BJUI compass最新文献

{"title":"Risk factors for readmission after ureteroscopy for stone disease: Modern single centre experience","authors":"Shuhei Hirano,&nbsp;Margaret A. Knoedler,&nbsp;Shuang Li,&nbsp;Emily C. Serrell,&nbsp;Ali S. Antar,&nbsp;Stephen Y. Nakada","doi":"10.1002/bco2.70007","DOIUrl":"https://doi.org/10.1002/bco2.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify factors that increase a patient's risk of readmission in the immediate postoperative period following ureteroscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An IRB-approved surgical database of patients with renal and ureteral stones at a single institution was retrospectively analysed for patients who underwent ureteroscopies and had 30 days follow-up from September 2016 to June 2019. We reviewed the most recent 600 cases (300 consecutive women and 300 consecutive men). Patient characteristics including gender, body mass index (BMI) and comorbidities (hypertension, gout, diabetes mellitus (DM), recurrent urinary tract infections (UTIs), chronic kidney disease (CKD), bowel disease), history of preoperative ED visit and surgical factors (preoperative stent, stone size) were used to conduct univariate and multivariable logistic regression analysis. Outcome measures included readmission within 30 days postoperatively. Exclusion criteria included age &lt;18 and &lt;30 days follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 600 patients, 40 (6.7%) visited the ED and 16 (2.7%) were admitted within 30 days postoperatively. None of the patient characteristics or surgical factors we examined were associated with ED visits postoperatively (all p &gt; 0.05). Patients were more likely to have a postoperative admission if they were older (age 68 ± 15 vs 56 ± 15, p &lt; 0.002; OR 1.06; 95% CI 1.01–1.10, p = 0.01) or had a history of recurrent UTIs (OR 7.40, 95%CI 1.78–30.67, p = 0.006). No other factors correlated with postoperative admissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older age and history of recurrent UTIs increased patients' risks of readmission within 30 days of ureteroscopy. This finding is particularly important when hospital beds are at a premium. Older patients and patients with recurrent UTIs should be targeted for preoperative interventions to prevent readmission.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689480","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":"Quality of English- and Spanish-language online content about prostate cancer genetics: Insights into potential contributors to prostate cancer disparities","authors":"Sophia M. Abusamra,&nbsp;Verónica Ochoa Cholán,&nbsp;Veda N. Giri,&nbsp;Susan T. Vadaparampil,&nbsp;Verónica Pérez-Rosas,&nbsp;Adrian Rivera,&nbsp;Tatiana Sanchez Nolasco,&nbsp;Mariana Rangel Camacho,&nbsp;Nataliya Byrne,&nbsp;Stacy Loeb","doi":"10.1002/bco2.70011","DOIUrl":"https://doi.org/10.1002/bco2.70011","url":null,"abstract":"&lt;p&gt;Genetic testing is increasingly important for prostate cancer (PCa) care and the risk of hereditary cancer for patients and families.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; However, it is currently underutilized, notably among racial and ethnic minorities. In particular, prior studies have shown lower uptake of genetic evaluation among Hispanic patients with prostate cancer in the U.S. as well as those who are non-English preferring, compared to those who are non-Hispanic White and English-preferring.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Health communications are important to raise knowledge and awareness about health issues and to increase demand for health services.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The majority of U.S. adults go online for health information, and rates of social media use are particularly high among Hispanic adults.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Our objective was to examine the extent and quality of online information about prostate cancer genetic testing and &lt;i&gt;BRCA&lt;/i&gt; in English and Spanish. We hypothesized that there is less high-quality online content about PCa genetics in Spanish than in English, as a potential contributor to the observed disparities in genetic evaluation.&lt;/p&gt;&lt;p&gt;We created a dataset with the first 25 websites listed on Google and the first 25 videos on YouTube (the most widely used social media platform&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;) with two different search terms (prostate cancer AND &lt;i&gt;BRCA&lt;/i&gt;, prostate cancer AND genetic testing) in English and Spanish. These searches were selected based on an examination of Google trends data related to PCa genetics. We examined the first 25 websites and 25 videos using each of the two queries above, for a total of 50 websites in English, 50 websites in Spanish, 50 YouTube videos in English and 50 YouTube videos in Spanish. Videos were excluded if they were not in the correct language (English or Spanish), were not consumer health information (e.g., course for doctors) or &gt;30 minutes in duration. Three investigators with clinical and/or research expertise in PCa independently examined the remaining relevant content from each platform using the validated DISCERN framework for the quality of consumer health information,&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; which has been extensively used to evaluate websites and YouTube videos in English and Spanish.&lt;span&gt;&lt;sup&gt;7, 8&lt;/sup&gt;&lt;/span&gt; We also examined understandability and actionability using the validated AHRQ Patient Education Materials Assessment Tool (PEMAT).&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;We used descriptive statistics to tally the total number of relevant consumer videos using each search string, as well as their quality, understandability and actionability. Chi-square and Mann–Whitney U tests were used to compare the proportion of relevant content and DISCERN and PEMAT scores, between Spanish and English content. We also created a composite measure for relevant videos that met quality criteria (DISCERN score of 4 or 5 out of 5, and both PEMAT scores &gt;75% ","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689479","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":"Renal parenchymal volume analysis: Clinical and research applications","authors":"Carlos Munoz-Lopez,&nbsp;Kieran Lewis,&nbsp;Nityam Rathi,&nbsp;Eran Maina,&nbsp;Akira Kazama,&nbsp;Anne Wong,&nbsp;Angelica Bartholomew,&nbsp;Worapat Attawettayanon,&nbsp;Yunlin Ye,&nbsp;Zhiling Zhang,&nbsp;Wen Dong,&nbsp;Rebecca A. Campbell,&nbsp;Nicholas Heller,&nbsp;Erick Remer,&nbsp;Christopher Weight,&nbsp;Steven C. Campbell","doi":"10.1002/bco2.70013","DOIUrl":"10.1002/bco2.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>In most patients, the renal parenchymal volumes in each kidney directly correlate with function and can be used as a proxy to determine split renal function (SRF). This simple principle forms the basis for parenchymal volume analysis (PVA) with semiautomated software, which can be leveraged to predict SRF and new-baseline glomerular filtration rate (NBGFR) following nephrectomy. PVA was originally used to evaluate renal transplantation donors and has replaced nuclear renal scans (NRS) in this domain. PVA has subsequently been explored for the management of patients with kidney cancer for whom difficult decisions about radical versus partial nephrectomy can be influenced by accurate prediction of NBGFR. Our objective is to present a comprehensive review of the applications of PVA in urology including their clinical and research implications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Key articles utilizing renal PVA to improve clinical care and facilitate urologic research were reviewed with special emphasis on take-home points of clinical relevance and their contributions to progress in the field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There have been considerable advances in renal PVA over the past 15 years, which is now established as a reference standard for the prediction of functional outcomes after renal surgery. PVA provides improved accuracy when compared to NRS-based estimates or non-SRF-based algorithms. PVA can be performed in minutes using routine preoperative cross-sectional imaging and can be readily applied at the point of care. Additionally, PVA has important research applications, enabling the precise study of the determinants of functional recovery after partial nephrectomy, which can affect surgical approaches to this procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite the wide availability of PVA, primarily for use in renal transplantation, it has not been widely implemented for other urologic purposes at most centres. Our hope is that this narrative review will increase PVA utilization in urology and facilitate further progress in the field.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665550","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":"Genomic prostate score and treatment selection in favourable intermediate-risk prostate cancer","authors":"Eric Margolis,&nbsp;Benjamin H. Lowentritt,&nbsp;Christopher M. Pieczonka,&nbsp;John P. Bennett,&nbsp;Marina Pavlova,&nbsp;Joao Paulo Zambon,&nbsp;Jack Groskopf,&nbsp;Edward Uchio","doi":"10.1002/bco2.494","DOIUrl":"https://doi.org/10.1002/bco2.494","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the factors associated with the use of active surveillance (AS) in NCCN favourable intermediate-risk (FIR) prostate cancer (PCa) patients who received the 17-gene Genomic Prostate Score (GPS) assay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Contemporary data were collected from academic and large community group practices across the United States. Eligible patients had localized PCa classified as FIR per NCCN guidelines and received a GPS report between May 2017 and April 2019. Higher GPS results (scale: 0–100) were associated with a higher risk of adverse outcomes. The proportion of patients selecting AS was calculated with 95% confidence intervals. Uni-and multivariable logistic regression analyses were performed to determine the association between AS selection and relevant covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 324 eligible patients (Gleason Score 3 + 4, 79%; PSA 10–20 ng/ml, 19%; clinical stage T2b-T2c, 2%; median percent positive cores, 16.7%; median GPS result, 26). The distribution of GPS results was 0–19 (23%), 20–40 (60%), and 41–100 (16%). Overall, 31% (95% CI 26%, 36%) selected AS: 58% (46%, 69%) with GPS 0–19, 27% (21%, 33%) with GPS 20–40, and 6% (1%, 16%) with GPS 41–100. In univariable models, the Gleason score, percent positive cores, PSA, and GPS results were significantly associated with AS selection. In a multivariable model, the percent positive cores and the GPS result remained significantly associated with AS selection. AS persistence was 91% (82%, 95%) at 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The GPS result and percent positive cores appear associated with AS use after controlling for relevant clinical variables in NCCN FIR prostate cancer patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639137","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 biopsy core length on the discrepancy in Gleason scores between biopsy and radical prostatectomy specimen","authors":"Cheng-hao Guo,&nbsp;Yin-shuai Geng,&nbsp;Liang-yong Zhu,&nbsp;Xue-fei Ding,&nbsp;Yang Luan","doi":"10.1002/bco2.70009","DOIUrl":"https://doi.org/10.1002/bco2.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the impact of the biopsy core length on the discrepancy in Gleason score between biopsy and radical prostatectomy specimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Retrospective analysis of clinical data from 247 patients who underwent transperineal prostate biopsy and radical prostatectomy of prostate cancer at our centre from 2022 to 2023. The clinical data included age, pre-biopsy prostate-specific antigen (PSA) levels, prostate volume, number of biopsy needles, number of positive biopsy needles, biopsy core length, biopsy Gleason score and post-radical prostatectomy Gleason score. Statistics were analysed by SPSS26.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>On histopathological examination, no changes in the Gleason score were observed in 127 (51.4%) patients, whereas the Gleason score was upgraded in 101 (40.9%) patients and downgraded in 19 (7.7%) patients at radical prostatectomy. Average biopsy core length for Gleason score upgraded on radical prostatectomy (44.3 %, n = 101) was 11.11 ± 1.34 mm compared to 11.88 ± 1.03 mm(p &lt; 0.01)for Gleason score consistent(55.7 %, n = 127). The multivariate logistic regression analysis revealed a significant association between the biopsy core length (P &lt; 0.01, OR = 0.556, 95%CI: 0.429–-0.722) and prostate volume (P &lt; 0.05, OR = 0.982, 95%CI: 0.429–-0.722), with both factors being significantly correlated with radical prostatectomy Gleason score increase. Furthermore, these variables were identified as independent predictors of radical prostatectomy Gleason score increase and exhibited a negative correlation. The biopsy core length was evaluated using a receiver operating characteristic (ROC) curve, with a cutoff value of 11.4 mm for the accurate diagnosis of prostate cancer (AUC: 0.702, sensitivity: 75.6%, specificity 51.2%, P &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The concordance between biopsy and radical prostatectomy may be improved with a longer biopsy core length. To enhance the consistency of Gleason scores between biopsy and radical specimens, it is recommended that the biopsy core length be at least 11.4 mm. Patients with a smaller prostate volume are at a higher risk of experiencing discordant pathological grades between biopsy and radical prostatectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554271","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":"Preoperative pelvic floor muscle diameter as a predictor of postoperative urinary incontinence in robotic-assisted laparoscopic total prostatectomy","authors":"Sho Hashimoto,&nbsp;Daisuke Obinata,&nbsp;Hideaki Uchida,&nbsp;Shigeyuki Arakawa,&nbsp;Yuki Inagaki,&nbsp;Ken Nakahara,&nbsp;Tsuyoshi Yoshizawa,&nbsp;Junichi Mochida,&nbsp;Kenya Yamaguchi,&nbsp;Satoru Takahashi","doi":"10.1002/bco2.70001","DOIUrl":"https://doi.org/10.1002/bco2.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the impact of preoperative pelvic floor muscle thickness on the early recovery of urinary continence following robot-assisted radical prostatectomy (RARP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted on 114 patients who underwent RARP at our institution between January 2019 and March 2021. Patients included were either confirmed to be pad-free or using only safety pads postoperatively or those with persistent incontinence, with a follow-up period of at least 6 months. Patient characteristics, perioperative outcomes, and pelvic floor muscle diameters were analysed. Preoperative magnetic resonance imaging or computed tomography was used to measure the diameters of the pelvic floor muscles, including the obturator internus and pubococcygeus muscles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median patient age was 68 years (interquartile ranges [IQR]: 64–72 years), with a median Prostate-Specific Antigen (PSA) of 7.8 ng/ml (IQR: 5.4–10.6 ng/ml). The median prostate volume was 26.6 ml (IQR: 23–35 ml) in the early recovery group and 29 ml (IQR: 19.5–40 ml) in the delayed recovery group. The median time to continence recovery was 5.0 months (95% confidence interval: 4.2–5.7 months), with an incontinence resolution rate of 85.1%. Significant associations were found between the thicknesses of the obturator internus (p = 0.025) and pubococcygeal muscles (p = 0.004) and early continence recovery. Nerve-sparing procedures were also associated with faster recovery (p = 0.016). Multivariate analysis identified the thickness of both muscles as independent predictors of early continence recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative evaluation of pelvic floor muscle thickness, particularly the obturator internus and pubococcygeal muscles, may help predict early postoperative urinary continence recovery in patients undergoing RARP. Preoperative pelvic floor muscle exercises to strengthen these muscles could improve the postoperative outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533253","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":"Flexible cystoscopy-guided implantation of ProACT: Surgical technique and long-term outcomes","authors":"Dimitri Paillusson,&nbsp;Marie-Liesse De Guerry,&nbsp;Stéphane De Vergie,&nbsp;Marie-Aimée Perrouin-Verbe","doi":"10.1002/bco2.70005","DOIUrl":"https://doi.org/10.1002/bco2.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to describe the ProACT implantation using flexible cystoscopic guidance and to report long-term outcomes in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This single-centre retrospective study include all men who underwent ProACT™ for SUI after RP using flexible cystoscopic guidance between 2007 and 2021. The implantation was performed via a perineal approach under general or locoregional anaesthesia. Accurate positioning was ensured using both real-time fluoroscopic and endoscopic guidance (flexible cystoscopy retroflexed toward the bladder neck).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 196 men were included; 18% (<i>n</i> = 36) had previously undergone radiotherapy and 24% (<i>n</i> = 46) had undergone SUI surgery. The median (IQR) follow-up time was 63 (24–108) months. At the last follow-up, 64% of participants still had their balloon in place, and the success and improvement rates were 62% and 17%, respectively. The perioperative complication rate was 5% (mainly bladder injury and acute urinary retention). Forty-two per cent (<i>n</i> = 82) experienced at least one complication, mainly device deflation (28%). Definitive explantation occurred in 36% (<i>n</i> = 71), with secondary implantation of an artificial urinary sphincter in 96% (<i>n</i> = 68).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ProACT® adjustable balloon implantation using flexible cystoscopic guidance appears to be an effective and safe long-term procedure for men with SUI after RP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533252","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":"Long-term outcomes of cutaneous ureterostomy with the aim of stent-free stoma","authors":"Chul Jang Kim,&nbsp;Masayuki Nagasawa,&nbsp;Eiki Hanada,&nbsp;Kayo Takeuchi,&nbsp;Toshiyuki Ihara,&nbsp;Susumu Kageyama","doi":"10.1002/bco2.499","DOIUrl":"https://doi.org/10.1002/bco2.499","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We evaluated post-surgical renal function and risk factors for renal function deterioration (RFD), defined as a &gt; 25% decrease in the estimated serum creatinine-based glomerular filtration rate (eGFR), after cutaneous ureterostomy (CU) and collected follow-up data on hydronephrosis after CU construction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>CU was performed following radical cystectomy in 46 patients (90 renal units [RUs]) with a minimum follow-up period of 12 months. The median follow-up period was 102.1 months. The stoma was created using the Toyoda method. A surgical stabilization step for the abdominal tunnel of the ureters was added. Post-surgical changes in renal function and hydronephrosis were reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the end of follow-up, RFD was observed in 19 (41.3%) of 46 patients. The 5- and 10-year RFD-free survivals were 61.3% and 47.2%, respectively. Seventy-six RUs (84.4%) exhibited no hydronephrosis, whereas six RUs (6.7%) in six patients progressed to atrophic kidneys. Stent catheters were inserted in eight RUs (8.9%) in six patients. After excluding 10 patients with progression to atrophic kidneys (six patients) or ureteral obstruction attributable to retroperitoneal lymph node metastasis by cancer progression (four patients), RFD was identified in 13 (36.1%) out of 36 patients. These patients were categorized into Group 1 (without RFD, 23 patients) and Group 2 (with RFD, 13 patients). Stent insertion was identified as a significant predictor of post-surgical RFD by univariate (<i>p</i> = 0.001) and multivariate analyses (<i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RFD was observed in 41.3% patients during follow-up. We achieved an 84.4% hydronephrosis-free rate following CU construction. Stent insertion was identified as a significant risk factor for RFD after CU construction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.499","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481472","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":"Robotic reconstruction of complex bladder neck stenosis: Single-centre experience with three techniques","authors":"Emily Rinderknecht,&nbsp;Simon Udo Engelmann,&nbsp;Veronika Saberi,&nbsp;Maximilian Haas,&nbsp;Sebastian Kälble,&nbsp;Christoph Eckl,&nbsp;Valerie Hartmann,&nbsp;Christopher Goßler,&nbsp;Christoph Pickl,&nbsp;Stefan Denzinger,&nbsp;Maximilian Burger,&nbsp;Johannes Bründl,&nbsp;Roman Mayr","doi":"10.1002/bco2.501","DOIUrl":"https://doi.org/10.1002/bco2.501","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate and compare surgical techniques for robot-assisted reconstruction of recurrent bladder neck stenosis (BNS). BNS following a simple prostatectomy represents a rare but challenging condition in operative urology. Various robotic reconstructive techniques have been described, showing differing success rates. This monocentric case series reports on three distinct robotic surgical approaches for managing recurrent BNS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on patients undergoing robot-assisted surgical repair for recurrent BNS at our institution. Clinical data, including patient history, comorbidities (Charlson Comorbidity Index), surgical treatment, complications (Clavien-Dindo classification) and follow-up outcomes, were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 27 patients underwent robotic bladder neck reconstruction for recurrent BNS. Twelve patients were treated with YV plasty, 12 with stricture resection and end-to-end anastomosis and 3 with reconstruction using a buccal mucosa graft (BMG). At a median follow-up of 18 months, therapy failure occurred in 9 patients (33.3%), with failure rates of 25.0% for YV plasty, 33.3% for stricture resection and 66.7% for BMG plasty. Nine patients (33.3%) experienced surgery-related complications, including 7 minor complications (5 in the stricture resection group, 1 in the YV plasty group and 1 in the BMG group) and 2 major complications (1 in the stricture resection group and 1 in the YV plasty group). De novo incontinence occurred in five patients (19.2%), all of whom had undergone stricture resection with end-to-end anastomosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Recurrent BNS poses a significant surgical challenge. Based on our experience, BMG reconstruction demonstrated suboptimal outcomes, while stricture resection was associated with the highest complication rate and the most frequent occurrence of de novo incontinence. YV plasty, with its relatively low morbidity and minimally invasive nature, has become the preferred technique in our institution for managing this condition. Prospective studies with larger cohorts are warranted to confirm these findings and further refine surgical approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466072","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":"Focal therapy in prostate cancer: Development, application and outcomes in the United Kingdom","authors":"Nadia Rokan,&nbsp;Deepika Reddy","doi":"10.1002/bco2.70000","DOIUrl":"https://doi.org/10.1002/bco2.70000","url":null,"abstract":"<p>Prostate cancer is a significant health issue in the United Kingdom, with rising incidence rates prompting the exploration of innovative treatment options. Focal therapy has emerged as a targeted approach that aims to treat localised prostate cancer while minimising damage to surrounding healthy tissue and subsequent adverse side effects. Focal therapy is National Institute for Health and Care Excellence (NICE)-approved treatment modality for patients with intermediate-risk localised prostate cancer. This is an evolving field, reflecting the rapidly improved understanding of both the trajectory patients face following a diagnosis of prostate cancer, and how best to apply ablative techniques.</p><p>In this narrative review, we evaluate the historical development, current practices, clinical outcome reported in UK-based studies, and future directions of focal therapy for prostate cancer in the United Kingdom, highlighting its evolution as a viable treatment option.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447117","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}