In 267,133 patients with microhaematuria, 1.5% had bladder cancer at two years — and the guideline's risk tiers barely separated them

The edition in brief

In 267,133 US veterans with new microhaematuria, only 11.9% had cystoscopy within two years and 1.5% were diagnosed with bladder cancer. Older age, male sex, smoking and 25 or more red cells per high-power field predicted cancer, and a model built on these performed better than the AUA risk categories (AUC 0.63 vs 0.52). Referral decisions should weigh these factors rather than treat every microhaematuria alike. A meta-analysis of four observational studies (72,980 men) associated androgen deprivation therapy with higher odds of acute kidney injury (OR 1.34), most clearly with GnRH agonists; renal function deserves checking on ADT. A meta-analysis of 17 studies found ileal neobladders gave better night-time continence and fewer early complications than sigmoid pouches, while sigmoid pouches voided more completely. In children, mini-PCNL and standard PCNL cleared stones equally, with fewer minor complications after mini-PCNL. In a salvage radiotherapy trial, failure-free survival was higher when fluciclovine PET guided treatment than with conventional imaging.