Although percutaneous nephrolithotomy (PCNL) has been performed for decades and has gone through many refinements, there are still concerns regarding its more widespread utilization because of the long learning curve and the potential risk of severe complications. Many technical details are not included in the guidelines because of their nature and research protocol.

To achieve an expert consensus viewpoint on PCNL indications, preoperative patient preparation, surgical strategy, management and prevention of severe complications, postoperative management, and follow-up.

An international panel of experts from the Urolithiasis Section of the European Association of Urology, International Alliance of Urolithiasis, and other urology associations was enrolled, and a prospectively conducted study, incorporating literature review, discussion on research gaps (RGs), and questionnaires and following data analysis, was performed to reach a consensus on PCNL.

The expert panel consisted of 36 specialists in PCNL sus, core technical aspects, as well as the urologist’s experience, are critical to the safety and effectiveness of PCNL.The prostate-specific antigen (PSA) threshold of 3.0 ng/ml is obsolete because it yields a test that is too sensitive. Urologists should adopt a more nuanced approach that accounts for benign prostate hypertrophy. This includes the use of magnetic resonance imaging, PSA density, and age-specific PSA reference ranges.

The ureteral access sheath (UAS) is an ancillary device widely used by urologists, but acute ureter injury may occur following its insertion. Preoperative selective oral α1-blockers can reduce intraureteral pressure, and prevent ureteral wall injury during UAS insertion.

To compare perioperative data of patients who underwent flexible ureterorenoscopy (fURS) with UAS with and without premedication with silodosin.

Single-blind, 100 patients from a single institution who underwent retrograde intrarenal surgery for kidney and upper ureter stone removal were prospectively allocated from May 2018 to March 2019.

The experimental groups received silodosin for 3 d preoperatively.

The primary endpoint included ureteral injuries after UAS insertion that were assessed according to endoscopic classification. The secondary endpoint was an evaluation of whether premedication with silodosin had any effect on postoperative outcomes.

A total of 44 and 43 patients were randomly assigned to the control and experimenodosin before surgery prevented ureter wall injury during surgery and immediately improved postoperative pain.

We investigated the preventive effect of an α-blocker against perioperative complication caused by ureteral access sheath inserted during flexible ureterorenoscopy. Taking silodosin before surgery prevented ureter wall injury during surgery and immediately improved postoperative pain.

Patients with metastatic urothelial carcinoma (mUC) have poor prognosis, so further development of novel combinations for these patients is needed.

To assess the safety and efficacy of eribulin mesylate (eribulin) with avelumab in mUC.

This was an open-label, phase 1b study in which patients with mUC who were cisplatin-ineligible and treatment-naïve or platinum-resistant were treated with eribulin and avelumab. A 3 + 3 design was used. The study was prematurely terminated because the free study drug became unavailable, but we performed extended follow-up for patients enrolled in the study.

Patients received eribulin 1.1 mg/m

plus avelumab 10 mg/kg on days 1 and 15 in every 28-d cycle in cohort 0, or eribulin 1.4 mg/m

plus avelumab 10 mg/kg on days 1 and 15 in every 28-d cycle in cohort +1.

The primary objectives were to determine the maximum tolerated dose (MTD) of eribulin with avelumab and assess the objective response rate. A key secondary endpoint was to assess efficacy by evaluating the disl different cancers) in a small group of patients with metastatic cancer of the urinary tract. The lower dose of eribulin was easier to tolerate and the combination had an anti-cancer effect. This trial is registered at ClinicalTrials.gov as NCT03502681.

We evaluated different doses of eribulin (a chemotherapy drug) in combination with a fixed dose of avelumab (an antibody used to treat several different cancers) in a small group of patients with metastatic cancer of the urinary tract. The lower dose of eribulin was easier to tolerate and the combination had an anti-cancer effect. GSK2334470 mouse This trial is registered at ClinicalTrials.gov as NCT03502681.The CATHETER II trial is expected to determine if and which policy for prophylactic catheter washout on a weekly basis improves the outcome of care for people living with a long-term catheter. By exploring the views and experiences of both the trial participants and health care professionals in relation to the trial delivery and outcomes, the CATHETER II qualitative study can provide context to the trial findings, clarify the fidelity of the intervention, and inform translation of the intervention into routine policy and practice.

Bariatric surgery is the most effective treatment for obesity. There is uncertainty regarding rates of adverse outcomes between the most common methods laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG).

To compare rates of readmission, reoperation, intervention, unplanned intensive care unit (ICU) admission, all-cause and procedure-related mortality, and postoperative complications at 30 days between LRYGB and LSG.

Retrospective, observational, multicenter registry.

We identified 611,619 patients from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) data registry between January 1, 2015, and December 31, 2018 (447,326 [73.1%] LSG; 164,293 [26.9%] LRYGB).

Adverse events were more common after LRYGB (readmission 3% with LSG versus 5.9% with LRYGB [P < .001; odds ratio OR, LSG/LRYGB = .489]; intervention .9% with LSG versus 2.4% with LRYGB [P < .001; OR, LSG/LRYGB = .357]; reoperation .8% with LSG versus 2.3% with LRYGB/LSG = 1.979 [P < .001]; readmission OR, LRYGB/LSG = 1.921 [P < .001]; unplanned ICU admission OR, LRYGB/LSG = 1.870 [P < .001]; intervention OR, LRYGB/LSG = 2.662 [P < .001]; reoperation OR, LRYGB/LSG = 2.646 [P < .001]; and Clavien-Dindo grade OR, LRYGB/LSG = 2.007 [P< .001]).

The rates of 30-day adverse outcomes are lower after LSG compared with after LRYGB. LRYGB independently conferred increased odds of adverse outcomes compared with LSG, and surgery type was among the strongest predictors of adverse outcomes.

The rates of 30-day adverse outcomes are lower after LSG compared with after LRYGB. LRYGB independently conferred increased odds of adverse outcomes compared with LSG, and surgery type was among the strongest predictors of adverse outcomes.