BJUI compass最新文献

{"title":"Targeted Prostate Health Checks, a novel system to identify men with prostate cancer—A pilot study","authors":"Stephen Langley,&nbsp;Jeremy Goad,&nbsp;Stephanie Bell,&nbsp;Lee Foster,&nbsp;Catherine Hodges,&nbsp;Marc Laniado,&nbsp;Michele Pietrasik,&nbsp;Alison Rooke,&nbsp;Matthew Knight,&nbsp;Edward Bosonnet,&nbsp;Simon Bott","doi":"10.1002/bco2.416","DOIUrl":"https://doi.org/10.1002/bco2.416","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to report the pilot phase of the Targeted Prostate Health Check programme that aims to identify men in the Surrey and Sussex region who have prostate cancer and who failed to be detected during the Covid era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects and methods</h3>\u0000 \u0000 <p>Men aged 50 to 70, or 45 to 70 if Black or with a family history of prostate cancer, were identified from participating general practitioner (GP) records. Short message service (SMS) texts invited men to visit www.talkprostate.co.uk for information on prostate cancer and give consent to prostate-specific antigen (PSA) checks coordinated by a third-party virtual healthcare provider. Elevated age-related PSA levels, or levels below age-related thresholds but at 3 ng/mL or more, triggered referral to a rapid access urology clinic. GPs were informed of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1842 text messages inviting 1549 people, 544 men consented to a PSA check. From 500 phlebotomy appointments, 485 (30% of invited men) took the PSA test of whom 68 (14%) were referred with an elevated PSA. After clinical review with multiparametric magnetic resonance imaging (mp-MRI), 22 patients underwent transperineal biopsies, and prostate cancer was detected in 18 men of whom 17 (95%) had clinically significant cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our Targeted Prostate Cancer Health Check system identifies men at risk without burdening primary care. Awareness on prostate cancer risk was raised in 1549 invited men, half of whom were further educated via the registration website. One third of invited men were checked in whom clinically significant prostate cancer was found in 3.5%.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 10","pages":"969-975"},"PeriodicalIF":1.6,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443475","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":"Bleeding us dry: The financial impact of full blood examinations in the immediate postoperative period","authors":"Bodie Chislett,&nbsp;Sachin Perera,&nbsp;Marlon Perera,&nbsp;Damien Bolton,&nbsp;Joseph Ischia,&nbsp;Nathan Lawrentschuk","doi":"10.1002/bco2.368","DOIUrl":"https://doi.org/10.1002/bco2.368","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction and objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Full blood examinations, often referred to as FBE, are commonly ordered postoperatively, despite limited utility in many of its markers in the acute phase. It is estimated that in the 2022–2023 financial year, the Australian healthcare system billed over $13 million for full blood examinations (FBEs) to Medicare. This study aims to assess the cost of using FBE following surgery. We explore potential cost savings by using a haemoglobin examination (HE) in replace of FBE, with both tests run on identical machines, producing the same result, but at a fraction of the cost.&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;A retrospective analysis was conducted at a single institution, including all patients who underwent minimally invasive laparoscopic pelvic surgeries between 1/7/2017 and 30/6/2019. Patient records were examined to identify patient demographics, postoperative pathology tests and interventions. Patients who received FBE in the first 24 h following surgery were identified and included in the study. Using national surgery and admission statistics, a potential cost-saving analysis will be performed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among 519 men who underwent robotic-assisted pelvic surgery, 325 patients had routine postoperative investigations, with 323 receiving FBE and 2 receiving HE. Abnormal results were found in the majority of patients that underwent FBE. Eight patients received packed red blood cell transfusion, none of these meeting the hospital-specific criteria for transfusion protocol. Twelve patients received antibiotics, none were in response to abnormal FBE, with all patients experiencing a fever, given prophylactically or in the days following the surgery. FBE and HE are both listed on the Medicare Benefits Scheme at $16.95 and $7.85, respectively, the difference being $9.10. Extrapolating the existing data, within the first 24 h following surgery, the estimated savings were $8818, with savings increasing accumulatively with longer observation intervals following surgery. When similar savings are applied to national figures, the potential savings to the Australian Public Healthcare system likely exceeds millions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our study revealed that over half of the patients who underwent a RARP received FBE within the first 24 h postoperatively, the vast majority of which exhibited abnormal results that were not acted upon. These findings substantiate the limited utility of FBE in the postoperative setting. Cell markers o","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"851-854"},"PeriodicalIF":1.6,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320781","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":"Analysis of urinary volatile organic compounds for prostate cancer diagnosis: A systematic review","authors":"Jonathon Dawson,&nbsp;Kraig Green,&nbsp;Henry Lazarowicz,&nbsp;Phil Cornford,&nbsp;Chris Probert","doi":"10.1002/bco2.423","DOIUrl":"https://doi.org/10.1002/bco2.423","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Prostate-specific antigen is non-specific for prostate cancer. This is improved by multiparametric MRI but a significant amount of indolent prostate cancer is detected by the current MRI pathway and data is emerging that clinically significant cancers maybe missed using a standard PSA threshold. Volatile organic compound (VOC) analysis may offer novel biomarkers for prostate cancer and clinically significant disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To perform a systematic review of the literature to evaluate the current evidence for the use of VOCs as novel biomarkers for prostate cancer and clinically significant prostate cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evidence Acquisition</h3>\u0000 \u0000 <p>A systematic search of MEDLINE, Scopus, Web of Science and the Cochrane Library was undertaken by two independent reviewers and papers were assessed for inclusion in the review. Study characteristics, sensitivity and specificity of GC–MS or eNose were extracted. Risk of bias and applicability issues were determined using QUADAS 2 and the quality of reporting using the STARD checklist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evidence Synthesis</h3>\u0000 \u0000 <p>Nineteen studies were included, of which 6 utilised eNose and 13 GC–MS. eNose sensitivity and specificity were 0.71–0.95 and 0.79–0.96, respectively, and GC–MS found a sensitivity and specificity of 0.66–1.00 and 0.53–0.97, respectively. There were concerns about bias in patient recruitment due to differences in the timing of the index test relative to the reference standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review has found promising early results for urinary metabolomics in the detection of prostate cancer. However, there is a need for larger, high-quality studies to validate this. Future work should focus on the detection of clinically significant prostate cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"822-833"},"PeriodicalIF":1.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320714","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":"Utility of dynamic contrast enhancement for clinically significant prostate cancer detection","authors":"Eric V. Li,&nbsp;Sai K. Kumar,&nbsp;Jonathan A. Aguiar,&nbsp;Mohammad R. Siddiqui,&nbsp;Clayton Neill,&nbsp;Zequn Sun,&nbsp;Edward M. Schaeffer,&nbsp;Anugayathri Jawahar,&nbsp;Ashley E. Ross,&nbsp;Hiten D. Patel","doi":"10.1002/bco2.415","DOIUrl":"https://doi.org/10.1002/bco2.415","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the association of dynamic contrast enhancement (DCE) with clinically significant prostate cancer (csPCa, Gleason Grade Group ≥2) and compare biparametric magnetic resonance imaging (bpMRI) and multiparametric MRI (mpMRI) nomograms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/patients and methods</h3>\u0000 \u0000 <p>We identified a retrospective cohort of biopsy naïve patients who underwent pre-biopsy MRI separated by individual MRI series from 2018 to 2022. csPCa detection rates were calculated for patients with peripheral zone (PZ) lesions scored 3–5 on diffusion weighted imaging (DWI) with available DCE (annotated as − or +). bpMRI Prostate Imaging Reporting and Data System (PIRADS) (3 = 3−, 3+; 4 = 4−, 4+; 5 = 5−, 5+) and mpMRI PIRADS (3 = 3−; 4 = 3+, 4−, 4+; 5 = 5−, 5+) approaches were compared in multivariable logistic regression models. Nomograms for detection of csPCa and ≥GG3 PCa incorporating all biopsy naïve patients who underwent prostate MRI were generated based on available serum biomarkers [PHI, % free prostate-specific antigen (PSA), or total PSA] and validated with an independent cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients (<i>n</i> = 1010) with highest PIRADS lesion in PZ were included in initial analysis with 127 (12.6%) classified as PIRADS 3+ (PIRADS 3 on bpMRI but PIRADS 4 on mpMRI). On multivariable analysis, PIRADS 3+ lesions were associated with higher csPCa rates compared to PIRADS 3− (3+ vs. 3−: OR 1.86, <i>p</i> = 0.024), but lower csPCa rates compared to PIRADS DWI 4 lesions (4 vs. 3+: OR 2.39, <i>p</i> &lt; 0.001). csPCa rates were 19% (3−), 31% (3+), 41.5% (4−), 65.9% (4+), 62.5% (5−), and 92.3% (5+). bpMRI nomograms were non-inferior to mpMRI nomograms in the development (<i>n</i> = 1410) and independent validation (<i>n</i> = 353) cohorts. Risk calculators available at: https://rossnm1.shinyapps.io/MynMRIskCalculator/.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While DCE positivity by itself was associated with csPCa among patients with highest PIRADS lesions in the PZ, nomogram comparisons suggest that there is no significant difference in performance of bpMRI and mpMRI. bpMRI may be considered as an alternative to mpMRI for prostate cancer evaluation in many situations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"865-873"},"PeriodicalIF":1.6,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.415","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320629","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":"Long-term oncological outcomes after multimodal treatment for locally advanced prostate cancer","authors":"Fiorella L. Roldan,&nbsp;Ugo Giovanni Falagario,&nbsp;Mats Olsson,&nbsp;Rodolfo Sánchez Salas,&nbsp;Markus Aly,&nbsp;Lars Egevad,&nbsp;Anna Lantz,&nbsp;Henrik Grönberg,&nbsp;Olof Akre,&nbsp;Abolfazl Hosseini,&nbsp;N. Peter Wiklund","doi":"10.1002/bco2.414","DOIUrl":"https://doi.org/10.1002/bco2.414","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study is to evaluate treatment patterns and long-term oncological outcomes of patients with locally advanced prostate cancer (LAPCa).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This is a population-based study including LAPC (cT3-4, M0) patients from the Stockholm region (Sweden). A sub-analysis was performed in men treated with primary cystoprostatectomy or total pelvic exenteration (TPE) for cT4 prostate cancer (PCa).</p>\u0000 \u0000 <p>Cox regression was used to identify predictors of overall mortality (OM) and cancer-specific mortality (CSM). Biochemical progression-free survival (BPFS) and 90 days complications were reported for the radical surgery subgroup.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 2921 patients with cT3(<i>N</i> = 2713) or cT4(<i>N</i> = 208), M0 PCa diagnosed between 2003 and 2019. Out of these, 249(9%), 1497(51%) and 1175(40%) underwent radical prostatectomy, RT + ADT and androgen deprivation therapy (ADT), respectively. Survival rates were 76% (IQR: 68, 83), 47% (IQR: 44, 50) and 23% (IQR: 20, 27), respectively at 10 years. Irrespective of treatment modalities, cT4 patients had worse survival compared to cT3 patients (OM: HR1.44, IQR:1.17,1.77; PCSM: HR1.39, IQR:1.06,1.82). Twenty-seven patients with cT4, N0-1, M0 were treated with cystoprostatectomy or TPE. Twenty-two patients (81.5%) received neoadjuvant ADT. The 5-year BPFS, CSS and OS rates were 39.6%, 68.8% and 63.8%, respectively. Nine patients (33.3%) had Clavien-Dindo grade III and 1 (3.7%) grade IV complication within 90 days after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pelvic surgery with radical intent as part of a multidisciplinary management may be an effective alternative for selected patients with locally advanced PCa leading to local tumour control and an acceptable morbidity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"885-892"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.414","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320628","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":"ChatGPT and generative AI in urology and surgery—A narrative review","authors":"Shane Qin,&nbsp;Bodie Chislett,&nbsp;Joseph Ischia,&nbsp;Weranja Ranasinghe,&nbsp;Daswin de Silva,&nbsp;Jasamine Coles-Black,&nbsp;Dixon Woon,&nbsp;Damien Bolton","doi":"10.1002/bco2.390","DOIUrl":"10.1002/bco2.390","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>ChatGPT (generative pre-trained transformer [GPT]), developed by OpenAI, is a type of generative artificial intelligence (AI) that has been widely utilised since its public release. It orchestrates an advanced conversational intelligence, producing sophisticated responses to questions. ChatGPT has been successfully demonstrated across several applications in healthcare, including patient management, academic research and clinical trials. We aim to evaluate the different ways ChatGPT has been utilised in urology and more broadly in surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a literature search of the PubMed and Embase electronic databases for the purpose of writing a narrative review and identified relevant articles on ChatGPT in surgery from the years 2000 to 2023. A PRISMA flow chart was created to highlight the article selection process. The search terms ‘ChatGPT’ and ‘surgery’ were intentionally kept broad given the nascency of the field. Studies unrelated to these terms were excluded. Duplicates were removed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multiple papers have been published about novel uses of ChatGPT in surgery, ranging from assisting in administrative tasks including answering frequently asked questions, surgical consent, writing operation reports, discharge summaries, grants, journal article drafts, reviewing journal articles and medical education. AI and machine learning has also been extensively researched in surgery with respect to patient diagnosis and predicting outcomes. There are also several limitations with the software including artificial hallucination, bias, out-of-date information and patient confidentiality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The potential of ChatGPT and related generative AI models are vast, heralding the beginning of a new era where AI may eventually become integrated seamlessly into surgical practice. Concerns with this new technology must not be disregarded in the urge to hasten progression, and potential risks impacting patients' interests must be considered. Appropriate regulation and governance of this technology will be key to optimising the benefits and addressing the intricate challenges of healthcare delivery and equity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"813-821"},"PeriodicalIF":1.6,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.390","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802945","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":"Day-case artificial urinary sphincter for post-prostatectomy incontinence: A comparative pilot study","authors":"Konstantinos Kapriniotis,&nbsp;Ioannis Loufopoulos,&nbsp;Richard Nobrega,&nbsp;Anthony Noah,&nbsp;Helena Gresty,&nbsp;Tamsin Greenwell,&nbsp;Jeremy Ockrim","doi":"10.1002/bco2.412","DOIUrl":"10.1002/bco2.412","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Implantation of an artificial urinary sphincter (AUS) to treat post-prostatectomy incontinence (PPI) has been traditionally offered with an overnight hospital stay. The aim of this prospective, comparative pilot study was to assess the feasibility and outcomes of the AUS procedure in a day-case setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>We included consecutive patients having primary or redo AUS surgery over an 18-month period. We excluded patients with previous urethral erosion of AUS, urethroplasty or high anaesthetic risk. All patients were offered day-case surgery. Patients who declined or could not have day-case surgery for logistical reasons had standard care with overnight stay and formed the control group for the study. Primary outcome was the proportion of successful same day-discharges in the day-case group. We also compared baseline characteristics, complications and continence at 1 year post surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve patients consented for day-case procedure, and 13 patients had standard overnight care. Mean age was 69.5 years (range 58–79). Twenty-one patients (84%) had primary AUS, whereas 4 (16%) had a redo procedure. There were no significant differences between the groups in baseline demographics. Median number of pads/24 h was 5 in the day-case group and 4 in the overnight group. Eight of 12 patients (66.7%) in the day-case group were successfully discharged on the same day. Failed discharges were due to anaesthetic recovery (<i>n</i> = 2), high post-void residuals that resolved spontaneously (<i>n</i> = 1) and intraoperative superficial urethral injury (<i>n</i> = 1). All patients in the day-case group and all but one in the standard of care group were socially continent (0–1 pads) at 1 year post procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Day-case catheter-free discharge of AUS patients is feasible and safe in selected patients with comparable continence outcomes and complication rates to those with standard overnight stays.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"845-850"},"PeriodicalIF":1.6,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141803254","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":"Shedding light on night-time erections: Determining the feasibility of nocturnal erection detection with penile transdermal light reflection of haemoglobin","authors":"Evelien J. Trip,&nbsp;Hille J. Torenvlied,&nbsp;Henk W. Elzevier,&nbsp;Rob C. M. Pelger,&nbsp;Jack J. H. Beck","doi":"10.1002/bco2.410","DOIUrl":"10.1002/bco2.410","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Utilizing penile saturation and temperature measurements presents a promising avenue for the development of an innovative sensor system aimed at nocturnal erection detection. This study aims to determine the feasibility of erection detection with light reflection of haemoglobin (LRH), as a precursor for penile saturation measurements, as well as penile temperature by comparison with simultaneous overnight RigiScan measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This is a proof-of-concept observational study on 10 healthy volunteers with a cross sectional design. A penile transdermal haemoglobin and temperature sensor was developed to measure penile LRH through real-time monitoring with receiving photodiodes and emitting light-emitting diode (LED). Besides statistical analysis on LRH, temperature and RigiScan data, a visual assessment was done to determine detectability of changes in the LRH and temperature course during the RigiScan-annotated erections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 40 nocturnal erections from 10 healthy volunteers were annotated with the RigiScan. The LRH values significantly increase during a nocturnal erection (<i>p</i> &lt; 0.01) and penile temperature (<i>p</i> &lt; 0.01). The largest elevation of temperature was seen in the last erection, with an increase of 0.94°C. The corrected temperature shows an increase of 1.29°C in the last erection. Furthermore, visual detectability was feasible for 80% of the erections with LRH values and 90% with the temperature output.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Penile LRH and temperature have the potential to serve as an alternative methodology for nocturnal erection detection compared with the currently applied circumference and rigidity measurements. This is an important step in the development of a patient-friendly and modernized tool for erectile dysfunction diagnostics. An improved sensor should be developed to allow for calculation of saturation percentage from LRH values. In combination with penile temperature measurements, this allows for conduction of further validity studies to work towards translation into clinical practice for non-invasive ED diagnostics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"837-844"},"PeriodicalIF":1.6,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141832616","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":"Influences on androgen deprivation therapy prescribing before surgery in high-risk prostate cancer","authors":"Jennifer Dunsmore,&nbsp;Eilidh Duncan,&nbsp;Sara J. MacLennan,&nbsp;James N'Dow,&nbsp;Philip Cornford,&nbsp;Francesco Esperto,&nbsp;Nicola Pavan,&nbsp;María J. Ribal,&nbsp;Monique J. Roobol,&nbsp;Ted A. Skolarus,&nbsp;Steven MacLennan","doi":"10.1002/bco2.411","DOIUrl":"10.1002/bco2.411","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To understand how best to further reduce the inappropriate use of pre-surgical androgen deprivation therapy (ADT), we investigated the determinants (influences) of ADT prescribing in urologists in two European countries using an established behavioural science approach. Additionally, we sought to understand how resource limitations caused by COVID-19 influenced this practice. Identification of key determinants, of undistributed and disrupted practice, will aid development of future strategies to reduce inappropriate ADT prescribing in current and future resource-limited settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants and Methods</h3>\u0000 \u0000 <p>We conducted semi-structured qualitative interviews with urologists practicing in Italy and the UK from February to July 2022. Interviews focussed on undisrupted (usual) practice and disrupted practice (changes made during COVID-19 restrictions). Codes were generated inductively and were mapped to the 14 domains of the Theoretical Domains Framework. Relevant domains of influence were identified, and the similarities and differences between the UK and Italy were distinguished.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 10 domains that were influential to ADT prescribing in the UK and eight in Italy. The role of guidance and evidence, the cancer care setting, the patients and the urologist's beliefs and experiences were identified as areas that were influential to ADT prescribing before surgery. Twenty-one similarities and 22 differences between the UK and Italy, for usual and COVID-19 practice, were identified across these 10 domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Similarities and differences influencing ADT prescribing prior to surgery should be considered in behavioural strategy development and tailoring to reduce inappropriate ADT use. We gained an understanding of usual, undistributed care and resource-limited or disrupted care due to COVID-19 in two European countries. This gives an indication of how influences on ADT prescribing may change in future resource-limited circumstances and where efforts can be focused now and in future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"874-884"},"PeriodicalIF":1.6,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141650415","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":"Prostate cancer detection after atypical small acinar proliferation (ASAP): A 10-year single-centre cohort","authors":"Thineskrishna Anbarasan,&nbsp;Mutie Raslan,&nbsp;Kanchan Ghosh,&nbsp;Philip Macklin,&nbsp;Claudia Mercader,&nbsp;Tom Leslie,&nbsp;Freddie C. Hamdy,&nbsp;Richard Colling,&nbsp;Lisa Browning,&nbsp;Ian Roberts,&nbsp;Clare Verrill,&nbsp;Richard J. Bryant,&nbsp;Francisco Lopez,&nbsp;Alastair D. Lamb","doi":"10.1002/bco2.407","DOIUrl":"10.1002/bco2.407","url":null,"abstract":"&lt;p&gt;Atypical small acinar proliferation (ASAP), found in 5% of prostate biopsies, represents a focus of atypical cells that fall short of a cancer diagnosis.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; ASAP may be associated with a diagnosis of prostate cancer (PCa) upon repeat biopsy in 25%–50% of patients within 5 years.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The proportion of these cases that may be classified as being intermediate- or high-grade PCa varies in the literature, ranging from 6.0% to 22.5%.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; Until recently, diagnosis of ASAP was an indication for early repeat biopsy in international guidelines. However, recent studies referenced by the European Association of Urology (EAU) guidelines suggest low rates of subsequent Gleason grade group (GG) ≥ 2 PCa, similar to following a previous negative biopsy, leading to a softening of the recommendation for ASAP as an indication for performing early repeat biopsy.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; We therefore aimed to test the hypothesis that prostate cancer diagnosed on early re-biopsy after detection ASAP is always low grade by interrogating a large prospective pathology database. We also aimed to determine the time interval between detection of ASAP and diagnosis of csPCa, if present.&lt;/p&gt;&lt;p&gt;We scrutinised pathology records according to a prospectively derived protocol (ID: CU96T) for all consecutive patients with ASAP on needle biopsy, transurethral resection of the prostate (TURP) chippings, or holmium laser enucleation of the prostate (HoLEP) specimens between January 2010 and November 2021 at a single tertiary institution. We classified pathological upgrading to csPCa as any Gleason pattern 4 disease identified within 2 years of the initial biopsy/TURP/HoLEP specimen detecting ASAP. Where available, we reviewed pre-biopsy multiparametric MRI (mpMRI) reports for PI-RADS scores at the time of ASAP diagnosis and obtained the prostate volume in order to derive the PSA density (PSAD). A multi-variable logistic regression model (including age, PSAD and PI-RADS) was constructed to determine factors associated with the development of csPCa.&lt;/p&gt;&lt;p&gt;Approximately 13 240 prostate samplings were performed (11 240 needle biopsy and 2000 HoLEP/TURP specimens) over the 10-year period. ASAP was identified in 617 (4.7%) biopsy samplings, involving 523 patients. Of these, 51 (9.7%) patients had a pre-existing history of PCa and were excluded from further analysis, leaving a sample size of 472 individuals with de novo ASAP (Table 1). The baseline characteristics of the cohort are summarised in Table 1. Two hundred and thirty-seven (50.2%) patients had a repeat biopsy (Table S1) within a median of 92 days (IQR: 56–283). The median PSA within 3–6 months of ASAP detection was higher amongst patients who underwent repeat biopsy (6.7 vs. 5.08 ng/ml, &lt;i&gt;p&lt;/i&gt; = 0.001) consistent with clinical judgement advocating repeat biopsy. In the 248 of 472 (52.5%) patients with pre-biopsy MRI, logistic regression revealed age &lt;65 years","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"5 9","pages":"834-836"},"PeriodicalIF":1.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661668","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}