CT urography and cytology missed two-thirds of upper tract recurrences

The edition in brief

In 133 patients under surveillance after endoscopic kidney-sparing surgery for upper tract urothelial carcinoma, CT urography and urinary cytology together detected only 35.5% of recurrences found at ureteroscopy; relying on them would have avoided 69% of ureteroscopies but missed 64.5% of recurrences, and recurrence rates stayed at about 0.3 per person-year through year four. Swedish three-generation data showed that second-degree relatives with prostate cancer add to risk in men under 69: two affected brothers carried a standardised incidence ratio of 4.1, rising to 10.1 with an affected uncle or grandfather, and maternal and paternal lines were equally informative. In 1,887 men having Aquablation, the 109 with previous BPH surgery had similar complications, retreatment and symptom improvement to first-time patients. A 50-woman pilot trial of the probiotic E. coli Nissle 1917 showed fewer recurrent UTIs than placebo (16.7% vs 42.3%), but the difference was not significant. The pearl: wait about six weeks after a UTI before checking PSA.