Pub Date : 2025-10-09DOI: 10.1097/ju.0000000000004666
Joshua J Meeks,Michiel S van der Heijden,Thomas Powles,Matthew D Galsky,Hikmat Al-Ahmadie,Hiroyuki Nishiyama,Alexandra Drakaki,Toan Quang Vu,Lorenzo Antonuzzo,Pawel Wiechno,Vagif Atduev,Ariel G Kann,Tae-Hwan Kim,Cristina Suárez,Albert Font Pous,Chao-Hsiang Chang,Wenjing Xin,Svetlana Ho,Małgorzata Gula,James W F CattoVolume
{"title":"PD37-09 The First Report Of Disease-Free Survival Analyses From The Niagara Trial Of Perioperative Durvalumab Plus Neoadjuvant Chemotherapy In Muscle-Invasive Bladder Cancer: Erratum.","authors":"Joshua J Meeks,Michiel S van der Heijden,Thomas Powles,Matthew D Galsky,Hikmat Al-Ahmadie,Hiroyuki Nishiyama,Alexandra Drakaki,Toan Quang Vu,Lorenzo Antonuzzo,Pawel Wiechno,Vagif Atduev,Ariel G Kann,Tae-Hwan Kim,Cristina Suárez,Albert Font Pous,Chao-Hsiang Chang,Wenjing Xin,Svetlana Ho,Małgorzata Gula,James W F CattoVolume","doi":"10.1097/ju.0000000000004666","DOIUrl":"https://doi.org/10.1097/ju.0000000000004666","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"114 1","pages":"556"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-09DOI: 10.1097/ju.0000000000004689
{"title":"Urinary Carcinogen Concentrations in Electronic Cigarette Users Compared to Cigarette Smokers, Dual Users and Nonsmokers: Findings From the Path Study: Retraction.","authors":"","doi":"10.1097/ju.0000000000004689","DOIUrl":"https://doi.org/10.1097/ju.0000000000004689","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"43 1","pages":"558"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-03DOI: 10.1097/ju.0000000000004796
Melissa R Kaufman,Hadley M Wood,Ryan Terlecki,Daniel Moon,Jeremy Myers,Alex J Vanni,LeRoy Jones,Joshua A Broghammer,Gerard Henry,Benjamin N Breyer,Bradley Erickson,Arthur L Burnett,Niels V Johnsen,Lewis Wen Loong Chan,Brian J Flynn,Rose Khavari,Thomas G Smith,Sean Elliott,Erin L Chaussee,Kaitlyn Rainbow,Andrew C Peterson
PURPOSEThe artificial urinary sphincter endures as the standard of care treatment for mild to severe male stress urinary incontinence. Prior studies report outcomes from predominantly single-center retrospective series. Herein we present data from a multi-institutional analysis of artificial urinary sphincter outcomes (AUSCO) to assess efficacy, safety, and quality of life to standardize result reporting.MATERIALS AND METHODSAUSCO is a single-arm, prospective, multi-center study designed to evaluate the AMS 800™ in men with primary stress urinary incontinence (NCT04088331). One hundred fifteen participants were implanted at 17 sites. The primary endpoint was > 50% improvement in 24-hour pad weight 12 months post device activation. Secondary endpoints including pad use, urinary incontinence events per day, quality of life and device satisfaction were measured between 3- and 12- months post device activation and compared to baseline.RESULTSAt 12 months, 94% (91/97) participants experienced >50% pad weight reduction (p<0.001) and 60% (61/101) reported zero pad use. Participants also reported substantial improvement in quality of life scores and incontinence events per day post device activation. Seventeen participants (15%) had serious adverse events, 10 (8.7%) in which the events were device related. Nine participants (7.8%) had revisions: mechanical malfunction (3), erosion (2), lack of efficacy (1), other (3), and zero due to infection.CONCLUSIONSIn this prospective trial, the artificial urinary sphincter allowed most men to achieve total continence with a serious adverse event rate less than 15%. Participants experienced significant continence recovery with transformational improvement in patient-reported outcomes.
{"title":"The Artificial Urinary Sphincter Clinical Outcomes Trial: Primary Results.","authors":"Melissa R Kaufman,Hadley M Wood,Ryan Terlecki,Daniel Moon,Jeremy Myers,Alex J Vanni,LeRoy Jones,Joshua A Broghammer,Gerard Henry,Benjamin N Breyer,Bradley Erickson,Arthur L Burnett,Niels V Johnsen,Lewis Wen Loong Chan,Brian J Flynn,Rose Khavari,Thomas G Smith,Sean Elliott,Erin L Chaussee,Kaitlyn Rainbow,Andrew C Peterson","doi":"10.1097/ju.0000000000004796","DOIUrl":"https://doi.org/10.1097/ju.0000000000004796","url":null,"abstract":"PURPOSEThe artificial urinary sphincter endures as the standard of care treatment for mild to severe male stress urinary incontinence. Prior studies report outcomes from predominantly single-center retrospective series. Herein we present data from a multi-institutional analysis of artificial urinary sphincter outcomes (AUSCO) to assess efficacy, safety, and quality of life to standardize result reporting.MATERIALS AND METHODSAUSCO is a single-arm, prospective, multi-center study designed to evaluate the AMS 800™ in men with primary stress urinary incontinence (NCT04088331). One hundred fifteen participants were implanted at 17 sites. The primary endpoint was > 50% improvement in 24-hour pad weight 12 months post device activation. Secondary endpoints including pad use, urinary incontinence events per day, quality of life and device satisfaction were measured between 3- and 12- months post device activation and compared to baseline.RESULTSAt 12 months, 94% (91/97) participants experienced >50% pad weight reduction (p<0.001) and 60% (61/101) reported zero pad use. Participants also reported substantial improvement in quality of life scores and incontinence events per day post device activation. Seventeen participants (15%) had serious adverse events, 10 (8.7%) in which the events were device related. Nine participants (7.8%) had revisions: mechanical malfunction (3), erosion (2), lack of efficacy (1), other (3), and zero due to infection.CONCLUSIONSIn this prospective trial, the artificial urinary sphincter allowed most men to achieve total continence with a serious adverse event rate less than 15%. Participants experienced significant continence recovery with transformational improvement in patient-reported outcomes.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"111 1","pages":"101097JU0000000000004796"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PURPOSEUrine-based assays currently have a limited role in the management of patients with upper tract urothelial carcinoma (UTUC), due to insufficient accuracy. This study evaluated a multiplex urine assay designed to accurately and non-invasively diagnose UTUC.MATERIALS AND METHODSOncuria-Detect is a multiplex immunoassay capable of detecting urothelia cancer using a single voided urine specimen. In the current multi-institutional study, we tested the assay's utility in identifying UTUC in 60 subjects presenting for evaluation of upper tract mass compared with samples from 60 age-, sex-, and race-matched controls. Cancer status was confirmed via histopathological assessment of tissue specimens obtained during ureteroscopy/biopsy or at the time of definitive surgical intervention (nephroureterectomy or ureterectomy).RESULTSFor detecting UTUC, Oncuria-Detect provided an AUC of 0.77 (95% CI: 0.70-0.84) with an overall sensitivity of 93%, specificity of 55%, negative predictive value (NPV) 89%, and positive predictive value (PPV) 67%. Assay sensitivity values for low-grade, high-grade, non-invasive, and invasive UTUC were 94%, 93%, 93% and 92%, respectively. Voided urine cytology showed an overall sensitivity of 54%, specificity of 100%, NPV 31.0%, and PPV 100%. Selective (upper tract) cytology had a sensitivity of 80%. Oncuria-Detect outperformed both non-invasive voided urinary cytology and invasive selective cytology in overall assay performance.CONCLUSIONSOncuria-Detect accurately identified and categorized UTUC and discriminated patients with cancer from non-tumor bearing individuals. The Oncuria-Detect test provides a rapid, accurate, and non-invasive method for detecting UTUC.
{"title":"Diagnostic Accuracy of the Oncuria-Detect Multiplex Immunoassay in Detecting Upper Tract Urothelial Carcinoma.","authors":"Kazutoshi Fujita,Makito Miyake,Mamoru Hashimoto,Takuto Shimizu,Jennifer Linehan,Joshua Gottlieb,Ian Pagano,Sergei Tikhonenkov,Michael Luu,Sunao Tanaka,Fernando Siguencia,Kaoru Murakami,Riko Lee,Toru Sakatani,Charles J Rosser,Hideki Furuya","doi":"10.1097/ju.0000000000004803","DOIUrl":"https://doi.org/10.1097/ju.0000000000004803","url":null,"abstract":"PURPOSEUrine-based assays currently have a limited role in the management of patients with upper tract urothelial carcinoma (UTUC), due to insufficient accuracy. This study evaluated a multiplex urine assay designed to accurately and non-invasively diagnose UTUC.MATERIALS AND METHODSOncuria-Detect is a multiplex immunoassay capable of detecting urothelia cancer using a single voided urine specimen. In the current multi-institutional study, we tested the assay's utility in identifying UTUC in 60 subjects presenting for evaluation of upper tract mass compared with samples from 60 age-, sex-, and race-matched controls. Cancer status was confirmed via histopathological assessment of tissue specimens obtained during ureteroscopy/biopsy or at the time of definitive surgical intervention (nephroureterectomy or ureterectomy).RESULTSFor detecting UTUC, Oncuria-Detect provided an AUC of 0.77 (95% CI: 0.70-0.84) with an overall sensitivity of 93%, specificity of 55%, negative predictive value (NPV) 89%, and positive predictive value (PPV) 67%. Assay sensitivity values for low-grade, high-grade, non-invasive, and invasive UTUC were 94%, 93%, 93% and 92%, respectively. Voided urine cytology showed an overall sensitivity of 54%, specificity of 100%, NPV 31.0%, and PPV 100%. Selective (upper tract) cytology had a sensitivity of 80%. Oncuria-Detect outperformed both non-invasive voided urinary cytology and invasive selective cytology in overall assay performance.CONCLUSIONSOncuria-Detect accurately identified and categorized UTUC and discriminated patients with cancer from non-tumor bearing individuals. The Oncuria-Detect test provides a rapid, accurate, and non-invasive method for detecting UTUC.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"121 1","pages":"101097JU0000000000004803"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-29DOI: 10.1097/ju.0000000000004794
Meghan F Davis,Dmitriy Nikolavsky,Andre G Cavalcanti,Brian J Flynn,Reynaldo G Gomez,Jeff Loh-Doyle,Stuart D Boyd,Akio Horiguchi,Matthias D Hofer,Margit Fisch,Roland Dahlem,Francisco E Martins,Felix Campos-Juanatey,Paul J Rusilko,Henriette Veiby Holm,Jay Simhan,Javier C Angulo,Tim A Ludwig,Jose O Bernal,Margaret Higgins,Sasha Vereecken,Josh Sterling,Erin K Hays,Peter G Kolyvas,Alexander Stanisic,Juan F Dorado,Krishnan Venkatesan
PURPOSEThe artificial urinary sphincter (AUS) is the gold standard for male stress urinary incontinence (SUI). There is limited and conflicting evidence examining outcomes in AUS insertion after urethroplasty particularly whether and how urethroplasty techniques affect them. We evaluated complications of AUS insertion after urethroplasty in a multi-institutional cohort. We hypothesize that complications occur at higher rates and vary between transecting and non-transecting urethroplasty.MATERIALS AND METHODSWe retrospectively reviewed patients who underwent AUS after urethroplasty at 15 institutions. Demographic and clinical variables were analyzed. Urethroplasties were categorized as transecting or non-transecting. Long-term complications included AUS infection, erosion, and mechanical failure.RESULTS178 cases were identified performed by 17 surgeons (range 4-40) from 15 institutions with median follow-up of 33.5 (IQR 46) months). AUS complications requiring explantation, including infection, erosion and mechanical failure following transecting urethroplasty occurred in 56.2% compared to 23.5% following non-transecting urethroplasty (p < 0.001). Transecting urethroplasty technique was correlated with increased risk of device explant both from erosion (p=0.004) and atrophy (p=0.008). Radiation (HR 0.46, 95% CI 0.28-0.76, p=0.002), hypertension (HR 0.44, 95% CI 0.27-0.73, p=0.0008) and patient age (>68) (HR 0.5, 95% CI 0.3-0.81, p=0.004) also correlated to risk of device explantation.CONCLUSIONSRisk of experiencing AUS complications is higher in patient with transecting urethroplasty compared to the non-transecting group. Non-transecting urethroplasty may be advisable if a subsequent need for AUS is anticipated.
目的人工尿括约肌（AUS）是男性压力性尿失禁（SUI）的金标准。关于输尿管成形术后AUS插入的结果，特别是输尿管成形术是否以及如何影响输尿管成形术的证据有限且相互矛盾。我们在一个多机构队列中评估输尿管成形术后AUS插入的并发症。我们假设并发症发生率较高，并且在横断和非横断尿道成形术之间有所不同。材料和方法我们回顾性分析了15家机构的尿道成形术后行AUS的患者。分析人口学和临床变量。尿道成形术分为横切性和非横切性。长期并发症包括AUS感染、糜烂和机械故障。结果15家医院17位外科医生（范围4 ~ 40人）共手术178例，中位随访33.5个月（IQR 46个月）。横断尿道成形术后需要切除的AUS并发症，包括感染、糜烂和机械故障发生率为56.2%，而非横断尿道成形术后为23.5% （p < 0.001）。横断尿道成形术与外植体糜烂（p=0.004）和萎缩（p=0.008）的风险增加相关。辐射（HR 0.46, 95% CI 0.28-0.76, p=0.002）、高血压（HR 0.44, 95% CI 0.27-0.73, p=0.0008）和患者年龄（bbb68） （HR 0.5, 95% CI 0.3-0.81, p=0.004）也与器械外植的风险相关。结论尿道横断成形术患者发生AUS并发症的风险高于未行尿道横断成形术的患者。非横断尿道成形术可能是可取的，如果预期后续需要AUS。
{"title":"Multicenter Analysis of Long-Term Outcomes of Artificial Urinary Sphincter Surgery Following Urethroplasty.","authors":"Meghan F Davis,Dmitriy Nikolavsky,Andre G Cavalcanti,Brian J Flynn,Reynaldo G Gomez,Jeff Loh-Doyle,Stuart D Boyd,Akio Horiguchi,Matthias D Hofer,Margit Fisch,Roland Dahlem,Francisco E Martins,Felix Campos-Juanatey,Paul J Rusilko,Henriette Veiby Holm,Jay Simhan,Javier C Angulo,Tim A Ludwig,Jose O Bernal,Margaret Higgins,Sasha Vereecken,Josh Sterling,Erin K Hays,Peter G Kolyvas,Alexander Stanisic,Juan F Dorado,Krishnan Venkatesan","doi":"10.1097/ju.0000000000004794","DOIUrl":"https://doi.org/10.1097/ju.0000000000004794","url":null,"abstract":"PURPOSEThe artificial urinary sphincter (AUS) is the gold standard for male stress urinary incontinence (SUI). There is limited and conflicting evidence examining outcomes in AUS insertion after urethroplasty particularly whether and how urethroplasty techniques affect them. We evaluated complications of AUS insertion after urethroplasty in a multi-institutional cohort. We hypothesize that complications occur at higher rates and vary between transecting and non-transecting urethroplasty.MATERIALS AND METHODSWe retrospectively reviewed patients who underwent AUS after urethroplasty at 15 institutions. Demographic and clinical variables were analyzed. Urethroplasties were categorized as transecting or non-transecting. Long-term complications included AUS infection, erosion, and mechanical failure.RESULTS178 cases were identified performed by 17 surgeons (range 4-40) from 15 institutions with median follow-up of 33.5 (IQR 46) months). AUS complications requiring explantation, including infection, erosion and mechanical failure following transecting urethroplasty occurred in 56.2% compared to 23.5% following non-transecting urethroplasty (p < 0.001). Transecting urethroplasty technique was correlated with increased risk of device explant both from erosion (p=0.004) and atrophy (p=0.008). Radiation (HR 0.46, 95% CI 0.28-0.76, p=0.002), hypertension (HR 0.44, 95% CI 0.27-0.73, p=0.0008) and patient age (>68) (HR 0.5, 95% CI 0.3-0.81, p=0.004) also correlated to risk of device explantation.CONCLUSIONSRisk of experiencing AUS complications is higher in patient with transecting urethroplasty compared to the non-transecting group. Non-transecting urethroplasty may be advisable if a subsequent need for AUS is anticipated.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"20 1","pages":"101097JU0000000000004794"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-29DOI: 10.1097/ju.0000000000004797
Ana M Moser,Alissa Elanjian,Ava Zamani,Kevin B Ginsburg
{"title":"The risk of clinically significant prostate cancer on subsequent biopsies in men with HGPIN/ASAP on an MRI-informed index biopsy.","authors":"Ana M Moser,Alissa Elanjian,Ava Zamani,Kevin B Ginsburg","doi":"10.1097/ju.0000000000004797","DOIUrl":"https://doi.org/10.1097/ju.0000000000004797","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"5 1","pages":"101097JU0000000000004797"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-26DOI: 10.1097/ju.0000000000004793
Rafael Castilho Borges,Rafael Rocha Tourinho-Barbosa,Nuno Dias,Gustavo de Barros Pena Ribeiro Paiva,Sidney Glina,Oliver Rojas Claros,Lara Rodriguéz Sanchéz,François Rozet,Eric Barret,Yann Pierre Barbé,Camille Lanz,Rafael Sanchez-Salas,Xavier Cathelineau,Petr Macek,Fernando Korkes
PURPOSETo compare the detection rates of clinically significant prostate cancer (csPCa) between cognitively targeted micro-ultrasound-guided biopsy (MB) and MRI/ultrasound fusion-guided biopsy (PFB) in men with MRI-visible lesions.METHODSWe retrospectively analyzed 1,119 men who underwent MB (n=767) or PFB (n=352) between 2019 and 2022. Inverse probability of treatment weighting (IPTW) based on a logistic regression propensity score was applied to balance baseline characteristics between groups. Weighted logistic regression models were used to compare csPCa detection in the overall cohort and in subgroups of biopsy-naïve men and those with anterior lesions. A separate multivariable logistic regression was performed in the full cohort to identify independent predictors of csPCa. Concordance between biopsy and radical prostatectomy Gleason scores was also evaluated.RESULTSAfter IPTW adjustment, csPCa detection with MB was higher than with PFB in combined sampling (45% vs. 34%; OR 1.61; 95% CI 1.23-2.11; p<0.01). However, no significant difference was observed between techniques for targeted biopsies alone, both in the overall cohort and among biopsy-naïve men. In patients with anterior lesions, csPCa detection rates were also similar. In the full cohort multivariable model, MB and PIRADS 5 lesions were independently associated with csPCa. Gleason upgrading at prostatectomy was more frequent in the PFB group (38% vs. 17%; p=0.01).CONCLUSIONWhile MB demonstrated higher csPCa detection in adjusted analyses, the benefit was not consistent across all settings. Further studies are warranted to determine whether this reflects a methodological advantage or context-dependent factors.
目的比较认知靶向微超声引导活检（MB）与MRI/超声融合引导活检（PFB）对MRI可见病变男性临床显著性前列腺癌（csPCa）的检出率。方法我们回顾性分析了2019年至2022年期间接受MB （n=767）或PFB （n=352）的1119名男性。采用基于逻辑回归倾向评分的治疗加权逆概率（IPTW）来平衡各组之间的基线特征。使用加权逻辑回归模型比较整个队列和biopsy-naïve男性亚组与前病变患者的csPCa检测。在全队列中进行单独的多变量logistic回归，以确定csPCa的独立预测因素。活检和根治性前列腺切除术之间的一致性也被评估Gleason评分。结果经IPTW调整后，联合取样中MB的csPCa检出率高于PFB （45% vs. 34%; OR 1.61; 95% CI 1.23 ~ 2.11; p<0.01）。然而，在整个队列和biopsy-naïve男性中，单独的靶向活检技术之间没有观察到显著差异。在前病变患者中，csPCa的检出率也相似。在全队列多变量模型中，MB和PIRADS 5病变与csPCa独立相关。前列腺切除术后Gleason升级在PFB组更常见（38%比17%；p=0.01）。结论：虽然在调整分析中，MB显示出更高的csPCa检测，但在所有设置中获益并不一致。有必要进行进一步的研究，以确定这是否反映了方法上的优势或环境相关因素。
{"title":"Detection of Clinically Significant Prostate Cancer Using Micro-Ultrasound Versus MRI/Ultrasound Fusion Biopsy: A Propensity-Weighted Comparative Study.","authors":"Rafael Castilho Borges,Rafael Rocha Tourinho-Barbosa,Nuno Dias,Gustavo de Barros Pena Ribeiro Paiva,Sidney Glina,Oliver Rojas Claros,Lara Rodriguéz Sanchéz,François Rozet,Eric Barret,Yann Pierre Barbé,Camille Lanz,Rafael Sanchez-Salas,Xavier Cathelineau,Petr Macek,Fernando Korkes","doi":"10.1097/ju.0000000000004793","DOIUrl":"https://doi.org/10.1097/ju.0000000000004793","url":null,"abstract":"PURPOSETo compare the detection rates of clinically significant prostate cancer (csPCa) between cognitively targeted micro-ultrasound-guided biopsy (MB) and MRI/ultrasound fusion-guided biopsy (PFB) in men with MRI-visible lesions.METHODSWe retrospectively analyzed 1,119 men who underwent MB (n=767) or PFB (n=352) between 2019 and 2022. Inverse probability of treatment weighting (IPTW) based on a logistic regression propensity score was applied to balance baseline characteristics between groups. Weighted logistic regression models were used to compare csPCa detection in the overall cohort and in subgroups of biopsy-naïve men and those with anterior lesions. A separate multivariable logistic regression was performed in the full cohort to identify independent predictors of csPCa. Concordance between biopsy and radical prostatectomy Gleason scores was also evaluated.RESULTSAfter IPTW adjustment, csPCa detection with MB was higher than with PFB in combined sampling (45% vs. 34%; OR 1.61; 95% CI 1.23-2.11; p<0.01). However, no significant difference was observed between techniques for targeted biopsies alone, both in the overall cohort and among biopsy-naïve men. In patients with anterior lesions, csPCa detection rates were also similar. In the full cohort multivariable model, MB and PIRADS 5 lesions were independently associated with csPCa. Gleason upgrading at prostatectomy was more frequent in the PFB group (38% vs. 17%; p=0.01).CONCLUSIONWhile MB demonstrated higher csPCa detection in adjusted analyses, the benefit was not consistent across all settings. Further studies are warranted to determine whether this reflects a methodological advantage or context-dependent factors.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"54 1","pages":"101097JU0000000000004793"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-19DOI: 10.1097/ju.0000000000004789
Hriday P Bhambhvani,Manish Kuchakulla,Phillip Poppas,Daniel R Greenberg,James A Kashanian,Michael L Eisenberg
PURPOSETestosterone levels are influenced by behavioral and environmental factors. As modern lifestyles have become increasingly sedentary with less time spent outdoors, understanding how daily outdoor exposure relates to serum testosterone may offer insight into the hormonal effects of contemporary behavior patterns. We evaluated the correlation between daily time spent outdoors (TSO) and serum testosterone.METHODSWe identified adult men from the National Health and Nutrition Examination Survey (NHANES) database from 2011-2014. TSO was measured in average minutes per day (MPD). Low testosterone was defined as serum morning total testosterone < 300 ng/dL. Survey-weighted multivariable logistic and linear regression models were used to identify factors correlated with low testosterone and serum testosterone, respectively, while correcting for age, education, household income, BMI, physical activity (both self-reported and accelerometer-determined), diabetes, vitamin D concentration, and dietary habits.RESULTS2,205 men were included. Mean age, testosterone, and MPD TSO were 45.8 years, 448.34 ng/dL, and 144.3 minutes, respectively. 19.3% of men had low testosterone. TSO was significantly associated with both serum testosterone (β=9.25 per 1 hour outside daily, p=0.007) and decreased odds of low testosterone (OR=0.86 per 1 hour outside daily, 95% CI 0.76-0.97, p=0.01) in multivariate analysis. Increasing age, BMI, and diabetes were positively correlated with low testosterone, while increasing physical activity was inversely correlated with low testosterone (p≤0.01 for all).CONCLUSIONSThis is the first report to describe a correlation between increased outdoor time and lower prevalence of low testosterone, independent of age, education, household income, BMI, physical activity, diabetes, vitamin D concentration, and dietary habits.
目的睾酮水平受行为和环境因素的影响。随着现代生活方式越来越久坐不动，户外活动的时间越来越少，了解每天户外暴露与血清睾酮的关系可能有助于了解当代行为模式的激素影响。我们评估了每日户外活动时间（TSO）与血清睾酮之间的相关性。方法我们从2011-2014年国家健康与营养检查调查（NHANES）数据库中选取成年男性。TSO以每天平均分钟数（MPD）测量。低睾酮定义为血清早晨总睾酮< 300 ng/dL。使用调查加权的多变量logistic和线性回归模型分别确定与低睾酮和血清睾酮相关的因素，同时校正年龄、教育程度、家庭收入、BMI、体力活动（自我报告和加速度计确定）、糖尿病、维生素D浓度和饮食习惯。结果共纳入2205名男性。平均年龄、睾丸激素和MPD TSO分别为45.8岁、448.34 ng/dL和144.3分钟。19.3%的男性睾丸激素水平低。在多因素分析中，TSO与血清睾酮（β=9.25 /每天外出1小时，p=0.007）和低睾酮发生率（OR=0.86 /每天外出1小时，95% CI 0.76-0.97, p=0.01）显著相关。年龄增加、BMI、糖尿病与低睾酮呈正相关，体力活动增加与低睾酮呈负相关（p均≤0.01）。结论：这是第一份描述户外活动时间增加与低睾酮患病率降低之间相关性的报告，与年龄、教育程度、家庭收入、身体质量指数、身体活动、糖尿病、维生素D浓度和饮食习惯无关。
{"title":"Cross-Sectional Association of Time Spent Outdoors with Serum Testosterone: Results from NHANES.","authors":"Hriday P Bhambhvani,Manish Kuchakulla,Phillip Poppas,Daniel R Greenberg,James A Kashanian,Michael L Eisenberg","doi":"10.1097/ju.0000000000004789","DOIUrl":"https://doi.org/10.1097/ju.0000000000004789","url":null,"abstract":"PURPOSETestosterone levels are influenced by behavioral and environmental factors. As modern lifestyles have become increasingly sedentary with less time spent outdoors, understanding how daily outdoor exposure relates to serum testosterone may offer insight into the hormonal effects of contemporary behavior patterns. We evaluated the correlation between daily time spent outdoors (TSO) and serum testosterone.METHODSWe identified adult men from the National Health and Nutrition Examination Survey (NHANES) database from 2011-2014. TSO was measured in average minutes per day (MPD). Low testosterone was defined as serum morning total testosterone < 300 ng/dL. Survey-weighted multivariable logistic and linear regression models were used to identify factors correlated with low testosterone and serum testosterone, respectively, while correcting for age, education, household income, BMI, physical activity (both self-reported and accelerometer-determined), diabetes, vitamin D concentration, and dietary habits.RESULTS2,205 men were included. Mean age, testosterone, and MPD TSO were 45.8 years, 448.34 ng/dL, and 144.3 minutes, respectively. 19.3% of men had low testosterone. TSO was significantly associated with both serum testosterone (β=9.25 per 1 hour outside daily, p=0.007) and decreased odds of low testosterone (OR=0.86 per 1 hour outside daily, 95% CI 0.76-0.97, p=0.01) in multivariate analysis. Increasing age, BMI, and diabetes were positively correlated with low testosterone, while increasing physical activity was inversely correlated with low testosterone (p≤0.01 for all).CONCLUSIONSThis is the first report to describe a correlation between increased outdoor time and lower prevalence of low testosterone, independent of age, education, household income, BMI, physical activity, diabetes, vitamin D concentration, and dietary habits.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"90 1","pages":"101097JU0000000000004789"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-16DOI: 10.1097/ju.0000000000004782
Sam S Chang,Karim Chamie,Eugene Kramolowsky,Mark L Gonzalgo,Piyush Kumar Agarwal,Jeffrey C Bassett,Marc Bjurlin,Michael L Cher,William Clark,Barrett E Cowan,Richard David,Evan Goldfischer,Khurshid Guru,Mark W Jalkut,Samuel D Kaffenberger,Jed Kaminetsky,Anthony Corcoran,Alec S Koo,Wade J Sexton,Sergei N Tikhonenkov,Mihir S Shah,Edouard J Trabulsi,Andrew F Trainer,Patricia Spilman,Megan Huang,Paul Bhar,Leylah M Drusbosky,Lennie Sender,Bruce Brown,Sandeep Reddy,Patrick Soon-Shiong
PURPOSEIn QUILT-3.032, the efficacy of IL-15 receptor agonist, nogapendekin alfa inbakicept (NAI) in combination with BCG for BCG-unresponsive high-grade papillary-only non-muscle invasive bladder cancer (NMIBC) was assessed. Herein we report the 36-month follow-up among participants with BCG-unresponsive papillary disease (Cohort B).MATERIALS AND METHODSNCT03022825 is an open-label, multi-center study with BCG-unresponsive high-grade Ta/T1 papillary NMIBC who received 400μg NAI plus 50mg BCG intravesically weekly for six consecutive weeks. The primary endpoint is disease-free survival (DFS) at 12-months. Progression-free survival (PFS), disease-specific survival (DSS), and cystectomy avoidance were assessed. Treatment-related adverse events (TRAEs) were assessed.RESULTSAt July 15, 2024 data cutoff, the DFS rates at 12-, 24-, and 36-months were 58.2% (95% CI 46.6, 68.2), 52.1% (95% CI 40.3, 62.7), and 38.2% (95% CI 25.6, 50.6), respectively. The PFS rates at 12- and 36-months were 94.9% (95% CI 86.9, 98.0) and 83.1% (95% CI 69.5, 91.0). The DSS rates at 12- and 36-months were 98.7% (95% CI 91.4, 99.8) and 96.0% (95% CI 88.2, 98.7). The median DSS has not been reached. Cystectomy avoidance rates at 12- and 36-months were 92.2% (95% CI 83.4, 96.4) and 81.8% (95% CI 68.1, 90.1), with median time to cystectomy not reached. Most TRAEs were grade 1-2 (61%) with 3% grade 3, and no grade 4-5.CONCLUSIONSThe 12- and 36-month DFS, PFS, DSS, and cystectomy avoidance rates demonstrate the effectiveness and safety of NAI plus BCG in the management of BCG-unresponsive papillary disease.
目的：在QUILT-3.032中，评价IL-15受体激动剂诺加巴白金联合卡介苗治疗无BCG应答的高级别乳头状单纯非肌肉浸润性膀胱癌（NMIBC）的疗效。在此，我们报告了对bcg无反应的乳头状疾病参与者（队列B）进行的36个月随访。材料与方法snct03022825是一项开放标签、多中心研究，患者为BCG无反应的高级别Ta/T1乳头状NMIBC，接受400μg NAI + 50mg BCG静脉注射，连续6周。主要终点是12个月的无病生存期（DFS）。评估无进展生存期（PFS）、疾病特异性生存期（DSS）和避免膀胱切除术。评估治疗相关不良事件（TRAEs）。结果截至2024年7月15日，12个月、24个月和36个月的DFS率分别为58.2% （95% CI 46.6、68.2）、52.1% （95% CI 40.3、62.7）和38.2% （95% CI 25.6、50.6）。12个月和36个月的PFS率分别为94.9% （95% CI 86.9, 98.0）和83.1% （95% CI 69.5, 91.0）。12个月和36个月的DSS率分别为98.7% （95% CI 91.4, 99.8）和96.0% （95% CI 88.2, 98.7）。DSS的中位数尚未达到。12个月和36个月膀胱切除术避免率分别为92.2% （95% CI 83.4, 96.4）和81.8% (95% CI 68.1, 90.1)，未达到中位膀胱切除术时间。大多数trae为1-2级（61%），3级3%，4-5级无。结论12个月和36个月的DFS、PFS、DSS和膀胱切除术避免率表明NAI联合卡介苗治疗卡介苗无应答性乳头状疾病的有效性和安全性。
{"title":"Prolonged Progression-Free Survival, Disease-Free Survival and Cystectomy Avoidance with IL-15 Receptor Lymphocyte-Stimulating Agent NAI plus BCG in BCG-Unresponsive Papillary-Only NMIBC.","authors":"Sam S Chang,Karim Chamie,Eugene Kramolowsky,Mark L Gonzalgo,Piyush Kumar Agarwal,Jeffrey C Bassett,Marc Bjurlin,Michael L Cher,William Clark,Barrett E Cowan,Richard David,Evan Goldfischer,Khurshid Guru,Mark W Jalkut,Samuel D Kaffenberger,Jed Kaminetsky,Anthony Corcoran,Alec S Koo,Wade J Sexton,Sergei N Tikhonenkov,Mihir S Shah,Edouard J Trabulsi,Andrew F Trainer,Patricia Spilman,Megan Huang,Paul Bhar,Leylah M Drusbosky,Lennie Sender,Bruce Brown,Sandeep Reddy,Patrick Soon-Shiong","doi":"10.1097/ju.0000000000004782","DOIUrl":"https://doi.org/10.1097/ju.0000000000004782","url":null,"abstract":"PURPOSEIn QUILT-3.032, the efficacy of IL-15 receptor agonist, nogapendekin alfa inbakicept (NAI) in combination with BCG for BCG-unresponsive high-grade papillary-only non-muscle invasive bladder cancer (NMIBC) was assessed. Herein we report the 36-month follow-up among participants with BCG-unresponsive papillary disease (Cohort B).MATERIALS AND METHODSNCT03022825 is an open-label, multi-center study with BCG-unresponsive high-grade Ta/T1 papillary NMIBC who received 400μg NAI plus 50mg BCG intravesically weekly for six consecutive weeks. The primary endpoint is disease-free survival (DFS) at 12-months. Progression-free survival (PFS), disease-specific survival (DSS), and cystectomy avoidance were assessed. Treatment-related adverse events (TRAEs) were assessed.RESULTSAt July 15, 2024 data cutoff, the DFS rates at 12-, 24-, and 36-months were 58.2% (95% CI 46.6, 68.2), 52.1% (95% CI 40.3, 62.7), and 38.2% (95% CI 25.6, 50.6), respectively. The PFS rates at 12- and 36-months were 94.9% (95% CI 86.9, 98.0) and 83.1% (95% CI 69.5, 91.0). The DSS rates at 12- and 36-months were 98.7% (95% CI 91.4, 99.8) and 96.0% (95% CI 88.2, 98.7). The median DSS has not been reached. Cystectomy avoidance rates at 12- and 36-months were 92.2% (95% CI 83.4, 96.4) and 81.8% (95% CI 68.1, 90.1), with median time to cystectomy not reached. Most TRAEs were grade 1-2 (61%) with 3% grade 3, and no grade 4-5.CONCLUSIONSThe 12- and 36-month DFS, PFS, DSS, and cystectomy avoidance rates demonstrate the effectiveness and safety of NAI plus BCG in the management of BCG-unresponsive papillary disease.","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"17 1","pages":"101097JU0000000000004782"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-09DOI: 10.1097/ju.0000000000004651
Jennifer Gutierrez,Asha Ayub,Stacy E Piva,Joseph D Shirk
{"title":"IP11-07 A 3D Tumor Map for the Surgical Management of Bladder Cancer: Feasibility and Preliminary Analysis: Erratum.","authors":"Jennifer Gutierrez,Asha Ayub,Stacy E Piva,Joseph D Shirk","doi":"10.1097/ju.0000000000004651","DOIUrl":"https://doi.org/10.1097/ju.0000000000004651","url":null,"abstract":"","PeriodicalId":501636,"journal":{"name":"The Journal of Urology","volume":"32 1","pages":"458"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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