Pneumovesicum approach to en-bloc laparoscopic nephroureterectomy with bladder cuff excision for upper tract urothelial cancer: midterm oncological results.

Introduction: We reported the pneumovesicum (PV) approach to lower ureter and bladder cuff excision and closure. We believe that this approach bears the closest resemblance to the laparoscopic skill set of intravesical dissection and suturing. Herein, we report the midterm oncological results of the approach's use in a series of patients with upper tract urothelial cancer.

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.

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.

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.