Mark I. Sultan, Satoshi Yamazaki, Shady A. Ibrahim, Hadeel Haddad, Antoinette Abdelmalek, Sohrab N. Ali, Mac Kinnly T. Knoerzer, Muhammed A. M. Hammad, Ramy F. Youssef
Objectives
Twenty-four-hour urine collections are obtained as part of the metabolic workup for nephrolithiasis to identify modifiable abnormalities for stone prevention. We sought to discern trends in the prevalence of abnormalities based on body mass index (BMI) (kg/m2).
Material and Methods
All unique Litholink™ 24-Hour Urine outcomes for nephrolithiasis prior to medical or dietary therapy obtained at our institution between 2004 and 2020 were retrospectively reviewed. Patients with anthropometric data were classified according to body mass index (BMI) as underweight (<18.5), normal (18.5–25), overweight25-30 and obese (>30). Litholink™ 24-Hour Urine gender specific reference ranges were used to define abnormalities.
Results
A total of 1372 patients were included. The mean age was 56 15.3 (53.5% male, 46.5% female). Cumulatively, 30.7% (421/1372) were obese, 32.9% (452/1372) overweight, 33.4% (458/1372) normal and 3.0% (41/1372) underweight. Overall, elevated urine sodium was the most common metabolic abnormality (52.8%). In obese stone formers, hypercalciuria (p = 0.027), hyperoxaluria (p < 0.001), elevated urine sodium (p < 0.001), hyperuricosuria (p < 0.001) low urine pH (p < 0.001) and high uric acid supersaturation (p < 0.001) were more likely compared to normal BMI stone formers. Underweight patients demonstrated greater likelihood of oliguria (p = 0.001), without adjustment for weight, and hypocitraturia (p = 0.001) compared to normal BMI stone formers.
Conclusions
Body weight differences are associated with different risk profiles on 24-hour urine collection. Obese, and to a letter degree, underweight patients are more likely to harbour metabolic derangements on a 24-hour urine analysis compared to patients with normal BMI, thus underscoring the importance of directed medical therapy for stone formers.
目的收集24小时尿液作为肾结石代谢检查的一部分，以确定可改变的异常，以预防结石。我们试图根据体重指数（BMI） （kg/m2）来辨别异常患病率的趋势。材料和方法回顾性回顾了2004年至2020年在我们机构获得的所有在药物或饮食治疗前肾结石的独特Litholink™24小时尿液结果。根据体质指数（BMI）将有人体测量数据的患者分为体重过轻（18.5）、正常（18.5 - 25）、超重（25-30）和肥胖（30）。使用Litholink™24小时尿液性别特异性参考范围来确定异常。结果共纳入1372例患者。平均年龄56±$$ pm $$ 15.3 (53.5% male, 46.5% female). Cumulatively, 30.7% (421/1372) were obese, 32.9% (452/1372) overweight, 33.4% (458/1372) normal and 3.0% (41/1372) underweight. Overall, elevated urine sodium was the most common metabolic abnormality (52.8%). In obese stone formers, hypercalciuria (p = 0.027), hyperoxaluria (p < 0.001), elevated urine sodium (p < 0.001), hyperuricosuria (p < 0.001) low urine pH (p < 0.001) and high uric acid supersaturation (p < 0.001) were more likely compared to normal BMI stone formers. Underweight patients demonstrated greater likelihood of oliguria (p = 0.001), without adjustment for weight, and hypocitraturia (p = 0.001) compared to normal BMI stone formers. Conclusions Body weight differences are associated with different risk profiles on 24-hour urine collection. Obese, and to a letter degree, underweight patients are more likely to harbour metabolic derangements on a 24-hour urine analysis compared to patients with normal BMI, thus underscoring the importance of directed medical therapy for stone formers.
{"title":"Nephrolithiasis risk factors for obese patients on 24-hour urine collection metabolic evaluation","authors":"Mark I. Sultan, Satoshi Yamazaki, Shady A. Ibrahim, Hadeel Haddad, Antoinette Abdelmalek, Sohrab N. Ali, Mac Kinnly T. Knoerzer, Muhammed A. M. Hammad, Ramy F. Youssef","doi":"10.1002/bco2.70103","DOIUrl":"https://doi.org/10.1002/bco2.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Twenty-four-hour urine collections are obtained as part of the metabolic workup for nephrolithiasis to identify modifiable abnormalities for stone prevention. We sought to discern trends in the prevalence of abnormalities based on body mass index (BMI) (kg/m<sup>2</sup>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>All unique Litholink™ 24-Hour Urine outcomes for nephrolithiasis prior to medical or dietary therapy obtained at our institution between 2004 and 2020 were retrospectively reviewed. Patients with anthropometric data were classified according to body mass index (BMI) as underweight (<18.5), normal (18.5–25), overweight<sup>25-30</sup> and obese (>30). Litholink™ 24-Hour Urine gender specific reference ranges were used to define abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1372 patients were included. The mean age was 56 <span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 <mo>±</mo>\u0000 </mrow>\u0000 <annotation>$$ pm $$</annotation>\u0000 </semantics></math> 15.3 (53.5% male, 46.5% female). Cumulatively, 30.7% (421/1372) were obese, 32.9% (452/1372) overweight, 33.4% (458/1372) normal and 3.0% (41/1372) underweight. Overall, elevated urine sodium was the most common metabolic abnormality (52.8%). In obese stone formers, hypercalciuria (p = 0.027), hyperoxaluria (p < 0.001), elevated urine sodium (p < 0.001), hyperuricosuria (p < 0.001) low urine pH (p < 0.001) and high uric acid supersaturation (p < 0.001) were more likely compared to normal BMI stone formers. Underweight patients demonstrated greater likelihood of oliguria (p = 0.001), without adjustment for weight, and hypocitraturia (p = 0.001) compared to normal BMI stone formers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Body weight differences are associated with different risk profiles on 24-hour urine collection. Obese, and to a letter degree, underweight patients are more likely to harbour metabolic derangements on a 24-hour urine analysis compared to patients with normal BMI, thus underscoring the importance of directed medical therapy for stone formers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 11","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Esther H. J. Hamoen, Bas Israël, Marloes van der Leest, Erik B. Cornel, O. Sjoerd Klaver, Rianne J. Hendriks, Jeroen Veltman, Inge M. van Oort, Gerjon Hannink, J. Alfred Witjes, Jelle O. Barentsz, Maroeska M. Rovers
Objectives
To study the impact of the new MRI pathway and conventional transrectal ultrasound-guided systematic biopsies (TRUSGB) on anxiety and HRQoL in men with suspected PCa.
Materials and methods
A secondary analysis was performed of a randomized clinical trial including 626 biopsy-naïve patients. All patients underwent mpMRI and TRUSGB. Men with suspicious lesions on mpMRI underwent MRGB prior to TRUSGB. Anxiety was measured by State–Trait Anxiety Inventory-Trait Scale (STAI-6), completed at baseline, directly after mpMRI, MRGB, TRUSGB, after two/three weeks, and six months. HRQoL was measured by EuroQol (EQ-5D-5L), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) and Prostate Cancer Module (QLQ-PR25). Outcomes were compared between patients that underwent mpMRI and TRUSGB and patients that underwent mpMRI, MRGB and TRUSGB. Differences were considered relevant if the 95% confidence interval exceeded the minimal important clinical difference.
Results
No relevant differences were seen in anxiety scores and generic HRQoL at different time points in patients that underwent mpMRI, TRUSGB and MRGB compared to patients that underwent mpMRI and TRUSGB. Patients that underwent mpMRI, MRGB and TRUSGB reported lower incontinence aid and hormonal treatment-related symptom scores after 6 months compared to patients that underwent mpMRI and TRUSGB.
Conclusions
In men suspected of PCa, no differences were observed in anxiety levels or generic HRQoL scores across different diagnostic pathways. However, lower PCa-specific HRQoL subscores were noted in patients who underwent mpMRI, MRGB and TRUSGB.
{"title":"Impact of multiparametric MRI and prostate biopsies on anxiety and quality of life in men with suspected prostate cancer","authors":"Esther H. J. Hamoen, Bas Israël, Marloes van der Leest, Erik B. Cornel, O. Sjoerd Klaver, Rianne J. Hendriks, Jeroen Veltman, Inge M. van Oort, Gerjon Hannink, J. Alfred Witjes, Jelle O. Barentsz, Maroeska M. Rovers","doi":"10.1002/bco2.70087","DOIUrl":"https://doi.org/10.1002/bco2.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To study the impact of the new MRI pathway and conventional transrectal ultrasound-guided systematic biopsies (TRUSGB) on anxiety and HRQoL in men with suspected PCa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>A secondary analysis was performed of a randomized clinical trial including 626 biopsy-naïve patients. All patients underwent mpMRI and TRUSGB. Men with suspicious lesions on mpMRI underwent MRGB prior to TRUSGB. Anxiety was measured by State–Trait Anxiety Inventory-Trait Scale (STAI-6), completed at baseline, directly after mpMRI, MRGB, TRUSGB, after two/three weeks, and six months. HRQoL was measured by EuroQol (EQ-5D-5L), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) and Prostate Cancer Module (QLQ-PR25). Outcomes were compared between patients that underwent mpMRI and TRUSGB and patients that underwent mpMRI, MRGB and TRUSGB. Differences were considered relevant if the 95% confidence interval exceeded the minimal important clinical difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No relevant differences were seen in anxiety scores and generic HRQoL at different time points in patients that underwent mpMRI, TRUSGB and MRGB compared to patients that underwent mpMRI and TRUSGB. Patients that underwent mpMRI, MRGB and TRUSGB reported lower incontinence aid and hormonal treatment-related symptom scores after 6 months compared to patients that underwent mpMRI and TRUSGB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In men suspected of PCa, no differences were observed in anxiety levels or generic HRQoL scores across different diagnostic pathways. However, lower PCa-specific HRQoL subscores were noted in patients who underwent mpMRI, MRGB and TRUSGB.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ruotsalainen Jarno, Kallio Alvar, Korolainen Minna A, Raittinen Paavo, Nevalaita Liina, Korhonen Maarit Jaana, Matikainen Mika Petri
Objectives
To characterize patients diagnosed with prostate cancer (PC) in Finland in 2015–2019 and to follow-up the treatment patterns and healthcare resource use for patients with nonmetastatic PC (nmPC) and metastatic PC (mPC) until the end of 2020.
Patients and Methods
PC cases were identified from the Finnish Cancer Registry and the Care Register for Health Care. Data on inpatient and outpatient diagnoses, outpatient medicine use and sociodemographics were sourced from nationwide registers. Data on Gleason scores and in-hospital medication were available for a subset of the patients.
Results
In total, 25 045 men were diagnosed with PC in 2015–2019. The median age was 71 years, and 28% of these cases were considered as de novo mPC or progressed to mPC within one year from diagnosis. Of the whole cohort with PC, 1368 (5.5%) died within one year (2.3% from PC). Altogether, 70% received active treatment within one year from diagnosis (nmPC cohort: 59%; mPC cohort: 97%). In the nmPC cohort, the most common treatments within the first year were radiotherapy (31%), androgen deprivation therapy (ADT) (25%) and radical prostatectomy (25%). In the mPC cohort, ADT (92%), radiotherapy (38%) and first-generation antiandrogens bicalutamide or flutamide (22%) were the most common first-year treatments. The use of first-generation antiandrogens declined, and the use of second-generation antiandrogens increased towards the end of the study period. The total number of all-cause healthcare contacts per patient year was higher for mPC than for nmPC (61 vs. 29 contacts).
Conclusions
This large nationwide cohort study suggests that, in Finland, PC is generally diagnosed in the localized phase. As expected, the disease burden seems to be higher among men with metastatic disease. The estimated high proportion of patients with mPC at or soon after diagnosis should be interpreted with caution.
{"title":"Characteristics, treatment patterns and healthcare resource use of Finnish men with prostate cancer","authors":"Ruotsalainen Jarno, Kallio Alvar, Korolainen Minna A, Raittinen Paavo, Nevalaita Liina, Korhonen Maarit Jaana, Matikainen Mika Petri","doi":"10.1002/bco2.70098","DOIUrl":"https://doi.org/10.1002/bco2.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To characterize patients diagnosed with prostate cancer (PC) in Finland in 2015–2019 and to follow-up the treatment patterns and healthcare resource use for patients with nonmetastatic PC (nmPC) and metastatic PC (mPC) until the end of 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>PC cases were identified from the Finnish Cancer Registry and the Care Register for Health Care. Data on inpatient and outpatient diagnoses, outpatient medicine use and sociodemographics were sourced from nationwide registers. Data on Gleason scores and in-hospital medication were available for a subset of the patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 25 045 men were diagnosed with PC in 2015–2019. The median age was 71 years, and 28% of these cases were considered as de novo mPC or progressed to mPC within one year from diagnosis. Of the whole cohort with PC, 1368 (5.5%) died within one year (2.3% from PC). Altogether, 70% received active treatment within one year from diagnosis (nmPC cohort: 59%; mPC cohort: 97%). In the nmPC cohort, the most common treatments within the first year were radiotherapy (31%), androgen deprivation therapy (ADT) (25%) and radical prostatectomy (25%). In the mPC cohort, ADT (92%), radiotherapy (38%) and first-generation antiandrogens bicalutamide or flutamide (22%) were the most common first-year treatments. The use of first-generation antiandrogens declined, and the use of second-generation antiandrogens increased towards the end of the study period. The total number of all-cause healthcare contacts per patient year was higher for mPC than for nmPC (61 vs. 29 contacts).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This large nationwide cohort study suggests that, in Finland, PC is generally diagnosed in the localized phase. As expected, the disease burden seems to be higher among men with metastatic disease. The estimated high proportion of patients with mPC at or soon after diagnosis should be interpreted with caution.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khalil Chalhoub, Bawa Nonoa, Vincent Molinier, Vincent Ravery
Objectives
To study the characteristics of penile cancer in French Guiana (FG)— a French overseas department in South America. Indeed, penile cancer is a rare malignancy with significant geographic and socioeconomic disparities. While its epidemiology is well-documented in mainland France, data from FG remain limited.
Patients and Methods
We conducted a retrospective analysis of 22 cases of primary penile cancer diagnosed between 2004 and 2024 at the Centre Hospitalier de Kourou. Demographic, clinical, histopathological, and risk factor data were collected and reviewed.
Results
The average incidence was 1.07 cases per year, with a mean age at diagnosis of 54.9 years. Notably, 19% of patients were under 40 years. The Bushinengue population (descendants of escaped African slaves) accounted for 54.5% of cases. The most common risk factor was lack of circumcision (100%), followed by HPV-16 infection (40.9%). Most tumours were exophytic (68.2%), distal (72.7%), with a median size of 3.5 cm. Squamous cell carcinoma was the predominant histological type (90.9%), with 56.3% being well differentiated. Lymph node involvement was present in 68.2% of patients.
Conclusion
The incidence of penile cancer in FG appears higher than in neighbouring regions, potentially due to regional underreporting and cross-border healthcare access. The disproportionate impact on the Bushinengue population, younger age at diagnosis and advanced disease at presentation likely reflect cultural practices, low circumcision rates and barriers to early care. This first study on penile cancer in FG highlights the role of non-circumcision and HPV-16 infection as major risk factors. Public health efforts should prioritize HPV vaccination and early diagnostic access in vulnerable populations.
{"title":"Penile cancer in French Guiana: Epidemiology, histopathology and clinical aspects","authors":"Khalil Chalhoub, Bawa Nonoa, Vincent Molinier, Vincent Ravery","doi":"10.1002/bco2.70096","DOIUrl":"10.1002/bco2.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To study the characteristics of penile cancer in French Guiana (FG)— a French overseas department in South America. Indeed, penile cancer is a rare malignancy with significant geographic and socioeconomic disparities. While its epidemiology is well-documented in mainland France, data from FG remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of 22 cases of primary penile cancer diagnosed between 2004 and 2024 at the Centre Hospitalier de Kourou. Demographic, clinical, histopathological, and risk factor data were collected and reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average incidence was 1.07 cases per year, with a mean age at diagnosis of 54.9 years. Notably, 19% of patients were under 40 years. The Bushinengue population (descendants of escaped African slaves) accounted for 54.5% of cases. The most common risk factor was lack of circumcision (100%), followed by HPV-16 infection (40.9%). Most tumours were exophytic (68.2%), distal (72.7%), with a median size of 3.5 cm. Squamous cell carcinoma was the predominant histological type (90.9%), with 56.3% being well differentiated. Lymph node involvement was present in 68.2% of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The incidence of penile cancer in FG appears higher than in neighbouring regions, potentially due to regional underreporting and cross-border healthcare access. The disproportionate impact on the Bushinengue population, younger age at diagnosis and advanced disease at presentation likely reflect cultural practices, low circumcision rates and barriers to early care. This first study on penile cancer in FG highlights the role of non-circumcision and HPV-16 infection as major risk factors. Public health efforts should prioritize HPV vaccination and early diagnostic access in vulnerable populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yushan Yang, Johanna Seidl, Simon Udo Engelmann, Maximilian Haas, Roman Mayr, Maximilian Burger, Johannes Breyer, Markus Resch
Introduction
Treatment with anticoagulants or antiplatelet drugs can provoke gross haematuria. In some cases, this may demask urologic malignancies. The goal of this study was to determine the influence of anticoagulants and antiplatelet drugs on the diagnosis and therapy of patients with gross haematuria who presented in the emergency department.
Methods
This retrospective study analysed patients presenting with gross haematuria between January 1st, 2021 and December 31st, 2021 in a single centre university hospital. Information on pre-existing conditions, anticoagulant and antiplatelet medication, and the further diagnostic and treatment course was gathered with a follow-up time until December 31st, 2022.
Results
Nearly half of the 541 patients (49.5%) presenting with gross haematuria were taking anticoagulant or antiplatelet medication. Patients receiving these medications were more likely to need bladder irrigation (p < 0.001). They were also more likely to be hospitalized (p < 0.001) and receive operative intervention (p = 0.011). The most common cause for haematuria was malignant tumours. A malignant urologic disease was diagnosed in 27% of the patients. Among those who were diagnosed with a malignant disease, the number of patients taking anticoagulant medication was higher (p = 0.005). In a follow-up of 3 months, no thromboembolic events were observed after stopping or pausing anticoagulation or antiplatelet treatment.
Conclusion
Clinically significant gross haematuria is often associated with the intake of anticoagulant or antiplatelet medication and can unmask underlying malignant diseases. The intake of anticoagulation or antiplatelet therapy should not be a reason to postpone diagnostic and therapeutic measures.
{"title":"Gross haematuria in the era of anticoagulant therapy – Implications on treatment and diagnostic approaches in a large emergency department patient population","authors":"Yushan Yang, Johanna Seidl, Simon Udo Engelmann, Maximilian Haas, Roman Mayr, Maximilian Burger, Johannes Breyer, Markus Resch","doi":"10.1002/bco2.70099","DOIUrl":"10.1002/bco2.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Treatment with anticoagulants or antiplatelet drugs can provoke gross haematuria. In some cases, this may demask urologic malignancies. The goal of this study was to determine the influence of anticoagulants and antiplatelet drugs on the diagnosis and therapy of patients with gross haematuria who presented in the emergency department.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analysed patients presenting with gross haematuria between January 1st, 2021 and December 31st, 2021 in a single centre university hospital. Information on pre-existing conditions, anticoagulant and antiplatelet medication, and the further diagnostic and treatment course was gathered with a follow-up time until December 31st, 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nearly half of the 541 patients (49.5%) presenting with gross haematuria were taking anticoagulant or antiplatelet medication. Patients receiving these medications were more likely to need bladder irrigation (p < 0.001). They were also more likely to be hospitalized (p < 0.001) and receive operative intervention (p = 0.011). The most common cause for haematuria was malignant tumours. A malignant urologic disease was diagnosed in 27% of the patients. Among those who were diagnosed with a malignant disease, the number of patients taking anticoagulant medication was higher (p = 0.005). In a follow-up of 3 months, no thromboembolic events were observed after stopping or pausing anticoagulation or antiplatelet treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinically significant gross haematuria is often associated with the intake of anticoagulant or antiplatelet medication and can unmask underlying malignant diseases. The intake of anticoagulation or antiplatelet therapy should not be a reason to postpone diagnostic and therapeutic measures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin Parkin, Gavin Lamb, Nikolas Arestis, Anna Brown, Zack Slevin, Jane Hendry, Steve Leung, Julian Y. Keanie, James Blackmur, Sara Ramsey, Ross N. Clark, Abdel Hamed
Introduction
Aim to design and test a suitable risk-targeted imaging protocol for follow-up of complex renal cysts categorised IIF.
Patients and Methods
The Scottish Protocol was designed at a joint meeting with the Scottish Urological and Scottish Radiological societies according to published data on imaging modality, classification criteria and interval progression of Bosniak IIF renal cysts. Patients were listed prospectively to follow this protocol across five NHS health boards within Scotland. Patient data accessed between Aug 21 and Feb 22. All patients with a confirmed Bosniak IIF cyst on computerised tomography or magnetic resonance imaging after multi-disciplinary team review were included. Patients were reviewed according to progression, interval, treatment and histology.
Results
A total of 160 patients were identified with Bosniak IIF cysts. 98 (61%) were male (age range 29–97, median 67, IQR 57–75). Thirty-four patients completed the proposed 4-year follow-up. Seventeen patients advanced to treatment, with 15 patients having confirmed malignancy (9.4% of the total database). The mean time from diagnosis to intervention was 1 year and 2 months (range 34 to 1172 days). No patients developed metastatic disease during follow-up.
Conclusions
The Scottish Complex Renal Cyst Protocol provides a risk-targeted imaging framework that reliably identifies patients with progressive lesions prior to the development of advanced disease. Incidence of progression is consistent with published data of 9.4% most commonly within 2 years, and not beyond 4 years of surveillance.
{"title":"Scottish National Complex Renal Cyst Surveillance Protocol","authors":"Benjamin Parkin, Gavin Lamb, Nikolas Arestis, Anna Brown, Zack Slevin, Jane Hendry, Steve Leung, Julian Y. Keanie, James Blackmur, Sara Ramsey, Ross N. Clark, Abdel Hamed","doi":"10.1002/bco2.70094","DOIUrl":"10.1002/bco2.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Aim to design and test a suitable risk-targeted imaging protocol for follow-up of complex renal cysts categorised IIF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>The Scottish Protocol was designed at a joint meeting with the Scottish Urological and Scottish Radiological societies according to published data on imaging modality, classification criteria and interval progression of Bosniak IIF renal cysts. Patients were listed prospectively to follow this protocol across five NHS health boards within Scotland. Patient data accessed between Aug 21 and Feb 22. All patients with a confirmed Bosniak IIF cyst on computerised tomography or magnetic resonance imaging after multi-disciplinary team review were included. Patients were reviewed according to progression, interval, treatment and histology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 160 patients were identified with Bosniak IIF cysts. 98 (61%) were male (age range 29–97, median 67, IQR 57–75). Thirty-four patients completed the proposed 4-year follow-up. Seventeen patients advanced to treatment, with 15 patients having confirmed malignancy (9.4% of the total database). The mean time from diagnosis to intervention was 1 year and 2 months (range 34 to 1172 days). No patients developed metastatic disease during follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Scottish Complex Renal Cyst Protocol provides a risk-targeted imaging framework that reliably identifies patients with progressive lesions prior to the development of advanced disease. Incidence of progression is consistent with published data of 9.4% most commonly within 2 years, and not beyond 4 years of surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The number of ureterorenoscopies in Germany is rising. Hospitals must operate economically while ensuring quality. Environmental assessment of medical procedures is gaining focus. This study aims to perform a comparative analysis of the economic and ecological aspects of single-use versus reusable ureterorenoscopes using real-world routine data, acknowledging their trade-offs between hygienic advantages, costs and environmental impacts.
Materials and Methods
A total of 210 ureterorenoscopy cases (2022/2023) at the University Hospital of Würzburg were evaluated. A simulation assessed the impact of the OPS code 5-98b.0 on DRG (diagnosis-related groups) classification and reimbursement. Economic analysis included acquisition, repair and sterilization costs, while ecological assessment considered manufacturing, waste, reprocessing, transport and repair.
Results
In 44.3% of cases, use of OPS code 5-98b.0 resulted in an upgraded DRG (L20B instead of L20C), yielding approximately €62 000 in additional revenue over 2 years. This was outweighed by roughly €147 000 in extra costs for single-use devices, assuming repair costs for reusable devices remained around €300 per case. Environmentally, single-use devices generated 42 kg more CO2 per 100 procedures.
Conclusion
Single-use ureterorenoscopes are economically justifiable only when reusable devices incur frequent repair costs. Reusable scopes perform better ecologically due to lower CO2 emissions. Instrument choice should be guided by each clinic's specific economic and environmental context.
{"title":"Green endoscopy: Economic and ecological evaluation of single-use versus reusable ureterorenoscopes","authors":"Marcel Schwinger, Charis Kalogirou","doi":"10.1002/bco2.70100","DOIUrl":"10.1002/bco2.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The number of ureterorenoscopies in Germany is rising. Hospitals must operate economically while ensuring quality. Environmental assessment of medical procedures is gaining focus. This study aims to perform a comparative analysis of the economic and ecological aspects of single-use versus reusable ureterorenoscopes using real-world routine data, acknowledging their trade-offs between hygienic advantages, costs and environmental impacts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 210 ureterorenoscopy cases (2022/2023) at the University Hospital of Würzburg were evaluated. A simulation assessed the impact of the OPS code 5-98b.0 on DRG (diagnosis-related groups) classification and reimbursement. Economic analysis included acquisition, repair and sterilization costs, while ecological assessment considered manufacturing, waste, reprocessing, transport and repair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 44.3% of cases, use of OPS code 5-98b.0 resulted in an upgraded DRG (L20B instead of L20C), yielding approximately €62 000 in additional revenue over 2 years. This was outweighed by roughly €147 000 in extra costs for single-use devices, assuming repair costs for reusable devices remained around €300 per case. Environmentally, single-use devices generated 42 kg more CO<sub>2</sub> per 100 procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Single-use ureterorenoscopes are economically justifiable only when reusable devices incur frequent repair costs. Reusable scopes perform better ecologically due to lower CO<sub>2</sub> emissions. Instrument choice should be guided by each clinic's specific economic and environmental context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angelo Cormio, Vineet Gauhar, Bhaskar K. Somani, Jaisukh Kalathia, Nariman Gadzhiev, Marek Zawadzki, Mahmoud Laymon, Karl Tan, Gopal Ramdas Tak, Theodoros Tokas, Madhu Sudan Agrawal, Jean de la Rosette, Kremena Petkova, Kazumi Taguchi, Dmitriy Gorelov, Alexey G. Martov, Leonardo Gomes Lopes, Mehmet ilker Gökce, Wissam Kamal, Stefania Ferretti, Devang Desai, Yadgar Abduljabbar Shwani, Khi Yung Fong, Steffi Kar Kei Yuen, Andreas Skolarikos, Marcos Cepeda, Thomas R. W. Herrmann, Daniele Castellani
Objectives
To compare perioperative outcomes, complications and stone-free rates (SFRs) between laser and non-laser lithotripsy in suction-assisted mini-PCNL (SM-PCNL).
Subjects and Methods
This prospective multicentre study enrolled adults with normal kidneys undergoing SM-PCNL (14–22 Fr) across 30 international centres (March–November 2024). Patients were divided into laser (Group 1) and non-laser (Group 2) groups. Propensity score matching (2:1) was performed based on age, sex, Guy's score and patient position. Primary outcomes were complications and 30-day SFR assessed by CT. Multivariable logistic regression identified predictors of complete stone clearance and complications.
Results
After matching, 748 patients were analysed (Group 1: 448; Group 2: 300). Non-laser devices were associated with shorter lithotripsy (12 vs 18 min, p < 0.001) and operative times (37 vs 45 min, p < 0.001) and higher SFR (intraoperative: 91.3% vs 80.7%; 30-day: 87.7% vs 82.1%). However, transfusions (3.3% vs 0.2%), pelvic perforation and pleural injury (each 3.0%) were more common in Group 2. On multivariable analysis, single-step dilation (OR 3.05) and sheath sizes of 16.5–18 Fr (OR 1.98) or 20–22 Fr (OR 2.72) were associated with higher odds of stone-free status, while skin-to-stone distance >8 cm (OR 0.5) and combined fluoroscopy/ultrasound access (0.28) reduced this likelihood. Stone volume (OR 1.03), serial dilation with non-metal dilators (OR 2.64) and combined fluoroscopy/ultrasound access (OR 2.11) were factors associated with higher odds of complications. The lithotripsy technology had no direct bearing on complications.
Conclusions
Both laser and non-laser lithotripsy are effective in SM-PCNL. Non-laser devices improve efficiency and lasers were preferentially used with 14–18 fr access tracts.
{"title":"Comparing laser vs mechanical lithotripsy in suction mini-PCNL for kidney stone disease: A prospective multicentre study by the endourology section of EAU","authors":"Angelo Cormio, Vineet Gauhar, Bhaskar K. Somani, Jaisukh Kalathia, Nariman Gadzhiev, Marek Zawadzki, Mahmoud Laymon, Karl Tan, Gopal Ramdas Tak, Theodoros Tokas, Madhu Sudan Agrawal, Jean de la Rosette, Kremena Petkova, Kazumi Taguchi, Dmitriy Gorelov, Alexey G. Martov, Leonardo Gomes Lopes, Mehmet ilker Gökce, Wissam Kamal, Stefania Ferretti, Devang Desai, Yadgar Abduljabbar Shwani, Khi Yung Fong, Steffi Kar Kei Yuen, Andreas Skolarikos, Marcos Cepeda, Thomas R. W. Herrmann, Daniele Castellani","doi":"10.1002/bco2.70075","DOIUrl":"10.1002/bco2.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare perioperative outcomes, complications and stone-free rates (SFRs) between laser and non-laser lithotripsy in suction-assisted mini-PCNL (SM-PCNL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects and Methods</h3>\u0000 \u0000 <p>This prospective multicentre study enrolled adults with normal kidneys undergoing SM-PCNL (14–22 Fr) across 30 international centres (March–November 2024). Patients were divided into laser (Group 1) and non-laser (Group 2) groups. Propensity score matching (2:1) was performed based on age, sex, Guy's score and patient position. Primary outcomes were complications and 30-day SFR assessed by CT. Multivariable logistic regression identified predictors of complete stone clearance and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After matching, 748 patients were analysed (Group 1: 448; Group 2: 300). Non-laser devices were associated with shorter lithotripsy (12 vs 18 min, p < 0.001) and operative times (37 vs 45 min, p < 0.001) and higher SFR (intraoperative: 91.3% vs 80.7%; 30-day: 87.7% vs 82.1%). However, transfusions (3.3% vs 0.2%), pelvic perforation and pleural injury (each 3.0%) were more common in Group 2. On multivariable analysis, single-step dilation (OR 3.05) and sheath sizes of 16.5–18 Fr (OR 1.98) or 20–22 Fr (OR 2.72) were associated with higher odds of stone-free status, while skin-to-stone distance >8 cm (OR 0.5) and combined fluoroscopy/ultrasound access (0.28) reduced this likelihood. Stone volume (OR 1.03), serial dilation with non-metal dilators (OR 2.64) and combined fluoroscopy/ultrasound access (OR 2.11) were factors associated with higher odds of complications. The lithotripsy technology had no direct bearing on complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both laser and non-laser lithotripsy are effective in SM-PCNL. Non-laser devices improve efficiency and lasers were preferentially used with 14–18 fr access tracts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samantha Shekar, Megan Crumbaker, Anthony Joshua, Andrew Yam, Phillip Stricker, Carlo Yuen, David Ende, Benjamin Namdarian, James Thompson, Raji Kooner, Gordon O'Neill, Jeremy Mo, Hao-Wen Sim, George Hruby, Farshad Kasraei, Annie Ho, Jeremy De Leon
Objectives
This work aimed to report real-world outcomes from the use of SBRT to treat ADT naïve, PSMA-detected oligometastatic prostate cancer (OPCa) and to assess disease and treatment characteristics in this heterogeneous population intersect or impact treatment response.
Subjects and Methods
This retrospective single-institution study examined PSMA-PET–detected oligometastases (n = 1–5) in ADT-naïve OPCa patients, treated with metastasis-directed therapy (MDT) using SBRT delivered via MRI- or CT-guided linear accelerator. Primary endpoint was biochemical progression free survival (PSA ≥ 25% if baseline <2 ng/mL or ≥2 ng/mL from nadir if baseline ≥ 2 ng/mL, start of systemic therapy, death). Secondary endpoints included time to PSA progression, time to next intervention, ADT-free survival. Univariate and multivariate analyses were conducted for prognostic factors associated with bPFS, time to PSA progression and PSA50 response. Baseline clinical and treatment characteristics, PSA responses and local failure rates were analysed. Those with castrate-resistant disease, prior systemic therapy or interval follow-up of <6 weeks were excluded.
Results
Sixty-seven patients treated from January 2019 to August 2024 were analysed with a median follow-up of 18.8 months. Ninety-three oligometastatic lesions were treated; 55.3% were treated for nodal disease, 38.8% bone and 5% with lung disease. All lesions were PSMA-detected with median SUVmax 6.3. Median bPFS was 22.1 m; TTNI was 28.8 m. Lower initial T stage and longer duration from OPCa diagnosis to MDT were associated with prolonged bPFS. Lower T stage and PSA doubling time >3 m at MDT were associated with prolonged time to PSA progression. Median PSA fall was 68.9%; PSA 50% response was observed in 55.2%. Twenty-nine patients (43%) had a complete metabolic response after MDT. Median ADT-free survival was not reached.
Conclusions
MDT in PSMA-PET-detected OPCa can provide clinically meaningful disease control in a subset of patients. This study supports this approach but warrants continued prospective study and exploration into the castrate-resistant setting.
{"title":"Real-world clinical outcomes of oligometastatic prostate cancer using SBRT: An Australian experience","authors":"Samantha Shekar, Megan Crumbaker, Anthony Joshua, Andrew Yam, Phillip Stricker, Carlo Yuen, David Ende, Benjamin Namdarian, James Thompson, Raji Kooner, Gordon O'Neill, Jeremy Mo, Hao-Wen Sim, George Hruby, Farshad Kasraei, Annie Ho, Jeremy De Leon","doi":"10.1002/bco2.70055","DOIUrl":"10.1002/bco2.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This work aimed to report real-world outcomes from the use of SBRT to treat ADT naïve, PSMA-detected oligometastatic prostate cancer (OPCa) and to assess disease and treatment characteristics in this heterogeneous population intersect or impact treatment response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects and Methods</h3>\u0000 \u0000 <p>This retrospective single-institution study examined PSMA-PET–detected oligometastases (<i>n</i> = 1–5) in ADT-naïve OPCa patients, treated with metastasis-directed therapy (MDT) using SBRT delivered via MRI- or CT-guided linear accelerator. Primary endpoint was biochemical progression free survival (PSA ≥ 25% if baseline <2 ng/mL or ≥2 ng/mL from nadir if baseline ≥ 2 ng/mL, start of systemic therapy, death). Secondary endpoints included time to PSA progression, time to next intervention, ADT-free survival. Univariate and multivariate analyses were conducted for prognostic factors associated with bPFS, time to PSA progression and PSA50 response. Baseline clinical and treatment characteristics, PSA responses and local failure rates were analysed. Those with castrate-resistant disease, prior systemic therapy or interval follow-up of <6 weeks were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-seven patients treated from January 2019 to August 2024 were analysed with a median follow-up of 18.8 months. Ninety-three oligometastatic lesions were treated; 55.3% were treated for nodal disease, 38.8% bone and 5% with lung disease. All lesions were PSMA-detected with median SUVmax 6.3. Median bPFS was 22.1 m; TTNI was 28.8 m. Lower initial T stage and longer duration from OPCa diagnosis to MDT were associated with prolonged bPFS. Lower T stage and PSA doubling time >3 m at MDT were associated with prolonged time to PSA progression. Median PSA fall was 68.9%; PSA 50% response was observed in 55.2%. Twenty-nine patients (43%) had a complete metabolic response after MDT. Median ADT-free survival was not reached.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MDT in PSMA-PET-detected OPCa can provide clinically meaningful disease control in a subset of patients. This study supports this approach but warrants continued prospective study and exploration into the castrate-resistant setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the real-world clinical use of maintenance bacillus Calmette-Guérin (mBCG) therapy for high-risk non-muscle-invasive bladder cancer (HR-NMIBC) in Japan.
Patients and methods
This multicentre, retrospective, observational study included patients who received intravesical mBCG for HR-NMIBC following transurethral resection of bladder tumours between 2000 and 2023, and who were included in the Japan Urological Oncology Group registry database. Assessments included real-world mBCG treatment duration, the completion rate of planned treatment, reasons for treatment discontinuation and mBCG effectiveness.
Results
The study included 886 patients (median [interquartile range] age 71.0 [65.0–77.0] years; male, 83.5%). The median (interquartile range) treatment duration was 11 (6–17) months, with 43.8% of patients completing the physician-determined planned treatment duration. The percentage of patients with mBCG treatment duration of 3, 6, 12, 18 and 24 months was 21.6%, 21.8%, 31.3%, 7.6% and 9.2%, respectively. Adverse events were the most common reason for mBCG discontinuation (49.1%). The recurrence-free survival, progression-free survival, overall survival and bladder preservation durations were numerically shorter in patients treated for 3 months.
Conclusions
This first comprehensive study of the real-world use of mBCG treatment for HR-NMIBC in Japan found diverse treatment patterns, with approximately 40% of patients receiving mBCG for <1 year, which is shorter than the guideline-recommended treatment duration. The results underscore the need for early and sustained adverse event management, and provide valuable reference data for optimising mBCG therapy in clinical practice.
{"title":"Real-world use of maintenance bacillus Calmette-Guérin therapy in patients with non-muscle-invasive bladder cancer in Japan: ASUKA study","authors":"Makito Miyake, Jumpei Tokumaru, Hiroshi Oi, Hiroshi Kitagawa, Kiyohide Fujimoto, Naotaka Nishiyama, Hiroshi Kitamura","doi":"10.1002/bco2.70091","DOIUrl":"10.1002/bco2.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the real-world clinical use of maintenance bacillus Calmette-Guérin (mBCG) therapy for high-risk non-muscle-invasive bladder cancer (HR-NMIBC) in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This multicentre, retrospective, observational study included patients who received intravesical mBCG for HR-NMIBC following transurethral resection of bladder tumours between 2000 and 2023, and who were included in the Japan Urological Oncology Group registry database. Assessments included real-world mBCG treatment duration, the completion rate of planned treatment, reasons for treatment discontinuation and mBCG effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 886 patients (median [interquartile range] age 71.0 [65.0–77.0] years; male, 83.5%). The median (interquartile range) treatment duration was 11 (6–17) months, with 43.8% of patients completing the physician-determined planned treatment duration. The percentage of patients with mBCG treatment duration of 3, 6, 12, 18 and 24 months was 21.6%, 21.8%, 31.3%, 7.6% and 9.2%, respectively. Adverse events were the most common reason for mBCG discontinuation (49.1%). The recurrence-free survival, progression-free survival, overall survival and bladder preservation durations were numerically shorter in patients treated for 3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This first comprehensive study of the real-world use of mBCG treatment for HR-NMIBC in Japan found diverse treatment patterns, with approximately 40% of patients receiving mBCG for <1 year, which is shorter than the guideline-recommended treatment duration. The results underscore the need for early and sustained adverse event management, and provide valuable reference data for optimising mBCG therapy in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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