Purpose: We postulate that the number of lymph nodes examined in cystectomy specimens can have an impact on the outcome of patients with bladder cancer. Materials and Methods: We analyzed data on 322 patients with muscle invasive bladder cancer who underwent radical cystectomy and bilateral pelvic lymphadenectomy. We evaluated the associations of the number of lymph nodes identified by the pathologist in the surgical specimen with the local recurrence rate and survival outcome. Results: Patients were divided into groups by lymph node status and the distribution of the number of lymph nodes examined. In stages pN 0 and pN + cases improved survival was associated with a greater number of lymph nodes examined. We determined that at least nine lymph nodes should be studied to define lymph node status accurately. Conclusions: These results indicate that surgical resection and pathological assessment of an adequate number of lymph nodes in cystectomy specimens increases the likelihood of proper staging and impacts patient outcome. Such information is important not only for the therapy and prognosis of individuals, but also for identifying those who may benefit from adjuvant chemotherapy.

Impact of the number of lymph nodes retrieved on outcome in patients with muscle invasive bladder cancer.

https://www.europeanurology.com/article/S0302-2838(14)01263-9/pdf/systematic-review-and-cumulative-analysis-of-oncologic-and-functional-outcomes-after-robot-assisted-radical-cystectomy

Systematic Review and Cumulative Analysis of Oncologic and Functional Outcomes After Robot-assisted Radical Cystectomy

https://www.europeanurology.com/article/S0302-2838(10)00756-6/pdf/influence-of-modified-posterior-reconstruction-of-the-rhabdosphincter-on-early-recovery-of-continence-and-anastomotic-leakage-rates-after-robot-assisted-radical-prostatectomy

Influence of Modified Posterior Reconstruction of the Rhabdosphincter on Early Recovery of Continence and Anastomotic Leakage Rates after Robot-Assisted Radical Prostatectomy

Following curative treatment for localised renal cell carcinoma (RCC), up to 30% of patients develop tumour recurrence. Prognostic scores are essential to guide individualised surveillance protocols, patient counselling and potentially in the future to guide adjuvant therapy. In metastatic RCC, prognostic scores are routinely used for treatment selection in clinical practice as well as in all major trials. We performed a literature review on the current evidence based on prognostic factors and models for localised and metastatic RCC. A number of prognostic factors have been identified, of which tumour node metastasis classification remains the most important. Multiple prognostic models and nomograms have been developed for localised disease, based on a combination of tumour stage, grade, subtype, clinical features, and performance status. However, there is poor level of evidence for their routine use. Prognostic scores for patients with metastatic RCC receiving targeted treatments are used routinely, but have limited accuracy. Molecular markers can improve the accuracy of established prognostic models, but frequently lack external, independent validation. Several factors and models predict prognosis of localised and metastatic RCC. They represent valuable tools to provide estimates of clinically important endpoints, but their accuracy should be improved further. Validation of molecular markers is a future research priority.

Prognostic factors and prognostic models for renal cell carcinoma: a literature review.

This review summarizes all studies that compare the effect of a MBSR program to a control group intervention, in which the participants had been randomly allocated to be in either the MBSR group or a control group. The review summarizes the results in two categories. First, where the effect of the MBSR program was compared to an inactive group (either a wait list group or one receiving ordinary care also received by the MBSR group). Second, where MBSR was compared with an alternative active group intervention.

Based on this review it is reasonable to consider MBSR a moderately well-documented method for helping adults improve their health and cope better with the challenges and stress that life brings. New research should improve the way the trials are conducted addressing the pitfalls in research on mind-body interventions.

https://onlinelibrary.wiley.com/doi/pdf/10.4073/csr.2017.11

Mindfulness‐based stress reduction (MBSR) for improving health, quality of life and social functioning in adults: a systematic review and meta‐analysis

Genitourinary trauma is second most common cause of trauma in pediatric patient with an estimated rate of 3–10%;with renal trauma contributing to 50% of GU injuries. Most injuries are result of motor vehicle accidents and it can precipitate unique urological problems and morbidity associated with the injury. The following is a review of pertinent clinical information and surgical managements regarding pediatric urologic trauma with supporting evidence from the current literature and guidelines.

Pediatric Urologic Trauma

Diverticulae of the male urethra are relatively rare entities and review of literature regarding their cause, classification, and management is multifaceted and controversial. Acquired anterior urethral diverticuli without adequate or intact corpus spongiosum and those with well-defined thick walls are best treated oy open surgical techniques. [1] A micturating cystourethrogram (MCU) and ultrasonography (USG) to determine the presence of surrounding tissue (corpus spongiosum) and the wall thickness plays a major role in determining the management. Thin walled and intact diverticula's can be treated by visual urethral urethrotome. [2]

Anterior urethral diverticulum: Report of two cases

Robotic assisted laparoscopic radical prostatectomy in patients with penile implants: technique and outcome

Mp40-04 embryonic testis contains vascular endothelial precursor cells- a new insight

We present a rare case of genital hemangiomas. Generally, hemangiomas are present at birth or in the first year of life and completely resolve by age 10. Most are asymptomatic. We present an 11 year old girl who presented with incidentally diagnosed asymptomatic bilateral hemangiomas on her labia majora. The treatment for genital hemangiomas is not well defined in the literature. We elected to choose watchful waiting as our treatment approach at this time. Long term follow-up is necessary with intention to intervene with multispeciality approach involving gynaecology and plastic surgery to avoid any disfigurement of the local anatomy.

/pdf/bilateral-asymptomatic-incidental-vulvar-labial-hemangioma-3i58tx5lhq.pdf

Pankaj P. Dangle

Papers

Pediatric Urologic Trauma

Anterior urethral diverticulum: Report of two cases

Robotic assisted laparoscopic radical prostatectomy in patients with penile implants: technique and outcome

Mp40-04 embryonic testis contains vascular endothelial precursor cells- a new insight

Bilateral asymptomatic incidental vulvar/labial hemangioma: Kissing Hemangiomas