BJUI compass最新文献

{"title":"Factors associated with contralateral renal parenchymal volume changes after partial nephrectomy: A retrospective cohort study.","authors":"Qilong Jiao, Jialong Song, Ben Cao, Jianwen Chen, Shaopeng Zhou, Yibo Chen, Cheng Peng, Lei Wang, Haiyi Wang, Qingbo Huang, Xu Zhang, Xin Ma","doi":"10.1002/bco2.70249","DOIUrl":"10.1002/bco2.70249","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study is to assess contralateral renal parenchymal volume (CRPV) changes in patients with renal cell carcinoma (RCC) after PN and identify the clinical factors associated with CRPV increase.</p><p><strong>Methods: </strong>This retrospective study included 143 RCC patients (aged 24-76 years) who underwent PN between 2017 and 2018. Preoperative and postoperative CRPV were assessed using 3D Slicer software. Patients were categorized into CRPV-increase and CRPV-decrease groups based on volumetric changes. Univariate and multivariable logistic regression analyses were conducted to determine independent factors influencing CRPV increase.</p><p><strong>Results: </strong>With a median follow-up of 904 days (IQR: 605<b>-</b>1707), the overall median CRPV increase was 4.1% (IQR: -2.8% to 12.6%) relative to the preoperative volume, and 68.5% (98/143) of patients exhibited CRPV enlargement. Multivariable analysis identified postoperative acute kidney injury (AKI) as a significant independent predictor associated with CRPV increase (OR = 2.990, 95% CI: 1.050-8.513, <i>p</i> = 0.040), whereas preexisting hypertension was inversely associated with CRPV growth (OR = 0.446, 95% CI: 0.206-0.966, <i>p</i> = 0.041).</p><p><strong>Conclusions: </strong>Contralateral renal compensation following PN is relatively modest compared to radical nephrectomy. Postoperative AKI is associated with compensatory renal hypertrophy, whereas hypertension is negatively associated with this process. These hypothesis-generating findings underscore the importance of perioperative renal function management and blood pressure control. Prospective studies are needed to validate these associations.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":"e70249"},"PeriodicalIF":2.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581214","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":"Correction to ‘Clinical trial protocol of PODRACING: A randomized controlled trial evaluating 3D perfusion zone models for selective arterial clamping during robot-assisted partial nephrectomy’","authors":"","doi":"10.1002/bco2.70254","DOIUrl":"10.1002/bco2.70254","url":null,"abstract":"<p>\u0000 <span>Vangeneugden, J</span>, <span>Vermijs, S</span>, <span>De Backer, P</span>, <span>Berquin, C</span>, <span>Lumen, N</span>, <span>De Kuyper, P</span>, et al. <span>Clinical trial protocol of PODRACING: A randomized controlled trial evaluating 3D perfusion zone models for selective arterial clamping during robot-assisted partial nephrectomy</span>. <i>BJUI Compass.</i> <span>2026</span>; <span>7</span>(<span>4</span>):e70191. https://doi.org/10.1002/bco2.70191\u0000 </p><p>We would like to disclose a competing interest that was inadvertently omitted from the published Conflict of Interest Statement. Since March 2024, author Pieter De Backer has been a co-founder and shareholder of MEDANNOT s.r.o. (Spania Dolina, Slovakia). As described in the Methods, the trial uses the Medannot 3D segmentation platform to create the 3D models, so the financial interest in this company is relevant to the study and should have been declared.</p><p>This omission was not intentional. The same oversight affected the Funding section, in which PDB's VLAIO Baekeland mandate (HBC.2020.2252), active at the time, was also not listed.</p><p>The revised conflict of interest statement and added funding information are as follows:</p><p>Conflict of Interest (amended): “Pieter De Backer (P.D.B.) has been a co-founder and shareholder of MEDANNOT s.r.o. (Spania Dolina, Slovakia) since March 2024. The Medannot 3D modelling platform was used in this study. This constitutes a competing interest that was not declared in the original publication. The competing-interest declarations of the remaining authors are unchanged.”</p><p>Funding (addition): “Pieter De Backer was supported by a VLAIO Baekeland mandate (HBC.2020.2252).”</p><p>We apologise for these errors.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551548","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":"New-Onset Urethral Stricture After HoLEP: Incidence, Predictors and Treatment Outcomes From an 8-Year Single-Centre Analysis","authors":"Juanita Velasquez-Ospina,&nbsp;Gurpremjit Singh,&nbsp;Ahmad Abdelaziz,&nbsp;Adam Williams,&nbsp;Haşim Bakbak,&nbsp;Jonathan Katz,&nbsp;Robert Marcovich,&nbsp;Hemendra N. Shah","doi":"10.1002/bco2.70251","DOIUrl":"10.1002/bco2.70251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to evaluate the incidence, timing, anatomical characteristics, predictors and management outcomes of urethral stricture formation following HoLEP at an academic institution in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted of 857 patients who underwent HoLEP at a single academic institution between July 2017 and August 2025. Patients with prior or incidental urethral stricture diagnosis at the time of HoLEP were excluded. Enucleation was performed using a 26-Fr resectoscope, and morcellation was completed through a 26-Fr morcelloscope sheath. If initial cystoscopy suggested small-sized meatus or non-distensible penile urethra, Otis urethrotomy or urethral calibration was performed. Demographic, clinical and perioperative data were collected and analysed using multivariable logistic regression to identify predictors of postoperative urethral stricture formation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 857 patients, 16 had preoperative or intraoperative strictures and were excluded. Seventeen patients (2.0%) developed urethral stricture at a mean of 6.2 months postoperatively. Patients with stricture had lower BMI (24.1 vs. 27.4 kg/m², <i>p</i> = 0.0042) and smaller prostates (65 vs. 105 ml, <i>p</i> = 70.0131). Median age was higher in the stricture group (73 vs. 69 years, <i>p</i> = 0.0702). On multivariable analysis, higher BMI was independently associated with lower odds of postoperative urethral stricture. (OR 0.84, 95% CI 0.73–0.97; <i>p</i> = 0.016). Stricture locations included bulbar (52.9%), bulbo-membranous (11.8%), sub-meatal (11.8%), penile (5.9%), membranous (5.9%), prostatic (5.9%) and combined bulbar and sub-meatal (5.9%). Most strictures (76.5%) were &lt;1 cm. Initial management included laser incision (seven), dilation (nine) and drug-coated balloon dilation (one). At mean post-treatment follow-up of 17.53 months, four patients (23.5%) experienced recurrence of stricture that required additional management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The overall risk of urethral stricture following HoLEP was low (2%). Higher BMI was associated with a lower risk of urethral stricture formation. Following initial intervention, 23.5% experienced relapse needing additional management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13370666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457738","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 utility of PSA density for selection of targeted versus systematic transperineal prostate biopsy: A retrospective cohort study","authors":"Johnny Wang,&nbsp;Narmina Khanmammadova,&nbsp;Karim Hanna,&nbsp;Ashley Gao,&nbsp;Angelina Wang,&nbsp;Kimberly Tran,&nbsp;Mohamad Ibrahim,&nbsp;Mackinnly Knoerzer,&nbsp;Kristene Myklak,&nbsp;Sohrab Ali,&nbsp;Michael Daneshvar,&nbsp;Mohammed Shahait,&nbsp;David Lee","doi":"10.1002/bco2.70247","DOIUrl":"10.1002/bco2.70247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to evaluate PSA density (PSAD) as an adjunctive predictor of prostate cancer (PCa) detection on magnetic resonance imaging (MRI)-guided transperineal biopsy and to identify PSAD thresholds across which systematic sampling may be safely omitted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected from men who underwent MRI-ultrasound software-assisted fusion transperineal biopsy from July 2023 to August 2025. The cancer detection rate of targeted, systematic and combined strategies was stratified by PSAD. Multivariable logistic regression was used to identify predictors of grade group (GG) ≥ 2 and GG ≥ 3 PCa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 379 men undergoing biopsy, overall GG ≥ 2 detection increased with PSAD: 29.2% (&lt;0.1), 42.7% (0.1–0.1499), 61.2% (0.15–0.1999) and 78.4% (≥0.2). On multivariable analysis, PSAD was associated with higher odds of GG ≥ 2 (OR 2.4, 95% CI 1.73–3.3, <i>p</i> &lt; 0.001) and GG ≥ 3 (OR 2.3, 95% CI 1.65–3.2, <i>p</i> &lt; 0.001) PCa. At PSAD ≥ 0.2, the inclusion of systematic biopsy increased detection of GG 1 cancer by 42.3% but only increased detection of GG ≥ 2 and GG ≥ 3 cancer by 7.2% and 6.2%, respectively. Among 96 men who underwent radical prostatectomy, combined biopsy demonstrated the strongest grade group concordance at prostatectomy (κ = 0.747), though the difference between targeted and combined biopsy narrowed among those with PSAD ≥ 0.2 (κ = 0.628 vs. 0.584).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PSAD is an accessible metric that may guide risk stratification and biopsy strategy selection. A PSAD threshold of 0.2 may identify those in whom systematic sampling increases detection of low-grade disease with limited incremental yield for clinically significant disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457773","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":"Transferring robotic expertise from multi-port to single-port partial nephrectomy: A comparative analysis of perioperative outcomes and learning curves","authors":"Andres Affentranger,&nbsp;Silvan Sigg,&nbsp;David Abt,&nbsp;Miranda Fanconi,&nbsp;Christoph Würnschimmel,&nbsp;Philipp Baumeister,&nbsp;Agostino Mattei,&nbsp;Christian D. Fankhauser,&nbsp;Ernest Kaufmann","doi":"10.1002/bco2.70253","DOIUrl":"10.1002/bco2.70253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to evaluate perioperative outcomes and learning curves following implementation of single-port robot-assisted partial nephrectomy (SP-RAPN) at a European tertiary referral centre and to assess the transferability of robotic expertise from established multi-port (MP) platforms to single-port (SP) surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This single-centre retrospective cohort study included consecutive patients undergoing RAPN between February 2023 and August 2025. Procedures were performed by four surgeons (two experts and two trainees) using da Vinci Xi MP or da Vinci SP systems. Primary outcomes included operative time, warm ischemia time, complications and trifecta (negative margins, ischemia ≤25 min and no major complications). Learning curves were analyzed using risk-adjusted CUSUM methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MP-RAPN was performed in 65 patients and SP-RAPN in 62. Mean operative time was 193 min in both groups, and trifecta was 80% for MP-RAPN versus 69% for SP-RAPN (<i>p</i> = 0.17); however, given the limited sample size, we could not rule out a clinically meaningful difference. Intraoperative complications occurred in three MP-patients (5%) and in no SP-patients. Length of stay was significantly shorter following SP-RAPN (2 vs. 3 days, <i>p</i> &lt; 0.001). CUSUM analysis demonstrated a potential learning curve in experienced surgeons (<i>R</i>² = 0.91, proficiency at case 18), with patterns in other surgeons limited by case volume.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SP-RAPN can be safely implemented in experienced robotic centres with outcomes comparable to MP approaches and shorter hospital stays. Excellent skill transferability from MP to SP platforms was demonstrated in experienced surgeons. Supervised trainee adoption was feasible without complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439140","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":"Comparison of software vs. cognitive-based fusion-targeted biopsies for prostate cancer diagnosis","authors":"Marcus Westerberg,&nbsp;Rolf Gedeborg,&nbsp;Hans Garmo,&nbsp;Fredrik Jäderling,&nbsp;Pär Stattin,&nbsp;David Robinson","doi":"10.1002/bco2.70248","DOIUrl":"10.1002/bco2.70248","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to compare the effectiveness of software-based fusion-targeted biopsies (STBx) versus cognitive fusion-targeted biopsies (CogTBx) in detecting prostate cancer (PCa) and clinically significant PCa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Men aged 30–85 were included in a target trial emulation if they had undergone a STBx or CogTBx of Prostate Imaging Reporting and Data System (PI-RADS) 3–5 lesions in 2020–2024. Using log-link binary regression models with inverse probability of treatment weighting to adjust for confounding, we estimated the associations between biopsy technique and detection of PCa and clinically significant PCa (Gleason ≥3 + 4 and Gleason ≥4 + 3) by use of adjusted relative risks (aRR) with 95% confidence intervals (CIs) obtained via bootstrapping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2092 men who underwent STBx and 7933 men who underwent CogTBx in 2020–2024 were identified in PCBase Xtend. The overall proportion diagnosed with PCa was 64%. STBx detected PCa with a slightly higher frequency (aRR, 1.05; 95% CI, 1.02–1.09), corresponding to an absolute increase of 3.3 percentage points (95% CI 1.2–5.3). The relative risk for detection of Gleason ≥4 + 3 was somewhat larger (aRR, 1.13; 95% CI, 1.03–1.23). The largest relative difference for detection of PCa was observed in PI-RADS 3 lesions (aRR, 1.12; 95% CI, 1.01–1.24), and this pattern became even more apparent when the outcome was restricted to clinically significant PCa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Software-based fusion-targeted biopsies detected slightly more PCa and clinically significant PCa compared to cognitive fusion-targeted biopsies, particularly in men with PI-RADS 3 lesions. Prioritizing PI-RADS 3 lesions for software-based targeted fusion biopsy could optimize diagnostic effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439112","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 performance of prostate-specific antigen density in long-term prostate cancer-mortality risk prediction","authors":"Sara Saliba,&nbsp;Anders Kjellman,&nbsp;Anna Thor,&nbsp;Ulf Norming,&nbsp;Anna Lantz,&nbsp;Ove Gustafsson,&nbsp;Per-Olof Lundgren","doi":"10.1002/bco2.70250","DOIUrl":"10.1002/bco2.70250","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to examine whether a baseline calculation of PSAD is associated with prostate cancer-specific mortality after 30 years of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One-thousand seven-hundred and seventy-nine men were screened for prostate cancer with a PSA test, digital rectal exam (DRE) and ultrasound of the prostate (TRUS). Outcomes, that is, prostate cancer-specific mortality, were extracted from the Swedish National Cause of Death Registry. Hazard ratios for cancer-specific deaths were estimated using Cox proportional hazard regression model. The area under the receiver operating curve (AUC) was determined using logistic regression for men with a baseline PSA in the interval between 3.0 and 10.0 ng/ml.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PSAD was available for 1748 men. Median PSAD was 0.095 ng/ml/cm³ (IQR 0.073–0.14). The age-adjusted hazard ratio for lethal prostate cancer in the cohort of men with PSA between 3.0 and 10.0 ng/ml was 10.1 (95% CI 2.4–42.2) if PSAD was ≥0.15 compared to &lt;0.15.</p>\u0000 \u0000 <p>A model including PSAD, palpation and ultrasound findings could distinguish lethal prostate cancer from non-cases at 30 years of follow-up with an AUC of 0.75.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For men with PSA between 3 and 10 ng/ml, PSAD is a predictor of the long-term risk for lethal prostate cancer. One limitation to this study is the lack of clinical data during follow-up apart from cancer-specific mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426855","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":"Comparative performance of mFI-5 and mFI-11 thresholds in predicting outcomes after holmium laser enucleation of the prostate","authors":"Hasim Bakbak,&nbsp;Gurpremjit Singh,&nbsp;Ahmad Abdelaziz,&nbsp;Adam Williams,&nbsp;Juanita Velasquez Ospina,&nbsp;Jonathan E. Katz,&nbsp;Robert Marcovich,&nbsp;Alan Jerome Wein,&nbsp;Hemendra N. Shah","doi":"10.1002/bco2.70244","DOIUrl":"10.1002/bco2.70244","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work aimed to evaluate the safety and efficacy of holmium laser enucleation of the prostate across different degrees of frailty using the 11-item and 5-item modified frailty indices and to compare perioperative and postoperative outcomes across multiple frailty thresholds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed patients who underwent HoLEP at our institution between July 2017 and August 2025. Frailty was assessed using mFI-11 (cutoffs ≥0.18, ≥0.27, ≥0.36) and mFI-5 (≥0.40). Perioperative variables, functional outcomes, and postoperative complications were compared. Agreement between frailty definitions was assessed using Cohen's kappa. Logistic regression was used to evaluate complication risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 857 patients, overall frailty burden was low ranging from 16.2% with mFI-11 ≥0.36 to 52.6% with mFI-11 ≥0.18, and 27.5% by mFI-5 ≥0.40. Functional outcomes improved in all groups, though patients defined as frail by mFI-11 ≥0.36 demonstrated less improvement in IPSS at 1 year and lower Qmax at select time points. Major complications were uncommon and did not demonstrate a consistent frailty gradient. Transfusion risk was higher only at mFI-11 ≥0.36. Urinary tract infection showed a dose–response relationship with increasing mFI-11, with approximately a 20% increase in odds per one-point increase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HoLEP is safe and effective across frailty definitions. Frailty cutoff selection meaningfully influences risk stratification, with mFI-11 ≥0.36 providing the most clinically informative discrimination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426841","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":"Ten-year update on the European Association of Urology Robotic Section (ERUS) fellowship training for robot-assisted radical prostatectomy","authors":"Marco Paciotti,&nbsp;Christian Wagner,&nbsp;Nicola Frego,&nbsp;Edoardo Beatrici,&nbsp;Angelo Mottaran,&nbsp;Carlo Andrea Bravi,&nbsp;Federico Piramide,&nbsp;Maria Peraire Lores,&nbsp;Luca Sarchi,&nbsp;Adele Piro,&nbsp;Rui Farinha,&nbsp;Gabriele Sorce,&nbsp;Eleonora Balestrazzi,&nbsp;Luigi Nocera,&nbsp;Claudia Collà Ruvolo,&nbsp;Silvia Rebuffo,&nbsp;Nikolaos Liakos,&nbsp;Paolo Dell'Oglio,&nbsp;Mike Wenzel,&nbsp;Marcio Covas Moschovas,&nbsp;Filippo Turri,&nbsp;Fabrizio Di Maida,&nbsp;Edward Lambert,&nbsp;Christoph Wurnschimmel,&nbsp;Ruben De Groote,&nbsp;Ben van Cleynenbreugel,&nbsp;Alessandro Larcher,&nbsp;Iulia Andras,&nbsp;Nicolò Maria Buffi,&nbsp;Henk G. van der Poel,&nbsp;Alberto Breda,&nbsp;Alexandre Mottrie,&nbsp;Anthony G. Gallagher,&nbsp;ERUS Working Group on Education and Junior ERUS/YAU Working Group on Robot-assisted Surgery","doi":"10.1002/bco2.70227","DOIUrl":"10.1002/bco2.70227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this paper is to evaluate fellowship outcomes 10 years after implementation of the European Association of Urology Robotic Section (ERUS) structured curriculum for robot-assisted radical prostatectomy (RARP), with a focus on completion rates and reasons for non-completion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects and methods</h3>\u0000 \u0000 <p>Data were obtained from institutional records and a trainee survey. The primary outcome was fellowship completion (i.e., Certificate of Excellence achievement). Secondary outcomes included reasons for non-completion and satisfaction. Completion rates were analysed annually, with trends assessed using the Cochran–Armitage test and log-linear regression for the Estimated Annual Percentage Change (EAPC). Comparisons before and after introduction of a procedural diary (2023) and between pandemic and non-pandemic years used Fisher's Exact Test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 126 fellows, a total of 42 (33%) completed the fellowship by achieving the Certificate of Excellence. The trainee survey achieved a response rate of 77%, supporting the representativeness of the collected data. The main barriers to fellowship completion included limited console access (49%), insufficient programme duration (20%), logistical difficulties (20%) and COVID-19-related disruptions (11%). Despite these limitations, overall satisfaction with the fellowship was high (83%), with particularly strong approval of the ORSI hands-on training week (100%). Completion rates demonstrated a progressive increase over time, rising from 20% in 2018 to 52% in 2023. The Cochran–Armitage test confirmed a statistically significant upward trend in completion rates over the study period (<i>p</i> &lt; 0.001), while log-linear regression analysis showed a numerical but non-significant EAPC of 13% (95% CI –0.6 to 28.6). Although 2023 represented the highest observed completion rate, this peak was not significantly different from previous years (OR 2.63, 95% CI 0.91–7.63).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The RARP ERUS Fellowship remains a benchmark in robotic training, but unsatisfactory completion rates highlight the need for improvement. Recent reforms, including the procedural diary, show promise and warrant expansion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426875","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 efficiency and diagnostic outcomes during the learning curve of transperineal MRI-guided prostate biopsy","authors":"Mario Hallaschek,&nbsp;Jeremy Kwe,&nbsp;Friedrich Helke,&nbsp;Ivan Platzek,&nbsp;Katharina Böhm,&nbsp;Martin Baunacke,&nbsp;Angelika Borkowetz,&nbsp;Christian Thomas,&nbsp;Roman Herout,&nbsp;Benedikt Hoeh","doi":"10.1002/bco2.70237","DOIUrl":"10.1002/bco2.70237","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work aimed to investigate the role of surgeon experience on operating time and detection rate of clinically significant prostate cancer (csPCa) in a large contemporary cohort undergoing transperineal (TP) MRI-targeted prostate biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed patients who underwent TP MRI-guided prostate biopsies between 10/2018 and 04/2024. Patients with suspicious MRI lesions (PI-RADS 3, 4 and 5) formed the study cohort. All patients underwent MRI-targeted biopsies of suspicious lesions combined with a standard 12-core systematic biopsy. Caseloads—both total and in increments of 50 cases—were calculated for each surgeon. We employed univariable and multivariable Poisson regression models to analyse biopsy duration, and logistic regression models to assess csPCa detection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 3336 MRI-guided TP biopsies, 1148 (34%) involved PI-RADS 3, 1398 (42%) PI-RADS4 and 790 (24%) PI-RADS 5 as index lesions. Most patients (55%) had one suspicious lesion. The median caseload per surgeon was 63 (IQR [interquartile range]: 30–110). Biopsy duration significantly decreased after the first 50 procedures (13 min [95% CI: 10–18] to 10 min [95% CI: 8–15]) and plateaued thereafter. Multivariable Poisson regression demonstrated increased caseload independently associated with shorter biopsy duration (IRR 0.891 [95% CI: 0.833–0.899], <i>p</i> &lt; 0.001). The overall csPCa detection rate was 43%, with no significant correlation to caseload. These findings were consistent across subgroup analyses based on PI-RADS score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This large, contemporary study demonstrated that biopsy duration decreased significantly after approximately 50 cases, indicating a learning curve without compromising the detection rate of csPCa.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414080","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}