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Serial manual bolus irrigation leads to critical intrarenal pressures during flexible ureterorenoscopy – time to abandon this manoeuvre 在柔性输尿管造影术中,连续手动栓剂灌注会导致肾内压达到临界值--是时候放弃这种操作方法了
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-18 DOI: 10.1111/bju.16535
Anne Hong, Cliodhna Browne, Greg Jack, Damien Bolton
To characterise the effect of solitary and serial manual bolus irrigations on intrarenal pressures (IRPs) and observe the clinical consequences.
描述单独和连续人工栓剂灌注对肾内压力(IRP)的影响,并观察其临床后果。
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引用次数: 0
Forging academic excellence: crafting an open academic curriculum for European Urologists 打造卓越学术:为欧洲泌尿科医生精心设计开放式学术课程
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-17 DOI: 10.1111/bju.16550
Daniel A. González-Padilla, Riccardo Campi, Juan Gomez Rivas
<p>It has been reported that there is a limited amount of training on research/methodological skills during urological residency in Europe [<span>1</span>]. The Young Academic Urologists (YAU) of the European Association of Urology (EAU) aims to promote and perform high-quality research to provide high-quality evidence for the best urological care, as well as to promote educational programmes to boost European training standards and forge a platform for close international cooperation for the future urology leaders in Europe and beyond.</p><p>One of the goals at the YAU is to develop an open academic curriculum accessible to all EAU members. This curriculum strives to be pan-European, impartial, and of the highest quality, covering from basic to advanced topics in research skills, and led by consolidated experts in the field. For this purpose, a survey was developed to build the foundations of the project.</p><p>We created an on-line survey made of 11 questions using the SurveyMonkey platform (http://www.surveymonkey.com/). This cross-sectional survey study aimed to assess the design of a training curriculum for academic research. As there is no validated survey in this regard, the YAU board reviewed the survey before its distribution. The survey was a self-administered questionnaire that collected demographic variables, including age, gender, country, years of experience post-residency, and work setting. No personally identifiable information was gathered. Respondents were tasked with evaluating the potential content of the YAU academic curriculum (full survey available in the Data S1). The survey was distributed in three rounds: initially on 17 and 20 April 2023, with a reminder in May 2023, via mailing lists of the YAU (<i>N</i> = 186). Only complete surveys were included in the final analysis. We adhered to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines as recommended by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network [<span>2</span>]. As no identifiable personal information was collected, it was deemed exempt from formal Institutional Review Board approval [<span>3</span>]. Descriptive statistics were used to summarise demographic characteristics and survey responses.</p><p>We obtained 127 complete responses out of 186 recipients (response rate of 68%). Respondents had a median (range) age of 35 (26–67) years, with 80% (<i>n</i> = 102) being male. The sample represented 23 countries, predominantly Italy, Germany, and Spain, constituting 54% (<i>n</i> = 69) of the respondents. Of the participants, 111 (87%) work in a University Hospital setting, and the median (interquartile range) years of experience post-residency were 4 (2–7) years.</p><p>Regarding the curriculum, 124 (97%) of respondents agreed that mentors should be evaluated by trainees at the programme's end, and 125 (98%) concurred that the programme itself should undergo evaluation. Concerning the programme's durati
涉及积极参与研究的评估方法,如在导师协助下撰写科学论文或接受导师的持续评估,突出了实践学习和导师指导在研究培训中的重要性。这些方法不仅能培养学员的实际研究技能,还能鼓励导师与学员之间进行有意义的互动,促进知识的传授。相对于面对面的互动,在线和混合形式更受青睐,这反映了技术在教育和培训中的日益融合。在线和混合形式提供了更大的灵活性和可及性,使学员能够不受地域限制地参与教育活动,这与之前发表的关于混合科学会议的研究[6]是一致的。然而,针对演讲技巧等主题的面对面互动强调了人际沟通和实践培训在专业发展某些方面的价值[7]。虽然该调查从多个国家的不同青年泌尿科医师样本中获得了宝贵的见解,但也应承认存在一些局限性。首先,对自我报告数据的依赖可能会带来反应偏差,影响调查结果的外部有效性。此外,样本可能无法完全代表所有青年泌尿科医师,尤其是那些来自代表性不足的地区或执业环境的青年泌尿科医师。从这项调查中获得的见解有助于了解青年泌尿科医师学术课程需要包含哪些内容(图 1),重点是促进高质量的研究和专业发展。同样,青年泌尿科医生办公室推出了补充性的 "人才孵化计划"(https://uroweb.org/eau-talent-incubator-programme),这是一个由四个训练营组成的系列课程,旨在培养从领导力和沟通到心理健康以及数字技术和研究等多项非技术技能。最后,通过纳入学员的偏好和优先事项,拟议的学术课程旨在涵盖研究方法学方面的一整套主题,重点关注定性和定量方法、研究设计、数据收集和统计分析。课程强调文献综述技能,教授对现有文献进行批判性评估和综合,找出知识差距,并提出研究问题。还将提供研究项目提案指导,包括制定明确的目标、方法和研究的意义。此外,课程还将重点关注数据管理(组织、存储、记录和遵守数据保护法规)。还将介绍出版流程,包括稿件准备、写作风格、期刊选择、同行评审和回应反馈。演示技能,包括公开演讲、幻灯片设计和观众参与,以加强研究结果的口头和视觉交流。此外,还将教授撰写资助金的策略,包括确定资金来源、制定预算和阐明研究影响。最后,课程将介绍人工智能、机器学习和大数据分析等新技术的使用,并探讨这些技术如何改变从数据收集到传播的研究过程。本次调查收集的数据将有助于实现这一开放式学术课程的第一版。
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引用次数: 0
Bladder irrigation with tap water to reduce antibiotic use for urinary tract infections in catheter users 用自来水冲洗膀胱,减少导尿管使用者尿路感染的抗生素用量
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-16 DOI: 10.1111/bju.16552
Stefan den Hoedt, Felice E.E. van Veen, Jeroen R. Scheepe, Bertil F.M. Blok
To evaluate the safety and effectiveness of bladder irrigation (BI) with tap water to reduce antibiotic use for the treatment of urinary tract infections (UTIs) in patients with recurrent UTI symptoms and to assess the treatment satisfaction of BI.
目的:评估用自来水进行膀胱冲洗(BI)以减少抗生素使用的安全性和有效性,从而治疗反复出现尿路感染(UTI)症状的患者,并评估 BI 的治疗满意度。
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引用次数: 0
Undetectable pre-radical cystectomy circulating tumour DNA status predicts improved oncological outcomes 根治性膀胱切除术前检测不到循环肿瘤 DNA 状态可预示肿瘤治疗效果的改善
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-16 DOI: 10.1111/bju.16556
Reuben Ben-David, Sarah Lidagoster, Jack Geduldig, Kaushik P. Kolanukuduru, Yuval Elkun, Neeraja Tillu, Asher Mandel, Mohammed Almoflihi, Basil Kaufmann, Kyrollis Attalla, Reza Mehrazin, Peter Wiklund, John P. Sfakianos
To assess recurrence-free survival (RFS) in patients with undetectable tumour-informed circulating tumour DNA (ctDNA) before radical cystectomy (RC) and evaluate if those who converted from detectable to undetectable ctDNA status after RC have similar RFS outcomes as those with persistently undetectable ctDNA status.
目的:评估根治性膀胱切除术(RC)前检测不到肿瘤信息循环肿瘤DNA(ctDNA)的患者的无复发生存期(RFS),并评估RC后从检测到ctDNA转为检测不到的患者是否与持续检测不到ctDNA的患者具有相似的RFS结果。
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引用次数: 0
Embracing diversity, equity, and inclusion in academic urology: the Young Academic Urologists (YAU) perspective. 在泌尿外科学术领域实现多样性、公平性和包容性:泌尿外科青年学者 (YAU) 的观点。
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-15 DOI: 10.1111/bju.16549
Rianne J M Lammers,Amelia Pietropaolo,Giovanni Cacciamani,Juan Gomez Rivas,Riccardo Campi,Beatriz Bañuelos Marco,
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引用次数: 0
Efficacy of decision aid delivery modes in prostate cancer screening: umbrella review and network meta-analysis 前列腺癌筛查中决策辅助工具提供模式的功效:总体回顾和网络荟萃分析
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-14 DOI: 10.1111/bju.16545
Zen Yang Ang, Yuke-Lin Kong, Zarith Nameyrra Md Nesran, Shaun Wen Huey Lee
To review and compare the efficacy of different delivery modes of decision aids (DAs), including computer-based, print-based, multimedia-based, video-based, and website-based on decision-making outcomes for prostate cancer screening compared to usual care (UC) and among the delivery modes.
回顾并比较不同决策辅助工具(DAs)提供模式的效果,包括计算机型、印刷型、多媒体型、视频型和网站型,与常规护理(UC)相比以及不同提供模式之间对前列腺癌筛查决策结果的影响。
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引用次数: 0
VI‐RADS followed by Photodynamic Transurethral Resection of Non‐Muscle‐Invasive Bladder Cancer vs White‐Light Conventional and Second‐resection: the ‘CUT‐less’ Randomised Trial Protocol 非肌层浸润性膀胱癌的 VI-RADS 光动力经尿道切除术 vs 白光传统切除术和二次切除术:"无切口 "随机试验方案
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-14 DOI: 10.1111/bju.16531
Francesco Del Giudice, Annarita Vestri, Danilo Alunni Fegatelli, Tanja Hüsch, Jonathan Belsey, Rajesh Nair, Eila C. Skinner, Benjamin I. Chung, Martina Pecoraro, Alessandro Sciarra, Giorgio Franco, Benjamin Pradere, Paola Gazzaniga, Fabio Massimo Magloicca, Valeria Panebianco, Ettore De Berardinis
BackgroundA second transurethral resection of bladder tumour (Re‐TURBT) is recommended by European Association of Urology (EAU) Guidelines on non‐muscle‐invasive bladder cancers (NMIBCs) due to the risk of understaging and/or persistent disease following the primary resection. However, in many cases this may be unnecessary, potentially harmful, and significantly expensive constituting overtreatment. The CUT‐less trial aims to combine the preoperative staging accuracy of Vesical Imaging‐Reporting and Data System (VI‐RADS) and the intraoperative enhanced ability of photodynamic diagnosis (PDD) to overcome the primary TURBT pitfalls thus potentially re‐defining criteria for Re‐TURBT indications.Study DesignSingle‐centre, non‐inferiority, phase IV, open‐label, randomised controlled trial with 1:1 ratio.EndpointsThe primary endpoint is short‐term BC recurrence between the study arms to assess whether patients preoperatively categorised as VI‐RADS Score 1 and/or Score 2 (i.e., very‐low and low likelihood of MIBC) could safely avoid Re‐TURBT by undergoing primary PDD‐TURBT. Secondary endpoints include mid‐ and long‐term BC recurrences and progression (i–ii). Also, health‐related quality of life (HRQoL) outcomes (iii) and health‐economic cost–benefit analysis (iv) will be performed.Patients and MethodsAll patients will undergo preoperative Multiparametric Magnetic Resonance Imaging of the bladder with VI‐RADS score determination. A total of 327 patients with intermediate‐/high‐risk NMIBCs, candidate for Re‐TURBT according to EAU Guidelines, will be enrolled over a 3‐year period. Participants will be randomised (1:1 ratio) to either standard of care (SoC), comprising primary white‐light (WL) TURBT followed by second WL Re‐TURBT; or the Experimental arm, comprising primary PDD‐TURBT and omitting Re‐TURBT. Both groups will receive adjuvant intravesical therapy and surveillance according to risk‐adjusted schedules. Measure of the primary outcome will be the relative proportion of BC recurrences between the SoC and Experimental arms within 4.5 months (i.e., any ‘early’ recurrence detected at first follow‐up cystoscopy). Secondary outcomes measures will be the relative proportion of late BC recurrences and/or BC progression detected after 4.5 months follow‐up. Additionally, we will compute the HRQoL variation from NMIBC questionnaires modelled over a patient lifetime horizon and the health‐economic analyses including a short‐term cost–benefit assessment of incremental costs per Re‐TURBT avoided and a longer‐term cost‐utility per quality‐adjusted life year gained using 2‐year clinical outcomes to drive a lifetime model across the two arms of treatment.Trial RegistrationClinicalTrial.gov identifier (ID): NCT05962541; European Union Drug Regulating Authorities Clinical Trials Database (EudraCT) ID: 2023‐507307‐64‐00.
背景欧洲泌尿外科协会(EAU)关于非肌层浸润性膀胱癌(NMIBCs)的指南建议进行第二次经尿道膀胱肿瘤切除术(Re-TURBT),因为初次切除术后可能会出现分期不足和/或疾病持续存在的风险。然而,在很多情况下,这可能是不必要的、潜在有害的,而且费用高昂,构成过度治疗。CUT-less试验旨在将膀胱造影报告和数据系统(VI-RADS)的术前分期准确性与光动力诊断(PDD)的术中增强能力相结合,克服原发性TURBT的缺陷,从而有可能重新定义Re-TURBT的适应症标准。研究设计单中心、非劣效、IV 期、开放标签、随机对照试验,比例为 1:1。终点主要终点是研究臂之间的短期 BC 复发率,以评估术前被归类为 VI-RADS 评分 1 和/或评分 2(即:极低和低心肌梗死可能性)的患者是否复发、或评分 2(即发生 MIBC 的可能性很低和很低)的患者是否可以通过接受初级 PDD-TURBT 术安全地避免再次 TURBT。次要终点包括 BC 的中长期复发和进展(i-ii)。此外,还将进行健康相关生活质量(HRQoL)结果(iii)和健康经济成本效益分析(iv)。患者和方法所有患者将在术前接受膀胱多参数磁共振成像,并进行VI-RADS评分。根据 EAU 指南,共有 327 名中/高危 NMIBC 患者将在 3 年内接受 Re-TURBT 治疗。参试者将按 1:1 的比例随机分配到标准护理组(SoC),包括初级白光 (WL) TURBT,然后进行第二次 WL Re-TURBT;或实验组,包括初级 PDD-TURBT,省略 Re-TURBT。两组患者都将根据风险调整后的计划接受膀胱内辅助治疗和监测。衡量主要结果的指标是 SoC 组和实验组在 4.5 个月内 BC 复发的相对比例(即首次随访膀胱镜检查时发现的任何 "早期 "复发)。次要结局指标将是随访 4.5 个月后发现的晚期 BC 复发和/或 BC 进展的相对比例。此外,我们还将计算NMIBC问卷的HRQoL变化,并在患者的终生范围内进行建模。健康经济分析包括短期成本效益评估,即每避免一次Re-TURBT的增量成本,以及长期成本效用,即每获得一个质量调整生命年,使用2年的临床结果来驱动两个治疗臂的终生模型:NCT05962541; European Union Drug Regulating Authorities Clinical Trials Database (EudraCT) ID: 2023-507307-64-00。
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引用次数: 0
Ureteroscopy and lasertripsy for lower pole stones <2 cm, in situ vs displacement? A systematic review and meta-analysis 输尿管镜和激光碎石术治疗小于2厘米的下段结石,原位与移位?系统回顾和荟萃分析
IF 4.5 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-13 DOI: 10.1111/bju.16534
Arran Dingwall, James Leighton, Angus Luk, Mark Chambers, Bhaskar Somani, Robert Geraghty
To investigate the outcomes of ureteroscopy and lasertripsy in lower pole renal stones <2 cm when treated in situ compared to displacement to the upper pole.
研究输尿管镜检查和激光碎石术对下极肾结石<2 cm原位治疗与上极肾结石移位治疗的效果。
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引用次数: 0
Characteristics and outcomes among patients with delayed orchidectomy for advanced germ cell tumours. 晚期生殖细胞瘤延迟睾丸切除术患者的特征和预后。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-10 DOI: 10.1111/bju.16546
Patrick Ngo, Nariman Ahmadi, Peter Ferguson, Ciara Conduit, Sophie O'Haire, Anna Kuchel, Ganes Pranavan, Andrew Weickhardt, Ben Tran, Peter Grimison
{"title":"Characteristics and outcomes among patients with delayed orchidectomy for advanced germ cell tumours.","authors":"Patrick Ngo, Nariman Ahmadi, Peter Ferguson, Ciara Conduit, Sophie O'Haire, Anna Kuchel, Ganes Pranavan, Andrew Weickhardt, Ben Tran, Peter Grimison","doi":"10.1111/bju.16546","DOIUrl":"https://doi.org/10.1111/bju.16546","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399253","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
Response to Lin et al. 'RE: urinary incontinence recovery and surgical techniques in endoscopic enucleation of the prostate'. 对 Lin 等人 "RE:前列腺内窥镜去核术中尿失禁的恢复和手术技术 "的回应。
IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2024-10-09 DOI: 10.1111/bju.16555
Shao-Wei Wu, Chi-Shin Tseng, Shi-Wei Huang
{"title":"Response to Lin et al. 'RE: urinary incontinence recovery and surgical techniques in endoscopic enucleation of the prostate'.","authors":"Shao-Wei Wu, Chi-Shin Tseng, Shi-Wei Huang","doi":"10.1111/bju.16555","DOIUrl":"https://doi.org/10.1111/bju.16555","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387701","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
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