BJUI compass最新文献

{"title":"A prospective analysis of ureteral stenting during radical cystectomy and ileal conduit urinary diversion: Paediatric feeding tubes versus single-J stents","authors":"Jonathan T. Ryan,&nbsp;Tarek Ajami,&nbsp;Adam Williams,&nbsp;Dinno Mendiola,&nbsp;Bruno Nahar,&nbsp;Sanoj Punnen,&nbsp;Chad R. Ritch,&nbsp;Dipen J. Parekh,&nbsp;Mark L. Gonzalgo","doi":"10.1002/bco2.70032","DOIUrl":"https://doi.org/10.1002/bco2.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study compares postoperative outcomes of radical cystectomy (RC) with ileal conduit urinary diversion (ICUD) using paediatric feeding tubes versus single-J ureteral stents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients underwent RC with ICUD for bladder cancer between 2011 and 2018. Prospective preoperative clinical, operative and postoperative data were collected. Postoperative complications including stricture, urine leak, urinary tract infection (UTI) and ileus were compared between patients who received 5-Fr paediatric feeding tubes or 7-Fr single-J ureteral stents during surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred thirty-four patients underwent RC with ICUD including 26 with paediatric feeding tubes and 208 with single-J ureteral stents; 41% had robotic cystectomy, with 36% of these undergoing intracorporeal ICUD. Both groups were comparable in age, gender, kidney function and comorbidities. No significant differences were observed between groups for rates of ileus (20% vs. 34%, <i>p</i> = 0.14), urine leak (4% vs. 10%, <i>p</i> = 0.3), uretero-ileal stricture (16% vs. 18%, <i>p</i> = 0.7) or overall urinary complications (20% vs. 37%, <i>p</i> = 0.12), except for a lower UTI rate in the feeding tube group (4% vs. 23%, <i>p</i> = 0.02). Median hospital stay was shorter in the feeding tube group (6 vs. 8 days, <i>p</i> = 0.015) with similar readmission rates compared to the stent group (<i>p</i> = 0.96).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Using 5-Fr feeding tubes for ureteral stenting during RC with ICUD is a safe alternative to 7-Fr single-J stents, especially for patients with small ureters or delicate anatomy. Stent type showed no significant impact on postoperative urinary complications except for a lower UTI rate with feeding tubes, suggesting comparable overall outcomes between the two stent types.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135819","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":"Performance and safety of transverse scrotal vs transperineal AUS for PPUI: A retrospective cohort study","authors":"Christine R. Reus,&nbsp;Izabelle Brattås,&nbsp;Daniela Volz,&nbsp;Filip Sydén,&nbsp;Renata Zelic,&nbsp;Katarina Hallén Grufman,&nbsp;Lotta Renström Koskela","doi":"10.1002/bco2.70027","DOIUrl":"https://doi.org/10.1002/bco2.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To primarily compare efficacy and safety of transverse scrotal (TS) versus transperineal (TP) artificial urinary sphincter (AUS) implantation for post-prostatectomy urinary incontinence (PPUI). The AUS is the gold standard for managing severe refractory male SUI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This single-centre, retrospective, cohort study, analyses 179 consecutive patients who underwent primary AUS implantation for PPUI between 2005 and 2018. Data on 24-h pad weight tests (PWT), validated quality of life questionnaires (I-QoL), surgical technique, related complications, salvage radiation and transcorporeal cuff placement (TC) were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The TP approach was performed in 43 cases, whilst 136 patients underwent TS incision, of which 31 benefited from TC placement. The median PWT reduction was 458 g (320, 701) in the TP and 479 g (258, 745) in the TS group (p = 0.807). The median I-QoL index increase was 40 (26, 52) in the TP and 48 (36, 60) in the TS group, showing a significant difference in favour of the TS group (p = 0.012). The overall postoperative infection rate was 3.9%, with a lower risk in the TS group (RR = 0.23, p = 0.049). Erosion occurred in 9.0% of patients, with a higher relative risk observed in the TS group (<i>RR = 1.34, p = 0.636</i>); however, we found that the TC patients (consisting of salvage radiation patients) in the TS group drove this higher risk. Mechanical failure and subsequent revision were lower in the TS cohort <i>(RR = 0.43, p = 0.004)</i> and <i>(RR = 0.42, p = 0.002),</i> respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TS and TP approaches resulted in similar improvements in continence but a greater increase in quality of life in the TS group. While post-operative erosion rates and device survival were comparable, the TP group had higher rates of infection and mechanical failure, which may be relevant for surgical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108823","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":"PSMA PET/CT findings in high-risk biochemical recurrence after local treatment of prostate cancer","authors":"Nicole Handa,&nbsp;Richard Bennett IV,&nbsp;Eric V. Li,&nbsp;Austin Ho,&nbsp;Mitchell M. Huang,&nbsp;Sai Kumar,&nbsp;Clayton Neill,&nbsp;Ridwan Alam,&nbsp;Hiten D. Patel,&nbsp;Edward M. Schaeffer,&nbsp;Ashley E. Ross","doi":"10.1002/bco2.70028","DOIUrl":"https://doi.org/10.1002/bco2.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To describe PSMA PET/CT characteristics of patients with high-risk BCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/patients and methods</h3>\u0000 \u0000 <p>This was a retrospective analysis of patients with high-risk BCR prostate cancer (PSA ≥ 2 ng/ml above nadir after radiation therapy [RT] or ≥1 ng/ml after radical prostatectomy [RP] +/− RT) who underwent PET/CT from July 2021–March 2023. Patients with prior cytotoxic chemotherapy, androgen deprivation therapy (ADT) initiated &gt;3 months prior to PET/CT or positive conventional imaging within 3 months of PET/CT were excluded. Neoadjuvant/adjuvant ADT completed ≥9 months prior was allowed. Logistic regression, Pearson's Chi-squared, Wilcoxon rank sum and Fisher's exact tests were used for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 113 of 145 (77%) included patients in the analysis had ≥1 lesion on PSMA PET/CT. There was no difference in PSMA PET/CT positivity based on age, race, Gleason Grade at initial biopsy or PSA. Overall, 29 (20%) patients had lesions in the prostate/prostate bed only, 31 (21%) had lesions consistent with N1M0 disease and 53 (37%) had lesions consistent with M1 disease. For M1 patients, 21/53 (40%) had oligometastatic disease (1–3 lesions), and 32/53 (60%) had a higher burden (&gt;3 lesions). Local recurrence was more common with RT and nodal recurrence with RP, with no difference in distant metastasis by initial treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nearly 80% of patients with high-risk BCR after local treatment for prostate cancer with RP and/or RT will have positive findings on PSMA PET/CT. In addition to intensified systemic therapy, up to 55% of the patients may have benefitted from salvage local therapy, nodal pelvic radiation or metastasis-directed therapies for oligometastatic disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939008","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":"Concordance of renal tumour assessments by urologists using CT scans versus Hyper-Accuracy 3D Virtual Models for surgical planning: A single-centre multireviewer analysis","authors":"Francesco Ditonno,&nbsp;Michele Boldini,&nbsp;Francesco Cianflone,&nbsp;Lorenzo Treccani,&nbsp;Lorenzo De Bon,&nbsp;Francesca Fumanelli,&nbsp;Francesco Artoni,&nbsp;Claudio Brancelli,&nbsp;Iolanda Palumbo,&nbsp;Alberto Baielli,&nbsp;Alberto Bianchi,&nbsp;Filippo Migliorini,&nbsp;Riccardo Bertolo,&nbsp;Alessandro Veccia,&nbsp;Alessandro Antonelli","doi":"10.1002/bco2.70002","DOIUrl":"https://doi.org/10.1002/bco2.70002","url":null,"abstract":"&lt;p&gt;Robot-assisted partial nephrectomy (RAPN) might represent a surgically demanding procedure that conceals several pitfalls, including proximity to vessels or calyces and lesions not visible upon kidney exposure. Therefore, a comprehensive understanding of key anatomical landmarks is crucial for precise surgical planning and procedural success. Several innovative technological tools have been proposed, including three-dimensional virtual models (3DVMs).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Their routine use could enhance preoperative and intraoperative guidance, broadening the indication for RAPN.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The primary aim of the present study was to evaluate the inter-rater agreement of urologists interpreting conventional CT scans versus hyperaccuracy (HA)-3DVMs (MEDICS Srl, Turin, Italy) to guide preoperative planning for renal masses.&lt;/p&gt;&lt;p&gt;A prospectively maintained database of patients undergoing kidney surgery for renal masses at our Institution was queried to retrieve data of all consecutive RAPN interventions, with preoperative CT scans and HA-3DVMs available. Patients with a history of prior renal surgery and bilateral or multiple ipsilateral tumours were discarded. Performance of CT scans followed a standard internal protocol for staging solid renal masses, using a contrast-medium multidetector CT with 3/5-mm sections from the pulmonary base to the pelvis, with basal, arterial, venous, and excretory phases. The respective HA-3DVMs were developed in selected cases as previously described,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; based on the expected surgical complexity.&lt;/p&gt;&lt;p&gt;The primary outcome was interobserver agreement across 12 specific preoperative surgical planning domains, assessed using a custom-designed questionnaire (Supplementary Material).&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The questionnaire comprised 12 items covering different aspects of preoperative surgical planning. Twelve urologists, including six residents and six experienced practitioners, evaluated each clinical case using both the CT scan and the respective HA-3DVMs.&lt;/p&gt;&lt;p&gt;Interobserver agreement was measured using Cohen's kappa (k) statistics for each domain across multiple raters, with 95% confidence intervals (CI) determined by 1000 bootstrap repetitions. Kappa values could range from 0 to 1, with agreement defined as almost perfect (&lt;i&gt;k&lt;/i&gt; &gt; 0.8), substantial (&lt;i&gt;k&lt;/i&gt; &gt; 0.6), moderate (&lt;i&gt;k&lt;/i&gt; &gt; 0.4), fair (&lt;i&gt;k&lt;/i&gt; &gt; 0.2), or none to slight (&lt;i&gt;k&lt;/i&gt; &lt; 0.2).&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Each clinician evaluated all 31 cases twice: once using CT scans and once with HA-3DVMs. The order of evaluation (CT first or HA-3DVM first) was left to clinicians' preference. Each imaging modality was reviewed independently, without back-to-back comparisons, to ensure an unbiased assessment. The time required to complete the evaluation of either the CT scan or HA-3DVMs was recorded. Differences in evaluation times were estimated using the Wilcoxon signed-rank test. A subgrou","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914080","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":"Outcomes in BCG failure: Outcome from a single centre UK experience","authors":"Elizabeth Day,&nbsp;Rachel Aquilina,&nbsp;Lazaros Tzelves,&nbsp;Ashwin Sridhar,&nbsp;Anthony Ta,&nbsp;John Kelly,&nbsp;Bernadett Szabados","doi":"10.1002/bco2.70025","DOIUrl":"https://doi.org/10.1002/bco2.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe real-world outcomes of patients with BCG failure undergoing bladder-sparing treatments (BSTs) vs radical cystectomy in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A single institution audit was conducted at a tertiary bladder cancer referral service (UCLH, London, UK). Patients with BCG failure treated between January 2017 and September 2022 were included. BSTs included endoscopic surveillance, hyperthermic mitomycin and further BCG. The primary outcome was event free survival (EFS). Complete response (CR) rate and duration of response (DoR) were investigated in patients undergoing BST. The secondary outcomes were 3- and 5-year cancer-specific (CSS) and overall survival (OS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 112 patients were included: 30% (34/112), 32% (36/112) and 27% (30/112) had BCG unresponsive, exposed and intolerant disease and 11% (12/112) had progressed to muscle invasive disease (MIBC).</p>\u0000 \u0000 <p>In the BCG unresponsive and exposed groups, 79% (27/34) and 72% (26/36) underwent RC, with the remaining receiving BSTs. Comparing RC vs BST in BCG unresponsive and exposed groups combined, there was a significantly poorer EFS in the BST group (p &lt; 0.001); 35.3% (6/17) patients transitioned to second-line BST due to recurrence or intolerance and a further 50% (3/6) transitioned a third line BST. There was no significant difference in CSS or OS rates. In BCG intolerance, the EFS rate was 90% as three patients experienced high-grade recurrence and underwent RC. There were no cancer-related deaths. In MIBC group, 5/12 presented with metastatic disease and 3- and 5-year CSS rates was 66% and 0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This data reports real-world practice in a UK centre. BSTs in BCG unresponsive and exposed disease are supported as an alternative to RC providing the increased risk of recurrence is accepted. Additionally, consideration of formal guidance supporting BST is needed in BCG intolerance, which appears to have an excellent outcome in a cohort managed with endoscopic surveillance. Upstaging to MIBC remains a poor prognostic factor and is key to improving survival outcomes in BCG failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914512","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":"Risk of upper urinary tract urothelial carcinoma after primary non-muscle-invasive urinary bladder cancer: A nationwide population-based cohort study","authors":"Christel Häggström,&nbsp;Oskar Hagberg,&nbsp;Lars Holmberg,&nbsp;Abolfazl Hosseini,&nbsp;Tomas Jerlström,&nbsp;Viveka Ströck,&nbsp;Karin Söderkvist,&nbsp;Anders Ullén,&nbsp;Fredrik Liedberg,&nbsp;Staffan Jahnson,&nbsp;Firas Aljabery","doi":"10.1002/bco2.70021","DOIUrl":"https://doi.org/10.1002/bco2.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the risk of upper urinary tract urothelial carcinoma (UTUC) in patients with non-muscle-invasive bladder cancer (NMIBC), in relation to the primary NMIBC tumour risk categories, calendar time trends and intravesical Bacillus Calmette-Guerin (BCG) treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and methods</h3>\u0000 \u0000 <p>All patients with primary NMIBC diagnosed 1997–2019 registered in Bladder Cancer Data base Sweden (BladderBaSe) 2.0 were included in the study. Risk of UTUC was calculated by cumulative incidence proportion using competing risk analysis. Associations with risk of UTUC by tumour stage category, calendar time, and intravesical BCG treatment was estimated by hazard ratios from multivariable Cox regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 36 038 NMIBC patients, 537 (1.5%) were diagnosed with UTUC during a mean time of 7 years in follow-up. The risk of UTUC within 10 years from NMIBC diagnosis was 1.7% (95% 1.6–1.9) with highest estimates for TaG3/CIS. Stage T1 and TaG3/CIS, as compared with TaG1–2 was associated to risk, with stronger associations during later calendar times. Within high-risk NMIBC patients (CIS/TaG3/T1), intravesical BCG treatment was associated with higher risk of UTUC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This large study of more than 36 000 patients with NMIBC found 1.7% (95% 1.6–1.9) risk of UTUC within 10 years of diagnosis. Differences by tumour stage category indicate the need for refined studies accounting for tumour characteristics, location in the bladder and given treatment to optimise follow-up routines in NMIBC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905037","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 outcomes of salvage robotic radical prostatectomy following radiation versus focal therapy: Does the primary treatment modality matter?","authors":"Alireza Ghoreifi,&nbsp;Lorenzo Storino Ramacciotti,&nbsp;Masatomo Kaneko,&nbsp;Luis G. Medina,&nbsp;Giovanni E. Cacciamani,&nbsp;Shiran Konganige,&nbsp;Manju Aron,&nbsp;Sarmad Sadeghi,&nbsp;Hossein Jadvar,&nbsp;Hooman Djaladat,&nbsp;Rene Sotelo,&nbsp;Mihir M. Desai,&nbsp;Inderbir S. Gill,&nbsp;Monish Aron,&nbsp;Andre Luis Abreu","doi":"10.1002/bco2.70019","DOIUrl":"https://doi.org/10.1002/bco2.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to compare salvage robotic radical prostatectomy (sRRP) for recurrent prostate cancer (PCa) after primary radiation (RT) versus focal therapy (FT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients who underwent sRRP following primary local therapy for PCa were identified. Perioperative findings and functional/oncologic outcomes were compared in RT versus FT groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 112 patients were included, with 84 receiving RT and 28 FT as primary treatment. Median age and PSA were 68 years and 5.4 ng/mL, respectively. There was one rectal injury in the RT group. The overall 90-day complications were significantly higher in RT group (33% vs. 11%, <i>p</i> = 0.03). On multivariable analysis, history of RT and prolonged operative time were associated with a higher rate of 90-day complications. The 6- and 12-month continence rates were higher in FT group (50% vs. 20%, <i>p</i> = 0.02 and 69% vs. 33%, <i>p</i> = 0.03). Potency at 12 months was better preserved in FT group (46% vs. 12%, <i>p</i> = 0.01). On final sRRP pathology, the rates of grade group ≥ 4 (51% vs. 36%, <i>p</i> = 0.2), pT3 (69% vs. 75%, <i>p</i> = 0.6), positive nodes (30% vs. 18%, <i>p</i> = 0.2) and positive margins (33% vs. 39%, <i>p</i> = 0.5) were similar for RT versus FT, respectively. The 3-year biochemical recurrence-free survival was 86% for RT versus 94% for FT (<i>p</i> = 0.6).</p>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>sRRP for recurrent PCa after FT is associated with lower complications and higher urinary continence and potency rates than patients who received primary RT.</p>\u0000 </section>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of overactive bladder with all-cause and cardiovascular mortality in women: A propensity-matched NHANES study","authors":"Weipu Mao,&nbsp;Sagar Barge,&nbsp;Zhaobo Luo,&nbsp;Weiqun Yu","doi":"10.1002/bco2.70022","DOIUrl":"https://doi.org/10.1002/bco2.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the impact of overactive bladder (OAB) on all-cause and cardiovascular mortality in women in a real-world setting, and to examine the association of TyG-related indices with OAB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on 6580 women aged ≥20 years were collected from the National Health and Nutrition Examination Survey (NHANES) database. Kaplan–Meier curves and Cox survival analysis were used to evaluate the association between OAB and all-cause and cardiovascular mortality. Biomarkers for metabolic syndrome were assessed for their association with OAB, including triglyceride-glucose (TyG) and TyG-related indices. The association between TyG-related indices and OAB was evaluated using restricted cubic splines (RCS), receiver operating characteristic (ROC) curves and multivariate logistic regression, with propensity score matching (PSM) employed to balance confounders between OAB and non-OAB groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Kaplan–Meier curves showed that OAB was associated with a poorer prognosis, and multivariate Cox regression analyses indicated that OAB was an independent risk factor for both all-cause and cardiovascular mortality. RCS revealed a positive association between TyG-related indices and OAB. Both ROC curves and multivariate logistic regression analysis indicated that TyG-WHtR (TyG combined with waist-to-height ratio) was strongly associated with OAB, with a higher TyG-WHtR associated with an increased risk of OAB. The retrospective design and selection bias may be the potential limitations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>OAB is positively associated with all-cause and cardiovascular mortality in women. TyG-related indices are positively associated with OAB, with TyG-WHtR as the most effective index.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889079","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":"Female urethral stricture: A multi-centre experience and lessons learnt","authors":"Madeleine Bain,&nbsp;Daniel Esteban Gomez Zapata,&nbsp;Kapilan Ravichandran,&nbsp;Cora Fogaing,&nbsp;Apurva Anand,&nbsp;Amey Talpallikar,&nbsp;Shreyas Bhadranawar,&nbsp;Sanjay Kulkarni,&nbsp;Devang Desai,&nbsp;Pankaj Joshi","doi":"10.1002/bco2.70024","DOIUrl":"https://doi.org/10.1002/bco2.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To review demographics, surgical techniques and outcomes of female patients undergoing buccal mucosal graft substitution urethroplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>An international multi-institutional study was performed through a retrospective review of a prospectively managed database of female urethroplasty outcomes at two sites from December 2016 to June 2023. Institutions included a high-volume tertiary referral centre performing 500 urethroplasties annually, and a regional centre with a fellowship-trained urethroplasty surgeon performing ~50 urethroplasties annually. Female urethroplasty accounted for 2% of urethroplasties performed, utilising dorsal onlay, ventral inlay and double-face techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-two patients underwent female urethroplasty between 2016 and 2023; 20 dorsal onlay grafts, 14 ventral inlay grafts and 8 double-face urethroplasty. The mean age was 45 years (SD 12.07) and mean follow-up 27 months (SD 17.22). The most common aetiology was idiopathic in 59%. The most common presenting symptom was obstructive lower urinary tract symptoms in 86%. Urethral dilatations were the most common treatment before urethroplasty, with a mean of 9 (SD 1.2) dilations pre-urethroplasty. Stricture locations seen were; proximal 7%, proximal to mid-14%, mid-31%, mid to distal 10% and distal 38%. A total of 88% were successful overall; dorsal onlay was 100%, ventral inlay urethroplasties 71% and double-face 88%. Mean Qmax improvement was 291% at 6 months. In those who required dilatations or further surgery postoperatively (n = 5); four were ventral inlay (one mid-distal, three distal), and one double-face distal stricture. All patients including those requiring secondary treatments were continent and did not require intermittent self-catheterisation or suprapubic catheter insertion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Urethroplasty is an effective long-term therapeutic option for managing female urethral strictures. Dorsal onlay urethroplasty demonstrated the highest success rate, and stands out as a versatile technique, addressing distal to proximal urethral strictures. However, the chosen urethroplasty technique should be tailored to the characteristics of the stricture, patient and surgeons experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889030","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":"VPAC receptor positivity in comparison with mp-MRI in the diagnosis of prostate cancer: A preliminary study","authors":"Nishant Setya,&nbsp;Shridhar C. Ghagane,&nbsp;Rajendra B. Nerli,&nbsp;Ashwin Bokare,&nbsp;Madhukar L. Thakur,&nbsp;Leonard Gomella","doi":"10.1002/bco2.70006","DOIUrl":"https://doi.org/10.1002/bco2.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to prospectively evaluate the feasibility of diagnosing PCa using voided urine samples and by targeting the genomic VPAC (vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide) receptors in comparison with multiparametric magnetic resonance imaging (mp-MRI) in male patients (≥40 years of age) with lower urinary tract symptoms and having a serum PSA of &gt;4 but &lt;15 ng/ml.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Male patients attending urological services ≥40 years old, with lower urinary tract symptoms and serum PSA levels of &gt;4 but &lt;15 ng/ml formed the study group. Voided urine samples were collected to target VPAC receptors on malignant cells. All patients underwent mp-MRI. A 12-core transrectal ultrasound-guided prostate biopsy was performed in all, and the results were compared for the diagnosis of PCa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 61 patients with a median age of 65.33 ± 8.11 years and with a median serum PSA of 9.56 ± 2.78 ng/ml were further evaluated with both urinary biomarker assessment and mp-MRI. Histopathological (HPR) confirmation of PCa was noted in 25 (40.98%) patients and benign prostatic hyperplasia in the remaining 36 (59.01%) patients. Of the 25 patients with histologically proven PCa, the urinary biomarker (VPAC positivity) was positive for malignancy in 24 (96%), one case showed false negative results (4%) and there were no false positive cases (0%). HPR confirming PCa was seen in 3/16 patients with a PIRADS 2 score, 7/21 patients with a PIRADS 3 score, 7/14 patients with a PIRADS 4 score and 8/8 patients with a PIRADS score of 5.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VPAC receptor positivity of prostate cancer cells is an easy test to perform using a voided urine sample. VPAC receptor positivity can be used as an indication for prostate biopsy in patients having a negative previous biopsy but highly suspicious of cancer, in patients with an elevated serum PSA but with a normal digital rectal examination and in patients with benign features and borderline elevation of serum PSA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857163","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}