European urology focus最新文献

{"title":"Re: Stamatio Katsimperis, Lazaros Tzelves, Zafer Tandogdu, et al. Complications After Radical Cystectomy: A Systematic Review and Meta-analysis of Randomized Controlled Trials with a Meta-regression Analysis. Eur Urol Focus 2023;9:920–9","authors":"Francesco Montorsi, Marco Moschini, Giuseppe Rosiello, Andrea Salonia, Alberto Briganti","doi":"10.1016/j.euf.2024.03.009","DOIUrl":"10.1016/j.euf.2024.03.009","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"10 5","pages":"Page 858"},"PeriodicalIF":4.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080822","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":"Glycomimetics as Candidates for Treatment and Prevention of Catheter-associated Biofilms Formed by Pseudomonas aeruginosa","authors":"Christian Vogel ,&nbsp;Katharina Rox ,&nbsp;Florian Wagenlehner ,&nbsp;Alexander Titz","doi":"10.1016/j.euf.2024.08.011","DOIUrl":"10.1016/j.euf.2024.08.011","url":null,"abstract":"<div><div>Bacteria develop biofilms for protection and persistent colonization. Biofilms of pathogenic bacteria can lead to serious medical problems. Bacterial biofilms on catheters used in the treatment of urinary tract diseases represent a major challenge for antibiotic therapy. Several attempts to eradicate biofilms using classical antibiotics and various alternatives, including antibiotic treatment of surfaces, surfaces that release silver ions, and surfaces with anti-adhesive properties, have not shown clinical efficacy in biofilm prevention or removal. <em>Pseudomonas aeruginosa</em> is one of the most problematic biofilm-forming uropathogens and accounts for approximately 10% of urinary tract infections. Novel glycomimetics that inhibit bacterial lectins have shown promising results in the prevention of <em>P. aeruginosa</em> biofilms and in interference with bacterial virulence. This mini-review summarizes the status of glycomimetic development and provides a perspective on their use in clinical practice.</div></div><div><h3>Patient summary</h3><div>For patients with recurrent urinary tract infections and patients needing long-term catheter use to manage urinary problems, biofilms formed by bacteria can be a problem and are difficult to treat. New compounds that mimic carbohydrates, called glycomimetics, have shown promise in inhibiting these bacteria and the biofilms they form. More research on these compounds is needed before they can be used to treat patients.</div></div>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"10 5","pages":"Pages 720-721"},"PeriodicalIF":4.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Alec Zhu, Mary O. Strasser, Timothy D. McClure, et al. Comparative Effectiveness of Partial Gland Cryoablation Versus Robotic Radical Prostatectomy for Cancer Control. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2024.04.008.","authors":"Kaushik P Kolanukuduru, Michael A Gorin, Ash K Tewari, Mani Menon","doi":"10.1016/j.euf.2024.07.018","DOIUrl":"https://doi.org/10.1016/j.euf.2024.07.018","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105851","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":"Advancements in the front-line treatment of metastatic urothelial carcinoma.","authors":"Sarah M H Einerhand, Michiel S van der Heijden","doi":"10.1016/j.euf.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.euf.2024.06.003","url":null,"abstract":"<p><p>Both the CheckMate-901 (gemcitabine-cisplatin plus nivolumab) trial and the EV-302 (enfortumab-vedotin plus pembrolizumab; EV+P) trial have shown a significant improvement in OS over standard (cis)platinum-based chemotherapy. The effect size, as well as the broader eligibility criteria for EV+P position this regimen as a compelling preferred candidate for the new standard of care in front-line mUC treatment.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105849","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":"Evolution of Robotic Urology in Clinical Practice from the Beginning to Now: Results from the GRAND Study Register.","authors":"Nikolaos Pyrgidis, Yannic Volz, Benedikt Ebner, Thilo Westhofen, Michael Staehler, Michael Chaloupka, Maria Apfelbeck, Friedrich Jokisch, Robert Bischoff, Julian Marcon, Philipp Weinhold, Armin Becker, Christian Stief, Gerald B Schulz","doi":"10.1016/j.euf.2024.08.004","DOIUrl":"https://doi.org/10.1016/j.euf.2024.08.004","url":null,"abstract":"<p><strong>Background and objective: </strong>Major urological guidelines do not currently recommend robot-assisted surgery compared with laparoscopic or open surgery due to the lack of high-quality evidence. We aimed to provide real-world data on the evolution of robotic urology and to compare its perioperative outcomes with those of laparoscopic and open surgeries.</p><p><strong>Methods: </strong>We used the GeRmAn Nationwide inpatient Data (GRAND), provided by the Research Data Center of the Federal Bureau of Statistics (2005-2021), and performed multiple patient-level analyses. We included patients undergoing major urological surgeries and report the largest study in the field with 993 276 patients.</p><p><strong>Key findings and limitations: </strong>An open approach was performed in 733 416 cases, a laparoscopic approach in 109 428, and a robot-assisted approach in 150 432. Overall, 442 811 (45%) patients underwent radical prostatectomy, 129 943 (13%) radical cystectomy, 192 340 (19%) radical nephrectomy, 123 648 (12%) partial nephrectomy, 56 114 (5.6%) nephroureterectomy, and 48 420 (4.9%) pyeloplasty. The number of patients undergoing robot-assisted surgery increased exponentially, while the number of patients undergoing open surgery decreased substantially throughout the past few years. Patients undergoing minimally invasive surgery displayed slightly better, but clinically insignificant, baseline characteristics. After adjusting for the major risk factors in the multivariate regression analysis, robotic versus open surgery was associated with significantly lower odds of mortality for all five major oncological surgeries and with lower odds of intensive care unit admission, transfusion, and length of hospital stay for all six major urological surgeries.</p><p><strong>Conclusions and clinical implications: </strong>Robotic surgery is becoming the mainstay in major urological operations.</p><p><strong>Patient summary: </strong>Patients selected for robotic surgery in Germany presented better perioperative outcomes compared to those operated with an open approach.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105850","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":"Testicular Germ Cell Tumors with Venous Tumor Thrombus: Prevalence, Presentation, and Management.","authors":"Sophia Y Chahine, Khalid Y Alkhatib, Gevorg Arakelyan, Claire Buxton, Gianluca Giannarini, Robert J Hamilton, Sarah K Holt, Jean-Christophe Bernhard, Di Maria Jiang, Daniel Lin, Jen-Jane Liu, Brandon Manley, Viraj A Master, Vsevolod Matveev, Andrea Necchi, Vignesh T Packiam, Sunil H Patel, Taylor Peak, Charles C Peyton, Phillip M Pierorazio, Gagan Prakash, Keyan Salari, Wade J Sexton, Nirmish Singla, Philippe E Spiess, Sarah P Psutka","doi":"10.1016/j.euf.2024.07.017","DOIUrl":"https://doi.org/10.1016/j.euf.2024.07.017","url":null,"abstract":"<p><strong>Background and objective: </strong>There are limited data on the prevalence and management of testicular germ cell tumor (TGCT) cases presenting with venous tumor thrombus (VTT). Our objectives were to describe the prevalence of TGCT with VTT, to identify a multicenter retrospective cohort, and to ascertain expert opinion regarding optimal management of this entity.</p><p><strong>Methods: </strong>Using the IBM Marketscan database, we identified men with testicular cancer who underwent retroperitoneal lymph node dissection (RPLND) with concurrent VTT or inferior vena cava (IVC) tumor thrombectomy to estimate the prevalence of VTT in TGCT. To identify a multicenter retrospective cohort of patients, we surveyed surgeons and described the presentation, management, and outcomes for the cohort.</p><p><strong>Key findings and limitations: </strong>The prevalence of TGCT with VTT in the IBM Marketscan database was 0.3% (n = 7/2517) when using stringent criteria and 3.1% (n = 79/2517) when using broad criteria. In response to our survey, 16 surgeons from ten centers contributed data for 34 patients. Most patients (n = 29, 85%) presented with nonseminomatous germ cell tumor. Surgical management was used for 93.9% (n = 31), including postchemotherapy tumor thrombectomy with primary cavorrhaphy in 63%. The Marketscan analysis was limited to insured individuals and did not include clinicopathological details, and use of billing codes may have included patients with stromal tumors. In addition, lack of responses to the anonymous survey limited data capture, and the RedCap survey did not address symptoms specific to IVC obstruction or allow central review of the imaging leading to VTT diagnosis.</p><p><strong>Conclusions and clinical implications: </strong>VTT among males with TGCT is rare and requires complex multidisciplinary management, including venous tumor thrombectomy at the time of postchemotherapy RPLND.</p><p><strong>Patient summary: </strong>Using a medical database, we estimated that the frequency of testicular cancer cases in which the tumor extends into a blood vessel (called venous tumor thrombus, VTT) is just 0.3-3.1%. We carried out a survey of surgeons with experience of this condition. Our results indicate that although testicular cancers respond well to chemotherapy, VTT is less responsive and complex surgery is necessary for this rare condition.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987719","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 Validation of Stockholm3 in a Retrospective German Clinical Cohort.","authors":"Derya Tilki, Niclas Rejek, Florian Nohe, Alexander Haese, Markus Graefen, Imke Thederan","doi":"10.1016/j.euf.2024.07.009","DOIUrl":"https://doi.org/10.1016/j.euf.2024.07.009","url":null,"abstract":"<p><strong>Background and objective: </strong>Stockholm3 is a comprehensive blood test amalgamating protein biomarkers, genetic indicators, and clinical data to predict clinically significant prostate cancer risk (International Society of Urological Pathology grade ≥2 upon biopsy). Our study aims to externally validate Stockholm3 and compare its performance with the use of prostate-specific antigen (PSA) and the Rotterdam Prostate Cancer Risk Calculator (RPCRC) for clinically significant prostate cancer detection.</p><p><strong>Methods: </strong>We gathered data from men subjected to prostate biopsies at the Martini-Klinik, Germany, between 2014 and 2017. Participants were selected based on elevated PSA levels or suspicious digital rectal examinations, all undergoing a 10-12-core systematic biopsy without a magnetic resonance imaging-targeted biopsy. We assessed Stockholm3 and RPCRC performance for clinically significant prostate cancer detection. Furthermore, we compared the proportion of men recommended for biopsy and biopsy outcomes with Stockholm3 and RPCRC against PSA ≥3 ng/ml.</p><p><strong>Key findings and limitations: </strong>Our study encompassed 405 biopsied men, with a median age of 66 yr (interquartile range [IQR]: 60-72), PSA levels at 7 ng/ml (IQR: 5.2-10.8), and Stockholm3 scores at 18 (IQR: 10-34). Among them, 128 men (31%) received clinically significant prostate cancer diagnoses. Employing the recommended Stockholm3 threshold (≥15) could have reduced unnecessary biopsies by 52%, while detecting 92% of clinically significant cases compared with using PSA ≥3 ng/ml as a biopsy criterion. Both Stockholm3 and RPCRC exhibited strong discrimination, with area under the curve values of 0.80 (95% confidence interval [CI]: 0.76-0.85) and 0.75 (95% CI: 0.70-0.80), respectively. Stockholm3 demonstrated good calibration, while RPCRC underestimated the risk compared with observed outcomes. Moreover, Stockholm3 yielded positive clinical net benefits, whereas RPCRC yielded negative net benefits for clinically relevant thresholds.</p><p><strong>Conclusions and clinical implications: </strong>Stockholm3 utilization could detect 92% of clinically significant prostate cancer cases while simultaneously reducing unnecessary biopsies by 52%, compared with the PSA ≥3 ng/ml criterion, based on our analysis within a cohort of men who underwent systematic biopsies.</p><p><strong>Patient summary: </strong>In a German clinical cohort of 405 men, Stockholm3, a blood test for early prostate cancer detection, exhibited favorable clinical benefits. It identified a substantial number of clinically significant cases while reducing unnecessary biopsies by over half in men without the disease and those with clinically nonsignificant prostate cancer.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901435","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":"Targeting Androgen Receptor Alterations in Metastatic Prostate Cancer.","authors":"Pawel Rajwa, Piotr Zapała, Axel S Merseburger","doi":"10.1016/j.euf.2024.07.012","DOIUrl":"https://doi.org/10.1016/j.euf.2024.07.012","url":null,"abstract":"<p><p>There have been significant advances in our understanding of the biology of metastatic prostate cancer (mPCa) and its response to therapy. Androgen receptor (AR) alterations, including mutations, amplifications, splice variants, and alternative activations, play a significant role in mPCa resistance to treatment. Recent studies indicate that AR alterations detected via genomic testing can be considered predictive biomarkers in men with castration-resistant PCa and can guide treatment strategies. Novel therapeutic approaches, including AR antagonists and inhibitors of ACK1, the AR N-terminal domain, or cytochrome P450 11A1, have shown promise in overcoming treatment resistance. Ongoing clinical trials are exploring the efficacy of these treatments in relation to AR mutation status and could potentially transform the treatment landscape for mPCa. PATIENT SUMMARY: Our mini review highlights advances in the treatment of metastatic prostate cancer, with a focus on drugs that target genetic alterations affecting a protein called the androgen receptor. Some promising results have been obtained and clinical trials are ongoing.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897171","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":"Macroplastique Is a Safe and Effective Long-term Surgical Treatment for Stress Urinary Incontinence: Prospective Study with 10-Year Follow-up.","authors":"Maurizio Serati, Chiara Scancarello, Giada Mesiano, Chiara Cimmino, Maria Rosaria Campitiello, Stefano Salvatore, Fabio Ghezzi, Giorgio Caccia, Andrea Papadia, Andrea Braga","doi":"10.1016/j.euf.2024.07.010","DOIUrl":"https://doi.org/10.1016/j.euf.2024.07.010","url":null,"abstract":"<p><strong>Background and objective: </strong>Until a few years ago, a midurethral sling was considered the gold standard for the treatment of female stress urinary incontinence (SUI) after failure of conservative therapies. However, criticisms regarding the rate of mesh exposure and lack of long-term efficacy have led to reconsideration of other surgical procedures. Our aim was to investigate long-term subjective and objective outcomes after injection of Macroplastique, a urethral bulking agent.</p><p><strong>Methods: </strong>We prospectively enrolled all consecutive women complaining of pure SUI symptoms with urodynamically proven SUI who received a Macroplastique injection. We investigated patient-reported subjective outcomes using International Consultation on Incontinence Questionnaire-Short Form, Urogenital Distress Inventory, Patient Global Impression of Improvement, and Visual Analog Scale (VAS) questionnaires, and the cough stress test to assess objective outcomes. Adverse events were recorded during follow-up.</p><p><strong>Key findings and limitations: </strong>At 10 yr after Macroplastique injection, the objective cure rate was 56% and 71% of patients reported that they were satisfied. Long-term data revealed no significant decline in subjective or objective cure rates. No serious complications were reported. Study limitations include the small sample size and the lack of pad tests and bladder diaries for postoperative evaluations.</p><p><strong>Conclusions and clinical implications: </strong>Our study shows that Macroplastique injection can be an effective and safe option for the treatment of female SUI in the long term, even when used in the first-line setting.</p><p><strong>Patient summary: </strong>We evaluated outcomes for women with stress urinary incontinence (SUI) who were treated with an injection of Macroplastique gel into the wall of the urethra to prevent leakage of urine. We found that this is a safe option for treatment of female SUI that is effective in the long term.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878613","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 Association of Obstructive Sleep Apnea with Urological Cancer Incidence and Mortality-A Systematic Review and Meta-analysis.","authors":"Brian Sheng Yep Yeo, Dominic Wei Ting Yap, Nicole Kye Wen Tan, Benjamin Kye Jyn Tan, Yao Hao Teo, Yao Neng Teo, Alvin Lee, Anna See, Henry Sun Sien Ho, Jeremy Yuen-Chun Teoh, Kenneth Chen, Song Tar Toh","doi":"10.1016/j.euf.2024.07.004","DOIUrl":"https://doi.org/10.1016/j.euf.2024.07.004","url":null,"abstract":"<p><strong>Background and objective: </strong>While obstructive sleep apnea (OSA) and urological cancer are both strongly associated with hypoxia, controversy exists regarding their association with each other. This study aims to summarize and synthesize evidence to clarify the association between OSA and urological cancer incidence and mortality.</p><p><strong>Methods: </strong>According to a prespecified protocol, PubMed, Embase, Cochrane Library, and Scopus were searched from inception to November 16, 2023, for observational and randomized studies reporting the association of OSA with urological cancer incidence or mortality. We pooled maximally covariate-adjusted hazard ratios (HRs) using a random-effects inverse variance-weighted model. Two reviewers independently assessed the quality of evidence using the Newcastle-Ottawa Scale and the Grading of Recommendations, Assessment, Development and Evaluation framework.</p><p><strong>Key findings and limitations: </strong>From 1814 records, we included 12 studies comprising 9 290 818 participants in total, of which nine studies were analyzed quantitatively. OSA patients had an increased risk of kidney (HR: 1.75, 95% confidence interval [CI]: 1.21-2.53) and bladder (HR: 1.76, 95% CI: 1.05-2.96) cancer. However, OSA was not associated with prostate cancer incidence (HR: 1.29, 95% CI: 0.82-2.04). We systematically reviewed evidence surrounding OSA and testicular cancer incidence and urological cancer mortality.</p><p><strong>Conclusions and clinical implications: </strong>OSA may be associated with a higher risk of kidney and bladder cancer, but not prostate cancer. Future work may help clarify the possibility of a dose-response relationship between OSA and urological cancer, and the effect of OSA treatment on urological cancer incidence or progression.</p><p><strong>Patient summary: </strong>This research highlights a potential longitudinal association between OSA and kidney and bladder cancer, but not prostate cancer.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874553","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}