BJU International最新文献

{"title":"Risk stratification and conditional recurrence after radical cystectomy: toward adaptive follow-up.","authors":"Roberto Contieri,Alberto Martini,Marc Furrer,David D'Andrea,Francesco Claps,Markus von Deimling,Francesco Soria,Andrea Mari,Lorenzo Bianchi,Elena Tonin,Ronan Flippot,Jeremy Y C Teoh,Gauthier Marcq,Pierre-Emmanuel Desprez,Renate Pichler,Aleksander Ślusarczyk,José Daniel Subiela,Francesco Del Giudice,Valerio Santarelli,Angelo Porreca,Antonio Amodeo,Nicola Pavan,Alchiede Simonato,Pietro Scilipoti,Sisto Perdonà,Paolo Gontero,Bas Wg van Rhijn,Rodolfo Hurle,Marco Moschini,Benjamin Pradere,Laura S Mertens, ","doi":"10.1111/bju.70232","DOIUrl":"https://doi.org/10.1111/bju.70232","url":null,"abstract":"OBJECTIVETo develop a data-driven risk-stratification model to identify high-risk patients following radical cystectomy (RC) for bladder cancer and propose a risk-adapted follow-up (FU) schedule.PATIENTS AND METHODSWe performed a retrospective analysis of an individual patient data registry comprising 3196 patients with clinical T stage (cT)2-T4 N0M0 bladder cancer who underwent RC at 16 European centres (1990-2024). All treatment decisions, including the use of neoadjuvant chemotherapy, adjuvant therapy, and the FU schedule, were made at the discretion of the treating physician in accordance with the patient's preference. A Classification and Regression Tree (CART) analysis, incorporating pathological T and N stages, lymphovascular invasion (LVI), and other features, was used to stratify patients into Low-Risk and High-Risk groups for recurrence. The primary endpoint was recurrence-free survival (RFS). We used a landmark analysis to evaluate the conditional risk of recurrence at 1, 2, 3, 4, and 5 years after RC.RESULTSAt a median FU of 81.8 months, 891 patients recurred. CART analysis identified a High-Risk group (pathological T stage [pT]3-pT4, node-positive disease, or pT2 with LVI) with significantly worse 5-year RFS than the Low-Risk group (37.8% vs 76.2%; P < 0.001). This stratification was strongly prognostic for recurrence (hazard ratio [HR] 4.29; 95% confidence interval 3.63-5.00), cancer-specific survival (subdistribution HR 5.80), and overall survival (HR 3.04) (all P < 0.001). Landmark analysis confirmed that the elevated risk persisted up to 4 years; however, the conditional risk for event-free patients converged after 5 years (HR 1.37; P = 0.3).CONCLUSIONSThis study establishes a simple, pathologically derived model (pT3-4/pN+/pT2 + LVI) that effectively stratifies post-RC patients, enabling a risk-adapted FU strategy. Prospective evaluation of this framework is required to confirm its clinical utility, safety, and cost-effectiveness.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"19 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439543","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":"Perioperative nutritional optimisation in radical cystectomy: a response to Kapil et al.","authors":"Mohammed Lotfi Amer, Sameh Fawzy Elnasharty","doi":"10.1111/bju.70227","DOIUrl":"https://doi.org/10.1111/bju.70227","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430666","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":"The prostate cancer electronic health (eHealth) literacy instrument: a tool for eHealth design and patient communication.","authors":"Stuart Robert Jackson, Paul Yu, Steven Sowter, Stefano Occhipinti, Suzanne Chambers, Scott Leslie, Manish I Patel","doi":"10.1111/bju.70225","DOIUrl":"https://doi.org/10.1111/bju.70225","url":null,"abstract":"<p><strong>Objective: </strong>To describe the development and validation of the Prostate Cancer Electronic Health (eHealth) Literacy Instrument (P-CeHLI). This is in response to: (i) a lack of clear and validated eHealth literacy measurement for men with prostate cancer; (ii) the unique information processing, decision making, and digital communication experience of men with prostate cancer as a single sex, older age, cancer cohort; and (iii) modern eHealth literacy theory and research, which now greatly considers the transactional nature of web technologies and digital communicative practice.</p><p><strong>Patients and methods: </strong>A total of 349 men with prostate cancer participated in a three-phase, longitudinal instrument development study. This was undertaken with end-user participation, and a multidisciplinary and international collaboration of prostate cancer, psycho-oncology, communication, and biostatistics experts. Exploratory and confirmatory factor analysis evaluated construct validity. The P-CeHLI was compared to respondents' eHealth literacy measured with the Transactional eHealth Literacy Instrument (TeHLI), as well as respondent eHealth utilisation and sociodemographic characteristics.</p><p><strong>Results: </strong>A four-factor model was demonstrated with acceptable fit properties (root mean square error of approximation = 0.074; comparative fit index = 0.931; Tucker-Lewis index = 0.924; standardised root mean square residual = 0.051) and excellent reliability (subscale alphas of 0.85-0.96). Domains of the P-CeHLI included cancer-specific functional, communicative, critical and translational eHealth literacy. Association between the scores of the scales and respondents' characteristics were similar; however, for all four subdomains, the P-CeHLI added significant predictive value when assessing eHealth use in men with prostate cancer whilst controlling for respective TeHLI scores.</p><p><strong>Conclusion: </strong>The P-CeHLI establishes a novel cancer-specific multidomain eHealth literacy instrument, validated in men with prostate cancer, and positioned to respond to their needs in the digital cancer care era. The P-CeHLI provides a new opportunity for clinicians and researchers to accurately identify and enhance the eHealth literacy skills of patients with prostate cancer, which may improve future clinical outcomes through digital intervention and improved communicative practice.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430725","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":"Curriculum-based training improves transurethral resection of bladder tumour performance compared to conventional training: the EuropeaN Training in uRologY (ENTRY) project.","authors":"Pietro Diana,Francesco Di Bello,Laura Mas,Andrea Gallioli,Marco Paciotti,Nicola Frego,Alex Mottrie,Joan Palou,Nicolòmaria Buffi,Alberto Breda","doi":"10.1111/bju.70223","DOIUrl":"https://doi.org/10.1111/bju.70223","url":null,"abstract":"OBJECTIVETo evaluate the efficacy in residents of the EuropeaN Training in uRologY (ENTRY) training curriculum for transurethral resection of bladder tumour (TURBT) vs conventional methodology, as TURBT is one of the most performed procedures by residents and early-career urologists.SUBJECTS/PATIENTS AND METHODSWe compared resident performance in TURBT trained through the ENTRY curriculum vs a conventional methodology. All residents underwent a TURBT educational rotation of 4 months supervised by uro-oncology attendings. In the conventional methodology group TURBT training was a standard tutoring in the operating room (OR). The ENTRY curriculum group underwent a pre-clinical: theoretical learning of metrics with a tutor and dry laboratory; and a surgical phase: supervised OR training by trained mentors.RESULTSWe evaluated 162 patients undergoing TURBT. Of these 74 (46%) TURBTs were performed by three conventionally-trained residents and 88 (54%) TURBT by three ENTRY curriculum-trained residents. Despite not being statistically different (P = 0.07), the reduction in high-grade perforation (DEpth of Endoscopic Perforation [DEEP] scale 2-3) in the ENTRY curriculum-trained group (12% vs 4.5%) was clinically meaningful. Postoperative complications was significantly lower in the ENTRY curriculum-trained group, for overall (13% vs 30%, P = 0.007), minor (10% vs 23%, P = 0.04), and major events (2.3% vs 6.8%, P = 0.1). Detrusor muscle presence was significantly higher in the ENTRY curriculum-trained group (91% vs 80%, P = 0.04).CONCLUSIONSThe ENTRY training curriculum for residents is effective in improving pivotal clinical outcomes in TURBT training vs conventional training. This training is a step towards standardised training and optimal outcomes in urology education.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"196 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439545","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":"What makes a great urology sub-internship? A survey of medical students, residents, and faculty.","authors":"Robert Adler, John R Heard, Andrew G Winer, Andrew L Freedman","doi":"10.1111/bju.70200","DOIUrl":"https://doi.org/10.1111/bju.70200","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430733","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 'Impact of perioperative nutrition on recovery after radical cystectomy: a randomised trial'.","authors":"Manas Jyoti Kapil, Bipul Nath, Neelakshi Sharma","doi":"10.1111/bju.70226","DOIUrl":"https://doi.org/10.1111/bju.70226","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430641","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":"The Australian Penile Cancer Clinical Registry: a comprehensive national approach to data collection.","authors":"Henry Y C Pan,David Homewood,Harrison Lucas,Brendan Dittmer,Jiasian Teh,Jonathan S O'Brien,Jianliang Liu,Ben Tran,Justin Chee,James A Churchill,Nathan Lawrentschuk,Niall M Corcoran","doi":"10.1111/bju.70188","DOIUrl":"https://doi.org/10.1111/bju.70188","url":null,"abstract":"BACKGROUNDPenile cancer is a rare malignancy, with an Australian incidence of 0.6 in 100 000 men, with a wide range of clinical presentations, from localised, curable tumours to aggressive forms with high morbidity and mortality. Epidemiological data and management guidelines for penile cancer in Australia are limited. The Australian Penile Cancer Clinical Registry (APCCR) aims to address this gap through a centralised database studying local risk factors, treatment effectiveness, and outcomes.STUDY DESIGNThe APCCR is a national, multicentre, prospective clinical quality registry.ENDPOINTSThe primary objective is to map demographic and tumour characteristics, human papillomavirus infection rates, long-term surgical and non-surgical (radiotherapy and chemotherapy) interventions in penile cancer. Secondary objectives include elucidating disparities and interdisciplinary gaps in care and identifying areas for further studies.PATIENTS AND METHODSThe registry aims to capture adult men with penile cancer in, utilising retrospective data collection and a prospective cohort design. Retrospective data are extracted from existing medical records, and prospective data are collected at enrolled sites. The registry is built in Research Electronic Data Capture (REDCap) and hosted on BioGrid Australia servers, enabling standardised data collection. Registration with the Australian Register of Clinical Registries is pending approval.RESULTSThe pilot phase of the APCCR is currently operational, with ongoing site recruitment. Five sites in Victoria and New South Wales are currently enrolled in the registry. The APCCR Steering Committee determined reporting and data protocols to ensure accurate data collection. The dataset was developed to comprise relevant clinical metrics on penile cancer diagnosis, disease, intervention, and surveillance.CONCLUSIONThe APCCR is a robust platform for furthering the understanding of penile cancer diagnostic and treatment practices in Australia, aiming to further research and clinical practice changes. This will drive further collaboration and improvements in outcomes for Australian men affected by penile cancer, particularly with ongoing national expansion and improved longitudinal data.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"77 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147383599","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":"Targeted microwave ablation of localised prostate cancer (VIOLETTE trial): a prospective multicentre study.","authors":"Nicolas Barry Delongchamps,Alexandre Peltier,Eric Potiron,Franck Bladou,Romain Diamand,Aurel Messas,Jean-Baptiste Roche,Grégoire Robert,Jean-Louis Hoepffner,Thierry Piechaud,Julien Anract,Roland van Velthoven","doi":"10.1111/bju.70220","DOIUrl":"https://doi.org/10.1111/bju.70220","url":null,"abstract":"OBJECTIVETo assess the oncological outcomes of targeted microwave ablation (TMA) using organ-based tracking (OBT) Fusion® via KOELIS Trinity® (KOELIS, Meylan, France) in men with intermediate-risk prostate cancer (PCa): the VIOLETTE trial (ClinicalTrials.gov identifier: NCT04582656) PATIENTS AND METHOD: In this prospective phase II, multicentre European study, men with a prostate-specific antigen (PSA) level <20 ng/mL, a single magnetic resonance imaging (MRI)-visible lesion ≤15 mm, International Society of Urological Pathology (ISUP) Grade Group 2 on MRI-targeted biopsy, and clinical T stage ≤2, were enrolled. The microwave applicator was placed using OBT Fusion guidance, either transperineally or transrectally. The primary endpoint was the absence of clinically significant PCa (csPCa), defined as ISUP Grade Group ≥2, within the treated area at 12 months. Secondary endpoints included safety, functional outcomes using validated measures, and the need for subsequent radical treatment.RESULTSA total of 76 patients were treated across six centres with 66 (87%) completing the 12-month follow-up. At 6 months, six patients had csPCa after positive MRI control, including four within the treated area. At 12 months, csPCa was detected in 15 additional patients, including nine in-field recurrences, yielding an 81% in-field csPCa-free rate. Five serious adverse events in three patients were reported. Sexual (-2.5 points; P < 0.001) and ejaculatory (-1 points; P < 0.001) scores decreased significantly, whereas urinary function remained stable. Radical treatment was required in four (5.2%) patients at 12 months.CONCLUSIONTargeted microwave ablation using OBT Fusion technology appears to be a safe and effective focal therapy procedure for localised intermediate-risk PCa. The VIOLETTE trial achieved its primary endpoint, with 81% patients free of in-field csPCa at 12 months.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"19 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147383600","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":"The 24-h pad test in the assessment of post-prostatectomy incontinence: is there still a role for counting pads per day?","authors":"Raimundo Domínguez Argomedo,Pedro de Pablos-Rodríguez,Alicia Palop Moscardó,Álvaro Gómez-Ferrer Lozano,Isidora Calvo Bernasconi,Juan Luis Casanova Ramón-Borja,Argimiro Collado Serra","doi":"10.1111/bju.70224","DOIUrl":"https://doi.org/10.1111/bju.70224","url":null,"abstract":"OBJECTIVESTo evaluate the correlation between the pad-per-day (PPD) count and the 24-h pad test (24 h-PT) during the first postoperative year after radical prostatectomy (RP), and to determine the clinical utility of the PPD count for quantitative urinary incontinence (UI) assessment.PATIENTS AND METHODSWe retrospectively analysed a prospectively maintained database of 2040 men who underwent RP between 2001 and 2025 at a tertiary referral centre. A total of 8787 paired measurements of PPD count and 24 h-PT were analysed. Urinary leakage was assessed at standardised timepoints (1 week, 6 weeks, 3, 6, and 12 months) using count of PPD and nurse-supervised 24 h-PT. UI severity was classified as mild (<100 g), moderate (100-400 g), or severe (>400 g). Correlations were calculated using Spearman's ρ.RESULTSThe correlation between the PPD count and 24 h-PT was strong across all timepoints and increased over the postoperative year, from ρ = 0.77 at 1 week to 0.99 at 12 months. The overall correlation for all paired measurements was ρ = 0.94 (95% confidence interval 0.93-0.94). The median (interquartile range) 24 h-PT values rose consistently with increasing PPD count categories: from 15 (7-38) g for 1 pad/day to 781 (478-1200) g for ≥5 pads/day. At 12 months, 94% of men using one pad had urine loss <100 g, whereas 85% of those using ≥5 pads/day exceeded 400 g. Intermediate categories (2-4 pads/day) showed wide variability, limiting their discriminative value.CONCLUSIONSThe PPD count shows a strong correlation with 24 h-PT throughout the first postoperative year after RP. Use of 0-1 pad/day effectively excluded moderate-to-severe UI, whereas ≥5 pads/day reliably identified severe UI. The PPD count is a practical follow-up tool, while 24 h-PT remains necessary for patients using 2-4 pads/day.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"18 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147394015","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":"Transrectal vs transperineal prostate biopsy: a systematic review and meta-analysis.","authors":"Gavin G Calpin,Cian M Hehir,Mariyah Alzayer,Benjamin M MacCurtain,Fintan R Ryan,Mohammud Shakeel Inder,Diarmaid C Moran,David J Galvin,Kieran J Breen","doi":"10.1111/bju.70204","DOIUrl":"https://doi.org/10.1111/bju.70204","url":null,"abstract":"OBJECTIVETo compare transrectal ultrasonography (TRUS) and local anaesthetic transperineal (LATP) biopsy.METHODSA systematic review of randomised control trials and prospective studies meeting eligibility criteria was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.RESULTSA total of 12 studies with 8497 patients were included. LATP biopsy was performed in 3961 patients and TRUS biopsy in 4536. Patient characteristics were comparable in both groups. Infection (risk ratio [RR] 0.68, 95% confidence interval [CI] 0.56-0.84, P < 0.001) and sepsis rates were significantly lower in the LATP group (RR 0.16, 95% CI 0.08-0.33, P < 0.001) and urinary retention rates were comparable (RR 0.87, 95% CI 0.61-1.25, P = 0.46). Overall cancer detection rates were significantly higher in LATP biopsy (RR 1.07, 95% CI 1.03-1.10, P < 0.001) as were Gleason Grade Group 2-5 or clinically significant cancer detection rates (RR 1.12, 95% CI 1.06-1.18, P < 0.001). Gleason GG 1 detection rates were comparable (RR 0.92, 95% CI 0.82-1.04, P = 0.20).CONCLUSIONThe LATP biopsy is associated with lower rates of infection and sepsis compared to TRUS biopsy. The LATP biopsy also detects a higher overall incidence of prostate cancer and clinically significant prostate cancer (Gleason Grade Group 2-5).","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"40 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147374109","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}