Hugo W Schuil,Nora Hendriks,Mohamed El Alili,Judith E Bosmans,Ruben G Duijnhoven,Bart C H Oskam,Tom J H Arends,Diederick Duijvesz,Alexander D Horsch,Bart van der Heij,Irene Tjiam,Hans van Overhage,Armand B G N Lamers,Otto M van Delden,Wout Scheepens,Jamie M A Drossaerts,Frank C H d'Ancona,Steven Boering,Janneke I M van Uhm,Rutger W van der Meer,Herman J H van Roijen,Martin de Kiefte,Ad J M Hendrix,Saskia Weltings,Rob C M Pelger,Harrie P Beerlage,Guido M Kamphuis,Barbara M A Schout
OBJECTIVETo evaluate whether percutaneous nephrostomy (PCN) is cost-effective compared to JJ ureteric stent in the acute treatment of obstructive urolithiasis.PATIENTS AND METHODSA randomised controlled non-inferiority trial with 204 patients with obstructive urolithiasis requiring decompression. Participants were randomly assigned to either PCN or JJ stent, with follow-up until the stone was surgically removed or passed spontaneously. Effectiveness outcomes included time to recovery and quality-adjusted life years (QALYs). Costs were assessed from a societal perspective, incorporating healthcare, patient-related, and lost productivity costs.RESULTSWeighted mean procedure costs were €685 for PCN and €792 for JJ. Mean total societal costs were €8468 for PCN and €7122 for JJ. Largest cost differences were in productivity loss and home care. Time to recovery and QALYs were similar between groups. The probability that JJ was cost-effective compared to PCN was 0.74 for quicker recovery time and 0.74 for QALYs at a willingness-to-pay threshold of €0. Some cost and quality-of-life data were self-reported, and the analysis reflects the Dutch healthcare system, which may limit generalisability.CONCLUSIONThe JJ ureteric stent was found to be the likely cost-effective option compared to PCN, despite higher procedural costs. Procedural costs can be lowered by performing procedures outside of an operating theatre. Most societal costs were made during the waiting period for definitive stone removal; future research should investigate whether total cost can be lowered by reducing waiting times.
{"title":"Cost-effectiveness of percutaneous nephrostomy vs JJ stent in obstructive urolithiasis: economic evaluation alongside the STent Or NEphrostomy (STONE) randomised controlled trial.","authors":"Hugo W Schuil,Nora Hendriks,Mohamed El Alili,Judith E Bosmans,Ruben G Duijnhoven,Bart C H Oskam,Tom J H Arends,Diederick Duijvesz,Alexander D Horsch,Bart van der Heij,Irene Tjiam,Hans van Overhage,Armand B G N Lamers,Otto M van Delden,Wout Scheepens,Jamie M A Drossaerts,Frank C H d'Ancona,Steven Boering,Janneke I M van Uhm,Rutger W van der Meer,Herman J H van Roijen,Martin de Kiefte,Ad J M Hendrix,Saskia Weltings,Rob C M Pelger,Harrie P Beerlage,Guido M Kamphuis,Barbara M A Schout","doi":"10.1111/bju.70218","DOIUrl":"https://doi.org/10.1111/bju.70218","url":null,"abstract":"OBJECTIVETo evaluate whether percutaneous nephrostomy (PCN) is cost-effective compared to JJ ureteric stent in the acute treatment of obstructive urolithiasis.PATIENTS AND METHODSA randomised controlled non-inferiority trial with 204 patients with obstructive urolithiasis requiring decompression. Participants were randomly assigned to either PCN or JJ stent, with follow-up until the stone was surgically removed or passed spontaneously. Effectiveness outcomes included time to recovery and quality-adjusted life years (QALYs). Costs were assessed from a societal perspective, incorporating healthcare, patient-related, and lost productivity costs.RESULTSWeighted mean procedure costs were €685 for PCN and €792 for JJ. Mean total societal costs were €8468 for PCN and €7122 for JJ. Largest cost differences were in productivity loss and home care. Time to recovery and QALYs were similar between groups. The probability that JJ was cost-effective compared to PCN was 0.74 for quicker recovery time and 0.74 for QALYs at a willingness-to-pay threshold of €0. Some cost and quality-of-life data were self-reported, and the analysis reflects the Dutch healthcare system, which may limit generalisability.CONCLUSIONThe JJ ureteric stent was found to be the likely cost-effective option compared to PCN, despite higher procedural costs. Procedural costs can be lowered by performing procedures outside of an operating theatre. Most societal costs were made during the waiting period for definitive stone removal; future research should investigate whether total cost can be lowered by reducing waiting times.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"20 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147447001","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}
Felix Seelemeyer,David Pfister,Ruben Gößmann,Olivia Steenbock,Roberto Pappesch,Sabine Merkelbach-Bruse,Axel Heidenreich
OBJECTIVESTo evaluate the diagnostic performance of the Conformité Européenne [CE]-certified microRNA-371a-3p (miR371a) assay in patients undergoing inguinal exploration for small testicular masses of unknown histology in a real-world setting.PATIENTS AND METHODSBetween March 2023 and March 2024, 60 patients underwent inguinal exploration for testicular masses of unknown histology. For miR371a analysis, peripheral venous blood was obtained and sent to the Department of Molecular Pathology within 30 min. The extracted miRNA was reverse-transcribed into complementary DNA (cDNA) with miRNA-specific stem-loop primers, followed by a pre-amplification step. Using quantitative polymerase chain reaction, the miR371a is quantified. The median crossing points of the triplicates was calculated and converted into a relative quantification value.RESULTSThe evaluation of the miR371a assay showed a true-positive result in 25 patients with seminoma. Eight patients with seminoma had false-negative results. In the non-seminoma group, six of seven (86%) patients had a true positive result. The false-negative finding derived from a non-seminomatous germ cell tumour (NSGCT) with predominant teratoma. The test was true-negative in 16 patients with sarcoma, diffuse large B-cell lymphoma, Leydig cell tumour, and Sertoli cell tumour. False-positive results were obtained in four patients. The results yield a sensitivity of 77.5%, a specificity of 80% and a positive predictive value of 88.6% and negative predictive value of 64% for the miR371a test in our cohort. In the seminoma cohort, the sensitivity of the serum tumour markers was 12%. In the NSGCT cohort, the sensitivity was 66%.DISCUSSIONIn the absence of suitable markers, the miR371a assay shows promising results in the preoperative diagnosis of suspected localised small testicular tumour. Standardisation of pre-analytical handling and prospective multicentre validation are essential to define its optimal role in preoperative decision-making.
{"title":"Diagnostic performance of the microRNA-371a assay in small testicular masses: a real-world cohort study.","authors":"Felix Seelemeyer,David Pfister,Ruben Gößmann,Olivia Steenbock,Roberto Pappesch,Sabine Merkelbach-Bruse,Axel Heidenreich","doi":"10.1111/bju.70215","DOIUrl":"https://doi.org/10.1111/bju.70215","url":null,"abstract":"OBJECTIVESTo evaluate the diagnostic performance of the Conformité Européenne [CE]-certified microRNA-371a-3p (miR371a) assay in patients undergoing inguinal exploration for small testicular masses of unknown histology in a real-world setting.PATIENTS AND METHODSBetween March 2023 and March 2024, 60 patients underwent inguinal exploration for testicular masses of unknown histology. For miR371a analysis, peripheral venous blood was obtained and sent to the Department of Molecular Pathology within 30 min. The extracted miRNA was reverse-transcribed into complementary DNA (cDNA) with miRNA-specific stem-loop primers, followed by a pre-amplification step. Using quantitative polymerase chain reaction, the miR371a is quantified. The median crossing points of the triplicates was calculated and converted into a relative quantification value.RESULTSThe evaluation of the miR371a assay showed a true-positive result in 25 patients with seminoma. Eight patients with seminoma had false-negative results. In the non-seminoma group, six of seven (86%) patients had a true positive result. The false-negative finding derived from a non-seminomatous germ cell tumour (NSGCT) with predominant teratoma. The test was true-negative in 16 patients with sarcoma, diffuse large B-cell lymphoma, Leydig cell tumour, and Sertoli cell tumour. False-positive results were obtained in four patients. The results yield a sensitivity of 77.5%, a specificity of 80% and a positive predictive value of 88.6% and negative predictive value of 64% for the miR371a test in our cohort. In the seminoma cohort, the sensitivity of the serum tumour markers was 12%. In the NSGCT cohort, the sensitivity was 66%.DISCUSSIONIn the absence of suitable markers, the miR371a assay shows promising results in the preoperative diagnosis of suspected localised small testicular tumour. Standardisation of pre-analytical handling and prospective multicentre validation are essential to define its optimal role in preoperative decision-making.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"52 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439541","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}
Jasmine Lin, Ludovica Cella, Mitchell G Goldenberg, Andrew J Hung
Objective: To review recent advances in the use of artificial intelligence (AI) to address shortcomings in assessing and improving surgical performance/training by automating surgical skills assessment and feedback.
Methods: We searched PubMed for studies published between 2015 and 2025 pertaining to AI for surgical training. Search terms included 'artificial intelligence or 'machine learning' or 'deep learning' and 'surgical feedback' or 'surgical training' or 'surgical skill'. Articles were identified with special attention given to those published in the last 5 years with a focus on AI for surgical skill assessment or feedback.
Results: Artificial intelligence has been used to successfully automate surgical skill assessment across a variety of surgical disciplines via approaches such as kinematics, sabermetrics, computer vision, and gesture analysis. Many of these studies have developed AI models capable of a binary classification of skill (novice vs expert), which demonstrate concordance when verified against ground truths from human raters. Based on these skills assessments, AI approaches may be further leveraged to generate automatic feedback, which has proven effective in improving surgeon performance metrics, particularly for underperformers. AI has also shown utility in categorising and analysing the content and impact of live surgical feedback, enabling more efficient analysis of how feedback can be best delivered to trainees.
Conclusions: Artificial intelligence is a promising tool for augmenting surgical training and improving the objectivity and scalability of surgical skill assessment and feedback. To date, AI models are adept at detecting relatively large differences in surgical performance and providing rudimentary feedback. Further work is required to create models capable of doing more fine-tuned skill assessments and generating more detailed, constructive feedback.
{"title":"Artificial intelligence-based approaches to augmenting and automating surgical training.","authors":"Jasmine Lin, Ludovica Cella, Mitchell G Goldenberg, Andrew J Hung","doi":"10.1111/bju.70229","DOIUrl":"https://doi.org/10.1111/bju.70229","url":null,"abstract":"<p><strong>Objective: </strong>To review recent advances in the use of artificial intelligence (AI) to address shortcomings in assessing and improving surgical performance/training by automating surgical skills assessment and feedback.</p><p><strong>Methods: </strong>We searched PubMed for studies published between 2015 and 2025 pertaining to AI for surgical training. Search terms included 'artificial intelligence or 'machine learning' or 'deep learning' and 'surgical feedback' or 'surgical training' or 'surgical skill'. Articles were identified with special attention given to those published in the last 5 years with a focus on AI for surgical skill assessment or feedback.</p><p><strong>Results: </strong>Artificial intelligence has been used to successfully automate surgical skill assessment across a variety of surgical disciplines via approaches such as kinematics, sabermetrics, computer vision, and gesture analysis. Many of these studies have developed AI models capable of a binary classification of skill (novice vs expert), which demonstrate concordance when verified against ground truths from human raters. Based on these skills assessments, AI approaches may be further leveraged to generate automatic feedback, which has proven effective in improving surgeon performance metrics, particularly for underperformers. AI has also shown utility in categorising and analysing the content and impact of live surgical feedback, enabling more efficient analysis of how feedback can be best delivered to trainees.</p><p><strong>Conclusions: </strong>Artificial intelligence is a promising tool for augmenting surgical training and improving the objectivity and scalability of surgical skill assessment and feedback. To date, AI models are adept at detecting relatively large differences in surgical performance and providing rudimentary feedback. Further work is required to create models capable of doing more fine-tuned skill assessments and generating more detailed, constructive feedback.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430714","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}
Roberto Contieri,Alberto Martini,Marc Furrer,David D'Andrea,Francesco Claps,Markus von Deimling,Francesco Soria,Andrea Mari,Lorenzo Bianchi,Elena Tonin,Ronan Flippot,Jeremy Y C Teoh,Gauthier Marcq,Pierre-Emmanuel Desprez,Renate Pichler,Aleksander Ślusarczyk,José Daniel Subiela,Francesco Del Giudice,Valerio Santarelli,Angelo Porreca,Antonio Amodeo,Nicola Pavan,Alchiede Simonato,Pietro Scilipoti,Sisto Perdonà,Paolo Gontero,Bas Wg van Rhijn,Rodolfo Hurle,Marco Moschini,Benjamin Pradere,Laura S Mertens,
OBJECTIVETo develop a data-driven risk-stratification model to identify high-risk patients following radical cystectomy (RC) for bladder cancer and propose a risk-adapted follow-up (FU) schedule.PATIENTS AND METHODSWe performed a retrospective analysis of an individual patient data registry comprising 3196 patients with clinical T stage (cT)2-T4 N0M0 bladder cancer who underwent RC at 16 European centres (1990-2024). All treatment decisions, including the use of neoadjuvant chemotherapy, adjuvant therapy, and the FU schedule, were made at the discretion of the treating physician in accordance with the patient's preference. A Classification and Regression Tree (CART) analysis, incorporating pathological T and N stages, lymphovascular invasion (LVI), and other features, was used to stratify patients into Low-Risk and High-Risk groups for recurrence. The primary endpoint was recurrence-free survival (RFS). We used a landmark analysis to evaluate the conditional risk of recurrence at 1, 2, 3, 4, and 5 years after RC.RESULTSAt a median FU of 81.8 months, 891 patients recurred. CART analysis identified a High-Risk group (pathological T stage [pT]3-pT4, node-positive disease, or pT2 with LVI) with significantly worse 5-year RFS than the Low-Risk group (37.8% vs 76.2%; P < 0.001). This stratification was strongly prognostic for recurrence (hazard ratio [HR] 4.29; 95% confidence interval 3.63-5.00), cancer-specific survival (subdistribution HR 5.80), and overall survival (HR 3.04) (all P < 0.001). Landmark analysis confirmed that the elevated risk persisted up to 4 years; however, the conditional risk for event-free patients converged after 5 years (HR 1.37; P = 0.3).CONCLUSIONSThis study establishes a simple, pathologically derived model (pT3-4/pN+/pT2 + LVI) that effectively stratifies post-RC patients, enabling a risk-adapted FU strategy. Prospective evaluation of this framework is required to confirm its clinical utility, safety, and cost-effectiveness.
目的建立数据驱动的风险分层模型，以识别膀胱癌根治性膀胱切除术（RC）后的高危患者，并提出风险适应随访（FU）计划。患者和方法我们对一项包括3196例临床T期（cT）2-T4 N0M0膀胱癌患者的个人数据登记进行了回顾性分析，这些患者在16个欧洲中心接受了RC（1990-2024）。所有的治疗决定，包括使用新辅助化疗、辅助治疗和FU计划，都是由治疗医生根据患者的偏好做出的。采用分类回归树（CART）分析，结合病理T和N分期、淋巴血管浸润（LVI）和其他特征，将患者分为低危和高危复发组。主要终点为无复发生存期（RFS）。我们采用里程碑式分析来评估术后1、2、3、4和5年的复发风险。结果中位FU为81.8个月，891例患者复发。CART分析发现，高危组（病理性T分期[pT]3-pT4、淋巴结阳性疾病或pT2伴LVI）的5年RFS明显差于低危组（37.8% vs 76.2%, P < 0.001）。这种分层对复发（危险比[HR] 4.29； 95%可信区间3.63-5.00）、癌症特异性生存（亚分布HR 5.80）和总生存（HR 3.04）（均P < 0.001）具有很强的预后作用。里程碑式分析证实，升高的风险持续4年；然而，无事件患者的条件性风险在5年后趋于一致（HR 1.37; P = 0.3）。本研究建立了一种简单的病理衍生模型（pT3-4/pN+/pT2 + LVI），可有效地对rc后患者进行分层，从而实现风险适应FU策略。需要对该框架进行前瞻性评估，以确认其临床实用性、安全性和成本效益。
{"title":"Risk stratification and conditional recurrence after radical cystectomy: toward adaptive follow-up.","authors":"Roberto Contieri,Alberto Martini,Marc Furrer,David D'Andrea,Francesco Claps,Markus von Deimling,Francesco Soria,Andrea Mari,Lorenzo Bianchi,Elena Tonin,Ronan Flippot,Jeremy Y C Teoh,Gauthier Marcq,Pierre-Emmanuel Desprez,Renate Pichler,Aleksander Ślusarczyk,José Daniel Subiela,Francesco Del Giudice,Valerio Santarelli,Angelo Porreca,Antonio Amodeo,Nicola Pavan,Alchiede Simonato,Pietro Scilipoti,Sisto Perdonà,Paolo Gontero,Bas Wg van Rhijn,Rodolfo Hurle,Marco Moschini,Benjamin Pradere,Laura S Mertens, ","doi":"10.1111/bju.70232","DOIUrl":"https://doi.org/10.1111/bju.70232","url":null,"abstract":"OBJECTIVETo develop a data-driven risk-stratification model to identify high-risk patients following radical cystectomy (RC) for bladder cancer and propose a risk-adapted follow-up (FU) schedule.PATIENTS AND METHODSWe performed a retrospective analysis of an individual patient data registry comprising 3196 patients with clinical T stage (cT)2-T4 N0M0 bladder cancer who underwent RC at 16 European centres (1990-2024). All treatment decisions, including the use of neoadjuvant chemotherapy, adjuvant therapy, and the FU schedule, were made at the discretion of the treating physician in accordance with the patient's preference. A Classification and Regression Tree (CART) analysis, incorporating pathological T and N stages, lymphovascular invasion (LVI), and other features, was used to stratify patients into Low-Risk and High-Risk groups for recurrence. The primary endpoint was recurrence-free survival (RFS). We used a landmark analysis to evaluate the conditional risk of recurrence at 1, 2, 3, 4, and 5 years after RC.RESULTSAt a median FU of 81.8 months, 891 patients recurred. CART analysis identified a High-Risk group (pathological T stage [pT]3-pT4, node-positive disease, or pT2 with LVI) with significantly worse 5-year RFS than the Low-Risk group (37.8% vs 76.2%; P < 0.001). This stratification was strongly prognostic for recurrence (hazard ratio [HR] 4.29; 95% confidence interval 3.63-5.00), cancer-specific survival (subdistribution HR 5.80), and overall survival (HR 3.04) (all P < 0.001). Landmark analysis confirmed that the elevated risk persisted up to 4 years; however, the conditional risk for event-free patients converged after 5 years (HR 1.37; P = 0.3).CONCLUSIONSThis study establishes a simple, pathologically derived model (pT3-4/pN+/pT2 + LVI) that effectively stratifies post-RC patients, enabling a risk-adapted FU strategy. Prospective evaluation of this framework is required to confirm its clinical utility, safety, and cost-effectiveness.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"19 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439543","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":"Perioperative nutritional optimisation in radical cystectomy: a response to Kapil et al.","authors":"Mohammed Lotfi Amer, Sameh Fawzy Elnasharty","doi":"10.1111/bju.70227","DOIUrl":"https://doi.org/10.1111/bju.70227","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430666","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}
Stuart Robert Jackson, Paul Yu, Steven Sowter, Stefano Occhipinti, Suzanne Chambers, Scott Leslie, Manish I Patel
Objective: To describe the development and validation of the Prostate Cancer Electronic Health (eHealth) Literacy Instrument (P-CeHLI). This is in response to: (i) a lack of clear and validated eHealth literacy measurement for men with prostate cancer; (ii) the unique information processing, decision making, and digital communication experience of men with prostate cancer as a single sex, older age, cancer cohort; and (iii) modern eHealth literacy theory and research, which now greatly considers the transactional nature of web technologies and digital communicative practice.
Patients and methods: A total of 349 men with prostate cancer participated in a three-phase, longitudinal instrument development study. This was undertaken with end-user participation, and a multidisciplinary and international collaboration of prostate cancer, psycho-oncology, communication, and biostatistics experts. Exploratory and confirmatory factor analysis evaluated construct validity. The P-CeHLI was compared to respondents' eHealth literacy measured with the Transactional eHealth Literacy Instrument (TeHLI), as well as respondent eHealth utilisation and sociodemographic characteristics.
Results: A four-factor model was demonstrated with acceptable fit properties (root mean square error of approximation = 0.074; comparative fit index = 0.931; Tucker-Lewis index = 0.924; standardised root mean square residual = 0.051) and excellent reliability (subscale alphas of 0.85-0.96). Domains of the P-CeHLI included cancer-specific functional, communicative, critical and translational eHealth literacy. Association between the scores of the scales and respondents' characteristics were similar; however, for all four subdomains, the P-CeHLI added significant predictive value when assessing eHealth use in men with prostate cancer whilst controlling for respective TeHLI scores.
Conclusion: The P-CeHLI establishes a novel cancer-specific multidomain eHealth literacy instrument, validated in men with prostate cancer, and positioned to respond to their needs in the digital cancer care era. The P-CeHLI provides a new opportunity for clinicians and researchers to accurately identify and enhance the eHealth literacy skills of patients with prostate cancer, which may improve future clinical outcomes through digital intervention and improved communicative practice.
{"title":"The prostate cancer electronic health (eHealth) literacy instrument: a tool for eHealth design and patient communication.","authors":"Stuart Robert Jackson, Paul Yu, Steven Sowter, Stefano Occhipinti, Suzanne Chambers, Scott Leslie, Manish I Patel","doi":"10.1111/bju.70225","DOIUrl":"https://doi.org/10.1111/bju.70225","url":null,"abstract":"<p><strong>Objective: </strong>To describe the development and validation of the Prostate Cancer Electronic Health (eHealth) Literacy Instrument (P-CeHLI). This is in response to: (i) a lack of clear and validated eHealth literacy measurement for men with prostate cancer; (ii) the unique information processing, decision making, and digital communication experience of men with prostate cancer as a single sex, older age, cancer cohort; and (iii) modern eHealth literacy theory and research, which now greatly considers the transactional nature of web technologies and digital communicative practice.</p><p><strong>Patients and methods: </strong>A total of 349 men with prostate cancer participated in a three-phase, longitudinal instrument development study. This was undertaken with end-user participation, and a multidisciplinary and international collaboration of prostate cancer, psycho-oncology, communication, and biostatistics experts. Exploratory and confirmatory factor analysis evaluated construct validity. The P-CeHLI was compared to respondents' eHealth literacy measured with the Transactional eHealth Literacy Instrument (TeHLI), as well as respondent eHealth utilisation and sociodemographic characteristics.</p><p><strong>Results: </strong>A four-factor model was demonstrated with acceptable fit properties (root mean square error of approximation = 0.074; comparative fit index = 0.931; Tucker-Lewis index = 0.924; standardised root mean square residual = 0.051) and excellent reliability (subscale alphas of 0.85-0.96). Domains of the P-CeHLI included cancer-specific functional, communicative, critical and translational eHealth literacy. Association between the scores of the scales and respondents' characteristics were similar; however, for all four subdomains, the P-CeHLI added significant predictive value when assessing eHealth use in men with prostate cancer whilst controlling for respective TeHLI scores.</p><p><strong>Conclusion: </strong>The P-CeHLI establishes a novel cancer-specific multidomain eHealth literacy instrument, validated in men with prostate cancer, and positioned to respond to their needs in the digital cancer care era. The P-CeHLI provides a new opportunity for clinicians and researchers to accurately identify and enhance the eHealth literacy skills of patients with prostate cancer, which may improve future clinical outcomes through digital intervention and improved communicative practice.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430725","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}
Pietro Diana,Francesco Di Bello,Laura Mas,Andrea Gallioli,Marco Paciotti,Nicola Frego,Alex Mottrie,Joan Palou,Nicolòmaria Buffi,Alberto Breda
OBJECTIVETo evaluate the efficacy in residents of the EuropeaN Training in uRologY (ENTRY) training curriculum for transurethral resection of bladder tumour (TURBT) vs conventional methodology, as TURBT is one of the most performed procedures by residents and early-career urologists.SUBJECTS/PATIENTS AND METHODSWe compared resident performance in TURBT trained through the ENTRY curriculum vs a conventional methodology. All residents underwent a TURBT educational rotation of 4 months supervised by uro-oncology attendings. In the conventional methodology group TURBT training was a standard tutoring in the operating room (OR). The ENTRY curriculum group underwent a pre-clinical: theoretical learning of metrics with a tutor and dry laboratory; and a surgical phase: supervised OR training by trained mentors.RESULTSWe evaluated 162 patients undergoing TURBT. Of these 74 (46%) TURBTs were performed by three conventionally-trained residents and 88 (54%) TURBT by three ENTRY curriculum-trained residents. Despite not being statistically different (P = 0.07), the reduction in high-grade perforation (DEpth of Endoscopic Perforation [DEEP] scale 2-3) in the ENTRY curriculum-trained group (12% vs 4.5%) was clinically meaningful. Postoperative complications was significantly lower in the ENTRY curriculum-trained group, for overall (13% vs 30%, P = 0.007), minor (10% vs 23%, P = 0.04), and major events (2.3% vs 6.8%, P = 0.1). Detrusor muscle presence was significantly higher in the ENTRY curriculum-trained group (91% vs 80%, P = 0.04).CONCLUSIONSThe ENTRY training curriculum for residents is effective in improving pivotal clinical outcomes in TURBT training vs conventional training. This training is a step towards standardised training and optimal outcomes in urology education.
目的评估欧洲泌尿外科培训（入门）培训课程经尿道膀胱肿瘤切除术（TURBT）与传统方法的效果，因为TURBT是住院医师和早期泌尿科医生最常进行的手术之一。受试者/患者和方法我们比较了通过入门课程和传统方法培训的住院医师在TURBT中的表现。所有住院医师都在泌尿肿瘤主治医师的指导下进行了为期4个月的TURBT轮转教育。在常规方法组中，TURBT培训是一种标准的手术室辅导。入门课程组在导师和干燥实验室进行了临床前：计量学的理论学习；手术阶段：由训练有素的导师进行监督或培训。结果我们对162例接受TURBT的患者进行了评估。其中74例（46%）TURBT由3名接受常规培训的住院医生执行，88例（54%）TURBT由3名接受入门课程培训的住院医生执行。尽管没有统计学差异（P = 0.07），但在入门课程训练组中，高级别穿孔（内镜穿孔深度[DEEP]分级2-3）的减少（12% vs 4.5%）具有临床意义。在总体（13% vs 30%, P = 0.007）、次要（10% vs 23%, P = 0.04）和重大事件（2.3% vs 6.8%, P = 0.1）方面，入门课程训练组的术后并发症显著降低。在入门课程训练组中，逼尿肌的存在明显更高（91% vs 80%, P = 0.04）。结论与常规培训相比，住院医师入门培训课程能有效改善TURBT培训的关键临床结果。该培训是泌尿外科教育朝着标准化培训和最佳结果迈出的一步。
{"title":"Curriculum-based training improves transurethral resection of bladder tumour performance compared to conventional training: the EuropeaN Training in uRologY (ENTRY) project.","authors":"Pietro Diana,Francesco Di Bello,Laura Mas,Andrea Gallioli,Marco Paciotti,Nicola Frego,Alex Mottrie,Joan Palou,Nicolòmaria Buffi,Alberto Breda","doi":"10.1111/bju.70223","DOIUrl":"https://doi.org/10.1111/bju.70223","url":null,"abstract":"OBJECTIVETo evaluate the efficacy in residents of the EuropeaN Training in uRologY (ENTRY) training curriculum for transurethral resection of bladder tumour (TURBT) vs conventional methodology, as TURBT is one of the most performed procedures by residents and early-career urologists.SUBJECTS/PATIENTS AND METHODSWe compared resident performance in TURBT trained through the ENTRY curriculum vs a conventional methodology. All residents underwent a TURBT educational rotation of 4 months supervised by uro-oncology attendings. In the conventional methodology group TURBT training was a standard tutoring in the operating room (OR). The ENTRY curriculum group underwent a pre-clinical: theoretical learning of metrics with a tutor and dry laboratory; and a surgical phase: supervised OR training by trained mentors.RESULTSWe evaluated 162 patients undergoing TURBT. Of these 74 (46%) TURBTs were performed by three conventionally-trained residents and 88 (54%) TURBT by three ENTRY curriculum-trained residents. Despite not being statistically different (P = 0.07), the reduction in high-grade perforation (DEpth of Endoscopic Perforation [DEEP] scale 2-3) in the ENTRY curriculum-trained group (12% vs 4.5%) was clinically meaningful. Postoperative complications was significantly lower in the ENTRY curriculum-trained group, for overall (13% vs 30%, P = 0.007), minor (10% vs 23%, P = 0.04), and major events (2.3% vs 6.8%, P = 0.1). Detrusor muscle presence was significantly higher in the ENTRY curriculum-trained group (91% vs 80%, P = 0.04).CONCLUSIONSThe ENTRY training curriculum for residents is effective in improving pivotal clinical outcomes in TURBT training vs conventional training. This training is a step towards standardised training and optimal outcomes in urology education.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"196 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439545","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}
Robert Adler, John R Heard, Andrew G Winer, Andrew L Freedman
{"title":"What makes a great urology sub-internship? A survey of medical students, residents, and faculty.","authors":"Robert Adler, John R Heard, Andrew G Winer, Andrew L Freedman","doi":"10.1111/bju.70200","DOIUrl":"https://doi.org/10.1111/bju.70200","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430733","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":"Manas Jyoti Kapil, Bipul Nath, Neelakshi Sharma","doi":"10.1111/bju.70226","DOIUrl":"https://doi.org/10.1111/bju.70226","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430641","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}
Henry Y C Pan,David Homewood,Harrison Lucas,Brendan Dittmer,Jiasian Teh,Jonathan S O'Brien,Jianliang Liu,Ben Tran,Justin Chee,James A Churchill,Nathan Lawrentschuk,Niall M Corcoran
BACKGROUNDPenile cancer is a rare malignancy, with an Australian incidence of 0.6 in 100 000 men, with a wide range of clinical presentations, from localised, curable tumours to aggressive forms with high morbidity and mortality. Epidemiological data and management guidelines for penile cancer in Australia are limited. The Australian Penile Cancer Clinical Registry (APCCR) aims to address this gap through a centralised database studying local risk factors, treatment effectiveness, and outcomes.STUDY DESIGNThe APCCR is a national, multicentre, prospective clinical quality registry.ENDPOINTSThe primary objective is to map demographic and tumour characteristics, human papillomavirus infection rates, long-term surgical and non-surgical (radiotherapy and chemotherapy) interventions in penile cancer. Secondary objectives include elucidating disparities and interdisciplinary gaps in care and identifying areas for further studies.PATIENTS AND METHODSThe registry aims to capture adult men with penile cancer in, utilising retrospective data collection and a prospective cohort design. Retrospective data are extracted from existing medical records, and prospective data are collected at enrolled sites. The registry is built in Research Electronic Data Capture (REDCap) and hosted on BioGrid Australia servers, enabling standardised data collection. Registration with the Australian Register of Clinical Registries is pending approval.RESULTSThe pilot phase of the APCCR is currently operational, with ongoing site recruitment. Five sites in Victoria and New South Wales are currently enrolled in the registry. The APCCR Steering Committee determined reporting and data protocols to ensure accurate data collection. The dataset was developed to comprise relevant clinical metrics on penile cancer diagnosis, disease, intervention, and surveillance.CONCLUSIONThe APCCR is a robust platform for furthering the understanding of penile cancer diagnostic and treatment practices in Australia, aiming to further research and clinical practice changes. This will drive further collaboration and improvements in outcomes for Australian men affected by penile cancer, particularly with ongoing national expansion and improved longitudinal data.
{"title":"The Australian Penile Cancer Clinical Registry: a comprehensive national approach to data collection.","authors":"Henry Y C Pan,David Homewood,Harrison Lucas,Brendan Dittmer,Jiasian Teh,Jonathan S O'Brien,Jianliang Liu,Ben Tran,Justin Chee,James A Churchill,Nathan Lawrentschuk,Niall M Corcoran","doi":"10.1111/bju.70188","DOIUrl":"https://doi.org/10.1111/bju.70188","url":null,"abstract":"BACKGROUNDPenile cancer is a rare malignancy, with an Australian incidence of 0.6 in 100 000 men, with a wide range of clinical presentations, from localised, curable tumours to aggressive forms with high morbidity and mortality. Epidemiological data and management guidelines for penile cancer in Australia are limited. The Australian Penile Cancer Clinical Registry (APCCR) aims to address this gap through a centralised database studying local risk factors, treatment effectiveness, and outcomes.STUDY DESIGNThe APCCR is a national, multicentre, prospective clinical quality registry.ENDPOINTSThe primary objective is to map demographic and tumour characteristics, human papillomavirus infection rates, long-term surgical and non-surgical (radiotherapy and chemotherapy) interventions in penile cancer. Secondary objectives include elucidating disparities and interdisciplinary gaps in care and identifying areas for further studies.PATIENTS AND METHODSThe registry aims to capture adult men with penile cancer in, utilising retrospective data collection and a prospective cohort design. Retrospective data are extracted from existing medical records, and prospective data are collected at enrolled sites. The registry is built in Research Electronic Data Capture (REDCap) and hosted on BioGrid Australia servers, enabling standardised data collection. Registration with the Australian Register of Clinical Registries is pending approval.RESULTSThe pilot phase of the APCCR is currently operational, with ongoing site recruitment. Five sites in Victoria and New South Wales are currently enrolled in the registry. The APCCR Steering Committee determined reporting and data protocols to ensure accurate data collection. The dataset was developed to comprise relevant clinical metrics on penile cancer diagnosis, disease, intervention, and surveillance.CONCLUSIONThe APCCR is a robust platform for furthering the understanding of penile cancer diagnostic and treatment practices in Australia, aiming to further research and clinical practice changes. This will drive further collaboration and improvements in outcomes for Australian men affected by penile cancer, particularly with ongoing national expansion and improved longitudinal data.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"77 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147383599","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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