BJUI compass最新文献

{"title":"Understanding the long-term impact of the COVID-19 pandemic on non-muscle-invasive bladder cancer outcomes: 12-Month follow-up data from the international, prospective COVIDSurg Cancer study","authors":"Cameron E. Alexander,&nbsp;Arjun Nathan,&nbsp;Alexander Light,&nbsp;Chuanyu Gao,&nbsp;Vinson Chan,&nbsp;Sinan Khadhouri,&nbsp;Kevin Gallagher,&nbsp;Kevin G. Byrnes,&nbsp;Michael Walters,&nbsp;Terry Hughes,&nbsp;Rita Perry,&nbsp;Kelvin Okoth,&nbsp;Laura Magill,&nbsp;Thomas Pinkney,&nbsp;Joseph B. John,&nbsp;John S. McGrath,&nbsp;Alexandra Colquhoun,&nbsp;Yuhao Zhang,&nbsp;James Blackmur,&nbsp;Eric Etchill,&nbsp;Stanley Tang,&nbsp;Damián García Escudero,&nbsp;Grant Stewart,&nbsp;Veeru Kasivisvanathan,&nbsp;COVIDSurg Collaborative","doi":"10.1002/bco2.432","DOIUrl":"10.1002/bco2.432","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to report the 12-month oncological outcomes for patients with non-muscle-invasive bladder cancer (NMIBC) within the prospective, international COVIDSurg Cancer study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>Eligible patients were aged ≥18 years and scheduled for elective surgical management of NMIBC with curative intent (transurethral resection of bladder tumour [TURBT] or bladder biopsy) from 21 January to 14 April 2020. The primary outcome was disease recurrence within 12 months of previous elective TURBT/bladder biopsy. Secondary outcomes included disease progression within 12 months of previous elective TURBT/bladder biopsy, site-declared delay to surgery from diagnosis as a consequence of COVID-19 and deviation in standard care due to COVID-19. Comparisons were made to cohorts from the pre-pandemic era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Bladder cancer accounted for 2.2% (<i>n</i> = 446) of patients in the COVIDSurg Cancer study, with data contributed by 27 centres across 12 countries internationally. Within this included cohort, 229 patients had NMIBC and 12-month follow-up data available. On application of National Institute for Health and Care Excellence (NICE) criteria, 47.2% were classified as having high-risk disease. Overall disease recurrence and progression rates were 29.3% and 9.7% at 12 months, respectively. In purely high-risk pre-pandemic cohorts, the International Bladder Cancer Group (IBCG) estimates a recurrence rate of 25% at 12 months, and the European Association of Urology (EAU) NMIBC 2021 scoring model estimates a 12-month progression rate of 3.5%. As a consequence of the COVID-19 pandemic, 10.9% of patients had site-declared delay to TURBT/bladder biopsy; 7.4% did not undergo intravesical therapy or had early discontinuation of this; 9.2% did not undergo early repeat resection for high-risk disease; and 18.3% had a delay to cystoscopic follow-up surveillance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This prospective study indicates that there were widespread deviations in usual care for NMIBC during the pandemic and that 12-month oncological outcomes appear to be impaired compared to published pre-pandemic outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1044-1051"},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633980","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":"Treatment preferences of patients with muscle invasive bladder cancer: A discrete choice experiment","authors":"Liam Mannion,&nbsp;Verity Watson,&nbsp;Vinod Mullassery,&nbsp;Rajesh Nair,&nbsp;Thomas Charlton,&nbsp;Margaret Northover,&nbsp;Deborah Enting,&nbsp;Mieke Van Hemelrijck,&nbsp;Muhammad Shamim Khan,&nbsp;Ramesh Thurairaja,&nbsp;Suzanne Amery,&nbsp;Kathryn Chatterton,&nbsp;Kate Smith,&nbsp;Simon Hughes","doi":"10.1002/bco2.443","DOIUrl":"10.1002/bco2.443","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>When faced with treatment options, patients are asked to participate in decision-making. We sought to determine which treatment aspects matter most for individuals treated for muscle invasive bladder cancer (MIBC), with an aim to improve understanding of patient preferences and what trade-offs patients are willing to accept. Our study consisted of a discrete choice experiment (DCE): a type of questionnaire used to elicit preferences in the absence of real-world choice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The DCE had five attributives, each with three levels. Participants were asked to complete a questionnaire in which they were asked to choose between two hypothetical MIBC treatments. The data were analysed using a conditional logit model, and preferences for, and trade-offs between, attributes were estimated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We recruited patients with MIBC who had either already completed, were undergoing or had yet to commence radical treatment for MIBC (<i>n</i> = 60). Participants indicated a strong preference for treatments that increased their life expectancy (<i>p</i> = &lt;0.001), had a lower risk of long-term complications (<i>p</i> = &lt;0.001) and less changes to their body image (<i>p</i> = &lt;0.001). Changes to sexual wellbeing (<i>p</i> = 0.09) or an increase in acute side effects (<i>p</i> = 0.99) did not influence preferences. Patients were willing to accept treatments with higher risk of long-term complications to improve their life expectancy or body image.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>When deciding on the type of treatment, increased life expectancy is the most important consideration for people with MIBC. The risk of long-term complications and changes to overall body image as a result of treatment are also important. Our study also highlighted that patients are willing to accept a higher risk of long-term complications to improve other treatment outcomes. Understanding patient preferences is important for shared decision-making, which has an impact on quality of care for people living with MIBC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1059-1068"},"PeriodicalIF":1.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633975","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 between beta-blocker atenolol use and prostate cancer upgrading in active surveillance†","authors":"Ali H. Zahalka,&nbsp;Ethan Fram,&nbsp;Evan Garden,&nbsp;Lauren Howard,&nbsp;Emily Wiggins,&nbsp;Mustufa Babar,&nbsp;Jay Annam,&nbsp;Allison Reagan,&nbsp;Benjamin Eilender,&nbsp;Amanda de Hoedt,&nbsp;Stephen J. Freedland,&nbsp;Ash Tewari,&nbsp;Kara L. Watts","doi":"10.1002/bco2.441","DOIUrl":"10.1002/bco2.441","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to investigate the association between the use of beta-adrenergic antagonist atenolol and risk of pathologic upgrade in patients on active surveillance, considering growing literature implicating adrenergic innervation with disease progression mediated through beta-adrenergic signalling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Men with low-risk or favourable intermediate-risk prostate cancer who were placed on an active surveillance protocol between 2006 and 2020 across three diverse urban hospitals were included. Exposure was duration of atenolol use, and outcome was pathologic grade group upgrading (to GG ≥ 3) on final prostate biopsy. Cox proportional hazard regression models were used to determine the associations between atenolol use and risk of upgrading with time, on a per-examination basis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 467 men with initial GG ≤ 2 were included. Postdiagnosis atenolol use was associated with a decreased risk of pathologic upgrade to GG ≥ 3 on final repeat biopsy (HR 0.81, 95% CI 0.39–0.98). Longer duration of postdiagnosis atenolol use (&gt;2 years) and greater cumulative atenolol dose (&gt;730 defined daily doses) were associated with a more pronounced decreased risk of upgrade to GG ≥ 3 (HR 0.41, 95% CI 0.05–0.88, and HR 0.32, 95% CI 0.15–0.99, respectively). Initiation of atenolol use prior to prostate cancer diagnosis had a slightly greater protective effect than drug initiation postdiagnosis (HR 0.79, 95% CI 0.43–0.98, and HR 0.83, 95% CI 0.30–0.99, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Beta-adrenergic blockade with atenolol use in men on active surveillance is associated with a reduced risk for clinically significant grade group pathologic upgrade.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1095-1100"},"PeriodicalIF":1.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633888","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":"Integrated enhanced recovery after surgery protocol in radical cystectomy for bladder tumour—A retroprospective study","authors":"Waseem Ashraf,&nbsp;Arif Hamid,&nbsp;Sajad Ahmad Malik,&nbsp;Rouf Khawaja,&nbsp;Sajad Ahmad Para,&nbsp;Mohammad Saleem Wani,&nbsp;Saqib Mehdi","doi":"10.1002/bco2.438","DOIUrl":"10.1002/bco2.438","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Enhanced recovery after surgery (ERAS) is a patient-centerd, evidence-based approach to improve postoperative outcomes. The protocol involves multidisciplinary collaboration and standardisation of perioperative interventions. ERAS has shown positive results in reducing hospitalisation and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study conducted in the Department of Urology was a retro-prospective study. It included an ERAS cohort group of 47 patients, studied prospectively from May 2021 to May 2023. These patients were compared to a historical cohort of 47 consecutive patients who underwent radical cystectomy with traditional care before the ERAS pathway was implemented. The primary outcome was hospital length of stay (LOS). Secondary outcomes included perioperative management, time to recovery milestones and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Implementation of ERAS pathway for radical cystectomy was associated with reduced hospital LOS (mean LOS 16.19 ± 2.53 days vs. 10.26 ± 3.33 days 7 days; <i>p</i> &lt; 0.0001), reduced time to key recovery milestones, including days to first flatus (3.17 vs. 2.68; <i>p</i> = 0.013) and days to first solid food (5.19 vs. 3.45 <i>p</i> value &lt; 0.0001), first stool (5.53 vs. 4.23; <i>p</i> &lt; 0.0001), reductions in some complications like postoperative ileus (<i>p</i> value = 0.021) and need for total parental nutrition (<i>p</i> value = 0.023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, the implementation of the integrated approach facilitates a more efficient recovery process, potentially reducing healthcare costs and enhancing patient comfort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1069-1080"},"PeriodicalIF":1.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633949","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":"Outcome of post-prostatectomy stress urinary incontinence surgery in men with preoperative idiopathic detrusor overactivity","authors":"Nikita R. Bhatt,&nbsp;Simona Ippoliti,&nbsp;Arjun Nambiar,&nbsp;Cristian Ilie,&nbsp;Ruth Doherty,&nbsp;Lee Smith","doi":"10.1002/bco2.442","DOIUrl":"10.1002/bco2.442","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urodynamic evidence of storage dysfunction such as detrusor overactivity (DO) and/or poor compliance are present in up to 30–40% of patients after Radical Prostatectomy (RP). However, the current optimal management of men with DO on preoperative urodynamics prior to male stress urinary incontinence (SUI) surgery is not known.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a systematic search of the literature including articles on patients undergoing SUI surgery after prostatectomy with preoperative DO between January 2003 and May 2023 to ensure contemporaneous data was obtained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 11 eligible publications with a total of 792 patients. On Urodynamics, 29% (n = 229) patients had DO prior to SUI surgery. Overall 69% patients had a successful outcome after SUI surgery while 26% (132/499) failed while 34% (32/95) patients who had proven DO preoperatively failed SUI surgery. The difference was not statistically significant. Considering the sub-group analysis, the failure rate with preoperative DO was significantly higher in the sling group (43%) than in the AUS group (18%). The review was limited by the outcome heterogeneity, variability in study inclusion criteria, reporting and analysis and the quality of the available studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Within the limitations of the data, this review did not show a statistically significant higher failure rate of male incontinence surgery in patients with DO. Hence, patients with DO on preoperative urodynamics who are eligible for male SUI surgery should not be denied surgery but should be counselled appropriately of the risks and potential need for subsequent treatment, to manage expectations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1001-1010"},"PeriodicalIF":1.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633951","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":"Indian consensus statements on the management of small renal masses, non-muscle invasive bladder cancer and high-risk/locally advanced prostate cancer","authors":"Simon Hughes,&nbsp;Rajesh Nair,&nbsp;Bhav Radia,&nbsp;Ravimohan S. mavuduru,&nbsp;Prokar Dasgupta,&nbsp;Amit Ghose","doi":"10.1002/bco2.440","DOIUrl":"10.1002/bco2.440","url":null,"abstract":"<p>No pan-India-specific guidelines exist for the management of urological cancers. Although western guidelines are useful for informing management strategies, they do not account for the nuances of management in the Indian context. A modified Delphi method was used to provide a framework for the systematic development of India-centric guidelines for the management of three uro-oncology disease states: small renal masses, non-muscle invasive bladder cancer and high-risk/locally advanced prostate cancer.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1034-1043"},"PeriodicalIF":1.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633917","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":"Bilateral orchidopexy for intermittent testicular torsion","authors":"Paul K. Hegarty,&nbsp;Mona Kalantar,&nbsp;Penelope A. Hegarty,&nbsp;Helen Zafirakis,&nbsp;Jack E. Monahan","doi":"10.1002/bco2.439","DOIUrl":"10.1002/bco2.439","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the effect of bilateral orchidopexy in preventing future torsion and testicular loss in patients with intermittent testicular torsion. Secondarily, this study aims to assess the rate of pain improvement following orchidopexy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a prospective cohort of patients. Participants were men who underwent elective bilateral orchidopexy for intermittent testicular torsion. All consecutive cases were treated by a single surgeon in a single centre between 2015 and 2023. The primary outcomes were prevention of torsion and testicular loss. The secondary outcome was the resolution or improvement in pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The success rate of bilateral orchidopexy in preventing testicular loss due to torsion was 100%, at a follow-up of mean 33.5 months. Of the 50 patients, 88% were pain-free following orchidopexy, and 12% had an improvement in their pain. There were no cases of hydrocoele or haematoma in this series. To our knowledge, this is the largest series reported in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elective bilateral orchidopexy prevents torsion and preserves testicular viability. Pain is resolved in most but not all cases. This is important in counselling men who are considering surgical management of intermittent torsion of the testicle.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1017-1022"},"PeriodicalIF":1.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633894","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":"Dorsal venous complex ligation-free and parietal endopelvic fascia preserving in laparoscopic radical prostatectomy: A prospective study of single centre","authors":"Zhong-Hua Yang,&nbsp;Yong-Zhi Wang,&nbsp;Tao Liu,&nbsp;Hang Zheng,&nbsp;Xing-Huan Wang","doi":"10.1002/bco2.437","DOIUrl":"10.1002/bco2.437","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to describe a novel dorsal venous complex (DVC) ligation-free and parietal endopelvic fascia preserving technique for laparoscopic radical prostatectomy and to evaluate its post-operative outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From April 2020 to May 2021, a total of 125 patients with localized prostate cancer received laparoscopic radical prostatectomy by a single surgeon. In the procedure, a novel technique of DVC ligation-free and parietal endopelvic fascia preserving was used. Preoperative characteristics of patients and perioperative results were recorded. In this study, continence was defined as zero to one pad per day. Oncological outcomes were evaluated based on positive surgical margin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five patients required a blood transfusion. Mean post-operative hospital stay was 3.9 days (2–5), and the catheter could be removed on post-operative day 7 to 9. Final pathologic evaluations were 87 stage pT2, 22 stage pT3a, and 7 pT3b, 9 stage pT4, respectively. The positive surgical margin rate was 10.4% in total. Ninety-three patients (74.4%) returned to urinary continence 2 months post-operatively, and 11 patients (11/125) developed biochemical recurrence 6 months post-operatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The DVC ligation-free and parietal endopelvic fascia preserving technique provides early recovery from incontinence without adversely affecting the oncological outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1101-1105"},"PeriodicalIF":1.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633901","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":"Uropathogen antibiogram regional variations—Are Australian antimicrobial guidelines appropriate?","authors":"Gavin Wei,&nbsp;James Antony Sidney Sewell,&nbsp;Caroline Bartolo,&nbsp;Amelia Pearce,&nbsp;Owen Harris,&nbsp;Richard Grills","doi":"10.1002/bco2.429","DOIUrl":"10.1002/bco2.429","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objectives of this study are as follows: to assess the uropathogen antibiogram at two tertiary hospitals in Victoria to look at the difference in susceptibility patterns, to assess whether national guideline recommendations were applicable and to assess the feasibility of local antibiogram analysis to guide development of hospital-specific guidelines for empirical treatment of urosepsis and for pre-operative prophylaxis for urological procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>All positive urine cultures analysed at Barwon Health and Monash Health, two tertiary hospitals in regional and metropolitan Victoria, Australia, respectively, between January 2019 and December 2020 were retrospectively identified. Data obtained included the organism cultured and their susceptibility profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three thousand seven hundred and seventy-seven positive urine cultures from Barwon Health and 6821 from Monash Health were identified. The most common uropathogen was <i>Escherichia coli</i>, which was cultured in 53.4% and 59.1% of urine cultures at Barwon Health and Monash Health, respectively. The main differences observed were in <i>Enterococcus</i> spp., which were cultured in 8.8% and 4.9% of cultures at Barwon Health and Monash Health, respectively, and <i>Candida</i> spp. in 4.2% and 1.5% of cultures at Barwon Health and Monash Health, respectively. The largest differences were found in fluoroquinolone resistance with 12.1% of organisms resistant to ciprofloxacin at Barwon Health compared to 6.4% at Monash Health and 7.1% of organisms resistant to vancomycin compared to 20.1% at Barwon Health and Monash Health, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates that there is considerable variability in the uropathogens and their antimicrobial susceptibility profile in two large health services in the same state. We recommend that each centre performs regular analysis of their uropathogen antibiogram to develop local guidelines for treatment and pre-operative prophylaxis for uropathogens.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1011-1016"},"PeriodicalIF":1.6,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633982","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":"The accuracy of ultrasensitive PSA in predicting disease progression after radical prostatectomy","authors":"Heikki Seikkula,&nbsp;Jaakko Hyysalo,&nbsp;Mikael Högerman,&nbsp;Peter J. Boström,&nbsp;Otto Ettala","doi":"10.1002/bco2.413","DOIUrl":"10.1002/bco2.413","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the role of ultrasensitive PSA values (usPSA) after radical prostatectomy in predicting the subsequent biochemical recurrence (BCR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and methods</h3>\u0000 \u0000 <p>The study included 1836 patients who underwent open or robot-assisted RP at Turku University Hospital between 2003 and 2018. Exclusion criteria involved patients with adjuvant treatments and those who did not reach a PSA nadir &lt;0.1 ng/ml, resulting in a final cohort of 1313 patients. The prognostic impact of the optimal usPSA nadir cut-off value 6 months after RP was investigated to predict subsequent BCR for the whole cohort (<i>N</i> = 1313). The optimal usPSA cut-off value was determined for patients at 3–5 years post-surgery (<i>N</i> = 806) and beyond 5 years (<i>N</i> = 493) of follow-up. We used the area under the curve (AUC) calculation and the Kaplan–Meier method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In a cohort with a median age of 64, primarily featuring Gleason score 7 prostate cancer. uPSA nadir of 0.01 ng/ml (AUC = 0.80) at the first monitoring post-surgery emerged as the optimal cut-off for identifying subjects at low (80%) or high (20%) risk of BCR within the first 3 years. Beyond this period, uPSA values during the first 3 [(AUC = 0.89; 3–5 years post-surgery) and (AUC = 0.81; beyond 5 years)] and 5 post-surgery years (AUC = 0.85) outperformed uPSA nadir in predicting subsequent BCR. Notably, EAU-defined high-risk patients with low uPSA nadir maintained substantial BCR-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, a low usPSA predicts minimal BCR risk over the next 2–3 years post-measurement. Patients with low usPSA can benefit from reduced post-surgery PSA monitoring at 2- to 3-year intervals without compromising outcomes. This strategic approach optimizes resource allocation in busy urological outpatient clinics, especially valuable in publicly reimbursed healthcare systems like Finland.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 11","pages":"1106-1113"},"PeriodicalIF":1.6,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633971","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}