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Introduction: The blood-based inflammatory marker, neutrophil-to-lymphocyte ratio (NLR), is a reliable prognostic biomarker for several cancers. Although the literature supports the correlation between preoperative NLR, clinicopathological characteristics, and oncological outcomes in upper tract urothelial carcinoma (UTUC), the cutoff of NLR is still debated. This study aimed to determine the prognostic value of NLR in patients with UTUC. Methods: This was a retrospective analysis of prospectively collected data from July 2012 to December 2022 evaluating patients with UTUC who underwent radical nephroureterectomy (RNU). NLR was calculated using the neutrophil and lymphocyte counts obtained a day before the surgery and the cutoff value was set as 2.5. Kaplan-Meier and Cox's proportional hazards regression were used to analyze the association between NLR and the oncological outcomes. Results: The study included 91 patients (78 males, 13 females) in the final analysis with a median follow-up of 49 months (8-130). The mean age of the patients with NLR <2.5 and NLR >2.5 was 56.88 years and 56.35 years, respectively, and the pathological stage was pT1 in 48%, pT2 in 20.88%, pT3 in 27.47%, and pT4 in 3.30% of the patients. Multivariable Cox regression analysis showed that the preoperative NLR >2.5 was significantly associated (Hz = 7.17) with higher T stage, lymphovascular invasion, necrosis, nodal involvement, adjuvant chemotherapy, and worse overall survival (OS) (Hz = 9.87). The Kaplan-Meier analysis revealed an improved OS in patients with NLR <2.5, but a statistically significant difference in the recurrence-free survival was not found. Conclusions: Preoperative NLR is an easily available, inexpensive, and important prognostic biomarker of survival in patients with UTUC and has a potential role in risk stratification by predicting adverse clinicopathological characteristics. [ABSTRACT FROM AUTHOR]

Byline: Rishi. Nayyar, Shritosh. Kumar, . Collaborative Working Group on Use of Antibiotics in Endourology Introduction: Antibiotic use during endourological procedures is often discordant from the reported guidelines, despite the [...]

Byline: Harshit. Garg, Brusabhanu. Nayak, Ashish. Kumar, Prabhjot. Singh, Rishi. Nayyar, Aashir. Kaul, Amlesh. Seth Background: Renal cell carcinoma (RCC) presents with inferior vena cava (IVC) thrombus in 10%-30% cases [...]

Objectives: To study the presentation and natural course of cystitis cystica et glandularis. Methods: A retrospective analysis of patients with histopathologically confirmed cystitis cystica et glandularis from March 2016 to March 2018 who at least completed their 2 years' follow-up was performed. Perioperative details along with the last available follow-up were included in the analysis. Results: A total of 10 patients were included. The mean age (± standard deviation) was 33.4 (±14.0) years and nine (90%) were men. The most common presentation was storage and voiding lower urinary tract symptoms (80%) along with haematuria (40%) and dysuria (20%). Four patients had the presence of hydronephrosis in preoperative imaging, of which three patients had bilateral mild hydroureteronephrosis. All the patients underwent transurethral resection of the bladder tumour as all were diagnosed with urinary bladder mass on preoperative imaging. All the patients had a trigonal lesion with a bullous appearance partially obstructing the bladder neck. Six patients underwent double J stenting in the perioperative period. The mean (± standard deviation) follow-up duration was 32.8 (±7.5) months. Patients were kept on regular surveillance with imaging and cystoscopy as indicated. Eight patients (80%) developed recurrence in the follow-up period. The mean number of recurrences was 1.5 (±1.1). One of the patients had to undergo augmentation ileocystoplasty with bilateral ureteric reimplantation because of the recurrent lesion with small contracted bladder, while another patient underwent cystectomy with urinary diversion owing to recurrence and refractory lower urinary tract symptoms. Besides, there was no evidence of malignancy after this entity in any of the patients. Conclusion: Cystitis cystica et glandularis is a rare clinic pathological entity which often mimics bladder tumour. Cystitis cystica et glandularis is common in men and often presents with lower urinary tract symptoms. Transurethral resection forms the mainstay of treatment. However, it is often associated with upper tract hydronephrosis. Its controversial premalignant nature compounded with recurrence and risk of upper tract deterioration warrants close surveillance. Level of evidence: 4 [ABSTRACT FROM AUTHOR]

Byline: Devanshu. Bansal, Brusabhanu. Nayak, Prabhjot. Singh, Rishi. Nayyar, Rashmi. Ramachandran, Rajeev. Kumar, Amlesh. Seth We thank the authors for their kind appreciation and keen observations. We performed a randomized [...]

Byline: Harshit. Garg, Deviprasad. Tiwari, Brusabhanu. Nayak, Prabhjot. Singh, Siddharth. Yadav, Rajeev. Kumar, Amlesh. Seth, Rishi. Nayyar, Premnath. Dogra Background: Nephron-sparing surgery (NSS) is the standard of care for small [...]

Byline: Rishi. Nayyar [INLINE:1] Editors : Vipul R Patel, Manickam Ramalingam Edition : 2nd Publisher : Springer International Publishing, Switzerland ISBN : 978-3-319-33231-4 Pages : 710 Price : Rs. 22,572 [...]

Byline: Rishi. Nayyar, Bharti. Uppal, Asuri. Krishna A 17-year-girl presenting with features of intestinal obstruction and managed with colostomy was referred for continuing to pass feces per anus despite a [...]

Byline: Ritesh. Singh, Devashish. Kaushal, Nikhil. Khattar, Rishi. Nayyar, T. Manasa, Rajeev. Sood Pelvic fracture with urethral injury in girls is an uncommon entity that is usually associated with concomitant [...]

Anterior urethral valve (AUV) is a long known but rare anomaly, which is occasionally encountered in boys with obstructive uropathy. We present a case of AUV with a diverticulum which was misdiagnosed at other center as neurogenic bladder resulting in chronic renal failure. The case was further complicated by breakage of tip of the catheter used for clean intermittent catheterization (CIC) in the diverticulum presenting as a foreign body in the urethra. This article highlights the frequently missed diagnosis of AUV by most practitioners wrongly labeling it as neurogenic bladder, leading to improper management and renal failure in young boys.