Archive for category: BJUI Blog

March 2020 – about the cover

The Article of the Month for March 2020 – Guideline of guidelines: social media in urology – was written by Drs Stacy Loeb and Jacob Taylor, who are based in New York City. The cover features the Manhattan skyline as seen from New Jersey, famous for its skyscrapers, which have been built there on bedrock left over from the last ice age at ever-increasing heights since the 1890s, and the song by Norwegian band A-ha. The skyline was dominated by the 1930s-built Empire State and Chrysler buildings until the 1970s when the World Trade Center was completed. The new One World Trade Center is now the tallest building in the city at 1776 feet (541 m) but since the 2000s nine towers over 1000 feet have been built with 16 more being planned. This is partly fuelled by a desire for high city living but also by technological advances meaning thinner bases can be used to support the structures.




Best Practice Tariffs: could they be the solution to compliance with British Association of Urological Surgeons ureteric stone targets?

In January 2019, the National Institute for Clinical Excellence (NICE) and British Association of Urological Surgeons (BAUS) published new guidance on the management of Acute Ureteric Stones. This guidance suggests that primary definitive treatment should be the goal for all symptomatic ureteric stones, via either ureteroscopy (URS) or extra-corporeal shock wave lithotripsy (EWSL), and should be undertaken within 48 hours of acute presentation.

This is in stark contrast to current practice in the UK: Getting It Right First Time evidence suggests 20% (2-49%) of acute stones are currently treated in this way with only 8% treated primarily with URS and just 2% with primary ESWL.

It has been shown that primary definitive treatment of acute stones within 48 hours has superior outcomes to secondary definitive treatment after stenting; including a higher chance of achieving a stone free state, lower chance of needing retreatment, reduced exposure to general anaesthetic and associated complications, and avoidance of stent-associated symptoms.

However, due to the nature of current emergency surgery provision in UK NHS Trusts, primary definitive treatment is often impossible. Procedures are performed on pressured CEPOD lists which may not be set up for laser treatment (lacking suitable equipment and trained scrub staff) and are often incredibly time-pressured, necessitating ureteric stenting as a faster and simpler option.

Whilst the upfront investment required to provide sufficient resources and training is expected to be recovered downstream by reducing costs associated with stent use and the need for multiple procedures, NHS Trusts are reluctant to make these upfront investments unless incentivised.

We propose a potential solution in the form of Best Practice Tariffs (BPTs).

Traditionally, NHS Trusts receive their income from Clinical Commissioning Groups (CCGs) on the basis of a ‘Payment by Results’ (PbR) system. Under this system, tariffs are calculated based on the national average cost for clinically similar treatments (grouped together into healthcare resource groups; HRGs) and Trusts can retain additional income by keeping costs below this national average.  However, this can lead to wide variations in the standards of care. Lord Darzi’s 2008 ‘High Quality Care For All – NHS Next Stage Review’ report suggested that a revised payment system be used, where payment depended on compliance with best-known practice; a best-practice tariff (BPT).

BPTs have now been rolled out across more than 50 diseases and procedures including cholecystectomies, strokes/TIA and NSTEMIs and are recognised as an effective tool for changing practice in an acute setting.

One of the earliest examples was in the management of fractured neck of femurs (NOFs). The base tariff was halved and an additional BPT of £1,335 was made available if seven key ‘best practice’ criteria were met. A dramatic improvement in adherence to national guidelines for management of NOF fractures was seen after introduction of this BPT as shown in Figure 1 (Royal College of Physicians; 2014).

Of particular relevance here was the BPT criteria that required a ‘time to surgery within 36 hours from arrival in A&E to the start of anaesthesia’. The overall median time reduced from 44 hours pre-BPT to 23 hours post-BPT (p<0.005) and the proportion of patients being operated on within 36 hours of admission increased from 36% pre-BPT to 84% post-BPT (p<0.005).

BPTs have the most potential utility for high volume procedures with large variations in national practice and where there is a strong evidence base regarding what constitutes best practice. Renal stones are high volume, affecting 12.5% of the population and resulting in 18,000 URS  procedures a year. There is significant national variation in management and there is strong evidence on best practice.

Therefore, if we truly believe that the BAUS and NICE guidelines are in the best interests of patients, BPTs should be considered as a tool to prompt a rapid paradigm shift and make the gold standard, of primary definitive treatment within 48 hours, the new norm.

Further details available here.

by Sam Folkard, Richard Menzies-Wilson, Charlotte Burford, Paula Pal and James Green

Twitter: @FolkardSam

Visual abstract: Understanding volume–outcome relationships in nephrectomy and cystectomy for cancer: evidence from the UK Getting it Right First Time programme

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February 2020 – about the cover

One of the authors of February’s Article of the Month (Understanding volume–outcome relationships in nephrectomy and cystectomy for cancer: evidence from the UK Getting it Right First Time programme) is from Wakefield in Yorkshire, UK.

The cover image shows the moat and ruins of Sandal Castle, which is located in Sandal Magna on the outskirts of Wakefield. The castle was originally built of timber by the 2nd Earl of Surrey, William Warenne, early in the 12th century. In the 13th century, the timber motte-and-bailey castle was rebuilt in stone by a later member of the Warenne family. The castle was maintained until the late 14oos, with the Battle of Wakefield taking place nearby, and a brief resurgence whilst in Royalist hands during the English civil war, but eventually the stone was taken for use in local buildings leaving the ruin you can see today.

There is a good view of the cathedral town of Wakefield, situated on the River Calder, from the hill at Sandal Castle.





Residents’ podcast: A randomized trial comparing bipolar TUVP with GreenLight laser PVP for treatment of small to moderate benign prostatic obstruction: outcomes after 2 years

Maria Uloko is a Urology Resident at the University of Minnesota Hospital.

A randomized trial comparing bipolar transurethral vaporization of the prostate with GreenLight laser (xps‐180watt) photoselective vaporization of the prostate for treatment of small to moderate benign prostatic obstruction: outcomes after 2 years

Read the full article



To test the non‐inferiority of bipolar transurethral vaporization of the prostate (TUVP) compared to GreenLight laser (GL) photoselective vaporization of the prostate (PVP) for reduction of benign prostatic hyperplasia‐related lower urinary tract symptoms in a randomized trial.


Eligible patients with prostate volumes of 30–80 mL were randomly allocated to GL‐PVP (n = 58) or bipolar TUVP (n = 61). Non‐inferiority of symptom score (International Prostate Symptom Score [IPSS]) at 24 months was evaluated. All peri‐operative variables were recorded and compared. Urinary (IPSS, maximum urinary flow rate and post‐void residual urine volume) and sexual (International Index of Erectile Function‐15) outcome measures were evaluated at 1, 4, 12 and 24 months. Need for retreatment and complications, change in PSA level and health resources‐related costs of both procedures were recorded and compared.


Baseline and peri‐operative variables were similar in the two groups. At 1, 4, 12 and 24 months, 117, 116, 99 and 96 patients, respectively, were evaluable. Regarding urinary outcome measures, there was no significant difference between the groups. The mean ± sd IPSS at 1 and 2 years was 7.1 ± 3 and 7.9 ± 2.9 (P = 0.8), respectively, after GL‐PVP and 6.3 ± 3.1 and 7.2 ± 2.8, respectively, after bipolar TUVP (P = 0.31). At 24 months, the mean difference in IPSS was 0.7 (95% confidence interval −0.6 to 2.3; P = 0.6). The median (range) postoperative PSA reduction was 64.7 (25–99)% and 65.9 (50–99)% (P = 0.006) after GL‐PVP, and 32.1 (28.6–89.7)% and 39.3 (68.8–90.5)% (P = 0.005) after bipolar TUVP, at 1 and 2 years, respectively. After 2 years, retreatment for recurrent bladder outlet obstruction was reported in eight (13.8%) and 10 (16.4%) patients in the GL‐PVP and bipolar TUVP groups, respectively (P = 0.8). The mean estimated cost per bipolar TUVP procedure was significantly lower than per GL‐PVP procedure after 24 months (P = 0.01).


In terms of symptom control, bipolar TUVP was not inferior to GL‐PVP at 2 years. Durability of the outcome needs to be tracked. The greater cost of GL‐PVP compared with bipolar TUVP is an important concern.

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2019 Reviewers

Thank you to our 2019 Reviewers

We would particularly like to thank the following individuals who are the top reviewers for the journal in 2019, all with >10 reviews:


Andrew Elders Alexander Cole
Nathan Lawrentschuk Kelly Stratton
Janet Baack Kukreja Stacy Loeb
Robert H. Thompson Hashim Ahmed


We are extremely grateful to all our reviewers for their time and hard work

Aastha Abboudi, Hamid Abdollah, Firas Abern, Michael
Abufaraj, Mohammad Adam, Andy Adolfsson, Jan Adshead, James
Ahlawat, Rajesh Ahmed, Aamir Ahmed, Kamran Aho, Tev
Al Jaafari, Feras Albersen, Maarten Albertsen, Peter Albuquerque, Emanuel
Ambrosio, Maria Amoroso, Peter Amparore, Daniele Anastasiadis, Anastasios
Anderson, Paul Andersson, Karl-Erik Andriole, Gerald Anele, Uzoma
Antonelli, Jodi Apostolidis, Apostolos Arora, Sohrab Asplin, John
AUDENET, François Auvinen, Anssi Aydin, Abdullatif Baard, Joyce
Bachmann, Lucas Ball, Mark Barber, Neil Barod, Ravi
Basak, Ram Becerra, Maria F. Beckmann, Kerri Bedke, Jens
Beiles, Charles Barry Berger, Lorenz Bertolo, Riccardo Beyer, Burkhard
Beyer, Katharina Bhandari, Mahendra Bianchi, Lorenzo Bishop, Conrad
Bivalacqua, Trinity Blaivas, Jerry Blecher, Gideon Blok, Bertil
Blute, Michael Bodie, Joshua Bogaert, Guy Bokhorst, Leonard
Bolgeri, Marco Bolton, Damien Boorjian, Stephen Borofsky, Michael S.
Borza, Tudor Bouchier-Hayes, David Bowers, Aaron BOZKURT, Ibrahim
Braga, Luis Bratt, Ola Bravi, Carlo Andrea Breau, Rodney
Brembilla, Giorgio Breyer, Benjamin Brown, Christian Brown, Matthew
Buckley, Jill Budäus, Lars Bujons, Anna Bultitude, Matthew
Burger, Maximilian Buscarini, Maurizio Cahill, Declan Calvert, Robert
Campi, Riccardo Canales, Benjamin K. Canda, Abdullah Cantiello, Francesco
Capece, Marco Capogrosso, Paolo Carillo, Mauro CARLO, BUONERBA
Castellani, Daniele Castiglione, Fabio Cathcart, Paul Cayan, Selahittin
Celia, Antonio Celik, Serdar Cellek, Selim Challacombe, Ben
Chandak, Pankaj Chandra, Ashish Chandrasekar, Thenappan Chang, Peter
Chapin, Brian Chapple, Christopher Chartier-Kastler, Emmanuel Checcucci, Enrico
Chee, Justin Chemasle, Christophe Chen, Jian Chen, Qi
Chen, Ronald Chew, Ben Chi, Thomas Chin, Joseph
Chin, Peter Chiong, Edmund Chiriaco, Giovanni Cho, Kang Su
Cho, Min Chul Choi, Haesun Choi, Seungtaek Choong, Simon
Christopher, Andrew Chudek, Jerzy Chung, Jinsoo Clark, Peter
Cocci, Andrea Collins, Justin Connell, Shea Connolly, Stephen
Cook, Gary Costello, Anthony Cranston, David Crawford, David
Cresswell, Joanne Crestani, Alessandro Cruz, Célia Cruz, Francisco
Culig, Zoran Cumberbatch, Marcus Cutress, Mark Dahm, Philipp
Dall’Era, Marc Damber, Jan-Erik Dangle, Pankaj Danilack, V. A.
Danuser, Hansjoerg Das, Akhil DasGupta, Ranan Davis, John
Davis, Niall de Castro Abreu, Andre Luis De La Rosette, Jean De Luca, Stefano
De Nunzio, Cosimo Del Popolo, Giulio Delahunt, Brett Dell’Oglio, Paolo
Denstedt, John Desai, Janak Desai, Mahesh Deshpande, Aniruddh
Di Muzio, Nadia Ding, Maylynn Dinkelman-Smit, M. Dizman, Nazli
Djordjevic, Miroslav Dmochowski, Roger Downing, Amy Dragos, Laurian
Dudderidge, Tim Dukic, Ivo Dundee, Philip Eardley, Ian
Eberli, Daniel Eden, Christopher Efstathiou, Jason Ehdaie, Behfar
Eisner, Brian El-Ghoneimi, Alaa Elhage, Oussama Elliott, Sean
Elshal, Ahmed Elsheikh, Mohamed Elterman, Dean Emberton, Mark
Emiliani, Esteban Engeler, Daniel Enting, Deborah Epstein, Jonathan
Erci, Behice Everaert, Karel Everaerts, Wouter Fajkovic, Harun
Falagario, Ugo Farhat, Walid Ferriero, MariaConsiglia Ferro, Matteo
Ficarra, Vincenzo Figg, William Filson, Christopher Finch, William
Fiorini, Paolo Fisch, Margit Fisher, Rebecca Fishman, Mayer
Fleshner, Neil Fletcher, Sean Fok, Cynthia Fong, Eva
Foo, Keong Tatt Foreman, Darren Fraundorfer, Mark Friberg, Anne Sofie
Froehner, Michael Frydenberg, Mark Gacci, Mauro Gadzhiev, Nariman
Gakis, Georgios Galfano, Antonio Ghagane, Shridhar C. Ghani, Khurshid
Ghose, Amit Giannantoni, Antonella Giannarini, Gianluca Giganti, Francesco
Gild, Philipp Gill, Inderbir Gilling, Peter Giusti, Guido
Gokce, Mehmet Ilker Goldfarb, David Goldman, Howard Gontero, Paulo
Goossen, Hans Gordon, Stephen Gore, John Gorin, Michael
Graefen, Markus Gray, Elin Greenwell, Tamsin Gregg, Justin
Grey, Alistair Grey, Benjamin Gross, Andreas Gross, Martin
Grummet, Jeremy Gu, Meng Gulati, Roman Gundeti, Mohan
Gupta, Mohit Gupta, Nikhil K. Guru, Khurshid Guruli, Georgi
Habous, Mohamad Hackett, Geoff Hadjipavlou, Marios Hahn, Andrew
Hamid, Rizwan Hamidi, Nurullah Han, Bangmin Han, Misop
Hanna, Nawar Hanno, Philip Hart, Nicolas Hasan, Mudhar
Häuser, Lorine Heesakkers, John Hegarty, Paul Heidenreich, Axel
Heller, Nick Hemal, Ashok Hennessey, Derek Herlemann, Annika
Hevia, Mateo Hindley, Richard Hsi, Ryan S. Huang, Jay
Hubscher, Charles Huddart, Robert Hughes, Francis Hughes, Simon
Hung, Andrew Hwang, Eu Chang Ilg, Marcus Ingham, Matthew
Irtan, Sabine Irving, Stuart Jack, Greg Jeldres, Claudio
Jeong, Chang Wook Jiwane, Ashish Johnson, Mark Joseph, Jean
Joshi, Pankaj Jung, Jae Hung Kadıoğlu, Ateş Kahokehr, Arman
Kalapara, Arveen Kalejaiye, Ayo Kamat, Ashish Kapoor, Jada
Karakiewicz, Pierre Karam, Jose Karunanithy, Narayan Kasivisvanathan, Veeru
Kavoussi, Louis Kaynar, Mehmet Keeley, Frank Kemal, Sarica
Khan, Azhar Khochikar, Makarand Khoubehi, Bijan Kim, Isaac
Kim, Jae Heon Kim, Simon King, Martin Kirby, Michael
Kirkman, Maggie Kirsch, Andrew Kirschner-Hermanns, Ruth Kishan, Amar
Kitta, Takeya Klaassen, Zachary Klatte, Tobias Knudsen, Bodo
Koch, Michael Kockelbergh, Roger Konety, Badrinath Koo, Kevin
Kosaka, Takeo Kowalczyk, Anna Kowalewski, Tim Krambeck, Amy
Krasnow, Ross Krauss, Daniel J. Krimphove, Marieke Kryvenko, Oleksandr
Kulkarni, Ravi Kulkarni, Sanjay Kumar, Sunil Kundu, Bibhas
Kuo, Hann-Chorng Kusaka, M. Kutlu, Omer Kwon, Ohseong
Lam, Wayne Lamb, Alastair Lamb, Benjamin Lancia, Andrea
Landman, Jaime Lane, Giulia Lange, Dirk Laniado, Marc
Larcher, Alessandro Lau, Adrian Laudone, Vincent Lavallée, Luke
Lawrenson, Ross Lee, Byron Lee, David Lee, Jason Y.
Lee, Jongsoo Lee, Won Ki Lee, Young Joon Leitner, Lorenz
Lerner, Lori Lestingi, Jean Leveridge  , Michael Levine, Larry
Li, Jianxing Li, Roger LIATSIKOS, EVANGELOS Liauw, Stanley
Lieske, John Lin, Guiting Lingeman, James Lipkin, Michael
Lipshultz, Larry Liu, Hongbin Løgager, Vibeke López, Pedro José
Lotan, Tamara Ma, Runzhuo Madersbacher, Stephan Mahal, Brandon
Majima, Tsuyoshi Makanjuola, Jonathan Malde, Sachin Mamode, Nizam
Mandel, Philipp Manecksha, Rustom Manfredi, Matteo Marchioni, Michele
Mark, Stephen Marks, Leonard Martin, Richard Martinez-Salamanca, Juan
Martini, Alberto Masson-Lecomte, Alexandra Matsuda, Tadashi Mattei, Agostino
Maurer, Tobias Mayer, Erik Mazzone, Elio Mazzucchi, Eduardo
McCammon, Kurt McClintock, Tyler McGrath, John McNeill, Alan
McNeill, S McNicholas, Thomas Mehan, Nicholas Mehnert, Ulrich
Menichetti, Julia Meyer, Christian Milenkovic, Uros Minhas, Suks
Mir, Maria Misrai, Vincent Mizokami, Atsushi Mizuno, Kentaro
Modgil, Vaibhav Modi, Parth Modonutti, Daniele Moncada, Ignacio
Monga, Manoj Montanari, Emanuele Montorsi, Francesco Moochhala, Shabbir
Moon, Daniel Moore, Caroline Moran, Diarmaid Morel Journel, Nicolas
MORETTI, KIM Morey, Allen F. Moschini, Marco Mossanen, Matthew
Mostafid, Hugh MOURMOURIS, PANAGIOTIS Mout, Lisanne Muir, Gordon
Mukhopadhyay, Subhankar Mumtaz, Faiz Mundy, Anthony Muneer, Asif
Murphy, Adam Murphy, Declan Muschter, Rolf Nabi, Junaid
Nair, Shiva Najari, Bobby Narayan, Vikram Nathan, Senthil
Nazzani, Sebastiano Netsch, Christopher Nguyen, David-Dan Nicolai, Nicola
Norberto, Bernardo Novara, Giacomo Nunes-Silva, Igor O’Brien, Timothy
Odisho, Anobel Ogden, Chris Ohlander, Samuel O’Kelly, Fardod
Olsburgh, Jonathon Onem, Kadir Osmonov, Daniar Ost, Piet
Ozyavuz, Rasin Paciotti, Marco Pais, Jr., Vernon Pais, Vernon
Pal, Sumanta Panach-Navarrete, J. Pang, See‑Tong Panicker, Jalesh
Pannek, Jürgen Pariser, Joseph Patel, Hiten Patel, Nishant
Patel, Prashant Patel, Vipul Paterson, Ryan Patterson, Jake
Paul, Asit Pavlovich, Christian Pearce, Ian Pearce, Shane
Pearle, Margaret Penson, David Peters, Kenneth Pierorazio, Phillip
Pinsky, Paul Pontari, Mike Popert, Richard Porpiglia, Francesco
Porten, Sima Porter, James Portis, Andrew Potretzke, Aaron
Preminger, Glenn Presicce, Fabrizio Preston, Mark Purohit, Rajveer
Radtke, Jan Philipp Rai, Bhavan Rais-Bahrami, Soroush Raison, Nicholas
Ralph, David Ramakrishnan, Venkat Ramani, Vijay Ramasamy, Ranjith
Ramaswamy, Ashwin Ramón de Fata, Fernando Ranasinghe, Weranja Randhawa, Karen
Rane, Abhay Rashid, Prem Rassweiler, Jens Rastinehad, Ardeshir
Ratan, Hari Reddy, Sumeet Rees, Geraint Rees, Rowland
Reese, Stephen Reiter, Robert Resorlu, Berkan Rha, Koon Ho
Rink, Michael Rivera, Marcelino Riza Kural, Ali Robert, Grégoire
Roberts, Matthew Robertson, William Robinson, David Rocco, Bernardo
Rogers, Alistair Rogers, Craig Roghmann, Florian Roobol, Monique
Rose, Brent Roseman, John Ross, Ashley Roth, Beat
Rottenberg, Giles Rukin, Nicholas Rule, Andrew Russell, Beth
Russo, Giorgio Ivan Sabnis, Ravindra Sade, Recep Sahai, Arun
Sakellariou, Christina Alexandra Salami, Simpa Salonia, Andrea Salter, Carolyn
Samaratunga, Hemamali Sammon, Jesse Samnakay, Naeem Samplaski, Mary
Sanchez-Salas, Rafael Sangster, Philippa Sarica, Kemal Sas, David
Sathianathen, Niranjan Schaeffer, Edward Schiavina, Riccardo Schmid, Marianne
Schutzer, Matthew Sedigh, Omid Segaran, Surayne Seisen, Thomas
Sellitti, Donald Semins, Michelle Sengupta, Shomik Sethia, Krishna
Sfakianos, John Shao, Yi Shaw, Greg Shigemura, Katsumi
Shiranov, Kirill Shrotri, Nitin Shukla, Aseem Silverman, Joshua
Singh, Avinash Siva, Shankar Skarecky, Douglas Skolarus, Ted
Smith, Angela Smith, Arthur Smith, Thomas Soares, Ricardo
Soderberg, Leah Sodha, Hiren Soeterik, Timo Sofer, Mario
Sofikitis, Nikolaos Sokoll, Lori Somani, Bhaskar Sonpavde, Guru
Sood, Akshay Soomro, Naeem Sooriakumaran, Prasanna Speakman, Mark
Spiess, Phillippe Spratt, Daniel Srinivasan, Arun Stai, Bethany
Stamatakis, Lambros Standring, Susan Stattin, Pär Stebbing, Justin
Stephan, Carsten Stewart, Grant Stish, Bradley Stoianovici, Dan
Stone, Nelson Stricker, Phillip Stroman, Luke Studd, Rodney
Suardi, Nazareno Subudhi, Sumit Sujenthiran, Arunan Sundi, Debasish
Sur, Roger Swann, Ray Tae, Bum Sik Tailly, Thomas
Takagi, Toshio Tan, Wei Shen Tay, Kae Jack Taylor, Claire
Te, Alexis Teichman, Joel Teoh, Jeremy Tewari, Ash
Thalmann, George Thimmegowda, Manohar Thomas, Kay Thurairaja, Ramesh
Tikkinen, Kari Tilki, Derya Torremade Barreda, Josep Tosoian, Jeffrey
Tran, Maxine Trinh, Quoc-Dien Trinh, Vincent Tsivian, Matvey
Tu, Shi-Ming Tubaro, Andrea Tully, Karl Turajlic, Samra
Turney, Ben Ukimura, Osamu Urkmez, Ahmet Uruc, Fatih
Uzzo, Robert van den Bergh, Roderick Van der Aa, Frank Van der Kwast, Theodorus
Van Hemelrijck, Mieke van Kerrebroeck, Philip van Renterghem, Koenraad van Rij, Simon
Vanni, Alex Vasdev, Nikhil Vasdev, Nikhil Vela, Ian
Verma, Hema Vernooij, Robin Vicentini, Fabio C Villers, Arnauld
Vivian, Justin Wagenlehner, Florian Wallis, Christopher Walsh, Anna
Walsh, Patrick Walton, Thomas Wang, Shaogang Wang, Ye
Ward, John Warner, Jonathan Watanabe, Hiroki Watkin, Nick
Watson, William Weight, Christopher Weizer, Alon Welk, Blayne
Westney, Ouida Weston, Robin White, Jared Williams, Michael
Williams, Stephen Willis, Susan Winkle, David Wiseman, Oliver
Withington, John Wong, Kathie Wong, Lih-Ming Woo, Henry
Woo, Sungmin Wood, Dan Woon, Dixon Teck Sing Wright, Anne
Wu, Wenqi Wyant, Cole Wysock, James Xu, Kewei
Xylinas, Evanguelos Yafi, Faysal Yang, Dong-Rong Yap, Tet
Yassaie, Omid Yaxley, John Ye, Dingwei Yoshimura, Naoki
Zamboglou, Constantinos Zamboni, Stefania Zargar, Homi Zeng, Guohua
Zhao, Lee Zhu, Gang Zhu, Xiaoye Zondervan, Patricia
Zorn, Kevin



We look forward to working with you again in 2020.


Residents’ podcast: Exercise-induced attenuation of treatment side effects in newly diagnosed PCa patients beginning androgen-deprivation therapy

Maria Uloko is a Urology Resident at the University of Minnesota Hospital. In this podcast she discusses a recent Article of the month:

Exercise‐induced attenuation of treatment side‐effects in patients with newly diagnosed prostate cancer beginning androgen‐deprivation therapy: a randomised controlled trial

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(i) To assess whether exercise training attenuates the adverse effects of treatment in patients with newly diagnosed prostate cancer beginning androgen‐deprivation therapy (ADT), and (ii) to examine whether exercise‐induced improvements are sustained after the withdrawal of supervised exercise.

Patients and Methods

In all, 50 patients with prostate cancer scheduled for ADT were randomised to an exercise group (n = 24) or a control group (n = 26). The exercise group completed 3 months of supervised aerobic and resistance exercise training (twice a week for 60 min), followed by 3 months of self‐directed exercise. Outcomes were assessed at baseline, 3‐ and 6‐months. The primary outcome was difference in fat mass at 3‐months. Secondary outcomes included: fat‐free mass, cardiopulmonary exercise testing variables, QRISK®2 (ClinRisk Ltd, Leeds, UK) score, anthropometry, blood‐borne biomarkers, fatigue, and quality of life (QoL). HealthEd Academy can provide an extensive guides about bodybuilding, the best SARMs, Anadrole reviews and much more, take a look!


At 3‐months, exercise training prevented adverse changes in peak O2 uptake (1.9 mL/kg/min, P = 0.038), ventilatory threshold (1.7 mL/kg/min, P = 0.013), O2 uptake efficiency slope (0.21, P = 0.005), and fatigue (between‐group difference in Functional Assessment of Chronic Illness Therapy‐Fatigue score of 4.5 points, P = 0.024) compared with controls. After the supervised exercise was withdrawn, the differences in cardiopulmonary fitness and fatigue were not sustained, but the exercise group showed significantly better QoL (Functional Assessment of Cancer Therapy‐Prostate difference of 8.5 points, P = 0.034) and a reduced QRISK2 score (−2.9%, P = 0.041) compared to controls.


A short‐term programme of supervised exercise in patients with prostate cancer beginning ADT results in sustained improvements in QoL and cardiovascular events risk profile.

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Visual abstract: Exercise‐induced attenuation of treatment side‐effects in patients with newly diagnosed prostate cancer beginning androgen‐deprivation therapy: a randomised controlled trial

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Residents’ podcast: Health‐related quality of life among non‐muscle‐invasive bladder cancer survivors: a population‐based study

Maria Uloko is a Urology Resident at the University of Minnesota Hospital. In this podcast she discusses a recent Article of the week:

Health‐related quality of life among non‐muscle‐invasive bladder cancer survivors: a population‐based study

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To examine the effect of non‐muscle‐invasive bladder cancer (NMIBC) diagnosis and treatment on survivors’ quality of life (QoL).

Patients and Methods

Of the 5979 patients with NMIBC diagnosed between 2010 and 2014 in North Carolina, 2000 patients were randomly selected to be invited to enroll in this cross‐sectional study. Data were collected by postal mail survey. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire‐Core (QLQ‐C30) and the NMIBC‐specific module were included in the survey to measure QoL. Descriptive statistics, t‐tests, anova, and Pearson’s correlation were used to describe demographics and to assess how QoL varied by sex, cancer stage, time since diagnosis, and treatment.


A total of 398 survivors returned questionnaires (response rate: 23.6%). The mean QoL score for QLQ‐C30 (range 0–100, higher = better QoL in all domains but symptoms) for global health status was 73.6, function domain scores ranged from 83.9 to 86.5, and scores for the top five symptoms (insomnia, fatigue, dyspnoea, pain, and financial difficulties) ranged from 14.1 to 24.3. The lowest NMIBC‐specific QoL domain was sexual issues including sexual function, enjoyment, problems, and intimacy. Women had worse bowel problems, sexual function, and sexual enjoyment than men but better sexual intimacy and fewer concerns about contaminating their partner. Stage Ta had the highest global health status, followed by T1 and Tis. QoL did not vary by time since diagnosis except for sexual function. The cystectomy group (n = 21) had worse QoL in sexual function, discomfort with sexual intimacy, sexual enjoyment, and male sexual problems than the non‐cystectomy group (n = 336).


Survivors of NMIBC face a unique burden associated with their diagnosis and the often‐lifelong surveillance and treatment regimens. The finding has important implications for the design of tailored supportive care interventions to improve QoL for NMIBC survivors.

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Visual abstract: Health‐related quality of life among non‐muscle‐invasive bladder cancer survivors: a population‐based study

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