Do We Need a Urine Culture Before Cystoscopy? Time to Shift Away from Routine Testing.

OBJECTIVE: To determine if cystoscopy could be safely performed without a urine culture by analyzing 2 prospectively cohorts of patients undergoing outpatient cystoscopy, 1 without urine culture and the other cohort screened and treated for ASB as per protocol. We aim to report the rate of symptomatic UTI and the rate of urinary sepsis within 30 days of cystoscopy. METHODS: All patients who underwent cystoscopy between 2021 and 2022 were invited to participate. Patients were prospectively recruited in a 2:1 ratio. Cohort A: patients who did not require urine culture before cystoscopy. Cohort B: patients who were required to have sterile urine before the procedure. Primary endpoint was the occurrence of symptomatic UTI ≤ 30 days after cystoscopy. RESULTS: A total of 461 patients were recruited, 316 for cohort A and 145 for cohort B. Fifteen patients had symptomatic UTIs between both groups, 8 in Cohort A and 7 in Cohort B. The overall rate of symptomatic UTI was 3.2%, 2.5% for Cohort A and 4.8% for Cohort B. We had only 1 case of urinary sepsis in Cohort B. The RR for developing UTI in cohort B was 1.91 in the univariate model and 1.74 in the multivariate analysis. CONCLUSION: Routine urine culture before outpatient cystoscopy is unnecessary. In asymptomatic patients, subsequent UTIs are rare and can be easily treated. Avoiding routine urine culture helps prevent misuse of antibiotics, reduce cancellation rates, and ease the burden of patients that get cancelled because of ASB. The low risk of symptomatic UTI after the procedure must be discussed with the patient.

Metastatic renal cell carcinoma of the native kidney in a renal transplant recipient: Revisiting the era of tyrosine kinase inhibitors - Case report.

Patients who receive solid organ transplants are at higher risk for developing cancer, which is attributable to chronic immune suppression. Less than 8 cases of metastatic RCC (mRCC) have been reported until now. The aim of this article is to present the case of a 77-year-old male with mRCC of the native kidney and discuss treatment options including targeted therapy, which appears to be the treatment of choice, even in the era of immunotherapy.

Outpatient 180 W XPS GreenLight Laser Photoselective Vaporization of the Prostate: 7-Year Experience.

Purpose: GreenLight XPS Laser System (GL-XPS) photoselective vaporization of the prostate (PVP) is not only noninferior to transurethral resection of the prostate, but also with shorter rates of hospital stay and length of catheterization. Scarce literature has been published about the feasibility and safety of performing GL-XPS PVP in an outpatient setting. Our aim is to report our 7-year experience with outpatient GL-XPS PVP. Methods: Medical charts of all patients who underwent GL-XPS PVP between 2013 and 2020 were reviewed. Patients were discharged after careful monitoring in the recovery room and the catheter was removed either at home or at a scheduled hospital visit. We used the Shapiro-Wilk test to assess for normal distribution, and the evaluation of homoscedasticity was performed with the SD test. For qualitative variables, the comparison between groups was carried using the chi-square test and for the quantitative variables we used the nonparametric Mann-Whitney U test. Results: A total of 537 patients were treated, 517 in an outpatient basis. Median age was 68 years (interquartile range [IQR] 62-76), median prostate volume 50 cc (IQR 40-70). 22.8% were on anticoagulants or antiplatelet therapy. Median operative time was 100 minutes (IQR 75-125), length of hospital stay 5 hours (IQR 4-6.45), mean length of catheterization 48 hours (SD 14.92). Readmission rate within 90 days of surgery was 11.7%, 58 (10.8%) for surgical-related complications. Median time for readmission was 4 days (IQR 2-24). Immediate readmission (within 10 days) was recorded in 7.6% of patients, urinary retention was the main cause. No significant differences were found trying to find perioperative predictors for readmission. Conclusions: Our experience suggests that outpatient GL-XPS PVP could be performed safely with a predefined outpatient pathway, with a low readmission and complication rate. (IRB number CEI-521).

Translocación de dispositivo intrauterino de cobre a vejiga y litiasis vesical secundaria ­ Reporte de caso clínico / Translocation of Copper Intrauterine Device to Bladder and Secondary Vesical Lithiasis ­ Clinical Case Report

El dispositivo intrauterino (DIU), ha sido utilizado en nuestro medio y en el mundo durante muchos años como método anticonceptivo. Una complicación infrecuente posterior a su inserción es la migración fuera del útero. La localización vesical y complicación con la vesicolitiasis, forman parte de las complicaciones asociadas a la migración. Presentamos un caso de migración de un DIU a la vejiga asociado a la formación de un cálculo entorno a ese dispositivo. Se describe el cuadro clínico, los estudios realizados y el tratamient

The intrauterine device (IUD) has been used in our environment and in the world for many years as a contraceptive method. One of the complications is the migration outside the uterus, being the bladder location unusual and much more the secondary bladder stone. We present a case of migration of an IUD to the bladder associated with the formation of a calculus around this foreign body. The clinical record, study and treatment are described.