BJU International最新文献

{"title":"A cavernous tissue without a blood pool that appears under the tunica albuginea during erection.","authors":"Yasuo Kawanishi,Takeshi Miyake,Masahito Yamanaka","doi":"10.1111/bju.16829","DOIUrl":"https://doi.org/10.1111/bju.16829","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"16 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370361","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":"Rethinking research in urology: pitfalls from the Talent Incubator Programme.","authors":"Clara Cerrato,Juan Luis Vásquez,","doi":"10.1111/bju.16837","DOIUrl":"https://doi.org/10.1111/bju.16837","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"16 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370359","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":"Systematic review of PSA reference intervals in the gender diverse population with prostates","authors":"Rose Hall, Rue Ball, Elizabeth Bancroft, Rosalind Eeles, Alison May Berner","doi":"10.1111/bju.16825","DOIUrl":"https://doi.org/10.1111/bju.16825","url":null,"abstract":"ObjectivesTo determine mean/median serum total prostate‐specific antigen (PSA) levels in transgender women and non‐binary people with prostates (TWNBPP) who have received gender‐affirming hormone therapy (GAHT) or an orchidectomy. The secondary objective was to identify other quantitative information that influences PSA levels in this population.MethodsSystematic review of existing publications from primary studies published in English, excluding case reports and guidelines. Included studies: TWNBPP who have received GAHT/post‐orchidectomy, without a diagnosis of prostate pathology, with recorded serum PSA levels. MEDLINE and Embase databases were searched, up to July 2024.ResultsFour papers met the inclusion criteria, with 290 participants. Two papers measured the mean PSA level after 4 and 12 months of GAHT (mean [range] age 30 [18–45] years). A third paper measured the mean PSA level after a median of 9 years of GAHT (mean [range] age 40.1 [19–67] years). The fourth study measured 852 PSA levels in 210 participants receiving oestradiol therapy, over a 23‐year period (mean [range] age 60 [40–79] years). The mean and median PSA levels ranged from 0.020 to 0.525 ng/mL. Meta‐analysis of these data was unfeasible, due to low quantity, comparability, and quality of the studies.ConclusionsExisting data for serum PSA reference intervals for TWNBPP without prostate pathology were from four studies and cannot be used to make clinical recommendations. The evidence indicates that GAHT in TWNBPP lowers PSA levels from baseline, below expected levels for age‐matched cisgender controls. Not all TWNBPP over the age of 40 years should be offered PSA testing; however, those with a genetic predisposition, family history, or symptoms of prostate cancer, may request or be offered a PSA test. There are currently no clinical PSA thresholds to guide interpretation of PSA levels in TWNBPP when being evaluated for suspected prostate cancer or for those seeking PSA testing.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"38 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340869","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":"Prospective health‐related quality of life in women undergoing radical cystectomy and urinary diversion","authors":"Matthew B. Clements, Kelly R. Pekala, Amy L. Tin, Daniel D. Sjoberg, Benjamin Beech, Thomas Atkinson, Harry Herr, S. Machele Donat, Andrew J. Vickers, Guido Dalbagni, Bernard H. Bochner","doi":"10.1111/bju.16821","DOIUrl":"https://doi.org/10.1111/bju.16821","url":null,"abstract":"ObjectivesTo assess health‐related quality of life (HRQoL) in women undergoing radical cystectomy (RC) for bladder cancer, focusing on identifying the pattern of recovery among women and any gender‐specific differences.Patients and MethodsWe analysed a prospective study of HRQoL in 411 participants undergoing RC (88 females), including 14 patient‐reported outcome measures over 2 years of follow‐up. Generalised estimating equation models were used to estimate recovery in domain scores among women and analyse baseline HRQoL (among women based on diversion type and then comparing outcomes to males).ResultsWomen who received a continent diversion (vs ileal conduit) had lower baseline Body Image (<jats:italic>P</jats:italic> = 0.037) and Social Functioning scores (<jats:italic>P</jats:italic> = 0.046). In comparison to men, women had lower baseline Social Functioning (<jats:italic>P</jats:italic> = 0.033), Body Image (<jats:italic>P</jats:italic> = 0.011), Sexual Functioning (<jats:italic>P</jats:italic> &lt; 0.001), Emotional Functioning (<jats:italic>P</jats:italic> &lt; 0.001), and Mental Health (<jats:italic>P</jats:italic> &lt; 0.001). Postoperatively, considerable improvements were seen in women for psychosocial health domains, but Emotional Functioning (<jats:italic>P</jats:italic> &lt; 0.001) and Mental Health (<jats:italic>P</jats:italic> = 0.024), for instance, remained meaningfully lower among women despite the improvements. Domains such as Physical Functioning (<jats:italic>P</jats:italic> = 0.2) and Global QoL (<jats:italic>P</jats:italic> = 0.12) were similar, although Pain (<jats:italic>P</jats:italic> = 0.026) and Fatigue (<jats:italic>P</jats:italic> = 0.031) were worse in women postoperatively.ConclusionWomen exhibit a similar, positive recovery trajectory in HRQoL after RC. However, both pre‐ and postoperatively, there are meaningfully lower psychosocial domain scores. Lower baseline Sexual Functioning scores and the differences observed in continent and ileal conduit diversion suggests tailored attention to this area in women. These findings have clinical implications for additional attention to psychosocial and emotional health during recovery after RC.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"183 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328617","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 ChatGPT pass the urology fellowship examination? Artificial intelligence capability in surgical training assessment","authors":"Kathleen Lockhart, Ashan Canagasingham, Wenjie Zhong, Darius Ashrafi, Brayden March, Dane Cole‐Clark, Alice Grant, Amanda Chung","doi":"10.1111/bju.16806","DOIUrl":"https://doi.org/10.1111/bju.16806","url":null,"abstract":"ObjectivesTo assess the performance of ChatGPT compared to human trainees in the Australian Urology written fellowship examination (essay format).Materials and MethodsEach examination was marked independently by two blinded examining urologists and assessed for: overall pass/failure; proportion of passing questions; and adjusted aggregate score. Examining urologists also made a blinded judgement as to authorship (artificial intelligence [AI] or trainee).ResultsA total of 20 examination papers were marked; 10 completed by urology trainees and 10 by AI platforms (half each on ChatGPT‐3.5 and ‐4.0). Overall, 9/10 of trainees successfully passed the urology fellowship, whereas only 6/10 of ChatGPT examinations passed (<jats:italic>P</jats:italic> = 0.3). Of the ChatGPT failing examinations, 3/4 were undertaken by the ChatGPT‐3.5 platform. The proportion of passing questions per examination was higher in trainees compared to ChatGPT: mean 89.4% vs 80.9% (<jats:italic>P</jats:italic> = 0.2). The adjusted aggregate scores of trainees were also higher than those of ChatGPT by a small margin: mean 79.2% vs 78.1% (<jats:italic>P</jats:italic> = 0.8). ChatGPT‐3.5 and ChatGPT‐4.0 achieved similar aggregate scores (78.9% and 77.4%, <jats:italic>P</jats:italic> = 0.8). However, ChatGPT‐3.5 had a lower percentage of passing questions per examination: mean 79.6% vs 82.1% (<jats:italic>P</jats:italic> = 0.8). Two examinations were incorrectly assigned by examining urologists (both trainee candidates perceived to be ChatGPT); therefore, the sensitivity for identifying ChatGPT authorship was 100% and overall accuracy was 91.7%.ConclusionOverall, ChatGPT did not perform as well as human trainees in the Australian Urology fellowship written examination. Examiners were able to identify AI‐generated answers with a high degree of accuracy.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"44 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328620","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":"Outcomes of non‐reduction vs reduction pyeloplasty: a systematic review and meta‐analysis","authors":"Michelangelo S. Cobangbang, Kay Chua Rivera, Mandy Rickard, Joana Dos Santos, Armando Lorenzo, Jin Kyu Kim, Jessie Cunningham, Michael E. Chua","doi":"10.1111/bju.16820","DOIUrl":"https://doi.org/10.1111/bju.16820","url":null,"abstract":"ObjectiveTo compare the surgical outcomes between non‐reduction and reduction pyeloplasty in the management of pelvi‐ureteric junction obstruction among patients such as postoperative functional outcomes, complication rate, and failure rate through a meta‐analysis of comparative studies.Patients and MethodsElectronic databases including PubMed, EMBASE, Scopus, and Cochrane Library, including the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were searched to identify published literature comparing reduction and non‐reduction pyeloplasty in adult and paediatric patients. Data on anteroposterior pelvic diameter (APPD), differential renal function (DRF), and complications were extracted. Data synthesis and statistical analysis were done using ReviewManager. Random‐effects model and standard mean difference (SMD) were used for calculation of all effect estimates with 95% confidence intervals (CIs) for extrapolation. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO:CRD42021288645).ResultsFive studies were selected for analysis, encompassing 177 renal units, of which 88 cases were reduction pyeloplasty and 89 cases were non‐reduction pyeloplasty. Continuous variables were presented as SMDs with their 95% CIs. Our overall pooled effect estimates showed a statistically significant difference favouring reduction pyeloplasty in terms of postoperative APPD (SMD 1.77, 95% CI 0.43–3.10) and change in APPD (SMD 1.21, 95% CI 0.07–2.36). No statistically significant difference was observed for postoperative DRF (SMD 0.27, 95% CI −0.10 to 0.64) and change in DRF (SMD 0.68, 95% CI −0.39 to 1.74). Subgroup analyses revealed no statistically significant difference for all functional outcomes. Analysis of both groups revealed no significant difference in terms of postoperative complication rate (relative risk [RR] 0.91, 95% CI 0.38–2.16) and failure rate (RR 1.50, 95% CI 0.28–8.04).ConclusionThe evidence suggests that non‐reduction pyeloplasty results in comparable postoperative DRF and change in DRF. Although reduction pyeloplasty results in superior APPD and change in APPD compared to non‐reduction pyeloplasty, these findings may be clinically negligible. Complication and failure rates between the two groups are comparable.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"6 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328611","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":"Prevalence of cardiac dysfunction in men with erectile dysfunction: the EDcard study.","authors":"Emil Durukan,Christian Fuglesang S Jensen,Maria Dons,Morten Sengeløv,Nino Emanuel Landler,Kristoffer Grundtvig Skaarup,Mats C Højbjerg Lassen,Niklas Dyrby Johansen,Peter Busch Østergren,Jens Sønksen,Mikkel Fode,Tor Biering-Sørensen","doi":"10.1111/bju.16824","DOIUrl":"https://doi.org/10.1111/bju.16824","url":null,"abstract":"OBJECTIVESTo assess the prevalence of myocardial impairment in men with erectile dysfunction (ED) as compared with the general population using conventional and two-dimensional speckle-tracking echocardiography.SUBJECTS AND METHODSIn this cross-sectional study, men with ED underwent clinical, electrocardiographic, and transthoracic echocardiographic evaluation including left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) according to a predefined protocol. All participants were matched 1:1 with controls from the general population on sex, age, and body mass index (BMI).RESULTSIn total, 796 people were included, 398 men with ED and 398 controls. The ED group had a median (interquartile range [IQR]) age of 61 (53-70) years and a median (IQR) BMI of 26.3 (24-29) kg/m2. Left ventricular (LV) systolic dysfunction was found in 232 (58.3%) men with ED compared to 102 (25.6%) controls (P < 0.001). Nineteen (4.8%) men with ED were referred for further cardiovascular evaluation.CONCLUSIONMore than half of men with ED exhibited signs of cardiac dysfunction, particularly LV systolic dysfunction. Further research should explore the long-term prognostic implications of these findings.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"29 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328634","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":"Stapled vs totally handsewn robotic intracorporeal neobladder: perioperative and functional outcomes","authors":"Riccardo Mastroianni, Giuseppe Chiacchio, Gabriele Tuderti, Aldo Brassetti, Umberto Anceschi, Mariaconsiglia Ferriero, Leonardo Misuraca, Simone D'annunzio, Alfredo Maria Bove, Marianna Anselmi, Salvatore Guaglianone, Rocco Simone Flammia, Flavia Proietti, Costantino Leonardo, Giuseppe Simone","doi":"10.1111/bju.16826","DOIUrl":"https://doi.org/10.1111/bju.16826","url":null,"abstract":"ObjectivesTo compare perioperative, postoperative and functional outcomes between stapled (ST) and handsewn (HS) intracorporeal orthotopic neobladder (iON) configuration during robot‐assisted radical cystectomy (RARC).Patients and MethodsOur single centre institutional bladder cancer dataset was queried for ‘RARC’ ‘stapled’ and ‘handsewn’ iON. Baseline, peri‐ and postoperative features of patients treated between January 2018 and July 2023 were collected. Continuous and categorical variables were compared using Kruskal–Wallis and chi‐square tests. The Kaplan–Meier method was applied to assess functional outcomes. Cox regression analysis was performed to identify predictors of continence recovery.ResultsOverall, 116 patients were enrolled (HS‐iON, 60 patients). There were no differences in perioperative outcomes, except for the hospital length of stay, being shorter in the HS‐iON cohort (<jats:italic>P</jats:italic> &lt; 0.001). There were no differences in the 30‐ (<jats:italic>P</jats:italic> = 0.17) and 90‐day (<jats:italic>P</jats:italic> = 0.69) postoperative complications. The stone rate was lower in the HS‐iON cohort (<jats:italic>P</jats:italic> = 0.01). At Kaplan–Meier analysis, patients with HS‐iON had higher day‐ (<jats:italic>P</jats:italic> &lt; 0.001) and night‐time (<jats:italic>P</jats:italic> &lt; 0.001) continence recovery probabilities. At multivariable analysis, the only independent predictor of continence recovery was ‘sex‐sparing approach’. Excluding patients who underwent sex‐sparing procedures, the HS approach was the only predictor of night‐time continence recovery (hazard ratio 2.6, 95% confidence 1.27–5.34; <jats:italic>P</jats:italic> = 0.009).ConclusionHand sewing may represent a preferable option for iON configuration during RARC. ST‐iON did not prove to either reduce operative times or perioperative complications, while seemed to significantly impact on the risk of stone formation and continence recovery. Whenever oncologically feasible, a sex‐sparing approach should be preferred to improve day‐ and night‐time continence recovery.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"606 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311336","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 association of smoking with urinary and sexual function recovery following radical prostatectomy.","authors":"Jordi Visscher,Billie Bonevski,Michael O'Callaghan","doi":"10.1111/bju.16817","DOIUrl":"https://doi.org/10.1111/bju.16817","url":null,"abstract":"OBJECTIVETo investigate the association of smoking with post-prostatectomy functional recovery in a large population-based cohort using standardised outcome measures.PATIENTS AND METHODSWe conducted a cohort study and reported findings according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. We used a registry with prospectively gathered patient-reported outcome measures (PROMs) regarding health and morbidity. We included all men who underwent radical prostatectomy (RP) for localised prostate cancer, without (neo)adjuvant hormone or radiotherapy treatment. In our analysis, we compared Expanded Prostate Cancer Index Composite-26 (EPIC-26) scores between people who had ever smoked and those who had not during 24 months' follow-up. We identified significant confounders by means of a causal directed acyclic graph, adjusted for these, and performed subgroup and sensitivity analyses.RESULTSIn total, 2676 patients were included in the analysis. PROM data were available for 61% of the total 4356 otherwise eligible participants. Multivariable regression analysis showed that patients who had ever smoked (ever smokers) scored 11 points lower for sexual function (95% confidence interval -15.0, -7.0) compared to never smokers during 24 months' follow-up. Subgroup analysis showed that individuals with baseline scores above 80 were more at risk of sexual function loss. Urinary incontinence scores were similar between ever smokers and never smokers.CONCLUSIONSmoking was associated with lower sexual function scores in the first 2 years after RP, but not with changes in urinary incontinence outcomes.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"42 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319867","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 'Stone dust in endourology: a systematic review of its definition, management, and clinical impact'.","authors":"Renu Sah,Ankita Mathur","doi":"10.1111/bju.16834","DOIUrl":"https://doi.org/10.1111/bju.16834","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"30 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311424","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}