Preston Kerr

Urethral Steinstrasse following Laser Lithotripsy of Prostatic Urethral Calculi

Symptomatic prostatic calculi are rare occurrences with several management options, the most popular of which is currently transurethral laser lithotripsy. This is a generally well-tolerated procedure with minimal complications. To date, no reported episodes of steinstrasse at the urethral level following prostatic calculi lithotripsy have been documented to our knowledge. We report a unique case of acute urinary retention secondary to obstructive calculi fragments following a transurethral laser lithotripsy of large prostatic calculi, further complicated by stricture at the fossa navicularis.

A Rare Case of Multifocal Prostatic Blue Nevus

Prostatic blue nevus is a rare benign pathologic diagnosis most commonly diagnosed incidentally on many different types of prostate specimens. Blue nevus is the deposition of stromal melanin characterized by spindle cells within the fibromuscular stroma which stains positive for melanin-specific stains Fontana-Masson and S100 and stains negative for CD68, HMB45, and iron stains. We report the case of a multifocal and bilateral blue nevus in a 52-year-old Hispanic male who presented with an elevated prostate-specific antigen of 4.3 and mild obstructive lower urinary tract symptoms, found by transrectal ultrasound-guided prostate needle biopsy. The biopsy also revealed benign prostatic tissue with postatrophic hyperplasia and chronic inflammation. This is the 35th reported case of prostatic blue nevus and the third to show multifocal blue nevus.

MP21-11 INCREASED UTILIZATION OF ADVANCED IMAGING TECHNOLOGY AND ITS ECONOMIC IMPACT FOR PATIENTS DIAGNOSED WITH BLADDER CANCER IN THE UNITED STATES

vs 8.4 4.8 days no readmission, p1⁄40.003), there was no significant relationship after adjusting for other factors (20.6% 0-6 days vs 19.5% 10+ days, adjusted OR 1.03, 95% 0.79-1.35, Figure). A subset analysis examining only surgery-related readmissions demonstrated similar findings. CONCLUSIONS: If no in-hospital complications occur following radical cystectomy, applying arbitrary minimum thresholds for length of stay may not decrease the risk of hospital readmission.

Increased Utilization of Positron Emission Tomography/Computed Tomography (PET/CT) Imaging and Its Economic Impact for Patients Diagnosed With Bladder Cancer

Background The purpose of this study was to examine temporal nationwide utilization patterns and predictors for use of positron emission tomography/computed tomography (PET/CT) in comparison with magnetic resonance imaging (MRI) and computed tomography (CT) among patients diagnosed with bladder cancer. Materials and Methods A total of 36,855 patients aged 66 years or older diagnosed with clinical stage TI‐IV, N0M0 bladder cancer from 2004 to 2011 were analyzed. We used multivariable logistic regression analyses to discern factors associated with receipt of imaging within 12 months from diagnosis. The Cochran‐Armitage test for trend was used to determine changes in the proportion of patients receiving imaging after cancer diagnosis. Results Independent of clinical stage, there was marked increase in use of PET/CT throughout the study period (2011 vs. 2004: odds ratio, 17.55; 95% confidence interval, 10.14‐30.38; P < .001). Although use of CT imaging remained stable during the study period, there was significantly decreased utilization of MRI (odds ratio, 0.60; 95% confidence interval, 0.49‐0.75; P < .001) in 2011 versus 2004. The mean incremental cost of PET/CT versus CT and MRI was

Atypical small acinar proliferation at index prostate biopsy: rethinking the re-biopsy paradigm

1040 and

Impact of proximity to NCI- and NCCN-designated cancer centers on outcomes for patients with prostate cancer undergoing radical prostatectomy.

612 (in 2016 dollars), respectively. Extrapolating these findings to the patients with bladder cancer in the United States results in excess spending of

Discerning Patterns and Quality of Neoadjuvant Chemotherapy Use Among Patients with Muscle-invasive Bladder Cancer

11.6 million for PET/CT imaging. Conclusion We identified rapid adoption of PET/CT imaging independent of clinical stage, resulting in excess national spending of

A 25-Year-old Woman With Gross Hematuria

11.6 million for this imaging modality alone. Further value‐based research discerning the clinical versus economic benefits of advanced imaging among patients with bladder cancer are needed. Micro‐Abstract The American Society of Clinical Oncologys Value of Cancer Care Task Force is promoting sustainable high‐quality and high–value‐based cancer care. This study examines utilization trends and costs associated with advanced imaging in patients with bladder cancer, using a large population‐based cancer registry data. We found a significant shift from low‐cost to high‐cost imaging without evidence documenting clinical superiority.