BJUI compass最新文献

{"title":"The impact of haemostatic agent used during robot-assisted radical prostatectomy on post-op infection and anastomotic leak","authors":"Jamie Krishnan, Rory Brennan, Osman El-Koubani, Sailantra Sivathasan, Kevin Gallagher, Linda Taylor, Abhishek Sharma, Daniel Good, Alan McNeill","doi":"10.1002/bco2.70023","DOIUrl":"10.1002/bco2.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Despite the widespread use of robotic-assisted radical prostatectomy (RARP), considerable variation exists in practice with regard to postoperative cystograms prior to trial without catheter (TWOC).</p>\u0000 \u0000 <p>Our practice was to undertake a cystogram at 7–14-day post-op and proceed with TWOC if the leak was small or absent.</p>\u0000 \u0000 <p>In this study, we evaluate the risk factors for anastomotic leak and post-op urinary tract infection (UTI), while assessing the impact of using powdered haemostat Arista AH on post-op UTIs and cystographic leaks to rationalise the use of cystograms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was carried out in two phases, the first a retrospective review of 154 patients undergoing RARP between January and October 2022, where Oxitamp (an absorbable haemostat of oxidised regenerated cellulose) was used as the haemostatic agent.</p>\u0000 \u0000 <p>The second phase was prospective, involving 62 patients between November and June 2023, in whom the powdered haemostat Arista AH (microporous polysaccharide haemospheres) was used instead.</p>\u0000 \u0000 <p>Data were collated from a prospectively collected database (REDCap<sup>Ò</sup>) and electronic patient records. RARP was performed by two experienced surgeons using similar techniques. Analysis was carried out on R-studios, using Fisher's exact test for categorical variables and unpaired student <i>t</i>-test for continuous variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-op UTI occurred in 19 (12%) patients in Cohort 1 (with Oxitamp) and leaks were associated with 15 (79%). In comparison, seven (11%) patients in Cohort 2 (with Arista AH) suffered from post-op UTI, and only one (14%) was associated with leak.</p>\u0000 \u0000 <p>There was an overall reduction in leaks on post-op cystograms from 44 (29%) in Cohort 1 to only nine (15%) in Cohort 2 (<i>p</i> = 0.036).</p>\u0000 \u0000 <p>One hundred per cent of the leaks in Cohort 2 were small, compared to nine (20%) in Cohort 1 (<i>p</i> = 0.0002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A selective approach can be implemented with regard to post-op cystograms.</p>\u0000 \u0000 <p>We propose that when using Arista AH cystograms should be carried out in patients in need of bladder neck reconstruction. We will also continue to undertake routine cystograms in those with a history of transurethral resection of p","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/bco2.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524738","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 allium stent for the complex ureteral stricture-deeper experience of a series case review","authors":"Hanqi Lei, Yajiao Cui, Mengjun Huang, Donggen Jiang, Yamei Li, Jun Pang","doi":"10.1002/bco2.70042","DOIUrl":"10.1002/bco2.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Allium stents are widely used in patients with ureteral stricture, with ongoing research continuously evaluating their clinical safety and efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to describe our technique and report the outcomes of Allium stent in the treatment of refractory ureteral strictures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design, setting and participants</h3>\u0000 \u0000 <p>We retrospectively collected perioperative data on all patients treated with Allium stents in our department between January 2017 and April 2024 and assessed their clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Surgical procedure</h3>\u0000 \u0000 <p>Following ureteroscopy, a guidewire was advanced under fluoroscopic guidance into the renal pelvis. The retrograde ureterography was performed to determine the location and length of the ureteral stricture. Dilation was performed using a ureteral balloon dilator, a flexible ureteroscope sheath, or a rigid ureteroscope. Subsequently, the Allium stent was deployed into the stricture segment and confirmed via fluoroscopic imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 23 patients (25 ureters) were included, with a mean age of 57.7 years (32–76 years). The mean length of ureteral strictures was 4.5 cm (range: 1–18 cm). All stents were successfully positioned. As of December 2024, the stent patency rate was 68%, with a median follow-up of 39.5 months (13–67 months). In eight patency failure cases, the mean indwelling time was 14 months, with the shortest recorded duration being 2 months. Causes of failure included four (50%) stent migration, one (12.5%) encrustation, two (25%) persistent stenosis and severe infection (12.5%). Management strategies for these cases included two (25%) stent removal, two (25%) robot-assisted pyeloureteroplasty, one (12.5%) ureterolithotripsy, one (12.5%) exchange with a new Allium stent, one (12.5%) add new Allium stent, and one (12.5%) replacement with a different type of metal stent. Notably, one case of a ruptured ureter was successfully bridged with an Allium stent, and another case of a uretero-vaginal fistula was effectively treated with Allium stent, both without complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Allium stents appear to be a feasible and effective treatment for various ureteral strictures, includin","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519765","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 past, present and future of penile cancer in the Nordic countries. Results from NORDCAN","authors":"Christian Arvei Moen,&nbsp;Axel Gerdtsson,&nbsp;Mikael Aagaard,&nbsp;Andreas Hopland,&nbsp;Peter Kirrander,&nbsp;Jakob Kristian Jakobsen","doi":"10.1002/bco2.70041","DOIUrl":"10.1002/bco2.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work aims to present epidemiological data on penile cancer from the Nordic region (Denmark, Finland, Iceland, Norway, Sweden) and discuss the results in light of the present knowledge and possible future treatment strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>All patients diagnosed with penile cancer in the Nordic countries between 2000 and 2022 were identified in the NORDCAN database. Data on the number of new cases per year, incidence (presented as an age-standardized rate using the Nordic population as a reference), prevalence, mortality, relative survival and predictions on the future societal impact of this cancer was retrieved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 6106 cases of penile cancer were registered in a population that increased from about 12–14 million men over the period. The age-standardized incidence has significantly increased over time and is now above 2.0 per 100 000 men. Currently, more than 300 new cases are diagnosed each year, and more than 3000 men live with a penile cancer diagnosis. Mortality, as well as both 1-year and 5-year relative survival have, however, remained nearly unchanged. Using the NORPRED model, it is predicted that the yearly number of penile cancer cases will continue to increase in all the countries investigated over the next decade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Penile cancer incidence and prevalence have increased in the Nordic region over the last 20 years. Mortality and survival, however, have remained unchanged. The number of new penile cancer cases is predicted to increase over the next decade. Better treatment options for these patients are therefore urgently needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492972","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 use of intradetrusor botulinum toxin in the geriatric population","authors":"William Chui,&nbsp;Alvaro Bazo,&nbsp;Henry H. Yao,&nbsp;Joshua Kealey,&nbsp;Lana Pepdjonovic,&nbsp;Helen E. O'Connell,&nbsp;Johan Gani,&nbsp;Richard Parkinson","doi":"10.1002/bco2.70048","DOIUrl":"10.1002/bco2.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to explore the impact of age on long-term outcomes associated with intradetrusor botulinum toxin (BoNT) usage (up to four cycles) in elderly patients with refractory overactive bladder syndrome (OAB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a retrospective observational cohort study across institutions in Nottingham (UK) and Melbourne (Australia). Patients with refractory OAB and treated with intradetrusor BoNT between January 2005 and January 2020 were stratified into age groups: ≤40, 40–49, 50–59, 60–69 and ≥70 years. Efficacy was defined as patient self-reported improvement in symptoms post-BoNT injection. Duration of effect was time (months) between BoNT injection to patient reported onset of symptom recurrence. Data on BoNT type and dosing, urinary tract infection (UTI), urinary retention, ICIQ-OAB and International Consultation on Incontinence Questionnaire Urinary Incontinence (ICIQ-UI) questionnaires were also collected. Statistical analyses were conducted with SPSS® 25 software. <i>P</i>-value &lt; 0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 943 patients stratified into age groups: &lt; 40 (183), 40–49 (150), 50–59 (173), 60–69 (219) and ≥ 70 (218). Median age was 58 (IQR 44–69). Most patients were female 724/943 (76.8%). From Cycles 1 to 4, age group ≥ 70 efficacy rates were 85.1%, 84.1%, 92.6% and 89.3%. Corresponding median duration of effect (months) were 6.8, 8.0, 7.0 and 8.0. For Cycle 2; age ≥ 70 was a predictor of reduced efficacy (<i>P</i> = 0.004). Neurogenic causes of OAB were predictors of increased efficacy for Cycles 2 (<i>P</i> = 0.004) and 3 (<i>P</i> = 0.0145). Men had higher rates of urinary retention than women in Cycles 1 (42.4% vs 29.3%, <i>P</i> = 0.003) and 2 (37.9% vs 23.0%, <i>P</i> = 0.0018). All age groups showed improvement in patient-reported outcome measures (PROMs) post-BoNT injection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In elderly patients with refractory OAB and treated with intradetrusor BoNT (up to four cycles), age ≥ 70 was an independent predictor for reduced BoNT efficacy (84.1%) in Cycle 2.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472992","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 the oncological and functional outcomes among patients with high-risk upper tract urothelial cancer undergoing segmental ureterectomy based on tumour location","authors":"Maksym Pikul,&nbsp;Prokip Gordiychuk,&nbsp;Eduard Stakhovsky","doi":"10.1002/bco2.70046","DOIUrl":"10.1002/bco2.70046","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Segmental ureterectomy (SU) represents a viable alternative to radical nephroureterectomy (RNU) for the management of distal ureteral tumours when technically feasible. However, SU of the proximal two-thirds of the ureter is associated with higher failure rates compared to distal ureteral tumours. This study aims to compare oncologic outcomes and renal function in patients undergoing SU for tumours located in the distal versus proximal ureter.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Prospective, non-randomized cohort study, which included adult patients with high-risk cT2–3 cN0–1 M0 ureteral tumours deemed suitable for SU, with preoperative affected kidney function &gt; 15 ml/min. Patients were treated at a reference centre between March 2019 and March 2023. Patients were divided into two cohorts based on the primary tumour location: distal or proximal two-thirds of the ureter. All patients received neoadjuvant chemotherapy (Gem-Cis) and cases that underwent RNU were excluded from the study. Kaplan–Meier analysis was employed to evaluate local- recurrence-free survival (L-RFS), progression-free survival (PFS) and overall survival (OS).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 41 patients underwent SU (21/20 proximal/distal location). The cohorts were matched by age, sex, BMI, ECOG status, T-stage, pN status, tumour length, preoperative eGFR, primary pathology and positive cytology (p &gt; 0.05). Following segmental ureterectomy, all patients with distal ureteral tumours underwent neostomy reconstruction. In the proximal ureter group, reconstruction techniques included end-to-end anastomosis in 9 (43%), Andersen-Heinz plasty in 8 (38%) and ureter-ileum interposition in 4 cases (19%).&lt;/p&gt;\u0000 \u0000 &lt;p&gt;No statistically significant differences were observed between the two cohorts in terms of surgery duration, average blood loss, Grade ≥3 complications, length of postoperative stay or 30-day readmission rate (p &gt; 0.05). Postoperative eGFR was similar between the groups (60.4 ± 8.5 vs. 59.4 ± 11.4; p = 0.81). Furthermore, no significant differences were found between patients with proximal versus distal ureteral tumours in terms of 2-year L-RFS (72% vs. 85%; p = 0.29), PFS (85% vs. 77%; p = 0.69) or OS (65% vs. 77%; p = 0.43).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The current study demonstrates that segmental ureterectomy provides comparable oncologic outcomes and renal function preservation for both proximal and distal ureteral cancer. SU can be considere","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315044","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":"Mental well-being in prostate cancer: A multi-institutional prospective cohort study","authors":"Oliver Brunckhorst,&nbsp;Jaroslaw Liszka,&nbsp;Callum James,&nbsp;Jack B. Fanshawe,&nbsp;Mohamed Hammadeh,&nbsp;Robert Thomas,&nbsp;Shahid Khan,&nbsp;Matin Sheriff,&nbsp;Gordon Muir,&nbsp;Hashim U. Ahmed,&nbsp;Mieke Van Hemelrijck,&nbsp;Robert Stewart,&nbsp;Prokar Dasgupta,&nbsp;Kamran Ahmed","doi":"10.1002/bco2.70040","DOIUrl":"10.1002/bco2.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the patient, treatment and oncological prognostic factors for multiple mental well-being outcomes in prostate cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and Methods</h3>\u0000 \u0000 <p>The MIND-P study was a multi-institutional prospective cohort study recruiting newly diagnosed prostate cancer patients for 12 months post-diagnosis across eight centres. Periodic data collection evaluated mental, physical and social well-being measures incorporating five mental well-being outcomes selected based on prior research as important measures in patients with prostate cancer. This included depression, anxiety, fear of recurrence, body image, and masculinity. Treatment, patient, and oncological prognostic factors for developing significant well-being symptoms were evaluated along with symptom trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 300 patients recruited, 13.7% and 11.0% developed depression or anxiety symptoms, with 45.0% developing at least one significant mental well-being symptom. Those undergoing hormone monotherapy had higher depression scores from 6 months post-diagnosis (all <i>p</i> &lt; 0.05), with prostatectomy patients having poorer body image and masculinity scores, when compared with surveillance patients (all <i>p</i> &lt; 0.02). Metastatic disease at diagnosis was associated with increased depression, anxiety and fear of cancer recurrence. Patient factors for poorer mental well-being included younger age, a previous psychiatric history, social deprivation, poorer baseline mental health symptoms and poorer baseline sexual and urinary function. Symptom trajectory analysis demonstrated the increasing symptom load in body image and masculine self-esteem experienced post any active treatment modality, with more stable scores for other mental well-being measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A high incidence of multiple mental well-being issues was identified post-diagnosis, highlighting their individual importance during follow-up. Baseline mental and functional symptoms, a previous psychiatric history and stage at diagnosis appear to be particularly important prognostic factors for the development of significant symptoms. A comprehensive initial biopsychosocial assessment incorporating these could identify high-risk patients for improved monitoring and subsequent support.</p>\u0000 \u0000 <p>ClinicalTrials.gov number - NCT04647474.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300466","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":"Questionable role of opioids for analgesia in renal colic and its urological interventions","authors":"Anna Krieger,&nbsp;Nadim Zaidan,&nbsp;Philip Zhao,&nbsp;James F. Borin,&nbsp;David S. Goldfarb","doi":"10.1002/bco2.70038","DOIUrl":"10.1002/bco2.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To review the different analgesic modalities and benefits of non-opioid pain management options as well as their evidence-based, established superiority, compared to opioid medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials</h3>\u0000 \u0000 <p>We review the updated literature about pain management of renal colic, a prevalent and painful urologic condition. Prescribers must know the efficacy, safety and possible ramifications of analgesic selections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Commonly prescribed medications in the United States (US) include non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and opioids. In the context of the current epidemic of death from overdoses of opioids in the US, the frequency of opioid prescribing for renal colic is likely excessive, problematic and potentially remediable. We also present analgesic modalities revolving around interventions with peri-procedural pain management for ureteroscopy and percutaneous nephrolithotomy. After touching on the implications of misguided opioid use, especially in the context of kidney stone disease, and despite the evidence and consensus guidelines supporting NSAIDs in renal colic, current evidence has shown that many clinicians continue to prescribe opioids as first-line treatment. Finally, we highlight current efforts targeted at the reduction of opioid use and prescription in the setting of provider education and decision aids in curbing misguided opioid use in renal colic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While the evidence against treating kidney stones with opioids is clear, more work is needed to shift current practices to reflect that renal colic is a non-opioid-requiring condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256033","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":"Real-world oncological and toxicity outcomes with the Moscow strain of intravesical BCG for non-muscle invasive bladder cancer—Implications for global shortage","authors":"Amandeep Arora,&nbsp;Sugam Godse,&nbsp;Mahendra Pal,&nbsp;Ankit Misra,&nbsp;Ravi Teja Sepuri,&nbsp;Naveen Thimiri Mallikarjun,&nbsp;Ajit Gujela,&nbsp;Sachin Patel,&nbsp;Anuj Sharma,&nbsp;Santosh Menon,&nbsp;Ganesh Bakshi,&nbsp;Gagan Prakash","doi":"10.1002/bco2.70034","DOIUrl":"10.1002/bco2.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to determine the oncological effectiveness and adverse-effect profile of the Moscow strain of intravesical bacille Calmette–Guérin (BCG) for intermediate and high-risk non-muscle invasive bladder cancer (NMIBC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>We performed a retrospective search of consecutive intermediate and high-risk non-muscle invasive bladder cancer patients who were started on intravesical BCG at 80 mg dose from January 2020 to December 2021. Data were collected for oncological outcomes and adverse effects of BCG. High-grade recurrence-free survival (HGRFS) was defined as any relapse of high-grade (HG) urothelial cancer or carcinoma in situ (CIS). The primary outcome was to determine the HGRFS for those with originally HG disease. The RFS and HGRFS were calculated for the entire cohort, and also stratified by whether the patients had received adequate BCG or not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 166 patients during the study period, of which 79.6% had HG disease. There were 25 recurrences (15.1%) in the entire cohort over a median follow-up of 29 months. The RFS for the entire cohort at 12 and 24 months was 89.8% and 86.7%, respectively. For those with baseline HG disease, the 12- and 24-month HG-RFS was 90.9% and 87.1%. For the overall cohort, those who had received adequate BCG (<i>n</i> = 130, 78.3%) had a 12- and 24-month RFS of 96.9% and 95.4%, which was significantly higher than those who were not able to receive adequate BCG (<i>n</i> = 31, 18.6%) (12- and 24-month RFS of 74.2% and 64.5%), <i>p</i> &lt; 0.001. Around 10% patients dropped out at each sequential maintenance phase, either because of BCG intolerance or because of failure to comply with the BCG instillation schedule. Severe side effects led to BCG discontinuation in 38.5% patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Moscow strain BCG at 80 mg dose has excellent oncological outcomes, especially in patients who can take adequate BCG instillations, but BCG intolerance is a problem in a significant proportion of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244718","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":"Low-carbohydrate diet score and risk of bladder cancer: Findings from a prospective cohort study","authors":"Yen Thi-Hai Pham,&nbsp;Renwei Wang,&nbsp;Jian-Min Yuan,&nbsp;Hung N. Luu","doi":"10.1002/bco2.70033","DOIUrl":"10.1002/bco2.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Low carbohydrate diet (LCD), a summary score considering sources of all macronutrients in a dietary pattern, is defined by lower intakes of carbohydrates and higher intakes of proteins and fats. Research on the role of LCD and risk of bladder cancer is scare. We, therefore, prospectively examined the association between LCS scores and bladder cancer risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We used data from the Singapore Chinese Health Study, a prospective cohort study of 63 275 participants aged 45–74 living in Singapore who were recruited during 1993–1998 period. LCD scores were derived from the semi-quantitative food frequency questionnaire at baseline. Bladder cancer cases were identified through record linkage with the Singapore cancer registry. Cox proportional hazard regression method was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for bladder cancer in relation with LCD scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 17.6 years of follow-up with 819 573 person-years, 250 participants developed bladder cancer. We found a statistically significant, positive association for bladder cancer risk with increasing level of animal-based LCD (HR_{per-SD increment} = 1.16, 95% CI: 1.02–1.32; <i>P</i>_<i>trend</i> = 0.01), but a null association with an increased level of plant-based LCD (HR_{per-SD increment} = 1.08, 95% CI: 0.91–1.28, <i>P</i>_<i>trend</i> = 0.78).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In summary, we showed that an LCD diet with fat and protein from animal-based food was associated with increased risk while an LCD diet with fat and protein derived mainly from plant-based food was not associated with bladder cancer risk. Our findings have implications for diet modifications in the prevention and control program of bladder cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197517","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":"Incidental crossed fused renal ectopia detected during prostate cancer staging: A photorealistic three-dimensional rendering","authors":"Kei Ushijima,&nbsp;Kosuke Kojo,&nbsp;Tomoyuki Ohta,&nbsp;Keita Okamoto,&nbsp;Daisuke Numahata,&nbsp;Hiromu Inai,&nbsp;Katsunori Uchida,&nbsp;Hideki Takeshita,&nbsp;Hiroyuki Nishiyama,&nbsp;Tatsuya Takayama","doi":"10.1002/bco2.70039","DOIUrl":"10.1002/bco2.70039","url":null,"abstract":"&lt;p&gt;Crossed fused renal ectopia (CFRE), also referred to as crossed fused ectopic kidney, is a congenital malformation in which both kidneys are located unilaterally, and one ureter opens into the ureteral orifice on the contralateral side.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In addition to cases detected in infancy due to multiple congenital anomalies or in adolescence due to delayed menarche associated with concurrent genital malformations, CFRE is often incidentally discovered in adults without significant complications.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; An autopsy series reported an incidence of 1 in 2000–7500 cases, while a large CT study estimated an occurrence rate of approximately 1 in 3078 scans, making CFRE the second most common fusion anomaly after horseshoe kidneys.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;However, the clinical significance of asymptomatic CFRE in older adults is unclear. Notably, only three published cases have reported CFRE in patients undergoing evaluation for prostate cancer.&lt;span&gt;&lt;sup&gt;3-5&lt;/sup&gt;&lt;/span&gt; Herein, we present the fourth case discovered incidentally in a 72-year-old man with no remarkable medical history. He underwent a prostate biopsy to confirm prostate cancer, and a subsequent CT scan for metastatic screening revealed a CFRE. With his written informed consent, we reconstructed a photorealistic three-dimensional (3D) image from the CT data for illustrative purposes.&lt;/p&gt;&lt;p&gt;This imaging study was conducted as a part of an ongoing multi-institutional observational research project aimed at visualising various genitourinary malformations (University of Tsukuba, Institutional Review Board approval number: R05-199). Portal-phase contrast-enhanced CT images (2-mm slice thickness) were acquired for prostate cancer staging. We performed image segmentation and reconstruction using SYNAPSE 3D Version 7.00 (Fujifilm Medical Co., Ltd., Tokyo, Japan), also known as SYNAPSE VINCENT in Japan, following a previously described manual approach.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; We meticulously segmented the renal parenchyma, associated arteries and veins (including bilateral gonadal veins), ureters, bilateral adrenal glands and bones. For final rendering, we employed a technique commonly known as cinematic rendering, provided as ‘Photorealistic Rendering’ in SYNAPSE 3D. Compared with standard volume rendering, cinematic rendering offers enhanced shadow realism and depth perception, producing ‘photo-like’ images that could potentially improve anatomical education for students, enhance communication with patients and help clinicians plan surgical interventions by providing images that more closely resemble the intraoperative view.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Figure 1 presents the final rendering clearly demonstrating the inferior location of the ectopic kidney relative to the orthotopic kidney. Both renal pelves were oriented in the same direction, classically described by McDonald and McClellan as ‘inferior ectopia’, the most common subtype of CFRE.&lt;span&gt;&lt;","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190832","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}