European urology focus最新文献

{"title":"Practical Considerations for Patients Undergoing Benign Urinary Diversion.","authors":"Tyler R Compher, Seth Swinney, Kevin J Hebert","doi":"10.1016/j.euf.2026.04.005","DOIUrl":"https://doi.org/10.1016/j.euf.2026.04.005","url":null,"abstract":"<p><p>Urinary diversion (UD) can significantly improve the quality of life in patients with severe benign urologic conditions. In this clinical consultation guide, we aim to provide practical considerations for patients undergoing benign UD.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766694","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":"Consolidative Surgery for Advanced Upper Urinary Tract Urothelial Carcinoma After Enfortumab Vedotin and/or Immune Checkpoint Inhibitors.","authors":"Satoru Taguchi, Michinori Shimizu, Ibuki Tsuru, Jun Kamei, Shigenori Kakutani, Yoichi Mori, Takashi Murata, Yuta Yamada, Haruki Kume","doi":"10.1016/j.euf.2026.03.006","DOIUrl":"https://doi.org/10.1016/j.euf.2026.03.006","url":null,"abstract":"<p><p>Upper urinary tract urothelial carcinoma (UTUC) is a rare malignancy with a poor prognosis in advanced disease. With the advent of novel systemic therapies, including enfortumab vedotin (EV) and immune checkpoint inhibitors (ICIs), deep and durable responses can now be achieved, potentially enabling consolidative surgery with curative intent. However, evidence supporting this approach in advanced UTUC remains scarce. We report a case series of five patients with advanced UTUC who underwent consolidative surgery after EV and/or ICI therapy. All patients achieved sufficient disease control with systemic therapy to allow surgical consolidation, including cases in which the primary tumor showed regrowth and metastatic lesions had nearly or completely resolved during systemic therapy. Consolidative surgery was successfully performed with negative surgical margins in all cases. At a median follow-up of 12 (6-30) mo after surgery, all five patients remained alive, with no evidence of disease, and three patients achieved complete discontinuation of systemic therapy. These findings suggest that consolidative surgery after modern systemic therapy, including EV and/or ICIs, may provide durable disease control and treatment-free survival in selected patients with advanced UTUC.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722209","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":"Health-related Quality of Life With ARPIs in mHSPC: Insights From a Network Meta-analysis.","authors":"Neal D Shore, Noman Paracha, Howard Thom, Philip Orishaba, Elaine Gallagher, Alicia K Morgans","doi":"10.1016/j.euf.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.euf.2026.03.001","url":null,"abstract":"<p><p>Androgen receptor pathway inhibitors (ARPIs) combined with androgen deprivation therapy (ADT) have transformed the management of metastatic hormone-sensitive prostate cancer (mHSPC). However, no head-to-head randomised controlled trials (RCTs) have directly compared ARPIs. This study compared the impact of darolutamide plus ADT versus other doublet ARPIs on patient-reported health-related quality of life (HRQoL) outcomes in men with mHSPC using a network meta-analysis (NMA) of RCTs. A Bayesian proportional hazards NMA was conducted using the Bayesian generalised linear model framework to compare time to deterioration in Functional Assessment of Cancer Therapy-Prostate (FACT-P) total score using data from the ARANOTE, ARCHES, TITAN, and LATITUDE studies. Darolutamide plus ADT showed a meaningful difference in delaying time to deterioration in FACT-P total score versus ADT (hazard ratio [HR] 0.76, 95% credible interval [CrI] 0.61-0.94) and apalutamide plus ADT (HR 0.74 [95% CrI 0.56-0.99]). Darolutamide plus ADT demonstrated numerically favourable effects compared with abiraterone plus ADT (0.89 [95% CrI 0.69-1.16]) and enzalutamide plus ADT (0.79 [95% CrI 0.60-1.04]), although there was no evidence of a difference. Across treatments, darolutamide plus ADT had the highest probability of being the most effective treatment for delaying deterioration in HRQoL. These findings suggest that darolutamide plus ADT may maintain HRQoL longer than other ARPIs and support darolutamide plus ADT as a patient-centred treatment option.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716472","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 Forgotten Suffering of Patients who Survived Fournier's Gangrene: A Systematic Review of Long-term Outcomes and Quality of Life Impairment.","authors":"Laura Wimmer, Christian Daniel Fankhauser, Agostino Mattei, Laila Schneidewind, Fabian Joel Aschwanden","doi":"10.1016/j.euf.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.euf.2026.04.002","url":null,"abstract":"<p><p>Fournier's gangrene (FG) is a rare but life-threatening necrotizing fasciitis of the perineogenital region. While acute outcomes are well described, data on long-term morbidity remain scarce. We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-compliant systematic review to describe long-term mortality, quality of life (QoL), and functional outcomes after FG. Of 3366 records screened, five retrospective studies (2007-2025) including 291 patients were eligible, all at moderate to critical risk of bias. In-hospital mortality ranged from 3% to 16% across studies. Long-term mortality ranged from 5% to 21%, with follow-up varying from 60 d to 11 yr. QoL and functional outcomes were inconsistently reported but suggested a substantial burden, including fecal incontinence, sexual dysfunction, urinary symptoms, and psychosocial impairment. Overall, available evidence indicates that FG carries a sustained burden beyond the acute phase; however, conclusions are limited by the scarcity and low methodological quality of existing studies. PATIENT SUMMARY: We reviewed studies on long-term outcomes after FG. Survivors often seem to experience lasting bowel, bladder, sexual, and social problems. Continued follow-up care is important to improve recovery and QoL.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689040","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":"Making the Most of Pharmacologic Interventions: Urodynamic Effects of Different Therapies for Neurogenic Lower Urinary Tract Dysfunction Following Spinal Cord Injury.","authors":"Bridget Lang Findlay, Katherine T Anderson","doi":"10.1016/j.euf.2026.03.011","DOIUrl":"https://doi.org/10.1016/j.euf.2026.03.011","url":null,"abstract":"<p><p>Management of neurogenic lower urinary tract dysfunction in individuals with spinal cord injury (SCI) involves consideration of patient-specific and bladder-specific factors. Although individuals with SCI prioritize treatment of their symptoms, providers should pay equal, if not more, attention to addressing urodynamic (UDS) parameters such as neurogenic detrusor overactivity (NDO) and impaired compliance due to the associated risk for upper tract deterioration. Anticholinergics, β-3 agonists, and onabotulinumtoxin A (BTX-A) are guideline-supported pharmacotherapies. Though each therapy variably improves NDO, changes in compliance are not well demonstrated. PATIENT SUMMARY: In this review, we examine the efficacy of different classes of pharmacotherapy for improving UDS storage parameters in individuals with SCI. We found that β-3 agonists, particularly vibegron, and anticholinergics make meaningful changes in overactive bladder on UDS, although β-3 agonists may be better tolerated. BTX-A is highly effective even when oral options fail.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671604","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: Amy Lockefeer, Arianne Schild, Swapneel Anaokar, et al. Efficacy and Safety of Mirabegron in Patients with Overactive Bladder and Cardiovascular Comorbidities: A Post Hoc Analysis of Randomised Trials. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2026.01.010.","authors":"Neeraj Singh, Monika Srivastav","doi":"10.1016/j.euf.2026.03.010","DOIUrl":"https://doi.org/10.1016/j.euf.2026.03.010","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671568","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":"\"EASY Study\": A European, Prospective, Postmarket, Single-arm Study of Altis Single-incision Mini-sling for Female Stress Urinary Incontinence.","authors":"Jean-Nicolas Cornu, Hugo van Eijndhoven, Gery Lamblin, Ursula Peschers, Giuseppe Ettore, Zaida Furio Bernardo, Gilles Karsenty, Carmen Gonzalez Enguita, Christian Saussine, Laurent Wagner, Martine Dehez, Philippe Grise, Brigitte Fatton","doi":"10.1016/j.euf.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.euf.2026.03.004","url":null,"abstract":"<p><strong>Background and objective: </strong>To substantiate data on objective and subjective effectiveness and clinical benefits-including health-related quality of life and patient satisfaction-following treatment with a single-incision mini-sling (SIMS) in real-life practice.</p><p><strong>Methods: </strong>Women with predominant stress urinary incontinence (SUI) who were candidates for surgical treatment were prospectively enrolled in a multicenter, single-arm clinical trial and implanted with Altis (Coloplast Corp, Minneapolis, MN) SIMS under general anesthesia or sedation. The primary composite endpoint was the 12-mo cure rate, defined as a negative cough stress test (CST) and a \"no\" response to question 3 of the Urological Distress Inventory (UDI)-6 questionnaire (ie, no SUI symptoms). Cure rate, self-reported symptoms, quality of life, impression of improvement, satisfaction and adverse events were reported at each time point until 36 mo.</p><p><strong>Key findings and limitations: </strong>Cure rate was 75.7% (81/107 evaluable patients) at 12 mo, mainly explained by persistent SUI in subjective patient questionnaires, whereas more than 90% of patients had a negative CST, and used no more pads or a security pad. The mean 24 h pad weight declined significantly at 12 mo compared to baseline (41.2 ± 77.2 g, to 1.2 ± 4.7 g, p < 0.001). At 36 mo (after a 36% dropout rate), all scores and questionnaires were significantly improved, with a high level of improvement and satisfaction. Complication rates were low and similar to those reported for other midurethral slings.</p><p><strong>Conclusion and clinical implications: </strong>Our study contributes to the growing body of data on Altis's safety and effectiveness in SUI.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608471","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 Case for AdVance XP Male Urethral Sling for Men with Mild Stress Urinary Incontinence.","authors":"Allen F Morey","doi":"10.1016/j.euf.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.euf.2026.03.009","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573131","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":"Minimally Invasive Surgical Therapies in Patients with Catheter-Dependent Urinary Retention: A Collaborative Mini-review.","authors":"Pietro Scilipoti, Marie Chicaud, Mikael Abi Abdallah, Nathan Wirtzfeld, Stefano Moretto, Stessy Kutchukian, Steeve Doizi","doi":"10.1016/j.euf.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.euf.2026.03.003","url":null,"abstract":"<p><strong>Context: </strong>Catheter-dependent urinary retention is a severe manifestation of benign prostatic obstruction, frequently affecting older and comorbid patients not eligible for standard surgery. Minimally invasive surgical therapies (MISTs) may be alternative options, although catheter-dependent men are often excluded from pivotal trials.</p><p><strong>Objective: </strong>A structured review of studies reporting outcomes of MISTs in this population was performed.</p><p><strong>Evidence acquisition: </strong>Twenty-four studies including 1137 patients were identified, mostly retrospective, single-arm, and monocentric.</p><p><strong>Evidence synthesis: </strong>Duration of preoperative catheter dependence varied widely (2-47 wks). Across MIST modalities, catheter-free rates (CFR) ranged from 66% to 100%.</p><p><strong>Conclusions: </strong>Prostatic artery embolization and water vapor thermal therapy (Rezūm) were the most frequently evaluated treatments, with CFR of 66-95.2% and 68-100%, respectively, and reintervention rates generally below 15%.</p><p><strong>Patient summary: </strong>Major complications were uncommon. Overall, MISTs can achieve high CFR with low major morbidity in selected patients, but evidence remains heterogeneous, highlighting the need for standardized outcomes and comparative studies.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520342","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":"Tissue Penetration of Gemcitabine and Gemcitabine Phosphate Metabolites Following Gemcitabine Intravesical System Administration Versus Standard Intravesical Instillation in a Preclinical Minipig Model.","authors":"Siamak Daneshmand, Koen Wuyts, Marc De Meulder, Liesbeth Vereyken, Marjolein van Heerden, Herman Borghys, Geert Mannens, Karen Daniel, Samuel Spigelman, Benjamin Pradere","doi":"10.1016/j.euf.2026.03.007","DOIUrl":"https://doi.org/10.1016/j.euf.2026.03.007","url":null,"abstract":"<p><p>Intravesical instillation of gemcitabine is an effective treatment for non-muscle-invasive bladder cancer but is hampered by short indwelling times, which can limit tissue exposure and efficacy. Gemcitabine intravesical system (gem-iDRS; formerly TAR-200) is a novel intravesical drug-releasing system designed for prolonged local gemcitabine delivery within the bladder, offering the potential for sustained tissue penetration. We investigated the penetration, tissue distribution, and retention of gemcitabine and its active metabolites following gem-iDRS administration versus traditional intravesical instillation in a preclinical model. Five female minipigs received either a 2-h bolus gemcitabine hydrochloride (n = 3) intravesical instillation or insertion of gem-iDRS (n = 2) into the bladder. Bladder tissue regions and layers (dome, left and right lateral walls, and trigone) were collected at postinstillation time points and analyzed using liquid chromatography-tandem mass spectrometry. Following traditional intravesical gemcitabine instillation, active phosphorylated metabolites were detected across bladder layers at 2 h but were undetectable by 24 h. In contrast, gem-iDRS maintained measurable metabolite levels across bladder regions and layers for at least 96 h. This small sample size and the use of only healthy animals limit the generalizability of the findings to tumor-bearing bladder tissue. These findings demonstrate that gem-iDRS prolongs bladder tissue exposure compared with traditional intravesical instillation of gemcitabine. PATIENT SUMMARY: Our study compared two different ways of delivering gemcitabine (a chemotherapy drug) into the bladder of minipigs. We found that gem-iDRS (a new intravesical drug-releasing system) kept gemcitabine and active metabolites in the bladder tissue for a longer time than the traditional way of delivering gemcitabine.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493632","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}