Our findings support observations of decreased penile length after radical prostatectomy. Men should be counseled before radical prostatectomy that penile shortening may occur.

Information from this study could be useful in constructing interventions that allow the physician and the prostate cancer 'couple' to reflect on issues of sexual function and psychological distress that might once have been considered taboo. The results characterize the disparities between patients with prostate cancer and their partners on self-reported questionnaires, and underscore how important it is to hear the voice of the 'couple'.

Small, recurrent, low grade appearing bladder tumors are slow growing and pose minimal risk. Therefore, as an alternative to in office fulguration to minimize morbidity and cost associated with repeat transurethral resection it may not be necessary to remove these tumors promptly at new tumor occurrence or recurrence.

No abstract

TURBT is a reasonably safe procedure when performed by urologists in training under direct attending supervision. The complication rate was 5.8%, however only 1 case required surgical intervention. Contrary to expected findings, more senior residents were involved in the complications, likely secondary to their disproportionate roles in more difficult resections.

The considerable experience of the University of Miami in treating TCC is reviewed in the first article in this section. The authors found that the incidence of upper tract tumour after radical cystectomy for TCC is low, but that patients with prostatic urethral involvement at cystectomy have a greater risk of developing upper tract tumours. A questionnaire‐based study in the UK attempted to assess how upper tract surveillance is carried out by British urologists in patients with urinary tract TCC. They found a wide variation in practice, which presumably is similar to that also found in other parts of the world. They recommend a follow‐up strategy and suggest that this surveillance should continue for at least 15 years. There is an evaluation of the long‐term results of salvage cystectomy after interstitial radiotherapy and external beam radiotherapy for TCC reported from Amsterdam. They found that salvage cystectomy gives acceptable morbidity and for any type of urinary diversion. OBJECTIVE To review the incidence, pattern and outcome of upper tract transitional cell carcinoma (TCC) after radical cystectomy for carcinoma of the bladder, and identify risk factors for its development. PATIENTS AND METHODS The records of 235 consecutive patients who had a radical cystectomy and urinary diversion for TCC at the authors’ institution by one surgeon between January 1992 and August 2003 were retrospectively reviewed. RESULTS Five (2%) of 235 patients developed an upper tract urothelial tumour. The mean follow‐up for all patients was 42 months, and was 52.2 months for those with an upper tract tumour. Four of the five patients presented with haematuria and one was diagnosed on routine follow‐up intravenous urography. The mean time to the diagnosis of an upper tract tumour was 39.6 months. Of the potential risk factors, only the presence of TCC of the prostatic urethra had a statistically significant association with eventual upper tract tumour (P < 0.01). At the last follow‐up, four patients died from urothelial cancer and one was disease‐free. CONCLUSIONS The incidence of upper tract tumour after cystectomy for TCC is low; most patients present with symptoms (haematuria) and have advanced disease at diagnosis. Patients with prostatic urethral involvement at cystectomy are at greater risk of developing upper tract tumour.

No abstract

After 3 yrs of deployment of a telemedicine intensive care unit program, this retrospective observational study of mortality and length of stay outcomes included all cases admitted to an adult intensive care unit and found statistically significant decreases in severity-adjusted hospital length of stay of 14.2%, intensive care unit length of stay of 12.6%, and relative risk of hospital mortality of 23%, respectively, in a multihospital healthcare system.