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Objective: To assess differences in bleeding risk between retrograde intrarenal surgery (RIRS) and minimally invasive miniaturised percutaneous nephrolithotomy (mini-PCNL) for 10-20 mm renal stones., Patients and Methods: A total of 176 patients with a renal stone between 10 and 20 mm were treated. For all patients the Stone Management According to Size-Hardness (SMASH) score was calculated: Hounsfield units × stone maximum size (cm)/100. Patients with score of <15 underwent RIRS (90 patients, Group A), whereas patients with score ≥15 underwent mini-PCNL (86 patients, Group B). In both groups the Cyber Ho laser was used. A statistical analysis was carried out to assess differences in the risk of bleeding., Results: Preoperative features were comparable. The mean maximum stone diameter was 17.1 and 16.8 mm in Groups A and B, respectively (P = 0.13). The stone-free rate was comparable (87.8% vs 95.3%, P = 0.07). The overall complication rate was 14.4% and 18.6% in Groups A and B, respectively (P = 0.09). Gross haematuria was observed in five cases (5.5%) after RIRS and seven (8.1%) after mini-PCNL (P = 0.07). The mean haemoglobin drop was 12 and 2 g/L at the first and third postoperative day after RIRS vs 17 and 3 g/L after mini-PCNL (P = 0.06 and P = 0.21, respectively). Blood transfusions and renal embolisation were never necessary., Conclusion: When managing renal stones between 10 and 20 mm taking into account both size and hardness with the application of the SMASH score, RIRS and mini-PCNL show comparable efficacy. A higher bleeding risk has been expected with percutaneous approaches; however, in our cohort the incidence of clinically significant bleeding was low and comparable between the two groups when adopting mini-PCNL., (© 2024 BJU International.)

Purpose: To assess the 30-day stone-free rate and peri-operative outcomes of flexible ureteroscopy (FURS) with flexible and navigable suction ureteral access sheaths (FANS) in adults undergoing same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS)., Methods: Prospectively data of 115 adult patients with bilateral kidney stone disease undergoing SSB-RIRS across 14 global centers between July 2023 and March 2024 were analyzed. Patient demographics, stone characteristics and operative outcomes were recorded. A low-dose non contrast CT scan was performed at 30 days to assess the stone-free rate and clinical outcomes., Results: Overall bilateral zero residual fragment(ZRF) was 42.6%; unilateral ZRF was 75.7%. Only two patients were noted to have residual fragments > 4 mm. 1.7% experienced Traxer-Thomas grade 1 ureteric injury which was managed with a ureteral stent for four weeks. No pelvicalyceal injury occured. Postoperative mean loin pain score was 1.7 ± 1.0. None had sepsis nor required blood transfusion. 4.3% required readmission within 30 days of surgery. Multivariate analysis indicated longer total operation time correlated with lower odds of achieving a 100% bilateral stone-free (ZRF) (OR 0.978, 95%CI = 0.959-0.994, p = 0.013)., Conclusion: To our knowledge, this is the first multicenter study demonstrating the use of FANS in SSB-RIRS can achieve bilateral ZRF with low complication and re-intervention rates. However, prolonged surgical time may negatively impact outcomes. The indications of bilateral renal stones management with FURS can be expanded in appropriate chosen patients., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: To compare the effect on sexual function of ejaculation-sparing enucleation of the prostate using Thulium: YAG laser (ES-ThuLEP) versus continuous-wave Thulium Fiber Laser (ES-ThuFLEP)., Methods: 112 patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia who wished to preserve ejaculation were treated. 58 patients underwent ES-ThuLEP (Group A) using the Cyber TM generator. 54 patients underwent ES-ThuFLEP (Group B) using the Fiber Dust generator. Sexual function was evaluated through the International Index of Erectile Function 5 (IIEF-5) score, the four-item Male Sexual Health Questionnaire (MSHQ-EjD), personal satisfaction and the occurrence of haemospermia and painful ejaculation 3 and 6 months after surgery., Results: Mean age of patients was 65.8 years in Group A and 66.7 years in Group B. Groups were comparable according to preoperative features. Mean preoperative IIEF-5 score was 18.8 in Group A and 17.9 in Group B (p = 0.14). In all cases an ejaculation-sparing procedure was performed sparing the tissue around the veru montanum and near the prostate apex. Three months after surgery mean IIEF-5 score was 19.3 in Group A and 18.0 in Group B (p = 0.12). Six months after surgery mean IIEF-5 score was 17.8 in Group A and 18.1 in Group B (p = 0.09). No significant differences were observed according to anterograde ejaculation (81.0% vs. 81.5%, p = 0.07), subjective satisfaction (72.4% vs. 74.1%, p = 0.10), painful ejaculation (10.3% vs. 11.1%, p = 0.14) and haemosparmia rate (12.1% vs. 14.8%, p = 0.08). Ejaculation and satisfaction rate were significantly higher with prostates ≥ 80 ml in both groups., Conclusion: Ejaculation-sparing enucleation of the prostate effectively preserved sexual function in the majority of patients, with high rate of anterograde ejaculation and subjective satisfaction, low rates of painful ejaculation and haemospermia and no significant differences between Thulium: YAG and Thulium Fiber Laser. Preservation of ejaculation and personal satisfaction were significantly higher with prostates ≥ 80 ml compared to smaller ones., Competing Interests: Declarations. Ethical approval: All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent: All patients included in the study signed an informed consent. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To assess differences in safety and efficacy between 24 and 18 Fr pneumatic balloon dilators for percutaneous nephrolithotripsy (PCNL) of renal stones between 10 and 20 mm., Methods: Patients were randomized to dilatation with a 24 Fr (Group A) versus 18 Fr (Group B) Ultraxx pneumatic dilator (Cook Medical ® ). In all procedures percutaneous puncture was performed under ultrasound guidance. In both groups the Holmium: YAG Cyber Ho laser generator was used (Quanta System ® ). Stone-free rate (SFR) and postoperative complications were assessed., Results: 42 and 44 patients were assigned to Groups A and B, respectively. Preoperative features were comparable. Mean stone size was 17.8 vs. 16.6 mm in Group A vs. B (p = 0.21). SFR was 95.2% in Group A and 95.4% in Group B (p = 0.19). Postoperative gross haematuria was observed in 5 vs. 2 cases in Group A vs. B (p = 0.04). Mean haemoglobin drop at first postoperative day (POD) was higher in Group A (2.4 vs. 1.1 mg/dl, p = 0.04), while comparable at third POD. Blood transfusion was required in 2 cases in Group A and 1 case in Group B. No patients required embolization. No significant difference was observed in terms of postoperative pain and urinary infection., Conclusions: 24 and 18 Fr pneumatic dilators are both effective to access renal cavity during PCNL for the treatment of renal stones between 10 and 20 mm. Gross haematuria rate and mean haemoglobin decrease at first POD were significantly higher with 24 Fr dilator, but with no differences in the need for blood transfusions and renal embolization., Competing Interests: Declarations. Ethical statement: All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Competing interests: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. All patients included in the study signed an informed consent., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: We aim to evaluate stone-free rate (SFR) and complications after flexible ureteroscopy (F-URS) for kidney stones, using a flexible and navigable suction ureteral access sheath (FANS), comparing thulium fiber laser (TFL) and high-power holmium:yttrium-aluminum-garnet laser (HPHL). Methods: Data from adults who underwent F-URS in 15 centers were prospectively analyzed (August 2023-January 2024). Exclusion criteria were ureteral stones, concomitant bilateral procedures, and renal abnormalities. One-to-one propensity score matching for age, gender, stone location, stone volume, and Hounsfield unit was performed. SFR was assessed using computed tomography scan within 30 days and defined as zero fragments. Data are presented as median (25th-75th quartiles). Multivariable logistic regression was performed to evaluate predictors of SFR. Results: Of included patients, HPHL was used in 114 patients and TFL in 181 patients. After matching, 96 patients from each group with similar baseline characteristics were included. There was no difference between the groups regarding the use of disposable scopes, lithotripsy mode, and ureteroscopy, lasing and total surgical time. There was no case of sepsis, and blood transfusion was necessary for only one patient in the HPHL group. The incidence of transient fever was similar (3.4% in HPHL vs 3.8% in TFL group). Postoperative day 1 loin pain did not differ significantly. Postoperative stay did not differ significantly [1 [0, 2] in HPHL vs 1 [0, 1] days in TFL group, p = 0.12]. Thirty-day SFR was similar (52.1% for HL vs 64.6% for TFL group, p = 0.11). At multivariable analysis, the use of TFL (odds ratio 1.95, 95% confidence interval 1.01-3.82) was significantly associated with higher odds of being stone-free. Conclusions: Both lasers are safe and efficacious and can be suitably used for F-URS with FANS with high SFR and minimal complications.

Objective: To assess urologists' perceptions and current practices of using suction-based techniques and technologies in percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for kidney stones., Materials and Methods: A customized web-based 28-item questionnaire was created. All participation was voluntary. The survey was hosted on Google Forms between November 15, 2023 and November 25, 2023. Descriptive statistics were applied to demographic details and categorical responses., Results: Six hundred thirty-two responses were received. 56.5% were from Asia. Around 41.6% of respondents underwent an endourology fellowship. Personal experience of suction for PCNL was noted in 55.4% and 42.7% for RIRS. Exactly 34.9% believe that currently there is enough evidence that suction can improve stone-free rates and lower complications for both endourology surgeries. Around 55.69% believe that as evidence evolves, suction has the potential to be a game changer in endourology management of urolithiasis. Exactly 55.7% believe that the leading barrier to the adoption of suction in endourology is the lack of availability of technology. Other barriers include lack of procedural standardization (37.65%), lack of evidence (34.9%), lack of proper training (29.58%) and lack of advocation in the current guidelines (17.72%)., Conclusion: Our survey shows that urologists are keen to adopt suction for PCNL and RIRS but the lack of definitive evidence, standardization, equipment availability and training preclude them from using so. More high-level evidence regarding the utility of suction in endourology is required for its routine adoption in clinical practice., Competing Interests: Declaration of Competing Interest All authors declare no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Gelatinous drop-like corneal dystrophy (GDLD) is a rare autosomal recessive eye disease. GDLD is characterized by the loss of barrier function in corneal epithelial cells (CECs) and amyloid deposition due to pathogenic variants in the TACSTD2 gene. Limbal stem cell transplantation (LSCT) has been suggested as an effective therapeutic alternative for patients with GDLD. However, despite LSCT, amyloid deposition recurs in some patients. The pathogenesis of recurrence is poorly studied. We present the case of a patient with GDLD. Genetic analysis revealed a homozygous deletion, NM&#95;002353.3:c.653del, in the TACSTD2 gene. Functional analysis in a cell model system revealed the loss of the transmembrane domain and subcellular protein mislocalization. The patient with GDLD underwent direct allogeneic LSCT with epithelial debridement followed by deep anterior lamellar keratoplasty 10 months later due to amyloid deposition and deterioration of vision. Taken together, the results of transcriptome analysis and immunofluorescence staining of post-LSCT corneal sample with amyloid deposits obtained during keratoplasty demonstrated complete restoration of wild-type TACSTD2 expression, indicating that donor CECs replaced host CECs. Our study provides experimental evidence that amyloid deposition can recur after LSCT despite complete restoration of wild-type TACSTD2 expression., (© 2024. The Author(s).)

Purpose: To compare vapor tunnel (VT) and virtual basket (VB) tools to reduce retropulsion in the treatment of proximal ureteral stones., Methods: Patients with a single proximal ureteral stone were randomly assigned to holmium laser lithotripsy with the use of VT (Group A) or VB (Group B) tool. The 150W holmium:YAG cyber Ho generator was used. We compared operative time, dusting time, need for flexible ureteroscopy due to stone push-up and occurrence of ureteral lesions. The stone-free rate (SFR) and the occurrence of postoperative ureteral strictures were assessed., Results: 186 patients were treated, of which 92 with the VT (49.5%, Group A) and 94 with the VB (50.5%, Group B). Mean stone size was 0.92 vs. 0.91 cm in Groups A vs. B (p = 0.32). Mean total operative time and dusting time were comparable between groups. 7 (7.6%) vs. 6 (6.4%) patients in Groups A vs. B required a flexible ureteroscope because of stone push-up (p = 0.12). Ureteral mucosa lesions were observed in 15 (16.3%) vs. 18 (19.1%) cases in the VT vs. VB group (p = 0.09). 1-Month SFR was comparable (97.8% vs. 95.7%, p = 0.41). We observed one case (1.1%) of postoperative ureteral stricture in the VT group vs. two cases (2.1%) in the VB group (p = 0.19)., Conclusions: VT and VB are equally safe and effective tools in reducing retropulsion of ureteral stones. Operative time, dusting time and SFR were comparable. They also equally avoided stone push-up and prevented ureteral lesions, which may later occur in ureteral strictures., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The use of the new thulium fiber laser in enucleation of the prostate (ThuFLEP) has been introduced recently., Objective: To evaluate complications and urinary incontinence (UI) after ThuFLEP in small and large prostate volume (PV)., Design Setting and Participants: We retrospectively reviewed patients who underwent ThuFLEP in six centers (from January 2020 to January 2023). The exclusion criteria were concomitant lower urinary tract surgery, previous prostate/urethral surgery, prostate cancer, and pelvic radiotherapy., Outcome Measurements and Statistical Analysis: Patients were divided into two groups: group 1: PV ≤80 ml; group 2: PV >80 ml. Univariable and multivariable logistic regression analyses were performed to evaluate the independent predictors of overall UI., Results and Limitations: There were 1458 patients in group 1 and 1274 in group 2. There was no significant difference in age. The median PV was 60 (61-72) ml in group 1 and 100 (90-122) ml in group 2. En bloc enucleation was employed more in group 1, while the early apical release technique was used more in group 2. The rate of prolonged irrigation for hematuria, urinary tract infection, and acute urinary retention did not differ significantly. Blood transfusion rate was significantly higher in group 2 (0.5% vs 2.0%, p  = 0.001). There was no significant difference in the overall UI rate (12.3% in group 1 vs 14.7% in group 2, p  = 0.08). A multivariable regression analysis showed that preoperative postvoiding urine residual (odds ratio 1.004, 95% confidence interval 1.002-1.007, p  < 0.01) was the only factor significantly associated with higher odds of UI. A limitation of this study was its retrospective nature., Conclusions: Complications and UI rates following ThuFLEP were similar in patients with a PV up to or larger than 80 ml except for the blood transfusion rate that was higher in the latter., Patient Summary: In this study, we looked at outcomes after thulium fiber laser in enucleation of the prostate stratified by PV. We found that blood transfusion was higher in men with PV >80 ml, but urinary incontinence was similar., (© 2024 The Author(s).)

Purpose: To evaluate complications and urinary incontinence (UI) after endoscopic enucleation of the prostate (EEP) stratified by prostate volume (PV)., Methods: We retrospectively reviewed patients with benign prostatic hyperplasia who underwent EEP with different energy sources in 14 centers (January 2019-January 2023)., Inclusion Criteria: prostate volume ≥ 80 ml., Exclusion Criteria: prostate cancer, previous prostate/urethral surgery, pelvic radiotherapy., Primary Outcome: complication rate., Secondary Outcomes: incidence of and factors affecting postoperative UI. Patients were divided into 3 groups. Group 1: PV = 80-100 ml; Group 2 PV = 101-200 ml; Group 3 PV > 200 ml. Multivariable logistic regression analysis was performed to evaluate independent predictors of overall incontinence., Results: There were 486 patients in Group 1, 1830 in Group 2, and 196 in Group 3. The most commonly used energy was high-power Holmium laser followed by Thulium fiber laser in all groups. Enucleation, morcellation, and total surgical time were significantly longer in Group 2. There was no significant difference in overall 30-day complications and readmission rates. Incontinence incidence was similar (12.1% in Group 1 vs. 13.2% in Group 2 vs. 11.7% in Group 3, p = 0.72). The rate of stress and mixed incontinence was higher in Group 1. Multivariable regression analysis showed that age (OR 1.019 95% CI 1.003-1.035) was the only factor significantly associated with higher odds of incontinence., Conclusions: PV has no influence on complication and UI rates following EEP. Age is risk factor of postoperative UI., (© 2024. The Author(s).)

Introduction: The Core Curriculum in Cariology (CCC) was developed by ORCA and ADEE in 2010. This article summarizes challenges for the implementation of the CCC at university/country level identified at the "Education Platform" of the ORCA 2022 conference in Cagliari, Sardinia., Methods: Participants from universities from 3 European (Italy, Poland, and UK), 2 Asian (India and Russia), and 3 American countries (Brazil, Colombia, and USA) led the presentations, discussion, and generation of statements. Presentations were transcribed and summarized through qualitative content analysis. Key themes were identified, transformed into key topics, and sent to the panel for agreement., Results: Regardless of the wide variety of dental schools per country, from few (Poland n = 10) to many (India n = 318, Brazil n = 563) or from country/continent itself, frequent challenges to CCC implementation were highlighted. These included lack of agreement on a basic CCC as standard (96%), insufficient support or reimbursement for caries prevention and management (90%), separation between cariology and restorative dentistry (68%), focus on restorative/surgical management with prevention and nonoperative management being disconnected (73%). The group agreed that the integration of cariology and restorative dentistry remains essential to enhancing evidence-based decision-making, resulting in a shift of emphasis from cure to care., Conclusion: There is variation in the level of implementation of the CCC. A frequent challenge is the disconnect between cariology and restorative dentistry. The CCC should be disseminated and promoted as a uniform blueprint/framework to facilitate the implementation of a common cariology curriculum among universities within each country, as well as internationally., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Studies examining the effects of new anti-doping measures on sports performance in elite athletes are scarce. During the last decade, a number of new anti-doping methods for the detection of anabolic androgenic steroids were developed. We hypothesized that the implementation of these methods may cause a decrease of performance in athletic disciplines where given substances are widely used. For this purpose, the performance results for 10 athletic disciplines from country (Country A), which was widely accused of systematic doping use, were gathered and pooled into the 2012-2015 and 2016-2019 periods. These periods were seen as before and following the implementation periods, where the effects of new anti-doping methods could be manifested. Also, the performance results of their rival athletes from Country B were analyzed for comparison. The incidence of anti-doping rule violations for both countries was followed. The analysis revealed a decrease in performance results of Country A athletes in eight of 10 disciplines. The performance results of Country B's athletes in seven of 10 disciplines did not and in three disciplines did demonstrate statistically significant change. The decrease in performance of Country A athletes followed a high incidence of steroid detection cases by means of new anti-doping methods. It is highly likely that the consequent performance decrease is due to the implementation of new anti-doping methods. The results of the study bring new facts on the effects of new anti-doping methods implementation and demonstrate following decrease in performance results in population of athletes from the country widely accused of doping use., (© 2023 John Wiley & Sons Ltd.)

Our understanding of the various aspects of pregnancy in women with kidney diseases has significantly improved in the last decades. Nevertheless, little is known about specific kidney diseases. Glomerular diseases are not only a frequent cause of chronic kidney disease in young women, but combine many challenges in pregnancy: immunologic diseases, hypertension, proteinuria, and kidney tissue damage. An international working group undertook the review of available current literature and elicited expert opinions on glomerular diseases in pregnancy with the aim to provide pragmatic information for nephrologists according to the present state-of-the-art knowledge. This work also highlights areas of clinical uncertainty and emphasizes the need for further collaborative studies to improve maternal and fetal health., (Copyright © 2022 International Society of Nephrology. All rights reserved.)

Purpose: The most crucial step in deep anterior lamellar keratoplasty (DALK) is to achieve a bare Descemet's membrane. We aimed to assess a new femtosecond laser software that allows for a precise intrastromal tunnel creation for big bubble (BB) air injection using a real-time microscope-integrated optical coherence tomography., Materials and Methods: A retrospective review of 61 eyes of 61 patients with keratoconus. Before introducing the new software update, DALK was performed using a partial-assisted femtosecond laser (partial-thickness circular cut followed by a lamellar cut) with manual intrastromal tunnel creation (partial FS-DALK group). After the software update, the femtosecond laser created the intrastromal tunnel (full FS-DALK group)., Results: In the full FS-DALK group, the BB's formation was significantly higher (64.3% vs. 36.4%, p = 0.04), and surgery time was shorter (21.8 ± 5.1 vs. 25.6 ± 6.8 min, p = 0.025) than in the partial FS-DALK. Penetrating keratoplasty conversion rate (7.1% vs. 15.1%, p = 0.432) was similar between the groups. Both groups showed statistically significant improvement in uncorrected and corrected distance visual acuity, central corneal thickness, surface asymmetry, and regularity indices. Endothelial cell density loss at 12 and 18 months was lower in the full compared with the partial FS-DALK group (12 months:10.0% vs. 16; 18 months: 10.7 vs. 16.5%, p < 0.001 for both comparisons)., Conclusions: Creating the intrastromal guiding tunnel using FS laser for air injection resulted in a higher rate of BB formation, reduced long-term endothelial cell loss, and operating room time., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To evaluate the use, effectiveness and safety of Helicobacter pylori empirical rescue therapy in third and subsequent treatment lines in Europe., Design: International, prospective, non-interventional registry of the clinical practice of European gastroenterologists. Data were collected and quality reviewed until October 2021 at Asociación Española de Gastroenterología-Research Electronic Data Capture. All cases with three or more empirical eradication attempts were assessed for effectiveness by modified intention-to-treat and per-protocol analysis., Results: Overall, 2144 treatments were included: 1519, 439, 145 and 41 cases from third, fourth, fifth and sixth treatment lines, respectively. Sixty different therapies were used; the 15 most frequently prescribed encompassed >90% of cases. Overall effectiveness remained <90% in all therapies. Optimised treatments achieved a higher eradication rate than non-optimised (78% vs 67%, p<0.0001). From 2017 to 2021, only 44% of treatments other than 10-day single-capsule therapy used high proton-pump inhibitor doses and lasted ≥14 days. Quadruple therapy containing metronidazole, tetracycline and bismuth achieved optimal eradication rates only when prescribed as third-line treatment, either as 10-day single-capsule therapy (87%) or as 14-day traditional therapy with tetracycline hydrochloride (95%). Triple amoxicillin-levofloxacin therapy achieved 90% effectiveness in Eastern Europe only or when optimised. The overall incidence of adverse events was 31%., Conclusion: Empirical rescue treatment in third and subsequent lines achieved suboptimal effectiveness in most European regions. Only quadruple bismuth-metronidazole-tetracycline (10-day single-capsule or 14-day traditional scheme) and triple amoxicillin-levofloxacin therapies reached acceptable outcomes in some settings. Compliance with empirical therapy optimisation principles is still poor 5 years after clinical practice guidelines update., Trial Registration Number: NCT02328131., Competing Interests: Competing interests: OPN has received research funding from Mayoly and Allergan. JPG has served as speaker, consultant and advisory member for or has received research funding from Mayoly, Allergan, Diasorin, Gebro Pharma and Richen. MC-F has received retribution from Allergan for formative actions. AP-A has received retribution from Allergan and Mylan for formative actions. Laimas Jonaitis has served as speaker for KRKA. AL has served as a consultant to Bayer., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To assess the Candida species occurrence rate and concentration in periodontal pockets in chronic periodontitis (CP) by meta-analysis., Materials and Methods: A search was performed of articles published between January 1, 2010, and October 1, 2020, in English and in Russian, in the electronic databases MEDLINE-PubMed, Google Scholar, The Cochrane Library, ClinicalTrials.gov, Research Gate, eLIBRARY, and Cyberleninka (PROSPEROCRD42021234831). The odds ratio (OR), standardized mean difference (SMD), and 95% confidence interval (CI) were calculated using Review Manager 5.4.1 to compare the risk of CP when Candida spp. were detected in the gingival sulcus or periodontal pocket and to compare Candida spp. density counts in patients with CP and periodontally healthy patients., Results: Twenty-six studies were included in the systematic review and 11 were included in the meta-analysis. The results showed that Candida spp. may increase the chance of CP development by 1.76 times (OR = 1.76; 95% CI = 1.04-2.99; Z = 2.10; p = .04; I 2  = 61%). More Candida spp. were found in patients with CP than in periodontally healthy patients (SMD = 1.58; 95% CI = 0.15-3.02; p = .03; I 2  = 98%). No data were found relating to the statistically significant influence of Candida glabrata, Candida krusei and Candida tropicalis on CP development., Conclusion: We found that Candida albicans insignificantly increased the risk of CP development but, due to the heterogeneity of the included studies, further research is necessary to determine the exact role of Candida spp. in the development and course of the inflammatory periodontal diseases., (© 2022 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

The current data on climate change and environmental degradation are dramatic. The consequences of these changes are already having a significant impact on people's health. Physicians - as advocates of the patients, but also as citizens - have an ethical obligation to be involved in efforts to stop these changes. The European Federation of Internal Medicine (EFIM) strongly encourages the Internal Medicine societies and internists across Europe to play an active role in matters related to climate change and environmental degradation. At a national level, this includes advocating the adoption of measures that reduce greenhouse gas (GHG) emissions and environmental degradation and contributing to policy decisions related to these issues. At a hospital level and in clinical practice, supporting actions by the health sector to reduce its ecological footprint is vital. At the level of EFIM and its associated internal societies, promoting educational activities and developing a toolkit to prepare internists to better care for citizens who suffer from the consequences of climate change. In addition to advocating and implementing effective actions to reduce the ecological footprint of the health industry, recommending the introduction of these themes in scientific programs of Internal Medicine meetings and congresses and the pre- and postgraduate medical training. At a personal level, internists must be active agents in advocating sustainable practices for the environment, increasing the awareness of the community about the health risks of climate change and environmental degradation, and being role models in the adoption of environmentally friendly behaviour., Competing Interests: Declaration of Competing Interest The authors declare they have no conflicts of interest., (Copyright © 2022. Published by Elsevier B.V.)

Background: Urinary incontinence (UI) is a urological problem in women. Currently, suburethral slings are the standard of surgical treatment for stress UI in the female population., Objective: To prove the feasibility of an operating technique using suburethral adjustment-controlled tape (SACT) placement., Design, Setting, and Participants: A single-center comparative randomized controlled trial included patients randomized according to the CONSORT checklist from April to October 2018 and from November 2018 to April 2019. The inclusion criteria were women from 21 to 81 yr, stress and mixed UI forms, and positive cough test. The exclusion criteria were pregnancy, lactation, neurogenic bladder dysfunction, recurrent forms of UI, radiation therapy and pelvic surgery in anamnesis, genital prolapse (Pelvic Organ Prolapse Quantification system >2), urinary infection, and obstructive urination., Intervention: The first group (50 patients) was using synthetic SACT and the second group (75 patients) a transobturator tape (TOT) midurethral sling (MUS)., Outcome Measurements and Statistical Analysis: Subjective efficacy of 96% was established in group 1 and 86% in group 2, with a median follow-up of 12 mo. According to gynecological examination results, the objective surgical treatment efficiency was 96% in group 1 and 90.7% in group 2. This statistically significant indicator was evaluated in each group. However, when comparing both groups, no statistical difference was revealed. According to urodynamic studies, 1 mo after surgery in group 1, terminal and phase detrusor overactivity signs were 18% (n = 9) and 12% (n = 6), respectively. In group 2, these were 14.7% (n = 11) and 12% (n = 9), respectively., Results and Limitations: The block approach was used to randomize patients into groups. A total of 125 patients (50 in the main group and 75 in the control group) were analyzed., Conclusions: Our results prove the efficacy and safety of SACT in treating UI in women. The subjective and objective effectiveness results of treating patients in the study group show the possibility of using SACT in the same row with TOT MUS., Patient Summary: Our purpose was to standardize the surgery stage for urinary incontinence, and evaluate the effectiveness and safety of suburethral adjustment-controlled tape placement. We analyzed women with urinary incontinence and used two different surgical methods. Our results prove the efficacy and safety of suburethral adjustment-controlled tape in treating urinary incontinence in women., (Copyright © 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Background: Bladder pain syndrome/interstitial cystitis (BPS/IC) is a persistent pain perceived in the urinary bladder region, accompanied by at least one symptom, such as pain worsening with bladder filling and daytime or nighttime urinary frequency without any proven infection or obvious pathology. The aim of this study is to evaluate the efficacy and safety of pentosan polysulfate (PPS) in patients with BPS/IC., Methods: Systematic search was performed by PRISMA checklist. Electronic databases, including PubMed and Cochrane library, were checked until 2021 using keywords: 'pentosan polysulfate', 'pain syndrome', 'interstitial cystitis', and bibliography of relevant papers was checked., Inclusion Criteria: Patients with confirmed diagnosis of BPS/IC and cystoscopy criteria - Hunner's lesions. Exclusion criteria included hypersensitivity, pregnancy, lactation, and oral therapy for BPS/IC in the period of 1 month before the study and abstracts or unpublished papers., Results: In total, 13 clinical trials were included in systematic review and 7 were included in meta-analysis. Studies evaluated the effectiveness and safety of oral PPS versus placebo or other treatment options. In the first meta-analysis, three studies compared oral PPS with placebo: [relative risk (RR) = 2.07, 95% confidence interval (CI): 1.37-3.13, p  = 0.0006]. The second meta-analysis of two studies compared oral PPS with another treatment options (intravesical liposome and CyA): (RR = 0.44, 95% CI: 0.10-1.93, p  = 0.28). The third meta-analysis of two studies included intravesical regimen of PPS compared with intravesical placebo: (RR = 1.09, 95% CI: 0.54-2.22, p  = 0.80). The majority of studies do not report any particular serious side effects., Conclusion: PPS treatment has a statistically significant effect over placebo on the subjective improvement of patients with BPS/IC. There was no difference between PPS and other treatment options. Intravesical regimen of PPS had no significant impact on response rates. None of included studies reported severe side effects after intervention., Competing Interests: Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s), 2022.)

Purpose: To describe a new technique for removing residual cortical material adjacent to posterior lens capsule during cataract surgery with the help of cohesive ophthalmic viscosurgical devices., Methods: In this technique, if there are still cortical remnants and lens epithelial cells left after the routine irrigation-aspiration and polishing at the final steps of cataract surgery, the capsule is filled to about one-third with a highly viscous cohesive ophthalmic viscosurgical device. Rinsing is performed from the anterior chamber with the water jet directed tangentially to the ophthalmic viscosurgical device bolus and towards the posterior capsule, which creates a turbulence creating a "grindstone effect". The ophthalmic viscosurgical device bolus transforms into a ball and starts to rotate very quickly within the capsule, grinding away the cortical remnants., Results: In the first series of 62 cases, there were no intra-operative or post-operative complications. At day 1 there was no corneal oedema and no hypertension of intraocular pressure. Visual outcomes were good with a mean best corrected distance visual acuity of -0.01 ± 0.11 logMAR., Conclusion: This technique appears to be effective and fast in removing persistent cortical remnants from the surface of the posterior capsule, while minimising risks such as capsule aspiration during irrigation/aspiration. There is limited pressure and mechanical force applied on the capsule; the anterior chamber and the corneal endothelium remain safe since the ophthalmic viscosurgical device stays inside the capsular bag to its high cohesiveness and molecular weight. More data on a larger cohort of patients is planned to confirm these results and evaluate long-term effects on posterior capsule opacification.

According to world statistics, men are more susceptible to the coronavirus disease 2019 (COVID-19) than are women. Considering the interconnection between infections and male infertility, investigation of the potential impact of COVID-19 on men's reproductive health is now a particularly relevant topic. Published data indicate decreased sperm quality and orchitis development in patients with COVID-19, including reduced sperm count, decreased sperm motility, and elevated DNA fragmentation index. Although mass vaccination against COVID-19 is currently being carried out worldwide using available authorized vaccines, the effect of these vaccines on men's reproductive health has not yet been investigated. There is currently no evidence that SARS-CoV-2 can be transmitted in semen, but available data suggest that it can infect spermatogonia, spermatids, Leydig cells, and Sertoli cells. Therefore, SARS-CoV-2 orchitis and reduced male fertility may be long-term complications of COVID-19, which requires further investigation. Currently, there is also no evidence that vaccines against SARS-CoV-2 have any pathological effects on spermatogenesis or male reproductive health. Thus, further studies are needed to determine the effects of COVID-19 and COVID-19 vaccines on men's reproductive health, which will help to optimize the management and rehabilitation of these patients. This review aims to discuss recent studies on the impact of the COVID-19 and COVID-19 vaccines on men's reproductive health. The article addresses various issues such as the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on testosterone biosynthesis, semen parameters, testicular tissue, and epididymis.

Purpose of Review: The application of lasers in treating urological disorders is a developing area. In the laparoscopic and robotic surgery, laser energy is not so popular as in the treatment of stone disease and benign prostatic hyperplasia. The aim of this review is to clarify the current status of laser applications in laparoscopic and robotic urology., Recent Findings: Laser welding of the pyeloureteral anastomosis is not performed in routine clinical practice. Most investigation of laser applications in laparoscopic and robotic urology has centered on laparoscopic partial nephrectomy and robot-assisted partial nephrectomy. Much less work has been done with regard to lower tract laser laparoscopic and robotic applications. However, laser laparoscopic radical prostatectomy has been investigated., Summary: Current literature regarding lasers in laparoscopic and robotic surgery is extremely limited. Available data consist mostly of small cohorts providing a low level of evidence. Even though initial studies with currently available laser modalities demonstrated promising results, several drawbacks in each technique need to be addressed before being widely accepted as a standard care. Despite investigation, laser usage during laparoscopic and robotic urological procedures has not gained widespread acceptance and remains experimental at this time., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Urinary tract infections (UTIs) have long been among the most common diseases. In the structure of the general infectious morbidity, UTIs rank second after acute respiratory viral infection. Every year, researchers note an increasing number of mutations in the genomes of bacteria that cause infectious diseases, which leads to the formation of more and more aggressive forms of pathogens. Patients with infectious diseases of the urinary system have the highest risk of biofilm formation, the frequency of which is directly proportional to the length of time the urethral catheter is located and accounts for more than half of all nosocomial infections. The presence of resistant strains of pathogenic bacteria and the development of bacterial biofilms are major problems in the treatment of urinary tract infections. The increasing number of nosocomial bacterial strains in the hospital increases the postoperative bed-day, the frequency of readmission and the number of antibacterial drugs used. In light of increasing antibacterial resistance, the use of medical resources is dramatically increasing, which ultimately leads to an increase in the cost of treatment. Along with this, the selection of resistant strains brings to the fore both the rational use of antibacterial drugs and the search for alternative methods of therapy. This review of publications on the problem of bacterial biofilm formation in urological practice demonstrates updated information on the role of enzymes, probiotics, and bacteriophages in preventing biofilm formation on various medical biomaterials, such as urethral catheters.

The purpose of the study was to establish a simple ex vivo corneal re-epithelization model and study the labial mucosal epithelium grafting as a potential approach for ocular surface reconstruction. Four human donor corneal buttons were overstored in a corneal cold storage solution at 4 °C for 32-52 days. Four labial oral mucosa strips were dissected from four patients during fornix reconstruction after they signed informed consent. The substantia propria was trimmed off, and the resulting graft was sutured near the corneal limbus with running sutures (thus forming the tissue construct). Constructs were cultured under the standard conditions with the anterior corneal side outwards. After 3 weeks of culture, constructs were removed, washed, and fixed. Sections were stained with hematoxylin and eosin (HE), anti-keratins 4, 13, 19, and p63. Nuclei were counterstained with Hoechst. After the cultivation, all constructs were integral with the attached graft and non-loosened sutures. The native cells were absent in all donor corneas. Histological evaluation demonstrated that the labial mucosal grafts were attached to the Bowman's membrane (BM), and its cellular outgrowths were found to be transit from the graft to the BM over the anterior surface in all constructs. Cells expressed mucosal epithelial keratins 4, 13, and 19, and several were p63-positive in nuclei. In the study, a simple ex vivo corneal re-epithelization model was successfully established. The model was potent in studying the labial mucosal epithelium grafting as an option for autologous ocular surface reconstruction in patients with bilateral limbal stem cell deficiency., (Copyright © 2022 Elsevier Ltd. All rights reserved.)