European urology focus最新文献

{"title":"Impact of Lifestyle and the Microbiome on Male Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia.","authors":"Tommaso Cai, Tommaso Ceccato, Simone Botti, Jennifer Kranz, Paolo Verze, Gernot Bonkat, Antonio Aversa, Vito Racanelli, Truls Erik Bjerklund Johansen","doi":"10.1016/j.euf.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.euf.2025.04.013","url":null,"abstract":"<p><p>Recent studies have facilitated a new understanding of how the microbiome and lifestyle contribute to the pathophysiology of prostatic diseases. This mini review explores evidence on the role of lifestyle, diet, and the microbiome in the development and progression of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Diet, physical activity, and the gut microbiome may influence LUTS/BPH by modulating systemic inflammation and metabolic processes. Proinflammatory diets, particularly those high in animal-based foods and low in fiber, affect systemic inflammation, leading to LUTS. Changes in the gut microbiota can alter the production of short-chain fatty acids and contribute to insulin resistance and other metabolic disturbances that may exacerbate prostate inflammation and accelerate LUTS progression. BPH development is influenced by a complex interplay of lifestyle factors, the metabolic syndrome, and the composition of the microbiota. More research into the pathophysiology of BPH is warranted to increase the evidence supporting lifestyle-based strategies in BPH prevention and management. PATIENT SUMMARY: There seems to be a link between lower urinary tract symptoms (LUTS) caused by an enlarged prostate and lifestyle, diet, and gut microbes. LUTS can be increased by factors such as a diet rich in red meat and animal protein and poor in fiber, and physical inactivity. Obesity may change the composition of microbes in the gut, which in turn increases inflammation, including in the prostate. Addressing these factors could help in preventing LUTS.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981743","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":"Undertreatment or Overtreatment in the Adjuvant Setting for M1 No Evidence of Disease in Renal Cell Carcinoma: A Clinical Conundrum.","authors":"Wesley Yip, Brian I Rini","doi":"10.1016/j.euf.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.euf.2025.04.009","url":null,"abstract":"<p><p>Guidelines recommend consideration of 1 yr of adjuvant pembrolizumab for selected patients with oligometastatic renal cell carcinoma who are disease-free after metastasectomy. Owing to the heterogeneity of this population, it is unclear whether patients would benefit more from single-agent pembrolizumab or from observation and salvage therapy with multiagent regimens. Better prognostic biomarkers are needed to guide treatment decisions in this setting.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976043","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":"Future Directions for Circulating Tumor DNA Studies in Renal Cell Carcinoma.","authors":"Adanma Ayanambakkam, Arnab Basu","doi":"10.1016/j.euf.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.euf.2025.04.006","url":null,"abstract":"<p><p>Circulating tumor DNA (ctDNA) is a minimally invasive biomarker that has attracted significant attention for its prognostic and predictive roles in oncology. In renal cell carcinoma (RCC), ctDNA profiling has revealed shorter ctDNA fragments and greater variability in ctDNA levels that are influenced by disease biology, tumor burden, timing, and tumor growth. Advanced detection methods, such as tumor-guided plasma analysis and methylation profiling, have enhanced sensitivity but require standardization. Emerging evidence highlights the prognostic potential of ctDNA, which correlates with worse outcomes in persistent or preoperative ctDNA positivity, advanced stage, and tumor burden. ctDNA dynamics align with therapeutic responses, and ctDNA profiling can reveal genomic alterations associated with resistance (eg, TP53, TERT) and responsiveness (eg, NF1, PIK3CA), and rare actionable mutations (eg, HER2, EGFR, BRCA1, ALK fusions). Despite limitations such as discordance in isolated intracranial progression, ctDNA complements tissue-based next-generation sequencing and facilitates real-time tumor monitoring and tracking of clonal evolution, and can guide personalized treatment strategies to improve patient outcomes. PATIENT SUMMARY: A blood test called circulating tumor DNA (ctDNA) can help doctors in monitoring cancer progression and predicting how well treatments might work. In kidney cancer, this test can detect tumor changes, guide personalized treatments, and predict outcomes earlier than traditional scans.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985605","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":"Clinical Protocol for Same-day-discharge Percutaneous Nephrolithotomy.","authors":"David Chung, Gregory Hosier","doi":"10.1016/j.euf.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.euf.2025.04.005","url":null,"abstract":"<p><p>Same-day percutaneous nephrolithotomy has emerged as a safe and feasible alternative to inpatient treatment that is gaining in popularity. The quality of the puncture, appropriate patient counseling, and optimization of patient comfort and pain are key points for effective implementation of the same-day approach.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986186","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":"External Urinary Devices for Stress Urinary Incontinence: Does One Size Fit All?","authors":"Hanny Cobussen-Boekhorst, Nancy van Benthum-van Ooijen, Vera Janssen, Clair Schuurmans","doi":"10.1016/j.euf.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.018","url":null,"abstract":"<p><p>Both males and females can be effected by stress urinary incontinence (SUI), with symptoms ranging from mild to severe. External urinary devices (EUDs) can help in managing incontinence in daily life and thus improve quality of life. EUDs include absorbent products, female external catheters, male external catheters/sheaths, and penile compression devices/clamps. To address the needs of individual patient, a shared decision-making process is essential, with the involvement of health care professionals specialized in continence care. Future challenges include the sustainability of devices (in particular absorbent products) owing to their significant carbon footprint. Advances in digital and technical processes present opportunities for innovation in this field. PATIENT SUMMARY: A wide range of external urinary devices are available for patients with stress urinary incontinence. To ensure the best choice for each patient according to their individual needs, shared decision-making is essential with guidance from a health care professional with expertise in continence care. For patients without access to such expertise, reliable noncommercial information can be found online.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998531","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":"Reoperation for Benign Prostatic Obstruction Following Transurethral Resection and Holmium Laser Enucleation of the Prostate: A 3-year Follow-up Study of Over 33 000 Primary Surgical Interventions.","authors":"Christian Gilfrich, Matthias May, Christian Gratzke, Claus Fahlenbrach, Christian Günster, Elke Jeschke, Gralf Popken, Jan Roigas, Jens-Uwe Stolzenburg, Hanna Leicht","doi":"10.1016/j.euf.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.euf.2025.02.017","url":null,"abstract":"<p><strong>Background and objective: </strong>Large-scale studies comparing the efficacy of transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) are scarce, particularly concerning the influence of hospital volume. This study aims to evaluate the 3-yr reoperation risk for benign prostatic obstruction (BPO) following TURP versus HoLEP, adjusted for procedure-specific annual hospital volume.</p><p><strong>Methods: </strong>This retrospective study is based on pseudonymized data from the German local health care funds (Allgemeine Ortskrankenkassen [AOK]) for BPO patients who underwent TURP (n = 29 790) or HoLEP (n = 3330) between 2017 and 2019. Three-year reoperation risk was assessed using the Kaplan-Meier (KM) method and a multivariate Cox proportional-hazard model adjusted for comorbidities.</p><p><strong>Key findings and limitations: </strong>The unadjusted KM survival rate without reoperation was 93.5% (95% confidence interval [CI]: 93.2-93.7%) after TURP compared with 97.0% after HoLEP (96.3-97.5%; p < 0.001). In a multivariate analysis, HoLEP was associated with a lower reoperation risk than TURP (hazard ratio [HR] ranging from 0.23 [95% CI: 0.14-0.38] to 0.65 [95% CI: 0.42-0.98], depending on hospital volume). However, HoLEP hospital volumes of one to 49 (HR 2.74, 95% CI: 1.44-5.22) and 50-99 (HR 2.36, 95% CI: 1.27-4.39) cases annually were linked to a higher risk of reoperation than volumes of ≥250 cases, while no such volume effect was observed for TURP. The limitations of this study are the following: it is a retrospective, nonrandomized study and it lacks clinical information (eg, prostate volume and functional results).</p><p><strong>Conclusions and clinical implications: </strong>HoLEP demonstrates a significantly reduced reoperation risk for BPO compared with TURP at intermediate follow-up, with dependence on procedure-specific hospital volume, which is not evident for TURP.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005121","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":"Salvage Radiotherapy Following Nonradiotherapy Ablative Techniques for Primary Prostate Cancer: A Systematic Review and Meta-analysis.","authors":"Osama Mohamad, Lucas Mose, Maiwand Ahmadsei, Ramez Kouzy, Constantinos Zamboglou, Luca Nicosia, Filippo Alongi, Thomas Zilli, Stefano Arcangeli, Giulia Marvaso, Barbara A Jereczek-Fossa, Matthias Guckenberger, Daniel M Aebersold, Mohamed Shelan","doi":"10.1016/j.euf.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.euf.2025.02.001","url":null,"abstract":"<p><strong>Background and objective: </strong>The treatment landscape for localized prostate cancer has evolved with the increasing use of nonradiotherapy ablative interventions (NRAIs) such as high-intensity focused ultrasound (HIFU) and cryotherapy. These minimally invasive therapies promise fewer side effects and quicker recovery but come with a higher risk of recurrence, often necessitating salvage treatments. Salvage radiotherapy (SRT) is a potential option, but its efficacy and safety following NRAIs remain uncertain. Our aim was to conduct a systematic review and meta-analysis of the safety and efficacy of SRT in patients with recurrent prostate cancer after NRAI. The primary objective was SRT safety in terms of acute and late gastrointestinal (GI) and genitourinary (GU) toxicities. The secondary objectives were SRT efficacy in terms of biochemical relapse rates according to prior NRAI type (HIFU vs cryotherapy).</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Web of Science, Scopus, and the Cochrane Library up to August 2023. Studies were included if they assessed SRT outcomes in patients with prostate cancer recurrence after NRAI, focusing on GI and GU toxicities and biochemical relapse. Data were extracted and pooled using a random-effects meta-analysis model to estimate the incidence of acute and late toxicities and biochemical recurrence rates. Statistical analysis included assessments of heterogeneity and publication bias.</p><p><strong>Key findings and limitations: </strong>Twenty-one studies involving 817 patients were included. The pooled rate for acute SRT grade 1-2 GI toxicity was 22% (95% confidence interval [CI] 10-34%; p < 0.01) and was higher for prior HIFU versus cryotherapy. The pooled rate for acute SRT grade 1-2 GU toxicity was 37% (95% CI 22-52%) and was higher for prior HIFU. The incidence of late grade 1-2 toxicity was 12% (95% CI 5-19%; p < 0.01) for GI and 26% (95% CI 12-39%; p < 0.01) for GU toxicity. Grade ≥3 toxicities were rare, occurring in less than 5% of patients. The biochemical relapse rate after SRT was ∼20% (95% CI 14-26%; p < 0.01) for both HIFU and cryotherapy, indicating similar efficacy. The odds ratio for biochemical relapse was 0.19 (95% CI 0.12-0.26; p < 0.01) for HIFU and 0.22 (95% CI 0.10-0.35; p < 0.01) for cryotherapy. There was evidence of publication bias and high heterogeneity.</p><p><strong>Conclusions and clinical implications: </strong>SRT following NRAI for localized prostate cancer has low toxicity rates, particularly following cryotherapy, and reasonable biochemical control. Despite these findings, short follow-up and variability in treatments for patients with varying risk profiles highlight the need for further studies to refine SRT protocols and establish more definitive long-term outcomes.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993779","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":"Reprogramming of Androgen Receptor Activity in Castration-resistant Prostate Cancer is Shaped by Truncated Variants.","authors":"Mitchell G Lawrence, Shivakumar Keerthikumar, Scott L Townley, Ashlee K Clark, Georgia B Cuffe, Geraldine Laven-Law, Adrienne R Hanson, Raj K Shrestha, Todd P Knutson, Michelle G Richards, Linda Teng, Nicholas Choo, Megan Crumbaker, Anthony M Joshua, Eva Corey, Peter S Nelson, Scott M Dehm, Gail P Risbridger, Wayne D Tilley, Theresa E Hickey, Renea A Taylor, Luke A Selth","doi":"10.1016/j.euf.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.euf.2025.03.017","url":null,"abstract":"<p><strong>Background and objective: </strong>Under the selective pressure of treatment, prostate cancer cells express constitutively active androgen receptor (AR) variants. Whether AR variants mediate therapy resistance remains contested, because they are often coexpressed with abundant full-length AR. Therefore, we sought to determine how truncated variants shape AR chromatin occupancy and responses to treatments in both the presence and absence of full-length AR.</p><p><strong>Methods: </strong>We used a cohort of patient-derived xenografts of metastatic prostate cancer with diverse AR alterations. Chromatin immunoprecipitation and RNA sequencing were used to compare the landscape of AR binding and transcriptomic features. We assessed responses to castration by castrating host mice and evaluated responses to bipolar androgen therapy by administering testosterone cypionate.</p><p><strong>Key findings and limitations: </strong>By profiling the AR cistrome, we identified a distinct group of tumours defined by ARv567es expression, a variant arising due to structural rearrangements of the AR gene. ARv567es-positive tumours also had a distinct epigenomic profile and altered transcriptional features, including loss of canonical AR-regulated gene signatures and elevated expression of AR-repressed genes. ARv567es-positive tumours were resistant to castration and bipolar androgen therapy. In tumours that coexpress full-length AR, this involves dampened transcriptional responses and disruption of the autoregulatory loop that modulates AR levels. Study limitations include the need for additional models of AR-driven prostate cancer.</p><p><strong>Conclusions and clinical implications: </strong>The emergence of ARv567es via gene rearrangements causes transcriptional reprogramming and therapy resistance. This highlights ARv567es as a potential as a marker to guide treatment decisions.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981366","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":"Long-term Oncological Outcomes of Partial Gland Cryoablation of Localized Prostate Cancer with Median Follow-up of 7 Years: A Single-institution Experience.","authors":"Sriram Deivasigamani, Srinath Kotamarti, Mahdi Mottaghi, Alireza Ghoreifi, Thomas J Polascik","doi":"10.1016/j.euf.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.004","url":null,"abstract":"<p><strong>Background and objective: </strong>Traditional radical approaches to treat clinically localized prostate cancer (PCa) have largely been effective oncologically, but associated with complications and decline in functional outcomes, arguably making them unsuitable in all cases for treatment. This necessitates an alternative option, focal therapy (FT), which has good oncological control while reducing treatment-related functional detriments. Although midterm oncological and functional outcomes of FT have been demonstrated, the long-term outcomes were lacking. We sought to report the long-term oncological outcomes of partial gland cryoablation (PGA) for nonmetastatic PCa treatment.</p><p><strong>Methods: </strong>This is an institutional review board-approved retrospective analysis of a prospectively maintained database of patients who have undergone PGA of the prostate at Duke between 2005 and 2020, with a minimum follow-up of 3 yr. The primary outcome was to determine the 5- and 10-yr failure-free survival (FFS), defined as a requirement of radical, whole-gland therapy for recurrence and/or systemic therapy, or metastases/death (cancer specific). The secondary outcomes include cancer-specific (CSS), overall (OS), and metastasis-free (MFS) survival. We also evaluated the functional outcomes, including the continence rate defined as strictly \"pad free\" and preserved erectile function (patient reported, with/without pharmacological intervention, defined as an erection sufficient for sexual intercourse of those patients who were initially potent, International Index of Erectile Function 5 ≥17) at 12 mo.</p><p><strong>Key findings and limitations: </strong>A total of 70 patients with complete data met the study inclusion criteria. The median follow-up was 86 mo (interquartile range [IQR], 46-113). The median age was 75 yr (IQR, 69-80) and the median preoperative prostate-specific antigen was 6.5 ng/ml (IQR, 4.7-9.34). Of 70 patients, 43 (61%) and six (9%) had D'Amico intermediate- and high-risk disease, respectively. FFS was 92% (95% confidence interval [CI]: 81-96%) at 5 yr and 70% (95% CI: 52-82%) at 10 yr. The MFS, CSS, and OS at 10 yr were 96% (95% CI: 86-99%), 98% (95% CI: 89-99%), and 89% (95% CI 75-95%), respectively. There was a significant improvement in the median International Prostate Symptom Score from 6.5 (IQR, 3-12) at baseline to 4 (IQR, 2-9) at 12 mo (p = 0.03). About 73% (32/44) of patients who were initially potent were able to maintain erections sufficient for sexual intercourse, and 97% (68/70) of patients are continent requiring no pad usage at 12-mo follow-up.</p><p><strong>Conclusions and clinical implications: </strong>Primary focal cryoablation for PCa has good long-term oncological control in men with localized PCa. FT may be a better option for men who desire to preserve good functional outcomes and thus quality of life.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998536","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":"Personalized Digital, Multilevel Program for Preparation and Early Recovery After Urologic Surgery: A Prospective, Multicenter, Pre- and Postintervention Trial.","authors":"Alessandro Uleri, Michael Baboudjian, Gilles Pasticier, Victor Basset, Guillaume Cordier, Bernard Malavaud, Pourya Pashootan, Jean-Baptiste Beauval, Guillaume Ploussard","doi":"10.1016/j.euf.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.euf.2025.02.008","url":null,"abstract":"<p><strong>Background and objective: </strong>Electronic health can help improve perioperative outcomes and overcome organizational constraints related to human resources and health care-related costs. This study assesses the impact of implementing a digital smartphone app pathway with pre-/rehabilitation programs, checklists, and electronic patient-reported outcomes, on perioperative outcomes following urologic surgery.</p><p><strong>Methods: </strong>In this prospective, multicenter, pre- and postintervention trial, we evaluated the impact of an app-based digital pathway. The primary endpoint was the rate of postoperative complications. The secondary endpoints were hospital stay, readmission and same-day discharge rates, number of days out of hospital, prolonged care at discharge, unplanned visits, and patient satisfaction. All endpoints were collected within 3 mo after surgery.</p><p><strong>Key findings and limitations: </strong>Overall, 415 consecutive patients were included in the analysis: 208 before and 207 after the digital program implementation. Overall complications were lower in the intervention group (15% vs 28.4%; p < 0.001), as well as the major complications (1.9% vs 5.8%; p = 0.048). A reduction was also noticed in unplanned visits (1.9% vs 12.5%; p < 0.001) and readmission (5.3% vs 10.6%; p = 0.048). The need for prolonged care after discharge was reduced (13% vs 26.9%; p < 0.001) in the intervention group. The median patient satisfaction was 8/10 (5-9) before and 9/10 (9-10) after implementing the app pathway (p < 0.001).</p><p><strong>Conclusions and clinical implications: </strong>The implementation of a digital pathway with pre-/rehabilitation, and checklists, was associated with better postoperative outcomes, faster recovery, and improved patient satisfaction.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959368","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}