BJU International最新文献

{"title":"‘BJUI Clinical Dilemma’: the incidental small renal mass in a solitary kidney","authors":"Bruce Gao, Pratik Kanabur, Riccardo Campi, Maxine Tran, Jaime Landman, Ivan Pedrosa, Ben Challacombe, Tze Min Wah, Shankar Siva, Michael Jewett, Grant D. Stewart, Brian Shuch, Ralph Clayman","doi":"10.1111/bju.16627","DOIUrl":"10.1111/bju.16627","url":null,"abstract":"<p>The incidental small renal mass (SRM; ≤4 cm; clinical T stage [cT]1a) has become increasingly common due to the widespread utilisation of ultrasonography and cross-sectional imaging. Today, most such patients present with asymptomatic, localised disease that can be surgically treated with curative intent; however, up to 25% of SRMs are benign [<span>1</span>]. This creates a clinical dilemma: balancing the removal of malignant tumours with avoiding needless active treatment for benign masses.</p><p>This ‘<i>BJUI</i> Clinical Dilemma’ presents a structured format to address the common clinical presentation of a SRM through a case vignette approach. Following the vignette, leading experts will provide brief commentary, explaining the rationale behind their preferred management strategies. This approach encourages a balanced, expert-driven discussion on alternative strategies, offering readers insights into decision-making processes for common, yet nuanced cases in urological practice.</p><p>A 63-year-old man presented to his primary care physician with an incidental CT finding of a 2.9-cm left renal mass in a congenital solitary left kidney, something the patient was previously unaware of, as part of an emergency room evaluation for brief epigastric pain—now completely resolved. He is an unmarried schoolteacher. He is overweight (body mass index of 29.7 kg/m<sup>2</sup>) and has well-controlled hypertension (on atenolol). He denies any history of smoking or occupational exposures and has no relevant family history.</p><p>He denies any urinary symptoms, haematuria, flank pain, weight loss, or constitutional symptoms. His blood pressure is within the normal range, and physical examination reveals moderate central abdominal adiposity without any palpable masses or surgical scars.</p><p>A full blood count and comprehensive metabolic panel are normal; urine analysis is unremarkable. Creatinine is 88 μmol/L and estimated GFR (eGFR) is 75 mL/min/1.73 m<sup>2</sup>.</p><p>A contrast-enhanced CT scan was performed, including images without and with contrast during the arterial phase, revealing a 2.9 × 2.7 cm enhancing, exophytic renal mass arising from the posterior interpolar region of the left kidney (Radius, Exophytic/Endophytic, Nearness to collecting system or sinus, Anterior/Posterior, Location [R.E.N.A.L.] nephrometry score 8; Fig. 1). The mass briskly enhances, is well-defined, and appears to be predominantly solid. There are no signs of sinus, renal vein or perinephric fat invasion and no enlarged regional lymph nodes. The contralateral kidney is absent. A diagnostic chest X-ray was unremarkable.</p><p>The patient seeks your opinion as to what would be his best course of action.</p><p>This is a complex clinical scenario requiring individualised care, ideally delivered at a referral centre by an experienced multidisciplinary team (MDT). The case has many interconnected decision-points (Table 1) [<span>2, 3</span>].</p><p>The CT characteristics of","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 3","pages":"371-379"},"PeriodicalIF":3.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16627","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935138","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":"Selective treatment de-escalation in advanced prostate cancer: have we come full circle?","authors":"Bryan Chong, Marniza Saad, Tsung Wen Chong, John Thng, Yu Guang Tan, Kae Jack Tay, Christopher Cheng, Po-Hung Lin, Jeremy Teoh, Peter Ka-Fung Chiu, Nathan Lawrentschuk, Renu Eapen, Declan Murphy, Johan Chan, Melvin L.K. Chua, Jeffrey Tuan, John Yuen, Ravindran Kanesvaran, Kenneth Chen","doi":"10.1111/bju.16632","DOIUrl":"https://doi.org/10.1111/bju.16632","url":null,"abstract":"Compelling evidence has solidified the notion of early treatment intensification in managing patients with metastatic hormone-sensitive prostate cancer (mHSPC). Landmark trials have provided Level 1 evidence for the survival benefits achieved by combining multiple agents. The efficacy of combined therapy relies not only on how treatment is intensified but also on how it is de-escalated. This underscores the importance of tailored treatment approaches, potentially involving a reduction in therapy for specific patients, to strike a balance between the benefits of hormonal treatment and its associated adverse effects. While de-escalation of therapy in mHSPC remains challenging due to limited evidence, it is recommended for elderly or frail patients, those with poor performance status, or experiencing significant toxicity. However, for patients with excellent prostate-specific antigen responses or favourable biomarkers, decisions should be personalised, weighing the potential benefits of continued treatment against the risk of long-term side effects, using risk stratification tools where appropriate.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"132 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142917426","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":"TYTOCARE™ home telemonitoring device after radical cystectomy to optimise postoperative outcomes","authors":"Daniele Amparore, Sabrina De Cillis, Marco Colombo, Valentina Garzena, Michele Sica, Enrico Checcucci, Alberto Piana, Federico Piramide, Alberto Quarà, Matteo Manfredi, Cristian Fiori, Francesco Porpiglia","doi":"10.1111/bju.16637","DOIUrl":"https://doi.org/10.1111/bju.16637","url":null,"abstract":"ObjectivesTo evaluate the role of the TYTOCARE™ telemedicine programme for home telemonitoring during the early postoperative period following radical cystectomy (RC) in a prospective single‐centre study.Materials and MethodsThe study included patients aged &lt;80 years with internet access who underwent RC at our institution between March 2021 and August 2023. Upon discharge, patients were monitored at home using the TYTOCARE™ telemedicine system. Daily, patients completed a symptom questionnaire and recorded heart rate, body temperature, intestinal sounds, and urine output, and wound/ostomy evaluations via photos. Weekly televisits via the TYTOCARE<jats:sup>TM</jats:sup> platform and app were scheduled, with additional controls as needed. After 30 days, patients assessed their satisfaction using a visual analogue scale (VAS; 0–100) and a Telemedicine Satisfaction Questionnaire (TSQ; 1–5) and any technical issues were documented. A control group of patients, who underwent RC in the same study period but who did not take part in a postoperative telemonitoring programme, was chosen for comparison, with analysis of demographics, peri‐operative data, postoperative complications and hospital readmissions within 30 days after discharge.ResultsA total of 16 patients were included in the TYTOCARE<jats:sup>TM</jats:sup> group, and 88 in the control group. The mean VAS satisfaction scores were 86.4 (patients) and 92.3 (healthcare providers). The mean TSQ score was 4.3, indicating high satisfaction. All TYTOCARE<jats:sup>TM</jats:sup> patients reported they would use and recommend the device. Two patients encountered minor technical issues, which were easily resolved. The TYTOCARE<jats:sup>TM</jats:sup> group had a shorter hospital stay (11 vs 14 days; <jats:italic>P</jats:italic> = 0.04) and fewer medical complications ( 2/16 vs 21/88; <jats:italic>P</jats:italic> = 0.02). No TYTOCARE<jats:sup>TM</jats:sup> patients were readmitted within 30 days, compared to 20.4% in the control group.ConclusionThe TYTOCARE<jats:sup>TM</jats:sup> telemonitoring programme seems to be feasible and highly adhered to by patients and caregivers, with reductions in length of hospital stay, medical complications and hospital readmissions within the first 30 days post‐discharge.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"48 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142888104","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":"Correction to “How can we reduce morbidity after robot-assisted radical cystectomy with intracorporeal neobladder? A report on postoperative complications by the European Association of Urology Robotic Urology Section Scientific Working Group”","authors":"","doi":"10.1111/bju.16619","DOIUrl":"10.1111/bju.16619","url":null,"abstract":"&lt;p&gt;Pellegrino F., Martini A., Falagario U.G. et al. How can we reduce morbidity after robot-assisted radical cystectomy with intracorporeal neobladder? A report on postoperative complications by the European Association of Urology Robotic Urology Section Scientific Working Group, BJU Int. 2024 Jun;133(6):673–677. doi: 10.1111/bju.16283&lt;/p&gt;&lt;p&gt;The author affiliations published in the June 2024 issue were incorrect. Additionally, the surname of one coauthor was misspelled. The correct author affiliations and surnames appear below:&lt;/p&gt;&lt;p&gt;Francesco Pellegrino&lt;sup&gt;1,3,7&lt;/sup&gt;, Alberto Martini&lt;sup&gt;9&lt;/sup&gt;, Ugo Giovanni Falagario&lt;sup&gt;4,8&lt;/sup&gt;, Juhana Rautiola&lt;sup&gt;7&lt;/sup&gt;, Antonio Russo&lt;sup&gt;2,10&lt;/sup&gt;, Laura S Mertens&lt;sup&gt;11&lt;/sup&gt;, Luca Di Gianfrancesco&lt;sup&gt;6&lt;/sup&gt;, Carlo Andrea Bravi &lt;sup&gt;14,15,18&lt;/sup&gt;, Jonathan Vollemaere&lt;sup&gt;20&lt;/sup&gt;, Muhammad Abdeen&lt;sup&gt;20&lt;/sup&gt;, Marco Moschini&lt;sup&gt;1,3&lt;/sup&gt;, Mikolaj Mendrek&lt;sup&gt;21&lt;/sup&gt;, Eirik Kjøbli&lt;sup&gt;24&lt;/sup&gt;, Stephan Buse&lt;sup&gt;22&lt;/sup&gt;, Carl Wijburg&lt;sup&gt;13&lt;/sup&gt;, Alae Touzani&lt;sup&gt;9,25&lt;/sup&gt;, Guillaume Ploussard&lt;sup&gt;9&lt;/sup&gt;, Alessandro Antonelli&lt;sup&gt;5&lt;/sup&gt;, Laura Schwenk&lt;sup&gt;26&lt;/sup&gt;, Jan Ebbing&lt;sup&gt;26&lt;/sup&gt;, Nikhil Vasdev&lt;sup&gt;19&lt;/sup&gt;, Gabriel Froelicher&lt;sup&gt;27&lt;/sup&gt;, Hubert John&lt;sup&gt;27&lt;/sup&gt;, Abdullah Erdem Canda&lt;sup&gt;28,29&lt;/sup&gt;, Mevlana Derya Balbay&lt;sup&gt;28,30&lt;/sup&gt;, Marcel Stoll&lt;sup&gt;23&lt;/sup&gt;, Sebastian Edeling&lt;sup&gt;23&lt;/sup&gt;, Camille Berquin&lt;sup&gt;16&lt;/sup&gt;, Charles Van Praet&lt;sup&gt;16&lt;/sup&gt;, Sami-Ramzi Leyh-Bannurah&lt;sup&gt;21&lt;/sup&gt;, Stefan Siemer&lt;sup&gt;20&lt;/sup&gt;, Michael Stoeckle&lt;sup&gt;20&lt;/sup&gt;, Alexander Mottrie&lt;sup&gt;14,15&lt;/sup&gt;, Frederiek D'Hondt&lt;sup&gt;14,15&lt;/sup&gt;, Alessandro Crestani&lt;sup&gt;6&lt;/sup&gt;, Angelo Porreca&lt;sup&gt;6&lt;/sup&gt;, Alberto Briganti&lt;sup&gt;1,3&lt;/sup&gt;, Francesco Montorsi&lt;sup&gt;1,3&lt;/sup&gt;, Hendrik van der Poel&lt;sup&gt;11,12&lt;/sup&gt;, Karel Decaestecker&lt;sup&gt;17,16,32&lt;/sup&gt;, Richard Gaston&lt;sup&gt;10&lt;/sup&gt;, Abolfazl Hosseini&lt;sup&gt;7&lt;/sup&gt;, N Peter Wiklund&lt;sup&gt;8,31&lt;/sup&gt;&lt;/p&gt;&lt;p&gt;&lt;sup&gt;1&lt;/sup&gt;Division of Oncology/Unit of Urology, URI, IRCCS San Raffaele Scientific Institute, Milan, Italy; &lt;sup&gt;2&lt;/sup&gt;Department of Urology, IRCCS Ospedale San Raffaele, Milan, Italy; &lt;sup&gt;3&lt;/sup&gt;Vita-Salute San Raffaele University, Milan, Italy; &lt;sup&gt;4&lt;/sup&gt;Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy; &lt;sup&gt;5&lt;/sup&gt;Department of Urology, University of Verona, Verona, Italy; &lt;sup&gt;6&lt;/sup&gt;Oncological Urology, IRCCS Veneto Institute of Oncology, Padua, Italy; &lt;sup&gt;7&lt;/sup&gt;Department of Urology, Karolinska University Hospital, Solna, Sweden; &lt;sup&gt;8&lt;/sup&gt;Department of Molecular Medicine and Surgery, Karolinska institute, Stockholm, Sweden; &lt;sup&gt;9&lt;/sup&gt;Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France; &lt;sup&gt;10&lt;/sup&gt;Department of Urology, Clinique Saint Augustin, Bordeaux, France; &lt;sup&gt;11&lt;/sup&gt;Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands; &lt;sup&gt;12&lt;/sup&gt;Department of Urology, Amsterdam University Medical Centers, Amsterdam, The Netherlands; &lt;sup&gt;13&lt;/sup&gt;Department of Urology, ","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 3","pages":"544"},"PeriodicalIF":3.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16619","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887228","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":"Inhibition of phosphodiesterases 1 and 4 prevents myofibroblast transformation in Peyronie's disease","authors":"Sophie L. Harding, Marcus M. Ilg, Stephen A. Bustin, David J. Ralph, Selim Cellek","doi":"10.1111/bju.16631","DOIUrl":"https://doi.org/10.1111/bju.16631","url":null,"abstract":"To investigate which phosphodiesterase (PDE) isoforms are expressed in fibroblasts isolated from the tunica albuginea (TA) of patients with Peyronie's disease (PD), and to measure the potency of PDE inhibitors in preventing transformation of these fibroblasts to profibrotic myofibroblasts.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"36 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880150","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":"External validation of predictive models for antibiotic susceptibility of urine culture","authors":"Glenn T. Werneburg,&nbsp;Daniel D. Rhoads,&nbsp;Alex Milinovich,&nbsp;Sean McSweeney,&nbsp;Jacob Knorr,&nbsp;Lyla Mourany,&nbsp;Alex Zajichek,&nbsp;Howard B. Goldman,&nbsp;Georges-Pascal Haber,&nbsp;Sandip P. Vasavada","doi":"10.1111/bju.16626","DOIUrl":"10.1111/bju.16626","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop, externally validate, and test a series of computer algorithms to accurately predict antibiotic susceptibility test (AST) results at the time of clinical diagnosis, up to 3 days before standard urine culture results become available, with the goal of improving antibiotic stewardship and patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Machine learning algorithms were developed and trained to predict susceptibility or resistance using over 4.7 million discrete AST classifications from urine cultures in a cohort of adult patients from outpatient and inpatient settings from 2012 to 2022. The algorithms were validated on a cohort from a geographically-distant hospital system, ~1931 km (~1200 miles) from the training cohort facilities, from the same time period. Finally, algorithms were clinically validated in a contemporary cohort and compared to the empiric therapy prescribed by clinicians. Appropriateness of the antibiotics selected by clinicians and the algorithm during the clinical validation was compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Algorithms were accurate during clinical validation (area under the receiver operating characteristic curve [AUC] 0.71–0.94) for all 11 tested antibiotics. The algorithms’ accuracy improved as the organism was identified (AUC 0.79–0.97). In external validation in a geographically-distant cohort, the algorithms remained accurate even without additional training on this group (AUC 0.69–0.87). When the algorithms were trained on the antibiogram from the geographically-distant hospital, the accuracy improved (AUC 0.70–0.93). When algorithms’ performances were tested against clinicians in a contemporary cohort for the empiric prescription of oral antibiotics, the drug agent suggested by the algorithms more frequently resulted in adequate empiric coverage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Machine learning algorithms trained on a large dataset are accurate in prediction of urine culture susceptibility vs resistance up to 3 days prior to urine AST availability. Clinical implementation of such an algorithm could improve both clinical care and antimicrobial stewardship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"629-637"},"PeriodicalIF":3.7,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873945","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":"Metastatic risk in clear cell renal cell carcinoma: a tool incorporating sex, size, and grade","authors":"Frederik F. Thomsen, Marcus Westerberg, Rasmus D. Petersson, Rasmine Bak, Julie Bak Lindholst, Hayder Al-Husseinawi, Emma Heeno, Nessn H. Azawi","doi":"10.1111/bju.16624","DOIUrl":"https://doi.org/10.1111/bju.16624","url":null,"abstract":"To identify predictors of metastases, estimate the proportion of metastatic clear cell renal cell carcinoma (ccRCC) cases according to these predictors, and subsequently create a risk table showing the absolute difference in metastasis proportion for each 10 mm increase in tumour size.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857537","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":"Sharing surgical images on social media: a snapshot of practices and some reflections for improvement","authors":"Patrick Juliebø-Jones,&nbsp;Vineet Gauhar,&nbsp;Ali Talyshinskii,&nbsp;Christian Arvei Moen,&nbsp;Ingunn Roth,&nbsp;Lazaros Tzelves,&nbsp;Christian Beisland,&nbsp;Bhaskar K Somani","doi":"10.1111/bju.16625","DOIUrl":"10.1111/bju.16625","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 3","pages":"424-425"},"PeriodicalIF":3.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142825539","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 patient positioning during surgery on neuropathies after robot‐assisted laparoscopic radical prostatectomy: a randomised controlled trial","authors":"Nico Christian Grossmann, Fabian Joel Aschwanden, Julian Cornelius, Christian Malkmus, Leutrim Zahiti, Pascal Viktorin, Lea Fierley, Einar Wilder‐Smith, Philipp Baumeister, Agostino Mattei, Christian Daniel Fankhauser","doi":"10.1111/bju.16623","DOIUrl":"https://doi.org/10.1111/bju.16623","url":null,"abstract":"ObjectiveTo investigate whether ankle braces or shoulder support used for fixation during robot‐assisted radical prostatectomy (RARP), where patients are commonly positioned in the head‐down Trendelenburg position, differ in their potential to cause peripheral nerve injury.Patients and MethodsA prospective, double‐blind, randomised controlled trial was conducted on patients undergoing RARP for prostate cancer between May 2020 and September 2021 using the da Vinci<jats:sup>®</jats:sup> Si system (Intuitive Surgical Inc., Sunnyvale, CA, USA). Patients were randomly assigned to either the shoulder or ankle brace fixation group and were positioned in a modified lithotomy position. Neurological examinations were performed pre‐ and postoperatively. The primary endpoint was the prevalence of any peripheral neuropathy on the first postoperative day.ResultsA total of 98 patients were treated using the da Vinci Si system: 46 in the lithotomy lower fixation group and 52 in the lithotomy upper fixation group. Both groups mainly recorded neuropathies in the lower extremity, with a total incidence of 6.9% for lower neuropathies and 3.9% for upper neuropathies. All neuropathies were sensory, with one exception in the upper fixation group presenting a motor deficit. Over a median follow‐up of 12 months, no neuropathies persisted. Neuropathy on the first postoperative day was observed in 15% of patients in the upper fixation group and 6.5% in the lower fixation group (<jats:italic>P</jats:italic> = 0.2).ConclusionWe observed neuropathies in a clinically relevant proportion of men undergoing RARP. We were not able to demonstrate a significant difference regarding postoperative neuropathies between ankle braces or shoulder support during RARP.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"29 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815502","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":"Survival after trimodal therapy in octogenarians with organ‐confined urothelial bladder cancer","authors":"Mattia Longoni, Francesco Di Bello, Natali Rodriguez Peñaranda, Fabian Falkenbach, Andrea Marmiroli, Quynh Chi Le, Zhe Tian, Jordan A. Goyal, Nicola Longo, Salvatore Micali, Markus Graefen, Gennaro Musi, Felix K. H. Chun, Fred Saad, Shahrokh F. Shariat, Marco Moschini, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Pierre I. Karakiewicz","doi":"10.1111/bju.16622","DOIUrl":"https://doi.org/10.1111/bju.16622","url":null,"abstract":"ObjectivesIt is not known whether cancer‐specific mortality (CSM) differences distinguish radical cystectomy (RC) from trimodal therapy (TMT) in octogenarians harbouring organ‐confined (T2N0M0) urothelial cancer of the urinary bladder (UCUB).MethodsWithin the Surveillance, Epidemiology, and End Results database (2004–2021), CSM and other‐cause mortality (OCM) rates were computed in octogenarian patients with organ‐confined UCUB undergoing either TMT or RC. Smoothed cumulative incidence plots depicted 5‐year CSM and OCM rates according to RC vs TMT. Competing risks regression (CRR) models were fitted, adjusting for age, gender, and race/ethnicity. Nearest‐neighbour 1:1 propensity‐score matching (PSM) for age and gender was also applied. Sensitivity analyses were additionally performed, focusing on White patients.ResultsOf 2335 octogenarian patients with T2N0M0 UCUB, 1562 (66.3%) received TMT and 793 (33.7%) received RC. Of those, 2082 (88.4%) were White. TMT rates increased from 53.5% in 2004 to 82.2% in 2021 (<jats:italic>P</jats:italic> &lt; 0.001). The 5‐year CSM rate was 50.1% for TMT vs 31.1% for RC. After multivariable CRR, TMT independently predicted 1.7‐fold higher CSM (<jats:italic>P</jats:italic> &lt; 0.001). After additional PSM, TMT also independently predicted 1.7‐fold higher CSM (<jats:italic>P</jats:italic> &lt; 0.001). In sensitivity analyses exclusively focusing on White patients, almost identical results were recorded.ConclusionRates of TMT have nearly doubled in octogenarian patients with organ‐confined UCUB in recent years; however, CSM rates after TMT are also nearly twice as high as those observed after RC. It is crucial to communicate these observations.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"20 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815503","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}