BJU International最新文献

{"title":"Re-defining the interpretation of 24-h urine studies for stone formers","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1111/bju.16760","DOIUrl":"https://doi.org/10.1111/bju.16760","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"25 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890103","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":"Retrospective clinical and molecular characterisation of patients with penile intraepithelial neoplasia","authors":"Sara Kaczor Elbæk, Philippe Lamy, Simen Laugesen, Christina Stilling, Iver Nordentoft, Lars Dyrskjøt, Jakob Kristian Jakobsen","doi":"10.1111/bju.16754","DOIUrl":"https://doi.org/10.1111/bju.16754","url":null,"abstract":"ObjectivesTo provide the first comprehensive molecular characterisation of penile intraepithelial neoplasia (PeIN) and to define the molecular alterations and clinical parameters associated with recurrence in order to enhance our ability to manage this disease.Patients and MethodsWe conducted a retrospective audit of records and an analysis of archived formalin‐fixed paraffin‐embedded (FFPE) tissue from a single‐centre population‐based consecutive sample, to characterise the genetic landscape of 28 PeIN patients through DNA copy number analysis, RNA expression analysis, and gene set enrichment analysis (GSEA). The primary and secondary study outcomes were alterations in the genetic landscape of recurring vs non‐recurring PeIN and clinical risk factors for recurrence.ResultsIn patients with PeIN recurrence, we identified seven significantly overexpressed genes (e.g., <jats:italic>MYC</jats:italic>, <jats:italic>SCN8A</jats:italic> and <jats:italic>PSTK</jats:italic>). Importantly, in the DNA analysis, the MYC locus was amplified (8q24.12‐8q24.22 gain), the RNA analysis showed overexpression of MYC, and the MYC pathways (GSEA) were enriched compared to patients without PeIN recurrence. Limitations of the study include treatment heterogeneity and FFPE specimens challenging for RNA quality.ConclusionWe identified seven overexpressed genes in patients with PeIN recurrence. Some of these transcripts were previously reported to be involved in invasive penile cancer. These findings provide molecular evidence, that PeIN is a precursor lesion with a correlation to invasive penile cancer, and could potentially lead to new topical treatment strategies for PeIN and low‐risk penile cancer.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"9 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880332","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":"Can only AI can save us from the burden of administration?","authors":"Nathan Lawrentschuk","doi":"10.1111/bju.16762","DOIUrl":"https://doi.org/10.1111/bju.16762","url":null,"abstract":"&lt;p&gt;As health systems adopt ever more expensive and complex electronic medical record (EMR) systems – clearly with minimal design input from doctors and with almost no thought to research and with limited focus on improving patient outcomes – we are left burdened with yet more and more menial tasks that are taking us away from face-to-face patient care [&lt;span&gt;1, 2&lt;/span&gt;]. How do we re-balance “the system” that is often beyond our control? Perhaps AI may save us. Amongst many applications, AI is perfect for navigating repetitive processes and for being a scribe to assist us with our activities.&lt;/p&gt;&lt;p&gt;Opportunities exist in the AI space to make positive changes. Such technology should follow the “SAFE” mnemonic:&lt;/p&gt;&lt;p&gt;&lt;b&gt;S&lt;/b&gt;-afe for patients and staff.&lt;/p&gt;&lt;p&gt;&lt;b&gt;A&lt;/b&gt;-ffordable and accurate.&lt;/p&gt;&lt;p&gt;&lt;b&gt;F&lt;/b&gt;-used with existing technologies.&lt;/p&gt;&lt;p&gt;&lt;b&gt;E&lt;/b&gt;-asy to use.&lt;/p&gt;&lt;p&gt;This will ensure that they are not just expensive “plug-ins” and that there is integration that is smooth and reliable. Predictive tools for patient prognosis can be enhanced alongside simpler tasks of obtaining accurate patient histories and notes [&lt;span&gt;3&lt;/span&gt;]. Education of patients about procedures could become more interactive and faster.&lt;/p&gt;&lt;p&gt;Diagnostics will also be aided by AI to not miss and guide interpretation whilst adding consistency in subjective reports [&lt;span&gt;4&lt;/span&gt;]. Even more exciting are applications that may aid in the early diagnosis of malignancies, particularly rare ones like penile cancer, taking a de-identified picture on a smartphone, feeding through AI online and triaging back to patients and health workers are upon us [&lt;span&gt;5&lt;/span&gt;]. The accuracy and educative power of such initiatives is potentially overwhelming, particularly when we consider the blockchain technology and how it may be utilised in urology and medicine [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;However, there are potential pitfalls. AI can lead to lazy and indeed sloppy attention to detail where, in the health system, mistakes can be life threatening. “Cut and pasting” from notes to letters and discharge summaries is already becoming a problem, as is remembering doses of drugs, drugs to cease before surgery and common interactions of drugs that should not be discharged to AI without human input [&lt;span&gt;7&lt;/span&gt;]. Furthermore, where free thought is abolished, and we become homogenised with few new ideas, we can become complacent. It may be easier for some to be comfortably safe in the knowledge that we have acceptable AI ideas to put forward, but this robs us of the innovation and free thought that we must foster to solve problems and improve patient outcomes.&lt;/p&gt;&lt;p&gt;A further danger is that AI is actually cheap but like everything else in healthcare, those in the space can only see the inflated prices for average systems to help repay investors and bring returns. Governments need to partner with universities to develop our own AI programmes that are cheap, reliable and can be rolled out across Austra","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"135 S3","pages":"3-4"},"PeriodicalIF":3.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16762","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883814","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":"Incidence, surveillance and natural history of high‐grade prostatic epithelial neoplasia in the era of multiparametric MRI and targeted biopsy","authors":"Nathalie Eid, Herbert Lepor","doi":"10.1111/bju.16748","DOIUrl":"https://doi.org/10.1111/bju.16748","url":null,"abstract":"ObjectivesTo determine the incidence of isolated high grade prostatic epithelial neoplasia (iHGPIN) following magnetic resonance imaging (MRI)–ultrasonography co‐registration fusion targeted biopsy (MRFTB) coupled with systematic biopsy (SB) and to assess the detection rates of clinically significant prostate cancer (csPCa).Patients and MethodsBeginning in June 2012, most patients at our institution underwent multiparametric MRI (mpMRI) before prostate biopsy. Biopsies were performed between June 2012 and October 2021. The surveillance protocol for iHGPIN included prostate‐specific antigen assessment every 6 months, digital rectal examinations annually, and multiparametric MRI (mpMRI) at 3 years. Repeat biopsies were recommended primarily for suspicious mpMRI, defined as a new Prostate Imaging‐Reporting and Data System (PI‐RADS) score &gt;2 region of interest (ROI) or an increase in size of the pre‐existing ROI.ResultsOf the 628 biopsies, 230 (33.7%), 48 (7.0%), 404 (59.2%) were interpreted as benign, iHGPIN, or prostate cancer (PCa), respectively. Of these cancers 140 (34.7%) and 264 (65.3%) were low‐risk PCa and csPCa, respectively. iHGPIN was detected in MRRFTB only, SB only, and both MRFRB + SB in six (12.5%) 36 (75%), and six patients (12.5%), respectively. Of the 32 MRI scans performed at 3 years, a new PI‐RADS score &gt;2 ROI or an increase in the size or PI‐RADS score of a pre‐existing ROI was observed in four and eight patients, respectively. Nine of these underwent biopsy. Three additional biopsies were performed on non‐suspicious mpMRI. csPCa was detected in two patients, both with an enlarging ROI.ConclusionTo our knowledge, this is the first study examining the incidence, natural history, and subsequent csPCa detection rates for iHGPIN in the era of mpMRI and MRI targeted biopsy. The lower prevalence of iHGPIN is attributed to the selection of biopsy candidates based on mpMRI and an increased likelihood of detecting pre‐existing csPCa. Our findings provide compelling evidence that biopsy strategies limited to MRI targets will almost eliminate iHGPIN detection while decreasing detection of csPCa. A 3‐year biopsy should be performed only in men with suspicious mpMRI.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"254 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875729","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 challenges of conducting a surgical trial—reflections on the en bloc resection of urothelium carcinoma of the bladder (EBRUC) II trial","authors":"Stephan Brönimann, Altug Tuncel, Rodolfo Hurle, David D'Andrea","doi":"10.1111/bju.16749","DOIUrl":"https://doi.org/10.1111/bju.16749","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"27 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872605","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":"Percentage of free to total PSA as a biomarker of survival in metastatic castration-resistant prostate cancer","authors":"Andrew W. Silagy, Dixon T.S. Woon, Louise Kostos, Rui Bernardino, Ting W. Yiu, Marian S. Wettstein, Hanan Goldberg, Jaime O. Herrera-Cáceres, Hina Shiakh, Gregory Nason, Alexandre Zlotta, Eleftherios Diamantis, Damien Bolton, Neil Fleshner","doi":"10.1111/bju.16751","DOIUrl":"https://doi.org/10.1111/bju.16751","url":null,"abstract":"To analyse whether the percentage of free to total prostate-specific antigen (%fPSA) is a prognostic biomarker in metastatic castration-resistant prostate cancer (mCRPC), as novel studies suggest an elevated %fPSA is associated with adverse oncological outcomes for men with biochemical recurrence of prostate cancer.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"28 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872503","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":"Challenges in assessing long-term urinary and fecal outcomes following bladder exstrophy repair: Response to Liao et al.","authors":"Abdellaoui Sarah, Cazzorla Fabiana, Morel-Journel Nicolas, Bidault Valeska, Neuville Paul, Ruffion Alain, Pierre D.E. Mouriquand, Demède Delphine","doi":"10.1111/bju.16753","DOIUrl":"https://doi.org/10.1111/bju.16753","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"1 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872607","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":"Positive surgical margin and oncological outcomes after robot‐assisted radical prostatectomy in different Cancer of the Prostate Risk Assessment risk groups","authors":"Anna Hagman, Anna Lantz, David Grannas, Stefan Carlsson, Olof Akre, Mats Olsson, Lars Egevad, Jonas Höijer, Peter Wiklund","doi":"10.1111/bju.16732","DOIUrl":"https://doi.org/10.1111/bju.16732","url":null,"abstract":"ObjectiveTo evaluate the impact of a positive surgical margin (PSM) in relation to the risk of biochemical recurrence (BCR) and additional treatment in different preoperative Cancer of the Prostate Risk Assessment (CAPRA) risk groups after robot‐assisted radical prostatectomy (RARP).Patients and methodsRetrospective cohort study of 1039 patients subjected to RARP for prostate cancer at a single European institution. PSM was stratified by extent (focal extensive). The CAPRA score was used for risk group stratification. BCR was defined as a prostate‐specific antigen level &gt;0.2 ng/mL. Additional treatment was defined as salvage radiotherapy (sRT) and/or androgen‐deprivation therapy (ADT).ResultsIn total 227 patients had a PSM (21.8%). When compared to a negative surgical margin, an extensive PSM was associated with an increased risk of BCR (hazard ratio [HR] 2.16, 95% confidence interval [CI] 2.09–8.29; HR 3.76, 95% CI 2.33–6.06; HR 2.35, 95% CI 1.03–5.38) and sRT (HR 3.75, 95% CI 1.45–9.7; HR 4.57, 95% CI 2.47–8.43; HR 9.32, 95% CI 1.06–14.82) in the low‐, intermediate‐ and high‐risk groups, respectively. In high‐risk patients a focal PSM was associated with an increased risk of BCR (HR 5.79, 95% CI 1.62–20.65), sRT (HR 9.32, 95% CI 1.7–50.95) and ADT (HR 4.11, 95% CI 1.08–15.57) whereas in low‐ and intermediate‐risk patients a modest effect on BCR but no significant effect on sRT or ADT was found. We found no significant interaction between CAPRA risk group and PSM (<jats:italic>P =</jats:italic> 0.25).ConclusionsWhile an extensive PSM was associated with an increased risk of recurrence in all risk groups, a focal PSM was associated with additional treatment only among men with high‐risk tumours.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"9 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875732","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":"A 360° multidisciplinary appraisal of novel surgical technologies – is this a new standard?","authors":"Anthony Emmanuel, Sachin Malde, Prokar Dasgupta, Majed Shabbir","doi":"10.1111/bju.16756","DOIUrl":"https://doi.org/10.1111/bju.16756","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"33 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872606","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":"Matched‐pair analysis of peri‐operative and oncological outcomes of robot‐assisted vs open retroperitoneal lymph node dissection","authors":"Pailin Pongratanakul, Marieke Vermeulen‐Spohn, Carolin Wöltjen, Sophia Thy, Andreas Hiester, Peter Albers, Yue Che","doi":"10.1111/bju.16747","DOIUrl":"https://doi.org/10.1111/bju.16747","url":null,"abstract":"ObjectiveTo analyse a comparatively large cohort of patients who underwent robot‐assisted retroperitoneal lymph node dissection (R‐RPLND) in a single centre, assessing the peri‐operative and oncological safety of this procedure compared to that in a matched‐pair cohort of patients who underwent open retroperitoneal lymph node dissection (O‐RPLND).MethodsWe retrospectively identified 100 patients who underwent R‐RPLND between October 2010 and January 2024. A matched‐pair analysis of R‐RPLNDs and O‐RPLNDs was conducted based on the following criteria: surgical indication, histology, clinical stage (CS), and tumour size. The primary endpoint of this analysis was progression‐free survival (PFS). Secondary endpoints were peri‐operative parameters.ResultsBased on surgical indication, the R‐RPLND cohort was divided into four groups: CS II seminoma (Group 1, 42 patients); marker‐negative CS II non‐seminoma (Group 2, 15 patients); CS I non‐seminoma with high‐risk factors (Group 3, seven patients), and post‐chemotherapy patients (Group 4, 34 patients). Two patients were excluded due to uncommon testicular histology. With a mean follow‐up of 32, 31, 32 and 28 months in the four groups, respectively, relapses occurred in 10/42 of Group 1, 3/15 of Group 2, and 1/7 of Group 3, while all patients remained relapse‐free in Group 4. The matched‐pair analysis revealed that histological retroperitoneal lymph node dissection specimens, relapse rates, and PFS were similar in the R‐RPLND and O‐RPLND groups. R‐RPLND had advantages in terms of a shorter hospital stay as a surrogate for less morbidity.ConclusionIn selected patients and selected surgical indications, R‐RPLND represents a minimally invasive alternative to O‐RPLND in the management of patients with testicular germ cell tumours.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"46 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857481","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}