European urology最新文献

{"title":"Re: Gallagher et al. RESECT, A Randomised Controlled Trial of Audit and Feedback in Non–muscle-invasive Bladder Cancer Surgery. Eur Urol 2026. 2026;89:355–365","authors":"Francesco Di Bello, Andrea Gallioli, Pietro Diana, Giulio Avesani, Joan Palou, Alberto Breda","doi":"10.1016/j.eururo.2026.03.040","DOIUrl":"10.1016/j.eururo.2026.03.040","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Page e63"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984912","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":"Sutureless Purely Off-clamp Robotic Partial Nephrectomy: Evidence from a Randomized Controlled Noninferiority Trial","authors":"Aldo Brassetti,&nbsp;Gabriele Tuderti,&nbsp;Umberto Anceschi,&nbsp;Alfredo Maria Bove,&nbsp;Eugenio Bologna,&nbsp;Lorenzo Capecchi,&nbsp;Giuseppe Chiacchio,&nbsp;Simone D’annunzio,&nbsp;Mariaconsiglia Ferriero,&nbsp;Rocco Simone Flammia,&nbsp;Salvatore Guaglianone,&nbsp;Sabrina Iuculano,&nbsp;Claudia Denaro,&nbsp;Arianna Di Luzio,&nbsp;Costantino Leonardo,&nbsp;Leslie Claire Licari,&nbsp;Riccardo Mastroianni,&nbsp;Leonardo Misuraca,&nbsp;Flavia Proietti,&nbsp;Isabella Sperduti,&nbsp;Giuseppe Simone","doi":"10.1016/j.eururo.2026.04.019","DOIUrl":"10.1016/j.eururo.2026.04.019","url":null,"abstract":"<div><h3>Background and objective</h3><div>The sutureless (SL) purely off-clamp robotic partial nephrectomy (ocRPN) technique has been proposed to minimize postoperative functional damage. We assessed whether this approach is noninferior to renorrhaphy (RR) in terms of surgical quality.</div></div><div><h3>Methods</h3><div>Patients with cT1–2N0M0 renal tumors were randomly assigned to SL or RR-ocRPN within a single-center, single-surgeon randomized controlled trial (NCT06846112). A covariate-adaptive 1:1 randomization algorithm ensured balance between treatment arms for age, sex, baseline renal function, and tumor surgical complexity. The primary endpoint was Trifecta achievement at discharge. A prespecified noninferiority test (margin −10%) compared Trifecta rates using one-sided testing and confidence intervals. Secondary outcomes were descriptively analyzed and compared between study arms. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method.</div></div><div><h3>Key findings and limitations</h3><div>Among 248 patients, baseline characteristics were balanced. Trifecta was achieved in 93% and 95% of cases (absolute difference −2.4%; 90% confidence interval [CI] −7.4%–2.6%), meeting the criterion for noninferiority (one-sided <em>p</em> = 0.006). Blood transfusions (2.4% vs 0%) and acute kidney injury (1.6% in both groups) were rare. Nine urinary fistulae occurred overall, all managed with temporary stenting; rates were higher in the SL group but not statistically significant (<em>p</em> = 0.08). Renal function remained stable up to 12 mo, and 1-yr RFS was 99% in all cohorts. Limitations include single-center design, surgeon expertise, and short oncologic follow-up.</div></div><div><h3>Conclusions and clinical implications</h3><div>SL-ocRPN is safe and effective and represents a feasible alternative to RR-ocRPN in selected cT1–2N0M0 renal tumors.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Pages 291-300"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Kitamura H, Tsukamoto T, Kakehi Y, et al. Active surveillance versus intravesical bacillus Calmette-Guérin for high-grade T1 bladder cancer with negative second transurethral resection: the randomized noninferiority phase 3 JCOG1019 trial. Eur Urol. 2026;89:437–445","authors":"Niyati Lobo,&nbsp;Roberto Contieri,&nbsp;Laura Mertens,&nbsp;Ashish M. Kamat","doi":"10.1016/j.eururo.2026.03.032","DOIUrl":"10.1016/j.eururo.2026.03.032","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Pages e57-e58"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792995","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":"Management of Testicular Germ Cell Tumours: Personalised Treatment Approaches Are on Their Way","authors":"Axel Heidenreich,&nbsp;Julian Heidenreich,&nbsp;David Pfister","doi":"10.1016/j.eururo.2026.04.015","DOIUrl":"10.1016/j.eururo.2026.04.015","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Pages 200-201"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824945","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: Bevacizumab and Erlotinib in Hereditary and Sporadic Papillary Kidney Cancer","authors":"Javier Molina-Cerrillo,&nbsp;Teresa Alonso-Gordoa","doi":"10.1016/j.eururo.2026.04.007","DOIUrl":"10.1016/j.eururo.2026.04.007","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Pages 304-305"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825011","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: Artificial Intelligence Tools Expand Scientists’ Impact but Contract Science’s Focus","authors":"David D’Andrea,&nbsp;Riccardo Campi","doi":"10.1016/j.eururo.2026.04.004","DOIUrl":"10.1016/j.eururo.2026.04.004","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Pages 303-304"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847746","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":"Diagnostic Accuracy of Circulating Tumor DNA to Predict Retroperitoneal Histology in Patients Treated With Retroperitoneal Lymph Node Dissection for Testicular Germ Tumor","authors":"Parth U. Thakker,&nbsp;Connor Drake,&nbsp;Jiping Zeng,&nbsp;Amy Tennant,&nbsp;Timothy A. Masterson,&nbsp;Clint Cary","doi":"10.1016/j.eururo.2026.03.018","DOIUrl":"10.1016/j.eururo.2026.03.018","url":null,"abstract":"<div><div>Testicular germ cell tumor (GCT) has survival rates exceeding 90% and thus contemporary research has focused on reducing morbidity. While chemotherapy is efficacious, long-term effects are significant. Primary retroperitoneal lymphadenectomy (P-RPLND) has been offered, and postchemotherapy lymphadenectomy (PC-RPLND) is considered, based on residual node size, to reduce overtreatment. A significant number of patients have necrosis in the retroperitoneum and are thus overtreated. Circulating tumor DNA (ctDNA) may be used to determine which patients would benefit from RPLND. This retrospective analysis sought to determine the performance of ctDNA to detect retroperitoneal GCT only, teratoma only, and GCT/teratoma. All patients had a ctDNA obtained preoperatively and at 3, 6, and 12 months postoperatively. Ninety-two patients underwent P or PC-RPLND. The sensitivity, specificity, and positive predictive values (PPVs) and negative predictive values (NPVs) for detecting active GCT/teratoma in the entire cohort were 60%, 87%, 96%, and 30%, respectively. For GCT only these were 85%, 75%, 73%, and 86%. For teratoma only, these were 31%, 34%, 23%, and 43%. These findings indicate that patients with a positive ctDNA likely harbor active GCT and/or teratoma, as suggested by a PPV of 96%. Future studies may use whole-genome ctDNA assays to improve detection of teratoma and incorporate ctDNA into surveillance protocols.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Pages 196-199"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617493","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: Kitamura et al. Active Surveillance Versus Intravesical Bacillus Calmette-Guérin for High-grade T1 Bladder Cancer with Negative Second Transurethral Resection (JCOG1019). Eur Urol 2026. 2026;89:437–445","authors":"Spyridon P. Basourakos,&nbsp;Jonathan Shoag,&nbsp;Adam Calaway","doi":"10.1016/j.eururo.2026.03.037","DOIUrl":"10.1016/j.eururo.2026.03.037","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Pages e60-e61"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935986","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: Brian F. Chapin, Marc Smaldone, Amado J. Zurita, et al. A Phase 2, Randomized, Controlled Trial of Best Systemic Therapy versus Best Systemic Therapy with Definitive Treatment of the Primary Tumor in Metastatic Prostate Cancer. Eur Urol. 2026;90:125–136","authors":"Michael Froehner","doi":"10.1016/j.eururo.2026.05.021","DOIUrl":"10.1016/j.eururo.2026.05.021","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Page e65"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213722","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":"European Association of Urology Guidelines on Neuro-urology: Summary of the 2026 Update","authors":"Andrea M. Sartori,&nbsp;Thomas M. Kessler,&nbsp;Hazel Ecclestone,&nbsp;Dennis Frings,&nbsp;Maria L. Gallo,&nbsp;Oliver Gross,&nbsp;Rizwan Hamid,&nbsp;Claire Hentzen,&nbsp;Gilles Karsenty,&nbsp;Stefania Musco,&nbsp;Bárbara Padilla-Fernández,&nbsp;Jalesh N. Panicker,&nbsp;Peter de Keijzer,&nbsp;Angela van der Vorm,&nbsp;Natasha Schouten,&nbsp;Bertil F.M. Blok","doi":"10.1016/j.eururo.2026.04.012","DOIUrl":"10.1016/j.eururo.2026.04.012","url":null,"abstract":"<div><h3>Context</h3><div>Neurological disorders frequently impair the lower urinary tract, sexual, and reproductive function and require lifelong, individualised management. This review summarises the latest update of the European Association of Urology (EAU) Guidelines on Neuro-Urology, highlighting refined terminology, a stronger patient-centred approach, and current diagnostic and therapeutic strategies.</div></div><div><h3>Objective</h3><div>To present a summary of the 2026 Neuro-Urology guideline updated using a standardised methodology to provide reproducible evidence for the management of neuro-urology.</div></div><div><h3>Evidence acquisition</h3><div>Recommendations are derived from the updated EAU Neuro-Urology Guidelines following structured evaluation of recent literature and expert panel consensus. Evidence levels, risk–benefit considerations, and patient perspectives informed the formulation of clinically oriented recommendations.</div></div><div><h3>Evidence synthesis</h3><div>Early risk stratification, urodynamic evaluation, and regular surveillance remain central to preventing complications. Conservative and pharmacological therapies are first-line treatments, whereas minimally invasive and surgical options should be individualised according to neurological status and patient preference. Updated sections reflect refined terminology, integration of patient perspectives, and expanded guidance on urinary tract infection management, neuromodulation, reconstructive strategies, and sexual and reproductive health. Evidence remains heterogeneous, and high-level comparative data are limited for several interventions.</div></div><div><h3>Conclusions</h3><div>The updated Guidelines emphasise protection of upper urinary tract function, optimisation of bladder dynamics, and shared decision-making within multidisciplinary care. Integration of sexual health and structured long-term follow-up reflects the evolving needs of patients with neurological conditions.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"90 3","pages":"Pages 241-253"},"PeriodicalIF":29.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}