Objective: To obtain international expert consensus on the rationale, clinical relevance, and potential usefulness of the International Bladder & Prostate Symptom Score (IBPSS) and to assess whether it may influence clinical decision-making. The IBPSS was developed to emphasize bladder dysfunction in male LUTS and to align symptom assessment with the 5Stages of Bladder Health model.Methods: Two-phase study included a structured survey of BPH/BPO experts followed by a Delphi consensus (incorporating clinical vignette exercise) comparing management decisions based on the IPSS versus the IBPSS. Consensus was primarily defined as ≥80% agreement.Results: Of 100 invited experts, 80 completed the survey and 62 participated in the Delphi round. Among survey respondents, 91.9% used the IPSS, while 80.6% considered it insufficient for effective patient–clinician communication. In the Delphi phase, 95.7% of statements reached consensus, including agreement on the IBPSS clinical usefulness. IBPSS-based information modified clinical decisions in 38.2% of vignette responses (95% CI33.9–42.7).Conclusions: International experts strongly endorsed the IBPSS as a complementary tool that broadens symptom assessment, enhances patient dialogue, and influences management decisions in men with LUTS/BPH. Formal validation and real-world implementation studies are required to define its potential role in routine practice.
Since 2023, two preventive tools (monoclonal antibodies, nirsevimab, and preF maternal vaccine) were approved to protect infants against severe RSV infections. During winter 2024–2025, nirsevimab started to be administered in Belgium to infants < 6 months old encountering their first RSV season. We aim to evaluate on a national scale the impact of RSV prevention in the pediatric hospital setting. This survey pooled data from two surveillance systems: the prospective SARI (Severe Acute Respiratory Infection) surveillance (6 hospitals) and the retrospective RSVPed study (25 hospitals). Both used the same case definition and clinical questionnaire to record RSV hospitalizations in children < 5 years. Seasonal incidences and clinical data were compared between seasons 2023–2024 (pre-prevention) and 2024–2025 (first year of prevention). Our study covered 47
The history of pre peritoneal groin hernia surgery start only after solving the problems related to asepsis, antisepsis and anesthesia. Fundamental work on the use of a new form of polyethylene to create synthetic meshes was carried out in the 1950s by C. Usher. L. Nyhus was the first to popularize the use of a mesh. But the inventor of the first synthetic prosthesis was Don Eugène Acquaviva in 1944, and the first surgeon to discuss the installation of a pre-peritoneal prosthesis for the treatment of hernias of the groin is Jerome Corti in his thesis in 1949. In the 50 s and 60 s H. Fruchaud had particularly and directly influenced Jean Rives and René Stoppa, and due to the poor results of techniques without prosthesis, particularly for complex hernias Rives and Stoppa techniques were then disseminated with lots of variations, (G. Wantz, J.H. Alexandre, R. D. Kugel….) But the parietalization step was difficult to achieve for many colleagues and the development of endoscopy has made it possible to clearly demonstrate this crucial step in order to properly unroll the prosthesis. Franz Ugahary put up resistance against endoscopy with the Grid Iron technique in 1995, the fist open minimal invasive pre peritoneal approach. In 2004, Pelissier invented a specific semi-rigid prosthesis, which made it possible to codify with colleagues the Trans Inguinal Pre-Peritoneal (TIPP) technique. But it was also necessary to master the step of parietalization of the cord, this is probably why the ONSTEP technique was created in 2005. It is a partially preperitoneal technique without parietalization W. Akkersdick has tackled the challenge with the Trans Rectus sheath Pre Peritoneal (TREPP) technique in 2006, a pure posterior approach. For my part I modified the TIPP technique in 2011 using Ugahary’s dissection principles, the Minimal Open Pre Peritoneal (MOPP) technique was created. It is only in recent years that the literature has provided data about TIPP, TREPP, MOPP, with comparisons with others techniques. Now the new route, preperitoneal, minimal open and minimal invasive has its place in the treatment of groin hernias!
BACKGROUND AND OBJECTIVE:Angiogenesis-targeting tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) are standard treatments for metastatic clear-cell renal cell carcinoma (ccRCC). However, therapeutic options remain limited after progression on these agents. Prostate-specific membrane antigen (PSMA) is highly expressed on the surface of endothelial cells in ccRCC, making radioligand therapy with [177Lu]Lu-PSMA-617 a promising approach. CLINICAL TRIAL DESIGN AND TIMEFRAME:RENALUT (NCT06783348) is a single-arm, open-label, phase 2 trial investigating the safety and efficacy of [177Lu]Lu-PSMA-617 in metastatic ccRCC after TKI and ICI failure. Eligible patients must have PSMA-positive lesions on PSMA positron emission tomography imaging. Patients will receive four cycles of [177Lu]Lu-PSMA-617 every 6 wk, with up to two additional cycles in cases with stable disease or a partial response. ENDPOINTS:The primary endpoint is the objective response rate according to Response Evaluation Criteria in Solid Tumours version 1.1. DATA SOURCES AND STATISTICAL ANALYSIS PLAN:Assuming a PSMA negativity rate of 15%, a total of 56 patients will be screened to achieve the target enrolment of 48 patients. European centres from three countries (Belgium, France, and Spain) will participate. First patient enrolment is expected in September 2025. STRENGTHS AND LIMITATIONS:This is the first multicentre trial to assess PSMA-targeted radioligand therapy for patients with metastatic ccRCC selected on the basis of PSMA expression, which may be a potential biomarker in this setting. FUNDING:RENALUT is funded by Novartis and is being conducted as a research collaboration trial. The trial is sponsored by the EORTC. ETHICS AND TRIAL REGISTRATION:The trial has been approved by the ethics committee of the coordinating institution in the lead country (Belgium) and is registered on ClinicalTrials.gov as NCT06783348. Twelve centres across three countries will be participating. Regulatory submissions are ongoing at all participating sites in compliance with national requirements. Enrolment will begin only after all required approvals are in place. PATIENT SUMMARY:This trial is looking at a new treatment, called [177Lu]Lu-PSMA-617, for patients with advanced kidney cancer that has spread and no longer responds to standard inhibitor and immunotherapy treatments. [177Lu]Lu-PSMA-617 is a radioactive agent that targets a molecule called PSMA (prostate-specific membrane antigen). Patients who have PSMA detected on a PET (positron emission tomography) scan will receive the treatment every 6 weeks for up to four cycles, with the possibility of two extra cycles if their cancer is stable or shrinking. The aim of the trial is to test a new treatment option for patients who have few remaining alternatives.
