European Urology Open Science最新文献

{"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}

{"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}

{"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 (StO₂) 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. StO₂ 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}

{"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}

{"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}

{"title":"Secular Trends in the Prevalence of Total and Latent Prostate Cancer over Half a Century According to Consecutive Autopsy Cases in a Japanese community: The Hisayama Study","authors":"Junichi Taira ,&nbsp;Kenji Kawatoko ,&nbsp;Dai Takamatsu ,&nbsp;Masaki Shiota ,&nbsp;Hiroaki Ogata ,&nbsp;Jun Hata ,&nbsp;Emi Oishi ,&nbsp;Satoko Sakata ,&nbsp;Yoshihiko Furuta ,&nbsp;Mao Shibata ,&nbsp;Tomoyuki Ohara ,&nbsp;Yoshinao Oda ,&nbsp;Masatoshi Eto ,&nbsp;Toshiharu Ninomiya","doi":"10.1016/j.euros.2025.05.013","DOIUrl":"10.1016/j.euros.2025.05.013","url":null,"abstract":"<div><h3>Background and objective</h3><div>Our aim was to investigate secular trends in the period prevalence of total prostate cancer (PC) and latent PC (LPC) according to consecutive autopsy cases in a Japanese community.</div></div><div><h3>Methods</h3><div>A total of 1355 deceased men aged &gt;40 yr in a Japanese community underwent consecutive autopsy examination between 1962 and 2020. The period prevalence of total PC and of LPC was calculated for 15-yr intervals, and secular trends were analyzed using a logistic regression model.</div></div><div><h3>Key findings and limitations</h3><div>The period prevalence of both total PC (from 1.7% in 1962–1976 to 19% in 2007–2020; <em>p</em> &lt; 0.001) and LPC (from 1.3% in 1962–1976 to 11% in 2007–2020; <em>p</em> &lt; 0.001) significantly increased over time (<em>p</em>_trend &lt; 0.001). The age-specific period prevalence of total PC also increased for the age groups 60–79 yr (from 0.55% in 1962–1976 to 9.8% in 2007–2020; <em>p</em> = 0.005) and ≥80 yr (from 6.5% in 1962–1976 to 26% in 2007–2020; <em>p</em> = 0.003). There was no evidence of a secular change in the pathology of LPC.</div></div><div><h3>Conclusions and clinical implications</h3><div>The period prevalence of autopsy-proven total PC and LPC increased over the past 60 yr in a Japanese community. It is likely that this upward trend has involved additional factors beyond improvements in screening and diagnostic techniques or the aging of the population.</div></div><div><h3>Patient summary</h3><div>We used data from autopsy examinations in a Japanese population to analyze long-term trends for the occurrence of prostate cancer. We found a significant rise in the occurrence of both diagnosed prostate cancer and latent prostate cancer over the past 60 years in this Japanese community.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"78 ","pages":"Pages 9-15"},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322420","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":"P20 In-bore MRI-guided prostate biopsy. Single centre experience","authors":"M. Astapova,&nbsp;D. Korotots,&nbsp;V. Terjajeva,&nbsp;I. Alas","doi":"10.1016/S2666-1683(25)00170-3","DOIUrl":"10.1016/S2666-1683(25)00170-3","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"77 ","pages":"Page S22"},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290464","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":"P44 3D printed adiposal and mucosal stem-cells enriched versus acellular scaffold for urethral repair in a rabbit experimental model","authors":"A. Grybas,&nbsp;P. Barasa,&nbsp;R. Tamasauske Zilinskaite,&nbsp;E. Simoliunas,&nbsp;E. Baltrukonyte,&nbsp;I. Simoliune,&nbsp;D. Dasevicius,&nbsp;A. Zelvys,&nbsp;G. Verkauskas,&nbsp;F. Jankevicius","doi":"10.1016/S2666-1683(25)00221-6","DOIUrl":"10.1016/S2666-1683(25)00221-6","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"77 ","pages":"Page S44"},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290466","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":"P13 Exploring the diagnostic value of inflammatory markers in prostate cancer: A serum and tissue-based study","authors":"E. Buržinskis,&nbsp;I. Janulaityte,&nbsp;M. Jievaltas,&nbsp;D. Skaudickas,&nbsp;A. Vitkauskiene","doi":"10.1016/S2666-1683(25)00164-8","DOIUrl":"10.1016/S2666-1683(25)00164-8","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"77 ","pages":"Page S15"},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290727","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":"P54 Immunotherapy with Bacillus Calmette-Guérin (BCG) for intermediate- and high-risk patients: A retrospective study in a Latvian population","authors":"M. Rate,&nbsp;R. Heinrihsone,&nbsp;E. Bitina-Barlote,&nbsp;J. Plonis,&nbsp;M. Nakazawa-Miklasevica","doi":"10.1016/S2666-1683(25)00231-9","DOIUrl":"10.1016/S2666-1683(25)00231-9","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"77 ","pages":"Pages S56-S57"},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144290732","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}