Up-front dissection of the uterovesical space or "bladder-first approach" reduces hemorrhage and bladder injury during hysterectomy for placenta accreta spectrum: reconfirmed in 78 more cases in a prospective single-center study.

Background: Cesarean hysterectomy for placenta accreta spectrum disorder may be associated with severe hemorrhage because of placental invasion of the myometrium and the uterovesical space or parametrium. It leads to serious complications, such as massive hemorrhage requiring massive transfusion, coagulopathy, bladder and ureteric injuries, need for intensive care unit admission and prolonged hospital stay. To reduce the complications of cesarean hysterectomy for placenta accreta spectrum disorder, ongoing efforts are being made to develop different surgical approaches.

Indian consensus statements on the management of small renal masses, non-muscle invasive bladder cancer and high-risk/locally advanced prostate cancer.

No pan-India-specific guidelines exist for the management of urological cancers. Although western guidelines are useful for informing management strategies, they do not account for the nuances of management in the Indian context. A modified Delphi method was used to provide a framework for the systematic development of India-centric guidelines for the management of three uro-oncology disease states: small renal masses, non-muscle invasive bladder cancer and high-risk/locally advanced prostate cancer.

Adjuvant Radiotherapy in Bladder Cancers: A Dosimetric Study Focusing on Ileal Conduit Sparing.

Purpose: To compare ileal conduit (IC) and other organ at risk (OAR) dosimetry between treatment techniques in a prospective cohort of patients planned for adjuvant radiotherapy (RT) after radical cystectomy and IC reconstruction.

Methods And Materials: Computed tomography (CT datasets of twenty patients who underwent adjuvant RT were obtained and used prospectively for delineation of target volumes (primary and nodal) and OARs, including IC, uretero-ileal anastomosis and ileal stoma using a specified protocol for simulation including a delayed CT to identify IC. Three RT plans were generated for each patient for a dose of 54 gray (Gy) in 27 fractions (PTV V95% >95%): 3-dimensional conformal radiotherapy (3DCRT) with (3DCRT_S) and without (3DCRT_N) stoma shielding, and volumetric modulated arc therapy (VMAT), with OAR constraints specified for VMAT plans (IC: Dmax<54Gy, V50Gy < 20 cc).