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Prostate specific antigen screening has led to an increase in the number of patients undergoing prostate biopsy which, in turn, has increased the incidence of post-biopsy complications. However, most of the complications are minor and self-limiting. In this large study population the increased number of biopsy cores did not result in an increased incidence of major post-biopsy complications.

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Background Potential differences in efficacy of different BCG strains are of importance for daily practice, especially in the era of BCG shortage. Objective To retrospectively compare the outcome with BCG Connaught and BCG Tice in a large study cohort of pT1 high grade non muscle-invasive bladder cancer (NMIBC) patients. Design, setting, and participants Individual patient data were collected for 2451 patients with primary T1G3 tumors from 23 centers who were treated with BCG for the first time between 1990 and 2011. Outcome measurements and statistical analysis Using Cox multivariable regression and adjusting for the most important prognostic factors in this non randomized comparison, BCG Connaught and TICE were compared for time to recurrence, progression and the duration of cancer specific (CSS) and overall survival (OS). Results and limitations Information on the BCG strain was available for 2099 patients: 957 on Connaught and 1142 on TICE. 765 (36%) patients received some form of maintenance BCG, 560 (59%) on Connaught and 205 (18%) on TICE. Without maintenance, Connaught was more effective than TICE only for the time to first recurrence (HR = 1.48, 95% CI: 1.20 – 1.82, p < 0.001). With maintenance, TICE was more effective than Connaught for the time to first recurrence (HR = 0.66, 95% CI: 0.47 – 0.93, p=0.019) with a trend for CSS (HR = 0.36, 95% CI: 0.14 – 0.92, p = 0.033). For time to progression and OS, Connaught and TICE had a similar efficacy. Compared to no maintenance therapy, maintenance BCG significantly reduced the risk of recurrence, progression and death, both overall and disease specific, for TICE but not for Connaught. Conclusions We found that BCG Connaught results in a lower recurrence rate as compared to BCG Tice when no maintenance is used. However, the opposite is true when maintenance is given. Patient summary Since there is currently a BCG shortage, information on the efficacy of different BCG strains is important. In this non randomized retrospective comparison in over 2000 patients, we found that BCG Connaught reduces the recurrence rate compared to BCG Tice when no maintenance is used, but the opposite is true when maintenance is given.

were reviewed retrospectively. During this period, 26 patients (mean age 43.5 years, range 17-85) had surgical management of XGP; information on the mode of presentation, surgical management, hospital course and complications were analysed. RESULTSTwelve (46%) and 14 (54%) patients had ON and LN, respectively. The LN group had significantly lower blood loss ( P = 0.002), transfusion rates ( P = 0.02), time to resumption of oral intake ( P = 0.002) and length of hospital stay ( P = 0.002) than the ON group. One (7%) LN was converted to ON due to failure to progress. The overall complication rates between the ON and LN groups were not significantly different ( P = 0.95). CONCLUSIONSLN in the setting of XGP is often difficult and requires advanced laparoscopic skills. In highly selected patients this approach can be offered, with acceptable morbidity, allowing for lower blood loss and shorter convalesce times. KEYWORDSxanthogranulomatous pyelonephritis, laparoscopic nephrectomy, outcomes Study Type -Therapy (case series) Level of Evidence 4

urinary and sexual function and bother was also constructed. RESULTSThere were no differences in the QoL scores among the three groups; group 3 (control) tended to have a better QoL for all domains except emotional functioning. Urinary function was seriously affected in group 1, with more daytime leakage than in groups 2 and 3 (37.8% vs 10%, P = 0.005, and 9.3%, P = 0.01), night loss of urine (39.5% vs 28%, P = 0.07, and 3.7%, P = 0.002) and urine odour (58.6% vs 4%, and 5.5%, both P = 0.001). Patients in group 2 differed from healthy individuals only in night loss of urine. Consequently urinary bother was more pronounced in group 1, as fewer were satisfied (68.9% vs 86% and 83.2%, both P = 0.03). Sexual function was seriously and similarly affected in groups 1 and 2; the erection rate was 28.9% for group 1, 35.5% for group 2 ( P = 0.1) and 83.3% in group 3 ( P = 0.003), while firm erections were present at 17.7%, 22.2% ( P = 0.2) and 83.3% ( P = 0.002). Women reported equivalent dysfunction in all three groups (15.4%, 20% and 16.6%, P = 0.3). Sexual desire was also equal in all groups (48.2%, 50% and 48.1). Patients in group 1 expressed more bother, while those in group 2 seemed more satisfied by their sexual life (84.4%, 68% and 68.5%, P = 0.04). CONCLUSIONSRadical cystectomy does not affect QoL whichever urinary reconstruction is used, and this implies a determination by the patients to live and adjust to their new conditions. On the contrary, urinary and sexual function are affected and related to the method used to reconstruct the urinary system. KEYWORDSquality of life, bladder cancer, radical cystectomy, ileal conduit, modified S-pouch. OBJECTIVESTo measure the quality-of-life (QoL) outcome and urinary and sexual function and bother after radical cystectomy and different types of urinary tract reconstruction (Bricker vs modified S-pouch neobladder), also assessing differences between them and a normal population. PATIENTS, SUBJECTS AND METHODS

Perioperative parameters for CP are encouraging. However, the costs are a clear disadvantage. In our hospital, it is more cost effective to teach and perform LP than to perform CP.

Introduction: Impacted stones are those that remain unchanged in the same location for at least 2 months. Materials and Methods: We evaluated 42 patients with impacted ureteral stones, and followed them for two and a half years to check for long-term results. The calculi location included all three segments of the ureter (proximal, mid and distal). Patients’ age ranged from 22 to 83 years (mean 52.5 years). Primarily, patients were manipulated with extracorporeal shock wave lithotripsy (ESWL) in situ, or following stenting. If the result was not satisfactory, then we proceeded to retrograde ureteroscopy and ureterolithotripsy. Open ureterolithotomy was our final choice. Results: Thirty-six of the 42 patients (85.7%) were stone-free without the need of an open procedure. Follow-up period ranged from 10 up to 40 months, with a median period of 30 months and was achieved in 30 patients (71.4%). Stone recurrence was noted in 4 cases, while hydronephrosis without evidence of stone presence in 2. Conclusions: The initial approach for the treatment of impacted lithiasis should be attempted by ESWL. If this fails, alternative therapeutic solutions such as endoscopy can result in removal of the stone.