Scandinavian Journal of Urology最新文献

{"title":"Detection of prostate cancer by magnetic resonance imaging before biopsy - real-world evidence from a nationwide cohort study.","authors":"Amalie H Simoni, Anne Ording, Jakob N Hedegaard, Michael Borre, Søren P Johnsen, Henrik Møller","doi":"10.2340/sju.v61.46161","DOIUrl":"https://doi.org/10.2340/sju.v61.46161","url":null,"abstract":"<p><strong>Objective: </strong>Magnetic resonance imaging (MRI) improves prostate cancer detection, but some tumours may be undetectable. This study assessed prostate cancer detection in biopsy-naïve men undergoing first-time prostate MRI.</p><p><strong>Material and methods: </strong>In this nationwide Danish cohort (2018-2022), men aged ≥ 40 years undergoing first-time prostate MRI were classified as MRI-positive if biopsied within 30 days, and MRI-negative if not. This served as a proxy for the radiology report findings. One-year cumulative incidence of prostate cancer diagnosis in the Danish Prostate Cancer Registry, repeated MRI, biopsy and mortality was estimated by MRI-status (positive/negative) and prostate-specific antigen (PSA) level, using the Aalen-Johansen estimator. Occurrence of high-grade cancer was also assessed.</p><p><strong>Results: </strong>Among 10,777 men, 40% were MRI-positive and 60% MRI-negative. The cumulative incidence of prostate cancer was higher in the MRI-positive than the MRI-negative men during 1-year follow-up (63% vs. 5% at PSA levels 2-3.9 µg/L), increasing with higher PSA levels (91% vs. 38% at PSA levels ≥ 20 µg/L). At 1 year, repeated MRI occurred in 21% of MRI-positive men and 9% of MRI-negative men; the subsequent 1-year biopsy incidence was 15% among MRI-negative men. Mortality was comparable between MRI-positive and MRI-negative men (1% vs. 1%). The risk of high-grade prostate cancer at the time of diagnosis was 80% in MRI-positive and 74% in the MRI-negative men.</p><p><strong>Conclusions: </strong>Among biopsy-naïve men undergoing first-time prostate MRI, MRI-positive status strongly predicts prostate cancer, even in men with low PSA. In MRI-negative men with PSA < 4.0 µg/L, prostate cancer risk remains low within the 2-year follow-up.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"178-184"},"PeriodicalIF":2.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric stone treatment in the Nordic countries - a multicentre study from the Scandinavian Collaboration Group for Urinary Stones.","authors":"Øyvind Ulvik, Line Vigrestad, Dan Helgø, Stein Øverby, Kristian Stritesky Larssen, Pertti Nurminen, Jóhann Páll Ingimarsson, John Åkerlund, Rita Ferrito, Tomas Thiel","doi":"10.2340/sju.v61.46270","DOIUrl":"10.2340/sju.v61.46270","url":null,"abstract":"<p><strong>Objective: </strong>To explore differences and similarities in paediatric stone treatment between hospitals in the Nordic countries.</p><p><strong>Material and methods: </strong>A retrospective review of the medical records was performed for children receiving stone treatment in nine Nordic hospitals between January 2014 and December 2023. Variables of interest included diagnostic imaging, treatment modalities, complication rates and stone free rates (SFR).</p><p><strong>Results: </strong>Five hundred and sixty two treatments among 319 children were included; 117 girls and 202 boys with a median age of 10 years (interquartile range 5 - 14). Preoperative diagnostic imaging with computed tomography was performed in 442 cases (79%), and 120 patients (21%) were diagnosed with ultrasound, MRI or X-ray. In 150 cases (27%), stones treated were located in the ureter only and in 412 cases (73%) in the renal pelvis ± ureter. Ureteroscopic stone treatment (URS) was performed in 248 (44%), shock wave lithotripsy (SWL) in 242 (43%) and percutaneous lithotripsy (PCNL) in 72 cases (13%). The distribution of treatment modalities varied considerably between hospitals. URS treatments increased, and SWL procedures declined throughout the study period. A follow-up consultation was carried out in 505 cases (90%). Overall SFR after each session across treatment modalities and location was 49%. The SFRs after URS was 68%, SWL 30% and PCNL 61% and significantly higher after URS compared to SWL, p < 0.001. Postoperative complications leading to readmission occurred in 10% of patients.</p><p><strong>Conclusion: </strong>The study reveals differences in preferred treatment modalities and results between the hospitals. Standardising diagnostics, treatment and follow-up could improve outcomes for children with kidney stone disease.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"170-177"},"PeriodicalIF":2.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optilume® for panurethral stricture: the good, the bad, and the ridiculous.","authors":"Lukas Andrius Jelisejevas, Gennadi Tulchiner, Peter Rehder","doi":"10.2340/sju.v61.46024","DOIUrl":"https://doi.org/10.2340/sju.v61.46024","url":null,"abstract":"","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"166-169"},"PeriodicalIF":2.1,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sweden's nationwide transition to transperineal prostate biopsy: implications for implementation across Europe.","authors":"Matthias May, Christian Gilfrich, Uwe-Bernd Liehr, Steffen Lebentrau","doi":"10.2340/sju.v61.45984","DOIUrl":"https://doi.org/10.2340/sju.v61.45984","url":null,"abstract":"","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"163-165"},"PeriodicalIF":2.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological assessment practices in adult male circumcision and detection of lichen sclerosus: a retrospective single-centre study.","authors":"Jenny Engman, Wilma Håkansson, Nirina Andersson, Johan Svensson, Elisabet Nylander, Amir Sherif, Maja Af Klinteberg","doi":"10.2340/sju.v61.45886","DOIUrl":"10.2340/sju.v61.45886","url":null,"abstract":"<p><strong>Objective: </strong>To investigate histopathological assessment practices following medical circumcision, analyse the prevalence of lichen sclerosus (LS) and assess the management of circumcised LS patients.</p><p><strong>Material and methods: </strong>This retrospective study was conducted at Umeå University Hospital. A total of 416 patients aged ≥18 years who underwent medical circumcision between 2016 and 2023 were included. The variables investigated were the frequency of histopathological diagnosis of preputial tissue, pre- and post-surgery treatment, further management and the prevalence of LS.</p><p><strong>Results: </strong>The mean (standard deviation [SD]) age of included patients was 47 (21) years. Before circumcision, 34% (141/416) of the study population had received treatment with potent or ultrapotent topical corticosteroids. A pre-operative diagnosis of LS was set in 4.8% (20/416) of the patients. Histopathological analysis of circumcised material was performed in 44% (183/416) of cases. Amongst these, LS was confirmed in 60% (110/183). Amongst the patients with histologically confirmed LS, 13% (14/110) received a recorded diagnosis of LS. A total of 15% (16/110) of the patients with LS were either referred to a dermatovenereologist and/or received treatment with an ultrapotent topical corticosteroid.</p><p><strong>Conclusions: </strong>LS appears to be both underdiagnosed and not adequately treated in patients undergoing medical circumcision. Less than half of the circumcised specimens were analysed, which means a risk of missing LS and potential dysplastic changes. Most patients with LS did not receive adequate diagnosis and treatment after surgery. Failure to diagnose LS limits patient awareness, follow-up and appropriate care, factors that may contribute to disease progression and increased cancer risk.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"156-162"},"PeriodicalIF":2.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of asymptomatic bacteriuria on the outcomes and tolerability of Bacillus Calmette-Guérin immunotherapy.","authors":"Antti Nummi, Pertti Nurminen, Olli Kesti, Mikael Högerman, Otto Ettala, Peter J Boström, Antti Kaipia, Jukka Sairanen, Riikka Järvinen","doi":"10.2340/sju.v61.45539","DOIUrl":"10.2340/sju.v61.45539","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether asymptomatic bacteriuria (ABU) prior to Bacillus Calmette-Guérin (BCG) immunotherapy has an impact on the oncological results and overall tolerability of BCG treatment in patients with non-muscle-invasive bladder cancer (NMIBC).</p><p><strong>Materials and methods: </strong>We analyzed retrospectively all patients who received ≥ 1 BCG instillations as treatment of NMIBC in Helsinki University Hospital and Turku University Hospital during 2009-2018. Patients submitted urine specimen 1-7 days prior to the initiation of BCG therapy. ABU was classified as having any positive urine culture but no dysuria or fever. Our primary endpoints were 5-yr recurrence-free survival and progression-free survival. Discontinuation rate of BCG therapy was a secondary endpoint.</p><p><strong>Results: </strong>We identified 795 patients, of whom 154 (19%) had ABU prior to the first BCG instillation. The 5-yr recurrence-free survival rates in the uninfected and bacteriuric groups were 63% (95% confidence interval [CI]: 59-67%) vs. 69% (95% CI: 62-78%), respectively (hazard ratio [HR] 0.83, 95% CI 0.60-1.14). The 5-yr progression-free survival rates were 88% (95% CI: 86-90%) vs. 89% (95% CI: 84-94%), respectively (HR 0.86, 95% CI 0.50-1.49). The 3-yr discontinuation-free survival rates were 51% (95% CI: 47-54%) vs. 51% (95% CI: 44-60%), respectively (HR 0.98, 95% CI 0.75-1.28).</p><p><strong>Conclusion: </strong>ABU did not significantly affect BCG immunotherapy outcomes. Intravesical BCG during ABU is safe, with similar discontinuation rates, indicating very similar treatment tolerability.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"148-155"},"PeriodicalIF":2.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Swedish national guidelines on prostate cancer: recurrent, metastatic and castration resistant disease.","authors":"Johan Stranne, Elin Axen, Ola Bratt, Stefan Carlsson, Jon Kindblom, Kimia Kohestani, Anna Kristiansen, Ingela Franck Lissbrant, Gabriel Moise, Elinor Nemlander, David Robinsson, Christian Torbrand, Elin Trägårdh, Jonas Wallström, Camilla Wennerberg, Camilla Thellenberg Karlsson","doi":"10.2340/sju.v61.45715","DOIUrl":"10.2340/sju.v61.45715","url":null,"abstract":"<p><strong>Objective: </strong>This article presents a summary of the 2025 Swedish prostate cancer guidelines, focusing on recurrence after local treatment, metastatic disease, and castration-resistant prostate cancer.</p><p><strong>Results: </strong>The 2025 Swedish guidelines introduce several important updates. Prostate specific membrane antigen (PSMA)-PET/CT is recommended only when PSA exceeds 0.2 µg/L, and reporting should follow the defined PSMA-RADS-scale. PSMA-PET/CT is preferred over lymph-node dissection for staging. A strong recommendation is issued for radiotherapy to the primary tumour in all oligometastatic men with a life expectancy > 5 years, whereas metastasis-directed therapy is restricted to clinical trials. Systemic treatment pathways now prioritise androgen receptor pathway inhibitors (ARPI) plus androgen deprivation therapy (ADT), with triple therapy (including docetaxel) used more selectively. Pathway-specific staging algorithms have been revised. The oly (ADP-ribose) polymerase inhibitor (PARPi) section has expanded, with broader genomic-based selection and integration into treatment sequencing. Two new chapters and an appendix address cardiovascular risk assessment before ARPI or chemotherapy. Supportive care is substantially strengthened. Compared with the EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer 2025, the Swedish guidelines 2025 applies PSMA-PET/CT more conservatively, restricts PSMA-guided nodal salvage therapy, and issues a more universal recommendation for local radiotherapy in oligometastatic disease. The Swedish guidelines 2025 prioritise ARPI + ADT and limit triple therapy and PARPi combinations due to regulatory and reimbursement constraints. PARPi are largely reserved for BRCA1/2-mutated disease. The Swedish guidelines 2025 provide a more comprehensive framework for rehabilitation and survivorship.</p><p><strong>Conclusions: </strong>The 2025 Swedish prostate cancer guidelines introduce multiple new recommendations and differ in several aspects from the European guidelines.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"138-147"},"PeriodicalIF":2.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the International Bladder Cancer Group prediction model for recurrence-free survival on a national cohort of primary intermediate risk non-muscle invasive bladder cancer.","authors":"Denis Mesinovic, Johannes Bobjer, Oskar Hagberg, Firas Aljabery, Truls Gårdmark, Staffan Jahnson, Tomas Jerlström, Henrik Kjölhede, Per-Uno Malmström, Viveka Ströck, Karin Söderkvist, Anders Ullén, Lars Holmberg, Christel Häggström, Fredrik Liedberg","doi":"10.2340/sju.v61.45712","DOIUrl":"10.2340/sju.v61.45712","url":null,"abstract":"<p><p>The International Bladder Cancer Group (IBCG) has proposed a prognostic model for intermediate risk (IR) non-muscle invasive bladder cancer (NMIBC) for clinical decision-making. We applied the IBCG IR model in a population-based Swedish setting in patients with primary IR NMIBC diagnosed 2013-2014 in BladderBaSe 2.0. Patients were stratified into low-risk (unifocal and tumour size < 3 cm) and intermediate-risk (multiple and/or tumour size ≥ 3 cm) for estimation of 1- and 3-year recurrence-free survival (RFS). Among 710 patients with IR NMIBC, 329 (46%) and 381 (54%) were categorized as low- and intermediate-risk, respectively. Probabilities of disease recurrence or death at 1 and 3 years in low-risk patients were 19% (95% confidence interval [CI]: 15-23) and 41% (95% CI: 35-46), versus 27% (95% CI: 22-31) and 45% (95% CI: 40-50) in the intermediate-risk group. In a sensitivity analysis including only patients receiving serial adjuvant instillations (n = 152) the corresponding probabilities at 1 and 3 years were 19% (95% CI: 10-28) and 33% (95% CI: 22-43) versus 15% (95% CI: 7-23) and 31% (95% CI: 20-41), respectively. Thus, no clinically meaningful difference in recurrence-free survival was observed between International Bladder Cancer Group low- and intermediate-risk groups in this population-based primary non-muscle invasive bladder cancer setting.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"127-130"},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early recurrence after primary TURBT for non-muscle-invasive bladder cancer in Iceland: the critical role of surgical quality.","authors":"Oddur Björnsson, Guðmundur Geirsson, Árni Stefán Leifsson, Sigfús Þór Nikulásson, Sigurður Guðjónsson","doi":"10.2340/sju.v61.45711","DOIUrl":"10.2340/sju.v61.45711","url":null,"abstract":"<p><strong>Introduction: </strong>Transurethral resection of bladder tumor (TURBT) is the standard treatment for non-muscle-invasive bladder cancer (NMIBC), but early recurrences remain frequent. The objective of this study was to standardize TURBT management at our institution through the implementation of a treatment protocol designed to reduce early recurrence after primary TURBT.</p><p><strong>Material and methods: </strong>All patients with newly diagnosed NMIBC who underwent primary TURBT at Landspítali University Hospital between 2013-2015 (control) and 2017-2019 (intervention) were included. The treatment protocol restricted procedures to four surgeons, mandated blue-light cystoscopy, routine postoperative bladder irrigation, and guideline-based instillation therapy. The primary endpoint was recurrence rate at first follow-up cystoscopy; secondary endpoints included adherence to protocol measures and recurrence-free survival.</p><p><strong>Results: </strong>A total of 133 control and 138 intervention patients were included. Baseline characteristics were comparable. After implementation, bladder irrigation increased from 46 to 90%, blue-light cystoscopy was used in 59% of intervention cases, and instillation therapy rates rose (Mitomycin-C: 0-49% in intermediate-risk; Bacillus Calmette-Guérin (BCG):35-63% in high-risk patients). Early recurrence rates remained comparable (15% vs. 16%). Early recurrence varied markedly between surgeons (11-40%) and correlated strongly with detrusor muscle presence. No significant difference in recurrence-free survival was observed, though a trend toward lower recurrence was seen in the intervention group after adjusting for risk factors.</p><p><strong>Conclusion: </strong>Implementation of a standardized TURBT protocol improved adherence to recommended measures but did not reduce early recurrence. Marked inter-surgeon variability highlights surgical quality as the key determinant of early recurrence in non-muscle-invasive bladder cancer.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"131-137"},"PeriodicalIF":2.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Achilles tendon rupture following single-dose ciprofloxacin use in transrectal prostate biopsies.","authors":"Michaela Runnaes, Erik Lampa, Johan Styrke, Karl-Johan Lundström","doi":"10.2340/sju.v61.45649","DOIUrl":"10.2340/sju.v61.45649","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the risk of Achilles tendon rupture (ATR) following single-dose ciprofloxacin prophylaxis for transrectal prostate biopsy.</p><p><strong>Methods: </strong>Using the Prostate Cancer data Base Sweden (PCBaSe 5.0), we analysed 44,959 prostate biopsy exposures versus 662,520 non-exposures to assess the risk of ATR. Prostate biopsy served as a proxy for quinolone use, with single-dose ciprofloxacin being the recommended and most extensively documented prophylaxis in Sweden for this procedure. The outcome was ATR in men who underwent a biopsy compared to those who did not.</p><p><strong>Results: </strong>The incidence rate of ATR was 60.46 per 100,000 person-years in the no-biopsy group, compared to 62,77 per 100,000 person-years in the biopsy group. The multivariable analysis yielded a hazard ratio of 0.98 (95% confidence interval [CI]: 0.83-1.15).</p><p><strong>Conclusions: </strong>Transrectal prostate biopsy was not associated with an elevated risk of Achilles tendon rupture. This provides some evidence against single-dose ciprofloxacin being a relevant risk factor for this outcome, but there is remaining uncertainty related to study limitations.</p>","PeriodicalId":21542,"journal":{"name":"Scandinavian Journal of Urology","volume":"61 ","pages":"121-126"},"PeriodicalIF":2.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}