BJU International最新文献

{"title":"Impact of three-dimensional prostate models during robot-assisted radical prostatectomy on surgical margins and functional outcomes.","authors":"Nawal Khan,Davide Prezzi,Nicholas Raison,Andrew Shepherd,Michela Antonelli,Nick Byrne,Maia Heath,Christopher Bunton,Carlo Seneci,Eoin Hyde,Andres Diaz-Pinto,Findlay Macaskill,Benjamin Challacombe,Jonathan Noel,Christian Brown,Ata Jaffer,Paul Cathcart,Margherita Ciabattini,Armando Stabile,Alberto Briganti,Giorgio Gandaglia,Francesco Montorsi,Sebastien Ourselin,Prokar Dasgupta,Alejandro Granados","doi":"10.1111/bju.16850","DOIUrl":"https://doi.org/10.1111/bju.16850","url":null,"abstract":"BACKGROUNDRobot-assisted radical prostatectomy (RARP) is the standard surgical procedure for the treatment of prostate cancer. RARP requires a trade-off between performing a wider resection in order to reduce the risk of positive surgical margins (PSMs) and performing minimal resection of the nerve bundles that determine functional outcomes, such as incontinence and potency, which affect patients' quality of life. In order to achieve favourable outcomes, a precise understanding of the three-dimensional (3D) anatomy of the prostate, nerve bundles and tumour lesion is needed.STUDY DESIGNThis is the protocol for a single-centre feasibility study including a prospective two-arm interventional group (a 3D virtual and a 3D printed prostate model), and a prospective control group.ENDPOINTSThe primary endpoint will be PSM status and the secondary endpoint will be functional outcomes, including incontinence and sexual function.PATIENTS AND METHODSThe study will consist of a total of 270 patients: 54 patients will be included in each of the interventional groups (3D virtual, 3D printed models), 54 in the retrospective control group and 108 in the prospective control group. Automated segmentation of prostate gland and lesions will be conducted on multiparametric magnetic resonance imaging (mpMRI) using 'AutoProstate' and 'AutoLesion' deep learning approaches, while manual annotation of the neurovascular bundles, urethra and external sphincter will be conducted on mpMRI by a radiologist. This will result in masks that will be post-processed to generate 3D printed/virtual models. Patients will be allocated to either interventional arm and the surgeon will be given either a 3D printed or a 3D virtual model at the start of the RARP procedure. At the 6-week follow-up, the surgeon will meet with the patient to present PSM status and capture functional outcomes from the patient via questionnaires. We will capture these measures as endpoints for analysis. These questionnaires will be re-administered at 3, 6 and 12 months postoperatively.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"7 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144622010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"August's reviewers of the month","authors":"","doi":"10.1111/bju.16852","DOIUrl":"https://doi.org/10.1111/bju.16852","url":null,"abstract":"<p>Like most journals, BJUI relies on the hard work and dedication of its peer reviewers and we are grateful to them all. Each month the Editorial Team nominates peer reviewers whose reviews have stood out for their quality and timeliness and those selected as the best are highlighted on this page in recognition of their exceptional work.</p><p>Dr Luca Lambertini is an Academic Doctor based at the Careggi University Hospital in Florence (IT) with a clinical and academic interest in Uro-Oncology and Robot Assisted Surgery. He completed his medical degree at Univerity of Bologna (2013–18), followed by the Residency Programme at the Careggi University Hospital in Florence (IT) with research focused on Robot Assisted Radical Cystectomy with Intra Corporeal Neobladder. He attended a Research Fellowship at the University of Illinois in Chicago focused on Single Port surgery and Training programs. He is currently a Clinical Research Training Fellow undertaking his PhD at Careggi Hospital (IT) and UIH (2024+) in the development of a modular training program for Single Port Extraperitoneal Radical Prostatectomy.</p><p>Professor Arkadiusz Miernik, MD, PhD, FEBU, MHBA, is a senior urologist and academic based at the University Medical Center Freiburg, Germany, where he serves as Director of the Division of Urotechnology. He earned his medical degree from the Medical University of Vienna and completed his PhD and urology training in Freiburg. His clinical and scientific focus lies in minimally invasive urological surgery, innovations in endourology, and surgical education.</p><p>In 2015, he received the Maximilian Nitze Prize, the highest scientific award in German urology. Professor Miernik remains committed to advancing both clinical innovation and academic excellence in urology.</p><p>Dr Hari Vigneswaran is a physician–scientist with clinical training in urology and a focus on early cancer detection and translational diagnostics. He earned his medical degree from the Warren Alpert Medical School of Brown University and completed surgical training in urology at the University of Illinois at Chicago. He currently practices urology at Gundersen Health System in Wisconsin and is a clinical fellow at Karolinska University Hospital in Stockholm. He is also in his final year as a PhD candidate at the Department of Medical Epidemiology and Biostatistics (MEB) at Karolinska Institutet, where his research focuses on biomarker-driven strategies for prostate cancer screening and risk stratification. He currently serves as Chief Medical Officer at A3P, where he leads clinical development for precision diagnostic programs, including the implementation of Stockholm3.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"136 2","pages":"175-176"},"PeriodicalIF":3.7,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16852","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longer-term effects of intraoperative cone-beam computed tomography in percutaneous nephrolithotomy: 18-month retrospective randomised controlled trial analysis.","authors":"Chris A Suijker,Riemer A Kingma,Rosanne van Ee,Emelie N Steffens,Emanuela Altobelli,Mieke T J Bus,Igle J de Jong,Stijn Roemeling","doi":"10.1111/bju.16859","DOIUrl":"https://doi.org/10.1111/bju.16859","url":null,"abstract":"OBJECTIVESTo assess the longer-term impact of intraoperative cone-beam computed tomography (CBCT) on stone-related morbidity after percutaneous nephrolithotomy (PCNL), since intraoperative CBCT allows for the detection and removal of residual fragments during the same procedure, improving stone clearance and thereby potentially diminishing stone-related morbidity.PATIENTS AND METHODSThis study was a retrospective analysis of a previously conducted single-centre randomised controlled trial at a tertiary complex endourology centre, in which patients were randomised intraoperatively to PCNL with intraoperative CBCT or conventional PCNL. We analysed 18-month follow-up data to assess differences in stone-related events (SREs), including re-interventions, emergency department visits, and hospital admissions. Stone-free rates and time to stone recurrence, as determined by follow-up CT scans, were also evaluated.RESULTSThe CBCT group (n = 80) had a significantly lower detection rate of new or residual fragments >4 mm (hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.38-0.97), with 29 (36%) cases during 18 months of follow-up compared to 40 (50%) cases in the conventional PCNL group (n = 80). The restricted mean (standard deviation [SD]) time to fragment detection was 420 (44) days in the CBCT group vs 318 (53) days in the conventional PCNL group. In the CBCT group, 15 (19%) cases experienced 26 SREs, compared to 23 (29%) cases with 39 SREs in the conventional PCNL group. The restricted mean (SD) time to SRE was 499 (26) days for CBCT cases, compared to 447 (39) days for conventional PCNL cases. The rate of SREs did not decrease significantly when comparing CBCT-PCNL to conventional PCNL (HR 0.61, 95% CI 0.32-1.17).CONCLUSIONThis study found 10% fewer patients with SREs in the 18-month period after PCNL with intraoperative CBCT compared to conventional PCNL. This difference is likely due to the notable increase in stone-free rates following a single PCNL with intraoperative CBCT.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"52 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sentinel lymph node staging in urological cancer surgery: advances in imaging, intra‐operative detection and translational research","authors":"Erik J. van Gennep, Gijs H. KleinJan, Teele Kuusk, Rick W.A. Verdijk, Esther M.K. Wit, Bas W.G. van Rhijn, Axel Bex, Laura S. Mertens","doi":"10.1111/bju.16848","DOIUrl":"https://doi.org/10.1111/bju.16848","url":null,"abstract":"ObjectivesTo review the clinical utility, outcome and possible future applications of sentinel lymph node biopsy (SLNB) in penile cancer (PeC), bladder cancer (BCa), prostate cancer (PCa), testicular cancer (TCa) and renal cell carcinoma (RCC), focusing in particular on current SLNB standards and exploring advancements in imaging agents, intra‐operative detection, surgical navigation, and the potential application of SLNB in translational and clinical research.MethodsA literature search was conducted in PubMed and EMBASE for studies published between 2000 and 2024, providing a narrative review of SLNB in oncological urology.ResultsIn PeC, SLNB offers a lower adverse event rate compared to inguinal lymph node (LN) dissection, while maintaining high detection rates and acceptable sensitivity (92%–96%) for identifying inguinal LN metastases. Similarly, in PCa, SLNB achieves a sensitivity of 95%, potentially reinforcing its role in nodal staging and guiding personalised treatment strategies. For RCC, BCa and TCa, SLNB is currently under investigation in trials. In RCC, detection rates seem acceptable; however, in BCa and TCa, detection rates and false‐negative rates vary, limiting its clinical usefulness. Contemporary approaches utilise various radiotracers, (fluorescent) dyes, and hybrid tracers for SLNB. Ongoing research refines tumour‐targeted LN detection, including prostate‐specific membrane antigen targeting in PCa, potential c‐MET targeting in PeC, and <jats:sup>89</jats:sup>Zr‐girentuximab in RCC.ConclusionThe use of SLNB has transformed nodal staging in PeC, influencing treatment decisions and reducing morbidity in patients undergoing surgery. In other urological malignancies, it has not yet established itself as a standard tool for nodal staging. Its impact on survival, quality of life, and translational research remains to be determined.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"112 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Zhu et al.","authors":"Davide Perri, Giorgio Bozzini","doi":"10.1111/bju.16854","DOIUrl":"https://doi.org/10.1111/bju.16854","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"109 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing risk assessment in renal stone surgery: a commentary on bleeding risks in retrograde intrarenal surgery vs miniaturised percutaneous nephrolithotomy","authors":"Zhengbin Zhu, Bin Xie, Jianbin Luo","doi":"10.1111/bju.16858","DOIUrl":"https://doi.org/10.1111/bju.16858","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"706 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline health‐related quality‐of‐life metrics among patients with testicular germ cell tumours","authors":"Samuel A. Gold, Rebecca Yu, Viranda H. Jayalath, Fady Baky, Nicole Liso, Brandon Williams, Amy L. Tin, Darren R. Feldman, Samuel A. Funt, Andrew J. Vickers, Joel Sheinfeld, Richard S. Matulewicz","doi":"10.1111/bju.16855","DOIUrl":"https://doi.org/10.1111/bju.16855","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"109 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual function in adolescence after childhood hypospadias repair: a patient‐reported outcome study","authors":"Annaleena Anttila, Niklas Pakkasjärvi, Seppo Taskinen","doi":"10.1111/bju.16857","DOIUrl":"https://doi.org/10.1111/bju.16857","url":null,"abstract":"ObjectiveTo present data on sexual function in post‐pubertal patients after hypospadias surgery in childhood.Patients and MethodsWe assessed 169 (96 distal, 20 midshaft, 53 proximal) patients with hypospadias born between 1991 and 2003, who underwent surgery before the age of 5 years. At a median (interquartile range) follow‐up age of 16.2 (16.0–16.8) years, participants completed a pre‐mailed sexual function questionnaire, including the Erection Hardness Score (EHS) during the last control visit. Dorsal Nesbit‐like plication was used for curvature correction in 62 patients. Previously published normative data served as controls.ResultsAll patients reported having erections; 73% achieved EHS 4 (completely hard and fully rigid). In patients with distal hypospadias, EHS 4 was reported in 68% of cases, 85% of midshaft and 79% of proximal cases. Among those with and without curvature correction by Nesbit‐like plication, EHS 4 was reported in 72% and 74%, respectively. The proportion reporting EHS 4 exceeded that of published controls (<jats:italic>P</jats:italic> &lt; 0.01). Penile straightness during erection was reported by 95% of patients overall, with no significant differences across hypospadias subtypes or curvature correction status. Only one patient reported pain during ejaculation; none reported pain during erection. Ejaculation was reported by 95% of participants.ConclusionAdolescents who underwent early hypospadias repair reported favourable sexual function outcomes, including high rates of erectile rigidity and ejaculatory function. Neither hypospadias severity nor the need for curvature correction affected these outcomes. These findings support the long‐term sexual well‐being of patients undergoing surgery for hypospadias in childhood.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"33 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of timing of computed tomography staging and patient factors on the detection of 'true' cN+ bladder cancer.","authors":"Markus von Deimling,Marc Furrer,Alberto Bianchi,Renate Pichler,Moritz Maas,Karl H Tully,Mattia Longoni,Laura S Mertens,Jacob Taylor,Francesco Del Giudice,Roger Li,Andrea Gallioli,Simone Albisinni,Felice Crocetto,Maud Velev,Luca Afferi,Andrea Mari,Ekaterina Laukhtina,Jakob Klemm,Nirmish Singla,Margit Fisch,Philippe E Spiess,Yair Lotan,Marco Moschini,Peter C Black,Alessandro Antonelli,Bernhard Kiss,Shahrokh F Shariat,Benjamin Pradere, ","doi":"10.1111/bju.16851","DOIUrl":"https://doi.org/10.1111/bju.16851","url":null,"abstract":"OBJECTIVESTo evaluate whether computed tomography (CT) scans should be performed before or after transurethral resection of bladder tumour (TURBT) for accurate lymph node staging in clinically lymph node-positive bladder cancer (BCa). Additionally, to identify patient factors that can aid in predicting lymph node metastasis.PATIENTS AND METHODSIn this retrospective, multicentre study, we analysed patients with cN+ M0 BCa staged by CT and treated with upfront radical cystectomy (RC) and pelvic lymph node dissection. We stratified patients by the interval between TURBT and CT into three groups: (1) before TURBT; (2) within 30 days after TURBT; and (3) more than 30 days post-TURBT. Staging accuracy, defined as concordance between clinical and pathological lymph node status, was evaluated. We utilised logistic regression analyses to identify patient factors, including the optimal timing of staging, in predicting pathological lymph node status at RC.RESULTSAmong 183 patients with cN+ disease, 90 (49%) had pN0 disease at RC. Of these, 40, 36 and 14 were staged before TURBT, within 30 days after TURBT, and more than 30 days post-TURBT, respectively (P = 0.2). Pathological downstaging was most common in cN1 (22%) and cN2 (20%) disease. The overall concordance rate was 23%. The timing of staging did not correlate with pathological lymph node status on logistic regression (all P > 0.05). Lymphovascular invasion (LVI) at TURBT was associated with pN status (odds ratio 4.25, confidence interval 2.02-9.34; P < 0.001) at RC.CONCLUSIONOverall, we found no association between the timing of CT-based staging and pathological lymph node metastases in cN+ BCa. The data suggest that performing a TURBT prior to staging does not increase the finding of false-positive nodes on imaging. LVI was the only factor at the time of TURBT associated with pathological lymph node metastasis at RC. Limitations include the multicentre retrospective design and the inclusion of only patients with clinically node-positive disease.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"8 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: ‘Residents surgical training using metrics for transurethral resection of bladder tumours’","authors":"Pietro Diana, Andrea Gallioli, Marco Paciotti, Alex Mottrie, Nicolòmaria Buffi, Alberto Breda","doi":"10.1111/bju.16853","DOIUrl":"https://doi.org/10.1111/bju.16853","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"9 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}