{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T09:53:50Z","timestamp":1781862830263,"version":"3.54.5"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>There are few reports investigating urodynamic changes after radiotherapy and hormonal therapy (HT) for prostate cancer. We prospectively evaluated differences in bladder outlet obstruction (BOO) using pressure\u2010flow studies (PFS) before and after HT and radiotherapy in patients with high\u2010risk localized or locally advanced prostate cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center prospective observational study enrolled 20 consecutive men scheduled for HT followed by intensity\u2010modulated radiotherapy. PFS, uroflowmetry, symptom questionnaire surveys, and magnetic resonance imaging (MRI) were performed at baseline, 6\u2009months, and 24\u2009months after initiation of HT. Radiotherapy was initiated after the 6\u2010month evaluation. The primary endpoint was the change in the bladder outlet obstruction index (BOOI), defined as the difference between baseline and 24\u2009months after initiation of HT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All patients completed the 24\u2010month protocol. Mean BOOI decreased from 44.3\u2009\u00b1\u200923.4 at baseline to 26.8\u2009\u00b1\u200925.0 at 6\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and remained significantly reduced at 33.2\u2009\u00b1\u200929.1 at 24\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Prostate volume was reduced significantly by 43% at 6\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and by 41% at 24\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). MRI demonstrated resolution of malignant lesions by 6\u2009months in all patients, with no recurrence at 24\u2009months. Three patients (15%) exhibited a BOOI reduction\u2009&gt;\u200930, and all three had periurethral tumors prior to treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This first prospective PFS\u2010based study demonstrates that combined HT and radiotherapy improve BOO, particularly during HT, likely through reduction of prostate and tumor volume. Patients with periurethral tumors may achieve greater improvement in BOO. These findings underscore the importance of considering treatment\u2010induced BOO changes in therapeutic decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: UMIN\u2010CTR; UMIN000040312<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70502","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:20:58Z","timestamp":1778822458000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Hormonal and Radiation Therapy on Bladder Outlet Obstruction in High\u2010Risk Localized Prostate Cancer: A Prospective Pressure\u2010Flow Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2046-5051","authenticated-orcid":false,"given":"Yuki","family":"Kyoda","sequence":"first","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Hori","sequence":"additional","affiliation":[{"name":"Department of Radiology Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Division of Radiology and Nuclear Medicine Sapporo Medical University Hospital  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4990-8330","authenticated-orcid":false,"given":"Tetsuya","family":"Shindo","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0873-4642","authenticated-orcid":false,"given":"Kohei","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-9302","authenticated-orcid":false,"given":"Toshiaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Urology Sapporo Medical University School of Medicine  Sapporo 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