Société Internationale d’Urologie Journal

The SIU wishes to extend its gratitude to the urologists who contributed their time to review abstract submissions for the 45th SIU Congress:Refaat Abusamra, Libya;Sanjai Addla, India;Kinju Adhikari, India;Neeraj Agarwal, United States;Madhu Agrawal, India;Sachin Agrawal, United Kingdom;Thomas Ahlering, United States;Shusuke Akamatsu, Japan;Peter Albers, Germany;Salah Albuheissi, United Kingdom;Naif Alhathal, Saudi Arabia;Bedeir Ali-El-Dein, Egypt;Murtadha Almusafer, Iraq;Anastasios Anastasiadis, Greece;Mohamed Arafa, Qatar;Amandeep Arora, India;Zeeshan Aslam, United Kingdom;Hammad Ather, Pakistan;Widi Atmoko, Indonesia;Melanie Aubé-Peterkin, QC;Riccardo Autorino, United States;Ben Ayres, United Kingdom;Puskal Kumar Bagchi, India;Ganesh Bakshi, India;Mevlana Derya Balbay, Turkey;Neil Barber, United Kingdom;John Barry, United States;Jens Bedke, Germany;Elisa Berdondini, Italy;Gajanan Bhat, India;Amit Bhattu, United States;Naeem Bhojani, Canada;N I Bhuiyan, Bangladesh;Marta Bizic, Serbia;Damien Bolton, Australia;Vincenzo Borgna, Chile;Muhammad Bulbul, Lebanon;Gian Maria Busetto, Italy;Ana Gabriela Caballero Garcia, Mexico;Adam Calaway, United States;Amparo Camacho, United States;Kevin Campbell, United States;Francesco Capelan, Switzerland;Manuel Castanheira de Oliveira, Portugal;Christine Joy Castillo, Philippines;David Castro-Diaz, Spain;Arun Chawla, India;Manohar ChikkaMoga Siddaiah, India;Archil Chkhotua, Georgia;Sung Yong Cho, Korea, Rep [...]

Background/Objectives: Renal colic poses a significant burden on patients and healthcare systems. Negative ureteroscopy in the setting of stented patients is reported at up to 14%, resulting in unnecessary surgeries and inefficiencies. While ureteral stents have demonstrated efficacy in relieving obstruction, their exact effect on spontaneous stone passage (SSP) is unclear. Hence, a systematic evaluation of the literature was performed to identify the impact of ureteral stents on spontaneous stone passage rates. Methods: A systematic search was conducted in MEDLINE, Embase, and PubMed (January 1989–February 2025) to identify studies investigating indwelling ureteric stents and SSP. Two independent reviewers screened the abstracts and full texts, with a third resolving conflicts. Quality assessment was conducted using The Risk Of Bias In Non-randomized Studies—of Interventions (ROBINS-I) and Cochrane Risk of Bias 2 (RoB-2) tools. Results: A total of 2437 patients in 14 studies investigating SSP in stented patients were included. One included study was a randomised controlled trial, but the rest were observational (n = 13). Three studies compared stented and control groups, whereas 11 studies only investigated patients with stents. Mean/median overall stone sizes ranged from 4.7 to 7.8 mm in diameter. Overall, SSP rates with stents varied significantly, ranging from 1.7 to 42.3%, in the setting of variable stone size, location, duration of follow-up, and method of stone passage detection. When comparing stented and non-stented patients, two studies demonstrated impaired SSP rates in stented patients (13.9% vs. 26.8% and 14% vs. 20%), but only one of these differences was statistically significant. Three studies comparing patients with retrograde ureteral stents and nephrostomies found increased SSP rates in nephrostomy cohorts (p < 0.001). Conclusions: Stone passage rates with stents vary widely due to heterogeneity in study design, patient characteristics, and follow-up. Some studies suggest that stents may impair passage; however, evidence remains inconclusive due to the limited availability of high-quality comparative data. This study underscores the need for larger prospective trials to clarify the actual impact of stenting on stone passage.

Background/Objectives: Malignant ureteric obstruction is an increasingly common problem; however, its treatment remains challenging due to associated poor survival and quality of life outcomes. There is a lack of consensus on how to best manage these patients. We provide a description of the survival outcomes, renal function outcomes, complications, and prognostic factors associated with the treatment of malignant ureteric obstruction in a cohort of patients at our tertiary Urology unit. Methods: A retrospective review of prospectively identified patients treated for malignant ureteric obstruction at our tertiary Urology unit was performed. Obstruction was relieved with either retrograde insertion of a ureteric stent or percutaneous nephrostomy between the 1st of January 2018, and 31st of December 2023. Renal function, complications, and survival data were recorded. Subgroup analysis and survival analysis were performed to determine prognostic factors. Results: Eighty-four patients underwent treatment for malignant ureteric obstruction with a median survival of 197 days (3–1549 days). A total of 51% percent of patients had a stent-related complication requiring hospitalisation, resulting in a total of 966 additional days in hospital. A total of 78% of patients had improved renal function at 12 months. Factors associated with worse survival included emergency treatment of malignant ureteric obstruction, having no further oncological treatment, receiving no oncological-specific treatment for malignancy, bilateral obstruction, female gender, and poor Primary site, Laterality, serum Creatinine level, and Treatment for primary site (PLaCT) prognosis group (p =< 0.01). Conclusions: Patients with malignant ureteric obstruction have a poor prognosis despite intervention. Treatment is often futile and associated with a significant burden of complications related to ureteric stents and percutaneous nephrostomies.