BJUI compass最新文献

{"title":"Competing risk of death in patients with low, intermediate and high risk of recurrence after radical surgery for clear cell renal cell carcinoma","authors":"Anna Brännbäck,&nbsp;Ivan Mustonen,&nbsp;Teemu D. Laajala,&nbsp;Paula Vainio,&nbsp;Magnus Lindskog,&nbsp;Anders Kjellman,&nbsp;Per-Olof Lundgren,&nbsp;Panu M. Jaakkola,&nbsp;Kalle E. Mattila","doi":"10.1002/bco2.70047","DOIUrl":"10.1002/bco2.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Adjuvant pembrolizumab has improved overall survival after surgery for clear cell renal cell carcinoma (ccRCC) with an intermediate-high and high risk of recurrence according to the inclusion criteria of Keynote-564 study, but non-RCC mortality is common during postoperative follow-up. We aimed to evaluate the competing risk of death after surgery in patients with ccRCC stratified according to the risk of recurrence with Keynote-564, Three-feature and Leibovich models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>A total of 1108 patients with ccRCC operated with curative intent between 2005 and 2021 before the use of adjuvant immunotherapy were identified from two academic centres in Finland and Sweden. Patients with cytoreductive nephrectomy, multiple kidney tumours or non-ccRCC were excluded. Baseline characteristics and survival outcomes were described, and the Kaplan–Meier method was used to estimate overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the median postoperative follow-up of 5.0 years, 134 (12%) patients had died from RCC with a median time to death of 3.7 years (IQR 1.6–6.6) while for 220 (20%) patients the cause of death was other than RCC, most commonly other cancers (n = 59, 5%) and cardiovascular diseases (n = 54, 5%). According to the Keynote-564 criteria, 34 (3%) patients were classified as having high risk of recurrence, 336 (30%) patients intermediate-high risk and 738 (67%) patients low risk of recurrence with 41% of RCC deaths observed in this subgroup. Limitations of this study include the lack of information on performance status, comorbidities and systemic treatments for recurrent RCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In addition to deaths from RCC, deaths from other cancers and cardiovascular diseases were common after surgery for ccRCC. As 41% of RCC deaths were observed among patients currently excluded from adjuvant therapy, more research on patient selection for perioperative immunotherapy is needed as well as interventions improving the treatment of comorbidities and lifestyle after nephrectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673142","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 population-based analyses of the evolving management of cN1M0 prostate cancer in the PSMA-PET era","authors":"Jennifer Ward,&nbsp;Kevin Armstrong,&nbsp;Therese Min-Jung Kang,&nbsp;Jodie Tham,&nbsp;Yuan-Hong Lin,&nbsp;Marcus Cheng,&nbsp;Jeremy Grummet,&nbsp;Nathan Lawrentschuk,&nbsp;Marlon Perera,&nbsp;Shomik Sengupta,&nbsp;David Chang,&nbsp;Michael Ng,&nbsp;Jonathan Bensley,&nbsp;Michelle Steeper,&nbsp;Krupa Krishnaprasad,&nbsp;Maggie Johnson,&nbsp;Nikolajs Zeps,&nbsp;Jeremy Millar,&nbsp;Wee Loon Ong","doi":"10.1002/bco2.70059","DOIUrl":"10.1002/bco2.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the patterns of management of clinical node-positive non-metastatic prostate cancer (cN1M0PC) at a population-based level over time, and to identify factors associated with the different management approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>The study included men diagnosed with cN1M0PC in Prostate Cancer Outcome Registry Victoria (PCOR-Vic) in Australia between 2008 and 2022. The primary outcome was the use of local therapy (radical prostatectomy or prostate+/− pelvic radiation therapy) within the first 12 months of diagnosis. Multivariable logistic regressions were used to evaluate factors associated with local therapy use among all men and the likelihood of having a radical prostatectomy among men who had local therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 819 men included in this study, 52% had PSMA-PET staging, and this increased over time to 74% in 2018–2022. There were 530 (65%) who had local therapy (169 radical prostatectomy, and 361 radiation therapy), 259 (32%) had systemic therapy alone, and 30 (4%) did not have any treatment. There was an increase in the proportion of men who had local therapy over time, from 52% in 2008–2012 to 72% in 2018–2022. In multivariable analyses, increased age, higher PSA and residency in regional/remote areas were independently associated with lower likelihood of local therapy use, while PSMA-PET staging and more recent year of diagnosis were associated with higher likelihood of local therapy use. Of the 530 men who had local therapy, increased age, higher PSA, higher ISUP grade group and higher clinical T categories were associated with a lower likelihood of having radical prostatectomy while men diagnosed in private institutions and from higher socioeconomic quintiles were more likely to have radical prostatectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the largest contemporaneous population-based study on the management of cN1M0PC in the PSMA-PET era. There is an increasing use of local therapy for cN1M0PC over time, with large variations in practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666258","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 pilot study evaluating the safety and efficacy of En-bloc holmium laser enucleation of the prostate in patients with a history of radiation therapy or high intensity focused ultrasound for management of organ confined prostate cancer with review of the literature","authors":"Renil S. Titus,&nbsp;Ansh Bhatia,&nbsp;Joao G. Porto,&nbsp;Jean C. Daher,&nbsp;Adele Raymo,&nbsp;Maggie Meyreles,&nbsp;Archan Khandekar,&nbsp;Aravindh Rathinam,&nbsp;Jonathan Katz,&nbsp;Robert Marcovich,&nbsp;Hemendra N. Shah","doi":"10.1002/bco2.70061","DOIUrl":"10.1002/bco2.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the safety and efficacy of Holmium Laser Enucleation of the Prostate (HoLEP) in managing patients with a history of organ-preserving treatments (OPT: Radiation Therapy – RT, High Intensity Focused Ultrasound - HIFU) for Organ-Confined Prostate Cancer (OC-PCa).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed men undergoing “en-bloc” HoLEP between July 2017 and December 2023 from our institutional database to identify those with a history of OPT for OC-PCa (study group). A 1:2 matched-pair analysis was performed comparing these patients with a control group of men undergoing HoLEP for benign prostatic hyperplasia (BPH) without prior OPT. Demographic, perioperative and postoperative voiding parameters up to 1 year, as well as complications, were compared between groups. Unpaired t-tests were used for parametric variables and Wilcoxon Rank tests for non-parametric variables. A p-value&lt;0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 660 patients, 15 had prior OPT before HoLEP. The time between OPT and HoLEP ranged from 3-month to 12-year. Associated urethral stricture and/or extensive prostatic calcification were present in five patients. Demographic and preoperative parameters were similar between the groups. However, the study group patient had significantly less resected tissue and higher rate of urinary incontinence at 3-month. Two patients (13.3%) continued to experience incontinence at 1-year. There was no clinically significant difference in postoperative improvement in voiding parameters amongst both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HoLEP in patients with history of OPT for treatment of OC-PCa is associated with a higher risk of transient urinary incontinence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673143","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":"Primary urethral cancer: Treatment patterns, responses and survival in localized, advanced and metastatic patients","authors":"Ilfad Blazevic,&nbsp;Aude Fléchon,&nbsp;Géraldine Pignot,&nbsp;Benoît Mesnard,&nbsp;Jérôme Rigaud,&nbsp;Mathieu Roumiguié,&nbsp;Michel Soulié,&nbsp;Constance Thibault,&nbsp;Laurence Crouzet,&nbsp;Camille Goislard De Monsabert,&nbsp;Felix Lefort,&nbsp;Marine Gross-Goupil,&nbsp;Luca Campedel,&nbsp;Mathieu Laramas,&nbsp;Thomas Filleron,&nbsp;Elodie Martin,&nbsp;Léonor Chaltiel,&nbsp;Damien Pouessel","doi":"10.1002/bco2.70056","DOIUrl":"10.1002/bco2.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Primary urethral cancer (PUC) is rare, and limited data exist on optimal treatment and survival, particularly in metastatic cases. The objective of this study was to describe treatment patterns, responses and survival in a contemporary cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Data from patients diagnosed with PUC between January 1, 2000 and December 31, 2018, were retrospectively collected from nine French tertiary centres. To enhance the statistical power of survival analysis in the metastatic stage, patients with synchronous and metachronous metastatic disease were pooled.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 71 patients (62% males, 38% females). The most common histological types were urothelial (40.0%), squamous cell (34.3%) and adenocarcinomas (14.3%). At diagnosis, 35.2% had localized disease, 49.3% had locally advanced disease and 15.5% had distant metastases. Twenty-seven patients had a metachronous metastatic cancer. Multimodal therapy was used in 24% of localized and 57.1% of locally advanced disease. Among the 60 patients with non-metastatic disease, median disease-free survival (DFS) was 21.2 months. Nodal involvement was associated with worse DFS (HR: 2.03, p = 0.039), while multimodal treatment did not improve DFS (HR: 1.22, p = 0.5419). For metastatic patients, median overall survival was 15.2 months, and progression-free survival was 6.4 months. Main study limitations were an overrepresentation of locally advanced disease and the small cohort size.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This retrospective study highlights the significant heterogeneity in terms of histology, stage at diagnosis and treatment of PUC. This study is one of the few to describe treatments and survival in metastatic PUC patients. Efforts must be made to improve survival in these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647275","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":"Modified technique for dissection of working space in retroperitoneal laparoscopic surgery: A step-by-step guide","authors":"Xiaofeng Xu,&nbsp;Yuhao Chen,&nbsp;Xiuquan Shi,&nbsp;Zhe Liu,&nbsp;Changjie Shi,&nbsp;Wen Cheng,&nbsp;Jingping Ge","doi":"10.1002/bco2.70035","DOIUrl":"10.1002/bco2.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work aims to describe with a step-by-step guide for modified dissection technique to create a retroperitoneal working space during laparoscopic surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>From May 2021 to December 2022, we performed a modified dissection technique to create a retroperitoneal working space prior retroperitoneal laparoscopic surgery in 47 patients. The retroperitoneum is initially accessed by puncturing the trocar through a 10-mm transverse skin incision in the midaxillary line. Under endoscopic monitoring, the tip of the trocar is adjusted to a relative avascular layer between the transversus abdominis muscle and the pararenal fat. Laparoscopic dissection is performed to develop until the working space is fully established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In all cases, a satisfactory retroperitoneal space was created for surgery. No dissection-related complications were noted within a median follow-up period of 9 (IQR:7,15) months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Modified retroperitoneal dissection with laparoscopy is a safe, simple, effective, and minimally invasive technique. It provides an adequate working space and an excellent view without obvious bleeding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647274","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 outcome of transurethral laser ablation for recurrent non-muscle invasive bladder cancer: An EORTC risk-matched study","authors":"Chase Peng Yun Ng,&nbsp;Alexander Light,&nbsp;Charis Eleftheriou,&nbsp;Oliver Hug,&nbsp;Ellie Richardson,&nbsp;Tarra Gill-Taylor,&nbsp;Altaf Shamsuddin,&nbsp;Hamid Abboudi,&nbsp;Sachin Agrawal","doi":"10.1002/bco2.70052","DOIUrl":"10.1002/bco2.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Elderly and comorbid patients with non-muscle invasive bladder cancer (NMIBC) often undergo repeated transurethral resection of bladder tumour (TURBT) under general anaesthesia. Transurethral laser ablation (TULA) is an outpatient-based alternative with lower morbidity, cost and carbon footprint, but its long-term efficacy is not well-established. We report the long-term outcomes of recurrent NMIBC treated with TULA, stratified by European Organisation for Research and Treatment of Cancer (EORTC) risk groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a single-centre, retrospective cohort study, including all consecutive NMIBC patients treated with TULA between 2012 and 2023. The primary outcomes were recurrence-free survival (RFS) and progression-free survival (PFS) and secondary outcomes included cancer-specific survival (CSS), overall survival (OS) and complications, stratified by EORTC risk groups. Data were analysed using Kaplan–Meier survival analysis and Cox regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred and nineteen patients (1186 TULAs), with a median age of 77 and median Charleson Comorbidity Index of 7, were included. Median follow up was 4.4 years. The 5-year RFS of intermediate-risk and high-risk NMIBC treated with TULA were 31.8% (95%CI:25.6–39.7%) and 29.0% (95%CI: 20.1–42.0%), respectively, with no significant difference (p:0.47). The 5-year PFS were 86.8% (95%CI: 82.1–91.7%) and 93.1% (95%CI: 85.2–100.0%), respectively. Overall, the 10-year OS and CSS were 50.7% (95% CI: 41.8–61.5%) and 96.1% (95%CI: 93.3–98.9%), respectively. The complication rate was 4.0%. Age was the only positive predictor of recurrence. Limitations include missing data (7.9%) and single-centre retrospective design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TULA is a safe, minimally invasive treatment with long-term efficacy for elderly and comorbid patients with recurrent NMIBC. Although recurrence rate at 5 years were high, progression rate, especially muscle invasion, was low and reassuring. Long-term overall survival and cancer-specific survival remained excellent.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647273","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":"Early clinical experience with the Carina robotic platform in urologic surgery","authors":"Hongkai Wang,&nbsp;Dalong Cao,&nbsp;Marcio Covas Moschovas,&nbsp;Junlong Wu,&nbsp;Beihe Wang,&nbsp;Kun Chang,&nbsp;Hui Wang,&nbsp;Yun Zhu,&nbsp;Bo Dai,&nbsp;Yao Zhu,&nbsp;Hailiang Zhang,&nbsp;Vipul R. Patel,&nbsp;Dingwei Ye","doi":"10.1002/bco2.70050","DOIUrl":"10.1002/bco2.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the feasibility and safety of a new modular robotic surgical platform - Carina Platform (Ronovo Surgical, Shanghai, China) in prostate and renal surgeries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed 11 robot-assisted radical prostatectomies (RARP) and 7 robot-assisted partial nephrectomies (RAPN) using the novel Carina Platform at Fudan University Shanghai Cancer Center (Shanghai, China). The port placements, operating space setting, cart distances and patient positions for all surgeries were recommended according to the procedure cards developed by Ronovo Surgical. Outcomes include success rate (completion without conversion to laparoscopy or open surgery), docking time, total surgery time and safety evaluations such as estimated blood loss (EBL) and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The age of the patients ranged from 37 to 73 years, and the BMI ranged from 19.9 to 29.1 kg/m². All operations were successfully completed without conversion to laparoscopy or extra port placement. For RARP, the mean docking time was 6.8 ± 5.6 min; the mean total surgery time was 156.3 ± 27.8 min; and mean EBL was 67.3 ± 39.2 ml. For RAPN, the mean docking time was 8.9 ± 1.6 min; the mean total surgery time was 146.0 ± 38.0 min; and mean EBL was 47.1 ± 7.6 ml. The mean warm ischemia time was 23.9 ± 6.7 min. There were no severe intraoperative or postoperative complications in 1-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first clinical reporting outcomes of the Carina Platform in urologic procedures. The study provides evidence of feasibility and safety when performing RARP and RAPN with acceptable perioperative outcomes and minimal complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647337","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 functional outcomes and complications of robot-assisted laparoscopic supratrigonal cystectomy with augmentation cystoplasty in adult patients with neurogenic lower urinary tract dysfunction and interstitial cystitis/bladder pain syndrome: A single-centre experience","authors":"Thomas Batard,&nbsp;Benoit Mesnard,&nbsp;Amelie Levesque,&nbsp;Loïc Le Normand,&nbsp;Brigitte Perrouin-Verbe,&nbsp;Jerome Rigaud,&nbsp;Marie-Aimee Perrouin-Verbe","doi":"10.1002/bco2.70029","DOIUrl":"10.1002/bco2.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To report the long-term functional outcomes and complications of robot-assisted laparoscopic supratrigonal cystectomy with augmentation cystoplasty (RA-SC-AC) in adult patients with neurogenic lower urinary tract dysfunction (NLUTD) or Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We retrospectively analysed the records of adult patients who underwent RA-SC-AC at our institution between 2012 and 2020. Patients with NLUTD had refractory neurogenic detrusor overactivity or poor bladder compliance; patients with IC/BPS presented with severe pain and/or reduced bladder capacity (&lt;400 ml). Our centre is a national referral institution for advanced BPS/IC. We recorded early and late complications, urodynamic parameters, pain scores, continence status and quality of life (Patient Global Impression of Improvement, PGI-I). We also report how many patients eventually required self-catheterization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-one patients were included (41 NLUTD, 30 IC/BPS); the median follow-up was 4.8 years ± 2.2. Overall, 36.7% experienced early (&lt;30 days) complications, mostly minor (Clavien ≤2). Three major late complications occurred (one bladder perforation, two bowel obstructions). Among NLUTD patients, 90.2% achieved a low-pressure reservoir, and the continence rate rose from 48.0% preoperatively to 92.7%. In IC/BPS, pain scores significantly decreased (7.8 ± 2.0 to 2.2 ± 0.4; p &lt; 0.001) and maximum cystometric capacity increased (112 ± 39 ml to 304 ± 54 ml; p &lt; 0.001). Four patients (13.3%) were surgical failures, persisting with severe symptoms. Eleven patients (36.7%) required de novo intermittent self-catheterization.</p>\u0000 \u0000 <p>Overall, 73.0% reported improved quality of life at last follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RA-SC-AC is feasible, with acceptable morbidity and long-term functional benefits in both NLUTD and IC/BPS patients failing conservative treatments. Most patients experienced significantly improved bladder function and pain relief, as well as an enhanced quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647336","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":"ISUP grade upgrade prediction after radical prostatectomy: Role of Luteinizing Hormone to Testosterone ratio","authors":"Zhihua Pan,&nbsp;Ruizhe Zhao,&nbsp;Jinjiang Fan,&nbsp;Shaobo Zhang,&nbsp;Jie Li,&nbsp;Bianjiang Liu","doi":"10.1002/bco2.70043","DOIUrl":"10.1002/bco2.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to evaluate the predictive value of the luteinizing hormone to testosterone (LH/T) ratio in postoperative International Society of Urological Pathology (ISUP) grade upgrading following radical prostatectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Clinical data from 503 patients who underwent radical prostatectomy (RP) at Jiangsu Provincial People's Hospital between June 2022 and October 2024 were collected. A stratified random sampling method was used to divide the patients into a training set and a validation set at a 7:3 ratio. In the training set, binary logistic regression analysis was applied to identify key predictive factors for postoperative ISUP classification upgrading. A nomogram predictive model and a multivariate forest plot were constructed. The validation set was assessed using the bootstrap method for C-index, calibration curve, clinical impact curve (CIC) and decision curve analysis (DCA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The postoperative ISUP upgrading rate was 31.2% (157/503). LH/T, Prostate Imaging Reporting and Data System (PI-RADS) score, preoperative ISUP grade and biopsy method were identified as key predictors of pathological upgrading. The C-index of the training set was 0.800, the validation set was 0.776, and the bootstrap resampling (500 times) in the validation set yielded a C-index of 0.799, indicating high sensitivity and specificity in distinguishing different categories. Calibration curves demonstrated consistency between predicted and actual values, while clinical impact curve (CIC) and DCA confirmed the model's ability to optimize preoperative decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A lower LH/T ratio is associated with a higher risk of ISUP grade upgrading. As a novel predictive biomarker, LH/T may enhance preoperative risk assessment, aiding in more precise treatment decisions for prostate cancer patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624465","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":"Optimising prostate cancer pathways: Improving post-biopsy waiting times in a tertiary centre","authors":"Shayan Soroush,&nbsp;Sean Lim,&nbsp;Prachi Beniwal,&nbsp;Gavin Wei,&nbsp;Ying Lu,&nbsp;Kylie Yen-Yi Lim,&nbsp;Kirsten Holden,&nbsp;Matt Harper,&nbsp;Scott Donnellan,&nbsp;Weranja Ranasinghe","doi":"10.1002/bco2.70045","DOIUrl":"10.1002/bco2.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the effectiveness of a streamlined Prostate Cancer Care Pathway (PCCP) in reducing post-biopsy waiting times and improving patient satisfaction in a high-volume tertiary centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Patients undergoing prostate biopsies were prospectively followed through PCCP for one year and were retrospectively compared to 150 patients who were treated at our centre either immediately prior to PCCP implementation (2022) or during Covid-19 lockdowns (2020). Waiting times were compared using the Kruskal-Wallis H-test. Patient satisfaction was assessed using the modified PCa Questionnaire for Patients (PCQ-P).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 398 patients were included. 248 patients went through PCCP, compared with 75 patients pre-PCCP implementation (2022) and 75 patients during the 2020 pandemic. The median time from biopsy to results post-PCCP was 15.0 days (IQR 13.0–19.0). This was significantly shorter than pre-PCCP introduction of 21.0 days (17.0–28.0) and during 2020 lockdowns, 18.0 days (14.0–21.0, p &lt; 0.001). A total of 131 patients (52.8%) requiring treatment under PCCP were streamlined for multidisciplinary discussion following imaging at a median time of 38.0 (29.8–42.0) days and seen at Urology or Radiation Oncology Consultant clinic for treatment discussion at a median of 38.0 days (31.0–49.0), compared to 63.0 days (45.0–84.0) pre-PCCP (2022) and 52.0 days in 2020 (38.0–75.0, p &lt; 0.001). A total of 176 PCCP patients (70.1%) participated in PCQ-P with 93.2% of participants reporting satisfaction with waiting time durations (n = 176).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PCCP implementation reduced waiting times in all post-biopsy care measures following significant Covid-19 delays in PCa care delivery. Streamlining resources using similar pathways can reduce waiting times in cancer care and other conditions to alleviate anxiety during healthcare system strain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536880","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}