Objective To present the initial experience of a senior urology resident with holmium laser enucleation of the prostate (HoLEP)

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Rupture of intracranial dermoid cysts (RICDC) is a rare phenomenon. The mechanism of rupture, pathophysiology of fat in the ventricles and subarachnoid spaces, possible complications, and proper management of such conditions are proposed on the basis of a review of the literature and experience with two cases of ruptured intracranial dermoid cysts (One was in the pineal region, while another was in the fourth ventricle). It is concluded that rupture of intracranial dermoid cysts is usually spontaneous and non-fatal. Persistence of fat in the subarachnoid spaces postoperatively may last asymptomatically for years. Surgery is the only way to deal with these benign lesions. If the capsule is adherent to vital areas, incomplete removal is advised as recurrence and malignant transformation are unlikely to occur.

What ' s known on the subject? and What does the study add? It is well established that upper tract urothelial carcinoma is a rare cancer with an aggressive course. Currently, radical nephroureterectomy with bladder cuff excision remains the standard of care in the treatment of these tumours. Previous studies demonstrate that stage, grade and lymphovascular invasion have prognostic signifi cance on recurrence and outcome whereas the prognostic impact of tumour location remains unclear.

What ' s known on the subject? and What does the study add?In a previous randomized controlled trial, barbed polyglyconate suture for vesicourethral anastomosis was associated with more frequent cystogram leaks, longer mean catheterization times and greater suture costs per case.In the current randomized controlled trial, we show that barbed polyglyconate suture is associated with decreased anastomosis time, decreased need to readjust suture tension, cost reduction, and equal continence and early/late urinary complication rates. OBJECTIVE• To examine the effectiveness of barbed polyglyconate suture (V-Loc 180; Covidien, Mansfi eld, MA, USA) compared with standard monofi lament for posterior reconstruction (PR) and vesico-urethral anastomosis (VUA) during robot-assisted radical prostatectomy (RARP). PATIENTS AND METHODS• A prospective randomized controlled trial was conducted in 70 consecutive RARP cases by a single surgeon (K.C.Z.).• Standard VUA was performed using three 4-0 poliglecaprone 25 (Monocryl; Ethicon Endosurgery, Cincinnati, OH, USA) sutures secured with absorbable suture clips (LapraTy, Ethicon; one single 6-inch [ 15.2 cm ] for PR and two attached 6-inch [ 15.2 cm ] for VUA).• Barbed suture VUA was performed using two 3-0 6-inch (15.2 cm) barbed polyglyconate sutures.• Time to complete the suture set-up by the nursing team, anastomosis time and need to adjust suture tension were recorded. Suture-related complications, validated-questionnaire continence and cost were also examined. RESULTS• Compared with a conventional reconstruction technique, there was a signifi cant reduction in mean nurse set-up time (31 vs. 294 s; P < 0.01) and reconstruction time (13.1 vs. 20.8 min; P < 0.01) for the barbed suture technique.• Need to readjust suture tension or to place additional suture clips for watertight closure was greater in the standard monofi lament group than in the barbed suture group (6% vs. 24%; P = 0.03).• A cost reduction was recorded at our institution (48.05 vs. 70.25 $CAN) with the barbed suture technique.• With a mean follow-up of 6.2 months, no delayed anastomotic leak or bladder neck contracture was observed in either group.• Pad-free continence outcomes for the monofi lament suture vs the barbed suture groups at 1 (64 vs. 69%, P = 0.6), 3 (76 vs. 81%, P = 0.5) and 6 months (88 vs. 92%, P = 0.7) were similar. CONCLUSIONS• Compared with standard monofi lament suture, the unidirectional barbed polyglyconate suture appears to provide safe, effi cient and cost-effective PR and VUA during RARP.• Use of the interlocked barbed polyglyconate suture technique prevents slippage, precluding the need for assistance, knot-tying and constant reassessment of anastomosis integrity.

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Hemorrhagic cystitis is an uncommon urological problem. It is most often caused by radiation therapy and cyclophosphamide, but can be associated with other contributing factors. Technological advances in radiation therapy have resulted in greater treatment efficacy, with significant reduction in side-effects such as hemorrhagic cystitis. Higher dose radiation treatment, however, is more often associated with problematic hemorrhagic cystitis. Treatment of hemorrhagic cystitis is multifactorial and can range from simple bladder irrigation to cystectomy with urinary diversion.