BJUI compass最新文献

{"title":"Intravesical gemcitabine and docetaxel vs. re-induction Bacillus Calmette Guerin as first-line salvage therapy for non-muscle invasive bladder cancer","authors":"Kylie Yen-Yi Lim,&nbsp;Tran Ngoc An Huynh,&nbsp;Gavin Wei,&nbsp;Jincy Kuriakose,&nbsp;Obaidullah Fazli,&nbsp;David Pook,&nbsp;Sarah Ransley,&nbsp;Janice Downie,&nbsp;Scott Donnellan,&nbsp;Weranja Ranasinghe","doi":"10.1002/bco2.70012","DOIUrl":"10.1002/bco2.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the outcomes between re-induction Bacillus Calmette-Guérin (BCG) and sequential intravesical gemcitabine-docetaxel (Gem/Doce) therapy in patients with high-grade (HG) non-muscle invasive bladder cancer (NMIBC) following failure of initial induction BCG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>We retrospectively identified patients who received induction BCG therapy between 2017 and 2023. Inclusion criteria were high-grade NMIBC recurrence post-BCG induction, with subsequent treatment by either re-induction BCG or Gem/Doce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 2017 to 2023, 140 patients received induction BCG, with 30 (21.4%) showing persistent HG NMIBC. Of these, five (16.7%) were treated with re-induction BCG and 11 (36.7%) with Gem/Doce. In the re-induction BCG group, four patients (80%) had HGTa and one (20%) had HGT1. In the Gem/Doce group, eight patients (73%) had HGTa, two (18%) had HGT1 and one (9%) had carcinoma in situ (CIS). Initial post-treatment cystoscopy showed recurrence in one re-induction BCG patient (20%) with HGT1 and CIS and in two Gem/Doce patients (18%) with HGTa. No adverse events were reported with Gem/Doce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our initial experience with intravesical Gem/Doce suggests that it is better tolerated, with fewer adverse events and comparable recurrence rates at three months, compared to re-induction BCG in patients with BCG-failure NMIBC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762214","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 significant costs of prostate cancer management—An analysis from a Caribbean hospital","authors":"Geneva Pantoja,&nbsp;Amanda Wibben,&nbsp;Visham Bhagaloo,&nbsp;Sara Seetaram,&nbsp;Satyendra Persaud","doi":"10.1002/bco2.70003","DOIUrl":"10.1002/bco2.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this paper is to analyse the annual costs associated with the diagnosis and treatment of prostate cancer at San Fernando General Hospital, a large, public hospital in Trinidad.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A prospective cost-of-illness study analysed 1 month of all prostate cancer-related events at San Fernando General Hospital. These included inpatient admissions, outpatient visits and surgical procedures. All resources utilized during these visits were logged, itemized and assigned a cost via the Costing Unit of San Fernando General Hospital (SFGH). The annual cost was extrapolated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred eight outpatient visits and eight acute presentations were recorded for the month in addition to scheduled surgical presentations. An estimated 2496 outpatient visits and 96 acute admissions occurred annually. The mean age of presenting patients was 69 years old, with the majority (61%) of patients of African ethnicity. The overall estimated cost to the Regional Health Authority was TTD $14052157.66 (USD $2066493). Outpatient visits related to screening, diagnosis or management of prostate cancer, including prostate biopsies, comprised the majority of the costs (57%), while nephrostomies related to upper urinary tract obstruction from prostate cancer contributed least (0.7%). The total cost of metastatic disease was disproportionate to its presentation, with 17% of cases being metastatic but contributing 32% toward overall cost. Of cases with a documented chief complaint, visits related to cancer diagnostics, presentations with symptoms of prostate cancer and biopsies contributed to two thirds of the total cost, while follow-up visits for previously diagnosed prostate cancer contributed to one third.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This analysis shows that prostate cancer has a significant financial burden on the Trinidadian economy. Efforts must be dedicated to early screening and prevention, and policymakers should be aware of the economic impact of the disease when making budgetary allocations. Although diagnostics can be costly, it likely minimizes larger costs associated with extensive treatment and acute hospitalizations related to metastatic disease, as seen in this study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762113","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":"Feasibility study of using the PREDICT kidney tool for patients with localised renal cell carcinoma","authors":"Panayiotis Laouris,&nbsp;Chiara Re,&nbsp;Georgia Stimpson,&nbsp;Axel Bex,&nbsp;James Blackmur,&nbsp;Alexander Laird,&nbsp;Carley Batley,&nbsp;Grant D. Stewart,&nbsp;Hannah Harrison,&nbsp;Juliet A. Usher-Smith","doi":"10.1002/bco2.70014","DOIUrl":"10.1002/bco2.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Localised renal cell carcinoma (RCC) is usually treated surgically, with post-operative imaging-based surveillance to monitor for recurrence. However, surveillance practices vary widely, and patients often lack a clear understanding of their risk of recurrence and follow-up care. The PREDICT Kidney tool has been developed to enhance risk communication by providing individualised recurrence and mortality risk estimates. The tool uses the Leibovich score augmented with English national data to provide a personalised risk assessment of cancer recurrence and death from other causes, presented in both numerical and visual formats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>A multicentre, prospective feasibility study of incorporating the PREDICT Kidney risk communication tool into the first follow-up consultation for localised RCC patients post-surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Endpoints</h3>\u0000 \u0000 <p>Patient uptake into the study, completeness of data collection, consultation duration, the acceptability of the tool to both patients and clinicians, clinician adherence to the study “best-practice” guide, variability in tool usage across clinicians and sites and patient-level clinical outcomes including subjective and objective comprehension of risk of recurrence and follow-up, perceived risk of cancer recurrence, risk conviction, satisfaction with the information provided on risk of recurrence and follow-up, and fear of cancer recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We aim to recruit 60 patients from three hospitals in England and Scotland. Patients treated with surgery for primary localised clear-cell RCC awaiting their first follow-up appointment will be invited to take part. Participants will be allocated into two groups: standard care and standard care supplemented with the use of the PREDICT Kidney tool. Data will be collected through questionnaires, audio/video recordings of consultations and interviews with a subset of patients and clinicians. The study period is planned from September 2024 to July 2025. The findings will guide the design of a future randomised controlled trial to evaluate the tool's efficacy in clinical settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741344","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":"Risk factors for readmission after ureteroscopy for stone disease: Modern single centre experience","authors":"Shuhei Hirano,&nbsp;Margaret A. Knoedler,&nbsp;Shuang Li,&nbsp;Emily C. Serrell,&nbsp;Ali S. Antar,&nbsp;Stephen Y. Nakada","doi":"10.1002/bco2.70007","DOIUrl":"10.1002/bco2.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify factors that increase a patient's risk of readmission in the immediate postoperative period following ureteroscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An IRB-approved surgical database of patients with renal and ureteral stones at a single institution was retrospectively analysed for patients who underwent ureteroscopies and had 30 days follow-up from September 2016 to June 2019. We reviewed the most recent 600 cases (300 consecutive women and 300 consecutive men). Patient characteristics including gender, body mass index (BMI) and comorbidities (hypertension, gout, diabetes mellitus (DM), recurrent urinary tract infections (UTIs), chronic kidney disease (CKD), bowel disease), history of preoperative ED visit and surgical factors (preoperative stent, stone size) were used to conduct univariate and multivariable logistic regression analysis. Outcome measures included readmission within 30 days postoperatively. Exclusion criteria included age &lt;18 and &lt;30 days follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 600 patients, 40 (6.7%) visited the ED and 16 (2.7%) were admitted within 30 days postoperatively. None of the patient characteristics or surgical factors we examined were associated with ED visits postoperatively (all p &gt; 0.05). Patients were more likely to have a postoperative admission if they were older (age 68 ± 15 vs 56 ± 15, p &lt; 0.002; OR 1.06; 95% CI 1.01–1.10, p = 0.01) or had a history of recurrent UTIs (OR 7.40, 95%CI 1.78–30.67, p = 0.006). No other factors correlated with postoperative admissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older age and history of recurrent UTIs increased patients' risks of readmission within 30 days of ureteroscopy. This finding is particularly important when hospital beds are at a premium. Older patients and patients with recurrent UTIs should be targeted for preoperative interventions to prevent readmission.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689480","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":"Quality of English- and Spanish-language online content about prostate cancer genetics: Insights into potential contributors to prostate cancer disparities","authors":"Sophia M. Abusamra,&nbsp;Verónica Ochoa Cholán,&nbsp;Veda N. Giri,&nbsp;Susan T. Vadaparampil,&nbsp;Verónica Pérez-Rosas,&nbsp;Adrian Rivera,&nbsp;Tatiana Sanchez Nolasco,&nbsp;Mariana Rangel Camacho,&nbsp;Nataliya Byrne,&nbsp;Stacy Loeb","doi":"10.1002/bco2.70011","DOIUrl":"10.1002/bco2.70011","url":null,"abstract":"&lt;p&gt;Genetic testing is increasingly important for prostate cancer (PCa) care and the risk of hereditary cancer for patients and families.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; However, it is currently underutilized, notably among racial and ethnic minorities. In particular, prior studies have shown lower uptake of genetic evaluation among Hispanic patients with prostate cancer in the U.S. as well as those who are non-English preferring, compared to those who are non-Hispanic White and English-preferring.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Health communications are important to raise knowledge and awareness about health issues and to increase demand for health services.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The majority of U.S. adults go online for health information, and rates of social media use are particularly high among Hispanic adults.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Our objective was to examine the extent and quality of online information about prostate cancer genetic testing and &lt;i&gt;BRCA&lt;/i&gt; in English and Spanish. We hypothesized that there is less high-quality online content about PCa genetics in Spanish than in English, as a potential contributor to the observed disparities in genetic evaluation.&lt;/p&gt;&lt;p&gt;We created a dataset with the first 25 websites listed on Google and the first 25 videos on YouTube (the most widely used social media platform&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;) with two different search terms (prostate cancer AND &lt;i&gt;BRCA&lt;/i&gt;, prostate cancer AND genetic testing) in English and Spanish. These searches were selected based on an examination of Google trends data related to PCa genetics. We examined the first 25 websites and 25 videos using each of the two queries above, for a total of 50 websites in English, 50 websites in Spanish, 50 YouTube videos in English and 50 YouTube videos in Spanish. Videos were excluded if they were not in the correct language (English or Spanish), were not consumer health information (e.g., course for doctors) or &gt;30 minutes in duration. Three investigators with clinical and/or research expertise in PCa independently examined the remaining relevant content from each platform using the validated DISCERN framework for the quality of consumer health information,&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; which has been extensively used to evaluate websites and YouTube videos in English and Spanish.&lt;span&gt;&lt;sup&gt;7, 8&lt;/sup&gt;&lt;/span&gt; We also examined understandability and actionability using the validated AHRQ Patient Education Materials Assessment Tool (PEMAT).&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;We used descriptive statistics to tally the total number of relevant consumer videos using each search string, as well as their quality, understandability and actionability. Chi-square and Mann–Whitney U tests were used to compare the proportion of relevant content and DISCERN and PEMAT scores, between Spanish and English content. We also created a composite measure for relevant videos that met quality criteria (DISCERN score of 4 or 5 out of 5, and both PEMAT scores &gt;75% ","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689479","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":"Renal parenchymal volume analysis: Clinical and research applications","authors":"Carlos Munoz-Lopez,&nbsp;Kieran Lewis,&nbsp;Nityam Rathi,&nbsp;Eran Maina,&nbsp;Akira Kazama,&nbsp;Anne Wong,&nbsp;Angelica Bartholomew,&nbsp;Worapat Attawettayanon,&nbsp;Yunlin Ye,&nbsp;Zhiling Zhang,&nbsp;Wen Dong,&nbsp;Rebecca A. Campbell,&nbsp;Nicholas Heller,&nbsp;Erick Remer,&nbsp;Christopher Weight,&nbsp;Steven C. Campbell","doi":"10.1002/bco2.70013","DOIUrl":"10.1002/bco2.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>In most patients, the renal parenchymal volumes in each kidney directly correlate with function and can be used as a proxy to determine split renal function (SRF). This simple principle forms the basis for parenchymal volume analysis (PVA) with semiautomated software, which can be leveraged to predict SRF and new-baseline glomerular filtration rate (NBGFR) following nephrectomy. PVA was originally used to evaluate renal transplantation donors and has replaced nuclear renal scans (NRS) in this domain. PVA has subsequently been explored for the management of patients with kidney cancer for whom difficult decisions about radical versus partial nephrectomy can be influenced by accurate prediction of NBGFR. Our objective is to present a comprehensive review of the applications of PVA in urology including their clinical and research implications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Key articles utilizing renal PVA to improve clinical care and facilitate urologic research were reviewed with special emphasis on take-home points of clinical relevance and their contributions to progress in the field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There have been considerable advances in renal PVA over the past 15 years, which is now established as a reference standard for the prediction of functional outcomes after renal surgery. PVA provides improved accuracy when compared to NRS-based estimates or non-SRF-based algorithms. PVA can be performed in minutes using routine preoperative cross-sectional imaging and can be readily applied at the point of care. Additionally, PVA has important research applications, enabling the precise study of the determinants of functional recovery after partial nephrectomy, which can affect surgical approaches to this procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite the wide availability of PVA, primarily for use in renal transplantation, it has not been widely implemented for other urologic purposes at most centres. Our hope is that this narrative review will increase PVA utilization in urology and facilitate further progress in the field.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665550","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":"Genomic prostate score and treatment selection in favourable intermediate-risk prostate cancer","authors":"Eric Margolis,&nbsp;Benjamin H. Lowentritt,&nbsp;Christopher M. Pieczonka,&nbsp;John P. Bennett,&nbsp;Marina Pavlova,&nbsp;Joao Paulo Zambon,&nbsp;Jack Groskopf,&nbsp;Edward Uchio","doi":"10.1002/bco2.494","DOIUrl":"10.1002/bco2.494","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the factors associated with the use of active surveillance (AS) in NCCN favourable intermediate-risk (FIR) prostate cancer (PCa) patients who received the 17-gene Genomic Prostate Score (GPS) assay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Contemporary data were collected from academic and large community group practices across the United States. Eligible patients had localized PCa classified as FIR per NCCN guidelines and received a GPS report between May 2017 and April 2019. Higher GPS results (scale: 0–100) were associated with a higher risk of adverse outcomes. The proportion of patients selecting AS was calculated with 95% confidence intervals. Uni-and multivariable logistic regression analyses were performed to determine the association between AS selection and relevant covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 324 eligible patients (Gleason Score 3 + 4, 79%; PSA 10–20 ng/ml, 19%; clinical stage T2b-T2c, 2%; median percent positive cores, 16.7%; median GPS result, 26). The distribution of GPS results was 0–19 (23%), 20–40 (60%), and 41–100 (16%). Overall, 31% (95% CI 26%, 36%) selected AS: 58% (46%, 69%) with GPS 0–19, 27% (21%, 33%) with GPS 20–40, and 6% (1%, 16%) with GPS 41–100. In univariable models, the Gleason score, percent positive cores, PSA, and GPS results were significantly associated with AS selection. In a multivariable model, the percent positive cores and the GPS result remained significantly associated with AS selection. AS persistence was 91% (82%, 95%) at 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The GPS result and percent positive cores appear associated with AS use after controlling for relevant clinical variables in NCCN FIR prostate cancer patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639137","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 impact of biopsy core length on the discrepancy in Gleason scores between biopsy and radical prostatectomy specimen","authors":"Cheng-hao Guo,&nbsp;Yin-shuai Geng,&nbsp;Liang-yong Zhu,&nbsp;Xue-fei Ding,&nbsp;Yang Luan","doi":"10.1002/bco2.70009","DOIUrl":"10.1002/bco2.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the impact of the biopsy core length on the discrepancy in Gleason score between biopsy and radical prostatectomy specimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Retrospective analysis of clinical data from 247 patients who underwent transperineal prostate biopsy and radical prostatectomy of prostate cancer at our centre from 2022 to 2023. The clinical data included age, pre-biopsy prostate-specific antigen (PSA) levels, prostate volume, number of biopsy needles, number of positive biopsy needles, biopsy core length, biopsy Gleason score and post-radical prostatectomy Gleason score. Statistics were analysed by SPSS26.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>On histopathological examination, no changes in the Gleason score were observed in 127 (51.4%) patients, whereas the Gleason score was upgraded in 101 (40.9%) patients and downgraded in 19 (7.7%) patients at radical prostatectomy. Average biopsy core length for Gleason score upgraded on radical prostatectomy (44.3 %, n = 101) was 11.11 ± 1.34 mm compared to 11.88 ± 1.03 mm(p &lt; 0.01)for Gleason score consistent(55.7 %, n = 127). The multivariate logistic regression analysis revealed a significant association between the biopsy core length (P &lt; 0.01, OR = 0.556, 95%CI: 0.429–-0.722) and prostate volume (P &lt; 0.05, OR = 0.982, 95%CI: 0.429–-0.722), with both factors being significantly correlated with radical prostatectomy Gleason score increase. Furthermore, these variables were identified as independent predictors of radical prostatectomy Gleason score increase and exhibited a negative correlation. The biopsy core length was evaluated using a receiver operating characteristic (ROC) curve, with a cutoff value of 11.4 mm for the accurate diagnosis of prostate cancer (AUC: 0.702, sensitivity: 75.6%, specificity 51.2%, P &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The concordance between biopsy and radical prostatectomy may be improved with a longer biopsy core length. To enhance the consistency of Gleason scores between biopsy and radical specimens, it is recommended that the biopsy core length be at least 11.4 mm. Patients with a smaller prostate volume are at a higher risk of experiencing discordant pathological grades between biopsy and radical prostatectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554271","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":"Preoperative pelvic floor muscle diameter as a predictor of postoperative urinary incontinence in robotic-assisted laparoscopic total prostatectomy","authors":"Sho Hashimoto,&nbsp;Daisuke Obinata,&nbsp;Hideaki Uchida,&nbsp;Shigeyuki Arakawa,&nbsp;Yuki Inagaki,&nbsp;Ken Nakahara,&nbsp;Tsuyoshi Yoshizawa,&nbsp;Junichi Mochida,&nbsp;Kenya Yamaguchi,&nbsp;Satoru Takahashi","doi":"10.1002/bco2.70001","DOIUrl":"10.1002/bco2.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the impact of preoperative pelvic floor muscle thickness on the early recovery of urinary continence following robot-assisted radical prostatectomy (RARP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted on 114 patients who underwent RARP at our institution between January 2019 and March 2021. Patients included were either confirmed to be pad-free or using only safety pads postoperatively or those with persistent incontinence, with a follow-up period of at least 6 months. Patient characteristics, perioperative outcomes, and pelvic floor muscle diameters were analysed. Preoperative magnetic resonance imaging or computed tomography was used to measure the diameters of the pelvic floor muscles, including the obturator internus and pubococcygeus muscles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median patient age was 68 years (interquartile ranges [IQR]: 64–72 years), with a median Prostate-Specific Antigen (PSA) of 7.8 ng/ml (IQR: 5.4–10.6 ng/ml). The median prostate volume was 26.6 ml (IQR: 23–35 ml) in the early recovery group and 29 ml (IQR: 19.5–40 ml) in the delayed recovery group. The median time to continence recovery was 5.0 months (95% confidence interval: 4.2–5.7 months), with an incontinence resolution rate of 85.1%. Significant associations were found between the thicknesses of the obturator internus (p = 0.025) and pubococcygeal muscles (p = 0.004) and early continence recovery. Nerve-sparing procedures were also associated with faster recovery (p = 0.016). Multivariate analysis identified the thickness of both muscles as independent predictors of early continence recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative evaluation of pelvic floor muscle thickness, particularly the obturator internus and pubococcygeal muscles, may help predict early postoperative urinary continence recovery in patients undergoing RARP. Preoperative pelvic floor muscle exercises to strengthen these muscles could improve the postoperative outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533253","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":"Flexible cystoscopy-guided implantation of ProACT: Surgical technique and long-term outcomes","authors":"Dimitri Paillusson,&nbsp;Marie-Liesse De Guerry,&nbsp;Stéphane De Vergie,&nbsp;Marie-Aimée Perrouin-Verbe","doi":"10.1002/bco2.70005","DOIUrl":"10.1002/bco2.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to describe the ProACT implantation using flexible cystoscopic guidance and to report long-term outcomes in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This single-centre retrospective study include all men who underwent ProACT™ for SUI after RP using flexible cystoscopic guidance between 2007 and 2021. The implantation was performed via a perineal approach under general or locoregional anaesthesia. Accurate positioning was ensured using both real-time fluoroscopic and endoscopic guidance (flexible cystoscopy retroflexed toward the bladder neck).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 196 men were included; 18% (<i>n</i> = 36) had previously undergone radiotherapy and 24% (<i>n</i> = 46) had undergone SUI surgery. The median (IQR) follow-up time was 63 (24–108) months. At the last follow-up, 64% of participants still had their balloon in place, and the success and improvement rates were 62% and 17%, respectively. The perioperative complication rate was 5% (mainly bladder injury and acute urinary retention). Forty-two per cent (<i>n</i> = 82) experienced at least one complication, mainly device deflation (28%). Definitive explantation occurred in 36% (<i>n</i> = 71), with secondary implantation of an artificial urinary sphincter in 96% (<i>n</i> = 68).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ProACT® adjustable balloon implantation using flexible cystoscopic guidance appears to be an effective and safe long-term procedure for men with SUI after RP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533252","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}