BJUI compass最新文献

{"title":"Impact of body mass index on outcomes after radical cystectomy: A retrospective Australian cohort study","authors":"Samiha Arulshankar,&nbsp;Xinyi Wei,&nbsp;Charis Ting,&nbsp;Tran Ngoc An Huynh,&nbsp;Yashvrdhan Khanna,&nbsp;Kylie Lim,&nbsp;Munad Khan,&nbsp;James Huang,&nbsp;Nieroshan Rajarubendra,&nbsp;Kevin Chu,&nbsp;Matthew Harper,&nbsp;Scott Donnellan,&nbsp;Weranja Ranasinghe","doi":"10.1002/bco2.70238","DOIUrl":"10.1002/bco2.70238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to assess the association between body mass index and perioperative outcomes and survival after radical cystectomy for bladder cancer in an Australian cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/patients and methods</h3>\u0000 \u0000 <p>We conducted a retrospective single-centre study of patients undergoing radical cystectomy between 2008 and 2021. Preoperative body mass index (BMI) was analysed categorically and continuously. Outcomes included overall survival (OS), Clavien–Dindo grade ≥2 complications and length of hospital stay. Survival was analysed using Kaplan–Meier methods and multivariable Cox regression adjusting for age, sex, tumour stage, nodal status and chemotherapy. Restricted cubic splines were used to explore non-linear associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort comprised 135 patients (median age 70 years; median BMI 27.2 kg/m²). Overweight patients had superior OS compared with normal-weight and obese patients (adjusted hazard ratio [HR] 0.42, 95% CI 0.24–0.76). Obesity was associated with higher complication rates and longer hospital stay (<i>p</i> &lt; 0.05). BMI analysed as a continuous variable was not independently associated with OS. Spline modelling demonstrated no significant non-linear association, although the lowest estimated risk occurred in the overweight range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overweight BMI was associated with improved survival following radical cystectomy, while obesity was linked to greater perioperative morbidity. These findings are consistent with the obesity paradox and underscore the limitations of BMI alone for perioperative risk stratification.</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/PMC13342837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414087","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":"External validation of the preoperative risk evaluation for partial nephrectomy (PREP) score","authors":"Jacob O'Hara,&nbsp;Kennedy Okhawere,&nbsp;Nicolas A. Soputro,&nbsp;Jewel Bamby,&nbsp;Laurence Hou,&nbsp;Ruben Sauer Calvo,&nbsp;Reza Mehrazin,&nbsp;Ronney Abaza,&nbsp;Simone Crivellaro,&nbsp;Srinivas Vourganti,&nbsp;Ithaar Derweesh,&nbsp;Riccardo Autorino,&nbsp;Craig Rogers,&nbsp;Nitin Yerram,&nbsp;Jihad Kaouk,&nbsp;Mutahar Ahmed,&nbsp;Ketan Badani,&nbsp;Michael Stifelman","doi":"10.1002/bco2.70239","DOIUrl":"10.1002/bco2.70239","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aims to externally validate the preoperative risk evaluation for partial nephrectomy (PREP) score, recently introduced to predict the risk of major complications after partial nephrectomy based on patient characteristics, in a large multi-institutional cohort of robot-assisted partial nephrectomy (RAPN) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective review was performed on the IRB-approved, multi-institutional United States Kidney Cancer Data Network (US-KIDNET) to identify 10 154 patients who underwent RAPN from 2018 to 2025. Major complications were defined as Clavien–Dindo grade III–V within 30 days. Patients were assigned to risk categories for major complications based on weighted comorbidities, as defined by the PREP score, and the alignment of predicted complication rates with actual complication rates was evaluated. Discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). Calibration was examined using the Hosmer–Lemeshow (HL) goodness-of-fit test. Subgroup analysis was performed by robotic platform and surgical approach. Exploratory univariate and multivariate logistic regression were performed to evaluate associations between individual PREP components and major complication rates. All computations were performed in Python (v3.8).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 8615 patients who underwent RAPN were included in the final validation cohort. The PREP score did not perform well in this robotic surgery cohort, with limited overall discrimination (AUC 0.547; 95% CI 0.518–0.580). On calibration, the model's predicted probabilities were not well-aligned with observed outcomes (HL χ² = 150.2; <i>p</i> &lt; 0.001). Performance did not differ significantly across robotic platform or surgical approach subgroups. In the adjusted analysis, coronary artery disease (CAD, aOR 2.22), chronic obstructive pulmonary disease (COPD, aOR 2.75), chronic kidney disease (CKD, aOR 1.48), and obesity (aOR 1.73) were independently associated with major complications, but not congestive heart failure (CHF; aOR 0.50, <i>p</i> = 0.36).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our real-world external validation for the PREP score demonstrates that this score does not perform well in a large, multicentre, robotic cohort. Our findings suggest that coefficient re-estimation, rather than simple recalibration, may be required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407100","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":"Recognition to repair: Managing reservoir complications in inflatable penile prosthesis surgery","authors":"Sarah Michael,&nbsp;Peter Grice,&nbsp;Adam Oumeziane,&nbsp;Michael George,&nbsp;David Riding,&nbsp;Deena Harji,&nbsp;Theodora Stasinou,&nbsp;Ian Pearce,&nbsp;Vaibhav Modgil","doi":"10.1002/bco2.70246","DOIUrl":"10.1002/bco2.70246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Reservoir placement during three-piece inflatable penile prosthesis (IPP) implantation is the step most commonly associated with serious intraoperative complications. The reservoir is traditionally positioned within the space of Retzius, where it lies in close proximity to the bladder, bowel and major pelvic vessels. Although injuries are uncommon, damage to these structures can result in significant morbidity, particularly in patients with prior pelvic surgery, radiotherapy or distorted pelvic anatomy. As prosthetic surgery expands to more complex patient populations, surgeons must be prepared to recognise and manage these complications when they occur.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This review focuses on the intraoperative injuries associated with reservoir insertion during IPP surgery and provides a practical framework for their recognition and management. Bladder, bowel and vascular injuries are discussed with emphasis on intraoperative warning signs, methods of confirmation and immediate management strategies. Key principles of repair, haemorrhage control and involvement of specialist surgical teams are outlined. Guidance is also provided on intraoperative decision-making, including when reservoir relocation, staged implantation or procedure abandonment may be appropriate to minimise the risk of prosthesis infection and other complications. Alternative reservoir placement techniques are briefly discussed in the context of risk reduction, particularly for patients with hostile pelvic anatomy. However, the primary aim of this review is to provide pragmatic guidance for surgeons confronted with intraoperative complications during reservoir insertion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early recognition, prompt management and a structured approach to intraoperative decision-making are essential to minimise morbidity and preserve the favourable functional outcomes associated with IPP surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407088","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 prostatic urethral lift (PUL) versus water vapour thermal therapy (WVTT): A focus on drug-free status and unplanned admissions","authors":"Athena Y. H. Lee,&nbsp;Brian W. H. Siu,&nbsp;Kelly H. Y. Tsang,&nbsp;Chi Ho Leung,&nbsp;Jeremy M. H. Ho,&nbsp;Yvonne Y. Y. Chan,&nbsp;Jeremy Y. C. Teoh,&nbsp;Peter K. F. Chiu,&nbsp;Ka Lun Lo,&nbsp;Chi Fai Ng","doi":"10.1002/bco2.70242","DOIUrl":"https://doi.org/10.1002/bco2.70242","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare prostatic urethral lift (PUL) and water vapour thermal therapy (WVTT) for benign prostatic hyperplasia (BPH) in a real-world setting, this study compares clinical management outcomes that are less thoroughly documented in current literature—such as drug-free status, complications and post-procedure readmission rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>BPH patients (age ≥50) with prostate volumes 30–80 cc who underwent either PUL or WVTT between January 2021 and December 2024 were identified. Patients were given BPH medications (alpha-blockers and/or 5-alpha reductase inhibitors) till 3 months postoperatively. The two groups were matched using a 1:3 propensity score matching; multivariable logistic regression analyses were performed on the full unmatched cohort. The primary outcome is drug-free status, defined as the cessation of alpha-blockers and 5-alpha reductase inhibitors at 6 months post-procedure. Secondary outcomes include unplanned readmission within 30 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 421 eligible patients were analysed (363 WVTT; 58 PUL). In propensity score matched analyses (174 WVTT; 58 PUL), patients were more likely to be drug-free after PUL at 6 months compared to WVTT (weighted OR: 2.62 [95% CI: 1.22–5.61], <i>p</i> = 0.013). The association remained significant in multivariable regression analysis (adjusted OR: 2.41 [95% CI: 1.31–4.58], <i>p</i> = 0.006). No statistically significant difference in 30-day readmission rates was found between the two groups in either the propensity score (<i>p</i> = 0.097) or multivariable analysis (<i>p</i> = 0.123).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this retrospective propensity-score-matched study, PUL was associated with less BPH medication use at 6 months; readmission rates were comparable for PUL and WVTT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381092","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":"Chronic idiopathic urinary retention and Fowler's syndrome in women: A multidisciplinary framework for assessment and nonsurgical management","authors":"Sarah McRae,&nbsp;Caoimhe McLoughlin,&nbsp;Carolyn Davie,&nbsp;Claire Hentzen,&nbsp;Dani Coombe,&nbsp;Claire Todd,&nbsp;Clare Nicholson,&nbsp;Beatrice Garcin,&nbsp;Glenn Nielsen,&nbsp;Helen Simpson,&nbsp;Laura McWhirter,&nbsp;Helen Jinadu,&nbsp;Jalesh Panicker,&nbsp;Anne Sanderson,&nbsp;Alan Carson,&nbsp;Martine Cornillet,&nbsp;Miriam Gamble,&nbsp;Voula Granitsiosis,&nbsp;Sioned Hancock,&nbsp;Collete Haslam,&nbsp;Leila Heelas,&nbsp;Victoria Hulman,&nbsp;Emily Jay,&nbsp;Mahreen Pakzad,&nbsp;Caroline Selai,&nbsp;Natalia Vasquez,&nbsp;Louise Young,&nbsp;Jon Stone,&nbsp;Ingrid Hoeritzauer","doi":"10.1002/bco2.70240","DOIUrl":"10.1002/bco2.70240","url":null,"abstract":"<p>Chronic idiopathic urinary retention and Fowler's syndrome are a debilitating problem primarily affecting women, characterised by an inability to urinate in the absence of any identifiable structural or other cause. An increasingly wide range of multifactorial predisposing, precipitating, and perpetuating biopsychosocial factors are being recognised. This has led to interest in nonsurgical treatments that may complement existing surgical approaches. We reviewed existing literature on nonsurgical management and combined this information with collective multidisciplinary professional and lived experience, to produce a new definition of chronic idiopathic urinary retention (the Fife Definition) and a framework for the assessment and nonsurgical treatment for women with chronic idiopathic urinary retention. The article provides a stepped care approach to nonsurgical treatment including explanation and formulation, basic bladder healthcare, optimising catheterisation, management of relevant comorbidities, multidisciplinary treatment and additional treatment options and emerging therapies.</p>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13325401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378323","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":"External validation of the European association of urology biochemical recurrence risk groups to predict mortality after radical prostatectomy or radiation therapy in a North American cohort","authors":"Carlo Silvani,&nbsp;Alfonso Santangelo,&nbsp;Alex Stephens,&nbsp;Jack Considine,&nbsp;Shane Tinsley,&nbsp;Bassel Salka,&nbsp;Akshay Sood,&nbsp;Sebastiano Nazzani,&nbsp;Alberto Briganti,&nbsp;Andrea Salonia,&nbsp;Francesco Montorsi,&nbsp;Nicola Nicolai,&nbsp;Emanuele Montanari,&nbsp;Craig Rogers,&nbsp;Firas Abdollah","doi":"10.1002/bco2.70241","DOIUrl":"10.1002/bco2.70241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to externally validate the European Association of Urology (EAU) biochemical recurrence (BCR) risk stratification in a North American population after radical prostatectomy (RP) and radiation therapy (RT), where validation remains lacking despite prior European and Asian validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>We identified all patients with BCR after RP or RT between 1995 and 2023 from a North American institutional database and classified them by EAU criteria. Primary outcome was prostate cancer-specific mortality (CSM). We calculated Harrell's concordance indices (C-index) and used competing-risk regression to assess associations between EAU risk groups and CSM, comparing performance to multivariable models including age, clinical stage, Gleason grade, PSA doubling time and time to BCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 940 patients (646 RP, 294 RT; 40.5% African American), 563 (59.9%) had low-risk and 377 (40.1%) high-risk BCR. The 10-year cumulative incidence of CSM was 3.6% versus 12% for low-risk versus high-risk RP patients and 18.4% versus 49.5% for low-risk versus high-risk RT patients. EAU high-risk BCR was associated with increased CSM in both groups (RP: HR 2.83, 95% CI 1.47–5.46; RT: HR 3.98, 95% CI 2.43–6.53). The EAU classification showed moderate discrimination (Harrell's C-index 0.62 for RP, 0.69 for RT). Multivariable models including clinical variables demonstrated a Harrell's C-index of 0.76 for both RP and RT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This first North American validation confirms moderate EAU discriminative ability. For RP patients, low 10-year CSM in low-risk BCR (3.6%) supports surveillance. However, low-risk RT BCR showed substantial CSM (18.4%), exceeding high-risk RP (12%), suggesting current criteria inadequately stratify risk after RT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364261","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":"Retroperitoneal lymph-node dissection for isolated nodal recurrence of renal cell carcinoma after nephrectomy: Contemporary outcomes of a case series","authors":"Alberto Costa Silva,&nbsp;Noel Clarke,&nbsp;Aziz Gulamhusein","doi":"10.1002/bco2.70190","DOIUrl":"10.1002/bco2.70190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and objective</h3>\u0000 \u0000 <p>Isolated retroperitoneal lymph-node (RPLN) recurrence after radical nephrectomy (RN) for renal cell carcinoma (RCC) is uncommon, and optimal management remains undefined. This study reports contemporary outcomes of retroperitoneal lymph-node dissection (RPLND) for isolated nodal recurrence, including in patients previously treated with stereotactic ablative body radiotherapy (SABR) or systemic therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was performed of all patients undergoing RPLND for isolated nodal recurrence of RCC between July 2023 and October 2024. Clinical, operative, and pathologic variables were collected, and postoperative complications were graded using the Clavien–Dindo system. Recurrence-free survival (RFS) was calculated from RPLND to recurrence or last follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight patients met inclusion criteria. Median age at RPLND was 59.5 years, and six were male. The median interval from RN to RPLND was 29 months. Median operative time was 255 min, estimated blood loss 300 mL, and hospital stay 6.5 days. One patient experienced postoperative complication (Clavien–Dindo IIIa). All specimens confirmed malignancy with negative margins. After a median follow-up of 18 months, three patients (37.5%) recurred, with a mean RFS of 15.3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RPLND is a safe and viable option for isolated nodal recurrence of RCC, offering complete resection and oncologic outcomes comparable to historical data, and may serve as an important component of multimodal management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355057","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":"When disease travels downstream: The effect of intravesical recurrences in patients treated for upper tract urothelial carcinoma","authors":"Orlane J. A. Figaroa,&nbsp;Sanne J. Jonker,&nbsp;Felix J. Fris,&nbsp;Guido M. Kamphuis,&nbsp;Adriaan D. Bins,&nbsp;R. Jeroen A. van Moorselaar,&nbsp;Joyce Baard","doi":"10.1002/bco2.70225","DOIUrl":"10.1002/bco2.70225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment of upper tract urothelial carcinoma (UTUC) depends on risk stratification and tumour characteristics. Kidney-sparing surgery (KSS) is preferred for low-risk disease, whereas radical nephroureterectomy (RNU) is the standard for high-risk UTUC. Intravesical recurrences (IVR) are common after both treatment modalities, but their impact on survival remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the IVR rate and cumulative hazard following UTUC treatment and oncological outcomes based on the presence of IVR during follow-up. Second, the relation between UTUC and IVR tumour grade in patients treated with endoscopic KSS (eKSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-centre study, including non-metastatic UTUC patients treated between 2010 and 2023. Analysis was performed in a cohort of patients without a history of bladder cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total 164 patients were selected; 85 treated with eKSS, 79 by RNU. Overall, 91 patients (55%) developed an IVR, 53 (62%) after eKSS and 38 (48%) after RNU, during a median follow-up of 33 months (IQR 11–72). eKSS-treated patients showed a significantly higher cumulative hazard for IVR (HR 0.6, 95% CI 0.42–0.95, <i>p</i> = 0.02). The CSS and MFS were comparable between patients with or without IVR during follow-up. In patients treated by eKSS, we found IVR upgrading in 24% of patients treated with eKSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients treated by eKSS showed a higher cumulative hazard of IVR, without an impact on oncological outcomes. These findings support the use of kidney-sparing approaches in well-selected cases and highlight the need for proper follow-up including the bladder and evaluate IVR preventive measures as intravesical instillations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354980","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":"State of the nation: Understanding the current NHS treatment pathway to identify opportunities to advance future care of patients with high-risk non-muscle invasive bladder cancer in the UK (SPAN-UK)","authors":"Jonathan Aning,&nbsp;James W. F. Catto,&nbsp;Rebecca Martin,&nbsp;Kathryn Chatterton,&nbsp;Paramananthan Mariappan,&nbsp;Edward Ottley,&nbsp;Joseph Hickey,&nbsp;Stephen McCormack,&nbsp;Simran Gill,&nbsp;Bernadett Szabados","doi":"10.1002/bco2.70236","DOIUrl":"10.1002/bco2.70236","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to understand clinical pathways for patients with high-risk non-muscle-invasive bladder cancer (HR-NMIBC) from diagnosis to follow-up and to identify opportunities to improve care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A cross-sectional survey was conducted via structured online interviews with consented NHS healthcare professionals (HCPs) from the United Kingdom (UK) between June and September 2025. Topics surveyed included MDT structures/roles, diagnostic timelines, adjuvant treatment, radical cystectomy (RC) decision making, current bladder-sparing treatment and clinical trial access. Quantitative data were analysed descriptively. Qualitative responses were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy HCPs were included and reported that typically; 88.5% of patients achieve diagnosis within 6–8 weeks of referral, and 11.4% reported delays beyond 8 weeks. BCG maintenance duration and completion rates varied. Following BCG induction, a median (IQR) of 20.0% (5.0–32.5%) and 60.0% (40.0–70.0%) of patients completed ≥2 or ≤1 years of maintenance, respectively; 1.0% (1.0–2.0%) failed to complete induction. For BCG-unresponsive HR-NMIBC, HCPs reported that a mean (<i>SD</i>) proportion of 53.4 (18.1)% of patients tend to be eligible for and consent to RC, 22.0 (12.6)% tend to be eligible but decline RC and 24.6 (14.9)% tend to be ineligible. Bladder-sparing options remain limited, with 60% of HCPs regarding further BCG as the most appropriate option. All respondents agreed that adherence to quality performance indicators (QPIs) and a national bladder cancer audit would be beneficial. Insufficient specialist nurse capacity to meet foreseeable demands of HR-NMIBC patient care was reported by 70% (<i>n</i> = 49) of HCPs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Results reveal variability in real-world HR-NMIBC care within the NHS. Delays in diagnosis, inconsistent BCG maintenance duration, lack of evidence-based alternatives to BCG and a lack of bladder-sparing treatment and trial options in the BCG-unresponsive setting were identified. Findings highlight unmet needs in relation to MDT resourcing, diagnostic efficiency, trial access, QPI adherence and a national bladder cancer audit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355007","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 penile prosthesis infections in the contemporary antimicrobial era: Incidence and predictive factors from a regional cohort","authors":"Imaad Amanulla,&nbsp;Mohamed Mubarak,&nbsp;John Hayes,&nbsp;Michael Rafeh,&nbsp;Ethan Clifford,&nbsp;Jon Barclay,&nbsp;Trevor Dorkin,&nbsp;Anthony Emmanuel","doi":"10.1002/bco2.70235","DOIUrl":"https://doi.org/10.1002/bco2.70235","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the incidence and predictive factors of early penile prosthesis (PP) infection within a contemporary regional cohort in the North of England.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>A retrospective review of all PP implantations was conducted at a tertiary urology and andrology centre between 2018 and 2025, with variables including age, BMI, smoking, relevant comorbidities, pre-operative HbA1C, immunosuppressant use and device-related variables. Data were analysed using SPSS v29, with univariate logistic regression performed to identify factors of early infection (≤30 days). A <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>A total of 103 patients underwent PP implantations. Mean age at implant was 59.4 ± 9.9 years. The comorbidity burden of diabetes, hypertension and dyslipidaemia was 35.0%, 49.5% and 39.8%, respectively, with mean pre-operative HbA1C at 45.6 mmol/mol. Notably, 9.7% of patients were on chronic immunosuppressive therapy. Early prosthetic infection was identified in six patients (5.8%). On univariate analysis, there was a strong association between immunosuppressant use and infection (50.0% vs 7.2%, <i>p</i> = 0.02; OR 12.0, 95% CI 1.7–85.0). The variables of age, BMI, diabetes, hypertension, dyslipidaemia, HbA1C and implant type were not associated with infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this contemporary regional study, early PP infection was identified in 5.8% of the cohort, with chronic immunosuppressant use being the dominant predictor of infection. Other metabolic, clinical and implant factors were not predictive of infection. This demonstrates immunosuppression being a persistent biological vulnerability requiring risk stratification and targeted perioperative strategies. Larger, prospective multicentre studies are required to further validate its impact and inform evidence-based infection-prevention protocols.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148325019","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}