BJU International最新文献

{"title":"Renal pelvic pressure drives fluid absorption in mini‐percutaneous nephrolithotomy: a quantitative model for absorption rate","authors":"Guilin Wang, Luyang Zhang, Qi Jin, Jiangtao Bai, Xiaoran Li, Qiqi He, Wei Shi, Teng Ma, Hui Ding, Zhilong Dong, Yunxin Zhang, Jun Mi, Zhiping Wang","doi":"10.1111/bju.16812","DOIUrl":"https://doi.org/10.1111/bju.16812","url":null,"abstract":"ObjectiveTo determine the quantitative impact of renal pelvic pressure (RPP) parameters on irrigation fluid absorption dynamics during mini‐percutaneous nephrolithotomy (mPCNL).Materials and MethodsIn this prospective observational study, 50 patients undergoing mPCNL were enrolled. Continuous synchronised RPP monitoring was performed using a calibrated pressure transduction system, while fluid absorption was quantified via a clinical grade endoscopic surgical monitor. Analytical approaches included Pearson correlation analysis and simple linear regression modelling to characterise pressure absorption dynamics.ResultsThe median (interquartile range [IQR]) baseline, mean and maximum RPP values were 12.0 (10.3–14.8) mmHg, 16.7 (14.6–23.1) mmHg and 60.0 (35.0–67.3) mmHg, respectively. The median (IQR) fluid absorption was 625.5 (270.8–1296.5) mL, corresponding to an absorption rate of 838.0 (385.9–1349.4) mL/h. Mean RPP exhibited a significant positive correlation with absorption rate (Pearson <jats:italic>R</jats:italic> = 0.54, <jats:italic>P</jats:italic> &lt; 0.001), with linear regression modelling demonstrating a 54.2‐mL/h increase in absorption rate per 1‐mmHg rise in mean RPP (<jats:italic>R</jats:italic><jats:sup>2</jats:sup> = 0.29, <jats:italic>P</jats:italic> &lt; 0.001). Transient RPP spikes exceeding 100 mmHg occurred in 9% of cases, primarily linked to access sheath obstructions from calculus migration or blood clots.ConclusionsThis study presents the first quantitative model identifying mean RPP as a critical predictor of irrigation fluid absorption during mPCNL. Acute pressure surges driven by sheath obstruction underscore the necessity for real‐time RPP monitoring and optimised outflow strategies to minimise absorption‐related risks.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"47 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237733","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":"Clarifying study design in papillary versus non‐papillary access in percutaneous nephrolithotomy: a response to Bicaklioglu","authors":"Mohammed Lotfi Amer","doi":"10.1111/bju.16814","DOIUrl":"https://doi.org/10.1111/bju.16814","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"17 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237731","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":"Dorsal‐ vs ventral‐onlay buccal mucosal graft urethroplasty for urethral strictures: 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.16811","DOIUrl":"https://doi.org/10.1111/bju.16811","url":null,"abstract":"ObjectiveTo compare ventral‐ and dorsal‐onlay buccal mucosal graft (BMG) urethroplasty in patients with urethral stricture, as the optimal placement of BMG in urethroplasty for bulbar urethral strictures remains debated.MethodsA systematic search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library. Studies comparing dorsal‐ and ventral‐onlay BMG urethroplasty were analysed. Pooled effect sizes were calculated using a random‐effects model. Subgroup analyses and publication bias assessments were performed.ResultsEight studies with 655 patients were included. The success rate showed no significant difference between the dorsal‐ and ventral‐onlay techniques (relative risk [RR] 1.00, 95% confidence interval [CI] 0.94–1.06; <jats:italic>P</jats:italic> = 0.97, <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0%). The maximum urinary flow rate at 3 months (mean difference [MD] −0.64, 95% CI −2.14 to 0.86 mL/s; <jats:italic>P</jats:italic> = 0.41) and 12 months (MD −0.57, 95% CI −2.00 to 0.85 mL/s; <jats:italic>P</jats:italic> = 0.43) was comparable. Transient erectile dysfunction (ED) was significantly lower with the ventral technique (RR 0.24, 95% CI 0.08–0.67; <jats:italic>P</jats:italic> = 0.006), while permanent ED rates were similar (RR 0.57, 95% CI 0.03–12.20; <jats:italic>P</jats:italic> = 0.72). Sensitivity analysis confirmed robustness, and no publication bias was detected.ConclusionDorsal‐ and ventral‐onlay BMG urethroplasty have similar success rates and urinary flow outcomes. However, ventral onlay may reduce transient ED.International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD420250654329.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"519 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237729","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":"Re: ‘The perioperative outcomes of papillary versus non‐papillary access in percutaneous nephrolithotomy’","authors":"Fatih Bicaklioglu","doi":"10.1111/bju.16813","DOIUrl":"https://doi.org/10.1111/bju.16813","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"10 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237734","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":"Perspectives on technology: All STEPS count – an integrated framework for net zero urological care","authors":"Jamie Hyde,&nbsp;Eleanor King,&nbsp;Joseph John,&nbsp;Kieran O'Flynn,&nbsp;Ian Pearce,&nbsp;John McGrath,&nbsp;William K. Gray,&nbsp;Manraj Phull","doi":"10.1111/bju.16800","DOIUrl":"10.1111/bju.16800","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To present a narrative review of evidence to guide the delivery of high-quality, low-carbon urological care using a structured framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Academic and policy papers which outline actions focused on decarbonising urological care and surgical care more broadly were identified and reviewed. The ‘STEPS to Low-Carbon Care’ framework (an acronym for low-carbon care across ‘Settings and Treatments, Efficiency, Prevention and System change’) was then used to categorise and present the evidence-based decarbonisation actions, using the National Health Service in England as a case study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across all STEPS framework elements, tangible actions were identified alongside opportunities for future research and innovation. The evidence-based actions that were identified to transition to low-carbon care settings and treatments included tackling known carbon hotspots in operating theatres: anaesthetic gases, consumables and electricity use. Outside the operating theatre, urology pathway transformation through one-stop clinics, day-case surgery, appropriate use of virtual appointments and streamlined pathways demonstrated opportunities to reduce carbon emissions, with potential additional benefits in terms of cost, efficiencies, and patient outcome improvements. Key climate mitigation actions that support keeping people healthy were identified. There was a paucity of evidence demonstrating the implementation of climate change action as part of routine service delivery. Embedding sustainability across organisational processes and ways of working requires actions to upskill, engage and enable the workforce to deliver and to establish clinical leadership.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review identified a range of interventions to decarbonise urological care, whilst highlighting a need for further research. Categorising the evidence according to components of the STEPS framework indicated the potential utility of this framework when determining unrealised decarbonisation opportunities in urology and more widely across healthcare. Delivering sustained and system-wide low-carbon urological care will require the collective action of all who design, deliver and influence patient care across the specialty and all urology patient pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"136 2","pages":"198-207"},"PeriodicalIF":3.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16800","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219071","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":"July's reviewers of the month","authors":"","doi":"10.1111/bju.16803","DOIUrl":"https://doi.org/10.1111/bju.16803","url":null,"abstract":"<p>Like most journals, BJUI relies on the hard work and dedication of its peer reviewers and we are grateful to them all. Each month the Editorial Team nominates peer reviewers whose reviews have stood out for their quality and timeliness and those selected as the best are highlighted on this page in recognition of their exceptional work.</p><p>She graduated in Medicine from King's College London in 2017 and completed Academic Foundation training at Imperial College NHS Healthcare Trust. From 2019–2022, she was an Academic Clinical Fellow in Urology at the University of Oxford and secured external funding from the Medical Research Council to undertake a DPhil in Surgical Sciences from 2022–2025. She has recently successfully defended her thesis on “The genetic and metabolic basis of kidney stone disease”. From August 2025, Catherine will join the University of Glasgow as Clinical Lecturer in Urology, enabling her to continue her clinical training alongside research focused on identifying personalised medicine approaches for patients with kidney stone disease.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"136 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16803","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206592","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":"Prostate cancer: detection, treatment and follow-up","authors":"","doi":"10.1111/bju.16801","DOIUrl":"https://doi.org/10.1111/bju.16801","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"136 1","pages":"2-3"},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206593","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":"Bridging the evidence gap in gender-affirming care: urgent research needs","authors":"Isabella Dolendo, Lee Zhao, Rachel Bluebond-Langner, Jennifer T. Anger","doi":"10.1111/bju.16783","DOIUrl":"https://doi.org/10.1111/bju.16783","url":null,"abstract":"Gender-affirming care has emerged as a critical component of healthcare, addressing the specific medical and psychosocial needs of transgender and non-binary individuals. In this review article, we address what we see as the most pressing evidence gaps in the gender health literature: long-term effects of pubertal blockers and gender-affirming hormone therapy and the lack of standardised outcome measures of gender-affirming care. Substantial uncertainties persist regarding long-term effects of hormone therapy and the implications of gender-affirming therapy on cancer risk. Though there is some uncertainty about the long-term effects of gender-affirming medical therapy, providers must also consider the potential negative consequences of prolonging a dysphoric experience. Additionally, there is a dearth of validated measures for patient-reported outcomes and a lack of standardisation in the reporting of data that is detrimental to the progress of understanding the impacts of gender-affirming care.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"70 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144202233","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":"Quartz sand as a phantom for urinary stone dust","authors":"Bingyuan Yang, Aditi Ray, James Zhang, Ben Turney","doi":"10.1111/bju.16810","DOIUrl":"https://doi.org/10.1111/bju.16810","url":null,"abstract":"&lt;p&gt;There is no universal consensus on which fragments can safely be left behind following ureteroscopy (if any). There is growing interest in achieving a true zero-fragment status in patients [&lt;span&gt;1, 2&lt;/span&gt;] and this has led to the development of technologies such as suction ureteric access sheaths and direct in-scope suction [&lt;span&gt;3&lt;/span&gt;]. This research demands a high-quality model for urinary stone dust. The most commonly used phantoms for urinary stones are gypsum-based phantoms such as BegoStone [&lt;span&gt;4&lt;/span&gt;], but gypsum is highly soluble in water even after casting, resulting in &gt;40% mass being lost when small submillimetre particles are involved [&lt;span&gt;5&lt;/span&gt;]. The properties of quartz sand are described here, and it is proposed as a suitable phantom for stone dust.&lt;/p&gt;\u0000&lt;p&gt;The following candidate dust phantom materials were considered based on availability across a wide range of small particle sizes from &lt;100 μm to &gt;1 mm: quartz, glass, BegoStone, polyethylene, polystyrene, and polypropylene. Their physical properties were considered first for authenticity (in comparison to common human urinary stone types) and next for experimental viability.&lt;/p&gt;\u0000&lt;p&gt;Quartz sand was investigated in more detail as a potential model. Pure graded quartz sand (Sika AG, Baar, Switzerland) was used at three grain sizes: 0.06–0.3, 0.3–0.8 and 0.7–1.2 mm. Samples of this quartz sand were separated by size using wet sieving techniques described by Keller et al. [&lt;span&gt;6&lt;/span&gt;]. The resulting size fractions were &lt;63, 63–125, 125–250, 250–500, 500–1000, and 1000–2000 μm.&lt;/p&gt;\u0000&lt;p&gt;The fluid dynamic properties of quartz sand were compared to size-matched calcium oxalate stone dust (separated in the same way) in a sedimentation experiment. Approximately 100 mg of quartz particles of each size fraction were placed in 10-cm long cuvettes filled with 0.9% saline solution. These were rapidly rotated 180° and the time taken for the first particle to sediment to the bottom of the cuvette was measured, to mirror the methodology described by Keller et al. [&lt;span&gt;6&lt;/span&gt;], and repeated five times.&lt;/p&gt;\u0000&lt;p&gt;The physical properties investigated were density and solubility in water, as these directly impact the fluid dynamics and experimental viability of particles. These properties are shown in Table 1 for the most common human stone types (calcium oxalate monohydrate and dihydrate, struvite, uric acid, cystine, and the calcium phosphate-based brushite and hydroxyapatite) and the proposed phantom materials [&lt;span&gt;4, 7&lt;/span&gt;]. Other properties such as hardness, compressive strength and tensile strength are not considered as these phantoms are not expected to be used for lithotripsy experiments.&lt;/p&gt;\u0000&lt;div&gt;\u0000&lt;header&gt;&lt;span&gt;Table 1. &lt;/span&gt;Density and solubility of types of urinary stone and proposed stone dust phantom materials. Properties of the monohydrate and dihydrate forms of calcium oxalate are reported together.&lt;/header&gt;\u0000&lt;div tabindex=\"0\"&gt;\u0000&lt;table&gt;\u0000&lt;thead&gt;\u0000&lt;t","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"5 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176992","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":"Chronic pelvic pain syndrome: the most common urological disease medicine chose to forget","authors":"Datesh Daneshwar","doi":"10.1111/bju.16802","DOIUrl":"https://doi.org/10.1111/bju.16802","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"39 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183864","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}