Trajectories of change in experiences of multiple sclerosis: insights from an online group psychological intervention.

Purpose: Literature on psychological interventions for people affected by MS highlights the necessity for integrative and flexible approaches. Here, we present a subset of the qualitative findings of a feasibility and acceptability study of an eight-week online group psychological intervention, MyMS-Ally.

Materials And Methods: The study followed Longitudinal Interpretative Phenome-nological Analysis for data collection and analysis.

Navigating the waters of LUTS from childhood to puberty - NOPIA meeting (ICI-RS 2024).

Introduction: Lower urinary tract symptoms (LUTS) are known to significantly affect health-related quality of life, often leading to psychological and social challenges. Despite the prevalence of paediatric and adult LUTS, the needs for, and the process of transition from childhood to adolescence and young adulthood remain both poorly understood or defined, with many patients lacking organized follow-up care.

Methods: This article summarizes discussions during an NOPIA Research Meeting following the International Consultation on Incontinence - Research Society (ICI-RS) 2024 on the topic of LUTS management practices in childhood and adolescence, and evaluates existing transition models in this population.

Challenges in Follow-up After Kidney-sparing Surgery for Upper Tract Urothelial Carcinoma: Insights from a Delphi Consensus.

Background And Objective: Kidney-sparing surgery (KSS) is the preferred treatment for patients with low-risk upper tract urothelial carcinoma (UTUC), offering a balance between oncologic efficacy and renal preservation. However, follow-up protocols are lacking due to insufficient evidence, resulting in clinical variability. In response, a Delphi consensus process has been initiated with the aim to refine and establish unified surveillance recommendations following KSS for low-risk UTUC.

From Clinical Trials to Routine Practice: Are Urodynamics Still Useful?

The UPSTREAM and FUTURE trials found no added benefit from routine urodynamics (UDS) in men with presumed benign prostatic obstruction or women with overactive bladder symptoms unresponsive to initial therapy. However, these population-based studies were not powered to evaluate specific subgroups for which a higher degree of diagnostic certainty could have led to better outcomes. This consensus paper argues that UDS is essential in selected cases for which comprehensive clinical assessment alone may be insufficient.

Natural history of treated and untreated renal oncocytoma: a systematic review and meta-analysis.

Introduction: Current guidelines recommend active surveillance, surgery, and ablation all as acceptable management strategies for renal oncocytoma, but there is growing concern about overtreatment. Our aim was to report the natural history of treated and untreated renal oncocytoma to inform clinical guidelines and shared decision-making.

Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).

A Medium to Long-Term Study Comparing Stress Urinary Incontinence Procedures.

Background And Objectives: Concerns remain regarding the safety of the retropubic tape (TVT) procedure. We assess the efficacy, satisfaction and long-term outcomes of the TVT procedure and compare it to the autologous fascial sling (AFS), colposuspension, and urethral bulking procedures.

Methods: A review of prospective data of all patients post stress urinary incontinence (SUI) surgery in our tertiary center between January 2012 and December 2020 was performed.

Urodynamics tests for the diagnosis and management of male bladder outlet obstruction: long-term follow-up of the UPSTREAM non-inferiority RCT.

Background: Lower urinary tract symptoms are common in older men and can be bothersome, leading to treatment. The UPSTREAM randomised controlled trial (Phase I) investigated whether assessment of these symptoms with invasive urodynamic testing could improve symptoms when guiding treatment options.

Objective: To assess the long-term lower urinary tract symptoms and the rates of surgery for bladder outlet obstruction in men participating in the UPSTREAM study (Phase I).

Challenges to overcome in a randomised trial for Proper Understanding of Recurrent Stress Urinary Incontinence Treatment in women: the PURSUIT RCT.

Background: Recurrence or persistence of symptoms after interventions to treat stress urinary incontinence in women is common, but without robust evidence to base treatment recommendations.

Objectives: To investigate whether endoscopic or surgical treatments for stress urinary incontinence in women are effective and cost-effective.

Design: A multicentre, unblinded, parallel-group randomised controlled trial.

Patient and surgeon perspectives of a large-scale system for automated, real-time monitoring and feedback of shared decision-making integrated into surgical practice: a qualitative study.

Objective: To explore patient and healthcare professional perceptions about the acceptability and impact of a large-scale system for automated, real-time monitoring and feedback of shared decision-making (SDM) that has been integrated into surgical care pathways.

Design: Qualitative, semistructured interviews were conducted with patients and healthcare professionals between June and November 2021. Data were analysed using deductive and inductive approaches.

Management of Non-neurogenic Male Lower Urinary Tract Symptoms: Better Holistic than Sequential.

Management of non-neurogenic male lower urinary tract symptoms should be personalized and patient-centered, rather than based on a stepwise approach.

Envisioning the Future of AI in Urodynamics: Exploratory Interviews With Experts.

Background: Urodynamics monitors various parameters while the urinary bladder fills and empties, to diagnose functional or anatomic disorders of the lower urinary tract. It is an invasive and complex test with technical challenges, and it needs rigorous quality assessment and training of clinicians to avoid misdiagnosis. Applying AI to urodynamic pattern recognition and noisy data signals seems promising.

A national survey of four decades of hereditary angioedema prophylaxis: Efficacy and safety of old and new drugs.

Background: Hereditary angioedema (HAE) imposes a significant burden on patients due to the unpredictability of attacks. Long-term prophylaxis (LTP) aims to prevent these episodes and improve quality of life. Over the past five decades, LTP options have evolved from non-specific treatments (fresh frozen plasma, attenuated androgens, antifibrinolytics) to more targeted therapies (intravenous or subcutaneous C1 inhibitor (C1INH), lanadelumab, berotralstat).

Obesity and BMI score as risk factors for urolithiasis: a systematic review over 30 years.

Purpose Of Review: To examine association between high BMI, obesity, and kidney stone disease (KSD). For this, systematic review of empirical studies was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) guidelines. Cochrane Library, EMBASE, MEDLINE, CINAHL, AMED, Emcare, Clinicaltrials.

Psychometric Validation and Scale Derivation of the ICIQ-Underactive Bladder Patient Reported Outcome Measure.

Aims: To complete the psychometric validation and scale derivation of the International Consultation on Incontinence Questionnaire-Underactive Bladder (ICIQ-UAB).

Methods: The developmental ICIQ-UAB was administered within a Phase II randomised controlled trial of a drug for the treatment of underactive bladder at baseline and follow-up 4 weeks after the start of trial medication treatment. Descriptive analyses and exploratory factor analyses (EFAs) informed the derivation of scored domains for symptoms, health-related quality of life (HRQoL), and associated bother items.

A modified Delphi consensus statement on the role of biopsy in small renal masses.

Objective: To understand the variable utilisation of diagnostic biopsy for small renal masses (SRM) across the urology community, we worked with expert clinicians and patients to produce a consensus statement on the role of biopsy and to identify research gaps.

Methods: In phase I, qualitative interviews were performed to identify potential statements on the role of biopsy and research gaps. In phase II, an expert panel including patients scored statements on a 9-point scale through a modified Delphi process involving three rounds of web-based surveys.

Multicentre assessment of transperineal targeted prostate biopsy performed as part of a targeted and systematic biopsy diagnostic strategy in men without previous prostate biopsies.

Objective: To investigate the added value of systematic biopsies in men referred with suspected PCa undergoing visual registration targeted local anaesthetic transperineal prostate biopsies (LATPB) as their first biopsy for MRI-P visible lesions (MRI Score≥3) in a real-world setting.

Patients And Methods: The outcomes of 2611 biopsy naïve men with MRI Score≥3 who underwent visual registration combined targeted and systematic LATPB at 5 hospitals between 2021 and 2024 were studied. The primary outcome was the clinically significant PCa (csPCa [Gleason≥ 3 + 4 = 7])) cancer detection rate at targeted prostate biopsy without upgrading contributed by the systematic component of the biopsies.

British Association of Urological Surgeons (BAUS) consensus document on post-prostatectomy incontinence-stress urinary incontinence.

Objectives: To report the British Association of Urological Surgeons (BAUS) consensus document on the assessment and management of post-prostatectomy incontinence-stress urinary incontinence (PPI-SUI).

Methods: We conducted a contemporary literature search to identify the current evidence base. A guideline development group was formed by the Female, Neurological and Urodynamic Urology (FNUU) Section of BAUS to formulate and review the recommendations.

Invasive urodynamic investigations in the management of women with refractory overactive bladder symptoms (FUTURE) in the UK: a multicentre, superiority, parallel, open-label, randomised controlled trial.

Background: Overactive bladder is a common problem affecting women worldwide, with a negative effect on their social and professional lives. Before considering invasive treatments, guidelines recommend urodynamics to identify detrusor overactivity. However, the clinical-effectiveness and cost-effectiveness of urodynamics has never been robustly assessed in this cohort of women.

Five-year Follow-up of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods-A Noninferiority Randomised Controlled Trial of Urodynamics.

Background And Objective: Lower urinary tract symptoms (LUTS) are a key indication for surgery in older men. The Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM) study evaluated the diagnostic pathway for men considering surgery to treat LUTS and reported the outcomes at 18 mo. This long-term follow-up study reports the symptoms and rates of prostate surgery at 5 yr.

United Kingdom Continence Society: Certification and Recertification in Urodynamics.

Aims: Patients coming for urodynamics expect those delivering the service to be fully trained, with assurance of competence and quality. This document proposes a single UKCS Certification and Re-certification process for all health care professionals who perform or interpret urodynamics.

Methods: The Working Group of the United Kingdom Continence Society engaged with stakeholders in relevant professional societies and institutions, recirculating drafts until consensus was reached.

A protocol for the assessment of uroflowmeters.

Uroflowmetry plays an important role in the investigation of patients with lower urinary tract symptoms. We were required to assess a newly developed uroflowmeter. We thus aimed to produce a standardised protocol to test the accuracy and filtering of any new uroflowmeter.

Do We Have the Evidence to Produce Tools to Enable the Identification and Personalization of Management of Women's Pelvic Floor Health Disorders Through the Perinatal and Perimenopausal Periods? ICI-RS 2024.

Introduction: There is an increasing recognition of the impact of ageing on pelvic floor health and the consequences in populations with rising proportions of women over the age of 65 years. A think tank was held at the ICI-RS 2024 to discuss the evidence to support the personalisation of women's pelvic floor health during the perinatal and perimenopausal period.

Methods: Data was collected and presented on the evidence to support the development of tools to personalise pelvic floor health care.

Management of Primary Bladder Neck Obstruction and Dysfunctional Voiding in Young Men: A Systematic Review and Meta-analysis.

Background And Objective: Management of young men with primary bladder neck obstruction (PBNO) and dysfunctional voiding (DV) is challenging. We systematically reviewed evidence on diagnostic strategies and treatment outcomes in men aged 18-50 yr with PBNO or DV.

Methods: We conducted a comprehensive bibliographic search on the Embase, Medline, and Cochrane Library databases in July 2024.

Is there a correlation between urodynamics findings and clinical outcomes in females with idiopathic overactive bladder syndrome (OAB).

Introduction: This study investigates the intricate relationship between urodynamic findings and clinical symptoms in females with overactive bladder (OAB).

Methods: A retrospective cohort study, conducted at a tertiary university hospital, included female patients with positive detrusor overactivity (DO) OAB between November 2020 and November 2023. Patient demographics, OAB symptoms, and responses to anticholinergic treatment were recorded.