BJU International最新文献

{"title":"Overcoming parenthood challenges: supporting trainees to becoming well‐rounded Urologists","authors":"Jennifer Xu, Marnique Basto, Caroline Dowling, Joseph Ischia, Damien Bolton, Dixon Woon","doi":"10.1111/bju.70397","DOIUrl":"https://doi.org/10.1111/bju.70397","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"137 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595563","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":"AI ‐based anatomical recognition for bladder neck dissection in robot‐assisted radical prostatectomy","authors":"Shinnosuke Fujiwara, Keishiro Fukumoto, Masashi Takeuchi, Yuichiro Konnai, Yota Yasumizu, Nobuyuki Tanaka, Toshikazu Takeda, Kazuhiro Matsumoto, Takeo Kosaka, Hirofumi Kawakubo, Masaru Ishida, Yuko Kitagawa, Mototsugu Oya","doi":"10.1111/bju.70390","DOIUrl":"https://doi.org/10.1111/bju.70390","url":null,"abstract":"Objective To develop an artificial intelligence (AI) system for anatomical recognition that can automatically identify key anatomical structures during bladder neck dissection in robot‐assisted radical prostatectomy (RARP), a critical yet technically demanding step. Materials and Methods We constructed an AI model and evaluated its accuracy using 210 RARP videos from two institutions. A total of 1353 frames of bladder neck dissection were extracted from 25 videos, and the boundaries of the prostate, bladder and retrotrigonal layer were annotated. The DeepLabV3+ model was employed in developing the anatomical recognition AI model. An active learning approach was applied by iteratively retraining the model using frames with poor initial performance. The model was further evaluated using 202 independent test frames derived from seven surgeons. Segmentation performance was evaluated using the intersection over union (IoU) and Dice similarity coefficient. Results The IoU of the initial AI model was 0.41 for the prostate and 0.44 for the bladder. The retrained model demonstrated improved segmentation performance, with final IoU values of 0.75 and 0.68, respectively. In an independent test dataset derived from seven surgeons, segmentation performance for the prostate and bladder was maintained. Conclusion We developed an AI system for anatomical recognition and improved its accuracy by using retraining processes. The retrained AI model demonstrated high accuracy, and its use is anticipated to support surgeons and aid in the education of novice surgeons.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"180 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589029","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":"Active surveillance for intermediate‐risk prostate cancer: a systematic review and pooled analysis","authors":"Alessandro Uleri, Ludovica Cella, Thibaut Long‐Depaquit, Federica Sordelli, Alba Farré, Victor Caballero, Josep Comet, Pawel Rajwa, Romain Diamand, Bertrand Tombal, Morgan Roupret, Veeru Kasivisvanathan, Michael S. Leapman, Guillaume Ploussard, Michael Baboudjian","doi":"10.1111/bju.70388","DOIUrl":"https://doi.org/10.1111/bju.70388","url":null,"abstract":"Objective Active surveillance (AS) is the preferred management for individuals with low‐risk prostate cancer (PCa), but its role in intermediate‐risk (IR) disease remains underreported. Given growing interest and published data, we performed an updated systematic review and meta‐analysis to evaluate AS outcomes in selected patients with Gleason Grade Group (GG) 1–2 IR PCa. Methods A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines (PROSPERO CRD420251138532). PubMed/MEDLINE, Embase, and Web of Science databases were searched for studies published up to September 2025 reporting outcomes of AS in IR PCa. Primary outcomes were AS discontinuation‐free survival and GG ≥3 upgrade‐free survival. Results In total, 18 studies, including 3783 selected patients with IR PCa, were analyzed. Pooled AS discontinuation‐free survival rates were 70% (95% confidence interval [CI] 62–78) at 3 years, 63% (95% CI 58–68) at 5 years, and 53% (95% CI 38–67) at 10 years. In analyses restricted to GG 2 cohorts, corresponding pooled estimates were 72% at 3 years, 56% at 5 years, and 40% at 10 years. GG ≥3 upgrade‐free survival was 84% (95% CI 76–92) at 3 years and 78% (95% CI 65–91) at 5 years in all cohorts and 92% (95% CI 86–98) and 87% (95% CI 78–95) at 3 and 5 years in cohorts screened using multiparametric magnetic resonance imaging. No significant difference in AS discontinuation was observed between biopsy GG 1 and 2 (hazard ratio 1.08; 95% CI 0.86–1.35). Limitations include moderate risk of bias and heterogeneity across AS protocols. Conclusions Although long‐term data are lacking, particularly regarding robust oncological outcomes, growing evidence suggests that AS appears oncologically safe in well‐selected patients. Magnetic resonance imaging will play a key role in the appropriate selection and follow‐up of patients.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148589022","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":"Factors predicting operative exposure among UK urology trainees: a national analysis from 2010 to 2024.","authors":"Justina Cheh Juan Tai,Kelly Ong,Stuart Graham,Justine Royle,Tony Tien","doi":"10.1111/bju.70389","DOIUrl":"https://doi.org/10.1111/bju.70389","url":null,"abstract":"OBJECTIVESTo characterise national trends in operative experience among Urology Higher Specialty Trainees (HSTs) in the UK over time, and to identify demographic, training, and institutional factors associated with operative volume.SUBJECTS AND METHODSThis national, retrospective study analysed Intercollegiate Surgical Curriculum Programme (ISCP) and electronic surgical logbook (eLogbook) data for all UK Urology HSTs between 2010 and 2024. Baseline variables included gender, age at Specialty Training (ST)3 start, ethnicity, training grade, and hospital type, i.e., district general hospital (DGH) vs tertiary centre (TC). Procedures were categorised, using the 2021 ISCP Urology curriculum, into index and special interest procedures. Analyses were made between the above factors and number of cases logged on eLogbook.RESULTSA total of 1140 trainees were included. Gender and age at ST3 start did not significantly affect total operative volume. A global difference in operative volume across ethnic groups was observed (chi-square = 11.85, P = 0.019); however, no pairwise differences remained significant after adjustment. Operative volume declined over 15 years, with trainees performing 10.8 fewer operations each year than the year before (β₁ = -10.8 procedures/trainee/year, t = -9.31, P < 0.001), with the lowest recorded volume in 2020. The total number of procedures logged decreased with increasing ST level (Rs = -0.284; P < 0.001). However, higher ST level trainees logged more fascial sling, percutaneous nephrolithotomy, nephrectomy, radical prostatectomy, radical cystectomy, ileal conduit formation, and penile straightening procedures. Trainees in DGHs logged more procedures overall (U = 2 × 10-47, P < 0.001), although trainees in TCs logged more special interest procedures (U = 1.6 × 10-24, P < 0.001).CONCLUSIONOperative experience among HSTs in the UK has declined over the past 15 years with significant variation in case mix by training grade and hospital type. These findings highlight the need for effective rotation planning and targeted strategies are required to ensure adequate operative exposure to produce safe and competent consultants who can provide the best possible patient care.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"25 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148522393","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":"Intrarenal thermal and pressure dynamics during ureteroscopy: an in vitro study","authors":"Alejandra Bravo‐Balado, Letizia Maria Ippolita Jannello, Federico Zorzi, Alberto Quarà, Stefano Moretto, Mariela Corrales, Esteban Emiliani, Steeve Doizi, Frédéric Coste, Olivier Traxer, Frédéric Panthier","doi":"10.1111/bju.70384","DOIUrl":"https://doi.org/10.1111/bju.70384","url":null,"abstract":"Objectives To evaluate <jats:italic>in vitro</jats:italic> determinants of intrarenal temperature (IRT) and pressure (IRP) during laser lithotripsy. Materials and Methods A silicone urinary tract model was used to perform laser lithotripsy on artificial stones placed in the renal pelvis. Three laser sources (thulium fibre laser, holmium:yttrium‐aluminium‐garnet [Ho:YAG] with Magneto Technology, and pulsed thulium:YAG) with 200‐μm fibres were tested at four energy settings (0.6 J–10 Hz, 1 J–10 Hz, 0.2 J–50 Hz, and 1 J–40 Hz), delivering 2000 J per experiment. Irrigation was provided by gravity (40 cmH <jats:sub>2</jats:sub> O) or hand‐pump irrigation, combined with a standard ureteral access sheath (sUAS) or flexible and navigable suction sheath (FANS). Multivariable regression identified predictors of mean IRT and IRP. Results Baseline temperatures were comparable among groups (27.2–32.2 °C, <jats:italic>P</jats:italic> &gt; 0.05). Hand‐pump irrigation reduced mean IRT compared to gravity (−9.1 °C, <jats:italic>P</jats:italic> = 0.001). Laser power showed a dose–response effect (10 W: +2.5 °C, <jats:italic>P</jats:italic> = 0.003; 40 W: +8.2 °C, <jats:italic>P</jats:italic> = 0.001 vs 6 W). At equivalent power and irrigation settings, laser source did not influence IRT under the experimental conditions evaluated. The thermal‐risk threshold (&gt;43 °C) was reached in 16.7% of experiments, increased with power (2.8%, 15.3%, and 41.7% at 6, 10, and 40 W; <jats:italic>P</jats:italic> = 0.001) and decreased with hand‐pump irrigation and FANS ( <jats:italic>P</jats:italic> &lt; 0.05). Hand‐pump irrigation increased IRP by 21 cmH <jats:sub>2</jats:sub> O compared to gravity, while FANS reduced IRP by 12 cmH <jats:sub>2</jats:sub> O vs sUAS ( <jats:italic>P</jats:italic> = 0.001). Conclusions Mean IRT was associated with laser power and irrigation strategy. High‐power settings (40 W) frequently exceeded the thermal‐risk threshold. Although FANS was not associated with lower mean IRT, it reduced the likelihood of exceeding the thermal‐risk threshold. Laser source had no effect on mean IRT when power and irrigation conditions were comparable. Mean IRP was influenced by irrigation strategy and UAS configuration but was not associated with mean IRT. These findings underscore the need for advanced integrated irrigation–aspiration systems capable of dynamic control of flow, pressure, and temperature to optimise procedural safety.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"38 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148459303","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":"Letter to the Editor regarding: reducing complexity in International Bladder Cancer Group intermediate‐risk non‐muscle‐invasive bladder cancer stratification: a three‐factor approach","authors":"Qianchen Duan","doi":"10.1111/bju.70385","DOIUrl":"https://doi.org/10.1111/bju.70385","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"443 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148459304","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":"Micro-ultrasonography- vs MRI-targeted biopsy in prostate cancer: Updated systematic review and meta-analysis","authors":"José Pedro Cassemiro Micheleto,&nbsp;Tallys Ávila Suzuki,&nbsp;Lucas Amorim Santos,&nbsp;Luann Porpino Sales,&nbsp;Roberto Iglesias Lopes,&nbsp;Bárbara Miranda Martins,&nbsp;Bárbara Vieira Lima Aguiar Melão,&nbsp;Mauricio Dener Cordeiro,&nbsp;Walid Sharour,&nbsp;Walid Shabana,&nbsp;William Carlos Nahas,&nbsp;Leopoldo Alves Ribeiro Filho,&nbsp;Caio Vinicius Suartz","doi":"10.1111/bju.70270","DOIUrl":"10.1111/bju.70270","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To refine prostate cancer (PCa) pathways by comparing micro-ultrasonography-targeted biopsy (micro-US-TBx) with magnetic resonance imaging (MRI)-TBx for detecting clinically significant PCa (csPCa) and by evaluating diagnostic accuracy (sensitivity, specificity, positive predictive value, negative predictive value).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Medical Literature Analysis and Retrieval System Online (MEDLINE; PubMed), Excerpta Medica dataBASE (EMBASE), and ClinicalTrials.gov were searched on 4 July 2025 and updated 5 August 2025, without language/date limits. Eligible randomised and observational studies compared micro-US-TBx vs MRI-TBx (± systematic biopsy) in men with suspected PCa or on active surveillance; csPCa was Gleason Grade Group ≥2. Two reviewers screened/extracted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines; quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Detection ratios (DRs) were pooled with random-effects models; diagnostic accuracy used a bivariate random-effects model from 2 × 2 tables. Certainty of evidence was rated with the Grading of Recommendations, Assessment, Development, and Evaluation framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 22 studies (micro-US-TBx = 5581; MRI-TBx = 5937) were included. Micro-US-TBx detected 2037 csPCa cases and MRI-TBx 2043. The pooled DR (micro-US-TBx vs MRI-TBx) was 1.04 (95% confidence interval 0.95–1.15; <i>I</i>² = 61.1%). Pooled sensitivity/specificity were 0.88/0.25 for micro-US-TBx and 0.81/0.17 for MRI-TBx. Summary receiver operating characteristic curves overlapped (area under the curve: micro-US, 0.658; MRI, 0.547). Meta-regression found no significant modality effect on sensitivity (<i>P</i> = 0.192) or specificity (<i>P</i> = 0.257). Egger's test indicated no meaningful publication bias (<i>P</i> = 0.848).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The micro-US-TBx demonstrated csPCa detection and diagnostic accuracy comparable to MRI-TBx. Given its real-time imaging capability, accessibility, and potential workflow advantages, micro-US-TBx may represent a valuable complementary tool within contemporary PCa diagnostic pathways. Further cost-effectiveness studies are warranted to better define its role in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"138 2","pages":"196-207"},"PeriodicalIF":4.1,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.70270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147684842","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":"Alternate-day administration of intravesical gemcitabine and docetaxel to improve clinic utilisation","authors":"John R. Heard,&nbsp;Michael Ahdoot","doi":"10.1111/bju.70240","DOIUrl":"10.1111/bju.70240","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"138 2","pages":"231-233"},"PeriodicalIF":4.1,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147471558","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":"Deep-learning segmentation to guide bladder neck recognition in robot-assisted radical prostatectomy","authors":"Yoshinari Muto,&nbsp;Kenji Zennami,&nbsp;Kota Yagi,&nbsp;Masashi Takenaka,&nbsp;Kiyoshi Takahara,&nbsp;Ryoichi Shiroki","doi":"10.1111/bju.70287","DOIUrl":"10.1111/bju.70287","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To develop a deep-learning segmentation model for bladder neck dissection during robot-assisted radical prostatectomy (RARP) and evaluate its effectiveness in improving anatomical recognition in surgical videos across surgeons with varying levels of experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects, Patients and Methods</h3>\u0000 \u0000 <p>From April 2022 to March 2023, we collected 25 RARP procedures at Fujita Health University, specifically extracting bladder neck dissection segments. Three architectures (U-Net, U-Net++, and DeepLabv3+) were trained on 979 annotated frames from 10 RARP procedures performed by a single expert surgeon. The best-performing model was adopted as the base model for two-step, entropy-based active learning. Step one included selecting informative frames from the same videos used for the base model, with finer temporal sampling, to construct the prototype model. In step two, diverse procedures from additional surgeons were used to build the final model. Segmentation performance was evaluated using Intersection over Union (IoU; mean IoU [mIoU]). Clinical utility was assessed by quantifying the recognition of anatomical structures with and without guidance from the segmentation model among seven urologists (two expert surgeons and five novice surgeons). Anatomical recognition was evaluated by comparing annotation time and the average IoU of the bladder and prostate (bpIoU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DeepLabv3+ with LogCosh loss achieved the highest performance (mIoU = 0.815, 95% confidence interval [CI] 0.699–0.931) and was adopted as the base model. Active learning improved generalisability, increasing mIoU on the novice evaluation set from 0.709 (95% CI 0.584–0.833) to 0.713 (95% CI 0.586–0.839). Regarding the assessment of clinical utility, among novice surgeons, model guidance significantly reduced annotation time by 28 s and improved annotation quality of bpIoU by 0.124. No significant changes were observed among expert surgeons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The developed segmentation model enhanced the speed and performance of anatomical recognition, particularly for novice surgeons, and may support surgical education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"138 2","pages":"234-243"},"PeriodicalIF":4.1,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680405","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":"Surveillance patterns in non-muscle-invasive bladder cancer across risk groups: a real-world analysis","authors":"Lisa M. C. van Hoogstraten,&nbsp;Sita H. Vermeulen,&nbsp;Jasper P. Hof,&nbsp;Antoine G. van der Heijden,&nbsp;Alina Vrieling,&nbsp;Lambertus A. Kiemeney,&nbsp;Katja K. H. Aben","doi":"10.1111/bju.70297","DOIUrl":"10.1111/bju.70297","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To provide insight into real-world surveillance practices for patients with low-risk (LR), intermediate-risk (IR), and (very) high-risk (HR) non-muscle invasive bladder cancer (NMIBC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Cystoscopy surveillance patterns were analysed using real-world data from two population-based cohort studies in the Netherlands, comparing practices to guideline recommendations by risk group. As bladder cancer-related symptoms may prompt diagnostic investigations beyond routine follow-up, we evaluated the occurrence of such symptoms and the use of various diagnostics including cystoscopy in a subset of patients with available data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 2791 primary and recurrent tumours were included in the analyses. Among patients with LR NMIBC, 37.6% were monitored more intensively than recommended. The average number of cystoscopies in the first follow-up year was 1.3 (range 0–4). IR NMIBCs were generally monitored in accordance with guideline recommendations. However, adherence declined over the years following diagnosis, dropping from 78.1% to 59.3%. The proportion of patients with IR NMIBCs who were monitored less than recommended increased from 21.7% to 39.8%. Most HR NMIBCs (88.2%) were monitored less than recommended, though adherence improved over time. In-depth analysis of 204 tumours revealed that next to cystoscopy, cytology was frequently employed, increasing with risk group (LR: 50.0%, IR: 52.3%, HR: 88.9%). Imaging (25–65%) and biopsies (25–85%) were also commonly performed. Surveillance patterns varied especially among IR NMIBCs. Symptoms were reported in approximately one third of bladder tumours during follow-up but did not appear to affect surveillance patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings demonstrate substantial deviations from recommended NMIBC surveillance practices, with cystoscopy overuse in LR disease and underuse in HR cases. Surveillance of IR NMIBC was particularly heterogenous, using varying diagnostic investigations. These insights highlight the need to refine NMIBC surveillance schedules to improve patient outcomes and optimise healthcare resource allocation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"138 2","pages":"257-266"},"PeriodicalIF":4.1,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.70297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147733785","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}