BJU International最新文献

{"title":"Response to Sah and Mathur","authors":"Stefano Moretto, Steeve Doizi, Alberto Quarà, Federico Zorzi, Alejandra Bravo-Balado, Aideen Madden, Johan Cabrera, Luigi Candela, Mariela Corrales, Olivier Traxer, Frederic Panthier","doi":"10.1111/bju.16835","DOIUrl":"https://doi.org/10.1111/bju.16835","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"21 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311913","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":"Bladder neck involvement in non-muscle-invasive bladder cancer: risk implications and outcomes of BCG vs gemcitabine/docetaxel.","authors":"Ahmed Eraky,Reuben Ben-David,Brenda Hug,Kaushik P Kolanukuduru,Neeraja Tillu,Peter Wiklund,Reza Mehrazin,John P Sfakianos","doi":"10.1111/bju.16827","DOIUrl":"https://doi.org/10.1111/bju.16827","url":null,"abstract":"OBJECTIVESTo evaluate the impact of bladder neck involvement (BNI) on oncological outcomes in non-muscle-invasive bladder cancer (NMIBC) and compare outcomes between Bacillus Calmette-Guérin (BCG) and gemcitabine/docetaxel (Gem/Doce) intravesical therapies in this population.PATIENTS AND METHODSWe analysed consecutive patients with NMIBC who underwent transurethral resection of bladder tumour (TURBT) and received BCG or Gem/Doce from 2013 to 2023. BNI was defined as tumour presence at the bladder neck during TURBT. Recurrence-free survival (RFS) and progression-free survival (PFS) were assessed using Kaplan-Meier and Cox regression analyses.RESULTSAmong 474 patients, 58 (12%) had BNI. The median (interquartile range) follow-up time was 34 (12-58) months. The 2-year RFS was lower in the BNI group for any-grade (41% vs 57%, log-rank p = 0.003) and high-grade recurrence (56% vs 68%, log-rank p = 0.03). BNI independently predicted worse any-grade RFS (hazard ratio [HR] 1.59, p = 0.02), high-grade RFS (HR 1.68, p = 0.03), and PFS (HR 2.18, p = 0.03). While BCG and Gem/Doce had comparable 2-year high-grade RFS (59% vs 53%, log-rank p = 0.31) and PFS (88% vs 68%, log-rank p = 0.07), the multivariable analysis revealed significantly increased risk of any-grade recurrence (HR 1.75, p < 0.001) and progression (HR 2.72, p = 0.002). Maintenance therapy improved high-grade RFS (HR 0.43, p < 0.001) and PFS (HR 0.44, p = 0.003). Limitations include retrospective design and single-institution data.CONCLUSIONBladder neck involvement is an independent predictor of worse outcomes in NMIBC. While unadjusted outcomes were similar, multivariable analysis showed higher recurrence and progression risk with Gem/Doce. Recognising BNI as a high-risk factor may refine risk stratification and treatment decisions. Further studies are needed to validate these findings.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"146 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295705","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 decade review of mental health monitoring in clinical trials for United States Food and Drug Administration-approved genitourinary cancer treatments.","authors":"Farzad Teymouri,Parnian Jabbari,Omid Yazdanpanah,Aditya Mahadevan,Arash Rezazadeh Kalebasty,David J Benjamin","doi":"10.1111/bju.16815","DOIUrl":"https://doi.org/10.1111/bju.16815","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"10 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295702","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 prostate cancer assessment and management between Māori and non-Māori in New Zealand","authors":"Eng Ann Toh, Jared White, Judith Clarke, Phil Hider, Stephen Mark","doi":"10.1111/bju.16805","DOIUrl":"https://doi.org/10.1111/bju.16805","url":null,"abstract":"To identify possible causes for inequitable prostate cancer (PCa) outcomes in Māori by examining any differences in the assessment and management of Māori and non-Māori diagnosed with PCa in Aotearoa New Zealand (NZ).","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"21 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278707","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":"Clinically significant prostate cancer detected by systematic biopsy in patients with MRI lesions","authors":"Sean A. Fletcher, Mark N. Alshak, Seoho Lee, Nirmish Singla, Misop Han, Mohamad E. Allaf, Arvin K. George, Katarzyna J. Macura, Christian P. Pavlovich","doi":"10.1111/bju.16816","DOIUrl":"https://doi.org/10.1111/bju.16816","url":null,"abstract":"ObjectiveTo characterise the prevalence and distribution of biopsy cores found to be higher grade on systematic biopsy compared to targeted biopsy in patients with prostate magnetic resonance imaging (MRI) lesions.Patients and MethodsWe retrospectively identified patients with a pre‐biopsy MRI and a Prostate Imaging‐Reporting and Data System score ≥3 lesion, who underwent combined systematic and targeted biopsy between 2021 and 2024. Transrectal and transperineal approaches with either software‐based or cognitive fusion techniques were used. We compared the highest Gleason grade detected by systematic vs targeted biopsy for each patient. Clinically significant prostate cancer (csPCa) was defined as Gleason Grade Group ≥2. For those with higher‐grade csPCa detected on systematic compared to targeted biopsy, we correlated the pathological location of the higher‐grade systematic core to the corresponding MRI region(s) of interest (ROI). Multivariable logistic regression was used to determine factors associated with higher‐grade csPCa found on systematic biopsy.ResultsOur final cohort comprised 481 patients. Detection of higher‐grade csPCa on systematic biopsy outside of the MRI ROI occurred in 6.4% of all cases. Systematic biopsy detected higher‐grade csPCa contralateral to the MRI ROI in only 1.5% of all cases. There were no identifiable factors on multivariable analysis associated with detection of higher‐grade csPCa on systematic biopsy outside of the ROI.ConclusionThere exists a small percentage of patients with occult csPCa detected only on systematic biopsy outside of the MRI ROI, most of which is ipsilateral to the target. Systematic biopsy also increased detection of low‐grade cancer overall. An approach of systematic biopsy ipsilateral to MRI lesions should increase csPCa detection while reducing overdiagnosis of low‐grade disease.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"10 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278340","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":"An MRI/PET PSMA-based phase I–II study of salvage high-dose-rate brachytherapy after surgery and radiotherapy","authors":"Marta Gimeno-Morales, Marcos Torres, Javier Ancizu-Marckert, Luis Labairu Huerta, Luis Fuertes Vallés, Benigno Barbés, Alberto Benito, Macarena Rodríguez Fraile, Adriana Ayestarán, Rafael Martinez-Monge","doi":"10.1111/bju.16819","DOIUrl":"https://doi.org/10.1111/bju.16819","url":null,"abstract":"&lt;p&gt;Local failure is the main pattern of failure in patients with prostate cancer undergoing radical prostatectomy (RP) [&lt;span&gt;1&lt;/span&gt;] as well as in patients who receive salvage external beam radiation therapy (EBRT) combined with short-term (6-month) androgen deprivation therapy (ADT) [&lt;span&gt;2&lt;/span&gt;] after RP failure. Hence, there is a substantial percentage of patients with prostate cancer who will experience a second local relapse after RP and salvage EBRT with very limited local treatment options. Current guidelines and expert consensus recommendations support patient monitoring or initiation of ADT if maximal pelvic therapy has been given.&lt;/p&gt;\u0000&lt;p&gt;The advent of novel imaging techniques, such as &lt;sup&gt;68&lt;/sup&gt;Ga PSMA-PET, has yielded detection rates of 50% of areas with pathological metabolism in patients with PSA values &lt; 0.5 ng/mL [&lt;span&gt;3&lt;/span&gt;]. This paradigm shift has led many radiation oncologists to revisit reirradiation as a reasonable alternative to the use of ADT.&lt;/p&gt;\u0000&lt;p&gt;Focal reirradiation with brachytherapy has been mainly used as salvage therapy after EBRT failure when the prostate gland is intact [&lt;span&gt;4&lt;/span&gt;]. Although brachytherapy has a unique dosimetric profile that makes it specially suited for small prostatic recurrences that can be approached via the transperineal route, its use in the post-prostatectomy setting is limited [&lt;span&gt;4&lt;/span&gt;] and technically challenging.&lt;/p&gt;\u0000&lt;p&gt;Seven patients with a median follow-up of 7.6 years who fulfilled the eligibility criteria were enrolled in this investigator-initiated trial (NCT06982469: Prostate HDR Salvage post RP). Eligibility criteria included: (i) increasing PSA level after RP and salvage EBRT of at least 65 Gy and radiological evidence of isolated prostatic bed relapse (IPBR) visible on &lt;sup&gt;68&lt;/sup&gt;Ga PSMA-PET and multiparametric MRI; (ii) IPBR potentially implantable transperineally with TRUS guidance; (iii) absence of intraluminal infiltration of the vesico-urethral anastomosis, external urinary sphincter, rectum or bladder; (iv) patient written informed consent to participate in the institutional review board-approved study (University of Navarre IRB code 2020.212); and (v) life expectancy &gt; 5 years. Examples of the typical second salvage locations, as determined by multiparametric MRI and PSMA-PET, with the final dosimetric result are shown in Fig. 1.&lt;/p&gt;\u0000&lt;figure&gt;&lt;picture&gt;\u0000&lt;source media=\"(min-width: 1650px)\" srcset=\"/cms/asset/be670bd6-7af5-41a7-9496-62da57707856/bju16819-fig-0001-m.jpg\"/&gt;&lt;img alt=\"Details are in the caption following the image\" data-lg-src=\"/cms/asset/be670bd6-7af5-41a7-9496-62da57707856/bju16819-fig-0001-m.jpg\" loading=\"lazy\" src=\"/cms/asset/f0bff541-e9c1-4f91-abea-0c4089d37cf3/bju16819-fig-0001-m.png\" title=\"Details are in the caption following the image\"/&gt;&lt;/picture&gt;&lt;figcaption&gt;\u0000&lt;div&gt;&lt;strong&gt;Fig. 1&lt;span style=\"font-weight:normal\"&gt;&lt;/span&gt;&lt;/strong&gt;&lt;div&gt;Open in figure viewer&lt;i aria-hidden=\"true\"&gt;&lt;/i&gt;&lt;span&gt;PowerPoint&lt;/span&gt;&lt;/div&gt;\u0000&lt;/div&gt;\u0000&lt;div&gt;Gra","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"42 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278719","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":"Response to Jiang et al.","authors":"Davide Perri, Giorgio Bozzini","doi":"10.1111/bju.16823","DOIUrl":"https://doi.org/10.1111/bju.16823","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"89 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278718","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":"Comparison of bleeding risk between miniaturised percutaneous nephrolithotomy and retrograde intrarenal surgery for 10–20 mm renal stones: a comprehensive analysis","authors":"Biao Jiang, Zhonghua Sun, Jiansheng Xiao","doi":"10.1111/bju.16822","DOIUrl":"https://doi.org/10.1111/bju.16822","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"42 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278708","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":"Prostate artery EmbolisAtion Safety and efficacY: Preliminary and foLlow-Up urodynamic Studies (P-EASY PLUS).","authors":"Nicholas Brown, Sepinoud Firouzmand, Anthony Kiosoglous, Stephanie Castree, Duncan Walker, Rhiannon McBean, Boon Kua, Troy Gianduzzo, Rachel Esler, Peter Campbell, Joseph Schoeman, John Yaxley","doi":"10.1111/bju.16808","DOIUrl":"https://doi.org/10.1111/bju.16808","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of prostate artery embolisation (PAE) in the management of obstructive benign prostatic hyperplasia (BPH) by conducting formal urodynamic studies.</p><p><strong>Methods: </strong>Patients with symptomatic BPH underwent baseline assessments, including urodynamic evaluation, followed by PAE. Follow-up International Prostate Symptom Scores (IPSS), Quality of Life questionnaire (QoL) scores, prostate volume and urodynamic variables were assessed at a mean follow-up of 18 months.</p><p><strong>Results: </strong>A total of 105 patients underwent PAE, with average final follow-up at 18 months. Prostate volumes reduced by a mean of 30.6% and significant improvements were identified across all IPSS parameters (total IPPS decreased by 55%; P < 0.001), QoL scores (improved by 65.9%; P < 0.001), maximum urinary flow rate (increased by 5 mL/s; P < 0.001), postvoid residual urine volume (decreased by 24%; P = 0.049), detrusor pressure (decreased from 65.0 to 48.9 cmH₂O; P < 0.001) and bladder obstruction rates. Bladder obstruction decreased from 66.7% to 29.8% of patients following embolisation. Results were found to be positively correlated to the absolute amount of embolic material injected during the embolisation procedure. PAE was well tolerated, with expected post-embolisation symptoms resolving completely after a mean (sd; range) of 7 (±5; 1-28) days. There were no major procedural complications, no reported urinary incontinence, and new retrograde ejaculation occurred in 2%.</p><p><strong>Conclusion: </strong>In this study, PAE resulted in statistically significant improvements by both subjective and objective measures, including symptom severity, quality of life and urodynamic parameters. Whilst longer-term studies are required, these findings support PAE as a non-surgical option within the treatment algorithm for managing symptomatic, obstructive BPH.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274202","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":"Making peace with resilience","authors":"Gemma E. Scrimgeour, Kevin J. Turner","doi":"10.1111/bju.16818","DOIUrl":"https://doi.org/10.1111/bju.16818","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"588 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259991","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}