We describe 24 consecutive patients with cervical cancer stage III or IV who received palliative urinary diversion by percutaneous nephrostomy. All patients had proven malignant ureteric obstruction, uremia and failed ureteric stenting. 11 of 17 patients with extensive primary cancer and local lymph node involvement had an acceptable quality of life for 2 or more months while the mean survival was 5.6 months. Patients with disseminated metastasizing cancer were not satisfactorily served by nephrostomy.

Study Type – Practice patterns (retrospective cohort) Level of Evidence 2b OBJECTIVE • To evaluate the safety and feasibility of laparoscopic adrenalectomy (LA) performed in several German centres with different laparoscopic experience, as LA has become the gold‐standard approach for benign surgical adrenal disorders; however, for solitary metastasis or primary adrenal cancer its precise role is uncertain. PATIENTS AND METHODS • The data of 363 patients who underwent a LA were prospectively collected in 23 centres. • All centres were stratified into three groups according to their experience: group A (<10 LAs/year), group B (10–20 LAs/year) and group C (>20 LAs/year). • In all, 15 centres used a transperitoneal approach, four a retroperitoneal approach and four both approaches. • Demographic data, perioperative and postoperative variables, including operating time, surgical approach, tumour size, estimated blood loss, complications, hospital stay and histological tumour staging, were collected and analysed. RESULTS • The transperitoneal approach was used in 281 cases (77.4%) and the retroperitoneal approach was used in 82 patients (22.6%). • In all, 263 of 363 lesions (72.5%) were benign and 100 (27.5%) were malignant. • The mean (sd) operating time was 127.22 (55.56) min and 130.16 (49.88) min after transperitoneal and retroperitoneal LA, respectively. • The mean complication rates for transperitoneal and retroperitoneal LA were 5% and 10.9%, respectively. CONCLUSION • LAs performed by urologists experienced in laparoscopy is safe for the removal of benign and malignant adrenal masses. LA for malignant adrenal tumours should be performed only in high‐volume centres by a surgeon performing at least >10 LAs/year.

BACKGROUND: The authors investigated whether cancer patients who have comorbid mental health disorders (MD) are at greater risk of early retirement compared with those who do not have MD. METHODS: Individuals ages 18 to 55 years from a consecutive sample of patients who were admitted for inpatient oncologic treatment were interviewed using structured clinical interviews to ascertain MD. The patients were followed for 15 months, and the date of early retirement was documented. Rates of early retirement per 100 person-years (py) in patients with and without MD were compared using multivariate Poisson regression models. RESULTS: At baseline, 491 patients were interviewed, and 150 of those patients (30.6%) were diagnosed with MD. Forty-one patients began full early retirement during follow-up. In patients with MD, the incidence of early retirement was 9.3 per 100 py compared with 6.1 per 100 py in mentally healthy patients. The crude rate ratio (RR) was 1.5 (95% confidence interval [CI], 0.8-2.8). The effect of MD on early retirement was modified in part by income: in patients with low income, the adjusted RR was 11.7, whereas no effect was observed in higher income groups. Patients with depression were at greater risk of retirement when they had higher income (RR, 3.4; P 5.05). The effects of anxiety (RR, 2.4; P 5.05), adjustment disorders (RR, 1.7; P 5.21), and alcohol dependence (RR, 1.8; P 5.40) on early retirement were equal across income groups. CONCLUSIONS: Mental health conditions are risk factors for early retirement in cancer patients, although this effect differs according to the type of disorder and the patient's income level. Cancer 2014;120:2199-206.

CRMP4 promoter methylation in diagnostic biopsies could be a robust biomarker for LNM in PCa.

In an anatomical study of serial sections of the bladder neck taken from 65 cadavers of all age groups the ventral longitudinal muscle system is shown as a single unit. It is characterized by two origins and two insertions. A detailed description is given. It should be emphasized that there is no connection between this muscle system and any muscle layer of the urinary bladder. The muscle bundles of the upper part of the ventral longitudinal urethral muscle system cross in stages the whole ventral circumference of the trigonal sphincter muscle with functional consequences. The lower part is closely combined with the lumen of the urethra. During contraction the muscle could be able to open the musculus sphincter trigonalis and the musculus sphincter urethrae; we called them musculus dilator urethra. Summarizing all presented histomorphological results of parts 1–4 of these papers [Dorschner et al.; Urol Int 52; 1994] a new theory of micturition and its initiation is presented.