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Hamamoto S, Taguchi K, Kawase K, Unno R, Isogai M, Torii K, Iwatsuki S, Etani T, Naiki T, Okada A, Yasui T. Efficacy of Robot-Assisted Ureteroureterostomy in Patients with Complex Ureteral Stricture after Ureteroscopic Lithotripsy. J Clin Med 2023; 12:7726. [PMID: 38137795 PMCID: PMC10743600 DOI: 10.3390/jcm12247726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Ureteral stricture (US) postureteroscopic lithotripsy (URSL) has emerged as a severe complication with the widespread use of laser technology. Furthermore, managing a complex US is challenging. Therefore, this study evaluated the efficacy of robot-assisted ureteroureterostomy (RAUU) in addressing US post-URSL and analyzed the pathology of transected ureteral tissues to identify the risk factors for US. METHODS we conducted a prospective cohort study on patients who underwent RAUU for URSL-induced US from April 2021 to May 2023. RESULTS A total of 14 patients with a mean age of 49.8 years were included in this study. The mean stricture length on radiography was 22.66 ± 7.38 mm. Nine (64.2%) patients had experienced failure with previous interventions. The overall success rate was 92.9%, both clinically and radiographically, without major complications, at a mean follow-up of 12.8 months. The pathological findings revealed microcalcifications and a loss of ureteral mucosa in 57.1% and 28.6% of patients, respectively. CONCLUSIONS The RAUU technique shows promise as a viable option for US post-URSL in appropriately selected patients despite severe pathological changes in the ureter. Therefore, the migration of microcalcifications to the site of ureteral perforation may be a significant factor contributing to US development.
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Affiliation(s)
- Shuzo Hamamoto
- Department of Nephro-Urology, Nagoya City University Graduate School of Medical Sciences, Nagoya 4678601, Japan; (K.T.); (K.K.); (R.U.); (M.I.); (K.T.); (S.I.); (T.E.); (T.N.); (A.O.); (T.Y.)
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Okada T, Hamamoto S, Taguchi K, Okada S, Inoue T, Ando R, Okada A, Yasui T. Quality of life after urinary stone surgery based on Japanese Wisconsin Stone Quality of Life questionnaire: multicenter analysis from SMART study group. Urolithiasis 2023; 51:113. [PMID: 37707652 DOI: 10.1007/s00240-023-01486-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/23/2023] [Indexed: 09/15/2023]
Abstract
We aimed to evaluate the impact of surgical treatment for urinary stones on perioperative health-related quality of life (HRQOL) using the Japanese Wisconsin Stone Quality of Life questionnaire (J-WISQOL), an HRQOL measure designed for patients with urinary stones. This study prospectively enrolled 123 patients with urinary stones who visited three academic hospitals for stone treatment. The participants completed the J-WISQOL within 4 weeks before and after the urinary stone treatment. Treatments included shock wave lithotripsy (SWL), ureteroscopy lithotripsy, and endoscopic combined intrarenal surgery. J-WISQOL was assessed for age, stone size and location, type of treatment, stone-free status, postoperative ureteral stent placement, hospital stay, and complications in all patients. Patients with stones in the ureter had significantly greater social impact D1 and disease impact D3 than those with stones in the kidney. In a comparison of pre- and postoperative J-WISQOL, patients without postoperative ureteral stent placement scored significantly higher on social impact D1 and disease impact D3. Patients with shorter hospital stays had significantly higher social impact D1 and disease impact D3 (p < 0.001) than those with longer hospital stays. SWL significantly improved the total score, social impact D1, and disease impact D3 compared with other treatments. Perioperative HRQOL in patients with urinary stones is particularly affected by the type of treatment, ureteral stent placement, and hospital stay, which should be considered in surgical selection and patient decision-making.
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Affiliation(s)
- Tomoki Okada
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Shuzo Hamamoto
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Kazumi Taguchi
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Shinsuke Okada
- Department of Urology, Gyotoku General Hospital, Chiba, Japan
| | - Takaaki Inoue
- Department of Urology, Hara Genitourinary Hospital, Hyogo, Japan
| | - Ryosuke Ando
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Atsushi Okada
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
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Alrosan S, Al Mse'adeen M, Alkhawaldeh IM, Mishael J, Aljarab'ah N, Aljarajreh M, Yamin M, Abu-Jeyyab M. An Audit to Reevaluate the Adherence to the Guidelines in Patients With Urinary Tract Infection at the Al-Karak Hospital in Jordan. Cureus 2023; 15:e39509. [PMID: 37366451 PMCID: PMC10290742 DOI: 10.7759/cureus.39509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
Background Urinary tract infection (UTI) is a common and costly health problem that affects millions of people worldwide. The proper management of UTI requires adherence to clinical guidelines that are based on the best available evidence. However, compliance with these guidelines in real-world practice is often suboptimal. Objective This study is aimed to audit and reevaluate the adherence to the guidelines in UTI patients at Al-Karak Hospital, Jordan. Methods A retrospective cohort study was conducted. The first loop included 50 patients who presented with symptoms of simple uncomplicated UTI and were treated at the clinic during a three-month period. The second loop included a reevaluation of the first loop's findings after implementing changes to the clinical practice based on the initial audit results. Results The main factors that influenced the adherence were the type of UTI, the presence of comorbidities, the duration of hospitalization, and the antibiotic choice. At the first loop, the audit findings identified that the 100% standard National Institute for Health and Care Excellence (NICE) guidelines met the reach of 20 (40%) of the 50 patients. A revaluation of the audit findings identified that the 100% standard NICE guidelines met the reach of 36 of the 50 (72%) patients. Conclusion The study concluded that there is a need to improve adherence to the guidelines in UTI patients at the Al-Karak Hospital and suggested some recommendations to achieve this goal.
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Affiliation(s)
- Sallam Alrosan
- Internal Medicine, Saint Luke's Health System, Kansas City, USA
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Appel E, Thomas C, Steuwe A, Schaarschmidt BM, Brook OR, Aissa J, Hennenlotter J, Antoch G, Boos J. Evaluation of split-filter dual-energy CT for characterization of urinary stones. Br J Radiol 2021; 94:20210084. [PMID: 33989046 PMCID: PMC8553179 DOI: 10.1259/bjr.20210084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/22/2021] [Accepted: 04/26/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To assess accuracy of dual-energy computed tomography (DECT) to differentiate uric acid from calcium urinary stones in dual-energy split filter vs sequential-spiral vs dual-source acquisition. METHODS Thirty-four urinary stones (volume 89.0 ± 77.4 mm³; 17 calcium stones, 17 uric acid stones) were scanned in a water-filled phantom using a split-filter equipped CT scanner (SOMATOM Definition Edge, Siemens Healthineers, Forchheim, Germany) in split-filter mode at 120 kVp and sequential-spiral mode at 80 and 140 kVp. Additional DE scans were acquired at 80 and 140 kVp (tin filter) with a dual-source CT scanner (SOMATOM Definition FLASH, Siemens Healthineers). Scans were performed with a CTDIvol of 7.3 mGy in all protocols. Urinary stone categorization was based on dual energy ratio (DER) using an automated 3D segmentation. As reference standard, infrared spectroscopy was used to determine urinary stone composition. RESULTS All three DECT techniques significantly differentiated between uric acid and calcium stones by attenuation values and DERs (p < 0.001 for all). Split-filter DECT provided higher DERs for uric acid stones, when compared with dual-source and sequential-spiral DECT, and lower DERs for calcified stones when compared with dual-source DECT (p < 0.001 for both), leading to a decreased accuracy for material differentiation. CONCLUSION Split-filter DECT, sequential-spiral DECT and dual-source DECT all allow for the acquisition of DER to classify urinary stones. ADVANCES IN KNOWLEDGE Split-filter DECT enables the differentiation between uric acid and calcium stones despite decreased spectral separation when compared with dual-source and dual-spiral DECT.
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Affiliation(s)
- Elisabeth Appel
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, D-40225, Düsseldorf, Germany
| | - Christoph Thomas
- Radiologicum Krefeld, Oberdießemer Straße 96, 47805 Krefeld, Germany
| | - Andrea Steuwe
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, D-40225, Düsseldorf, Germany
| | - Benedikt M Schaarschmidt
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, D-45147, Essen, Germany
| | - Olga R Brook
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, USA
| | - Joel Aissa
- RIO - Radiologie Institut Oberhausen, Mülheimer Str. 87, 46045 Oberhausen, Germany
| | - Jörg Hennenlotter
- Department of Urology, University Hospital Tübingen, Tübingen, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, D-40225, Düsseldorf, Germany
| | - Johannes Boos
- Radiologie Münster MVZ, Von-Steuben-Str. 10a, 48143 Münster, Germany
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Trends in urinary stone composition in 23,182 stone analyses from 2011 to 2019: a high-volume center study in China. World J Urol 2021; 39:3599-3605. [PMID: 33779819 DOI: 10.1007/s00345-021-03680-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/20/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To evaluate the distribution and dynamic trends in constituents of urinary stones in China. MATERIALS AND METHODS The composition of 23,182 stones were analyzed and then recorded between January 2011 and December 2019. The characteristics in terms of stone patient's gender, age and calendar year were analyzed. RESULTS Most stones (22,172, 95.64%) had several crystal components, among which 40.25% (8925/22,172) were mixtures with infection components. Calcium oxalate (CaOx) and uric acid (UA) stones were more commonly encountered in men, but calcium phosphate (CaP), magnesium ammonium phosphate (MAP) and carbonate apatite (CA) stones were more prevalent in women (p < 0.05). In males, the proportion of CaOx stones increased up to the age of 40, but subsequently decreased (p < 0.001). Interestingly, females showed an inverse trend regarding CaOx stones (p < 0.001). The proportion of UA stones increased with age (p < 0.001), and CA stones most frequently were recorded at age 20-49. Over the past 9 years, UA, CA, and MAP stones increased over time, whereas there was a tendency for CaOx stones to decrease (p < 0.05). CONCLUSIONS The scarcity of pure stones and a certain proportion of mixtures with infection stone components (e.g., mixtures of CaOx and CA) suggest that treatment directed against a single stone component is insufficient for effective recurrence prevention. Age and gender were significant determinants of stone composition, and according to the observed chronological trends, it seems that in the future, more UA, CA and MAP stones and fewer CaOx stones may be encountered in the studied population.
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Okada T, Hamamoto S, Taguchi K, Okada S, Inoue T, Fukuta H, Chew BH, Penniston KL, Okada A, Yasui T. Validation of The Japanese Version of The Wisconsin Stone Quality of Life Questionnaire (WISQOL): Results from SMART Study Group. J Endourol 2021; 35:1852-1856. [PMID: 34162226 DOI: 10.1089/end.2021.0292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Wisconsin Stone Quality of Life questionnaire (WISQOL) is a health-related quality of life measure designed for patients with urinary stones. It has been translated and used in several languages. This study aimed to validate the Japanese version of the WISQOL (J-WISQOL). MATERIALS AND METHODS The J-WISQOL was translated and validated using a multistep process proposed by the World Health Organization that involved forward translation, back-translation, and pilot testing with a group of patients. This study enrolled 150 patients with urinary stones who visited three academic hospitals for stone treatment. We assessed convergent validity of correlation patterns and internal consistency of the J-WISQOL and Short-Form 36-item survey version 2 (SF-36v2). RESULTS Overall, 150 patients were enrolled. The mean total score of the J-WISQOL was 108.18 ± 20.26 (raw score min-max, 28-140), suggesting that the onset and symptoms of urinary stones reduced the health-related quality of life in the patients. The J-WISQOL showed good internal consistency (Cronbach's α = 0.96) and inter-domain associations (Spearman's correlation coefficient r = 0.67-0.94). The J-WISQOL was correlated with the SF-36v2 in all domains: social, emotional, health, and vitality impact (r = 0.47-0.66). CONCLUSION The J-WISQOL is a reliable instrument for evaluating health-related quality of life measures in patients with urinary stones. It could be a useful quality of life questionnaire for urinary stones in Japan.
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Affiliation(s)
- Tomoki Okada
- Nagoya City University Graduate School of Medical Science, Nephro-urology, Nagoya, Aichi, Japan.,SMART study group, Nagoya, Japan;
| | - Shuzo Hamamoto
- Nagoya City University Graduate School of Medical Sciences, Nephro-urology, Nagoya, Japan.,SMART study group, Nagoya, Japan;
| | - Kazumi Taguchi
- Nagoya City University Graduate School of Medical Science, Nephro-urology, Nagoya, Outside the United States or Canada, Japan;
| | - Shinsuke Okada
- Gyotoku General Hospital, Urology, Chiba, Japan.,SMART study group, Chiba, Japan;
| | - Takaaki Inoue
- Hara Genitourinary Hospital, Urology, Kobe, Japan.,SMART study group, Kobe, Japan;
| | - Hidekatsu Fukuta
- Nagoya City University Graduate School of Medical Science, Core Laboratory, Nagoya, Aichi, Japan;
| | - Ben H Chew
- University of British Columbia, Urologic Sciences, Vancouver, British Columbia, Canada;
| | - Kristina L Penniston
- University of Wisconsin School of Medicine and Public Health, Urology, 1685 Highland Avenue, 3258 MFCB, Madison, Wisconsin, United States, 53705-2281;
| | - Atsushi Okada
- Nagoya City University Graduate School of Medical Sciences, Nephro-urology, 1 Kawasumi,, Mizuho-cho,, Mizuho-ku,, Nagoya, Aichi, Japan, 467-8601;
| | - Takahiro Yasui
- Nagoya City University Graduate School of Medical Sciences, Nephro-urology, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan, 467-8601;
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Study of risk factor of urinary calculi according to the association between stone composition with urine component. Sci Rep 2021; 11:8723. [PMID: 33888737 PMCID: PMC8062512 DOI: 10.1038/s41598-021-87733-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 03/30/2021] [Indexed: 01/22/2023] Open
Abstract
Urolithiasis is a common urinary disease with high recurrence. The risk factor for the recurrence of calculi is not very clear. The object of the present study was to evaluate the association between calculi composition and urine component and analyse the risk factor for the recurrence of urolithiasis. In this study, a total of 223 patients with calculi and healthy control were enrolled, and the components of the calculi and urina sanguinis collected before surgery were analysed. Of the 223 patients, 157 were males and 66 were females. According to the stone composition, the case group was subdivided into three groups. 129 patients had single calcium oxalate stones, 72 had calcium oxalate stones mixed with other stones and 22 had other type of stones excluding calcium oxalate stones. Urine biochemicals were analysed and the associations were found between the chemicals in each group. Multivariate logistic analysis demonstrated that reduced urinary magnesium and uric oxalic acid were independent risk factors when comparing all cases with normal controls. Only decreased urinary magnesium was found to be a risk factor comparing the single calcium oxalate group with normal control group. Low level of urinary magnesium and uric oxalic acid were found to be risk factors comparing the mixed calcium oxalate group with normal control group. No risk factor was found comparing the other stone group with normal control group. In conclusion, there were clear relationships between stone components and urine chemicals. Urine chemicals might be risk factors to predicate the occurrence of urolithiasis.
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Mullen GR, Atallah W, Gupta KR, Zampini A, Bamberger J, Gallante B, Gupta M. Simple Solution to a Difficult Problem: Removal of Large Bladder Calculi Using a Laparoscopic Entrapment Sac. J Endourol 2021; 35:652-656. [PMID: 32988229 DOI: 10.1089/end.2020.0697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction and Objectives: Percutaneous management of large bladder calculi with the use of a laparoscopic entrapment sac is a minimally invasive procedure that may have advantages over open cystolithotomy and transurethral cystolithotripsy, as well as standard percutaneous cystolithotomy. We first performed this procedure in 2008, and refined it after our initial publication in 2013 by changing the position from lithotomy to supine by using a urethral catheter postoperatively instead of a suprapubic (SP) catheter, by using ultrasound guidance for access, and by changing the procedure from being inpatient to outpatient. Our objective is to assess the continued feasibility of percutaneous entrapment sac cystolithotomy (PESC) and describe modifications that simplify the technique (mPESC), comparing outcomes and complications. Methods: Forty seven male patients underwent PESC from 2008 to 2019, 16 who had PESC and 31 who had mPESC. After extraction of calculi, either an SP catheter was placed, or the wound was closed and a urethral catheter was placed. Operative and follow-up parameters were compared between the two cohorts. Results: All patients were rendered stone free. Procedure time and length of stay were both significantly shorter in the mPESC cohort. Stone burden and estimated blood loss were equivalent between cohorts. There were no complications of urethral trauma in either cohort. The PESC cohort had higher rates of leakage from the SP site (25% vs 0%), increased need for catheter over 5 days (18.8% vs 0%), and greater likelihood of recurrent retention (12.5% vs 6%). Conclusions: Modifications of PESC, mPESC, leads to fewer complications and reduced length of stay compared with the original PESC procedure. This safe and efficacious technique can reduce morbidity during the management of large bladder calculi and is well suited for an outpatient procedure.
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Affiliation(s)
- Gregory R Mullen
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - William Atallah
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Kasmira R Gupta
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Anna Zampini
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Jacob Bamberger
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Blair Gallante
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
| | - Mantu Gupta
- Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA
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Sakamoto S. Editorial Comment to Nomograms predicting the outcomes of endoscopic treatments for pediatric upper urinary tract calculi. Int J Urol 2020; 28:301. [PMID: 33368626 DOI: 10.1111/iju.14463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Shinichi Sakamoto
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
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Patel A, Mungray AA, Mungray AK. Technologies for the recovery of nutrients, water and energy from human urine: A review. CHEMOSPHERE 2020; 259:127372. [PMID: 32599379 DOI: 10.1016/j.chemosphere.2020.127372] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/15/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
The global demand for a constant supply of fertilizer is increasing with the booming of the population. Nowadays more focus is given to the recovery and reuse of the nutrients rather than synthesis of the fertilizer from chemicals. Human urine is the best available resource for the primary macronutrients (Nitrogen, Phosphorus and Potassium) for the fertilizer as it contains 10-12 g/L nitrogen, 0.1-0.5 g/L phosphorous and 1.0-2.0 g/L potassium. For the recovery of these nutrients from human urine, various technologies are available which requires source separation and treatment. . In this review, a wide range of the technologies for the treatment of source-separated human urine are covered and discussed in detail. This review has categorized the technologies based on the recovery of nutrients, energy, and water from human urine. Among the various technologies available, Bio-electrochemical technologies are environmental friendly and recovers energy along with the nutrients. Forward Osmosis is the best available technology for the water recovery and for concentrating the nutrients in urine, without or minimal consumption of energy. However, experimental work in this technology is at its prior stage. A single technology is still not sufficient to recover nutrients, water and energy. Therefore, integration of two or more technologies seems essential.
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Affiliation(s)
- Asfak Patel
- Chemical Engineering Department, Sardar Vallabhbhai National Institute of Technology, Surat, Gujarat, India.
| | - Alka A Mungray
- Chemical Engineering Department, Sardar Vallabhbhai National Institute of Technology, Surat, Gujarat, India.
| | - Arvind Kumar Mungray
- Chemical Engineering Department, Sardar Vallabhbhai National Institute of Technology, Surat, Gujarat, India.
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Sakamoto S. Editorial Comment to The Urological Association of Asia clinical guideline for urinary stone disease. Int J Urol 2019; 26:710. [DOI: 10.1111/iju.13958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Shinichi Sakamoto
- Department of Urology Chiba University Graduate School of Medicine Chiba Japan
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