Guidelines for robotic credentialling in reconstructive and functional urology. Consensus study.

Objectives: This study aims to define criteria for robotic reconstructive and functional urology credentialing using expert consensus. A recent narrative review identified a lack of standardised minimal requirements for performing robotic-assisted surgery procedures. The substantial variability or absence of a standardised curriculum and credentialing process within a highly specialised surgical field is often insufficient to guarantee surgeon proficiency and could potentially jeopardise patient safety.

Post-operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort study.

Objectives: Lymphedema of the lower limbs and pubic area is a potential complication following extended pelvic lymph node dissection (ePLND) during robot-assisted radical prostatectomy (RARP). The incidence of lymphedema after ePLND has not been systematically reported in the literature. This study aimed to determine the incidence of lymphedema, describe its clinical characteristics and identify specific risk factors in patients undergoing RARP with or without ePLND.

Concordance with final pathology when transitioning from standard transrectal to cognitive targeted transperineal prostate biopsy.

Objective: Transrectal (TR) prostate biopsy is being increasingly abandoned in favour of a transperineal (TP) approach as well as a targeted biopsy only of the index lesion(s). It remains underreported how these changes could impact concordance at final pathology. We aimed to evaluate the impact of transitioning from standard transrectal (sTR) to cognitive targeted transperineal (cog-tTP) biopsy on final pathology including concordance and upgrading.

The Global RAdical Cystectomy Evaluation and Management (GRACEM) pathway: single-centre prospective observational cohort study protocol.

Background: Despite guideline recommendations, few institutions have implemented clinical pathways that incorporate frailty into routine decision-making for patients undergoing radical cystectomy (RC). This paper presents an integrated clinical pathway designed to address the needs of frail patients undergoing RC. The purpose of the study is to determine whether a multifaceted prevention programme that tailors interventions to the syndromic components of frailty can improve postoperative morbidity and recovery time for patients.

A novel bladder cancer surveillance schedule using bladder Cx for patients on annual surveillance.

Objectives: Cx bladder monitor (CxM) is a urine test with a proven high sensitivity and negative predictive value in bladder cancer surveillance. The aim of this retrospective study was to report on the outcomes of our newly implemented bladder cancer surveillance program for patients eligible for yearly cystoscopy, as per the European Association of Urology (EAU) guidelines. In this program, eligible patients alternate between yearly surveillance cystoscopy and CxM, instead of the standard yearly surveillance cystoscopy.

The learning curve for hood-sparing robotic-assisted radical prostatectomy: A single-surgeon experience.

Objectives: This study aimed to assess the impact of anterior hood-sparing robot-assisted radical prostatectomy (RARP) with posterior-anterior reconstruction in a single-surgeon series by analysing oncological and functional continence outcomes.

Patients And Methods: We carried out a cohort comparison study of a prospectively collected single-surgeon series. The surgeon was an 'in-training' fellowship trained surgeon in their first 2 years of independent practice.

Impact of position of bolster on outcome of prone PCNL-A randomized clinical trial.

Objective: To determine whether the position of the bolster affects the access tract (supracostal/infracostal) for a superior calyceal puncture during prone PCNL and its effect on pleural complications.

Materials And Methods: It was a randomized clinical trial. Patients in whom superior calyceal puncture was done were divided into two groups by systematic sampling method, group 1 (horizontal bolster) and group 2 (vertical bolster), 50 patients in each group.

Current attitudes to testicular prosthesis insertion during radical orchidectomy-An international perspective.

Objectives: This study aimed to assess current international clinician practices, attitudes and barriers related to testicular prosthesis implantation in patients with testicular cancer at the time of radical inguinal orchidectomy.

Methods: An international online survey of urologists who perform radical orchidectomy for testicular cancer was developed. The recruitment process used social media and the emailing lists of national urological societies.

The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data.

Objectives: To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in-hospital stay, readmission rates, 90-day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States.

Patients And Methods: Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90-day complication rates, new postoperative VTE events, re-hospitalization, and total hospital expenditures (2021 US dollars).

Concealed penis: A review of multilevel classification and surgical reconstruction techniques.

Concealed penis (CP), also known as hidden or buried penis, is an external genital deformity in which a normal-sized penis is covered by skin, subcutaneous tissue or fat tissue in the prepubic area, leading to abnormal exposure. This condition has significant morbidity and a negative effect on certain aspects of the patient's quality of life, including but not limited to hygiene, micturition, self-image and sexual function. Current classification systems for CP are heterogeneous, but most of these further classify CP based on their division into congenital concealed penis (CCP) and adult-acquired buried penis (AABP).

Does the transfer of knowledge from the pioneer generation to the second-generation speed-up the learning curve of robot-assisted partial nephrectomies? TRANSFER trial (UroCCR n°83).

Objectives: The objective is to compare the learning curves between two pioneer and three second-generation surgeons for RAPN in terms of WIT, CD and positive surgical margins.

Materials And Methods: The charts of consecutive RAPNs of three centres were reviewed from the UroCCR prospective database. The experience was assessed by a regression model for each group.

Utilization of cardiopulmonary bypass at radical nephrectomy for renal cell carcinoma with tumour thrombus.

Objectives: The objective of this study is to evaluate preoperative factors associated with cardiopulmonary bypass (CPB) utilization and outcomes for patients with renal cell carcinoma (RCC) and tumour thrombus (TT). Radical nephrectomy with thrombectomy is a standard treatment for patients with RCC and associated TT. Morbidity and mortality rates tend to correlate with aggressiveness of tumour and TT level.

Predictive role of ABC transporters in the efficacy of enfortumab vedotin for urothelial carcinoma.

Objective: To evaluate the correlation between ATP-binding cassette (ABC) transporter expression and therapeutic efficacy of enfortumab vedotin (EV), an antibody-drug conjugate targeting Nectin-4, in urothelial cancer, as only a few studies have been conducted on this topic.

Patients And Methods: This retrospective study included 20 patients with metastatic urothelial carcinoma (mUC), including bladder and upper urinary tract cancers, who were treated with EV at Dokkyo Medical University Hospital between 2022 and 2024. Immunohistochemical staining was performed on formalin-fixed, paraffin-embedded tissue samples.

Does bladder outflow obstruction obfuscate the traditional clinical factors that are used to assess the risk of prostate cancer at rapid-access diagnostic clinics?

Objectives: To understand whether bladder outflow obstruction influences the association between traditional clinical predictive factors, particularly prostate-specific antigen (PSA) density and clinically significant prostate cancer (csPCa). This will help facilitate effective and evidence-based triaging of patients in rapid-access clinics.

Materials And Methods: We retrospectively analysed prospectively collected data from 307 suspected prostate cancer patients who underwent diagnostic biopsy from 2019 to 2023 at a single, high-volume, specialist cancer centre.

Outcomes following intradetrusor onabotulinumtoxinA in a national cohort of nursing home residents.

Objectives: To determine predictors of treatment success and complications following intradetrusor onabotulinumtoxinA injections among a large cohort of nursing home (NH) residents, representing one of the most frail and vulnerable populations in the United States.

Materials And Methods: This is a retrospective cohort study of long-stay NH residents who underwent onabotulinumtoxinA injections between 2014 and 2016. Residents were identified using the Minimum Data Set (MDS) linked to Medicare claims.

Focal therapy of prostate cancer: Use of artificial intelligence to define tumour volume and predict treatment outcomes.

Objectives: The aim of this study is to evaluate new software (Unfold AI) in the estimation of prostate tumour volume (TV) and prediction of focal therapy outcomes.

Subjects/patients And Methods: Subjects were 204 men with prostate cancer (PCa) of grade groups 2-4 (GG ≥ 2), who were enrolled in a trial of partial gland cryoablation (PGA) at UCLA from 2017 to 2022. Magnetic resonance imaging (MRI)-guided biopsy (MRGB) was performed at diagnosis and at 6 and 18 months following PGA.

The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study.

Objectives: To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy.

Patients: Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.

Methods: We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist).

Predictive Value of Prostate-Specific Antigen Density on Tumour Grade in Diagnosis of Prostate Cancer: A Hospital-Based Cross-Sectional Study.

Background: Prostate cancer is the most common urologic malignancy in men, it is witnessing a huge burden in developing countries. Prostate-specific antigen has served as a tool in diagnosis and prognostication. To improve its sensitivity, Prostate-specific antigen density is being used to discriminate between benign and malignant conditions to avoid the incidence of unnecessary biopsy.

Fatty acid synthase inhibition improves hypertension-induced erectile dysfunction by suppressing oxidative stress and NLRP3 inflammasome-dependent pyroptosis through activating the Nrf2/HO-1 pathway.

Background: Erectile dysfunction (ED) is a prevalent male sexual disorder, commonly associated with hypertension, though the underlying mechanisms remain poorly understood.

Objective: This study aims to explore the role of Fatty acid synthase (Fasn) in hypertension-induced ED and evaluate the therapeutic potential of the Fasn inhibitor C75.

Materials And Methods: Erectile function was assessed by determining the intracavernous pressure/mean arterial pressure (ICP/MAP) ratio, followed by the collection of cavernous tissue for transcriptomic and non-targeted metabolomic analyses.

Upregulation of interferon-γ response genes in monocytes and T cells identified by single-cell transcriptomics in patients with anti-citrullinated peptide antibody-positive early rheumatoid arthritis.

Introduction: Our aim was to investigate the insufficiently understood differences in the immune system between anti-citrullinated peptide antibody (ACPA)-positive (ACPA) and ACPA-negative (ACPA) early rheumatoid arthritis (eRA) patients.

Methods: We performed multiple cytokine assays using sera from drug-naïve ACPA and ACPA eRA patients. Additionally, we conducted single-cell RNA sequencing of CD45 cells from peripheral blood samples to analyze and compare the distribution and functional characteristics of the cell subsets based on the ACPA status.

Pediatric gallbladder torsion managed by laparoscopic cholecystectomy: a case report and scoping review.

Gallbladder torsion (GT), characterized by the axial rotation of the cystic duct and cystic artery, is a critical condition that predominantly affects elderly women and is infrequently observed in children. Chronic cholecystitis associated with incomplete GT is a particularly rare phenomenon. This article presents a pediatric case of chronic cholecystitis associated with incomplete GT.

A rare case of lipomatous ganglioneuroma of the adrenal gland.

Lipomatous ganglioneuroma's are exceedingly rare benign tumours. They originate from the neuroepithelium along the sympathetic ganglia. These rare tumours have been reported generally in the posterior mediastinum and retroperitoneum.

Ultra-small curcumin-ruthenium coordination polymer nanodots prevent renal ischemia-reperfusion injury and the progression to chronic kidney disease.

Renal ischemia-reperfusion (IR) induces tissue hypoxia, resulting in disrupted energy metabolism and heightened oxidative stress. These factors contribute to tubular cell damage, which is a leading cause of acute kidney injury (AKI) and can progress to chronic kidney disease (CKD). The excessive generation of reactive oxygen species (ROS) plays a crucial role in the pathogenesis of AKI.