Gauhar Vineet, Somani Bhaskar K, Seitz Christian, Castellani Daniele, Tefik Tzevat, Persaud Satyendra, Ragoori Deepak, Gauhar Vishesh, Tan Karl, Lakmichi Mohamed Amine, Gadzhiev Nariman, Malkhasyan Vigen, Kamal Wissam, Tanidir Yiloren, Chai Chu Ann, Tursunkulov Azimdjon N, Farahat Yasser, Keller Etienne Xavier, Chew Ben H, Herrmann Thomas, Traxer Olivier, Yuen Steffi Kar Kei
Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore.
Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK.
Urology. 2025 Mar;197:42-50. doi: 10.1016/j.urology.2024.12.009. Epub 2024 Dec 16.
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.
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.
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%).
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.
评估泌尿外科医生在经皮肾镜取石术（PCNL）和逆行肾内手术（RIRS）治疗肾结石中对基于吸引的技术和设备的认知及当前使用情况。
创建了一份基于网络的包含28个条目的定制问卷。所有参与均为自愿。该调查于2023年11月15日至2023年11月25日在谷歌表单上进行。对人口统计学细节和分类回答应用描述性统计。
共收到632份回复。56.5%来自亚洲。约41.6%的受访者参加过腔内泌尿外科进修。55.4%的受访者有PCNL吸引的个人经验，RIRS为42.7%。确切地说，34.9%的人认为目前有足够证据表明吸引可提高两种腔内泌尿外科手术的无石率并降低并发症。约55.69%的人认为随着证据的发展，吸引有可能成为泌尿外科结石病管理的变革性因素。确切地说，55.7%的人认为腔内泌尿外科采用吸引的主要障碍是技术可用性不足。其他障碍包括缺乏操作标准化（37.65%）、缺乏证据（34.9%）、缺乏适当培训（29.58%）以及当前指南中缺乏倡导（17.72%）。
我们的调查表明，泌尿外科医生渴望在PCNL和RIRS中采用吸引，但缺乏确凿证据、标准化、设备可用性和培训使他们无法这样做。在临床实践中常规采用吸引需要更多关于其在腔内泌尿外科效用的高级别证据。
