BJU International最新文献

{"title":"Intravesical recurrence after therapeutic ureteroscopy for upper tract urothelial carcinoma: a meta‐analysis","authors":"Francesco Di Bello, Andrea Gallioli, Donato Cannoletta, Stefano Mancon, Angelo Territo, Lucia Diéguez, Paula Izquierdo, Pedro Hernandez, Josep Maria Gaya Sopena, Joan Palou, Alberto Breda","doi":"10.1111/bju.16902","DOIUrl":"https://doi.org/10.1111/bju.16902","url":null,"abstract":"ObjectiveTo assess the role of ureteroscopy (URS) with laser ablation on oncological outcomes, namely, intravesical recurrence (IVR) rate, radical nephroureterectomy (RNU)‐to‐treat ratio and overall survival (OS), in patients with upper tract urothelial carcinoma (UTUC), an area of study that has been insufficiently addressed in the literature.Materials and MethodsA systematic search (PROSPERO: CRD42025642480) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) statement. A pooled analysis was performed to quantify the effect size (ES) for IVR rate, radical nephroureterectomy (RNU)‐to‐treat ratio and OS. Subgroup analyses were performed to evaluate patients who received postoperative instillations and to compare URS with laser ablation to RNU.ResultsOverall, 24 studies involving 1904 patients were included in the final analysis. The overall rate of IVR was 23.7% (<jats:italic>n</jats:italic> = 453). The overall pooled analysis showed an ES for IVR of 0.33, for RNU‐to‐treat ratio of 0.23, and for OS of 0.62 (all <jats:italic>P</jats:italic> ≤ 0.005). In the comparison between URS and RNU, the pooled ES of URS for IVR was 1.14 and for OS it was 1.43 (all <jats:italic>P</jats:italic> &gt; 0.05). Within the subgroup analysis of patients who received postoperative instillations, the pooled ES for IVR was 0.38 (<jats:italic>P</jats:italic> = 0.029) and for RNU‐to‐treat ratio it was 0.25 (<jats:italic>P</jats:italic> = 0.012).ConclusionsIn this systematic review, URS with laser ablation was found to exert a negligible effect on IVR rate. Moreover, no statistically significant differences in IVR nor in OS were recorded when URS was compared to RNU. URS can be performed without compromising the oncological outcomes of patients with UTUC.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"305 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915483","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":"Advancing value‐based healthcare in urology to improve outcomes that matter to patients","authors":"Lucinda Gabriel, Joseph Casey, Prokar Dasgupta","doi":"10.1111/bju.16912","DOIUrl":"https://doi.org/10.1111/bju.16912","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"164 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915486","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":"Defining statistical cure in patients with T1 high-grade non-muscle-invasive bladder carcinoma treated with BCG immunotherapy.","authors":"José Daniel Subiela, Irene de la Parra, Javier Taborda, Alberto Artiles Medina, Renate Pichler, Wojciech Krajewski, Cesar Mínguez Ojeda, Ana Fernández Mardomingo, Pedro Del Olmo Durán, Enrique López Pérez, Daniel A González-Padilla, Júlia Aumatell, Keiichiro Mori, Pietro Scilipoti, Mattia Longoni, Mario de Angelis, Jorge Caño-Velasco, Alfonso Lafuente Puentedura, Lucia Polanco Pujol, Roberto Contieri, Andrea Gallioli, Andrzej Tukiendorf, David D'Andrea, Jeremy Yuen-Chun Teoh, Luca Afferi, Francesco Del Giudice, Gautier Marcq, Simone Albisinni, Francesco Soria, Laura S Mertens, Ekaterina Laukhtina, Karl Tully, Andrea Mari, Félix Guerrero-Ramos, Mario Alvarez-Maestro, Carlos Casanova Martín, Franklin Anagua Melendres, Oscar Buisan, José Agustín López-González, José Luis Dominguez-Escrig, Javier Aranda, José Luis Rodríguez Elena, Giuseppe Basile, Victoria Gómez Dos Santos, Marco Moschini, Benjamin Pradere, Eduardo Albers Acosta, Fernando Lozano Palacio, Albert Carrión Puig, Pablo Gajate, Ana Saiz, Paolo Gontero, Francisco Javier Burgos Revilla","doi":"10.1111/bju.16913","DOIUrl":"https://doi.org/10.1111/bju.16913","url":null,"abstract":"<p><strong>Objective: </strong>To assess cure fraction and conditional survival probabilities for oncological outcomes in patients with T1 high-grade (T1HG) non-muscle-invasive bladder carcinoma (NMIBC) treated with adequate Bacillus Calmette-Guérin (BCG) immunotherapy.</p><p><strong>Patients and methods: </strong>This multi-institutional retrospective cohort study included 1403 patients with T1HG NMIBC treated between 2007 and 2020, adhering to modern guidelines including mandatory second transurethral resection of bladder tumour and adequate BCG, defined as at least five of six induction doses and at least two of three maintenance doses. Cure fraction, defined as the proportion of patients who will never experience the event of interest, was calculated for recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) using a mixture cure model. Conditional survival probabilities over 5 years were also computed.</p><p><strong>Results: </strong>Cure fractions were 41% (95% confidence interval [CI] 36%-46%) for RFS, 71% (95% CI 65%-76%) for PFS, 76% (95% CI 70%-83%) for CSS, and 38% (95% CI 28%-49%) for OS. Patients in very-high-risk subgroups, according to the European Association of Urology risk stratification, showed significantly lower cure fractions, particularly for PFS (61% [95% CI 50%-72%]) and CSS (59% [95% CI 34-84%]). Conditional survival analysis demonstrated that patient prognoses improved over time, with 5-year conditional RFS, PFS, CSS and OS probabilities exceeding 90% for patients who were event-free at 5 years from diagnosis.</p><p><strong>Conclusions: </strong>We found that BCG immunotherapy achieves a statistical cure in select T1HG NMIBC patients, with avoidance of progression to muscle-invasive bladder carcinoma in approximately 70% of cases. The probability of experiencing any adverse oncological event (recurrence, progression or death) is less than 10% among patients who remain event-free for 5 years.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941749","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 ‘Dorsal‐ vs ventral‐onlay buccal mucosal graft urethroplasty: a meta‐analysis’","authors":"Atef A. Hassan, Ahmed Mohamed Soliman, Hossam Ahmed Shouman, Mohamed Ibrahim Algammal, Mohamed Fawzy Salman, Mohamed Abdallah Hindawy, Ibrahim Tagreda, Mohamed Elsalhy, Ahmed Alrefaey, Hesham Abozied, Hassan Abdelazim, Mohammed Agha, Moaz Elsayed Abouelmagd, Mohamed Hamouda Elkasaby, Hesham Abdel‐Azim El‐Helaly","doi":"10.1111/bju.16908","DOIUrl":"https://doi.org/10.1111/bju.16908","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"23 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915491","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":"Suction in mini‐percutaneous nephrolithotomy: a meta‐analysis from the European Association of Urology Section of Endourology","authors":"Mohammed Zain Ulabedin Adhoni, Ethan Pooley, Kevin Byrnes, Lazaros Tzelves, Patrick Juliebø‐Jones, Vineet Gauhar, Steffi Kar Kei Yuen, Oliver Traxer, Bhaskar Somani","doi":"10.1111/bju.16891","DOIUrl":"https://doi.org/10.1111/bju.16891","url":null,"abstract":"ObjectiveTo conduct a meta‐analysis comparing the outcomes of vacuum‐assisted access sheath (VAAS) mini‐percutaneous nephrolithotomy (mPCNL) vs conventional access sheath (CAS) mPCNL.MethodsA systematic review and meta‐analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines, with registration in PROSPERO (CRD42024619780). A comprehensive search identified comparative studies (randomised controlled trials and observational studies). The primary outcomes included operating time, stone‐free rate (SFR) and complications. Secondary outcomes included transfusion rates, haemoglobin deficit, and length of hospital stay. Data were analysed using Review Manager V5.4, with quality of evidence assessed using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) tool.ResultsFourteen studies with 2510 patients (1298 in the VAAS and 1212 in the CAS mPCNL groups) were included. VAAS mPCNL significantly reduced operating time, by 17.45 (13.12–21.79) min (<jats:italic>P</jats:italic> &lt; 0.001), and was associated with a higher SFR: odds ratio (OR) 1.92 (95% confidence interval [CI] 1.57, 2.35; <jats:italic>P</jats:italic> &lt; 0.001). The VAAS mPCNL group also had a lower postoperative fever rate (OR 0.45 [95% CI 0.35, 0.61]; <jats:italic>P</jats:italic> &lt; 0.001) and a lower sepsis rate (OR 0.45 [95% CI 0.22, 0.93]; <jats:italic>P</jats:italic> = 0.03). The overall complication rate for VAAS mPCNL was significantly lower than for CAS mPCNL (<jats:italic>P</jats:italic> &lt; 0.001), with fewer minor complications. Hospital stay was shorter for VAAS mPCNL (mean reduction of 0.79 days; <jats:italic>P</jats:italic> = 0.03). There were no significant differences in transfusion rates (OR 0.78 [95% CI 0.46, 1.31]; <jats:italic>P</jats:italic> = 0.3) or haemoglobin deficit (0.00 g/dL [95% CI 0.22–0.22]; <jats:italic>P</jats:italic> &gt; 0.9).ConclusionThe use of VAAS mPCNL offers significant advantages over CAS mPCNL, including shorter operating time, improved stone clearance, and reduced complications. These findings support the use of VAAS mPCNL in managing kidney stones, with further high‐quality studies recommended.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"10 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919138","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 ‘Clinical features of medication‐related osteonecrosis of the jaw in prostate cancer management’","authors":"Prajnasini Satapathy, Rachana Mehta, Ranjana Sah","doi":"10.1111/bju.16914","DOIUrl":"https://doi.org/10.1111/bju.16914","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"34 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144910957","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":"ProMUS‐NET: Artificial intelligence detects more prostate cancer than urologists on micro‐ultrasonography","authors":"Steve R. Zhou, Lichun Zhang, Moon Hyung Choi, Sulaiman Vesal, Adam Kinnaird, Wayne G. Brisbane, Giovanni Lughezzani, Davide Maffei, Vittorio Fasulo, Patrick Albers, Richard E. Fan, Wei Shao, Geoffrey A. Sonn, Mirabela Rusu","doi":"10.1111/bju.16892","DOIUrl":"https://doi.org/10.1111/bju.16892","url":null,"abstract":"ObjectivesTo improve sensitivity and inter‐reader consistency of prostate cancer localisation on micro‐ultrasonography (MUS) by developing a deep learning model for automatic cancer segmentation, and to compare model performance with that of expert urologists.Patients and MethodsWe performed an institutional review board‐approved prospective collection of MUS images from patients undergoing magnetic resonance imaging (MRI)‐ultrasonography fusion guided biopsy at a single institution. Patients underwent 14‐core systematic biopsy and additional targeted sampling of suspicious MRI lesions. Biopsy pathology and MRI information were cross‐referenced to annotate the locations of International Society of Urological Pathology Grade Group (GG) ≥2 clinically significant cancer on MUS images. We trained a no‐new U‐Net model – the Prostate Micro‐Ultrasound Network (ProMUS‐NET) – to localise GG ≥2 cancer on these image stacks in a fivefold cross‐validation. Performance was compared vs that of six expert urologists in a matched sub‐cohort.ResultsThe artificial intelligence (AI) model achieved an area under the receiver‐operating characteristic curve of 0.92 and detected more cancers than urologists (lesion‐level sensitivity 73% vs 58%; patient‐level sensitivity 77% vs 66%). AI lesion‐level sensitivity for peripheral zone lesions was 86.2%.ConclusionsOur AI model identified prostate cancer lesions on MUS with high sensitivity and specificity. Further work is ongoing to improve margin overlap, to reduce false positives, and to perform external validation. AI‐assisted prostate cancer detection on MUS has great potential to improve biopsy diagnosis by urologists.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"33 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906128","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":"Biopsy‐all strategy in patients with a renal mass: simulation of a randomised controlled trial","authors":"Federico Belladelli, Giuseppe Rosiello, Lucia Salerno, Giacomo Musso, Francesco Cei, Chiara Re, Andrea Folcia, Giuseppe Fallara, Rayan Matloob, Nicholas Branger, Jochen Walz, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Roberto Bertini, Umberto Capitanio, Alessandro Larcher","doi":"10.1111/bju.16885","DOIUrl":"https://doi.org/10.1111/bju.16885","url":null,"abstract":"ObjectivesTo investigate the clinical benefit and cost‐effectiveness of a renal biopsy (RB)‐all strategy for patients with a renal mass, as in renal cancer the indication for upfront surgery (SUR) without previous RB invariably results in the overtreatment of patients with benign histology.Patients and MethodsA total of 1729 patients with clinical (c)T1–2 cM0 renal mass treated with SUR were included. To simulate a randomised clinical trial comparing patients who underwent SUR vs RB and subsequent treatment, a random binary variable assigned patients to Arm a‐SUR and Arm b‐RB. In Arm a‐SUR, patients are all treated with SUR; postoperative complications and costs are those recorded after surgery. In Arm b‐RB, we have assumed an 8–20% uncertain RB histology rate and a 0.07% RB‐related complication rate to build our simulation model. Patients are selected for RB and subsequently for surgery in case of malignant or uncertain RB histology; complications are those recorded after surgery in case of malignant or uncertain RB histology, but 0% in case of benign histology. The outcomes of the study were the rate of SUR avoided, the rate of Clavien–Dindo Grade specific complications avoided, and the net difference in per‐patient cost in Arm b‐RB relative to Arm a‐SUR. In all, 10 000 individual iterations of the simulation model were performed and among all iterations, the median and 95% confidence intervals were computed.ResultsIf a RB‐all strategy is implemented, the expected rate of SUR avoided is 6.7%. The rate of overall, Clavien–Dindo Grade &gt;II, and Clavien–Dindo Grade &gt;III complications avoided is 3.0%, 2.5%, and 0.5%, respectively, and the average net difference in per‐patient cost was −$840 (US dollars).ConclusionsThe non‐selective use of RB in patients with a renal mass avoids a significant number of SUR, a marginal but existing number of complications, and is associated with decreased healthcare expenditures.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"4 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906127","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":"Transpacific robot‐assisted single‐port telesurgery in porcine models: expanding surgical frontiers","authors":"Zhenjie Wu, Zheng Wang, Linhui Wang, Shady Saikali, Vipul Patel, Marcio Covas Moschovas","doi":"10.1111/bju.16880","DOIUrl":"https://doi.org/10.1111/bju.16880","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"13 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906126","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 ‘Suggestions for future trials comparing mini‐percutaneous nephrolithotomy and flexible ureteroscopy’","authors":"Hazem Elmansy","doi":"10.1111/bju.16910","DOIUrl":"https://doi.org/10.1111/bju.16910","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"28 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906129","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}