Open access

NEWS - Urology

Financial Conflicts of Interest Among Authors of Urology Clinical Practice Guidelines – European Urology (free)

“59% Urology Guideline writers received payments from companies AND 37% provided inaccurate COIs forms” (via @daviesbj see Tweet)


Nivolumab plus Ipilimumab versus Sunitinib in Advanced Renal-Cell Carcinoma – NEJM (link to abstract – $ for full-text)

Quick Take Video Summary: Sunitinib or Nivolumab plus Ipilimumab for Renal-Cell Carcinoma (free)

“Overall survival and objective response rates were significantly higher with nivolumab plus ipilimumab”.


Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

Commentary: One-off PSA screening for prostate cancer does not save lives – eCancer News (free)

“Largest ever prostate cancer trial – CAP – published in the JAMA. No effect from low intensity PSA screening on prostate cancer mortality at 10 years”. (via @KariTikkinen see Tweet)


Apalutamide Treatment and Metastasis-free Survival in Prostate Cancer – New England Journal of Medicine (free)

“Apalutamide improves castration resistant prostate CA survival compared with… placebo. Why wasn’t it compared w bicalutamide?” (via @RichardLehman1 see Tweet). See Richard Lehman’s point of view


Treatment of Non-neurogenic Male LUTS – European Urology Association (free, but not accessible via mobile devices) (via @KariTikkinen)


Systematic Review and Meta-analysis Comparing the Efficacy of Nonsteroidal Anti-inflammatory Drugs, Opioids, and Paracetamol in the Treatment of Acute Renal Colic – European Urology (free) (via @KariTikkinen and @EUplatinum)

“In kidney stone–related acute pain episodes in patients with adequate renal function, treatment with nonsteroidal anti-inflammatory drugs offers effective and most sustained pain relief, with fewer side effects, when compared with opioids or paracetamol”.


Incidence of and risk factors for nephrolithiasis in patients with gout and the general population, a cohort study – Arthritis Research & Therapy (free)

Commentaries: Gout Patients Run Higher Risk of Kidney Stones – MedPage Today (free registration required) AND Gout associated with elevated risk for kidney stones – MedWire News (free)

“60% increased risk of first-time nephrolithiasis versus general population, with little protection from allopurinol” (from MedPage Today)


Benefits and Harms of Treatment of Asymptomatic Bacteriuria: A Systematic Review and Meta-analysis by the European Association of Urology Urological Infection Guidelines Panel (free)

“For most people, treatment was not beneficial and may be harmful. Antibiotic treatment did appear to benefit women in pregnancy and those about to undergo urological surgery”.


High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies – Diabetic Medicine (link to abstract – $ for full-text)

Commentary: Screening for Erectile Dysfunction Should Be Routine in Diabetes – Medscape (free registration required)

“Erectile dysfunction 3.5 times more common in diabetes” (RT @kamleshkhunti see Tweet)


Viewpoint: The Evolving Story of Overlapping Surgery – JAMA (free) (RT @pash22 see Tweet)

Commentary: 3 steps to restore patient trust in overlapping surgeries – FierceHealthcare (free)

This interesting viewpoint discusses the practice of scheduling overlapping surgeries, in which a qualified practitioner finishes noncritical parts of the first operation while the primary surgeon moves to the next surgery.


The ABCs and Ds of Whether to Get Prostate Cancer Screening – The New York Times (10 articles per month are free)

See also the new USPSTF guidelines on prostate cancer screening and related commentaries in our April 12 issue (see #1) and in our April 13 issue (see #4)

Balanced point of view regarding prostate cancer screening.


A Meta-analysis of the Impact of Aspirin, Clopidogrel, and Dual Antiplatelet Therapy on Bleeding Complications in Noncardiac Surgery – Annals of Surgery (link to abstract – $ for full-text)

Source: EvidenceAlerts (free resource to find articles of interest)

“Antiplatelet therapy at the time of noncardiac surgery confers minimal bleeding risk with no difference in thrombotic complications. In many cases, it is safe to continue antiplatelet therapy in patients with important indications for their use”


Correspondence: Trial of Transplantation of HCV-Infected Kidneys into Uninfected Recipients – The New England Journal of Medicine (free)

Transplantation of HCV-infected-kidneys into uninfected recipients seems feasible in this era of direct-acting antiviral agents, maybe shortening waiting times for those willing to take the risk.


Urinary catheter care: what does the evidence say? – Cochrane Library (free)

“How frequently should indwelling urinary catheters be changed? Are catheter washouts effective? Which type of catheter reduces rates of urinary tract infection?”. This post look at the evidence regarding urinary catheter care.


Cost-effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria – JAMA Internal Medicine (free)

Invited commentary: Asymptomatic Microscopic Hematuria – Rethinking the Diagnostic Algorithm (free)

Routine urinalysis for screening is not presently recommended by any major health organization, but asymptomatic microscopic hematuria is a common incidental finding. This study suggests that the combination of renal ultrasound and cystoscopy is the most cost-effective approach for the evaluation of these patients.


European Association of Urology releases its 1st thromboprophylaxis guideline (free)


Procedure-specific Risks of Thrombosis and Bleeding in Urological Cancer Surgery: Systematic Review and Meta-analysis – European Urology (free)

“Extended thromboprophylaxis is warranted in some procedures (eg, open and robotic cystectomy) but not others (eg, robotic prostatectomy without pelvic lymph node dissection in low-risk patients)


Procedure-specific Risks of Thrombosis and Bleeding in Urological Non-cancer Surgery: Systematic Review and Meta-analysis – European Urology (free)

“Extended prophylaxis is warranted for some procedures (eg, kidney transplantation procedures in high-risk patients) but not others (transurethral resection of the prostate and reconstructive female pelvic surgery in low-risk patients)”


Prostate Cancer Screening Draft Recommendations – U.S. Preventive Services Task Force (free)

Viewpoint: The US Preventive Services Task Force 2017 Draft Recommendation Statement on Screening for Prostate Cancer: An Invitation to Review and Comment – JAMA (free)

See also: Should you get screened for prostate cancer? We break down the latest advice – STAT News (free)

For those aged 55 to 69 it recommends “informed, individualized decision making based on a man’s values and preferences”. According to a useful infographic from the draft recommendations, the benefits are likely small. For every 1000 men offered PSA based screening over a period of 10-15 years, the test would avoid cancer spreading in 3 men and death from prostate cancer in 1-2 men, with the undesired consequences of false positives and subsequent procedures in many patients.


ACR Appropriateness Criteria Adds Topics, Covers More Clinical Variants Than Ever Before (free)

Browse Appropriateness Criteria Topics (free)

Source: Newswise

This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.


Going Under the Knife, With Eyes and Ears Wide Open – New York Times (free access to 10 articles per month)

“More and more surgeries are being performed with the patient awake and looking on, for financial and medical reasons”.


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