Sheng-Han Tsai, MD

Surgeon @ Cheng-Hsin general hospital, Taipei, Taiwan

[Khurshid Ghani @peepeeDoctor]

Be smart - understand your laser for lithotripsy! Latest paper from @FUTURE_EndoSoc @Endo_Society https://t.co/VXfZGvBEIW @Current_Urology

[UroToday.com @urotoday]

🧬 Capivasertib + abiraterone offers a precision-medicine alternative to chemotherapy-based triplet therapy in PTEN-deficient metastatic APMN/S prostate cancer.

At #USPCC26, Dr. Russell Szmulewitz @UChicagoMed highlighted CAPItello-281: in 1,012 patients with PTEN-deficient de novo metastatic disease, capivasertib improved median rPFS from 25.7 to 33.2 months, with the largest apparent benefit in complete PTEN loss. OS is still immature, while toxicity—including diarrhea, hyperglycemia, rash, and anemia—was manageable but led to discontinuation in ~18%.

Bottom line: For high-volume, de novo PTEN-deficient disease, capivasertib + abiraterone targets a poor-prognosis biology at the earliest opportunity—without requiring docetaxel.
Written coverage by @zklaassen_md on UroToday > https://t.co/LEiVlqqq17

[Toni Choueiri, MD @DrChoueiri]

I enjoyed going through this paper by @FerMosele and @GustaveRoussy team. It outlines a roadmap for the future of ADCs from soup to nuts. It was just published in @NatureMedicine —a must read for everyone with @FIFAWorldCup ⚽️ withdrawal!

Link: https://t.co/t4mXf4Ajn7

[UroToday.com @urotoday]

Identifying biomarkers of response and mechanisms of resistance to enfortumab vedotin with and without pembrolizumab in metastatic #UrothelialCancer. Presentation by Aditi Gupta, MD @MSKCancerCenter. #BCANTT26 written coverage by @chavarriagaj @PSH_Urology. #ReadNow > https://t.co/8Y7bsdF78n @BladderCancerUS

[NEJM @NEJM]

In cisplatin-ineligible patients with muscle-invasive bladder cancer, enfortumab vedotin–pembrolizumab plus surgery led to better event-free survival (74.7%, vs. 39.4%) and overall survival (79.7%, vs. 63.1%) than surgery alone at 2 years. Full phase 3 KEYNOTE-905 trial results and Research Summary: https://t.co/bzVbmJXHMD

[NEJM @NEJM]

Original Article: Perioperative Enfortumab Vedotin and Pembrolizumab in Bladder Cancer (phase 3 KEYNOTE-905 trial) https://t.co/liPEVlPfHV

Editorial: Enfortumab Vedotin plus Pembrolizumab as Perioperative Therapy https://t.co/wIH8w21yJg

#Oncology

[Alireza Ghoreifi, MD @alirezaghoreifi]

Our @UrolOncol paper is live!

Consolidative surgery after EVP:
1⃣Feasible for select advanced UCs
2⃣45% pCR; 59% downstaging
3⃣0 intraop complications; all margins-
4⃣Postop complications: 64% (27% HG)
5⃣Median FU 14 mo: 5 recurrences, 2 deaths

🔗https://t.co/E2Ts7fFonV

[Dr. Chacón-Lozsán F .'. @franciscojlk]

🩻Contrast-induced AKI:
one of the biggest myths still shaping clinical decisions

For decades we were taught:

👉 “Contrast damages the kidneys”
👉 “Avoid CT with contrast in CKD”
👉 “Hydrate, protect, delay imaging if needed”

But what if… most of this is wrong?🤔

->The uncomfortable reality

Modern evidence shows:

👉 Low-osmolar contrast rarely causes true nephrotoxicity
👉 Even in CKD, AKI, and ICU patients
👉 The risk is often overestimated—or nonexistent

So where did the fear come from?

📍 1950s high-osmolar contrast (actually toxic)
📍 Poorly controlled observational studies
📍 “Creatinine rise = contrast injury” assumption

👉 Correlation became causation
👉 And the dogma stayed

⚠️What recent data tells us

✔ No difference in AKI rates with vs without contrast
✔ No benefit from bicarbonate, NAC, or aggressive hydration
✔ Even ICU and AKI patients show no worsening outcomes

->Translation to real life

👉 The patient was going to develop AKI anyway...Not because of contrast!!

->The real problem: “Renalism”

👉 Avoiding necessary imaging
👉 Delaying diagnosis
👉 Choosing inferior tests

And that leads to:

❌ Missed PE
❌ Delayed sepsis source control
❌ Worse outcomes

->Clinical mindset shift

Instead of asking:

👉 “Will contrast harm the kidneys?”

We should ask:

👉 “Will NOT doing the scan harm the patient?”

->Who still deserves caution?

✔ eGFR <30
✔ Severe hemodynamic instability
✔ Multiple nephrotoxins

Even then:

👉 Optimize volume
👉 Minimize dose
👉 Don’t delay critical imaging

🤓Bottom line

✔ Contrast nephrotoxicity exists… but is rare
✔ The fear is bigger than the risk
✔ The harm of NOT imaging is often greater

In critical care

👉 We don’t treat creatinine
👉 We treat patients

And sometimes…

👉 The most dangerous thing is NOT the contrast

👉 It’s hesitation.

📃Reference
Florens N, Demiselle J.
Kidney360 7: 445–449, 2026. doi: https://t.co/CWzi7WC9Wx

[Toni Choueiri, MD @DrChoueiri]

We keep rediscovering the same truth—hormonal biology works. Estrogen returns in prostate cancer, this time via patches, with noninferior outcomes and potentially better tolerability. Not new—just better applied. Study in @NEJM by the #Stampede group/@MRCCTU

https://t.co/Pq17ahdPgu

[UroToday.com @urotoday]

Safety profile of darolutamide + adt compared to enzalutamide, apalutamide, and abiraterone in #mCSPC #ProstateCancer: results from the first safety matching-adjusted indirect comparison. Presented by Neal Shore, MD, FACS @CURCMB. #GU26 written coverage by @RKSayyid @UAUrology > https://t.co/LmiyckHICi @ASCO

[UroToday.com @urotoday]

Real-world patient characteristics and treatment patterns among patients with #mCRPC treated with talazoparib + enzalutamide in the US. Presented by @PBarataMD @caseccc. #GU26 witten coverage by @RKSayyid @UAUrology &gt; https://t.co/rmigMrllud @ASCO #ASCOGU26

[European Urology @EUplatinum]

📢 New publication in European Urology
We are pleased to highlight a new study published in European Urology, titled "Reconstruction of a Devastated Ureter: Multi-institutional Experience with Robotic Intracorporeal Ileal Ureter Replacement".
👏 Congratulations to Ji E. et al. on this excellent contribution, together with all co-authors.
🔗 Read the full article here:
👉 https://t.co/MKSQI0yCbA
#EuropeanUrology #Urology #UroOncology #Research #MedicalResearch #AcademicUrology

[Ricardo Soares @soares_uro]

Perioperative systemic treatment for bladder cancer
@MayoUrology #MayoUroHawaii26

[Grand Rounds Urology @GRUrology]

.@SMacdonald_MD, @PSH_Urology, outlines evidence-based evaluation and management of chronic urogenital pain in men.

#CPPS #MensHealth #Urology

[UroToday.com @urotoday]

Enfortumab vedotin with pembrolizumab treatment outcomes in patients with histologic subtypes of advanced #UrothelialCarcinoma: analysis of the #UNITE study. Presentation by @TanyaJindal97 @UCSF. #ESMO25 written coverage by @RKSayyid @UAUrology &gt; https://t.co/8cvNpdWvw6 @myESMO

[Tom Powles @tompowles1]

1/2 KN905 Enfortumab Vedotin + Pembro continues to transform bladder cancer in spectacle fashion. In cisplatin ineligible operable disease it beats cystectomy with EFS HR 0.4, OS HR 0.5. pCR of 57% is much ⬆️ than anything before #ESMO25 pCR&gt; 50% questions unselected surgery

[UroToday.com @urotoday]

Optimizing patient selection and treatment timing for emerging intravesical therapies. @VigneshPackiam @RutgersCancer joins @zklaassen_md @GACancerCenter to discuss a patient case of a 74-year-old male with multifocal CIS. Dr. Packiam reviews the expanding treatment landscape and emphasizes that direct efficacy comparisons between trials are challenging due to selection bias and improved surgical techniques over time. #WatchNow on UroToday > https://t.co/yHYWv5A4ql

[UroToday.com @urotoday]

Persistent PSA after prostatectomy: Timing and mortality risk implications, #JournalClub. @RKSayyid @USC & @zklaassen_md @GACancerCenter discuss study results showing patients with persistent PSA at 2-3 months post-surgery, those with pre-surgical PSA >20 had significantly better survival outcomes than those with PSA ≤20—a 31% reduction in all-cause mortality and 59% reduction in prostate cancer-specific mortality. #WatchNow > https://t.co/uyZU68lzhj

[Dr. Catharine Young @DrCatharineY]

This chart unfortunately says it all.

NIH funding for new research grants under Trump 2025 is falling far far behind past administrations. This isn’t just slowing science - it is undermining America’s global leadership in research and innovation.

[Matt Cooperberg @dr_coops]

Among &gt;140k #prostatecancer radiation tx pts in the ⁦@VizientInc⁩ database, 21% rate of cystitis, with much higher rates by age, race &amp; social vulnerability #aua25