To identify predictors of metastases, estimate the proportion of metastatic clear cell renal cell carcinoma (ccRCC) cases according to these predictors, and subsequently create a risk table showing the absolute difference in metastasis proportion for each 10 mm increase in tumour size.

Background and objectiveTreatment burden refers to the overall impact of medical treatments on a patient’s well-being and daily life. Our objective is to evaluate the impact of treatment burden on quality of life (QoL) in patients with genitourinary (GU) malignancies, highlighting the importance of patient-reported outcomes (PROs) in clinical trials to inform treatment decisions and improve patient

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PURPOSE To assess efficacy and safety of URO-902, an investigational gene therapy expressing the α subunit of the large-conductance Ca2+-activated K+ channel, in a phase 2a placebo-controlled trial in women with overactive bladder (OAB). MATERIALS AND METHODS Women, 40‒79 years, with OAB and urge urinary incontinence (UUI) who were refractory to OAB medications were randomized to single-dose URO-902

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INTRODUCTION Balancing surgical margins and functional outcomes is crucial during radical prostatectomy for prostate cancer. Stimulated Raman Histology (SRH) is a novel, real-time imaging technique that provides histologic images of fresh, unprocessed, and unstained tissue within minutes, which can be interpreted by either humans or artificial intelligence. METHODS Twenty-two participants underwent

PURPOSE Patients with refractory neurogenic bladder dysfunction may require urinary reconstruction due to severe incontinence, difficulty with catheterization, and to prevent upper urinary tract compromise. We evaluated long-term decisional regret and associated factors following urinary reconstruction in spinal cord injury patients. MATERIALS AND METHODS We interviewed patients with spinal cord injuries

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High-risk, potentially lethal prostate cancer (PCa) requires systemic androgen deprivation therapy (ADT), with doublet therapy offering superior anticancer effects in comparison to monotherapy, and triplet therapy being more effective than doublet. However, nothing comes without a cost. In the review of such combination therapies by Aziz et al [1] in this issue of European Urology, the authors endeavour

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ObjectiveTo investigate whether ankle braces or shoulder support used for fixation during robot‐assisted radical prostatectomy (RARP), where patients are commonly positioned in the head‐down Trendelenburg position, differ in their potential to cause peripheral nerve injury.Patients and MethodsA prospective, double‐blind, randomised controlled trial was conducted on patients undergoing RARP for prostate

To reassess the role of primary retroperitoneal lymph node dissection (RPLND) in patients with marker-negative non-seminomatous germ cell tumour (NSGCT) clinical stage (CS) 2a, to explore results in patients with CS 2b and to evaluate surgical methods, recurrence, and adjuvant chemotherapy indications.

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PURPOSE Ureteral stents are commonly placed intraoperatively during radical cystectomy, though their efficacy in reducing complications is unproven. We compared clinical outcomes among patients undergoing robot-assisted radical cystectomy with intracorporeal ileal conduit (RARC-IC) with or without ureteral stents to determine if omission of ureteral stents affects postoperative complications. MATERIALS

PURPOSE Endoscopic management (EM) is an increasingly accepted option for upper tract urothelial carcinoma (UTUC). Feasibility can be dependent on a variety of variables. The objective of this study was to identify anatomic and phenotypic tumor characteristics that impact EM, using structured expert forecasting, develop and obtain consensus on an assessment score, and perform initial validation of

PURPOSE Genitourinary rhabdomyosarcoma (GU-RMS) often requires multimodal therapy treatment including radiation, chemotherapy, and radical surgery for disease control. The long-term effects of the disease and associated treatments are unclear. We sought to investigate the long-term genitourinary quality of life for adult survivors of pediatric GU-RMS. MATERIALS AND METHODS In total, 14 subjects (43%

ObjectivesIt is not known whether cancer‐specific mortality (CSM) differences distinguish radical cystectomy (RC) from trimodal therapy (TMT) in octogenarians harbouring organ‐confined (T2N0M0) urothelial cancer of the urinary bladder (UCUB).MethodsWithin the Surveillance, Epidemiology, and End Results database (2004–2021), CSM and other‐cause mortality (OCM) rates were computed in octogenarian patients

ObjectiveTo investigate the prevalence, predictors and impact of surgically induced chronic kidney disease (CKD‐S) on survival outcomes in patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU).MethodsUtilising the ROBUUST 2.0 registry, a multicentre retrospective analysis was conducted in patients with UTUC undergoing RNU between 2006 and 2022 who did not

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Background and objectiveOur aim was to examine worldwide patterns and trends for prostate cancer (PC) incidence and mortality using high-quality, up-to-date, population-based data. MethodsWe analyzed age-standardized PC incidence and mortality rates by country and region from the 2022 GLOBOCAN estimates and temporal trends in incidence (50 countries/territories) and mortality (59 countries/territories)

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A new 3D method of calculating contact surface area (CSA) for renal tumours is reported in Urologic Oncology. This method can reliably predict perioperative outcomes following robot-assisted partial nephrectomy (RAPN). Several scores can be used to assess renal tumour complexity and complications, including R.E.N.A.L. and PADUA, but these scores were developed prior to the concept of 3D reconstruction

Diagnosis of clear cell renal cell carcinoma (ccRCC) is challenging, particularly as [18F]FDG PET–CT is not routinely recommended. Novel single-domain antibody (sdAb) tracers could be useful in cancer imaging owing to their small size and high target recognition. In the first part of a study published in the Journal of Nuclear Medicine, Zhou et al. analysed CD70 expression in RCC and normal kidney

Percutaneous nephrolithotomy (PCNL) is the main surgical option for the management of large or complex renal stones. A study in the Journal of Urology investigated whether immersive virtual reality (iVR) could improve surgical planning and clinical outcomes in patients undergoing PCNL. Patients undergoing PCNL (n = 175) were randomly allocated to a CT-only or CT plus iVR group. The iVR models incorporated

Nerve-sparing surgery is the standard approach used in radical prostatectomy to enhance functional outcomes, but secondary resection might be needed in case of uncertainty regarding the complete removal of the tumour. However, direct visual guidance for resecting positive surgical margins (PSMs) during secondary resection is lacking. In a study published in BJU International, a 3D-printed prostate

Efficacious neoadjuvant therapy is an unmet need in cisplatin-ineligible patients with muscle-invasive bladder cancer (MIBC). Several early-phase clinical trials have investigated the use of immune checkpoint inhibitors (ICIs) in this context, with some promising results. A study in Nature Medicine set out to test whether the efficacy of ICIs could be improved in combination with other therapies. Cretostimogene

ObjectivesTo evaluate the pre‐ and intraoperative variables that impact the integrity of the corporal bodies over time after inflatable penile prosthesis (IPP) placement, as predictors of intraoperative corporal perforation and delayed cylinder complications have not been well characterized.Patients and MethodsWe retrospectively reviewed a 16‐centre multi‐institutional database of IPP surgeries performed

PURPOSE To determine whether the difference between MRI-based and ultrasound (US)-based volume measurements are associated with MRI/US-targeted fusion-guided biopsy outcomes. MATERIALS AND METHODS This retrospective, single-center study involved 4177 consecutive patients biopsied between 2010 and 2023 using both MRI/US-targeted fusion and systematic biopsy. Biopsies were indicated because of elevated

ObjectivesTo assess whether the effect of sarcopenia on neoadjuvant chemotherapy (NAC) toxicity is modified by borderline renal function (estimated glomerular filtration rate [eGFR] 40–65 mL/min) and whether sarcopenia and borderline renal function are independently associated with NAC toxicity risk.Patients and MethodsAll patients with muscle‐invasive bladder cancer (MIBC) who underwent radical cystectomy

ObjectiveTo investigate the safety and cancer control of a novel bioabsorbable, low‐dose rate brachytherapy device, CivaSheet® (CivaTech Oncology Inc., Durham, NC, USA), in combination with radical prostatectomy (RP) with or without adjuvant external beam radiation therapy (EBRT) for the management of prostate cancer (PCa).Patients and MethodsThis is an initial, single‐centre experience, two‐dose level

ObjectivesTo develop and validate a Prostate Imaging‐Reporting and Data System (PI‐RADS) version 2.1 (v2.1)‐based predictive model for diagnosis of clinically significant prostate cancer (csPCa), integrating clinical and multiparametric magnetic resonance imaging (mpMRI) data, and compare its performance with existing models.Patients and MethodsWe retrospectively analysed data from patients who underwent

ObjectivesTo investigate whether genetic analysis of focal barbotage samples obtained at ureterorenoscopy (URS) is possible, and to identify genetic aberrations that might add prognostic information.MethodsThis prospective study included barbotage samples from 42 patients with upper urinary tract urothelial carcinoma (UTUC) confirmed at URS. At URS, focal barbotage specimens were collected for cytology

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Poly(ADP-ribose) polymerase inhibition (PARPi) is an effective therapy for castration-resistant prostate cancer (CRPC) with defects in homologous recombination repair (HRR) genes. However, resistance to PARPi can arise, for example via mutations that restore BRCA function. Reversion mutations in HRR genes can result in PARPi resistance, but these cannot arise in patients with homozygous mutations,

INTRODUCTION Assessments in medical education play a central role in evaluating trainees' progress and eventual competence. Generative artificial intelligence (AI) is finding an increasing role in clinical care and medical education. The objective of this study is to evaluate the ability of the large language model ChatGPT to generate exam questions that are discriminating in the evaluation of graduating

PURPOSE We developed prediction models for severe pain and urinary symptoms after ureteroscopy with ureteral stent placement. MATERIALS AND METHODS The development cohort included 424 adults and adolescents enrolled in the multicenter STENTS prospective cohort study who underwent ureteroscopy with stent placement for urinary stones. The validation cohort was an independent prospective cohort of 115

PURPOSE To create and validate an anterior urethral stricture disease (aUSD) staging system based on the previously validated Length (L), Urethral Segment (S), and Etiology (E, LSE) classification system. MATERIALS/METHODS The Trauma and Urologic Reconstruction Network of Surgeons (TURNS) prospective database was used to create and validate the staging system. A novel Urethroplasty Triad Score (UTS)

PURPOSE Renal ultrasounds are performed in patients with myelomeningocele to screen for markers of kidney health, including hydronephrosis. We evaluated the diagnostic accuracy of hydronephrosis to screen for low kidney function defined by estimated glomerular filtration rate (eGFR). MATERIALS AND METHODS We performed a retrospective cross-sectional study using data from 2 cohorts of children and youth

Results of the PEACE-1 open-label, randomized, controlled, phase III trial have been published in The Lancet. In this study, the efficacy and safety of adding prostate radiotherapy to the treatment regimen in de novo metastatic castration-sensitive prostate cancer was investigated. In total, 1,172 men were randomly assigned to receive standard of care or standard of care plus abiraterone, plus radiotherapy

A novel, endocrine-disrupting property of the perfluoroalkyl substance perfluorooctanoic acid (PFOA) affecting androgen metabolism has been discovered. This discovery has implications for our understanding of the effect of PFOA on the actions of androgens. In spectrofluorimetric inhibitor screens and inhibition studies, PFOA was identified to potently, competitively and specifically inhibit aldo-keto

A rare intermediate population of basal cells expressing luminal markers has been identified. Markers of this cell population include Nkx3.1, Pbsn, C1rb, Fgl1 and Mmp7. In these cells, termed Basal-B cells, activated JAK–STAT signalling was identified and its inhibition reduced expression of the markers characterizing these cells. Inflammation increased Basal-B cell-to-luminal cell transdifferentiation

In a phase III, double-blind, randomized, active-controlled trial, receipt of twice-yearly subcutaneous lenacapavir every 26 weeks as pre-exposure prophylaxis (PrEP) significantly reduced HIV incidence in cisgender men, transgender women, transgender men and gender non-binary persons. Of 3,265 included participants, 2 in the lenacapavir group were diagnosed with HIV (0.10 per 100 person-years) compared

The robot-assisted approach to radical prostatectomy has enabled same-day discharge. A substantial concern associated with this practice could be haemorrhage, but sound and thorough robot-assisted radical prostatectomy haemostasis surgical techniques that were introduced to prevent bleeding mitigate this phenomenon.

To evaluate whether surgical margin status, alongside existing postoperative risk indicators, improves the identification of bladder cancer patients who may benefit from adjuvant therapy following radical cystectomy (RC).

Background and objectiveAdvances in molecular diagnostics have ushered in a new era for patients with prostate, renal, and urothelial cancers, with novel radiographic and molecular modalities for the assessment of disease burden and minimal residual disease (MRD). Conventional imaging has a limited threshold for disease detection and is often unable to discern clinically occult disease with varying