E 1 0 6 9What ' s known on the subject? and What does the study add? Of patients treated with an indwelling ureteric stent 80 -90% experience lower urinary tract symptoms that are a hindrance to health-related quality of life. The prevalence of the extraction/retrieval string after ureteroscopy for stone disease and stent placement varies signifi cantly between surgeons and published series, but the benefi ts of eliminating the need for a secondary procedure such as cystoscopy and stent removal, as well as the decrease in cost to the patient are well established.Published reports have not addressed the prevalence of post-procedure related events (PREs) in patients who have received an indwelling ureteric stent with the extraction/ retrieval string still intact after ureteroscopy for stone disease. By analysing PREs (Emergency Room visits, unscheduled clinic visits, and telephone calls) related to their stent or procedure for patients with and without an extraction/retrieval string, the feasibility of the extraction string can be validated and the misconceptions about their use can be alleviated. OBJECTIVE• To review a retrospective ureteric stent cohort with and without extraction string to compare post-procedure related events (PRE), as ureteric stent placement after endoscopic management of urolithiasis is common, but data regarding the potential benefi ts or disadvantages of ureteric stent placement with extraction string are sparse. PATIENTS AND METHODS• Between June 2009 and June 2010, 293 patients underwent ureteroscopy with or without lithotripsy for stone disease.• In all, 181 patients had a unilateral procedure and underwent stent placement postoperatively.• Records were retrospectively reviewed for operative data and PRE occurring within the fi rst 6 weeks after surgery, defi ned as unscheduled clinic or Emergency Room visits, or adverse event telephone calls. RESULTS• Of 181 patients who underwent ureteric stent placement, 43 (23.8%) included an extraction string.• In all, 34.3% of all patients had a PRE, including 37.2% and 33.3% of patients with and without extraction string, respectively ( P = 0.64).• PRE occurred in men with or without an extraction string (27.8 vs 32.4%, respectively; P = 0.71) and women with or without an extraction string (44.0 vs 34.3%, respectively, P = 0.39).• PRE occurred with relatively equal frequency between men and women ( P = 0.28).• Only two women (4.7%) reported removing their stent prematurely, on postoperative days 2 and 6. CONCLUSIONS• Ureteric stent placement with extraction string after ureteroscopy for stone disease does not seem to result in more PRE, regardless of gender.• Prospective randomised trials are needed to determine the benefi ts and disadvantages of ureteric stents with extraction string.

Anti-interleukin-10 receptor 1 mAb enhanced the bacillus Calmette-Guérin induced T-helper type 1 immune response and anti-bladder cancer immunity. A humanized form of this mAb warrants future investigation for bacillus Calmette-Guérin treatment of bladder cancer.

Giant renal angiomyolipomas have been reported, but typically have the pathognomonic finding of fat density on CT scan. We present the case of a 53-year-old male with a symptomatic, 35-cm, predominantly cystic renal mass without fat density on CT that on nephrectomy was found to be a fat-poor angiomyolipoma with predominantly epithelioid morphology weighing 17.9 kg. Giant renal angiomyolipoma without macroscopic fat density on CT scan is an exceedingly rare occurrence.

Basal cell carcinoma of the penis is an extremely rare entity, accounting for less than 0.03% of all basal cell carcinomas. Fortunately, wide local excision of such lesions is generally curative. Fewer than 25 cases have been reported in the literature describing penile basal cell carcinoma. Here we report a case of penile basal cell carcinoma cured with wide local excision.

A 23-year-old female was involved in a motor vehicle collision with multiple injuries, including a right acetabular fracture, but no pelvic fracture. Urology consultation was obtained due to difficulty placing a urethral catheter. Examination revealed a longitudinal urethral tear with vaginal laceration extending 2 cm from the urethral meatus proximally toward the bladder neck. The longitudinal urethral tear was repaired primarily. Traumatic female urethral injury in the absence of a pelvic fracture is an exceedingly rare occurrence.

No abstract

Bladder herniation within the inguinal canal is a relatively uncommon finding. We report an even less-common occurrence of transitional cell carcinoma located within a portion of inguinally herniated bladder. Fewer than 20 reports exist in the literature describing this scenario.

Introduction: Induction of Th1 immunity is required for effective intravesical BCG immunotherapy of bladder cancer. IL-10 down-regulates the Th1 response and is associated with BCG failure. We previously demonstrated that blocking IL-10 receptor (IL-10R) by systemic administration of anti-IL-10R1 mAb enhanced intravesical BCG (living Pasteur strain) treatment of bladder cancer in an orthotopic mouse model. Here we investigated the effect of anti-IL-10R1 mAb on clinically used BCG (lyophilized TICE strain) for induction of anti-bladder cancer immunity. Methods: Splenocytes were incubated with BCG alone or plus control IgG or ant-IL-10R1 mAb for 24 hours, followed by ELISA analysis of IFN-γ production. Bladder RNA was extracted after 6 treatments (twice weekly) with intravesical (i.b.) BCG plus intraperitoneal (i.p.) control IgG or anti-IL-10R1 mAb, followed by qPCR analysis of IFN-γ mRNA expression. Three groups of 20 mice were inoculated with luciferase-expressing MB49 bladder cancer cells and treated with i.b. PBS plus i.p. PBS (Group 1), i.b. BCG plus i.p. control IgG (Group 2), or i.b. BCG plus i.p. anti-IL-10R1 mAb (Group 3) 2x/wk for 6 total treatments. Mice were monitored weekly using IVIS luminescence and followed for 76 days. A bioluminesence cutoff of 5X104 p/s was used to establish the presence of bladder cancer. At animal death bladders were collected, weighed and processed for histological analysis. In suspected cases of metastatic disease the affected organs were also collected for histological analysis. Results: BCG plus anti-IL-10R1 mAb induced increased IFN-γ production by splenocytes in a dose-dependent manner. BCG plus anti-IL-10R1 mAb substantially increased IFN-γ mRNA. Eleven, 17 and 9 mice from Groups 1, 2 and 3, respectively, developed bladder cancer. One mouse in Group 2 and 2 mice in Group 3 showed cancer regression. 36%, 53% and 0% of Groups 1, 2 and 3 developed metastatic bladder cancer, respectively (p=0.020). While bladder weights for the groups were different, the differences did not reach statistical significance. Conclusions: Anti-IL-10R1 mAb enhances BCG-induced Th1 immune responses both in vitro and in vivo. Intravesical BCG plus anti-IL-10R1 mAb shows statistical significance in preventing metastasis of bladder cancer in an orthotopic bladder tumor mouse model. Anti-IL-10R1 mAb may prove useful in clinical practice for the prevention of metastatic bladder cancer in high-risk patients. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5390. doi:1538-7445.AM2012-5390