{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:08:47Z","timestamp":1792166927701,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,7,19]],"date-time":"2017-07-19T00:00:00Z","timestamp":1500422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2017,9]]},"abstract":"\n Aim of this study was to analyse the association between the use of diagnostic ureteroscopy (\n URS<\/jats:styled-content>\n ) and the development of intravesical recurrence (\n IVR<\/jats:styled-content>\n ) in patients undergoing radical nephroureterectomy (\n RNU<\/jats:styled-content>\n ) for high\u2010risk upper tract urothelial carcinoma. A systematic review of the published data was performed up to December 2016, using multiple search engines to identify eligible studies. A formal meta\u2010analysis was conducted of studies comparing patients who underwent\n URS<\/jats:styled-content>\n before\n RNU<\/jats:styled-content>\n with those who did not. Hazard ratios (\n HR<\/jats:styled-content>\n s), with their 95% confidence intervals (\n CI<\/jats:styled-content>\n s), from each study were used to calculate pooled\n HR<\/jats:styled-content>\n s. Pooled estimates were calculated using a fixed\u2010effects or random\u2010effects model according to heterogeneity. Statistical analyses were performed using\n RevMan<\/jats:sc>\n , version 5. Seven studies were included in the systematic review, but only six of these were deemed fully eligible for meta\u2010analysis. Among the 2 382 patients included in the meta\u2010analysis, 765 underwent diagnostic\n URS<\/jats:styled-content>\n prior to\n RNU<\/jats:styled-content>\n . All examined studies were retrospective, and the majority examined Asian populations. The\n IVR<\/jats:styled-content>\n rate ranged from 39.2% to 60.7% and from 16.7% to 46% in patients with and without prior\n URS<\/jats:styled-content>\n , respectively. In the pooled analysis, a statistically significant association was found between performance of\n URS<\/jats:styled-content>\n prior to\n RNU<\/jats:styled-content>\n and\n IVR<\/jats:styled-content>\n (\n HR<\/jats:styled-content>\n 1.56, 95%\n CI<\/jats:styled-content>\n 1.33\u20131.88;\n P<\/jats:italic>\n < 0.001). There was no heterogeneity in the observed outcomes, according to the\n I<\/jats:italic>\n 2<\/jats:sup>\n statistic of 2% (\n P<\/jats:italic>\n = 0.40). Within the intrinsic limitations of this type of analysis, these findings suggest a significant association between the use of diagnostic\n URS<\/jats:styled-content>\n and higher risk of developing\n IVR<\/jats:styled-content>\n after\n RNU<\/jats:styled-content>\n . Further research in this area should be encouraged to further investigate the possible causality behind this association and it potential clinical implications.\n <\/jats:p>","DOI":"10.1111\/bju.13935","type":"journal-article","created":{"date-parts":[[2017,6,16]],"date-time":"2017-06-16T04:56:41Z","timestamp":1497589001000},"page":"313-319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":136,"title":["Impact of diagnostic ureteroscopy on intravesical recurrence in patients undergoing radical nephroureterectomy for upper tract urothelial cancer: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"120","author":[{"given":"Michele","family":"Marchioni","sequence":"first","affiliation":[{"name":"Department of Urology SS Annunziata Hospital \u2018G. D'Annunzio\u2019 University of Chieti Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Primiceri","sequence":"additional","affiliation":[{"name":"Department of Urology SS Annunziata Hospital \u2018G. D'Annunzio\u2019 University of Chieti Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Cindolo","sequence":"additional","affiliation":[{"name":"Department of Urology ASL Abruzzo 2 Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance J.","family":"Hampton","sequence":"additional","affiliation":[{"name":"Division of Urology Virginia Commonwealth University Richmond VA USA"},{"name":"Division of Urology McGuire Veterans Affairs Hospital Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayer B.","family":"Grob","sequence":"additional","affiliation":[{"name":"Division of Urology Virginia Commonwealth University Richmond VA USA"},{"name":"Division of Urology McGuire Veterans Affairs Hospital Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgi","family":"Guruli","sequence":"additional","affiliation":[{"name":"Division of Urology Virginia Commonwealth University Richmond VA USA"},{"name":"Division of Urology McGuire Veterans Affairs Hospital Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Schips","sequence":"additional","affiliation":[{"name":"Department of Urology ASL Abruzzo 2 Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[{"name":"Department of Urology Comprehensive Cancer Centre Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Autorino","sequence":"additional","affiliation":[{"name":"Division of Urology Virginia Commonwealth University Richmond VA USA"},{"name":"Division of Urology McGuire Veterans Affairs Hospital Richmond VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,19]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"350","article-title":"Upper tract urothelial carcinoma: epidemiology, high risk populations and detection","volume":"68","author":"Redrow GP","year":"2016","journal-title":"Minerva Urol Nefrol"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2016.04.008"},{"key":"e_1_2_6_4_1","unstructured":"Roupr\u00eatM BabjukM B\u00f6hleAet al.EAU Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma. 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