Fracture risk doubled for women after radical cystectomy, but bone treatment did not rise

The edition in brief

In 2,908 Swedish patients who had radical cystectomy with urinary diversion, compared with 13,669 matched people from the general population, fracture risk was higher: women had about twice the risk of femoral fracture (HR 1.97) and any fracture (HR 2.06), and men a 51% higher risk of any fracture. Starting bone-protective drugs was no more common than in the comparison group, which suggests the risk goes unaddressed. A meta-analysis of 90 studies informing the 2026 American paediatric UTI guideline found renal and bladder ultrasound detected only half of vesicoureteral reflux after a first UTI (sensitivity 50%, specificity 71%), so a normal scan does not exclude reflux. In a 66-man single-centre study of equivocal PI-RADS 3 lesions with high-risk features, PSMA PET-targeted biopsy found more significant cancers than MRI-targeted biopsy (15% vs 6%), and no man with a negative PSMA scan had significant cancer. A German randomised trial of 100 patients found a sulfonic acid-coated ureteric stent halved encrustation and reduced stent symptoms over 30 days.