full free access: Risk of urothelial bladder cancer in Lynch syndrome is increased, in particular among MSH2 mutation carriers -- Journal of Medical Genetics

"Besides the high risk of developing colorectal carcinomas of 10–80%, Lynch syndrome family members are at increased risk of developing several extra-colonic cancers and tumours at a relatively young age: endometrial cancer, carcinomas of the ovary, small bowel and biliary tract cancer, sebaceous gland tumours and urothelial carcinomas (UC) of the upper urinary tract. The lifetime risk of upper urinary tract cancer in Lynch syndrome varies in different studies from 0.4–20%. Microsatellite instability (MSI) is present in these urothelial carcinomas of the upper urinary tract."

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abstract: Urinary tract injury: medical negligence or unavoidable complication?

"The incidence of urinary tract injury is low in most gynaecological operations but, if undiagnosed, is a cause of significant postoperative morbidity for the patient and litigation for the gynaecologist. A Medline search of studies of urinary tract injury at gynaecological surgery show that only one in 10 ureteral injuries and one in three bladder injuries are detected at the time of surgery without intra-operative cystoscopy. As cystoscopy is not routinely performed by the majority of gynaecologists during surgery, even in difficult cases, failure to detect injury to the urinary tract by itself should not be seen as negligence. However, all gynaecologists performing pelvic surgery should be encouraged to become competent in cystourethroscopy and perform this intra-operatively, at least in all high-risk cases of gynaecological surgery."