Asymptomatic bacteriuria in candidates for active treatment of renal stones: results from an international multicentric study on more than 2600 patients.

The occurrence of asymptomatic bacteriuria concomitant to urolithiasis is an issue for patients undergoing renal stone treatment. Disposing of a preoperative urine culture is essential to reduce the risk of septic events. The endpoint of the study is to report which characteristics of candidates for renal stone treatment are frequently associated with positive urine culture. 2605 patients were retrospectively enrolled from 14 centers; inclusion criteria were age > 18 and presence of a single renal stone 1-2 cm in size. The variables collected included age, gender, previous renal surgery, comorbidities, skin-to-stone distance, stone size, location, density, presence of hydronephrosis. After a descriptive analysis, the association between continuous and categorical variables and the presence of positive urine culture was assessed using a logistic regression model. Overall, 240/2605 patients (9%) had preoperative bacteriuria. Positive urine culture was more frequent in females, patients with previous renal interventions, chronic kidney disease, congenital anomalies, larger stones, increased density. Multivariate analysis demonstrated that previous renal interventions (OR 2.6; 95% CI 1.9-3.4; p < 0.001), renal-related comorbidities (OR 1.31; 95% CI 1.19-1.4; p < 0.001), higher stone size (OR 1.06; 95% CI 1.02-1.1; p = 0.01) and density (OR 1.00; 95% CI 1.0-1.00; p = 0.02) were associated with bacteriuria; male gender and lower caliceal location were inversely related to it. Beyond expected risk factors, such as female gender, other parameters are seemingly favoring the presence of positive urine culture. The awareness of variables associated with bacteriuria allows to assess which individuals are at increased risk of presenting bacteriuria and reduce the rate of septic complications.

Inteligencia artificial y simulación en urología / Artificial intelligence and simulation in urology

Introducción y objetivo: La inteligencia artificial (IA) está en pleno desarrollo, y su implementación en la medicina ha supuesto una mejora en la práctica clínica y quirúrgica. Una de sus múltiples aplicaciones es el entrenamiento quirúrgico, con la creación de programas que permiten evitar complicaciones y riesgos para el paciente. El objetivo de este artículo es analizar las ventajas de la IA aplicada al entrenamiento quirúrgico en urología.Material y métodosSe realiza una revisión de la literatura de los artículos publicados en inglés sobre la IA aplicada a la medicina, especialmente a la cirugía y a la adquisición de habilidades quirúrgicas.ResultadosEl entrenamiento quirúrgico ha evolucionado con el tiempo gracias a la IA. Se ha creado un modelo de aprendizaje quirúrgico en el que las habilidades se adquieren de forma gradual, evitando complicaciones al paciente. El uso de simuladores permite un aprendizaje progresivo en el que la cantidad y la complejidad de los procedimientos aumentan progresivamente. Adicionalmente, la IA se utiliza en pruebas de imagen para planificar cirugías o tratamientos.ConclusiónActualmente el uso de la IA en la práctica clínica diaria supone un avance en la medicina, y en particular en la formación quirúrgica. (AU)

Introduction and objective: Artificial intelligence (AI) is in full development and its implementation in medicine has led to an improvement in clinical and surgical practice. One of its multiple applications is surgical training, with the creation of programs that allow avoiding complications and risks for the patient. The aim of this article is to analyze the advantages of AI applied to surgical training in urology.Material and methodsA literary research is carried out to identify articles published in English regarding AI applied to medicine, especially in surgery and the acquisition of surgical skills.ResultsSurgical training has evolved over time thanks to AI. A model for surgical learning where skills are acquired in a progressive way while avoiding complications to the patient, has been created. The use of simulators allows a progressive learning, providing trainees with procedures that increase in number and complexity. On the other hand, AI is used in imaging tests for surgical or treatment planning.ConclusionCurrently, the use of AI in daily clinical practice has led to progress in medicine, specifically in surgical training. (AU)

Artificial intelligence and simulation in urology.

INTRODUCTION AND OBJECTIVE: Artificial intelligence (AI) is in full development and its implementation in medicine has led to an improvement in clinical and surgical practice. One of its multiple applications is surgical training, with the creation of programs that allow avoiding complications and risks for the patient. The aim of this article is to analyze the advantages of AI applied to surgical training in urology. MATERIAL AND METHODS: A literary research is carried out to identify articles published in English regarding AI applied to medicine, especially in surgery and the acquisition of surgical skills. RESULTS: Surgical training has evolved over time thanks to AI. A model for surgical learning where skills are acquired in a progressive way while avoiding complications to the patient, has been created. The use of simulators allows a progressive learning, providing trainees with procedures that increase in number and complexity. On the other hand, AI is used in imaging tests for surgical or treatment planning. CONCLUSION: Currently, the use of AI in daily clinical practice has led to progress in medicine, specifically in surgical training.

Artificial intelligence and simulation in urology. / Inteligencia artificial y simulación en urología.

INTRODUCTION AND OBJECTIVE: Artificial intelligence (AI) is in full development and its implementation in medicine has led to an improvement in clinical and surgical practice. One of its multiple applications is surgical training, with the creation of programs that allow avoiding complications and risks for the patient. The aim of this article is to analyze the advantages of AI applied to surgical training in urology. MATERIAL AND METHODS: A literary research is carried out to identify articles published in English regarding AI applied to medicine, especially in surgery and the acquisition of surgical skills. RESULTS: Surgical training has evolved over time thanks to AI. A model for surgical learning where skills are acquired in a progressive way while avoiding complications to the patient, has been created. The use of simulators allows a progressive learning, providing trainees with procedures that increase in number and complexity. On the other hand, AI is used in imaging tests for surgical or treatment planning. CONCLUSION: Currently, the use of AI in daily clinical practice has led to progress in medicine, specifically in surgical training.

Is remote live urologic surgery a reality? Evidences from a systematic review of the literature.

INTRODUCTION AND OBJECTIVES: The possibility of performing remote-surgery has been the goal to achieve, since the early development of the first surgical robotic platforms. This systematic review aims to analyse the state of the art in the field and to provide an overview of the possible growth of this technology. METHODS: All English language publications on Telementoring and Telesurgery for minimally invasive urologic procedures were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed®, Scopus®, and Web of Science™ databases (up to June 2019). RESULTS: Our electronic search identified a total of 124 papers in PubMed, Scopus, and Web of Science. Of these, 81 publications were identified for detailed review, which yielded 22 included in the present systematic review. Our results showed that remote surgery has been under-utilised until today, mostly due to the lack of appropriate telecommunication technologies. CONCLUSION: Remote live surgery is a growing technology that is catalyzing incremental interest. Despite not being yet reliable today on a regular basis in its most advanced applications, thanks to the advent of novel data-transmission technologies, telepresence might become a critical educational methodology, highly impacting the global healthcare system.

El aumento de vídeos en directo publicados en redes sociales durante congresos de urología: es hora de reflexionar sobre sus ventajas y daños potenciales. Un estudio de ESUT-YAU / Live videos shared on social media during urological conferences are increasing: Time to reflect on advantages and potential harms. An ESUT-YAU study

Introducción: Las redes sociales (RRSS) ofrecen excelentes oportunidades para la difusión del conocimiento científico y su aplicación en el ámbito de la urología es cada vez mayor. Sin embargo, existe controversia alrededor de este tema. Los vídeos en directo compartidos a través de las plataformas de las RRSS ofrecen muchas ventajas y desventajas; existen riesgos potenciales con respecto a la confidencialidad, infracción de derechos de autor, entre otros. Nuestro objetivo fue evaluar el papel de los vídeos compartidos en RRSS durante los congresos de urología. Materiales y métodos: Desde enero de 2016 hasta junio de 2018, se llevó a cabo un estudio exhaustivo de los vídeos compartidos en RRSS durante el Congreso de la Asociación Europea de Urología. Se utilizaron las herramientas online Symplur (Symplur.com), Twitter, Periscope y YouTube para la recopilación de datos. Se analizaron las siguientes variables: el número de vídeos, el tiempo de retransmisión y las visualizaciones de cada uno. Los vídeos se clasificaron como en directo o pregrabados y como científicos o no científicos. Se utilizó SPSS V22.0 para el procesamiento de datos. Resultados: Identificamos 108 vídeos compartidos en RRSS, 292,42 minutos de retransmisión, 67732 visualizaciones. De estos 79 (73%) eran vídeos en directo, de los cuales 78 (72%) se consideraron científicos y 30 (28%) no científicos. Durante los años del estudio (2016-2018) se observó un aumento en el tiempo de retransmisión (p = 0,031), el número de vídeos, visualizaciones (p = 0,018) y vídeos en directo (p = 0,019) durante el congreso anual de la Asociación Europea de Urología. Conclusiones: La publicación de vídeos de congresos urológicos en RRSS está en constante aumento. Estos vídeos proporcionan ventajas para la comunicación, la divulgación científica y amplían el alcance de los congresos. Sin embargo, existe un riesgo potencial al compartir información en tiempo real que podría no estar en línea con las recomendaciones para el uso apropiado de las redes sociales

Introduction: Social Media (SoMe) offers excellent opportunities for scientific knowledge dissemination and its use has been extended in urology. However, there is controversy about its use. Live videos shared trough SoMe platforms offer many advantages, but at the same time disadvantages and potential risks including confidentiality, copyright infringement, among others. We aimed to assess the activity of shared videos on SoMe during urological conferences. Materials and methods: A comprehensive study of videos shared on SoMe during European Association of Urology congress was carried out from January 2016 to June 2018. The online tools Symplur (Symplur.com), Twitter, Periscope and YouTube were searched to collect data. Number of videos, transmission time and views were analyzed. Videos were classified as live or pre-recorded and as scientific or non-scientific. SPSS V22.0 was used to process data. Results: We identified 108 videos shared on SoMe, 292.42minutes of transmission, 67732 views. 79 of 108 (73%) were live streaming videos, 78 (72%) of which were considered scientific vs. 30 (28%) non-scientific. An increase was observed trough the years of study (2016-2018) in transmission time (p = .031) number of videos, views (p = .018) and live videos (p = .019) during the annual congress of the European Association of Urology. Conclusions: Shared videos on SoMe from urological conferences are increasing. These provide advantages for communication, scientific dissemination and expand the scope of conferences. However, there is potential risk of sharing information in real time; that could not be in line with the recommendations for appropriate use of social networks

Caracterización precisa de la inervación del tracto urinario mediante reconstrucción tridimensional: una revisión contemporánea / Precise characterization of urinary tract innervation using three-dimensional reconstruction: A contemporary review?

Una comprensión precisa de la inervación autonómica del tracto urinario es crucial para el manejo exitoso de la enfermedad urológica dado el importante papel que desempeña la neurofisiología en la patología genitourinaria. Estudios recientes que combinan la histopatología contemporánea con la tecnología de la imagen nos dotan de una mayor comprensión de la distribución espacial de los nervios en los riñones, los uréteres y la vejiga. Los hallazgos de estos estudios pueden tener importantes aplicaciones clínicas al ampliar nuestro conocimiento de la etiología y el tratamiento de las enfermedades que afectan el tracto urinario. El objetivo de esta revisión narrativa es señalar el panorama general de la inervación autonómica del tracto urinario. En concreto, nuestra finalidad es proporcionar una descripción tridimensional específica de género de la inervación renal, ureteral y vesical. También destacamos las posibles aplicaciones clínicas e investigativas de estos nuevos conocimientos

A precise understanding of the autonomic innervation of the urinary tract is crucial to successful management of urologic disease given the important role that neurophysiology plays in genitourinary pathology. Recent studies using a combination of contemporary histopathology and imaging technologies have furthered our understanding of the spatial nerve distribution in the kidneys, ureters, and bladder. The findings of these recent studies may have important clinical applications in expanding our knowledge of the etiology and treatment of disease processes affecting the urinary tract. In this narrative review, our goal is to provide an overview of the autonomic innervation of the urinary tract. Specifically, we aim to provide a three-dimensional gender-specific description of renal, ureteral and vesical innervation. We also highlight some possible opportunities for clinical and investigational application of this new knowledge

Live videos shared on social media during urological conferences are increasing: Time to reflect on advantages and potential harms. An ESUT-YAU study. / El aumento de vídeos en directo publicados en redes sociales durante congresos de urología: es hora de reflexionar sobre sus ventajas y daños potenciales. Un estudio de ESUT-YAU.

INTRODUCTION: Social Media (SoMe) offers excellent opportunities for scientific knowledge dissemination and its use has been extended in urology. However, there is controversy about its use. Live videos shared trough SoMe platforms offer many advantages, but at the same time disadvantages and potential risks including confidentiality, copyright infringement, among others. We aimed to assess the activity of shared videos on SoMe during urological conferences. MATERIALS AND METHODS: A comprehensive study of videos shared on SoMe during European Association of Urology congress was carried out from January 2016 to June 2018. The online tools Symplur (Symplur.com), Twitter, Periscope and YouTube were searched to collect data. Number of videos, transmission time and views were analyzed. Videos were classified as live or pre-recorded and as scientific or non-scientific. SPSS V22.0 was used to process data. RESULTS: We identified 108 videos shared on SoMe, 292.42minutes of transmission, 67732 views. 79 of 108 (73%) were live streaming videos, 78 (72%) of which were considered scientific vs. 30 (28%) non-scientific. An increase was observed trough the years of study (2016-2018) in transmission time (p=.031) number of videos, views (p=.018) and live videos (p=.019) during the annual congress of the European Association of Urology. CONCLUSIONS: Shared videos on SoMe from urological conferences are increasing. These provide advantages for communication, scientific dissemination and expand the scope of conferences. However, there is potential risk of sharing information in real time; that could not be in line with the recommendations for appropriate use of social networks.

Precise characterization of urinary tract innervation using three-dimensional reconstruction: A contemporary review. / Caracterización precisa de la inervación del tracto urinario mediante reconstrucción tridimensional: una revisión contemporánea.

A precise understanding of the autonomic innervation of the urinary tract is crucial to successful management of urologic disease given the important role that neurophysiology plays in genitourinary pathology. Recent studies using a combination of contemporary histopathology and imaging technologies have furthered our understanding of the spatial nerve distribution in the kidneys, ureters, and bladder. The findings of these recent studies may have important clinical applications in expanding our knowledge of the etiology and treatment of disease processes affecting the urinary tract. In this narrative review, our goal is to provide an overview of the autonomic innervation of the urinary tract. Specifically, we aim to provide a three-dimensional gender-specific description of renal, ureteral and vesical innervation. We also highlight some possible opportunities for clinical and investigational application of this new knowledge.

Las redes sociales científicas, una nueva forma de ampliar el conocimiento. ¿Qué necesitan saber los urólogos? / Scientific social media, a new way to expand knowledge. What do urologists need to know?

Introducción y objetivos: Hoy en día es casi imposible desvincular la mayoría de las fuentes de conocimiento e información modernos a las tecnologías 2.0. El objetivo de este trabajo es realizar una revisión de las redes sociales (RRSS) científicas (RRSS-C) y el papel que estas desempeñan en la urología actual. Material y métodos: Se realizó una búsqueda bibliográfica en la base de datos PubMed hasta julio de 2018. Se utilizaron los siguientes términos de búsqueda: "Redes sociales", "Urología", "Ciencia", "Investigación". Resultados: Las RRSS ofrecen servicios integrados y herramientas sencillas para la comunicación, la colaboración y la participación. Las instancias prototípicas populares de las redes son Facebook, Twitter o Instagram. Las RRSS no solo han afectado la vida privada y la comunicación personal, sino que también han tenido un alto impacto en el mundo empresarial y la ciencia. En este sentido, el término RRSS-C describe el uso de las plataformas de tecnologías 2.0 en el trabajo científico. Existen diferentes modelos de RRSS-C. Están los identificadores de autor, que son identificadores únicos que permiten gestionar la identidad profesional de cada investigador, distinguiéndolos de otros investigadores y asociando inequívocamente su trabajo. Los perfiles de autor nos ayudan a gestionar nuestro propio perfil académico y a controlar la información disponible sobre nosotros. De esta manera nos aseguramos de que otros investigadores encuentren información correcta y completa sobre nuestra carrera e investigación. Algunos ejemplos de RRSS-C son: ResearchGate, ORCID y Mendeley, entre otros. Conclusiones: Las RRSS-C no solo deben proporcionar información y servicios importantes para la literatura y búsqueda de esta, sino que también podrían ser un catalizador importante para promover servicios apropiados y útiles en el contexto de un nuevo concepto de ciencia, la ciencia 2.0

Introduction and aims: Nowadays, it is almost impossible not to link most of the sources of modern knowledge to information of 2.0 technologies. The aim of this review is to analyse the role of scientific social media (Sc-SoMe) and its potential applications in urology. Material and methods: A literature search was carried out using the PubMed database until July 2018. The research was performed with the following terms: "Social Media", "urology", "science", "research". Results: Social media (SoMe) offers integrated services and easy tools for communication, collaboration and participation. Popular prototypical platforms of SoMe are Facebook, Twitter or Instagram. SoMe not only influence private life and personal communication, but these also affect business and science sectors. In this sense, the term Sc-SoMe describes the impact and usage of 2.0 technologies platforms on scientific work. There are different models of Sc-SoMe such as author identifiers which are unique identifiers that allow managing the professional identity of each researcher, distinguishing them from other researchers and unequivocally associating their work and author profiles. This helps us manage our own academic profile and control the information available about us and ensure that other researchers are finding correct and complete information about our research and career. Examples of Sc-SoMe are: ResearchGate, ORCID, Mendeley among others. Conclusions: Sc-SoMe should not only provide important information and services for literature and literature search. These could also be an important catalyst for promoting appropriate and helpful services in the context of a new concept of science, the science 2.0

Scientific social media, a new way to expand knowledge. What do urologists need to know? / Las redes sociales científicas, una nueva forma de ampliar el conocimiento. ¿Qué necesitan saber los urólogos?

INTRODUCTION AND AIMS: Nowadays, it is almost impossible not to link most of the sources of modern knowledge to information of 2.0 technologies. The aim of this review is to analyse the role of scientific social media (Sc-SoMe) and its potential applications in urology. MATERIAL AND METHODS: A literature search was carried out using the PubMed database until July 2018. The research was performed with the following terms: "Social Media", "urology", "science", "research". RESULTS: Social media (SoMe) offers integrated services and easy tools for communication, collaboration and participation. Popular prototypical platforms of SoMe are Facebook, Twitter or Instagram. SoMe not only influence private life and personal communication, but these also affect business and science sectors. In this sense, the term Sc-SoMe describes the impact and usage of 2.0 technologies platforms on scientific work. There are different models of Sc-SoMe such as author identifiers which are unique identifiers that allow managing the professional identity of each researcher, distinguishing them from other researchers and unequivocally associating their work and author profiles. This helps us manage our own academic profile and control the information available about us and ensure that other researchers are finding correct and complete information about our research and career. Examples of Sc-SoMe are: ResearchGate, ORCID, Mendeley among others. CONCLUSIONS: Sc-SoMe should not only provide important information and services for literature and literature search. These could also be an important catalyst for promoting appropriate and helpful services in the context of a new concept of science, the science 2.0.

[Endoscopic enucleation of the prostate: a short term trend or a new treatment standard?]

Endoscopic enucleation of the prostate (EEP) techniques such as HoLEP (holmium laser enucleation of the prostate), ThuLEP (thulium laser enucleation of the prostate) and electroenucleation (mono- or bipolar) are highly effective and safe. They have been endorsed by the latest version of the European Association of Urology guidelines as an alternative to not only open adenomectomy but also transurethral resection of the prostate (EAU Guidelines on Treatment of Non-neurogenic Male LUTS 2018). Therefore, many urologists face the possibility of replacing the treatments of BPH. In this article, we analyze the history of EEP techniques, both their pros and cons and, what are they today - just a popular trend or a new standard procedure for the surgical treatment of BPH?

La combinación de litotricia extracorpórea y ureterorrenoscopia flexible optimiza el tratamiento de litiasis renales / Combination of extracorporeal lithotripsy and flexible ureterorenoscopy optimize renal lithiasis therapy

Objetivos: Describir nuestra experiencia inicial en el tratamiento de las litiasis renales mediante litotricia extracorpórea controlada por ureterorrenoscopia flexible simultánea y combinada con litotricia mediante láser holmium. Material y métodos: Llevamos a cabo esta novedosa técnica en una paciente previamente seleccionada que presentaba litiasis renales izquierdas, 2 en cáliz superior, 2 en cáliz medio y 2 en cáliz inferior, la mayor de ellas en cáliz medio de 6 mm. Realizamos de forma simultánea una litotricia extracorpórea por ondas de choque y una ureterorrenoscopia flexible para un mejor control de la fragmentación de la litiasis y aplicando láser holmium. En el postoperatorio inmediato se realizó una ecografía y una tomografía computarizada (TC) de control al mes. Resultados: Se consiguió la completa fragmentación de todas las litiasis y se dejó un catéter doble J que se retiró posteriormente tras la comprobación de la ausencia de restos litiásicos mediante TC. No hubo complicaciones intraoperatorias, ni posquirúrgicas. Conclusiones: Esta técnica descrita es novedosa, segura y reproducible. El buen resultado obtenido mediante esta técnica combinada aumenta nuestro interés en seguirla empleando y considerarla como una opción de tratamiento para las litiasis renales de nuestros pacientes

Objective: Describe our initial experience in the treatment of renal lithiasis with extracorporeal lithotripsy controlled by simultaneous flexible ureterorenoscopy and combined with holmium laser lithotripsy. Material and methods: We performed this novel technique in a previously selected patient with left renal lithiasis, two in the superior calix, two in the medium calix and two in the inferior calix, the biggest of which was placed in medium calix and was 6 mm long. We proceeded to an extracorporeal shock wave lithotripsy and a simultaneous flexible ureterorenoscopy for better controlling the fragmentation of the lithiasis with the use of a holmium laser. In the immediate post-operative, an ultrasound was performed and, one month later, a computerized tomography (CT) was done. Results: The complete fragmentation of all the lithiasis was obtained and a double-J catheter was placed. After the assessment of the absence of stone fragments by CT the catheter was removed. No intra-operative or post-operative complications were described. Conclusions: The technique described is novel, safe and reproducible. The good result obtained through this combined technique increases our interest in continuing with its application and consider it as an option for the treatment of renal lithiasis in our patients

Combination of extracorporeal lithotripsy and flexible ureterorenoscopy optimize renal lithiasis therapy. / La combinación de litotricia extracorpórea y ureterorrenoscopia flexible optimiza el tratamiento de litiasis renales.

OBJECTIVE: Describe our initial experience in the treatment of renal lithiasis with extracorporeal lithotripsy controlled by simultaneous flexible ureterorenoscopy and combined with holmium laser lithotripsy. MATERIAL AND METHODS: We performed this novel technique in a previously selected patient with left renal lithiasis, two in the superior calix, two in the medium calix and two in the inferior calix, the biggest of which was placed in medium calix and was 6mm long. We proceeded to an extracorporeal shock wave lithotripsy and a simultaneous flexible ureterorenoscopy for better controlling the fragmentation of the lithiasis with the use of a holmium laser. In the immediate post-operative, an ultrasound was performed and, one month later, a computerized tomography (CT) was done. RESULTS: The complete fragmentation of all the lithiasis was obtained and a double-J catheter was placed. After the assessment of the absence of stone fragments by CT the catheter was removed. No intra-operative or post-operative complications were described. CONCLUSIONS: The technique described is novel, safe and reproducible. The good result obtained through this combined technique increases our interest in continuing with its application and consider it as an option for the treatment of renal lithiasis in our patients.