BJUI compass最新文献

{"title":"Natural history of artificial urinary sphincter cuff erosion in males: Experience from two tertiary centres in the United Kingdom","authors":"Loufopoulos Ioannis,&nbsp;Pace Keith,&nbsp;Toia Bogdan,&nbsp;Kapriniotis Konstantinos,&nbsp;Papaefstathiou Efstathios,&nbsp;Newman Thomas,&nbsp;Barratt Rachel,&nbsp;Nobrega Richard,&nbsp;Noah Anthony,&nbsp;Gresty Helena,&nbsp;Sharma Davendra,&nbsp;Greenwell Tamsin,&nbsp;Seth Jai,&nbsp;Ockrim Jeremy","doi":"10.1002/bco2.70277","DOIUrl":"https://doi.org/10.1002/bco2.70277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to describe the natural history of urethral cuff erosion (UCE) following artificial urinary sphincter (AUS) implantation, including the incidence of urethral stricture and fistula formation, and the outcomes of salvage AUS reimplantation, based on the experience of two UK tertiary centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and methods</h3>\u0000 \u0000 <p>Data collected prospectively from 2016 to 2024 was analysed retrospectively. Demographics, characteristics and outcomes of AUS re-implantation were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 273 AUS implantation were performed during the study period. Fifty had device explantation for UCE. Median age at explantation was 73 years. Median time from implantation to erosion was 32 months. About 12% had a history of neurogenic bladder and 58% pelvic irradiation. The most significant cause of acute erosion was traumatic catheterisation (44%).</p>\u0000 \u0000 <p>Following explantation, nine developed urethral stricture (18%), while five patients had urethro-cutaneous fistulae (10%). Twelve individuals underwent salvage AUS re-implantation with 6 (50%) requiring further explantation (50%) within 8 months. Of the remaining 38 patients, 17 continued with pad use alone and 21 underwent alternative conservative management including long-term catheterisation, convene drainage, penile clamp or urethral bulking. Four patients (8%) ultimately required urinary diversion, two following primary explantation and two following failed salvage reimplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, 18% of males having AUS implantation had UCE and explantation of the device. The vast majority of them had a history of pelvic irradiation or catheterisation for stricture disease (76%). The main risk for UCE was traumatic catheterisation. About 18% of explanted cases developed urethral stricture and 10% urethra-cutaneous fistulae. Only 24% of these patients had attempted salvage AUS re-implantation, with one half resulting in further early UCE/infection and removal.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146358","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":"Prostate MRI vascular markers and erectile function after nerve-sparing prostatectomy","authors":"Abdullah Al-Mitwalli,&nbsp;Matthew Megson,&nbsp;Dalia Mohammed,&nbsp;Ahmed Al-Nowfal,&nbsp;Conrad Von Stempel,&nbsp;Wai Gin Lee,&nbsp;David Ralph,&nbsp;Zafer Tandogdu","doi":"10.1002/bco2.70295","DOIUrl":"https://doi.org/10.1002/bco2.70295","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To determine whether preoperative multiparametric magnetic resonance imaging (mpMRI)-derived vascular markers are associated with baseline and postoperative erectile function (EF) and change in EF in men undergoing bilateral nerve-sparing robot-assisted radical prostatectomy (RARP).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patients and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A secondary retrospective imaging analysis was undertaken using prospectively collected cohort data. Men undergoing bilateral nerve-sparing RARP with a preoperative International Index of Erectile Function—erectile function domain score (IIEF-6) and preoperative mpMRI incorporating dynamic contrast-enhanced sequences were included. MRI-detected accessory pudendal artery (APA), prostate enhancement ratio (PER) and corporal enhancement ratio (CER) were assessed by two expert uro-radiologists. Associations with EF outcomes were examined using correlation analyses and univariable and multivariable linear regression.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Seventy-one patients (mean age 60 years) met inclusion criteria; APA was identified in 31 (43.6%). APA presence was associated with higher baseline IIEF-6 scores (mean 24.1 vs. 20.0, &lt;i&gt;p&lt;/i&gt; = 0.043). Baseline IIEF-6 demonstrated moderate negative correlation with PER (&lt;i&gt;ρ&lt;/i&gt; = −0.30, &lt;i&gt;p&lt;/i&gt; = 0.014) and moderate positive correlation with CER (&lt;i&gt;ρ&lt;/i&gt; = 0.30, &lt;i&gt;p&lt;/i&gt; = 0.018). On multivariable analysis, APA presence (&lt;i&gt;β&lt;/i&gt; = 5.20, &lt;i&gt;p&lt;/i&gt; = 0.019), PER (&lt;i&gt;β&lt;/i&gt; = −0.049, &lt;i&gt;p&lt;/i&gt; = 0.017) and CER (&lt;i&gt;β&lt;/i&gt; = 0.040, &lt;i&gt;p&lt;/i&gt; = 0.049) independently predicted baseline EF. Increasing age independently predicted lower baseline IIEF-6 (&lt;i&gt;β&lt;/i&gt; = −0.34, &lt;i&gt;p&lt;/i&gt; = 0.017), while higher body mass index correlated with poorer 24-month IIEF-6 scores (&lt;i&gt;ρ&lt;/i&gt; = −0.27, &lt;i&gt;p&lt;/i&gt; = 0.046). Bilateral intrafascial/intra-interfascial nerve-sparing techniques were associated with superior 24-month EF outcomes (mean 16.8 vs. 10.5, &lt;i&gt;p&lt;/i&gt; = 0.028). No MRI-derived marker predicted 24-month EF or EF change.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Preoperative mpMRI-derived vascular markers, particularly APA identification, independently correlate with baseline EF in men undergoing BNS RARP, supporting a contributory vascular component in post-prostatectomy ED. Prospective studies are warranted to determine whether intraoperative vascular preservation strategies, guided by preoperative MRI vascular mapping, influence functional recovery and can be integrated into surgical planning pathways.&lt;/p&gt;\u0000 &lt;/section","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis on the safety and efficacy of Aquablation","authors":"Kimberley Chan,&nbsp;Nico Christian Grossmann,&nbsp;Matthew Feyissa,&nbsp;Jeremy Nettleton,&nbsp;Philip Charlesworth,&nbsp;Neil Barber,&nbsp;Jeremy Teoh,&nbsp;Ben Challacombe,&nbsp;Garrett Pohlman,&nbsp;Evangelos Liatsikos,&nbsp;Dean Elterman,&nbsp;Nikhil Vasdev","doi":"10.1002/bco2.70292","DOIUrl":"10.1002/bco2.70292","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work aimed to evaluate the efficacy and safety of Aquablation for the treatment of benign prostatic enlargement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted in accordance with PRISMA 2020 guidelines (PROSPERO CRD420261401865). A comprehensive PubMed search identified prospective studies and randomised controlled trials published up to January 2026. Studies including ≥30 patients reporting clinical outcomes of Aquablation were included. Guidelines, case reports, review articles, letters, retrospective studies with pooled data were excluded. Primary outcomes were International Prostate Symptom Score, maximum flow rate, postvoid residual and sexual function. Secondary outcomes included perioperative parameters and complications. Random-effects meta-analysis using DerSimonian–Laird was performed for outcomes reported in three or more studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen studies comprising 1580 patients were included. Mean age and prostate volume were 67.0 years and 82.1 cc, respectively. Aquablation significantly improved urinary outcomes, with a pooled IPSS reduction of −15.80 at 6 months (95% confidence interval [CI] −17.88 to −13.73; <i>I</i>² = 97.8%), sustained to 36 months. <i>Q</i>_max increased by 11.0 mL/s (95% CI 8.93–13.02; <i>I</i>² = 95.1%), while PVR decreased by 103.8 mL (95% CI −139.5 to −68.0; <i>I</i>² = 98.1%) at 6 months. Ejaculatory dysfunction occurred in 7.4% of patients, with no reported erectile dysfunction. The transfusion rate was 2.5%, with lower rates observed using focal bladder neck cautery. Most complications were low grade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Aquablation provides durable and significant improvements in urinary outcomes with a favourable safety profile and low rates of sexual dysfunction, supporting its role as an effective surgical option for BPE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139432","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":"Are template prostate biopsies still required in patients with high-risk PI-RADS lesions? A retrospective study of 470 patients","authors":"Josh Tiro,&nbsp;Christian Kirk,&nbsp;Finley Breeze,&nbsp;Amir Zarrabi,&nbsp;Luiz Gustavo Modelli de Andrade,&nbsp;Paulo Roberto Kawano,&nbsp;Flavio Vasconcelos Ordones,&nbsp;Lodewikus Vermeulen","doi":"10.1002/bco2.70286","DOIUrl":"10.1002/bco2.70286","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the incremental diagnostic yield of systematic template sampling during transperineal prostate biopsy (TPPB) in biopsy-naïve men and to identify patient subgroups where systematic biopsy might be safely omitted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We retrospectively analysed 470 consecutive biopsy-naïve men with PI-RADS 3–5 lesions on multiparametric MRI who underwent combined MRI-targeted and systematic template TPPB between January 2022 and May 2026 at a single institution. Clinically significant prostate cancer (csPCa) was defined as ISUP grade group 2 or higher. The primary outcome was csPCa detected on template biopsy in men with non-significant disease (ISUP &lt; 2) on targeted biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, csPCa was detected in 356/470 men (75.7%). Systematic template biopsy identified csPCa missed by targeted biopsy in 10/470 men (2.1%, 95% CI 1.0%–3.9%), representing 2.8% of all csPCa diagnoses. Smaller index lesion size on MRI was the only statistically significant predictor of csPCa missed by targeted biopsy (OR 0.50 per 5 mm increase, 95% CI 0.28–0.90, <i>p</i> = 0.021). In subgroup analysis cross-tabulating PI-RADS category and PSA density (PSAD), template biopsy provided zero incremental yield in patients with PI-RADS 5 lesions and a PSAD &gt; 0.20 ng/mL² (0.0%, one-sided 95% upper bound 2.5%). The highest incremental yield was observed in men with PI-RADS 4 lesions (3.7%, 95% CI 1.7%–7.0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this biopsy-naïve cohort of men undergoing combined MRI-targeted and template TPPB, systematic template biopsy provided a small incremental diagnostic yield for csPCa (2.1%) overall, with no added value in men with PI-RADS 5 lesions and a PSAD &gt; 0.20 ng/mL². A risk stratified approach to systemic sampling in these men may be considered. Validation in larger, multicentre cohorts is warranted before these findings can be incorporated into future guideline recommendations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119233","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":"Malignancy yield and clinical predictors in radiologically detected adult urachal anomalies: A retrospective cohort study","authors":"Per Blomqvist,&nbsp;Lala Joulhay Ian,&nbsp;Emelie Holmin,&nbsp;Suleiman Abuhasanein","doi":"10.1002/bco2.70284","DOIUrl":"10.1002/bco2.70284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the occurrence of bladder malignancy or papillary urothelial neoplasm of low malignant potential (PUNLMP) detected at initial evaluation or during follow-up among adults with radiologically reported urachal anomalies, and to explore clinical factors associated with neoplasia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>We conducted a retrospective single-centre cohort study. Adult patients with radiologically reported urachal anomalies between 2000 and 2024 were identified through institutional radiology information system and report archive and underwent detailed chart review. Patients with a prior history of bladder or upper urinary tract malignancy were excluded. Clinical presentation, imaging findings, cystoscopy, histopathology and outcomes were analysed. Clinical variables associated with malignancy were explored using Firth penalized logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 245 patients were included: 92/245 (38%) had incidental/asymptomatic findings and 153/245 (62%) were symptomatic. Bladder malignancy/PUNLMP was detected in 14/245 patients (5.7%) overall, including 0/92 incidental/asymptomatic patients (0%) and 14/153 symptomatic patients (9.2%). Macroscopic haematuria was present in 12/14 patients with malignancy/PUNLMP and was associated with a higher frequency of neoplasia: 12/66 patients with haematuria (18%) versus 2/179 without haematuria (1%; p&lt;0.001). In exploratory multivariable analysis, macroscopic haematuria remained associated with malignancy/PUNLMP (OR 5.29, 95% CI 1.10–39.5). Most detected tumours were of non-urachal histology, and 8/14 (57%) were stage T2 or higher.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Incidentally detected urachal anomalies in adults were not associated with malignancy during follow-up, suggesting that conservative management may be appropriate in asymptomatic patients. In contrast, symptomatic presentation, particularly macroscopic haematuria, warrants thorough urological evaluation due to its association with a substantially increased risk of bladder malignancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119218","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":"Pain and patient-reported experience after freehand transperineal prostate biopsy under local anaesthesia","authors":"Keu Maoate,&nbsp;Josh Tiro,&nbsp;Ali Hooshyari,&nbsp;Maria McCoy,&nbsp;Christian Kirk,&nbsp;Lodewikus Vermeulen,&nbsp;Amir Zarrabi,&nbsp;Luiz Gustavo Modelli de Andrade,&nbsp;Paulo Roberto Kawano,&nbsp;Flavio Vasconcelos Ordones","doi":"10.1002/bco2.70290","DOIUrl":"10.1002/bco2.70290","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To characterise patient-reported pain, anxiety, satisfaction and willingness to undergo a repeat procedure, along with complication rate and diagnostic yield, in a large consecutive single-centre cohort of freehand transperineal prostate biopsies (TPPB) performed under local anaesthesia (LA) alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>Consecutive freehand TPPB cases entered into a single-centre clinical registry between 27 April 2022 and 12 January 2026 were reviewed. Cases performed under general anaesthesia or under LA with intravenous sedation were excluded. The primary outcome was patient-reported overall procedural pain on a 0–10 cm visual analogue scale (VAS), completed immediately after the procedure. Secondary outcomes were VAS scores for anxiety, distress, physical needs, emotional needs and satisfaction; association between pain and anxiety; procedural failure; complication rate; and detection of clinically significant prostate cancer (csPCa, ISUP grade group ≥2). The tertiary outcome was willingness to undergo a repeat biopsy if clinically indicated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 800 consecutive cases, 777 (97.1%) performed under LA alone formed the analytic cohort. Median overall procedural pain was 2.0 (IQR 1.0–3.0), and severe pain (VAS ≥ 7) was reported by 45 of 760 patients (5.9%). Anxiety was moderately correlated with pain (Spearman ρ = 0.51, 95% CI 0.44–0.57), and severe pain was ten times more common above than below the median anxiety score (10.8% vs. 1.0%). Overall, 748 of 756 patients (98.9%, 95% CI 97.9–99.5%) would undergo the procedure again if clinically indicated, including 42 of the 45 (93%) who reported severe pain. Procedural failure occurred in 5 of 777 cases (0.6%) and a complication was noted in 26 of 776 (3.4%). CsPCa was identified in 477 of 769 patients (62.0%), rising stepwise with PI-RADS score (1–2: 18.3%; 3: 22.6%; 4: 70.0%; 5: 88.4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Freehand TPPB under LA alone is well tolerated in the outpatient setting. Pain is low overall, severe pain is uncommon, and almost all patients would undergo the procedure again as indicated. Patient-reported anxiety is moderately associated with procedural pain and is a plausible modifiable target.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119272","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 OR black box in urology: A survey on patient acceptance and confidence in AI-assisted surgery","authors":"Julian Risch,&nbsp;Konrad Hügelmann,&nbsp;Leonhard Buck,&nbsp;Hans-Christoph von Knobloch,&nbsp;Jakob Kohler,&nbsp;Oscar Weische,&nbsp;Reha-Baris Incesu,&nbsp;Marie-Luise Weiss,&nbsp;Neele Heckmann,&nbsp;Patricia Schließer,&nbsp;Jonas Jarczyk,&nbsp;Philipp Nuhn,&nbsp;Severin Rodler","doi":"10.1002/bco2.70288","DOIUrl":"10.1002/bco2.70288","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to assess patient acceptance of intraoperative video recording with Operating Room (OR) black box technology, characterise consent conditions and use-case preferences, and identify predictors of patient confidence in artificial intelligence (AI)-assisted surgery in urological patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This prospective cross-sectional survey was conducted at the urology department of a university hospital from March 2024 to March 2025. Consecutive adults scheduled for elective procedures were enrolled (322 enrolled; 316 completed the binary consent item). A standardised questionnaire assessed consent to operative video storage and attitudes across four Likert-scaled domains (29 items: consent conditions, use cases, data access and AI confidence). The primary outcome was confidence in AI-assisted surgery for the full procedure. Analysis included Wilson 95% confidence intervals, between-group comparisons and multivariable linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 316 patients (82.9% male, mean age 65.4 years), 304 (96.2%, 95% CI 93.5–97.8%) consented to operative video storage, with universal acceptance among oncological patients (181/181, 100%). Nonconsenters (<i>n</i> = 12) were younger, without oncological diagnosis and reported lower AI confidence. All 29 attitudinal items received majority endorsement. Patient confidence in AI-assisted surgery was expressed by 55.2% for the full procedure, 63.5% for simple steps and 53.9% for complex steps (<i>p</i> &lt; 0.001). Older patients expressed greater confidence (<i>r</i>ₛ = −0.21, <i>p</i> &lt; 0.001). Age and three attitudinal composites independently predicted AI confidence (adjusted <i>R</i>² = 0.308), whereas demographic and clinical characteristics accounted for only 5.8% of variation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Urological patients broadly accept intraoperative recording and AI-assisted surgery when transparent governance is ensured. Attitudinal factors outweigh demographic and clinical characteristics, supporting patient-centred consent frameworks for OR black box implementation in urological practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119277","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":"Participation and satisfaction of prostate cancer patients on androgen deprivation therapy participating in a virtual supervised group exercise service","authors":"Emily Curtis,&nbsp;Alice Russell,&nbsp;Chris Cottrell,&nbsp;Siobhan Cowan-Dickie,&nbsp;Sarah Dewhurst,&nbsp;Netty Kinsella,&nbsp;Yae-eun Suh,&nbsp;Declan Cahill,&nbsp;Louis Fox,&nbsp;Mieke Van Hemelrijck,&nbsp;Alison Reid","doi":"10.1002/bco2.70243","DOIUrl":"https://doi.org/10.1002/bco2.70243","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To evaluate participation, satisfaction and selected health-related outcomes and to explore factors influencing engagement with a digitally delivered exercise programme among people with prostate cancer receiving androgen deprivation therapy (ADT) who took part in The Exercise Clinic® (TEC) component of the THRIVE service at The Royal Marsden NHS Foundation Trust.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patients and methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;THRIVE was developed at The Royal Marsden NHS Foundation Trust in collaboration with a private exercise provider, TEC, to improve access to exercise services for prostate cancer (PCa) patients. Between November 2020 and December 2023, 148 men on ADT for more than 6 months were enrolled in the TEC component of THRIVE. Participants received a home exercise programme, weekly virtual supervised group exercise sessions and access to the TEC mobile phone application (app) to record activity. Primary outcomes were participation and satisfaction. Secondary outcomes included activity levels, physical performance and quality of life. Quantitative outcomes were measured at baseline and quarterly reviews; exploratory analyses examined changes between baseline and 12 months using paired &lt;i&gt;t&lt;/i&gt;-tests. Qualitative data, collected via discussion groups and feedback questionnaires, was analysed using framework analysis to explore factors influencing engagement.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Participants attended 14 exercise sessions during the first 6 months. 88%, 90% and 88% of eligible participants completed their 3-, 6- and 12-month review, respectively. Almost two-thirds of participants used TEC app. Overall experience was rated highly (median 10 out of 10). Virtual delivery and peer support were identified as key factors influencing engagement. Statistically significant changes were observed in EQ-5D index values between baseline and 12 months and in sit-to-stand performance and average daily step count from quarter one to four.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This service evaluation demonstrates high engagement and satisfaction among a selected group of men receiving long-term ADT participating in a virtually delivered, supervised exercise programme embedded within routine care. Factors such as social support and the accessible delivery format may contribute to engagement with exercise in this population. Observed changes in patient-reported and functional outcomes should be interpreted cautiously given potential selection bias and the lack of a comparator group. Find","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing diagnostic prostate cancer biomarkers using a framework of clinically meaningful criteria","authors":"Shu Wang,&nbsp;Behnam Nabavizadeh,&nbsp;Ashwin Ramaswamy,&nbsp;Meena Davuluri,&nbsp;Tenny R. Zhang,&nbsp;Michael Tzeng,&nbsp;Nathan Feiertag,&nbsp;Jim C. Hu","doi":"10.1002/bco2.70275","DOIUrl":"10.1002/bco2.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To synthesize existing biomarker literature and generate a framework for meaningful comparison between five commonly used diagnostic prostate cancer biomarkers—prostate health index (<i>phi</i>), 4KScore, SelectMDx, ExoDx and MyProstate Score (MPS)—to provide evidence of greatest practical value to providers managing men with an elevated prostate-specific antigen (PSA) who are considering prostate biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Ten biomarker characteristics reflecting <i>validity</i>, <i>usability</i> and <i>utility</i> were designated as most clinically salient in guiding diagnostic prostate cancer biomarker selection. Whereas <i>usability</i> reflects how well a biomarker individualizes risk and optimizes patient concerns, <i>utility</i> reflects a biomarker's clinical usefulness. A systematic review of the biomarker literature from 2010 to 2022 was performed, and the criteria for each biomarker characteristic were first inductively defined and subsequently determined for each respective biomarker.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nearly all biomarkers possess wide <i>validity</i>, with <i>phi</i>, 4KScore and MPS validated in Black populations. Compared to other biomarkers, 4KScore had the best <i>usability</i>. For urine-based biomarkers, the better <i>usability</i> of ExoDx versus MPS is offset by its worse <i>validity</i> and <i>utility</i>. All serum-based biomarkers have very high discriminative accuracy and were consequently more accurate in detecting high-grade prostate cancer versus urine-based biomarkers. Overall, 4KScore had the best <i>utility</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our framework enables meaningful comparison of diagnostic prostate cancer biomarkers using criteria most salient to patients and clinicians. We demonstrate that the 4KScore currently possesses the best overall features; despite emerging evidence, more clinical utility, comparative and non-White population validation studies are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027040","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":"Lower trust in artificial intelligence than physicians coexists with high willingness to engage in artificial intelligence-assisted prostate cancer management among active surveillance patients","authors":"Eric S. Chai,&nbsp;Kaitlynn Abraham,&nbsp;Riley Hanes,&nbsp;Adam Williams,&nbsp;Howard Wolinsky,&nbsp;Oleksandr N. Kryvenko,&nbsp;Radka Stoyanova,&nbsp;Frank J. Penedo,&nbsp;Archan Khandekar,&nbsp;Bruno Nahar,&nbsp;Mark L. Gonzalgo,&nbsp;Dipen J. Parekh,&nbsp;Sanoj Punnen","doi":"10.1002/bco2.70262","DOIUrl":"10.1002/bco2.70262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to examine the sentiment for artificial intelligence (AI) among prostate cancer (PCa) patients on active surveillance (AS) and to evaluate how that sentiment relates to patient willingness to engage with AI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a 23-question online survey (November–December 2025) distributed through an AS platform. Analyses were restricted to 110 respondents with PCa on AS. Outcomes included trust ratings (10-point Likert scale) for physicians versus AI, responses to hypothetical AI management recommendations and perceived concerns and facilitators of trust. Statistical analyses included the Wilcoxon signed-rank tests, the McNemar tests and Fisher's exact tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median trust in urologists (8 [IQR 7–9]) exceeded that for AI (6 [IQR 5–7]), with smaller differences for radiologists and pathologists compared with diagnostic AI (all <i>p</i> ≤ 0.001). Despite lower trust in AI, most respondents anticipated improved PCa outcomes with AI integration. High willingness to consider AI recommendations was also observed. Only 4.6% (<i>n</i> = 5) of respondents outright rejected AI recommendation for treatment and only 3.7% (<i>n</i> = 4) rejected AI recommendation for AS, with all others willing to consider AI recommendations. No respondents fully accepted AI recommendation for treatment without additional verification, whereas 2.8% (<i>n</i> = 3) fully accepted AI recommendations for continued surveillance. Primary concerns included AI errors (57.3%) and lack of human oversight (48.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among AS patients, lower trust in AI compared to physicians coexists with a high optimism for AI and willingness to incorporate AI recommendations into decision-making. This discordance suggests that behavioural adoption of AI-assisted care may precede full patient confidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027057","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}