BJU International最新文献

{"title":"Comment on ‘Clinically significant prostate cancer detected by systematic biopsy in patients with MRI lesions’","authors":"Keerthi Sanapala, Rachana Mehta, Ranjana Sah","doi":"10.1111/bju.16868","DOIUrl":"https://doi.org/10.1111/bju.16868","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"147 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763340","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":"Oncological safety of testosterone replacement therapy in men with localised prostate cancer: a systematic review of observational studies","authors":"Jordan Santucci, Peter Stapleton, Marlon Perera, Joseph Ischia, Declan Murphy, Damien Bolton, Nathan Lawrentschuk, Mark Frydenberg, Niranjan Sathianathen","doi":"10.1111/bju.16870","DOIUrl":"https://doi.org/10.1111/bju.16870","url":null,"abstract":"ObjectivesTo evaluate the oncological safety of testosterone replacement therapy (TRT) in hypogonadal patients with prostate cancer, as testosterone deficiency (TD) rises in prevalence with age and in prostate cancer may be treatment‐related, whilst contributing to poor health outcomes.Patients and MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, Medline, EMBASE, PubMed, and Scopus were searched. Studies were included assessing progression and biochemical recurrence in men with prostate cancer and TD receiving TRT.ResultsSearches yielded 4067 studies, of which 19 were included: five in active surveillance, 10 post‐radical prostatectomy (RP), six post‐radiotherapy. Pooled meta‐analysis was not valid due to insufficient number of comparative studies and significant clinical and methodological heterogeneity. Progression rates on active surveillance ranged from 0% to 32% and did not differ significantly to non‐exposed controls on retrospective comparison at follow‐up as long as 70 months. Biochemical recurrence rates in TRT‐exposed cohorts were low post‐definitive treatment ranging from 0% to 7% post‐RP to 0–6% post‐radiotherapy (± androgen deprivation therapy) with up to 60 months of follow‐up. Overall certainty of TRT oncological safety is limited by lack of long‐term, prospective, controlled comparative data and lack of assessment of survival outcomes.ConclusionsRetrospective evidence supports cautious use of TRT in low–intermediate‐risk disease on active surveillance and favourable localised disease post‐RP or post‐radiotherapy with appropriate prostate‐specific antigen responses. Diligent patient selection and monitoring are required until randomised controlled trial data are available to inform safe management of TD in prostate cancer.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"14 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755903","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":"Preferences between three options for androgen deprivation therapy: a focus group study","authors":"Hannah L. Rush, Sophie Merrick, John Marshall, John Deighan, Hoda Abdel‐Aty, Abdulla Alhasso, Noel W. Clarke, Roger Kockelbergh, Stephen Mangar, Stuart D. Rosen, Nicholas D. James, Duncan C. Gilbert, Annabelle South, Ruth E. Langley","doi":"10.1111/bju.16863","DOIUrl":"https://doi.org/10.1111/bju.16863","url":null,"abstract":"ObjectivesAndrogen deprivation therapy (ADT) forms the mainstay of treatment for advanced prostate cancer. Traditionally administered as a luteinising hormone‐releasing hormone (LHRH) agonist depot injection, newer options for ADT include transdermal oestradiol patches (tE2) or oral LHRH antagonists. This study aimed to identify whether this is an important choice for men, which treatment men would choose if offered either LHRH agonist injections, tE2 patches or oral LHRH antagonists as ADT, and to explore the factors influencing this decision.Subjects, Patients, and MethodsFive focus groups were conducted. A total of 24 men from around the UK participated in discussions, of whom 10 had never had prostate cancer and 14 had early prostate cancer but had not received ADT. Focus groups were co‐facilitated with patient and public involvement representatives. Transcripts were analysed using a critical realist thematic analysis approach.ResultsParticipants reported that having a choice of ADT is important and being involved in making treatment decisions can help men maintain an element of control. Most men expressed a preference to avoid ADT with LHRH agonist injections; 14 of the 24 men reported they would choose an oral LHRH antagonist, eight reported they would choose tE2 patches, and two that they would choose LHRH agonist injections. Participants reported a large number of factors that influenced their treatment choice that were grouped into: (i) side‐effects of treatment, (ii) logistical aspects, and (iii) advice from trusted others. Personal preferences between different types of ADT were based on factors that participants identified as important to them, this prioritisation of factors was influenced by participants’ past experiences, current health beliefs, and future expectations.ConclusionsMen wish to have choice of ADT, and many would not choose LHRH agonists injections if there were other ADT options available. This should be considered, as reimbursement committees and guideline‐makers consider the role of alternative ADT strategies.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"27 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747233","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":"Chatbots in urology: accuracy, calibration, and comprehensibility; is DeepSeek taking over the throne?","authors":"Omer Faruk Asker, Muhammed Selim Recai, Yunus Emre Genc, Kader Ada Dogan, Tarik Emre Sener, Bahadir Sahin","doi":"10.1111/bju.16873","DOIUrl":"https://doi.org/10.1111/bju.16873","url":null,"abstract":"ObjectiveTo evaluate widely used chatbots’ accuracy, calibration error, readability, and understandability with objective measurements by 35 questions derived from urology in‐service examinations, as the integration of large language models (LLMs) into healthcare has gained increasing attention, raising questions about their applications and limitations.Materials and MethodsA total of 35 European Board of Urology questions were asked to five LLMs with a standardised prompt that was systematically designed and used across all models: ChatGPT‐4o, DeepSeek‐R1, Gemini, Grok‐2, and Claude 3.5. Accuracy was calculated by Cohen's kappa for all models. Readability was assessed by Flesch Reading Ease, Gunning Fog, Coleman–Liau, Simple Measure of Gobbledygook, and Automated Readability Index, while understandability was determined by scores of residents’ ratings by a Likert scale.ResultsThe models and answer key were in substantial agreement with a Fleiss’ kappa of 0.701, and Cronbach's alpha of 0.914. For accuracy, Cohen's kappa was 0.767 for ChatGPT‐4o, 0.764 for DeepSeek‐R, and 0.765 for Grok‐2 (80% accuracy for each), followed by 0.729 for Claude 3.5 (77% accuracy) and 0.611 for Gemini (68.4% accuracy). The lowest calibration error was found in ChatGPT‐4o (19.2%) and DeepSeek‐R1 scored the highest for readability. In understandability analysis, Claude 3.5 had the highest rating compared to others.ConclusionChatbots demonstrated various powers across different tasks. DeepSeek‐R1, despite being just released, showed promising results in medical applications. These findings highlight the need for further optimisation to better understand the applications of chatbots in urology.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"97 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747642","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":"Transcriptome profiling of prostatic tumours from ENACT trial patients with or without enzalutamide","authors":"Nicole Handa, Neal D. Shore, Matthew R. Cooperberg, Elai Davicioni, Xin Zhao, Dina Elsouda, Yang Liu, James A. Proudfoot, Gaston Kuperman, David Russell, Kenneth K. Iwata, Edward M. Schaeffer, Ashley Ross","doi":"10.1111/bju.16861","DOIUrl":"https://doi.org/10.1111/bju.16861","url":null,"abstract":"ObjectivesTo evaluate the longitudinal transcriptomic changes that occurred over time in patients from the ENACT trial (ClinicalTrials.gov identifier: NCT02799745). ENACT evaluated patients with low‐ or intermediate‐risk prostate cancer, comparing the efficacy and safety of enzalutamide plus active surveillance (AS) to AS alone.Patients and MethodsGene‐expression profiling was conducted using the Decipher Genomic Resource for Intelligent Discovery (GRID) platform (Veracyte, Inc.) on 131 patient samples (enzalutamide plus AS: <jats:italic>n</jats:italic> = 57; AS alone: <jats:italic>n</jats:italic> = 74) collected at screening, Year 1, and Year 2. Pre‐defined GRID signatures were analysed for associations with biological and clinical features, including immune activity, treatment sensitivity, metastatic risk, and molecular subtypes. Statistical analyses utilised Cox proportional hazards models and logistic/linear regression, while longitudinal changes were evaluated using linear mixed‐effects models.ResultsAt Year 1, patients treated with enzalutamide plus AS showed significant transcriptomic changes, such as downregulation of androgen‐receptor signalling and immune‐suppressor signatures, alongside upregulation of immune‐activated and basal‐like markers. Many of these transcriptomic alterations, including immune‐related changes, were transient and reverted to baseline levels at Year 2 after enzalutamide treatment cessation.ConclusionThis exploratory biomarker analysis highlights transcriptomic changes in patients undergoing AS and those treated with enzalutamide, providing insights into molecular disease progression on surveillance and the effects of transient exposure to enzalutamide. The observed immune modulation during enzalutamide treatment suggests opportunities to explore immunotherapy strategies.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"718 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747231","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":"Socioeconomic disparities in prostate cancer screening: the impact of the Area Deprivation Index on PSA screening frequency.","authors":"Alessandro Bertini,Giuseppe Ottone Cirulli,Alex Stephens,Alessio Finocchiaro,Silvia Viganò,Giovanni Lughezzani,Nicolò Buffi,Ettore Di Trapani,Vincenzo Ficarra,Andrea Salonia,Alberto Briganti,Francesco Montorsi,Akshay Sood,Craig Rogers,Firas Abdollah","doi":"10.1111/bju.16875","DOIUrl":"https://doi.org/10.1111/bju.16875","url":null,"abstract":"OBJECTIVETo investigate the impact of the Area Deprivation Index (ADI) on prostate-specific antigen (PSA) screening patterns in a North American cohort, as the influence of neighbourhood socioeconomic disadvantage on prostate cancer screening intensity has been scantly analysed.PATIENTS AND METHODSWe included all men receiving care in Henry Ford Health System, aged 50-69 years and without previous prostate cancer diagnosis at the 31 December 2022. Each patient was assigned an ADI score based on their census block group, categorised into quartiles, with the fourth quartile (Q4, ADI 75-100) representing the most disadvantaged areas. The screening rate was calculated as the total number of PSA tests divided by the number of years patients were aged 50 years and older. Multivariable Poisson regression analysis tested the ADI's influence on screening rate.RESULTSAmong the 266 203 patients initially included, 75 958 patients had at least one PSA test at our institution. Overall, 20.9% were non-Hispanic Black. Patients in the most disadvantage quartile (Q4) were more likely to be non-Hispanic Black (P < 0.001), had higher comorbidity rates (P < 0.001) and lower probability of receiving two or more PSA tests (P < 0.001) compared to the ones in the least disadvantaged quartile (first quartile [Q1]). At Poisson regression analysis, when compared to patients in Q4, patients from Q1, and the second and third quartile had a 1.87-, 1.70-, and 1.52-fold higher probability of receiving screening, respectively (P < 0.001).CONCLUSIONSLiving in more deprived areas was associated with lower rates of PSA screening frequency. These findings highlight how socioeconomic deprivation may limit access to preventive healthcare, reinforcing the need for more inclusive and targeted outreach strategies.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"19 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144737360","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":"Experimental stone clearance with in-scope suction and flexible and navigable suction access sheaths.","authors":"Richard Menzies-Wilson,Thijs Ruiken,Benjamin Turney","doi":"10.1111/bju.16849","DOIUrl":"https://doi.org/10.1111/bju.16849","url":null,"abstract":"OBJECTIVETo perform benchtop experiments using direct in-scope suction (DISS) ureteroscopes (Pusen Medical, Zhuhai, China; 3.6-Ch and 5.1-Ch working channels) and flexible and navigable suction (FANS) ureteric access sheaths (ClearPetra; Wellead, Guangzhou, China) to establish their ability to clear stones of different diameters.METHODSFor each experimental group, we conducted a series of experiments using mixes of progressively larger stone particles (<63, 63-125, 125-250, 250-500, 500-1000 and 1000-2000 μm) until suction through the respective lumen failed to achieve complete stone clearance; the first experiment's stone mix contained particles <63 μm; the second experiment's stone mix contained particles <63 μm + 63-125 μm; the third experiment's stone mix contained particles <63 μm + 63-125 μm + 125-250 μm, and so on, up to 2000 μm. The stone mixes were introduced in aliquots over the course of 30 min. In the first experimental group, either a 3.6-Ch or a 5.1-Ch working channel DISS ureteroscope (with a 200-μm laser) was used to aspirate stones. In the second experimental group, either an empty 5.1-Ch working channel DISS ureteroscope or an 11/13-Ch FANS with a 9.5-Ch ureteroscope (intermittently withdrawn) was used to aspirate stones.RESULTSThe use of DISS through a 3.6-Ch working channel (with laser fibre) cleared stones up to 250 μm. DISS through a 5.1-Ch working channel cleared stones up to 500 μm with and without an indwelling laser fibre. FANS cleared all stone sizes tested (up to 2000 μm).CONCLUSIONSDuring laser lithotripsy, DISS can aspirate 'dust' particles (<250 μm), which are known to most affect vision. However, particles >250 μm and >500 μm (with 3.6-Ch and 5.1-Ch working channels) may block the ureteroscope. The use of FANS, through successful clearance of larger fragments, may facilitate clearance of larger fragments.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"148 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144737362","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 Hof et al.: spurious associations between BCG instillations and outcomes in non-muscle-invasive bladder cancer.","authors":"Mattia Longoni,Pietro Scilipoti,Paolo Zaurito,Marco Moschini","doi":"10.1111/bju.16867","DOIUrl":"https://doi.org/10.1111/bju.16867","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"13 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720173","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":"Performance between surgically and medically inclined medical students in simulated laparoscopy","authors":"Hong Min Shaye Peng, Simone Ong Meiqi, Wei Zheng So, Jessica Yen, Yuen Chun Jeremy Teoh, Ho Yee Tiong","doi":"10.1111/bju.16874","DOIUrl":"https://doi.org/10.1111/bju.16874","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"28 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144766007","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":"Biased associations between number of BCG instillations and outcome in non-muscle-invasive bladder cancer.","authors":"Jasper Hof,Sita Vermeulen,Anke Richters","doi":"10.1111/bju.16866","DOIUrl":"https://doi.org/10.1111/bju.16866","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"11 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701097","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}