Paolo Zaurito, Pietro Scilipoti, Mattia Longoni, Alessandro Viti, Mario de Angelis, Alfonso Santangelo, Giovanni Tremolada, Leonardo Quarta, Andrea Cosenza, Angelo Occhi, Armando Galdieri, Natasha Disabato, Michele Brancaccio, Giusy Burgio, Andrea Necchi, Maurizio Colecchia, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Marco Moschini
{"title":"The value of maintenance therapy in intermediate‐risk non‐muscle‐invasive bladder cancer","authors":"Paolo Zaurito, Pietro Scilipoti, Mattia Longoni, Alessandro Viti, Mario de Angelis, Alfonso Santangelo, Giovanni Tremolada, Leonardo Quarta, Andrea Cosenza, Angelo Occhi, Armando Galdieri, Natasha Disabato, Michele Brancaccio, Giusy Burgio, Andrea Necchi, Maurizio Colecchia, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Marco Moschini","doi":"10.1111/bju.16905","DOIUrl":"https://doi.org/10.1111/bju.16905","url":null,"abstract":"ObjectiveTo evaluate which subgroups of patients with intermediate‐risk non‐muscle‐invasive bladder cancer (IR‐NMIBC) benefit from maintenance therapy based on the International Bladder Cancer Group (IBCG) risk stratification, as the role of a maintenance course in patients with IR‐NMIBC is debated.Patients and MethodsWe relied on a prospectively maintained database of patients with IR‐NMIBC who received intravesical chemotherapy or Bacillus Calmette–Guérin (BCG) (2010–2023). Patients were stratified according the IBCG prognostic algorithm (no, one to two, and three or more risk factors). All patients received at least six induction instillations after index transurethral resection of bladder tumour. We used 3‐month landmark stacked cumulative incidence and multivariable Cox regression models to assess the benefit from a maintenance course in terms of risk of recurrence and progression according to the IBCG risk groups stratification.ResultsAmong 464 patients, 205 (44%) received BCG treatment and 259 (56%) received intravesical chemotherapy. The median (interquartile range) number of maintenance instillations was 9 (5–11). Over a median follow‐up of 57 months, 139 (30%) patients had a recurrence. Patients with no IBCG risk factors had a similar risk of 5‐year disease recurrence according to treatment duration (7.7% vs 7.3%; hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.49–1.37, for induction only vs induction plus maintenance, respectively), whereas patients with one to two (5‐year risk: 16% vs 13%; HR 0.65, 95% CI 0.48–0.82) or three or more IBCG risk factors (5‐year risk: 21% vs 17%; HR 0.48, 95% CI 0.25–0.85) were associated with lower hazards of recurrence if treated with an induction plus maintenance course.ConclusionsThe IBCG algorithm effectively stratifies patients with IR‐NMIBC by recurrence risk. In this observational cohort, maintenance therapy was associated with lower recurrence rates in patients with one to two or three or more IBCG risk factors, but not in those with no risk factors. These findings suggest that the IBCG stratification may inform risk‐adapted treatment decisions in patients with IR‐NMIBC.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"71 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144901644","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}
Cait Bleakley, Nicholas Campain, Rosie Cockroft, Jonathan Michelmore, Joseph B. John
{"title":"Patient facing resources: a review of their readability in urology journals","authors":"Cait Bleakley, Nicholas Campain, Rosie Cockroft, Jonathan Michelmore, Joseph B. John","doi":"10.1111/bju.16904","DOIUrl":"https://doi.org/10.1111/bju.16904","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"39 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898156","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 ‘A mitochondrion‐centric approach to guide treatment de‐escalation in advanced prostate cancer’ by Su et al.","authors":"Bryan Chong, Kenneth Chen","doi":"10.1111/bju.16898","DOIUrl":"https://doi.org/10.1111/bju.16898","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"535 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898158","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}
Karen Chiam, Albert Bang, Visalini Nair‐Shalliker, Michael Caruana, Manish I. Patel, Shomik Sengupta, Ian Vela, Andrew Kneebone, Henry Woo, Michael O'Callaghan, Braden Higgs, Alex Jay, Karen Canfell, David P. Smith
{"title":"Treatment variations in localised prostate cancer in Australia and New Zealand: a registry study","authors":"Karen Chiam, Albert Bang, Visalini Nair‐Shalliker, Michael Caruana, Manish I. Patel, Shomik Sengupta, Ian Vela, Andrew Kneebone, Henry Woo, Michael O'Callaghan, Braden Higgs, Alex Jay, Karen Canfell, David P. Smith","doi":"10.1111/bju.16896","DOIUrl":"https://doi.org/10.1111/bju.16896","url":null,"abstract":"ObjectiveTo describe the patterns of care and factors associated with treatment uptake of localised prostate cancer, using the bi‐national Prostate Cancer Outcomes Registry–Australia and New Zealand (PCOR‐ANZ) database.MethodsData for 36 504 patients, diagnosed between 2015 and 2018, from New Zealand and seven Australian jurisdictions were evaluated. Multinomial logistic regression was performed to identify factors associated with the likelihood of receiving no active treatment, radiotherapy (RT), androgen deprivation therapy (ADT) and combined ADT + RT, compared to radical prostatectomy (RP).ResultsThe most common disease risk group and treatment were intermediate‐risk disease (49.2%) and RP (40.3%). Men with low‐risk disease were mostly managed by no active treatment (81.5%). Compared to men treated with RP, the likelihood of receiving other treatments was higher in residents from regional areas, those from lower socio‐economic status (SES) areas and those diagnosed at regional or public hospitals. Being in the lowest SES group was associated with an odds ratio (OR) of 1.84, (95% confidence interval [CI] 1.67–2.02) of having no active treatment, an OR of 1.53 (95% CI 1.32–1.78) for RT, an OR of 2.66 (95% CI 2.10–3.36) for ADT and an OR of 2.56 (95% CI 2.23–2.93) for ADT + RT.ConclusionsFactors related to SES and hospital provider were associated with treatment choices in localised prostate cancer patients, independent of their age or disease risk classification.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"21 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898219","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":"Evaluating the ‘2‐Week Wait pathway’ for testicular cancer: a UK audit with national implications","authors":"Mushtaq Hussain, Kanwal Naz, Debashis Sarkar","doi":"10.1111/bju.16906","DOIUrl":"https://doi.org/10.1111/bju.16906","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"25 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898222","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}
Sean A Fletcher, Katarzyna J Macura, Christian P Pavlovich
{"title":"Author response to comment on 'Clinically significant prostate cancer detected by systematic biopsy in patients with MRI lesions'.","authors":"Sean A Fletcher, Katarzyna J Macura, Christian P Pavlovich","doi":"10.1111/bju.16869","DOIUrl":"https://doi.org/10.1111/bju.16869","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871360","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}
Arnav Srivastava, Derrian Cooley, Steven M. Monda, Ulka N. Vaishampayan, Samuel D. Kaffenberger, Lindsey A. Herrel, Jeffrey S. Montgomery, Khaled Hafez, Aaron M. Udager, Zachery R. Reichert, D. Bryan Johnson, Daniel R. Rhodes, Scott A. Tomlins, Todd M. Morgan
{"title":"A prospective study of minimal residual disease in urological cancers using circulating tumour DNA","authors":"Arnav Srivastava, Derrian Cooley, Steven M. Monda, Ulka N. Vaishampayan, Samuel D. Kaffenberger, Lindsey A. Herrel, Jeffrey S. Montgomery, Khaled Hafez, Aaron M. Udager, Zachery R. Reichert, D. Bryan Johnson, Daniel R. Rhodes, Scott A. Tomlins, Todd M. Morgan","doi":"10.1111/bju.16890","DOIUrl":"https://doi.org/10.1111/bju.16890","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"8 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850535","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}
Manish Kuchakulla,Aaron A Gurayah,Jessica A Marinaro,Aaron Brant,Christopher D Gaffney,Philip Xie,Nahid Punjani,Caroline Kang,Jonathan Gal,Gianpiero D Palermo,James A Kashanian
{"title":"Impact of microsurgical varicocelectomy on sperm capacitation and birth outcomes.","authors":"Manish Kuchakulla,Aaron A Gurayah,Jessica A Marinaro,Aaron Brant,Christopher D Gaffney,Philip Xie,Nahid Punjani,Caroline Kang,Jonathan Gal,Gianpiero D Palermo,James A Kashanian","doi":"10.1111/bju.16888","DOIUrl":"https://doi.org/10.1111/bju.16888","url":null,"abstract":"OBJECTIVETo assess the impact of microsurgical subinguinal varicocelectomy on sperm capacitation, semen parameters, pregnancy rates, and live birth outcomes in men with clinical varicoceles.PATIENTS AND METHODSWe retrospectively reviewed 260 consecutive men with clinical varicoceles who underwent a microsurgical subinguinal varicocelectomy procedure by a single surgeon from January 2019 to March 2024. Of these, 46 men had pre- and postoperative semen analyses and sperm capacitation tests. The primary outcome measure was change in the sperm capacitation score (Cap-Score™; Androvia LifeSciences, Mountainside, NJ, USA). Secondary outcome measures included change in semen parameters, change in probability of generating a pregnancy (PGP), pregnancy rates, and live birth rates.RESULTSAmong all 46 patients, there was an improvement in median sperm concentration (21.9 vs 30.0 million/mL; P < 0.01), mean total motile sperm count (TMSC; 33.9 vs 49.5 million; P = 0.04), mean sperm capacitation as measured by Cap-Score (23.6% vs 27.7%; P < 0.01), and mean PGP (27.4% vs 34%; P < 0.01) after varicocelectomy. Of the 33 couples trying to conceive, 24 (72.7%) achieved a live birth or ongoing clinical pregnancy after varicocelectomy; however, 13 of these 24 couples (54.1%) utilised in vitro fertilisation. A normal postoperative sperm concentration and Cap-Score were associated with a 60% chance of achieving pregnancy via natural conception or intrauterine insemination (IUI).CONCLUSIONSignificant improvements in sperm concentration, TMSC, Cap-Score, and PGP were observed at 3 months after surgery. Patients with a normal post-varicocelectomy Cap-Score and semen concentration had the highest probability of conception naturally or through IUI.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"26 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825474","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":"Flexible ureterorenoscopy or extracorporeal shockwave lithotripsy in stone disease and bevacizumab for hereditary and sporadic papillary renal-cell cancer","authors":"","doi":"10.1111/bju.16886","DOIUrl":"10.1111/bju.16886","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"136 3","pages":"352-353"},"PeriodicalIF":4.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825463","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}