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To assess the long-term complications, pain status, sexual function and quality of life after cystectomy for bladder pain syndrome (BPS). We retrospectively reviewed functional variables for 35 patients (34 women/1 man, 67 ± 9 years old) who underwent cystectomy due to BPS since 1993 in our department. Cystectomy was offered to patients with BPS refractory to conservative treatments. Six cystectomies with ileal conduit (17.1%) and 29 supratrigonal cystectomies with enterocystoplasty (82.9%) were performed. Prospectively, patients completed questionnaires on pain [BPIC-SS, visual analogue scale (VAS) for pain], health-related quality of life (EQ-5D) and sexual function (FSFI; 2–36), rated satisfaction with surgery (0–10) and reported whether they would undergo the same surgery again. Mean follow-up was 107 ± 83 months. In two (5.7%) patients, pain persisted and in one patient (2.8%) pain recurred after 20 months. Significant improvements in daytime and nighttime frequency and bladder capacity were observed postoperatively. 21 patients completed questionnaires. Mean BPIC-SS was 7.5 ± 8.4, mean VAS score 2.5 ± 2.8. 14 (66.7%) patients reported no problems related to pain on the EQ-5D, similar to our regional reference population. 13 (61.9%) patients had sexual intercourse after surgery, ten of them without pain. Mean FSFI score was 9.5 ± 9. Satisfaction with surgery was 8.8 ± 1.7 and 20 (95.2%) patients would undergo the same surgery again. Pain persistence or recurrence after cystectomy for BPS is infrequent. Quality of life related to pain is similar to that in the general population and patients can resume sexual activity without pain.

Context The guidelines of the European Association of Urology (EAU), the First International Consultation on Bladder Tumors (FICBT), the National Comprehensive Cancer Network (NCCN), and the American Urological Association (AUA) all provide an excellent evidence-based background for the management of non-muscle invasive bladder cancer (NMIBC). Although there are areas of consensus among the four guidelines, their recommendations vary with respect to important issues surrounding NMIBC. Objective To provide community urologists with practical and unified guidance on the management of NMIBC through a comprehensive review of current influencing guidelines. Evidence acquisition A committee of internationally renowned leaders in bladder cancer management, known as the International Bladder Cancer Group (IBCG), was convened in October 2006 to review current literature surrounding the management of NMIBC as well as the current clinical practice guidelines of the EAU, the FICBT, the NCCN and the AUA. Following the inaugural meeting in October 2006, the IBCG met on three subsequent occasions (March 2007, September 2007, and March 2008) to critically analyze and compare the EAU, FICBT, NCCN, and AUA guidelines. Evidence synthesis The IBCG critically analyzed and summarized the EAU, FICBT, NCCN, and AUA guidelines and identified the key similarities and differences in their recommendations. Conclusions Established areas of consensus among the four guidelines include the importance of transurethral resection of the bladder tumour (TURBT) and an immediate, postoperative dose of chemotherapy (agent optional) in all patients with NMIBC, as well as the benefit of adjuvant bacillus Calmette-Guerin (BCG) therapy in high-risk disease. However, the four guideline recommendations vary with regard to the following important issues: (1) the definitions of low-, intermediate-, and high-risk disease, and (2) the appropriate management and follow-up of patients in each of these risk categories. Furthermore, there is currently no consensus on the definition and appropriate management strategies for primary intravesical treatment failures among the four guidelines.

Context Understanding the epidemiology and risk factors for non–muscle invasive bladder cancer (NMIBC) can assist in the prevention and early detection of the disease. Furthermore, staging, grading, and risk stratification are critical for determining the most appropriate management strategies for NMIBC based on risk of recurrence and progression. Objective To provide community urologists with an overview of the epidemiology of NMIBC as well as current approaches to staging, grading, and risk stratification. Evidence acquisition A committee of internationally renowned leaders in bladder cancer management, known as the International Bladder Cancer Group (IBCG), identified current key influencing guidelines and published English-language literature related to the epidemiology, staging, and grading of NMIBC available as of March 2008. The IBCG met on four occasions to review the main findings of the identified literature and the current clinical practice guidelines of the European Association of Urology (EAU), the First International Consultation on Bladder Tumors (FICBT), the National Comprehensive Cancer Network (NCCN), and the American Urological Association (AUA). Evidence synthesis Based on this review, the IBCG provided a summary on the epidemiology of NMIBC and recommendations for the staging, grading, and risk stratification of the disease. Conclusions Urologists should record the smoking habits of patients and monitor for possible occupational exposure to urothelial carcinogens. The tumour-node-metastases (TNM) classification for tumour staging and both the World Health Organization (WHO) 1973 and 2004 grading systems should be applied for appropriate staging and grading of NMIBC. Urologists should also consider the use of the European Organisation for Research and Treatment of Cancer (EORTC) risk tables for risk stratification of NMIBC based on risk of disease recurrence and progression.

This supplement provides a summary of the contributions made by urology experts in prostate cancer (PCa) at the Orion Pharma satellite symposium held during the 25th Annual Congress of the European Association of Urology in Barcelona, Spain. The symposium was chaired by Professor Joan Palou, Chief of Urology Oncology for the Department of Urology at Fundacio Puigvert, Barcelona, Spain. Speakers included Professor Francois Desgrandchamps of the Department of Urology at Saint-Louis Hospital, Paris, France; Dr. Neal Shore of the Carolina Urologic Research Center/Atlantic Urology Clinics, Myrtle Beach, South Carolina, USA; and Professor Bertrand Tombal of Cliniques universitaires Saint-Luc, Brussels, Belgium. Androgen-deprivation therapy (ADT) is a recommended palliative treatment for advanced andmetastatic PCa and an adjuvant therapy in patients receiving radiotherapy (RT) [1]. Over the years, long-acting luteinising hormonereleasing hormone (LHRH) agonists have become the mainstay for ADT because they avoid the physical and psychological discomfort associatedwith orchidectomy and lack the potential cardiotoxicity associated with oestrogens such as diethylstilboestrol [1]. To date, themajority of LHRH agonists have only been available as short-term depot injections; therefore, patients receiving long-term LHRH therapy have required multiple injections per year. Histrelin acetate is the first long-acting LHRH agonist to be made available as a once-yearly subcutaneous implant (Vantas; Endo Pharmaceuticals, Chadds Ford, PA, USA). Professor Desgrandchamps presented the changing role of hormonal therapy (HT) and the types of patients most likely to benefit from long-term treatment with LHRH agonists such as Vantas. He analysed immediate versus deferred treatment, risk factors of progression such as high prostate-specific antigen (PSA) level and/or short PSA doubling time, HT in patients with positive lymph nodes at radical prostatectomy, and ADT as adjuvant therapy to RT.