Systematic Review: Safety of Intravesical Therapy for Bladder Cancer in the Era of COVID-19.

A novel coronavirus has emerged in late 2019 capable of causing a severe respiratory disease known as COVID-19. Its pathogenesis appears to be the initiation of an immune response and resulting cytokine storm that damages the healthy lung tissue of the host. Some epidemiological studies found bacillus Calmette-Guérin (BCG) vaccine can help to decrease morbidity and mortality of the viral infection. We aim to review and summarize what is known about COVID-19 and the current implications of intravesical BCG with regard to the disease.

Bipolar vs monopolar resection of bladder tumours of >3 cm in patients maintained on low-dose aspirin: A randomised clinical trial.

OBJECTIVE: To compare the safety and efficacy of bipolar vs monopolar transurethral resection of bladder tumour (TURBT) in patients maintained on low-dose aspirin with tumours >3 cm. PATIENTS AND METHODS: A prospective randomised single-centre study was performed including 200 patients with bladder tumours of >3 cm, as measured by ultrasonography. All patients were using low-dose aspirin (81 mg/day), which was not stopped in the perioperative period. Patients were randomised into two groups: Group A, monopolar TURBT (M-TURBT); Group B, bipolar TURBT (B-TURBT). The primary endpoint of the study was the decrease in postoperative haemoglobin (Hb) concentration measured using an automated cell counter. The secondary endpoints of the study were intraoperative blood transfusion or the occurrence of urethral trauma during cystoscopy and the need for re-coagulation. RESULTS: The postoperative reduction in Hb concentration, was significantly lower in the B-TURBT group [mean (SD) 0.55 (0.26) g/dL] compared with the M-TURBT group [mean (SD) 1.24 (0.61) g/dL] (P < 0.001). There was also a significant difference (in favour of B-TURBT) between the groups in the mean postoperative reduction in haematocrit and the mean postoperative hospital stay. There was no significant difference between the groups for the occurrence of obturator jerk, bladder perforation, and the need for blood transfusion. CONCLUSION: B-TURBT in patients maintained on low-dose aspirin is better than M-TURBT for minimising postoperative drop in Hb concentration.

Mitochondrial DNA copy number variation as a potential predictor of renal cell carcinoma.

BACKGROUND: Peripheral blood mitochondrial DNA (mtDNA) copy number alteration has been suggested as a risk factor for several types of cancer. The aim of the present study was to assess the role of peripheral blood mtDNA copy number variation as a noninvasive biomarker in the prediction and early detection of renal cell carcinoma (RCC) in a cohort of Egyptian patients. METHODS: Quantitative real-time polymerase chain reaction (qPCR) was used to measure peripheral blood mtDNA copy numbers in 57 patients with newly diagnosed, early-stage localized RCC and 60 age- and sex-matched healthy individuals as a control group. RESULTS: Median mtDNA copy number was significantly higher in RCC cases than in controls (166 vs. 91, p<0.001). Increased mtDNA copy number was associated with an 18-fold increased risk of RCC (95% confidence interval: 5.065-63.9). On receiver operating characteristic curve analysis, it was found that mtDNA could distinguish between RCC patients and healthy controls, with 86% sensitivity, 80% specificity, 80.3% positive predictive value and 85.7% negative predictive value at a cutoff value of 108.5. CONCLUSIONS: Our results showed that increased peripheral blood mtDNA copy number was associated with increased risk of RCC. Therefore, RCC might be considered as part of a range of potential tumors in cases with elevated blood mtDNA copy number.

Studying the effect of type 2 diabetes mellitus on prostate-related parameters: A prospective single institutional study.

BACKGROUND: To examine the effects of type 2 diabetes mellitus (DM) on the variables associated with prostatic growth including serum prostate-specific antigen (PSA), serum testosterone, and prostate volume, and to correlate these variables with the duration of diabetes treatment. METHODS: Our study was conducted over 3 months recruiting 501 men aged ≥ 55 years; of whom 207 had type 2 DM. Exclusion criteria were active urinary tract infection, suspicious rectal examination, urologic cancer, end-organ damage, and recent urological manipulations. Serum PSA and serum testosterone were measured. Prostate volume was determined by abdominal ultrasonography using an ellipsoid formula. RESULTS: The mean patient age was 60.21 ± 5.95 years. The mean PSA, testosterone, and prostate volume for diabetic men were 2.3 ng/mL, 3 ng/mL, and 56 g, respectively. The corresponding values for nondiabetic men were 3.5 ng/mL, 4 ng/mL, and 51 g, respectively (P = 0.001, P = 0.001, P = 0.03, respectively). The mean PSA density was 0.049 ± 0.043 ng/mL/cm3 in diabetics versus 0.080 ± 0.056 ng/mL/cm3 in non-diabetics (P < 0.001). CONCLUSION: Type 2 DM is significantly associated with lower serum PSA and testosterone, and larger prostate volume.

Radiolucent renal stones in children: combined use of shock wave lithotripsy and dissolution therapy.

OBJECTIVES: To provide a noninvasive efficient modality for the treatment of radiolucent renal stones in children. Uric acid calculi comprise a significant proportion of urinary stones. METHODS: This study included 24 children (10 girls and 14 boys) with radiolucent renal stones. Of the 24 patients, 5 presented with bilateral renal stones, 8 with multiple stones, 4 with staghorn stones, and 7 with a solitary renal stone. Their age range was 2-12 years (mean 6.3 +/- 2.8). The stone size range was 12-65 mm in the largest diameter. All patients were treated with combined extracorporeal shock wave lithotripsy (ESWL) and medical therapy in the form of urinary alkalization using potassium sodium hydrogen citrate and allopurinol for the treatment of hyperuricosuria. Before ESWL, 3 patients had a percutaneous nephrostomy tube inserted and 2 patients had a ureteral stent placed to relieve obstruction. ESWL was performed with a Siemens Lithostar using either general anesthesia or intravenous sedation. The follow-up period after stone clearance was 12-36 months (mean 26 +/- 7.2). RESULTS: The stone-free rate of 100% was achieved in all 24 patients after 3 months of combined use of extracorporeal shock wave lithotripsy and dissolution therapy. CONCLUSIONS: Combined ESWL and dissolution therapy accelerated stone clearance and delayed stone recurrence. The use of ESWL and medical therapy as a combined modality is a safe and effective treatment of radiolucent renal stones in children.