{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:45:51Z","timestamp":1791776751204,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014841","name":"Medac","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014841","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the impact of personalized dwell\u2010time (DT) reductions on symptom prevalence and systemic toxicities in patients undergoing Bacillus Calmette\u2013Gu\u00e9rin (BCG) instillation for non\u2010muscle invasive bladder cancer (NMIBC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Within a multinational randomized controlled trial (North\u2010REG Dwell Time Study [NCT04701151]), 225 patients provided daily electronic patient\u2010reported outcomes data during BCG induction and maintenance cycles. Participants were randomized 1:1, stratified by clinical site, sex, and concomitant carcinoma in situ, to either a standard care arm (control) or an intervention arm. Toxicity was analysed using a \u2018worst\u2010day\u2019 principle to capture peak symptom burden. All patients initially received a standard 120\u2010min DT. In the intervention group, algorithm\u2010guided DT reductions (to 60 or 30\u2009min) were triggered by real\u2010time symptom severity, whereas the control group maintained a 120\u2010min DT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, 69% vs. 71% (control vs. intervention) of participants reported pre\u2010existing symptoms, primarily lower urinary tract symptoms such as pollakiuria and urgency. During induction, the intervention group experienced significantly lower rates of urgency at week 3 (34% vs. 47%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04) and week 6 (32% vs. 49%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01). Significant reductions were also observed during maintenance at week 9 for systemic symptoms (30% vs. 61%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and fatigue (22% vs. 47%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001). Total adherence to the 15\u2010instillation protocol was 38% in the intervention group and 40% in the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Daily electronic patient\u2010reported outcomes monitoring revealed that patients with NMIBC have a high baseline symptom burden prior to BCG therapy. Symptom\u2010guided DT reductions may reduce local urgency and systemic toxicity and improve treatment tolerability. However, treatment completion does not seem to be affected.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70396","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:05:40Z","timestamp":1785549940000},"page":"831-840","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptom\u2010guided reduction of\n                    <scp>BCG<\/scp>\n                    dwell time: findings from the north\u2010\n                    <scp>REG<\/scp>\n                    randomized trial"],"prefix":"10.1111","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1175-7515","authenticated-orcid":false,"given":"Lene","family":"Munk","sequence":"first","affiliation":[{"name":"Department of Urology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine Maria","family":"Hyldgaard","sequence":"additional","affiliation":[{"name":"Department of Urology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Gynecology and Obstetrics Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanaja","family":"Kumasegaram","sequence":"additional","affiliation":[{"name":"Department of Urology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke Vilsb\u00f8l","family":"Milling","sequence":"additional","affiliation":[{"name":"Department of Urology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone Buchardt","family":"Brandt","sequence":"additional","affiliation":[{"name":"Department of Urology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8005-3545","authenticated-orcid":false,"given":"Juan Luis","family":"V\u00e1squez","sequence":"additional","affiliation":[{"name":"Department of Urology Copenhagen University Hospital \u2013 Zealand University Hospital Roskilde  Roskilde Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knud","family":"Fabrin","sequence":"additional","affiliation":[{"name":"Department of Urology Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gitte Wrist","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Urology Herlev Regional Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasse","family":"Bro","sequence":"additional","affiliation":[{"name":"Department of Urology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigur\u00f0ur","family":"Gudjonsson","sequence":"additional","affiliation":[{"name":"Department of Urology Landspitali University Hospital  Reykjav\u00edk Iceland"},{"name":"Faculty of Medicine University of Iceland  Reykjav\u00edk Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2050-6466","authenticated-orcid":false,"given":"Viveka","family":"Str\u00f6ck","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Clinical Sciences Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Urology, Region V\u00e4stra G\u00f6taland Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4615-5238","authenticated-orcid":false,"given":"Tomas","family":"Jerlsstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medical Sciences, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"},{"name":"Department of Urology Karolinska University Hospital  Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Thiel","sequence":"additional","affiliation":[{"name":"Department of Urology Karolinska University Hospital  Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9845-5254","authenticated-orcid":false,"given":"Maria Skydt","family":"Lindgren","sequence":"additional","affiliation":[{"name":"Department of Urology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4347-739X","authenticated-orcid":false,"given":"J\u00f8rgen Bjerggaard","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Surgery Dronning Ingrids Hospital  Nuuk Greenland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2441-1790","authenticated-orcid":false,"given":"Charlotte","family":"Graugaard\u2010Jensen","sequence":"additional","affiliation":[{"name":"Department of Urology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-009-0395-z"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.08.010"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67707-5"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.07.021"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.12.024"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/PROM.S178344"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/21681805.2018.1538162"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-020-01013-y"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2024.01.017"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0056"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2013.11.003"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2005.05817.x"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2009.08427.x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2010.09993.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-022-00610-w"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.04.066"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.31557\/APJCP.2019.20.5.1389"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_11_20_1","article-title":"Collecting electronic patient\u2010reported outcomes via smartphone text messages in a bladder cancer RCT: a feasibility study","volume":"45","author":"Munk LK","year":"2026","journal-title":"Urol Oncol"},{"key":"e_1_2_11_21_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2020"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO-25-01651"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-025-04375-8"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30540-4"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70396","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bju.70396","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:09:00Z","timestamp":1791774540000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.70396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/bju.70396"],"URL":"https:\/\/doi.org\/10.1111\/bju.70396","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]},"assertion":[{"value":"2026-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}