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The carbon footprint of the perioperative transurethral resection of bladder tumour pathway 经尿道膀胱肿瘤切除术围手术期路径的碳足迹
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-25 DOI: 10.1111/bju.16477
Joseph B. John, Michael Collins, Sophie Eames, Kieran O’Flynn, Tim W.R. Briggs, William K. Gray, John S. McGrath
To evaluate the carbon footprint of the perioperative transurethral resection of bladder tumour (TURBT) pathway from decision to treat to postoperative discharge, and model potential greenhouse gas (GHG) emissions reduction strategies.
评估围手术期经尿道膀胱肿瘤切除术(TURBT)从决定治疗到术后出院整个过程的碳足迹,并模拟潜在的温室气体(GHG)减排策略。
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引用次数: 0
A randomised trial of short- vs long-term androgen deprivation with salvage radiotherapy for biochemical failure following radical prostatectomy: URONCOR 06-24 针对根治性前列腺切除术后生化治疗失败的短期与长期雄激素剥夺及挽救性放疗随机试验:URONCOR 06-24。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-23 DOI: 10.1111/bju.16484
Carmen González-San Segundo, Fernando López Campos, Alfonso Gómez Iturriaga, Aurora Rodríguez, Jesús Olivera, Víctor Duque-Santana, Gemma Sancho, Iván Henríquez, Antonio José Conde, Jeannette Valero, Xavier Maldonado, Luis Glaria, Begoña Caballero, Noelia Sanmamed, Joel Mases, Anna María Boladeras-Inglada, Miguel Montijano, Marina Santos, Ana Álvarez, Juan I. Martínez, Felipe Couñago

Background

Salvage radiotherapy (SRT) and androgen-deprivation therapy (ADT) are widely used in routine clinical practice to treat patients with prostate cancer who develop biochemical recurrence (BCR) after radical prostatectomy (RP). However, there is no standard-of-care consensus on optimal duration ADT. Investigators propose three distinct risk groups in patients with prostate cancer treated with SRT in order to better define the indications and duration of ADT combined with SRT.

Study design

The URONCOR 06-24 trial (ClinicalTrials.gov identifier NCT05781217) is a prospective, multicentre, randomised, open-label, phase III, clinical trial. The aim of the trial is to determine the impact of short-term (6 months) vs long-term (24 months) ADT in combination with SRT on distant metastasis-free survival (MFS) in patients with prostate cancer with BCR after RP (intermediate and high risk).

Endpoints

The primary endpoint is 5-year MFS rates in patients with prostate cancer treated with long- vs short-term ADT in combination with SRT. Secondary objectives are biochemical-relapse free interval, pelvic progression-free survival, time to start of systemic treatment, time to castration resistance, cancer-specific survival, overall survival, acute and late toxicity, and quality of life.

Methods and analysis

Total of 534 patients will be randomised 1:1 to ADT 6 months or ADT 24 months with a luteinizing hormone-releasing hormone analogue in combination with SRT, stratified by risk group and pathological lymph node status.

Ethics and dissemination

The study is conducted under the guiding principles of the World Medical Association Declaration of Helsinki. The results will be disseminated at research conferences and in peer-reviewed journals.

Trial registration number

EudraCT number 2021-006975-41.

背景:挽救性放疗(SRT)和雄激素剥夺疗法(ADT)在常规临床实践中被广泛用于治疗根治性前列腺切除术(RP)后出现生化复发(BCR)的前列腺癌患者。然而,目前尚未就 ADT 的最佳持续时间达成共识。研究人员建议对接受 SRT 治疗的前列腺癌患者分为三个不同的风险组,以便更好地确定 ADT 联合 SRT 的适应症和持续时间:URONCOR 06-24试验(ClinicalTrials.gov标识符NCT05781217)是一项前瞻性、多中心、随机、开放标签的III期临床试验。该试验旨在确定短期(6 个月)与长期(24 个月)ADT 联合 SRT 对 RP 后 BCR 的前列腺癌患者(中高危)无远处转移生存期(MFS)的影响:主要终点是接受长期与短期 ADT 联合 SRT 治疗的前列腺癌患者的 5 年无远处转移生存率。次要目标是无生化复发间隔期、盆腔无进展生存期、开始系统治疗的时间、出现阉割抵抗的时间、癌症特异性生存期、总生存期、急性和晚期毒性以及生活质量:共有534名患者将按1:1的比例随机接受ADT 6个月或ADT 24个月与促黄体生成素释放激素类似物联合SRT治疗,并根据风险组别和病理淋巴结状态进行分层:本研究在世界医学协会《赫尔辛基宣言》的指导原则下进行。研究结果将在研究会议和同行评审期刊上公布:EudraCT 编号:2021-006975-41。
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引用次数: 0
Conservative interventions for female exercise-induced urinary incontinence: a systematic review. 女性运动诱发尿失禁的保守干预:系统综述。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-23 DOI: 10.1111/bju.16474
Marina Petter Rodrigues, Marie-Ève Bérubé, Marylène Charette, Linda McLean

Objective: To systematically review and synthesise what is known about the effectiveness of non-pharmaceutical conservative interventions for the management of urinary incontinence (UI) experienced by women during physical exercise.

Methods: A systematic search was performed in the following databases in September 2023: the Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica dataBASE (EMBASE), Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), and Physiotherapy Evidence Database (PEDro). Studies were deemed eligible if population consisted of females who reported symptoms of UI while participating in physical exercise, and the interventions involved any non-pharmaceutical conservative treatment to manage symptoms during exercise. The primary outcome was severity of UI signs and symptoms. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO identifier: CRD42022379138).

Results: Of the 3429 abstracts screened, 19 studies were retained. Pelvic floor muscle training (PFMT) and intravaginal devices were the most commonly investigated modalities. Only two randomised controlled trials (RCTs), both among volleyball players, compared PFMT with no PFM exercise, showing a reduction in pad weight gain after the intervention in the experimental groups only. PFMT with and without biofeedback randomised among soldiers demonstrated a reduction in the frequency of urine leakage episodes in both groups, while supervised and unsupervised PFMT randomised among athletes from different sports showed pad weight gain reduction in the supervised group only. Seven single-arm studies suggested that PFMT alone or combined with other modalities may reduce UI severity in active women based on questionnaires, bladder diaries, and self-reported symptoms. A single-arm and a crossover study found pessary use beneficial in reducing urine leakage based on questionnaires and pad weight gain, respectively. When comparing pessary, tampon, and no intervention, two repeated-measures studies found tampons may reduce leakage more than pessaries in CrossFit exercisers and women performing aerobic exercises. A vaginal sponge also reduced pad weight gain during aerobic exercises. Other modalities (i.e., an intraurethral device, photobiomodulation, and combined therapies) were investigated using case series or single case studies. While all interventions showed some evidence of effectiveness, the results must be interpreted with caution due to methodological limitations and high risk of bias. In particular, despite a high reliance on pad tests as a primary outcome, we identified inconsistencies in how pad tests were administered and interpreted.

Conclusion: Only the effectiveness of PFMT to reduce ur

目的系统回顾并总结目前已知的非药物保守干预措施对治疗女性在体育锻炼中出现的尿失禁(UI)的有效性:方法:于 2023 年 9 月在以下数据库中进行了系统检索:医学文献分析和检索系统在线(MEDLINE)、护理和专职医疗文献累积索引(CINAHL)、Excerpta Medica 数据库(EMBASE)、科学电子图书馆在线(SciELO)、拉丁美洲和加勒比海健康科学文献(LILACS)以及物理治疗证据数据库(PEDro)。如果研究对象是在参加体育锻炼时报告有尿失禁症状的女性,且干预措施涉及在锻炼过程中控制症状的任何非药物保守疗法,则该研究符合条件。研究的主要结果是尿频症状的严重程度。研究方案已在国际前瞻性系统综述注册中心注册(PROSPERO标识符:CRD42022379138):结果:在筛选出的 3429 篇摘要中,保留了 19 篇研究。盆底肌肉训练(PFMT)和阴道内装置是最常见的研究方式。只有两项随机对照试验(RCT)比较了盆底肌训练与不进行盆底肌训练,结果显示只有实验组在干预后减轻了垫子的重量增加,这两项试验均针对排球运动员。在士兵中随机进行的带生物反馈和不带生物反馈的 PFMT 试验表明,两组的漏尿次数都有所减少,而在不同运动项目的运动员中随机进行的有监督和无监督的 PFMT 试验表明,只有监督组的尿垫增重有所减少。七项单臂研究表明,根据调查问卷、膀胱日记和自我报告的症状,PFMT 单独使用或与其他方法结合使用可降低活跃女性尿失禁的严重程度。一项单臂研究和一项交叉研究分别根据问卷调查和尿垫重量增加情况发现,使用膀胱塞可减少漏尿。在比较使用阴道塞、卫生棉条和不使用干预措施时,两项重复测量研究发现,在 CrossFit 运动者和进行有氧运动的女性中,卫生棉条比阴道塞更能减少漏尿。阴道海绵也能减少有氧运动中衬垫重量的增加。其他方式(如尿道内装置、光生物调节和综合疗法)则通过病例系列或单个病例研究进行了调查。虽然所有干预措施都显示出一定的有效性,但由于方法上的局限性和高偏倚风险,必须谨慎解释这些结果。特别是,尽管我们高度依赖垫测试作为主要结果,但我们发现在如何进行垫测试和解释垫测试方面存在不一致:结论:只有通过 RCT 评估了 PFMT 对减少运动时漏尿的有效性,并有一些有效性证据。我们发现,显然需要更高质量的研究,对干预措施进行更好的报告,并更明智地使用和解释结果测量。
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引用次数: 0
Identifying the facilitators and barriers to implementation of renal tumour biopsy in the diagnostic pathway for small renal masses 确定在肾脏小肿块诊断路径中实施肾脏肿瘤活检的促进因素和障碍。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-23 DOI: 10.1111/bju.16470
Veronica Ranieri, Hannah Warren, Isabella Florez, Joana B. Neves, Miles Walkden, Darryl E. Bernstein, Joseph Santiapillai, Norman Williams, William H. Wildgoose, Prasad Patki, Grant D. Stewart, Netty Kinsella, Elena Pizzo, Ravi Barod, Axel Bex, Faiz Mumtaz, Soha El-Sheikh, Kurinchi Gurusamy, Maxine G.B. Tran

Objectives

To understand the facilitators and barriers to the implementation of renal tumour biopsy (RTB) in the diagnostic pathway for renal tumours in England.

Patients and Methods

Participants consisted of patients who had a renal tumour diagnosed and/or treated at one of five tertiary centres in England, healthcare professionals involved in the direct care of patients diagnosed with renal tumours, and clinical service managers and commissioners. The study employed a mixed-methods research methodology consisting of individual interviews and an on-line survey that explored the types of facilitators and barriers individuals perceived and experienced and the frequency in which these were reported. A public dissemination event took place following the completion of data collection; to facilitate discussion of potential solutions to implementing RTB.

Results

There were 50 participant interviews (23 patients, 22 clinicians, and five health service commissioners/operations managers). The patient on-line survey received 52 responses, and the clinician survey received 22 responses. Patients most frequently reported influences in choosing whether to undergo RTB pertained to wanting to know the diagnosis of their kidney mass (40%), the advice or information provided by healthcare professionals (40%), and not wishing to delay treatment (23%). Clinicians most frequently reported barriers to recommending RTB related to their uncertainty of diagnostic accuracy (56%), availability of appointments or hospital beds (52%), concerns of risk of bleeding (44%), risk of seeding (41%), and delays in meeting national cancer pathway targets (41%). The dissemination event was attended by 18 participants (seven patients and 11 clinicians). Suggestions to improve implementation included reducing variation and promotion of standardisation of practice by a consensus statement, increasing the evidence base (clinicians) and improved communication by developing better patient aids such as videos and diagrams (patients and clinicians).

Conclusion

Implementation of RTB may be dependent on the quality of information provided, its format and perceived reliability of the information. Increased utilisation of RTB may be improved by development of a consensus statement on the role of biopsy, with patients expressing a preference for alternative information aids such as patient videos.

目的了解在英格兰肾肿瘤诊断路径中实施肾肿瘤活检(RTB)的促进因素和障碍:参与者包括在英格兰五个三级中心之一接受肾肿瘤诊断和/或治疗的患者、参与直接护理肾肿瘤患者的医护人员以及临床服务管理人员和专员。该研究采用了混合研究方法,包括个人访谈和在线调查,以探讨个人认为和经历的促进因素和障碍类型,以及报告这些因素和障碍的频率。数据收集工作完成后举行了一次公开宣传活动,以促进对实施 RTB 潜在解决方案的讨论:共进行了 50 次访谈(23 名患者、22 名临床医生和 5 名医疗服务专员/业务经理)。患者在线调查收到了 52 份回复,临床医生调查收到了 22 份回复。患者在选择是否接受 RTB 治疗时最常提到的影响因素包括:想知道肾脏肿块的诊断结果(40%)、医护人员提供的建议或信息(40%)以及不想延误治疗(23%)。临床医生最常报告的推荐 RTB 的障碍涉及诊断准确性的不确定性(56%)、预约或医院床位的可用性(52%)、出血风险的担忧(44%)、播种风险(41%)以及实现国家癌症路径目标的延迟(41%)。有 18 人(7 名患者和 11 名临床医生)参加了宣传活动。改善实施情况的建议包括:通过共识声明减少差异和促进实践标准化、增加证据基础(临床医生)以及通过开发更好的患者辅助工具(如视频和图表)改善沟通(患者和临床医生):RTB 的实施可能取决于所提供信息的质量、格式以及对信息可靠性的认知。通过就活检的作用制定共识声明可提高 RTB 的使用率,而患者则表示更倾向于使用其他信息辅助工具,如患者视频。
{"title":"Identifying the facilitators and barriers to implementation of renal tumour biopsy in the diagnostic pathway for small renal masses","authors":"Veronica Ranieri,&nbsp;Hannah Warren,&nbsp;Isabella Florez,&nbsp;Joana B. Neves,&nbsp;Miles Walkden,&nbsp;Darryl E. Bernstein,&nbsp;Joseph Santiapillai,&nbsp;Norman Williams,&nbsp;William H. Wildgoose,&nbsp;Prasad Patki,&nbsp;Grant D. Stewart,&nbsp;Netty Kinsella,&nbsp;Elena Pizzo,&nbsp;Ravi Barod,&nbsp;Axel Bex,&nbsp;Faiz Mumtaz,&nbsp;Soha El-Sheikh,&nbsp;Kurinchi Gurusamy,&nbsp;Maxine G.B. Tran","doi":"10.1111/bju.16470","DOIUrl":"10.1111/bju.16470","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To understand the facilitators and barriers to the implementation of renal tumour biopsy (RTB) in the diagnostic pathway for renal tumours in England.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Participants consisted of patients who had a renal tumour diagnosed and/or treated at one of five tertiary centres in England, healthcare professionals involved in the direct care of patients diagnosed with renal tumours, and clinical service managers and commissioners. The study employed a mixed-methods research methodology consisting of individual interviews and an on-line survey that explored the types of facilitators and barriers individuals perceived and experienced and the frequency in which these were reported. A public dissemination event took place following the completion of data collection; to facilitate discussion of potential solutions to implementing RTB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 50 participant interviews (23 patients, 22 clinicians, and five health service commissioners/operations managers). The patient on-line survey received 52 responses, and the clinician survey received 22 responses. Patients most frequently reported influences in choosing whether to undergo RTB pertained to wanting to know the diagnosis of their kidney mass (40%), the advice or information provided by healthcare professionals (40%), and not wishing to delay treatment (23%). Clinicians most frequently reported barriers to recommending RTB related to their uncertainty of diagnostic accuracy (56%), availability of appointments or hospital beds (52%), concerns of risk of bleeding (44%), risk of seeding (41%), and delays in meeting national cancer pathway targets (41%). The dissemination event was attended by 18 participants (seven patients and 11 clinicians). Suggestions to improve implementation included reducing variation and promotion of standardisation of practice by a consensus statement, increasing the evidence base (clinicians) and improved communication by developing better patient aids such as videos and diagrams (patients and clinicians).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementation of RTB may be dependent on the quality of information provided, its format and perceived reliability of the information. Increased utilisation of RTB may be improved by development of a consensus statement on the role of biopsy, with patients expressing a preference for alternative information aids such as patient videos.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16470","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pseudoephedrine for ejaculatory dysfunction after retroperitoneal lymph node dissection in testicular cancer 伪麻黄碱治疗睾丸癌腹膜后淋巴结清扫术后的射精功能障碍。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-23 DOI: 10.1111/bju.16481
Ciara Conduit, Jeremy Lewin, Wei Hong, Ie-Wen Sim, Gulfam Ahmad, Matt Leonard, Sophie O'Haire, Mary Moody, Amanda D. Hutchinson, Nathan Lawrentschuk, Benjamin Thomas, Haryana M. Dhillon, Ben Tran

Objective

To assess the impact of ejaculatory dysfunction (EjD; failure of emission or retrograde ejaculation) on health-related quality of life (HRQoL) after retroperitoneal lymph node dissection (RPLND) for testicular cancer and explore the efficacy of pseudoephedrine hydrochloride as treatment.

Patients and Methods

In a single arm, phase II trial, patients at ≥6 months after RPLND were invited to complete patient-reported outcome measures (European Organisation for Research and Treatment of Cancer [EORTC] quality of life questionnaire [QLQ]-30-item core, EORTC QLQ-testicular cancer-26, and Brief Male Sexual Function Inventory) evaluating HRQoL and sexual function in follow-up (ACTRN12622000537752/12622000542796). If EjD was reported, post-ejaculatory urine ± semen analysis was undertaken. In eligible patients, pseudoephedrine hydrochloride 60 mg was administered orally every 6 h for six doses. The primary endpoint was sperm count >39 million sperm/ejaculate (>5th centile) following treatment. The trial was powered to detect a clinically relevant 36% achieving sperm count of >39 million sperm/ejaculate. Secondary endpoints included semen volume >1.5 mL, total motile sperm count, safety, and HRQoL impacts.

Results

Of the 58 patients enrolled, the median (interquartile range [IQR]) age was 35 (29–41) years, with a median (IQR) of 37 (18–60) months from RPLND. EjD was reported in 33 (57%), including 27/52 (52%) receiving follow-up at our centre. There were no differences in global HRQoL; however, role functioning (P = 0.045), sexual problems (P < 0.005), and sexual enjoyment (P = 0.005) was poorer if EjD was present. In all, 24/33 (73%) patients with EjD consented to pseudoephedrine treatment. Of 22 evaluable patients, four (18%) achieved a sperm count of >39 million/ejaculate (P = 0.20), and four (18%) had a semen volume of >1.5 mL (P = 0.20). There was a mean increase of 105 million sperm/ejaculate (P = 0.051) and 1.47 mL increase in semen volume (P = 0.01). No safety concerns arose.

Conclusion

Ejaculatory dysfunction is common after RPLND but did not impact global HRQoL in our cohort. Pseudoephedrine improved EjD for some; however, its efficacy was lower than expected. Pseudoephedrine may be considered on an individualised basis.

目的评估睾丸癌腹膜后淋巴结清扫术(RPLND)后射精功能障碍(EjD;射精失败或逆行射精)对健康相关生活质量(HRQoL)的影响,并探讨盐酸伪麻黄碱的治疗效果:在一项单臂 II 期试验中,邀请 RPLND 术后≥6 个月的患者完成患者报告的结果测量(欧洲癌症研究和治疗组织 [EORTC] 生活质量问卷 [QLQ]-30 项核心内容、EORTC QLQ-睾丸癌-26 和简明男性性功能量表),在随访中评估 HRQoL 和性功能(ACTRN12622000537752/12622000542796)。如果报告有射精障碍,则进行射精后尿液和精液分析。对符合条件的患者口服盐酸伪麻黄碱 60 毫克,每 6 小时一次,共 6 次。主要终点是治疗后精子数量大于 3,900 万个/射精(大于第 5 百分位数)。试验结果显示,有 36% 的患者精子数量大于 3,900 万/射精次数,达到临床相关水平。次要终点包括精液量 >1.5 mL、总活动精子数、安全性和 HRQoL 影响:在 58 名入选患者中,年龄中位数(四分位数间距 [IQR])为 35(29-41)岁,距离 RPLND 的中位数(IQR)为 37(18-60)个月。33例(57%)报告有EjD,其中27/52例(52%)在本中心接受随访。总体 HRQoL 没有差异;但是,角色功能(P = 0.045)、性问题(P 3,900 万/次射精(P = 0.20),4 人(18%)的精液量大于 1.5 mL(P = 0.20)。精子/射精量平均增加了 1.05 亿个(P = 0.051),精液量增加了 1.47 毫升(P = 0.01)。没有出现安全问题:结论:射精功能障碍在 RPLND 后很常见,但在我们的队列中不会影响整体 HRQoL。伪麻黄碱可改善部分患者的射精功能,但其疗效低于预期。可根据个体情况考虑使用伪麻黄碱。
{"title":"Pseudoephedrine for ejaculatory dysfunction after retroperitoneal lymph node dissection in testicular cancer","authors":"Ciara Conduit,&nbsp;Jeremy Lewin,&nbsp;Wei Hong,&nbsp;Ie-Wen Sim,&nbsp;Gulfam Ahmad,&nbsp;Matt Leonard,&nbsp;Sophie O'Haire,&nbsp;Mary Moody,&nbsp;Amanda D. Hutchinson,&nbsp;Nathan Lawrentschuk,&nbsp;Benjamin Thomas,&nbsp;Haryana M. Dhillon,&nbsp;Ben Tran","doi":"10.1111/bju.16481","DOIUrl":"10.1111/bju.16481","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the impact of ejaculatory dysfunction (EjD; failure of emission or retrograde ejaculation) on health-related quality of life (HRQoL) after retroperitoneal lymph node dissection (RPLND) for testicular cancer and explore the efficacy of pseudoephedrine hydrochloride as treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In a single arm, phase II trial, patients at ≥6 months after RPLND were invited to complete patient-reported outcome measures (European Organisation for Research and Treatment of Cancer [EORTC] quality of life questionnaire [QLQ]-30-item core, EORTC QLQ-testicular cancer-26, and Brief Male Sexual Function Inventory) evaluating HRQoL and sexual function in follow-up (ACTRN12622000537752/12622000542796). If EjD was reported, post-ejaculatory urine ± semen analysis was undertaken. In eligible patients, pseudoephedrine hydrochloride 60 mg was administered orally every 6 h for six doses. The primary endpoint was sperm count &gt;39 million sperm/ejaculate (&gt;5th centile) following treatment. The trial was powered to detect a clinically relevant 36% achieving sperm count of &gt;39 million sperm/ejaculate. Secondary endpoints included semen volume &gt;1.5 mL, total motile sperm count, safety, and HRQoL impacts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 58 patients enrolled, the median (interquartile range [IQR]) age was 35 (29–41) years, with a median (IQR) of 37 (18–60) months from RPLND. EjD was reported in 33 (57%), including 27/52 (52%) receiving follow-up at our centre. There were no differences in global HRQoL; however, role functioning (<i>P =</i> 0.045), sexual problems (<i>P</i> &lt; 0.005), and sexual enjoyment (<i>P</i> = 0.005) was poorer if EjD was present. In all, 24/33 (73%) patients with EjD consented to pseudoephedrine treatment. Of 22 evaluable patients, four (18%) achieved a sperm count of &gt;39 million/ejaculate (<i>P</i> = 0.20), and four (18%) had a semen volume of &gt;1.5 mL (<i>P</i> = 0.20). There was a mean increase of 105 million sperm/ejaculate (<i>P</i> = 0.051) and 1.47 mL increase in semen volume (<i>P</i> = 0.01). No safety concerns arose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ejaculatory dysfunction is common after RPLND but did not impact global HRQoL in our cohort. Pseudoephedrine improved EjD for some; however, its efficacy was lower than expected. Pseudoephedrine may be considered on an individualised basis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bju.16481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
'Case of the Month' from the Western General Hospital, Edinburgh, UK: invasive vesical Candida infection causing ureteric obstruction in a female diabetic patient. 英国爱丁堡西部综合医院的 "本月病例":一名女性糖尿病患者因浸润性膀胱念珠菌感染导致输尿管梗阻。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-22 DOI: 10.1111/bju.16458
Jamie V Krishnan, Marie O'Donnell, Alexander Laird
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引用次数: 0
Prospective study of urinary incontinence recovery following endoscopic enucleation of the prostate 前列腺内窥镜切除术后尿失禁恢复情况的前瞻性研究
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-19 DOI: 10.1111/bju.16475
Shao-Wei Wu, Chi-Shin Tseng, Lun-Hsiang Yuan, Yu-Wen Huang, Yi-Jhou Chen, Ming-Chieh Kuo, Jeff Shih-Chieh Chueh, Shi-Wei Huang

Objective

To investigate the clinical trajectories and identify risk factors linked to post-enucleation urinary incontinence (UI).

Patients and Methods

In this prospective study (April 2020 to March 2022) at a single institution, 316 consecutive patients receiving endoscopic enucleation due to benign prostatic enlargement were included. Patient information and perioperative details were collected. Follow-ups, from 1 to 6 months, assessed postoperative UI using International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form and a four-item pad questionnaire, classified per International Continence Society definitions. Logistic regression analysed predictors at 1 week, while generalised estimating equation assessed risk factors from 1 to 3 months postoperatively.

Results

Patients with a median prostate volume of 57 mL underwent enucleation, with 22.5% experiencing postoperative UI at 1 week, 5.6% at 3 months, decreasing to 1.9% at 6 months. Multivariable analysis identified age (>80 years), specimen weight (>70 g), en bloc with anteroposterior dissection, and anal tone (Digital Rectal Examination Scoring System score <3) as potential factors influencing UI. Subgroup analysis revealed that specimen weight was associated with both continuous and stress UI. Anal tone was related to both other types and stress UI, while overactive bladder symptoms were associated with urge UI.

Conclusion

In summary, our study elucidates transient risk factors contributing to temporary post-enucleation UI after prostatectomy. Informed decisions and personalised interventions can effectively alleviate concerns regarding postoperative UI.

调查临床轨迹并确定与核磁共振成像后尿失禁(UI)相关的风险因素。
{"title":"Prospective study of urinary incontinence recovery following endoscopic enucleation of the prostate","authors":"Shao-Wei Wu,&nbsp;Chi-Shin Tseng,&nbsp;Lun-Hsiang Yuan,&nbsp;Yu-Wen Huang,&nbsp;Yi-Jhou Chen,&nbsp;Ming-Chieh Kuo,&nbsp;Jeff Shih-Chieh Chueh,&nbsp;Shi-Wei Huang","doi":"10.1111/bju.16475","DOIUrl":"10.1111/bju.16475","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the clinical trajectories and identify risk factors linked to post-enucleation urinary incontinence (UI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>In this prospective study (April 2020 to March 2022) at a single institution, 316 consecutive patients receiving endoscopic enucleation due to benign prostatic enlargement were included. Patient information and perioperative details were collected. Follow-ups, from 1 to 6 months, assessed postoperative UI using International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form and a four-item pad questionnaire, classified per International Continence Society definitions. Logistic regression analysed predictors at 1 week, while generalised estimating equation assessed risk factors from 1 to 3 months postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with a median prostate volume of 57 mL underwent enucleation, with 22.5% experiencing postoperative UI at 1 week, 5.6% at 3 months, decreasing to 1.9% at 6 months. Multivariable analysis identified age (&gt;80 years), specimen weight (&gt;70 g), <i>en bloc</i> with anteroposterior dissection, and anal tone (Digital Rectal Examination Scoring System score &lt;3) as potential factors influencing UI. Subgroup analysis revealed that specimen weight was associated with both continuous and stress UI. Anal tone was related to both other types and stress UI, while overactive bladder symptoms were associated with urge UI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In summary, our study elucidates transient risk factors contributing to temporary post-enucleation UI after prostatectomy. Informed decisions and personalised interventions can effectively alleviate concerns regarding postoperative UI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141726370","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}
引用次数: 0
Penile intraepithelial neoplasia incidence, clinical classification, microenvironment and implications for imiquimod treatment 阴茎上皮内瘤变的发病率、临床分类、微环境以及对咪喹莫特治疗的影响
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-19 DOI: 10.1111/bju.16473
Ofir Avitan, Tynisha Rafael, Manon Vreeburg, Laura Elst, Elise M. Bekers, Maarten Albersen, Ekaterina S. Jordanova, Oscar Brouwer
To provide an outline of the existing data on penile intraepithelial neoplasia (PeIN), as well as a narrative review on imiquimod (IQ; a toll-like receptor 7 agonist) treatment and immune microenvironment markers that may predict response to treatment.
概述有关阴茎上皮内瘤变(PeIN)的现有数据,并对咪喹莫特(IQ,一种toll样受体7激动剂)治疗和可预测治疗反应的免疫微环境标志物进行叙述性综述。
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引用次数: 0
August's reviewers of the month 八月份的月度评论员
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-17 DOI: 10.1111/bju.16461
{"title":"August's reviewers of the month","authors":"","doi":"10.1111/bju.16461","DOIUrl":"10.1111/bju.16461","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141726068","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}
引用次数: 0
Acupuncture: a promising adjuvant strategy for pain management among the patients with prostate cancer 针灸:治疗前列腺癌患者疼痛的有效辅助策略。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-07-17 DOI: 10.1111/bju.16467
Jie Yang, Xingyu Xiong, Qiang Wei, Lu Yang
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引用次数: 0
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BJU International
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