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Purpose: Guidelines advocate cystoscopy surveillance (CS) for non-muscle invasive bladder cancer (NMIBC) post-resection. However, cystoscopy is operator dependent and may miss upper tract lesions or carcinoma in-situ (CIS). Urine cytology is a common adjunct but lacks sensitivity and specificity in detecting recurrence. A new mRNA biomarker (CxBladder) was compared with urine cytology as an adjunct to cystoscopy in detecting a positive cystoscopy findings during surveillance cystoscopy in our center.Materials and Methods: Consented patients older than 18, undergoing CS for NMIBC, provide paired urine samples for cytology and CxBladder test. Patients with positive cystoscopy findings would undergo re-Trans Urethral Resection of Bladder Tumor (TURBT).Results: Thirty-five patients were enrolled from April to June 2019. Seven contaminated urine samples were excluded. The remaining cohort of 23 (82%) and 5 (18%) females had a mean age of 66.69 (36–89). Eight (29%) patients with positive cystoscopy finding underwent TURBT. All 8 patients also had positive CxBladder result. This shows that CxBladder has a sensitivity and negative predictive value (NPV) of 100%, specificity of 75% and positive predictive value (PPV) of 62% in predicting a positive cystoscopy finding. TURBT Histo-pathological findings showed Low-grade Ta NMIBC in one patient (4%), and 7 (25%) patients had inflammatory changes. Urine cytology was only positive in one patient with a positive cystoscopy finding. This led to a sensitivity of merely 13% and NPV of 74%, while specificity and PPV was 100% in predicting a positive cystoscopy finding.Conclusion: CxBladder had high NPV and sensitivity which accurately predicted suspicious cystoscopy findings leading to further investigation. It has great potential for use as adjunct to cystoscopy for surveillance of NMIBC.

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Purpose: We evaluated stone-free rate and complications after flexible ureteroscopy for renal stones, comparing thulium fiber laser and holmium:YAG laser with MOSES technology. Materials and Methods: Data from adults who underwent flexible ureteroscopy in 20 centers worldwide were retrospectively reviewed (January 2018-August 2021). Patients with ureteral stones, concomitant bilateral procedures, and combined procedures were excluded. One-to-one propensity score matching for age, gender, and stone characteristics was performed. Stone-free rate was defined as absence of fragments >2 mm on imaging within 3 months after surgery. Multivariable logistic regression analysis was performed to evaluate independent predictors of being stone-free.

The objective was to evaluate outcomes of retrograde renal surgery for intrarenal stones of any size, number, and position, comparing hard versus soft stones based on their attenuation on computed tomography (Hounsfield Unit-HU). Exclusion criteria; children/adolescents, ureteric stones, renal anomalies, or bilateral surgery. Patients were divided into two groups according to the type of laser employed, i.e. Holmium:YAG (HL) and Thulium fiber laser (TFL). Residual fragments (RF) were defined as > 2 mm. Multivariable logistic regression analysis was performed to evaluate factors associated with RF and RF needing further intervention. 4208 patients from 20 centers were included. 3070 patients were operated on with HL. In HU < 1000 stones, the TFL group had larger stones (11.56 ± 10.38 vs 9.98 ± 6.89 mm,p < 0.001). Multiple and lower pole stones were more prevalent in the HL group. Lasing time was shorter in the TFL group (15.34 ± 12.55 vs 23.32 ± 15.66 minutes,p < 0.001). HL group had a higher incidence of RF (29.1% vs 13.7%,p < 0.001). Age, stone size, and HL were predictors of RF, whereas multiple stones, and HL of RF requiring retreatment. In HU ≥ 1000 stones, stone size was similar between the two groups, whilst multiple and lower pole stones were more prevalent in the HL group. Surgical time was significantly shorter in the HL group (64.48 ± 33.92 vs 79.54 ± 88.56,p < 0.001). Significantly higher incidence of RF was noted in HL (22.7% vs 9.8%,p < 0.001), whilst reintervention rate was significantly higher TFL group (69.6% vs 43.8%,p < 0.001). Age, stone size, and use of HL were predictors of RF, whilst recurrent stone formers, multiple stones, and use of TFL of RF requiring retreatment.