European urology最新文献

{"title":"Bridging Evidence Gaps in Upper Tract Urothelial Carcinoma: Divergent Strategies Between the American Urological Association and European Association of Urology Guidelines","authors":"Philipp Korn, Nirmish Singla","doi":"10.1016/j.eururo.2025.09.4170","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4170","url":null,"abstract":"<h2>Section snippets</h2><section><section><section><h2>Imaging</h2>The EAU guidelines recommend fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging (weak recommendation) as a first-line staging modality in high-risk cases. By contrast, the AUA takes a more conservative position in only recommending FDG PET when standard computed tomography (CT) or magnetic resonance imaging is not feasible.</section><section><h2>Ureteroscopy</h2>The role of ureteroscopy (URS) differs between the two guidelines. While the AUA guidelines strongly recommend URS with biopsy as a standard diagnostic</section></section></section><section><section><h2>Discussion</h2>The management of UTUC remains challenging owing to the limited high-quality data available. Both the AUA and EAU have provided robust evidence-based guidelines on UTUC, but nuanced differences that may have clinical significance are evident from a side-by-side comparison, as summarized in Table 1.Accurate staging remains a cornerstone of UTUC management, particularly given its role in risk stratification. Conventional CT shows low sensitivity of 25% (95% confidence interval [CI] 20–31%), but</section></section>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"35 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Emmeli Palmstedt, Marianne Månsson, Jonas Hugosson, Rebecka Arnsrud Godtman. Active Surveillance for Screen-detected Low- and Intermediate-risk Prostate Cancer: Extended Follow-up up to 25 Years in the GÖTEBORG-1 Trial. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2025.06.012","authors":"Ziheng Wang, Xuenan Li, Xin Zhao, Yi Yang","doi":"10.1016/j.eururo.2025.08.035","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.08.035","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"122 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“PRIME” Time for Boosting the Immune Response to Bacillus Calmette-Guérin","authors":"Joshua J. Meeks","doi":"10.1016/j.eururo.2025.09.4166","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4166","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"1 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathology-only Artificial Intelligence for Prostate Cancer: Towards Accessible Risk Stratification","authors":"Irbaz Bin Riaz, Liang Cheng, Rodolfo Montironi","doi":"10.1016/j.eururo.2025.09.4164","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4164","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"110 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IP8-FLUORESCE: A Prospective Paired Cohort Study Evaluating the Diagnostic Accuracy of Fluorescence Confocal Microscopy for Real-time Assessment of Surgical Margins in Radical Prostatectomy","authors":"Nikhil Mayor, Alexander Light, Anna Silvanto, Aiman Haider, Emma Cullen, Chase Ng, Ranil Johann Boaz, Archana Gopalakrishnan, Bijan Khoubehi, Giles Hellawell, Ricardo Almeida-Magana, Larissa Mendes, Eoin Dinneen, Greg Shaw, Ben Challacombe, Paul Cathcart, Martin J. Connor, Taimur T. Shah, Hashim U. Ahmed, Francesca Fiorentino, Mathias Winkler","doi":"10.1016/j.eururo.2025.09.4171","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4171","url":null,"abstract":"<h3>Background and objective</h3>Positive surgical margins (PSMs) following radical prostatectomy (RP) are linked to adverse oncological outcomes. Intraoperative margin assessment facilitates immediate secondary resection, enabling more men to undergo “nerve-sparing” RP and improving functional outcomes. Existing techniques, however, have not been adopted widely due to inherent limitations. Fluorescence confocal microscopy (FCM) is a more feasible alternative, offering rapid, high-resolution imaging of unprocessed tissue. This study evaluates the diagnostic performance of FCM for detecting PSMs during RP.<h3>Methods</h3>In this multicentre, prospective, blinded, paired cohort study, men undergoing RP for localised or locally advanced prostate cancer were enrolled across three UK uro-oncology centres between August 17, 2023, and September 23, 2024. FCM was performed on fresh prostatectomy specimens using the Histolog scanner. The whole specimen was examined en face with no tissue resection. Final histopathology served as the reference standard. The primary outcome was the diagnostic performance of FCM for PSM detection on a per-patient level, assessed by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Multiple definitions of PSMs were evaluated. This study was prospectively registered on ISRCTN (21536411).<h3>Key findings and limitations</h3>A total of 156 patients were recruited. The prevalence of all PSMs was 30.8% (48/156). For all lengths of PSMs, including focally positive and &lt;1 mm margins, sensitivity, specificity, PPV, and NPV were 48% (95% confidence interval 33–63%), 94% (88–98%), 79% (60–92%), and 80% (72–87%), respectively. For PSMs of ≥3 mm, FCM demonstrated sensitivity of 79% (54–94%), specificity of 94% (89–97%), PPV of 71% (48–89%), and NPV of 96% (91–99%). Of the false negative cases, 84% were ≤2 mm; 52% were at the apex.<h3>Conclusions and clinical implications</h3>FCM is a feasible, rapid technique for intraoperative margin assessment in RP. Its diagnostic accuracy is reasonable for clinically significant, longer PSMs, but limited for shorter margins, particularly at the apex. These findings support further evaluation in a clinical utility study to determine whether intraoperative FCM can guide surgical decision-making, optimise nerve sparing, and ultimately improve oncological and functional outcomes.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Nicolas Demogeot, Paul Sargos, Julia Salleron, et al. Short-term Androgen Deprivation Therapy and High-dose Radiotherapy in Intermediate- and High-risk Localized Prostate Cancer: Results from the GETUG 14 Randomized Phase 3 Trial. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2025.07.019","authors":"Federico Iori, Emanuele Alì, Cinzia Iotti","doi":"10.1016/j.eururo.2025.09.4167","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4167","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"74 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Polygenic Risk Scores for Depression, Anxiety, and Neuroticism with Lower Urinary Tract Symptoms Among Women","authors":"Zayn Rajan, Christina Dardani, Kimberley Burrows, Oliver Bastiani, Marcus J. Drake, Carol Joinson","doi":"10.1016/j.eururo.2025.09.4154","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4154","url":null,"abstract":"<h3>Background and objective</h3>Observational studies have found that depression, anxiety, and neuroticism are prospectively associated with lower urinary tract symptoms (LUTS) among women, but are limited by confounding and measurement errors. We examined whether genetic liability for these psychiatric traits is associated with LUTS among women.<h3>Methods</h3>Participants were from the mothers cohort of the Avon Longitudinal Study of Parents and Children (ALSPAC). Polygenic risk scores (PRSs) for depression, anxiety, and neuroticism were calculated using summary data from genome-wide association studies. LUTS were assessed using validated questionnaires at two time points: 2002–2004 (<em>n</em> = 4758; median age 40 yr, interquartile range [IQR] 37–43) and 2011–2012 (<em>n</em> = 3026; median age 50 yr, IQR 47–53). Separate logistic regression models, adjusted for age and population structure, were fitted to examine the association of each PRS with each LUTS.<h3>Key findings and limitations</h3>The neuroticism PRS was associated with nocturia at both time points [odds ratio and 95% confidence intervals=1.24 (1.10,1.40) and 1.21 (1.07,1.37)], and with any urinary incontinence (UI), any urgency, and mixed UI (2002-04) [1.14 (1.05,1.23), 1.12 (1.02,1.23), and 1.23 (1.07,1.43), respectively]. The depression PRS was associated with nocturia [OR 1.33, 95% CI 1.17–1.50) and 1.24 (1.09,1.40)] and any UI [1.09 (1.01,1.18); 1.11 (1.02,1.20)] at both time points, and with any urgency (2011-12) [1.13 (1.03,1.24)]. The anxiety PRS was associated with mixed UI (2002-04) [1.20 (1.03,1.39)]. Limitations include PRS not capturing all genetic liability, potential pleiotropic effects, and restriction of the cohort to parous women of predominantly European ancestry.<h3>Conclusions and clinical implications</h3>Genetic liability for depression, anxiety, and neuroticism is associated with higher risk of LUTS among women. This finding indicates a potential shared aetiology or a possible contribution of mental health problems in the development of LUTS.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"35 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Comprehensive Tumor-immune Profiling Reveals Mediators of Paradoxical Immune Sensitivity in Sarcomatoid Renal Cell Carcinoma","authors":"Hangbiao Zhang, Yifan Liu, Bingnan Lu, Yuntao Yao, Xingang Cui, Xiuwu Pan","doi":"10.1016/j.eururo.2025.09.4160","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4160","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"35 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Laura Manuela Olarte Bermúdez, Ana M. Rendón-Garavito, and Juan Francisco Ayala’s Letter to the Editor re: Andreas Skolarikos, Robert Geraghty, Bhaskar Somani, et al. European Association of Urology Guidelines on the Diagnosis and Treatment of Urolithiasis. Eur Urol 2025;88:64–75","authors":"Andreas Skolarikos, Robert Geraghty, Bhaskar Somani, Lazaros Tzelves","doi":"10.1016/j.eururo.2025.08.023","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.08.023","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"85 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platinum Hall of Fame","authors":"","doi":"10.1016/j.eururo.2025.09.4135","DOIUrl":"10.1016/j.eururo.2025.09.4135","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"88 5","pages":"Pages e87-e98"},"PeriodicalIF":25.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145247872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}