European urology focus最新文献

{"title":"Extent of Vagus Innervation to the Pelvic Organs: A Scoping Review.","authors":"Ursula-Marie Hampton, Bernadette Lemmon, Alison Mears, Arwa Mullamitha, Agnes Kocsis, Katie E Webb, Marcus J Drake","doi":"10.1016/j.euf.2026.10.004","DOIUrl":"https://doi.org/10.1016/j.euf.2026.10.004","url":null,"abstract":"<p><strong>Context: </strong>The vagus nerve (VN) has diverse impacts on the gastrointestinal tract, but there is conflicting and limited information on any pelvic organ innervation. Spinal cord neurological disease affects pelvic organ function, and the possibility of extraspinal innervation has implications for function and potential therapy development.</p><p><strong>Objective: </strong>We aimed to explore current literature evidence on VN in relation to the pelvic viscera, to map the distal VN, anatomically and functionally.</p><p><strong>Evidence acquisition: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews checklist was used. MEDLINE, EMBASE, and Scopus were systematically searched up to October 28, 2025, extracting into Covidence. Two reviewers independently screened titles, abstracts, and full texts, excluding papers not available in English, nonprimary data papers, and papers focused on unrelated systems. Data were extracted using a customised Covidence form to capture study design, methodology, and functional outcomes. Reviewer disagreements were resolved by consensus.</p><p><strong>Evidence synthesis: </strong>Overall, 51 experimental studies were included (six human studies, 45 using animal models). Animal models suggest a direct uterine-vagal connection, with sparse anatomical evidence of the VN projecting to the distal colon, bladder, and very little evidence for testicular innervation. Human studies support the existence of vagal innervation of the female genital tract.</p><p><strong>Conclusions: </strong>The findings challenge the traditional view of exclusive spinal innervation of pelvic organs and underscore the need for specific and focused vagal-pelvic research. Future studies should be aimed at in situ anatomical mapping in animal models, along with functional assessment in larger human cohorts to determine the extent and functionality of vagal innervation in humans.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active Surveillance for Intermediate-risk Prostate Cancer: Implications of AI-enabled Pattern Quantification.","authors":"Gesa Mittmann, Roderick C N van den Bergh, Samson W Fine, Andrew J Vickers, Titus J Brinker","doi":"10.1016/j.euf.2026.09.007","DOIUrl":"https://doi.org/10.1016/j.euf.2026.09.007","url":null,"abstract":"<p><p>Active surveillance (AS) mitigates overtreatment in prostate cancer. Although men with pure Gleason pattern (GP) 3 disease are well-established candidates, criteria for AS in men with GP4 disease remain heterogeneous and weakly evidence based. Recent studies have demonstrated the absolute amount of GP4 to be the dominant predictor of outcome in men with GP4, raising the possibility that GP4 volume could refine AS selection. Clinical translation is limited by inconsistent measurement and interobserver variability, particularly in small-volume disease. Artificial intelligence and digital pathology offer a potential route to reproducible, scalable quantification but are not yet sufficiently validated for clinical decision-making. PATIENT SUMMARY: Active surveillance allows some men with prostate cancer to delay treatment and avoid side effects. For intermediate-risk disease, it remains unclear who can be safely monitored. Measuring higher-grade tumour volume may help but is difficult and not yet standardised. Computer-based analysis may improve this but is not ready to guide treatment decisions.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Informed Patients Revolution: How the Ageing Baby Boomer Generation Will Reshape Urological Practice.","authors":"Enrico Checcucci, Francesco Porpiglia","doi":"10.1016/j.euf.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.euf.2026.09.010","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Giulia Giannini, Isabel Heidegger, and Ilias Giannakodimos's Letter to the Editor re: Marie Semmler, Julian Marcon, Elena K. Berg, et al. Radical Prostatectomy Without Prior Biopsy? Final Histopathology of Radical Prostatectomies in 103 Consecutive Biopsy-naive Patients who Underwent Radical Prostatectomy. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2026.06.030.","authors":"Marie Semmler, Julian Marcon, Elena K Berg, Gerald B Schulz, Patrick Keller, Darjusch Askari, Sarah Takayama Fouladgar, Benazir Enzinger, Benedikt Ebner, Paulo L Pfitzinger, Stephan Ledderose, Philipp M Kazmierczak, Lennert Eismann, Alexander Buchner, Philipp Weinhold, Christian G Stief, Robert Bischoff","doi":"10.1016/j.euf.2026.10.005","DOIUrl":"https://doi.org/10.1016/j.euf.2026.10.005","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Oncological and Patient-reported Outcomes of Intravesical Gemcitabine/Docetaxel in BCG-unresponsive Non-muscle-invasive Bladder Cancer: A Multi-institutional Prospective Cohort Study.","authors":"Yu Guang Tan, J Dudinec, A M Kamat, B J H Lim, A Ghoreifi, J S P Yuen, K Chen, R Kanesvaran, J Chan, A M Shah, K J Tay, M R Abern","doi":"10.1016/j.euf.2026.09.008","DOIUrl":"https://doi.org/10.1016/j.euf.2026.09.008","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the oncological and patient-reported outcomes (PROs) of patients receiving sequential gemcitabine/docetaxel (Gem/Doce) for Bacillus Calmette-Guérin (BCG)-unresponsive non-muscle-invasive bladder cancer (NMIBC).</p><p><strong>Design, setting, and participants: </strong>Patients enrolled in prospective databases at two academic medical institutions who received Gem/Doce -for BCG-unresponsive NMIBC between January 2021 and January 2026 were included. The primary outcome was the 3-mo and 12-mo high-grade recurrence-free survival (HGRFS). Secondary outcomes included progression-free survival (PFS), radical treatment-free survival (RTFS), cancer-specific survival (CSS) and overall survival (OS). Subgroup analyses compared BCG refractory versus early-relapsing and carcinoma in situ (CIS) ± papillary versus papillary-only disease. Adverse events were reported with the common terminology criteria for adverse events version 6.0. PRO assessments were performed using the validated European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and NMIBC24 questionnaires.</p><p><strong>Results and limitations: </strong>Sixty-three patients were included. The median follow-up was 14 mo (interquartile range = 8-27). HGRFS rates at 3 and 12 mo were 88.8% (95% confidence interval [CI] = 81.3-97.0) and 68.1% (95% CI = 56.6-81.8), respectively. PFS at 12 mo was 90.1% (82.0-98.9%), RTFS 89.1% (80.5-98.7%), CSS 98.0% (94.3-100.0%), and OS 90.6% (80.9-100.0%). The BCG-refractory subgroup was associated with a higher risk of high-grade recurrence compared with early-relapsing (hazard ratio 2.44, 95% CI = 1.01-5.94, p = 0.048), whereas no difference was observed between CIS ± papillary and papillary-only subgroup (p = 0.20). Eight patients (12.7%) underwent radical cystectomy and six patients (9.5%) experienced disease progression. Twenty patients (31.7%) experienced mild irritative symptoms and no grade 3 or 4 adverse events were reported. Urinary symptom burden, global function, and functional outcomes remained stable during treatment.</p><p><strong>Conclusions: </strong>In this multi-institutional prospective study, intravesical Gem/Doce demonstrated favorable intermediate oncological outcomes for BCG-unresponsive NMIBC. Gem/Doce was well tolerated with few reported side effects and preserved PROs.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-in-clinical Evaluation of Dual Contrast-enhanced Ultrasound-guided PCNL: A Multicenter Randomized Trial Versus Fluoroscopy.","authors":"Donglai Shen, Shoupeng Li, Zhi Li, Haomin Liang, Wei Zhu, Hairui Chen, Jisong Tian, Wei Wang, Xu Zhang, Bingding Huang, Haixing Mai","doi":"10.1016/j.euf.2026.09.003","DOIUrl":"https://doi.org/10.1016/j.euf.2026.09.003","url":null,"abstract":"<p><strong>Background and objective: </strong>Puncture is critical in percutaneous nephrolithotomy (PCNL), influencing access failure and vascular or adjacent organ injury. This study aimed to compare the clinical efficacy and safety of dual contrast-enhanced ultrasound (D-CEUS) with fluoroscopic guidance for renal access during PCNL.</p><p><strong>Methods: </strong>This two-center prospective trial was conducted between January 2024 and November 2024. A total of 150 patients were randomized to the D-CEUS group (n = 75) or the fluoroscopy group (n = 75). Outcomes included first-attempt puncture success rate, puncture and tract establishment time, stone-free rate, hospital stay, hemoglobin changes, and complications.</p><p><strong>Key findings and limitations: </strong>In the intention-to-treat analysis, the first-attempt puncture success rate was higher with D-CEUS than with fluoroscopy (92% vs 80%; difference 12%, 95% confidence interval [CI] = 0.77-23%; Mantel-Haenszel odds ratio [OR] 2.87, 95% CI = 1.04-7.87; p = 0.040). The per-protocol analysis showed consistent results (95% vs 83%; difference 11%, 95% CI = 0.81-22%; Mantel-Haenszel OR 3.45, 95% CI = 1.06-11.24; p = 0.040). Median puncture time (56 vs 120 s; p < 0.001) and tract establishment time (236 vs 480 s; p < 0.001) were shorter with D-CEUS. Median hospital stay was shorter (2 vs 5 d; p < 0.001), with lower hemoglobin loss (median 7.0 vs 11.5 g/l; p = 0.023). There was no significant difference in the complication rate (8.2% vs 15%; p = 0.19). A limitation is that the open-label design may compromise the robustness of the findings.</p><p><strong>Conclusions and clinical implications: </strong>D-CEUS facilitates accurate and safe puncture, efficient tract establishment, and real-time confirmation of calyceal access while avoiding radiation exposure. These findings support further evaluation of D-CEUS as a radiation-free alternative to fluoroscopy for renal access during PCNL.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Flavio L. Heldwein et al's Letter to the Editor re: Little M, Wolstenholme J, Landeiro F, Marian IR, Williams R, Francisco Lopez J, et al. Cost Effectiveness of Local Anaesthetic Transperineal Versus Transrectal Biopsy: Results from the TRANSLATE Study. Eur Urol Focus 2026;12:227-36.","authors":"Richard J Bryant, Ioana R Marian, Jane Wolstenholme, Alastair D Lamb","doi":"10.1016/j.euf.2026.09.005","DOIUrl":"https://doi.org/10.1016/j.euf.2026.09.005","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Biopsy in Prostate Cancer Screening and Early Detection and Who Needs Antibiotics.","authors":"Pinky Kotecha, Jim Hu, Alastair Lamb","doi":"10.1016/j.euf.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.euf.2026.09.002","url":null,"abstract":"<p><p>For prostate cancer screening, transperineal biopsy offers better clinically significant cancer detection and lower infection risk than transrectal biopsy. Despite greater discomfort, its overall benefits and antibiotic-sparing approach support its use in population-based screening.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Benedikt Hoeh, Giovanni Mazzucato, Pierre Tennstedt, et al. Natural History of Patients Eligible for PROTEUS Diagnosed with Prostate Cancer and Treated with Radical Prostatectomy Without Perioperative Systemic Treatment. Eur Urol Focus. In press. http://dx.doi.org/10.1016/j.euf.2026.05.002.","authors":"Lara Rodriguez-Sanchez, Gianluca Giannarini, Juan Gomez-Rivas","doi":"10.1016/j.euf.2026.08.015","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.015","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Marie Semmler, Julian Marcon, Elena K. Berg, et al. Radical Prostatectomy Without Prior Biopsy? Final Histopathology of Radical Prostatectomies in 103 Consecutive Biopsy-naïve Patients Who Underwent Radical Prostatectomy. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2026.06.030.","authors":"Ilias Giannakodimos, Zisis Kratiras, Michael Chrisofos","doi":"10.1016/j.euf.2026.08.014","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.014","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}