Billy Cordon

Reflex fluorescence in situ hybridization assay for suspicious urinary cytology in patients with bladder cancer with negative surveillance cystoscopy

To assess the ability of reflex UroVysion fluorescence in situ hybridization (FISH) testing to predict recurrence and progression in patients with non‐muscle‐invasive bladder cancer (NMIBC) with suspicious cytology but negative cystoscopy.

Reflex fluorescencein situhybridization assay for suspicious urinary cytology in patients with bladder cancer with negative surveillance cystoscopy: Reflex FISH assay for suspicious urinary cytology in patients with bladder cancer

To assess the ability of reflex UroVysion fluorescence in situ hybridization (FISH) testing to predict recurrence and progression in patients with non‐muscle‐invasive bladder cancer (NMIBC) with suspicious cytology but negative cystoscopy.

Contemporary surgical and non-surgical management of Peyronie’s disease

Numerous treatments have been proposed for Peyronie’s disease (PD). As the evidence base has expanded, the field of operative and non-operative options for patients has narrowed. Collagenase clostridium hystolyticum (CCH) injection now comprises the medical option, and surgical possibilities entail penile plication, plaque incision/excision and grafting, and prosthesis implantation. Still, questions abound regarding the optimal approach and indication for each of these treatments. We conducted a review of literature exploring the contemporary management of PD with a particular focus on work since the last American Urologic Association’s (AUA) guidelines update for PD. Recent results and discussion indicate trends toward minimal invasiveness, toward a more holistic approach to the PD patient, and away from algorithmic management, galvanized, in part, by data challenging long-held beliefs.

MP36-16 SALVAGE INTERNAL URETHROTOMY FOR MANAGEMENT OF URETHRAL STRICTURE FOLLOWING URETHROPLASTY

quality of the surgeries using a Likert rating scale from excellent to bad (1-5). RESULTS: Participants0 survey showed that overall the surgeons (1.34, n1⁄422.9), the surgical technique (1.48 n1⁄417.6) and the surgical presentation (1.55, n1⁄419.8) were perceived as excellent. The structural quality of the meeting was found to be very high (faculty: 1.35, n1⁄424; program: 1.38, n1⁄424; presentation: 1.55, n1⁄423.6; poster sessions: 1.82, n1⁄421.67; technique: 1.4, n1⁄423,34). Improvement of knowledge (1.8, n1⁄424.3) and surgical armamentarium (2.06, n1⁄423.7) were both rated good, suggesting that most participants value the educational benefit. Eighty seven percent of participants would attend the meeting again. CONCLUSIONS: We demonstrated a high educational/learning benefit for visitors participating at a live and semi-live surgery meeting. Standardized participant surveys may be helpful to compare surgical outcomes and educational benefits of live and semi-live surgery meetings.

V5-07 PERINEAL ARTIFICIAL URINARY SPHINCTER (AUS) WITH HIGH SUBMUSCULAR (HSM) PLACEMENT OF PRESSURE REGULATING BALLOON (PRB)

configuration. Patients were preoperatively assessed with transrectal ultrasound and uroflowmetry. Baseline functional parameters including International Prostate Symptom Score (IPSS), Maximum Flow Rate (Qmax) and Post-Void Residual (PVR) were assessed postoperatively during the follow-up. Perioperative outcomes included operative time (OR time), catheterization time (CV time) and length of hospital stay (LOS). Complications were recorded and graded according to the Clavien-Dindo classification. RESULTS: The median age was 69 years (IQR 66-76) and 48 (62%) of the patients had a Charlson Comorbidity Index of 2 or more. The median prostate volume was 130 ml (IQR 111e190) and 28 (34%) patients had an indwelling catheter prior surgery. Patients showed a significative improvement of functional outcomes, with a median Qmax improvement of +15 ml/s and a decrease of the IPSS and PVR of -20 and -73 ml respectively. The median OR time was 105 min (IQR 85150) and the median estimated blood loss was 250 ml (IQR 105-320). The median CV time and LOS time was 3 and 4 days respectively. The overall postoperative complication rate was 31% with no grade 4 and 5 complications. CONCLUSIONS: In our RASP series we obtained a significative improvement of functional outcomes with an acceptable risk of perioperative complications. This technique could be considered an interesting option for surgeons that have completed their learning curve performing an adequate number of robot-assisted radical prostatectomys and in case of concomitant pathologies needing a surgical approach as vescical stones, bladder diverticula or inguinal hernia.

PD22-03 OXIDIZED REGENERATED CELLULOSE (FIBRILLAR™) REDUCES RISK OF POSTOPERATIVE HEMATOMA FOLLOWING INFLATABLE PENILE PROSTHESIS

INTRODUCTION AND OBJECTIVES: Oxidized regenerated cellulose (ORC) (Fibrillar ) is a topical absorbable hemostatic agent widely used in various urologic surgical procedures. Little is known regarding the impact of hemostatic agents in reducing risk of hematoma formation among men undergoing urologic prosthetic surgery. This study reports our initial experience with ORC as a hemostatic adjunct during inflatable penile prosthesis (IPP) surgery to determine the effect on postoperative drain output and subsequent complications. METHODS: Beginning in March 2016 ORC was placed as a pledget within the corporotomy closure of all men undergoing IPP insertion. Demographic, intraoperative, and postoperative parameters including cumulative overnight postoperative drain output were evaluated among cases with (March 2016 to present) and without ORC (December 2015 to March 2016) using an identical surgical technique by a single surgeon. Continuous variables were compared with the Mann-Whitney U test. Categorical variables were compared with Fisher’s exact test. RESULTS: During the study period 61 men underwent IPP procedures. ORC was used in 27/61 cases (44%) causing a 38% reduction in median drainage output compared to the control group (40 mL vs. 65 mL; p1⁄40.01). There was no difference in demographic, perioperative, or device-related characteristics. There were 2 IPP explantations secondary to infection, both of which occurred in the control group; one of which was directly related to hematoma formation. After controlling for other clinical features, the use of ORC (b -31, 95% CI: -61 to -1.3; p1⁄40.04) was the only factor independently associated with a reduction in drain output. CONCLUSIONS: This study suggests that the use of ORC pledgets during corporotomy closure of IPP reduces risk of hematoma formation.

MP28-01 PROFOUND INFLUENCE OF ANDROGENS ON HISTOLOGIC ARCHITECTURE OF THE RAT URETHRA

invasion. The aim of this study is to investigate the prognostic value of maximum tumor diameter (MTD), which is a simple index for evaluating size of tumors, in UTUC patients treated by radical nephroureterectomy (RNU). In the study, we hypothesize that primary tumor location would affect the outcomes. METHODS: We retrospectively analyzed the clinical records of 740 patients with non-metastatic UTUC (Ta-4N0M0) at our Japanese institutions between 1993 and 2010. The median follow-up period was 2.8 years. We examined MTD in extirpated surgical specimen at the time of RNU, and analyzed the association between MTD and UTUC clinical outcomes. We also evaluated the prognostic significance of MTD in renal pelvic tumor (RPT) (N1⁄4393, 53.1%) and ureteral tumor (UT) (N1⁄4347, 46.9%) separately. RESULTS: A total of 190 patients experienced disease recurrence, and of these 144 died of the disease during follow-up. Mean value of MTD in all patients was 31.3mm, while those of RPT and UT groups were 34.4mm and 27.8 mm (P<0.001), respectively. Using the defined cut-off value of MTD 31.3mm, multivariate analysis in overall patients revealed that high MTD ( 31.3mm ) was an independent prognostic indicator in addition to tumor grade, pT stage, LVI, and the existence of skip lesion for cancer-specific survival (P 1⁄4 0.019, HR 1⁄4 1.50), although it did not independently predict subsequent disease recurrence following RNU. In a subgroup of patients with RPT, multivariate analyses revealed that high MTD ( 34.4mm) was an independent prognostic indicator of both disease recurrence (P 1⁄4 0.030, HR 1⁄4 1.57) and cancer-specific survival (P 1⁄4 0.001, HR 1⁄4 2.16) in addition to tumor grade, pT stage, and LVI. The 5-year recurrence-free and cancer-specific survival rates were 61.6% and 66.4% in patients with high MTD, and 73.0% and 80.4% in their counterparts, respectively (P < 0.05). In a subgroup of patients with UT, multivariate analyses revealed pT stage but not high MTD ( 27.8mm) were independent predictors for disease recurrence/cancer-specific survival. CONCLUSIONS: Results show that impact of MTD may differ between RPT and UT patients, suggesting MTD represents a clinically relevant predictor of patient prognosis especially in RPT group.