Field Of Urology Research Articles

Awareness and knowledge about Female Genital Schistosomiasis among European healthcare workers

Abstract Background Female Genital Schistosomiasis (FGS) is a gynaecological manifestation of persistent infection with Schistosoma haematobium, which can lead to severe consequences, such as miscarriage and infertility. It is estimated to affect 56 million women globally, mostly in sub-Saharan Africa (SSA). Most migrants in Europe are female, often from SSA and therefore at risk of FGS, hence healthcare workers (HCWs) knowledge of FGS is essential for the provision of adequate care. This study aims to assess awareness and knowledge of FGS among European HCWs to inform strategies to improve the management of migrant health. Methods In June 2023 - January 2024 we conducted a cross-sectional online survey targeting medical doctors (MDs), nurses and midwives (NMs) working in fields of infectiology, gynaecology, urology, family, travel, internal or occupational medicine. The prevalence of FGS awareness and knowledge was estimated, Poisson regression was used to identify factors associated with MDs’ awareness of FGS. Results Among 922 surveyed HCWs, 43.7% (CI95%: 39.6-47.9) of MDs and 12.0% (CI95%: 8.8-16.0) NMs have heard about FGS. FGS awareness among MDs was associated with work in clinics for migrants (prevalence ratio (PR)=1.33, CI95%: 1.10-1.59) and specialization, being lower for gynaecology (PR = 0.67; CI95%:0.51-0.88), and family medicine (PR = 0.42, CI95%:0.30-0.59). Among MDs, 7.1% (CI95%: 5.1- 9.5) had medium knowledge, while 25.3% (CI95%: 21.8-29.0) had low, and 67.6% (CI95%: 63.7-71.4) no knowledge on symptoms, complications or diagnostic tools for FGS. FGS knowledge was mostly acquired through academic curricula (34.7%), scientific literature (28.4%) and conferences (25.6%). Conclusions The study shows limited awareness of FGS among European MDs and NMs, and highlights that European HCWs may not be adequately prepared to deal with diseases that are gaining relevance on the European continent due to the global connectivity and the dynamic nature of our societies. Key messages • In Europe, the health specialities that are the first point of patient access to the health system show a low level of awareness and knowledge of Female Genital Schistosomiasis. • Rising knowledge of FGS among European HCWs through academic curricula and continuous medical education is important to ensure adequate diagnosis and management of disease in migrant populations.

Analysis of environmental factors affecting the incidence of testicular cancer, with particular emphasis on testicular germ cell tumors (TGCTs). Literature review

Introduction: Testicular cancer is the most common malignancy among men in the 20-44 age group. Most of the incidence is testicular germ cell tumor. In recent years there has been a steady increase in the incidence of this cancer. For this reason, we analyzed available articles on environmental risk factors that may influence the incidence of increased testicular malignancies Material and methods: Review of the specialized literature in the field of urology and articles available on PubMed, searching by the keywords “testicular cancer,” “testicular cancer risk factors,” “germ cell tumor,” “tgct‘’Aim of the study: The purpose of the study is to review the available literature and research papers regarding risk factors for malignant tumors of the testis. Summary: In recent years, there has been an increase in the incidence of testicular cancer, especially among men aged 20-44 years. The vast majority of it is germ cell tumors (TGCT). This article discusses the influence of environmental factors on the development of testicular cancer, with particular emphasis on the induction of TGCT. Studies indicate an association between exposure to trichloroethylene and other solvents and the risk of TGCT induction. The role of exposure to pesticides (especially fungicides), organic chlorine compounds, and viruses was also indicated to increase the risk of developing TGCTs,. The association of neoplasia with marijuana and tobacco use has also been studied, but needs further research. There is a need for continued research regarding heavy metals, infertility and factors related to pregnancy and the perinatal period. It is necessary to know the mechanisms that induce the process of carcinogenesis in the testis, which will enable the use of prevention and prophylaxis.

Practical Step-by-step SYNAPSE VINCENT Rendering of Three-dimensional Graphics in Horseshoe Kidney with Bilateral Varicoceles.

Medical illustration serves as a cornerstone for understanding intricate anatomical anomalies, with three-dimensional (3D) rendering emerging as a pioneering tool for emphasizing basic medical concepts and clinical practices. In Japan, the SYNAPSE VINCENT software package (SVSP; Fujifilm Medical Co., Ltd., Tokyo, Japan), internationally known as "SYNAPSE 3D," is a widely embraced solution for 3D rendering. However, despite its prevalence, resources elucidating its practical usage and offering insightful tips are scarce. In this review, we focus on the use of SVSP for 3D rendering of complex anatomical anomalies, particularly in the field of urology. We demonstrate a step-by-step process of 3D rendering. 3D rendering was performed in a sample case of a patient with horseshoe kidney and coexisting bilateral varicoceles through inputting of multiphase contrast-enhanced CT images into the application, followed by segmentation of the renal parenchyma, image registration, and segmentation of the arterial and venous systems as well as the upper urinary tract. Manual adjustments were made using the "Mask edit" and "Diameter setting" tools to ensure accuracy, particularly in cases of significant anomalies. Then, color-coded structures appeared, including the renal parenchyma, arterial and venous systems, and upper urinary tract, which provided a comprehensive visualization of the anatomical anomalies. This review highlights the effectiveness of the SVSP in visualizing complex anatomical abnormalities and detailing the practical rendering process, which could promote wider adoption of the application among urologists despite the challenges associated with the software.

Indwelling Urological Device Biofilm Composition and Characteristics in the Presence and Absence of Infection

ObjectiveTo characterize microbial biofilms associated with different device types used in the urological field including ureteral stents, sacral neuromodulation (SNM) devices, penile prostheses, and artificial urinary sphincters (AUS). Materials and MethodsData from four studies, each reporting biofilm composition of a particular device type, were pooled and included for inter-device analysis. Studies recruited adults scheduled for ureteral stent, SNM, IPP, or AUS removal/revision. Device (n=115) biofilms and controls were analyzed with multi-omics approaches, and compositions were compared across device types and clinical factors. ResultsMicrobiota present on each device type was distinct from that of perineal, rectal, or urine flora (p<0.01). Biofilm microbial counts (p<0.001) and diversity (p=0.024) differed by device type. Ureteral stents had greater microbial counts than other device types (p<0.001). Staphylococcus, Pseudomonas, Lactobacillus, Ureaplasma were commonly detected across devices. Device biofilms harbored a greater proportion of Proteobacteria phylum, and the rectal, perineal, and urine flora harbored a greater proportion of Firmicutes. Unique microbe-metabolite interaction networks were identified in presence and absence of infection. Antibiotic resistance genes including sul2 (sulfonamide resistance) and rpoB (rifampin resistance) were detected in biofilms across device types. Biofilm reconstitution in vitro differed by device type from which strains were isolated. ConclusionsUreteral stents, sacral neuromodulation devices, penile prostheses, and artificial urinary sphincters harbored unique microbial and metabolite profiles that differed from those of skin, urine, and rectal flora. The findings of this study set the groundwork for investigation of novel strategies to reduce device-associated infection risk within and outside urology. Data availability statementData are available from corresponding author upon reasonable request.

Balancing family and career for female physicians in Germany: insights from asurvey of female urologists

The shortage of skilled labor in medicine is one of the most pressing challenges in healthcare. The increasing number of women in medicine, particularly in the field of urology, raises questions about the compatibility of family and career, especially concerning the work environment and working time models. The aim of this study is to capture the impact of motherhood on the professional lives of female physicians and scientists in the field of urology in Germany. Specific challenges in this surgical specialty and the compatibility of family and career will be highlighted. The working group "Female Physicians and Scientists in Urology" of the German Society of Urology (DGU) surveyed its 1343female members regarding demographic data, professional status, and aspects of work-life balance. Among 487female urologists in Germany, 53.4% had children. Mothers tended to be older, less frequently in training, less often in inpatient settings, and less frequently engaged in surgical activities. Notably, the proportion of full-time working mothers (36.2%) was significantly lower compared to female urologists without children (92.4%). Among female urologists with children, 32.3% reported having changed their workplace because of their children, while 10.7% indicated that their responsibilities had changed at least once after pregnancy. Additionally, 76.9% of mothers had reduced their weekly working hours due to family commitments. Multivariate analysis showed an influence of motherhood on professional status and parttime work. The fact that starting afamily for women in urology in Germany is associated with areduction in working hours and the end of clinical careers suggests aneed for optimizing the compatibility of family and career in Germany. The increasing feminization of the medical profession exacerbates the existing shortage of skilled workers due to the exit of mothers from professional life. To meet the needs of working parents, particularly mothers, urgent adjustments in the work environment are necessary. Promoting flexible working time models and creating supportive conditions are crucial to preventing the loss of skilled professionals and maintaining job satisfaction in this field.

Serious Games as a Therapeutic Tool in Pediatric Urology: A Review of Current Applications and Future Directions.

This paper examines the use of serious games that integrate engaging gameplay with educational and therapeutic benefits with a particular focus on their application in urology. The study reviews both domestic and international cases to evaluate the current practices and implications of these digital therapies. While serious games have been widely utilized in the treatment of pediatric cancer and psychiatric disorders-areas that require long-term care and management-their application in urology, in particular pediatric urology, has been limited. Although digital therapies like serious games are still emerging in the field of urology, they hold promise as effective supplements to traditional treatments while offering new options for managing a range of urological conditions. Pediatric conditions such as bedwetting, urinary incontinence, and dysuria, which often benefit from long-term training and habit formation, are particularly well-suited to this approach. By helping pediatric patients better understand and manage their symptoms, serious games can play a supportive role in the treatment process and have shown positive medical outcomes. This paper reviews the definitions and therapeutic effects of serious games, analyzes their current use in the medical field, and argues for their increased application in treating pediatric urinary conditions.

Percutaneous nephrolithotomy versus open surgery for the treatment of unilateral staghorn stone, Erbil province

Background and objective: Staghorn stones are large branching stones that completely or partially occupy the renal pelvis and renal calyces. The developments in the urological field have decreased the role of open surgery (OS) and currently percutaneous nephrolithotomy (PCNL) is considered as the gold standard procedure for the management of staghorn stone. This study aimed to determine the outcomes of open surgery and percutaneous nephrolithotomy for the treatment of unilateral staghorn stone. Methods: This retrospective analysis included 76 patients with unilateral staghorn stone who had been treated with either percutaneous nephrolithotomy (57) or open surgery (19). A comparison was made between the mentioned groups (PCNL vs. OS). Results: The differences between the two groups were not significant in term of preoperative characteristics. In addition, there was no significant difference between the two groups for intraoperative, postoperative complications and the rate of stone clearance (P = 0.447, P = 0.180, P = 0.259 respectively). The means of postoperative hospital stay (days) and recovery time (weeks) were significantly lower in the PCNL than OS (P &lt;0.001). However, the mean operative time was significantly less in the OS group (P = 0.018). Conclusion: The PCNL is a very efficient treatment option for staghorn stones. However, the open surgery still has a role in the treatment of kidney stones (especially staghorn stone).

The first detailed annual record on the National Clinical Database Urology Division in Japan: A report on five surgical procedures.

The National Clinical Database (NCD) Urology Division commenced registration in April 2018 in Japan. This is the first report to focus on five surgeries for which detailed information is registered. We herein describe annual trends in and the complication grades of the following five surgeries: partial nephrectomy, radical nephrectomy, radical cystectomy, radical prostatectomy, and pyeloplasty, using the NCD. A total of 149 417 patients treated with the five types of surgeries based on NCD data were enrolled in this report. The number of patients was 55 630 for partial/radical nephrectomy from April 2018 to December 2021, 83 653 for radical prostatectomy from April 2018 to December 2021, and 9342 for radical cystectomy from January 2020 to December 2021. In 2021, partial nephrectomy was performed on 7416 cases, radical nephrectomy on 7739 cases, radical prostatectomy on 22 692 cases, radical cystectomy on 4677 cases, and pyeloplasty on 792 cases. The results obtained showed that a robot-assisted or laparoscopic procedure has replaced open surgery as the common approach for all five surgeries. An analysis of NCD data may be useful for understanding trends in surgical procedures across the major field of urology.

Role of ChatGPT and Gemini in the Urology Field: A Case-Based Study

Introduction The healthcare sector is witnessing a transformation with the advent of artificial intelligence (AI), exemplified by ChatGPT and Gemini AI. These AI systems emulate human conversation and provide accurate medical responses. This study explores their integration into medical decision-making in the urology field. Methods The study presented a collection of 20 medical case scenarios, carefully crafted and revised by a team of authors in the field of urology. Each case was presented to ChatGPT and Gemini in September of 2023, and their responses were recorded and analyzed. Results Both AI tools displayed varying accuracy in diagnoses and management recommendations. ChatGPT failed in identifying congenital penile curvature, while Gemini succeeded. Conversely, ChatGPT excelled in recommending a management plan for renal artery aneurysms. Gemini outperformed in explaining iodinated contrast material toxicity. Both struggled with a bladder prolapse prevention question. Conclusion AI integration in urology is promising but has limitations. AI provides valuable insights but cannot replace human expertise. Research is vital to improve AI's role in urology. Clinicians should view AI suggestions as supplements to their judgment, fostering collaborative healthcare decisions.

Robotic urologic applications of the hinotori™ Surgical Robot System

ObjectiveTo assess the safety and effectiveness of urological tumor surgeries using the hinotori™ Surgical Robot System (hinotori) in a real-world clinical setting. MethodsAll surgeries including procedures of robot-assisted radical prostatectomy (RARP), robot-assisted partial nephrectomy (RAPN), robot-assisted radical nephrectomy (RARN), robot-assisted nephroureterectomy (RANU), robot-assisted adrenalectomy (RAA), and robot-assisted radical cystectomy with intracorporeal urinary diversion (RARC+ICUD) for urological tumors with hinotori and da Vinci surgical system (da Vinci) from January 2022 through September 2023 were enrolled. We evaluated the safety and effectiveness of surgery using hinotori compared using da Vinci. ResultsRobotic surgeries using hinotori were performed in a total of 91 cases, comprising 42 cases of RARP, 18 cases of RAPN, six cases of RARN, 10 cases of RANU, 13 cases of RAA, and two cases of RARC+ICUD. No major intraoperative complications were observed in any cases using hinotori. No major postoperative complications occurred in any of the cases. No case experienced unrecoverable equipment error during surgery. Meanwhile, robotic surgeries using da Vinci were performed in a total of 277 cases that included 126 cases of RARP, 94 cases of RAPN, 12 cases of RARN, 10 cases of RANU, 20 cases of RAA and 15 cases of RARC+ICUD. Major intraoperative complications occurred two cases. Major postoperative complications occurred in seven cases. Seven cases required transfusion. One case underwent conversion to open surgery. During the study period, no case experienced an unrecoverable equipment error. Surgical outcomes for cases with hinotori were comparable to those with da Vinci. ConclusionsThis study demonstrated that hinotori is a safe and feasible tool for robotic surgeries in the field of urology.

ERN GENTURIS clinical practice guidelines for the diagnosis, surveillance and management of people with Birt-Hogg-Dubé syndrome.

Birt-Hogg-Dubé syndrome (BHD syndrome) is an autosomal dominant multisystem disorder with variable expression due to pathogenic constitutional variants in the FLCN gene. Patients with BHD syndrome are predisposed to benign cutaneous fibrofolliculomas/trichodischomas, pulmonary cysts with an associated risk of spontaneous pneumothorax, and renal cell carcinoma. A requirement for updated International consensus recommendations for the diagnosis and management of BHD syndrome was identified. Based on a comprehensive literature review and expert consensus within the fields of respiratory medicine, urology, radiology, dermatology, clinical oncology and clinical genetics, updated recommendations for diagnosis, surveillance and management in BHD syndrome were developed. With the widespread availability of FLCN genetic testing, clinical scenarios in which a diagnosis should be considered and criteria for genetic testing were defined. Following a clinical and/or molecular diagnosis of BHD syndrome, a multidisciplinary approach to disease management is required. Regular renal cancer surveillance is recommended in adulthood and life-long, but the evidence base for additional tumour surveillance is limited and further research warranted. Recommendations for the treatment of cutaneous, pulmonary and renal manifestations are provided. Awareness of BHD syndrome needs to be raised and better knowledge of the clinical settings in which the diagnosis should be considered should enable earlier diagnosis. Further details, including areas for future research topics are available at: https://www.genturis.eu/l=eng/Guidelines-and-pathways/Clinical-practice-guidelines.html .

Minocycline-rifampin-impregnated penile prosthesis surfaces retain antimicrobial activity following irrigation with 0.05% chlorhexidine gluconate and antibiotic solutions.

0.05% Chlorhexidine gluconate (CHG; Irrisept [IrriMax]) is a commercial wound irrigation solution approved by the Food and Drug Administration that has seen recent adoption in the field of prosthetic urology; however, no study has evaluated whether 0.05% CHG is compatible with the minocycline-rifampin-impregnated surface (InhibiZone) of the AMS 700 penile prosthesis (Boston Scientific). To evaluate whether 0.05% CHG alters the antibiotic efficacy of the minocycline-rifampin-impregnated penile prosthesis surface. Discs (8 mm) were taken by a punch biopsy (Sklar) from sterile penile prosthesis reservoirs whose surfaces had been impregnated with rifampin and minocycline. Discs (n = 10) were suspended in 0.05% CHG, vancomycin and gentamicin, or normal saline for 2minutes to simulate intraoperative irrigation. Discs were then rinsed in normal saline to remove any unbound solution and incubated with methicillin-sensitive Staphylococcus aureus for 48hours. Adherent surface bacteria were suspended by shaking in a 0.3% Tween 20 solution, serially diluted, plated onto 3M PetriFilms, and counted. Kirby-Bauer disc diffusion assays were conducted to generalize findings across various organisms. Outcomes included (1) bacterial adherence to the implant surface measured as bacterial counts (in colony-forming units per milliliter) and (2) bacterial growth reduction measured as zones of inhibitions (in millimeters). Incubation of implant surfaces in 0.05% CHG did not alter recovered bacterial counts as compared with normal saline and vancomycin/gentamycin. Similarly, within a single bacterial species, 0.05% CHG and vancomycin/gentamycin did not alter zone-of-inhibition measurements in Kirby-Bauer disc diffusion studies. This study demonstrates in vitro that 0.05% CHG may be used directly on the minocycline-rifampin-impregnated surface without altering the antibiotic efficacy of the coating. Strengths include that this is the first study to evaluate if 0.05% CHG affected the minocycline-rifampin-impregnated surface. Limitations include the use of in vitro studies, which serve as a proxy for in vivo practices and may not be entirely accurate or translatable in a clinical setting. 0.05% CHG does not alter the antimicrobial activity of the minocycline-rifampin-impregnated surface as compared with vancomycin/gentamycin and normal saline in vitro; however, its efficacy in clinical practice remains to be evaluated.

The role of alternative medicine and complimentary therapies in urologic disease: New horizons.

The world of complementary and alternative medicine (CAM) encompasses a wide range of practices, treatments, and products that fall outside the realm of conventional (mainstream) medicine. The use of complementary and CAM has become increasingly popular in Western nations. People are turning to CAM for a variety of reasons, including managing chronic diseases, relieving symptoms of various conditions, and improving their overall health and well-being. There's a growing trend of people using and showing interest in complementary and alternative medicine therapies, especially in Western countries. CAM encompasses a wide range of treatments, some offering complete alternatives to conventional medicine, while others aim to complement existing medical approaches. Urologists should stay informed about CAM to guide their patients effectively to treat patients in a modern and personalized way. The aim of review is to analyze the scenario of complimentary and alternative medicine with a specific focus in the urological field.

Male and female urinary incontinence management

The article summarises the guidelines of the International Continence Society (ICI-7) for the management of male and female urinary incontinence. The author's opinion on the state of the problem from the perspective of its relevance in the field of modern practical urology is expressed.

Amplifying Chinese physicians' emphasis on patients' psychological states beyond urologic diagnoses with ChatGPT-A multi-center cross-sectional study.

Artificial intelligence (AI) technologies, particularly large language models (LLMs), have been widely employed by the medical community. In addressing the intricacies of urology, ChatGPT offers a novel possibility to aid in clinical decision-making. This study aimed to investigate the decision-making ability of LLMs in solving complex urology-related problems and assess its effectiveness in providing psychological support to patients with urological disorders. This study evaluated the clinical and psychological support capabilities of ChatGPT 3.5 and 4.0 in the field of urology. A total of 69 clinical and 30 psychological questions were posed to the AI models, and their responses were evaluated by both urologists and psychologists. As a control, clinicians from Chinese medical institutions provided responses under closed-book conditions. Statistical analyses were conducted separately for each subgroup. In multiple-choice tests covering diverse urological topics, ChatGPT 4.0, performed comparably to the physician group, with no significant overall score difference. Subgroup analyses revealed variable performance, based on disease type and physician experience, with ChatGPT 4.0 generally outperforming ChatGPT 3.5 and exhibiting competitive results against physicians. When assessing the psychological support capabilities of AI, it is evident that ChatGPT4.0 outperforms ChatGPT3.5 across all urology-related psychological problems. The performance of LLMs in dealing with standardized clinical problems and providing psychological support has certain advantages over clinicians. AI stands out as a promising tool for potential clinical aid.

Transforming urology: exploring the innovations and utilizations of robotic systems

Robot-assisted surgery represents the pinnacle of minimally invasive surgical techniques, surpassing laparoscopic surgery in its efficacy. This study aimed to evaluate the current status of robotic surgery in urological practice, examining its advantages and disadvantages. A literature review was conducted using PUBMED and the pertinent articles in the field of urology selected. Various single-port and multiport robotic platforms, such as Da Vinci, Versius, Hugo RAS, Revo-I, Senhance, Mantra, Avatera, hinotori, and MicroSurge, are discussed along with their respective pros and cons. Details of the 4 robotic platforms used in our centers are also included. With an influx of diverse medical surgical robots entering the market and a competitive drive to establish the next standard of care in robotic surgery, it is inevitable that robotic surgery will soon become economically comparable to laparoscopic procedures.

Современные поколения урологических дренажных систем. Достижения и перспективы.

Introduction. Currently, stents are used in the treatment of various benign and malignant diseases of the upper urinary tract and urethra. Modern stents made of a superelastic alloy, coated with a polymer, regardless of location, are characterized by higher and longer-lasting patency in terms of decompression and relief of obstruction, fewer irritative symptoms of the genitourinary system and no need for frequent replacement, which leads to improved quality of life in addition to cost savings. Despite promising results, there are few studies in the literature regarding their use, and these tend to be peer-to-peer, retrospective, involving small numbers of patients, and based on the surgeon's personal experience. Materials and methods. In literature review used data about using minimally invasive methods for treatment of ureteral strictures, published in PubMed’s base (https://www.ncbi.nlm.nih.gov/pubmed/), scientific electronic library of RF – Elibrary.ru (https://elibrary.ru/) and also professional endourological association websites. The databases were searched using the following keywords: «ureteral stent», «urethral stent», «allium», «uventa» and «memokath». At the first stage, 93 sources no older than 5 years were found that were relevant to the topic of the review. Conference abstracts, short communications, and duplicate publications were excluded. Then, based on the relevance of the data, the reliability of the sources, the impact factors of the journals and the sequence of presentation of the material in the manuscript, 43 articles in scientific international peer-reviewed journals, practical guidelines and clinical recommendations were selected directly for citation in the review. Results. The stent is one of the most common urological prostheses used in the treatment of obstructive uropathy. The main causes of obstruction of the ureter and urethra include benign and malignant factors. Active introduction of minimally invasive technologies into everyday urological practice using ureteral or urethral stents are effective and safe methods of urine diversion (especially in comorbid patients), however, unfortunately, side effects from the use of these prosthetic systems continue to reduce the quality of life of patients. The use of polymer materials in urology has made it possible to introduce a huge number of non-metallic stents used by urologists, however, due to the occurrence of various kinds of complications, an attempt has been made to introduce a new generation of stents – made of a superelastic alloy, coated with polymer. Stents made of superelastic alloy coated with polymer have been used in the treatment of various pathologies of the ureter and urethra for more than two decades. The need for reliable long-term urinary tract drainage has led to the development of improved urinary tract stent designs such as Memokath, Allium, and Uventa. The main advantages of the latter are a convenient delivery system, a self-expanding mechanism, low adhesive properties, no tissue ingrowth, ease of removal, and no need for frequent replacement. Despite the evolution of ureteral and urethral stent designs, complications continue to arise that limit their use and the search for «ideal» drainage systems continues. Conclusion. Today it is difficult to overestimate the role of drainage systems in the treatment of obstructive urological and oncological diseases. However, despite significant success in their use, prostheses are constantly subject to constant modifications and developments aimed at increasing their suitability, durability, ease of implantation and functionality, while reducing the complications associated with them. Future developments in the field of urogenital prosthetic surgery and urology in general continue to attract interest, and ongoing research into new biomaterials, stem cells and tissue engineering is expanding the boundaries of possible interventions in the human genitourinary tract.

Clinical Advances and Current Status in the Treatment of Ureteral Calculi.

Ureteral calculi are a common urological disease with a consistently high incidence and an increasing trend each year. Ureteral calculi treatment is an essential and hot topic in the urology field and holds a vital status in the urological work system. Recently, with rapid advances in urology, there have been continuous updates and developments in treatment modalities, and many new methods and techniques have emerged and are being applied in clinical settings; This has effectively improved the clinical treatment outcomes of individuals with ureteral calculi. However, each treatment modality has its specific indications, and owing to the uneven distribution of medical resources and the effect of the patients' conditions and nature of the stones, standardization and randomness in selecting the treatment regimens for ureteral calculi are lacking. Therefore, selecting the diagnostic and therapeutic plan is vital for improving treatment efficacy. In this review, we summarize the findings of recent domestic and international studies to provide an outline of the progress and current status of ureteral calculi treatment from aspects such as pharmacotherapy, surgery, and minimally invasive treatment to provide a basis for treating this disease in clinical settings.

Transitional Urology in Korea: Initial Insights Through a Cross-Sectional Study.

In Korea, the field of transitional urology (TU) is in its nascent stages, with its introduction only beginning. This study aims to evaluate the existing state of TU prior to implementing a transition protocol, and to identify key areas of focus for the development of an effective transition protocol. From June 1, 2021 to May 31, 2023, clinical data were retrospectively collected for patients who visited the adult urology or pediatric urology outpatient departments of this hospital and were aged 10 or older, with medical conditions falling under the category of TU. We analyzed the patient distribution across different disease groups. The transitional stages were categorized from T1, indicating initial care by pediatric urologists, to T4, denoting complete transition to adult care. 'T4x' was used for patients with unknown medical histories, and 'T4only' for those who had never been under pediatric urology care. During a 2-year period, a total of 1,484 patients received outpatient care for diseases in TU field. The most prevalent diseases were hypospadias (40.4%), spinal bifida (37.3%), and congenital ureteral anomalies (17.7%), with other conditions accounting for 4.6%. Among 553 spinal bifida patients, only 5.3% completed transitional care (T4), while 80.1% were in the initial phase (T1). For patients introduced to adult urology (T2-T4), 37.7% reached T4, highlighting a marked increase in transition completion within this subset (P<0.001). TU in Korea is in its nascent stage, with a significant gap in the initiation and completion of transitional care for patients with congenital urologic conditions. Early initiation and active engagement in transitional care are crucial for successful transition. This study highlights the need for structured transition protocols to address the complex needs of this patient population.

Evaluating the Performance of ChatGPT in Urology: A Comparative Study of Knowledge Interpretation and Patient Guidance.

Background/Aim: To evaluate the performance of Chat Generative Pre-trained Transformer (ChatGPT), a large language model trained by Open artificial intelligence. Materials and Methods: This study has three main steps to evaluate the effectiveness of ChatGPT in the urologic field. The first step involved 35 questions from our institution's experts, who have at least 10 years of experience in their fields. The responses of ChatGPT versions were qualitatively compared with the responses of urology residents to the same questions. The second step assesses the reliability of ChatGPT versions in answering current debate topics. The third step was to assess the reliability of ChatGPT versions in providing medical recommendations and directives to patients' commonly asked questions during the outpatient and inpatient clinic. Results: In the first step, version 4 provided correct answers to 25 questions out of 35 while version 3.5 provided only 19 (71.4% vs 54%). It was observed that residents in their last year of education in our clinic also provided a mean of 25 correct answers, and 4th year residents provided a mean of 19.3 correct responses. The second step involved evaluating the response of both versions to debate situations in urology, and it was found that both versions provided variable and inappropriate results. In the last step, both versions had a similar success rate in providing recommendations and guidance to patients based on expert ratings. Conclusion: The difference between the two versions of the 35 questions in the first step of the study was thought to be due to the improvement of ChatGPT's literature and data synthesis abilities. It may be a logical approach to use ChatGPT versions to inform the nonhealth care providers' questions with quick and safe answers but should not be used to as a diagnostic tool or make a choice among different treatment modalities.