Pub Date : 2024-06-10DOI: 10.1016/j.euf.2024.05.023
Cheng Shen, Weigang Yan, Silu Chen, Weifeng Xu, Xiang Wang, Jie Dong, Zhongyuan Zhang, Kunlin Yang, Shubo Fan, Zhihua Li, Xu Chen, Meng Zhang, Zaoheng Jin, Yisen Meng, Lin Cai, Kai Zhang, Zheng Zhang, Li Mu, Zhigang Ji, Liqun Zhou, Xuesong Li
Background: The KangDuo Surgical Robot (KD-SR) is a newly developed surgical robot.
Objective: To compare the safety and efficacy of robot-assisted radical prostatectomy (RARP) using the KD-SR with those of the da Vinci Si Surgical System (DV-SS-Si).
Design, setting, and participants: A prospective double-center noninferiority randomized controlled trial was conducted among 18-75-yr-old patients with suspected T1-2N0M0 prostate cancer (PCa) scheduled for RARP.
Intervention: RARP with the KD-SR (KD-RARP) versus RARP with the DV-SS-Si (DV-RARP).
Outcome measurements and statistical analysis: The primary outcome was surgical success, defined as follows: surgery can be performed according to the established protocol, without switching to other surgical modalities, and without secondary surgery due to surgical complications after surgery. The secondary outcome was short-term functional and oncological outcomes. The noninferiority threshold was set at 10%.
Results and limitations: Eighty patients were enrolled, while the full analysis set finally included 79 patients (40 with KD-RARP and 39 with DV-RARP). The success rate was 100% in both groups. We could not find differences in urinary continence rate at 1, 2, 3, and 4 wk after catheter removal between the groups (p > 0.05). The rate of Clavien-Dindo grade II adverse events was 20% in the KD-RARP group and 17.9% in the DV-RARP group (p = 0.82), and no grade ≥III adverse events occurred. The median operation time was significantly longer in the KD-RARP group than in the DV-RARP group (177.5 vs 145 min, p = 0.012). The main limitations were the short follow-up period and that survival was not considered as the primary outcome.
Conclusions: The KD-SR is a viable option for RARP, with acceptable short-term outcomes compared with the DV-SS-Si for T1-2 PCa.
Patient summary: This is the first prospective randomized controlled trial to compare the KangDuo Surgical Robot (KD-SR) versus the da Vinci Si Surgical System (DV-SS-Si) for robot-assisted radical prostatectomy, which determines that the KD-SR is noninferior to the DV-SS-Si regarding safety and efficacy for T1-T2 prostate cancer.
{"title":"Robot-assisted Radical Prostatectomy with the KangDuo Surgical System Versus the da Vinci Si System: A Prospective, Double-center, Randomized Controlled Trial.","authors":"Cheng Shen, Weigang Yan, Silu Chen, Weifeng Xu, Xiang Wang, Jie Dong, Zhongyuan Zhang, Kunlin Yang, Shubo Fan, Zhihua Li, Xu Chen, Meng Zhang, Zaoheng Jin, Yisen Meng, Lin Cai, Kai Zhang, Zheng Zhang, Li Mu, Zhigang Ji, Liqun Zhou, Xuesong Li","doi":"10.1016/j.euf.2024.05.023","DOIUrl":"https://doi.org/10.1016/j.euf.2024.05.023","url":null,"abstract":"<p><strong>Background: </strong>The KangDuo Surgical Robot (KD-SR) is a newly developed surgical robot.</p><p><strong>Objective: </strong>To compare the safety and efficacy of robot-assisted radical prostatectomy (RARP) using the KD-SR with those of the da Vinci Si Surgical System (DV-SS-Si).</p><p><strong>Design, setting, and participants: </strong>A prospective double-center noninferiority randomized controlled trial was conducted among 18-75-yr-old patients with suspected T1-2N0M0 prostate cancer (PCa) scheduled for RARP.</p><p><strong>Intervention: </strong>RARP with the KD-SR (KD-RARP) versus RARP with the DV-SS-Si (DV-RARP).</p><p><strong>Outcome measurements and statistical analysis: </strong>The primary outcome was surgical success, defined as follows: surgery can be performed according to the established protocol, without switching to other surgical modalities, and without secondary surgery due to surgical complications after surgery. The secondary outcome was short-term functional and oncological outcomes. The noninferiority threshold was set at 10%.</p><p><strong>Results and limitations: </strong>Eighty patients were enrolled, while the full analysis set finally included 79 patients (40 with KD-RARP and 39 with DV-RARP). The success rate was 100% in both groups. We could not find differences in urinary continence rate at 1, 2, 3, and 4 wk after catheter removal between the groups (p > 0.05). The rate of Clavien-Dindo grade II adverse events was 20% in the KD-RARP group and 17.9% in the DV-RARP group (p = 0.82), and no grade ≥III adverse events occurred. The median operation time was significantly longer in the KD-RARP group than in the DV-RARP group (177.5 vs 145 min, p = 0.012). The main limitations were the short follow-up period and that survival was not considered as the primary outcome.</p><p><strong>Conclusions: </strong>The KD-SR is a viable option for RARP, with acceptable short-term outcomes compared with the DV-SS-Si for T1-2 PCa.</p><p><strong>Patient summary: </strong>This is the first prospective randomized controlled trial to compare the KangDuo Surgical Robot (KD-SR) versus the da Vinci Si Surgical System (DV-SS-Si) for robot-assisted radical prostatectomy, which determines that the KD-SR is noninferior to the DV-SS-Si regarding safety and efficacy for T1-T2 prostate cancer.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305821","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}
Pub Date : 2024-06-08DOI: 10.1016/j.euf.2024.05.020
Sabine Kliesch, Jann-Frederik Cremers, Claudia Krallmann, Robin Epplen, Bettina Scheffer, Tim Schubert, Maria Schubert, Nici Markus Dreger, Ralph Raschke, Ehsan Khaljani, Andreas Maxeiner, Kurt Miller, Laura Wiemer, Michael Zitzmann
Background and objective: While international guidelines advocate for a multifaceted approach to treating erectile dysfunction (ED) involving physical activities, psychological support, and education, structured programs are infrequent. To address this gap, an app-based therapy was developed, offering a systematic approach. This randomized, single-blind controlled trial aimed to assess the effectiveness of an app-based therapeutic in improving ED.
Methods: A total of 241 patients (49.74, standard deviation 12.73 yr) with ED (International Index of Erectile Function [IIEF]-5 <22) were randomized to the 12-wk app-based therapy (treatment group [TG], n = 122) or a waiting list for the app with continuation of their current management protocol (control group [CG], n = 119). Patients on long-term medication for ED were included, but subsequent exclusion occurred for those starting new medication. Coprimary endpoints were improvements from baseline to 12 wk in erectile function (IIEF-5), disease-related quality of life (QOL-Med-15), and patient activation (Patient Activation Measure [PAM-13]).
Key findings and limitations: Erectile function (IIEF-5) improved by 4.5 points in the TG versus 0.2 points in the CG (p < 0.0001, 95% confidence interval [CI] 3.4-5.0) group. Quality of life (QOL-Med) improved by 20.5 points in the TG versus -0.0 points in the CG (p < 0.0001, 95% CI 19.2-26.0) group. Patient activation (PAM-13) improved by 11.2 points in the TG versus 0.6 points in the CG (p < 0.0001, 95% CI 9.1-13.6) group. Phosphodiesterase type 5 inhibitor intake had no influence on all observed treatment effects.
Conclusions and clinical implications: App-based therapy of patients with ED provided a significant, clinically meaningful improvement. Quality of life and patient activation were also enhanced significantly. This program has the potential to change clinical practice in the treatment of ED.
Patient summary: A therapy app improved sexual function and overall well-being for men experiencing erectile dysfunction, leading to better quality of life.
背景和目的:虽然国际指南提倡采用多方面的方法治疗勃起功能障碍(ED),包括体育活动、心理支持和教育,但结构化的方案并不多见。为了弥补这一不足,我们开发了一种基于应用程序的疗法,提供了一种系统化的方法。这项随机、单盲对照试验旨在评估基于应用程序的疗法在改善勃起功能障碍方面的效果:共有 241 名 ED 患者(49.74 岁,标准差为 12.73 岁)接受了治疗(国际勃起功能指数 [IIEF]-5 主要发现和局限性:TG组的勃起功能(IIEF-5)提高了4.5分,而CG组提高了0.2分(P < 0.0001,95% 置信区间 [CI] 3.4-5.0)。TG组的生活质量(QOL-Med)提高了20.5分,而CG组为-0.0分(p 结论和临床意义:基于应用程序的 ED 患者治疗效果显著,具有临床意义。患者的生活质量和积极性也得到了显著提高。患者总结:一款治疗应用程序改善了勃起功能障碍男性的性功能和整体健康,从而提高了生活质量。
{"title":"App-based Therapy of Erectile Dysfunction Using a Digital Health Application (EDDIG Study): A Randomized, Single-blind, Controlled Trial.","authors":"Sabine Kliesch, Jann-Frederik Cremers, Claudia Krallmann, Robin Epplen, Bettina Scheffer, Tim Schubert, Maria Schubert, Nici Markus Dreger, Ralph Raschke, Ehsan Khaljani, Andreas Maxeiner, Kurt Miller, Laura Wiemer, Michael Zitzmann","doi":"10.1016/j.euf.2024.05.020","DOIUrl":"https://doi.org/10.1016/j.euf.2024.05.020","url":null,"abstract":"<p><strong>Background and objective: </strong>While international guidelines advocate for a multifaceted approach to treating erectile dysfunction (ED) involving physical activities, psychological support, and education, structured programs are infrequent. To address this gap, an app-based therapy was developed, offering a systematic approach. This randomized, single-blind controlled trial aimed to assess the effectiveness of an app-based therapeutic in improving ED.</p><p><strong>Methods: </strong>A total of 241 patients (49.74, standard deviation 12.73 yr) with ED (International Index of Erectile Function [IIEF]-5 <22) were randomized to the 12-wk app-based therapy (treatment group [TG], n = 122) or a waiting list for the app with continuation of their current management protocol (control group [CG], n = 119). Patients on long-term medication for ED were included, but subsequent exclusion occurred for those starting new medication. Coprimary endpoints were improvements from baseline to 12 wk in erectile function (IIEF-5), disease-related quality of life (QOL-Med-15), and patient activation (Patient Activation Measure [PAM-13]).</p><p><strong>Key findings and limitations: </strong>Erectile function (IIEF-5) improved by 4.5 points in the TG versus 0.2 points in the CG (p < 0.0001, 95% confidence interval [CI] 3.4-5.0) group. Quality of life (QOL-Med) improved by 20.5 points in the TG versus -0.0 points in the CG (p < 0.0001, 95% CI 19.2-26.0) group. Patient activation (PAM-13) improved by 11.2 points in the TG versus 0.6 points in the CG (p < 0.0001, 95% CI 9.1-13.6) group. Phosphodiesterase type 5 inhibitor intake had no influence on all observed treatment effects.</p><p><strong>Conclusions and clinical implications: </strong>App-based therapy of patients with ED provided a significant, clinically meaningful improvement. Quality of life and patient activation were also enhanced significantly. This program has the potential to change clinical practice in the treatment of ED.</p><p><strong>Patient summary: </strong>A therapy app improved sexual function and overall well-being for men experiencing erectile dysfunction, leading to better quality of life.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295886","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}
Pub Date : 2024-06-04DOI: 10.1016/j.euf.2024.05.007
Cora N Sternberg, Yohann Loriot, Ernest Choy, Daniel Castellano, Fernando Lopez-Rios, Giuseppe Luigi Banna, Friedemann Zengerling, Ugo De Giorgi, Craig Gedye, Cristina Masini, Aristotelis Bamias, Xavier Garcia Del Muro, Ignacio Duran, Thomas Powles, Margitta Retz, Marija Gamulin, Lajos Geczi, Robert A Huddart, Fabio Calabrò, Geetha Kandula, Pari Skamnioti, Axel S Merseburger
Background and objective: We assessed the safety of atezolizumab in unselected patients (including understudied populations typically excluded from clinical trials) with pretreated urinary tract carcinoma (UTC). The prespecified final analysis updates previously reported safety and efficacy data.
Methods: The single-arm prospective SAUL study (NCT02928406) enrolled 1004 patients with locally advanced/metastatic urothelial/non-urothelial UTC that had progressed during/after one to three prior treatment lines for advanced UTC (or <12 mo after [neo]adjuvant therapy). Broad eligibility criteria allowed enrollment of patients with complex comorbidities approximating the real-world setting. Patients received atezolizumab 1200 mg every 3 wk until disease progression or unacceptable toxicity. The primary endpoint was safety. Secondary endpoints included duration of response and overall survival (OS).
Key findings and limitations: The treated cohort included 10% of patients with poor performance status, 5% with creatinine clearance <30 ml/min, and 4% with autoimmune disease. At median follow-up of 55 mo, median atezolizumab duration was 2.8 mo (range 0-62); 68 patients (7%) continued atezolizumab for >4 yr. Treatment-related grade ≥3 adverse events occurred in 16% of patients (death in 1%); 8% discontinued atezolizumab for adverse events. Median OS was 8.6 mo (95% confidence interval 7.8-9.7) and 136 patients (14%) had OS longer than 4 yr. Limitations include the small sample size for some subgroups of special interest.
Conclusions and clinical implications: Long-term safety and efficacy data continue to show a benefit of atezolizumab in unselected patients with UTC. Remarkably, 14% of patients lived for >4 yr after starting atezolizumab. These results can inform multidisciplinary team discussions and treatment decision-making for patients with UTC with complex comorbidities.
Patient summary: The SAUL study looked at how well tolerated a drug called atezolizumab was in patients with urinary tract cancer who had already received up to three previous treatments for their cancer, including people who are usually not included in clinical trials because of other medical conditions. The length of survival after starting treatment was also assessed. Overall, the results show that atezolizumab was well tolerated. People for whom other therapies had failed lived for about 8.6 months on average after starting treatment, and 14% of the patients were still alive after 4 years.
背景和目的:我们评估了atezolizumab在未经选择的尿路癌(UTC)预处理患者(包括通常被排除在临床试验之外的未充分研究人群)中的安全性。预设的最终分析更新了之前报告的安全性和有效性数据:方法:单臂前瞻性 SAUL 研究(NCT02928406)招募了 1004 名局部晚期/转移性尿路上皮癌/非尿路上皮癌 UTC 患者,这些患者在晚期 UTC(或主要研究结果和局限性)的一至三线治疗期间/之后病情恶化:16%的患者发生了治疗相关的≥3级不良事件(1%的患者死亡);8%的患者因不良事件停用了阿特珠单抗。中位OS为8.6个月(95%置信区间为7.8-9.7),136名患者(14%)的OS超过4年。结论和临床意义:阿特珠单抗的长期安全性和疗效数据继续显示了阿特珠单抗对非选择性UTC患者的益处。值得注意的是,14%的患者在开始使用阿特珠单抗后存活了4年以上。患者摘要:SAUL研究考察了一种名为atezolizumab的药物在尿路癌患者中的耐受性,这些患者此前已接受过最多三次癌症治疗,包括通常因其他疾病而未被纳入临床试验的患者。此外,还对开始治疗后的生存期进行了评估。总体而言,结果显示阿特珠单抗的耐受性良好。其他疗法无效的患者在开始治疗后平均存活时间约为8.6个月,14%的患者在4年后仍然存活。
{"title":"Final Results from SAUL, a Single-arm International Study of Atezolizumab in Unselected Patients with Pretreated Locally Advanced/Metastatic Urinary Tract Carcinoma.","authors":"Cora N Sternberg, Yohann Loriot, Ernest Choy, Daniel Castellano, Fernando Lopez-Rios, Giuseppe Luigi Banna, Friedemann Zengerling, Ugo De Giorgi, Craig Gedye, Cristina Masini, Aristotelis Bamias, Xavier Garcia Del Muro, Ignacio Duran, Thomas Powles, Margitta Retz, Marija Gamulin, Lajos Geczi, Robert A Huddart, Fabio Calabrò, Geetha Kandula, Pari Skamnioti, Axel S Merseburger","doi":"10.1016/j.euf.2024.05.007","DOIUrl":"https://doi.org/10.1016/j.euf.2024.05.007","url":null,"abstract":"<p><strong>Background and objective: </strong>We assessed the safety of atezolizumab in unselected patients (including understudied populations typically excluded from clinical trials) with pretreated urinary tract carcinoma (UTC). The prespecified final analysis updates previously reported safety and efficacy data.</p><p><strong>Methods: </strong>The single-arm prospective SAUL study (NCT02928406) enrolled 1004 patients with locally advanced/metastatic urothelial/non-urothelial UTC that had progressed during/after one to three prior treatment lines for advanced UTC (or <12 mo after [neo]adjuvant therapy). Broad eligibility criteria allowed enrollment of patients with complex comorbidities approximating the real-world setting. Patients received atezolizumab 1200 mg every 3 wk until disease progression or unacceptable toxicity. The primary endpoint was safety. Secondary endpoints included duration of response and overall survival (OS).</p><p><strong>Key findings and limitations: </strong>The treated cohort included 10% of patients with poor performance status, 5% with creatinine clearance <30 ml/min, and 4% with autoimmune disease. At median follow-up of 55 mo, median atezolizumab duration was 2.8 mo (range 0-62); 68 patients (7%) continued atezolizumab for >4 yr. Treatment-related grade ≥3 adverse events occurred in 16% of patients (death in 1%); 8% discontinued atezolizumab for adverse events. Median OS was 8.6 mo (95% confidence interval 7.8-9.7) and 136 patients (14%) had OS longer than 4 yr. Limitations include the small sample size for some subgroups of special interest.</p><p><strong>Conclusions and clinical implications: </strong>Long-term safety and efficacy data continue to show a benefit of atezolizumab in unselected patients with UTC. Remarkably, 14% of patients lived for >4 yr after starting atezolizumab. These results can inform multidisciplinary team discussions and treatment decision-making for patients with UTC with complex comorbidities.</p><p><strong>Patient summary: </strong>The SAUL study looked at how well tolerated a drug called atezolizumab was in patients with urinary tract cancer who had already received up to three previous treatments for their cancer, including people who are usually not included in clinical trials because of other medical conditions. The length of survival after starting treatment was also assessed. Overall, the results show that atezolizumab was well tolerated. People for whom other therapies had failed lived for about 8.6 months on average after starting treatment, and 14% of the patients were still alive after 4 years.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261932","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}
Pub Date : 2024-06-04DOI: 10.1016/j.euf.2024.05.019
Maria Giovanna Asmundo, Emil Durukan, Giorgio Ivan Russo, Christian Fuglesang S Jensen, Peter Busch Østergren, Sebastiano Cimino, Mikkel Fode
Background and objective: It is considered standard for authors of scientific papers to provide access to their raw data. The purpose of this study was to investigate data availability statements (DAS) and the actual availability of data in urology.
Methods: The DAS policies of the top ten urology journals were retrieved. Then 190 selected papers were classified according to their DAS status. Finally, we contacted the corresponding authors of papers that stated that data were available on request to enquire about this possibility.
Key findings and limitations: All journals either required or highly recommended a DAS. Among the selected articles, 52% (99/190) included a DAS stating data availability, most often on reasonable request to the corresponding author. A formal DAS was lacking in 29.5% (56/190) of the articles, with an additional 18.3% (35/190) citing various reasons for data unavailability. On contact, 23.4% (15/64) of corresponding authors indicated a willingness to share their data. Overall, data were unavailable in 73.7% (140/190) of cases. There was no difference between papers dealing with malignant and benign diseases.
Conclusions and clinical implications: There is a gap between the intention to share data and actual practice in major urological journals. As data sharing plays a critical role in safeguarding the reliability of published results and in the potential for reanalysis and merging of datasets, there is a clear need for improvement. Easier access to data repositories and stronger enforcement of existing journal policies are essential.
Patient summary: To ensure the reliability of data and allow further analyses, major urology journals require authors to make their data available to other researchers when possible. However, in practice we found that data were only accessible for about a quarter of published scientific papers.
背景和目的:科学论文的作者提供原始数据是一项标准要求。本研究旨在调查数据可用性声明(DAS)和泌尿科数据的实际可用性:方法:检索了排名前十的泌尿学期刊的 DAS 政策。方法:我们检索了排名前十的泌尿外科期刊的数据可用性声明(DAS)政策,然后根据其 DAS 状态对 190 篇选定论文进行了分类。最后,我们联系了声明可应要求提供数据的论文的通讯作者,询问这种可能性:所有期刊都要求或强烈推荐DAS。在所选文章中,52%(99/190)的文章包含了DAS,说明了数据的可用性,最常见的情况是向通讯作者提出合理要求。29.5%(56/190)的文章未提供正式的 DAS,另有 18.3%(35/190)的文章以各种理由说明数据不可用。经联系,23.4%(15/64)的通讯作者表示愿意共享数据。总体而言,73.7%(140/190)的论文无法提供数据。涉及恶性和良性疾病的论文之间没有差异:结论与临床意义:主要泌尿外科期刊共享数据的意愿与实际做法之间存在差距。由于数据共享在保障发表结果的可靠性以及重新分析和合并数据集的可能性方面发挥着至关重要的作用,因此显然有必要加以改进。患者摘要:为了确保数据的可靠性并允许进一步分析,主要泌尿学期刊要求作者在可能的情况下向其他研究人员提供数据。然而,在实践中,我们发现仅有约四分之一的已发表科学论文可以获取数据。
{"title":"Data Availability Statements and Data Sharing in Urology: A False Promise?","authors":"Maria Giovanna Asmundo, Emil Durukan, Giorgio Ivan Russo, Christian Fuglesang S Jensen, Peter Busch Østergren, Sebastiano Cimino, Mikkel Fode","doi":"10.1016/j.euf.2024.05.019","DOIUrl":"https://doi.org/10.1016/j.euf.2024.05.019","url":null,"abstract":"<p><strong>Background and objective: </strong>It is considered standard for authors of scientific papers to provide access to their raw data. The purpose of this study was to investigate data availability statements (DAS) and the actual availability of data in urology.</p><p><strong>Methods: </strong>The DAS policies of the top ten urology journals were retrieved. Then 190 selected papers were classified according to their DAS status. Finally, we contacted the corresponding authors of papers that stated that data were available on request to enquire about this possibility.</p><p><strong>Key findings and limitations: </strong>All journals either required or highly recommended a DAS. Among the selected articles, 52% (99/190) included a DAS stating data availability, most often on reasonable request to the corresponding author. A formal DAS was lacking in 29.5% (56/190) of the articles, with an additional 18.3% (35/190) citing various reasons for data unavailability. On contact, 23.4% (15/64) of corresponding authors indicated a willingness to share their data. Overall, data were unavailable in 73.7% (140/190) of cases. There was no difference between papers dealing with malignant and benign diseases.</p><p><strong>Conclusions and clinical implications: </strong>There is a gap between the intention to share data and actual practice in major urological journals. As data sharing plays a critical role in safeguarding the reliability of published results and in the potential for reanalysis and merging of datasets, there is a clear need for improvement. Easier access to data repositories and stronger enforcement of existing journal policies are essential.</p><p><strong>Patient summary: </strong>To ensure the reliability of data and allow further analyses, major urology journals require authors to make their data available to other researchers when possible. However, in practice we found that data were only accessible for about a quarter of published scientific papers.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261929","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}
Pub Date : 2024-06-04DOI: 10.1016/j.euf.2024.05.009
Bruno Bucca, Luca M Gobbi, Orietta Dalpiaz, Vincenzo Asero, Carlo M Scornajenghi, Federico Alviani, Leslie Claire Licari, Eugenio Bologna, Christian Gozzi
Background and objective: Several minimally invasive treatments have been developed to treat benign prostatic obstruction (BPO) via a transurethral approach, with a non-negligible risk of complications such as urethral stricture and external sphincter damage. Our aim was to present the Gozzi surgical technique for suprapubic transvesical adenoma resection of the prostate (STAR-P) for BPO and to assess its safety, feasibility, and outcomes.
Methods: We conducted a retrospective analysis of 44 consecutive patients who underwent STAR-P for BPO. All the procedures were performed in a single private hospital by one surgeon from 2020 to 2022. An innovative resectoscope designed by the surgeon was subsequently produced by Tontarra Medizintechnik (Wurmlingen, Germany) with a 42.06 Fr external sheath that allows the use of loops of three different sizes. The instrument is inserted into the bladder via suprapubic access, which ensures greater freedom of movement without compromising the external sphincter. Clinical data were retrospectively collected. Preoperative and intraoperative variables, postoperative complications, and functional outcomes of the STAR-P procedure were assessed. A descriptive statistical analysis was performed.
Key findings and limitations: No intraoperative complications were observed. Two patients (4.5%) experienced urinary urgency symptoms after catheter removal that resolved within 90 d. Median times were 105 min for surgery overall and 65 min for resection. All patients showed an improvement in voiding quality.
Conclusions and clinical implications: STAR-P is a safe, feasible, and cost-effective procedure that spares the bulbomembranous and penile urethra and the external urethral sphincter, and should be discussed with patients as a possible option for treatment of BPO.
Patient summary: We describe a new, safe, and feasible technique for surgical treatment of urinary obstruction caused by a large prostate. Keyhole surgery is performed through the lower abdomen, which means that the urethra below the prostate is not damaged. Only a small scar of 2-3 cm in the lower abdomen is evident at the end of the healing process.
{"title":"Suprapubic Transvesical Adenoma Resection of the Prostate (STAR-P): A Novel Technique for Surgical Treatment of Benign Prostatic Hyperplasia.","authors":"Bruno Bucca, Luca M Gobbi, Orietta Dalpiaz, Vincenzo Asero, Carlo M Scornajenghi, Federico Alviani, Leslie Claire Licari, Eugenio Bologna, Christian Gozzi","doi":"10.1016/j.euf.2024.05.009","DOIUrl":"https://doi.org/10.1016/j.euf.2024.05.009","url":null,"abstract":"<p><strong>Background and objective: </strong>Several minimally invasive treatments have been developed to treat benign prostatic obstruction (BPO) via a transurethral approach, with a non-negligible risk of complications such as urethral stricture and external sphincter damage. Our aim was to present the Gozzi surgical technique for suprapubic transvesical adenoma resection of the prostate (STAR-P) for BPO and to assess its safety, feasibility, and outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 44 consecutive patients who underwent STAR-P for BPO. All the procedures were performed in a single private hospital by one surgeon from 2020 to 2022. An innovative resectoscope designed by the surgeon was subsequently produced by Tontarra Medizintechnik (Wurmlingen, Germany) with a 42.06 Fr external sheath that allows the use of loops of three different sizes. The instrument is inserted into the bladder via suprapubic access, which ensures greater freedom of movement without compromising the external sphincter. Clinical data were retrospectively collected. Preoperative and intraoperative variables, postoperative complications, and functional outcomes of the STAR-P procedure were assessed. A descriptive statistical analysis was performed.</p><p><strong>Key findings and limitations: </strong>No intraoperative complications were observed. Two patients (4.5%) experienced urinary urgency symptoms after catheter removal that resolved within 90 d. Median times were 105 min for surgery overall and 65 min for resection. All patients showed an improvement in voiding quality.</p><p><strong>Conclusions and clinical implications: </strong>STAR-P is a safe, feasible, and cost-effective procedure that spares the bulbomembranous and penile urethra and the external urethral sphincter, and should be discussed with patients as a possible option for treatment of BPO.</p><p><strong>Patient summary: </strong>We describe a new, safe, and feasible technique for surgical treatment of urinary obstruction caused by a large prostate. Keyhole surgery is performed through the lower abdomen, which means that the urethra below the prostate is not damaged. Only a small scar of 2-3 cm in the lower abdomen is evident at the end of the healing process.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260239","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}
Pub Date : 2024-05-29DOI: 10.1016/j.euf.2024.05.013
Jean-Nicolas Cornu, Laurence Donon, Caroline Thullier, François Meyer, Julia Klap, Sandrine Campagne-Loiseau, Akshaya Mariadassou, Benoit Peyronnet
Background and objective: Our aim was to report the first clinical trial of TENSI+, a new device for transcutaneous posterior tibial nerve stimulation (TNS) for treatment of overactive bladder (OAB).
Methods: A prospective, multicentre clinical trial was conducted in adults with OAB in seven French centres. The main exclusion criteria were prior percutaneous or transcutaneous TNS or invasive OAB treatment, current antimuscarinic use, 24-h polyuria, known bladder disease, postvoid residual volume >150 ml, and pelvic organ prolapse stage >2. Patients self-administered daily TTNS sessions of 20 min with TENSI+ at home after education by a specialized nurse. A bladder diary, Urinary Symptom Profile and OAB-q questionnaires, and Patient Global Impression of Improvement (PGI-I) scores were evaluated at baseline and 3 and 6 mo. The primary endpoint was efficacy, based on PGI-I and variations in bladder diary parameters. Success was defined as a PGI-I score ≤3 and any improvement ≥30% in bladder diary parameters.
Key findings and limitations: The study included 78 patients (13 males). Nine patients had neurological disease, 21 had previously tried antimuscarinics, and 41 had wet OAB at baseline. At 3 mo, 65/78 patients had a full analysis set. Treatment was successful in 44/65 patients (67%), with 25/65 (38%) reporting both an objective improvement and high satisfaction. All OAB-related endpoints were significantly improved, except bladder capacity and total voided volume per 24 h. At 6 mo, only five of 44 patients had interrupted their treatment. No factor predictive of success was identified. Two adverse events (pain at stimulation site and/or pelvic pain) were reported and spontaneously resolved without treatment interruption.
Conclusions and clinical implications: TENSI+ is a safe and effective TTNS treatment option for OAB management.
Patient summary: TENSI+ is a new device for nerve stimulation in patients with overactive bladder. Patients use the device at home every day. In our short-term trial, TENSI+ use improved symptoms in 67% of patients. Further evaluation over a longer period of time is needed.
{"title":"New TENSI+ Device for Transcutaneous Posterior Tibial Nerve Stimulation: A Prospective, Multicentre, Post-market Clinical Study.","authors":"Jean-Nicolas Cornu, Laurence Donon, Caroline Thullier, François Meyer, Julia Klap, Sandrine Campagne-Loiseau, Akshaya Mariadassou, Benoit Peyronnet","doi":"10.1016/j.euf.2024.05.013","DOIUrl":"https://doi.org/10.1016/j.euf.2024.05.013","url":null,"abstract":"<p><strong>Background and objective: </strong>Our aim was to report the first clinical trial of TENSI+, a new device for transcutaneous posterior tibial nerve stimulation (TNS) for treatment of overactive bladder (OAB).</p><p><strong>Methods: </strong>A prospective, multicentre clinical trial was conducted in adults with OAB in seven French centres. The main exclusion criteria were prior percutaneous or transcutaneous TNS or invasive OAB treatment, current antimuscarinic use, 24-h polyuria, known bladder disease, postvoid residual volume >150 ml, and pelvic organ prolapse stage >2. Patients self-administered daily TTNS sessions of 20 min with TENSI+ at home after education by a specialized nurse. A bladder diary, Urinary Symptom Profile and OAB-q questionnaires, and Patient Global Impression of Improvement (PGI-I) scores were evaluated at baseline and 3 and 6 mo. The primary endpoint was efficacy, based on PGI-I and variations in bladder diary parameters. Success was defined as a PGI-I score ≤3 and any improvement ≥30% in bladder diary parameters.</p><p><strong>Key findings and limitations: </strong>The study included 78 patients (13 males). Nine patients had neurological disease, 21 had previously tried antimuscarinics, and 41 had wet OAB at baseline. At 3 mo, 65/78 patients had a full analysis set. Treatment was successful in 44/65 patients (67%), with 25/65 (38%) reporting both an objective improvement and high satisfaction. All OAB-related endpoints were significantly improved, except bladder capacity and total voided volume per 24 h. At 6 mo, only five of 44 patients had interrupted their treatment. No factor predictive of success was identified. Two adverse events (pain at stimulation site and/or pelvic pain) were reported and spontaneously resolved without treatment interruption.</p><p><strong>Conclusions and clinical implications: </strong>TENSI+ is a safe and effective TTNS treatment option for OAB management.</p><p><strong>Patient summary: </strong>TENSI+ is a new device for nerve stimulation in patients with overactive bladder. Patients use the device at home every day. In our short-term trial, TENSI+ use improved symptoms in 67% of patients. Further evaluation over a longer period of time is needed.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179371","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}
Pub Date : 2024-05-23DOI: 10.1016/j.euf.2024.05.010
Vineet Gauhar, Olivier Traxer, Daniele Castellani, Christian Sietz, Ben Hall Chew, Khi Yung Fong, Saeed Bin Hamri, Mehmet Ilker Gökce, Nariman Gadzhiev, Andrea Benedetto Galosi, Steffi Kar Kei Yuen, Albert El Hajj, Raymond Ko, Marek Zawadzki, Vikram Sridharan, Mohamed Amine Lakmichi, Mariela Corrales, Vigen Malkhasyan, Deepak Ragoori, Boyke Soebhali, Karl Tan, Chu Ann Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Tzevat Tefik, Anil Shrestha, Heng Chin Tiong, Bhaskar Kumar Somani
Background and objective: The aim of this study was to evaluate the stone-free status (SFS) rate and complications after flexible ureteroscopy (fURS) for treatment of renal stones using a flexible and navigable suction (FANS) ureteral access sheath.
Methods: Data for adults undergoing fURS in 25 centers worldwide were prospectively collected (August 2023 to January 2024). Exclusion criteria were abnormal renal anatomy and ureteral stones. All patients had computed tomography scans before and within 30 d after fURS with a FANS ureteral access sheath. SFS was defined as follows: grade A, zero fragments; grade B, a single fragment ≤2 mm; grade C, a single fragment 2.1-4 mm; and grade D, single/multiple fragments >4 mm. Data for continuous variables are presented as the median and interquartile range (IQR). Multivariable logistic regression was performed to evaluate predictors of grade A SFS.
Key findings and limitations: The study enrolled 394 patients (59.1% male) with a median age of 49 yr (IQR 36-61). The median stone volume was 1260 mm3 (IQR 706-1800). Thulium fiber laser (TFL) was used in 45.9% of cases and holmium laser in the rest. The median lasing time was 18 min (IQR 11-28) and the median operative time was 49 min (IQR 37-70). One patient required a blood transfusion and 3.3% of patients had low-grade fever. No patient developed sepsis. Low-grade ureteral injury occurred in eight patients (2%). The grade A SFS rate was 57.4% and the grade A + B SFS rate was 97.2%, while 2.8% of patients had grade C or D SFS. Eleven patients underwent repeat fURS. Multivariable analysis revealed that a stone volume of 1501-3000 mm3 (odds ratio 0.50) and of >3000 mm3 (odds ratio 0.29) were significantly associated with lower probability of grade A SFS, while TFL use was associated with higher SFS probability (odds ratio 1.83). Limitations include the lack of a comparative group.
Conclusions and clinical implications: fURS using a FANS ureteral access sheath resulted in a high SFS rate with negligible serious adverse event and reintervention rates.
Patient summary: We looked at 30-day results for patients undergoing telescopic laser treatment for kidney stones using a special type of vacuum-assisted sheath to remove stone fragments. We found a high stone-free rate with minimal complications.
{"title":"Could Use of a Flexible and Navigable Suction Ureteral Access Sheath Be a Potential Game-changer in Retrograde Intrarenal Surgery? Outcomes at 30 Days from a Large, Prospective, Multicenter, Real-world Study by the European Association of Urology Urolithiasis Section.","authors":"Vineet Gauhar, Olivier Traxer, Daniele Castellani, Christian Sietz, Ben Hall Chew, Khi Yung Fong, Saeed Bin Hamri, Mehmet Ilker Gökce, Nariman Gadzhiev, Andrea Benedetto Galosi, Steffi Kar Kei Yuen, Albert El Hajj, Raymond Ko, Marek Zawadzki, Vikram Sridharan, Mohamed Amine Lakmichi, Mariela Corrales, Vigen Malkhasyan, Deepak Ragoori, Boyke Soebhali, Karl Tan, Chu Ann Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Tzevat Tefik, Anil Shrestha, Heng Chin Tiong, Bhaskar Kumar Somani","doi":"10.1016/j.euf.2024.05.010","DOIUrl":"https://doi.org/10.1016/j.euf.2024.05.010","url":null,"abstract":"<p><strong>Background and objective: </strong>The aim of this study was to evaluate the stone-free status (SFS) rate and complications after flexible ureteroscopy (fURS) for treatment of renal stones using a flexible and navigable suction (FANS) ureteral access sheath.</p><p><strong>Methods: </strong>Data for adults undergoing fURS in 25 centers worldwide were prospectively collected (August 2023 to January 2024). Exclusion criteria were abnormal renal anatomy and ureteral stones. All patients had computed tomography scans before and within 30 d after fURS with a FANS ureteral access sheath. SFS was defined as follows: grade A, zero fragments; grade B, a single fragment ≤2 mm; grade C, a single fragment 2.1-4 mm; and grade D, single/multiple fragments >4 mm. Data for continuous variables are presented as the median and interquartile range (IQR). Multivariable logistic regression was performed to evaluate predictors of grade A SFS.</p><p><strong>Key findings and limitations: </strong>The study enrolled 394 patients (59.1% male) with a median age of 49 yr (IQR 36-61). The median stone volume was 1260 mm<sup>3</sup> (IQR 706-1800). Thulium fiber laser (TFL) was used in 45.9% of cases and holmium laser in the rest. The median lasing time was 18 min (IQR 11-28) and the median operative time was 49 min (IQR 37-70). One patient required a blood transfusion and 3.3% of patients had low-grade fever. No patient developed sepsis. Low-grade ureteral injury occurred in eight patients (2%). The grade A SFS rate was 57.4% and the grade A + B SFS rate was 97.2%, while 2.8% of patients had grade C or D SFS. Eleven patients underwent repeat fURS. Multivariable analysis revealed that a stone volume of 1501-3000 mm<sup>3</sup> (odds ratio 0.50) and of >3000 mm<sup>3</sup> (odds ratio 0.29) were significantly associated with lower probability of grade A SFS, while TFL use was associated with higher SFS probability (odds ratio 1.83). Limitations include the lack of a comparative group.</p><p><strong>Conclusions and clinical implications: </strong>fURS using a FANS ureteral access sheath resulted in a high SFS rate with negligible serious adverse event and reintervention rates.</p><p><strong>Patient summary: </strong>We looked at 30-day results for patients undergoing telescopic laser treatment for kidney stones using a special type of vacuum-assisted sheath to remove stone fragments. We found a high stone-free rate with minimal complications.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092943","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}
Pub Date : 2024-05-21DOI: 10.1016/j.euf.2024.03.009
Francesco Montorsi, Marco Moschini, Giuseppe Rosiello, Andrea Salonia, Alberto Briganti
{"title":"Re: Stamatio Katsimperis, Lazaros Tzelves, Zafer Tandogdu, et al. Complications After Radical Cystectomy: A Systematic Review and Meta-analysis of Randomized Controlled Trials with a Meta-regression Analysis. Eur Urol Focus 2023;9:920-9.","authors":"Francesco Montorsi, Marco Moschini, Giuseppe Rosiello, Andrea Salonia, Alberto Briganti","doi":"10.1016/j.euf.2024.03.009","DOIUrl":"https://doi.org/10.1016/j.euf.2024.03.009","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080822","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}
Pub Date : 2024-05-14DOI: 10.1016/j.euf.2024.05.004
Giuseppe Fallara, Giuseppe Basile, Adrian Poterek, Marco Tozzi, Karl H Pang, Omer Onur Çakir, Marco Bandini, Matteo Ferro, Gennaro Musi, Maria Satchi, Angelo Territo, Christian Fankhauser, Fabio Castiglione
Context: Penile shaft sparing (PSS) surgery for localised penile cancer (PeCa) aims to balance oncological and functional outcomes.
Objective: To summarise the published evidence on different PSS approaches.
Evidence acquisition: We performed a systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The systematic search was performed on PubMed, EMBASE, and Scopus databases up to February 14, 2023. The inclusion criteria encompassed retrospective or prospective studies including patients ≥18 yr of age with localised PeCa treated with different PSS approaches, classified as laser ablation, circumcision, wide local excision, glansectomy with or without split skin graft, glans resurfacing, and mixed technique excision. The risk of bias was assessed using the Newcastle-Ottawa scale. A quantitative synthesis was not performed due to anticipated data heterogeneity and a lack of comparative studies.
Evidence synthesis: Out of 4343 articles identified, 47 met our inclusion criteria, including 10 847 patients. The year of publication ranged between 1983 and 2021. Nine studies were prospective case series, while the remaining studies were retrospective. No comparative studies were identified. Most of the cases included in these studies were Ta and T1. The oncological outcomes were good for all the approaches, with cancer-specific mortality ranging between 0% and 18%. Sexual and cosmetic outcomes, despite being under-reported, were good for all the approaches, with almost all patients being satisfied with their quality of life after surgery. The Newcastle and Ottawa scale revealed a high or severely high risk of bias in all the included studies.
Conclusions: PSS approaches were safe and had good functional outcomes, considering however the overall low quality of the studies on this issue.
Patient summary: The perioperative, function, and oncological outcomes of penile shaft sparing approaches are good. However, high-quality studies are needed to determine whether these approaches benefit patients with localised penile cancer.
{"title":"Oncological and Functional Outcomes of Penile Shaft Sparing Surgery for Localised Penile Cancer: A Systematic Review.","authors":"Giuseppe Fallara, Giuseppe Basile, Adrian Poterek, Marco Tozzi, Karl H Pang, Omer Onur Çakir, Marco Bandini, Matteo Ferro, Gennaro Musi, Maria Satchi, Angelo Territo, Christian Fankhauser, Fabio Castiglione","doi":"10.1016/j.euf.2024.05.004","DOIUrl":"https://doi.org/10.1016/j.euf.2024.05.004","url":null,"abstract":"<p><strong>Context: </strong>Penile shaft sparing (PSS) surgery for localised penile cancer (PeCa) aims to balance oncological and functional outcomes.</p><p><strong>Objective: </strong>To summarise the published evidence on different PSS approaches.</p><p><strong>Evidence acquisition: </strong>We performed a systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The systematic search was performed on PubMed, EMBASE, and Scopus databases up to February 14, 2023. The inclusion criteria encompassed retrospective or prospective studies including patients ≥18 yr of age with localised PeCa treated with different PSS approaches, classified as laser ablation, circumcision, wide local excision, glansectomy with or without split skin graft, glans resurfacing, and mixed technique excision. The risk of bias was assessed using the Newcastle-Ottawa scale. A quantitative synthesis was not performed due to anticipated data heterogeneity and a lack of comparative studies.</p><p><strong>Evidence synthesis: </strong>Out of 4343 articles identified, 47 met our inclusion criteria, including 10 847 patients. The year of publication ranged between 1983 and 2021. Nine studies were prospective case series, while the remaining studies were retrospective. No comparative studies were identified. Most of the cases included in these studies were Ta and T1. The oncological outcomes were good for all the approaches, with cancer-specific mortality ranging between 0% and 18%. Sexual and cosmetic outcomes, despite being under-reported, were good for all the approaches, with almost all patients being satisfied with their quality of life after surgery. The Newcastle and Ottawa scale revealed a high or severely high risk of bias in all the included studies.</p><p><strong>Conclusions: </strong>PSS approaches were safe and had good functional outcomes, considering however the overall low quality of the studies on this issue.</p><p><strong>Patient summary: </strong>The perioperative, function, and oncological outcomes of penile shaft sparing approaches are good. However, high-quality studies are needed to determine whether these approaches benefit patients with localised penile cancer.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944441","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}