Patients with a positive FISH and atypical cytology are more likely to recur even in the absence of visible tumor. FISH positivity may portend a higher risk for progression. These findings require prospective validation.

No abstract

No abstract

No abstract

Objective To assess the ability of reflex UroVysion fluorescence in situ hybridization (FISH) testing to predict recurrence and progression in non-muscle invasive bladder cancer (NMIBC) patients with suspicious cytology but negative cystoscopy. Patients and methods Patients on NMIBC surveillance were followed with office cystoscopy and urinary cytology every three-to-six months. Between March 2007 and February 2012, 500 consecutive patients with suspicious cytology underwent reflexive FISH analysis. Clinical and pathologic data were reviewed retrospectively. Predictors for recurrence, progression, and findings on subsequent cystoscopy (within two-to-six months after FISH) were evaluated using univariate and multivariate Cox regression. Results 243 patients with suspicious cytology also had negative surveillance cystoscopy. Positive FISH was a significant predictor for recurrence (hazard ratio 2.35, 95% confidence interval [CI] 1.42, 3.90, p=0.001) in multivariate analysis and for progression (hazard ratio 3.01, 95% CI 1.10, 8.21, p=0.03) in univariate analysis, compared to negative FISH. However, positive FISH was not significantly associated with evidence of tumor on subsequent surveillance cystoscopy compared to negative FISH (odds ratio 0.8, 95% CI 0.26, 2.74, p=1). Conclusion Positive FISH predicts for recurrence and progression in NMIBC surveillance patients with suspicious cytology but negative cystoscopy. However, an association was not found between FISH result and tumor recurrence in the immediate follow-up period. Reflex FISH testing for suspicious cytology may have limited ability to modify surveillance strategies in NMIBC.

No abstract

No abstract

Introduction Frequently encountered morbidities after prostatectomy include stress urinary incontinence and erectile dysfunction. Patients with severe disease may undergo placement of both a penile prosthesis (PP) and an artificial urethral sphincter (AUS). Aim We hypothesized that concomitant PP may promote AUS cuff erosion by impaired corporal blood flow and/or direct pressure on the cuff. The aim of this study was to compare the rate of AUS cuff erosion in patients with and without a PP. Methods We reviewed 366 AUS operations at our tertiary center between 2007 and 2015 with a mean follow-up of 41 months (range 6–104). Included in the analysis were first-time AUS cuff erosions. Patients with recurrent erosions, AUS revisions, and iatrogenic erosions were excluded. In a separate analysis, we analyzed AUS explantations for all causes. Cohorts were compared by demographic information, preoperative characteristics, and rates of erosion and explantation. Main Outcome Measures Erosion confirmed by cystourethroscopy and explantation of the AUS for all causes. Results Among 366 AUS surgeries at a mean follow-up of 41 months, there were 248 (67.8%) AUS alone cases compared to 118 (32.2%) AUS and PP cases (AUS/PP). Sixty-two patients met exclusion criteria for first-time cuff erosion. Among 304 evaluable AUS patients, we found a significantly higher rate of erosion in the AUS/PP group (11/95, 11.6%) compared to the AUS alone group (9/209, 4.3%, P = .037). When examining explantations for all causes in the entire cohort (n = 366), we observed a significantly higher rate of device removal, (20/118, 17%) in the AUS/PP group compared to the AUS group (23/248, 9.2%, P = .044). Conclusion AUS/PP patients appear to have a higher risk of AUS cuff erosion and explantation compared to men with AUS alone.