European Urology Open Science最新文献

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Implementing Standardised Training and Education: The Vision of the European Association of Urology Led by the European School of Urology 实施标准化培训和教育:由欧洲泌尿外科学院领导的欧洲泌尿外科协会的愿景
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-16 DOI: 10.1016/j.euros.2025.06.006
Bhaskar K. Somani , Carlotta Nedbal , Tiago Ribeiro de Oliveira , Chandra Shekhar Biyani , Domenico Veneziano , Ton Brouwers , Claudia Herrmann , Jacobijn Sedelaar-Maaskant , Nan Li , Patricia Zondervan , Panagiotis Kallidonis , Alessandro Larcher , Paolo Verze , Véronique Phé , Veeru Kasivisvanathan , Bogdan Petrut , Nicholas Raison , Mesrur Selçuk Sılay , Romain Boissier , Juan Gómez-Rivas , Evangelos Liatsikos
{"title":"Implementing Standardised Training and Education: The Vision of the European Association of Urology Led by the European School of Urology","authors":"Bhaskar K. Somani , Carlotta Nedbal , Tiago Ribeiro de Oliveira , Chandra Shekhar Biyani , Domenico Veneziano , Ton Brouwers , Claudia Herrmann , Jacobijn Sedelaar-Maaskant , Nan Li , Patricia Zondervan , Panagiotis Kallidonis , Alessandro Larcher , Paolo Verze , Véronique Phé , Veeru Kasivisvanathan , Bogdan Petrut , Nicholas Raison , Mesrur Selçuk Sılay , Romain Boissier , Juan Gómez-Rivas , Evangelos Liatsikos","doi":"10.1016/j.euros.2025.06.006","DOIUrl":"10.1016/j.euros.2025.06.006","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Pages 72-76"},"PeriodicalIF":3.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adaption of the Memorial Sloan Kettering Cancer Center Nomograms for the Prediction of Prostate Cancer–specific Death in Sweden: A Population-based Cohort Study 采用纪念斯隆凯特琳癌症中心的nomogram来预测瑞典前列腺癌特异性死亡:一项基于人群的队列研究
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-14 DOI: 10.1016/j.euros.2025.06.003
Renata Zelic , Marcus Westerberg , Pär Stattin , Hans Garmo , Lorenzo Richiardi , Olof Akre , Andreas Pettersson
{"title":"Adaption of the Memorial Sloan Kettering Cancer Center Nomograms for the Prediction of Prostate Cancer–specific Death in Sweden: A Population-based Cohort Study","authors":"Renata Zelic ,&nbsp;Marcus Westerberg ,&nbsp;Pär Stattin ,&nbsp;Hans Garmo ,&nbsp;Lorenzo Richiardi ,&nbsp;Olof Akre ,&nbsp;Andreas Pettersson","doi":"10.1016/j.euros.2025.06.003","DOIUrl":"10.1016/j.euros.2025.06.003","url":null,"abstract":"<div><h3>Background and objective</h3><div>Prognostication is a cornerstone of the clinical management of prostate cancer. This study aims to update the pre- and postoperative Memorial Sloan Kettering Cancer Center (MSKCC) nomograms for the prediction of 10-yr prostate cancer–specific mortality in the competing risk setting in Sweden, and to evaluate the added value of comorbidities.</div></div><div><h3>Methods</h3><div>A cohort study was conducted including all men in the National Prostate Cancer Register of Sweden diagnosed with localised prostate cancer in 2007–2020, who underwent radical prostatectomy. Follow-up was until December 31, 2022. We used cause-specific Cox proportional hazard models to obtain the cumulative incidence of prostate cancer–specific and other-cause mortality. The models were validated in terms of discrimination (concordance [C] index) and calibration by internal-external validation in six Swedish health care regions and by bootstrapping (<em>N</em> = 500).</div></div><div><h3>Key findings and limitations</h3><div>The cohort included 31 106 men, of whom 629 died from prostate cancer and 2415 died from other causes during a median follow-up of 8.3 yr (interquartile range: 5.2, 11.8). Comorbidities added more value to the other-cause mortality model than to the prostate cancer–specific mortality model, and were included in all models. Both the preoperative and the postoperative model showed high discrimination for prostate cancer–specific death (optimism-corrected C-index: 0.81 and 0.87, respectively), but not for other-cause mortality (0.67, both models). All models were well calibrated, with minimal overestimation at the higher range of predicted cumulative incidences for the preoperative, but not for the postoperative, model.</div></div><div><h3>Conclusions and clinical implications</h3><div>The updated MSKCC nomograms performed well in terms of discrimination and calibration, and can be used in clinical practice in Sweden. In this study, comorbidity added minimal prognostic value for predicting prostate cancer–specific mortality. External validation is advised for application in other populations.</div></div><div><h3>Patient summary</h3><div>Prognostication is a cornerstone in the clinical management of prostate cancer. In this study, we adapted the best preforming risk classification system, the pre- and postoperative Memorial Sloan Kettering Cancer Center nomograms, for the prediction of prostate cancer–specific death in Swedish setting. The adapted models perform well and can be applied directly to Swedish men with prostate cancer.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Pages 41-50"},"PeriodicalIF":3.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Capillary Blood for Prostate-specific Antigen Testing: The PSA-CAP Study 毛细管血前列腺特异性抗原检测:PSA-CAP研究
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-14 DOI: 10.1016/j.euros.2025.05.004
Martin Wallisch , Peter Albers , Nikolaus Becker , Friedrich Boege , Derik Hermsen , Tanmay Ramesh Londhe , Jale Lakes , Jan Philipp Radtke , Agne Krilaviciute , Petra Seibold , Axel Benner , Maral Saadati , Stefan Holdenrieder , Rouvier Al-Monajjed
{"title":"Capillary Blood for Prostate-specific Antigen Testing: The PSA-CAP Study","authors":"Martin Wallisch ,&nbsp;Peter Albers ,&nbsp;Nikolaus Becker ,&nbsp;Friedrich Boege ,&nbsp;Derik Hermsen ,&nbsp;Tanmay Ramesh Londhe ,&nbsp;Jale Lakes ,&nbsp;Jan Philipp Radtke ,&nbsp;Agne Krilaviciute ,&nbsp;Petra Seibold ,&nbsp;Axel Benner ,&nbsp;Maral Saadati ,&nbsp;Stefan Holdenrieder ,&nbsp;Rouvier Al-Monajjed","doi":"10.1016/j.euros.2025.05.004","DOIUrl":"10.1016/j.euros.2025.05.004","url":null,"abstract":"<div><div>Risk-adapted prostate cancer (PC) screening is currently based on a combination of prostate-specific antigen (PSA) testing, risk assessment, and magnetic resonance imaging (MRI). Classical venous blood sampling is usually performed by health care professionals, which may reduce participation in future population-based screening programmes due to limited resources. The PSA-CAP study (NCT06626386) evaluated the feasibility of using capillary blood from fingertip sampling compared with venous blood for PSA determination, in order to facilitate access for PSA testing. This prospective study analysed 196 men aged 40–75 yr. PSA levels were measured from both capillary and venous blood using the same analytical method. The stability of samples stored at room temperature was assessed over a week. Discomfort associated with both collection methods was evaluated using a numerical pain scale. No significant differences were found between capillary and venous PSA measurements. Samples remained stable up to 7 d without immediate centrifugation. Pain scores for capillary (1.52/10) and venous (1.61/10) collections were generally low and not significantly different (<em>p</em> = 0.27). Four cases had insufficient capillary blood for an analysis, and two outliers were resolved upon retesting. Capillary blood sampling is a viable alternative to venous puncture for PSA measurement, offering the same level of accuracy and stability with no difference in discomfort. This approach could enhance participation rates in future PC screening programmes.</div></div><div><h3>Patient summary</h3><div>We studied an alternative method of blood collection to measure prostate-specific antigen level, a key test for prostate cancer risk, using fingertip sampling instead of venous blood. The results were comparable with and as stable as those from venous blood collection, with similar comfort levels. This technique may simplify future prostate cancer screening programmes and could lead to a higher acceptance rate.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Pages 28-31"},"PeriodicalIF":3.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Re: Ruben Raychaudhuri, Daniel W. Lin, R. Bruce Montgomery. Prostate cancer: a review. JAMA 2025;333:1433–46 回复:Ruben Raychaudhuri, Daniel W. Lin, R. Bruce Montgomery。前列腺癌:综述。《美国医学会杂志》2025;333:1433-46
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-14 DOI: 10.1016/j.euros.2025.06.010
Rocio Roldan-Testillano, Rafael Sanchez-Salas
{"title":"Re: Ruben Raychaudhuri, Daniel W. Lin, R. Bruce Montgomery. Prostate cancer: a review. JAMA 2025;333:1433–46","authors":"Rocio Roldan-Testillano,&nbsp;Rafael Sanchez-Salas","doi":"10.1016/j.euros.2025.06.010","DOIUrl":"10.1016/j.euros.2025.06.010","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Page 68"},"PeriodicalIF":3.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Local Therapy of the Primary Tumor: An Option for Metastatic Urothelial Carcinoma in the Era of Novel Combination Therapies? 原发肿瘤局部治疗:新型联合治疗时代转移性尿路上皮癌的一种选择?
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-14 DOI: 10.1016/j.euros.2025.05.016
Renate Pichler , José Daniel Subiela , Roman Mayr , Marco Moschini , Roger Li , Benjamin Pradére
{"title":"Local Therapy of the Primary Tumor: An Option for Metastatic Urothelial Carcinoma in the Era of Novel Combination Therapies?","authors":"Renate Pichler ,&nbsp;José Daniel Subiela ,&nbsp;Roman Mayr ,&nbsp;Marco Moschini ,&nbsp;Roger Li ,&nbsp;Benjamin Pradére","doi":"10.1016/j.euros.2025.05.016","DOIUrl":"10.1016/j.euros.2025.05.016","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Pages 69-71"},"PeriodicalIF":3.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Single-port Robot-assisted Ureteral Reimplantation via Low Anterior Access: Step-by-step Procedure and Preliminary Comparative Results 经低前通道的单端口机器人辅助输尿管再植:一步一步的程序和初步的比较结果
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-12 DOI: 10.1016/j.euros.2025.06.002
Luca Lambertini , Giulio Avesani , Hakan Bahadir Haberal , Juan Ramon Torres Anguiano , Ruben Sauer Calvo , Luca Morgantini , Andrea Minervini , Simone Crivellaro
{"title":"Single-port Robot-assisted Ureteral Reimplantation via Low Anterior Access: Step-by-step Procedure and Preliminary Comparative Results","authors":"Luca Lambertini ,&nbsp;Giulio Avesani ,&nbsp;Hakan Bahadir Haberal ,&nbsp;Juan Ramon Torres Anguiano ,&nbsp;Ruben Sauer Calvo ,&nbsp;Luca Morgantini ,&nbsp;Andrea Minervini ,&nbsp;Simone Crivellaro","doi":"10.1016/j.euros.2025.06.002","DOIUrl":"10.1016/j.euros.2025.06.002","url":null,"abstract":"<div><h3>Background and objective</h3><div>Multiport robotic management of distal ureteral strictures is still burdened by the mandatory transperitoneal approach and the steep Trendelenburg patient position. Our aim was to describe the largest series of patients treated with single-port robot-assisted ureteral reimplantation (SP-RAUR) via a supine extraperitoneal approach, with a focus on the surgical technique, perioperative surgical outcomes, and functional results.</div></div><div><h3>Methods and surgical procedure</h3><div>Clinical and surgical data for all consecutive adult patients treated with SP-RAUR between January 2021 and September 2023 were prospectively collected. Patients were stratified by surgical approach into low anterior access (LAA) and transperitoneal (TP) groups. Ureteral reimplantation was performed extraperitoneally with patients in a supine position.</div></div><div><h3>Key findings and limitations</h3><div>Overall, 20 patients who underwent SP-RAUR and had minimum follow-up of 1 yr were included in the analysis, of whom 50% were treated via an LAA approach. There were no significant differences in baseline characteristics between the groups. No open conversions or intraoperative complications occurred. The operative time was shorter in the LAA group than in the TP group (165 vs 191 min; <em>p</em> = 0.01). In terms of perioperative features, the LAA approach was associated with lower postoperative pain and opioid use and shorter length of stay (8 vs 26.5 h; <em>p</em> = 0.016). No major postoperative complications or recurrent urinary obstruction were observed after median follow-up of 14.5 mo.</div></div><div><h3>Conclusions and clinical implications</h3><div>SP-RAUR via LAA represents a feasible and safe procedure with potential to improve perioperative recovery for patients with a distal ureter stricture.</div></div><div><h3>Patient summary</h3><div>We assessed a new robot-assisted surgery technique to treat narrowing of the tube that drains urine from the kidney into the bladder. This technique uses just a single small incision. Our results show that the procedure is safe and that patients have a quick recovery and a fast return to everyday activities. Larger studies with more patients are needed to confirm these results.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Pages 51-58"},"PeriodicalIF":3.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-world Evidence from a Retrospective Multicentre Analysis on First-line Therapy for Metastatic Papillary Renal Cell Carcinoma. A GUARDIANS Project 来自转移性乳头状肾细胞癌一线治疗的多中心回顾性分析的真实证据。守护者项目
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-12 DOI: 10.1016/j.euros.2025.06.011
Thomas Hilser , Jozefina Casuscelli , Can Aydogdu , Stefanie Zschäbitz , Marco Julius Schnabel , Emily Rinderknecht , Angelika Mattigk , Martin Schostak , Anna-Lisa Volk , Philipp Ivanyi , Jonas Wiegmann , Christopher Darr , Luka Flegar , Subhajit Mandal , Katrin Schlack , Daniel Seidl , Analena Handke , Melanie Klee , Tim Nestler , Marc Rehlinghaus , Pia Paffenholz
{"title":"Real-world Evidence from a Retrospective Multicentre Analysis on First-line Therapy for Metastatic Papillary Renal Cell Carcinoma. A GUARDIANS Project","authors":"Thomas Hilser ,&nbsp;Jozefina Casuscelli ,&nbsp;Can Aydogdu ,&nbsp;Stefanie Zschäbitz ,&nbsp;Marco Julius Schnabel ,&nbsp;Emily Rinderknecht ,&nbsp;Angelika Mattigk ,&nbsp;Martin Schostak ,&nbsp;Anna-Lisa Volk ,&nbsp;Philipp Ivanyi ,&nbsp;Jonas Wiegmann ,&nbsp;Christopher Darr ,&nbsp;Luka Flegar ,&nbsp;Subhajit Mandal ,&nbsp;Katrin Schlack ,&nbsp;Daniel Seidl ,&nbsp;Analena Handke ,&nbsp;Melanie Klee ,&nbsp;Tim Nestler ,&nbsp;Marc Rehlinghaus ,&nbsp;Pia Paffenholz","doi":"10.1016/j.euros.2025.06.011","DOIUrl":"10.1016/j.euros.2025.06.011","url":null,"abstract":"<div><h3>Background and objective</h3><div>Papillary renal cell carcinoma (pRCC) is a rare disease. The optimal treatment of metastatic pRCC is still unclear. We evaluated real-world treatment outcomes of first-line treatment in this cohort in Germany.</div></div><div><h3>Methods</h3><div>Patients with advanced or metastatic pRCC were eligible. Adverse events (AEs) were reported according to Common Terminology Criteria for Adverse Events version 5.0. The overall response rate was accessed according to the local standard. Progression-free survival (PFS) was calculated from the start of treatment to progression or death. Descriptive statistics and Kaplan-Meier plots were utilised, where appropriate.</div></div><div><h3>Key findings and limitations</h3><div>In total, 121 suitable patients (77% male) with a median age of 63 yr (quartiles 55, 70) were included. Prior nephrectomy was performed in 78%. Eastern Cooperative Oncology Group performance status 0–1 was reported in 74%. Lymphatic (68%) and pulmonary (42%) metastases were most common. Of the patients, 59% received first-line immune checkpoint inhibitor (ICI) combination therapies (ICI-ICI: 20%, tyrosine kinase inhibitor [TKI]-ICI: 39%), and 41% of patients received TKI monotherapy, predominantly sunitinib. The median follow-up time was 33.3 mo (interquartile range 14.8–46.7). The median PFS was 5.4 mo (95% confidence interval [CI]: 3.2–7.6) for ICI-ICI combinations, 16.9 mo (95% CI: 7.2–26.6) for ICI-TKI combinations, and 8.8 mo (95% CI: 7.0–10.7) for TKI monotherapy. Of all the patients, 70% and 35% experienced all-grade and grade 3–5 AEs, respectively. AEs of any cause led to discontinuation in 33% of patients.</div></div><div><h3>Conclusions and clinical implications</h3><div>TKI-based therapies are applied frequently in pRCC patients. Our data support the use of ICI plus TKI as a first-line standard for patients with pRCC. The major limitations were the retrospective data capture and short follow-up of our study. Additional analyses to tailor treatment strategies in patients with metastatic pRCC are warranted.</div></div><div><h3>Patient summary</h3><div>In this report, we looked at the outcome of first-line treatment of patients with metastatic papillary renal cell cancer (pRCC). Tyrosine kinase inhibitor (TKI)-based therapies are applied frequently in pRCC. Our data support the use of immune checkpoint inhibitor plus TKI as a first-line standard for patients with pRCC. However, further studies are needed to optimise treatment in patients with metastatic pRCC.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Pages 59-67"},"PeriodicalIF":3.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hyperspectral Imaging Accurately Detects Renal Malperfusion Due to High Intrarenal Pressure 高光谱成像准确检测肾内高压引起的肾灌注不良
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-11 DOI: 10.1016/j.euros.2025.06.007
Luisa Egen , Moritz Hommel , Caelan Max Haney , Berkin Özdemir , Samuel Knoedler , Jan Sellner , Silvia Seidlitz , Maximilian Dietrich , Gabriel Alexander Salg , Felix Nickel , Lena Maier-Hein , Maurice Stephan Michel , Alexander Studier-Fischer , Karl-Friedrich Kowalewski
{"title":"Hyperspectral Imaging Accurately Detects Renal Malperfusion Due to High Intrarenal Pressure","authors":"Luisa Egen ,&nbsp;Moritz Hommel ,&nbsp;Caelan Max Haney ,&nbsp;Berkin Özdemir ,&nbsp;Samuel Knoedler ,&nbsp;Jan Sellner ,&nbsp;Silvia Seidlitz ,&nbsp;Maximilian Dietrich ,&nbsp;Gabriel Alexander Salg ,&nbsp;Felix Nickel ,&nbsp;Lena Maier-Hein ,&nbsp;Maurice Stephan Michel ,&nbsp;Alexander Studier-Fischer ,&nbsp;Karl-Friedrich Kowalewski","doi":"10.1016/j.euros.2025.06.007","DOIUrl":"10.1016/j.euros.2025.06.007","url":null,"abstract":"<div><h3>Background and objective</h3><div>High intrarenal pressure (IRP) is a significant concern in both endoscopic procedures and acute hydronephrosis, and may cause renal parenchymal damage, forniceal rupture, and long-term impaired renal function. Its pathomechanism and effect on renal perfusion patterns remain undetermined. This study investigates the impact of elevated IRP on renal perfusion and oxygen saturation (StO<sub>2</sub>) using hyperspectral imaging (HSI).</div></div><div><h3>Methods</h3><div>In vivo experiments were conducted on porcine models establishing hydronephrosis on specific IRP levels (30, 50, 70, and 90 mmHg) by pressure-controlled infusion of crystalloid solution into the ureter after distal ureteral clamping. HSI data were recorded at baseline, during IRP application, and after release to measure hydronephrosis-induced changes in reflectance and perfusion in a total of 501 recordings. The results were compared with spectral patterns of renal malperfusion states from previous internal studies. In total, data of 73 pigs and 1744 HSI recordings were included.</div></div><div><h3>Key findings and limitations</h3><div>Elevated IRP significantly affected renal perfusion and oxygenation. StO<sub>2</sub> decreased from 70.3% ± 10.9% (physiological) to 39.9% ± 9.5% in hydronephrotic kidneys. Perfusion values in hydronephrosis decreased significantly at the renal poles (6.5% ± 4.0%) compared with physiological values (34.8% ± 7.5%). A principal component analysis and machine learning classification confirmed distinct malperfusion states, with hydronephrosis resembling ischemic conditions.</div></div><div><h3>Conclusions and clinical implications</h3><div>HSI revealed that high IRP reduces renal oxygenation and perfusion, with the poles being disproportionately affected. The results from this study provide quantitative evidence of perfusion restriction and ischemic conditions as the pathomechanism behind hydronephrosis-induced kidney damage. These findings underscore the importance of monitoring IRP during endourological procedures to mitigate renal damage and associated complications.</div></div><div><h3>Patient summary</h3><div>High pressure in the kidneys during surgery or kidney disease can severely reduce blood flow and oxygen, causing damage. This study used a special camera to show this damage, especially at the end of the kidney. These findings highlight the importance of monitoring kidney pressure carefully during procedures to prevent damage to the kidney.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Pages 16-27"},"PeriodicalIF":3.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact of Real-world Use of Overactive Bladder Medications on Dementia Risk in Younger Adults 实际使用过度膀胱药物对年轻人痴呆风险的影响
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-11 DOI: 10.1016/j.euros.2025.06.008
Bruce Li , Jennifer Reid , Andrew McClure , Kristin K Clemens , Blayne Welk
{"title":"The Impact of Real-world Use of Overactive Bladder Medications on Dementia Risk in Younger Adults","authors":"Bruce Li ,&nbsp;Jennifer Reid ,&nbsp;Andrew McClure ,&nbsp;Kristin K Clemens ,&nbsp;Blayne Welk","doi":"10.1016/j.euros.2025.06.008","DOIUrl":"10.1016/j.euros.2025.06.008","url":null,"abstract":"<div><h3>Background and objective</h3><div>Overactive bladder (OAB) is often treated with anticholinergic medications, but concerns have emerged regarding their potential long-term risk of dementia. Our objective was to investigate whether the use of OAB anticholinergics, as compared with beta-3 agonists, is associated with new-onset dementia individuals under 65 yr of age.</div></div><div><h3>Methods</h3><div>A retrospective, propensity-weighted cohort study was conducted using population-based data from Canada. The study population included people aged 18–64 yr who started a prescription of an OAB anticholinergic medication or the beta-3 agonist mirabegron. Inverse propensity of treatment weighting was used to balance baseline characteristics. The primary outcome was the incidence of dementia. The Fine-Gray subdistribution hazard model, adjusted for age and sex, was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).</div></div><div><h3>Key findings and limitations</h3><div>A total of 57 975 patients were included in the study, with 48 454 in the OAB anticholinergic group (305 724 person-years of follow-up) and 9521 in the beta-3 agonist group (34 605 person-years of follow-up). After propensity score weighting, there was no significant difference in the risk of dementia between OAB anticholinergic users and beta-3 agonist users (HR 0.99, 95% CI 0.86–1.15, <em>p</em> = 0.9). The study limitations are the risk of misclassification and residual confounding.</div></div><div><h3>Conclusions and clinical implications</h3><div>Among people &lt;65 yr of age, the use of OAB anticholinergics versus beta-3 agonists was not significantly associated with dementia. This serves to reassure physicians and patients who use these medications in younger adults.</div></div><div><h3>Patient summary</h3><div>In adults aged 18–64 yr who have overactive bladder, the use of different types of oral medications are not associated with dementia.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Pages 32-40"},"PeriodicalIF":3.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Copyright page 版权页
IF 3.2 3区 医学
European Urology Open Science Pub Date : 2025-07-01 DOI: 10.1016/S2666-1683(25)00259-9
{"title":"Copyright page","authors":"","doi":"10.1016/S2666-1683(25)00259-9","DOIUrl":"10.1016/S2666-1683(25)00259-9","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"77 ","pages":"Page I"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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