BJUI compass最新文献

{"title":"Single-port extraperitoneal robot-assisted simple prostatectomy for benign prostatic hyperplasia: Surgical technique and initial clinical experience","authors":"Sij Hemal, Samantha H. Rosen, Simon Kim, Joon Yau Leong, Michael Eppler, Patrick Ford, Jacob S. Hershenhouse","doi":"10.1002/bco2.70273","DOIUrl":"10.1002/bco2.70273","url":null,"abstract":"<p>Simple prostatectomy via an open, laparoscopic or robotic approach is recommended by both the American Urologic Association (AUA) and European Association of Urology (EAU) guidelines for male lower urinary tract symptoms (LUTS) attributable to benign prostatic hyperplasia (BPH) for large (80–150 cm<sup>3</sup> [cc]) and very large prostate glands (>150 cc).<span><sup>1, 2</sup></span> Laser enucleation using the holmium or thulium laser is also recommended for these gland sizes, but a steep learning curve and the operator-dependent rates of transient initial incontinence have limited adoption of this treatment modality in the United States. In 2018, the Food and Drug Administration cleared the da Vinci single-port (SP) system for performing robot-assisted simple prostatectomy (RASP). Abou Zeinab et al. subsequently described a transvesical (TV) approach with robust clinical outcomes relative to multi-port RASP, including high rates of same-day discharge (SDD) and shorter length of stay (LOS) secondary to surgical regionalization.<span><sup>3</sup></span> Furthermore, the excellent long-term durability and promising outcomes at 1 year following the index operation with sustained improvement in International Prostate Symptom Score (IPSS), quality of life, maximum flow rates, post-void residual volumes (PVRs) and no reported long-term stress urinary incontinence (SUI), bladder neck contracture or urethral stenosis has led to the widespread adoption of the SP TV RASP among the SP robotic surgeons in the United States.<span><sup>4</sup></span></p><p>The TV approach to RASP has demonstrated several advantages, though certain limitations exist in the anterior/apical adenoma dissection, performance of vesicourethral anastomosis in a narrow working space and the rare risk of an air embolism, arising from pneumovesicum in a valveless port insufflation system. Herein, we describe an alternative SP RASP technique using an extraperitoneal (EP) approach that maintains the benefits of regionalized surgery, may facilitate en bloc anatomic enucleation, simplifies anterior/apical enucleation, accommodates moderate-to-large median lobes and achieves a vesicourethral reconstruction that obviates continuous bladder irrigation (CBI).</p><p>We included all consecutive patients undergoing SP EP RASP performed by a single robotic surgeon (S.H.) at a high-volume academic medical centre between July 2025 and April 2026. This cohort captures the surgeon's first independently performed SP EP simple prostatectomies and describes the technique and initial outcomes. Baseline demographics, clinical characteristics, perioperative variables and postoperative outcomes were collected in a prospectively maintained database and analysed retrospectively.</p><p>Baseline patient characteristics included age at time of surgery, race, ethnicity, body mass index (BMI), Charlson Comorbidity Index (CCI), American Society of Anesthesiologists (ASA) score and relevant comorbidities includ","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820320","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":"Reducing paralytic ileus after radical cystectomy: The role of advanced haemodynamic monitoring","authors":"Constantin Rieger,&nbsp;Till Löhr,&nbsp;Julian Heidenreich,&nbsp;Anna Rieger,&nbsp;Alexander Mathes,&nbsp;David Sander,&nbsp;Florian A. Schmid,&nbsp;Christian Bach,&nbsp;David Pfister,&nbsp;Axel Heidenreich","doi":"10.1002/bco2.70232","DOIUrl":"10.1002/bco2.70232","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Despite highly standardized surgical procedures, approximately 20%–30% of patients develop postoperative paralytic ileus following radical cystectomy, representing the highest incidence among abdominopelvic surgeries. The objective of this study was to identify additional predictors of paralytic ileus in a large single-centre cohort. Particular emphasis was placed on expanding the evidence regarding the effectiveness of advanced hemodynamic monitoring using the FloTrac® system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>We retrospectively analysed 383 patients and finally included 296 patients who underwent open or robotic radical cystectomy between 2018 and 2024 at our centre. Of these, 49 patients (16.6%) received intraoperative, minimal invasive FloTrac® monitoring. Perioperative variables were compared between groups, and predictors of paralytic ileus were determined using univariable and multivariable logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Paralytic ileus occurred in 23.0% of patients overall, with a significantly lower incidence in the FloTrac® group (10.2% vs. 21.3%), corresponding to a 60% relative risk reduction. In multivariable analysis, FloTrac® monitoring (OR 0.37, 95% CI 0.18–0.78, <i>p</i> = 0.008), female sex (OR 3.78, 95% CI 1.83–7.81, <i>p</i> &lt; 0.001) and higher body weight (OR 1.04, 95% CI 1.00–1.08, <i>p</i> = 0.034) emerged as independent predictors. FloTrac® monitoring was further associated with reduced intraoperative blood loss and lower colloid infusion volumes. All other peri-operative and postoperative variables, including complication rates (Clavien-Dindo ≥ 3), did not differ significantly between FloTrac® and control group (<i>p</i> ≥ 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FloTrac® monitoring was independently associated with a markedly lower risk of postoperative paralytic ileus after radical cystectomy. Female sex and higher body weight were identified as additional risk factors. Our findings underscore the potential of FloTrac®-Monitoring to enhance postoperative gastrointestinal recovery for radical cystectomy. Nevertheless, overall surgical complication rates remained comparable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820386","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":"Combining PSA density and imaging data with transcript markers from urinary cells to improve prediction of prostate cancer reclassification in patients on active surveillance","authors":"Angelika Borkowetz,&nbsp;Sebastian Gräfe,&nbsp;Jeremy Kwe,&nbsp;Susanne Fuessel,&nbsp;Christian Thomas,&nbsp;Kati Erdmann","doi":"10.1002/bco2.70276","DOIUrl":"https://doi.org/10.1002/bco2.70276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate selected transcripts from urinary cells regarding their potential to predict risk reclassification in patients with prostate cancer (PCa) on active surveillance (AS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>Urine samples were prospectively collected from 74 patients before control biopsy and immediately processed to obtain urinary cells. A panel of 29 PCa-associated transcripts with PPIA, RPLP0 and TBP as reference genes was determined by quantitative PCR following multiplexed reverse transcription of RNA with a pre-amplification step. Receiver operating characteristic (ROC) curve analyses including the calculation of the area under the curve (AUC) were conducted to assess the predictive ability for reclassification of the respective parameters. A multivariate regression analysis was performed to identify independent predictors suitable for combination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 31 patients (42%) showed PCa risk reclassification (defined by ISUP group 1 with PSA &gt; 10 ng/mL or ISUP group 2–5 with any PSA level) at control biopsy. The AUC values and accuracies of PSA, PSA density, PSA velocity and maxPI-RADS for indicating PCa risk reclassification ranged between 0.738 and 0.767 and 66% and 73%, respectively. Of the investigated transcripts, a predictive potential could be shown for MALAT1, MCL1, NEAT1, STAT3 and STAT5B (AUC = 0.622–0.713, accuracies 64%–73%). A model combining PSA density, maxPI-RADS and the transcript MCL1 resulted in an AUC of 0.828 with a sensitivity, specificity and accuracy of 58%, 93% and 78%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings highlight the potential of urinary transcripts, particularly in combinations with clinical parameters, for the non-invasive monitoring of PCa during AS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784984","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":"Reassessing re-TURBT in the modern era: Is it time to move from routine to selective?","authors":"Mithilesh Yadav,&nbsp;Swarnendu Mandal,&nbsp;Sambit Tripathy,&nbsp;Pranjal Chowdhury,&nbsp;Vivek Rathod,&nbsp;Manoj Kumar Das,&nbsp;Kalandi Barik,&nbsp;Prasant Nayak","doi":"10.1002/bco2.70269","DOIUrl":"https://doi.org/10.1002/bco2.70269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work aimed to determine the pathological yield of restaging transurethral resection of bladder tumour (re-TURBT) in patients with non-muscle-invasive bladder cancer (NMIBC) managed at a contemporary tertiary-care setting and to describe clinicopathological features among patients with positive restaging histopathology to select patients most likely to benefit from re-TURBT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This single-centre retrospective observational case–control analysis within a re-TURBT cohort included patients who underwent macroscopically complete index TURBT for presumed NMIBC and subsequently underwent restaging TURBT within the institutional pathway. Patients with muscle-invasive disease at index TURBT, benign pathology, non-urothelial carcinoma, variant histology, or ineligibility for re-TURBT for any reason were excluded. The primary outcome was positive restaging histopathology, defined as residual urothelial neoplasia or pathological progression. In addition, clinicopathological variables were explored to identify factors potentially associated with positive re-TURBT, including tumour size, multifocality, age, sex, tumour grade, detrusor muscle status, and carcinoma in situ on index histopathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 188 TURBT records assessed, 79 patients underwent re-TURBT and formed the analysed cohort. Median age was 64 years (IQR 56–69), 69 patients (87.3%) were male, and detrusor muscle was present in 77 index specimens (97.5%). Positive restaging histopathology occurred in nine patients (11.4%), comprising residual disease in eight (10.1%) and Ta high-grade to T1 high-grade progression in one (1.3%); no muscle-invasive upstaging was observed. In the T1-only analysis, positivity occurred in 8/69 (11.6%). Larger tumours, multifocality and CIS were more frequent among positive cases. Follow-up recurrence admission occurred in 9 patients (11.4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this contemporary re-TURBT series, the pathological yield of restaging was low, with uncommon progression. Positivity clustered in those with larger tumours (≥3 cm) and high-risk biology (multifocal disease and carcinoma in situ on index histopathology). These findings are hypothesis-generating and support prospective evaluation of selective restaging strategies in the contemporary era.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784985","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 functional outcomes after minimally invasive partial nephrectomy, single-surgeon experience","authors":"Mohamed Elsaqa,&nbsp;Ahmed Rabie,&nbsp;Israel Franco,&nbsp;Andrew Fishman,&nbsp;Wayne Debeatham,&nbsp;Michael Grasso","doi":"10.1002/bco2.70268","DOIUrl":"https://doi.org/10.1002/bco2.70268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to report the impact of minimally invasive partial nephrectomy (PN) on short- and long-term renal functional outcomes through a single-institution, long-term experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>We retrospectively reviewed consecutive patients who underwent retroperitoneal laparoscopic and/or robotic-assisted PN for renal masses by a single surgeon between 2016 and 2025. A multimodal perioperative renal-protective protocol was routinely utilized. Baseline estimated glomerular filtration rate (eGFR) was compared with early and late postoperative eGFR changes surveilled over a 2-year period post-PN. Multivariate regression analysis of multiple variables was performed for the association with change in eGFR at 2-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 281 patients with a mean (standard deviation [SD]) age of 67.70 (±10.05) years were included. Mean (SD) baseline serum creatinine and eGFR were 1.04 (±0.31) mg/dL and 74.08 (±19.28) mL/min, respectively. Mean eGFR showed an early postoperative significant decline to 63.98 ± 19.8 mL/min at 2 weeks, followed by delayed recovery at 6 months (69.23 ± 20.87) and then stabilization through 1- (69.4 ± 19.26) and 2-year (68.15 ± 19.67) follow-up. Multivariate logistic regression analysis identified renal mass size (<i>p</i> &lt; 0.001, odds ratio [OR] = 4.78, 95% confidence interval [CI]: 3.34 to 6.23) and preop eGFR (<i>p</i> &lt; 0.001, OR = 0.13, 95% CI: 0.06 to 0.2) as the independent significant predictors of functional decline at 2-year follow-up, whereas other variables including warm ischaemia time (WIT) were statistically insignificant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After PN, renal function demonstrates a pattern of early decline followed by substantial recovery over time. Tumour size and preoperative eGFR were the main predictors of late eGFR changes. With proper surgical techniques and perioperative renal-protective strategies, the effect of WIT can be mitigated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784256","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":"Procedure-specific temperature dependence and lag structure of urinary stone surgery: A nationwide open-data study in Japan, 2019–2024","authors":"Yuto Sakurai,&nbsp;Takashi Kawahara,&nbsp;Akihito Hashizume,&nbsp;Masanobu Yamazaki,&nbsp;Teppei Takeshima,&nbsp;Shinnosuke Kuroda,&nbsp;Tomoyuki Tatenuma,&nbsp;Hiroji Uemura,&nbsp;Kazuhide Makiyama,&nbsp;Jun-ichi Teranishi","doi":"10.1002/bco2.70270","DOIUrl":"https://doi.org/10.1002/bco2.70270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine whether the seasonality of urinary stone surgery and its association with ambient temperature differ between surgical procedures and to compare the time lag between temperature and each procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects and methods</h3>\u0000 \u0000 <p>We used the nationwide open data of the National Database of health insurance claims in Japan for fiscal years 2019–2024 (April 2019 to March 2025, 72 months). We counted monthly inpatient surgeries for extracorporeal shock wave lithotripsy (ESWL), ureteroscopic lithotripsy (URS), percutaneous nephrolithotomy (PCNL) and transurethral cystolitholapaxy and expressed them as a seasonal index of surgeries per business day normalized to a mean of 1 within each fiscal year. Observed monthly mean temperatures for 12 representative meteorological stations were correlated with the index at lags of −1 to +4 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 71 791 ESWL, 320 863 URS, 71 272 cystolitholapaxy and 20 387 PCNL procedures were performed. Volume rose from summer to autumn and was lowest in winter for ESWL, URS and cystolitholapaxy. In the same month, the correlation with temperature was strongest for ESWL (<i>r</i> = 0.83, 95% CI 0.74–0.89), followed by URS (<i>r</i> = 0.43, 0.22–0.60) and cystolitholapaxy (<i>r</i> = 0.35, 0.13–0.54), whereas PCNL showed no association (<i>r</i> = 0.05, −0.19–0.27). The correlation peaked at 1 month for ESWL (<i>r</i> = 0.87), at 2 months for URS (<i>r</i> = 0.69) and cystolitholapaxy (<i>r</i> = 0.52) and at 3 months for PCNL, where it was not significant at any lag. PCNL showed significant month-to-month variation that was not explained by temperature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The seasonality of urinary stone surgery and the time lag relative to ambient temperature differ by procedure, being shortest for ESWL and longer for procedures requiring anaesthesia and hospitalization, while PCNL shows no association with temperature.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784387","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":"Dartos pouch orchiopexy for adult testicular torsion and symptomatic retractile testis: Technique, early outcomes and critical appraisal of trans-tunical suture fixation","authors":"Dinesh K. Agarwal","doi":"10.1002/bco2.70272","DOIUrl":"https://doi.org/10.1002/bco2.70272","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To describe a reproducible single-incision dartos pouch orchiopexy technique for adult patients requiring testicular fixation, report early outcomes from an initial adult series and critically appraise the evidence supporting conventional trans-tunical suture fixation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A stepwise description is presented of a proximal-reflection dartos pouch orchiopexy performed through a single high transverse scrotal incision, in which the parietal tunica vaginalis is reflected proximally over the spermatic cord before dependent subdartos placement of the testis without trans-tunical or transparenchymal fixation sutures. Perioperative outcomes from an initial adult case series are reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 22 dartos pouch orchiopexies were performed in 12 adult patients with a median age of 23 years (range 18–31), including eight patients with intermittent testicular torsion, two with acute torsion and viable testes following detorsion and two with symptomatic retractile testis. Structured ultrasonographic follow-up ranged from 15 to 21 months (mean 19.2 months). Scrotal ultrasonography demonstrated preserved testicular vascularity and stable dependent positioning of all testes. There were no cases of recurrent torsion, testicular atrophy, chronic scrotal pain or scrotal complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Single-incision dartos pouch orchiopexy appears to be a safe, atraumatic and reproducible non-parenchymal technique for adult testicular fixation and may represent a viable alternative to conventional trans-tunical suture fixation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784257","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 ERBB2 alterations in muscle-invasive bladder cancer after neoadjuvant chemotherapy","authors":"Earle F. Burgess,&nbsp;Hilary Elom,&nbsp;Landon C. Brown,&nbsp;Michael McCormack,&nbsp;Ericson Stoen,&nbsp;Metamia Ciampricotti,&nbsp;Edward Williams,&nbsp;James T. Symanowski","doi":"10.1002/bco2.70274","DOIUrl":"10.1002/bco2.70274","url":null,"abstract":"&lt;p&gt;Cisplatin-based neoadjuvant chemotherapy (NAC) has been a standard treatment for muscle-invasive bladder cancer (MIBC), although peri-operative management is evolving to include immune checkpoint inhibitor (ICI) and enfortumab vedotin (EV)-based regimens.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Despite these advances, access to EV and ICIs remains limited in much of the world, and cisplatin-based NAC continues to represent a standard option for a large proportion of patients globally. Identification of biomarkers associated with response to NAC therefore remains clinically important.&lt;/p&gt;&lt;p&gt;Both pathogenic &lt;i&gt;ERBB2&lt;/i&gt; mutations and gene amplification are well-recognized genomic alterations in MIBC.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Prior studies have reported conflicting findings regarding the association of &lt;i&gt;ERBB2&lt;/i&gt; mutations and amplification with response to NAC in MIBC,&lt;span&gt;&lt;sup&gt;4-6&lt;/sup&gt;&lt;/span&gt; which may be due to heterogeneity in chemotherapy regimens, genomic sequencing methodologies and definitions of treatment response across these studies. These discordant results highlight the need for additional study to clarify the prognostic value of &lt;i&gt;ERBB2&lt;/i&gt; alterations in MIBC.&lt;/p&gt;&lt;p&gt;We previously reported that tumour mutational burden (TMB) ≥ 10 mutations per megabase (Mut/Mb) was associated with improvement in pathologic complete response rate (pCR), relapse-free survival (RFS) and overall survival (OS) in a retrospective cohort of 91 patients with MIBC treated with cisplatin-based NAC followed by radical cystectomy.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; In this cohort, all patients received NAC with either gemcitabine and cisplatin or standard or dose-dense methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) across two campuses at our institution. Only four (4.4%) patients received adjuvant nivolumab, minimizing the potential for ICI-related confounding of survival outcomes in this cohort. Genomic profiling of pretreatment transurethral resection specimens was performed using the commercially available Tempus xT next-generation sequencing (NGS) platform. Associations between &lt;i&gt;ERBB2&lt;/i&gt; gene variants, TMB and clinical outcomes were assessed using logistic regression, Cox proportional hazards models and Kaplan–Meier techniques.&lt;/p&gt;&lt;p&gt;&lt;i&gt;ERBB2&lt;/i&gt; alterations were identified in 17/91 (18.7%) patients, including four pathogenic mutations (4.4%) and 13 amplifications (14.3%); all mutations were p.S310F. pCR was achieved in 29/91 (31.9%) patients overall. Among those with &lt;i&gt;ERBB2&lt;/i&gt; alterations, pCR occurred in 3/4 (75.0%) patients with a mutation and 6/13 (46.2%) patients with amplification. In aggregate, the presence of an &lt;i&gt;ERBB2&lt;/i&gt; alteration (mutation + amplification) was associated with improved likelihood of pCR compared to non-&lt;i&gt;ERBB2&lt;/i&gt; altered patients (OR 3.038, &lt;i&gt;p&lt;/i&gt; = 0.048).&lt;/p&gt;&lt;p&gt;Given the favourable impact of &lt;i&gt;ERBB2&lt;/i&gt; alterations on pCR, we next assessed survival endpoints. Median follow-up for the entire cohort was 63.6 months; 38/9","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763520","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":"Incidence of penile cancer in Southeast Wales: A 15-year retrospective review","authors":"Joseph Latham,&nbsp;Oliver Lane,&nbsp;David Gower,&nbsp;Adrian Sale,&nbsp;Anthony Shanahan,&nbsp;Mohammed Ali,&nbsp;Gareth Brown","doi":"10.1002/bco2.70185","DOIUrl":"https://doi.org/10.1002/bco2.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to determine the 15-year incidence of penile cancer (PeCa) and penile intraepithelial neoplasia (PeIN) in Southeast Wales, evaluate regional variation and compare findings to UK and global rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted of all PeCa and PeIN cases diagnosed between January 2009 and December 2024 within the referral population served by the Royal Glamorgan Hospital, the tertiary centre for Southeast Wales. Postcodes were matched to local authorities and linked to mid-year male population estimates from the Office for National Statistics. Crude incidence rates per 100 000 males were calculated for each region across the 15-year study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 298 cases were identified across 11 local authorities, representing 64% of the Welsh population. The mean crude incidence was 2.61 per 100 000 males (95% CI 1.59–3.62), ranging from 0.29 to 5.96. Blaenau Gwent demonstrated the highest incidence (5.96 per 100 000), followed by Merthyr Tydfil (3.68), Rhondda Cynon Taf (3.39), Newport (3.32) and Monmouthshire (2.90). Nine of 11 regions exceeded the reported UK average of 1.30 per 100 000, and 10 exceeded the global average of 0.80 per 100 000. Areas with higher incidence corresponded strongly with measures of socioeconomic deprivation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The incidence of PeCa and PeIN in Southeast Wales is substantially higher than previously reported UK and global rates. Regions with greater socioeconomic deprivation exhibit disproportionately elevated incidence. These findings highlight an urgent need for targeted public health interventions, including smoking cessation, HPV vaccination uptake and improved recognition of early penile lesions in primary care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753696","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":"Image-fusion-guided focal irreversible electroporation for prostate cancer: Step-by-step technique","authors":"Masatomo Kaneko,&nbsp;Yuta Inoue,&nbsp;Federico Eskenazi,&nbsp;Andre Luis Abreu","doi":"10.1002/bco2.70266","DOIUrl":"https://doi.org/10.1002/bco2.70266","url":null,"abstract":"&lt;p&gt;Irreversible electroporation (IRE) is a non-thermal ablation for prostate cancer (PCa) that uses high-voltage electrical pulses to disrupt cell membranes and induce targeted cell death while potentially eliciting a PCa-specific systemic immune response.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; The procedure is typically performed under transrectal ultrasound (TRUS) guidance. Fusion of preoperative prostate magnetic resonance imaging (MRI) with real-time TRUS may facilitate precise lesion targeting while preserving urogenital function.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;To date, no educational paper has described in detail image-fusion-guided focal IRE for PCa. Herein, we describe our step-by-step technique for MRI/TRUS image-fusion-guided focal IRE for PCa, along with the outcomes of a case series.&lt;/p&gt;&lt;p&gt;A total of 12 patients who underwent IRE were screened, and one patient was excluded due to the unavailability of mpMRI based on PI-RADS. The median (interquartile range [IQR]) age, PSA, PSA density and follow-up duration were 74 years, 6.86 ng/mL, 0.14 ng/mL&lt;sup&gt;2&lt;/sup&gt; and 11 months, respectively. The baseline GG distribution was 9.1% GG1 and 91% GG2, corresponding to 9.1% low-risk and 91% intermediate-risk disease. PI-RADS scores were 3 in 36% and 4 in 64% of the patients.&lt;/p&gt;&lt;p&gt;After IRE, median PSA decreased by 70% to a nadir of 2.0 ng/mL among patients with available follow-up PSA (8/11). During follow-up, treatment failure (GG ≥ 2 on FU-PBx, salvage whole-gland/systemic treatment, metastasis or PCa-specific mortality)&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; was observed in 18% (2/11); both cases were GG ≥ 2 on FU-PBx and were managed with active surveillance. The FU-PBx rate was 45% (5/11). No biochemical failure (PSA nadir + 2 ng/mL) (0/8), radical treatment (0/11), metastasis (0/11) or PCa-specific mortality (0/11) was observed.&lt;/p&gt;&lt;p&gt;Regarding functional outcomes, the median change in International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5 (IIEF-5) scores from pre- to post-IRE were 1 and 3, respectively.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Continence (zero-pad) was maintained in 100%. Ninety-day postoperative complications occurred in 27% (3/11), including Clavien grade 1 urinary tract infection and grade 1 and 2 urinary tract retentions.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;This step-by-step video provides a practical overview of image-fusion-guided IRE and serves as an educational resource for clinicians adopting this technique. In conjunction with our case series, the findings support the technical feasibility of image-fusion-guided IRE for predominantly MRI-visible intermediate-risk PCa, the typical target population of focal therapy,&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; with favourable short-term oncologic and functional outcomes.&lt;/p&gt;&lt;p&gt;Intraoperative TRUS guidance alone provides limited visualization of PCa, particularly for lesions anterior to the urethral catheter or obscured by calcifications, and remains highly operator dependent. MRI/TRUS image","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753382","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}