Clinical Research Directory

Effect of Vulvar Re-Antisepsis Before Cystoscopy on Urinary Infections in Laparoscopic Hysterectomy

This prospective observational study aims to evaluate whether additional vulvar re-antisepsis before intraoperative cystoscopy reduces the incidence of postoperative urinary tract infections (UTIs) in patients undergoing total laparoscopic hysterectomy for benign indications. In our institution, cystoscopy is routinely performed at the end of laparoscopic hysterectomy using carbon dioxide (CO₂) as the distension medium to assess bladder integrity and ureteral jet flow. However, potential contamination from the vaginal flora during cystoscopy may increase the risk of postoperative UTI. The study will compare two groups of patients: those receiving standard preoperative antisepsis only and those undergoing additional vulvar re-antisepsis immediately before cystoscopy. The primary outcome is the incidence of postoperative UTI diagnosed according to CDC criteria. Secondary outcomes include cystoscopy duration, catheterization time, and need for postoperative antibiotic therapy. Findings from this study may help determine whether an additional antisepsis step can improve infection control during laparoscopic hysterectomy.

Guiding Value of Urinary Tumor DNA Testing in Cystoscopy for High-Risk/Very High-Risk Non-Muscle-Invasive Bladder Cancer

Non-muscle-invasive bladder cancer (NMIBC) is usually treated with surgery to remove the tumor (transurethral resection of bladder tumor, or TURBT), often followed by bladder-instilled medications to reduce the chance of the cancer coming back. Even with this treatment, high-grade NMIBC can return or progress, so patients need regular check-ups, usually with cystoscopy (a camera examination of the bladder) and urine cytology. Cystoscopy is effective but invasive, can cause discomfort, and carries risks such as infection and bleeding. This makes follow-up costly and sometimes burdensome for patients. This study is testing whether a urine tumor DNA (utDNA) test - a type of "liquid biopsy" that detects cancer-related DNA changes in urine - can help guide the timing of cystoscopy for people with high-risk or very high-risk NMIBC. utDNA testing is non-invasive and has shown high accuracy in detecting bladder cancer, sometimes spotting signs of recurrence earlier than standard methods. By combining utDNA testing with cystoscopy, we hope to safely reduce the number of unnecessary cystoscopies without missing cancer recurrences. The study will evaluate whether this approach can make bladder cancer follow-up more comfortable, more precise, and more efficient.

Accuracy and Precision of Train-of-Four Ratios Obtained With Acceleromyography and Electromyography in Restricted-Movement Settings in the Absence of Neuromuscular Blocking Drugs

The purpose of this research is to compare the performance of acceleromyograph and electromyograph-based quantitative neuromuscular monitors when the arms are tucked for surgical positioning.

Bladder EpiCheck European Haematuria Study

The goal of this observational study is to further validate the sensitivity and specificity of Bladder EpiCheck in primary detection of urothelial carcinoma in participants aged 45 years or older presenting with haematuria, compared to cystoscopy and pathology, if performed. Participants will provide a voided urine sample, and data from standard of care haematuria work-up will be collected.

The Effect of Classical Hand Massage, Lavender Inhalation and Hand Massage With Lavender on Anxiety, Pain and Comfort

Cystoscopy is one of the most commonly performed urologic procedures to examine the anatomy and evaluate pathologies of the lower urinary tract. Although cystoscopy is a safe procedure with a low risk of morbidity, it can often cause pain, anxiety and restlessness in patients. This study aims to determine the effects of classical hand massage, lavender inhalation and lavender hand massage applied to patients undergoing cystoscopy on the patient's anxiety, pain and comfort. The population of the study will consist of patients who underwent cystoscopy between July 2024 and April 2025. Data will be obtained with the Patient Identification Form, Vital Signs Follow-up Form, State Anxiety Scale, Numerical Pain Scale and Numerical Comfort Scale. The research will be conducted in three stages: before, during and after the cystoscopy procedure. In the pre-cystoscopy period, patients who meet the study inclusion criteria will be informed about the procedure and verbal and written permissions will be obtained. Randomization will be performed according to the order of application and the patients will be divided into four groups as the classical hand massage group, the lavender inhalation group, the lavender hand massage group and the control group. The Patient Identification Form will be filled in and the scales will be introduced. The vital signs of the patients in the intervention groups will be assessed half an hour before the procedure and the State Anxiety Scale will be filled in. In addition, a ten-minute application will be performed before the procedure and their vital signs and the State Anxiety Scale will be assessed five minutes after the procedure. During the cystoscopy period, after the patients in the intervention group are taken to the cystoscopy table and lidocaine gel is applied, their vital signs and pain levels will be assessed during the passage of the cystoscopy instrument from the urethra to the bladder. A ten-minute application will be performed during the procedure in the intervention groups and their vital signs and pain will be assessed immediately after the cystoscopy is completed. In the post-procedure period, half an hour after the cystoscopy procedure, the vital signs of the patients will be measured again, and the Numerical Pain Scale and Numerical Comfort Scale will be filled. The same data will be collected from the patients in the control group without any application.

Xpert Bladder Monitor: a Non-Invasive Follow-Up Tool for Detecting Relapse in High Grade or High Risk Bladder Cancer

Main objectives: Qualitative and quantitative monitoring of recurrences in patients with a previous diagnosis of high-grade bladder cancer at high risk of persistence/recurrence. Endpoints: Presence or absence of mRNA in urine with a dichotomous result; concordance between Xpert BM and histopathological examination Clinical relevance: reduces by half the number of (invasive) cystoscopies during follow-up. The non-invasive nature of the test could improve patient compliance with follow-up. Interventional study because it would reduce by half the number of cystoscopies during follow-up of bladder cancer which is considered the gold standard in the follow-up of this tumor. However, these markers are already CE validated and described in the European guidelines and for this reason the risk would be low.

Augmented Bladder Tumor Detection Using Real Time Based Artificial Intelligence

Today the standard for the diagnosis and monitoring of bladder tumors is bladder endoscopy. The performance of this exam is not perfect. With this work, based on artificial intelligence, the investigators wish to combine endoscopy with a complementary diagnostic tool in order to improve patient care. The main objective will be to reduce diagnostic errors / wanderings in patients treated or followed for bladder tumors, by imposing a new standard of diagnostic bladder mapping (high PPV and VPN, high precision)(primary purpose diagnostic). The secondary objective will be to homogenize and systematize the descriptive part of the lesions, and to use AI to better characterize tumor aggressiveness. The final objective being to validate a new precision tool (diagnostic companion) essential for developing and standardizing the therapeutic management of bladder tumors (correcting inter-observer heterogeneity). In this project, video frame will be first extracted from our dataset of cystoscopy videos hosted in in the Next Cloud Recherche. Selected medical image will be segmented and analyzed using our pre-trained CNN model with a feature detection algorithm to obtain features. Data will be analyzed on both patient and lesion levels. The study will assess the Bladder-PAD accuracy on the detection of bladder tumors, and its ability to predict tumor risk of recurrence and progression.