BJUI compass最新文献

{"title":"How to clean a catheter: Development of an intervention for intermittent catheter reuse","authors":"Sandra Wilks,&nbsp;Margaret Macaulay,&nbsp;Jacqui Prieto,&nbsp;Miriam Avery,&nbsp;Catherine Bryant,&nbsp;Debbie Delgado,&nbsp;Cathy Murphy,&nbsp;Nicola Morris,&nbsp;Mandy Fader","doi":"10.1002/bco2.487","DOIUrl":"https://doi.org/10.1002/bco2.487","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Much intermittent catheterisation (IC) is carried out using single-use catheters. Waste and costs could be reduced by cleaning and reusing catheters, but is it safe to do so? To answer these questions of safety and sustainability, clinical trials are needed. In this study, we developed a user-tested catheter cleaning method and training materials for use in a clinical trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Focus groups selected candidate cleaning methods and developed draft instructions. Users then home tested these methods on uncoated, plastic-based catheters, which were cleaned and reused up to 28 times. Reused and cleaned catheters were analysed using advanced microbiological analysis methods. The refined cleaning method was further tested by a naïve user panel. Additionally, a silicone catheter designed for reuse was tested in the laboratory and for user acceptability. User panel feedback was gathered throughout testing and thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six IC users were recruited to three user panels. Focus groups identified soap and water (SW) and soap and water plus a 15-minute soak in a chlorine-based cleaning solution (SW-Cl) as the preferred cleaning methods. User testing (≤3 reuses) and laboratory analysis showed SW alone to be less effective than SW-Cl: bacteria were detected in 23/120 (19%) male and 56/108 (52%) female SW samples versus 16/228 (7%) and 16/201 (8%) for SW-Cl. Bacteria were detected in only 1/240 (&lt;0.5%) of catheter samples after 8–≥28 reuses with the SW-Cl method. Naïve user panel results were similar. The silicone catheter was acceptable to users and had comparable laboratory results using SW-Cl. User panel feedback informed refinement and simplification of the SW-Cl cleaning method and instructions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A chlorine-based method for cleaning catheters, which effectively removed bacteria from catheters reused multiple times, has been developed, tested and refined by users, and captured in an instruction booklet and video for inclusion in a clinical trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.487","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143112065","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":"Sociodemographic landscape of suspected prostate cancer referrals and diagnoses across North East London","authors":"Muhammad Haider,&nbsp;Jeffrey J. Leow,&nbsp;James S. A. Green,&nbsp;Chamkhor Dhillon,&nbsp;Angela S. Wong,&nbsp;Yin Zhou,&nbsp;Sara Paparini,&nbsp;Benjamin W. Lamb,&nbsp;Prabhakar Rajan,&nbsp;for the North East London Cancer Alliance Urology Expert Reference Group","doi":"10.1002/bco2.495","DOIUrl":"https://doi.org/10.1002/bco2.495","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to identify healthcare inequities in referrals and diagnoses of suspected prostate cancer (PCa) in an ethnically diverse and socially deprived large urban region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort study of 2-Week Wait (2WW) suspected PCa patients (<i>n</i> = 12 947) referred to two acute NHS Trusts in North East London (NEL) from February 2019 to August 2023. Sociodemographics, diagnosis and pretreatment staging data were collected from patient records. We examined referral and diagnosis statistics, age at referral, radiological T-stage at diagnosis, levels of deprivation by ethnicity and the impact of COVID-19 pandemic lockdowns on proportion of referrals and diagnoses by ethnicity and T-stage at diagnosis. Uni- and multivariable logistic regression was performed to identify predictors of locally advanced (T-stage ≥T3) disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of all referrals, 22% were diagnosed with PCa. There were no statistically significant differences in referrals, diagnoses or T-stage of PCa by ethnicity during COVID lockdown versus non-lockdown periods (<i>p</i> &gt; 0.05). Compared to men from any other ethnicity, Black men (from Black British, Black African and Black Caribbean ethnic groups) were diagnosed at a younger age (mean = 65 years), had the highest age-adjusted PCa incidence rate of 149 per 100 000 person-years, were from the most deprived backgrounds, and were diagnosed with the highest proportion of localised PCa (74%). Multivariable analysis of a patient subgroup revealed age bands 71–80 years (OR 2.01, 95% CI 1.31–3.07) and &gt;80 (OR 4.27, 95% CI 2.25–8.08) as independent positive predictors of locally advanced PCa, and Black ethnicity as an independent predictor of localised disease (OR 0.66, 95% CI 0.43–1.00). Limitations of this study include the exclusion of PCa cases diagnosed outside the 2WW pathway, as well as missing data on Prostate-Specific Antigen (PSA) levels, distant radiological staging and histopathological findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We identify disparities in PCa incidence, stage and age at presentation, as well as socio-economic deprivation among Black men in NEL. Targeted efforts are needed to mitigate these healthcare inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143112064","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":"Impact of pre-stenting and bladder dranaige on intrapelvic pressure during retrograde intrarenal surgery","authors":"Sezgin Yeni,&nbsp;Hakan Kilicarslan,&nbsp;Gokhan Ocakoglu,&nbsp;Burhan Coskun,&nbsp;Mehmet Cagatay Cicek,&nbsp;Kadir Omur Gunseren,&nbsp;Ismet Yavascaoglu,&nbsp;Onur Kaygisiz","doi":"10.1002/bco2.490","DOIUrl":"https://doi.org/10.1002/bco2.490","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to assess the effect of pre-stenting and bladder drainage on intrapelvic pressure (IP) during Retrograde Intrarenal Surgery (RIRS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eighty-five consecutive patients were prospectively enrolled and meticulously recorded in a data form. Forty-two patients meeting the inclusion criteria after applying exclusion factors. The patients were divided into two groups: Group 1 (21 patients with preoperative JJ stents) and Group 2 (21 patients without preoperative JJ stents). IP was measured during RIRS, and the impact of various factors, including pre-stenting, bladder drainage and hydronephrosis (HN) grade, on IP was analysed through univariate and multiple linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The perioperative mean highest IP (78 ± 18.2 mmHg vs. 110 ± 23.9 mmHg), median lowest IP (29 mmHg vs. 42 mmHg) and median overall IP (41 mmHg vs. 69 mmHg) were significantly lower in Group 1 compared to Group 2 (all p &lt; 0.001). Multivariate analysis showed that pre-stenting and mild HN (Grade 0–1) were independent predictors of reduced IP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pre-stenting led to a significant reduction in IP during RIRS, likely due to passive ureteral dilation. Additionally, bladder drainage with urethral catheter further decreased IP. These findings suggest that pre-stenting and bladder drainage should be considered as strategies to reduce IP during RIRS, potentially improving surgical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143112123","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":"Retzius-sparing radical prosatectomy: First 200 Australian cases","authors":"Troy Richard John Gianduzzo,&nbsp;Philip Ellard Dundee","doi":"10.1002/bco2.489","DOIUrl":"https://doi.org/10.1002/bco2.489","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to report the first multi-centred Australian series of 200 cases of Retzius-sparing radical prostatectomy (RSRP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>Between April 2017 and June 2024, 200 RSRP procedures (197 robotic, three laparoscopic) were performed separately by the authors in five centres across two Australian cities (Melbourne, Victoria and Brisbane, Queensland). Data were collected prospectively with ethics committee approval (UCH-HREC 2019.01.279) at weeks 1, 4–6, and three-monthly. Exclusion criteria included prostate size &gt;80 cc, significant middle lobe, large anterior tumour, previous TURP or any clinical factor deemed to make RSRP unsuitable. These criteria were relaxed as experience was gained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median (interquartile range) age, body mass index and PSA were 65 (60–70) years, 26 (25–29) kg/m² and 5.2 (4.0–7.0) ng/mL. Low, intermediate and high D'Amico risk groups were 3.5%, 75.0% and 21.5%, respectively. Median (interquartile range) skin-to-skin operative time was 163 (125–210) min and blood loss 200 (100–350) mL. There were 17 (8.5%) Clavien–Dindo grade 1–2 complications and 8 (4%) grade 3 complications. Final pT stage was 60.5% pT2 and 39.5% pT3. The overall positive surgical margins (PSM) rate was 14.5% including 3.3% pT2 and 29.1% pT3. At 1 week post catheter removal 53.5% were pad-free, increasing to 58.5% and 65.0% at 4 and 6 weeks, then 79.5%, 84.6%, 88.2% and 91.3% at 3, 6, 9 and 12 months, respectively. When a security pad is included, 71.5% and 85.5% of men were continent at 4 and 6 weeks, then 94%, 96%, 96% and 97% at 3, 6, 9 and 12 months, respectively. Three men required a suburethral sling and one an artificial urinary sphincter. Ninety of 140 (60.4%) preoperatively potent men were potent at 12 months with or without phosphodiesterase-5 inhibitors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RSRP provides excellent early continence and can be introduced safely with good oncological results by experienced minimally- invasive surgeons.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143112122","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 novel bladder cancer surveillance schedule using bladder Cx for patients on annual surveillance","authors":"Arjun Guduguntla,&nbsp;Thomas Whish-Wilson,&nbsp;Lauren Chandler,&nbsp;Dennis Gyomber","doi":"10.1002/bco2.468","DOIUrl":"10.1002/bco2.468","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Cx bladder monitor (CxM) is a urine test with a proven high sensitivity and negative predictive value in bladder cancer surveillance. The aim of this retrospective study was to report on the outcomes of our newly implemented bladder cancer surveillance program for patients eligible for yearly cystoscopy, as per the European Association of Urology (EAU) guidelines. In this program, eligible patients alternate between yearly surveillance cystoscopy and CxM, instead of the standard yearly surveillance cystoscopy. Outcomes measures were overall results of CxM and subsequent treatment patterns of patients, impact on waiting lists, cost comparison and patient satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In 2022, 109 eligible and consenting patients were identified, with 98 commencing on the new surveillance program, starting with CxM instead of cystoscopy. A negative CxM, would result in a planned flexible cystoscopy in 12 months. If a patient had a positive CxM, they proceeded to undergo a cystoscopy, and if required, imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 98 that underwent testing, 90 had a negative CxM test and 8 patients had a positive CxM test. Three of these eight were true positive (PPV 0.375). Seventy negative CxM patients had no recurrence at the time of the next cystoscopy/imaging. Of the remaining 20 negative CxM patients, 11 were found to have a recurrence at subsequent cystoscopy/imaging and 9 did not proceed with further surveillance for various reasons. All of the tumour recurrences diagnosed after a negative CxM were non-invasive, thus there was no progression to muscle-invasive disease. All suitable patients consented to continuing with the CxM protocol. The hospital surveillance cystoscopy waitlist was reduced by approximately 59% and CxM was approximately $850 AUD cheaper than a cystoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CxM can be safely used in an alternating schedule with Flexible Cystoscopy for patients on annual bladder cancer surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061608","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":"PARP inhibitor-based treatment in metastatic, castration-resistant prostate cancer (mCRPC): A systematic review and meta-analysis","authors":"Michela Roberto,&nbsp;Mattia Alberto Di Civita,&nbsp;Daniele Marinelli,&nbsp;Andrea Torchia,&nbsp;Nertila Cara,&nbsp;Giulia Maltese,&nbsp;Iolanda Speranza,&nbsp;Daniele Santini","doi":"10.1002/bco2.455","DOIUrl":"10.1002/bco2.455","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We present a systematic review and meta-analysis of randomized clinical trials (RCTs) with PARPi either as monotherapy or in combination with an androgen receptor-targeted agent (ARTA) in first- and second-line settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Primary endpoints are radiographic progression free survival (rPFS) and overall survival (OS) in patients with mCRPC and either unselected, homologous recombination repair wild-type (HRR−), homologous recombination repair mutated (HRR+) or with BRCA1, BRCA2, or ATM mutation. The effect of PARPi + ARTA in the second-line setting is also explored. Safety is a secondary end-point.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of five phase III (first line: MAGNITUDE, PROpel, TALAPRO-2; second line: PROfound, TRITON3) and two phase II RCTs (second line: NCT01972217, NCT01576172) were selected. In the first-line setting, rPFS was significantly improved in PARPi + ARTA arm in all comers (HR 0.70, <i>p</i> &lt; 0.00001), HRR− (HR 0.76, <i>p</i> = 0.005), HRR+ (HR 0.57, <i>p</i> = 0.0003), and BRCA1/2-mutated patients (HR: 0.33, <i>p</i> &lt; 0.00001). OS was improved in the population with HRR+ status (HR 0.76, <i>p</i> = 0.02) but not statistically significant in BRCA1/2-mutated patients (HR 0.57, 95% CI 0.30–1.08, <i>p</i> = 0.08). In the second line, PARPi improves rPFS (HR for BRCA2 0.31, <i>p</i> = 0.002) and OS (HR for BRCA1/2 0.71, <i>p</i> = 0.01) only in such patients. In this setting, no advantage was reported by adding a PARPi to an ARTA. The arm with PARPi either as monotherapy or in combination with ARTA showed a significantly higher toxicity profile.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PARPi-based therapy represents a compelling treatment option for HRR+ mCRPC, mainly BRCA1/2-mutated patients. However, further biomarker analysis are needed in order to identify other responsive patients across the different disease settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061087","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 with final pathology when transitioning from standard transrectal to cognitive targeted transperineal prostate biopsy","authors":"Alfred Honoré,&nbsp;Karsten Gravdal,&nbsp;Patrick Juliebø-Jones,&nbsp;Lars Anders Rokne Reisæter,&nbsp;Christian Beisland,&nbsp;Christian Arvei Moen","doi":"10.1002/bco2.486","DOIUrl":"10.1002/bco2.486","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Transrectal (TR) prostate biopsy is being increasingly abandoned in favour of a transperineal (TP) approach as well as a targeted biopsy only of the index lesion(s). It remains underreported how these changes could impact concordance at final pathology. We aimed to evaluate the impact of transitioning from standard transrectal (sTR) to cognitive targeted transperineal (cog-tTP) biopsy on final pathology including concordance and upgrading.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and methods</h3>\u0000 \u0000 <p>Analysis of consecutive patients undergoing prostate biopsy and prostatectomy (RP) between January 2018 and May 2022 at a tertiary centre in Western Norway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 210 and 239 patients in the sTR and cog-tTP groups, respectively. The mean [IQR] number of biopsies decreased from 12 [4–12] to 3 [3–4] (<i>p</i> &lt; 0.001). The overall rate of concordance between biopsy and final pathology was 64% in both groups (Table 3, Figure 1). 24% Twenty-four per cent (cog-tTP) versus 19% (sTR) had grade group (GG) upgrading, while 12% versus 17% were downgraded (<i>p</i> = 0.2). Regarding positive surgical margins (PSMs) that were &gt;3 mm in extension, there were only 3.3% and 2.1% in the sTR and cog-tTP groups, respectively (<i>p</i> = 0.4). For surgical outcomes associated with RP, no differences in terms of postoperative complications between the groups were found (cog-tTP:10% vs. sTR:6%, <i>p</i> = 0.10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Transitioning from sTR biopsy to targeted cog-tTP biopsy does not compromise concordance at final pathology nor does it increase the risk of tumour upgrading.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061612","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 impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data","authors":"Anas S. Tresh,&nbsp;Francesco Del Giudice,&nbsp;Shufeng Li,&nbsp;Satvir Basran,&nbsp;Ettore De Berardinis,&nbsp;Dalila Carino,&nbsp;Valerio Santarelli,&nbsp;Bernardo Rocco,&nbsp;Maria Chiara Shighinolfi,&nbsp;Roman Mayr,&nbsp;Matteo Ferro,&nbsp;Riccardo Autorino,&nbsp;Gabriele Bignante,&nbsp;Felice Crocetto,&nbsp;Biagio Barone,&nbsp;Renate Pichler,&nbsp;José Daniel Subiela,&nbsp;Jorge Caño Velasco,&nbsp;Marco Moschini,&nbsp;Andrea Mari,&nbsp;Andrea Gallioli,&nbsp;Francesco Soria,&nbsp;Simone Albisinni,&nbsp;Wojciech Krajewski,&nbsp;Jan Łaszkiewicz,&nbsp;Łukasz Nowak,&nbsp;Tomasz Szydełko,&nbsp;Benjamin Challacombe,&nbsp;Rajesh Nair,&nbsp;Benjamin I. Chung","doi":"10.1002/bco2.481","DOIUrl":"10.1002/bco2.481","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in-hospital stay, readmission rates, 90-day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90-day complication rates, new postoperative VTE events, re-hospitalization, and total hospital expenditures (2021 US dollars). Sensitivity analyses on VTE severity (pulmonary embolism [PE], deep venous thrombosis [DVT] or superficial thrombophlebitis/phlebitis [SVT]), as well as TURBT extent (minor vs. major) were additionally examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 139 800 patients were identified, with 5.3% having preoperative VTE, including DVT (<i>n</i> = 3112, 42.20%), PE (<i>n</i> = 2046, 27.74%) and SVT (<i>n</i> = 2217, 30.06%). A history of preoperative VTE predicted higher rates of any complication (adjusted odds ratio [aOR] 1.28, 95% CI 1.14–1.43) and also higher rates of infectious and haemorrhagic complications. Additionally, preoperative VTE increased the risk of novel VTE events following TURBT (aOR 17.30, 95% CI 16.05–18.65), hospital length of stay (aOR 2.23, 95% CI 1.90–2.62), readmissions (aOR 1.47, 95% CI 1.39–1.56), and hospital associated costs (aOR 1.17, 95% CI 1.12–1.23). DVT and non-minor TURBT procedures did not increase the risk of any, infectious, or haemorrhagic complications, but other associations were maintained regardless of the severity of VTE (PE, DVT, SVT) or TURBT extent (minor/major).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A history of VTE before undergoing transurethral procedures for BCa is associated with significantly worse perioperative outcomes and higher healthcare costs. These findings may help us to counsel on the risks of the intervention and hopefully improve our ability to mitigate such risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061011","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":"Evaluating the utility of the HAS-BLED bleeding-estimator tool for transurethral resection of prostate","authors":"Lu Yu Kuo,&nbsp;Zhong Li Titus Lim,&nbsp;Caitlin Letch,&nbsp;Joshua Silverman,&nbsp;Jason Jae Yeun Kim,&nbsp;Scott McClintock","doi":"10.1002/bco2.480","DOIUrl":"10.1002/bco2.480","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the utility of the HAS-BLED bleeding risk-estimation tool to predict for clinically significant postoperative haematuria in patients receiving transurethral resection of prostate (TURP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A single-centre, retrospective cohort analysis of patients underwent TURP from April 2019 to December 2023 for treatment of symptomatic benign prostate hyperplasia. The primary objective was to evaluate reliability of HAS-BLED score in predicting postoperative bleeding event. A focus sub-analysis was performed on anticoagulated patient cohort. Each patient was categorised in to HASBLED low-, moderate- and high-risk group according to the preestablished estimator tool. Patients' demographics, clinical, pathological and operative details were collected. Events of clinically significant haematuria within 3 months postoperatively were captured. Cohort characteristics and outcome were analysed with two-sided <i>t</i> test and ANOVA test. Further weight-adjusted multivariable analysis and ROC curve was performed to evaluate the predictive value of HAS-BLED score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis showed that patients assigned as high-risk by HAS-BLED were at 2.17-times higher chance of developing clinically significant haematuria compared to the low-risk patients. The risk for high-risk patient was 18.5% (95%CI 11.7–25.3%) and 8.5% (95%CI 4.6–12.4%) for low-risk patients. Moderate-risk did not demonstrate any significant difference relative to the low-risk group. Sub-analysis of 113 patients receiving long-term anticoagulation accentuates the utility of the tool. The risk of haematuria for high-risk patient was 32.7% (95%CI 20.7–44.7%), moderate-risk patient was 28.7% (95%CI 17.0–40.3%), and low-risk patient was 9.7% (95%CI 4.2–15.2%). In this cohort, the risk of haematuria was 3.37 and 2.96 times higher in the high and moderate-risk compared to the low-risk group, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study to validate a bleeding estimator tool for TURP patients. High HAS-BLED score positively predicts clinically significant post-TURP haematuria, particularly for patients receiving anticoagulation therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061618","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":"Predictive role of ABC transporters in the efficacy of enfortumab vedotin for urothelial carcinoma","authors":"Toshiki Kijima,&nbsp;Atsuko Takada-Owada,&nbsp;Hiroki Shimoda,&nbsp;Hidetoshi Kokubun,&nbsp;Toshitaka Uematsu,&nbsp;Kohei Takei,&nbsp;Hironori Betsunoh,&nbsp;Masahiro Yashi,&nbsp;Kazuyuki Ishida,&nbsp;Takao Kamai","doi":"10.1002/bco2.488","DOIUrl":"10.1002/bco2.488","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the correlation between ATP-binding cassette (ABC) transporter expression and therapeutic efficacy of enfortumab vedotin (EV), an antibody-drug conjugate targeting Nectin-4, in urothelial cancer, as only a few studies have been conducted on this topic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This retrospective study included 20 patients with metastatic urothelial carcinoma (mUC), including bladder and upper urinary tract cancers, who were treated with EV at Dokkyo Medical University Hospital between 2022 and 2024. Immunohistochemical staining was performed on formalin-fixed, paraffin-embedded tissue samples. Progression-free survival (PFS) was estimated using the Kaplan–Meier method, and differences between subgroups (e.g., Nectin-4 and ABC transporter expression) were compared using the log-rank test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Immunohistochemical analysis indicated that tumours with high ABC transporter expression exhibited shorter PFS time and poorer response to EV. Furthermore, a decrease in Nectin-4 expression and an increase in ABC transporter expression were observed as the disease progressed from non-muscle-invasive to muscle-invasive and metastatic. Patients with Nectin-4-positive and ABC transporter-negative tumours had the longest PFS, underscoring the prognostic significance of these biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To our knowledge, this study is the first to show a correlation between ABC transporter expression and EV efficacy in urothelial carcinoma. Future research should focus on optimizing treatment strategies based on Nectin-4 and ABC transporter expression to improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061090","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}