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Study design: Prospective monocentric follow-up study. Objectives: To assess long-term functional and urodynamic results of augmentation enterocystoplasty in spinal cord injury (SCI) patients with detrusor hyperre¯exia and re¯ex incontinence who failed to respond to conservative treatment. Settings: Department of Urology (Pitie -Salpe trieÁ re Hospital, Paris, France), Department of Neurological Rehabilitation (Raymond Poincare Hospital, Garches, France), Assistance Publique ± Hopitaux de Paris, University Paris VI and V, France. Methods: Prospective study of 17 SCI patients (four above T6 level, nine between T6 and T12, and four below T12) with history of refractory urge incontinence to pharmacotherapy. Partial cystectomy (subtrigonal for 15) was performed with Hautmann enterocystoplasty (15) or detubularized clam cystoplasty (two). Results: Mean follow-up was 6.3+3.8 years (range 1.25 ± 10.5 years). Fifteen of 17 (88.5%) patients were completely continent under self clean intermittent catheterization (CIC) (mean 4.6/day, range 4 ± 7). The remaining two patients with pudendal nerve denervation had persistent stress urinary incontinence. No operative complications were noted. Long-term complications included recurrent pyelonephritis for one patient. Maximal cystometric capacity increased from 174.1+103.9 to 508.1+215.8 ml (P50.05). Maximal end ®lling pressure decreased from 65.5+50.2 to 18.3+7.9 cm H 2 O (P50.05). Conclusion: Urodynamic evaluation and clinical assessment demonstrate long-term success of augmentation enterocystoplasty in an homogeneous population (SCI) without delayed complications in SCI patients. Spinal Cord (2000) 38, 490 ± 494

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Pages 11 2 A. Méjean et al. Résultats. -La prise en charge médicale et chirurgicale des patients atteints de cancers de l'appareil urinaire et génital masculin doit être adaptée en modifiant les modalités de consultation, en priorisant les interventions en fonction du pronostic intrinsèque des cancers en tenant compte des comorbidités du patient. La protection des urologues vis-à-vis du COVID-19 doit être prise en considération. Conclusion. -Le CCAFU émet un avis d'experts quant aux mesures à prendre pour adapter la prise en charge des cancers de l'appareil urinaire et génital masculin au contexte de pandémie par COVID-19. Summary Aim. -The French population is facing the COVID-19 pandemic and the health system have been reoriented in emergency for the care of patients with coronavirus. The management of cancers of the urinary and male genital tracts must be adapted to this context. Material and method. -An expert opinion documented by a literature review was formulated by the Cancerology Committee of the French Association of Urology (CCAFU). Results. -The medical and surgical management of patients with any cancers of the urinary and male genital tracts must be adapted by modifying the consultation methods, by prioritizing interventions according to the intrinsic prognosis of cancers, taking into account the patient's comorbidities. The protection of urologists from COVID-19 must be considered. Conclusion. -The CCAFU issues an expert opinion on the measure to be taken to adapt the management of cancers of the male urinary and genital tract to the context of pandemic by COVID-19.

In this study the incidence of post-prostate biopsy sepsis was 2.8% and no deaths were reported. Risk factors identified on multivariate analysis were noncompliance with antibiotic prophylaxis according to guidelines, antibiotic treatment in the previous 6 months and a history of prostatitis.

Purpose: Developing strategies to overcome resistance to sunitinib is a major challenge in human renal cell carcinoma (RCC). We hypothesized that sunitinib-induced tumor necrosis-associated hypoxia could interact with renal cancer stem cells in patients with metastatic RCC.Experimental Design: We studied tissue samples from 7 patients with primary metastatic RCC, before and after sunitinib treatment, and from six xenograft models derived from human RCC. Two xenograft models were responders to sunitinib, the four others were nonresponders. CD133/CXCR4-coexpressing cells derived from the two responder xenograft models were used for in vitro studies.Results: In the seven primary RCCs, we identified a significantly larger number of CD133/CXCR4-coexpressing cells in perinecrotic versus perivascular areas. Their numbers also significantly increased after treatment, in perinecrotic areas. We reproduced these clinical and pathologic results in all six RCC xenograft models with again a preferential perinecrotic distribution of CD133-expressing cells. Necrosis occurred at day 7 in the two responder models treated with sunitinib, whereas it occurred at day 21 in the untreated controls and in the four nonresponder models. Strikingly, when we studied the six RCC xenograft models at the time necrosis, whether spontaneous or sunitinib-induced, occurred, necrosis area correlated with stem-cell number in all 120 xenografted RCCs. When studied under experimental hypoxia, the number of CD133/CXCR4-coexpressing cells and their tumorigenic potency increased whereas their sensitivity to sunitinib decreased.Conclusions: In human RCC, sunitinib was able to generate resistance to its own therapeutic effect via induced hypoxia in perinecrotic areas where cancer stem cells were found in increased numbers.

Large pelvic stones are frequently managed with percutaneous nephrolithotomy (PCNL) but laparoscopic transperitoneal pyelolithotomy (LTP) can be an alternative. We compared PCNL and LTP for the treatment of pelvic stones >20 mm in diameter. Patients and Methods: Between November 1999 and November 2004, 16 consecutive patients, mean age 42, with a single pelvic stone >20 × 10 mm (group I), underwent LTP as first-line treatment or after shockwave lithotripsy failure. They were compared with a similar population of 16 consecutive patients, mean age 45 (group II), who underwent PCNL for the same indication and were assessed retrospectively. We evaluated operative characteristics, complications, and results for each technique. Results: There was no difference between the two groups regarding the characteristics of patients and stones. Operative time duration was significantly longer in group I (129 vs. 75 min; p = 0.001) and conversion was required in 2 patients (12%). The main postoperative complications were urinary leakage (2 patients, 12%) in group I and bleeding (3 patients, 18%) in group II, but only 1 required blood transfusion. Mean hospital stay was respectively 6.5 and 5.6 days in groups I and II (p = 0.17). Stone-free rates were assessed at 3 months and were not different between group I and group II (88 vs. 82%). Conclusions: The operative time of LTP is longer and the results of both techniques are comparable but postoperative morbidity is different. Specific indications of each technique must be determined although PCNL remains the gold standard for most large pelvic stones.

BackgroundNon-muscle-invasive bladder cancer (NMIBC) is a high incidence form of bladder cancer (BCa), where genetic and epigenetic alterations occur frequently. We assessed the performance of associating a FGFR3 mutation assay and a DNA methylation analysis to improve bladder cancer detection and to predict disease recurrence of NMIBC patients.MethodsWe used allele specific PCR to determine the FGFR3 mutation status for R248C, S249C, G372C, and Y375C. We preselected 18 candidate genes reported in the literature as being hypermethylated in cancer and measured their methylation levels by quantitative multiplex-methylation specific PCR. We selected HS3ST2, SLIT2 and SEPTIN9 as the most discriminative between control and NMIBC patients and we assayed these markers on urine DNA from a diagnostic study consisting of 167 NMIBC and 105 controls and a follow-up study consisting of 158 NMIBC at diagnosis time’s and 425 at follow-up time. ROC analysis was performed to evaluate the diagnostic accuracy of each assay alone and in combination.ResultsFor Diagnosis: Using a logistic regression analysis with a model consisting of the 3 markers’ methylation values, FGFR3 status, age and known smoker status at the diagnosis time we obtained sensitivity/specificity of 97.6 %/84.8 % and an optimism-corrected AUC of 0.96. With an estimated BCa prevalence of 12.1 % in a hematuria cohort, this corresponds to a negative predictive value (NPV) of 99.6 %. For Follow-up: Using a logistic regression with FGFR3 mutation and the CMI at two time points (beginning of the follow-up and current time point), we got sensitivity/specificity/NPV of 90.3 %/65.1 %/97.0 % and a corrected AUC of 0.84. We also tested a thresholding algorithm with FGFR3 mutation and the two time points as described above, obtaining sensitivity/specificity/NPV values of, respectively, 94.5 %/75.9 %/98.5 % and an AUC of 0.82.ConclusionsWe showed that combined analysis of FGFR3 mutation and DNA methylation markers on urine can be a useful strategy in diagnosis, surveillance and for risk stratification of patients with NMIBC. These results provide the basis for a highly accurate noninvasive test for population screening and allowing to decrease the frequency of cystoscopy, an important feature for both patient quality of life improvement and care cost reduction.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2748-5) contains supplementary material, which is available to authorized users.