BJUI compass最新文献

{"title":"Urinary microbiota diversity and composition in patients with advanced renal cell cancer.","authors":"Frederico Leal, Romualdo Morandi Filho, Lilian T Inoue, Vitor Heidrich, Ernande X Dos Santos, Diogo A Bastos, Anamaria A Camargo, Denis L F Jardim","doi":"10.1002/bco2.70186","DOIUrl":"https://doi.org/10.1002/bco2.70186","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the role of urinary microbiota in renal cell carcinoma; we analysed urinary microbiota in kidney cancer patients and explored its potential role as biomarker.</p><p><strong>Subjects and methods: </strong>Samples were collected from 49 males (28 patients planned to undergo systemic therapy and 21 healthy volunteers). Two samples were collected from each patient, one prior to treatment and one after 8 to 12 weeks of systemic therapy. Microbiota was analysed by 16S rRNA sequencing. Microbiota diversity, taxonomic composition and relative abundance were compared between groups and longitudinal samples.</p><p><strong>Results: </strong>Amplicon sequence variant (ASV) richness was higher in renal cancer patients (<i>p</i> = 0.042) than controls. Beta diversity also differed between patients and controls by means of Jaccard (<i>p</i> = 0.001), Bray-Curtis (<i>p</i> = 0.008), and nonweighted UniFrac metrics (<i>p</i> = 0.001). <i>Acetobacter, Lacticaseibacillus, Alloscardovia, Brevibacterium</i> and the family Propicionibactericeae had higher relative abundance in cancer patients, while <i>Prevotella</i>, <i>Microbacterium</i> and <i>Sphingomonas</i> were more abundant in controls. Beta diversity differed between pretreatment and posttreatment samples (<i>p</i> = 0.008). After systemic treatment, we found an increased relative abundance for <i>Prevotella, Rothia, Bradyrhizobium, Methylobacterium/Methylobrum, Porphiromonas</i> and <i>Fusobacterium</i> and a decreased one for the <i>Burkeholderia-Caballeronia-Paraburkholderia</i> group. Higher ASV richness was predictive of poor prognosis for RCC patients (<i>p</i> = 0.043) but not of treatment response.</p><p><strong>Conclusions: </strong>Urinary microbiota in patients with renal cell carcinoma differed from controls. Changes in microbiota composition were observed after systemic treatment. Urinary microbiota should be further investigated as a potential biomarker in renal cell carcinoma.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 5","pages":"e70186"},"PeriodicalIF":1.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-port robot-assisted ureterolysis for retroperitoneal fibrosis: A less invasive path to functional recovery.","authors":"Filippo Carletti, Alexandru Turcan, Flavia Tamborino, Luca Alfredo Morgantini, Lorenzo Salvodirocco, Marwan Alkassis, Fabrizio Dal Moro, Simone Crivellaro","doi":"10.1002/bco2.70218","DOIUrl":"https://doi.org/10.1002/bco2.70218","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to evaluate the outcomes of an initial series of single-port robot-assisted ureterolysis (SP-RAU) in patients with retroperitoneal fibrosis (RPF).</p><p><strong>Patients and methods: </strong>We prospectively collected surgical and clinical data from all consecutive patients undergoing SP-RAU at our institution between April 2016 and May 2024. The primary endpoint was the achievement of a stent-free status at 12 months.</p><p><strong>Results: </strong>Overall, 16 patients (21 renal units) underwent SP-RAU with a minimum follow-up of 12 months. All five patients with bilateral disease were managed with a staged approach in two separate surgical sessions. RPF was idiopathic in 37% and secondary in 62% of cases. Four procedures (19%) were aborted due to extensive fibrosis or high vascular risk (one unilateral right, two unilateral left and one second-stage left unit). These patients had significantly longer preoperative stent duration (60 vs. 9 months; <i>p</i> = 0.006). Among the 17 completed procedures, no open conversions, intraoperative complications or transfusions occurred. Median operative time was 215 min (IQR 195-240), and median blood loss was 10 ml (IQR 10-20). Median length of stay was 11.5 h (IQR 7.8-26), with 52% of patients discharged the same day. At a median follow-up of 25 months (IQR 18-50), complete symptom resolution was achieved in 82% of renal units, whereas 64% remained stent-free at 12 months. The main limitations are the small sample size, single-surgeon experience and absence of a comparator arm.</p><p><strong>Conclusion: </strong>SP-RAU is a safe and feasible minimally invasive option for managing RPF. It achieves good functional success with minimal morbidity and enables same-day discharge in over half of patients. Larger multicentre studies with longer follow-up are needed to confirm these findings and establish the role of SP-RAU in the management of RPF.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 ","pages":"e70218"},"PeriodicalIF":1.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of anatomical outcomes in the upper urinary tract following flexible ureteroscopy with flexible and navigable suction ureteral access sheath: 1-year results from a multicentre study.","authors":"Steffi Kar Kei Yuen, Chi-Fai Ng, Khi Yung Fong, Bhaskar Kumar Somani, Boyke Soebhali, Mohamed Elshazly, Vigen Malkhasyan, Karl Tan, Luis Rico, Mehmet Ilker Gokce, Han Jie Lee, Nariman Gadzhiev, Tzevat Tefik, Jianwei Cao, Albert El Hajj, Chi-Ho Leung, Jeremy Yuen Chun Teoh, Oliver Traxer, Ben Hall Chew, Daniele Castellani, Vineet Gauhar","doi":"10.1002/bco2.70213","DOIUrl":"https://doi.org/10.1002/bco2.70213","url":null,"abstract":"<p><strong>Introduction: </strong>Flexible and navigable suction access sheath (FANS) with flexible ureterorenoscopy (FURS) has demonstrated favourable 30-day and 3-month outcomes for renal stones in normal anatomy. We aimed to investigate the long-term 1-year safety and efficacy of FANS for renal and ureteric stones in normal or anomalous anatomy.</p><p><strong>Methods: </strong>This prospective multicentre study included adults undergoing FURS with FANS across 11 centres in 9 countries (April 2023 to August 2024), with follow-up until August 2025. Anatomical outcomes were assessed by contrast CT (or ultrasound if CT not available) at 1 year; stone-free rate (SFR) was assessed via noncontrast CT at 30 days. The primary aim was to report if altered anatomy, such as pelvicalyceal or pelviureteric or ureteric stricture, occurs at a later stage.</p><p><strong>Results: </strong>Among 288 patients, median age was 55 years, and 4.5% had anomalous renal anatomy. About 49% were prestented. Stones were located only in the kidney (62%), ureter (18%) or both (20.1%). Median stone volume was 725 mm³; median Hounsfield unit was 1100. Most procedures (84%) used a 7.5Fr scope with 10/12 Fr FANS. Regarding exit strategies, 65% were stented, 14% had an overnight ureteric catheter and 21% were tubeless. Mild bleeding occurred in 17% with no postoperative sepsis, transfusions or persistent hematuria. One patient (0.35%) experienced a Grade 1 ureteric injury. On a 30-day CT, 82% achieved zero residual fragments (Grade A SFR). On 1-year CT, five patients (1.7%) were diagnosed with ureteric stricture, 9.7% had persistent residual fragments, and 5.6% developed new ipsilateral stones. Of the five patients with strictures, three had a history of ureteric re-implantation and only one had been prestented. Serum creatinine showed no significant change from baseline.</p><p><strong>Conclusions: </strong>This study reports the longest 1-year follow-up data for patients undergoing FURS with FANS to date. The study did not identify a high rate of late anatomical complications after successful FANS deployment in the treatment of renal and ureteric stones. Caution is warranted in patients with a history of ureteral re-implantation due to elevated risk of stricture formation.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 ","pages":"e70213"},"PeriodicalIF":1.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of erectile dysfunction and male lower urinary tract symptoms in a Japanese cross-sectional survey.","authors":"Katsuya Yamaguchi, Akihito Hashizume, Hiroki Ito, Yasushi Yumura, Shinnosuke Kuroda, Teppei Takeshima, Hisashi Hasumi, Daiki Ueno, Kazuhide Makiyama, Hiroji Uemura, Jun-Ichi Teranishi, Takashi Kawahara","doi":"10.1002/bco2.70219","DOIUrl":"https://doi.org/10.1002/bco2.70219","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to evaluate the correlation between erectile dysfunction (ED) and lower urinary tract symptoms (LUTSs) using the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS).</p><p><strong>Methods: </strong>An online survey was conducted among 4800 Japanese men using the International Index of Erectile Function-5 (IIEF-5), International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS). After excluding one incomplete response, data from 4799 participants were analysed. Participants were grouped by ED severity according to IIEF-5 score. The total and subcategory scores of the IPSS and OABSS were compared among the groups. LUTSs were categorized as post-micturition, storage, voiding symptoms and incontinence. An additional analysis was conducted by age group: younger (40s-50s) and older (≥70s).</p><p><strong>Results: </strong>Lower ED severity was associated with significantly lower IPSS and OABSS total scores (<i>p</i> < 0.001). Voiding symptoms and incontinence scores increased with ED severity (<i>p</i> < 0.001). Severe ED (IIEF-5 to <8) was significantly associated with worse scores across all the LUTS domains. Younger men without ED had significantly lower scores in all LUTS categories (<i>p</i> < 0.001). However, among older men, no significant differences in LUTS scores were observed according to ED status.</p><p><strong>Conclusion: </strong>ED severity is positively correlated with LUTS severity, particularly voiding symptoms and incontinence. This relationship was more prominent in younger men.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 ","pages":"e70219"},"PeriodicalIF":1.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymph node surgery after centralization of penile cancer care in Sweden: Extent of use and complications.","authors":"Åsa Warnolf, Gediminas Baseckas, Dominik Glombik, Oskar Hagberg, Peter Kirrander, Kimia Kohestani, Per Nordlund, Erik Persson, Fredrik Liedberg, Axel Gerdtsson","doi":"10.1002/bco2.70220","DOIUrl":"https://doi.org/10.1002/bco2.70220","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study is to compare the use of lymph node surgery and complication rates before and after centralization of penile cancer (PeCa) surgery in Sweden. In January 2015, curative surgical care for PeCa was centralized to the Skåne University Hospital in Malmö and the Örebro University Hospital in Örebro.</p><p><strong>Patients and methods: </strong>All 1079 patients with invasive PeCa in the Swedish National Penile Cancer Register (NPECR) diagnosed between 2009 and 2020 were included, 458 before and 621 after centralization. The proportion of patients subjected to lymph node surgery 2009-2014 versus 2015-2020 was compared using Pearson's Chi-squared test. Odds ratios (ORs) for complications were calculated using a logistic regression model adjusting for age, nodal stage and extent of penile surgery. Continuous variables were presented as medians and compared using Wilcoxon's rank sum test.</p><p><strong>Results: </strong>Before centralization, 270/458 (59%) of patients were subjected to lymph node surgery compared to 474/621 (76%) after 2014. Overall complication rate for patients undergoing such surgery was unaltered before and after centralization. The incidence of any complications increased after Dynamic Sentinel Lymph Node Biopsy from 18% (22/122) to 36% (91/256), corresponding to an adjusted OR of 1.89 (95% confidence interval [CI] 1.09-3.27). For lymphocele, lymphedema or infection after modified or radical inguinal or pelvic lymphadenectomy, the adjusted OR was 0.47 (95% CI 0.29-0.75) after centralization. The register-based setting is a study limitation.</p><p><strong>Conclusions: </strong>The proportion of men undergoing lymph node surgery increased, and the risk of lymphocele, lymphedema and infection after inguinal and pelvic lymph node surgery decreased after centralization of PeCa care.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 ","pages":"e70220"},"PeriodicalIF":1.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic immune dysregulation in patients experiencing urogynaecological mesh failure.","authors":"Shannon Jamieson, Cameron R Dougan, Eloise Rennie, Patrick Card, Sudarshan Nallappa, Karen Smith, David J Deehan, Karen Brown, Catharien M U Hilkens, Christopher Harding","doi":"10.1002/bco2.70210","DOIUrl":"https://doi.org/10.1002/bco2.70210","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the systemic immune landscape in patients experiencing urogynaecological mesh failure. The use of urogynaecological mesh was paused in the UK following an independent safety review that found ~1 in 15 women required removal due to complications. However, the mechanisms underpinning mesh failure remain largely unknown, with few studies focussing on localised tissue responses and no reports characterising systemic immune dysregulation.</p><p><strong>Materials and methods: </strong>Serum samples collected from patients during mesh removal surgery were analysed for immunomodulatory protein content using enzyme-linked immunosorbent assay (ELISA) and multiplex Luminex Discovery Assay. Peripheral blood mononuclear cells (PBMCs) collected were cultured with or without exposure to pristine mesh, and immunomodulatory protein secretion was measured in the same way. Patient serum was also used as a migratory stimulus for healthy PBMCs to test the functionality of chemotactic proteins present.</p><p><strong>Results: </strong>Mesh patient serum had increased chemotactic protein levels, particularly CCL2, CXCL5, CCL12 and CCL4, which had a functional effect and induced significant cell migration. Mesh patient PBMCs also secreted immunomodulatory proteins including MMP-9 and CCL2. Future studies should focus on expanding cohort numbers and including a control group of mesh patients not experiencing complications to further determine both underlying biology and mesh responses.</p><p><strong>Conclusions: </strong>This study characterised an altered systemic immune landscape not previously investigated in mesh failure patients. Clinically, the ability to identify phenotypic factors or develop biomarkers which predict and monitor mesh responses would help guide clinicians and patients in shared decision making.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 ","pages":"e70210"},"PeriodicalIF":1.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative FAN score predicts survival outcomes after radical cystectomy for bladder cancer.","authors":"Yu Ishizuya, Atsunari Kawashima, Shimpei Yamashita, Takeshi Ujike, Tetsuya Takao, Osamu Miyake, Hiroki Osaki, Hiromu Horitani, Toshichika Iwanishi, Tsuyoshi Takada, Yuta Oki, Takahiro Yoshida, Makoto Matsushita, Ken-Ichi Kakimoto, Akira Nagahara, Takuji Hayashi, Yoshiyuki Yamamoto, Taigo Kato, Koji Hatano, Yasuo Kohjimoto, Isao Hara, Norio Nonomura","doi":"10.1002/bco2.70221","DOIUrl":"https://doi.org/10.1002/bco2.70221","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate whether the preoperative FAN score-composed of the fibrosis-4 (Fib-4) index, albumin-bilirubin (ALBI) score and neutrophil-lymphocyte ratio (NLR)-predicts recurrence-free, cancer-specific and overall survival after radical cystectomy for bladder cancer.</p><p><strong>Patients and methods: </strong>We retrospectively analysed 1121 patients who underwent radical cystectomy at 13 institutions between April 2010 and March 2024. Associations between the FAN score and recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) were evaluated. Prognostic performance was assessed in an independent cohort of 296 patients from three institutions.</p><p><strong>Results: </strong>FAN score distribution was 0 (<i>n</i> = 600, 53.5%), 1 (<i>n</i> = 409, 36.5%) and ≥2 (<i>n</i> = 112, 10.0%). Patients with a FAN score ≥2 had significantly worse RFS (median: not reached vs 12.3 months; <i>p</i> < 0.0001), CSS (not reached vs 22.8 months; <i>p</i> < 0.0001) and OS (112.5 vs 16.1 months; <i>p</i> < 0.0001) than those with a FAN score ≤1. On multivariable analysis, a FAN score ≥2 was an independent predictor of poorer RFS (HR 2.12, 95% CI 1.55-2.91; <i>p</i> < 0.0001), CSS (HR 2.80, 95% CI 2.00-3.92; <i>p</i> < 0.0001) and OS (HR 2.70, 95% CI 2.03-3.59; <i>p</i> < 0.0001). These associations were consistently observed in an independent cohort of 296 patients.</p><p><strong>Conclusions: </strong>The FAN score is an independent prognostic marker of adverse outcomes after radical cystectomy for bladder cancer and may help stratify patients for perioperative management and follow-up.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 ","pages":"e70221"},"PeriodicalIF":1.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside risk score for medical therapy failure in small-volume BPH: Temporal validation.","authors":"Numan Alam, Naveed Ahmad, Syed Hamzah Shirazi, Aftab Ahmed, Bilal Suria, Jamahid Ali, Muhammad Anas Ghazi, Elham Shenawa, Mirza Muhammad Hadeed Khawar","doi":"10.1002/bco2.70217","DOIUrl":"https://doi.org/10.1002/bco2.70217","url":null,"abstract":"<p><strong>Purpose: </strong>Medical therapy is the first-line treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). However, predictors of treatment failure in men with small prostate volume (<30 ml) remain poorly defined. This study aimed to develop and temporally validate a simple bedside risk score for predicting medical therapy failure in this specific subgroup.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of 201 men aged ≥50 years with IPSS ≥8 and prostate volume <30 ml who started medical therapy between 2015 and 2025. Treatment failure was defined as surgical intervention, acute urinary retention or IPSS worsening by ≥4 points. Independent predictors were identified using multivariable logistic regression. A practical integer risk score was derived from the strongest predictors. Temporal validation was conducted by splitting the cohort chronologically (derivation set 2015-2020, <i>n</i> = 120; validation set 2021-2025, <i>n</i> = 81).</p><p><strong>Results: </strong>During a median follow-up of 24 months, 66 patients (32.8%) experienced treatment failure. Independent predictors included higher IPSS, greater BPH Impact Index, increased intravesical prostatic protrusion, lower maximum flow rate, higher post-void residual volume and diabetes mellitus. The bedside risk score stratified patients into low-risk (0-3 points: 11.0% failure), moderate-risk (4-7 points: 32.9%) and high-risk (8-13 points: 77.5%) categories. The model demonstrated good discrimination (AUC 0.789; bootstrap-corrected 0.782) and maintained strong performance in temporal validation (derivation AUC 0.799; validation AUC 0.821).</p><p><strong>Conclusion: </strong>This novel bedside risk score reliably predicts medical therapy failure in small-volume BPH using readily available clinical parameters. It may enable early risk stratification and timely intervention, particularly in populations with high diabetes prevalence.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 ","pages":"e70217"},"PeriodicalIF":1.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymph node dissection during cystectomy for non-muscle-invasive bladder cancer: A systematic review.","authors":"Sean Lim, Lucielle Standish, Harrison Liu, Eldho Paul, Weranja Ranasinghe","doi":"10.1002/bco2.70201","DOIUrl":"https://doi.org/10.1002/bco2.70201","url":null,"abstract":"<p><strong>Background and objective: </strong>Radical cystectomy (RC) is standard for muscle-invasive disease (MIBC) and utilised frequently in high-risk non-muscle-invasive bladder cancer (NMIBC). Pelvic lymph node dissection (PLND) is routinely performed during RC for MIBC, demonstrating a survival benefit. However, the oncologic value in NMIBC remains uncertain. As such, a systematic review was conducted to determine whether PLND confers an oncologic benefit in NMIBC patients undergoing RC.</p><p><strong>Materials and methods: </strong>A systematic search of MEDLINE, Embase and PubMed (January 1989-January 2025) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (CRD42023443011). Eligible studies included NMIBC patients undergoing RC with or without PLND. Data extraction and quality assessment (ROBINS-I, MINORS) were performed independently by two reviewers.</p><p><strong>Results: </strong>Twenty-one retrospective studies (<i>n</i> = 35 793) met inclusion criteria. Lymph node positivity ranged from 0% to 13%. Comparative studies consistently demonstrated improved overall survival and cancer-specific survival with PLND, particularly among pT1 subgroups (pooled 5-year OS = 71.8%, 95% CI 59.3-84.3). Several studies demonstrated a dose-response association between lymph node yield or dissection extent and improved outcomes. Benefits were inconsistent for Ta/Tis disease. Pathological upstaging occurred in 16%-36% of clinically staged cohorts. However, study quality was moderate, with heterogeneity in PLND definitions, staging methods and adjuvant treatment use.</p><p><strong>Conclusions: </strong>PLND appears to improve staging and survival in high-risk NMIBC, especially pT1 disease. Routine PLND for low-risk Ta/Tis disease is unsupported. Standardised definitions of PLND extent and prospective evaluation are needed to confirm its therapeutic role.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 ","pages":"e70201"},"PeriodicalIF":1.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urodynamics assessment in patients with multiple sclerosis.","authors":"Nicholas Faure Walker, Alexandra Bacon, Manisha Teji, Eskinder Solomon, Arun Sahai, Ross Stephens, Emmanuel Okpii, Charlotte Dunford, Sarah Wood, Emily Speck, Ruth Doherty, Angie Rantell, George Araklitis, Lydia Lilis, Tharani Nitkunan, Michelle Carey, Suzanne Biers, Brendan Berry, Mahreen Pakzad, Hashim Hashim","doi":"10.1002/bco2.70208","DOIUrl":"https://doi.org/10.1002/bco2.70208","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to review initial urodynamics (UDS) findings in patients with multiple sclerosis (MS) related lower urinary tract symptoms, establish where UDS happen in treatment pathways and to evaluate the benefit of video over standard UDS.</p><p><strong>Patients and methods: </strong>OnaBotulinumToxin A (BTX-A) naïve, MS patients who had undergone UDS were identified from prospectively maintained databases from UK hospitals.</p><p><strong>Results: </strong>One hundred fifty-seven patients were identified from seven UK departments. One (0.9%) female patient and 3 (6.7%) males had end fill pressures > 40 cmH₂O. No female and two (5.1%) males showed vesico-ureteric reflux. Of female patients reporting pure overactive bladder (OAB) symptoms, 61 (67.2%) showed neurogenic detrusor overactivity (NDO), 10 (11.1%) showed loss of compliance (LoC) and 28 (31.1%) showed no NDO or LoC. Following UDS, 134 (85.4%) patients underwent management changes: 61 (72.6%) females and 25 (78.1%) males were offered non-medical treatment, oral or topical medication; 30 (30.9%) females and 7 (18.9%) males were advised to start self-catheterisation; 16 (19.0%) females and 4 (12.5%) males were offered intra-vesical BTX-A; two (2.4%) females were offered SUI surgery and one (3.1%) male was offered bladder outflow obstruction surgery.</p><p><strong>Conclusion: </strong>Many patients underwent UDS prior to conservative and medical management, which is earlier than most guidelines recommend, potentially delaying non-invasive treatment. This study supports the need for VUDS at initial assessment of men with MS. Standard UDS suffice in women with MS and pure OAB symptoms unresponsive to conservative measures and oral medication unless they have abnormal renal function, hydronephrosis or significant post void volumes.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 ","pages":"e70208"},"PeriodicalIF":1.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}