Kristijan Skok, Lukas Scheipner, Sebastian Mannweiler, Karl Kashofer, Ariane Aigelsreiter, Ivana Milosevic, Conrad Leitsmann, Herbert Augustin, Martina Rößmann-Tsybrovskyy, Sascha Ahyai, Bernadette Liegl-Atzwanger, Johannes Mischinger
To assess the diagnostic accuracy, workflow feasibility, and downstream compatibility of fluorescence confocal microscopy (Histolog® Scanner [HS]; SamanTree Medical SA, Lausanne, Switzerland) compared with frozen section (FS) for intraoperative margin evaluation (IME) during nerve-sparing robot-assisted radical prostatectomy (RARP).
{"title":"Feasibility and workflow analysis of confocal microscopy in robot-assisted prostatectomy","authors":"Kristijan Skok, Lukas Scheipner, Sebastian Mannweiler, Karl Kashofer, Ariane Aigelsreiter, Ivana Milosevic, Conrad Leitsmann, Herbert Augustin, Martina Rößmann-Tsybrovskyy, Sascha Ahyai, Bernadette Liegl-Atzwanger, Johannes Mischinger","doi":"10.1111/bju.70157","DOIUrl":"https://doi.org/10.1111/bju.70157","url":null,"abstract":"To assess the diagnostic accuracy, workflow feasibility, and downstream compatibility of fluorescence confocal microscopy (Histolog® Scanner [HS]; SamanTree Medical SA, Lausanne, Switzerland) compared with frozen section (FS) for intraoperative margin evaluation (IME) during nerve-sparing robot-assisted radical prostatectomy (RARP).","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"295 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on 'Impact of perioperative nutrition on recovery after radical cystectomy: a randomised trial'.","authors":"Longtu Ma, Zeming Qiu, Zhilong Dong","doi":"10.1111/bju.70160","DOIUrl":"https://doi.org/10.1111/bju.70160","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth Day, Francesco Pio Bizzarri, Elizabeth Waine, Rebecca Martin, Adam W. Nelson, Alexandra J. Colquhoun, Helena Burden, Benjamin Ayres, Vishwanath Hanchanale, Jonathan Aning, James Douglas, Niyati Lobo
Objective To characterise contemporary practice patterns in female radical cystectomy (RC) across the UK and Ireland, focusing on preoperative counselling, operative strategies, and postoperative care. Subjects and Methods A 36‐item survey was distributed to consultant urologists performing RC, identified via the British Association of Urological Surgeons (BAUS) and Cancer Alliances. The questionnaire addressed surgeon demographics, preoperative assessment and counselling, operative decision‐making including organ‐ and nerve‐sparing techniques, and survivorship care. Responses were analysed descriptively; group comparisons were made using the Wilcoxon rank‐sum and Fisher's exact tests. Results A total of 64 surgeons responded (56.1% [64/114]), representing 41 cystectomy centres (70.7% [41/58]). Preoperative assessment of sexual activity (68.8%) and menopausal status (78.1%) was common, whereas sexual orientation (15.6%) and prolapse (26.6%) were rarely addressed. Female surgeons were significantly more likely to enquire about menopausal status ( P = 0.025). Counselling on sexual dysfunction (98.4%) and vaginal shortening (96.9%) was routine, but other complications, including prolapse (68.8%), menopause (82.8%), or fistula (6.3%), were inconsistently discussed. Organ‐sparing practice varied: 28.1% rarely or never performed organ preservation, citing oncological concerns. High‐volume centres were more likely to offer organ‐sparing RC ( P = 0.013). Over half reported inadequate access to female‐specific rehabilitation services, with most centres lacking formal pathways for vaginal complications. Conclusions Female RC practice across the UK and Ireland is heterogeneous, with clear gaps in preoperative counselling, uptake of organ‐sparing techniques, and survivorship care. There is an urgent need for standardised, evidence‐based pathways and consensus guidance to optimise outcomes for female patients.
{"title":"Contemporary practice patterns in female radical cystectomy: results of a UK and Ireland survey","authors":"Elizabeth Day, Francesco Pio Bizzarri, Elizabeth Waine, Rebecca Martin, Adam W. Nelson, Alexandra J. Colquhoun, Helena Burden, Benjamin Ayres, Vishwanath Hanchanale, Jonathan Aning, James Douglas, Niyati Lobo","doi":"10.1111/bju.70159","DOIUrl":"https://doi.org/10.1111/bju.70159","url":null,"abstract":"Objective To characterise contemporary practice patterns in female radical cystectomy (RC) across the UK and Ireland, focusing on preoperative counselling, operative strategies, and postoperative care. Subjects and Methods A 36‐item survey was distributed to consultant urologists performing RC, identified via the British Association of Urological Surgeons (BAUS) and Cancer Alliances. The questionnaire addressed surgeon demographics, preoperative assessment and counselling, operative decision‐making including organ‐ and nerve‐sparing techniques, and survivorship care. Responses were analysed descriptively; group comparisons were made using the Wilcoxon rank‐sum and Fisher's exact tests. Results A total of 64 surgeons responded (56.1% [64/114]), representing 41 cystectomy centres (70.7% [41/58]). Preoperative assessment of sexual activity (68.8%) and menopausal status (78.1%) was common, whereas sexual orientation (15.6%) and prolapse (26.6%) were rarely addressed. Female surgeons were significantly more likely to enquire about menopausal status ( <jats:italic>P</jats:italic> = 0.025). Counselling on sexual dysfunction (98.4%) and vaginal shortening (96.9%) was routine, but other complications, including prolapse (68.8%), menopause (82.8%), or fistula (6.3%), were inconsistently discussed. Organ‐sparing practice varied: 28.1% rarely or never performed organ preservation, citing oncological concerns. High‐volume centres were more likely to offer organ‐sparing RC ( <jats:italic>P</jats:italic> = 0.013). Over half reported inadequate access to female‐specific rehabilitation services, with most centres lacking formal pathways for vaginal complications. Conclusions Female RC practice across the UK and Ireland is heterogeneous, with clear gaps in preoperative counselling, uptake of organ‐sparing techniques, and survivorship care. There is an urgent need for standardised, evidence‐based pathways and consensus guidance to optimise outcomes for female patients.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"216 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Methodological clarifications of perioperative nutritional outcomes: a response to Ma et al.","authors":"Mohammed Lotfi Amer,Sameh Fawzy Elnasharty","doi":"10.1111/bju.70158","DOIUrl":"https://doi.org/10.1111/bju.70158","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"2 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVESTo determine the short-term oncological results and safety of the ProFocal Laser Therapy for Prostate Tissue Ablation (PFLT-PC) trial, the first phase II clinical trial of ProFocal® (Medlogical Innovations, Sydney, Australia), a novel, cooled laser focal therapy (cLFT) device for prostate cancer (PCa) treatment.PATIENTS AND METHODSMen with localised PCa, prostate-specific antigen (PSA) level ≤15 ng/mL, T stage ≤T2c, International Society of Urological Pathology (ISUP) score 2-3 concordant with multiparametric magnetic resonance imaging (mpMRI) visible disease were recruited for this trial (Australian and New Zealand Clinical Trial Registry [ACTRN]12618001774213p) at Nepean Hospital, Australia. The cLFT was performed under general anaesthesia as a day procedure. Primary outcome was adequacy of tissue ablation assessed by mpMRI within 72 h and biopsy at 3 months. Secondary outcomes of functional measures were assessed using validated questionnaires (International Prostate Symptom Score, Sexual Health Inventory for Men [SHIM], Expanded Prostate cancer Index Composite [EPIC], 12-item Short-Form Health Survey). Complications and adverse events within 90 days were reported using Clavien-Dindo classification grading.RESULTSA total of 100 patients were recruited. The median (interquartile range [IQR]) age was 66 (60-72) years, PSA level 5.9 (3.9-7.6) ng/mL, prostate volume 39 (30-51) mL and MRI lesion volume 0.84 (0.57-1.2) mL. The median (IQR) treatment time was 60 (47-70) min. In all, 84% had no ISUP Grade Group ≥2 PCa in their 3-month treatment zone biopsies. Erectile dysfunction was reported in 12% of the men, with a 15% mean decline in the SHIM and EPIC-sexual domains scores. There was a 4.5% decrease on EPIC-urinary domain scores. There was no decline in any other functional measures. This study's main limitations were the absence of a control group and the short follow-up.CONCLUSIONSThe PFLT-PC trial demonstrates that at 3 months, cLFT using the ProFocal device provides an 84% treatment success with low morbidity.
{"title":"Focal therapy using a novel cooled laser device for prostate cancer: early trial results.","authors":"Jonathan Kam,Bishoy Hanna,Stuart Jackson,Stephen McCombie,George McClintock,Matthew J Roberts,Jeremy Teoh,Mohan Arianayagam,Bertram Canagasingham,Ahmed Saeed Goolam,Nicola Jeffery,Matthew Winter,Mohamed Khadra,Raymond Ko,Nicholas Mehan,Isaac Thangasamy,Celi Varol","doi":"10.1111/bju.70150","DOIUrl":"https://doi.org/10.1111/bju.70150","url":null,"abstract":"OBJECTIVESTo determine the short-term oncological results and safety of the ProFocal Laser Therapy for Prostate Tissue Ablation (PFLT-PC) trial, the first phase II clinical trial of ProFocal® (Medlogical Innovations, Sydney, Australia), a novel, cooled laser focal therapy (cLFT) device for prostate cancer (PCa) treatment.PATIENTS AND METHODSMen with localised PCa, prostate-specific antigen (PSA) level ≤15 ng/mL, T stage ≤T2c, International Society of Urological Pathology (ISUP) score 2-3 concordant with multiparametric magnetic resonance imaging (mpMRI) visible disease were recruited for this trial (Australian and New Zealand Clinical Trial Registry [ACTRN]12618001774213p) at Nepean Hospital, Australia. The cLFT was performed under general anaesthesia as a day procedure. Primary outcome was adequacy of tissue ablation assessed by mpMRI within 72 h and biopsy at 3 months. Secondary outcomes of functional measures were assessed using validated questionnaires (International Prostate Symptom Score, Sexual Health Inventory for Men [SHIM], Expanded Prostate cancer Index Composite [EPIC], 12-item Short-Form Health Survey). Complications and adverse events within 90 days were reported using Clavien-Dindo classification grading.RESULTSA total of 100 patients were recruited. The median (interquartile range [IQR]) age was 66 (60-72) years, PSA level 5.9 (3.9-7.6) ng/mL, prostate volume 39 (30-51) mL and MRI lesion volume 0.84 (0.57-1.2) mL. The median (IQR) treatment time was 60 (47-70) min. In all, 84% had no ISUP Grade Group ≥2 PCa in their 3-month treatment zone biopsies. Erectile dysfunction was reported in 12% of the men, with a 15% mean decline in the SHIM and EPIC-sexual domains scores. There was a 4.5% decrease on EPIC-urinary domain scores. There was no decline in any other functional measures. This study's main limitations were the absence of a control group and the short follow-up.CONCLUSIONSThe PFLT-PC trial demonstrates that at 3 months, cLFT using the ProFocal device provides an 84% treatment success with low morbidity.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"77 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146056496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION AND OBJECTIVESLuminal Index magnetic resonance imaging (LI-MRI) is a novel technique that has recently been proposed for prostate cancer (PCa) characterisation. It is based on multi-echo T2-weighted sequences and requires <10 min to be performed. However, evidence on its diagnostic performance in the diagnostic evaluation of PCa is lacking. The 'Comparison of diagnostic accuracy of Luminal Index and standard of care MRI for Accelerated deTEction of prostate cancer' (CLIMATE) trial aims to compare the diagnostic accuracy of LI-MRI and standard of care (SOC) MRI (multiparametric or biparametric MRI) for the detection of clinically significant PCa (csPCa).TRIAL DESIGNThe CLIMATE trial is a prospective, multicentre, paired, non-randomised comparative trial of LI-MRI and SOC MRI targeted biopsy in participants with clinically suspected PCa.ENDPOINTSThe primary endpoint of the trial is to compare the per-participant diagnostic accuracy of LI-MRI and SOC MRI for csPCa using targeted biopsies as the standard of reference.PATIENTS AND METHODSAdult men (aged ≥18 years) with clinical suspicion of PCa and no prior PCa diagnosis or treatment will be invited. Each participant will undergo LI-MRI and SOC MRI in a single scan session, with each test interpreted without knowledge of the other test images or results. LI-MRI and SOC MRI will be reported on a 1-5 scale for suspicion of tumour (Likert scale or Prostate Imaging-Reporting and Data System). Targeted biopsies will be taken for any suspicious lesions detected, defined as MRI score of ≥3.TRIAL REGISTRATIONClinicalTrials.gov Registry (NCT05020522).
{"title":"The 'Comparison of diagnostic accuracy of Luminal Index and standard of care MRI for Accelerated deTEction of prostate cancer' (CLIMATE) trial protocol.","authors":"Tarek Al-Hammouri,Giorgio Brembilla,Mrishta Brizmohun,Juel Tuazon,Joey Clemente,Manju Mathew,Ingrid Potyka,Chris Brew-Graves,Julia Markus,Francesco Giganti,Tom Parry,Aiman Haider,Sue Mallett,Tim Dudderidge,Tristan Barrett,Gerhardt Attard,Caroline Moore,Shonit Punwani, ","doi":"10.1111/bju.70108","DOIUrl":"https://doi.org/10.1111/bju.70108","url":null,"abstract":"INTRODUCTION AND OBJECTIVESLuminal Index magnetic resonance imaging (LI-MRI) is a novel technique that has recently been proposed for prostate cancer (PCa) characterisation. It is based on multi-echo T2-weighted sequences and requires <10 min to be performed. However, evidence on its diagnostic performance in the diagnostic evaluation of PCa is lacking. The 'Comparison of diagnostic accuracy of Luminal Index and standard of care MRI for Accelerated deTEction of prostate cancer' (CLIMATE) trial aims to compare the diagnostic accuracy of LI-MRI and standard of care (SOC) MRI (multiparametric or biparametric MRI) for the detection of clinically significant PCa (csPCa).TRIAL DESIGNThe CLIMATE trial is a prospective, multicentre, paired, non-randomised comparative trial of LI-MRI and SOC MRI targeted biopsy in participants with clinically suspected PCa.ENDPOINTSThe primary endpoint of the trial is to compare the per-participant diagnostic accuracy of LI-MRI and SOC MRI for csPCa using targeted biopsies as the standard of reference.PATIENTS AND METHODSAdult men (aged ≥18 years) with clinical suspicion of PCa and no prior PCa diagnosis or treatment will be invited. Each participant will undergo LI-MRI and SOC MRI in a single scan session, with each test interpreted without knowledge of the other test images or results. LI-MRI and SOC MRI will be reported on a 1-5 scale for suspicion of tumour (Likert scale or Prostate Imaging-Reporting and Data System). Targeted biopsies will be taken for any suspicious lesions detected, defined as MRI score of ≥3.TRIAL REGISTRATIONClinicalTrials.gov Registry (NCT05020522).","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"28 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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