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INTRODUCTION AND OBJECTIVE:Prostate cancer (PCa) is the most common male cancer. Most patients treated with androgen deprivation therapy progress to castration-resistant PCa. To overcome the limita...

INTRODUCTION AND OBJECTIVES:Post-prostatectomy erectile dysfunction (ED) is the major problem for patients with prostate cancer. Recently, tissue-engineering approach has been attempted for post-pr...

NGF and PGs in the bladder can be affected by pathological changes in the bladder and these changes can be detected in urine. We investigated changes in urinary NGF and PGs in women with OAB.The study groups included 65 women with OAB and 20 without bladder symptoms who served as controls. Evaluation included patient history, urinalysis, a voiding diary and urodynamic studies. Urine samples were collected. NGF, PGE2, PGF2alpha and PGI2 were measured using enzyme-linked immunosorbent assay and compared between the groups. In addition, correlations between urinary NGF and PG, and urodynamic parameters in patients with OAB were examined.Urinary NGF, PGE2 and PGF2alpha were significantly increased in patients with OAB compared with controls (p0.05). However, urinary PGI2 was not different between controls and patients with OAB. In patients with OAB urinary PGE2 positively correlated with volume at first desire to void and maximum cystometric capacity (p0.05). Urinary NGF, PGF2alpha and PGI2 did not correlate with urodynamic parameters in patients with OAB.NGF and PGs have important roles in the development of OAB symptoms in female patients. Urinary levels of these factors may be used as markers to evaluate OAB symptoms.

significant linkage. In contrast, O-IPSS showed a negative association (r1⁄4-0.3, p

of the PC away from normal renal parenchyma) is classically used for familial Renal Cell Carcinoma (RCC) but has not been widely adopted for sporadic RCC. We investigate whether tumor histology predicts the presence, thickness, and extension of tumor through the PC, potentially identifying tumors best suited for a TE nephron-sparing approach. METHODS: Twenty-five consecutive total or partial nephrectomies for pT1 clear cell, papillary, chromophobe, and oncocytoma were included (N 100 total tumors). Specimens were reviewed for numerous pathological features including stage, grade, lympho-vascular invasion, as well as characteristics of PC such as capsular presence/ absence, mean thickness, continuity, and tumor capsule invasion (TCI). PC parameters (thinnest, thickest and mean) were calculated from multiple measurements using an ocular micrometer, rounded to the nearest tenth of a millimeter. RESULTS: Tumor sizes in each group were similar. PC was complete in: papillary (n 21, 84%), clear cell (n 19, 76%), chromophobe (n 7, 28%), and oncocytoma (n 1, 4%); present but incomplete in oncocytoma (n 14, 56%), chromophobe (n 11, 44%), clear cell (n 6, 24%), and papillary (n 2, 8%); and absent in oncocytoma (n 10, 40%), chromophobe (n 7, 28%), papillary(n 2, 8%), and clear cell (0%). TCI was seen in 30% of papillary and only 8% of clear cell (p-value 0.006) PC. When present, mean thickness of the PC was significantly thicker for clear cell (0.8mm) when compared to the other tumors (papillary and chromophobe 0.6mm and oncocytoma 0.3mm). Multivariate logistic regression demonstrated only tumor type to be significantly associated with TCI (p-value 0.046, OR 10.3 (95%CI)). CONCLUSIONS: In pT1 renal tumors, PC appears predictable based on tumor histology. The PC is likely to be absent or incomplete in renal oncocytoma and chromophobe. Papillary RCC demonstrates the highest % of TCI which could predict higher surgical margin rates during TE surgery. Clear cell RCC possesses the thickest, most complete tumor capsule with minimal TCI and may be best suited for TE partial nephrectomy.

Introduction and Objectives LESS has slowly adopted its role in current urological practice. The objective of our study is to confirm the efficacy and safety of laparoendoscopic single-site surgery (LESS) compared to conventional laparoscopic surgery for upper urinary tract stones Methods Patients with UPJ stones with maximum diameter over 1.5cm and concomitant hydroureteronephrosis within recent 1 year were included. The surgery was done by two experienced laparoscopic surgeons. The patients were randomly assigned into two groups as conventional laparoscopy group and LESS group. 10 patients were included in each group. Surgical methods were all the same except for the number of incision. OctoportTM was used in the LESS group. We approached the area of interest transperitoneally with medial traction of the colon. An incision was then made at the Ureteropelvic junction to gain access to the stones. We used the flexible ureteroscope to remove the remaining calyceal stones after the main UPJ stone has been removed. Intraoperative ureteral stents were inserted antegradely. Mann-Whitney U-test and chi-square test were used to compare factors of patients, stones, and surgery between the two groups. Results There was no difference between the two groups in preoperative factors. There was no difference in operative time, estimated intraoperative blood loss, duration of indwelling urethral catheter, length of hospital stay, postoperative pain scores before discharge and change in renal function. There was no difference in analgesic use and complication rates. According to Clavien classification, there were two cases of IIIa at CL group, and there was no case of more than IIIa at LESS group. There was no conversion to open surgery at both groups. The incidence of residual stones which were found in CT 1 month after surgery was 40% at both group, but the size of all stones was 4mm or less. Conclusions LESS showed the equivalent effectiveness and safety compared to CL surgery for the treatment of upper urinary tract stones.

bypass and hypothermic circulatory arrest(CA) from December 2007. No patients pre-treated with systemic therapy. Indication: curative intent(n 11), cytoreductive(n 10). In 9 thrombus was asymptomatic; 7 leg swelling; 2 Budd-Chiari syndrome; 2 pulmonary emboli; 1 heart failure. RESULTS: Median age 69 years(50-78). Median ECOG performance status(PS) 3. Median operation time 300 mins; blood loss 3000mls; CA time 23mins. 4 reoperations for bleeding and 1 for gastric perforation. 3 in-hospital deaths(all 70yrs). 6 prolonged ITU stays( 72hrs). Median tumour size 110mms (50-230mm). Histology: 16 clear cell carcinoma, 2 papillary, 1 neuroendocrine, 1 carcinosarcoma and 1 leiomyosarcoma. Median Fuhrman grade 3. 1 patient lost to follow-up. Curative intent: 1 year survival 71% . 1 in-hospital death. 8 developed metastasis. 3 patients received TKI’s. Ineligibility for TKI: histology 2; poor PS 2; observation 1. Cytoreductive intent: 1 year survival 30%; 2 in-hospital deaths; 1 underwent resection of metastasis and TKI; 4 received TKIs alone; 3 Poor PS precluded TKIs. CONCLUSIONS: Perioperative morbidity and mortality is considerable however survival at 1 year with curative intent is 71%. Results in the elderly and cytoreductive settings are less satisfactory. The main determinant of whether a patient receives a TKI appears to be performance status and histology, not whether the surgery was performed with curative or cytoreductive intent.

pulmonary metastasis received neoadjuvant chemotherapy (Vincristine, Dactinomycin, and Cyclophosphamide). Pathologic stage was: I-25 (49%), II-8 (15.7%), III-7 (13.7%), IV-9 (17.6%), and V-2 (4%). Renal capsule invasion in 13 and lymphovascular invasion in 4 were observed, but adrenal invasion was not identified in all nephrectomy specimens. Complete resection rate was 80% and adjuvant chemotherapy was performed following radical nephrectomy in all 51 patients. CONCLUSIONS: Adrenal involvement is not likely in patients with Wilms’ tumor, and adrenalectomy is unnecessary in all cases eventually. These results suggest that unconditional ipsilateral adrenalectomy during radical nephrectomy for the treatment of Wilms’ tumor could be avoided.

INTRODUCTION AND OBJECTIVES: Although surgical resection is the current standard of treatment for localized renal cell carcinoma (RCC), active surveillance remains an option in selected patients with comorbidities or limited life expectancy. The aim of this study is to identify the predictors of other cause related death in patients with localized RCC. METHODS: We identified 1,101 patients with pathologically confirmed T1 or T2 RCC with follow up duration over 6 months. Survival according to the cause of death was evaluated using the Kaplan-Meier analysis with log-rank test. Prognostic factors for non-cancer related death were assessed by multivariate analysis using the Cox proportional hazard regression model. Once the prognostic factors were identified, a risk-group variable was created by counting the number of unfavorable features presented for each patient. RESULTS: Median follow-up was 62 month, and RCC related death was occurred in 50 patients (4.5%) while death from other cause occurred in 47 (4.3%). Patients died from other cause had higher ASA score (2.4 vs. 1.7, p 0.032), older age (63.4 vs. 55.0 years, p 0.001), smaller mass size (5.1 vs. 7.9cm, p 0.001), and lower nuclear grade (2.2 vs. 2.9, p 0.0160). On multivariate Cox regression analysis, older age, higher ASA score, and lower BMI were independent factors to predict other cause related death in patients with localized RCC (Table). Based on the number of risk factors for other cause related death, 5-year other cause specific survival was 98.3% (0 risk factor), 84.7% (1 risk factor), and 67.6% (2 or 3 risk factors), respectively (Figure, p 0.001). CONCLUSIONS: Older age, higher ASA score, and lower BMI were independent predictors of other cause related death in patients with localized RCC. Source of Funding: None