BJU International最新文献

{"title":"Extraperitoneal single-site robot-assisted radical prostatectomy with extended pelvic lymph node dissection: technique and experience","authors":"Yubo Wang, Mingzhao Li, Kai Yao, Zhuyinjun Zong, Yifan Chang, Yongda Liu, Chao Cai, Fadi Mousa Al Kalailah, Shancheng Ren, Guohua Zeng, Di Gu","doi":"10.1111/bju.16670","DOIUrl":"10.1111/bju.16670","url":null,"abstract":"<p>For patients with locally advanced or high-risk localised prostate cancer who require lymph node dissection (LND), guidelines recommend an extended pelvic LND (ePLND). Such an extensive dissection ensures accurate staging information for most patients [<span>1</span>]. Advancements in surgical instrumentation and optimisation of surgical techniques could potentially empower surgeons to perform an ePLND in a more minimally invasive manner.</p><p>Extraperitoneal single-site or single-port robot-assisted radical prostatectomy (ESSRARP) has emerged as an intriguing concept. However, data from SSRARP with PLND studies have presented a less promising picture. The median number of lymph nodes (LNs) removed using the ESSRARP approach was only five [<span>2, 3</span>]. Compared with the transperitoneal anterior approach, the main difficulties for ePLND through an extraperitoneal approach are restricted workspace and a high incidence of symptomatic lymphocele [<span>4, 5</span>]. Exploring bridge technique is particularly interesting and appears to serve as good training for transitioning to the use of the single-port platform. Our primary aim in this study was to describe the surgical steps and technique of the ESSRARP with ePLND, along with the preliminary data.</p><p>Between June 2023 and December 2023, 31 patients underwent ESSRARP and ePLND (Table S1). The participants had a median age of 69 years and a median body mass index (BMI) of 21.71 kg/m<sup>2</sup>. The median (IQR) PSA level at biopsy was 32.10 (16.7–51.0) ng/mL. Overall, five (16.13%), and 26 (83.78%) patients had pathological Gleason score of 7, and 8–10, respectively. Five patients (16.13%) had LN metastasis detected by <sup>18</sup>F-prostate-specific membrane antigen positron emission tomography (PSMA PET)-CT.</p><p>The median (IQR) surgery duration and console time were 210 (185–226) min and 150 (136–170) min, respectively (Table S2). The median (IQR) estimated blood loss was 50 (40–50) mL. The (IQR) median number of LNs removed was 23 (18–29). Pathological LNI was diagnosed in seven patients (22.58%). Positive surgical margins were found in six (19.35%) patients.</p><p>Postoperative complications occurred in two patients (6.45%) (Table S3). One patient developed deep vein thrombosis requiring readmission, while the other developed acute epididymitis on postoperative Day 3, necessitating prolonged antibiotic therapy. No symptomatic lymphocele formation was observed (Table S3).</p><p>Our technique offers a valuable and timely alternative for urologists who lack access to dedicated single-port surgical systems. Our study achieved a median LN yield of 23, demonstrating a substantial improvement compared to prior research. It typically takes ~10 cases to complete the learning curve.</p><p>From the surgical technique standpoint, our approach maintained a distance between the camera and the surgical field, adjusting focus to maintain clarity. The shortened working arms of the robotic arms","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"700-705"},"PeriodicalIF":3.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16670","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056741","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":"The 5-year results of the Stratified Cancer Active Surveillance programme for men with prostate cancer","authors":"Vincent J. Gnanapragasam,&nbsp;Alexandra Keates,&nbsp;Artitaya Lophatananon,&nbsp;Vineetha Thankapannair","doi":"10.1111/bju.16666","DOIUrl":"10.1111/bju.16666","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To report 5-year outcomes from the STRATified CANcer Surveillance (STRATCANS) programme based on progression risks using National Institute for Health and Clinical Excellence (NICE) Cambridge Prognostic Group (CPG) at diagnosis, prostate specific antigen density and magnetic resonance imaging (MRI) visibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Men with CPG1 and CPG2 disease selecting active surveillance (AS) were included into STRATCANS and allocated to one of three increasing follow-up intensities. Outcome measures were: (i) treatment for CPG≥3 progression (main outcome), (ii) any treatment, (iii) conversion to watchful waiting (WW), (iv) patient self-attrition, and (v) mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 297 men (median age 66.0 years) were reviewed. The median (interquartile range, mean) follow-up for men still on AS was 4.9 (2.7–7.6, 5.3) years. In the cohort, 38.0% were CPG2 and 25.0% Grade Group (GG) 2 at AS entry. Overall, 214/297 (72.1%) remained treatment free: 158 (53.1%) were still on AS, 17 (5.7%) died of other causes, and 39 (13.1%) progressed to WW/discharge. Only 10 (3.4%) left AS from anxiety. There were no cancer deaths or metastatic events. In all, 80 men (26.9%) converted to treatment due to biopsy/MRI progression but only 35 (11.7%) of these reached CPG≥3 disease. Treatment for CPG≥3 occurred in 7.6% of CPG1 and 18.5% of CPG2 disease and 9.9% of GG1 and 17.5% of GG2 disease. By STRATCANS tier, treatment for CPG≥3 disease was 4.7% in STRATCANS 1, 12.9% in STRATCANS 2, and 27.4% in STRATCANS 3 (<i>P</i> &lt; 0.001). STRATCANS had an area under the curve (AUC) of 0.74 for predicting CPG≥3 progression out-performing stratification by GG (AUC 0.64), CPG (0.69) and Likert score (0.51) alone or a combination of MRI visibility and GG (0.64). Longitudinal data have allowed further refinement of the STRATCANS schedule.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The STRATCANS 5-year outcomes demonstrate that a simple risk stratified surveillance using a prognostically meaningful endpoint is safe, durable, has low treatment rates, high patient compliance and appropriately tailors monitoring based on risks of progression. A website and implementation toolkit are now available.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 5","pages":"851-859"},"PeriodicalIF":3.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16666","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056495","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":"Growth kinetics of renal tumours during pregnancy in patients with hereditary renal cancer syndromes","authors":"Nityam Rathi,&nbsp;Rabindra Gautam,&nbsp;Jason Hyman,&nbsp;Daniel Nethala,&nbsp;W. Marston Linehan,&nbsp;Mark W. Ball,&nbsp;Sandeep Gurram","doi":"10.1111/bju.16593","DOIUrl":"10.1111/bju.16593","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"591-593"},"PeriodicalIF":3.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143055305","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":"Robotic surgery for paediatric neurogenic lower urinary tract dysfunction: a systematic review","authors":"Ihtisham Ahmad,&nbsp;Dheidan Alshammari,&nbsp;Priyank Yadav,&nbsp;Michael Chua,&nbsp;Margarita Chancy,&nbsp;Mohd S. Ansari,&nbsp;Mohan S. Gundeti","doi":"10.1111/bju.16658","DOIUrl":"10.1111/bju.16658","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate in a systematic review the outcomes, benefits, and limitations of robot-assisted surgeries for paediatric neurogenic lower urinary tract dysfunction (LUTD), as robot-assisted techniques have emerged as a potential alternative, offering enhanced precision, dexterity, and visualisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO identifier CRD42023464849) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included studies of paediatric patients (aged &lt;18 years) with neurogenic LUTD undergoing robot-assisted continence surgery, assessing safety and efficacy. Literature searches in the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), and Scopus were conducted until 12 July 2024. Data extraction included surgical procedures, complications, operative times, lengths of stay, and bladder function outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 42 studies (20 case reports, 10 case series, six cohort studies, six comparative cohort studies) were included. Robotic procedures for continent catherisable channel construction, augmentation cystoplasty, and bladder neck reconstruction showed comparable peri- and postoperative outcomes. Meta-analysis of five studies comparing robotic vs open appendicovesicostomy indicated a significant reduction in length of stay for robotic groups, while operative time, complications, and re-intervention rates were not significantly different. Conversions to open surgery were rare, indicated by adhesions or small appendices during channel constructions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Robot-assisted surgeries for paediatric neurogenic LUTD demonstrate potential benefits, including reduced hospital stays and comparable complication rates to open surgery in certain contexts. However, the available evidence is limited by heterogeneity in study designs, small sample sizes, and single-centre experiences, which constrain generalisability. Standardised reporting of complications and outcomes, alongside multicentre studies, is essential to clarify the long-term efficacy and broader applicability of these techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"557-566"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16658","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050839","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":"Improving environmental sustainability in urology as a resident","authors":"Bushra Abdelqader,&nbsp;Archie McGrath,&nbsp;Pinky Kotecha,&nbsp;John S McGrath,&nbsp;Joseph John","doi":"10.1111/bju.16657","DOIUrl":"10.1111/bju.16657","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"546-548"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050877","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":"Tumour size is associated with growth rates of >0.5 cm/year and delayed intervention in small renal masses in patients on active surveillance","authors":"Maximilian Pallauf,&nbsp;Michael Rezaee,&nbsp;Roy Elias,&nbsp;Tina Wlajnitz,&nbsp;Sean A. Fletcher,&nbsp;Joseph Cheaib,&nbsp;Khalid Alkhatib,&nbsp;Peter Chang,&nbsp;Andrew A. Wagner,&nbsp;James M. McKiernan,&nbsp;Mohamad E. Allaf,&nbsp;Phillip M. Pierorazio,&nbsp;Nirmish Singla","doi":"10.1111/bju.16651","DOIUrl":"10.1111/bju.16651","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the association between tumour size and the growth rate (GR) of small renal masses (SRMs) in patients managed by active surveillance (AS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We queried the prospective, multi-institutional Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) registry for patients on AS with an imaging interval of ≥6 months, identifying 456 patients. We tracked tumour size over time; a GR &gt;0.5 cm/year was defined as a GR event. We used multivariable recurrent events and time-to-event Cox regression modelling to evaluate the association between tumour size and GR events (primary outcome) and tumour size and delayed intervention (DI; secondary outcome). We tested tumour size as a continuous variable and dichotomised tumour size by predefined (2-cm) and calculated (2.9-cm) cutoffs. We calculated the cutoff using maximally selected rank statistics and time to progression, defined according to the DISSRM registry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median (interquartile range) follow-up of patients on AS was 40.1 (26.4–71.2) months, during which 128 patients (28%) had ≥1 GR event, and 80 (18%) underwent DI. Larger tumour size was an independent predictor for GR events and DI when tested as a continuous and a dichotomous variable in multivariable analyses (all <i>P</i> &lt; 0.05). The association was strongest when accounting for the change in tumour size over time and when applying the 2.9-cm cutoff. The study is limited by the mixed tumour pathology inert to SRMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Larger tumour size was independently associated with GR events and DI for patients with SRMs on AS. A 2.9-cm cutoff may provide valuable information for patient counselling.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 5","pages":"860-868"},"PeriodicalIF":3.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050808","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":"Fluid intake and recurrence and progression risk of patients with non-muscle-invasive bladder cancer","authors":"Ivy Beeren, Hilde Meijer, Antoine G. van der Heijden, Katja K.H. Aben, J. Alfred Witjes, Lambertus A.L.M. Kiemeney, Alina Vrieling","doi":"10.1111/bju.16665","DOIUrl":"https://doi.org/10.1111/bju.16665","url":null,"abstract":"To evaluate the association of pre- and post-diagnosis fluid intake with non-muscle-invasive bladder cancer (NMIBC) recurrence and progression risk.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"58 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031088","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":"Metabolic syndrome is associated with postoperative complications after holmium laser enucleation of the prostate","authors":"Victoria S. Edmonds,&nbsp;Daniel J. Heidenberg,&nbsp;Connor Mayes,&nbsp;Carolyn Mead-Harvey,&nbsp;Mitchell R. Humphreys","doi":"10.1111/bju.16663","DOIUrl":"10.1111/bju.16663","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare postoperative complication rates of patients with metabolic syndrome (MetS) with patients without MetS after holmium laser enucleation of the prostate (HoLEP) for management of benign prostatic hyperplasia (BPH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed patients aged &gt;40 years who underwent HoLEP at our institution from 2007 to 2022. Criteria for MetS were diagnoses of at least three of the following: diabetes mellitus, hypertension, hyperlipidaemia, or obesity (body mass index ≥30 kg/m²). Uni- and multivariable logistic regression were used to compare the likelihood of immediate, 30-day, and 90-day complications between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1500 patients were included with a median (interquartile range) age of 70 (65–76) years. Patients with MetS were more likely to develop complications at both 30 and 90 days, including urinary incontinence, irritative voiding symptoms, and bleeding (<i>P</i> &lt; 0.001). After adjusting for potential confounders, patients with MetS had a greater than three times odds of both 30- and 90-day complications compared to patients without MetS (30-day adjusted odds ratio [aOR] 3.32, 95% confidence interval [CI] 2.21–5.01, <i>P</i> &lt; 0.001; and 90-day aOR 3.64, 95% CI 2.49–5.31, <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Metabolic syndrome was associated with a three-fold likelihood of 30- and 90-day complications after HoLEP. This could be an important factor to consider in preoperative counselling and patient selection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"684-690"},"PeriodicalIF":3.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026434","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":"Comparing open and video endoscopic lymphadenectomy for penile cancer: a systematic review and meta-analysis of prospective studies","authors":"Caio Vinícius Suartz,&nbsp;Richard Dobrucki de Lima,&nbsp;Luiza Rafih Abud,&nbsp;Pedro Henrique Souza Brito,&nbsp;Ketlyn Assunção Galhardo,&nbsp;Thalita Bento Talizin,&nbsp;André Lopes Salazar,&nbsp;Fernando Korkes,&nbsp;Giuliano Guglielmetti,&nbsp;Stênio de Cássio Zequi,&nbsp;Leopoldo Alves Ribeiro-Filho,&nbsp;Paul Toren,&nbsp;Michele Lodde","doi":"10.1111/bju.16661","DOIUrl":"10.1111/bju.16661","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To conduct the first meta-analysis using only prospective studies to evaluate whether video endoscopic inguinal lymphadenectomy (VEIL) offers advantages in perioperative outcomes compared to open IL (OIL) in patients with penile cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review with meta-analysis was conducted across multiple databases, including Cochrane Central Register of Controlled Trials (CENTRAL), the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Latin America and Caribbean Health Sciences Literature (LILACS), Scopus, Web of Science, and several trial registries up to June 2024. Only randomised controlled trials (RCTs) and prospective cohort studies were included. Data extraction focused on operative time, perioperative complications, drainage time, hospital stay, number of nodes retrieved and oncological outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four prospective studies, including three RCTs and one non-randomised study, were included in the analysis, totalling 95 patients and 174 operated limbs. VEIL demonstrated significantly fewer wound infections (<i>P</i> &lt; 0.001; 95% confidence interval [CI] 0.01–0.18; <i>I</i>² = 0), skin necrosis (<i>P</i> = 0.002; 95% CI 0.04–0.49; <i>I</i>² = 0), and lymphoedema (<i>P</i> = 0.05; 95% CI 0.09–0.99; <i>I</i>² = 27%) compared to OIL. The VEIL group also had a shorter drainage period (<i>P</i> = 0.001; mean difference [MD] –1.94, 95% CI −3.15 to −0.74) and hospital stay (<i>P</i> &lt; 0.01; MD –5.48, 95% CI −6.34 to −4.62). Pain intensity and operative time were lower in the VEIL group, contributing to fewer postoperative complications overall. Oncological outcomes showed no significant differences between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The meta-analysis indicates that VEIL offers significant advantages over OIL in terms of reducing wound infections, skin necrosis, and lymphoedema, leading to shorter hospital stays and overall improved perioperative outcomes. However, the limited sample of 95 patients across four studies underscores the need for further randomised trials and a cautious interpretation of the results, which currently support the use of VEIL in managing patients with penile cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"567-576"},"PeriodicalIF":3.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031302","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":"Re-defining the interpretation of 24-h urine studies for stone formers","authors":"Wilson Sui,&nbsp;Heiko Yang,&nbsp;Maria C. Velasquez,&nbsp;Marshall L. Stoller,&nbsp;Thomas Chi","doi":"10.1111/bju.16659","DOIUrl":"10.1111/bju.16659","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify associations between 24-h urine abnormalities and clinical risk factors for recurrent stone formers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>The Registry for Stones of the Kidney and Ureter was queried for all patients who underwent 24-h urine studies. Patients were categorised by the number of clinical risk factors for recurrent stone disease. Stone recurrence was calculated by stone events per person-year. We utilised a novel method to calculate an overall severity score for 24-h urine parameters. The stone recurrence and 24-h urinary analyte values were then compared using Student's <i>t</i>-tests, chi-square analysis and negative binomial regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 614 stone patients met our inclusion criteria and were categorised by the number of clinical stone risk factors. On adjusted and unadjusted analysis, an escalating number of clinical risk factors predicted increased stone recurrence risk. However, there were no differences in mean 24-h urine analyte values amongst these groups aside from higher urinary calcium. However, after calculation of a 24-h urine severity score there was a significantly higher mean severity as the number of clinical risk factors increased. This severity score also independently predicted stone recurrence on adjusted negative binomial regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Utilising a novel 24-h urine scoring system, we showed that higher-risk stone patients have more severe 24-h urine characteristics, which was not apparent using conventional analysis. Both the severity score and clinical characteristics independently identified those at risk of stone recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 4","pages":"691-699"},"PeriodicalIF":3.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021011","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}