Objectives To assess the incidence of bacteriuria and urinary tract infection following use of Endosheath®, and to assess patient comfort and satisfaction post-procedure.  Patients and Methods One hundred thirty-five patients undergoing Endosheath® flexible cystoscopy (FC) were prospectively identified. Patients were excluded if pre-procedure urinalysis or symptoms suggested infection. Those who underwent FC were asked to provide a urine sample 72 hours post-procedure, assessing for bacterial culture and sensitivity. Patients completed a questionnaire assessing comfort, pain and whether they would recommend the procedure to others if required.  Results Of the 135 patients, 117 patients returned their post-procedure samples and processed. Thirteen (11.1%) of the urine cultures samples were positive. Four (3.4%) of this 13 patients had symptoms of urinary tract infection (UTI) and were treated with antibiotics. One hundred and seven (79%) patients found the procedure comfortable and 104 (77%) patients would recommend the procedure to others.  Conclusions Flexible Cystoscopy utilising Endosheath® appears to have comparable incidence of bacteriuria and UTI post procedure compared with standard FC, and is well tolerated by most patients.

Objectives: To identify the best practice policy and guideline for surveillance with check cystoscopies follow up for low-risk pTa urothelial bladder tumour and to identify the recurrence rate and the progression rate of low-risk urothelial bladder tumour and how safe is it to discharge them at 1- versus 5-years of follow up.Primary outcome: The primary goal is to assess both the rate of recurrence and rate of progression of low-risk Non-muscle Invasive Bladder Carcinoma (NMIBC) during the first 5-year after initial Trans-Urethral Resection of Bladder Tumour (TURBT) and how safe is to discharge this class of group after one year versus five years of surveillance and compare it to previous reports. Secondary outcome: To estimate the cost-effectiveness of a reduced follow-up scheme, if this is deemeda safe practice to follow. Methodology: It is a single centre, retrospective review of all low-risk NMIBC patients diagnosed with low-risk bladder tumors at our Trust between 2012 and 2014 from our local urological cancer multi-disciplinary team (MDT) registry and ensured a 5-year time-lapse from diagnosis. Histology grade and staging from the first TURBT, receiving of mitomycin within 24 hrs following the initial TURBT, the timing of cystoscopy follow-up, cystoscopy findings (evidence of recurrence), further procedures (bladder biopsy, fulguration or TURBT), histology of further procedures, recurrence rate and time from the first TURBT to discharge to primary care are reviewed and analysed. Result: Our initial review revealed a high likelihood of recurrence (33.9%) in the low-risk NMIBC patients after 12 months of being cancer free. It also demonstrated that there is further progression in (23.8%) of those who had a later recurrence despite being asymptomatic. Conclusion: We would recommend a 5-year follow-up surveillance and further national collaboration to audit this patient subgroup to define a safe period of cystoscopic follow-up for these patients and bring further evidence for NICE to build up their recommendations.

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AimsThe principal aim of this multicentre, international cohort study is to explore the safety concerns of clinicians when performing urodynamic studies (UDS) during the COVID-19 pandemic. This study will also assess provider preference on personal protective equipment (PPE) during UDS and awareness of relevant international guidelines. The outcome is to offer a practical means of reducing the risk of aerosol transmis-sion during UDS, to include a protocol for screening patients, and to consider safer methods of inducing urethral leak-point pressure. MethodsA 14-point, multiple-response, online questionnaire was designed through Survey Monkey. This was distributed to healthcare workers involved in UDS via email, WhatsApp, and Twitter. This included, of varying experience; urologists, urogynaecologists, clinical nurse specialists, and clinical scientists across the United Kingdom (UK), United States of America (USA), Australia, Europe, and Middle-East.ResultsThe study was conducted over two weeks and there were 104 responses to the survey. The majority of respondents were consultants (60%) and 73% of respondents performed UDS regularly. There were 56.7% of respondents who felt that UDS was safe to be re-instated and there were 52.8% who did not feel coughing was safe during the procedure. At the time of the survey, 83.5% were unaware of any national or international urological guidelines on the best practice for urodynamics during this era and 52.8% of clinicians stated they would wear PPE during UDS if it were reinstated. ConclusionThe majority of respondents felt safe to reinstate UDS; however, they felt more official guidance and recommendation is needed. Our proposed protocol can provide a safe and practical approach that keeps healthcare workers and patients safe.