The grasper-integrated disposable flexible cystoscope is comparable to the reusable, flexible cystoscope for the detection of bladder cancer.

Flexible cystoscopy under local anaesthesia is standard for the surveillance of bladder cancer. Frequently, several reusable cystoscopes fail to reprocess. With the new grasper incorporated single-use cystoscope for retrieval of ureteric stents, we explored the feasibility of using it off-label for diagnosis and the detection of bladder cancer. Consecutive diagnostic flexible cystoscopies between Mar 2016 and Nov 2018 were reviewed comparing the reusable versus the disposable cystoscopes. A total of 390 patients underwent 1211 cystoscopies. Median age was 61.5 years (SD 14.2, 18.8-91.4), males 331 (84.9%) and females 59 (15.1%). Indication for cystoscopy was prior malignancy in 1183 procedures (97.7%), haematuria 19 (1.6%) or bladder mass 7 (0.6%). There were 608 reusable and 603 disposable cystoscopies. There was no significant difference between groups at baseline in age, sex, BMI, smoking status, or prior tumor risk category. There was no significant difference in positive findings (123/608, 20.2% vs 111/603, 18.4%, p = 0.425) or cancer detection rates (95/608, 15.6% vs 88/603, 14.4%, p 0.574) among the two groups, respectively. We conclude that the disposable grasper integrated cystoscope is comparable to reusable cystoscope in the detection of bladder cancer.

BRCA2 gene mutation and prostate cancer risk. Comprehensive review and update.

The second most common type of tumor worldwide is prostate cancer (PCa). Certain genetic factors contribute to a risk of developing PCa of as much as 40%. BRCA1 and BRCA2 mutations have linked with an increased risk for breast, ovarian, and PCa. However, BRCA2 is the most common gene found altered in early-onset of PCa in males younger than 65. BRCA2 mutation has a higher chance of developing an advanced stage of the disease, resulting in short survival time. This review aimed to describe the genetic changes in BRCA2 that contribute to the risk of PCa, to define its role in the early diagnosis in a man with a strong family history, and to outline the purpose of genetic testing and counseling. Also, the review summarizes the impact of BRCA2 gene mutation in localized PCa, and the treatment strategies have used for PCa patients with a BRCA2 modification.

Robotic versus open pyeloplasty in pediatric patients: a single center experience in Saudi Arabia.

BACKGROUND: Robotic surgery in pediatric patients is performed in our center since 2013. This study aims to analyze the evolution of robot-assisted laparoscopic pyeloplasty (RALP) in our center to investigate its feasibility and safety compared with open pyeloplasty (OP) technique. METHODS: In this retrospective study, patients aged 2 to 14 years who underwent pyeloplasty procedure for ureteropelvic junction obstruction were divided into two groups according to the type of surgical approach (RALP and OP). The median age, weight, duration of the procedure, length of hospital stays, complication according to the Clavien grading system and success rates were recorded. We determined any trends in RALP activity, the length of hospital stay, and the patients' weight. We also compared the results of two equally divided periods (January 2015 to March 2016 and April 2016 to June 2017). RESULTS: Forty-one pyeloplasty were performed in this study. RALP and OP were performed in 26 (57.8%) and 15 (33.3%) cases, respectively. RALP was more utilized than OP in the second period (19 vs. 7). Comparing the two periods, a reduction in the median weight in the RALP group was observed (P=0.039); in the OP group, the weight remained almost unchanged (15 vs. 18 kg). The median duration of OP was shorter than that of RALP (P<0.04). The length of hospital stays reduced in the RALP group (P=0.013). CONCLUSIONS: RALP is safe and feasible and has a promising potential in pediatric urology. The rapid and favorable evolution in the studied indicators shows encouraging results as the indications for RALP are expanded and the length of hospital stay shortened.