BJUI compass最新文献

{"title":"Guidelines for robotic credentialling in reconstructive and functional urology. Consensus study","authors":"Frances Harley,&nbsp;Rasa Ruseckaite,&nbsp;Eva Fong,&nbsp;Henry Han-I Yao,&nbsp;Hashim Hashim,&nbsp;Helen E. O'Connell","doi":"10.1002/bco2.467","DOIUrl":"10.1002/bco2.467","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to define criteria for robotic reconstructive and functional urology credentialing using expert consensus. A recent narrative review identified a lack of standardised minimal requirements for performing robotic-assisted surgery procedures. The substantial variability or absence of a standardised curriculum and credentialing process within a highly specialised surgical field is often insufficient to guarantee surgeon proficiency and could potentially jeopardise patient safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects and Methods</h3>\u0000 \u0000 <p>Thirty-five international robotic surgery experts in urology and urogynaecology, selected based on surgical and research expertise, were invited to participate as expert panellists. Using a modified Delphi process the experts were asked to indicate their agreement with the proposed list of recommendations that was identified from the literature and review of relevant international credentialing policies in three electronic survey rounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen experts participated in round 1 of online surveys, 9 in round 2 and 13 in round 3. From 50 statements presented to the Delphi panel in round 1, a total of 39 recommendations (32 from round 1, 4 from round 2 and 3 from round 3) with median importance (MI) ≥ 7 and disagreement index (DI) &lt; 1 were proposed for inclusion into the final draft set and were reviewed by the project team. Panellists agreed reconstructive and functional urology required its own specific modular training curriculum as the foundation for robotic training and a surgeon must have appropriate training i.e., fellowship or evidence of speciality training in functional urology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This was the first study to develop preliminary guidelines on credentialing for robotic surgery in reconstructive and functional urology. A Delphi approach was employed to establish comprehensive credentialing criteria for robotic-assisted surgery. The consistent adoption of these criteria across institutions will foster the proficiency of robotic surgeons and has the potential to bring improvements in patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060786","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 learning curve for hood-sparing robotic-assisted radical prostatectomy: A single-surgeon experience","authors":"Keith R. S. Simpson,&nbsp;Jamie Krishnan,&nbsp;Linda Taylor,&nbsp;Alan McNeill,&nbsp;Daniel W. Good","doi":"10.1002/bco2.463","DOIUrl":"10.1002/bco2.463","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to assess the impact of anterior hood-sparing robot-assisted radical prostatectomy (RARP) with posterior-anterior reconstruction in a single-surgeon series by analysing oncological and functional continence outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We carried out a cohort comparison study of a prospectively collected single-surgeon series. The surgeon was an ‘in-training’ fellowship trained surgeon in their first 2 years of independent practice. There were three cohorts identified from electronic and scanned paper operation notes. The first cohort of standard anterior RARP (no hood sparing) included initial patients and any patient in the consecutive series who had completed 3 month FU after RARP. The second cohort was hemi-hood-sparing RARP again within the consecutive database of patients and lastly full-hood-sparing RARP. Early continence was defined by patients reporting being ‘dry’ and with 0 pad or 1 confidence/security pad. Data was collected in an Excel spreadsheet, and SPSS was used to assess distribution with non-parametric data being analysed using a Mann Whitney <i>U</i> test and parametric data with an unpaired <i>t</i>-test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 174 patients from March 2020 to February 2022 who were operated on. Full pathology and 6-week follow-up pad use data was available for all patients. At 12 months, some data for EPIC-26 was not available (lack of response/clinic non-attendance). The results demonstrate doubling in early continence to over 75% at 6-week follow-up with comparable positive margin rates. This difference was statistically significantly better in the dorsal venous complex RARP sparing group in comparison to standard RARP (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anterior hood-sparing RARP with anterior reconstruction is a modification to the standard anterior RARP approach with a short learning curve which provides patients with better early and late continence without compromise to oncological outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061013","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":"Utilization of cardiopulmonary bypass at radical nephrectomy for renal cell carcinoma with tumour thrombus","authors":"Chalairat Suk-Ouichai,&nbsp;Mitchell M. Huang,&nbsp;Clayton Neill,&nbsp;Christopher K. Mehta,&nbsp;Ashley E. Ross,&nbsp;Shilajit D. Kundu,&nbsp;Kent T. Perry Jr,&nbsp;Duc T. Pham,&nbsp;Hiten D. Patel","doi":"10.1002/bco2.460","DOIUrl":"10.1002/bco2.460","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to evaluate preoperative factors associated with cardiopulmonary bypass (CPB) utilization and outcomes for patients with renal cell carcinoma (RCC) and tumour thrombus (TT). Radical nephrectomy with thrombectomy is a standard treatment for patients with RCC and associated TT. Morbidity and mortality rates tend to correlate with aggressiveness of tumour and TT level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients undergoing radical nephrectomy with thrombectomy (2006–2023) were retrospectively identified. Inclusion criteria included RCC histology and preoperative imaging available for thrombus-level categorization based on the Mayo Clinic grading system. Logistic regression assessed predictors for utilizing CPB, and Cox regression identified factors associated with survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 72 patients with RCC and associated TT were identified. The median age was 67 years. RCC-related symptoms were present in 83%, and 28% had Levels 3 and 4 thrombi. Eleven patients (15.3%) had undergone neoadjuvant therapy, and 81% had clear-cell RCC. CPB was utilized in eight (11.1%) cases. The median tumour size was 10.5 cm. Metastatic disease was greater in the CPB cohort (75% vs. 28%, <i>p</i> = 0.008). All cases performed on CPB were Levels 3 and 4 thrombi (100% vs. 19% in the non-CPB group, <i>p</i> &lt; 0.001). CPB cases had significantly longer operative time, and hospital stays and rates of Clavien ≥ 3 complications. On multivariate analysis, metastatic disease was a predictor of CPB utilization. Median survival was 74 and 25 months in the non-CPB and CPB cohorts, respectively (<i>p</i> = 0.01). Pulmonary disease and metastatic disease with CPB utilization were significantly associated with worse survival on multivariate analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Surgical extirpation of kidney tumours with associated TT remains the standard of care among patients with locally advanced RCC. CPB can be utilized to increase the feasibility of resection for high-level thrombi. Preoperative planning and cooperation among surgical teams are key given the perioperative morbidity and mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061070","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":"Prospective per-target analysis of the added value of the PrecisionPoint Transperineal Access System in cognitive prostate biopsy of MRI targets","authors":"Luca Orecchia,&nbsp;Stefano Germani,&nbsp;Gaia Colalillo,&nbsp;Angelica Fasano,&nbsp;Matteo Ricci,&nbsp;Eleonora Rosato,&nbsp;Anastasios D. Asimakopoulos,&nbsp;Simone Albisinni,&nbsp;Enrico Finazzi Agrò,&nbsp;Guglielmo Manenti,&nbsp;Roberto Miano","doi":"10.1002/bco2.462","DOIUrl":"10.1002/bco2.462","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 diagnostic performance of perineal access cannulas tethered to a biplanar ultrasound probe in cognitive transperineal prostate biopsies of targets identified by multiparametric magnetic resonance imaging (mpMRI) by comparing the results of the PrecisionPoint (PP) Transperineal Access System with the double-freehand (DFH) technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>All patients who underwent cognitive transperineal prostate biopsy of mpMRI targets using the PP or DFH technique between November 2020 and September 2023 were enrolled. All data related to mpMRI target biopsies were stratified by technique, visibility in transrectal ultrasound and analysed by comparing PP versus DFH. A standardised anaesthesia protocol with 1% mepivacaine was used in all biopsies. The tolerability of the procedures was assessed using a visual analogue scale (VAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The number of mpMRI targets sampled was 166 in PP and 242 in DFH. In target biopsies, the PP system was associated with better diagnostic performance for clinically significant prostate cancer (Gleason score ≥3 + 4) compared to DFH for both ultrasound-visible targets (61.4% vs. 48.0%) and non-visible targets (41.4% vs. 14.9%) (<i>p</i> = 0.02). A higher rate of positive cores was obtained from targets sampled with PP (57.7% vs. 49.6%, <i>p</i> = 0.0002). The PP system was associated with the retrieval of significantly longer cores (<i>p</i> &lt; 0.0001). There was no significant difference between the techniques regarding pain reported during the biopsy, with a median VAS of 2.7/10, although the PP device required a lower amount of anaesthetic in the periprostatic planes (4.3 ± 2.0 mL vs. 5.9 ± 1.9 mL, <i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The PrecisionPoint Transperineal Access System enabled more precise and higher quality biopsies, resulting in improved histological characterisation of prostate cancer compared to the DFH approach. The use of a perineal cannula did not increase the pain perceived by patients and also required less local anaesthetic during the biopsy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 12","pages":"1288-1298"},"PeriodicalIF":1.6,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916405","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":"Efficacy of direct visual internal urethrotomy versus balloon dilation to treat recurrent urethral stricture following failed urethroplasty","authors":"David Gilbert,&nbsp;Anastasia Christ,&nbsp;Kyle Barclay,&nbsp;Shubham Gupta,&nbsp;Kirtishri Mishra","doi":"10.1002/bco2.458","DOIUrl":"10.1002/bco2.458","url":null,"abstract":"&lt;p&gt;Historically, direct visual internal urethrotomy (DVIU) and balloon dilation (BD) have been preferred as first line interventions for certain urethral strictures. Urethroplasty is considered the gold standard following failed primary intervention; however, no recommendations exist for intervention following a failed urethroplasty.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Thus far, DVIU and BD have been shown to display comparable outcomes as primary treatments in terms of freedom from recurrent stricture, time to recurrence, and complications.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In this research letter, we provide evidence that in the case of secondary interventions following failed urethroplasty, BD shows significantly improved 3-year outcomes compared to DVIU.&lt;/p&gt;&lt;p&gt;Urethral strictures are fairly common with a prevalence of 229–627 per 100 000 males.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; They typically impact men over the age of 65 and increase the risk for UTIs and incontinence. While some studies have compared the success of DVIU versus BD as primary interventions, reported success rates are highly variable with 32%–96% for DVIU and 35%–84% for BD.&lt;span&gt;&lt;sup&gt;2, 4, 5&lt;/sup&gt;&lt;/span&gt; Conversely, urethroplasty has a high reported success rate of 96%, though is a more complicated procedure requiring longer recovery and a skilled surgeon.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Due to the low frequency of recurrence following urethroplasty, recommendations for subsequent reoperations with DVIU or BD have not been adequately studied. Given the prevalence of urethral strictures and increasing use of urethroplasty, it is important to study the success of subsequent DVIU and BD. We performed a retrospective review using TriNetX (TriNetX, Inc., Cambridge, MA, USA), a clinical research platform that collects and stores over 125 million patients' electronic health record data, to determine whether urethroplasty patients with subsequent DVIU or BD had a higher chance of recurrent stricture. We are unaware of another study that directly compares success rates of DVIU versus BD as secondary interventions following urethroplasty.&lt;/p&gt;&lt;p&gt;Cohorts were constructed for both DVIU following urethroplasty and BD following urethroplasty. Patient ages ranged from 21 to 90, and exclusion criteria included benign prostatic hyperplasia, neurogenic bladder and bladder neck contracture. Specific inclusion and exclusion criteria can be found in Appendix S1. Given the small sample sizes, cohorts were not matched for comorbidities. Outcomes were defined as ≥1 instance of urethral stricture or stenosis, or retention of urine between 1 month and 3 years after DVIU or BD. Outcomes were assessed with Kaplan–Meier, hazard ratios (HR) and log-rank tests to determine significance (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), and a Kaplan–Meier curve was generated.&lt;/p&gt;&lt;p&gt;DVIU (&lt;i&gt;N&lt;/i&gt; = 45) had a significantly higher probability (&lt;i&gt;p&lt;/i&gt; = 0.0353) of recurrent urethral stricture compared to BD (&lt;i&gt;N&lt;/i&gt; = 25), with respective 3-year incidence probabilit","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061617","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":"Impact of race and ethnicity on clinical outcomes and recurrence post-ureteral reconstruction","authors":"Dhruv Puri,&nbsp;Eric Cho,&nbsp;Kian Ahmadieh,&nbsp;Nishant Garg,&nbsp;Cesar Delgado,&nbsp;Benjamin Cedars,&nbsp;Michael Witthaus,&nbsp;Michael Pan,&nbsp;Jill C. Buckley","doi":"10.1002/bco2.450","DOIUrl":"10.1002/bco2.450","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ureteral stricture disease (UTSD) poses significant challenges in reconstructive urology, with recent advances highlighting disparities in healthcare outcomes based on race and ethnicity. This study investigates the impact of race and ethnicity on clinical outcomes following ureteral reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-centre prospective analysis of 233 patients who underwent ureteral reconstruction for UTSD from 2014 to 2023. Patient demographics, clinical characteristics, surgical details and outcomes were collected. Patients were stratified by race (White vs. non-White) and ethnicity (Hispanic vs. non-Hispanic). Statistical analyses included Kruskal–Wallis, Mann–Whitney <i>U</i> tests, ANOVA, Kaplan–Meier analysis and multivariate logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our cohort included 233 patients who underwent ureteroplasty with 108 (46.4%) non-White patients, and 71 (30.5%) were Hispanic. No significant differences were found in recurrence rates, complications, or stricture-free survival between racial and ethnic groups. Prior reconstructions were more prevalent among non-White patients (26.9% vs. 16.0%; <i>p</i> = 0.043). Unadjusted and adjusted regressions showed significant associations between non-White race (unadjusted <i>β</i> = 0.76, <i>p</i> = 0.008; adjusted <i>β</i> = 0.82, <i>p</i> = 0.008) and Hispanic ethnicity (unadjusted <i>β</i> = 0.70, <i>p</i> = 0.025; adjusted <i>β</i> = 0.79, <i>p</i> = 0.020) with increased stricture lengths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights that although recurrence and complication rates do not significantly differ by race or ethnicity, disparities exist in clinical presentations, with non-White and Hispanic patients presenting with longer stricture lengths and higher body mass index. These findings underscore the need for targeted interventions to address underlying disparities in healthcare delivery and access.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 12","pages":"1255-1262"},"PeriodicalIF":1.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916375","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":"Trends in incidence and demographics of testicular cancer in California, 2000–2020","authors":"David J. Benjamin,&nbsp;Anshu Shrestha,&nbsp;Dimitra Fellman,&nbsp;Arash Rezazadeh Kalebasty","doi":"10.1002/bco2.451","DOIUrl":"10.1002/bco2.451","url":null,"abstract":"&lt;p&gt;The incidence of testicular cancer has been rising globally among young adult men for the past five decades for reasons not currently well-understood.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Although a rare genitourinary malignancy that is generally curable, testicular cancer remains a significant public health concern due to long-term medical, psychological and social burden associated with treatment and its short- and long-term toxicities.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Risk factors leading to the development of testicular cancer include age, family or personal history of testicular cancer, cryptorchidism, race/ethnicity and recreational drug use such as marijuana.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;White males have historically had the highest incidence rates of testicular cancer, while Black males have the lowest incidence rates. However, data from 2001 to 2016 extracted from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) programme demonstrated that the incidence of testicular cancer was rising throughout the United States and Asian/Pacific Islander men had the largest increases in incidence followed by Hispanic men.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Given that California is the most populous state in the United States and one of the most racially/ethnically diverse populations, we sought to evaluate trends in demographics including race/ethnicity from updated population data up to the year 2020.&lt;/p&gt;&lt;p&gt;Males diagnosed with testicular cancer between 2000 and 2020 were identified through the California Cancer Registry (CCR) database, one of the largest cancer registries in the United States. Cases were excluded if the age at the time of diagnosis was unknown. Incidence rates per 100 000, stratified by year of diagnosis, race/ethnicity and age were calculated, and age-adjusted to the 2000 US Standard Population. This study involved analysis of de-identified data from the state-mandated cancer registry database and as such, does not require patient informed consent. Therefore, the study was exempt from Institutional Review Board (IRB) approval.&lt;/p&gt;&lt;p&gt;We identified a total of 23 214 cases of testicular cancer during the study period. Most men (71.5%, &lt;i&gt;n&lt;/i&gt; = 16 599) were below age 40 at the time of diagnosis. The majority of men were non-Hispanic white (52.5%, &lt;i&gt;n&lt;/i&gt; = 12 191), followed by Hispanic (37.6%, &lt;i&gt;n&lt;/i&gt; = 8720), Asian/Pacific Islander (5.0%, &lt;i&gt;n&lt;/i&gt; = 1170) and non-Hispanic Black (1.8%, &lt;i&gt;n&lt;/i&gt; = 422). Testicular cancer diagnoses were equally distributed between neighbourhood socio-economic status (nSES) groups (highest quintile (20.3%), upper-middle (21.3%), middle (21.0%), lower-middle (20.2%) and lowest (17.3%)). Additional demographic information including marital status and Charlson comorbidity index are available in Table S1.&lt;/p&gt;&lt;p&gt;Testicular cancer incidence rate rose among all racial/ethnic groups in California between 2000 and 2020. The rates rose at a faster pace among Hispanic and Asian/Pacific Islander men durin","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 12","pages":"1249-1251"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the prognostic utility of GSTP1 promoter methylation in prostate cancer","authors":"Ruth Pidsley,&nbsp;Dilys Lam,&nbsp;Wenjia Qu,&nbsp;Phillip Stricker,&nbsp;James G. Kench,&nbsp;Lisa G. Horvath,&nbsp;Susan J. Clark","doi":"10.1002/bco2.445","DOIUrl":"10.1002/bco2.445","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to determine the prognostic significance of <i>glutathione S-transferase Pi 1</i> DNA methylation (<i>mGSTP1</i>) in two independent prostate cancer cohorts with long-term clinical follow-up data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/Patients and Methods</h3>\u0000 \u0000 <p>We first re-examined a published, in-house whole genome bisulphite sequencing (WGBS) prostate cancer dataset, derived from radical prostatectomy (RP) tissue (<i>n</i> = 15) with median follow-up 19.5 years, to confirm and visualise the association between <i>mGSTP1</i> and patient mortality. To validate prognostic significance, we used a quantitative methylation-specific head-loop (MS-HL) assay to measure <i>mGSTP1</i> levels in a larger, independent cohort (<i>n</i> = 186), and performed univariable and multivariable Cox survival analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Re-analysis of WGBS data showed a significant increase in <i>mGSTP1</i> in RP samples from patients with lethal versus non-lethal disease. Subsequent analysis in the larger cohort using the MS-HL assay confirmed that <i>mGSTP1</i> was detectable in 97% of RP samples, validating the diagnostic potential of <i>mGSTP1</i>. Univariable Cox survival analysis revealed a significant association between <i>mGSTP1</i> levels and biochemical recurrence and metastatic relapse free survival, with a near-significant association with prostate cancer specific mortality. Notably, multivariable Cox models demonstrated that <i>mGSTP1</i> did not add independent prognostic value beyond standard clinicopathological features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study supports the importance of DNA methylation as a tissue-based prostate tumour biomarker. <i>GSTP1</i> methylation is well established as a diagnostic marker, and in this study, we find that <i>GSTP1</i> methylation levels are also associated with disease prognosis. Further research is required into the clinical utility of prognostic methylation markers and their functional role in disease progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 12","pages":"1299-1306"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916378","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":"Comparing outcomes of Aquablation versus holmium laser enucleation of prostate in the treatment of benign prostatic hyperplasia: A network meta-analysis","authors":"Ansh Bhatia,&nbsp;Renil Titus,&nbsp;Joao G. Porto,&nbsp;Rajvi Goradia,&nbsp;Khushi Shah,&nbsp;Diana Lopategui,&nbsp;Thomas R. W. Herrmann,&nbsp;Hemendra N. Shah","doi":"10.1002/bco2.454","DOIUrl":"10.1002/bco2.454","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;Water Jet Ablation Therapy (WJAT) and Holmium Laser Enucleation of the Prostate (HoLEP) represent two common surgical treatments for Benign Prostatic Hyperplasia (BPH). Despite their increasing use, there is no study between these two methods. We aim to evaluate their efficacy and safety through a network meta-analysis (NMA), providing critical insights for clinical decision-making in the management of moderate to severe lower urinary tract symptoms (LUTS) due to BPH.&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;Pubmed, EMBASE and Cochrane Library were searched. Randomized controlled trials and prospective single-arm studies comparing WJAT and HoLEP with TURP, reporting symptom scores, flow rates and adverse events. Data extraction and quality assessments were independently performed. Bayesian modelling in RStudio was used for statistical analysis, evaluating continuous outcomes through mean difference and categorical variables via risk ratios. Risk-of-Bias (RoB) and GRADE assessments were performed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Twenty-three studies were included (WJAT-11, HoLEP-12). Most studies were at some or high risk of bias. At 12 months, the IPSS, Qol, PVR and Qmax improvements were 4.14 points (95% CI: -0.34 to 8.64, not-significant [NS], GRADE-rating: Low), 0.32-points (95% CI:-10.70 to 3.27, NS, GRADE-rating: Low), 2.45 ml/s (95% CI: -1.85 to 7.05, NS, GRADE-rating: Low), 63.10 ml (95% CI: 39.80 to 87.30, statistically-significant [SS], GRADE-rating: Moderate), respectively, all in favour of HoLEP. Haemoglobin-loss was lower with HoLEP, 1.16 g/dl (95% CI: -2.56 to 0.54 mg/dl, NS, GRADE-rating: Moderate) than WJAT. The risk of incontinence was higher with HoLEP; 4.48 (95% CI: 0.22 to 168.50, NS, GRADE-rating: Very Low) than WJAT in single–arm analysis. The risk of blood transfusion was higher with WJAT (RR = 0.14; 95% CI: 0.00 to 4.21, NS, GRADE-rating: Low) than HoLEP. Risk of Total Serious Adverse Events (Clavien-Dindo grade&gt;3) was higher with HoLEP (RR = 1.12, higher with HoLEP, 95% CI: 0.20 to 12.71, NS, GRADE-rating: Low) than WJAT. Retreatment was lower with HoLEP (RR = 0.46, 95% CI: 0.02 to 10.54 GRADE-rating: Low) than WJAT.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Interpretation&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our study suggests that both HoLEP and WJAT are effective treatments for BPH, both with similar IPSS and QoL improvements. HoLEP excels in functional outcomes, particularly in improving Qmax and PVR. Conversely, WJAT, with its shorter operation time and hospital stays, presents a compelling alter","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 12","pages":"1231-1245"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916396","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":"Targeted microwave ablation of localised prostate cancer: Initial results of VIOLETTE trial","authors":"Nicolas Barry Delongchamps,&nbsp;Alexandre Peltier,&nbsp;Eric Potiron,&nbsp;Franck Bladou,&nbsp;Julien Anract,&nbsp;Romain Diamand,&nbsp;Grégoire Robert,&nbsp;Aurel Messas,&nbsp;Roland Van Velthoven","doi":"10.1002/bco2.444","DOIUrl":"10.1002/bco2.444","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to assess the precision and safety of targeted microwave ablation (TMA) using organ-based tracking (OBT) fusion, in patients with intermediate risk prostate cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and method</h3>\u0000 \u0000 <p>We conducted a prospective, multicentric trial. Eligible patients had a prostate-specific antigen (PSA) &lt; 20 ng/mL, a magnetic resonance imaging (MRI)-visible index tumour of Gleason score 3 + 4, with largest axis ≤15 mm and distant of at least 5 mm from the rectum and apex. TMA was performed with microwave needle applicator using OBT fusion, with a transperineal or a transrectal approach. In this interim analysis, we evaluated precision, safety, urinary and sexual outcomes, and PSA density kinetics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At this point, 37 patients were treated in five centres. Median (interquartile range) age is 68 (63–72) years. Baseline median prostate volume and PSA are of 45 (34–57) mL and 8 (6.2–10.8) ng/mL, respectively. Median largest tumour axis on T2W MRI is of 11 mm (10–13). Patients were treated under general anaesthesia or conscious IV sedation in an outpatient setting. Anaesthesia had a median duration of 78 (66–90) min. A median number of 3 (2–4) 12-W ablations of 2 to 5 min were performed per patient. After a median follow-up of 6 (2.4–10) months, we observed 58 adverse events (AE) in 22 patients. These were of Common Terminology Criteria for Adverse Events (CTCAE) grade 1, 2 and 3 in 43 (74%), 13 (22%) and 2 (4%) cases. Six (15%) patients had an acute urinary retention, five of which considered as severe AE because of rehospitalisation. We did not observe any significant difference in International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire-ejaculatory dysfunction (MSHQ-EjD) and International Index of Erectile Function (IIEF5) from baseline to last follow-up. Median PSA density evolved from 0.2 (0.1–0.3) at baseline to 0.1 (0.07–0.16) at 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These preliminary results suggest that TMA using OBT fusion is precise and safe in patients with intermediate risk localised prostate cancer. Further inclusions and follow-up are needed to assess oncological outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 12","pages":"1307-1313"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916413","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}