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Objectives: To evaluate the efficacy of instillations with mitomycin C (MMC) or bacillus Calmette–Guerin (BCG) in patients with T1 high-grade bladder cancer (BC). Patients and Methods: From 2007 to 2015, 186 patients admitted to Taichung Veteran General Hospital with new diagnosis of T1 high-grade BC receive transurethral resection of the bladder tumor (TURBT) and 6 weekly adjuvant instillation following. Histological stage followed the WHO grading system. End point evaluation was recurrence and progression to muscle invasive BC. Results: A total of 118 patients received 6 weekly intravesical instillation chemotherapy with MMC and 68 with BCG. Above all, 93 patients received immediate intravesical MMC after TURBT. The mean follow-up period was 46.78 ± 19.05 months in the MMC group versus 50.13 ± 24.18 months in the BCG group (P = 0.512). The BCG group showed better outcomes with longer 5-year recurrence-free survivals (64.6% vs. 50.0%, P of log rank = 0.008*) and progression-free survivals (94.1% vs. 87.3%, P of log rank = 0.023*). The treatment efficacy of BCG in comparison to MMC was further adjusted in uni-multivariate analysis model (recurrence: Hazard ratio [HR] =0.511, 95% confidence interval [CI] = 0.304–0.858, P= 0.011*; progression: HR = 0.216, 95% CI = 0.068–0.683, P= 0.009*). We also explore smoker, multiple lesions, and tumor diameter >3 cm to be risk factors for recurrence. Conclusions: For patients with T1 high-grade nonmuscle invasive BC, the adjuvant therapy with BCG, as opposed to MMC, resulted in better outcomes based on recurrence and progression with tolerable complications. For immediate single instillations, in comparison, the efficacy was lower in preventing tumor recurrence and progression in the current stage.

Objective: To standardize the procedure of robotic assisted laparoscopic radical prostatectomy (RaLRP) after evolution, learning and modification from 1,200 experienced cases. Materials and Methods: From December 2005 to April 2016, 1,200 cases involved patients receiving RaLRP was performed by a single surgeon. A preoperative 3.0-Tesla magnet with a slice thickness 30), included 6% and 10.5% of prostate volume >70 cm3, 10.5% of previous transurethral resection of prostate, 1.08% of salvage-RALP. The trifecta rate was 83.20% and pentafecta rate was 63.33%. The 3-year, 5-year, and 7-year biochemical recurrence-free survival rates were 79.2%, 75.3%, and 70.2%, respectively. Conclusions: Meticulous preoperative evaluation, MRI planning and a dedicated robotic team to do RALP is essential. The procedure was standardized during each step. Complications were minimized. High risk patients had an acceptable oncologic outcome.

Instead of nephroureterectomy with bladder cuff excision, nephron-sparing surgery can be considered in selected patients with non-muscle invasive upper urinary tract urothelial carcinoma. The role of kidney-sparing surgery has been established for the management of low-grade urothelial carcinoma. We report a solitary kidney patient with high-grade renal pelvis urothelial carcinoma treated with nephron-sparing surgery by ex vivo tumor excision and autotransplantation. The results of the surgery were excellent.

s / Urological Science 26 (2015) 301e310 309 NDP26: LAPAROSCOPIC RADICAL NEPHROURETERECTOMY FOR UROTHELIAL CARCINOMA IN A HORSESHOE KIDNEY: A CASE REPORT AND LITERATURE REVIEW Shu-Chi Wang , Siu-Wan Hung , Kun-Yuan Chiu . Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan A 75-year-old male suffered from gross hematuria for months and was diagnosed with urothelial carcinoma in the left moiety of a horseshoe kidney. Laparoscopic left side radical nephroureterectomy with open bladder cuff excision through a Gibson incision. The patient was discharged on post-operative day five uneventfully. Preoperative computed tomography is quite valuable for the evaluation of the anatomical variations in horseshoe kidneys. In conclusion, laparoscopic approach is effective for managing malignancy in horseshoe kidneys. NDP27: SINGLE MASSIVE URETER POLYP CAUSING URETER INTUSSUSCEPTION: A CASE REPORT AND LITERATURE REVIEW Pao-Hwa Chen, Chun-Chi Chen, Bai-Fu Wang, Jesen Lin, Heng-Chieh Chiang, Meng-Yi Yan, Chang-Pao Chang, Sheng-Hsien Huang, Kuo-Hsuan Huang, Hung-Jen Shih, Jian-Xiang Zhang, Jian-ting Chen. Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua

Suprapubic cystostomy is commonly performed in patients with neurogenic bladder or bladder outlet obstruction. The most serious complication is bowel injury, which usually occurs during catheter insertion. Bowel perforation during suprapubic catheter exchange is rare. We herein report an extremely rare case of terminal ileal perforation resulting from a change of suprapubic catheter. After insertion of the suprapubic catheter, a feculent material was noted in the terminal ileum. A cystography revealed that the contrast medium passed directly into the terminal ileum and colon. A computed tomographic scan confirmed the presence of a balloon tip in the terminal ileum. Terminal ileum perforation was diagnosed. Emergent laparotomy and loop ileostomy were performed. The patient's recovery was uneventful.