JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 14

Journal of Clinical Urology 11(1S)

DFS events were reported; unadjusted HR=0.47 (95% CI:
0.29, 0.74) in favour of chemotherapy (log-rank p=
0.0009).
Conclusions: Adjuvant chemotherapy improved DFS in
UTUC. POUT was terminated early because of efficacy
favouring chemotherapy; follow-up for OS continues.
Results of POUT, the largest UTUC randomised trial,
support adjuvant chemotherapy as a new standard of
care.

P1-1 Long term oncological outcomes
following the randomised controlled
cystectomy: open, robotic and laparoscopic
(CORAL) trial

6 - Is it safe to carry out flexible cystoscopy
when urinary dipstick is positive for
'infection'? Results of a prospective clinical
study
M1,

JM1,

L1,

E1,

ePoster Session 1:
Bladder Cancer
Monday 25 June
10:30 - 12:00
Room 4
Chairs: Matthew Nielsen & Alex
Colquhoun

E1,

Trail
Cullen
Dick
Fulton
MacGregor
Clayton F1, Kalima P2, Donat R1, Mariappan P1
1Department of Urology, Western General Hospital, Edinburgh,
United Kingdom, 2Department of Medical Microbiology and Virology,
Western General Hospital, Edinburgh, United Kingdom

Introduction: There is significant under-utilisation of valuable NHS resources when patients scheduled for flexible
cystoscopy are cancelled consequent to positive pre-cystoscopy urinalysis, despite being asymptomatic for UTI.
With our pilot evaluation (JCU 2017;10(2S):7-82) supporting a protocol avoiding automatic cancellation, we performed a larger study to primarily identify the association
between the pre-flexible cystoscopy urinary Leucocyteesterase, Nitrites, urine culture and post-cystoscopy UTI,
whilst utilising this protocol.
Patients and Methods: We carried out a prospective
clinical study in a high-volume UK centre, recruiting all
patients undergoing flexible cystoscopy over a 6-month
period. Urinalysis was carried out prior to cystoscopy in
all patients. Cystoscopy was carried out regardless of the
dipstick result, unless patients were symptomatic, in
which case they were treated and rescheduled. Patients
asymptomatic but considered 'high-risk' for UTI (on the
basis of pre-determined criteria) were given prophylactic
Gentamicin prior to cystoscopy. Every patient was followed up by a phone call and urine culture when applicable. We defined post-cystoscopy UTI as one that
developed within 2 weeks of the procedure. Analysis of
association was carried out.
Results: From over 2000 patients, preliminary results
suggest that the overall risk of developing post-cystoscopy
UTI in this cohort is low. While Leucocyte-esterase and
Nitrite positivity appear to carry a slightly higher risk of
developing a UTI, this risk was not clinically significant.The
incidence of urosepsis is very low.
Conclusion: It appears safe to carry out flexible cystoscopy in asymptomatic patients with positive urinary
Leucocyte-esterase and/or Nitrites, without the need for
routine prophylactic antibiotics.

Omar K1, Nair R1, Thurairaja R1, Rimington P2,
Dasgupta P1, Khan S1
1Guy's Hospital, London, United Kingdom, 2Eastbourne District
General Hospital, United Kingdom

Introduction: CORAL trial is the first three-arm RCT
demonstrating peri-operative outcomes between the 3
techniques. We evaluate 5-year oncological outcomes.
Material and Methods: From 2009 to 2012, 60 patients
requiring radical cystectomy for muscle-invasive or highrisk non-muscle-invasive bladder cancer (HR-NMIBC)
were randomized. Oncological outcome at 5 years is demonstrated. The Fisher exact test, ANOVA and KaplanMeier used for analyses.
Results: 58 patients from the trial were followed up for a
median of 65 months (range 3-98).The mean age of patients
undergoing ORC, RARC and LARC was 66.6, 68.6 and
68.6yrs respectively. HR-NMIBC was 40% in ORC, 40% in
RARC and 26% in LRC. Positive margin (PSM) was 10%,
15% and 5% for ORC, RARC and LRC respectively. There
was no significant relationship between surgical arm and
PSMs (p=0.9). The mean lymph node (LN) retrieval was
18.8, 16.3, and 15.5 in ORC, RARC and LRC respectively
and difference was only significant between ORC and LRC
(p = 0.01). No port-site or peritoneal metastases were
observed in RARC and LRC. Five-year RFS is 71%, 53% and
60% in LRC, ORC and RARC respectively. 5-year CSS is
69%, 64% and 70% in LRC, ORC and RARC respectively.
5-year OS was 61%, 55%, 66% in LRC, ORC and RARC
respectively. RFS between the 3 groups was non-significant
(p=0.87), the difference in CSS was non-significant (p=
0.57) and difference in OS was non-significant (p=0.48).
Conclusion: There were no significant differences in RFS,
CSS and OS between ORC, LRC and RARC.
P1-2 Role of preoperative urinary cytology
and ureteroscopy in the management of
upper tract urothelial tumours treated by
laparoscopic radical nephroureterectomy: a
single centre experience

Table of Contents for the Digital Edition of JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018