BJUI compass最新文献

{"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}

{"title":"Precision in kidney-sparing surgery: Robot-assisted ureterectomy with novel Black Eye™ Ink","authors":"Hayder Alhusseinawi,&nbsp;Naomi Nadler,&nbsp;Helene Reif Andersen,&nbsp;Juan Luis Vásquez,&nbsp;Thomas Norus,&nbsp;Nessn Azawi","doi":"10.1002/bco2.502","DOIUrl":"https://doi.org/10.1002/bco2.502","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the feasibility, oncological efficacy and safety of robotic segmental ureterectomy (SU) for treating patients with localised upper tract urothelial carcinoma (UTUC). A key aspect of this research involves utilising Black Eye™ Endoscopic Marker Ink to delineate the boundary of the tumour in the ureter, helping to ensure precise surgical intervention and reducing the risk of positive surgical margin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In a prospective non-randomised trial from January 2018 to December 2022, patients with localised UTUC confirmed by CT-urography were enrolled. A Multidisciplinary Team assessed patients for suitability for kidney-sparing surgery (KSS) with SU, marked by endoscopic Black Eye™ Endoscopic Marker Ink. Black Eye Endoscopic Marker Ink marking aimed to enhance surgical precision by delineating clear resection margins. The primary endpoints were the feasibility of the technique, local and bladder recurrence rates and surgical outcomes. Propensity score matching was used for a balanced comparison to the standard treatment Radical Nephroureterectomy (RNU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty patients underwent SU, in the period of study with only one local recurrence reported with a median follow-up time of 35 months. SU was associated with a significantly shorter operative time (41 minutes less on average, <i>p</i> &lt; 0.001) than RNU. Tumour size was significantly larger in the RNU group (median size 42.5 mm, IQR: 30–60.5) compared to the SU group (median size 30 mm, IQR: 20–35) (<i>p</i> = 0.007), potentially indicating selection bias towards RNU for more advanced cases. No significant difference between the groups was found in the post-operative Clavien-Dindo complication score nor in oncological outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SU with Black Eye™ Endoscopic Marker Ink marking is a viable KSS technique that offers a safe and effective alternative to RNU for patients with a single tumour, no longer than 30 mm and of low grade. This novel approach is promising in lowering the risk of positive margins, ensuring cancer control and preserving renal function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439221","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":"Prevalence and risk factors of stress urinary incontinence in a 2023 Japanese community health survey - differences between males and females","authors":"Nobuhiro Haga,&nbsp;Mikako Yoshida,&nbsp;Takahiko Mitsui,&nbsp;Noritoshi Sekido,&nbsp;Naoya Masumori,&nbsp;Kenji Omae,&nbsp;Motoaki Saito,&nbsp;Yasue Kubota,&nbsp;Ryuji Sakakibara,&nbsp;Satoru Takahashi","doi":"10.1002/bco2.70004","DOIUrl":"https://doi.org/10.1002/bco2.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of the present epidemiological study was to evaluate the sex-related prevalence of stress urinary incontinence (SUI) and the associated factors using data from the 2023 Japan Community Health Survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated 3097 males and 3056 females aged 20–99 years. All participants answered web-based questionnaires on their health status and lower urinary tract symptoms. Data on the frequency of SUI, comorbidities and health-related behaviour were extracted. The Cochran-Armitage trend test was used to evaluate the trend between the prevalence of SUI and age. Multivariate analysis was performed using logistic regression analysis to identify factors associated with SUI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SUI was consistently observed in about 10% of individuals in their 20s and 30s, including in males. There were no age-related differences in the prevalence of SUI in males (P = 0.55). In females, the prevalence of SUI statistically significantly increased with age (P &lt; 0.0001). The frequency of SUI was, however, low in both sexes. Drinking habits (OR, 1.43; 95% CI, 1.10–1.87) and frequent spicy food intake (OR, 1.55; 95% CI, 1.19–2.01) were associated with SUI only in males. Age (OR, 1.36; 95% CI, 1.13–1.62), BMI (OR, 1.87; 95% CI, 1.50–2.32) and history of vaginal delivery (OR, 2.15; 95% CI, 1.77–2.63) were only associated with SUI in females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although the frequency of SUI was low in both sexes, the correlation between the prevalence of SUI and age was different between both sexes. Female SUI might involve weakness of the pelvic floor muscle, while male SUI might be affected by health-related behaviours.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of outcomes associated with patients admitted to hospital with emergency haematuria","authors":"Nikki Kerdegari,&nbsp;Raghav Varma,&nbsp;Simona Ippoliti,&nbsp;Cameron Alexander,&nbsp;Arjun Nathan,&nbsp;Kevin Gallagher,&nbsp;Sinan Khadhouri,&nbsp;Kevin Byrnes,&nbsp;Nikita Bhatt,&nbsp;Veeru Kasivisvanathan","doi":"10.1002/bco2.497","DOIUrl":"https://doi.org/10.1002/bco2.497","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Unscheduled admission for haematuria accounts for 15% of all urological emergencies with over 25 000 patients admitted each year in the UK. It is associated with prolonged admission and poor clinical outcomes. This systematic review aims to determine current management strategies and outcomes in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was performed in October 2023 across MEDLINE, EMBASE and Web of Science for randomised controlled trials and retrospective and prospective observational studies assessing the management of patients admitted as an emergency with haematuria. The primary outcome measure was the length of stay (LoS). Secondary outcomes included hospital readmission, mortality and health resource use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three eligible publications with a total of 219 patients were identified. Mean length of stay was 5.8 days. The pooled mean age of unscheduled emergency haematuria was 74.8 years and 87.9% of patients were male. Bladder cancer was present in 17% of patients and, similarly, prostate cancer was present in 17% of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Unscheduled admission for haematuria is associated with long LoS. This systematic review has demonstrated a lack of data reporting outcomes of unscheduled haematuria and its management strategies. There is a need to perform large-scale prospective studies to better understand this cohort of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431278","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":"Hydrocortisone treatment is associated with early recovery from severe septic shock in patients with obstructive pyelonephritis due to upper urinary tract stone","authors":"Isamu Otsuka,&nbsp;Koshiro Nishimoto,&nbsp;Taichi Kozako,&nbsp;Katsuhiro Kanemaru,&nbsp;Yasuhiro Yamashita,&nbsp;Toshiyuki Kamoto,&nbsp;Atsuro Sawada","doi":"10.1002/bco2.498","DOIUrl":"https://doi.org/10.1002/bco2.498","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The administration of hydrocortisone in patients with severe septic shock contributes to early recovery in intensive care. The purpose of this study was to evaluate the effect of hydrocortisone on early recovery from severe septic shock in patients with obstructive pyelonephritis due to upper urinary tract stone (stone pyelonephritis).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From January 2018 to October 2023, of all patients admitted for treatment of stone pyelonephritis, 28 did not respond to initial fluid infusion and vasopressors for urosepsis. Among these 28 patients, 14 were administered hydrocortisone for recovery from early shock. Characteristics and noradrenaline administration time of patients treated or not treated with hydrocortisone were retrospectively analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In patients with septic shock associated with stone pyelonephritis unresponsive to initial fluid and vasopressors, noradrenaline administration time in the hydrocortisone group (28.7 ± 17.5 h) was significantly shorter than in the non-treated group (46.0 ± 12.8 h, <i>p</i> = 0.006). The factors diabetes, blood culture results, age, performance status, severity of vital signs and laboratory data on sepsis severity were not significantly associated with the duration of noradrenaline administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest potential benefits of hydrocortisone administration for stone pyelonephritis unresponsive to initial fluid and vasopressors. Widespread adoption of hydrocortisone in the treatment of sepsis, which is common in intensive care, could become more important in urology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.498","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431272","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":"Differentiating between obstructive and non-obstructive azoospermia: A machine learning-based approach","authors":"Abdolreza Haghpanah,&nbsp;Nazanin Ayareh,&nbsp;Ashkan Akbarzadeh,&nbsp;Dariush Irani,&nbsp;Fatemeh Hosseini,&nbsp;Farid Sabahi Moghadam,&nbsp;Mohammad Ali Sadighi Gilani,&nbsp;Iman Shamohammadi","doi":"10.1002/bco2.493","DOIUrl":"https://doi.org/10.1002/bco2.493","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Infertility is a major global concern, with azoospermia, being the most severe form of male infertility. Distinguishing between obstructive azoospermia (OA) and non-obstructive azoospermia (NOA) is crucial due to their differing treatment approaches. This study aimed to develop a machine learning model to predict azoospermia subtypes using clinical, ultrasonographic, semen and hormonal analysis data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included all subjects diagnosed with azoospermia. All patients were evaluated by at least one urologist, had their semen sample assessed on at least two different occasions for diagnosis and underwent a testicular biopsy to determine the type of azoospermia, categorized into OA and NOA. Clinical factors, hormonal levels, semen parameters and testicular features were compared between the OA and NOA groups. Three machine learning models, including logistic regression, support vector machine and random forest, were evaluated for their accuracy in differentiating the two subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included a total of 427 patients with azoospermia, of which 326 had NOA and 101 had OA. The median age of the patients was 33.0 (IQR: 7.0) years. Our findings revealed that factors such as body mass index, testicular length, volume and longitudinal axis, semen parameters and hormonal levels differed significantly between the two groups. When these variables were input into the machine learning-based models, logistic regression achieved the highest F1-score and area under the curve value among the three models evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study underscores the potential of machine learning to differentiate between azoospermia subtypes using readily available clinical data. However, further research is required to validate and refine the model before it can be applied clinically.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431276","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}