{"title":"A comment on: ‘Comparing open and video endoscopic lymphadenectomy for penile cancer: a systematic review and meta-analysis of prospective studies’","authors":"Rachana Mehta, Shubham Kumar, Ranjana Sah","doi":"10.1111/bju.16792","DOIUrl":"10.1111/bju.16792","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"136 2","pages":"344-345"},"PeriodicalIF":3.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145957","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":"Robot-assisted vs open kidney transplantation from deceased donors.","authors":"Luca Afferi,Angelo Territo,Alessio Pecoraro,Lorenzo Masieri,Milla Ortved,Julia Abildgaard Dagnæs-Hansen,Begonya Etcheverry,Andrea Gallioli,Donato Cannoletta,Joris Vangeneugden,Jeremy Mercier,Thomas Prudhomme,Isacco Donnini,Antonino Vazzana,Malene Rohrsted,Francesc Vigués,Nicolas Doumerc,Karel Decaestecker,Joan Palou,Riccardo Campi,Sergio Serni,Andreas Roder,Alberto Breda","doi":"10.1111/bju.16799","DOIUrl":"https://doi.org/10.1111/bju.16799","url":null,"abstract":"OBJECTIVESTo test the hypothesis that the type of surgical approach, robot-assisted kidney transplantation (RAKT) vs open kidney transplantation (OKT), impacts intra-operative and postoperative surgical outcomes of patients receiving kidney transplantation from deceased donors.MATERIALS AND METHODSThis was a multicentre retrospective cohort study including 676 patients who received RAKT or OKT in the period 2015 to 2023 in one of seven European academic centres. Patient heterogeneity at baseline was balanced using 2:1 nearest neighbour propensity-score matching. Intra- and postoperative complications were reported according to the Clavien-Dindo classification system. Kaplan-Meier estimates and the log-rank test were used to compare dialysis-free survival (DFS), graft survival (GS), reintervention-free survival (RFS) and overall survival (OS) according to the surgical approach used.RESULTSAfter propensity-score matching, two cohorts of 72 recipients (65%) in the OKT group and 37 (35%) in the RAKT group with similar baseline characteristics were obtained. The site of transplantation was the right iliac fossa in 59 (82%) and 28 patients (76%) undergoing OKT and RAKT, respectively. RAKT was associated with shorter rewarming time (53 vs 39 min), total vascular anastomosis time (55 vs 36 min), and arterial (25 vs 17 min) and venous (28 vs 18 min) anastomosis times (all P < 0.001), whereas OKT was associated with reduced surgical time (180 vs 200 min; P = 0.01). Intra-operative complications were more commonly reported in recipients undergoing OKT (8.3% vs 2.7%; P = 0.4). During follow-up, no differences in terms of postoperative complications, DFS, GS, RFS or OS were detected.CONCLUSIONSThis is the largest comparative study of RAKT vs OKT in the deceased donor setting. While it confirms the safety of RAKT from deceased donors, it underscores the superiority of RAKT in selected patients in terms of achieving vascular anastomosis and rewarming time in a shorter timeframe.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"24 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136831","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}
Jethro C.C. Kwong, Keiran Pace, Zizo Al-Daqqaq, Yashan Chelliahpillai, Soomin Lee, Kellie Kim, Maximiliano Ringa, Amna Ali, Marian Wettstein, Amy Chan, Katherine Lajkosz, Theodorus van der Kwast, Nathan Perlis, Jason Y. Lee, Robert J. Hamilton, Neil E. Fleshner, Antonio Finelli, Munir Jamal, Frank Papanikolaou, Thomas Short, Andrew Feifer, Girish S. Kulkarni, Alexandre R. Zlotta
{"title":"Impact of concomitant carcinoma in situ distribution on non-muscle-invasive bladder cancer progression risk","authors":"Jethro C.C. Kwong, Keiran Pace, Zizo Al-Daqqaq, Yashan Chelliahpillai, Soomin Lee, Kellie Kim, Maximiliano Ringa, Amna Ali, Marian Wettstein, Amy Chan, Katherine Lajkosz, Theodorus van der Kwast, Nathan Perlis, Jason Y. Lee, Robert J. Hamilton, Neil E. Fleshner, Antonio Finelli, Munir Jamal, Frank Papanikolaou, Thomas Short, Andrew Feifer, Girish S. Kulkarni, Alexandre R. Zlotta","doi":"10.1111/bju.16793","DOIUrl":"10.1111/bju.16793","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess whether the distribution of concomitant carcinoma <i>in situ</i> (CIS; unifocal or multifocal) with papillary non-muscle-invasive bladder cancer (NMIBC) impacts the risk of progression, as concomitant CIS is an established risk factor for progression in papillary NMIBC and commonly used calculators do not make this distinction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In this multi-institutional retrospective cohort study from both academic and community hospitals, clinicopathological data were collected from patients with pTa/pT1 NMIBC treated from 2005 to 2022. Unifocal concomitant CIS was defined as CIS present in only one specimen (i.e., papillary disease with CIS at the tumour base or isolated CIS in one specimen). Multifocal concomitant CIS was characterised by CIS in multiple specimens. Progression was defined as the development of muscle-invasive or metastatic disease. Fine-Gray regression was performed to identify progression-associated factors, using all-cause mortality as a competing risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2923 patients, 383 (13%) progressed over a median (interquartile range) follow-up of 5.1 (3.0–8.5) years. Concomitant CIS was found in 327 patients (11%), with 233 and 94 harbouring unifocal and multifocal CIS, respectively. Recurrent tumours, T1 stage, high-grade disease, multifocal CIS, and multiple tumours were independently associated with increased progression risk (all <i>P</i> < 0.05). Among patients with concomitant CIS, multifocal CIS remained a significant prognosticator (sub-distribution hazard ratio 1.90, 95% confidence interval 1.18–3.05; <i>P</i> = 0.008) adjusting for age, sex, tumour history, stage, grade, number of tumours, tumour diameter, and Bacillus Calmette–Guérin treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Papillary NMIBC progression risk varies with concomitant CIS distribution. Only multifocal concomitant CIS is a risk factor for progression in patients with T1 NMIBC. If validated in further studies, risk calculators should consider including this CIS distinction. Submitting separate specimens at the time of transurethral resection, as recommended by guidelines, should be encouraged.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"136 2","pages":"236-244"},"PeriodicalIF":3.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16793","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136810","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}
Avani P. Desai, Ram Sankar Basak, Yair Lotan, John Sperger, Florian R. Schroeck, Robert Lipman, Iftach Chaplin, Hannah Roberson, Perla Lopez, Whitney Jenkins, John L. Gore, Michael R. Kosorok, Angela B. Smith
{"title":"Feasibility and outcomes of interventions to reduce cystoscopy discomfort: a multi‐site pilot study","authors":"Avani P. Desai, Ram Sankar Basak, Yair Lotan, John Sperger, Florian R. Schroeck, Robert Lipman, Iftach Chaplin, Hannah Roberson, Perla Lopez, Whitney Jenkins, John L. Gore, Michael R. Kosorok, Angela B. Smith","doi":"10.1111/bju.16794","DOIUrl":"https://doi.org/10.1111/bju.16794","url":null,"abstract":"ObjectiveTo investigate the feasibility and effectiveness of interventions aiming to decrease pain and anxiety during cystoscopy.Patients and MethodsA prospective study of 190 adults undergoing flexible office cystoscopy was conducted at the University of North Carolina and the University of Texas Southwestern from January to September 2023. Patients were offered 20 mL intraurethral 2% lidocaine with a dwell time of ≤10 or >10 min and either music on headphones or real‐time cystoscopy visualisation. Patients declining the offered intervention were provided their requested study intervention. Outcomes included pain (visual analogue scale [VAS], pain intensity) and anxiety. Multivariable regression models controlled for age, sex, prior cystoscopies, bladder cancer surveillance, site, and intervention preferences. Feasibility was evaluated by patient acceptance of interventions.ResultsOf 190 patients, 35% (66/190) declined their assigned intervention, with 8% (7/90) declining visualisation and 59% (59/100) declining music alone. Patients with prior cystoscopy were more likely to decline music (69%) than cystoscopy‐naïve patients (31%). Visualisation was associated with lower reported pain on the VAS and anxiety than music. Patients receiving both music and visualisation reported the highest proportion of no‐to‐mild pain. Lidocaine dwell time did not significantly affect outcomes.ConclusionsAllowing patients to visualise or listen to music during their office cystoscopy are simple, accessible means of reducing pain and discomfort with the procedure, particularly for cystoscopy‐naïve patients.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"97 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130255","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}
Marco Bandini, Pankaj Joshi, Sandeep Bafna, Christian Yepes, Ahmed Alrefaey, Mattia Longoni, Francesco Montorsi, Sanjay Kulkarni
{"title":"Establishing the role of single‐stage preputial spiral graft urethroplasty for panurethral stricture","authors":"Marco Bandini, Pankaj Joshi, Sandeep Bafna, Christian Yepes, Ahmed Alrefaey, Mattia Longoni, Francesco Montorsi, Sanjay Kulkarni","doi":"10.1111/bju.16796","DOIUrl":"https://doi.org/10.1111/bju.16796","url":null,"abstract":"ObjectiveTo assess whether single‐stage preputial spiral graft urethroplasty (PSGU) minimises panurethral stricture (PUS) recurrence, which often result from traditional multiple grafting for anterior urethral strictures exceeding 10 cm.Patients and MethodsWe prospectively collected 114 patients with PUS treated with single‐stage PSGU across five centres in India, Colombia, Egypt, and Italy since May 2021. Preoperative assessment included physical examination, medical history, uroflowmetry, International Prostate Symptom Score (IPSS), five‐item International Index of Erectile Function (IIEF‐5), and urethrography. Intraoperative urethroscopy assessed stricture length and severity. Follow‐up included uroflowmetry and patient‐reported outcomes. Treatment success was defined as a maximum urinary flow rate (Q<jats:sub>max</jats:sub>) >10 mL/s without symptoms. Outcomes were compared between teaching and fellows’ institutions.ResultsThe median stricture length was 16 cm, with instrumentation as the most frequent aetiology (64.0%). The median (interquartile range [IQR]) operative time was 134 (123–142) min. Postoperative complications rate was 23.0%, mostly Clavien–Dindo Grade I. At a median (IQR) follow‐up of 16 (7–24) months, the median Q<jats:sub>max</jats:sub> significantly increased from 4.5 preoperatively to 24 mL/s postoperatively (<jats:italic>P</jats:italic> < 0.001), while the median IPSS decreased by 24.3 points (<jats:italic>P</jats:italic> < 0.001) and the median IIEF‐5 score remained stable. Stricture recurrence occurred in 11 (9.6%) patients. No significant differences in patency/complications were found between teaching and fellows’ institutions. Key PSGU limitations are intact prepuce and absence of active lichen sclerosus.ConclusionsA single‐stage PSGU effectively manages PUS, showing comparable outcomes across institutions with varying experience levels. This technique is ready for broader adoption in clinical practice, pending further studies to confirm its long‐term efficacy.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"140 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130257","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}
Jons W van Hattum,Marinka J Remmelink,Sieb T Nuijens,Ben Max de Ruiter,Gerrit K J Hooijer,Jorg R Oddens,C Dilara Savci-Heijink,Ron Mathot,J Alfred Witjes,Michael N Pollak,Theo M de Reijke,Remco J Molenaar,Hanneke W Wilmink
{"title":"A study of oral metformin for the intravesical treatment of non-muscle-invasive bladder cancer.","authors":"Jons W van Hattum,Marinka J Remmelink,Sieb T Nuijens,Ben Max de Ruiter,Gerrit K J Hooijer,Jorg R Oddens,C Dilara Savci-Heijink,Ron Mathot,J Alfred Witjes,Michael N Pollak,Theo M de Reijke,Remco J Molenaar,Hanneke W Wilmink","doi":"10.1111/bju.16767","DOIUrl":"https://doi.org/10.1111/bju.16767","url":null,"abstract":"OBJECTIVESTo evaluate the effect of metformin on non-muscle-invasive bladder cancer (NMIBC) marker lesions.PATIENTS AND METHODSA phase II, open-label, multicentre, marker lesion trial using oral metformin in patients with primary or recurrent, multiple, low-grade Ta-T1 NMIBC was conducted. After transurethral resection for histological confirmation, leaving one tumour as a marker lesion, 11 patients were treated with oral metformin up to 3000 mg per day for 3 months. Reported outcomes included response of the marker lesion, safety of metformin, quality of life and pharmacological and immunohistochemical examinations of the mechanism of action of metformin.RESULTSOne complete response and one partial response were observed. In the other nine patients, the marker lesion remained, while five of these patients also developed new Ta low-grade lesions. Diarrhoea grade ≤ 2 was the most common adverse event (AE), observed in nine out of 11 patients. No serious AEs related to study treatment occurred. Metformin concentrations in the urine were significantly higher than metformin levels in the blood. Immunohistochemical analysis before and after treatment showed no difference in expression of markers associated with the mechanism of metformin.CONCLUSIONWe did not find conclusive evidence for the hypothesis of an antitumour effect of metformin in bladder cancer.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"57 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122020","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}
Jubin E. Matloubieh, Rutul D. Patel, Ethan Fram, Franklin C. Lowe
{"title":"Factors associated with Fournier's gangrene survival in a diverse urban community: a 15-year review","authors":"Jubin E. Matloubieh, Rutul D. Patel, Ethan Fram, Franklin C. Lowe","doi":"10.1111/bju.16766","DOIUrl":"10.1111/bju.16766","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess risk factors, scoring systems, microbiology, and outcomes associated with Fournier's gangrene (FG) in a diverse urban community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of patients with FG medical data from 2007 to 2021 was performed. Means were compared via <i>t</i>-tests, associations via chi-square analysis, and survival probability via Kaplan–Meier analysis. Statistical findings were considered significant if <i>P</i> ≤ 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 132 patients with FG, 14% died of FG, 47% were discharged home, and 39% were discharged to a nursing facility. Orchidectomies, thigh pouches, flap/graft wound closure, and immediate wound closure were performed in 9%, 12%, 22%, and 29% of cases, respectively. <i>Escherichia coli</i>, <i>Bacteroides</i>, <i>Streptococcus</i>, <i>Enterococcus</i>, and <i>Candida</i> were most frequently isolated. <i>Candida</i> and <i>Proteus</i> species were associated with lower survival probability, whereas <i>Streptococcus</i> and <i>Staphylococcus</i> species were associated with higher survival probability. Lower haemoglobin A1c was associated with orchidectomy and FG death, while higher A1c was associated with flap/graft use during wound closure. Compared to culture-concordant empiric antibiotics, culture-discordant empiric antibiotics were associated with longer hospital stay and worse outcomes. The Uludag Fournier's Gangrene Severity Index (UFGSI) was significantly associated with the most surgical and clinical outcomes of interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The microbiome responsible for the FG disease process evolved with the emergence of fungal FG. Along with causative organisms, this study also highlights comorbid conditions that adversely affect patient outcomes, especially mental illness. We also note the relative superiority of the UFGSI compared to other scoring systems. There is a need to reassess empiric antibiotic selection and surgical management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"136 2","pages":"314-320"},"PeriodicalIF":3.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122180","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}
Fintan R Ryan,Dearbhla Treacy,Diarmuid D Sugrue,Rustom P Manecksha,Robert J Flynn,Arun Z Thomas,Lisa G Smyth,Eoin MacCraith,Rowan G Casey,Clíodhna Browne
{"title":"Enhancing urology theatre waste management: impact of a 'Green Moment' in daily surgical practice.","authors":"Fintan R Ryan,Dearbhla Treacy,Diarmuid D Sugrue,Rustom P Manecksha,Robert J Flynn,Arun Z Thomas,Lisa G Smyth,Eoin MacCraith,Rowan G Casey,Clíodhna Browne","doi":"10.1111/bju.16787","DOIUrl":"https://doi.org/10.1111/bju.16787","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"35 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103787","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}
Mattia Longoni,Pietro Scilipoti,Mario De Angelis,Paolo Zaurito,Giovanni Tremolada,Alfonso Santangelo,Giuseppe Simone,Riccardo Mastroianni,Chiara Lonati,Stefania Zamboni,Nazareno Suardi,Gautier Marcq,Aleksandra Szostek,Jorge Caño Velasco,Alfonso Lafuente Puentedura,José Daniel Subiela,Pedro Del Olmo Durán,Aleksander Ślusarczyk,Pierre I Karakiewicz,Benjamin Pradere,Francesco Soria,Paolo Gontero,Morgan Rouprêt,Francesco Montorsi,Andrea Salonia,Alberto Briganti,Marco Moschini,
{"title":"Contemporary outcomes in non-muscle-invasive bladder cancer: a large European multicentre study.","authors":"Mattia Longoni,Pietro Scilipoti,Mario De Angelis,Paolo Zaurito,Giovanni Tremolada,Alfonso Santangelo,Giuseppe Simone,Riccardo Mastroianni,Chiara Lonati,Stefania Zamboni,Nazareno Suardi,Gautier Marcq,Aleksandra Szostek,Jorge Caño Velasco,Alfonso Lafuente Puentedura,José Daniel Subiela,Pedro Del Olmo Durán,Aleksander Ślusarczyk,Pierre I Karakiewicz,Benjamin Pradere,Francesco Soria,Paolo Gontero,Morgan Rouprêt,Francesco Montorsi,Andrea Salonia,Alberto Briganti,Marco Moschini,","doi":"10.1111/bju.16780","DOIUrl":"https://doi.org/10.1111/bju.16780","url":null,"abstract":"OBJECTIVETo report real-world rates of non-muscle-invasive bladder cancer (NMIBC) recurrence and progression within a European multicentre cohort with detailed information on intravesical instillation courses, as contemporary data on oncological outcomes in NMIBC are limited.PATIENTS AND METHODSA total of 1918 patients with NMIBC treated with transurethral resection of bladder tumour (TURBT) were retrospectively identified from six tertiary-referral European centres (2015-2022). Patients were stratified according to European Association of Urology 2021 criteria into low- (LR), intermediate- (IR), high- (HR) and very high-risk (VHR) categories. Cumulative incidence plots and multivariable competing risks regression models addressing 5-year rates of high-grade (HG) recurrence and progression were fitted. Sensitivity analyses focused on patients receiving intravesical instillations and tested for the effect of adequate course (Bacillus Calmette-Guérin: five or more induction + two or more maintenance instillations; mitomycin C: complete induction + ≥11 maintenance instillations).RESULTSOf all NMIBC patients identified, 467 (24.3%) were LR vs 582 (30.3%) IR vs 739 (38.5%) HR vs 130 (6.8%) VHR. The median (interquartile range) follow-up after TURBT was 26 (12-46) months. The 5-year HG recurrence rates were 7.2% in LR vs 17.3% in IR vs 26.7% in HR vs 30.9% in VHR patients, resulting in a three-, five- and seven-fold higher risk of IR, HR and VHR, respectively, relative to LR (all P < 0.001). The 5-year progression rates were 3.9% in LR vs 5.2% in IR vs 13.6% in HR vs 31.6% in VHR patients, resulting in a six- and nine-fold higher risk for HR and VHR, respectively, relative to LR (all P < 0.001). In all, 1001 (52.2%) patients underwent intravesical instillations. Those receiving adequate instillation course (244/1001 [24.3%]) had lower HG-recurrence (hazard ratio 0.3, P < 0.001) and progression (hazard ratio 0.2, P = 0.001) risk.CONCLUSIONSPatients with HR/VHR NMIBC face significantly higher HG recurrence and progression risks. While tailored treatment strategies are needed, adherence to adequate instillation course remains crucial for optimising oncological outcomes.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"32 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114263","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":"Building foundations: implementing the ‘new’ boot camp model for first-year urology residents in the UK","authors":"Chandra Shekhar Biyani, Mamoun Hamid Elmamoun, Vishwanath Hanchanale","doi":"10.1111/bju.16790","DOIUrl":"10.1111/bju.16790","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"136 2","pages":"182-184"},"PeriodicalIF":3.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113978","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}