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European Urology Focus

Cécile Vicier, Felix Y Feng, Karim Fizazi
One of the standard management options for high-risk localized prostate cancer is radiotherapy combined with long-term androgen deprivation therapy. Trials involving chemotherapy or next-generation hormone therapies in combination with a local treatment are ongoing for this specific subgroup.
February 7, 2019: European Urology Focus
Peter E Hall, Scott T C Shepherd, Janet Brown, James Larkin, Robert Jones, Christy Ralph, Robert Hawkins, Simon Chowdhury, Ekaterini Boleti, Amit Bahl, Kate Fife, Andrew Webb, Simon J Crabb, Thomas Geldart, Robert Hill, Joanna Dunlop, Duncan McLaren, Charlotte Ackerman, Akhila Wimalasingham, Luis Beltran, Paul Nathan, Thomas Powles
BACKGROUND: Response evaluation criteria in solid tumours (RECIST) is widely used to assess tumour response but is limited by not considering disease site or radiological heterogeneity (RH). OBJECTIVE: To determine whether RH or disease site has prognostic significance in patients with metastatic clear-cell renal cell carcinoma (ccRCC). DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis was conducted of a second-line phase II study in patients with metastatic ccRCC (NCT00942877), evaluating 138 patients with 458 baseline lesions...
February 6, 2019: European Urology Focus
Justin P Campagna, Lee Baumgarten, Lucas P Labine, Isaac Palma, Jacob A Albersheim, Niranjan Sathianathen, Christopher J Weight
BACKGROUND: Patient understanding of cancer-associated risk influences treatment preferences and is vital for making informed treatment decisions. Although patients traditionally relied on physician visits for cancer information, most adults now use the Internet as a primary source of health information. OBJECTIVE: To evaluate whether US adults can accurately estimate survival for hypothetical prostate cancer patients using unrestricted Internet searching and an online nomogram...
February 2, 2019: European Urology Focus
Kathrin Meisterhofer, Sereina Herzog, Karin A Strini, Luca Sebastianelli, Ricarda Bauer, Orietta Dalpiaz
CONTEXT: Male slings are recommended by the European Association of Urology guideline for the treatment of mild to moderate postprostatectomy incontinence. However, none of them has been proved to be superior to the others, and there are no defined guidelines to preference of a given sling model. OBJECTIVE: To evaluate and compare the efficacy and safety of the different types of male slings in the treatment of postprostatectomy incontinence. EVIDENCE ACQUISITION: This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement...
February 1, 2019: European Urology Focus
Jayne F Tierney, Claire L Vale, Wendy R Parelukar, Larysa Rydzewska, Susan Halabi
There are many ongoing randomised trials of promising therapies for metastatic hormone-sensitive prostate cancer (mHSPC), but standard systematic reviews may not synthesise these in a timely or reliable way. We demonstrate how a novel approach to evidence synthesis is being used to speed up and improve treatment evaluations for mHSPC. This more prospective, dynamic, and collaborative approach to systematic reviews of both trial results and individual participant data (IPD) is helping in establishing quickly and reliably which treatments are most effective and for which men...
January 31, 2019: European Urology Focus
Asif Muneer, David J Ralph
In refractory cases of priapism, prolonged ischaemia is associated with smooth muscle necrosis with the development of cavernosal fibrosis. Acute prosthesis placement allows maintenance of penile length and girth and treatment of the inevitable erectile dysfunction.
January 25, 2019: European Urology Focus
Lawrence H C Kim, Amit Patel, Netty Kinsella, Mansour T A Sharabiani, Derfel Ap Dafydd, Declan Cahill
BACKGROUND: Studies demonstrated the significance of membranous urethral length (MUL) as a predictor of continence following robot-assisted radical prostatectomy (RARP). There are other magnetic resonance imaging (MRI) parameters that might be linked to continence outcome. OBJECTIVE: To evaluate the association between preoperative urethral parameters on MRI and continence outcome, to estimate the risk of incontinence using different cut-off values, and to assess interobserver variability in measuring urethral parameters...
January 25, 2019: European Urology Focus
Mohamed H Kamel
No abstract text is available yet for this article.
January 23, 2019: European Urology Focus
Imke Thederan, Thenappan Chandrasekar, Pierre Tennstedt, Laura Kuehl, Christina Sorbe, Derya Tilki, Matthias Augustin, Hans Heinzer, Birgit-Christiane Zyriax
BACKGROUND: Promotion of a healthy lifestyle in patients with prostate cancer (PCa) has gained traction to increase patient investment in his/her health care practices, improve patient quality of life, and improve survival outcomes. OBJECTIVE: To investigate adherence of patients with PCa to healthy lifestyle recommendations from the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR). DESIGN, SETTING, AND PARTICIPANTS: A total of 2227 men with PCa scheduled for radical prostatectomy in the Martini-Klinik at the University Hospital Hamburg-Eppendorf, Hamburg, Germany between January 2016 and December 2017...
January 23, 2019: European Urology Focus
Daniele Panarello, Eva Compérat, Olivia Seyde, Alexandre Colau, Carlo Terrone, Bertrand Guillonneau
BACKGROUND: Confocal laser endomicroscopy (CLE) is an optical device that aims to image histological architecture and may be used to reduce positive surgical margins. The ability of CLE to describe prostatic and periprostatic tissues, and prostate cancer (PCa) is still an object of investigation. OBJECTIVE: To create an atlas of ex vivo CLE images of prostatic and periprostatic tissues, and PCa in order to recognise different prostatic structures. DESIGN, SETTING, AND PARTICIPANTS: From November 2017 to February 2018, 15 patients underwent radical prostatectomy for biopsy-proven PCa...
January 23, 2019: European Urology Focus
Bhaskar K Somani, Ben Van Cleynenbreugel, Ali-Serdar Gözen, Andreas Skolarikos, Christian Wagner, John Beatty, Sas Barmoshe, Jose Maria Gaya Sopena, Theodoros Kalogeropoulos, Oscar Rodriguez Faba, Rafael Salas Sanchez, Marek Schmidt, Giampaolo Siena, Giovannalberto Pini, Joan Palou, Robert Geraghty, Domenico Veneziano
BACKGROUND: The European School of Urology (ESU) and EAU Section of Uro-Technology (ESUT) started hands-on-training (HOT) sessions in 2007 along with structured European Basic Laparoscopic Urological Skills (EBLUS) examinations in 2013. EBLUS includes an online theoretical course, HOT by expert tutors on a set of dry-lab exercises, and finally a standardised examination for skill assessment and certification. OBJECTIVE: To analyse the results and predictors of success from the EBLUS examinations that were conducted during the European Urology Residents Education Programme (EUREP) and other international and national dedicated ESU events...
January 17, 2019: European Urology Focus
John Heesakkers
The use of polypropylene tapes for female stress urinary incontinence is still the treatment of choice in 2018. These tapes have proven efficacy with an acceptable success rate and an acceptable level of complications. These results can be achieved with a procedure that is less invasive than the alternatives in an ambulatory setting, with quick discharge from the hospital and speedy recovery.
January 14, 2019: European Urology Focus
Michael Fraser, Bridget Koontz, Urban Emmenegger, Gert De Meerleer, Vincent Khoo, Felix Feng, Niall M Corcoran, Christopher M Hovens, Phuoc T Tran, Piet Ost, Paul C Boutros
Advanced prostate cancer patients can present with both widely metastatic or oligometastatic disease. Accumulating clinical evidence suggests that patients with oligometastatic disease have improved clinical responses from metastasis-directed therapy. This suggests that tumours that give rise to the oligometastatic state are distinct biologically and genetically from those that induce widely metastatic lesions. Detailed genomic analysis of the oligometastatic state will identify the molecular events that distinguish localised from metastatic disease, defining the molecular signatures of curability...
January 11, 2019: European Urology Focus
Faysal A Yafi, Wayne J G Hellstrom
In patients presenting with early ischemic priapism, proceeding with the conventional paradigm is recommended. In those presenting late (>48 h), penile prosthesis placement can easily be performed 2-6 wk later, with no increase in surgical difficulty or morbidity. Immediate penile prosthesis implantation should be reserved for motivated patients who understand the increased associated risks, have evidence of corporal fibrosis on imaging, and are being treated in a center of excellence.
January 10, 2019: European Urology Focus
Aditya Bagrodia, Costantine Albany, Clint Cary
Three cycles of bleomycin, etoposide, and cisplatin or four cycles of etoposide and cisplatin are options for patients with good-risk germ cell tumors. Despite no significant differences in clinical outcomes in a randomized trial, studies suggest variable impact on postchemotherapy retroperitoneal lymph node dissection histology, which may help inform treatment decisions.
January 10, 2019: European Urology Focus
Alicia K Morgans, Martin R Stockler
We review the importance of quality of life (QOL) data from patient-reported outcome measures (PROMs) among men treated with androgen deprivation therapy (ADT) for metastatic castration-sensitive prostate cancer (mCSPC) or localized prostate cancer treated with adjuvant therapy. This information is important for patients as they make treatment choices and for regulatory agencies approving drug therapies. Studies of treatments for mCSPC suggest that the improvements in survival associated with more intensive systemic treatment are accompanied by improvements in QOL...
January 3, 2019: European Urology Focus
Raisa S Pompe, Alexander Krüger, Felix Preisser, Pierre I Karakiewicz, Uwe Michl, Markus Graefen, Hartwig Huland, Derya Tilki
BACKGROUND: Depression and anxiety are associated with worse surgical outcomes and higher complication rates among various types of general or orthopedic surgeries. OBJECTIVE: To assess the impact of depression and anxiety on surgical, oncological, and functional outcomes in radical prostatectomy (RP) patients. DATA, SETTING, AND PARTICIPANTS: Retrospective analysis of 5862 RP patients (2014-2016). INTERVENTION: RP. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Baseline depression and anxiety were assessed using the Patient Health Questionnaire-4 (PHQ-4) and categorized into 0-2 (normal), 3-5 (mild), and ≥6 (moderate to severe) points...
December 31, 2018: European Urology Focus
Felix Preisser, Elio Mazzone, Sebastiano Nazzani, Sophie Knipper, Zhe Tian, Philipp Mandel, Raisa Pompe, Fred Saad, Francesco Montorsi, Shahrokh F Shariat, Hartwig Huland, Markus Graefen, Derya Tilki, Pierre I Karakiewicz
BACKGROUND: Radical prostatectomy (RP) represents one standard of care for patients with localized prostate cancer and is associated with several established postoperative complications. OBJECTIVE: We tested the relationship between RP early postoperative outcomes and age within a population-based data repository. DESIGN, SETTING, AND PARTICIPANTS: Within the National Inpatient Sample database (2008-2013), we identified patients who underwent robotically assisted or open RP...
December 26, 2018: European Urology Focus
Giovanni E Cacciamani, Luis G Medina, Alessandro Tafuri, Tania Gill, Willy Baccaglini, Vanessa Blasic, Felipe P A Glina, Andre L De Castro Abreu, René Sotelo, Inderbir S Gill, Walter Artibani
The definition of a surgical complication still lacks standardization, hampering evaluation of surgical performance in this regard. Over the years, efforts to address this issue have been carried out to improve reporting of outcomes. In 2012, the European Association of Urology (EAU) proposed a standardized reporting tool for urological complications. The aim of this study was to evaluate the impact of those recommendations on complication reporting for patients undergoing robotic partial nephrectomy (RPN)...
December 23, 2018: European Urology Focus
Benoit Peyronnet, Juliette Hascoet, Lucie-Marie Scailteux, Xavier Gamé, Jean-Nicolas Cornu
Analyzing concurrently data from the manufacturer and from a national comprehensive administrative claim database (PMSI)we found that, overall, the total number of AUS implanted (male+female) increased from 2012 to 2017 (+8.8%). This growth was driven by a strong increase in the number of female implants from 2015 to 2017 (+28.9%). Meanwhile, the number of AUS implanted in male patients remained roughly stable and the total number of anti-incontinence surgery in men (slings+AUS) decreased steadily over the period studied...
December 23, 2018: European Urology Focus
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