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Purpose: There is a lack of guidelines for using angioembolization to manage renal cell carcinoma (RCC) patients with intractable symptoms. Therefore, the Korean Urologic Oncology Society (KUOS) developed a set of recommendations for angioembolization for RCC patients with intractable symptoms who are unfit for surgery.Materials and Methods: A rigorous systematic review was performed and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology was used to rate the certainty of the evidence for the patient outcomes and to develop the evidence into recommendations. The steering group, guidelines development group, systematic review team, and external review group consisted of KUOS members involved in the guideline development process.Results: The guidelines address the benefits, harms, patients’ values and preferences, costs, and resources related to angioembolization by using a single clinical question: Does angioembolization improve the quality of life for RCC patients with intractable symptoms who are unfit for surgery?Conclusions: The guideline development panel suggests angioembolization for RCC patients with intractable symptoms compared with supportive therapies, including systemic treatment (very low certainty of evidence, weak recommendation).

Background and Objectives: To assess the effects of fosfomycin compared with other antibiotics as a prophylaxis for urinary tract infections (UTIs) in men undergoing transrectal prostate biopsies. Materials and Methods: We searched multiple databases and trial registries without publication language or status restrictions until 4 January 2022. Parallel-group randomized controlled trials (RCTs) and non-randomized studies (NRS) were included. The primary outcomes were febrile UTI, afebrile UTI, and overall UTI. We used GRADE guidance to rate the certainty of evidence of RCTs and NRSs. The protocol was registered with PROSPERO (CRD42022302743). Results: We found data on five comparisons; however, this abstract focuses on the primary outcomes of the two most clinically relevant comparisons. Regarding fosfomycin versus fluoroquinolone, five RCTs and four NRSs with a one-month follow-up were included. Based on the RCT evidence, fosfomycin likely resulted in little to no difference in febrile UTIs compared with fluoroquinolone. This difference corresponded to four fewer febrile UTIs per 1000 patients. Fosfomycin likely resulted in little to no difference in afebrile UTIs compared with fluoroquinolone. This difference corresponded to 29 fewer afebrile UTIs per 1000 patients. Fosfomycin likely resulted in little to no difference in overall UTIs compared with fluoroquinolone. This difference corresponded to 35 fewer overall UTIs per 1000 patients. Regarding fosfomycin and fluoroquinolone combined versus fluoroquinolone, two NRSs with a one- to three-month follow-up were included. Based on the NRS evidence, fosfomycin and fluoroquinolone combined may result in little to no difference in febrile UTIs compared with fluoroquinolone. This difference corresponded to 16 fewer febrile UTIs per 1000 patients. Conclusions: Compared with fluoroquinolone, fosfomycin or fosfomycin and fluoroquinolone combined may have a similar prophylactic effect on UTIs after a transrectal prostate biopsy. Given the increasing fluoroquinolone resistance and its ease to use, fosfomycin may be a good option for antibiotic prophylaxis.