CT 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 would have avoided 69% of ureteroscopies but missed 65% of recurrences, and recurrence rates stayed steady at about one every three person-years through year four. An updated Cochrane review of six trials and 789,086 men found PSA screening likely reduces prostate cancer deaths by about two per 1,000 (RR 0.87, ERSPC sensitivity analysis), with low-certainty evidence for a small effect on overall mortality. Swedish three-generation data showed second-degree relatives on both the maternal and paternal side add to familial prostate cancer risk, with relative risk up to 10 when two brothers and an uncle or grandfather were affected. A meta-analysis of five retrospective studies associated a period of ureteral rest before robotic reconstruction with higher surgical success (93.5% vs 86.5%). The pearl covers visible haematuria.