{"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":"Giulia Giannini, Isabel Heidegger","doi":"10.1016/j.euf.2026.08.013","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.013","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":"149008143","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}
Afton Taborek, Jethro C C Kwong, Alice Wang, Noa Boulakia, Leyi B Yin, Kevin K Zhang, David-Dan Nguyen, John R Srigley, Theodorus Van der Kwast, Susan Prendeville, Ryan Booth, Aiman Shahid, Maximiliano Ringa, Amna Ali, Ivan Diamond, Sylvio Bruni, Laurence H Klotz, Nathan Perlis, Neil Fleshner, Antonio Finelli, Romain Diamand, Sangeet Ghai, Masoom Haider, Roger Buckley, Andrew Feifer, Badar M Mian, Girish S Kulkarni, Alexandre R Zlotta
{"title":"External Validation and Comparison of Magnetic Resonance Imaging-based Risk Calculators for Detection of Clinically Significant Prostate Cancer: A Multi-institutional Study Incorporating Transrectal and Transperineal Biopsy Approaches.","authors":"Afton Taborek, Jethro C C Kwong, Alice Wang, Noa Boulakia, Leyi B Yin, Kevin K Zhang, David-Dan Nguyen, John R Srigley, Theodorus Van der Kwast, Susan Prendeville, Ryan Booth, Aiman Shahid, Maximiliano Ringa, Amna Ali, Ivan Diamond, Sylvio Bruni, Laurence H Klotz, Nathan Perlis, Neil Fleshner, Antonio Finelli, Romain Diamand, Sangeet Ghai, Masoom Haider, Roger Buckley, Andrew Feifer, Badar M Mian, Girish S Kulkarni, Alexandre R Zlotta","doi":"10.1016/j.euf.2026.06.027","DOIUrl":"10.1016/j.euf.2026.06.027","url":null,"abstract":"<p><strong>Background and objective: </strong>Magnetic resonance imaging (MRI)-based risk calculators are widely used to inform prostate biopsy decision-making; however, they were predominantly developed for transrectal biopsies. Their performance using the transperineal approach remains unclear. This study externally validated five MRI-based risk calculators across a diverse cohort undergoing either approach.</p><p><strong>Methods: </strong>This retrospective cohort study included 4168 men with pre-biopsy MRI followed by prostate biopsy between October 2016 and December 2023 across four Canadian academic and community hospitals. Five MRI-based (Mehralivand, Kinnaird, Patel, Wang, and Peters) and one non-MRI-based (Prostate Biopsy Collaborative Group) risk calculators were compared. The primary outcome was the presence of clinically significant prostate cancer (csPCa; Grade Group ≥ 2). Model performance was characterized using area under the receiver-operating-characteristic curve (AUROC), calibration plots, and net benefit.</p><p><strong>Key findings and limitations: </strong>Overall, 1797 of 4168 men (43%) had csPCa. Seventy-four percent were of Caucasian ancestry. Biopsies were transperineal in 1379 cases (33%); 32% of patients were biopsy-naïve, 30% had a prior negative biopsy, and 38% had prior Grade Group 1 disease. The MRI-based calculators' performance was similar but worse than originally reported (AUROC = 0.78-0.80 vs 0.80-0.89) although better than that of the non-MRI-based model (AUROC = 0.67, p < 0.001). MRI-based models' performance remained consistent across subgroups, including age, ancestry, biopsy approach (transrectal or transperineal), clinical setting (academic or community), Prostate Imaging-Reporting and Data System (PI-RADS; v2.0 or v2.1), and MRI-fusion technique (cognitive or software). The Kinnaird, Patel, and Peters models showed superior calibration and net benefit.</p><p><strong>Conclusions and clinical implications: </strong>We did not see evidence of a difference in the performance of MRI-based risk calculators regardless of biopsy approach or fusion technique.</p>","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":"149008163","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":"Prostate Cancer Screening: The Population Benefit Outweighs the Harm (Pro).","authors":"Sigrid V Carlsson, Roderick van den Bergh","doi":"10.1016/j.euf.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.euf.2026.09.001","url":null,"abstract":"<p><p>Long-term evidence from randomized trials demonstrates that prostate-specific antigen (PSA)-based screening reduces prostate cancer (PCa)-specific mortality, and modern risk-adapted strategies reduce unnecessary investigations and overdiagnosis. The relevant policy choice is no longer between screening and no screening. PSA testing is already widespread and largely opportunistic. This \"Wild West\" approach has three fundamental shortcomings: it is less effective in reducing PCa mortality, consumes substantial health care resources, and perpetuates socioeconomic disparities. Organized screening offers an opportunity to screen better by focusing screening and diagnostic evaluation workup on men most likely to benefit while reducing unnecessary interventions among those at low risk. Replacing opportunistic testing with organized, risk-adapted screening can therefore maximize population benefit while minimizing harms, inefficient resource use, and inequity. The debate should move beyond whether PCa screening should occur to how screening can be organized to achieve the greatest population benefit.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982449","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":"Blue-light Laser for the Surgical Management of Benign Prostatic Hyperplasia: A Mini Review.","authors":"Amy Steigler, Henry H Woo","doi":"10.1016/j.euf.2026.08.007","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.007","url":null,"abstract":"<p><p>The 450 nm blue diode laser is a recently proposed minimally invasive treatment for benign prostatic obstruction. Its energy is strongly absorbed by haemoglobin and poorly by water, producing efficient vaporisation with a thin coagulation zone. This mini review synthesises the existing literature, comprising six clinical studies (four retrospective series, one prospective cohort, and one early randomised trial), two preclinical studies (an in vitro study and a canine study), and one narrative review. Across clinical studies, blue-light laser surgery achieved short-term urinary outcomes comparable to 532 nm photoselective vaporisation of the prostate (PVP), with a favourable perioperative profile in older men at high risk and superior preservation of erectile and ejaculatory function. The evidence is preliminary, with most studies being retrospective and single centre, and with follow-up rarely beyond 6 mo. Blue-light laser is a promising surgical treatment option for benign prostatic obstruction with theoretical advantages >532 nm PVP, which are yet to be confirmed by further clinical studies. PATIENT SUMMARY: Surgery for an enlarged prostate relieves urinary symptoms but can affect sexual function and cause bleeding. We reviewed early studies of a blue diode laser. It appears to work as well as existing methods in the short term, with less bleeding and better preservation of sexual function, though long-term evidence is currently lacking.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955347","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":"Association Between Castration-resistant Prostate Cancer Progression Patterns and Survival Outcomes in Metastatic Castration-sensitive Prostate Cancer: A Post Hoc Analysis of the TITAN Trial.","authors":"Tomohiro Hori, Hiroaki Iwamoto, Takahiro Inaba, Ryunosuke Nakagawa, Taiki Kamijima, Hiroshi Kano, Tomoyuki Makino, Renato Naito, Hiroshi Yaegashi, Kazuyoshi Shigehara, Takahiro Nohara, Kouji Izumi, Atsushi Mizokami","doi":"10.1016/j.euf.2026.07.003","DOIUrl":"https://doi.org/10.1016/j.euf.2026.07.003","url":null,"abstract":"<p><strong>Background and objective: </strong>In metastatic castration-sensitive prostate cancer, the prognostic implications of castration-resistant prostate cancer (CRPC) progression patterns under upfront androgen receptor signaling inhibitors remain unclear. We evaluated the prognostic impact of CRPC subtypes and baseline predictors using TITAN trial data (NCT02489318).</p><p><strong>Methods: </strong>Patients from the intention-to-treat population were analyzed (n = 525 for apalutamide; n = 527 for placebo). Patients who developed CRPC (n = 499) were classified as prostate-specific antigen (PSA)-CRPC (PSA progression preceding radiographic progression) or radiographic CRPC (radiographic progression concurrent with or preceding PSA progression). The 24-mo cumulative incidence of CRPC subtypes was estimated and compared between treatment groups using the Gray test. Overall survival was compared using inverse probability of treatment weighting-adjusted restricted mean survival time (RMST).</p><p><strong>Key findings and limitations: </strong>Apalutamide significantly reduced the 24-mo cumulative incidence of PSA-CRPC (19% vs 52%; p < 0.001) but not that of radiographic CRPC (13% vs 14%; p = 0.6) compared with placebo. In the placebo group, radiographic CRPC was associated with a significantly shorter RMST than PSA-CRPC. In contrast, this difference was not observed in the apalutamide group. Baseline visceral metastasis was associated with radiographic CRPC in both treatment arms.</p><p><strong>Conclusions and clinical implications: </strong>Prognosis differed between PSA-CRPC and radiographic CRPC in the placebo group, whereas this heterogeneity was less evident in the apalutamide group. Although apalutamide reduced the cumulative incidence of PSA-CRPC, the cumulative incidence of radiographic CRPC remained comparable to that with placebo. Baseline visceral metastasis was associated with radiographic progression, suggesting that these patients may warrant closer imaging surveillance.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944601","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}
Caner Civan, Madeleine J Karpinski, Christopher Darr, Thanusiah Selvamoorthy, Lisa Marie Rennau, Sebastian Hoberück, Matthias Miederer, Tobias Hölscher, Martin Bögemann, Michael Schäfers, Isabel Rauscher, Osman Güven, Jeremie Calais, Koichiro Kimura, Dominic Ufton, Marcin Miszczyk, Michael S Hofman, Thomas A Hope, Claudia Kesch, Ken Herrmann, Boris Hadaschik, Matthias Eiber, Wolfgang P Fendler, Kambiz Rahbar
{"title":"PSMA-PET Tumor Volume Stratifies Nonmetastatic Castration-resistant Prostate Cancer.","authors":"Caner Civan, Madeleine J Karpinski, Christopher Darr, Thanusiah Selvamoorthy, Lisa Marie Rennau, Sebastian Hoberück, Matthias Miederer, Tobias Hölscher, Martin Bögemann, Michael Schäfers, Isabel Rauscher, Osman Güven, Jeremie Calais, Koichiro Kimura, Dominic Ufton, Marcin Miszczyk, Michael S Hofman, Thomas A Hope, Claudia Kesch, Ken Herrmann, Boris Hadaschik, Matthias Eiber, Wolfgang P Fendler, Kambiz Rahbar","doi":"10.1016/j.euf.2026.06.006","DOIUrl":"https://doi.org/10.1016/j.euf.2026.06.006","url":null,"abstract":"<p><strong>Background and objective: </strong>Prostate-specific membrane-antigen positron emission tomography (PSMA-PET) detects distant metastases in more than half of patients with increasing prostate-specific antigen despite castrate levels of testosterone and high-risk nonmetastatic disease on conventional imaging. Here, we aim to evaluate prognostic implications of PSMA-PET staging in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC).</p><p><strong>Methods: </strong>Overall, 514 patients who underwent PSMA-PET for nmCRPC at investigator sites across the world between 2013 and 2022, were retrospectively evaluated in a large, international multi-center PROMISE-PET Registry study. PROMISE metrics and PSMA-PET reports were retrospectively analyzed in accordance with PROMISE V2 criteria. Total tumor volume, PSMA expression score, and molecular imaging metastatic disease (miM1) were analyzed to prognosticate overall survival (OS).</p><p><strong>Results: </strong>Median follow-up was 4.4 yr (interquartile range 2.9-6.7). Overall, 294 patients (57%) were deceased at last follow-up. PSMA-PET detected metastatic disease in 340 patients (66%), and visceral metastases in 28 patients (5.4%). The optimal cutoff point for tumor volume was identified as 7.8 ml, which significantly stratified the cohort into low- versus high-volume groups. Patients with high-volume disease had worse OS than those with low-volume disease (hazard ratio [HR], 2.47; 95% confidence interval [CI], 2.22-2.71; p < 0.001). Patients with any distant metastases (miM1) on PSMA-PET had significantly shorter OS compared to those without detectable metastatic disease (HR, 1.74; 95% CI, 1.49-2.00; p < 0.001).</p><p><strong>Conclusion: </strong>Higher tumor volume on PSMA-PET and presence of distant metastases were strongly associated with OS in patients with nmCRPC. PSMA-PET stage and tumor volume should be included in future nmCRPC risk stratification.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918414","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}
Patrick G Rice, Robyn S E Hawkins, Bhaskar K Somani
{"title":"Screening for Asymptomatic Bacteriuria Before Cystoscopy: A Systematic Review and Meta-analysis.","authors":"Patrick G Rice, Robyn S E Hawkins, Bhaskar K Somani","doi":"10.1016/j.euf.2026.07.016","DOIUrl":"https://doi.org/10.1016/j.euf.2026.07.016","url":null,"abstract":"<p><strong>Context: </strong>Controversy exists regarding whether routine screening of asymptomatic bacteriuria before cystoscopy reduces infectious complications.</p><p><strong>Objective: </strong>To determine whether screening for asymptomatic bacteriuria and treating patients with positive results before cystoscopy reduces infectious complications compared with no screening.</p><p><strong>Evidence acqui: </strong>We conducted a preregistered systematic review and meta-analysis (PROSPERO CRD420251073042) searching MEDLINE, Embase, Scopus, BASE, and the Cochrane Library up to July 16, 2025. Studies were eligible if they compared preprocedural urine culture with treatment of positive results or procedure cancellation against untreated positive urine cultures or unscreened controls in adults undergoing cystoscopy and reported postprocedural infectious outcomes. Risk of bias was assessed using Risk of Bias in Non-randomized Studies of Interventions version 2. Pooled odds ratios (ORs) were derived using a random-effects model with restricted maximum likelihood estimation and Hartung-Knapp adjustment.</p><p><strong>Evidence synthesis: </strong>Six studies comprising 6323 patients were included; five contributed to the urinary tract infection (UTI) meta-analysis. The risk of bias was moderate in five studies and serious in one. Preprocedural urine culture did not significantly reduce post-cystoscopy UTI rates (pooled OR = 0.40, 95% confidence interval = 0.11-1.42; p = 0.12), with between-study heterogeneity (prediction interval OR = 0.03-6.03; I<sup>2</sup> = 75%). Hospitalisation rates were very low in the intervention (0.05%) and control (0.3%) groups. Grading of Recommendations Assessment, Development and Evaluation certainty was low for UTI and urosepsis and very low for hospitalisation.</p><p><strong>Conclusions: </strong>Screening for asymptomatic bacteriuria did not significantly reduce UTI or hospital admission rates following cystoscopy. Given the associated costs, procedural delays, and antimicrobial stewardship concerns, routine screening before cystoscopy should not be performed.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910685","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}
Nick J Lee, Federico Polverino, Leonardo Quarta, Maximilian Filzmayer, Michele Petix, Jordan A Goyal, Nicola Longo, Gennaro Musi, Felix K H Chun, Alberto Briganti, Shahrokh F Shariat, Fred Saad, Pierre I Karakiewicz
{"title":"Contemporary Trends in Primary Retroperitoneal Lymph Node Dissection in Nonseminomatous Germ Cell Tumors.","authors":"Nick J Lee, Federico Polverino, Leonardo Quarta, Maximilian Filzmayer, Michele Petix, Jordan A Goyal, Nicola Longo, Gennaro Musi, Felix K H Chun, Alberto Briganti, Shahrokh F Shariat, Fred Saad, Pierre I Karakiewicz","doi":"10.1016/j.euf.2026.08.010","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.010","url":null,"abstract":"<p><strong>Background: </strong>Primary retroperitoneal lymph node dissection (RPLND) provides both curative and staging benefits in marker-negative stage I and IIa-b nonseminomatous germ cell tumors (NSGCTs) of the testis.</p><p><strong>Objective: </strong>To examine contemporary, population-based trends in primary RPLND utilization across marker-negative stage I and IIa-b NSGCT.</p><p><strong>Design, setting, and participants: </strong>Using the Surveillance, Epidemiology, and End Results (SEER) database (2007-2022), we identified adult patients (aged ≥18 yr) with marker-negative stage I, IIa, and IIb NSGCT.</p><p><strong>Outcome measurements and statistical analysis: </strong>Annual trends, multivariable logistic regression models, and propensity score matching with multivariable competing risks regression models were used.</p><p><strong>Results and limitations: </strong>We identified 6222 patients with marker-negative stage I, 766 with stage IIa, and 649 with stage IIb NSGCT. In stage I, primary RPLND use decreased from 39 patients (16%) in 2007 to 15 patients (2.4%) in 2022. In stage IIa, primary RPLND use decreased from 21 patients (33%) in 2007 to 16 patients (28%) in 2022. In stage IIb, primary RPLND use decreased from 15 patients (52%) to 13 patients (28%) in 2022. In all three stage settings, a more contemporary year of diagnosis independently predicted a lower primary RPLND rate (all p < 0.05). Those rates decreased most sharply in stage I, followed by stage IIb, and stage IIa. Ten-yr cancer-specific mortality rates were low and did not significantly differ between primary RPLND and chemotherapy in stage I or II disease. Limitations include the retrospective design of the SEER database and lack of information on patient comorbidities.</p><p><strong>Conclusions: </strong>Between 2007 and 2022, primary RPLND use declined substantially across marker-negative stage I and IIa-b NSGCT, raising concern about the long-term sustainability of adequate RPLND volume across centers.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905510","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}
Nicolas Carl, Eva Halber, Carl-Erik Dempfle, Dominik Loeschner, Christoph Wies, Daniel Duerschmied, Jochen Johannes Schoettler, Grietje Beck, Maurin Helen Mangold, Alexander Studier-Fischer, Frank Waldbillig, Marie-Claire Rassweiler-Seyfried, Frederik Wessels, Niklas Westhoff, Thomas Stefan Worst, Patrick Honeck, Maurice Stephan Michel, Karl-Friedrich Kowalewski
{"title":"Perioperative Management of Direct Oral Anticoagulants in Urological Surgery: The Prospective PAUSE-URO Study.","authors":"Nicolas Carl, Eva Halber, Carl-Erik Dempfle, Dominik Loeschner, Christoph Wies, Daniel Duerschmied, Jochen Johannes Schoettler, Grietje Beck, Maurin Helen Mangold, Alexander Studier-Fischer, Frank Waldbillig, Marie-Claire Rassweiler-Seyfried, Frederik Wessels, Niklas Westhoff, Thomas Stefan Worst, Patrick Honeck, Maurice Stephan Michel, Karl-Friedrich Kowalewski","doi":"10.1016/j.euf.2026.08.008","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.008","url":null,"abstract":"<p><strong>Background and objective: </strong>The perioperative management of patients receiving direct oral anticoagulants (DOACs) who require interruption of anticoagulation for elective urological surgery is a common clinical scenario but is poorly standardized. The primary aim of this study is to evaluate the safety of the novel perioperative PAUSE-URO protocol.</p><p><strong>Methods: </strong>The prospective, single-arm observational study, PAUSE-URO, enrolled 480 consecutive patients undergoing elective urological surgery at the Department of Urology, University Medical Center Mannheim, from 2023 to 2025. DOACs were paused for 2 or 4 d preoperatively and resumed on postoperative day 1 at a reduced dose for another 10 d. The primary end point was defined as clinically relevant urological bleeding events, with a safety threshold rate of 8%. Secondary end points included major bleeding, thromboembolic events, and mortality.</p><p><strong>Key findings and limitations: </strong>In the modified intention-to-treat and per-protocol cohorts, clinically relevant urological bleeding occurred in 4.3% (20/468; 95% confidence interval [CI] = 2.6-6.5%; p = 0.002) and 4.5% (18/399; 95% CI = 2.7-7.0%; p = 0.007) of the patients, respectively, with both rates below the predefined safety threshold. Major bleeding events occurred in <1% of the cases, suggesting the feasibility of the PAUSE-URO protocol. There were no deaths, strokes, or systemic embolic events. Peripheral venous thromboembolism occurred in one of the 468 (0.2%) patients and acute coronary syndrome in one of the 468 (0.2%) patients.</p><p><strong>Conclusion and clinical implications: </strong>The PAUSE-URO protocol met the predefined safety threshold in the overall study population, supporting feasibility and informing future randomized investigation. Procedure-specific variation, particularly after endourological procedures, should be considered when applying the protocol in routine urological care.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905601","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}
Francesco Di Bello, Angelo Territo, Andrea Gallioli, Óscar Rodriguez-Faba, Josep Maria Gaya, André R Belarmino, Giulio Avesani, Giorgio Graps, Alessio Pecoraro, Alicia Lopez-Abad, Muhammet I Dönmez, Muhammed Emin Polat, Karel Decaestecker, Riccardo Campi, Lorenzo Masieri, Sergio Serni, Joan Palou, Alberto Breda
{"title":"Corrigendum to \"Robot-assisted renal auto transplantation: state of the art\" [Eur Urol Focus 2026; Volume: Online ahead of print. doi: 10.1016/j.euf.2026.06.029].","authors":"Francesco Di Bello, Angelo Territo, Andrea Gallioli, Óscar Rodriguez-Faba, Josep Maria Gaya, André R Belarmino, Giulio Avesani, Giorgio Graps, Alessio Pecoraro, Alicia Lopez-Abad, Muhammet I Dönmez, Muhammed Emin Polat, Karel Decaestecker, Riccardo Campi, Lorenzo Masieri, Sergio Serni, Joan Palou, Alberto Breda","doi":"10.1016/j.euf.2026.08.012","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.012","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891366","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}