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Objective: The aim of this study was to report the outcomes from robotic-assisted radical cystectomy (RARC) at an Australian public teaching hospital since the introduction of this technique in 2012. Methods: A retrospective analysis was conducted on perioperative and pathological outcomes from a consecutive series of 43 patients who underwent RARC for bladder cancer between 2012 and 2020 at Nepean Public Hospital. Results: Median operative time was 352 minutes for 32 (74.4%) patients undergoing construction of an ileal conduit, 499 minutes for nine (20.9%) patients undergoing construction of a neo-bladder and 239 minutes for two (4.7%) patients undergoing percutaneous urostomy. Median estimated blood loss was 500 mL, and median length of stay was 12 days. Complications within 60 days of any grade occurred in 63.4% of patients, and major complications (Clavien–Dindo ⩾Grade III) occurred in 20.9% of patients. The median number of lymph nodes removed was 17. Positive surgical margins occurred in 11.6% of patients overall, all in patients with T3 and above disease. Neo-adjuvant chemotherapy was utilised in 34.9% of patients overall and in 71.4% of patients with muscle-invasive urothelial cancer. Conclusion: The perioperative and pathological outcomes from RARC at our institution are comparable to the international literature. Level of evidence: Level 4. [ABSTRACT FROM AUTHOR]

It is purported to be caused by episodic twisting of the spermatic cord leading to testicular ischaemia and pain, with spontaneous de-torsion and resolution of symptoms. Intermittent testicular torsion is a difficult diagnosis to confirm, as many of the findings of torsion-de-torsion cannot be seen on investigation or can only be inferred at the time of surgical exploration. Scrotal exploration within the hour confirmed a 540° torsion of the spermatic cord in the presence of a normal healthy viable left testis and a bell-clapper deformity (Fig. [Extracted from the article]