European urology focus最新文献

{"title":"The Future of Novel Antibody-drug Conjugates in Localized Urothelial Cancer.","authors":"Mikolaj Filon, Bogdana Schmidt","doi":"10.1016/j.euf.2025.07.016","DOIUrl":"https://doi.org/10.1016/j.euf.2025.07.016","url":null,"abstract":"<p><p>Antibody-drug conjugates (ADCs) have recently transformed the paradigm for metastatic urothelial carcinoma treatment. As these therapies demonstrate increasing efficacy and tolerability, attention is turning toward their use in earlier stages of disease. The current molecular targets for ADCs featured in large-scale trials have been Nectin-4 and TROP-2, leading to the development of enfortumab vedotin and sacituzumab govitecan; however, additional promising targets under investigation include HER2, FGFR3, EGFR, and CD-44. While identification of these targets is exciting, the next challenge is harnessing delivery mechanisms to maximize local responses, while limiting systemic toxicity. ADCs have the potential to enhance our ability to offer bladder-sparing therapies to patients with refractory non-muscle-invasive and potentially muscle-invasive disease, who were previously relying on radical cystectomy for treatment. ADCs represent an emerging frontier in the therapeutic landscape of urothelial carcinoma. While their use has thus far been limited to advanced disease, ongoing clinical trials and emerging data suggest possible expanded applications for ADCs in localized bladder cancer. PATIENT SUMMARY: A new standard has emerged for metastatic urothelial carcinoma treatment with the combination of immunotherapy and antibody-drug conjugates. The use of these agents has the potential to transform the space of localized bladder cancer. While promising, many questions remain unanswered about how these new agents will be integrated into the treatment paradigm of non-muscle-invasive and localized muscle-invasive disease.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741685","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: Salvador Arlandis. Management of Stress Urinary Incontinence in Patients with Underactive Bladder. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2025.04.030.","authors":"Jean-Nicolas Cornu","doi":"10.1016/j.euf.2025.06.023","DOIUrl":"https://doi.org/10.1016/j.euf.2025.06.023","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728971","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":"Urothelial Cancer: Leveraging Circulating Tumor DNA To Avoid Unnecessary Bladder-directed and Systemic Therapies.","authors":"Jonathan Chatzkel, Joshua Linscott, G Daniel Grass, Roger Li","doi":"10.1016/j.euf.2025.07.012","DOIUrl":"https://doi.org/10.1016/j.euf.2025.07.012","url":null,"abstract":"<p><p>Several studies have demonstrated the potential of circulating tumor DNA (ctDNA) for personalization of perioperative systemic treatment in muscle-invasive urothelial carcinoma (UC). Early studies focused on the ability to identify patients with residual disease who may benefit from additional systemic treatment. Further studies have suggested the potential of ctDNA measurement to tailor systemic and local treatments for patients with MIUC. This biomarker may ultimately reduce overtreatment, toxicity, and the financial burden associated with UC care. As ctDNA testing matures, it may offer clinicians a means to truly personalize treatment and thereby improve oncologic outcomes and enhance patients' quality of life. PATIENT SUMMARY: Our mini review looks at studies in which DNA from bladder cancer tumors that is circulating in the blood (called circulating tumor DNA, or ctDNA) is measured. Measurement of ctDNA levels after chemotherapy or immunotherapy can help predict cancer outcomes in patients undergoing bladder removal surgery.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728972","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":"Incisional Hernia After Transperitoneal Robot-assisted Radical Prostatectomy: A Call for Greater Awareness Among Urologists.","authors":"Arthur Peyrottes, Charles Dariane, Alexandre Colau, Maxime Pattou, Andrei Necsulescu, Arnaud Méjean, François Desgrandchamps, Olivier Oberlin, Guillaume Ploussard, Alexandra Masson-Lecomte","doi":"10.1016/j.euf.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.euf.2025.07.015","url":null,"abstract":"<p><p>Incisional hernia (IH) is a clinically relevant yet under-reported complication of transperitoneal robot-assisted radical prostatectomy (RARP). As this approach becomes standard, identification of procedure-specific risk factors to inform prevention strategies is essential to improve surgical outcomes for prostate cancer. We conducted an analysis of patients with localised prostate cancer who underwent transperitoneal RARP with supraumbilical specimen extraction between 2020 and 2024 in three academic centres in France. The primary endpoint was IH prevalence at 1 yr. Independent predictors were identified via multivariable analysis. A total of 629 patients were included. Median age was 61 yr (interquartile range [IQR] 66-70), and median prostate-specific antigen was 6.16 ng/ml (IQR 8.18-12). According to the D'Amico classification, 8% of patients had low risk, 75% had intermediate risk, and 17% had high risk. At 1-yr follow-up, 76 patients (12.1%) had developed IH at the supraumbilical extraction site, of whom 53 (70%) underwent surgical repair. Multivariable analysis identified higher body mass index, smoking, and postoperative parietal abscess as independent risk factors for IH. IH is a relatively frequent yet often overlooked complication of RARP. The IH incidence in our study suggests underdiagnosis of this complication, with potential consequences that include bowel obstruction and chronic pain. Optimisation of fascial closure and reconsideration of the extraction site location might reduce IH risk. Systematic imaging for high-risk patients could improve early detection. PATIENT SUMMARY: We looked at the risk of developing a hernia in the abdomen wall after robotic surgery for prostate cancer. We found that these hernias are more common than previously thought, especially in patients with obesity, smoking habits, or wound infections. A careful surgical technique and closer follow-up may help in reducing the risk of this complication and improve outcomes.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717810","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 Jean-Nicolas Cornu's Letter to the Editor re: Salvador Arlandis. Management of Stress Urinary Incontinence in Patients with Underactive Bladder. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2025.04.030.","authors":"Salvador Arlandis","doi":"10.1016/j.euf.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.euf.2025.07.013","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717811","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 Current State of Artificial Intelligence for Benign Prostatic Hyperplasia.","authors":"Liam Murad, Ethan Layne, Conner Ganjavi, Inderbir Gill, Mihir Desai, Kevin C Zorn, Giovanni E Cacciamani","doi":"10.1016/j.euf.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.euf.2025.07.004","url":null,"abstract":"<p><p>We review recent literature on the use of artificial intelligence (AI) for benign prostate hyperplasia (BPH). Many researchers have explored application of AI-based technologies for diagnosis and management of disease, prediction of treatment responses, and optimization of surgery and workflows. The latest research in urology is replete with AI-focused studies. However, AI applications in BPH have not been well established. Although many researchers have started to touch on key areas of interest, further research is necessary to fully elucidate the potential benefits of AI for patients with BPH. The development and implementation of standardized guidelines for model reporting and external validation are essential prerequisites for widespread adoption of AI within urology and across medicine in general. PATIENT SUMMARY: This mini review looks at how artificial intelligence AI) may help doctors in treating men with a large prostate gland. AI tools may help in picking treatments, improving surgery, and helping doctors to work faster, but not enough is known yet. More studies are needed before these tools can be routinely used to help patients.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717812","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":"Ureteral Stricture: Endoscopic Management.","authors":"Pablo Contreras, Javier Zeballos, Luis Rico, Daniel Fiandra, Lorena Banda Ramos, Jorge Musetti","doi":"10.1016/j.euf.2025.07.002","DOIUrl":"https://doi.org/10.1016/j.euf.2025.07.002","url":null,"abstract":"<p><p>The incidence of ureteral stricture (UST) seems to be rising. As for other iatrogenic event, prevention is key. For impacted stones, timely laser treatment using proper power, fluid, and frequency settings is crucial in prevent UST. The use of paclitaxel-coated balloons to prevent UST after ureteroscopy for impacted stones is a promising approach, but more data are needed to confirm the efficacy of this strategy.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717813","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":"What Is the Optimal Perioperative Treatment for Variant Subtypes of Bladder Cancer?","authors":"Scott M Gilbert","doi":"10.1016/j.euf.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.euf.2025.07.003","url":null,"abstract":"<p><p>Urothelial carcinoma subtypes are classified according to the 2022 World Health Organization scheme and are generally high-risk cancers that require multidisciplinary evaluation and management whenever possible. Perioperative systemic therapies (neoadjuvant and adjuvant) should be considered for subtypes that are responsive, but some very rare subtypes do not respond well to systemic therapy. Concerted efforts are needed to identify better therapies for these tumors.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706907","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":"Factors Associated with Recovery of Urinary Continence: A Multicenter Comparison of Pelvic Fascia-sparing and Standard Robotic-assisted Radical Prostatectomy.","authors":"Gal Wald, Evan Suzman, James B Mason, Sukhjeevan Nijhar, Oakley Strasser, May Ting, Catherine Pothier, Vanessa Dudley, Judy Zhong, Keith J Kowalczyk, Jim C Hu","doi":"10.1016/j.euf.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.euf.2025.06.005","url":null,"abstract":"<p><strong>Background and objective: </strong>Pelvic fascia-sparing (PFS) approaches during robotic-assisted radical prostatectomy (RARP) may lead to faster and better recovery of urinary continence. However, direct comparisons are limited. We compared continence recovery across standard, anterior PFS (APFS), and posterior PFS (PPFS) RARP approaches.</p><p><strong>Methods and surgical procedure: </strong>We conducted a multicenter retrospective study of 1155 RARP (593 standard, 332 PPFS, and 230 APFS) procedures performed between February 2012 and May 2024. Our primary outcome was urinary continence defined as the use of zero to one pad per day, identified from the Expanded Prostate Cancer Index Composite for Clinical Practice. Multivariable models evaluated the factors affecting early and long-term urinary continence.</p><p><strong>Key findings and limitations: </strong>PPFS and APFS versus the standard approach were associated with improved urinary continence at 3 mo (90%, 83%, and 64%, respectively; p < 0.001), 12 mo (96%, 89%, and 84%, respectively; p < 0.001), and 20 mo (97%, 99%, and 90%, respectively; p < 0.001). In adjusted analyses, PPFS (odds ratio [OR] 3.71; confidence interval [CI] 2.27-6.07; p < 0.001) and APFS (OR 3.54; CI 1.97-6.37; p < 0.001) were associated with improved 3-mo continence compared with standard RARP. Similar results were observed for both PFS approaches at 12 mo. Only PPFS was associated with better long-term continence (20 mo: OR 3.00; CI 1.74-5.17; p < 0.001). However, PPFS had the highest positive surgical margins (standard: 29.5%; PPFS: 37.4%; APFS: 30.0%; p = 0.04). The sequential adoption of techniques from standard RARP to PPFS and then to APFS leads to disparate follow-up and sample sizes as a limitation.</p><p><strong>Conclusions: </strong>PPFS and APFS were associated with better urinary continence recovery, although PPFS was found to have more positive surgical margins. Randomized trials are needed to validate our findings.</p><p><strong>Patient summary: </strong>We compared the recovery rate of urinary continence after three surgical approaches with varying degrees of pelvic fascia sparing (PFS). Our findings suggest that PFS improves short- and long-term urinary continence compared with the standard approach.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667512","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":"Special Issue on Benign Prostatic Hyperplasia: Introductory Editorial.","authors":"Silvia Secco, Dean Elterman","doi":"10.1016/j.euf.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.euf.2025.07.001","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648935","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}