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Introduction Ileal ureteral replacement is one of the treatment options for long ureteral strictures. Most ileal ureteral replacements anastomose the distal side of the ileal segment directly to the bladder. We have reported here an initial case of laparoscopic ileal ureteral replacement for preserving the natural anti‐reflux system. Case presentation A 29‐year‐old male presented with right flank pain, and his imaging results revealed multiple strictures of the right upper‐middle ureter. Hence, we performed a laparoscopic ileal ureteral replacement surgery. The normal distal ureter was preserved, and the distal side of the ileal segment was anastomosed to it. As such, the natural anti‐reflux system could be completely preserved. Following this, the renal function was maintained, and no urinary tract infection was recorded. Conclusion Laparoscopic ileal ureteral replacement, which preserves the natural anti‐reflux system, can be considered as a treatment option for refractory upper‐middle ureteral strictures.

Introduction Primary pure choriocarcinoma of the bladder is extremely rare and should be distinguished from urothelial carcinoma. GATA-3 is a zinc finger transcription factor and a known sensitive immunostaining marker for urothelial carcinoma. However, its accuracy in the detection of urothelial carcinoma is moderate and it is also an important factor in trophoblast differentiation. Case presentation A 78-year-old man presented with asymptomatic gross hematuria for 6 months. Cystoscopy and clinical imaging revealed local bladder carcinoma. He underwent a radical cystectomy and histological diagnosis revealed pure choriocarcinoma (pT2aN0M0) with positive immunostaining, indicating GATA-3 was present. Systemic chemotherapy could not be applied due to his poor general condition, and he died 7 months after surgery. Conclusion We reported the first case of pure choriocarcinoma of the bladder, which showed positive immunostaining results indicating the presence of GATA-3.

Objectives To examine the inhibitory effects of tumor necrosis factor-α on myogenic differentiation of human urethral rhabdosphincter cells. Methods A rhabdosphincter sample was obtained from a patient who underwent total cystectomy. To expand the lifespan of the primary cultured cells, rhabdosphincter myogenic cells were immortalized with mutated cyclin-dependent kinase 4, cyclin D1 and telomerase. The differential potential of the cells was investigated. The transfected human rhabdosphincter cells were induced for myogenic differentiation with recombinant human tumor necrosis factor-α and/or the tumor necrosis factor-α antagonist etanercept at different concentrations, and activation of signaling pathways was monitored. Results Human rhabdosphincter cells were selectively cultured for at least 40 passages. Molecular analysis confirmed the expression of myosin heavy chain, which is a specific marker of differentiated muscle cells, significantly increased after differentiation induction. Although tumor necrosis factor-α treatment reduced the myosin heavy chain expression in a concentration-dependent manner, etanercept inhibited this suppression. Tumor necrosis factor-α suppressed phosphorylation of protein kinase B and p38, whereas etanercept pretreatment promoted phosphorylation and myosin heavy chain expression in a concentration-dependent manner. Conclusions Tumor necrosis factor-α inhibits differentiation of urethral rhabdosphincter cells in part through the p38 mitogen-activated protein kinase and phosphoinositide 3-kinase pathways. Inhibition of tumor necrosis factor-α might be a useful strategy to treat stress urinary incontinence.

function was also assessed with fura-2 calcium imaging and ATP release in cultured urothelial cells. RESULTS: EPAC was expressed in the urothelium of rat bladder, however the agonist did not alter Ca2þ nor ATP release in cultured cells. Nevertheless, the EPAC agonist (used in rabbit UT) significantly increased transepithelial capacitance (30% vs 11% in control) in the absence of stretch; stretch-induced capacitance was reduced by the EPAC antagonist (9.0% vs 87% in control). CONCLUSIONS: These novel findings indicate that EPAC plays an important role in augmenting bladder filling induced increases in urothelial surface area. The lack of ATP involvement suggests that EPAC mediated pathways could lead to increasing bladder capacity without affecting underlying bladder nerves. This would suggest that EPAC agonists could be potentially used as therapeutic agents for pathological low volume bladder conditions such as OAB or BPS/IC.

There is a paucity of definitive evidence that supports the use of enoxaparin to prevent venous thromboembolism (VTE) after urologic laparoscopic surgery. The purpose of this study was to evaluate the efficacy and safety of postoperative subcutaneous enoxaparin injection in patients who underwent urologic laparoscopic surgery. A total of 63 patients were evaluated from June 2010 to December 2012. All patients received postoperative prophylaxis with enoxaparin (2000 IU twice daily for 5 days). None of the patients treated with enoxaparin developed symptomatic VTE, but two cases (3.2%) of pulmonary embolism were noted before initial enoxaparin administration. Statistically significant differences were observed between the prothrombin time (PT) and activated partial thromboplastin time (APTT) values and D-dimer levels obtained at baseline and on day 7 after surgery; however, the PT and APTT values did not exceed the normal range. In addition, signs of any adverse events were not encountered in any of the patients treated with enoxaparin. The use of enoxaparin immediately after a surgery may confer valuable thromboprophylaxis benefits for urologic laparoscopic surgery.