CT urography and cytology missed two-thirds of UTUC recurrences after kidney-sparing surgery

The edition in brief

In 133 patients with upper tract urothelial carcinoma managed endoscopically, CT urography and/or cytology before surveillance ureteroscopy had 35.5% sensitivity: using them to decide when to scope would have avoided 69% of ureteroscopies but missed 64.5% of recurrences. Recurrence rates stayed at about 0.3 per person-year through four years. In 16,322 US patients with pT1b–2 kidney cancer, surgery more than three months after diagnosis was associated with higher five-year cancer-specific mortality (7.6% vs 5.9%), rising with longer delay, but not in non-clear-cell tumours. A network meta-analysis found vibegron reduced frequency and urgency as add-on therapy in men on alpha-blockers, with no proven advantage over mirabegron. In a New Zealand registry of 4,889 men, robotic prostatectomy was associated with clinically meaningful better continence and sexual function at 12 months than open surgery. A national caregiver survey of 3,100 children found daytime urinary symptoms in 17.5%, enuresis in 5.1% and functional constipation in 14%.