Marie Buzzi, Jonathan Epstein, Zahi Hatem, Nadine Juge, Charles Mazeaud, Jean-Louis Lemelle, Nicolas Berte
Background
Neurogenic bladder is defined as a dysfunction of the bladder resulting from damage to the central or peripheral nervous systems. Its treatment is based on a progressive therapeutic escalation, rapidly involving invasive therapeutic procedures such as repeated intradetrusor injections and surgery. Given the risk of repeated general anaesthesia in children, there is a need for non-invasive treatment for young patients who do not respond to or have adverse effects from oral anticholinergic treatment. The ‘Place de l’OXybutynine Intravésicale chez le Patient Enfant Neurologique’ (POXIPEN) trial aims to assess the efficacy of intra-vesical oxybutynin on bladder capacity in a sample of French children with neurogenic bladder.
Study Design
The POXIPEN is a multicentre, randomised, double-blind, placebo-controlled trial.
Endpoints
The primary outcome is change in maximal bladder capacity after treatment. Secondary outcomes include changes in voiding, urodynamic and ultrasound parameters. We will also assess changes on quality of life and usability of the product.
Patients and Methods
We aim to randomly assign 60 children with neurogenic bladder secondary to spina bifida and deemed non-responders to first-line treatment with oral anticholinergics, to receive intravesical oxybutynin (IVO) or placebo for 4 weeks. Recruitment will start in September 2025. It will be the first prospective study to evaluate the efficacy of IVO in children, with a high level of evidence provided by its design. If IVO proves effective, it could lengthen the delay in therapeutic escalation to invasive procedures, thereby reducing the risk of complications associated with general anaesthesia in children with neurogenic bladder.
Trial registration
This trial is registered with the European Union (EU) Clinical Trials Information System (CTIS) under EU CT Number: 2022–501 902–36-00 (approved 09.01.2025) and ClinicalTrials.gov under identifier NCT07027020 (registered 18.06.2025).
{"title":"Intravesical oxybutynin for bladder capacity in children with spina bifida: the ‘Place de l’OXybutynine Intravésicale chez le Patient Enfant Neurologique’ (POXIPEN) trial protocol","authors":"Marie Buzzi, Jonathan Epstein, Zahi Hatem, Nadine Juge, Charles Mazeaud, Jean-Louis Lemelle, Nicolas Berte","doi":"10.1111/bju.70058","DOIUrl":"10.1111/bju.70058","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neurogenic bladder is defined as a dysfunction of the bladder resulting from damage to the central or peripheral nervous systems. Its treatment is based on a progressive therapeutic escalation, rapidly involving invasive therapeutic procedures such as repeated intradetrusor injections and surgery. Given the risk of repeated general anaesthesia in children, there is a need for non-invasive treatment for young patients who do not respond to or have adverse effects from oral anticholinergic treatment. The ‘Place de l’OXybutynine Intravésicale chez le Patient Enfant Neurologique’ (POXIPEN) trial aims to assess the efficacy of intra-vesical oxybutynin on bladder capacity in a sample of French children with neurogenic bladder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>The POXIPEN is a multicentre, randomised, double-blind, placebo-controlled trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Endpoints</h3>\u0000 \u0000 <p>The primary outcome is change in maximal bladder capacity after treatment. Secondary outcomes include changes in voiding, urodynamic and ultrasound parameters. We will also assess changes on quality of life and usability of the product.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We aim to randomly assign 60 children with neurogenic bladder secondary to spina bifida and deemed non-responders to first-line treatment with oral anticholinergics, to receive intravesical oxybutynin (IVO) or placebo for 4 weeks. Recruitment will start in September 2025. It will be the first prospective study to evaluate the efficacy of IVO in children, with a high level of evidence provided by its design. If IVO proves effective, it could lengthen the delay in therapeutic escalation to invasive procedures, thereby reducing the risk of complications associated with general anaesthesia in children with neurogenic bladder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial registration</h3>\u0000 \u0000 <p>This trial is registered with the European Union (EU) Clinical Trials Information System (CTIS) under EU CT Number: 2022–501 902–36-00 (approved 09.01.2025) and ClinicalTrials.gov under identifier NCT07027020 (registered 18.06.2025).</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"137 2","pages":"390-398"},"PeriodicalIF":4.4,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1111/bju.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427760","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}
Ashley C. Rhodes, Kaitlyn A. McClintic, Emily Witt, Ikenna Nwosu, Kyle R. Balk, Colin Reis, Ian C. Sutton, Jianling Bi, Melinda Z. Fu, Michael A. O’Donnell, Vignesh T. Packiam, James D. Byrne
<div> <section> <h3> Objectives</h3> <p>To develop a drug-releasing intravesical floating technology (DRIFT) device for controlled sequential delivery of gemcitabine and docetaxel (Gem/Doce) to optimise the treatment of non-muscle-invasive bladder cancer (NMIBC) while enabling patient mobility and self-removal, as sequential intravesical Gem/Doce has been increasingly utilised but has logistical limitations requiring prolonged clinic visits and patient immobilisation.</p> </section> <section> <h3> Materials and Methods</h3> <p>The DRIFT device features a three-dimensional printed perforated tube with latex sleeve, dissolvable polyvinyl acetate and polyvinylpyrrolidone end cap with adjustable fluorinated polymer (FluoroPel) coating, and patient-removal suture. A 14-F catheter is placed and intravesical gemcitabine is instilled. The deflated DRIFT device is inserted via catheter and inflated with docetaxel and air. The catheter is removed, allowing gemcitabine to dwell temporarily and be voided by the patient. The DRIFT device remains in the bladder and subsequently releases docetaxel in a controlled, delayed fashion, followed by patient removal. Its flexible, buoyant design supports patient mobility and maintains unimpeded urinary flow. Dissolution kinetics were evaluated using methylene blue, device performance was assessed in Merino sheep, and docetaxel tissue penetration was evaluated in rabbit bladder tissue using high-performance liquid chromatography analysis.</p> </section> <section> <h3> Results</h3> <p>The DRIFT device demonstrated adaptable drug release through FluoroPel coating optimisation, with dissolution times extending significantly from zero to three coatings (<i>P</i> < 0.001). Docetaxel release kinetics plateaued between 2.0 and 3.0 mL volumes. Sheep studies revealed similar timed drug release as <i>in vitro</i> testing. Escalating gemcitabine concentrations enhanced docetaxel tissue penetration, with peak concentrations reaching 0.45 vs 0.08 mg/mL in controls. Extended gemcitabine dwell time (up to 4 h) further improved docetaxel delivery, achieving significant enhancement in deep tissue penetration (<i>P</i> < 0.001).</p> </section> <section> <h3> Conclusion</h3> <p>The DRIFT enables controlled sequential delivery of Gem/Doce, reliably maintaining docetaxel containment for up to 120 min during gemcitabine pre-treatment. Future <i>in vivo</i> validation will establish safety and therapeutic potential. This platform has broader applications beyond NMIBC, including urinary tract infections and interstitial cystitis.</p> </s
开发一种药物释放膀胱内漂浮技术（DRIFT）装置，用于控制吉西他滨和多西他赛（Gem/Doce）的顺序递送，以优化非肌肉侵袭性膀胱癌（NMIBC）的治疗，同时使患者能够活动和自我清除，因为顺序膀胱内Gem/Doce的应用越来越多，但存在需要长时间临床就诊和患者固定的逻辑性限制。DRIFT装置的特点是一个三维打印穿孔管，带有乳胶套管，可溶解的聚醋酸乙烯和聚乙烯吡罗烷酮端帽，带有可调节的氟化聚合物（FluoroPel）涂层，以及患者移除缝线。放置14‐F导管，膀胱内灌注吉西他滨。将放气的DRIFT装置通过导管插入并用多西他赛和空气充气。将导管取出，使吉西他滨暂时停留并由患者排出。DRIFT装置留在膀胱内，随后以可控的延迟方式释放多西他赛，随后患者取出。其灵活，浮力设计支持病人的行动和保持畅通无阻的尿流。用亚甲基蓝评估溶出动力学，用高效液相色谱分析评估装置在美利奴羊中的性能，用高效液相色谱分析评估多西紫杉醇在兔膀胱组织中的组织渗透。结果通过FluoroPel包被优化，DRIFT装置表现出适应性药物释放，溶出时间从零到三层显著延长（P < 0.001）。多西紫杉醇释放动力学在2.0和3.0 mL之间趋于稳定。绵羊实验显示了与体外试验相似的药物释放时间。不断增加的吉西他滨浓度增强了多西他赛组织渗透，在对照组中峰值浓度达到0.45 mg/mL vs 0.08 mg/mL。延长吉西他滨停留时间（长达4小时）进一步改善了多西他赛的递送，实现了深层组织渗透的显著增强（P < 0.001）。DRIFT能够控制Gem/Doce的顺序递送，在吉西他滨预处理期间可靠地维持多西他赛的遏制长达120分钟。未来的体内验证将确定安全性和治疗潜力。该平台在NMIBC之外有更广泛的应用，包括尿路感染和间质性膀胱炎。
{"title":"Drug-releasing intravesical floating technology for sequential gemcitabine and docetaxel in non-muscle-invasive bladder cancer","authors":"Ashley C. Rhodes, Kaitlyn A. McClintic, Emily Witt, Ikenna Nwosu, Kyle R. Balk, Colin Reis, Ian C. Sutton, Jianling Bi, Melinda Z. Fu, Michael A. O’Donnell, Vignesh T. Packiam, James D. Byrne","doi":"10.1111/bju.70060","DOIUrl":"10.1111/bju.70060","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To develop a drug-releasing intravesical floating technology (DRIFT) device for controlled sequential delivery of gemcitabine and docetaxel (Gem/Doce) to optimise the treatment of non-muscle-invasive bladder cancer (NMIBC) while enabling patient mobility and self-removal, as sequential intravesical Gem/Doce has been increasingly utilised but has logistical limitations requiring prolonged clinic visits and patient immobilisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>The DRIFT device features a three-dimensional printed perforated tube with latex sleeve, dissolvable polyvinyl acetate and polyvinylpyrrolidone end cap with adjustable fluorinated polymer (FluoroPel) coating, and patient-removal suture. A 14-F catheter is placed and intravesical gemcitabine is instilled. The deflated DRIFT device is inserted via catheter and inflated with docetaxel and air. The catheter is removed, allowing gemcitabine to dwell temporarily and be voided by the patient. The DRIFT device remains in the bladder and subsequently releases docetaxel in a controlled, delayed fashion, followed by patient removal. Its flexible, buoyant design supports patient mobility and maintains unimpeded urinary flow. Dissolution kinetics were evaluated using methylene blue, device performance was assessed in Merino sheep, and docetaxel tissue penetration was evaluated in rabbit bladder tissue using high-performance liquid chromatography analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The DRIFT device demonstrated adaptable drug release through FluoroPel coating optimisation, with dissolution times extending significantly from zero to three coatings (<i>P</i> < 0.001). Docetaxel release kinetics plateaued between 2.0 and 3.0 mL volumes. Sheep studies revealed similar timed drug release as <i>in vitro</i> testing. Escalating gemcitabine concentrations enhanced docetaxel tissue penetration, with peak concentrations reaching 0.45 vs 0.08 mg/mL in controls. Extended gemcitabine dwell time (up to 4 h) further improved docetaxel delivery, achieving significant enhancement in deep tissue penetration (<i>P</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The DRIFT enables controlled sequential delivery of Gem/Doce, reliably maintaining docetaxel containment for up to 120 min during gemcitabine pre-treatment. Future <i>in vivo</i> validation will establish safety and therapeutic potential. This platform has broader applications beyond NMIBC, including urinary tract infections and interstitial cystitis.</p>\u0000 </s","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"137 2","pages":"360-367"},"PeriodicalIF":4.4,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1111/bju.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427761","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}
Muhammed Arif İbis, Tet Yap, Maria Satchi, Noman Ghazanfar, Murat Can Karaburun, Omer Onur Cakir, Onder Yaman, Fabio Castiglione
Objectives
To evaluate the clinical necessity and optimal pharmacological strategy for post-cycle therapy (PCT) in recreational anabolic-androgenic steroid (AAS) users with normal pre-cycle reproductive profiles.
Subjects and Methods
This retrospective, dual-centre cohort study included 79 males who had completed ≤6 months of AAS use and had documented normal pre-cycle reproductive hormone levels and semen parameters. Participants were managed with no treatment (NT; expectant monitoring), clomiphene citrate (CC) monotherapy (25 mg/day; selective oestrogen receptor modulation to stimulate gonadotrophin release), or CC + human chorionic gonadotrophin (hCG) (25 mg/day CC + hCG 1500 IU subcutaneously three times weekly; rapid androgen repletion and testicular stimulation). In patients with follicle-stimulating hormone (FSH) <1.5 IU/L, recombinant FSH (rFSH; 75 IU subcutaneously three times weekly) was suggested to promote spermatogenesis. Linear mixed models and logistic regression analyses were used to evaluate group differences and predictors of recovery.
Results
At baseline (T0), 89.9% of patients had erectile dysfunction and 69.7% exhibited azoospermia or severe oligozoospermia. Both pharmacological regimens accelerated hormonal recovery vs NT, with normalisation across groups by Month 6. Seminal recovery was significantly earlier in treated groups: at 12 months (T12), normozoospermia rates were 87.5% in CC + hCG, 69.2% in CC, and 58.6% in NT. Testicular volume increased ≥20% in 70.8% of CC + hCG vs 6.9% of NT. Combined therapy independently predicted normozoospermia (odds ratio [OR] 6.23, 95% confidence interval [CI] 1.32–29.4) and motility recovery (OR 4.85, 95% CI 1.27–18.4). All five men receiving rFSH achieved normozoospermia by T12. Sexual function improved across groups, with faster recovery in treated patients.
Conclusion
Spontaneous hormonal recovery occurs within 6–12 months after AAS cessation, yet PCT facilitates earlier hormonal normalisation. The addition of hCG to CC was associated with superior recovery of semen parameters and testicular volume. These findings underscore the potential short-term benefits of PCT and highlight the need for prospective randomised trials to establish evidence-based treatment protocols.
{"title":"Post-cycle therapy after short-term anabolic-androgenic steroid use: comparative outcomes in recreational bodybuilders","authors":"Muhammed Arif İbis, Tet Yap, Maria Satchi, Noman Ghazanfar, Murat Can Karaburun, Omer Onur Cakir, Onder Yaman, Fabio Castiglione","doi":"10.1111/bju.70059","DOIUrl":"10.1111/bju.70059","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the clinical necessity and optimal pharmacological strategy for post-cycle therapy (PCT) in recreational anabolic-androgenic steroid (AAS) users with normal pre-cycle reproductive profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects and Methods</h3>\u0000 \u0000 <p>This retrospective, dual-centre cohort study included 79 males who had completed ≤6 months of AAS use and had documented normal pre-cycle reproductive hormone levels and semen parameters. Participants were managed with no treatment (NT; expectant monitoring), clomiphene citrate (CC) monotherapy (25 mg/day; selective oestrogen receptor modulation to stimulate gonadotrophin release), or CC + human chorionic gonadotrophin (hCG) (25 mg/day CC + hCG 1500 IU subcutaneously three times weekly; rapid androgen repletion and testicular stimulation). In patients with follicle-stimulating hormone (FSH) <1.5 IU/L, recombinant FSH (rFSH; 75 IU subcutaneously three times weekly) was suggested to promote spermatogenesis. Linear mixed models and logistic regression analyses were used to evaluate group differences and predictors of recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline (T0), 89.9% of patients had erectile dysfunction and 69.7% exhibited azoospermia or severe oligozoospermia. Both pharmacological regimens accelerated hormonal recovery vs NT, with normalisation across groups by Month 6. Seminal recovery was significantly earlier in treated groups: at 12 months (T12), normozoospermia rates were 87.5% in CC + hCG, 69.2% in CC, and 58.6% in NT. Testicular volume increased ≥20% in 70.8% of CC + hCG vs 6.9% of NT. Combined therapy independently predicted normozoospermia (odds ratio [OR] 6.23, 95% confidence interval [CI] 1.32–29.4) and motility recovery (OR 4.85, 95% CI 1.27–18.4). All five men receiving rFSH achieved normozoospermia by T12. Sexual function improved across groups, with faster recovery in treated patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Spontaneous hormonal recovery occurs within 6–12 months after AAS cessation, yet PCT facilitates earlier hormonal normalisation. The addition of hCG to CC was associated with superior recovery of semen parameters and testicular volume. These findings underscore the potential short-term benefits of PCT and highlight the need for prospective randomised trials to establish evidence-based treatment protocols.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"137 1","pages":"154-165"},"PeriodicalIF":4.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145374026","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}
Giovanni Corona, Paolo Capogrosso, Sara Baldini, Giulia Rastrelli, Linda Vignozzi, Javier Romero-Otero, Andrea Salonia, Yacow Reisman, Carlo Bettocchi, Mario Maggi, Mikkel Fode
Objective
To systematically summarise and meta-analyse all uncontrolled and controlled studies evaluating the role of intravesical instillation of hyaluronic acid (HA), with or without chondroitin sulphate (ChS), in the treatment of bladder pain syndrome (BPS), recurrent urinary tract infection (rUTI) and post-radiation cystitis (pRC).
Methods
A systematic review was conducted, and a protocol was registered with PROSPERO (CRD42025640480). Studies published between 1 January 1969 and 31 August 2024 were retrieved from multiple databases. Data were analysed using random-effects and common-effects models with subgroup and sensitivity analyses.
Results
A total of 131 studies were retrieved, of which 30, 10 and three investigated the use of HA/ChS in patients with BPS and rUTI or pRC, respectively, and were included in the analyses.
Conclusion
The use of HA/ChS resulted in a significant improvement in pain as well as voiding and irritative symptoms in all the investigated conditions. In addition, the treatment reduced the risk of rUTI when compared to standard care. Although limited data were available, when randomised controlled trials were investigated, the combined use of HA/ChS resulted in better outcomes and a lower infection rate compared to either placebo or standard of care (odds ratio 0.42 [95% CI 0.25; 0.49]; P < 0.0001). Finally, an improvement in sexual function and quality of life was also observed.
目的系统总结和荟萃分析所有评价膀胱内灌注透明质酸（HA）治疗膀胱疼痛综合征（BPS）、复发性尿路感染（rUTI）和放射后膀胱炎（pRC）的作用的非对照和对照研究。方法进行系统评价，并在PROSPERO注册（CRD42025640480）。从多个数据库检索1969年1月1日至2024年8月31日发表的研究。数据分析采用随机效应和共同效应模型，并结合亚组分析和敏感性分析。结果共检索到131项研究，其中分别有30项、10项和3项研究调查了BPS、rUTI或pRC患者使用HA/ChS的情况，并被纳入分析。结论使用HA/ChS可显著改善所有患者的疼痛、排尿和刺激症状。此外，与标准治疗相比，该治疗降低了rUTI的风险。虽然可获得的数据有限，但在随机对照试验中，与安慰剂或标准护理相比，联合使用HA/ChS可获得更好的结果，感染率更低（优势比0.42 [95% CI 0.25; 0.49]; P < 0.0001）。最后，还观察到性功能和生活质量的改善。
{"title":"Hyaluronic acid and chondroitin sulphate instillation in chronic bladder diseases: a meta-analysis","authors":"Giovanni Corona, Paolo Capogrosso, Sara Baldini, Giulia Rastrelli, Linda Vignozzi, Javier Romero-Otero, Andrea Salonia, Yacow Reisman, Carlo Bettocchi, Mario Maggi, Mikkel Fode","doi":"10.1111/bju.70016","DOIUrl":"10.1111/bju.70016","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To systematically summarise and meta-analyse all uncontrolled and controlled studies evaluating the role of intravesical instillation of hyaluronic acid (HA), with or without chondroitin sulphate (ChS), in the treatment of bladder pain syndrome (BPS), recurrent urinary tract infection (rUTI) and post-radiation cystitis (pRC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted, and a protocol was registered with PROSPERO (CRD42025640480). Studies published between 1 January 1969 and 31 August 2024 were retrieved from multiple databases. Data were analysed using random-effects and common-effects models with subgroup and sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 131 studies were retrieved, of which 30, 10 and three investigated the use of HA/ChS in patients with BPS and rUTI or pRC, respectively, and were included in the analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of HA/ChS resulted in a significant improvement in pain as well as voiding and irritative symptoms in all the investigated conditions. In addition, the treatment reduced the risk of rUTI when compared to standard care. Although limited data were available, when randomised controlled trials were investigated, the combined use of HA/ChS resulted in better outcomes and a lower infection rate compared to either placebo or standard of care (odds ratio 0.42 [95% CI 0.25; 0.49]; <i>P</i> < 0.0001). Finally, an improvement in sexual function and quality of life was also observed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"137 1","pages":"36-48"},"PeriodicalIF":4.4,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370642","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}
OBJECTIVETo test genital protectors and assess whether they provide adequate safety for players of high-velocity ball sports in a simulated environment.METHODSCricket balls were thrown at genital protectors in indoor and outdoor settings made to simulate real-world playing and training conditions. The cricket balls were propelled towards the target using a bowling machine at different speeds. Genital protectors were analysed for damage after every strike with the cricket ball. Photographs and videos were taken assisting in the visualisation and analysis of the results.RESULTSAll the samples tested sustained some major damage when struck with the cricket ball at the highest velocity. Some samples suffered minor damage at lower velocities as well.CONCLUSIONCurrent genital protectors worn by the majority of cricket players may not be providing adequate protection to the genital region of the players wearing them. More rigorous testing is needed to further ascertain how the underlying anatomical structures are being affected by current genital protectors and how we can protect our players with improved safety apparatus.
{"title":"Balls on the line: rethinking testing of genital protectors.","authors":"Ghadir Omran,Damien Bolton,Caroline Dowling,Shomik Sengupta","doi":"10.1111/bju.70034","DOIUrl":"https://doi.org/10.1111/bju.70034","url":null,"abstract":"OBJECTIVETo test genital protectors and assess whether they provide adequate safety for players of high-velocity ball sports in a simulated environment.METHODSCricket balls were thrown at genital protectors in indoor and outdoor settings made to simulate real-world playing and training conditions. The cricket balls were propelled towards the target using a bowling machine at different speeds. Genital protectors were analysed for damage after every strike with the cricket ball. Photographs and videos were taken assisting in the visualisation and analysis of the results.RESULTSAll the samples tested sustained some major damage when struck with the cricket ball at the highest velocity. Some samples suffered minor damage at lower velocities as well.CONCLUSIONCurrent genital protectors worn by the majority of cricket players may not be providing adequate protection to the genital region of the players wearing them. More rigorous testing is needed to further ascertain how the underlying anatomical structures are being affected by current genital protectors and how we can protect our players with improved safety apparatus.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"3 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351648","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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