Objective: The objective of this study is to summarise the contemporary evidence regarding the prevalence, diagnosis, and management of osteitis pubis (OP) specially from urological point of view, while proposing an algorithm for the best management based on the current evidence. Methods:We performed a literature search using the PubMed database for the term 'osteitis pubis' until December 2020. We assessed pre-clinical and clinical studies regarding the aetiology, pathophysiology, and management of OP. Case reports and case series were evaluated by study quality and patient outcomes to determine a potential clinical management algorithm.Results: Osteitis pubis is a chronic painful condition of the symphysis pubis joint and its surrounding structures. Still, there is a paucity of data outlining the management plan and the possible triggers. The aetiology seems to be multifactorial with different proposals trying to explain the pathophysiology and correlate the findings to the outcome. The diagnosis is usually based on high suspicion index and clinical experience.The infective variant of the disease is aggressive and requires strict and active management. Universal consensus is still lacking regarding a formal algorithm of management of the condition, especially due to multiple specialities involved in the decision-making process. Conservative management remains the cornerstone; nevertheless, surgical interventions may be needed in special settings. Hence, a multi-disciplinary approach is of pivotal value in fashioning the plan for each case.The prognosis is usually satisfactory; however, a longstanding debilitating disease form is not uncommon. Conclusion:OP remains a rare condition with real challenges in its diagnosis. The current management is focused on conservative management; however, surgical intervention is still needed in some difficult scenarios. Continued research into the triggers of OP, multidisciplinary approach, and standardised clinical pathways can improve the quality of care for patients suffering from this condition.

Aims: To represent the demographic and functional data of a cohort of patients with invasive bladder cancer managed with Open Radical Cystectomy (ORC) in the Urology Department of Tanta University Hospital between January 2019 and January 2021. Methodology: A retrospective analysis was performed on the records of ORC for the period between January 2019 and January 2021. This cross-sectional study was done in the Urology Department, Tanta University Hospital in Egypt. Results: Data of 47 patients were collected. Most of the patients in were males (34 patients (72.3%), with male to female ratio of 3:1. Most of the patients were either smokers or ex-smokers, while only 18 patients (38.3%) never smoked before. Visible hematuria was the most common symptom at presentation (35 patients) 74.5%. The main radiological imaging used for staging was CT Urography. Most of the tumors were urothelial in 66% of patients. Squamous differentiation was the most common non urothelial variant with 8 patients. The presence of other non-urothelial variant histology was present in 6 patients. Conclusion: This study revealed that in the tertiary hospital of Tanta University, the mean age of patients presented with bladder cancer and undergoing ORC, was 63.5 years. Visible haematuria was the most common complaint reported. The use of MRI is valuable in staging of locally advanced bladder cancer. Most of the tumours were urothelial (66%) with significant reduction in the incidence of squamous cell bladder cancer than the previously reported data. Neoadjuvant chemotherapy has become an integral part of the treatment protocol in cases of muscle invasive bladder cancer.

Objective To report changing practice in the management of intra-diverticular bladder tumours. Methods We undertook a review of all intra-diverticular bladder tumours in our prospectively maintained institutional database. Results A total of 28 patients (male = 27, female = 1) with a median age of 71 years (IQR 61 to 76) were diagnosed with intra-diverticular bladder tumours (IDBT) between March 2013 and February 2021. Fourteen had visible and 3 had non-visible haematuria, while 11 patients had lower urinary tract symptoms. Median axial diameter of the diverticula was 46 mm (IQR 35 to 69), and median neck diameter was 9 mm (IQR 7 to 11). All patients had CT-urography and 5 patients also had an MRI. Surgical treatment consisted of diverticulectomy (n = 11), diverticulectomy and ipsilateral ureteric reimplantation (n = 11), radical cystectomy and ileal conduit (n = 4), or radical cystectomy and orthotopic bladder (n = 2). Eleven patients had open procedures, and 17 had robotic assisted surgery. Final pathological stages were T0 (n = 2), Ta (n = 5), T1 (n = 7), T3a (n = 8) and T3b (n = 6). Twenty-four patients had urothelial carcinoma (including one nested variant and 4 with squamous differentiation) and 2 had small cell carcinoma. Three patients had neoadjuvant systemic chemotherapy, 2 had intravesical bacillus Calmette-Guerin (BCG) with mitomycin, and one had BCG monotherapy preoperatively. Five patients had adjuvant systemic chemotherapy while 7 had adjuvant intravesical therapies. Mean follow-up period was 37.8 months (±25.3). Mean recurrence-free survival was 61.5% (CI 45.7 to 77.4) and mean overall survival 71.6 % (CI 57.4 to 85.8). Ten patients (37%) died of cancer. Conclusion Management of intra-diverticular bladder tumours is evolving. Bladder-sparing approaches are gaining popularity. Robot-assisted diverticulectomy is preferable as it reduces the morbidity resulting from treatment.