European Urology Open Science最新文献

{"title":"Treatment Trends for Anterior Urethral Stricture: An International Survey on Eligibility for Staged Urethroplasty","authors":"German Patino ,&nbsp;Benjamin Breyer ,&nbsp;Jaime Perez ,&nbsp;Juliana Arenas ,&nbsp;Alejandra Nino Alarcon ,&nbsp;Daniela Saaibi","doi":"10.1016/j.euros.2025.07.007","DOIUrl":"10.1016/j.euros.2025.07.007","url":null,"abstract":"<div><h3>Background and objective</h3><div>Anterior urethral strictures impact quality of life and often require surgical intervention. Urethroplasty is the definitive treatment, but consensus on the best approach or timing, particularly for staged procedures, is lacking. The aim of our study was to identify factors influencing the decision to perform staged versus one-stage urethroplasty and determine key factors for the timing of the second stage.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional survey to identify factors influencing surgical decision-making for urethral stricture treatment in adult patients. A survey designed for the study was distributed to 190 reconstructive urologists, of whom 187 returned complete responses. Responses were anonymous to minimize bias. The data were analyzed using STATA 18.0.</div></div><div><h3>Key findings and limitations</h3><div>Factors influencing staged urethroplasty included previous surgeries (74.3%), stricture length (67.9%), and etiology (65.7%). Timing of the second stage is determined by urethral plate characteristics and surgical plate length, with 56.7% of the respondents reporting that the second stage is performed within 6 mo. Notably, 37.4% do not use standardized symptom scales. Findings highlight the role of mentoring and training in surgical choices, which points to a need for standardized guidelines. Limitations include the use of a convenience sample and self-reported data, which may introduce bias.</div></div><div><h3>Conclusions and clinical implications</h3><div>Key factors influencing staged urethroplasty decisions include stricture length and prior surgeries. Most urologists schedule the second stage within 6 mo, guided by mentoring. Future research should develop international staging guidelines, standardize treatments, and assess long-term outcomes for consistent practices.</div></div><div><h3>Patient summary</h3><div>We carried out a survey to find out why urologists choose one- or two-stage surgery to repair narrowing of the urethra, and when they perform the second stage. Two-stage procedures are often used for complex cases and patients who have had previous surgeries, with the second stage mostly done within 6 months. Better tools to measure patient symptoms are needed to improve care.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"85 ","pages":"Pages 25-29"},"PeriodicalIF":4.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146075953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posteriorly Augmented Anastomotic Ureteroplasty with Lingual Mucosal Onlay Grafts: 8-year Multi-institutional Experience in 61 Cases","authors":"Yuancheng Zhou ,&nbsp;Shuaishuai Chai ,&nbsp;Kangxiang Xu ,&nbsp;Xincheng Gao ,&nbsp;Wang Wang ,&nbsp;Manshun Dong ,&nbsp;Ruoyu Li ,&nbsp;Chaoqi Liang ,&nbsp;Bing Li ,&nbsp;Xingyuan Xiao","doi":"10.1016/j.euros.2026.01.007","DOIUrl":"10.1016/j.euros.2026.01.007","url":null,"abstract":"<div><h3>Background and objective</h3><div>Management of long proximal ureteral strictures remains a significant challenge. Posteriorly augmented anastomotic ureteroplasty with lingual mucosal onlay grafts (PAAU-LMG) is a novel technique used for treating obliterated or diseased ureteral segments. This study aims to evaluate the long-term effectiveness of PAAU-LMG in a multi-institutional cohort of patients with long, complex proximal ureteral strictures.</div></div><div><h3>Methods</h3><div>This retrospective study involved data for 61 patients treated with PAAU-LMG at three centers between April 2017 and December 2024. Perioperative and follow-up data were collected. Surgical success is defined by the absence of clinical symptoms, no stricture on imaging, and no severe complications. A descriptive statistical analysis was performed.</div></div><div><h3>Key findings and limitations</h3><div>Of the 61 patients, 18 underwent laparoscopic surgery and 43 underwent robotic surgery. PAAU-LMG was performed in 45 (73.77%) cases, 16 (26.23%) cases underwent PAAU-LMG with ureteral dorsal adventitia “fold” technique. The reconstructed ureter was covered with perirenal fat in four cases (6.56%) and with omentum in 57 cases (93.44%). The median (range) stricture length was 3.60 (1.50–9.00) cm, operative time was 140 (84–306) min, estimated blood loss was 50 (10–400) ml, and postoperative hospital stay was 6 (4–10) d. No open conversions and intraoperative complications occurred. At a median (range) follow-up of 32 (7–98) mo, the overall success rate was 100% (61/61). The main limitation is the lack of a control group.</div></div><div><h3>Conclusions and clinical implications</h3><div>PAAU-LMG is a safe, effective, and feasible treatment for selected patients with long obliterated or diseased proximal ureteral strictures.</div></div><div><h3>Patient summary</h3><div>We evaluated the long-term follow-up outcomes of posteriorly augmented anastomotic ureteroplasty with lingual mucosal onlay grafts (PAAU-LMG), in which the diseased ureter was excised and reanastomosed primarily on the dorsal side, and a lingual mucosal graft was placed on the ventral side. For patients with obliterated or diseased ureter stricture, PAAU-LMG is a safe and feasible alternative with satisfactory outcome.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"85 ","pages":"Pages 9-15"},"PeriodicalIF":4.5,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146075951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related Quality of Life in Patients Undergoing Ileal Ureter Replacement for Extensive Ureteral Stricture: A Prospective Multi-institutional Study","authors":"Xiang Wang ,&nbsp;Derun Li ,&nbsp;Kunlin Yang ,&nbsp;Jiyu Yang ,&nbsp;Guanpeng Han ,&nbsp;Yunke Ma ,&nbsp;Xinfei Li ,&nbsp;Bing Wang ,&nbsp;Peng Zhang ,&nbsp;Jing Liu ,&nbsp;Hongjian Zhu ,&nbsp;Hua Guan ,&nbsp;Zhihua Li ,&nbsp;Liqun Zhou ,&nbsp;Kai Zhang ,&nbsp;Xuesong Li","doi":"10.1016/j.euros.2026.01.006","DOIUrl":"10.1016/j.euros.2026.01.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>Ileal ureter replacement (IUR) is the definitive management approach for extensive ureteral strictures (UrSs). Patients with UrS exhibit poor health-related quality of life (HRQoL). We conducted a long-term, multi-institutional evaluation of patients who underwent IUR to assess its durable safety and efficacy, as well as postoperative recovery of HRQoL.</div></div><div><h3>Methods</h3><div>A prospective multicenter study (January 2020–July 2022) enrolled patients with an extensive UrS scheduled for IUR. Participants completed the 36-item Short Form Survey (SF-36) before and at 6 mo and 12 mo after surgery. A significant HRQoL improvement was defined as an increase of ≥10 points from baseline.</div></div><div><h3>Key findings and limitations</h3><div>Overall, 82 consecutive patients who underwent IUR were evaluated. The mean age of the cohort was 44.6 yr, and 52/82 (63.4%) were female. During median follow-up of 48 mo, one patient experienced radiographic reobstruction, and eight patients had Clavien-Dindo grade III–IV complications. There was a significant decrease in serum creatinine after surgery (<em>p</em> &lt; 0.001), with a minor increase observed at long-term follow-up (<em>p</em> = 0.001). Some 45.5–79.2% of patients with poor HRQoL at baseline experienced significant improvements in different domains within 12 mo after surgery. Specifically, in comparison to baseline, 77 patients (93.9%) reported improvements at 6 mo (median improvements: physical function [PF] +15; role limitation due to physical health [RP] +87.5; bodily pain [BP] +10; general health perception [GH] +16; vitality [VT] +20; social function [SF] +25; role limitation due to emotional problems [RE] +100; mental health [MH] +12), and 79 (96.3%) reported improvements at 12 mo (PF +20; RP +100; BP +20; GH +18.5; VT +20; SF +25; RE +100; MH +12). The main limitations are the lack of a disease-specific questionnaire and the relatively short-term follow-up for HRQoL.</div></div><div><h3>Conclusions and clinical implications</h3><div>Our study confirms the safety and efficacy of IUR for complex ureteral reconstruction. IUR was associated with favorable HRQoL improvements within 12 mo in most domains.</div></div><div><h3>Patient summary</h3><div>We looked at changes in quality of life for patients who had surgery that used a piece of bowel tissue to repair a complex urinary blockage. Most patients reported a substantial improvement in their quality of life within 12 months. Our findings support use of this surgical procedure as an effective option when simpler treatments fail.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"85 ","pages":"Pages 16-24"},"PeriodicalIF":4.5,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146075952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Nondismembered Pyeloplasty for Ureteropelvic Junction Obstruction Using Axial Advancement of Renal Pelvic Flaps: Technique and Clinical Outcomes","authors":"Chi Yuan ,&nbsp;Liang Zhou ,&nbsp;Yuntian Chen ,&nbsp;Ya Li ,&nbsp;Zhongyu Jian ,&nbsp;Menghua Wang ,&nbsp;Kunjie Wang","doi":"10.1016/j.euros.2026.01.005","DOIUrl":"10.1016/j.euros.2026.01.005","url":null,"abstract":"<div><h3>Background and objective</h3><div>Nondismembered pyeloplasty (NDMP) has been extensively used to treat ureteropelvic junction obstruction (UPJO), but broader application is limited by certain factors. Our aim was to describe a novel, concise, modified NDMP (mNDMP) procedure using an axially advanced renal pelvic flap from the self-enlarged pelvis and to report clinical outcomes.</div></div><div><h3>Methods and surgical procedure</h3><div>Patients who underwent open or robot-assisted mNDMP between May 2018 and September 2023 were included. We collected perioperative variables and assessed the outcomes. The stenosis was longitudinally incised and cut in an antegrade fashion towards the normal distal ureter. The renal pelvic flap was advanced caudally and anastomosed to the normal distal ureter using finely interrupted sutures. Advancement of the contralateral renal pelvic flap depended on the stenosis severity. A broad “ureteral plate” was constructed by axially advancing the renal pelvic flaps, followed by antegrade placement of a double-J stent. Demographic, perioperative, and postoperative data were retrospectively compared. Success was defined as relief, stabilization, or the absence of hydronephrosis according to imaging or clinical symptoms.</div></div><div><h3>Key findings and limitations</h3><div>The study cohort comprised 82 patients with mean follow-up of 35.38 mo. The median stenosis length was 1.00 cm (interquartile range [IQR] 0.85–1.50) and median operative time was 115 min (IQR 95.50–131.50). The median postoperative length of stay was significantly shorter in the robotic group (6 d vs 8 d; <em>p</em> &lt; 0.001). No major perioperative complications occurred. A reduction in mean hydronephrosis volume from 151.46 ± 152.79 cm³ to 99.17 ± 177.66 cm³ after surgery (<em>p</em> = 0.044) was observed, with an overall success rate of 92.68% (76/82 patients).</div></div><div><h3>Conclusions and clinical implications</h3><div>The study results demonstrate that our concise mNDMP technique via both open and robotic approaches is safe and effective for UPJO repair.</div></div><div><h3>Patient summary</h3><div>We describe a modified technique to repair a narrow segment at the junction between the kidney and the tube draining urine to the bladder. The technique involves surgery without removing the narrow portion of tube that is blocking urine. Our results show that this is a feasible option for patients with this condition and that robot-assisted surgery resulted in faster recovery.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"85 ","pages":"Pages 1-8"},"PeriodicalIF":4.5,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Asim Armagan Aydin, Erkan Kayikcioglu, and Ramazan Oguz Yuceer’s Letter to the Editor re: Muhammet Demirbilek, Göktuğ Kalender, Said Bıyıkoglu, et al. External Validation of Nomograms for Predicting Pelvic Lymph Node Metastases in Patients with Prostate Cancer and the Added Value of the Prostate-specific Membrane Antigen Positron Emission Tomography–based PRIMARY Score. Eur Urol Open Sci 2025;82:170–7","authors":"Bülent Önal ,&nbsp;Muhammet Demirbilek ,&nbsp;Levent Kabasakal","doi":"10.1016/j.euros.2026.01.002","DOIUrl":"10.1016/j.euros.2026.01.002","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"84 ","pages":"Pages 58-59"},"PeriodicalIF":4.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Amar U. Kishan, Luca F. Valle, Holly Wilhalme, et al. 177Lu-Prostate-specific Membrane Antigen Neoadjuvant to Stereotactic Ablative Radiotherapy for Oligorecurrent Prostate Cancer (LUNAR): An Open-label, Randomized, Controlled, Phase II Study. J Clin Oncol 2025;43:3812–21","authors":"Vérane Achard ,&nbsp;Thomas Zilli ,&nbsp;Bertrand Tombal","doi":"10.1016/j.euros.2026.01.001","DOIUrl":"10.1016/j.euros.2026.01.001","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"84 ","pages":"Pages 60-61"},"PeriodicalIF":4.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of Transabdominal Ultrasound–based Versus Magnetic Resonance Imaging–based Prostate-specific Antigen Density for Clinically Significant Prostate Cancer","authors":"Zheng Xu ,&nbsp;Haifeng Song ,&nbsp;Haiwen Huang,&nbsp;Meng Fu,&nbsp;Yuzhe Tang,&nbsp;Peizhi Zhang,&nbsp;Gang Zhang,&nbsp;Jianxing Li","doi":"10.1016/j.euros.2026.01.003","DOIUrl":"10.1016/j.euros.2026.01.003","url":null,"abstract":"<div><h3>Background and objective</h3><div>Prostate-specific antigen (PSA) density (PSAD) improves risk stratification for clinically significant prostate cancer (csPCa) but depends on prostate volume estimation. Transrectal ultrasound is used widely, whereas transabdominal ultrasound (TAUS) is underexplored due to accuracy concerns. We compared PSAD derived from manual magnetic resonance imaging (MRI) segmentation, MRI ellipsoid, and TAUS ellipsoid.</div></div><div><h3>Methods</h3><div>In a single-centre retrospective cohort, men who underwent biopsy or prostatectomy with histopathological confirmation were included. (1) Manual MRI segmentation versus (2) ellipsoid formulae derived from MRI and TAUS diameters were compared. We evaluated discrimination (area under the curve [AUC]), decision curve net benefit, method agreement, and clinical utility defined by biopsy burden across illustrative PSAD thresholds.</div></div><div><h3>Key findings and limitations</h3><div>Of 486 men, 299 had complete MRI and TAUS data (mean age 71.5 [standard deviation 8.3] yr; median PSA 10.3 ng/ml); 98 (32.8%) had csPCa. Both ellipsoid formula underestimated volume, with TAUS marginally closer to the reference. However, at the illustrative threshold of PSAD = 0.15 ng/ml/cc, the estimated biopsy burden was comparable: 53.5 (manual), 57.2 (MRI), and 56.5 (TAUS) biopsies per 100 men, with identical sensitivity (0.837). Discrimination was similar, with AUCs of 0.83 (manual), 0.82 (MRI), and 0.81 (TAUS), and a decision curve analysis demonstrated overlapping net benefits. The main limitations are the retrospective single-centre design and the lack of external validation.</div></div><div><h3>Conclusions and clinical implications</h3><div>Despite volume differences, PSAD derived from TAUS and MRI ellipsoid formulae demonstrated discrimination and net benefit comparable with those of manual segmentation. TAUS-based PSAD represents a pragmatic alternative for risk stratification, particularly in resource-limited settings where MRI segmentation is infeasible.</div></div><div><h3>Patient summary</h3><div>We compared three ways to measure prostate volume to calculate prostate-specific antigen (PSA) density. All three ways showed similar accuracy for finding important prostate cancers, suggesting that ultrasound-based PSA density can be used when detailed magnetic resonance imaging measurements are not practical.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"84 ","pages":"Pages 70-76"},"PeriodicalIF":4.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Conventional Versus Flexible and Navigable Suction Ureteral Access Sheaths on Ureteral Temperature Modulation During High-power Ho:YAG Laser Lithotripsy: An In Vitro Evaluation","authors":"Yueqi Huang ,&nbsp;Shusheng Liu ,&nbsp;Steffi Kar Kei Yuen ,&nbsp;Vineet Gauhar ,&nbsp;Xuliang Pang ,&nbsp;Guanghan Zhang ,&nbsp;Weijie Liu ,&nbsp;Jia Zhou ,&nbsp;Qiulin Huang ,&nbsp;Guohua Zeng ,&nbsp;Wei Zhu","doi":"10.1016/j.euros.2026.01.004","DOIUrl":"10.1016/j.euros.2026.01.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>Ureteral thermal injury during high-power laser lithotripsy with holmium:yttrium-aluminum-garnet (Ho:YAG) laser has become a clinical concern. We evaluated the influence of irrigation flow rates on ureteral temperature profiles during high-power Ho:YAG lithotripsy in an in vitro model.</div></div><div><h3>Methods</h3><div>A customized silicone model of the urinary tract was used to simulate retrograde intrarenal surgery. A 6-mm stone was fixed 3 cm below the model ureteropelvic junction and treated with Ho:YAG laser at 6 W (0.6 J/10 Hz), 12 W (0.6 J/20 Hz), or 24 W (0.6 J/30 Hz) for 40 s. Steady irrigation at 30–60 ml/min was maintained via an automated irrigation system. We evaluated conventional ureteral access sheath (C-UAS) and flexible and navigable suction UAS (FANS) options in four sizes (10/12 Fr, 11/13 Fr, 12/14 Fr, 13/15 Fr). Temperature data were captured via four thermometer probes. Statistical analyses were performed using two-way analysis of variance (device × flow interaction test), with multiplicity controlled using Tukey’s honestly significant difference test.</div></div><div><h3>Key findings and limitations</h3><div>A higher flow rate and use of suction via FANS significantly reduced the elevation in ureteral temperature during laser application. At &lt;12 W and 30–35 ml/min, the temperature with a C-UAS remained safe (&lt;43°C) when the ratio of the endoscope to sheath diameter (RESD) was ≤0.75. At 24 W, maintenance of a safe temperature depended on the flow rate and RESD. With a C-UAS, the temperature exceeded 43°C at flows ≤40 ml/min; RESD of 0.77 (Fr 8.5/Fr 11–13) required a flow rate of 50 ml/min to remain below 43°C. When suction was applied via FANS, an endoscope size of 7.5 Fr kept the temperature at &lt;43°C, even at flow rates of ≤40 ml/min; an endoscope size of 8.5 Fr and sheath size of 10–12 Fr (RESD 0.85) required a flow rate of ≥45 ml/min. Limitations of our in vitro model include the absence of physiological factors such as renal blood flow, and the varied stone compositions encountered in clinical practice.</div></div><div><h3>Conclusion and clinical implications</h3><div>FANS demonstrated superior thermal safety over C-UAS, particularly at high laser power. FANS use with optimized irrigation can effectively prevent ureteral thermal injury during laser lithotripsy.</div></div><div><h3>Patient summary</h3><div>We looked at how the sheath design and the flow rate of the irrigation fluid affect the temperature during laser surgery for urinary stones. Our results suggest that an optimum flow rate and a special type of flexible sheath with suction can help in avoiding thermal damage to tissue, even at high laser power.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"84 ","pages":"Pages 62-69"},"PeriodicalIF":4.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related Quality of Life in Localized and Metastatic Renal Cell Carcinoma: Insights from Patient-reported Outcome Measures","authors":"Matthijs Duijn ,&nbsp;Hilin Yildirim ,&nbsp;Corina van den Hurk ,&nbsp;Arnoud W. Postema ,&nbsp;Maureen J.B. Aarts ,&nbsp;Katja Aben ,&nbsp;Martijn G.H. van Oijen ,&nbsp;Adriaan D. Bins ,&nbsp;Patricia J. Zondervan","doi":"10.1016/j.euros.2025.12.017","DOIUrl":"10.1016/j.euros.2025.12.017","url":null,"abstract":"<div><h3>Background and objective</h3><div>Patient-reported outcome measures (PROMs) are increasingly being used to evaluate health-related quality of life (HRQoL) in cancer care. We investigated the effects of treatment for both localized (M0) and metastatic renal cell carcinoma (mRCC) on generic and cancer-specific HRQoL up to 15 wk after diagnosis.</div></div><div><h3>Methods</h3><div>Patients were selected from the National PROspective infrastructure for renal cell carcinoma (PRO-RCC), including M0 and mRCC patients who participated in the HRQoL assessment. HRQoL was measured using the Dutch validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 at baseline (T₀), 15 wk (T₁), and 6 mo (T₂) after diagnosis. Within-group HRQoL changes over time were analyzed using paired t tests for patients with data available at multiple time points (T₀ vs T₁). Exploratory analyses comparing T₀ versus T₂ were also performed.</div></div><div><h3>Key findings and limitations</h3><div>A total of 295 patients were included, of whom 217 (73.6%) had M0 disease and 78 (26.4%) had mRCC. At follow-up, 89 patients with M0 disease (41%) and 38 with mRCC (48.7%) completed the T₁ assessment. In the M0 group, significant improvements at T₁ were observed in scores for emotional functioning (80.2 vs 87.4; change [Δ] 7.2, 95% confidence interval [CI] 3.8–10.5; <em>p</em> &lt; 0.001), social functioning (81.8 vs 86.7; Δ 4.9, 95% CI 0.2–9.6, <em>p</em> = 0.042), insomnia (31.5 vs 22.9; Δ −8.6, 95% CI −13.9 to −3.4; <em>p</em> = 0.002), and appetite loss (11.6 vs 6.4; Δ −5.2, 95% CI −9.3 to −1.2; <em>p</em> = 0.012). In the mRCC group, significant improvements at T₁ were noted in scores for emotional functioning (77.9 vs 84.7; Δ 6.8, 95% CI −1.4 to 14.9; <em>p</em> = 0.015), fatigue (31.6 vs 23.7; Δ −7.9, 95% CI −15.5 to −0.3; <em>p</em> = 0.042), and pain (18.4 vs 7.5; Δ −10.9, 95% CI −19.8 to −2.1; <em>p</em> = 0.017).</div></div><div><h3>Conclusions and clinical implications</h3><div>Patients with M0 disease and mRCC experienced improvements in several functional and symptom domains within 15 wk after diagnosis. Future studies should assess the impact of these changes on treatment continuation and/or responses.</div></div><div><h3>Patient summary</h3><div>We looked at health-related quality of life (HRQoL) in patients with localized or metastatic kidney cancer. In general, both groups reported improvements in emotional, social, and physical wellbeing at 15 weeks after their diagnosis, and results suggest further changes at 6 months after diagnosis. Patients reported improvements in symptoms such as fatigue, pain, sleep, and appetite. Our results indicate that patients can find meaningful improvements in their quality of life shortly after diagnosis and initiation of treatment.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"84 ","pages":"Pages 50-57"},"PeriodicalIF":4.5,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity of Gut Microbiota and Metabolites in Benign Prostatic Hyperplasia with Different Prostate Volumes","authors":"Jiayi Liu ,&nbsp;Yuanming Chen ,&nbsp;Yong Wang ,&nbsp;Deng Li ,&nbsp;Zijie Xu ,&nbsp;Jianong Zhang ,&nbsp;Liang Qin ,&nbsp;Bangmin Han ,&nbsp;Yifeng Jing ,&nbsp;Di Cui ,&nbsp;Yiping Zhu ,&nbsp;Shujie Xia ,&nbsp;Chenyi Jiang","doi":"10.1016/j.euros.2025.12.016","DOIUrl":"10.1016/j.euros.2025.12.016","url":null,"abstract":"<div><h3>Background and objective</h3><div>The gut microbiota, influenced by age and sex hormones, may correlate with the development and progression of benign prostatic hyperplasia (BPH). This study aims to characterize gut microbiota and metabolite profiles in BPH patients with varying prostate volumes.</div></div><div><h3>Methods</h3><div>Fecal samples from BPH patients were analyzed using 16S rDNA sequencing and untargeted metabolomics. Microbial and metabolic differences were assessed via the Linear discriminant analysis Effect Size, KEGG pathway enrichment, and a mediation analysis.</div></div><div><h3>Key findings and limitations</h3><div>We identified 26 differential amplicon sequence variants (ASVs) and 70 metabolites, with 18 microbes correlating significantly with clinical BPH indicators. The key pathways included unsaturated fatty acid and steroid hormone biosynthesis. <em>Akkermansia</em> (ASV549) may affect prostate volume through the regulation of intestinal amino acid metabolism and may negatively affect prostate-specific antigen levels by inhibiting heat shock protein (HSP) 90 (luminespib). Limitations include sample size and unmeasured confounders.</div></div><div><h3>Conclusions and clinical implications</h3><div>Gut microbiota and metabolite diversity are associated with prostate volume; further studies are warranted to elucidate the potential interventions via microbiome modulation or metabolic targeting for BPH management.</div></div><div><h3>Patient summary</h3><div>In this study, we identified the potential associations between gut and both prostate volume and benign prostatic hyperplasia symptoms. These findings suggest that dietary interventions or fecal microbiota transplantation may represent potential strategies for modulating prostate health in the future.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"84 ","pages":"Pages 40-49"},"PeriodicalIF":4.5,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}