{"title":"Refining the paradigm in urinary diversion: the MOSAIC trial and roadmap for future innovation.","authors":"DuJiang Yang,GuoYou Wang","doi":"10.1111/bju.70093","DOIUrl":"https://doi.org/10.1111/bju.70093","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"161 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559214","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}
Keiran J.C. Pace, Jethro C.C. Kwong, Harkanwal Randhawa, Maximiliano Ringa, Zizo Al‐Daqqaq, Yashan Chelliahpillai, Soomin Lee, Kellie Kim, Samuel Haile, Amna Ali, Marian Wettstein, Amy Chan, Nathan Perlis, Jason Lee, Robert Hamilton, Neil Fleshner, Antonio Finelli, Munir Jamal, Frank Papanikolaou, Thomas Short, Andrew Feifer, Girish Kulkarni, Alexandre R. Zlotta
Objective To determine the risk and timing of metachronous upper tract urothelial carcinoma (UTUC) after non‐muscle‐invasive bladder cancer (NMIBC). Patients and Methods In this multi‐institutional retrospective cohort study involving academic and community hospitals, clinicopathological data were collected from patients with NMIBC treated between 2005 and 2022. Patients with prior or synchronous UTUC at NMIBC diagnosis were excluded. The primary outcome was time to metachronous UTUC, confirmed on pathology or upper tract imaging. Secondary objectives included determining the cumulative incidence of UTUC stratified by the European Association of Urology risk groups and UTUC risk factors identified using Fine and Gray regression, with all‐cause mortality as a competing risk. Results Among 3003 patients, 1158 (39%) were low‐risk, 650 (22%) intermediate‐risk, 944 (31%) high‐risk, and 251 (8%) very high‐risk. During a median (interquartile range) follow‐up of 4.9 (2.7–8.4) years, 104 patients developed UTUC. On multivariable analysis, multiple tumours were an independent predictor of UTUC (subdistribution hazard ratio 1.86, 95% confidence interval 1.24–2.80; P = 0.003). The 10‐year cumulative incidence was 2.2% for low‐risk, 4.4% for intermediate‐risk, and 6.3% for high‐ and very high‐risk patients. Routine imaging detected UTUC in 40% of low‐risk, 58% of intermediate‐risk, and 53% of high‐ and very high‐risk patients. High‐grade UTUC was found in 36% of low‐risk, 63% of intermediate‐risk, and 64% of high‐ and very high‐risk patients. The majority of UTUC cases (77%) occurred within 5 years of NMIBC. Conclusions The contemporary risk of metachronous UTUC may be lower than historical data. Our findings demonstrate that UTUC incidence is low in patients with low‐ and intermediate‐risk NMIBC and increases in the high‐ and very high‐risk groups. These results support current guideline recommendations to omit routine upper tract imaging in low‐risk NMIBC and question its utility in intermediate‐risk disease. In high‐risk patients, routine imaging remains warranted, although the optimal frequency and duration are yet to be determined.
{"title":"Risk of metachronous upper tract urothelial carcinoma following non‐muscle‐invasive bladder cancer","authors":"Keiran J.C. Pace, Jethro C.C. Kwong, Harkanwal Randhawa, Maximiliano Ringa, Zizo Al‐Daqqaq, Yashan Chelliahpillai, Soomin Lee, Kellie Kim, Samuel Haile, Amna Ali, Marian Wettstein, Amy Chan, Nathan Perlis, Jason Lee, Robert Hamilton, Neil Fleshner, Antonio Finelli, Munir Jamal, Frank Papanikolaou, Thomas Short, Andrew Feifer, Girish Kulkarni, Alexandre R. Zlotta","doi":"10.1111/bju.70085","DOIUrl":"https://doi.org/10.1111/bju.70085","url":null,"abstract":"Objective To determine the risk and timing of metachronous upper tract urothelial carcinoma (UTUC) after non‐muscle‐invasive bladder cancer (NMIBC). Patients and Methods In this multi‐institutional retrospective cohort study involving academic and community hospitals, clinicopathological data were collected from patients with NMIBC treated between 2005 and 2022. Patients with prior or synchronous UTUC at NMIBC diagnosis were excluded. The primary outcome was time to metachronous UTUC, confirmed on pathology or upper tract imaging. Secondary objectives included determining the cumulative incidence of UTUC stratified by the European Association of Urology risk groups and UTUC risk factors identified using Fine and Gray regression, with all‐cause mortality as a competing risk. Results Among 3003 patients, 1158 (39%) were low‐risk, 650 (22%) intermediate‐risk, 944 (31%) high‐risk, and 251 (8%) very high‐risk. During a median (interquartile range) follow‐up of 4.9 (2.7–8.4) years, 104 patients developed UTUC. On multivariable analysis, multiple tumours were an independent predictor of UTUC (subdistribution hazard ratio 1.86, 95% confidence interval 1.24–2.80; <jats:italic>P</jats:italic> = 0.003). The 10‐year cumulative incidence was 2.2% for low‐risk, 4.4% for intermediate‐risk, and 6.3% for high‐ and very high‐risk patients. Routine imaging detected UTUC in 40% of low‐risk, 58% of intermediate‐risk, and 53% of high‐ and very high‐risk patients. High‐grade UTUC was found in 36% of low‐risk, 63% of intermediate‐risk, and 64% of high‐ and very high‐risk patients. The majority of UTUC cases (77%) occurred within 5 years of NMIBC. Conclusions The contemporary risk of metachronous UTUC may be lower than historical data. Our findings demonstrate that UTUC incidence is low in patients with low‐ and intermediate‐risk NMIBC and increases in the high‐ and very high‐risk groups. These results support current guideline recommendations to omit routine upper tract imaging in low‐risk NMIBC and question its utility in intermediate‐risk disease. In high‐risk patients, routine imaging remains warranted, although the optimal frequency and duration are yet to be determined.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"32 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145553624","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}
Israa Hussein, Simona Ippoliti, Alexander BCD Ng, Ranil Johann Boaz, Stefanie Croghan, Cameron Alexander, Arjun Nathan, Nikita Bhatt, Kevin Gerard Byrnes, Veeru Kasivisvanathan
<p>Despite clear guidance from the European Association of Urology (EAU) and the National Institute for Health and Care Excellence (NICE) advising against routine ureteric stenting after uncomplicated ureteroscopy (URS), stents are still widely used [<span>1, 2</span>]. Surveys report that up to 92% of urologists continue to insert stents in these circumstances, indicating a significant discrepancy between guidelines and real-world practice [<span>3</span>]. Stents are considered necessary in situations involving ureteric injury, obstruction, severe oedema, or sepsis risk. However, their use following an otherwise uncomplicated URS remains a matter of debate. Defining ‘uncomplicated URS’ is therefore crucial. Hiller et al. [<span>4</span>] proposed consensus criteria: unilateral, retrograde URS in patients with American Society of Anesthesiologists (ASA) Physical Status Classification System score <3, no anatomical abnormality, no active infection, no trauma or perforation, and no need for second-look procedures.</p><p>Despite this, practice variation persists. A Cochrane review found evidence on stenting vs omission was of very low to low-moderate certainty, with conflicting results regarding analgesic use, unplanned hospital visits, and quality of life [<span>5</span>]. Some studies suggest omitting stents reduces emergency visits and improves recovery. Yet, Bhatt et al. [<span>3</span>] showed that most urologists still use stents in the majority of uncomplicated cases, highlighting a gap between evidence and behaviour. We systematically review surgeons’ motivations for stenting after uncomplicated URS and examine patient experiences of living with and removing stents.</p><p>The review protocol was registered prospectively on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023456075). The ‘Enhancing transparency in reporting the synthesis of qualitative research’ (ENTREQ) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed [<span>6, 7</span>]. A structured PubMed/MEDLINE search was performed to August 2023, supplemented by hand-searching reference lists. Titles and abstracts were screened independently by three reviewers, with disagreements resolved by consensus. Data were extracted and synthesised narratively. Risk of bias in qualitative studies was assessed using the Critical Appraisal Skills Programme (CASP) checklist. Included studies examined surgeon motivations for stenting after uncomplicated URS using qualitative or survey methods or reported patient experiences with indwelling ureteric stents. Eligible designs included randomised trials, surveys, interviews, and observational studies. Reviews, non-human studies, children aged <12 years, and purely quantitative papers on stenting rates without explanatory data were excluded.</p><p>In our results, four studies met the inclusion criteria: one international surgeon survey and three qualitative studies
总之，这些研究揭示了支架的重大心理和功能负担，与外科医生对常规使用的偏好形成对比。这篇综述强调了一个显著的脱节：外科医生经常支架置入简单的尿路并发症以减轻感知风险，而患者却承受着症状和心理负担。目前的EAU和NICE指南建议在无并发症的病例中不要进行常规支架植入[1,2]。然而，调查显示，大多数泌尿科医生继续这种做法，往往是出于对罕见并发症的关注，而不是基于证据的必要性。这表明外科医生的决策是由风险规避和轶事经验指导的，而不是公开的数据。患者负担相当大，高达80%的患者报告留置支架导致生活质量下降，包括疼痛、尿频、血尿和性功能障碍。心理后果包括焦虑、抑郁和减少社会参与。撤资增加了另一层压力。从健康经济影响来看，英国尿石症的管理每年花费高达3.24亿英镑，常规支架置入进一步增加了费用。成本分析证实，选择性遗漏比常规支架置入更经济。尽管有证据和指南，支架置入术的持续存在反映了坚持临床实践指南的更广泛挑战。外科医生愿意参与试验表明，他们认识到高质量的证据可以推动变革。与此同时，更好地与患者沟通风险、症状和移除手术可以改善体验，并可能减少不必要的支架植入。关于局限性，我们的综述只纳入了四项符合条件的研究，这限制了其通用性。患者的经历均来自同一研究队列。然而，综合揭示了一致的主题：外科医生优先考虑安全性，而患者面临不成比例的发病率。总之，无并发症尿路尿潴留后的常规支架置入术仍然存在，尽管指南建议不这样做。对水肿和梗阻的担忧驱动着外科医生的决策，而患者则经历着明显的疼痛、排尿困难、心理困扰和生活质量受损。弥合这一差距需要从随机对照试验中获得更多实质性证据，加强患者教育，并更新具有更明确定义的指南。将手术决策与以患者为中心的结果相一致可以减少不必要的发病率和医疗成本。没有宣布。由于没有患者和/或公众参与本综述的研究目标、方法和分发的制定，因此不需要伦理批准。尼基塔·巴特（Nikita Bhatt）和凯文·杰拉德·伯恩斯（Kevin Gerard Byrnes）构想了这项研究。协议由伊斯拉·侯赛因起草，搜索策略由林恩·梅尔和伊斯拉·侯赛因制定和起草。israel Hussein， Alexander BCD Ng和Ranil Johann Boaz进行了摘要和全文综述。israel Hussein， Alexander BCD Ng和Ranil Johann Boaz对数据提取和合成做出了贡献。伊斯拉·侯赛因和西蒙娜·伊波利蒂参与了最终手稿的撰写和编辑。感谢临床联络馆员Lyn maair在进行文献检索和医学主题标题（MeSH）术语方面的帮助。
{"title":"Ureteric stenting after uncomplicated ureteroscopy: a systematic review of surgeons’ motivations and patient experiences","authors":"Israa Hussein, Simona Ippoliti, Alexander BCD Ng, Ranil Johann Boaz, Stefanie Croghan, Cameron Alexander, Arjun Nathan, Nikita Bhatt, Kevin Gerard Byrnes, Veeru Kasivisvanathan","doi":"10.1111/bju.70063","DOIUrl":"10.1111/bju.70063","url":null,"abstract":"<p>Despite clear guidance from the European Association of Urology (EAU) and the National Institute for Health and Care Excellence (NICE) advising against routine ureteric stenting after uncomplicated ureteroscopy (URS), stents are still widely used [<span>1, 2</span>]. Surveys report that up to 92% of urologists continue to insert stents in these circumstances, indicating a significant discrepancy between guidelines and real-world practice [<span>3</span>]. Stents are considered necessary in situations involving ureteric injury, obstruction, severe oedema, or sepsis risk. However, their use following an otherwise uncomplicated URS remains a matter of debate. Defining ‘uncomplicated URS’ is therefore crucial. Hiller et al. [<span>4</span>] proposed consensus criteria: unilateral, retrograde URS in patients with American Society of Anesthesiologists (ASA) Physical Status Classification System score <3, no anatomical abnormality, no active infection, no trauma or perforation, and no need for second-look procedures.</p><p>Despite this, practice variation persists. A Cochrane review found evidence on stenting vs omission was of very low to low-moderate certainty, with conflicting results regarding analgesic use, unplanned hospital visits, and quality of life [<span>5</span>]. Some studies suggest omitting stents reduces emergency visits and improves recovery. Yet, Bhatt et al. [<span>3</span>] showed that most urologists still use stents in the majority of uncomplicated cases, highlighting a gap between evidence and behaviour. We systematically review surgeons’ motivations for stenting after uncomplicated URS and examine patient experiences of living with and removing stents.</p><p>The review protocol was registered prospectively on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023456075). The ‘Enhancing transparency in reporting the synthesis of qualitative research’ (ENTREQ) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed [<span>6, 7</span>]. A structured PubMed/MEDLINE search was performed to August 2023, supplemented by hand-searching reference lists. Titles and abstracts were screened independently by three reviewers, with disagreements resolved by consensus. Data were extracted and synthesised narratively. Risk of bias in qualitative studies was assessed using the Critical Appraisal Skills Programme (CASP) checklist. Included studies examined surgeon motivations for stenting after uncomplicated URS using qualitative or survey methods or reported patient experiences with indwelling ureteric stents. Eligible designs included randomised trials, surveys, interviews, and observational studies. Reviews, non-human studies, children aged <12 years, and purely quantitative papers on stenting rates without explanatory data were excluded.</p><p>In our results, four studies met the inclusion criteria: one international surgeon survey and three qualitative studies ","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"137 2","pages":"238-240"},"PeriodicalIF":4.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1111/bju.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145559105","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}
Sophie Lewis, Riyad Peeraully, Eslam Ghazy, Harriet Corbett, Ian Maconochie, Simon Kenny, Rachel Harwood
Objectives To perform a systematic review to determine the effect of the duration of pain on early and late testicular survival after testicular torsion, and on the performance of diagnostic adjuncts for torsion, including the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score and ultrasonography (US) performance, to inform the development of the ‘Getting it Right First Time’ (GIRFT) national testicular pain pathway for children and young people (CYP). Methods The study was registered on the International Prospective Register of Online Systematic Reviews (CRD42023412619) and four databases were searched. Study inclusion criteria: all participants aged <25 years or where data for these patients could be extracted; studies including <20% neonates and <20% of undescended testes. The decision for inclusion in the study was made independently by two reviewers and conflicts resolved by a third. A weighted random‐effects model was used for meta‐analysis and results are shown as the test statistic (95% CI). Results Included studies were used to analyse the effect of duration of pain on testicular salvage (studies = 26), on the sensitivity and specificity of the TWIST score (studies = 10), and of US (studies = 34). The TWIST score performs best in its extremes, with a sensitivity of 94.2% (95% CI 72.8–99%) and specificity 98% (95% CI 91.5–99.5%), when comparing a high‐risk score of 5–7 with a low‐risk score of 0–2. The diagnostic sensitivity and specificity of US for testicular torsion has likely improved with time, with papers published after 2010 showing a sensitivity of 94.8% (95% CI 88.3–97.8%) and specificity 97.3% (95% CI 89.4–99.4%) compared to all‐time published studies showing a sensitivity 92.6% (95% CI 87.8–95.6%) and specificity of 97.8% (95% CI 94.7–99.1%). Conclusions These findings demonstrate the up‐to‐date literature on the effect of duration of pain on salvage of torted testes and on the performance of TWIST scores and US when evaluating CYP with testicular pain. They have been used within the development of the GIRFT testicular pain pathway.
目的：通过系统回顾，确定疼痛持续时间对睾丸扭转后早期和晚期睾丸生存的影响，以及对扭转诊断辅助工具的性能的影响，包括睾丸缺血和疑似扭转检查（TWIST）评分和超声检查（US）表现，为“第一次获得正确”（GIRFT）国家儿童和青少年睾丸疼痛途径（CYP）的制定提供信息。方法在国际在线系统评论前瞻性注册（CRD42023412619）中注册，并检索4个数据库。研究纳入标准：所有年龄在25岁或可以提取这些患者数据的参与者；研究包括20%的新生儿和20%的隐睾。纳入研究的决定由两位审稿人独立做出，冲突由第三位审稿人解决。采用加权随机效应模型进行meta分析，结果显示为检验统计量（95% CI）。结果纳入的研究分析了疼痛持续时间对睾丸保留的影响（研究= 26），对TWIST评分的敏感性和特异性的影响（研究= 10），以及对US的影响（研究= 34）。当比较5-7的高风险评分和0-2的低风险评分时，TWIST评分在极端情况下表现最好，灵敏度为94.2% (95% CI 72.8-99%)，特异性为98% （95% CI 91.5-99.5%）。随着时间的推移，US诊断睾丸扭转的敏感性和特异性可能有所提高，2010年以后发表的论文显示灵敏度为94.8% (95% CI 88.3-97.8%)，特异性为97.3% (95% CI 89.4-99.4%)，而所有发表的研究显示灵敏度为92.6% (95% CI 87.8-95.6%)，特异性为97.8% （95% CI 94.7-99.1%）。结论：这些发现证实了最新文献关于疼痛持续时间对损伤睾丸抢救的影响，以及在评估伴有睾丸疼痛的CYP时TWIST评分和US的表现。它们已被用于GIRFT睾丸疼痛途径的发展。
{"title":"A systematic review and meta‐analysis to inform the management of children and young people with acute testicular pain","authors":"Sophie Lewis, Riyad Peeraully, Eslam Ghazy, Harriet Corbett, Ian Maconochie, Simon Kenny, Rachel Harwood","doi":"10.1111/bju.70080","DOIUrl":"https://doi.org/10.1111/bju.70080","url":null,"abstract":"Objectives To perform a systematic review to determine the effect of the duration of pain on early and late testicular survival after testicular torsion, and on the performance of diagnostic adjuncts for torsion, including the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score and ultrasonography (US) performance, to inform the development of the ‘Getting it Right First Time’ (GIRFT) national testicular pain pathway for children and young people (CYP). Methods The study was registered on the International Prospective Register of Online Systematic Reviews (CRD42023412619) and four databases were searched. Study inclusion criteria: all participants aged <25 years or where data for these patients could be extracted; studies including <20% neonates and <20% of undescended testes. The decision for inclusion in the study was made independently by two reviewers and conflicts resolved by a third. A weighted random‐effects model was used for meta‐analysis and results are shown as the test statistic (95% CI). Results Included studies were used to analyse the effect of duration of pain on testicular salvage (studies = 26), on the sensitivity and specificity of the TWIST score (studies = 10), and of US (studies = 34). The TWIST score performs best in its extremes, with a sensitivity of 94.2% (95% CI 72.8–99%) and specificity 98% (95% CI 91.5–99.5%), when comparing a high‐risk score of 5–7 with a low‐risk score of 0–2. The diagnostic sensitivity and specificity of US for testicular torsion has likely improved with time, with papers published after 2010 showing a sensitivity of 94.8% (95% CI 88.3–97.8%) and specificity 97.3% (95% CI 89.4–99.4%) compared to all‐time published studies showing a sensitivity 92.6% (95% CI 87.8–95.6%) and specificity of 97.8% (95% CI 94.7–99.1%). Conclusions These findings demonstrate the up‐to‐date literature on the effect of duration of pain on salvage of torted testes and on the performance of TWIST scores and US when evaluating CYP with testicular pain. They have been used within the development of the GIRFT testicular pain pathway.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"182 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145553623","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}
Andrea Folcia, Davide Perri, Luca Villa, Nicole Albanese, Daniele Robesti, Christian Corsini, Giorgio Bozzini, Ioannis Kartalas Goumas, Thiago Hota, Francesco Montorsi, Andrea Salonia, Olivier Traxer, Eugenio Ventimiglia
Objectives
To compare the stone retropulsion of an artificial model of urinary stones in vitro using the new holmium:yttrium aluminium garnet (Ho:YAG) laser generator with a very low peak power pulse modulation mode (Quanta Magneto Technology™; Quanta System, Samarate, Italy) and thulium fibre laser (TFL).
Materials and Methods
The following laser energy settings were used: 0.2 J–50 Hz, 0.4 J–25 Hz, 0.8 J–12 Hz, 1.5 J–6 Hz, and 2 J–5 Hz. A 5 × 5 × 5 mm cubic artificial stone was placed on two perpendicularly aligned metal rulers to create a V-shaped cross-sectional rail submerged in a tank filled with 0.9% saline solution, with the laser fibre in contact with the stone. The laser was activated for 5 s. Stone retropulsion was captured by a camera and assessed using video tracking software. Five repetitions were performed for each setting. Descriptive statistics investigated differences between the two lasers in stone retropulsion distance and speed at selected time points (0.35, 1, 3, and 5 s) and over the first second following laser activation.
Results
Comparable stone retropulsion distance and speed were observed between ‘Magneto’ and TFL according to tested high-energy settings. Magneto exhibited lower mean stone displacement at selected time points (all P < 0.02) and lower mean retropulsion speed over the first second following laser activation (all P < 0.01), when compared to TFL at low-energy settings (0.2 and 0.4 J).
Conclusions
Although Ho:YAG lasers are generally associated with greater stone retropulsion compared to TFL, Magneto exhibited a retropulsion performance similar to TFL. Further research is needed to clarify the retropulsion dynamics observed with Magneto at low-energy settings.
{"title":"In vitro comparison of stone retropulsion between the new holmium:yttrium aluminium garnet laser generator with a very low peak power pulse modulation mode (Magneto technology) and the thulium fibre laser","authors":"Andrea Folcia, Davide Perri, Luca Villa, Nicole Albanese, Daniele Robesti, Christian Corsini, Giorgio Bozzini, Ioannis Kartalas Goumas, Thiago Hota, Francesco Montorsi, Andrea Salonia, Olivier Traxer, Eugenio Ventimiglia","doi":"10.1111/bju.70083","DOIUrl":"10.1111/bju.70083","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the stone retropulsion of an artificial model of urinary stones <i>in vitro</i> using the new holmium:yttrium aluminium garnet (Ho:YAG) laser generator with a very low peak power pulse modulation mode (Quanta Magneto Technology™; Quanta System, Samarate, Italy) and thulium fibre laser (TFL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The following laser energy settings were used: 0.2 J–50 Hz, 0.4 J–25 Hz, 0.8 J–12 Hz, 1.5 J–6 Hz, and 2 J–5 Hz. A 5 × 5 × 5 mm cubic artificial stone was placed on two perpendicularly aligned metal rulers to create a V-shaped cross-sectional rail submerged in a tank filled with 0.9% saline solution, with the laser fibre in contact with the stone. The laser was activated for 5 s. Stone retropulsion was captured by a camera and assessed using video tracking software. Five repetitions were performed for each setting. Descriptive statistics investigated differences between the two lasers in stone retropulsion distance and speed at selected time points (0.35, 1, 3, and 5 s) and over the first second following laser activation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Comparable stone retropulsion distance and speed were observed between ‘Magneto’ and TFL according to tested high-energy settings. Magneto exhibited lower mean stone displacement at selected time points (all <i>P</i> < 0.02) and lower mean retropulsion speed over the first second following laser activation (all <i>P</i> < 0.01), when compared to TFL at low-energy settings (0.2 and 0.4 J).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although Ho:YAG lasers are generally associated with greater stone retropulsion compared to TFL, Magneto exhibited a retropulsion performance similar to TFL. Further research is needed to clarify the retropulsion dynamics observed with Magneto at low-energy settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"137 2","pages":"306-311"},"PeriodicalIF":4.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145545184","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}
Amin Abdulmajeed,Fatima Bekiroglu,Aleyna Aydin,Pilar Laguna,Guohua Zeng,Valentin Pavlov,Mehmet Kocak,Rahim Horuz,Selami Albayrak,Jean de la Rosette,
OBJECTIVETo investigate the implementation and adherence of (inter)national guidelines (GLs) on non-muscle-invasive bladder cancer (NMIBC) across continents.SUBJECTS AND METHODSAn international, inter-lingual survey was designed to capture the practice of diagnosis and treatment of NMIBC globally, including questions designed to evaluate compliance to GLs. An invitation was sent to members of the Société Internationale d'Urologie (SIU). We assessed the adherence to GLs in relation to age, working environment, subspecialities, gender, and years of experience.RESULTSA total of 3595 urologists took part in the survey and 2319 provided information about their compliance to European Association of Urology (EAU), American Urological Association (AUA), and other (inter)national GLs. The survey comprised 92% males including >50% in clinical practice for >15 years; 57% were in general practice, whereas 17% were qualified uro-oncologist and 8% endourologist. The majority were in academic practice and most (60%) performed <5 transurethral resection of bladder tumour/month. GLs were followed in 42-70% of cases when taking bladder biopsies. The majority followed the EAU GLs (40%) followed by national GLs modified from the AUA, EAU or similar GLs (31%), or national GLs by their own societies (14%). Low participation from the Americas may limit the applicability of findings to that region; future studies should engage more diverse North American samples to enhance generalisability.CONCLUSIONThe EAU GLs were mostly preferred in NMIBC diagnosis and treatment across all continents. General adherence to the GLs was inconsistent, with notable variances among the different regions. As GLs provide the best evidence-based knowledge, it is advised to adhere to them more consistently in daily clinical practice.
{"title":"Guidelines adherence in non-muscle-invasive bladder cancer: a global survey of 3595 participants.","authors":"Amin Abdulmajeed,Fatima Bekiroglu,Aleyna Aydin,Pilar Laguna,Guohua Zeng,Valentin Pavlov,Mehmet Kocak,Rahim Horuz,Selami Albayrak,Jean de la Rosette, ","doi":"10.1111/bju.70079","DOIUrl":"https://doi.org/10.1111/bju.70079","url":null,"abstract":"OBJECTIVETo investigate the implementation and adherence of (inter)national guidelines (GLs) on non-muscle-invasive bladder cancer (NMIBC) across continents.SUBJECTS AND METHODSAn international, inter-lingual survey was designed to capture the practice of diagnosis and treatment of NMIBC globally, including questions designed to evaluate compliance to GLs. An invitation was sent to members of the Société Internationale d'Urologie (SIU). We assessed the adherence to GLs in relation to age, working environment, subspecialities, gender, and years of experience.RESULTSA total of 3595 urologists took part in the survey and 2319 provided information about their compliance to European Association of Urology (EAU), American Urological Association (AUA), and other (inter)national GLs. The survey comprised 92% males including >50% in clinical practice for >15 years; 57% were in general practice, whereas 17% were qualified uro-oncologist and 8% endourologist. The majority were in academic practice and most (60%) performed <5 transurethral resection of bladder tumour/month. GLs were followed in 42-70% of cases when taking bladder biopsies. The majority followed the EAU GLs (40%) followed by national GLs modified from the AUA, EAU or similar GLs (31%), or national GLs by their own societies (14%). Low participation from the Americas may limit the applicability of findings to that region; future studies should engage more diverse North American samples to enhance generalisability.CONCLUSIONThe EAU GLs were mostly preferred in NMIBC diagnosis and treatment across all continents. General adherence to the GLs was inconsistent, with notable variances among the different regions. As GLs provide the best evidence-based knowledge, it is advised to adhere to them more consistently in daily clinical practice.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"100 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145545187","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}
Richard Wassersug, Robert Watson, Carly Sears, Paul Schellhammer
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{"title":"Comment on: ‘Preferences between three options for androgen deprivation therapy…’","authors":"Richard Wassersug, Robert Watson, Carly Sears, Paul Schellhammer","doi":"10.1111/bju.70088","DOIUrl":"https://doi.org/10.1111/bju.70088","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"27 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145509214","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}
Anthony James Costello, Philip Ellard Dundee, Helen Rosemary Crowe, Michael Donald Cromer, Rodrigo Fraga-Silva, Mikael Sturny, Nikos Stergiopulos, Fiona Joseph, Arthur L. Burnett
{"title":"First in man study of cavernous nerve neurostimulator for erectile function preservation","authors":"Anthony James Costello, Philip Ellard Dundee, Helen Rosemary Crowe, Michael Donald Cromer, Rodrigo Fraga-Silva, Mikael Sturny, Nikos Stergiopulos, Fiona Joseph, Arthur L. Burnett","doi":"10.1111/bju.70066","DOIUrl":"10.1111/bju.70066","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"137 2","pages":"264-268"},"PeriodicalIF":4.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145498764","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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