Antibiotics and beyond: Unraveling the dynamics of bronchopulmonary dysplasia in very preterm infants.

Background: Bronchopulmonary dysplasia (BPD) remains a significant challenge in neonatal care. Prenatal inflammation and neonatal sepsis contribute to the multifactorial nature of BPD. A potential association between empirical antibiotic therapy and BPD risk has been proposed due to microbiota dysbiosis in very low birth weight premature infants.

Outcomes of urethral meatal preservation ventral urethroplasty for female urethral stricture: a series of cases.

Objective: To present a series of cases with our initial experience and short-term outcomes of a modified vaginal mucosal flap urethroplasty.

Methods: Patients diagnosed with urethral stricture and operated by the same operative technique between January 2012 and January 2018 were followed for at least 6 months. Uroflowmetry and clinical outcomes were evaluated.

Avoiding "Needless" nephrectomy: What is the role of small renal mass biopsy in 2024?

Current guidelines do not mandate routine preoperative renal mass biopsy (RMB) for small renal masses (SRMs), which results in a considerable rate (18%-26%) of needless nephrectomy/partial nephrectomy for benign renal tumors. In light of this ongoing practice, a narrative review was conducted to examine the role of routine RMB for SRM. First, arguments justifying the current non-biopsy approach to SRM are critically reviewed and contested.

Brazilian portuguese validation of the patient-reported outcome measure for urethral stricture surgery (USS-PROM) questionnaire.

Introduction: Urethral stricture is a common, albeit complex, condition that predominantly affects men. The aim of this study was to translate, culturally adapt, and validate the Patient-Reported Outcome Measure questionnaire for patients undergoing urethroplasty (USS-PROM) into Brazilian Portuguese using validated psychometric criteria.

Materials And Methods: The process involved translating and culturally adapting the original USS-PROM into Brazilian Portuguese (USS-PROMbr), synthesizing, back-translating, cross-culturally adapting, and analyzing the pre-final version with experts from our committee.

Surgical Force: Initial Study and Clinical Implications in the Assessment of Ureteral Access Sheath Induced Injury.

Ureteral access sheaths (UAS) pose the risk of severe ureteral injury. Our prior studies revealed forces ≤6 Newtons (N) prevent ureteral injury. Accordingly, we sought to define the force urologists and residents in training typically use when placing a UAS.

Alkaline Water: Help or Hype for Uric Acid and Cystine Urolithiasis?

Purpose: The consumption of alkaline water, water with an average pH of 8 to 10, has been steadily increasing globally as proponents claim it to be a healthier alternative to regular water. Urinary alkalinization therapy is frequently prescribed in patients with uric acid and cystine urolithiasis, and as such we analyzed commercially available alkaline waters to assess their potential to increase urinary pH.

Materials And Methods: Five commercially available alkaline water brands (Essentia, Smart Water Alkaline, Great Value Hydrate Alkaline Water, Body Armor SportWater, and Perfect Hydration) underwent anion chromatography and direct chemical measurements to determine the mineral contents of each product.

Surgical Artificial Intelligence: Endourology.

Endourology is ripe with information that includes patient factors, laboratory tests, outcomes, and visual data, which is becoming increasingly complex to assess. Artificial intelligence (AI) has the potential to explore and define these relationships; however, humans might not be involved in the input, analysis, or even determining the methods of analysis. Herein, the authors present the current state of AI in endourology and highlight the need for urologists to share their proposed AI solutions for reproducibility outside of their institutions and prepare themselves to properly critique this new technology.

Efficient and Accurate Computed Tomography-Based Stone Volume Determination: Development of an Automated Artificial Intelligence Algorithm.

Purpose: Given the shortcomings of current stone burden characterization (maximum diameter or ellipsoid formulas), we sought to investigate the diagnostic accuracy and precision of a University of California, Irvine-developed artificial intelligence (AI) algorithm for determining stone volume determination.

Materials And Methods: A total of 322 noncontrast CT scans were retrospectively obtained from patients with a diagnosis of urolithiasis. The largest stone in each noncontrast CT scan was designated the "index stone.

Association of nerve-sparing grading in robotic radical prostatectomy and trifecta outcome.

Purpose: To evaluate the neurovascular bundle preservation grades during robotic-assisted radical prostatectomy and compared to the trifecta combined outcome (oncologic control, continence, and sexual function) twelve months after the surgery.

Methods: Cohort of patients who underwent nerve-sparing robotic-assisted radical prostatectomy had the neurovascular bundle preservation retrospectively graded from 0 to 8 according to the Hopkins subjective visual classification. Patients then were divided into two groups, according to the median of nerve-sparing grading: those with score six or high and those with score less than six.

Evaluation of the surgical and functional outcomes of secondary vaginoplasties with free skin mesh graft in patients following transfeminine genital reconstructive surgery.

Background: Gender-affirming surgery is classically done using the penile inversion vaginoplasty technique, however in some patients it may not promote adequate depth. In patients whose vaginal conduits became short or stenotic, we propose to perform a secondary vaginoplasty using an abdominal free skin mesh graft. In this study, we present ours results of a series of cases using this technique.

Multicenter comparative study of open, laparoscopic, and robotic pyeloplasty in the pediatric population for the treatment of ureteropelvic junction obstruction (UPJO).

Introduction: Dismembered open pyeloplasty described by Anderson and Hynes is the "gold standard" for the treatment of ureteropelvic junction obstruction. The aim of our study was to compare the results of open (OP) vs laparoscopic (LP) vs robotic (RALP) pyeloplasty.

Material And Methods: A multicenter prospective review was conducted of pyeloplasty surgeries performed at five high-volume centers between 2014 and 2018.

Male-to-Female Gender-Affirming Surgery: 20-Year Review of Technique and Surgical Results.

Gender dysphoria (GD) is an incompatibility between biological sex and personal gender identity; individuals harbor an unalterable conviction that they were born in the wrong body, which causes personal suffering. In this context, surgery is imperative to achieve a successful gender transition and plays a key role in alleviating the associated psychological discomfort. In the current study, a retrospective cohort, we report the 20-years outcomes of the gender-affirming surgery performed at a single Brazilian university center, examining demographic data, intra and postoperative complications.

Urology Residents Simulation Training Improves Clinical Outcomes in Laparoscopic Partial Nephrectomy.

Background: Partial nephrectomy (PN) is the preferred modality of treatment for small renal masses. Laparoscopic partial nephrectomy (LPN) has been adopted worldwide and a fundamental role is played by surgical skills. The need for skill instruction outside the operating room is well recognized in the modern models of surgery residency training.

Burnout syndrome in pediatric urology: A perspective during the COVID-19 pandemic - Ibero-American survey.

Introduction: Burnout syndrome is a major cause of decreased life quality, mental health, and productivity for physicians. It is strongly related to work overload and has been a scarcely studied topic in pediatric urology. During the COVID-19 pandemic, authorities' recommendations have led to big changes in pediatric urology practice worldwide.

Laparoscopic ureteral reconstruction in infant with congenital mid ureteric valve.

Congenital mid ureteric valve (MUV) stenosis is a very rare cause of ureteric obstruction and hydronephrosis (HN) in children. We describe how we manage laparoscopically one case of a patient with congenital MUV. We describe a 6-month-old boy born with antenatal left HN, with an anteroposterior diameter (APD) of 1,5 cm.

Laparoscopic ureteroplasty with gonadal vein graft for long ureteral stenosis: A step by step video.

Strictures of the ureter may occur from iatrogenic injury or impacted kidney stones. Complications from ureteroscopy may result in ureteral stricture in 0,5-2% of patients. New techniques are being described in order to minimize the morbidity associated with classic approaches.

Garrahan U-Stitch laparoscopic appendicovesicostomy - Making surgery easier.

Appendicovesicostomy is an established continent urinary conduit. The development of minimally invasive techniques and the reduction of operative time instigated the search for new techniques. In this video we show the laparoscopic transabdominal technique for appendicovesicostomy using U-stitch technique as proposed by Santiago Weller et al.

How do we assess the efficacy of Ho:YAG low-power laser lithotripsy for the treatment of upper tract urinary stones? Introducing the Joules/mm and laser activity concepts.

Objectives: To estimate the total energy needed to ablate 1mm of stone volume (Joules/mm) during flexible ureteroscopic lithotripsy using a low-power Ho:YAG laser device, as a proxy of lithotripsy efficacy.

Patients And Methods: We selected 30 patients submitted to flexible ureteroscopy for renal stones whose volume was bigger than 500 mm. A 35 W Ho:YAG laser (Dornier Medilas H Solvo 35, Germany) was used for every procedure with a 272 µm laser fiber.

The impact of 5-alpha-reductase inhibitors on mortality in a prostate cancer chemoprevention setting: a meta-analysis.

Purpose: This study aims to evaluate the impact of 5-alpha-reductase inhibitors (5ARI) for prostate cancer (PCa) primary prevention on specific and overall mortality (primary outcomes), the incidence of PCa diagnosis and disease aggressiveness (secondary outcomes).

Methods: We searched MEDLINE, EMBASE, Cochrane, ClinicalTrials and BVS through April 2018 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement to identify randomized clinical trials (RCT) and cohort studies (CS). We included articles with data on mortality or PCa incidence for men using 5ARI previously to PCa diagnosis.

Laparoscopic Pielolitotomy: An option for the management of pelvic kidney stones.

Introduction:: Minimally invasive treatments such as extracorporeal shock wave lithotripsy and percutaneous nephrolithotripsy are standard procedures for the management of renal stones (1). However, renal position and rotation defects may significantly interfere in the results of these treatments (2). Open surgery has always been an option for these cases, but with the advancement of laparoscopy in the last decades, laparoscopic pielolitotomy has become a good alternative for approaching kidney stones in abnormal renal rotation and position (3).

Laparoscopic ureteroplasty with buccal mucosa graft for long proximal ureteral stenosis: A step by step video.

Introduction:: Strictures of the proximal ureter may occur from iatrogenic injury or impacted kidney stones. Many methods of surgical correction have been described, but the current treatment options can have significant morbidity associated with bowel substitution and vascular complications. Buccal mucosa grafting (BMG) has revolutionized the management of urethral strictures, but has not gained widespread use for ureteroplasties.

Identifying Current Trends in the Urologic Oncology Workforce-Does Completion of Fellowship Significantly Change Future Practice?

Introduction: To assess fellowship impact on subsequent practice type and case mix, we compared urologists who completed a urologic oncology fellowship to urologists who did not complete a fellowship.

Methods: Annualized case log data were obtained from the American Board of Urology from 2004 to 2016, including initial certification (C1) and recertifications 1 (R1) and 2 (R2). We evaluated trends in major urologic oncology case volume using relevant CPT codes.