BJUI compass最新文献

{"title":"Postoperative prostate-specific antigen kinetics after holmium laser enucleation of the prostate in men with low-risk prostate cancer","authors":"Hasim Bakbak,&nbsp;Gurpremjit Singh,&nbsp;Ahmad Abdelaziz,&nbsp;Juanita Velasquez Ospina,&nbsp;Shlomo Resnik,&nbsp;Connor Stephen Nee,&nbsp;Archan Khandekar,&nbsp;Jonathan E. Katz,&nbsp;Sanoj Punnen,&nbsp;Robert Marcovich,&nbsp;Mark L. Gonzalgo,&nbsp;Dipen J. Parekh,&nbsp;Hemendra Navinchandra Shah","doi":"10.1002/bco2.70255","DOIUrl":"10.1002/bco2.70255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To characterize postoperative prostate-specific antigen (PSA) kinetics after holmium laser enucleation of the prostate (HoLEP) in men with low-risk prostate cancer (PCa) managed with active surveillance and to compare these with men without PCa, establishing a benchmark for expected PSA behaviour after HoLEP in low-risk disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed a prospectively maintained HoLEP database at a tertiary centre from 2017 to 2025. Patients were stratified into benign and low-risk PCa cohorts, with low-risk PCa defined as Grade Group 1 disease. Patients with clinically significant PCa were excluded. PSA values were assessed at standardized postoperative time points up to 5 years. PSA reduction, PSA velocity (PSAV), PSA doubling time and surveillance outcomes were compared between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 769 patients were included (692 benign, 77 low-risk PCa). Baseline characteristics were broadly comparable. Both groups demonstrated marked and similar PSA reductions after HoLEP, with no significant difference in percent PSA decline from baseline (91.6% vs. 91.1%, <i>p</i> = 0.953) or 3-month PSA (0.39 vs. 0.40 ng/mL, <i>p</i> = 0.858). PSA remained low throughout follow-up in both cohorts. PSAV was numerically higher in the low-risk cohort but did not differ significantly (0.127 vs. 0.036 ng/mL/year, <i>p</i> = 0.259). PSA doubling time was shorter in the low-risk cohort, though not significantly (1.74 vs. 2.40 years, <i>p</i> = 0.297). A greater proportion of low-risk patients had PSA exceeding 1.0 ng/mL, though this was not significant (23.4% vs. 17.3%, <i>p</i> = 0.249).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HoLEP produces a substantial PSA ‘reset’ with sustained low postoperative PSA in both benign and low-risk PCa patients. Although low-risk patients showed numerically higher PSAV, shorter PSA doubling time and greater likelihood of PSA exceeding 1.0 ng/mL, overall postoperative PSA trajectories were statistically comparable between groups. These findings provide a reference for expected PSA kinetics after HoLEP in men with low-risk PCa undergoing active surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714866","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 addition of PSMA PET in selecting candidates for prostate cancer focal therapy","authors":"Kylie Yen-Yi Lim,&nbsp;Mohammad Asghari-Jafarabadi,&nbsp;Arveen A. Kalapara,&nbsp;Julian Smith,&nbsp;Mark Frydenberg,&nbsp;Weranja Ranasinghe","doi":"10.1002/bco2.70264","DOIUrl":"10.1002/bco2.70264","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to evaluate whether prostate-specific membrane antigen (PSMA) PET improves detection of index lesions and refines patient selection for focal therapy (FT) compared with standard diagnostic pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>We performed a retrospective review of men who underwent radical prostatectomy (RP) between 2015 and 2023. Pre-operative assessment included multiparametric MRI, PSMA PET/CT and transperineal prostate biopsy. RP whole-mount histopathology served as the reference standard. Focal therapy eligibility was assessed, and diagnostic performance compared between standard-of-care selection criteria and criteria incorporating PSMA PET.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty patients (26%) met SOC criteria for FT. On final RP histopathology, only 20/60 (33.3%) were truly eligible, with discordance most commonly due to bilateral clinically significant prostate cancer (80%). Incorporation of PSMA PET into the selection model improved specificity for appropriate FT selection from 80.3% to 89.7% and positive predictive value from 33.3% to 46.2%. For detection of outfield disease, addition of PSMA PET increased sensitivity to 75.5% and negative predictive value to 53.5%. Higher SUVmax was significantly associated with FT ineligibility (AUC 0.67), with an optimal cut-point of SUVmax &gt; 4.78 predicting unsuitable candidates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Only a small proportion of men fulfil criteria for focal therapy, with a high risk of bilateral or contralateral disease using MRI and biopsy alone. PSMA PET improves diagnostic accuracy by identifying outfield lesions and reducing inappropriate FT selection. These findings support integration of PSMA PET to optimise patient selection, with further studies in prospective focal therapy cohorts required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690344","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":"Noninvasive differentiation of upper tract urothelial carcinoma and renal cell carcinoma in challenging renal lesions using urinary DNA methylation","authors":"Ernest Kaufmann,&nbsp;Kilian Röthlin,&nbsp;Philipp Baumeister,&nbsp;Agostino Mattei,&nbsp;Paolo Piatti,&nbsp;Yap Ching Chew,&nbsp;Christian Daniel Fankhauser","doi":"10.1002/bco2.70265","DOIUrl":"10.1002/bco2.70265","url":null,"abstract":"&lt;p&gt;Upper tract urothelial carcinoma (UTUC) and renal cell carcinoma (RCC) may present with similar radiographic findings, making the diagnostic evaluation of indeterminate lesions challenging.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The distinction is clinically important because management diverges substantially: UTUC typically requires radical nephroureterectomy with bladder-cuff excision and intravesical chemotherapy instillation, whereas RCC is generally managed by (partial) nephrectomy.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; When imaging is inconclusive, patients frequently undergo additional invasive work-up, such as ureterorenoscopy (URS) with biopsy or percutaneous renal biopsy. URS remains the diagnostic reference standard for suspected UTUC but carries risk of procedure-related morbidity including ureteric injury, infection, haematuria, and potential intravesical recurrence, and its diagnostic yield is imperfect.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; Voided urinary cytology is noninvasive but has limited sensitivity (10%–70%), even when selective upper tract sampling is used.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; The urine-based DNA methylation assay Bladder CARE™ has demonstrated high accuracy for UTUC detection,&lt;span&gt;&lt;sup&gt;7, 8&lt;/sup&gt;&lt;/span&gt; but its ability to distinguish UTUC from RCC in patients with renal or renal-pelvic lesions has not yet been investigated. We addressed this question in a small, exploratory, post hoc analysis.&lt;/p&gt;&lt;p&gt;Between December 2023 and August 2025, we prospectively collected urine from patients presenting with renal or renal-pelvic lesions suspicious for malignancy in whom cross-sectional imaging did not reliably differentiate UTUC from RCC. Patients with radiologically unequivocal exophytic renal masses were not included. For this post hoc analysis we retained only patients with histologically confirmed UTUC or RCC and an available preoperative Bladder CARE™ result. Assay results were available to treating physicians but were not used to guide management; subsequent work-up and treatment followed clinical judgment, and histopathology of biopsy or surgical specimens served as the reference standard. The Bladder CARE™ assay measures methylation levels of three urothelial-cancer DNA biomarkers (TRNA-Cys, SIM2, and NX1-1) and reports a continuous Bladder CARE™ Index (BCI). A subset of patients overlapped with a previously published UTUC validation cohort&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;; the present analysis addresses a distinct question and adds further patients. Urinary cytology was evaluated using the Paris System for Reporting Urinary Cytology. Samples categorized as ‘Negative for High Grade Urothelial Carcinoma’ (NHGUC) or ‘Atypical Urothelial Cells’ (AUC) were considered cytology-negative, whereas ‘Suspicious for High Grade Urothelial Carcinoma’ (SHGUC) and ‘High Grade Urothelial Carcinoma’ (HGUC) were classified as positive. The study was approved by the responsible ethics committee (BASEC-ID 2025-01778), and all participants gave written informed consent. Give","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674648","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":"Vitamin D and adverse pathologic features in patients undergoing radical prostatectomy in the contemporary magnetic resonance imaging-guided management era","authors":"Sarita Chitjaroen,&nbsp;Kantima Jongjitaree,&nbsp;Varat Woranisarakul,&nbsp;Siros Jitpraphai,&nbsp;Tawatchai Taweemonkongsap,&nbsp;Sunai Leewansangtong,&nbsp;Sittiporn Srinualnad,&nbsp;Thitipat Hansomwong","doi":"10.1002/bco2.70261","DOIUrl":"10.1002/bco2.70261","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the association between serum 25-hydroxyvitamin D (25-OH D) levels and adverse pathologic features in patients undergoing radical prostatectomy (RP) in the contemporary magnetic resonance imaging (MRI)-guided management era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included patients who underwent RP between January 2022 and December 2024 at a single academic centre. Preoperative MRI was routinely incorporated into staging and treatment planning. Serum 25-OH D levels measured within 3 months prior to surgery were analysed. Vitamin D insufficiency was defined as 20–29.99 ng/mL and deficiency as &lt;20 ng/mL. Adverse pathologic features included International Society of Urological Pathology (ISUP) Grade Group 4 or 5, extraprostatic extension (EPE), seminal vesicle invasion (SVI) and pelvic lymph node metastasis. Associations were evaluated using multivariable logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 217 patients were included. Preoperative MRI was performed in 96.0% of patients and MRI-targeted biopsy in 78.3%. Adverse pathologic features were identified in 66.4% of patients. Vitamin D insufficiency and deficiency were present in 67.3% and 17.5%, respectively. Mean serum 25-OH D levels did not differ significantly between patients with and without adverse pathology (28.19 ± 8.41 ng/mL vs. 27.46 ± 9.26 ng/mL, <i>p</i> = 0.55). In multivariable analysis, body mass index and adverse MRI findings were independently associated with adverse pathology, whereas serum 25-OH D levels were not. An exploratory subgroup analysis demonstrated an association between serum 25-OH D levels and EPE in very-high-risk patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Serum 25-OH D levels were not independently associated with adverse pathologic features following RP in this contemporary MRI-guided management cohort. While established clinical and radiologic factors remain the primary predictors of adverse pathology, further studies are needed to clarify the role of vitamin D in long-term oncologic and functional outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674646","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":"Haemorrhagic risk of transperineal ultrasound-guided prostate biopsy performed under continued antithrombotic therapy","authors":"Naoki Akagi,&nbsp;Tatsuki Kinoshita,&nbsp;Motoki Fujita,&nbsp;Riki Obayashi,&nbsp;Akihiro Yamamoto,&nbsp;Akihiko Nagoshi,&nbsp;Tasuku Fujiwara,&nbsp;Takanari Kambe,&nbsp;Ryo Yamamoto,&nbsp;Atsushi Igarashi,&nbsp;Yuto Hattori,&nbsp;Noboru Shibasaki,&nbsp;Mutsushi Kawakita,&nbsp;Toshinari Yamasaki","doi":"10.1002/bco2.70260","DOIUrl":"10.1002/bco2.70260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to evaluate the safety of transperineal prostate biopsy performed with continued antiplatelet and anticoagulant therapies under caudal anaesthesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A total of 620 consecutive patients who underwent transperineal ultrasound-guided prostate biopsy at a tertiary care centre in Japan from March 2023 to June 2025 were retrospectively analysed. Antithrombotic agents were continued according to institutional policy, and all procedures were performed under caudal anaesthesia. Patients were categorised into a no-antithrombotic therapy group (NA group, <i>n</i> = 474) and an antithrombotic therapy group (AP/AC group, <i>n</i> = 146). The primary endpoint was any Clavien–Dindo grade I or higher haemorrhagic complications. Univariate and multivariate logistic regression analyses were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Haemorrhagic events occurred in 8.9% and 11.7% of patients in the NA and AP/AC groups, respectively (<i>p</i> = 0.33). Clinically significant haemorrhage (Clavien–Dindo grade II or higher) was rare (1.1% vs. 2.1%), and only one grade III event occurred in the AP/AC group. None of the patients required blood transfusion, and no sacral hematomas, neurological deficits or thromboembolic events were observed. Multivariate analysis adjusted for prostate-specific antigen level, platelet count, prostate volume and number of biopsy cores revealed that antithrombotic therapy was not independently associated with haemorrhagic complications (odds ratio: 1.14; 95% confidence interval: 0.60–2.08).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Continuation of antiplatelet or anticoagulant therapy during transperineal prostate biopsy under caudal anaesthesia was not associated with a clear increase in clinically relevant haemorrhagic complications, and no anaesthesia-related complications were observed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674573","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":"Investigating gender disparities in urological care for non-muscle invasive bladder cancer (NMIBC)","authors":"Aleyna Aydin,&nbsp;Amin Salaah Abdulmajeed,&nbsp;Fatima Betul Bekiroglu,&nbsp;Mehmet Kocak,&nbsp;Pilar Laguna,&nbsp;Rahim Horuz,&nbsp;Selami Albayrak,&nbsp;Valentin Pavlov,&nbsp;Guohua Zeng,&nbsp;Jean de la Rosette,&nbsp;the global NMIBC survey collaboration","doi":"10.1002/bco2.70245","DOIUrl":"10.1002/bco2.70245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to explore possible gender disparities in urological diagnostic and therapeutic care for NMIBC, particularly in the use of enhanced endoscopic imaging techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An international survey in seven languages was distributed to all members of the Société Internationale d'Urologie (SIU). We captured specifications related to TURBT performance, attitudes towards the use of enhanced imaging and adherence to international guidelines for non-muscle invasive bladder cancer. Data were analysed using descriptive statistics. Gender disparities were assessed using propensity score matching (PSM) for age, working environment, subspecialisation and years of experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3595 SIU members from 91 countries participated (response rate 35%). Male participants performed a higher volume of TURBTs per month (<i>p</i> = 0.0087). In accordance with guidelines, taking biopsies from normal or abnormal appearing tissue was rated equally among males and females (<i>p</i> = 0.68 for each). No significant gender-based differences were observed in attitudes towards the benefits of enhanced imaging techniques, including PPD, NBI and Image 1S. This was consistent for identification of satellite lesions (<i>p</i> = 0.99) and completeness of TURBT, including resection of margins (<i>p</i> = 0.07) and tumour floor (<i>p</i> = 0.66). Guidelines were followed equally by both sexes, with a strong preference for EAU guidelines. Similar findings were observed among residents and fellows.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No significant gender-related disparities were found in urological care for NMIBC, including the use of enhanced imaging techniques. These findings apply to both urologists and trainees, with comparable adherence to guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674615","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":"Single-layer versus double-layer suture during laparoscopic partial nephrectomy for renal tumours in close proximity to the collecting system or renal sinus: A propensity-matched analysis","authors":"Xiaofeng Xu,&nbsp;Xiuquan Shi,&nbsp;Xiumin Zhou,&nbsp;Yuhao Chen,&nbsp;Zhe Liu,&nbsp;Changjie Shi,&nbsp;Wen Cheng,&nbsp;Jingping Ge,&nbsp;Xuejun Shang","doi":"10.1002/bco2.70256","DOIUrl":"10.1002/bco2.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compares perioperative outcomes of single-layer suture (SLS) and double-layer suture (DLS) technique for laparoscopic partial nephrectomy (LPN) in patients with renal tumours in close proximity to the collecting system or renal sinus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A total of 178 patients with renal tumours adjacent to the collecting system or renal sinus were identified from the databases of our institution who underwent LPN between November 2020 and December 2023. SLS (<i>n</i> = 79) or DLS (<i>n</i> = 99) technique was used for renal defect suture. Propensity score matching was performed to minimize selection bias. Propensity scores were calculated for age, sex, body mass index, tumour diameter, renal nephrometry score, history of diabetes or hypertension, preoperative haemoglobin and preoperative estimated glomerular filtration rate (eGFR). Perioperative data were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In all, 76 patients could be matched in each group. Compared with DLS, SLS significantly reduced the warm ischaemia time (22.45 ± 7.75 vs. 28.87 ± 7.77 min, <i>p</i> &lt; 0.001). There was no difference between the two groups for postoperative complications including transfusion-treated blood loss (1.3% vs. 1.3%, <i>p</i> = 1.000). No grade III-V complications occurred. Moreover, no significant difference was found in postoperative haemoglobin decline between the two groups (1.27 ± 1.20 vs. 1.40 ± 1.20 g/dL, <i>p</i> = 0.508).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SLS during LPN offers effective renorrhaphy, reducing the warm ischaemia time without increasing the risk of complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671407","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":"Oncological outcomes of extended versus standard pelvic lymph node dissection in radical cystectomy: An updated systematic review and meta-analysis","authors":"Rafael Matos Vieira Gordilho,&nbsp;Nilo Jorge Carvalho Leão Barretto,&nbsp;Rodrigo Barbosa Freire Silvão,&nbsp;Felipe Pereira Garrido Pazos,&nbsp;Pedro Rodrigues Queiroz,&nbsp;Matheus Oliveira Figueiredo,&nbsp;Ricardo Andrade Freitas Souza,&nbsp;João Pedro Gomes da Conceição Oliva,&nbsp;Luma Gabriella Firme Sampaio Góes,&nbsp;Rafael Cintra Rosa Corrêa Oliveira,&nbsp;Lorena Barboza de Sousa,&nbsp;Felipe Pinho,&nbsp;Albuquerque Silva,&nbsp;Leonardo Marques Calazans,&nbsp;Wendel Souza Kruschewsky,&nbsp;Alexandre Azevedo Ziomkowski,&nbsp;Eduardo Deda Mendonça Filho,&nbsp;Gabriel Silva Rocha,&nbsp;Marcos Tobias-Machado,&nbsp;Raphael Brandão Moreira","doi":"10.1002/bco2.70257","DOIUrl":"10.1002/bco2.70257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to evaluate whether extended lymph node dissection (ePLND) improves overall survival (OS) and oncological outcomes compared with standard dissection (sPLND) in patients undergoing radical cystectomy for urothelial bladder cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were conducted according to PRISMA 2020 (PROSPERO CRD420261309465). PubMed/MEDLINE, EMBASE, Cochrane Library and Web of Science were searched. RCTs and observational studies comparing ePLND and sPLND were included. The primary outcome was OS; secondary outcomes included recurrence-free survival (RFS), cancer-specific survival (CSS), 5-year OS, 5-year RFS, major complications and lymphocele. A random-effects model was used, with sensitivity analyses and meta-regression. Risk of bias was assessed using RoB 2 and ROBINS-I.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen studies (<i>n</i> = 5960) were included. ePLND did not significantly improve OS compared with sPLND (HR = 0.86; 95% CI 0.72–1.03; <i>p</i> = 0.09; <i>I</i>² = 50%). The overall RFS analysis suggested a benefit favouring ePLND (HR = 0.74; 95% CI 0.63–0.81; <i>p</i> &lt; 0.00001); however, this effect did not persist in analyses restricted to RCTs. No consistent benefit was observed for 5-year OS, although recurrence was reduced. ePLND did not significantly affect major complications. Sensitivity analyses confirmed result stability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher quality evidence does not demonstrate a consistent benefit of ePLND for OS, although overall analyses show reduced recurrence. Current data do not support the routine adoption of ePLND with the sole objective of improving survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671371","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":"Nuclear PML expression as a prognostic biomarker in localised clear cell renal cell carcinoma","authors":"Sakari Kosola,&nbsp;Teemu D. Laajala,&nbsp;Iida Payne,&nbsp;Antti Kukkula,&nbsp;Lassi Luomala,&nbsp;Tuomas Mirtti,&nbsp;Kalle Mattila,&nbsp;Paula Vainio,&nbsp;Maria Sundvall,&nbsp;Panu M. Jaakkola","doi":"10.1002/bco2.70258","DOIUrl":"https://doi.org/10.1002/bco2.70258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate nuclear promyelocytic leukaemia protein (PML) expression as a prognostic biomarker in localised clear cell renal cell carcinoma (ccRCC), aiming to improve postoperative risk stratification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Two independent retrospective cohorts of patients undergoing surgery for localised ccRCC were analysed: an exploratory cohort (<i>n</i> = 191; Turku University Hospital) and a validation cohort (<i>n</i> = 173; Helsinki University Hospital). Patients underwent surgery between 2005 and 2014 and 2006–2013, respectively. Tissue microarrays from primary tumours were immunohistochemically stained and assessed for nuclear PML expression using both visual scoring and QuPath-assisted image analysis. Clinical data at the time of surgery and follow-up data were collected, with a median follow-up of 8 years in the exploratory cohort and 9 years in the validation cohort. Associations between nuclear PML expression and recurrence-free survival (RFS), cancer-specific survival (CSS), overall survival (OS) and diagnostic histopathological characteristics were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>High nuclear PML expression was associated with improved RFS (<i>p</i> = 0.022) and CSS (<i>p</i> = 0.027) in the exploratory cohort, with similar findings in the validation cohort in univariable analyses (both <i>p</i> &lt; 0.0001). In the validation cohort, high nuclear PML expression remained independently associated with improved RFS (HR 0.38, 95% CI 0.21–0.70; <i>p</i> = 0.002), CSS (HR 0.30, 95% CI 0.13–0.68; <i>p</i> = 0.004) and OS (HR 0.34, 95% CI 0.18–0.68; <i>p</i> = 0.002) after adjustment for established histopathological risk factors in multivariable analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nuclear PML expression is associated with favourable outcomes in localised ccRCC and may provide additional prognostic information. Independent validation and mechanistic studies are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647884","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":"Isosorbide dinitrate as an effective adjunct therapy for acute urinary retention: A randomized controlled trial.","authors":"Salman Soltani, Hamid Reza Ghorbani, Mahmoud Tavakkoli, Fatemeh Sadabadi, Seyyed Parham Ahmadi, Farid Zeinali","doi":"10.1002/bco2.70252","DOIUrl":"10.1002/bco2.70252","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the synergistic effect and safety of sublingual isosorbide dinitrate (ISDN) to facilitate successful voiding trial after catheterization for acute urinary retention (AUR) secondary to benign prostatic hyperplasia (BPH).</p><p><strong>Material and methods: </strong>In this randomized clinical trial, male patients aged ≥ 50 years presenting with first-episode AUR secondary to BPH at our urology emergency department were enrolled during 2019-2020. Participants were randomly assigned to receive either standard therapy (α1-blocker and 5α-reductase inhibitor) alone (<i>n</i> = 40) or in combination with daily sublingual ISDN 10 mg for 21 days (<i>n</i> = 40). Primary outcomes included successful voiding post-catheter removal as trial without catheter (TWOC) and post-void residual (PVR) volume. Secondary outcomes included post-treatment prostate-specific antigen (PSA) levels and adverse events. Data were analysed using independent <i>t</i>-tests and chi-square tests.</p><p><strong>Results: </strong>A total of 80 men with similar baseline characteristics were enrolled (mean ages: 70.3 ± 7.97 in the ISDN group vs. 68.2 ± 8.73 years in the controls). The rate of successful TWOC was significantly higher in the ISDN plus standard therapy group compared with standard therapy alone (50.0% vs. 22.5%, <i>p</i> = 0.011). PVR volume decreased significantly after treatment in both groups (within-group <i>p</i> < 0.001), with a greater overall reduction observed in the ISDN group (<i>p</i> = 0.002). PSA levels remained stable, with no significant within- or between-group differences. On multivariable logistic regression analysis, adjunctive ISDN therapy independently predicted successful TWOC (adjusted OR 3.27, 95% CI 1.23-8.70; <i>p</i> = 0.017). No serious adverse events were observed.</p><p><strong>Conclusions: </strong>Adjunctive sublingual ISDN significantly improves urinary outcomes following AUR and reduces residual urine volume without increasing adverse events. This combination therapy offers a safe and effective strategy to improve the success of TWOC in patients with BPH-related AUR.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":"e70252"},"PeriodicalIF":2.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13407321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610924","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}