Non-steroidal anti-inflammatory drugs for treating symptomatic uncomplicated urinary tract infections in non-pregnant adult women

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This review aims to investigate the benefits and risks associated with the use of NSAIDs in the treatment of symptomatic uncomplicated UTIs in non‐pregnant adult women

Multiple adenomatoid tumours in the Epididymis and Tunica vaginalis: Case report

We describe the case of a 65 year-old male presenting with a tender right testicular mass, confirmed to be a tumour on ultrasound. The patient underwent a radical inguinal orchidectomy and histology revealed multiple adenomatoid tumours in epididymis and tunica vaginalis. This is an infrequent benign tumour of mesothelial origin that has rarely been reported as multiple lesions in the literature. Immunohistochemistry demonstrates that adenomatoid tumour and mesotheliomas share the expression of podoplanin (D2-40) which is helpful to differentiate them from carcinomas. On the other hand adenomatoid tumour is differentiated from mesothelioma on morphological grounds since the former does not exhibit cellular atypia, mitotic activity or bland focal tumour necrosis. Although testis preserving surgery can be an option for benign adenomatoid tumours, most patients (as in our case) proceed to orchidectomy as diagnosing them confidently can be difficult.---------------------------Cite this article as: Abroaf A, Veeratterapillay R, Vasdev N, Majo J, Sherif AE, Paez E. Multiple adenomatoid tumours in the Epididymis and Tunica vaginalis : Case Report. Int J Cancer Ther Oncol 2014; 2(1):02021.DOI: http://dx.doi.org/10.14319/ijcto.0202.

Time to Turn on the Blue Lights: A Systematic Review and Meta-analysis of Photodynamic Diagnosis for Bladder Cancer.

CONTEXT: White light (WL) cystoscopy and transurethral resection of bladder tumour (TURBT) comprise the current gold standard technique for detecting and grading bladder cancer. However, with WL cystoscopy, recurrence following initial TURBT is high, and identification of smaller tumours and carcinoma in situ is poor. Photodynamic diagnosis (PDD) has been developed to improve the detection of bladder. OBJECTIVE: To assess the effect of PDD-guided TURBT compared with WL on recurrence rates (RRs) in non-muscle-invasive bladder cancer (NMIBC). EVIDENCE ACQUISITION: A systematic review of the literature from inception to April 2020 using Medline, EMBASE, and CENTRAL was undertaken. Randomised control trials comparing TURBT undertaken with PDD to WL that reported RRs of at least 12 mo were included in the analysis. The primary outcomes were RRs at 12 and 24 mo. The secondary outcomes were reported adverse effects. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the certainty of the evidence. EVIDENCE SYNTHESIS: Twelve randomised controlled trials (2288 patients) were included for the meta-analysis. PDD was found to reduce RRs at 12 mo (RR 0.73, confidence interval [CI] 0.60-0.88) and 24 mo (RR 0.75, CI 0.62-0.91). There was an increased risk of recurrence for patients undergoing WL at 12 mo (hazard ratio [HR] 1.14, CI 1.05-1.23) and 24 mo (HR 1.25, CI 1.15-1.35). Two studies reported recurrence data at 60 mo showing statistically significant outcomes in favour of PDD: one showed lower RRs for PDD (49% PDD vs 68% WL), whilst the other showed increased recurrence-free survival (68.2% PDD vs 57.3% WL). Adverse effects appeared to be minimal, though poorly reported. A GRADE analysis showed the evidence to be of moderate certainty overall. CONCLUSIONS: This systematic review found that PDD reduced RRs and improved recurrence-free survival compared with WL in NMIBC over at least 2-yr follow-up. These effects may persist up to 5 yr. Further research in a pragmatic study looking at longer-term outcomes beyond 24 mo will help guide recommendations on clinical adoption. PATIENT SUMMARY: This review suggests that photodynamic diagnosis, compared with white light cystoscopy, improves recurrence-free survival in non-muscle-invasive bladder cancer over at least 2 yr of follow-up. However, confirmatory pragmatic studies with longer-term outcomes are required for its clinical adoption

Non-antibiotic strategies for the prevention of infectious complications following prostate biopsy : A Systematic Review and Meta-analysis

Acknowledgments Emma Smith from the EAU Guidelines Office assisted with the systematic review, and Robert Pickard (deceased), Newcastle upon Tyne, United Kingdom, initiated this review.Peer reviewedPostprin

European Association of Urology Position Paper on the Prevention of Infectious Complications Following Prostate Biopsy

Funding support: This work is supported by the European Association of Urology Guidelines Office.Peer reviewedPostprin

What is the effectiveness of surgical and non-surgical therapies in the treatment of ischemic priapism in patients with sickle cell disease? A systematic review by the EAU Sexual and Reproductive Health Panel

The authors acknowledge the participants for their cooperation Conflict of Interest: None of the authors declare any interest. Formatting of funding sources: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Peer reviewedPostprin

Augmentation cystoplasty: Contemporary indications, techniques and complications

Augmentation cystoplasty (AC) has traditionally been used in the treatment of the low capacity, poorly compliant or refractory overactive bladder (OAB). The use of intravesical botulinum toxin and sacral neuromodulation in detrusor overactivity has reduced the number of AC performed for this indication. However, AC remains important in the pediatric and renal transplant setting and still remains a viable option for refractory OAB. Advances in surgical technique have seen the development of both laparoscopic and robotic augmentation cystoplasty. A variety of intestinal segments can be used although ileocystoplasty remains the most common performed procedure. Early complications include thromboembolism and mortality, whereas long-term problems include metabolic disturbance, bacteriuria, urinary tract stones, incontinence, perforation, the need for intermittent self-catheterization and carcinoma. This article examines the contemporary indications, published results and possible future directions for augmentation cystoplasty

Reconstructing the lower urinary tract: The Mitrofanoff principle

Since the original description of the trans-appendicular continent cystostomy by Mitrofanoff in 1980, a variety of techniques have been described for creating a continent catheterisable channel leading to the bladder, which avoids the native urethra. The Mitrofanoff principle involves the creation of a conduit going into a low pressure reservoir, which can emptied through clean intermittent catheterization through an easily accessible stoma. A variety of tissue segments have been used for creating the conduit, but the two popular options in current urological practice remain the appendix and Yang-Monti transverse ileal tube. The Mitrofanoff procedure has an early reoperation rate for bleeding, bowel obstruction, anastomotic leak or conduit breakdown of up to 8% and the most common long-term complication noted is stomal stenosis resulting in difficulty catheterizing the conduit. However, in both pediatric and adult setting, reports imply that the procedure is durable although it is associated with an overall re-operation rate of up to 32% in contemporary series. Initial reports of laparoscopic and robotic-assisted Mitrofanoff procedures are encouraging, but long-term outcomes are still awaited

Identification of CNGB1 as a Predictor of Response to Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer

Cisplatin-based neoadjuvant chemotherapy (NAC) is recommended prior to radical cystectomy for muscle-invasive bladder cancer (MIBC) patients. Despite a 5–10% survival benefit, some patients do not respond and experience substantial toxicity and delay in surgery. To date, there are no clinically approved biomarkers predictive of response to NAC and their identification is urgently required for more precise delivery of care. To address this issue, a multi-methods analysis approach of machine learning and differential gene expression analysis was undertaken on a cohort of 30 MIBC cases highly selected for an exquisitely strong response to NAC or marked resistance and/or progression (discovery cohort). RGIFE (ranked guided iterative feature elimination) machine learning algorithm, previously demonstrated to have the ability to select biomarkers with high predictive power, identified a 9-gene signature (CNGB1, GGH, HIST1H4F, IDO1, KIF5A, MRPL4, NCDN, PRRT3, SLC35B3) able to select responders from non-responders with 100% predictive accuracy. This novel signature correlated with overall survival in meta-analysis performed using published NAC treated-MIBC microarray data (validation cohort 1, n = 26, Log rank test, p = 0.02). Corroboration with differential gene expression analysis revealed cyclic nucleotide-gated channel, CNGB1, as the top ranked upregulated gene in non-responders to NAC. A higher CNGB1 immunostaining score was seen in non-responders in tissue microarray analysis of the discovery cohort (n = 30, p = 0.02). Kaplan-Meier analysis of a further cohort of MIBC patients (validation cohort 2, n = 99) demonstrated that a high level of CNGB1 expression associated with shorter cancer specific survival (p < 0.001). Finally, in vitro studies showed siRNA-mediated CNGB1 knockdown enhanced cisplatin sensitivity of MIBC cell lines, J82 and 253JB-V. Overall, these data reveal a novel signature gene set and CNGB1 as a simpler proxy as a promising biomarker to predict chemoresponsiveness of MIBC patients

Multiple adenomatoid tumours in the Epididymis and Tunica vaginalis: Case report

We describe the case of a 65 year-old male presenting with a tender right testicular mass, confirmed to be a tumour on ultrasound. The patient underwent a radical inguinal orchidectomy and histology revealed multiple adenomatoid tumours in epididymis and tunica vaginalis. This is an infrequent benign tumour of mesothelial origin that has rarely been reported as multiple lesions in the literature. Immunohistochemistry demonstrates that adenomatoid tumour and mesotheliomas share the expression of podoplanin (D2-40) which is helpful to differentiate them from carcinomas. On the other hand adenomatoid tumour is differentiated from mesothelioma on morphological grounds since the former does not exhibit cellular atypia, mitotic activity or bland focal tumour necrosis. Although testis preserving surgery can be an option for benign adenomatoid tumours, most patients (as in our case) proceed to orchidectomy as diagnosing them confidently can be difficult.---------------------------Cite this article as: Abroaf A, Veeratterapillay R, Vasdev N, Majo J, Sherif AE, Paez E. Multiple adenomatoid tumours in the Epididymis and Tunica vaginalis : Case Report. Int J Cancer Ther Oncol 2014; 2(1):02021.DOI: http://dx.doi.org/10.14319/ijcto.0202.1</p