{"title":"Cystectomy and lymphadenectomy – we now node how far to go!","authors":"Jordan Santucci, Sachin Perera, Niranjan Sathianathen, Marlon Perera, Declan Murphy, Nathan Lawrentschuk","doi":"10.1111/bju.16599","DOIUrl":"https://doi.org/10.1111/bju.16599","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"28 15 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678605","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}
Davide Perri, Umberto Besana, Matteo Maltagliati, Andrea Pacchetti, Tommaso Calcagnile, Antonio Luigi Pastore, Javier Romero-Otero, Salvatore Micali, Alexander Govorov, Bashkar Somani, Evangelos Liatsikos, Thomas Knoll, Bernardo Rocco, Giorgio Bozzini
Objective: To assess differences in bleeding risk between retrograde intrarenal surgery (RIRS) and minimally invasive miniaturised percutaneous nephrolithotomy (mini-PCNL) for 10-20 mm renal stones.
Patients and methods: A total of 176 patients with a renal stone between 10 and 20 mm were treated. For all patients the Stone Management According to Size-Hardness (SMASH) score was calculated: Hounsfield units × stone maximum size (cm)/100. Patients with score of <15 underwent RIRS (90 patients, Group A), whereas patients with score ≥15 underwent mini-PCNL (86 patients, Group B). In both groups the Cyber Ho laser was used. A statistical analysis was carried out to assess differences in the risk of bleeding.
Results: Preoperative features were comparable. The mean maximum stone diameter was 17.1 and 16.8 mm in Groups A and B, respectively (P = 0.13). The stone-free rate was comparable (87.8% vs 95.3%, P = 0.07). The overall complication rate was 14.4% and 18.6% in Groups A and B, respectively (P = 0.09). Gross haematuria was observed in five cases (5.5%) after RIRS and seven (8.1%) after mini-PCNL (P = 0.07). The mean haemoglobin drop was 12 and 2 g/L at the first and third postoperative day after RIRS vs 17 and 3 g/L after mini-PCNL (P = 0.06 and P = 0.21, respectively). Blood transfusions and renal embolisation were never necessary.
Conclusion: When managing renal stones between 10 and 20 mm taking into account both size and hardness with the application of the SMASH score, RIRS and mini-PCNL show comparable efficacy. A higher bleeding risk has been expected with percutaneous approaches; however, in our cohort the incidence of clinically significant bleeding was low and comparable between the two groups when adopting mini-PCNL.
{"title":"Risk of bleeding after retrograde intrarenal surgery vs miniaturised percutaneous nephrolithotomy for 10-20 mm renal stones: a not so different safety profile.","authors":"Davide Perri, Umberto Besana, Matteo Maltagliati, Andrea Pacchetti, Tommaso Calcagnile, Antonio Luigi Pastore, Javier Romero-Otero, Salvatore Micali, Alexander Govorov, Bashkar Somani, Evangelos Liatsikos, Thomas Knoll, Bernardo Rocco, Giorgio Bozzini","doi":"10.1111/bju.16585","DOIUrl":"10.1111/bju.16585","url":null,"abstract":"<p><strong>Objective: </strong>To assess differences in bleeding risk between retrograde intrarenal surgery (RIRS) and minimally invasive miniaturised percutaneous nephrolithotomy (mini-PCNL) for 10-20 mm renal stones.</p><p><strong>Patients and methods: </strong>A total of 176 patients with a renal stone between 10 and 20 mm were treated. For all patients the Stone Management According to Size-Hardness (SMASH) score was calculated: Hounsfield units × stone maximum size (cm)/100. Patients with score of <15 underwent RIRS (90 patients, Group A), whereas patients with score ≥15 underwent mini-PCNL (86 patients, Group B). In both groups the Cyber Ho laser was used. A statistical analysis was carried out to assess differences in the risk of bleeding.</p><p><strong>Results: </strong>Preoperative features were comparable. The mean maximum stone diameter was 17.1 and 16.8 mm in Groups A and B, respectively (P = 0.13). The stone-free rate was comparable (87.8% vs 95.3%, P = 0.07). The overall complication rate was 14.4% and 18.6% in Groups A and B, respectively (P = 0.09). Gross haematuria was observed in five cases (5.5%) after RIRS and seven (8.1%) after mini-PCNL (P = 0.07). The mean haemoglobin drop was 12 and 2 g/L at the first and third postoperative day after RIRS vs 17 and 3 g/L after mini-PCNL (P = 0.06 and P = 0.21, respectively). Blood transfusions and renal embolisation were never necessary.</p><p><strong>Conclusion: </strong>When managing renal stones between 10 and 20 mm taking into account both size and hardness with the application of the SMASH score, RIRS and mini-PCNL show comparable efficacy. A higher bleeding risk has been expected with percutaneous approaches; however, in our cohort the incidence of clinically significant bleeding was low and comparable between the two groups when adopting mini-PCNL.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667395","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":"December's reviewers of the month","authors":"","doi":"10.1111/bju.16576","DOIUrl":"10.1111/bju.16576","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"134 6","pages":"855"},"PeriodicalIF":3.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142672949","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":"Focus on advances in the management of bladder and kidney cancer","authors":"","doi":"10.1111/bju.16575","DOIUrl":"10.1111/bju.16575","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"134 6","pages":"856-857"},"PeriodicalIF":3.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667397","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}
Roei Golan, Aden Swayze, Zachary M Connelly, Justin Loloi, Kevin Campbell, Aaron C Lentz, Kara Watts, Alexander Small, Mustufa Babar, Rutul D Patel, Ranjith Ramasamy, Stacy Loeb
{"title":"Can artificial intelligence evaluate the quality of YouTube videos on erectile dysfunction?","authors":"Roei Golan, Aden Swayze, Zachary M Connelly, Justin Loloi, Kevin Campbell, Aaron C Lentz, Kara Watts, Alexander Small, Mustufa Babar, Rutul D Patel, Ranjith Ramasamy, Stacy Loeb","doi":"10.1111/bju.16583","DOIUrl":"10.1111/bju.16583","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667391","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}
Lorenzo Pierangelo Treccani, Francesco Artoni, Claudio Brancelli, Alessandro Veccia, Mirko D'Onofrio, Isabella Pichiri, Matteo Brunelli, Riccardo Giuseppe Bertolo, Alessandro Antonelli
{"title":"‘Case of the Month’ from the University of Verona, Italy—navigating the medical and surgical challenges of urinary bladder paraganglioma: insights from a clinical case","authors":"Lorenzo Pierangelo Treccani, Francesco Artoni, Claudio Brancelli, Alessandro Veccia, Mirko D'Onofrio, Isabella Pichiri, Matteo Brunelli, Riccardo Giuseppe Bertolo, Alessandro Antonelli","doi":"10.1111/bju.16596","DOIUrl":"https://doi.org/10.1111/bju.16596","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"46 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643157","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}
Nikhil Mayor, Alexander Light, Anna Silvanto, Emma Cullen, Peng Yun Ng, Almostafa Badreldin, Bijan Khoubehi, Giles Hellawell, Francesca Fiorentino, Martin J. Connor, Taimur T. Shah, Hashim U. Ahmed, Mathias Winkler
Radical prostatectomy (RP) represents the cornerstone of surgical treatment for prostate cancer. Assessing surgical margin status intraoperatively with current techniques remains challenging due to high costs in the context of an already stretched pathology workforce. Fluorescence confocal microscopy (FCM) is a promising technique to detect margins in prostate cancer surgery not bound by such limitations.
{"title":"Fluorescence confocal microscopy for margin assessment in prostatectomy: IP8-FLUORESCE study protocol","authors":"Nikhil Mayor, Alexander Light, Anna Silvanto, Emma Cullen, Peng Yun Ng, Almostafa Badreldin, Bijan Khoubehi, Giles Hellawell, Francesca Fiorentino, Martin J. Connor, Taimur T. Shah, Hashim U. Ahmed, Mathias Winkler","doi":"10.1111/bju.16588","DOIUrl":"https://doi.org/10.1111/bju.16588","url":null,"abstract":"Radical prostatectomy (RP) represents the cornerstone of surgical treatment for prostate cancer. Assessing surgical margin status intraoperatively with current techniques remains challenging due to high costs in the context of an already stretched pathology workforce. Fluorescence confocal microscopy (FCM) is a promising technique to detect margins in prostate cancer surgery not bound by such limitations.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"248 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643231","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}
Jack B. Fanshawe, Thomas Hughes, Karen Briggs, Raveen Sandher, Yacoub Khalaf, Tet Yap, Julia Kopeika, Majid Shabbir
ObjectiveTo determine the success rate of oncological microdissection testicular sperm extraction (onco‐microTESE) in patients with testicular cancer (TC) with azoospermia and severe oligoasthenoteratozoospermia (OAT; <1 million/mL sperm) and to explore any factors that may predict success.Patients and MethodsCase series of outcomes from all consecutive patients (42 testes in 38 patients) that presented or were referred to a single specialist tertiary referral centre for fertility management in the context of TC with severe OAT or azoospermia between August 2015 and August 2022. Biochemical, radiological, and histological parameters were collected for all patients. All patients underwent onco‐microTESE (simultaneous radical inguinal orchidectomy with ex vivo microTESE of the affected testis). Those with unsuccessful surgical sperm retrieval (SSR) from the affected testis underwent contemporaneous contralateral microTESE, if no contraindication was present. The primary outcome was successful SSR from the affected testicle sufficient for assisted reproductive techniques. Secondary outcomes included contralateral microTESE success, the time from referral to procedure, and the total successful fertility preservation rate.ResultsInitial onco‐microTESE was successful in 19 of 31 patients (61%) with azoospermia. Contralateral microTESE was successful in a further two of eight patients with azoospermia with failed onco‐microTESE. Overall, 22/31 patients with azoospermia (71%) had successful fertility preservation in this series. In addition, six of seven patients with severe OAT had further sperm harvested by onco‐microTESE to maximise their fertility preservation. All surgery was performed within median (interquartile range) of 7 (5–13) days from presentation.ConclusionsOnco‐microTESE represents an effective method of fertility preservation for sub‐fertile patients with TC without delaying oncological treatment. Knowledge of the fertility status at first presentation is essential to allow for such additional options for optimal fertility preservation in TC.
{"title":"Oncological microdissection testicular sperm extraction (Onco‐microTESE) outcomes for fertility preservation of patients with testicular cancer with azoospermia or severe oligoasthenoteratozoospermia","authors":"Jack B. Fanshawe, Thomas Hughes, Karen Briggs, Raveen Sandher, Yacoub Khalaf, Tet Yap, Julia Kopeika, Majid Shabbir","doi":"10.1111/bju.16553","DOIUrl":"https://doi.org/10.1111/bju.16553","url":null,"abstract":"ObjectiveTo determine the success rate of oncological microdissection testicular sperm extraction (onco‐microTESE) in patients with testicular cancer (TC) with azoospermia and severe oligoasthenoteratozoospermia (OAT; <1 million/mL sperm) and to explore any factors that may predict success.Patients and MethodsCase series of outcomes from all consecutive patients (42 testes in 38 patients) that presented or were referred to a single specialist tertiary referral centre for fertility management in the context of TC with severe OAT or azoospermia between August 2015 and August 2022. Biochemical, radiological, and histological parameters were collected for all patients. All patients underwent onco‐microTESE (simultaneous radical inguinal orchidectomy with <jats:italic>ex vivo</jats:italic> microTESE of the affected testis). Those with unsuccessful surgical sperm retrieval (SSR) from the affected testis underwent contemporaneous contralateral microTESE, if no contraindication was present. The primary outcome was successful SSR from the affected testicle sufficient for assisted reproductive techniques. Secondary outcomes included contralateral microTESE success, the time from referral to procedure, and the total successful fertility preservation rate.ResultsInitial onco‐microTESE was successful in 19 of 31 patients (61%) with azoospermia. Contralateral microTESE was successful in a further two of eight patients with azoospermia with failed onco‐microTESE. Overall, 22/31 patients with azoospermia (71%) had successful fertility preservation in this series. In addition, six of seven patients with severe OAT had further sperm harvested by onco‐microTESE to maximise their fertility preservation. All surgery was performed within median (interquartile range) of 7 (5–13) days from presentation.ConclusionsOnco‐microTESE represents an effective method of fertility preservation for sub‐fertile patients with TC without delaying oncological treatment. Knowledge of the fertility status at first presentation is essential to allow for such additional options for optimal fertility preservation in TC.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"32 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643219","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":"Response to Tang et al. ‘Evaluating the efficacy of physiotherapy in post‐prostatectomy continence and pelvic muscle function’","authors":"Mifuka Ouchi, Takeya Kitta","doi":"10.1111/bju.16592","DOIUrl":"https://doi.org/10.1111/bju.16592","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"107 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601207","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 investigate patient tolerability and safety (using urinary tract infection (UTI) as a proxy measure) following EndoSheath‐assisted flexible cystoscopy (eFC). EndoSheaths are single‐use, disposable sheaths used in FC. They reduce cystoscope turnaround times as complicated, time‐consuming and costly sterilisation is no longer necessary. This reduces patient waiting times as cystoscope idle time, the most common rate limiting step, is reduced.Patients and MethodsAll adult patients undergoing eFC over a 26‐month period at a single institution were evaluated prospectively. Post‐eFC, participants rated discomfort on a visual analogue scale (discomfort 1 = none, 2–4 = mild, 5–7 = moderate, 8–10 = severe). The diagnosis of UTI was broad and based on any one of patient self‐report, positive urine culture or antibiotic prescription within 30 days of eFC. Data were analysed using chi‐squared testing (P < 0.05, two‐tailed).ResultsOf the 1091 eFCs analysed, 33.2% and 48.2% of were ranked as causing no or mild discomfort, respectively, with just 3.1% ranked severe. Discomfort was greater in younger participants but similar between sexes. Overall, post‐eFC UTI incidence was 13.3%, with rates higher in females (18.1%) than males (11.2%). Participants aged ≥65 years reported a higher UTI rate (15.4%) than those aged <65 years (8.8%). No participants developed urosepsis.ConclusionThis large, prospective, unselected, real‐world study reports that eFC is well tolerated. UTI was higher in females than males, and in those aged ≥65 years, in line with other studies using the same broad based diagnostic criteria for UTI. The conclusion is that eFC is both well tolerated and safe.
{"title":"EndoSheath use in flexible cystoscopy: a prospective evaluation of >1000 cases","authors":"Lara Ratcliffe, Brian Birch","doi":"10.1111/bju.16578","DOIUrl":"https://doi.org/10.1111/bju.16578","url":null,"abstract":"ObjectivesTo investigate patient tolerability and safety (using urinary tract infection (UTI) as a proxy measure) following EndoSheath‐assisted flexible cystoscopy (eFC). EndoSheaths are single‐use, disposable sheaths used in FC. They reduce cystoscope turnaround times as complicated, time‐consuming and costly sterilisation is no longer necessary. This reduces patient waiting times as cystoscope idle time, the most common rate limiting step, is reduced.Patients and MethodsAll adult patients undergoing eFC over a 26‐month period at a single institution were evaluated prospectively. Post‐eFC, participants rated discomfort on a visual analogue scale (discomfort 1 = none, 2–4 = mild, 5–7 = moderate, 8–10 = severe). The diagnosis of UTI was broad and based on any one of patient self‐report, positive urine culture or antibiotic prescription within 30 days of eFC. Data were analysed using chi‐squared testing (<jats:italic>P</jats:italic> < 0.05, two‐tailed).ResultsOf the 1091 eFCs analysed, 33.2% and 48.2% of were ranked as causing no or mild discomfort, respectively, with just 3.1% ranked severe. Discomfort was greater in younger participants but similar between sexes. Overall, post‐eFC UTI incidence was 13.3%, with rates higher in females (18.1%) than males (11.2%). Participants aged ≥65 years reported a higher UTI rate (15.4%) than those aged <65 years (8.8%). No participants developed urosepsis.ConclusionThis large, prospective, unselected, real‐world study reports that eFC is well tolerated. UTI was higher in females than males, and in those aged ≥65 years, in line with other studies using the same broad based diagnostic criteria for UTI. The conclusion is that eFC is both well tolerated and safe.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"35 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601210","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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