Management of Node-Positive Bladder Cancer After Neoadjuvant Chemotherapy and Radical Cystectomy: A Survey of Current UK Practice.

Introduction: Because of the lack of published evidence, this study was done to explore the decisions and rationale of uro-oncology consultants regarding the treatment of patients with muscle-invasive bladder cancer who have positive lymph nodes after radical cystectomy (RC) and neoadjuvant chemotherapy (NAC).

Materials And Methods: An electronic survey was sent to UK pelvic cancer centers regarding: (1) choice of NAC regimen; (2) indications for reimaging; (3) choice and indication of adjuvant chemotherapy (AC) for patients with nodal disease after NAC and RC; (4) choice and indication of chemotherapy regimen if disease continues to progress in patients with advanced bladder cancer; and (5) guidelines used by those surveyed.

Results: Consultant uro-oncologists from 77% of UK pelvic cancer centers responded, who treated a median of 13 patients per year with NAC before RC.

A rare aetiology for increased drain output following a robotic-assisted prostatectomy.

Robotic prostatectomies are being performed increasingly, with greater visualisation and improved precision, resulting in fewer postoperative complications. Despite advances in surgical techniques, drain output still remains one of the first signs of potential complications. We present the case of an iatrogenic cause for high drain output postoperatively, in order to highlight the potential problems of the drain itself.

Unrecognized bladder perforation with mid-urethral slings.

Objective: To present a series of women with late presentation of mid-urethral synthetic slings perforating the bladder and their management, this is rare but can lead to significant morbidity with medico-legal consequences.

Patients And Methods: We retrospectively reviewed the case notes of nine women with urinary symptoms referred to our unit for further investigation after synthetic mid-urethral sling placement.

Results: The women presented between 8 weeks and 18 months after initial sling placement.

Successful use of steroids and ureteric stents in 24 patients with idiopathic retroperitoneal fibrosis: a retrospective study.

Background/aims: Retroperitoneal fibrosis (RPF) is a chronic inflammatory disorder causing obstructive nephropathy and renal failure. We reviewed our management of this condition.

Method: All patients with RPF treated at a single center over a 15-year period were identified.

Novel method for open-access laparoscopic port insertion using the killian nasal speculum: the lister technique.

Safe insertion of the first port during laparoscopic surgery has always been problematic, from the early use of the Veress needle to the open Hasson technique. We describe a novel, safe, and well-illuminated technique of port entry using the Killian nasal speculum. This technique has been used successfully in transperitoneal laparoscopic nephrectomy as well as extraperitoneal radical prostatectomy in our department.

Complications of vasectomy.

Introduction: Vasectomy is a common method of sterilisation. However, it is less popular than tubal ligation world-wide. It is also a frequent cause of litigation relating to its complications.