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Kidney transplant recipients have a heightened risk of developing neoplasms. Immunosuppressive treatments decrease the incidence of transplant rejection but increase the risk of infections, including BK virus (BKV). This infection is acquired in childhood and remains latent in the renal and urinary epithelium. In cases of immunodeficiency, BKV has been implicated as a tumor virus, but the role of BKV in cancer is a controversial topic and is difficult to determine. In the tumor cells, it is possible to detect fragments of the viral genome that could alter the control mechanisms of the cell cycle and DNA repair. We report the case of a kidney transplant recipient who developed BKV nephropathy and carcinoma of the bladder, supporting a possible role for BKV in the oncogenic pathway in this clinical setting, but the role of BKV in cancer remains a controversial topic and difficult to determine.

Study Type – Therapy (case series)
Level of Evidence 4 What’s known on the subject? and What does the study add? The superficial dorsal penile vein thrombosis (SDPVT) has been described in connection with different medical and surgical conditions but never in subinguinal varicocelectomy. This study provides the description of a new surgical complication in the subinguinal varicocelectomy: SDPVT. We analysed the pathophisiology and the management of this entity. OBJECTIVE To describe the symptomatology, diagnosis and treatment of superficial thrombosis of the dorsal penile vein – the most common complication of subinguinal varicocelectomy – and analyse the possible mechanisms involved in the development of the condition. PATIENTS AND METHODS The clinical records of 326 patients who underwent varicocele repair during the last 10 years was reviewed. The technique used was subinguinal varicocelectomy with arterial preservation. A mini‐Doppler probe was used during surgery for artery identification. We report on the postoperative complications of varicocelectomy, with special attention to superficial dorsal penile vein thrombosis, and provide a detailed description of the anatomy of the superficial venous system of the penis. RESULTS Complications usually associated with varicocele surgery occurred in less than 1% of patients. However, the most common complication in our series was superficial dorsal penile vein thrombosis, which occurred in 2.1% of patients. The use of the mini‐Doppler probe allowed us to identify and preserve the arteries in all 326 patients. CONCLUSION Subinguinal varicocelectomy with intra‐operative use of a mini‐Doppler probe is a rapid and safe technique. The outcomes and complications are similar to those reported for subinguinal microscopic varicocelectomy. Superficial dorsal penile vein thrombosis is a benign self‐limited condition whose association with subinguinal varicocelectomy has not been previously reported.

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486 Background: There is an unmet clinical need for new drugs able to delay or avoid cystectomy in patients with CIS unresponsive to BCG. Here, we report the safety and efficacy of Oncofid−P-B, is a new drug that originates from the chemical conjugation of paclitaxel with hyaluronic acid, in patients with CIS unresponsive or intolerant to BCG. Methods: This is an open-label, single arm, multicenter international study (Registered as EudraCT Number: 2016-004144-11) to assess safety, tolerability and efficacy of Oncofid-P-B administered in 20 patients with CIS, unresponsive or intolerant to BCG and unwilling or unfit for cystectomy. Oncofid-P-B was administered by intravesical instillation for 12 consecutive weeks (intensive phase). A 12 monthly (maintenance phase) in patients who were in complete response (CR) after the intensive phase is ongoing. The primary end-point was the overall safety profile. Secondary endpoints included i) efficacy after the intensive phase ii) compliance, iii) systemic absorption. The CR is defined as a negative cystoscopy including biopsy of the urothelium and negative cytology. Statistics will be calculated, as appropriate, for the quantitative variables. Results: Of the 20 enrolled patients who completed the intensive phase, CR was achieved in 15 patients (75%). Seven G1-G2 drug-related adverse events (AEs) were reported in only three patients over 240 instillations. No drug related serious AEs and no study withdrawal have been reported. In all plasma samples, the drug concentration was always below the Limit of Quantification (0.1ng/ml). Over 15 patients who ended the intensive course without CIS recurrence, five already completed the 12-month maintenance phase (four patients with no recurrence of CIS), thirteen were disease free after three months and six are completing the maintenance. Conclusions: The excellent safety profile of Oncofid-P-B is well positioned as compared with the most recent competitors, thus confirming its potential as therapeutic option in BCG unresponsive CIS patients, also with a prolonged treatment schedule, and deserves further clinical evaluation. Clinical trial information: 2016-004144-11.

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between responders and non-responders. Responders exhibited higher IL-8 levels at study entry and higher VEGF-A levels after Sunitinib; however, the changes seen in IL-8 (p[0.84) and VEGF-A (p[0.85) were not statistically significant. Responders exhibited lower VEGF-D levels until after Sunitinib at which point they developed a higher mean level and a greater change from study entry than non-responders. This effect was found to be statistically significant (p[0.04).CONCLUSIONS: The primary endpoint of our study was reached with 26 patients demonstrating 3-month CR. In addition, the statistically significant increase in VEGF-D levels in responders supports the theory that VEGF plays an important role in the pathogenesis of NMIBC and thus warrants further investigation.

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