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Residual nonvisible bladder cancer after proper treatment caused by technological and therapeutic limitations is responsible for tumor relapse and progression. This study aimed to demonstrate the feasibility of a solution for simultaneous detection and treatment of bladder cancer lesions smaller than one millimeter. The α5β1 integrin was identified as a specific marker in 81% of human high-grade nonmuscle invasive bladder cancers and used as a target for the delivery of targeted gold nanorods (GNRs). In a preclinical model of orthotopic bladder cancer expressing the α5β1 integrin, the photoacoustic imaging of targeted GNRs visualized lesions smaller than one millimeter, and their irradiation with continuous laser was used to induce GNR-assisted hyperthermia. Necrosis of the tumor mass, improved survival, and computational modeling were applied to demonstrate the efficacy and safety of this solution. Our study highlights the potential of the GNR-assisted theranostic strategy as a complementary solution in clinical practice to reduce the risk of nonvisible residual bladder cancer after current treatment. Further validation through clinical studies will support the findings of the present study. [ABSTRACT FROM AUTHOR]

Purpose: The primary outcome of this study is to compare the success rates of ONB techniques performed either with ultrasound guidance or with the blind technique. The second outcome is to compare the incidences of perioperative bleeding and the presence of recurrent tumors in the control cystoscopy performed in the 3rd postoperative month in both groups. Materials and Methods: The study was conducted in the urology operating room of Mugla Sitki Kocman Training and Research Hospital between December 2019 and March 2023. A total of 122 patients were included in the study: 22 females with a mean age of 56.63 ± 12.99 years and 100 males with a mean age of 63.18 ± 8.00 years. In one group (group 1), ONB was performed under ultrasound guidance by the same anesthesiologist, and in another group (group 2), ONB was performed blindly based on anatomical signs by the same urologist. Results: Adductor muscle contraction was not observed in 53 patients (91.4%) in group 1 and in 49 patients (76.6%) in group 2 (p = 0.027). Conclusion: The success rate of ONB was higher when using an ultrasound-guided technique than when using a blind technique. [ABSTRACT FROM AUTHOR]

Abstract Background To investigate the survival outcome of “radical” GreenLight photoselective vaporization of bladder tumor (RPVBT) in conjunction with postoperative chemotherapy for patients with single,

Abstract Background Sarcomatoid urothelial carcinoma (SUC) is a rare and highly malignant form of bladder cancer with a poor prognosis. Currently, there is limited information on the imaging features of bladder SUC and reliable indicators for distinguishing it from conventional urothelial carcinoma (CUC). The objective of our study was to identify the unique imaging characteristics of bladder SUC and determine factors that aid in its differential diagnosis. Materials and methods This retrospective study enrolled 22 participants with bladder SUC and 61 participants with CUC. The clinical, pathologic, and CT/MRI data from both groups were recorded, and a comparison was conducted using univariate analysis and multinomial logistic regression for distinguishing SUC from CUC. Results The majority of SUCs were located in the trigone of the bladder and exhibited large tumor size, irregular shape, low ADC values, Vesical Imaging-Reporting and Data System (VI-RADS) score ≥ 4, the presence of necrosis, and an invasive nature. Univariate analysis revealed significant differences in terms of tumor location, shape, the maximum long-axis diameter (LAD), the short-axis diameter (SAD), ADC-value, VI-RADS scores, necrosis, extravesical extension (EVE), pelvic peritoneal spread (PPS), and hydronephrosis/ureteral effusion (p

Bladder cancer (BC) ranks as the tenth most common cancer globally. Histopathologically, BC is broadly categorized into urothelial and non-urothelial BC. Urothelial carcinoma represents over 90% of BC in most regions worldwide. The standard treatment procedure for diagnosing and treating non-muscle-invasive bladder cancer (NMIBC) is transurethral resection of bladder tumors (TURBT). Currently, the standard of care for muscle-invasive bladder cancer (MIBC) is neoadjuvant chemotherapy followed by radical cystectomy. Cryoablation therapy is a medical technique that uses extremely low temperatures to destroy diseased tissue. This treatment serves as a therapeutic tool for both benign and malignant diseases in organs such as the kidney, prostate gland, lung, liver, and breast, and is particularly effective for unresectable tumors, offering less trauma, quick recovery, good tolerability, and symptom control. However, cryoablation has its limitations. Over the past few years, cryoablation therapy has emerged as a new method for treating early BC. This treatment is minimally invasive, precise, and offers quick recovery, providing patients with a new treatment option. Although randomized studies are still limited, increasing evidence suggests its potential application in bladder cancer combined with transurethral resection (TURBT) or medication. Cryoablation is not standard therapy for bladder cancer. Treatment decisions should be discussed by a multidisciplinary team of urologists, oncologists, and interventional physicians and require more randomized controlled trials to define patient selection criteria and treatment approaches.

Introduction A previous report has shown that cyclooxygenase‐2 inhibitors can prevent the recurrence of cystitis glandularis postoperatively. Herein, we present a case of cystitis glandularis in which the tumor volume was markedly reduced by preoperative oral administration of a cyclooxygenase‐2 inhibitor. Case presentation A 45‐year‐old man with voiding difficulty and lower abdominal pain during urination was referred to our hospital. Cystoscopy revealed multiple cystitis glandularis‐like edematous masses on the trigone and the neck of the bladder, completely involving the bilateral ureteral orifices. Cyclooxygenase‐2 inhibitor was orally administered at the patient's request. Six weeks later, the tumor volume was markedly reduced, bilateral ureteral orifices were identified, and the voiding difficulty and pain on urination disappeared. Complete transurethral resection of the residual tumor was performed, and the pathological diagnosis was intestinal‐type cystitis glandularis. Conclusion Cyclooxygenase‐2 inhibition can be considered a useful therapeutic strategy for cystitis glandularis.

Background: To investigate the survival outcome of "radical" GreenLight photoselective vaporization of bladder tumor (RPVBT) in conjunction with postoperative chemotherapy for patients with single, < 3 cm in diameter, T2 stage muscle invasive bladder cancer (MIBC). Methods: Thirty-eight patients with single, < 3 cm, T2 stage bladder cancer were treated with RPVBT combined with chemotherapy and were included in the RPVBT group. To compare the differences in survival outcome, 80 patients with Ta/T1 bladder cancer and 30 patients with T2 bladder cancer were included as controls. The 80 patients with Ta/T1 bladder cancer underwent GreenLight photoselective vaporization of bladder tumors(PVBT), while 30 patients with T2 bladder cancer underwent radical cystectomy (RC) combined with pelvic lymph node dissection (PLND). Tumor recurrence and death were recorded, and recurrence-free survival (RFS) and overall survival (OS) curves were plotted to compare the survival difference between the RPVBT and control groups. Results: No significant differences were observed in comorbidities or living habits between the RPVBT and control groups. Blood loss [RPVBT: 20 (IQR10, 20) vs. RC: 100 (IQR90, 150) mL] and postoperative hospital stay [RPVBT: 5.5 (IQR5, 6), vs. RC: 10 (IQR8, 12) days] in the RPVBT group were significantly lower than that in the RC group. Urinary tract infection [RPVBT: 6 (15.8%) vs. PVBT: 14 (17.5%)] and bladder irritation sign [RPVBT: 11 (28.9%) vs. PVBT: 23 (28.8%) ] were the most common short-term complications in the RPVBT group, with no statistical difference between the RPVBT and PVBT group. The median follow-up time for survival endpoints was 22 (16, 27) months for the included patients after surgery. The outcomes of tumor recurrence at 12, 24, and 36 months were 2 (5.3%), 3 (7.9%), and 5 (13.2%) patients in the RPVBT groups, 13 (16.3%) and 3 (10%) patients experienced recurrence in the PVBT and RC groups at 36 months. No significant differences were noted among the three groups (P = 0.778). Additionally, Kaplan–Meier survival analysis revealed no statistically significant differences in RFS (P = 0.791) and OS (P = 0.689) among the three groups. Conclusions: Our findings indicate that RPVBT combined with chemotherapy is a simple and feasible treatment option with fewer complications and satisfactory survival outcomes in patients with single, < 3 cm, T2 stage bladder cancer. [ABSTRACT FROM AUTHOR]

Objective: To improve the understanding, diagnosis and treatment of bladder large cell neuroendocrine carcinoma (LCNEC). Methods: A clinical case of bladder LCNEC admitted to our hospital was reported. The epidemiology, prognosis, diagnosis and treatment methods of large cell neuroendocrine carcinoma were reviewed. The diagnosis and treatment status and prognosis were discussed based on the literature. Results: The female patient was admitted to hospital for "more than 4 years after TURBT and intermittent hematuria for more than 2 years". She was diagnosed as recurrent bladder cancer and underwent "radical cystotomy + hysterectomy". The postoperative pathological findings were high-grade urothelial carcinoma of the bladder neck and large cell neuroendocrine carcinoma of the bladder. The patient recovered well after surgery, but refused radiotherapy and chemotherapy and is still under close follow-up. Conclusion: Bladder LCNEC is clinically rare, has unique pathological features, is more aggressive than traditional urothelial carcinoma, and has a poor prognosis. Surgery, chemotherapy and radiotherapy should be combined with multimode treatment. [ABSTRACT FROM AUTHOR]

Background: Rhabdomyosarcoma of the bladder is an infrequent neoplastic condition characterized by a pronounced malignant situation with challenges in treatment due to the lack of standardized guidelines and large-scale of clinical studies. The patient in this case is tested TP53 mutation that may provide new diagnostic and therapeutic options. Case presentation: Here, we reported a 34-year-old male who received bladder tumor resection, and diagnosed as bladder rhabdomyosarcoma with TP53 mutation after the pathology test. This patient underwent 6 rounds of chemotherapy. However, the pelvic tumor recurred 11 months after the first surgery. So, the patient accepted the pelvic tumor resection. Only 3 months after the surgical intervention, the patient underwent abdominal massive metastasis and ultimately succumbed to the illness six months following the second surgery. The course of the illness was 22 months. Conclusion: Bladder rhabdomyosarcoma is a disease with an extremely poor prognosis. Genetic testing holds significant value in the diagnosis and treatment. Perhaps targeted therapy against TP53 is potential valuable for such rare diseases. [ABSTRACT FROM AUTHOR]

Background: A second look trans-urethral resection of the bladder (re-TUR) is recommended after the diagnosis of T1 high grade (T1HG) bladder cancer. Few studies have evaluated the results of re-TUR after a first en bloc resection (EBR) and none of them have specifically reported the pathological results on the field of previous T1 disease. Objective: To report the rate of upstaging and the rate of residual disease (RD) on the field of T1HG lesions resected with EBR. Materials and methods: Between 01/2014 and 06/2022, patients from 2 centers who had a re-TUR after an EBR for T1HG urothelial carcinoma were retrospectively included. Primary endpoint was the rate of RD including the rate of upstaging to T2 disease on the scar of the primary resection. Secondary endpoints were the rate of any residual disease outside the field. Results: Seventy-five patients were included. No muscle invasive bladder cancer lesions were found after re-TUR. Among the 16 patients who had a RD, 4 were on the resection scar. All of these lesions were papillary and high grade. RD outside the field of the first EBR was observed in 12 patients. Conclusion: After EBR of T1HG disease, none of our patients had an upstaging to MIBC. However, the rate of RD either on and outside the field of the EBR remains quite significant. We suggested that predictive factors of residual papillary disease (number of tumors at the initial TUR and concomitant CIS) might be suitable to select patient who will benefit of the re-TUR. [ABSTRACT FROM AUTHOR]

The objective of this study was to describe the clinical spectrum of primary localized bladder amyloidosis (PLBA), its management options, outcomes, and follow-up. We retrospectively reviewed our medical records for patients with PLBA between April 2013 and April 2021. Patient's demographics, imaging, cystoscopic characteristics, treatment, and outcomes were recorded and analyzed. Serum and urine electrophoresis, abdominal fat aspiration, and rectal biopsy results where available were also recorded. We identified 20 patients with PLBA with a median age of 56 years. Hematuria (80%) was the most common symptom followed by irritative lower urinary tract symptoms (iLUTS) (50%). The bladder lesions were focal, multiple, and diffuse in 4 (20%), 14 (70%), and 2 (10%) patients, respectively. All patients had transurethral resection of the bladder tumor, except for 4 patients with exclusive iLUTS who had cold cup biopsy. At a median follow-up of 43.9 months, 4 patients (20%) developed recurrence with median time to recurrence being 19 months. All the recurrences were managed endoscopically by re-resection and none of the patients required radical surgery. PLBA is a rare entity with varied clinical presentations. Although histologically benign, recurrences can occur and require long-term cystoscopic surveillance. [ABSTRACT FROM AUTHOR]

Objective: To explore the effectiveness and safety of the extreme flexion and abduction hip combined with a stirrup-shaped multifunctional leg frame position in preventing obturator nerve reflex during plasma resection of bladder tumors (TUR-BT). Methods: A total of 112 patients with bladder tumors were included in the study. The control group was placed in a lithotomy position, while the experimental group was placed in an extreme flexion and abduction hip combined with a stirrup-shaped multifunctional leg frame position. The grade of leg jerking, operation time, and some operative complications were compared between groups. Results: The operation time, bleeding volume, the grade of leg jerking, second TUR-BT, and acquisition of detrusor muscle were significantly better in the experimental group compared to the control group (P = 0.018, P = 0.013, P < 0.001, P = 0.041, and P < 0.001, respectively). The grade of leg jerking in the experimental group was extremely low (distributed in grade 1 and 2), and there were no severe reactions in grade 3 and 4. Conclusion: The extreme flexion and abduction hip combined with a stirrup-shaped multifunctional leg frame position for TUR-BT is a safe and effective treatment method that can effectively prevent obturator nerve reflex, reduce complications, improve surgical efficacy, and reduce anesthesia dependence and risk. [ABSTRACT FROM AUTHOR]

This study introduces a compact Raman spectrometer with a 1064 nm excitation laser coupled with a fiber probe and an inexpensive motorized stage, offering a promising alternative to widely used Raman imaging instruments with 785 nm excitation lasers. The benefits of 1064 nm excitation for biomedical applications include further suppression of fluorescence background and deeper tissue penetration. The performance of the 1064 nm instrument in detecting cancer in human bladder resectates is demonstrated. Raman images with 1064 nm excitation were collected ex vivo from 10 human tumor and non-tumor bladder specimens, and the results are compared to previously published Raman images with 785 nm excitation. K-Means cluster (KMC) analysis is used after pre-processing to identify Raman signatures of control, tumor, necrosis, and lipid-rich tissues. Hierarchical cluster analysis (HCA) groups the KMC centroids of all specimens as input. The tools for data processing and hyperspectral analysis were compiled in an open-source Python library called SpectraMap (SpMap). In spite of lower spectral resolution, the 1064 nm Raman instrument can differentiate between tumor and non-tumor bladder tissues in a similar way to 785 nm Raman spectroscopy. These findings hold promise for future clinical hyperspectral Raman imaging, in particular for specimens with intense fluorescence background, e.g., kidney stones that are discussed as another widespread urological application. [ABSTRACT FROM AUTHOR]

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Abstract Background Although 5-aminolevulinic acid is useful for the photodynamic diagnosis of bladder tumors, it often causes severe intraoperative hypotension. We report a case of postoperative cardiac arrest in addition to severe intraoperative hypotension, probably owing to the use of 5-aminolevulinic acid. Case presentation An 81-year-old Japanese man was scheduled to undergo transurethral resection of bladder tumor. The patient took 5-aminolevulinic acid orally 2 hours before entering the operating room. After the induction of anesthesia, his blood pressure decreased to 47/33 mmHg. The patient’s hypotension did not improve even after noradrenaline was administered. After awakening from anesthesia, the patient’s systolic blood pressure increased to approximately 100 mmHg, but approximately 5 hours after returning to the ward, cardiac arrest occurred for approximately 12 seconds. Conclusion We experienced a case of postoperative cardiac arrest in a patient, probably owing to the use of 5-aminolevulinic acid. Although the cause of cardiac arrest is unknown, perioperative hemodynamic management must be carefully performed in patients taking 5-aminolevulinic acid.

Purpose: To investigate the relationship between urine cytology results after overnight continuous saline irrigation (OCSI) following transurethral resection of bladder tumor (TURBT) and bladder tumor recurrence in non-muscle invasive bladder cancer (NMIBC). Materials and Methods: A retrospective study was conducted on patients diagnosed with NMIBC between 2016 and 2020 after undergoing TURBT at our hospital. All patients received OCSI following TURBT and had urine cytology test at postoperative 1 day. Urine cytology was classified into three groups: Negative, low-grade urothelial neoplasm (LGUN)+atypical urothelial cells (AUC), and suspicious for high-grade urothelial carcinoma (SHGUC)+high-grade urothelial carcinoma (HGUC). Recurrence-free survival (RFS) in each group was compared using the Kaplan–Meier method. Univariable and multivariable Cox regression analyses were performed to evaluate independent prognostic factors. Results: A total of 172 patients were included in this study. Based on urine cytology group (after OCSI), RFS did not reach the median value in the Negative group. In the LGUN+AUC group, the median RFS was 615.00 days. In the SHGUC+HGUC group, the median RFS was 377.00 days. In survival analysis, the Negative group had a longer RFS than the SHGUC+HGUC group (p=0.013). However, Cox regression analysis showed that SHGUC+HGUC was not an independent prognostic factor for recurrence. Conclusions: Urine cytology results after OCSI following TURBT in NMIBC were associated with bladder tumor recurrence. Specifically, SHGUC or HGUC in urine cytology after OCSI showed earlier recurrence than negative cases. However, further research is needed to accurately determine whether it is an independent prognostic factor.

Background: Although 5-aminolevulinic acid is useful for the photodynamic diagnosis of bladder tumors, it often causes severe intraoperative hypotension. We report a case of postoperative cardiac arrest in addition to severe intraoperative hypotension, probably owing to the use of 5-aminolevulinic acid. Case presentation: An 81-year-old Japanese man was scheduled to undergo transurethral resection of bladder tumor. The patient took 5-aminolevulinic acid orally 2 hours before entering the operating room. After the induction of anesthesia, his blood pressure decreased to 47/33 mmHg. The patient's hypotension did not improve even after noradrenaline was administered. After awakening from anesthesia, the patient's systolic blood pressure increased to approximately 100 mmHg, but approximately 5 hours after returning to the ward, cardiac arrest occurred for approximately 12 seconds. Conclusion: We experienced a case of postoperative cardiac arrest in a patient, probably owing to the use of 5-aminolevulinic acid. Although the cause of cardiac arrest is unknown, perioperative hemodynamic management must be carefully performed in patients taking 5-aminolevulinic acid. [ABSTRACT FROM AUTHOR]

Introduction This paper aimed to evaluate the effect of opium on bladder cancer grade and stage. We analyzed the impact of opium on the stage and grade of bladder cancer. Methods In this retrospective study, we analyzed 446 patients with pathologically confirmed bladder cancer treated from February 2012 to January 2019. Demographic data including sex, age, body mass index, opium consumption, and smoking, were collected. Exclusion criteria were patients receiving chemotherapy, inaccessible pathologic reports, and previous abdominopelvic radiotherapy. Chi-squared test was used in case of categorical variables. The significance level was set at 0.05. The analyses were performed using the statistical software Stata ver. 13. Results Our results indicate show that higher muscle-invasive stages occurred in opium users group compared to the non-opium users (P-value<0.001 vs. P-value: 0.104). The BMIs≥25 indicated a greater high grades percentage in the opium users compared with non-users (P-values=0.137 and 0.316 for the ages <65 and ≥65 years and 0.602 and 0.013 for the BMIs <25 and ≥25). Accordingly, in people with BMIs≥25, odds of high grades were 2.8-fold, compared with non-users. Patients with BMIs of 25 or more had 2.8 times the chance of getting high grades compared to those who did not. Regarding muscle stages, while all subgroups showed significance, the largest effect size of 4.2 was obtained for the <65 age group. Conclusions Our data revealed the higher muscle-invasive stages in the opium users comparing compared to non-opium users. Also, in patients with BMIs≥25, odds of high grades were 2.8 folds, compared with non-opium users. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Upper tract urothelial carcinoma (UTUC) is a relatively rare but aggressive type of urologic cancer that includes renal pelvic tumors and ureteral tumors with a poor prognosis. Full-length nephroureterectomy plus sleeve bladder resection is the standard treatment for the disease, but patients are prone to recurrence of bladder tumors after surgery. Intravesical infusion therapy is the main means to prevent the recurrence and progression of bladder cancer. Epirubicin and gemcitabine are widely used in clinical practice as first-line or salvage therapy for intravesical chemotherapy; however, the effi- cacy of these agents is rarely discussed. The purpose of this study was to investigate the effects of epirubicin and gemcitabine on the occurrence of bladder cancer after radical nephroureterectomy for UTUC and to analyze the risk factors affecting the recurrence of postoperative bladder cancer. PATIENTS AND METHODS: A total of 215 patients with diagnosed UTUC and treated in our hospital from June 2019 to August 2021 were retrospectively selected as the research subjects, and they were divided into an observation group (120 cases) and a control group (95 cases) according to different treatment methods. The patients in the control group were treated with epirubicin, while those in the observation group received gemcitabine. All patients were followed up by telephone or outpatient examination for 12 months to record the occurrence of adverse reactions. The occurrence of bladder cancer was recorded at 3 months, 6 months, and 12 months after the surgery. According to the occurrence of bladder cancer after surgery, the patients were divided into a bladder cancer group (63 cases) and a non-bladder cancer group (152 cases). Multivariate Logistic regression analysis was used to analyze the risk factors of bladder cancer after surgery. RESULTS: The total incidence of adverse reactions in the control group was 49.47%, which was higher than that in the observation group with 15.00% (p<0.01). The incidence of bladder tumors in the observation group and the control group was 0.00% and 2.11% at 3 months, 5.00% and 8.42% at 6 months, 13.33% and 15.79% at 12 months, without significant difference (p>0.05). After 12 months of perfusion, the levels of acidic fibroblast growth factor (aFGF), basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF) in the two groups were significantly lower than those before perfusion (p<0.05). In the observation group, the levels of these three factors were slightly decreased compared with those in the control group, without a significant difference (p>0.05). Between the bladder cancer and non-bladder cancer groups, there were significant differences in tumor location, number of lesions, tumor stage, preoperative ureteral examination, and preoperative history of bladder cancer (p<0.05). The above indexes were all risk factors for postoperative bladder cancer (p<0.05). CONCLUSIONS: Epirubicin and gemcitabine reduced the occurrence of bladder cancer and effectively inhibited tumor angiogenesis after radical nephroureterectomy for UTUC. The tumor location, number of lesions, tumor stage, preoperative ureteral examination, and preoperative history of bladder cancer were risk factors for postoperative bladder cancer. [ABSTRACT FROM AUTHOR]

PEComa is a rare mesenchymal tumor with unique features, sometimes manifesting in younger patients and can exhibit malignant transformation. We present a 24-year-old woman with urinary symptoms and hematuria. Imagining revealed a protruding mass in the bladder dome, raising suspicion for adenocarcinoma due to its location and vascular appearance. Pathology revealed PEComa. Clinicians should inquire about macroscopic hematuria and assess the entire urinary tract even in young patients with apparent urinary tract infection. Practitioners should be mindful of PEComa tumors, especially in cases involving young patients with tumors concerning the bladder dome. A variety of immunohistochemical techniques facilitate the diagnosis.

We report a case of spontaneous bladder rupture due to bladder carcinoma. A 62-year-old man presented to the emergency department with acute urine retention; two days later, the patient presented with abdominal distension and a large intraperitoneal effusion on CT scan, as well as a breccia in the bladder.Exploratory laparotomy confirmed a definitive diagnosis: bladder rupture due to bladder carcinoma. He underwent radical cystectomy.Surgery is recommended to treat carcinomatous bladder rupture. Rapid diagnosis is essential to optimize patient outcomes. The possibility of spontaneous bladder rupture should not be overlooked as a differential diagnosis in cases of acute abdomen.

Abstract Purpose To explore the application of contrast-enhanced ultrasound (CEUS) for the diagnosis and grading of bladder urothelial carcinoma (BUC). Methods The results of a two-dimensional ultrasound, color Doppler ultrasound and CEUS, were analyzed in 173 bladder lesion cases. The ultrasound and surgical pathology results were compared, and their diagnostic efficacy was analyzed. Results There were statistically significant differences between BUC and benign lesions in terms of color blood flow distribution intensity and CEUS enhancement intensity (both P

Objective To observe the effects of ultrasound-guided modified obturator nerve block (ONB) combined with remazolam anesthesia on obturator nerve reflex (ONR) and postoperative recovery of patients with transurethral resection of bladder tumors (TURBT). Methods One hundred patients with bladder tumor admitted to Qinhuangdao Hospital from June 2019 to June 2021 were treated with TURBT. They were divided into conventional group (intraspinal anesthesia + traditional ONB anesthesia) and ultrasound group (intraspinal anesthesia + improved ONB combined with remidazolam anesthesia under ultrasound guidance) with 50 cases in each according to different ONB methods. Perioperative indexes, hemodynamic indexes at different time points, intraoperative ONR occurrence, complications and adverse anesthesia reactions were compared between the two groups. Results Compared with conventional group, ONB time, operation time, catheter indwelling time and hospital stay were shortened, and intraoperative blood loss was decreased in ultrasound group (P＜0.05). Compared with the conventional group at 30 min after administration (T1) and at the end of operation (T2), the mean arterial pressure (MAP) and oxygen saturation (SaO2) were increased in the ultrasound group (P＜0.05). Compared with the conventional group, the incidence of ONR and bladder bleeding was decreased, and the incidence of postoperative bradycardia, nausea and vomiting were decreased in the ultrasound group (P＜0.05). Conclusions Ultrasound-guided modified ONB combined with remazolam anesthesia can effectively improve perioperative indexes of TURBT, reduce intraoperative ONR and bladder bleeding, and have little influence on hemodynamics with few postoperative adverse anesthesia reactions.

Background: Ectopic tissue is rarely found in the bladder for adults. Currently, there have been reports of ectopic prostate and colon tissue in the bladder. These ectopic tissues are manifested as a bladder mass and cause lower urinary tract symptoms. However, the ectopic corpus cavernosum in the bladder has never been reported, and its clinical characteristics and treatment have not been explored yet. Case summary: A 3-year-old boy was admitted to the hospital due to 1 month of urinary frequency. The physical examination was unremarkable. Urine analysis from other hospitals showed an elevated urine white blood cell count of 17.9/ul. In addition, ultrasound indicated a possible bladder mass. CT and MRI showed a well-margined lesion (1.9x1.9 cm) in the bladder trigone. Through preoperative imaging, we diagnosed a bladder tumor (inclined towards benign). The transurethral resection of the bladder tumor was performed. Unfortunately, the surgery was unsuccessful due to the difficulty in removing the excised tissue through the urethra. Subsequently, bladder incision and tumor resection were performed. The tumor was successfully removed. Surprisingly, the postoperative pathology showed that the tumor tissue was corpus cavernosum. The pathological diagnosis was ectopic corpus cavernosum in the bladder. No complications were found after the operation, and no recurrence was observed during follow-up. Conclusion: The ectopic corpus cavernosum in the bladder has never been reported for children, which is presented as a benign tumor with rapid proliferation and large size. Surgery is recommended. However, the transurethral resection of bladder tumors is difficult to perform due to narrow urethra and limited surgical instruments. Bladder incision and tumor resection may be preferred. [ABSTRACT FROM AUTHOR]

Les lasers sont aujourd'hui des outils incontournables en endourologie, aussi bien pour le traitement des calculs urinaires, que des tumeurs urothéliales (vésicales ou du haut appareil) ou de l'hypertrophie bénigne de prostate. Si pendant une trentaine d'années, le laser Holmium : Yttrium-Aluminium-Grenat (Ho:YAG) a été l'acteur prépondérant pour ces applications, les lasers thulium fibré (TFL) et Thulium : YAG (Tm:YAG) sont aujourd'hui des alternatives grandissantes. Les TFL et Ho:YAG sont désormais recommandés pour le traitement des calculs urinaires, un manque de données cliniques limite les recommandations concernant le Tm:YAG. Pour le traitement des lésions urothéliales (énucléation « en-bloc » vésicales ou vaporisation des lésions du haut appareil urinaire), Ho:YAG, TFL et Tm:YAG sont utilisables mais il n'est pas possible à ce jour de recommander une source laser en particulier. De la même manière, ces trois sources lasers semblent utilisables pour réaliser une énucléation endoscopique de prostate, bien que le recul soit plus important pour l'Ho:YAG. Les techniques chirurgicales et les courbes d'apprentissage vont dépendre de la source laser, responsables d'effets bien différents, qu'il faut donc prendre en considération avant d'acquérir un générateur laser. Nowadays, laser technology has become the gold standard for many endourological applications, encompassing the treatment of urinary calculi, urothelial tumors (bladder or upper tract), and benign prostatic hyperplasia. While the Holmium: Yttrium-Aluminum-Garnet (Ho:YAG) laser dominated these applications for about thirty years, thulium fiber laser (TFL) and Thulium: YAG (Tm:YAG) lasers are emerging as growing alternatives. TFL and Ho:YAG are now recommended for urinary calculi treatment, but a lack of clinical data limits recommendations for Tm:YAG. For urothelial lesion treatment ("en-bloc" enucleation of a bladder tumor or vaporization of upper urinary tract lesions), Ho:YAG, TFL, and Tm:YAG are usable, but it is not currently possible to recommend a specific laser source. Similarly, these three laser sources appear usable for endoscopic prostate enucleation, although there is more extensive experience with Ho:YAG. Surgical techniques and learning curves will depend on the laser source, which can produce different effects, requiring careful consideration before acquiring a laser generator. [ABSTRACT FROM AUTHOR]

Background and purpose: Bladder tumors are among the most prevalent malignancies in the urinary system, and RAC3 has been linked to various types of cancer. This article seeks to explore the potential of RAC3 as both an early diagnostic marker for bladder tumors and a novel therapeutic target. Methods/patients: The expression of RAC3 in bladder tissue was detected using immunohistochemical staining. Additionally, the protein expression of RAC3 was measured and quantified through enzyme-linked immunosorbent assay (ELISA). Subsequently, the correlation between the expression level of RAC3 and bladder tumors was investigated through multifactorial analysis and survival analysis. Results: Our findings revealed that RAC3 expression was upregulated in bladder tumor tissues. Moreover, we observed higher levels of RAC3 expression in the serum and urine of patients with bladder tumors compared to those with non-bladder tumors. Additionally, we identified a significant positive correlation between RAC3 expression levels and the stage, degree of differentiation, and infiltration of bladder tumors. Importantly, high RAC3 expression emerged as an influential factor in the poor prognosis of bladder tumors, as patients with high RAC3 expression exhibited a lower overall survival rate than those with low RAC3 expression. Conclusion: Based on our results, RAC3 shows promise as both a marker for early diagnosis of bladder tumors and a potential therapeutic target. [ABSTRACT FROM AUTHOR]

Purpose: To explore the application of contrast-enhanced ultrasound (CEUS) for the diagnosis and grading of bladder urothelial carcinoma (BUC). Methods: The results of a two-dimensional ultrasound, color Doppler ultrasound and CEUS, were analyzed in 173 bladder lesion cases. The ultrasound and surgical pathology results were compared, and their diagnostic efficacy was analyzed. Results: There were statistically significant differences between BUC and benign lesions in terms of color blood flow distribution intensity and CEUS enhancement intensity (both P < 0.05). The area under the time-intensity curve (AUC), rising slope, and peak intensity of BUC were significantly higher than those of benign lesions (all P < 0.05). The H/T (height H / basal width T)value of 0.63 was the critical value for distinguishing high- and low-grade BUC, had a diagnostic sensitivity of 80.0% and a specificity of 60.0%. Conclusion: The combination of CEUS and TIC can help improve the diagnostic accuracy of BUC. There is a statistically significant difference between high- and low-grade BUC in contrast enhancement intensity (P < 0.05); The decrease of H/T value indicates the possible increase of the BUC grade. [ABSTRACT FROM AUTHOR]

The bladder paraganglioma, which makes up 0.06% of all bladder tumors, is a highly uncommon condition. A 30-year-old female patient who was diagnosed with bladder paragangliomas at our hospital. The study covers the patient's journey from the first clinical presentation to the follow-up after surgery, providing insight into this uncommon illness. Urinary bladder tumour shown on CT KUB. The case was established by a transurethral resection biopsy. In order to completely remove the tumour, the patient had a radical cystectomy along with a hysterectomy and a bilateral salpingo-oophorectomy. A tumour mostly seen in the detrusor muscle that is organised in zellbellen pattern and is bordered by pushing fibrovascular stroma. Upon CT follow-up at three and six months, the results were generally unremarkable in terms of margins, metastasis, and local recurrence. Urinary tract hyperplasia is the most typical sign in our instance of bladder paraganglioma, a very uncommon tumour. A tumour called a polypoid in the bladder's posterior wall suggests cancer. More investigation into this uncommon ailment is necessary, as surgical extraction is still the only treatment available to these people. [ABSTRACT FROM AUTHOR]

To observe the effects of ultrasound-guided modified obturator nerve block (ONB) combined with remazolam anesthesia on obturator nerve reflex (ONR) and postoperative recovery of patients with transurethral resection of bladder tumors (TURBT). Methods One hundred patients with bladder tumor admitted to Qinhuangd ao Hospital from June 2019 to June 2021 were treated with TURBT. They were divided into conventional group (intraspinal anesthesia + traditional ONB anesthesia) and ultrasound group (intraspinal anesthesia improved ONB combined with remidazolam anesthesia under ultrasound guidance) with 50 cases in each according to different ONB methods. Perioperative indexes, hemodynamic indexes at different time points, intraoperative ONR occur- rence, complications and adverse anesthesia reactions were compared between the two groups. Results Compared with conventional group, ONB time, operation time, catheter indwelling time and hospital stay were shortened, and intraoperative blood loss was decreased in ultrasound group (P<0.05). Compared with the conventional group at 30 min after administration (T1) and at the end of operation (T2), the mean arterial pressure (MAP) and oxygen saturation (SaO) were increased in the ultrasound group (P<0.05). Compared with the conventional group, the incidence of ONR and bladder bleeding was decreased, and the incidence of postoperative bradycardia, nausea and vomiting were decreased in the ultrasound group (P<0.05). Conclusions Ultrasound-guided modified ONB combined with remazolam anesthesia can effectively improve perioperative indexes of TURBT, reduce intraoperative ONR and bladder bleeding, and have little influence on hemodynamics with few postoperative adverse anesthesia reactions. [ABSTRACT FROM AUTHOR]

Angiomyxoma is a rare mesenchymal tumor arising in the pelvic and perineal regions. Diagnosis of urinary bladder angiomyxoma is difficult, as it lacks typical signs and symptoms, and relies on immunochemistry. We present the case of a 53 year old patient presenting with an incidental finding of bladder tumor during an ultrasound. After a complete transurethral resection was performed, the pathology report led to angiomyxoma diagnosis. After 6 weeks a secondary TURB, along with a CT urogram showed no evidence of residual volume. Transurethral resection seems to be a safe and effective treatment of urinary bladder angiomyxoma.

The purpose of the study was to develop and evaluate the technique for volumetric tumor segmentation based on diffusion-weighted magnetic resonance imaging (DW-MRI) in predicting and assessing the response to chemotherapy in patients with bladder cancer (BC). Material and Methods. We examined 26 patients with morphologically verified transitional cell carcinoma of the bladder. The group was characterized by the presence of one or several tumors with a size of 17 to 46 mm. Before planning chemotherapy according to the M-VAC scheme, a study and post-processing of DW-MRI with volumetric segmentation of lesions, assessment of the volume and apparent diffusion coefficient (ADC) in the entire tumor mass were performed. According to the ADC data, shape of the tumor and its relation to the bladder wall, the coefficient (C) for predicting the response to chemotherapy was calculated. Results. In the cases with a coefficient value below 0.51, a high risk of treatment failure was predicted, at C≥0.74, a positive effect of treatment was predicted. With a value of 0.51≤C

Background. Bladder paraganglioma (BPG) is a very rare tumor. Case report: We report the case of a 48-year-old woman with a history of isolated hematuria. Cystoscopy showed a solid mass on the bottom of the bladder. During the intervention the patient experienced a severe hypertensive episode. BPG was then suspected. Pathology findings confirmed the diagnosis.123I-metaiodobenzylguanidine scan showed a pathological tracer accumulation in the left bladder wall consistent with BPG. The patient underwent a transurethral resection of the bladder after drug preparation. The postoperative course was uneventful and our patient was normotensive. Conclusion. Diagnosis of BPG is often made on histological examination of the tumor.

Milena Taskovska,1 Maja Frelih,2 Toma&zcaron; Smrkolj,1 Metka Volavšek2 1Chair of Surgery, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; 2Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, SloveniaCorrespondence: Metka Volavšek; Milena Taskovska, Email metka.volavsek@mf.uni-lj.si; milena.taskovska@kclj.siPurpose: Basal cell carcinoma of the prostate is rare. Usually, it is diagnosed in elderly men with nocturia, urgency, lower urinary tract obstruction and normal PSA.Case Presentation: We report on a case of a 56-years-old patient who presented at the emergency ward with weight loss, nausea and vomiting. The diagnostic evaluation showed acute renal failure due to a bladder tumor. After admission to the urology ward and subsequent contrast-enhanced CT urography and contrast-enhanced chest CT, a non-metastatic bladder tumor that infiltrated the right side of the bladder and seminal vesicles was found. High-grade muscle-invasive urothelial carcinoma was diagnosed from TURBT specimens, followed by radical cystoprostatectomy with pelvic lymphadenectomy and formation of ureterocutaneostomy sec. Bricker. The histopathological examination of the resection specimen surprisingly revealed the presence of prostatic basal cell carcinoma pT4N0M0 and not urothelial cancer. Due to renal failure, the patient required hemodialysis. The recommendation of the multidisciplinary oncological meeting was to follow up with the patient by the surgeon-urologist. On imaging six months after surgery, it was suspicious for recurrence. Patient was considered for adjuvant oncological treatment.Conclusion: Although rare, basal cell carcinoma of the prostate should be considered in patients with lower urinary tract symptoms, hematuria and normal PSA. Transurethral resection of bladder tumor is indicated in patients presenting with hematuria and bladder tumor. In evaluation of such cases rare histological types should be included in the differential diagnosis.Keywords: prostate cancer, basal cell carcinoma of the prostate, renal failure, bladder tumor, transurethral resection of bladder tumor, cystoprostatectomy

Inflammatory myofibroblastic tumors of the bladder (IMTB) are rare neoplasms that can occur in children. These tumors have uncertain malignant potential and can present similarly to bladder sarcomas. It is important to differentiate between IMTB and bladder sarcomas using a careful immunohistochemical approach. We report a case of IMTB in a 12-year-old girl who presented with presyncope and gross hematuria. IMTB was diagnosed through immunohistochemical analysis, and clinical improvement was observed after resection of the tumor.

Purpose: Conventional transurethral resection of bladder tumors (cTURBT) has been the main technique for treating visible bladder tumor for decades. However, the reported rate of detrusor muscle presence in cTURBT specimen was lower than 80%, which is associated with imprecise staging and poor prognosis. Here, we present a retrospective analysis to compare the detrusor muscle detection rate and outcomes between en bloc resection of bladder tumor (ERBT) and cTURBT. Materials and Methods: Between January 2016 and December 2019, a total of 150 procedures performed by single surgeon in single institute were reviewed in this study. Of these procedures, 41 (27.3%) were ERBT and 109 (72.6%) were cTURBT. The two techniques were compared for pathological detrusor muscle detection, history of upper tract urothelial cancer, number of tumor lesions, histopathological grading and staging, time of operation, and time of catheterization and hospitalization. Results: The muscularis propria detection rate was statistically significantly higher in the ERBT group than in the cTURBT group (82.9% vs. 43.1%, P < 0.0001). The multivariate analysis showed resection method as an independent factor of detrusor muscle presentation (P < 0.0001). The mean Foley catheter indwelling and hospitalization days were longer in the ERBT group but were only 1 day longer than in the cTURBT group. Conclusion: ERBT significantly increases the muscularis propria detection rate than cTURBT. ERBT can provide more accurate cancer staging and contribute to proper decision-making. This study strengthens ERBT as a feasible and promising management of bladder cancer. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of UTI after TURBT in the early stages can result in morbidity, increase the length of stay, and patient costs, even if not treated can be a risk factor for bladder tumor recurrence. The global incidence of post-TURBT UTI varies between 2-39%. This study aims to determine the incidence of UTI in post-TURBT patients. Materials and Methods: This study was a cross-sectional retrospective study. The research data was taken from the medical records of patients who underwent TURBT between 2017 - 2021 at a tertiary hospital. UTI after the TURBT was defined by symptoms of fever (≥ 38℃) and the results of urinalysis examination with positive bacteriuria. While asymptomatic bacteriuria (ABU) is defined by the results of a positive bacteriuria examination without symptoms of fever. The results of the study were processed with descriptive statistics and then presented in the form of tables and explanatory narratives. Statistical analysis was performed using SPSS version 26 with a p-value < 0.05 considered statistically significant. Results: 140 patients underwent the TURBT. The data collected were 92 patients. In the pre TURBT, 56 (60,9%) patients were positive for bacteriuria, but 55 (59,8%) patients did not have fever symptoms. There were 1(1.1%) patient who had UTI before the TURBT. This patient was treated first with an antibiotic before the TURBT procedure. After the TURBT, 9 (9,7%) patients underwent urinalysis. A total of 4 (4.3%) patients experienced UTI after the TURBT and 3 (3.3%) experienced ABU after the TURBT. The incidence of UTI after the TURBT increased the length of stay of the patient (p = 0,003). Conclusion: The incidence of post-TURBT UTI is 4.3%. Only 9,8% of patients underwent urinalysis after the TURBT. [ABSTRACT FROM AUTHOR]

The urachus is an embryological remnant that lies between the bladder and umbilicus as a fibrous band that attaches the cloaca to the allantois in the intrauterine period. Urachal adenocarcinoma is a rare tumor and more aggressive in behavior than primary bladder tumors. In this case report, we present a 37 years old female patient with urachal adenocarcinoma in whom transurethral resection of the bladder revealed a signet ring adenocarcinoma of the bladder with invasion of the muscularis propria. The patient had left manubrium sterni and bone marrow infiltration. Partial cystectomy and sternal resection were performed, followed by radiotherapy and chemotherapy. There was no recurrence or new metastasis at the 4-year follow-up. In conclusion, a combination of surgery, chemotherapy, and radiotherapy is a suitable approach for the treatment of oligo-metastatic urachal carcinoma. [ABSTRACT FROM AUTHOR]

Objectives: To report the incidence, predictors, the impact of bladder perforation (BP), and our protocol of management in patients who underwent trans-urethral resection of bladder tumor (TURBT). Methods: This is a retrospective study, between 2006 and 2020, on patients who underwent TURBT for non-muscle-invasive bladder cancer (NMIBC). Bladder perforation was defined as any full thickness resection of the bladder wall. Bladder perforations were managed based on their severity and type. Small BP with no or mild symptoms were managed with prolongation of urethral catheters. Those with significant extraperitoneal extravasations were managed by insertion of a tube drain (TD). Abdominal exploration was done for extensive BP and all intraperitoneal extravasations. Results: Our study included 1,570 patients, the mean age was 58 ± 11 years and 86% were males. Bladder perforation was recorded in 10% (n = 158) of the patients. The perforation was extraperitoneal in 95%, and in 86%, the perforation was associated with no symptoms, mild symptoms, or mild fluid extravasation that required only prolongation of the urethral catheter. On the other hand, active intervention was required for the 21 remaining patients (14%) with TD being the most frequent management. History of previous TURBT (p = 0.001) and obturator jerk (p = 0.0001) were the only predictors for BP. Conclusions: The overall incidence of bladder perforation is 10%; however, 86% required only prolongation of urethral catheter. Bladder perforation did not affect the probability for tumor recurrence, tumor progression nor radical cystectomy. [ABSTRACT FROM AUTHOR]

This study introduces a compact Raman spectrometer with a 1064 nm excitation laser coupled with a fiber probe and an inexpensive motorized stage, offering a promising alternative to widely used Raman imaging instruments with 785 nm excitation lasers. The benefits of 1064 nm excitation for biomedical applications include further suppression of fluorescence background and deeper tissue penetration. The performance of the 1064 nm instrument in detecting cancer in human bladder resectates is demonstrated. Raman images with 1064 nm excitation were collected ex vivo from 10 human tumor and non-tumor bladder specimens, and the results are compared to previously published Raman images with 785 nm excitation. K-Means cluster (KMC) analysis is used after pre-processing to identify Raman signatures of control, tumor, necrosis, and lipid-rich tissues. Hierarchical cluster analysis (HCA) groups the KMC centroids of all specimens as input. The tools for data processing and hyperspectral analysis were compiled in an open-source Python library called SpectraMap (SpMap). In spite of lower spectral resolution, the 1064 nm Raman instrument can differentiate between tumor and non-tumor bladder tissues in a similar way to 785 nm Raman spectroscopy. These findings hold promise for future clinical hyperspectral Raman imaging, in particular for specimens with intense fluorescence background, e.g., kidney stones that are discussed as another widespread urological application.

Introduction: Today, surgical errors are becoming less and less frequent, thanks to the development of new techniques and the choice of different approaches. Nevertheless, they are still possible, and it is important to mention them in order to prevent them and avoid their recurrence. Case Presentation: We report a case of intravesical textiloma, rarely observed in urological surgery, in an 80-year-old patient who underwent laparoscopic inguinal hernia repair and presented to a urological consultation with hematuria and irritative lower urinary tract signs. Abdominal ultrasound revealed a hyperechoic tissue-like formation in the posterior wall of the bladder. The diagnosis of a bladder tumor was therefore raised, and cystoscopy was performed, which revealed an intravesical textiloma. All foreign bodies were removed endoscopically, and the patient had a good post-operative outcome. Conclusion: The rarity of the urological location of textilomas and the importance of their prevention remain a goal in surgery, whatever the specialty. [ABSTRACT FROM AUTHOR]

Eosinophilic cystitis is a rare inflammatory disorder of the bladder, characterized by eosinophilic infiltration of the bladder wall, fibrosis of the mucosa, and muscle necrosis. Ultrasonography, when performed, shows a pseudotumoral mass that can be mistaken for malignancy. We report a case of a woman referred to our department in which an ultrasound showed a bladder mass and the biopsy demonstrated the presence of eosinophilic cystitis. The patient was treated with medical treatment and the outcome was favorable with the disappearance of symptoms and no recurrence at controls. We carry a literature review of cystitis eosinophilic, the ultrasound appearance, and therapeutic modalities. [ABSTRACT FROM AUTHOR]

Background: The technique of laser en bloc resection of bladder tumor (ERBT) has been a valuable alternative technique to transurethral resection of bladder tumor (TURBT). However, the combination of laser ERBT and endoscopic submucosal dissection (ESD) technique has not been well studied. Here, a novel technique integrating a high-power green-light laser with ESD was presented. This study aimed to evaluate the safety and efficacy of high-power green-light laser endoscopic submucosal dissection (HPL-ESD) for the treatment of primary non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: From January 2015 to December 2018, a total of 56 patients with NMIBC underwent HPL-ESD. All tumors were transurethral en bloc resected in the ESD technique. Perioperative clinical data were retrospectively collected and analyzed. Results: All operations were safely performed by the technique of HPL-ESD without blood transfusion. The mean tumor diameter was 2.04 ± 0.65 cm, ranging from 0.5 to 3.5 cm. The mean operative time was 28.39 ± 16.04 min. The average serum hemoglobin decrease was 0.88 ± 0.54 g/dL. The mean postoperative catheterization time was 2.88 ± 0.94 days. The pathologic stages included pTa (32 cases), and pT1 (24 cases). Double-J stent indwelling was not performed for four patients whose tumors were adjacent to the ureteral orifice and no postoperative hydronephrosis was observed. Only one case of ectopic bladder tumor recurred due to irregular bladder irrigation during the 36-month follow-up. Conclusion: HPL-ESD is a safe and effective alternative for the treatment of primary NMIBCs, especially for tumors adjacent to the ureteral orifice. [ABSTRACT FROM AUTHOR]

Background: Breast phyllodes tumor has a distinct histologic appearance. There are no pediatric phyllodes tumors of the bladder in English literature reported. Case report: A 2-year-old boy presented with a urinary infection and obstructive urinary symptoms. A 3-cm slow-growing bladder mass revealed by repeated transabdominal ultrasonography was initially considered a ureterocele. Cystoscopic and laparoscopic exploration using pneumovesicum confirmed the diagnosis of a bladder neck tumor. Histologically, the features were of a benign phyllodes tumor, morphologically similar to those seen in breast tissue. The patient received no further treatment and showed no recurrence or metastasis. Conclusion: Phyllodes tumor can cause a pediatric bladder tumor. [ABSTRACT FROM AUTHOR]

Background: En bloc resection of bladder tumors (ERBT) has been used as a treatment option to improve pathologic diagnostic accuracy in non-muscle invasive bladder cancer. We report on the feasibility of a novel ERBT technique using an electrosurgical snare with flexible cystoscope: flexible cystoscopic En bloc Snare Resection of Bladder Tumor (f-ESRBT). Methods: We used the electrosurgical snare to resect a superficial bladder tumor after injection of 50% glucose in the submucosa at the tumor base. We collected each resected tumor with a basket catheter and coagulated the resected area with a coagulation electrode. A flexible cystoscope was used for all procedures. Results/Discussion: We performed 10 operations. Mean tumor size was 10.2 ± 7.3 mm and mean surgery time was 13.8 ± 6.8 minutes. All procedures were performed without complications. Results showed f-ESRBT to be simple and minimally invasive and to enable accurate pathologic diagnoses. Conclusion: f-ESRBT is a feasible treatment option for small and non-muscle invasive bladder cancer. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Intravesical textiloma is a rare surgical complication, that may cause nonspecific lower urinary tract symptoms. Clinicians should consider it in patients with a history of bladder surgery and persistent or new‐onset urinary symptoms. Intravesical textiloma is a rare condition usually presents asymptomatic or with non specific symptoms. A 72 years old man with prior open prostatectomy presented lower urinary tract symptoms and diagnosed with bladder stones, explorative laparotomy revealed semi calcified gauze. Similar history should prompt suspicion of this condition. [ABSTRACT FROM AUTHOR]

This study was conducted with the aim of exploring the molecular and cellular mechanisms of action of the chrysin (natural flavonoid compound) on bladder tumour cell lines with different status of TP53 (RT4, 5637 and T24). The cells were treated with different concentrations of chrysin (20, 40, 60, 80 and 100 µM) to analyze the cell viability, nuclear division index, mutagenicity, apoptosis rates and expression of genes related to epigenetic events (DNMT1, HAT1 and HDAC1). Results showed that the treatment with chrysin reduced the cell viability and caused apoptosis, regardless TP53. Moreover, in the TP53-mutated cell lines, chrysin modulated the expression of the DNMT1, HAT1 and HDAC1 epigenetic genes, which might be a plus to the death observed in the cells with p53 mutation. [ABSTRACT FROM AUTHOR]

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Purpose: Conventional transurethral resection of bladder tumors (cTURBT) has been the main technique for treating visible bladder tumor for decades. However, the reported rate of detrusor muscle presence in cTURBT specimen was lower than 80%, which is associated with imprecise staging and poor prognosis. Here, we present a retrospective analysis to compare the detrusor muscle detection rate and outcomes between en bloc resection of bladder tumor (ERBT) and cTURBT. Materials and Methods: Between January 2016 and December 2019, a total of 150 procedures performed by single surgeon in single institute were reviewed in this study. Of these procedures, 41 (27.3%) were ERBT and 109 (72.6%) were cTURBT. The two techniques were compared for pathological detrusor muscle detection, history of upper tract urothelial cancer, number of tumor lesions, histopathological grading and staging, time of operation, and time of catheterization and hospitalization. Results: The muscularis propria detection rate was statistically significantly higher in the ERBT group than in the cTURBT group (82.9% vs. 43.1%, P < 0.0001). The multivariate analysis showed resection method as an independent factor of detrusor muscle presentation (P < 0.0001). The mean Foley catheter indwelling and hospitalization days were longer in the ERBT group but were only 1 day longer than in the cTURBT group. Conclusions: ERBT significantly increases the muscularis propria detection rate than cTURBT. ERBT can provide more accurate cancer staging and contribute to proper decision-making. This study strengthens ERBT as a feasible and promising management of bladder cancer.