BJUI compass最新文献

{"title":"Mixed reality applications in percutaneous stone surgery: A systematic review and meta-analysis of stone-free rate and perioperative complications","authors":"Christopher Yong-Zyn Lo,&nbsp;Frida Toscano,&nbsp;John Joson Ng,&nbsp;Du Jingzeng,&nbsp;Archan Khandekhar,&nbsp;Hemendra Shah,&nbsp;Robert Marcovich,&nbsp;Julio Ojalvo,&nbsp;Sarvesh Saini,&nbsp;Jonathan Katz","doi":"10.1002/bco2.70278","DOIUrl":"10.1002/bco2.70278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study is to evaluate the effect of mixed reality (MR)-assisted percutaneous nephrolithotomy (PCNL) on stone-free rate (SFR), perioperative complications and operative efficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A search of PubMed, Embase and Web of Science from inception to February 2026 followed PRISMA guidelines. Studies comparing MR-assisted versus standard fluoroscopic or ultrasound-guided PCNL were included. Risk of bias was assessed using RoB2 and ROBINS-I. Random-effects meta-analyses calculated standardized mean differences (SMD) or risk ratios (RR) with 95% confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies (<i>n</i> = 774; 378 MR-assisted, 396 control) met inclusion criteria; eight studies (<i>n</i> = 730; 356 MR-assisted, 374 control) were included in meta-analysis. MR modalities included immersive virtual reality (VR) planning, holographic MR and CT-ultrasound (US) fusion navigation. The MR-assisted group had modest improvements in SFR compared to the control group (RR = 1.09; 95% CI 1.00–1.18; <i>p</i> = 0.044; <i>I</i>² = 17.3%, <i>p</i> = 0.29). Complication rates were similar between MR-assisted and standard approaches. There was no statistically significant difference in puncture time between MR-assisted and standard groups (SMD = −0.64; 95% CI −2.22 to 0.93; <i>p</i> = 0.42), with considerable heterogeneity. Similarly, there was no statistically significant difference in operative duration (SMD = −0.22; 95% CI -0.66 to +0.23; <i>p</i> = 0.34). While not meeting the threshold for pooled meta-analysis, narratively, we found that MR-assistance also reduced puncture attempts, blood loss and fluoroscopy time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MR-assisted PCNL is associated with an apparent increase in SFR while maintaining comparable operative parameters and complication rates compared with standard techniques. Heterogeneity in these technologies and their applications limits generalizability. Larger, adequately powered standardized trials are recommended to interrogate key outcome measures including SFR and complication rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027011","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":"Reproducibility of Aquablation outcomes across surgeon experience levels: A descriptive analysis of published studies","authors":"Eviatar Fields,&nbsp;Mario Henrique Bitar Siqueira,&nbsp;Philip Charlesworth,&nbsp;Garrett Pohlman,&nbsp;David Cuellar,&nbsp;Shin Koike,&nbsp;Naeem Bhojani,&nbsp;Bilal Chughtai,&nbsp;Kevin C. Zorn,&nbsp;Dean Elterman","doi":"10.1002/bco2.70282","DOIUrl":"10.1002/bco2.70282","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to descriptively evaluate the reported functional and symptomatic outcomes of Aquablation therapy across published series categorized by operator experience level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/Patients and Methods</h3>\u0000 \u0000 <p>We performed a non-systematic descriptive review of functional and symptomatic outcomes of eight published Aquablation clinical trials and real-world series. Studies were categorized based on inferred or known operator experience into early-experience (Water, Water II and Japan-PMS; total <i>n</i> = 332) and experienced groups (Water III, ASC Pilot, ASC Global, Mount Sinai and Madrid; total <i>n</i> = 664). Extracted variables included baseline and follow-up International Prostate Symptom Score (IPSS), IPSS-quality of life (QoL), maximum urinary flow rate (Qmax) and post-void residual volume (PVR). Weighted and sample-size weighted mean and standard deviation of change were calculated and evaluated descriptively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>IPSS, IPSS-QoL, Qmax and PVR all improved across the eight cohorts. Mean changes in patient-reported outcomes were similar between early-experience and experienced cohorts for IPSS (unweighted mean change: −14.77 vs. −15.15; weighted: −14.81 vs. −15.30) and IPSS-QoL (unweighted: −3.13 vs. −3.28; weighted: −3.14 vs. −3.13). Physiologic metrics (QMax and PVR) demonstrated higher absolute improvements and greater variance in the experienced cohort, heavily driven by cohorts with more severe baseline urinary retention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Across published series, Aquablation yields broadly consistent improvements in patient-reported symptom scores, regardless of baseline operator experience level. Observed differences in physiological outcomes appear primarily influenced by baseline patient selection rather than surgeon experience. These descriptive findings support the general reproducibility of Aquablation outcomes across real-world clinical settings. Formal prospective studies are required to define reproducibility across perioperative safety profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018782","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 use of biparametric magnetic resonance imaging in active surveillance of prostate cancer","authors":"Carlos A. Rivera López,&nbsp;Michelle I. Higgins,&nbsp;Yuezhou Jing,&nbsp;Mark N. Alshak,&nbsp;Joseph G. Cheaib,&nbsp;Mufaddal Mamawala,&nbsp;Patricia Landis,&nbsp;Mohammad E. Allaf,&nbsp;Katarzyna J. Macura,&nbsp;Christian P. Pavlovich","doi":"10.1002/bco2.70281","DOIUrl":"https://doi.org/10.1002/bco2.70281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to evaluate the performance of biparametric magnetic resonance imaging (bpMRI) compared to multiparametric MRI (mpMRI) for active surveillance (AS) in prostate cancer (PCa), focusing on lesion detection, PI-RADS classification changes and grade reclassification (GR) rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed our institutional AS database for men who underwent mpMRI followed by bpMRI. Lesion counts and PI-RADS classification were compared. Second, a subgroup of men who underwent mpMRI, biopsy, bpMRI and then repeat biopsy (‘bpMRI biopsy group’) was matched to a control group who underwent mpMRI, biopsy, another mpMRI and then repeat biopsy (‘mpMRI biopsy group’) based on age, PSA density, year of diagnosis and number of positive cores. GR rates at systematic and targeted biopsy of all PI-RADS 3–5 lesions were compared, as were PI-RADS changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 129 men with a median of 29 months between mpMRI and bpMRI were included. mpMRI identified 77 PI-RADS 3–5 lesions versus 114 on subsequent bpMRI (0.60 vs. 0.88 lesions/patient, <i>p</i> = 0.01); however, lesion distribution was similar, with rates of PI-RADS 3, 4 and 5 lesions of 53%, 40% and 6% on mpMRI and 53%, 37% and 11% on subsequent bpMRI (<i>p</i> = 0.87, 0.29 and 0.23, respectively). In the matched biopsy subgroups, when comparing men who had two surveillance mpMRIs with those who had a surveillance mpMRI followed by a surveillance bpMRI, lesion stability was not significantly different across PI-RADS categories. GR at last biopsy occurred in 29% of the bpMRI biopsy group versus in 25% of the mpMRI biopsy group (<i>p</i> = 0.7).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>bpMRI appears safe to incorporate into AS over the short term, as it was noninferior to mpMRI with similar GR rates and lesion stability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994274","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 battleship study: An innovation towards precision in prostate biopsy and brachytherapy grid usage","authors":"Vishen Naidoo,&nbsp;Duvern Ramiah,&nbsp;Marlon Perera,&nbsp;Ahmed Adam","doi":"10.1002/bco2.70279","DOIUrl":"https://doi.org/10.1002/bco2.70279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to compare the efficiency and accuracy of a conventional prostate brachytherapy grid with a novel <i>Zebra</i> grid using a laboratory-based simulation model (ProGrid model).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective and comparative experimental pilot study was conducted using a nonclinical brachytherapy simulation model (ProGrid Model). One hundred medical practitioners (Registrars and Consultants in Urology, Radiation Oncology and General Surgery) were recruited by randomization. Participants performed a series of predetermined coordinate needle insertions using either the conventional grid or the <i>Zebra</i> grid. Time taken to identify and accurately insert each coordinate was measured. Demographic and experiential variables were collected via questionnaire. The data were analysed using descriptive statistics, bivariate correlations and multiple regression modelling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no significant differences between groups in baseline characteristics, including level of training, department, brachytherapy experience, gaming experience, hand dominance and use of prescription glasses. The <i>Zebra</i> grid demonstrated significantly reduced insertion times across all 10 coordinates compared to the conventional grid (<i>p</i> &lt; 0.001). Mean overall time was significantly lower for the <i>Zebra</i> grid (3.675 ± 0.9 s) compared to the conventional grid (5.034 ± 1.4 s; <i>p</i> &lt; 0.001). No statistically significant differences in accuracy of insertion in the desired grid coordinate were observed between the two grids. Multivariate analysis confirmed grid type as an independent predictor of reduced procedural time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The <i>Zebra</i> brachytherapy grid significantly improves procedural efficiency without compromising accuracy in a simulated setting. This low-cost, easily reproducible modification has the potential to reduce operating theatre (OT) time and improve workflow in PB. Further clinical studies are recommended to validate these findings and assess their impact on patient outcomes and healthcare resource utilization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943315","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":"Low diagnostic yield of routine preoperative chest CT in patients undergoing partial nephrectomy: A national cohort study using UroCCR data (UroCCR n°216)","authors":"Ali Bourgi,&nbsp;Gaëlle Margue,&nbsp;Pierre Bigot,&nbsp;Norbert De Brek,&nbsp;Louis Surlemont,&nbsp;Martin Lorette,&nbsp;Nicolas Branger,&nbsp;Thomas Prudhomme,&nbsp;Aurélien Adypagavane,&nbsp;Véra Chatain,&nbsp;Thibaut Waeckel,&nbsp;Alexis Fontenil,&nbsp;Victor Gaillard,&nbsp;Jean-Jacques Patard,&nbsp;Constance Michel,&nbsp;Julien Guillotreau,&nbsp;Olivier Belas,&nbsp;Maxime Vallée,&nbsp;Stéphane De Vergie,&nbsp;Jean-Baptiste Beauval,&nbsp;Clément Sarrazin,&nbsp;Benjamin Delattre,&nbsp;Frédéric Panthier,&nbsp;Lionel Hoquetis,&nbsp;Romain Boissier,&nbsp;Julien Anract,&nbsp;Marie Chicaud,&nbsp;Alexandre Marsaud,&nbsp;Richard Mallet,&nbsp;Quentin-Côme Le Cerlc,&nbsp;Khalil Chalhoub,&nbsp;Idir Ouzaid,&nbsp;Jean-Christophe Bernhard,&nbsp;Franck Bruyère","doi":"10.1002/bco2.70203","DOIUrl":"10.1002/bco2.70203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to evaluate the diagnostic yield and downstream clinical impact of routine preoperative chest CT in patients undergoing partial nephrectomy (PN) for localized renal cell carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective multicentre study using data from the French Urological Cancer Comprehensive Cohort (UroCCR) registry. Adult patients who underwent PN for localized renal masses between 2010 and 2024 and had preoperative chest CT within 30 days before surgery were included. The primary endpoint was the detection rate of synchronous pulmonary metastases. Secondary endpoints included characteristics of metachronous metastases and diagnostic or scheduling consequences of preoperative imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 7351 patients, 6679 underwent surgery and 5016 had a preoperative chest CT. Of these, 4483 (89.4%) had clinical T1 tumours. Synchronous pulmonary metastases were identified in only 17 patients (0.38%), all with larger or higher grade tumours. These patients had significantly higher rates of positive surgical margins (17.6% vs. 6.1%, <i>p</i> = 0.04), but no significant difference in age, sex or comorbidity profile. Among 6075 patients with postoperative follow-up, 191 (3.14%) developed metachronous pulmonary metastases. Of these, 14 (7.3%) had a previously negative preoperative CT, with a median time to progression of 52.6 months. Importantly, 166 (3.7%) patients underwent additional, ultimately non-contributive thoracic investigations, and 2.1% experienced surgical delays due to incidental or equivocal CT findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The diagnostic yield of routine preoperative chest CT in patients with clinical T1 RCC is exceedingly low (&lt;0.5%). These data support the omission of routine chest CT in asymptomatic, low-risk cT1 RCC, potentially sparing over 95% of patients from unnecessary imaging, additional tests and surgical delays. A risk-adapted, symptom-guided strategy may optimize patient care while reducing radiation exposure and healthcare costs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921867","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":"Machine-learning prediction of urine-culture positivity in a multicentre test-ordered cohort: Model development and internal validation","authors":"Isaac Samir Wasfy,&nbsp;Jamal Ahmad,&nbsp;Hany Elsegeay,&nbsp;Mohamed F. Elebiary,&nbsp;Ahmed Haty,&nbsp;Eman M. El-Dydamony,&nbsp;Ahmed Mohamed Soliman,&nbsp;Ahmed Alrefaey,&nbsp;Hesham Abozied,&nbsp;Mohamed Algammal,&nbsp;Hossam A. Shouman,&nbsp;Maha M. Elzamek,&nbsp;Ahmed Abdel Galil Saleh,&nbsp;Ahmed Fetyan Abdelazim Shafi,&nbsp;Osama Mostafa Abdalla Mohamed","doi":"10.1002/bco2.70280","DOIUrl":"10.1002/bco2.70280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aim to develop, compare and internally validate machine-learning models for predicting urine-culture positivity in patients who had both urinalysis and culture ordered and to explore descriptive probability strata. Post hoc secondary analyses examined age subgroups, the incremental contribution of text-derived features, simpler comparators and calibration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Urine culture results are typically unavailable for 24–72 h, creating uncertainty during initial assessment, and machine-learning models may help estimate the probability of culture positivity from routinely collected data. This retrospective study included 2530 urine-sample records originating from three university hospitals. Eligibility was based on paired urinalysis and urine culture records rather than symptom-based diagnostic criteria for urinary tract infection (UTI). Thirteen supervised algorithms were evaluated using a stratified 75:25 sample-record split. This constituted internal validation; records were not grouped by patient or centre because stable cross-centre patient, centre and collection-date identifiers were unavailable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several gradient-boosting algorithms showed similar discrimination. CatBoost had the numerically highest test-set AUC of 0.858 (95% CI 0.829–0.892), but its AUC did not differ significantly from gradient boosting or XGBoost. At the reported operating threshold, sensitivity was 0.587 (95% CI 0.513–0.662), specificity 0.930 (0.903–0.951), PPV 0.766 (0.693–0.833) and NPV 0.851 (0.821–0.882). Exploratory probability strata separated records with different observed rates of culture positivity, but their clinical utility and safety were not evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Machine-learning models discriminated between culture-positive and culture-negative sample records in a sample-level internal validation. Culture positivity is not synonymous with symptomatic or clinically significant UTI. The findings support further evaluation as diagnostic risk-estimation tools after urinalysis results are available. They do not establish clinical UTI or the safety or effectiveness of starting, withholding or delaying antibiotics. Patient-grouped external validation with clinical outcomes is required before clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914111","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-assisted laparoscopic ureteral reimplantation using the LUAA technique: VCUG-confirmed outcomes, learning curve and CUSUM analysis","authors":"Daniel Fu,&nbsp;Priyank Yadav,&nbsp;Jorge Arias,&nbsp;David Kim,&nbsp;Mohan Saheb Gundeti","doi":"10.1002/bco2.70271","DOIUrl":"https://doi.org/10.1002/bco2.70271","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To delineate the learning curve of robotic-assisted laparoscopic ureteral reimplantation (RALUR) through the LUAA extravesical technique, we characterized efficacy and safety outcomes throughout surgical proficiency development using cumulative sum (CUSUM) analysis and perioperative trifecta outcomes. RALUR is the minimally invasive alternative to open reimplantation for paediatric vesicoureteral reflux (VUR); however, its learning curve remains poorly defined due to small series and inconsistent outcome reporting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>We performed a retrospective single-surgeon study of 125 patients undergoing RALUR for primary VUR divided into pre-LUAA (2008–2011), evolving LUAA (2011–2014) and standardized LUAA (2014–2025) phases. The primary outcome was radiographic VUR resolution on postoperative voiding cystourethrogram. Secondary outcomes included urinary retention and 90-day Clavien–Dindo grade ≥3 (CDG3+) complications. CUSUM analysis of operative time defined competency, proficiency and mastery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>VUR resolution improved from 76% (pre-LUAA) to 85.2% (evolving) and 94.4% (standardized) with an overall success rate of 87.2%. Urinary retention (4%) and CDG3+ complications (3.2%) remained low. CUSUM analysis demonstrated competency at case 28 and mastery at case 99 overall. Limitations include retrospective design, single-surgeon experience and lack of comparison with open surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This largest single-surgeon study with objective VCUG-based outcomes demonstrates that the LUAA technique achieves high radiographic success with low complication rates. Surgical proficiency is safely attained within a modest case volume for unilateral as well as bilateral cases. These findings provide a quantitative framework to guide training and credentialing in RALUR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849147","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":"Endoscopic management of upper tract urothelial carcinoma with laser ablation including Magneto pulse modulation","authors":"Davide Perri,&nbsp;Luis Rico,&nbsp;Giorgio Bozzini,&nbsp;Pablo Contreras","doi":"10.1002/bco2.70263","DOIUrl":"https://doi.org/10.1002/bco2.70263","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to assess the efficacy and safety of different laser technologies, including the new Holmium:YAG (Ho:YAG) Magneto pulse modulation, for the endoscopic ablation of upper tract urothelial carcinoma (UTUC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Sixty-eight patients with UTUC from two centres were treated between February 2022 and June 2025. Three different lasers were used based on the available technology in each centre at the time of treatment: Ho:YAG with Vapor Tunnel pulse modulation (VT, Group A), thulium fibre laser (TFL, Group B) and Ho:YAG with Magneto pulse modulation (Mag, Group C). Intraoperative parameters, postoperative complications and recurrence rates were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean tumour size was 13.7 mm (range 5–30 mm). The overall mean operative time was 44.3 min. No intraoperative complications occurred. The overall rate of post-procedural complications was 19.1%. The most frequent complication was haematuria, affecting 10.3% of patients. The recurrence rate was 17.6% (12 out of 68 patients) with a mean time to recurrence of 3.3 months. At the last follow-up, 80.9% of patients were alive and free of disease, whereas 11.8% were alive with disease. Mortality due to urothelial carcinoma occurred in 1.5% of patients, whereas 5.8% of patients died from other causes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endoscopic laser UTUC ablation is feasible and safe using both Ho:YAG and TFL, including the new Magneto pulse modulation technology. The low complication and recurrence rates support the use of this treatment in highly selected patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849108","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":"Salvage prostate therapies for local pelvic recurrence after primary radiation for prostate cancer","authors":"Jamie Michael,&nbsp;Kathryn Fink,&nbsp;Vivian Wan,&nbsp;Sai K. S. R. Kaushik,&nbsp;Clayton Neill,&nbsp;Yutai Li,&nbsp;Ridwan Alam,&nbsp;David J. VanderWeele,&nbsp;Shilajit Kundu,&nbsp;Ashley E. Ross","doi":"10.1002/bco2.70259","DOIUrl":"https://doi.org/10.1002/bco2.70259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The purpose of this study is to evaluate salvage treatment after primary radiation therapy (RT) for prostate cancer within our hospital system. Specifically, we aim to evaluate treatment patterns, oncologic outcomes and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>We retrospectively identified men with post-RT recurrence treated with salvage radical prostatectomy (sRP), seminal vesiculectomy, cryoablation, high-dose-rate brachytherapy (HDR) or irreversible electroporation (IRE). Salvage failure was defined as biochemical recurrence (BCR; Phoenix criteria, nadir + 2 ng/mL for cryoablation, HDR and IRE or prostate-specific antigen (PSA) &gt; 0.2 ng/mL for sRP and seminal vesiculectomy) or need for subsequent therapy. Cox regression identified factors associated with time to failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-one patients underwent salvage therapy after RT; 58 (81.7%) cryoablation, 7 (9.9%) sRP, 2 (2.8%) robotic seminal vesiculectomies, and 4 (5.6%) other modalities. Failure occurred in 30 (45%) patients at a median of 12.5 months (IQR 6, 23). Grade group (GG) 4–5 disease prior to RT was associated with time to failure (HR 2.18, 95% CI 0.96, 4.97, <i>p</i> = 0.063) on multivariable analysis; however, the difference was not significant. Treatment type was not significantly associated with failure-free survival (<i>p</i> = 0.7). Four patients experienced Clavien–Dindo grade III or higher complications: three following sRP (two anastomosis dehiscence, clot retention) and one following cryoablation (stricture). Ten patients (14%) underwent local salvage for prostate recurrences in the setting of N1/M1 disease with concurrent systemic therapy, with no treatment escalation or complications at median 16 months follow-up time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this institutional cohort, salvage cryoablation demonstrated an acceptable short-term failure-free survival with fewer observed high-grade complications than salvage prostatectomy. Salvage cryoablation also appeared feasible in select patients with low-volume nodal or metastatic disease. These findings are hypothesis-generating and require prospective validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849146","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":"Perioperative propranolol during robotic-assisted radical prostatectomy: A randomised, double-blind, placebo-controlled, pilot trial (PeP-RALP)","authors":"Shivanthe Sivanesan,&nbsp;Håkon Ramberg,&nbsp;Thomas Kristiansen,&nbsp;Suraj B. Thapa,&nbsp;Marthe Bjøre,&nbsp;Viktor Berge,&nbsp;Fredrik Ottosson,&nbsp;Bjørn Brennhovd,&nbsp;Anne M. H. Storås,&nbsp;Per M. Thorsby,&nbsp;Sandra R. Dahl,&nbsp;Alfonso Urbanucci,&nbsp;Helene Hartvedt Grytli,&nbsp;Lars Bjerke,&nbsp;Kristin Austlid Taskén","doi":"10.1002/bco2.70267","DOIUrl":"https://doi.org/10.1002/bco2.70267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine the feasibility and safety of administering perioperative propranolol, as an adjunct to reduce prostate cancer recurrence, in patients undergoing robotic-assisted laparoscopic prostatectomy (RALP) for European Association of Urology (EAU) intermediate- or high-risk prostate cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>Treatment-naïve men aged 40–80 years with EAU intermediate- or high-risk prostate cancer scheduled for RALP were enrolled in this single-centre, randomised, double-blind, placebo-controlled, phase 2 pilot trial. Participants were randomised 1:1 to receive propranolol or placebo for approximately 3 weeks (about 1 week pre-RALP and 2 weeks post-RALP). Serial blood sampling was performed to measure catecholamine metabolites, serum propranolol and short-interval prostate-specific antigen (PSA) dynamics. Participants self-monitored pulse rate and blood pressure twice daily.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over 36 weeks in 2023, 160 patients underwent RALP; 111 were prescreened, 49 were fully screened and 40 were randomised, corresponding to inclusion rates of 36% among prescreened and 82% among fully screened patients. Pre-RALP adherence was 98% in both arms; post-RALP adherence was lower in the propranolol arm. No Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 grade ≥3 adverse events were attributed to propranolol, and no surgeries were delayed. The epinephrine metabolite metanephrine increased intraoperatively in both arms and declined by the end of treatment. Mean preoperative PSA decreased more with propranolol than with placebo. As this pilot was not powered to detect between-group differences, such differences are hypothesis-generating only.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PeP-RALP demonstrated that perioperative propranolol is operationally feasible and demonstrated an acceptable safety profile within RALP workflows, with strong preoperative adherence. Our study supports a multicentre efficacy randomised controlled trial with standardised anaesthetic protocols, postoperative adherence support and oncological endpoints. All physiological and molecular results, including PSA dynamics, in this pilot are exploratory and solely intended to inform the design of any future trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816608","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}