BJUI compass最新文献

{"title":"Focal therapy in prostate cancer: Development, application and outcomes in the United Kingdom","authors":"Nadia Rokan,&nbsp;Deepika Reddy","doi":"10.1002/bco2.70000","DOIUrl":"https://doi.org/10.1002/bco2.70000","url":null,"abstract":"<p>Prostate cancer is a significant health issue in the United Kingdom, with rising incidence rates prompting the exploration of innovative treatment options. Focal therapy has emerged as a targeted approach that aims to treat localised prostate cancer while minimising damage to surrounding healthy tissue and subsequent adverse side effects. Focal therapy is National Institute for Health and Care Excellence (NICE)-approved treatment modality for patients with intermediate-risk localised prostate cancer. This is an evolving field, reflecting the rapidly improved understanding of both the trajectory patients face following a diagnosis of prostate cancer, and how best to apply ablative techniques.</p><p>In this narrative review, we evaluate the historical development, current practices, clinical outcome reported in UK-based studies, and future directions of focal therapy for prostate cancer in the United Kingdom, highlighting its evolution as a viable treatment option.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447117","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":"Precision in kidney-sparing surgery: Robot-assisted ureterectomy with novel Black Eye™ Ink","authors":"Hayder Alhusseinawi,&nbsp;Naomi Nadler,&nbsp;Helene Reif Andersen,&nbsp;Juan Luis Vásquez,&nbsp;Thomas Norus,&nbsp;Nessn Azawi","doi":"10.1002/bco2.502","DOIUrl":"https://doi.org/10.1002/bco2.502","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the feasibility, oncological efficacy and safety of robotic segmental ureterectomy (SU) for treating patients with localised upper tract urothelial carcinoma (UTUC). A key aspect of this research involves utilising Black Eye™ Endoscopic Marker Ink to delineate the boundary of the tumour in the ureter, helping to ensure precise surgical intervention and reducing the risk of positive surgical margin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In a prospective non-randomised trial from January 2018 to December 2022, patients with localised UTUC confirmed by CT-urography were enrolled. A Multidisciplinary Team assessed patients for suitability for kidney-sparing surgery (KSS) with SU, marked by endoscopic Black Eye™ Endoscopic Marker Ink. Black Eye Endoscopic Marker Ink marking aimed to enhance surgical precision by delineating clear resection margins. The primary endpoints were the feasibility of the technique, local and bladder recurrence rates and surgical outcomes. Propensity score matching was used for a balanced comparison to the standard treatment Radical Nephroureterectomy (RNU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty patients underwent SU, in the period of study with only one local recurrence reported with a median follow-up time of 35 months. SU was associated with a significantly shorter operative time (41 minutes less on average, <i>p</i> &lt; 0.001) than RNU. Tumour size was significantly larger in the RNU group (median size 42.5 mm, IQR: 30–60.5) compared to the SU group (median size 30 mm, IQR: 20–35) (<i>p</i> = 0.007), potentially indicating selection bias towards RNU for more advanced cases. No significant difference between the groups was found in the post-operative Clavien-Dindo complication score nor in oncological outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SU with Black Eye™ Endoscopic Marker Ink marking is a viable KSS technique that offers a safe and effective alternative to RNU for patients with a single tumour, no longer than 30 mm and of low grade. This novel approach is promising in lowering the risk of positive margins, ensuring cancer control and preserving renal function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439221","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":"Prevalence and risk factors of stress urinary incontinence in a 2023 Japanese community health survey - differences between males and females","authors":"Nobuhiro Haga,&nbsp;Mikako Yoshida,&nbsp;Takahiko Mitsui,&nbsp;Noritoshi Sekido,&nbsp;Naoya Masumori,&nbsp;Kenji Omae,&nbsp;Motoaki Saito,&nbsp;Yasue Kubota,&nbsp;Ryuji Sakakibara,&nbsp;Satoru Takahashi","doi":"10.1002/bco2.70004","DOIUrl":"https://doi.org/10.1002/bco2.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of the present epidemiological study was to evaluate the sex-related prevalence of stress urinary incontinence (SUI) and the associated factors using data from the 2023 Japan Community Health Survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated 3097 males and 3056 females aged 20–99 years. All participants answered web-based questionnaires on their health status and lower urinary tract symptoms. Data on the frequency of SUI, comorbidities and health-related behaviour were extracted. The Cochran-Armitage trend test was used to evaluate the trend between the prevalence of SUI and age. Multivariate analysis was performed using logistic regression analysis to identify factors associated with SUI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SUI was consistently observed in about 10% of individuals in their 20s and 30s, including in males. There were no age-related differences in the prevalence of SUI in males (P = 0.55). In females, the prevalence of SUI statistically significantly increased with age (P &lt; 0.0001). The frequency of SUI was, however, low in both sexes. Drinking habits (OR, 1.43; 95% CI, 1.10–1.87) and frequent spicy food intake (OR, 1.55; 95% CI, 1.19–2.01) were associated with SUI only in males. Age (OR, 1.36; 95% CI, 1.13–1.62), BMI (OR, 1.87; 95% CI, 1.50–2.32) and history of vaginal delivery (OR, 2.15; 95% CI, 1.77–2.63) were only associated with SUI in females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although the frequency of SUI was low in both sexes, the correlation between the prevalence of SUI and age was different between both sexes. Female SUI might involve weakness of the pelvic floor muscle, while male SUI might be affected by health-related behaviours.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424004","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":"A systematic review of outcomes associated with patients admitted to hospital with emergency haematuria","authors":"Nikki Kerdegari,&nbsp;Raghav Varma,&nbsp;Simona Ippoliti,&nbsp;Cameron Alexander,&nbsp;Arjun Nathan,&nbsp;Kevin Gallagher,&nbsp;Sinan Khadhouri,&nbsp;Kevin Byrnes,&nbsp;Nikita Bhatt,&nbsp;Veeru Kasivisvanathan","doi":"10.1002/bco2.497","DOIUrl":"https://doi.org/10.1002/bco2.497","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Unscheduled admission for haematuria accounts for 15% of all urological emergencies with over 25 000 patients admitted each year in the UK. It is associated with prolonged admission and poor clinical outcomes. This systematic review aims to determine current management strategies and outcomes in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was performed in October 2023 across MEDLINE, EMBASE and Web of Science for randomised controlled trials and retrospective and prospective observational studies assessing the management of patients admitted as an emergency with haematuria. The primary outcome measure was the length of stay (LoS). Secondary outcomes included hospital readmission, mortality and health resource use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three eligible publications with a total of 219 patients were identified. Mean length of stay was 5.8 days. The pooled mean age of unscheduled emergency haematuria was 74.8 years and 87.9% of patients were male. Bladder cancer was present in 17% of patients and, similarly, prostate cancer was present in 17% of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Unscheduled admission for haematuria is associated with long LoS. This systematic review has demonstrated a lack of data reporting outcomes of unscheduled haematuria and its management strategies. There is a need to perform large-scale prospective studies to better understand this cohort of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431278","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":"Hydrocortisone treatment is associated with early recovery from severe septic shock in patients with obstructive pyelonephritis due to upper urinary tract stone","authors":"Isamu Otsuka,&nbsp;Koshiro Nishimoto,&nbsp;Taichi Kozako,&nbsp;Katsuhiro Kanemaru,&nbsp;Yasuhiro Yamashita,&nbsp;Toshiyuki Kamoto,&nbsp;Atsuro Sawada","doi":"10.1002/bco2.498","DOIUrl":"https://doi.org/10.1002/bco2.498","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The administration of hydrocortisone in patients with severe septic shock contributes to early recovery in intensive care. The purpose of this study was to evaluate the effect of hydrocortisone on early recovery from severe septic shock in patients with obstructive pyelonephritis due to upper urinary tract stone (stone pyelonephritis).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From January 2018 to October 2023, of all patients admitted for treatment of stone pyelonephritis, 28 did not respond to initial fluid infusion and vasopressors for urosepsis. Among these 28 patients, 14 were administered hydrocortisone for recovery from early shock. Characteristics and noradrenaline administration time of patients treated or not treated with hydrocortisone were retrospectively analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In patients with septic shock associated with stone pyelonephritis unresponsive to initial fluid and vasopressors, noradrenaline administration time in the hydrocortisone group (28.7 ± 17.5 h) was significantly shorter than in the non-treated group (46.0 ± 12.8 h, <i>p</i> = 0.006). The factors diabetes, blood culture results, age, performance status, severity of vital signs and laboratory data on sepsis severity were not significantly associated with the duration of noradrenaline administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest potential benefits of hydrocortisone administration for stone pyelonephritis unresponsive to initial fluid and vasopressors. Widespread adoption of hydrocortisone in the treatment of sepsis, which is common in intensive care, could become more important in urology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.498","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431272","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":"Differentiating between obstructive and non-obstructive azoospermia: A machine learning-based approach","authors":"Abdolreza Haghpanah,&nbsp;Nazanin Ayareh,&nbsp;Ashkan Akbarzadeh,&nbsp;Dariush Irani,&nbsp;Fatemeh Hosseini,&nbsp;Farid Sabahi Moghadam,&nbsp;Mohammad Ali Sadighi Gilani,&nbsp;Iman Shamohammadi","doi":"10.1002/bco2.493","DOIUrl":"https://doi.org/10.1002/bco2.493","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Infertility is a major global concern, with azoospermia, being the most severe form of male infertility. Distinguishing between obstructive azoospermia (OA) and non-obstructive azoospermia (NOA) is crucial due to their differing treatment approaches. This study aimed to develop a machine learning model to predict azoospermia subtypes using clinical, ultrasonographic, semen and hormonal analysis data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included all subjects diagnosed with azoospermia. All patients were evaluated by at least one urologist, had their semen sample assessed on at least two different occasions for diagnosis and underwent a testicular biopsy to determine the type of azoospermia, categorized into OA and NOA. Clinical factors, hormonal levels, semen parameters and testicular features were compared between the OA and NOA groups. Three machine learning models, including logistic regression, support vector machine and random forest, were evaluated for their accuracy in differentiating the two subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included a total of 427 patients with azoospermia, of which 326 had NOA and 101 had OA. The median age of the patients was 33.0 (IQR: 7.0) years. Our findings revealed that factors such as body mass index, testicular length, volume and longitudinal axis, semen parameters and hormonal levels differed significantly between the two groups. When these variables were input into the machine learning-based models, logistic regression achieved the highest F1-score and area under the curve value among the three models evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study underscores the potential of machine learning to differentiate between azoospermia subtypes using readily available clinical data. However, further research is required to validate and refine the model before it can be applied clinically.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431276","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":"Comparing GreenLight PVP and HoLEP beyond 5 years: A systematic review of long-term functional outcomes and reoperation rates","authors":"Arthur Yim,&nbsp;Matthew Alberto,&nbsp;Xingqi Yan,&nbsp;Damien Bolton,&nbsp;Lih-Ming Wong,&nbsp;Kapil Sethi","doi":"10.1002/bco2.483","DOIUrl":"https://doi.org/10.1002/bco2.483","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to compare long-term (≥ 5 years) functional outcomes and reoperation rates following holmium laser enucleation of prostate (HoLEP) vs GreenLight photoselective vaporisation of prostate (GLPVP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MEDLINE, Embase and Cochrane databases were searched from inception to December 2023. Included were randomised controlled trials (RCTs), cohort studies and case series studying HoLEP and/or GLPVP, where functional outcomes and reoperation rates were reported. Studies with &lt;5-year follow-up were excluded. Evidence was synthesised as a comparison across all parameters. Quality of evidence was assessed with the Newcastle–Ottawa Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 3047 records identified, 25 were eligible, including two RCTs, two cohort studies, one cross-sectional study and 20 case series. Twenty-three studies focused on HoLEP or GLPVP, whilst two were comparative studies. HoLEP demonstrated long-term durability of outcomes and low reoperation rates (mean 4.1%, range 2.0%–6.3%) at a mean follow-up of 7.3 years. GLPVP also had durable outcomes at 5-year follow-up, but inconclusive evidence for improvements at 10 years. Reoperation rates were also higher (mean 12.6%, range 3.8%–33.3%). This is in keeping with findings of comparative studies, where HoLEP demonstrated greater improvements in all functional parameters except PVR, and lower reoperation rates. Findings are limited by patient attrition, lack of comparative studies and long-term data beyond 10 years. Three studies examined the 180-W GLPVP model at 5 years showed superior durability to earlier 80-W/120-W models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Current evidence suggests that HoLEP provides significantly greater functional improvements and a lower reoperation rate when compared with the GLPVP 80-W/120-W model at 5-year follow-up. The 180-W model is comparable with HoLEP based on limited data at 5 years, but there is a lack of data beyond 10 years for longer-term functional outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.483","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431366","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":"Testosterone levels at diagnosis: A key predictor of overall survival among patients with prostate cancer","authors":"Ilkka Jussila,&nbsp;Juha P. Ahtiainen,&nbsp;Eija K. Laakkonen,&nbsp;Pirjo Käkelä,&nbsp;Maisa Parviainen,&nbsp;Heikki Pohjolainen,&nbsp;Jarno Aaltonen,&nbsp;Ninamaria Onni,&nbsp;Koskimaa Mikko,&nbsp;Teemu J. Murtola,&nbsp;Heini Huhtala,&nbsp;Heikki Seikkula","doi":"10.1002/bco2.484","DOIUrl":"https://doi.org/10.1002/bco2.484","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>The exact relationship between testosterone levels at diagnosis and prostate cancer (PCa) prognosis remains inadequately explored. The objective was to determine whether serum testosterone levels at the time of PCa diagnosis are associated with overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>The study cohort involved 2544 PCa patients, divided into three groups; normal (&gt;10.4 nmol/L), grey zone (8.0–10.4 nmol/L) and low (2.0–8.0 nmol/L) serum testosterone groups. Survival outcomes were analysed using Kaplan–Meier curves and Cox regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis revealed an increased risk of death among patients with low testosterone levels compared to those with normal levels in uni- (HR = 1.67, 95% CI: 1.37–2.05, <i>p</i> &lt; 0.001) and multivariable-adjusted (HR = 1.58, 95% CI: 1.24–1.98, <i>p</i> &lt; 0.001) analysis. Sensitivity analysis on patients with normal glucose metabolism revealed similar results (HR = 1.93, CI: 1.48–2.51, <i>p</i> &lt; 0.001), as well as after stratified with age below 70 years (HR = 1.55, 95% CI: 1.02–2.36, <i>p</i> &lt; 0.001) and over 70 years (HR = 1.83, 95% CI: 1.46–2.28, <i>p</i> &lt; 0.001.) There was no difference in survival between the grey zone compared to other testosterone groups. The retrospective design limits our ability to infer causality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Low testosterone at the time of PCa diagnosis is an independent predictor of overall survival. Findings highlight the potential of testosterone for prognostic evaluation in PCa.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431271","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":"Expert consensus on Rezūm™: Indications, surgical technique and postoperative care","authors":"Emilio López Alcina,&nbsp;Manuel Fernández Arjona,&nbsp;Ester Fernández Guzmán,&nbsp;Jorge Rioja Zuazu,&nbsp;Iván Schwartzman Jochamowitz","doi":"10.1002/bco2.491","DOIUrl":"https://doi.org/10.1002/bco2.491","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lower urinary tract symptoms associated to benign prostatic hyperplasia (LUTS/BPH) is a growing condition in males associated to a high clinical, economic and humanistic burden. Currently, there is a wide range of therapeutic options, both pharmacological and surgical. In recent years, several minimally invasive therapies have emerged, but they still have limitations. In this context, water vapour thermal therapy (WVTT), Rezüm™, is a new minimally invasive surgical technique with a low retreatment rate and the ability to preserve sexual function. The objective of this study is to establish recommendations for the correct execution of WVTT, as well as to define the ideal patient profile for the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search was conducted in PubMed, without date limitations, using the terms ‘benign prostatic hyperplasia’, ‘benign prostatic enlargement’, ‘prostatic hyperplasia’, ‘bph’, ‘Rezūm’, ‘water vapour thermal therapy’, ‘quality of life’ and ‘HRQOL’. A systematic review of the evidence was conducted and subsequently discussed in a face-to-face meeting with a panel of five experts in the field of urology. The aspects addressed were classified into patient profile, pre-intervention, intervention and post-intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search returned 172 results, ultimately leading to the analysis of 49 articles. Evidence and expert opinion showed that WVTT could be a good option for patients with moderate to severe symptomatology, no age restriction, Qmax &lt;15 mL/s and prostate volume greater than 30 cm³, but not necessarily less than 80 cm³. Low retreatment rate and low impact on erectile capacity and ejaculatory function were also demonstrated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>WVTT is considered a safe treatment option, even as a first-line approach for certain patient profiles. However, further research is needed in areas where evidence and clinical experience remain limited, including postoperative catheter management, anaesthesia, antibiotic prophylaxis and follow-up care for patients after the procedure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424053","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":"Method to determine the nadir PSA following partial gland ablation","authors":"Nelson N. Stone,&nbsp;Vassilios Skouteris,&nbsp;Rendi Shu,&nbsp;Richard G. Stock,&nbsp;Ben GL Vanneste","doi":"10.1002/bco2.496","DOIUrl":"https://doi.org/10.1002/bco2.496","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to propose a novel method of determining the nadir PSA (nPSA) for men with prostate cancer treated by partial gland ablation (PGA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Two cohorts of men were analyzed to develop a formula for the nPSA in men undergoing PGA. First, 123 men with a suspicion of prostate cancer underwent transperineal mapping biopsy (TPMB) and found to have benign pathology. Their prostate-specific antigen (PSA) was compared to the prostate volume using curve estimation regression analysis. Second, the contribution of PSA from an ablated region was determined by using a surrogate of 545 men who had whole-gland brachytherapy followed by prostate biopsy. Biopsy results were compared to radiation dose (calculated as the biological equivalent dose) levels in men who were free from biochemical failure. The nPSA was then calculated by using the PSA density (PSAD) for the untreated volume plus the PSA from the post-brachytherapy patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The PSAD with the highest <i>R</i>² (0.80, <i>p</i> &lt; 0.001) for the 123 men who had TPMB and a negative biopsy was 0.12 ng/mL². In the brachytherapy patients, five 20 Gy dose groups were analyzed from ≤140 to ≥220 Gy, which demonstrated a progressive decrease in the positive biopsy rate to 1.5% at the highest dose (<i>p</i> = 0.036). PSA was &lt;0.2 ng/mL in 98.2% of these men. If brachytherapy was used for PGA and a dose of ≥ 220 Gy was delivered to the ablation zone, the nPSA could be calculated from the remaining untreated volume as: the [(pretreatment PV)–treated volume] ×0.12 ng/mL².</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A method for determining the nPSA following PGA using brachytherapy was developed. The formula relies on complete ablation of the treated volume, which resulted in no PSA contribution from that component. Other forms of ablative energy should yield similar results. Further clinical validation of this concept is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404583","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}