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Prognostic factors for survival after recurrent MIBC are unknown and were evaluated using a population-based series of 1409 MIBC patients. 330 Patients who underwent RC or RT with curative intent and who suffered from recurrence were selected. Multivariable survival analyses were performed. Clinicopathological factors that predict survival after recurrence are recurrence location, treatment for recurrence and age at recurrence diagnosis.

An unusual case is presented of a renal transplant recipient on immunosuppressive medication who underwent orchiectomy for a testicular seminoma. Since the surgical resection plane showed seminoma cells, radiotherapy was applied to the para-aortic and inguinal regions. Tumor recurred in the bladder 3 years later as demonstrated by urine cytology and later by bladder biopsies. After chemotherapy, repeated bladder biopsies were normal and a complete remission was achieved. The possible metastatic pathways are discussed. Accepted for publication January 17, 1992.

A case is presented of a healthy young man who had Fournier’s gangrene after standard bilateral vasectomy. Despite maximal treatment, including extensive necrectomy and broad-spectrum antibiotics, this complication was lethal. To our knowledge a lethal complication of vasectomy has not been reported in the literature.