Pneumovesicum method in en-Bloc laparoscopic nephroureterectomy with bladder cuff resection for upper-tract urothelial cancer.

Background And Purpose: A novel technique for managing the distal ureter and bladder cuff during laparoscopic nephroureterectomy is introduced.

Technique: The procedure consists of three steps: (1) cystoscopy and PediPort (Tyco) insertion; (2) establishment of pneumovesicum and intramural ureter mobilization; and (3) laparoscopic nephroureterectomy. The use of PediPorts, a 5-mm lens, and Ski needles greatly facilitates the pneumovesicum.

Breast metastasis from prostate cancer and interpretation of immunoreactivity to prostate-specific antigen.

A case of prostate cancer metastasized to the breast is presented, the latter being prostate-specific antigen (PSA) positive. This is the first of such cases reported in Hong Kong and China in the English literature. As PSA expression also can be found in primary breast cancer, prostatic acid phosphatase staining was employed to confirm the diagnosis.

Twelve-year follow up of a randomized prospective trial comparing bacillus Calmette-Guerin and epirubicin as adjuvant therapy in superficial bladder cancer.

Aim: To compare bacillus Calmette-Guerin (BCG) with epirubicin in adjuvant therapy of superficial bladder transitional cell carcinoma, with respect to recurrence, progression and survival. Prognostic factors are also evaluated.

Methods: Between October 1991 and September 1999, all patients harboring superficial bladder cancers (Ta or T1) with any of the relevant criteria (stage>a, grade>1, size>1 cm, multiple or recurrent tumors), after complete transurethral resection were randomized to receive either 81 mg Connaught strain BCG or 50 mg epirubicin.

Is surveillance necessary for inverted papilloma in the urinary bladder and urethra?

Background: A case series of inverted papilloma of the urinary bladder and urethra is presented, together with a review of the literature with respect to multiplicity, recurrence rate and association with transitional cell carcinoma, and a discussion on surveillance of the lesion.

Methods: Cases of inverted papilloma of the lower urinary tract in a single centre were reviewed. Patient and tumour characteristics, recurrence and associated transitional cell carcinoma are reported.

Carcinosarcoma of the bladder diverticulum and a review of the literature.

We report a carcinosarcoma within a bladder diverticulum together with a review of 18 previously reported cases of intradiverticular sarcomas and carcinosarcomas with respect to their clinical features, treatments and outcomes. Frequent deaths with intra-abdominal recurrences suggest the need for total cystectomy, rather than diverticulectomy.

Can normal saline be used to fill the balloon of a Foley catheter? The experience of a prospective randomized study in China.

Background: Despite the lack of evidence, using normal saline for inflating the balloon of a Foley urethral catheter is frequently regarded as a cause for deflation failure. We have investigated the issue by comparing the rate of deflation failure of Foley catheter balloon, using either sterile water or normal saline as the filling solution.

Methods: Four thousand latex Foley urethral catheters (14 Fr) were randomly assigned to one of two groups: sterile water or normal saline.

A rare cause of acute urinary retention: urethral metastasis from renal cell carcinoma.

Metastatic renal cell carcinoma in the urethra is exceedingly rare, with only three cases of metachronous metastases previously reported. We report a 78-year-old man with acute urinary retention secondary to urethral metastasis presented as the first clinical manifestation. Subsequent investigation confirmed a primary in the right kidney.

15-year experience on intravesical therapy of T1G3 urinary bladder cancer: a conservative approach.

Objective: To report the recurrence, progression and survival in patients with T1G3 transitional cell carcinoma (TCC) of the urinary bladder treated with sequential intravesical bacillus Calmette-Guérin (BCG) and chemotherapeutic agents (doxorubicin or epirubicin) on long-term follow up.

Methods: Between July 1988 and September 1999, all patients in a single center with T1G3 bladder TCC, after complete transurethral resection (TURBT), received either 81 mg of Connaught strain BCG or 50 mg of doxorubicin or epirubicin as adjuvant therapy. A conservative approach was adopted whereby those with superficial recurrences were eligible to crossover, even repeatedly, until progression to muscle invasion.