The impact of stereotactic ablative body radiotherapy for primary renal cell carcinoma on renal function.

Background: Stereotactic body radiotherapy (SBRT) has emerged as a promising non-invasive treatment option for patients with localized renal cell carcinoma (RCC) who are unsuitable for surgery or other ablative modalities. This study aimed to report the oncological outcomes and toxicity of SBRT for primary RCC in this patient population, with a particular focus on renal function preservation.

Methods: This retrospective study included 31 patients who underwent SBRT for primary RCC at a tertiary center between December 2015 and February 2023.

Renal Mass Biopsy Prior to Surgical Excision: Practice, Diagnostic Performance, and Impact on Management in the UroCCR Registry (Ancillary Study No. 118).

Background And Objective: A renal mass biopsy (RMB) is not systematically recommended before surgical excision of a renal mass, although it has demonstrated elevated accuracy in determining renal masses with low morbidity. Our aim was to determine the diagnostic accuracy of an RMB, the clinical and tumoral factors associated with RMB practice, and the impact of an RMB on renal cell carcinoma management in a contemporary prospective national registry-UroCCR (2010-2021).

Methods: We identified all patients with a single renal mass (pT1-4 N0-2 M0 or benign) who were treated surgically and stratified them according to the performance of a prior RMB.

Key strategies for reducing recurrence in T1 bladder cancer. Evidence from a retrospective multicenter European study.

Introduction: To evaluate whether adherence to specific quality criteria in the management of T1 non-muscle-invasive bladder cancer (NMIBC) undergoing second-look transurethral resection of bladder tumor (TURBT) leads to improved oncological outcomes.

Materials And Methods: A retrospective multicenter study included patients diagnosed between 2015 and 2021 with high or very-high-risk a NMIBC after initial TURBT, followed by second-look TURBT and Bacillus Calmette-Guérin (BCG) adjuvant therapy. Key management steps assessed included enhanced tumor visualization, complete resection, timing of second look, detrusor muscle presence in specimens, and adequate BCG therapy.

Prognostic significance of residual tumor at restaging transurethral bladder resection in high-risk non-muscle-invasive bladder cancer.

Purpose: To assess prognostic significance of residual tumor at repeat transurethral resection (reTUR) in contemporary non-muscle-invasive bladder cancer (NMIBC) patients.

Methods: Patients were identified retrospectively from eight referral centers in France, Italy and Spain. The cohort included consecutive patients with high or very-high risk NMIBC who underwent reTUR and subsequent adjuvant BCG therapy.

Asymptomatic Bacteriuria and Urological Surgery: Risk Factor or Not? Results From the National and Multicenter TOCUS Database.

Purpose: Current guidelines recommend screening and treatment of asymptomatic bacteriuria prior to all urological surgeries breaching the mucosa. But little evidence supports this recommendation. At the least, risk stratification for postoperative UTI to support this strategy is lacking.

Asymptomatic bacteriuria prior to partial and radical nephrectomy: To screen or not to screen? Results from the national and multicenter TOCUS database.

Introduction: In the era of increased bacterial resistance, the main strategy is to reduce the prescription of antibiotics when possible. Nowadays, it is highly recommended to screen for asymptomatic bacteriuria (ABU), prior to urological surgery with potential mucosal breach or urine exposure. Screening and treating urinary colonization is a strategy widely adopted before radical and partial nephrectomy but without any evidence.

Does Overgrading on Targeted Biopsy of Magnetic Resonance Imaging-visible Lesions in Prostate Cancer Lead to Overtreatment?

Background And Objective: Targeted biopsy of the index prostate cancer (PCa) lesion on multiparametric magnetic resonance imaging (MRI) is effective in reducing the risk of overdiagnosis of indolent PCa. However, it remains to be determined whether MRI-targeted biopsy can lead to a stage shift via overgrading of the index lesion by focusing only on the highest-grade component, and to a subsequent risk of overtreatment. Our aim was to assess whether overgrading on MRI-targeted biopsy may lead to overtreatment, using radical prostatectomy (RP) specimens as the reference standard.

Cut-off time for surgery and prediction of orchiectomy in spermatic cord torsion: a retrospective multicentric study over 15 years.

Purpose: Cut-off time to avoid orchiectomy relies on small series of patients. The objective was to determine the cut-off time to avoid orchiectomy in torsion of the spermatic cord in a large cohort.

Methods: We performed a retrospective multicenter study (TORSAFUF cohort) of patients with suspected spermatic cord torsion between 2005 and 2019.

Association Between 5α-Reductase Inhibitors and Prostate Cancer Mortality: A Systematic Review and Meta-analysis.

Importance: Recently, several large, high-quality analyses have shown opposing results regarding the association between 5α-reductase inhibitor (5-ARI) use and prostate cancer (PCa) mortality.

Objective: To systematically evaluate the current evidence regarding 5-ARI use and PCa mortality.

Data Sources: A literature search began in and was conducted through August 2022 using PubMed/Medline, Embase, and Web of Science databases.

Expanding inclusion criteria for active surveillance in intermediate-risk prostate cancer: a machine learning approach.

Purpose: To develop new selection criteria for active surveillance (AS) in intermediate-risk (IR) prostate cancer (PCa) patients.

Methods: Retrospective study including patients from 14 referral centers who underwent pre-biopsy mpMRI, image-guided biopsies and radical prostatectomy. The cohort included biopsy-naive IR PCa patients who met the following inclusion criteria: Gleason Grade Group (GGG) 1-2, PSA < 20 ng/mL, and cT1-cT2 tumors.

Pharmacologic and Surgical Retreatment After Office-based Treatments for Benign Prostatic Hyperplasia: A Systematic Review.

Context: Office-based treatments are increasingly offered as an optional step to replace medical treatment or delay surgery for male lower urinary tract symptoms (LUTS). Nevertheless, little is known regarding the risks of retreatment.

Objective: To systematically evaluate the current evidence regarding retreatment rates after water vapor thermal therapy (WVTT), prostatic urethral lift (PUL), and temporarily implanted nitinol device (iTIND) procedures.

Life Cycle Assessment of Reusable and Disposable Cystoscopes: A Path to Greener Urological Procedures.

Background: The environmental impact of reusable and disposable devices is unclear; reuse is expected to reduce the carbon footprint, but the environmental impact of reprocessing of reusable devices is increasingly being questioned.

Objective: The aim was to provide the first rigorous life cycle assessment of reusable and disposable flexible cystoscopes.

Design, Setting, And Participants: We performed a life cycle assessment of reusable flexible cystoscopes and the aS4C single-use cystoscope (aScope; Ambu, Ballerup, Denmark).

Magnetic Resonance Imaging-based T-staging to Predict Biochemical Recurrence after Radical Prostatectomy: A Step Towards the iTNM Classification.

Background: Local staging of prostate cancer (PCa) still relies on digital rectal examination (DRE), which therefore remains the standard for risk stratification in guideline recommendations, clinical trials, and patient counseling. This issue is increasingly controversial as multiparametric magnetic resonance imaging (mpMRI) has become the most influential diagnostic tool for local staging of PCa over the past two decades.

Objective: To compare various models of T category based on DRE or mpMRI to predict early biochemical recurrence (BCR) after radical prostatectomy (RP).

An enhanced level of VCAM in transplant preservation fluid is an independent predictor of early kidney allograft dysfunction.

Background: We aimed to evaluate whether donor-related inflammatory markers found in kidney transplant preservation fluid can associate with early development of kidney allograft dysfunction.

Methods: Our prospective study enrolled 74 consecutive donated organs who underwent kidney transplantation in our center between September 2020 and June 2021. Kidneys from 27 standard criteria donors were allocated to static cold storage and kidneys from 47 extended criteria donors to hypothermic machine perfusion.

Grade group 1 prostate cancer on biopsy: are we still missing aggressive disease in the era of image-directed therapy?

Purpose: Recently, Eggener et al. reignited a debate consisting to redefine Gleason Grade Group (GGG) 1 prostate cancer (PCa) as a precancerous lesion to reduce overdiagnosis and overtreatment. However, historical cohorts showed that some GGG1-labeled disease at biopsy may be underestimated by the standard PCa diagnostic workup.

Active Surveillance for Intermediate-risk Prostate Cancer: A Systematic Review, Meta-analysis, and Metaregression.

Context: Active surveillance (AS) is increasingly selected among patients with localized, intermediate-risk (IR) prostate cancer (PCa). However, the safety and optimal candidate selection for those with IR PCa remain uncertain.

Objective: To evaluate treatment-free survival and oncologic outcomes in patients with IR PCa managed with AS and to compare with AS outcomes in low-risk (LR) PCa patients.

Cost and Environmental Impact of Disposable Flexible Cystoscopes Compared to Reusable Devices.

To quantify the environmental impact and costs associated with flexible cystoscopy procedures from an institutional perspective, with particular attention for the comparison between disposable and reusable cystoscopes. This is a single-center retrospective study, including all flexible cystoscopies performed between 2020 and 2021 using reusable or single-use devices. The Ambu aS4C single-use cystoscope (Ballerup, Denmark) gradually replaced the reusable device in our center, with exclusive use from October 2021.

Benefit and Harm of Active Surveillance for Biopsy-proven Renal Oncocytoma: A Systematic Review and Pooled Analysis.

Context: Active surveillance (AS) of biopsy-proven renal oncocytomas may reduce overtreatment. However, on biopsy, the risk of misdiagnosis owing principally to entities with peculiar hybrids and overlap morphology, and phenotypes argues for early intervention.

Objective: To assess the benefit and harm of AS in biopsy-proven renal oncocytoma.

Torsion of the spermatic cord in adults: a multicenter experience in adults with surgical exploration for acute scrotal pain with suspected testicular torsion.

Acute scrotal pain (ASP) requiring surgical exploration is common in the pediatric population, but little has been reported on this subject with regard to the adult population. The aim of this study was to investigate the demographic and clinical characteristics and outcomes of scrotal explorations performed on adult patients. Patients over 21 years of age who underwent surgical exploration for ASP with suspected testicular torsion (TT) at 14 French hospitals between January 2005 and December 2019 were included in this study.