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Background: Recurrent Testicular Torsion (RTT) is a rarely reported event after previous testicular torsion (TT) repair. Both conditions have similar signs and symptoms. Various techniques have been attempted to reduce the incidence of retorsion. This review assesses the presentation, diagnosis, risk factors, management and outcomes associated with RTT. Methods: After PROSPERO Registration (CRD42021258997), a systematic search of PubMed, Google Scholar, Embase, Scopus, Web of Science, Cochrane Database of Systematic Reviews, Global Index Medicus and Cumulative Index to Nursing and Allied Health Literature (CIANHL) was performed using specific search terms. Study metadata including patient demographics, orchidopexy techniques, RTT rates and RTT timing were extracted. Results: Twenty‐six articles, comprising 12 case series and 14 case reports, with a total of 46 patients were included. Overall, the median (IQR) age of the pooled cohort was 18 (15–26) years, the median (IQR) time to presentation was 6 (3–36) hours from the onset of testicular pain. The most common presenting features were testicular pain (100%), testicular swelling (60.9%) and a high riding testicle (34.8%). The left testicle was most commonly affected (63.0%), RTT was on the ipsilateral side in relation to the primary episode of TT in 52.2% of cases, the median (IQR) interval between torsion and retorsion events was 4 (1.3–10.0) years, non‐absorbable sutures were the most common suture material used during orchidopexy after RTT (88.9%). Conclusion: RTT is a rare presentation to the Emergency Department. Even with a prior history of TT, RTT should be considered in patients presenting with classic symptoms. [ABSTRACT FROM AUTHOR]

Background: We aimed to define the published impact, efficacy, cost‐effectiveness and precise role of the Isiris‐α device: the world's first sterile, single‐use grasper integrated flexible cystoscope (SUGIFC) for ureteral stent removal. Methods: After PROSPERO registration (CRD42021228755), the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) guidelines were utilized. The search terms "Grasper Integrated Flexible Cystoscope," and "Isiris," within the following databases: PubMed, Scopus, Cochrane Library, Web of Science and EMBASE were searched. Results: In this review, a cumulative total experience (10 publications) included 970 "SUGIFC" procedures (755 patients). However, only 366/970 procedures were actually used for "ureteral stent removal," with the remainder being surveillance cystoscopy only (603/970) or foreign body retrieval (1/970). Procedure‐related and device failures in planned "removal of ureteral stents," was reported in 8/366 (346 patients) and 1/366 (346 patients), respectively. The cost–benefit utilizing the SUGIFC device is advantageous compared to "in‐theatre" stent removals and favours less busy centres where maintenance, repair and replacement costs are more relevant. Other listed benefits include shorter stent indwelling times, shorter procedure duration, lower rates of bacteriuria and urinary tract infections, fewer emergency department visits and lower readmission rates. Technical limitations include the absence of an independent working channel, a narrower visual field and the lack of image universality since the monitor is device‐specific. Conclusion: The SUGIFC device needs to be outweighed against local costs and individual health systems. Its application in ambulatory ureteral stent removal may become significant due to the accessibility and convenience that it offers the attending urologist. [ABSTRACT FROM AUTHOR]

Background: Ureteral stent insertion and subsequent removal remains one of the most common procedures performed in endourology. We aimed to evaluate a novel, one‐step method, permitting simultaneous stent removal and guidewire passage using a self‐constructed suture snare via standard cystoscopy. This method should be used prior to ureteroscopy, in cases of minimal stent encrustation and peri‐ureteral mucosal oedema, where identification and subsequent cannulation of the ureteral orifice may be a challenge. Methods: A self‐constructed suture snare is constructed using an open‐ended ureteral catheter to facilitate this novel 'Switch' technique. Operative duration, cost feasibility and potential complications with this novel method were assessed in patients with an indwelling stent duration above 100 days. Results: Age inclusion in this study ranged from 21 to 35 years, with kidney, ureter and bladder scores below 6, in the five patients assessed. Previous ureteral stent indwelling time ranged from 106 to 315 days. Reasons for (pre‐stented) ureteroscopy were mostly stone related. The overall recorded procedure time for the Switch technique was successfully performed in less than 96 s (range 68–95 s) in all cases within this series. No procedure‐related complications were reported. Conclusion: Utilizing the suture snare, the novel Switch technique was successfully performed in all cases assessed. This method is both time and cost feasible and could be easily utilized in resource‐limited areas, regional centres or in cases where a stent grasper is not available, may have malfunctioned or cannot adequately approximate due to distal ureteral stent encrustation. [ABSTRACT FROM AUTHOR]

Background: Testicular torsion (TT) is a urological emergency that affects one in 4000 males younger than 25 years. Delays in the management of TT may result in testicular ischaemia, testicular necrosis, orchidectomy and infertility. This review assesses the validity of near‐infrared spectroscopy (NIRS) as a diagnostic tool in the assessment and diagnosis of TT. Methods: A systematic search of Cochrane Database of Systematic Reviews, EMBASE, Google Scholar, PubMed, Scopus and Web of Science databases was performed in January 2019 using specific search terms. Selected studies were ranked and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines and the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. Results: A total of nine studies that included 253 subjects (88 animals and 165 humans) with a mean sample size of 28.1 (standard deviation 40.8) subjects were included. The mean difference in testicular tissue oxygen saturation between torsed and non‐torsed testes (Δ%StO2) were 45%, 42% (±5%), 26% and 5–18% in four animal studies and 2.0%, 3.0%, 6.7%, 6.8% and 23.0% in five human studies. The tissue oxygen saturation difference between contralateral healthy testes (controls) ranged from 1% to 10% in the five studies that alluded to this. Conclusion: The current body of evidence does not support the use of NIRS in the work‐up of TT. Well‐designed clinical trials with large patient samples are required to determine whether NIRS may have some future role as a diagnostic modality in TT. [ABSTRACT FROM AUTHOR]

Background: Intestinal volvulus is a potentially life‐threatening condition that occurs when loops of bowel twist around its supporting mesentery and associated vasculature. Clinicians often rely on various radiological investigations for prompt diagnosis to avoid complications such as bowel infarction. This review assesses the clinical reliability of the ultrasonographic whirlpool sign (WS) in the diagnosis of intestinal volvulus. Methods: In adherence with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta‐analyses) statement, a systematic search of BMJ Best Practice, Cochrane Database of Systematic Reviews, EMBASE, Google Scholar, PubMed, Scopus and Web of Science databases was performed (August 2017), using relevant search terms. Selected studies were ranked for quality and relevance using the CASP (Critical Appraisal Skills Program) tool. Results: Sixteen articles (1640 participants) were assessed. The mean and median sample size was 102.5 (SD ± 192.23) and 28 (range 7–770), respectively. The WS was positive in 212 of 255 (83.1%) patients with intestinal volvulus. Meta‐analysis of the studies that provided sufficient data resulted in a pooled sensitivity and specificity of 87.42% (95% confidence interval (CI): 81.05–92.25) and 98.63% (95% CI: 97.88–99.18), respectively, with an estimated summary effect of 5.28 (95% CI: 4.47–6.08, P < 0.001). There was negligible inter‐study heterogeneity, which was suggested by an I2 statistic of 0% (95% CI: 0.00–76.34) and a τ2 parameter of 0 (95% CI: 0.00–5.35). Conclusion: Though the pooled sensitivity was less than ideal (87.42%), this review and meta‐analysis nevertheless supports the reliability of the ultrasonographic WS as an acceptable indicator of intestinal volvulus. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 3‐month‐old male infant with a history of antenatal hydronephrosis. Topics discussed include the endoscopic incision revealing arterial bleeding originating from the ureterocele, the patient undergoing a relook procedure to prevent all bleeding, and Doppler flow revealing an underlying left iliac arteriovenous malformation.