European Urology Open Science最新文献

{"title":"Copyright page","authors":"","doi":"10.1016/S2666-1683(25)00114-4","DOIUrl":"10.1016/S2666-1683(25)00114-4","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"75 ","pages":"Page I"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874260","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}

{"title":"Phenazopyridine Inhibits Bladder Mechanosensory Signalling via the Bladder Lumen","authors":"Aaron Clark, Georgia Bourlotos, Meera Elmasri, Luke Grundy","doi":"10.1016/j.euros.2025.04.001","DOIUrl":"10.1016/j.euros.2025.04.001","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"76 ","pages":"Pages 14-16"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873142","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}

{"title":"ProstaPilot: A Comparative Study of Biparametric Magnetic Resonance Imaging Versus Prostate-specific Antigen as a Screening Test for Prostate Cancer","authors":"Michal Staník ,&nbsp;Michal Standara ,&nbsp;David Miklánek ,&nbsp;Kateřina Hejcmanová ,&nbsp;Miloš Pacal ,&nbsp;Roman Hrabec ,&nbsp;Ondřej Ngo ,&nbsp;Karel Hejduk ,&nbsp;Jan Křístek ,&nbsp;Michal Uher ,&nbsp;Ondřej Májek ,&nbsp;Alexandr Poprach","doi":"10.1016/j.euros.2025.03.016","DOIUrl":"10.1016/j.euros.2025.03.016","url":null,"abstract":"<div><h3>Background and objective</h3><div>Our aim was to compare detection rates for clinically significant prostate cancer (csPC) between biparametric magnetic resonance imaging (bpMRI) and prostate-specific antigen (PSA) screening pathways in the Czech population, which has a high prevalence of opportunistic PSA testing (45% in the target age group).</div></div><div><h3>Methods</h3><div>Between May 2022 and May 2023, 423 men aged 50–69 yr who were enrolled via volunteer-based recruitment, underwent both PSA testing and bpMRI of the prostate. Positive results were defined as PSA ≥3 μg/l or a Prostate Imaging-Reporting and Data System score of 4-5. Those with positive tests were referred for further evaluation, including an MRI-targeted biopsy and a systematic 12-core biopsy. csPC was defined as any cancer of International Society of Urological Pathology grade group ≥2.</div></div><div><h3>Key findings and limitations</h3><div>Of the 423 men, 35 (8.3%) had at least one positive screening test. The PSA-based pathway identified 25 men (5.9%), whereas the MRI-based pathway identified 16 (3.8%) with suspicion of PC, with potential to reduce the number of biopsies required by 36%. Subsequent biopsy revealed PC in seven men (1.7%) with a positive PSA test and 14 men (3.3%) with positive MRI findings. Nonsignificant PC and csPC rates were 1.0% (<em>n</em> = 4) and 0.7% (<em>n</em> = 3) for the PSA pathway, and 1.7% and 1.7% (<em>n</em> = 7) for the MRI pathway, respectively.</div></div><div><h3>Conclusions and clinical implications</h3><div>In a highly prescreened population, bpMRI may increase the csPC detection rate while reducing the number of biopsies needed in comparison to PSA-based diagnosis. However, bpMRI may also slightly increase the detection of grade group 1 cancers.</div></div><div><h3>Patient summary</h3><div>We compared a blood test for PSA (prostate-specific antigen) and an MRI scan (magnetic resonance imaging) for detection of prostate cancer in men aged 50–69 years. We found that MRI scans may reduce the number of biopsies that need to be performed for cancer diagnosis while increasing the detection rate for cancers that are significant.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"76 ","pages":"Pages 7-13"},"PeriodicalIF":3.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859708","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}

{"title":"Uncovering the Risk: Incidence of Upper Tract Urothelial Carcinoma Following Renal Transplantation in the Netherlands","authors":"Orlane J.A. Figaroa ,&nbsp;J. Bek ,&nbsp;C.D. Savci-Heijink ,&nbsp;M.M. Idu ,&nbsp;A.D. Bins ,&nbsp;R.J.A. van Moorselaar ,&nbsp;J. Baard","doi":"10.1016/j.euros.2025.03.004","DOIUrl":"10.1016/j.euros.2025.03.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>Renal transplant (RTx) recipients appear to have an elevated risk of urothelial carcinoma compared with the general population. While Asia reports a high incidence of upper tract urothelial carcinoma (UTUC) following RTx, this incidence remains underinvestigated in Western countries. The main objective of this study is to determine the incidence of UTUC after RTx in the Netherlands, and to evaluate and compare the incidence and tumour characteristics with those of the general Dutch population diagnosed with UTUC.</div></div><div><h3>Methods</h3><div>A retrospective nationwide analysis was conducted using data from the Dutch Pathology Registry on patients with UTUC after RTx between 1991 and 2023. We analysed patient and tumour characteristics, and treatment details.</div></div><div><h3>Key findings and limitations</h3><div>Out of 24 270 RTx patients (1991–2023), 30 developed UTUC, showing a 0.12% cumulative incidence and a 3.7 per 100 000 person-years incidence rate. The median age at UTUC diagnosis was 59 yr, and 47% had grade 3 UTUC. The overall incidence of UTUC in the Dutch population between 1991 and 2023 is 3.3 per 100 000 using the revised European standardised rate, with a median age of 71 yr and 40% grade 3 UTUC. Given that the study is retrospective, an inevitable bias needs to be considered.</div></div><div><h3>Conclusions and clinical implications</h3><div>We found a modestly higher incidence of UTUC after RTx within the Netherlands, with patients showing a lower median age at diagnosis and a higher percentage of grade 3 tumours than the general Dutch population diagnosed with UTUC.</div></div><div><h3>Patient summary</h3><div>In this report, we evaluated the incidence of upper tract urothelial cancer in patients who received kidney transplantation. Outcomes suggest a modestly higher incidence in patients after kidney transplantation than in the general Dutch population diagnosed with upper tract urothelial cancer.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"76 ","pages":"Pages 1-6"},"PeriodicalIF":3.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838866","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}

{"title":"Personalised Prostate Cancer Diagnosis: Evaluating Biomarker-based Approaches to Reduce Unnecessary Magnetic Resonance Imaging and Biopsy Procedures","authors":"Timo F.W. Soeterik ,&nbsp;Xiaobo Wu ,&nbsp;Roderick C.N. Van den Bergh ,&nbsp;Claudia Kesch ,&nbsp;Fabio Zattoni ,&nbsp;Ugo Falagario ,&nbsp;Alberto Martini ,&nbsp;Marcin Miszczyk ,&nbsp;Vittorio Fasulo ,&nbsp;Martina Maggi ,&nbsp;Veeru Kasivisvanathan ,&nbsp;Pawel Rajwa ,&nbsp;Giancarlo Marra ,&nbsp;Giorgio Gandaglia ,&nbsp;Peter K.F. Chiu ,&nbsp;EAU-YAU Prostate Cancer Working Party","doi":"10.1016/j.euros.2025.03.006","DOIUrl":"10.1016/j.euros.2025.03.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>Efforts made over the last decade for the detection of prostate cancer (PCa) have revolutionised disease diagnostics, and implementation of prebiopsy magnetic resonance imaging (MRI) has received widespread acceptance. However, universal adoption of prebiopsy MRI and the benefits achieved have been limited by availability and equivocal MRI findings. This review aims to evaluate the latest evidence on the role of existing PCa risk calculators (RCs), and blood and urinary biomarkers as part of the diagnostic algorithm to improve the diagnosis of clinically significant PCa (csPCa) and reduce unnecessary MRI procedures and biopsies. We will also evaluate the potential of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) to enhance sensitivity and specificity for PCa diagnosis, complement MRI, and refine biopsy strategies within the diagnostic pathway.</div></div><div><h3>Methods</h3><div>We performed a narrative review using the PubMed/MEDLINE database, which included papers published between January 2014 and June 2024. The outcome measures included rates of reduced diagnoses of nonsignificant PCa (defined as International Society of Urological Pathology [ISUP] grade group 1) cases, diagnoses of csPCa (defined as ISUP grade group ≥2) cases missed, and MRI scans and prostate biopsies avoided.</div></div><div><h3>Key findings and limitations</h3><div>In men with abnormal prostate-specific antigen (PSA) levels, further risk stratification using RCs, or blood or urine biomarkers can reduce up to 16–51% MRI scans, while missing 1–16% csPCa cases. In case of equivocal MRI results or Prostate Imaging Reporting and Data System 3 lesions, RCs or biomarkers could reduce up to 72% of biopsies, while missing only 3–13% csPCa cases. PSMA PET has emerging potential to improve csPCa prediction in combination with MRI and may further reduce unnecessary biopsies. A limitation of this study is that this is a narrative but not a systematic review.</div></div><div><h3>Conclusions and clinical implications</h3><div>RCs and biomarkers have been demonstrated to enhance the performance and efficiency of MRI in detecting csPCa in men with elevated PSA levels. PSMA PET shows promise in detecting csPCa, complementing MRI and refining biopsy indications.</div></div><div><h3>Patient summary</h3><div>In men with a suspicion of prostate cancer, magnetic resonance imaging prostate scans are effective in predicting clinically relevant cancer, but challenges including availability and equivocal scans exist. A personalised approach by adding one or more of clinical risk calculators, blood or urine biomarkers, or even novel imaging techniques such as positron emission tomography scans may improve cancer prediction further and reduce unnecessary scans and biopsies.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"75 ","pages":"Pages 106-119"},"PeriodicalIF":3.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829030","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}

{"title":"Managing Preoperative Anxiety and Thromboprophylaxis in Children Undergoing Urological Procedures: An Update of the European Association of Urology/European Society for Paediatric Urology Guidelines on Paediatric Urology","authors":"Michele Gnech ,&nbsp;Lisette ’t Hoen ,&nbsp;Martin Skott ,&nbsp;Guy Bogaert ,&nbsp;Marco Castagnetti ,&nbsp;Fardod O’Kelly ,&nbsp;Josine Quaedackers ,&nbsp;Yazan F. Rawashdeh ,&nbsp;Uchenna Kennedy ,&nbsp;Allon van Uitert ,&nbsp;Yuhong Yuan ,&nbsp;Marco Capecchi ,&nbsp;Andrea Artoni ,&nbsp;Gülhan Karaöz-Bulut ,&nbsp;Niklas Pakkasjärvi ,&nbsp;Berk Burgu ,&nbsp;Anna Bujons ,&nbsp;Mesrur Selcuk Silay ,&nbsp;Christian Radmayr","doi":"10.1016/j.euros.2025.02.006","DOIUrl":"10.1016/j.euros.2025.02.006","url":null,"abstract":"<div><h3>Context</h3><div>The literature on preventative measures against anxiety and antithrombotic management in children undergoing urological procedures is still limited, resulting in a generally low level of evidence. These guidelines aim to provide a practical approach based on a consensus from the European Association of Urology (EAU)/European Society for Paediatric Urology (ESPU) Paediatric Urology Guidelines Panel.</div></div><div><h3>Objective</h3><div>The authors aim to provide the 2024 EAU/ESPU Paediatric Urology Guidelines Panel update of the chapter on perioperative management of urological procedures in children.</div></div><div><h3>Evidence acquisition</h3><div>A structured literature review was performed for all relevant publications published from the last update until April 03, 2023.</div></div><div><h3>Evidence synthesis</h3><div>The most important updates include the following: anxiety and distress should be prevented or relieved by combining measures such as premedication, distraction techniques, and presence of parents or caregivers. Clinicians should select the appropriate premedication depending on the patient’s age, underlying conditions, and psychological status. A particular focus must be placed on paediatric patients with “special needs”, including children with psychophysical disorders that impact their relational and cognitive abilities. This unique population requires carefully tailored perioperative management. The incidence of perioperative thromboembolic events in the paediatric population is generally low. Controversies still exist on whether to perform a preoperative coagulation panel test on a routine basis. Neonates and adolescents are at a higher risk of perioperative thromboembolic events than the other children. Standard perioperative antithrombotic prophylaxis is not recommended due to a lack of high-quality evidence-based data.</div></div><div><h3>Conclusions</h3><div>This paper is a summary of evidence on preventative measures against anxiety and antithrombotic management in children undergoing urological procedures.</div></div><div><h3>Patient summary</h3><div>In this summary and update of the European Association of Urology/European Society for Paediatric Urology guidelines on paediatric urology, we provide practical considerations for preventative measures against anxiety and antithrombotic management in children undergoing urological procedures.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"75 ","pages":"Pages 133-140"},"PeriodicalIF":3.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833785","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}

{"title":"Robot-assisted Laparoscopic Retroperitoneal Lymph Node Dissection for Testicular and Upper Tract Urothelial Cancer—Surgical Technique and Outcomes of a Single-surgeon Series","authors":"Marc A. Furrer ,&nbsp;Benjamin C. Thomas","doi":"10.1016/j.euros.2025.03.015","DOIUrl":"10.1016/j.euros.2025.03.015","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and objective&lt;/h3&gt;&lt;div&gt;Retroperitoneal lymph node dissection (RPLND) is essential in managing testicular and upper urinary tract urothelial cancer (UTUC). While open RPLND remains the gold standard, robot-assisted RPLND (RA-RPLND) is gaining traction in selected cases. This study aims to describe the surgical technique and our experience with RA-RPLND, and to demonstrate the peri-and postoperative safety and efficacy of this approach for the treatment of testicular cancer and UTUC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We analyzed the data from a single-surgeon series of 96 patients (64 testicular cancer and 32 UTUC) who underwent RA-RPLND between 2016 and 2024. The procedures included left (&lt;em&gt;n&lt;/em&gt; = 49), right (&lt;em&gt;n&lt;/em&gt; = 31), and bilateral (&lt;em&gt;n&lt;/em&gt; = 16) template dissection. Bilateral and unilateral templates were used for testicular cancer, while unilateral templates were applied to all UTUC cases involving high-grade disease in the kidney, proximal ureter, or midureter. Surgical indications, preoperative assessment, and postoperative care protocols are described. Baseline characteristics, peri- and postoperative data, and oncological outcomes were assessed. Complications were graded using the Clavien-Dindo classification.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Key findings and limitations&lt;/h3&gt;&lt;div&gt;Median length of stay was 1 (IQR 1–1) d for testicular cancer and 2.5 (IQR 2–4) d for UTUC patients. Open conversion occurred in two testicular cancer salvage cases. Major complications (Clavien-Dindo ≥3a) occurred in 9% (testicular cancer) and 13% (UTUC) of patients. Two patients died within 90 d after RA-RPLND for UTUC: one due to an acute myocardial infarction and the other due to progressive disease. Six patients (19%) with UTUC died due to progressive disease within a median follow-up of 38 (range 4–66) mo, whereas all patients with testicular cancer were still alive after a median follow-up of 46 (range 1–97) mo. Overall and cancer-specific survival rates at the end of follow-up were 78% and 69% in patients with UTUC, and 100% and 100% in patients with testicular cancer, respectively. No retroperitoneal recurrences occurred in either cohort until the end of follow-up. Limitations include the steep learning curve and nonreproducibility by surgeons without expertise in advanced robotic surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions and clinical implications&lt;/h3&gt;&lt;div&gt;RA-RPLND remains a technically challenging operation, but is safe and effective in expert hands and should therefore be considered for selected patients in high-volume centers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patient summary&lt;/h3&gt;&lt;div&gt;In this study, we examined the outcomes after robot-assisted retroperitoneal lymph node dissection. We conclude that it is a safe and effective procedure for patients with testicular cancer and cancer of the renal pelvis and ureter when performed by experienced surgeons. Therefore, it can be a suitable choice for certain patients, depending on their individual ci","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"75 ","pages":"Pages 120-132"},"PeriodicalIF":3.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829031","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}

{"title":"Off-label Use of the Optilume Drug-coated Balloon in the Treatment of Bladder Neck Stenosis and Vesicourethral Anastomosis Stenosis","authors":"Georgi Tosev ,&nbsp;Ivan Damgov ,&nbsp;Franklin Kuehhas ,&nbsp;Hendrik Borgmann ,&nbsp;Julian Struck ,&nbsp;Johannes Salem ,&nbsp;Timur H. Kuru","doi":"10.1016/j.euros.2025.03.002","DOIUrl":"10.1016/j.euros.2025.03.002","url":null,"abstract":"<div><div>Bladder neck stenosis (BNS) and vesicourethral anastomosis stenosis (VUAS) are uncommon but clinically significant complications following transurethral surgery and radical prostatectomy (RP), often presenting important clinical challenges because of high recurrence rates with standard treatments. We retrospectively evaluated the efficacy of the Optilume paclitaxel-coated balloon in managing recurrent BNS and VUAS. Sixteen patients who had undergone open or robotic RP, transurethral resection of the prostate, or GreenLight laser photoselective vaporization of the prostate were assessed. At 12 mo after BNS/VUAS surgery, the International Prostate Symptom Score (IPSS), postvoid residual volume (PVR), and freedom from repeat intervention were evaluated. All patients remained free from repeat intervention and anatomic recurrence at 1-yr follow-up. Among the 16 patients (seven with preexisting incontinence), 12-mo follow-up demonstrated stable continence with no worsening, and all patients reported high satisfaction and willingness to repeat the procedure. Significant improvements in scores were observed for IPSS (<em>p</em> &lt; 0.001; <em>n</em> = 16) and IPSS quality of life (<em>t</em> = 4.75, <em>p</em> &lt; 0.001; <em>n</em> = 16), while PVR did not change significantly (<em>p</em> = 0.442; <em>n</em> = 8). These findings suggest that the Optilume paclitaxel-coated balloon is an effective off-label treatment for recurrent BNS and VUAS as applied in two urology practices in Germany, corroborating evidence from randomized controlled trials on the treatment of anterior urethral strictures.</div></div><div><h3>Patient summary</h3><div>We evaluated off-label use of the new drug-coated Optilume balloon for treatment of recurrent narrowing of the bladder neck or VA (vesicourethral anastomosis; surgical join between the bladder and urethra) in patients who had previously undergone prostate surgery. Our findings show that this treatment significantly improved urinary function assessed 1 year after the procedure and prevented the need for further surgeries.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"75 ","pages":"Pages 101-105"},"PeriodicalIF":3.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821241","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}

{"title":"Characterisation of Multiparametric Magnetic Resonance Imaging of the Prostate in Younger Men with Normal Prostate-specific Antigen Within the PROBASE Study","authors":"Rouvier Al-Monajjed ,&nbsp;Lars Schimmöller ,&nbsp;Jan Philipp Radtke ,&nbsp;Jale Lakes ,&nbsp;Agne Krilaviciute ,&nbsp;Heinz-Peter Schlemmer ,&nbsp;Kathleen Herkommer ,&nbsp;Petra Seibold ,&nbsp;Nikolaus Becker ,&nbsp;Rudolf Kaaks ,&nbsp;Boris Hadaschik ,&nbsp;Gerald Antoch ,&nbsp;Peter Albers ,&nbsp;Matthias Boschheidgen","doi":"10.1016/j.euros.2025.03.014","DOIUrl":"10.1016/j.euros.2025.03.014","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and objective&lt;/h3&gt;&lt;div&gt;Multiparametric magnetic resonance imaging (mpMRI) has emerged as an essential tool for the diagnosis of prostate cancer (PC). However, the right time to start screening for PC is not defined. This study aims to analyse mpMRI in young men at the age of 47–52 yr with normal prostate-specific antigen (PSA) values of ≤3 ng/ml.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this prospective analysis, consecutive men undergoing PSA screening with PSA levels below 3 ng/ml were offered mpMRI as part of the PROBASE study. Magnetic resonance imaging (MRI) parameters were assessed, and the findings included changes in T2-weighted (T2w) images, apparent diffusion coefficient (ADC), and dynamic contrast enhancement (DCE). Prostate Imaging Reporting and Data System (PI-RADS) category 4 or 5 would indicate a biopsy. The Kruskal-Wallis test was used to compare the ADC and PSA values across different PI-RADS categories, and the Spearman rho test was used to examine the relationship between T2w changes and PSA values for PI-RADS categories.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Key findings and limitations&lt;/h3&gt;&lt;div&gt;Forty-seven men were included (median PSA 1.22 ng/ml; interquartile range 0.47–1.79 ng/ml) between September 2021 and March 2022. High-quality MRI (median Prostate Imaging Quality [PI-QUAL] score 5) resulted in a median PI-RADS classification of 2 with low prostate volumes (median 27 ml). PI-RADS 3 classification occurred in 45% (median PSA 1.51 ng/ml). No score higher than PI-RADS 3 was observed. After 2-yr follow-up, no PC was reported in these men. For the peripheral zone (PZ), diffuse T2w changes were present in 81%. Focal and accentuated T2w changes were detected in 11% and 40%, respectively. DCE of the PZ was observed partially and severely in 53% and 17%, respectively. Limitations of this study are its small sample size, which provides more uncertainty regarding whether we were able to find reliable estimates for the outcomes explored in this study, the single-centre design, and the limited histopathological proof of nonmalignant cases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions and clinical implications&lt;/h3&gt;&lt;div&gt;In younger men with normal PSA levels, clinically significant PC was not detected on MRI. When using the PI-RADS classification, extensive T2w changes and DCE led to a classification in category 3, an observation that we made frequently in this cohort. The MRI appearance in these cases seem more likely to be age specific or inflammatory due to not PC-specific ADC values, but nonetheless PC cannot be excluded safely.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patient summary&lt;/h3&gt;&lt;div&gt;Magnetic resonance imaging characteristics in young healthy men with normal prostate-specific antigen levels are, in particular, diffuse T2-weighted hypointensity and dynamic contrast enhancement of the peripheral zone. These seem to be more likely age specific or inflammatory, but resulted in a higher proportion of patients with Prostate Imaging Reporting and Data System 3","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"75 ","pages":"Pages 94-100"},"PeriodicalIF":3.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807342","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}

{"title":"National Trends in Medication Prescriptions for Male Lower Urinary Tract Symptoms and Erectile Dysfunction: Findings from the Norwegian Prescription Database","authors":"Patrick Juliebø-Jones ,&nbsp;Ingunn Roth ,&nbsp;Christian Arvei Moen ,&nbsp;Peder Gjengstø ,&nbsp;Christian Beisland","doi":"10.1016/j.euros.2025.03.013","DOIUrl":"10.1016/j.euros.2025.03.013","url":null,"abstract":"<div><h3>Background and objective</h3><div>Trends for the medical management of male lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) remain-under reported at a national level. Our aim was to analyse national trends in prescribing patterns for ED and LUTS medications among men in Norway.</div></div><div><h3>Methods</h3><div>Data were extracted from the Norwegian Prescription Database (Norwegian Institute of Public Health) for the period 2004–2020. Medications were identified according to the Anatomical Therapeutic Chemical classification system.</div></div><div><h3>Key findings and limitations</h3><div>For BPH medications collectively, the total annual number of prescriptions increased from 23 711 in 2014 to 102 531 in 2020. α-Adrenoceptor antagonists were prescribed five times more often than 5α-reductase inhibitors. Ten in 100 men aged ≥75 yr now receive a prescription for a BPH medication. By 2020, 19 per 1000 men received a prescription for ED medication. Sildenafil was the most popular choice (47%), followed by tadalafil (43%) and vardenafil (4.8%); the number of users per 1000 men increased from 4.4 to 9.3. Among medications used for urinary incontinence/urgency, mirabegron was the most popular choice (62%) in 2020, followed by oxybutynin (17%).</div></div><div><h3>Conclusions and clinical implications</h3><div>Prescriptions for medications for BPH, ED, and urinary incontinence/frequency have increased at a national level. Further studies are needed to link this with individual data to ascertain discontinuation rates and conversion from pharmacotherapy to surgical intervention.</div></div><div><h3>Patient summary</h3><div>In Norway, there were increasing trends in the use of medications to treat benign prostate enlargement (BPE), erectile dysfunction, and urinary incontinence between 2004 and 2020. The biggest rise was for medications for BPE, which are now prescribed more often than for medications for erectile dysfunction. In recent years, the number of surgeries performed for BPE has fallen.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"75 ","pages":"Pages 89-93"},"PeriodicalIF":3.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807341","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}