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Henry H Woo,1 Declan G Murphy,2,3 Gerard M Testa,4 Jeremy P Grummet,5 Michael Chong,6 Andrew P Stork7 1Sydney Adventist Hospital Clinical School, University of Sydney, Wahroonga, NSW, 2Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, 3Australian Prostate Cancer Research Centre, Epworth Healthcare, Richmond, VIC, 4Shire Urology, Miranda, NSW, 5Australian Urology Associates, Malvern, VIC, 6Department of Urology, Repatriation General Hospital, Daw Park, SA, 7Ipsen Pty Ltd, Glen Waverley, VIC, Australia Purpose: Prostate cancer is often comorbidly associated with lower urinary tract symptoms (LUTS), but few studies have assessed the effects of androgen deprivation therapy on LUTS in this patient group.Patients and methods: We conducted a prospective, noninterventional, multicenter, observational study to assess the effectiveness of triptorelin (11.25mg every 12weeks) over 48weeks in men presenting with local stage T3/4 prostate cancer and moderate to severe LUTS (International Prostate Symptom Score [IPSS] >7) in a routine practice setting in Australia.Results: Of the 44 men who enrolled, effectiveness data were available for 39 men. By the end of the study, 30% of men no longer met the IPSS criteria for moderate to severe LUTS. The proportion of patients with moderate to severe LUTS was 69.6% (16/23) at week 48 and 76.9% (30/39) at the last available visit (coprimary outcomes). An IPSS reduction of ≥3 from week 0 was observed in 47% of men at week 4, 56% at week 24, 61% (14/23) at week 48, and 61.5% (24/39) at the last available visit. Quality of life was rated as mostly satisfied-to-delighted by 39.5% of patients at week 0, 53.9% at week 24, and 77.3% at week 48. Triptorelin was well tolerated with 8 treatment-related adverse events reported, half of which were hot flushes; 5patients discontinued due to the reported treatment-related adverse events.Conclusion: This observational study suggests that triptorelin improves moderate to severe LUTS in prostate cancer patients in a routine clinical practice setting. Keywords: GnRH agonist, IPSS

Gallstone spillage is recognised as a possible complication of laparoscopic cholecystectomy and there are countless examples of untoward short and long term sequelae resulting from their non-retrieval. We present the case of a 65-year-old gentleman with sterile pyuria and lower midline abdominal mass which proved to be a complex gallstone inflammatory mass related to the dome of the bladder. This patient’s investigative course was exhaustive and the definitive diagnosis not achieved until histopathological assessment of the intraoperative specimen. The diagnosis of these lower abdominal wall masses can be difficult, particularly with complex lesions.