimal surgical definition — “MIC” — and a new optimal surgical definition: the “Novel TRIFECTA” (NT) concept. We sought to strengthen the PN evidence and to test the NT’s performance.Recent FindingsThe study population comprehended 505 cases of localized kidney cancer from two tertiary centers between 2012 and 2019. The NT achievement was higher in the RAPN group when compared to LPN (70.5 vs. 87.4%;p...
Source: Current Urology Reports - May 25, 2021 Category: Urology & Nephrology Source Type: research

New Technologies for Kidney Surgery Planning 3D, Impression, Augmented Reality 3D, Reconstruction: Current Realities and Expectations
AbstractPurpose of reviewWe aim to summarize the current state of art about 3D applications in urology focusing on kidney surgeries. In addition we aim to provide a snapshot about future perspective of intraoperative applications of augmented reality (AR).Recent findingsA variety of applications in different fields have been proposed. Many applications concern current realities and 3D reconstruction, while some others are about future perspective. The majority of recent studies have focused their attention on preoperative surgical planning, patient education, surgical training, and AR.SummaryThe disposability of 3D models ...
Source: Current Urology Reports - May 25, 2021 Category: Urology & Nephrology Source Type: research

Optimal Surgical Outcome of Minimally Invasive Partial Nephrectomy (MIPN) Based on an Early Postoperative Estimated Glomerular Filtration Rate (eGFR)
AbstractPurpose of ReviewTo compare laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) performed in two European tertiary centers using the classic optimal surgical definition — “MIC” — and a new optimal surgical definition: the “Novel TRIFECTA” (NT) concept. We sought to strengthen the PN evidence and to test the NT’s performance.Recent FindingsThe study population comprehended 505 cases of localized kidney cancer from two tertiary centers between 2012 and 2019. The NT achievement was higher in the RAPN group when compared to LPN (70.5 vs. 87.4%;p...
Source: Current Urology Reports - May 25, 2021 Category: Urology & Nephrology Source Type: research

Association of Kidney Stone Disease (KSD) with Primary Gastrointestinal Surgery: a Systematic Review over Last 2 Decades
AbstractPurpose of reviewWe aim to provide an up-to-date literature review to further characterise the association of kidney stone disease (KSD) with gastrointestinal (GI) surgery. As KSD is associated with significant morbidity, it is important to quantify and qualify this association to provide better care and management for the patient subgroup.ObjectiveTo perform a systematic review of the existing literature to evaluate the association of KSD following GI surgery.MethodsA literature search was performed of the following databases: MEDLINE, EMBASE, Scopus, Google Scholar, Key Urology, Uptodate and Cochrane Trials from ...
Source: Current Urology Reports - May 24, 2021 Category: Urology & Nephrology Source Type: research

Retroperitoneal Robot-Assisted Partial Nephrectomy (rRAPN): Surgical Technique and Review
AbstractPurpose of ReviewWe aim to offer a description of the surgical technique and to review the current state retroperitoneal robot-assisted partial nephrectomy (rRAPN).Recent FindingsPartial nephrectomy is the standard treatment for localized kidney tumours. rRAPN is especially useful for kidney tumours of posterior location. It offers advantages such as direct access to the renal artery and no need for bowel mobilization. The disadvantages are the small working space and the less familiar anatomical landmarks. It is a reproducible technique that achieves similar oncological and functional results to the more tradition...
Source: Current Urology Reports - May 20, 2021 Category: Urology & Nephrology Source Type: research

Staged Fowler Stephens, Who Requires a Third Procedure?
AbstractPurpose of ReviewThe two-stage Fowler-Stephens orchiopexy is a well-described surgical approach for most pediatric urologists tackling the high intra-abdominal testis. Testicular ascent is a well-reported outcome of the surgery and a problem that could be fixed with a repeat procedure. The purpose of this review is to determine the rate of subsequent testicular ascent and repeat surgery after a two-stage Fowler-Stephens using best available evidence.Recent Findings/ResultWe selected 16 studies that pertained to our topic. 0 –13% of testicles were deemed to be in an inappropriate position on follow-up (6&ndash...
Source: Current Urology Reports - May 19, 2021 Category: Urology & Nephrology Source Type: research

Biomarkers for Renal Cell Carcinoma Recurrence: State of the Art
AbstractPurpose of ReviewWe aim to summarize the current state of art about the possible use of biomarkers for predicting renal cell carcinoma (RCC) recurrence after curative treatment. In addition, we aim to provide a snapshot about the clinical implication of biomarkers use for follow-up planification.Recent FindingsA wide variety of biomarkers have been proposed. RCC biomarkers have been individuated in tumoral tissue, blood, and urine. A variety of molecules, including proteins, DNA, and RNA, warrant a good accuracy for RCC recurrence and progression prediction. Their use in prediction models might warrant a better pat...
Source: Current Urology Reports - April 22, 2021 Category: Urology & Nephrology Source Type: research

Artificial Urinary Sphincter Complications: Risk Factors, Workup, and Clinical Approach
We present our algorithm for diagnosis and management of AUS complications.SummaryDespite being the gold standard of treatment for men with SUI, major and minor complications can occur at any point after AUS insertion. Careful consideration of the urologic, medical, and operative risk factors for each patient can help prevent complications. A systematic approach to early and late complications facilitates their identification and effective management. The evaluating urologist must have a thorough understanding of potential AUS complications in order to restore quality of life in men with bothersome SUI. (Source: Current Urology Reports)
Source: Current Urology Reports - March 29, 2021 Category: Urology & Nephrology Source Type: research

RE: RE: Kidney Transplantation in Transgender Patients
(Source: Current Urology Reports)
Source: Current Urology Reports - March 29, 2021 Category: Urology & Nephrology Source Type: research

A Response to Jue et al, “Kidney Transplantation in Transgender Patients”
(Source: Current Urology Reports)
Source: Current Urology Reports - March 29, 2021 Category: Urology & Nephrology Source Type: research

Artificial Urinary Sphincter Complications: Risk Factors, Workup, and Clinical Approach
We present our algorithm for diagnosis and management of AUS complications.SummaryDespite being the gold standard of treatment for men with SUI, major and minor complications can occur at any point after AUS insertion. Careful consideration of the urologic, medical, and operative risk factors for each patient can help prevent complications. A systematic approach to early and late complications facilitates their identification and effective management. The evaluating urologist must have a thorough understanding of potential AUS complications in order to restore quality of life in men with bothersome SUI. (Source: Current Urology Reports)
Source: Current Urology Reports - March 29, 2021 Category: Urology & Nephrology Source Type: research

RE: RE: Kidney Transplantation in Transgender Patients
(Source: Current Urology Reports)
Source: Current Urology Reports - March 29, 2021 Category: Urology & Nephrology Source Type: research

A Response to Jue et al, “Kidney Transplantation in Transgender Patients”
(Source: Current Urology Reports)
Source: Current Urology Reports - March 29, 2021 Category: Urology & Nephrology Source Type: research

Techniques and Outcomes of MRI-TRUS Fusion Prostate Biopsy
AbstractPurpose of ReviewThe goal of this study is to review recent findings and evaluate the utility of MRI transrectal ultrasound fusion biopsy (FBx) techniques and discuss future directions.Recent FindingsFBx detects significantly higher rates of clinically significant prostate cancer (csPCa) than ultrasound-guided systematic prostate biopsy (SBx), particularly in repeat biopsy settings. FBx has also been shown to detect significantly lower rates of clinically insignificant prostate cancer. In addition, a dedicated prostate MRI can assist in more accurately predicting the Gleason score and provide further information re...
Source: Current Urology Reports - March 22, 2021 Category: Urology & Nephrology Source Type: research

Innovations in Urologic Surgical Training
AbstractPurpose of ReviewThis review aims to summarize innovations in urologic surgical training in the past 5 years.Recent FindingsMany assessment tools have been developed to objectively evaluate surgical skills and provide structured feedback to urologic trainees. A variety of simulation modalities (i.e., virtual/augmented reality, dry-lab, animal, and cadaver) have been utilized to facilitate the acquisition of surgical skills outside the high-stakes operating room environment. Three-dimensional printing has been used to create high-fidelity, immersive dry-lab models at a reasonable cost. Non-technical skills such as t...
Source: Current Urology Reports - March 13, 2021 Category: Urology & Nephrology Source Type: research

Primary Renal Synovial Sarcoma and Clinical and Pathological Findings: a Systematic Review
AbstractPurpose of ReviewTo update epidemiological, diagnostic, and therapeutic information on primary synovial sarcoma of the kidney.Recent FindingsA total of 96 studies were analyzed; age at presentation was 38.6 ±14.2 years, predominant location of tumor was right kidney; frequent reported symptoms at diagnosis were hematuria and pain. For definitive diagnosis, cytogenetic technique was used. Detected oncogene was available in 37.8% cases with fusion of SS18-SSX in most patients. Surgery is treatment of ch oice, with adjuvant chemotherapy; most frequently ifosfamide-based associated with doxorubicin or epirubicin...
Source: Current Urology Reports - March 11, 2021 Category: Urology & Nephrology Source Type: research

Precision Stone Surgery: Current Status of Miniaturized Percutaneous Nephrolithotomy
AbstractPurpose of ReviewInnovations in lasers and surgical technology have led to a renewed interest in the miniaturization of percutaneous nephrolithotomy (PCNL). We review the different approaches and evidence on the efficacy of mini-PCNL.Recent FindingsMini-PCNL encompasses a range of techniques using tract sizes from 4.8 to 22 F to treat renal stones. The most common device uses irrigation to passively extract stones out of the sheath. Super-mini-PCNL incorporates active suction. Ultra- and micro-techniques reduce the tract to smaller diameters. Laser fragmentation is the main lithotripsy modality. Studies demonstrate...
Source: Current Urology Reports - February 12, 2021 Category: Urology & Nephrology Source Type: research