BJU International最新文献

{"title":"The PENIMA project : artificial intelligence decision‐support tool for penile lesions – protocol paper and invitation to participate","authors":"Janni Mølsted, Anne Birgitte Als, Jørgen Bjerggaard Jensen, Mikael Aagaard, Lisa Anni Larsen Lethan, Sinja Kristiansen, Christian Arvei Moen, Axel Gerdtsson, Line Kibsgaard, Christina Gade Jespersen, Frederikke Eichner Sørensen, Ann‐Kathrine Rossau, Jens Kramer Rangen, Jakob Kristian Jakobsen","doi":"10.1111/bju.70489","DOIUrl":"https://doi.org/10.1111/bju.70489","url":null,"abstract":"Objectives To present and describe the design, data collection framework, and interim cohort characteristics of the PENIMA project, a multicentre initiative establishing a clinically annotated penile lesion image repository to support future artificial intelligence (AI)‐driven decision‐support development – and to encourage urology and dermatology colleagues working with penile lesions to participate in the project. Patients and Methods Prospective participant inclusion commenced in March 2023 across Scandinavian urological and dermatological departments. Patients with penile anatomy undergoing clinically indicated genital examination are invited to participate and provide oral and written consent as defined by local authority regulations. Clinical photographs and structured metadata are collected. Lesion classification is based on a specialist evaluation, clinical follow‐up and histopathology when available. Images are pseudonymised and annotated using a secure, containerised Computer Vision Annotation Tool (CVAT) environment. Supervised machine‐learning model development using convolutional neural networks is planned with patient‐level dataset partitioning and evaluation using standard diagnostic performance metrics. The study was approved by relevant local authorities, and the approval number is 1‐10‐72‐150‐22. Results As of February 2026, 1125 participants and approximately 7000 images have been included. In all, 40% represented normal anatomical variants. Among lesional cases, 33% are clinically assessed as benign, 13% premalignant, and 8% malignant; 22% of all cases have histopathological verification. Concordance between clinical suspicion and histopathology is highest for penile carcinoma (84.6%, 95% confidence interval 75.0–91.0%). Conclusion The PENIMA project includes a multicentre, clinically grounded image repository reflecting real‐world penile lesion presentations. The feasible and successful infrastructure provides a foundation for future development and validation of image‐based clinical decision‐support tools.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"11 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149218580","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":"Urinary oxalate excretion in astronauts during long‐duration spaceflight: an exploratory analysis","authors":"Juliana Villanueva‐Congote, Stephanie Smith, Nathaniel Hansen, Raeann Dalton, Evelyn James, Jay Buckey, Daniel A. Wollin, David W. Sobel","doi":"10.1111/bju.70484","DOIUrl":"https://doi.org/10.1111/bju.70484","url":null,"abstract":"Objectives To explore the relationship between diet, mission phase, urinary calcium, and urinary oxalate during long‐duration spaceflight. Subjects and Methods Dietary intake of calcium and oxalate and 24‐h urine parameters from 12 astronauts during long‐duration spaceflight while consuming controlled diets were analysed. Mixed‐effects models assessed differences in urinary calcium and oxalate levels, adjusting for daily intake of calcium and oxalate, and for in‐flight status relative to pre‐flight status. Results From pre‐flight to in‐flight, median urinary calcium increased from 178.9 to 270.3 mg/day ( <jats:italic>P</jats:italic> &lt; 0.01) and urinary oxalate from 37.9 to 42.3 mg/day ( <jats:italic>P</jats:italic> &lt; 0.05). Post‐flight, urinary calcium decreased to 185.8 mg/day ( <jats:italic>P</jats:italic> &lt; 0.01) and urinary oxalate to 31.5 mg/day ( <jats:italic>P</jats:italic> &lt; 0.01), relative to in‐flight values. Dietary oxalate remained similar pre‐flight and in‐flight (382.0 vs 339.4 mg/day; <jats:italic>P</jats:italic> ≥ 0.05) but decreased post‐flight to 241.6 mg/day ( <jats:italic>P</jats:italic> &lt; 0.01). Adjusted in‐flight urinary oxalate was 10.71 mg/day higher than pre‐flight and increased by 0.050 mg/day per 1‐mg/day increase in dietary oxalate (95% confidence interval 0.036–0.064; <jats:italic>P</jats:italic> &lt; 0.001); dietary calcium was not associated with urinary oxalate ( <jats:italic>P</jats:italic> ≥ 0.05). Conclusions Hyperoxaluria was observed during long‐duration spaceflights and persisted throughout the in‐flight phase under controlled dietary conditions. Although high dietary oxalate was the strongest predictor, evidence of inter‐individual susceptibility was observed, with some astronauts exhibiting elevated oxalate pre‐flight levels, which increased further during flight. Assessment of oxalate content in current astronaut food systems, mitigation of dietary oxalate load through timed calcium intake, and further investigation of microgravity‐related effects on oxalate absorption and metabolism are required.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"30 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199003","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":"Flexible and navigable suction ureteric access sheath and direct‐in‐scope suction in endourology: a systematic evidence map of study characteristics and research trends","authors":"Pietro Scilipoti, Federico Zorzi, Carlos Gonzalez Gonzalez, Nicola Nannola, Marie Chicaud, Luigi Candela, Eugenio Ventimiglia, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Luca Villa, Steeve Doizi, Frederic Panthier, Olivier Traxer","doi":"10.1111/bju.70498","DOIUrl":"https://doi.org/10.1111/bju.70498","url":null,"abstract":"Objective To characterise the global research landscape of suction technologies in flexible ureteroscopy, specifically the flexible and navigable suction ureteric access sheath (FANS) and direct‐in‐scope suction (DISS), mapping study design, geographical and temporal trends, risk of bias, and clinical and experimental applications. Methods A systematic search of PubMed, the Excerpta Medica dataBASE (EMBASE), and Web of Science was performed per Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines (International Prospective Register of Systematic Reviews: CRD420261371338). All study designs were eligible, including randomised controlled trials (RCTs), prospective and retrospective observational studies, experimental studies ( <jats:italic>in vivo</jats:italic> , <jats:italic>ex vivo</jats:italic> , <jats:italic>in vitro</jats:italic> ), and case series. Country was assigned by first‐author affiliation as a proxy for research leadership. Risk of bias was assessed with design‐appropriate tools: the Cochrane Risk of Bias 2 (RoB 2) tool for RCTs, Risk Of Bias In Non‐randomised Studies of Interventions (ROBINS‐I) for non‐randomised studies, Quality Assessment Tool For <jats:italic>In Vitro</jats:italic> Studies (QUIN) for laboratory studies, and the Newcastle–Ottawa Scale for case series. Results A total of 154 studies were included (2022–2026). Annual publication rate increased from three studies in 2022 to &gt;80 in 2025. China accounted for 48.7% of publications, followed by Singapore (11.7%) and Armenia (5.2%). Retrospective comparative studies were the largest design group (49 [31.8%]), followed by <jats:italic>in vitro</jats:italic> experiments (22 [14.3%]), prospective comparative studies (19 [12.3%]), and RCTs (11 [7.1%]). Most clinical studies were single‐centre (55.8%); multicentre collaboration was more common in prospective and European Association of Urology‐affiliated research. Adult urolithiasis accounted for 72% of clinical studies; paediatric studies, 2.6% (FANS only). Under ROBINS‐I, 61% of observational studies were rated moderate risk of bias; 81% of RCTs raised some concerns under RoB 2; laboratory studies were predominantly low risk. Conclusions This evidence map shows FANS and DISS have generated a rapidly expanding literature, heavily dominated by single‐centre retrospective studies from Asia. RCT‐level evidence is emerging for FANS, while DISS evidence remains earlier‐stage and less mature. Standardised outcome reporting, multicentre prospective designs, and broader geographic representation are the priorities this evidence map identifies for the field.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"85 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198952","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":"Variation in PSA level referral thresholds for suspected prostate cancer across NHS trusts in England.","authors":"Allan Cameron, Laura Miller","doi":"10.1111/bju.70506","DOIUrl":"https://doi.org/10.1111/bju.70506","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191307","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 BICEP classification for bladder injury during endoscopic enucleation of the prostate: considerations for clinical application","authors":"Ranil Johann Boaz, Max Johnston, James Brewin, Helen Teixeira, Tevita Aho","doi":"10.1111/bju.70456","DOIUrl":"https://doi.org/10.1111/bju.70456","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"49 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172534","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":"Reply to: Comment on the BICEP classification for bladder injury during AEEP","authors":"Selim Soyturk, Selcuk Guven","doi":"10.1111/bju.70457","DOIUrl":"https://doi.org/10.1111/bju.70457","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"53 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172543","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":"[ 18 F] fluorodeoxyglucose PET/CT refines staging and treatment selection in high‐risk upper tract urothelial carcinoma","authors":"Renee A. G. Lijnen, Joanneke B. Ringia, Kees Hendricksen, Wouter V. Vogel, Thierry N. Boellaard, Michiel S. van der Heijden, Arthur J. A. T. Braat, Bas W. G. van Rhijn, Laura S. Mertens","doi":"10.1111/bju.70483","DOIUrl":"https://doi.org/10.1111/bju.70483","url":null,"abstract":"Objectives To evaluate the incremental clinical value of [ <jats:sup>18</jats:sup> F]fluorodeoxyglucose positron emission tomography/computed tomography ([ <jats:sup>18</jats:sup> F]FDG‐PET/CT) beyond contrast‐enhanced computed tomography (CECT) for primary staging of suspected high‐risk upper tract urothelial carcinoma (UTUC). Patients and Methods We conducted a consecutive paired‐imaging cohort study of patients with suspected high‐risk UTUC undergoing primary staging with both CECT and [ <jats:sup>18</jats:sup> F]FDG‐PET/CT at a tertiary cancer centre between 2013 and 2025. The primary outcome was clinically relevant stage migration, defined as a transition between non‐metastatic and metastatic disease, and its impact on multidisciplinary treatment recommendation. Secondary outcomes included diagnostic performance in cases with histopathological verification. Results Among 203 patients, [ <jats:sup>18</jats:sup> F]FDG‐PET/CT resulted in stage migration in 45 (22%), predominantly through upstaging (39 patients [19%]), comprising regional nodal upstaging in 19 patients (9.4%) and distant metastatic upstaging in 22 (11%), with both occurring in two patients. [ <jats:sup>18</jats:sup> F]FDG‐PET/CT led to treatment modification in 43 patients (21%). Stage migration was more frequent in the presence of CECT‐suspicious lymph nodes (odds ratio 3.4, 95% confidence interval 1.6–7.3). Among the 62 patients with histopathological verification, [ <jats:sup>18</jats:sup> F]FDG‐PET/CT demonstrated significantly higher sensitivity for nodal metastases than CECT (74% vs 33%) with similar specificity (89% vs 86%). Limitations include the retrospective single‐centre design and incomplete pathological confirmation, mostly due to neoadjuvant treatment and omission of surgery in metastatic disease. Conclusion [ <jats:sup>18</jats:sup> F]FDG‐PET/CT provides actionable staging information beyond CECT in high‐risk UTUC, leading to treatment modification in one in five patients and in half of those with CECT‐suspicious nodal disease. These findings support selective use of [ <jats:sup>18</jats:sup> F]FDG‐PET/CT in primary staging to refine treatment selection.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"26 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172544","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":"Surgical waiting times in patients with high‐ and low‐risk renal cell carcinoma in England","authors":"Raghav Varma, Emily Mayne, Will Cuningham, Marina A. Parry, Arjun Nathan, Aurelia Chen, Adrian Cook, Maxine G. B. Tran, James M. Douglas, Axel Bex, Jan van der Meulen, Amit Bahl, Grant D. Stewart, Thomas E. Cowling","doi":"10.1111/bju.70490","DOIUrl":"https://doi.org/10.1111/bju.70490","url":null,"abstract":"Objectives To assess to what extent hospitals meet the uniform English National Health Service ‘timely’ treatment standard, what happens after a breach, and determinants of delay for patients with high‐risk renal cell carcinoma (RCC). Patient and Methods Population‐based study using linked data for 7030 patients with high‐risk and 10 708 patients with low‐risk RCC, 2019–2023. The probabilities of ‘timely’ treatment and prolonged delay (≤31 days or &gt;62 days from decision‐to‐treat, respectively) were estimated using multilevel logistic regression. Daily treatment probabilities beyond 31 days were represented using smoothed hazard rates. Results For a typical patient with high‐risk RCC, timely treatment declined from 83.7% (2019) to 64.8% (2023), with a corresponding decline in the low‐risk group from 71.3% to 47.6%, while prolonged delays more than doubled, from 3.9% to 9.4%. Patients with high‐risk RCC were prioritised over those with low‐risk disease (73.6% vs 58.2%; adjusted risk ratio 1.26, 95% confidence interval 1.22–1.31). Older and more socioeconomically deprived patients experienced longer delays. Once the standard was breached, the daily probability of surgery declined sharply. Adjusted percentages of patients with high‐ and low‐risk RCC treated within the standard were strongly correlated ( <jats:italic>r</jats:italic> = 0.78). Conclusion Prioritisation of patients with high‐risk RCC was maintained throughout the study period but did not prevent a system‐wide decline in timely treatment. Patients who breach the timely treatment standard face diminishing daily probabilities of surgery. Risk‐stratified standards, ring‐fenced surgical capacity, and monitoring beyond defined timely treatment standards are needed to safeguard patients against delays that have significant prognostic implications.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"16 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149151790","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":"Transurethral ultrasound ablation (TULSA) for prostate cancer: a systematic review and meta-analysis.","authors":"Eugene Wang, Xinyi Wei, Yajat Dua, Marlon Perera, Jeremy Grummet","doi":"10.1111/bju.70471","DOIUrl":"https://doi.org/10.1111/bju.70471","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to synthesise evidence on oncological, functional and safety outcomes of magnetic resonance imaging-guided transurethral ultrasound ablation (TULSA) for primary and recurrent prostate cancer.</p><p><strong>Methods: </strong>MEDLINE, Embase, Web of Science and Scopus were systematically searched from inception to July 2025. The primary outcomes were 12-month biopsy-proven clinically significant prostate cancer (csPCa) recurrence-free survival (RFS) and rates of pad-free continence and preserved erectile function at last follow-up. Secondary outcomes included biochemical recurrence, progression to salvage treatment and rates of adverse effects.</p><p><strong>Results: </strong>Twelve studies comprising 630 patients were analysed. In total, 563 (89%) patients underwent primary TULSA, 57 (9%) patients underwent salvage TULSA, and 10 (2%) patients had palliative TULSA. Pooled 12-month csPCa RFS was 70% (95% confidence interval [CI] 50-84) for primary TULSA and 80% (95% CI 66-89) for salvage TULSA. Stratifying by ablation fraction, pooled 12-month csPCa RFS was 75% (95% CI 60-86) for whole-gland TULSA, and 71% (95% CI 51-86) for focal TULSA. The proportion of pad-free continence was 90% (95% CI 71-97), and the rate of preservation of erectile function was 81% (95% CI 56-94). Incidence of grade 3 severity adverse events was 6% (95% CI 4-11). There was heterogeneity in multiple outcomes, likely reflecting variation in endpoint definitions, treatment approaches and follow-up protocols among the included studies.</p><p><strong>Conclusion: </strong>Primary TULSA is a safe treatment modality with a low risk of functional morbidity. However, there is a lack of evidence on long-term oncological control, with modifications of the treatment technique and ablation parameters still being experimental. Fewer data are available for salvage TULSA, where preliminary studies have recorded relatively high rates of incontinence.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164600","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":"Prognostic biomarkers in non‐muscle‐invasive bladder cancer: biological basis and evidence","authors":"Jinghong Wang, Yitao Zhao, Yushan Ye, Xiaolong Qi, Dahong Zhang, Shiwei Duan, Haibin Wei","doi":"10.1111/bju.70488","DOIUrl":"https://doi.org/10.1111/bju.70488","url":null,"abstract":"Objectives To review prognostic and treatment‐response biomarkers for non‐muscle‐invasive bladder cancer (NMIBC), with particular attention to biological function, specimen type, assay method, statistical evidence, and possible clinical use. Methods We conducted a focused narrative search of PubMed, Web of Science, and the Cochrane Library for English‐language human studies published from January 2015 to August 2026, supplemented by earlier pivotal studies and reference‐list screening. Priority was given to NMIBC cohorts reporting recurrence, progression, survival, or response to intravesical therapy. We considered cohort specificity, sample size, multivariable analysis, testing in an independent population, and assay standardisation. Results Tumour‐tissue markers such as stromal antigen 2 (STAG2), fibroblast growth factor receptor 3 (FGFR3), fibroblast activation protein‐α, the urokinase plasminogen activator system, and cadherins are linked to chromosomal stability, growth‐factor signalling, stromal remodelling, extracellular‐matrix invasion, and epithelial–mesenchymal transition. Urinary RNAs and plasma circulating tumour DNA permit non‐invasive sampling, although results depend on specimen handling and assay conditions. Blood‐derived inflammatory indices are inexpensive but non‐specific. Most evidence comes from retrospective single‐cohort studies; reported effects and cut‐offs are not always consistent, and few markers materially improve clinicopathological models. Conclusions None of the biomarkers reviewed can currently replace guideline‐based risk stratification or cystoscopic surveillance. Future studies should define assays and thresholds prospectively, test them in independent cohorts, and show that adding a biomarker improves prediction and patient management at an acceptable cost.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"12 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149151788","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}