BJUI compass最新文献

{"title":"Indications and added value of videourodynamics in men with spinal cord injury","authors":"Marc Françot,&nbsp;Chloé Lefevre,&nbsp;Bénédicte Reiss,&nbsp;Marc Lefort,&nbsp;Georges Karam,&nbsp;Jerome Rigaud,&nbsp;Loic Le Normand,&nbsp;Alain Ruffion,&nbsp;Brigitte Perrouin-Verbe,&nbsp;Marie-Aimee Perrouin-Verbe","doi":"10.1002/bco2.370","DOIUrl":"10.1002/bco2.370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The primary aim of this study was to evaluate the indications and additional information provided by videourodynamic study (VUDS) over urodynamic studies (UDS) in men with spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction (NLUTD). The secondary aim was to determine the added value of VUDS and its impact on bladder management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Single-centre retrospective study of all men with SCI who underwent VUDS between 2011 and 2021. Participant characteristics, clinical data and indications for UDS and VUDS as well as bladder management were recorded. The added value of VUDS was defined as additional information not provided by standard UDS that impacted on bladder management (choice of voiding mode, surgical indication or type of surgery).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-eight men with a median age of 52 years were included. In 20 men who were unable to perform self-catheterisation, the VUDS clarified the nature and extent of the obstruction and enabled targeted surgery to achieve reflex bladder emptying in all of them. VUDS also clarified the type and level of obstruction in 28 patients, enabling targeted surgery in 24. In 11 men, VUDS was performed as part of the preoperative assessment for a Brindley procedure or after this operation if a complication occurred during follow-up to confirm the need for further surgery or to target surgical revision. Overall, VUDS had added value in 59 patients (67%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VUDS had added value over UDS in specific situations; the additional information provided impacted on bladder management in men with SCI and NLUTD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 8","pages":"761-769"},"PeriodicalIF":1.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141669443","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":"Suction use in ureterorenoscopy: A systematic review and meta-analysis of comparative studies","authors":"Lazaros Tzelves,&nbsp;Robert Geraghty,&nbsp;Patrick Juliebø-Jones,&nbsp;Yuhong Yuan,&nbsp;Konstantinos Kapriniotis,&nbsp;Daniele Castellani,&nbsp;Vineet Gauhar,&nbsp;Andreas Skolarikos,&nbsp;Bhaskar Somani","doi":"10.1002/bco2.408","DOIUrl":"10.1002/bco2.408","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Ureterorenoscopy is seeing a bloom of technological advances, one of which is incorporating suction. The objective of this study is to systematically review existing literature regarding suction use in rigid and flexible ureterorenoscopy and perform meta-analysis of studies comparing suction versus no suction ureteroscopy or mini percutaneous nephrolithotomy (PCNL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search was performed (November 2023) in MEDLINE, Embase and Cochrane CENTRAL. Study protocol was registered at PROSPERO (CRD42023482360). Comparative studies (observational and randomized) were eligible for inclusion if they compared suction versus no suction group and reported at least one primary outcome of interest (stone-free or complication rate).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen studies (5 randomized and 11 observational), analysing 1086 and 1109 patients in standard and suction groups, respectively, were included. Final stone-free rates (SFRs), overall and infectious complications and length of hospital stay exhibited significant improvement when suction was used. When mini-PCNL was compared with flexible ureterorenoscopy with suction, no differences were found in terms of stone-free and infectious complications rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ureterorenoscopy is a commonly performed endoscopic procedure for urolithiasis treatment, the success of which is defined by SFRs and complication rates. Application of suction via ureteral access sheaths, ureteral catheters or scopes may provide improved SFRs, reduced overall and infectious complication rates, along with a reduction in length of hospital stay. Further randomized studies are needed to validate these findings and standardize indications and protocols.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 10","pages":"895-912"},"PeriodicalIF":1.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668491","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":"Imaging modalities for characterising T1 renal tumours: A systematic review and meta-analysis of diagnostic accuracy","authors":"Hannah Warren,&nbsp;Jack B. Fanshawe,&nbsp;Valerie Mok,&nbsp;Priyanka Iyer,&nbsp;Vinson Wai-Shun Chan,&nbsp;Richard Hesketh,&nbsp;Eleanor Zimmermann,&nbsp;Veeru Kasivisvanathan,&nbsp;Mark Emberton,&nbsp;Maxine G. B. Tran,&nbsp;Kurinchi Gurusamy","doi":"10.1002/bco2.355","DOIUrl":"https://doi.org/10.1002/bco2.355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>International guidelines recommend resection of suspected localised renal cell carcinoma (RCC), with surgical series showing benign pathology in 30%. Non-invasive diagnostic tests to differentiate benign from malignant tumours are an unmet need. Our objective was to determine diagnostic accuracy of imaging modalities for detecting cancer in T1 renal tumours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was performed for reports of diagnostic accuracy of any imaging test compared to a reference standard of histopathology for T1 renal masses, from inception until January 2023. Twenty-seven publications (including 2277 tumours in 2044 participants) were included in the systematic review, and nine in the meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forest plots of sensitivity and specificity were produced for CT (seven records, 1118 participants), contrast-enhanced ultrasound (seven records, 197 participants), [^99mTc]Tc-sestamibi SPECT/CT (five records, 263 participants), MRI (three records, 220 participants), [¹⁸F]FDG PET (four records, 43 participants), [⁶⁸Ga]Ga-PSMA-11 PET (one record, 27 participants) and [¹¹¹In]In-girentuximab SPECT/CT (one record, eight participants). Meta-analysis returned summary estimates of sensitivity and specificity for [^99mTc]Tc-sestamibi SPECT/CT of 88.6% (95% CI 82.7%–92.6%) and 77.0% (95% CI 63.0%–86.9%) and for [¹⁸F]FDG PET 53.5% (95% CI 1.6%–98.8%) and 62.5% (95% CI 14.0%–94.5%), respectively. A comparison hierarchical summary receiver operating characteristic (HSROC) model did not converge. Meta-analysis was not performed for other imaging due to different thresholds for test positivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The optimal imaging strategy for T1 renal masses is not clear. [^99mTc]Tc-sestamibi SPECT/CT is an emerging tool, but further studies are required to inform its role in clinical practice. The field would benefit from standardisation of diagnostic thresholds for CT, MRI and contrast-enhanced ultrasound to facilitate future meta-analyses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 7","pages":"636-650"},"PeriodicalIF":1.6,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141631240","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":"Muscle matters: Skeletal muscle index and body mass index impact on complications and survival in renal cancer","authors":"Alexander Hintze Hillers,&nbsp;Signe Wang Bach,&nbsp;Atena Saito,&nbsp;Nessn Azawi","doi":"10.1002/bco2.405","DOIUrl":"10.1002/bco2.405","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to independently assess skeletal muscle index (SMI) and body mass index (BMI) as prognostic determinants for renal cell carcinoma (RCC) and investigate their correlation with surgical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>A retrospective cohort study of 524 RCC patients diagnosed between August 2010 and July 2018 was conducted using data from the Zealand University Hospital Renal Cancer Database in Denmark. Patient information was extracted from electronic patient records and the National Cancer Registry and encompassed demographics, clinical factors, tumour characteristics and surgical details. SMI was calculated from a single third lumbar vertebra (L3) axial computed tomography (CT) image via CoreSlicer software and classified into high using gender-specific thresholds. Primary outcomes focused on complications within 90 days as well as survival outcomes, and their relation with both SMI and BMI. Multivariable analysis assessed SMI's independent prognostic significance in RCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 524 patients, 18.5% experienced complications, with high SMI correlating significantly (<i>p</i> = 0.018) with a 72% higher complication risk. High SMI patients had a 22.7% complication rate compared to 14.5% in the low SMI group. High SMI was also linked to prolonged survival (110.95 vs. 94.87 months; <i>p</i> = 0.001), whereas BMI showed no significant survival differences (<i>p</i> = 0.326). Multivariable analysis (<i>n</i> = 522) revealed high SMI associated with improved survival (hazard ratio [HR] = 0.738; 95% CI, 0.548–0.994; <i>p</i> = 0.046). Advanced T-stage significantly impacted mortality (T2: HR = 2.057; T3: HR = 4.361; <i>p</i> &lt; 0.001), and each additional year of age raised mortality risk by 4.3% (HR = 1.043; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher SMI increases the risk of postoperative complications, yet it significantly improves overall survival rates. Different BMI categories lack RCC prognostic significance. The increasing incidence in RCC calls for the use of CT scan to assess SMI and aid treatment planning in patients who might benefit from preoperative interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 8","pages":"783-790"},"PeriodicalIF":1.6,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141346786","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":"Recurrence patterns following nephrectomy for renal cell carcinoma in a Danish nationwide cohort","authors":"Goran Bencina,&nbsp;Rolf Billeskov,&nbsp;Rasmine Bak,&nbsp;Ahmed Al-Sabbagh,&nbsp;Julie Højgaard Pedersen,&nbsp;Marina Lunetcas,&nbsp;Emma Heeno,&nbsp;Sara Tolouee,&nbsp;Tuba Ashraf,&nbsp;Niels Fristrup,&nbsp;Nessn Azawi","doi":"10.1002/bco2.375","DOIUrl":"https://doi.org/10.1002/bco2.375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to characterize the demographic and clinical features of patients with renal cell carcinoma (RCC) post-surgery for localized or locally advanced disease in a national Danish cohort, with a specific focus on describing recurrence patterns in a subgroup aligned with the adjuvant KEYNOTE-564 trial classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective analysis of the Danish Renal Cancer (DaRenCa) database. Eligible subjects were individuals with an RCC diagnosis between January 2014 and December 2017 who subsequently underwent radical or partial nephrectomy. Variables of interest were demographic and clinical characteristics, rates and sites of recurrence. Recurrence rates were also assessed in a subpopulation stratified using the risk classifications of the KEYNOTE-564 trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2164 RCC patients were identified. Most patients (84.8%) had non-metastatic RCC (stage M0). A recurrence was observed in 250 of the M0 patients (13.6%). Patients with a recurrence were older, male, had a higher tumour stage, had undergone radical nephrectomy and had a higher Leibovich score. The majority (74.8%) of M0 patients had recurrence at distant metastatic sites. A total of 392 patients were stratified by the KEYNOTE-564 risk classification: 335 intermediate-high risk, 17 high risk and 40 M1 NED (metastatic with no evidence of disease). Recurrence was observed in 37.0%, 88.2% and 27.5% of these risk groups, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study elucidates the rates and determinants of post-surgical RCC recurrence in Denmark, underscoring the potential of adjuvant immunotherapy in refining therapeutic strategies, identifying suitable beneficiaries and minimizing overtreatment risks in RCC care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 8","pages":"791-798"},"PeriodicalIF":1.6,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994111","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":"Trans-rectovesical pouch urethral-sparing robotic-assisted simple prostatectomy: A case series","authors":"Xinnan Chen,&nbsp;Kangkang Zhao,&nbsp;Hao Wang,&nbsp;Chengwei Zhang,&nbsp;Lin Du,&nbsp;Wendi Wang,&nbsp;Tianyi Chen,&nbsp;Haixiang Qin,&nbsp;Xuefeng Qiu,&nbsp;Hongqian Guo,&nbsp;Gutian Zhang","doi":"10.1002/bco2.389","DOIUrl":"10.1002/bco2.389","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To detail a novel technique of robotic-assisted simple prostatectomy that makes handling the gland protruding into the bladder neck easier and can preserve the urethra and retain ejaculation function as much as possible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This is a prospective case series. Clinical data of 17 male patients who had large volume (&gt;80 mL) benign prostatic hyperplasia (BPH) were enrolled to undergo trans-rectovesical pouch urethral-sparing robotic-assisted simple prostatectomy (usRASP). We adopted the approach through the space between the bladder neck and seminal vesicle to perform a usRASP that can avoid the detrusor skirt and fibrous matrix area of the retropubic prostate. Between the transitional zone and the peripheral zone of the large prostate, the hyperplastic prostatic gland tissue can be enucleated under direct vision while preserving the prostatic urethra and retaining the ejaculatory duct and bladder neck intact. All preoperative, perioperative and postoperative clinical data were collected, and descriptive analysis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median intravesical prostatic protrusion was 19.3 mm (8.5–32.2). The median operative time was 100 min (75–140), and the median estimated blood loss was 100 mL (10–500). The median time to catheter removal was 7 days (5–7), with a median postoperative hospital stay of 2 days (2–4). After at least 6-month follow-up, the median maximum urine flow rate and postvoid residual volume were 40.1 mL/s (12.7–52.4) and 15 mL (5–23), respectively; the median International Prostate Symptom Score and Quality of Life score were 0 (0–6.3) and 1 (0–3), respectively; and the median total prostate-specific antigen was 0.84 ng/mL (0.15–1.01). All patients successfully underwent usRASP. Fifty-eight percent of patients with normal ejaculation function before surgery can still retain normal ejaculation function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We described a new approach to performing usRASP. This new method remarkably improved the voiding function, maintained antegrade ejaculation and did not increase the post-operative complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 8","pages":"776-782"},"PeriodicalIF":1.6,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141380138","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":"Value of a confirmatory re-biopsy as part of a modern risk stratified cancer surveillance programme for early prostate cancer","authors":"Harry Gabb,&nbsp;Vincent J. Gnanapragasam","doi":"10.1002/bco2.406","DOIUrl":"10.1002/bco2.406","url":null,"abstract":"&lt;p&gt;Active Surveillance (AS) is an important management strategy for patients diagnosed with early prostate cancer. Current National Institute for Health and Care Excellence (NICE) guidelines recommend AS as first-line for patients in Cambridge Prognostic Group 1 (CPG1), as an equal option for CPG2 and an alternative for those with CPG3 who decline radical treatment (https://www.nice.org.uk/guidance/ng131). The elements of modern AS incorporate regular prostate-specific antigen (PSA) tests and MRI scans at defined timepoints. Early repeat or confirmatory biopsies, however, are not currently mandated in any modern guidance or protocol. Previous research has shown that first diagnostic biopsies can under-represent disease burden in men on AS and is improved if pre-biopsy MRI guidance is used.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; We have previously published that MRI pre-biopsy improves disease characterisation at diagnosis that can translate into lower rates of AS progression compared with benchmark series.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; However, the value of confirmatory/early re-biopsy in addition to pre-MRI diagnostics remains unknown. This is particularly important if AS follow-up is to be individualised at its commencement based on predicted disease behaviour, progression risk and to minimise future use of protocol re-biopsies.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;We have developed and implemented the Stratified Cancer Active Surveillance (STRATCANS) programme in our centre details of which we have reported and are in this webtool https://stratcans.com.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; In summary, STRATCANS defines three tiers of follow-up based on the risk of progression determined by diagnostic CPG, PSA density and MRI. In STRATCANS, men with the least burden of disease (STRATCANS tier-1, that is, CPG1 and a low PSA density) are managed primarily by PSA (which can be patient self-monitored) and may not need clinical review for up to 18 months. MRI repeat is based on daignostic PIRADS score and biopsies used only if there is a change. This light touch review mandates that the disease burden at the start of AS is very well characterised. Given this context the goal of this study was to assess the value of confirmatory re-biopsy in STRATCANS in confirming the disease burden at the start of AS and hence allocation to the correct STRATCANS tier.&lt;/p&gt;&lt;p&gt;A retrospective case notes review of men on STRATCANS who agreed to confirmatory re-biopsy (within 12 months of diagnosis) was performed as part of an ongoing service evaluation of STRATCANS in our unit (Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; registration number: PRN11857). Men were routinely offered early re-biopsy when selecting AS management unless unfit for another procedure. Data from all men who agreed are included here, and there were no other case selections applied. The only other exclusion was therefore if a patient declined based on their own preferences. Those with significant co-morbi","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 7","pages":"662-664"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141274213","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":"Multiparametric-magnetic resonance imaging (mp-MRI) of the prostate and Urolift: Identifying artefact size, location and clinical implications","authors":"Cameron James Parkin,&nbsp;Rajeev Jyoti,&nbsp;Peter Chin","doi":"10.1002/bco2.392","DOIUrl":"https://doi.org/10.1002/bco2.392","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We sought to define the degree of artefact caused by prostatic urethral lift (PUL) on multiparametric-magnetic resonance imaging (mp-MRI) to determine the location, size of artefact and if the device could potentially obscure a diagnosis of prostate cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten patients were prospectively enrolled to undergo PUL for treatment of benign prostatic hyperplasia and follow-up imaging. A standard mp-MRI protocol using a 3.0 Tesla scanner was performed prior to and following Urolift insertion. Pre- and post-PUL images were compared to measure maximum artefact diameter around each implant in each MRI parameter. A transverse relaxation time weighted (T2) artefact reduction protocol was also evaluated. The location of each artefact was then compared to a separate database of 225 consecutive patients who underwent magnetic resonance guided prostate biopsies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Artefact occurred around the stainless steel urethral implant component only. Mean T2 artefact maximum diameter was 7.7 mm (sd = 1.71 mm), with an artefact reduction protocol reducing this to 5.4 mm (sd = 1.43). Mean dynamic-contrast-enhancement artefact was 10 mm (sd = 2.5 mm), and mean diffusion-weighted-imaging artefact was 28.2 mm (sd = 7.8 mm). All artefacts were confined to the posterior transition zone only. In the 225 consecutive patients who had undergone magnetic resonance guided prostate biopsies, there were 55 positive biopsies with prostate cancer, with 13 cases found in the transition zones and no cancer identified solely in the posterior transitional zone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The stainless steel urethral component of the PUL does cause artefact, which is confined to the posterior transition zone only. PUL artefact occurs in an area of the prostate that has a very low incidence of a single focus of prostate cancer. If there is concern for prostate cancer in the posterior TZ (e.g. if every other area is clear with a high PSA), this area can undergo targeted biopsy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 8","pages":"770-775"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.392","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994112","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":"Safety of urethral preservation using urethral frozen section analysis in radical cystectomy","authors":"Yuto Hattori,&nbsp;Akihiko Nagoshi,&nbsp;Tasuku Fujiwara,&nbsp;Takanari Kambe,&nbsp;Yuta Mine,&nbsp;Hiroki Hagimoto,&nbsp;Yohei Abe,&nbsp;Daisuke Yamashita,&nbsp;Naofumi Tsutsumi,&nbsp;Noboru Shibasaki,&nbsp;Toshinari Yamasaki,&nbsp;Mutsushi Kawakita","doi":"10.1002/bco2.377","DOIUrl":"https://doi.org/10.1002/bco2.377","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of this study is to assess whether urethral preservation can be performed safely using frozen section analysis (FSA) of the urethral stump on urethral recurrence after radical cystectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between June 2012 and July 2022, we investigated consecutive male patients who underwent urethral FSA during radical cystectomy for urothelial carcinoma. For FSA-abnormal cases, urethrectomy was performed, and for FSA-normal cases, the urethra was preserved. The diagnostic accuracy of FSA was assessed in comparison with the pathological findings of the permanent sections of the same tissue. Postoperatively, computed tomography and urinary cytology were performed as routine surveillance of recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 77 patients included in this study, three patients with abnormal FSA underwent concurrent urethrectomy. The negative predictive value of urethral FSA was 100%. With a median postoperative follow-up of 38 months (interquartile ranges 21–71), no urethral recurrence was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FSA may be useful in determining the indication for urethrectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 8","pages":"806-810"},"PeriodicalIF":1.6,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994059","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":"‘Feeling Hot’: Exploring the feasibility of nocturnal erection detection through penile temperature measurements","authors":"Hille J. Torenvlied,&nbsp;Evelien Trip,&nbsp;Wouter Olthuis,&nbsp;Loes I. Segerink,&nbsp;Rob C. M. Pelger,&nbsp;Jack J. H. Beck","doi":"10.1002/bco2.372","DOIUrl":"https://doi.org/10.1002/bco2.372","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The observational ‘Feeling Hot’ study aims to evaluate the feasibility of employing overnight penile temperature measurements for the detection of nocturnal erections, thereby contributing to the advancement and modernization of a non-invasive diagnostic system for erectile dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/Patients and Methods</h3>\u0000 \u0000 <p>In this proof-of-concept study, 10 healthy men aged 20–25 were recruited, following the methodology outlined in the ‘Staying Hot’ study by Torenvlied et al. Participants underwent ambulatory overnight penile temperature measurements concurrent with RigiScan recordings. Key outcome measures included baseline and peak penile temperatures during RigiScan-annotated nocturnal erections. Reference measurements of the thigh temperature were also taken to assess nocturnal temperature variations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Statistically significant penile temperature increases (<i>p</i> = 0.008, <i>n</i> = 9) were observed during nocturnal erections, with an average elevation of 1.47°C noted during the initial erections. This underscores the practical utility of penile temperature measurements in detecting erection onset. Challenges arose in accurately determining erection duration and subsequent erection onsets due to the persistence of elevated temperatures following initial erections, termed the ‘Staying Hot effect’. Reference thigh temperature measurements aided in addressing this challenge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Examining overnight penile temperature alongside simultaneous RigiScan recordings has yielded valuable insights into the viability of using the temperature methodology for detecting nocturnal erections. The ‘Feeling Hot’ study findings demonstrate significant penile temperature elevation during nocturnal erections in healthy young men, highlighting the potential of integrating this measurement methodology into the design of a modernized tool for ambulatory erectile dysfunction diagnostics. Further development of an advanced sensor system to comprehensively assess erection duration and quality is essential for enhancing clinical applicability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 7","pages":"668-674"},"PeriodicalIF":1.6,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141631164","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}