Malakoplakia is an uncommon granulomatous disease reported to affect mainly the urinary bladder and, less frequently, the urogenital tract, gastrointestinal tract, and lymph nodes. We describe cases of malakoplakia within the renal medulla of 2 dogs. Both dogs had a history of recurrent urinary tract infections with urine culture growth of Escherichia coli. Autopsy findings in dog 1 included ~60 tan-to-yellow, irregular nodules within the renal medulla, and tan-to-red, semi-firm nodules within the urinary bladder mucosa. Dog 2 had no gross changes within the kidneys but rather had ~20 red, semi-firm nodules along the surface of the apex of the urinary bladder. Histologically, the renal medulla of both dogs had sheets of foamy IBA1-positive macrophages with cytoplasmic granules and inclusions of intensely periodic acid-Schiff (PAS)-positive and occasional intracytoplasmic von Kossa- and Prussian blue-positive Michaelis-Gutmann bodies, consistent with malakoplakia. Fluorescence in situ hybridization and/or immunohistochemistry confirmed E. coli within macrophages. An underlying endocrinopathy could be a predisposing factor in the development of malakoplakia in older dogs.

The urinary bladder is a primary target organ for environmental toxicants such as arsenic. The objects of this study were two-fold. First, we constructed a novel 3D urinary bladder mucosa model (3D-UBMM) composed of an overlying epithelium and a supporting subepithelial layer. Primary human bladder urothelial and fibroblast cells were immortalized by introducing the human CDK4R24C and TERT genes. The construction of the 3D-UBMM involved incorporating immortalized fibroblast cells into a collagen raft, while immortalized urothelial cells were cultured at the air-liquid interface. This 3D-UBMM closely resembles the human bladder epithelium in terms of morphology and marker protein expression, including uroplakin 1b, P63, and cytokeratin 5. Second, using the 3D-UBMM we investigated the cytotoxicity of sodium arsenite (iAsIII) and dimethylarsenic acid (DMAV). Exposure to iAsIII and DMAV resulted in increased urothelial necrosis, increased γ-H2AX-positive cells, and reduced P63-positive cells, all in a dose–response manner. These findings affirm that this novel 3D-UBMM resembles the human bladder epithelium and offers a practical in vitro model for evaluating bladder toxicants and carcinogens, identifying mechanisms of carcinogenesis, and supporting hazard identification and risk assessment.

The reliability of molecular diagnostic and prognostic tools is contingent on the quality of biospecimens, which are often collected during surgical procedures. This study investigated the impact of surgical manipulation on gene expression in the urinary bladder mucosa during radical cystectomy. Seventeen patients with urinary bladder cancer were enrolled, and paired pre- and post-surgery biopsies were analyzed. Pre-surgical biopsies were obtained in situ under anesthesia, while post-surgical biopsies were collected ex vivo following bladder removal. Total RNA was extracted, and gene expression was assessed using qPCR arrays, measuring the expression of 374 inflammation-related genes. The findings from the exploratory phase were further validated by analyzing key genes in an independent patient cohort using TaqMan® gene-specific assays. Exploratory analysis revealed significant differential expression in 27 genes, with key genes such as IL6, FOS, and PTGS2 being upregulated post-surgery. Validation of five selected genes in an independent cohort confirmed these findings. This study reinforces the necessity of accounting for surgery-induced alterations in gene expression when analyzing tissue samples collected intraoperatively. By elucidating the molecular impact of surgical interventions, this work provides critical insights for refining experimental methodologies and enhancing the interpretability of gene expression studies in clinical and research settings.

The urothelium and lamina propria (LP) contribute to sensations of bladder fullness by releasing multiple mediators, including prostaglandins (PGs) and adenosine 5'-triphosphate (ATP), that activate or modulate functions of cells throughout the bladder wall. Mediators that are simultaneously released in response to bladder distention likely influence each other's mechanisms of release and action. This study investigated whether PGs could alter the extracellular hydrolysis of ATP by soluble nucleotidases (s-NTDs) released in the LP of nondistended or distended bladders. Using an ex vivo murine detrusor-free bladder model to access the LP during bladder filling and a sensitive HPLC-FLD detection methodology, we evaluated the decrease in ATP and the increase in adenosine 5'-diphosphate (ADP), adenosine 5'-monophosphate (AMP), and adenosine by s-NTDs released in the LP. Endogenous PGE2 increased the spontaneous but not the distention-induced release of s-NTD via EP2 and EP3 prostanoid receptors, whereas exogenous PGE2 increased the spontaneous s-NTD release via EP3, EP4, and FP receptors and the distention-induced s-NTD release via EP1-4 and FP receptors. Endogenous PGF2α, PGD2, and PGI2 did not change the s-NTD release. Exogenous PGD2 increased the spontaneous s-NTD release via DP2 receptors and the distention-induced s-NTD release via DP1 and DP2 receptors. Exogenous PGF2α increased the spontaneous but not the distention-induced release of s-NTD via FP receptors. It is possible that higher concentrations of PGE2, PGF2α, and PGD2 (as expected in inflammation, bladder pain syndrome, or overactive bladder) potentiate the release of s-NTDs and the consecutive degradation of ATP as a safeguard mechanism to prevent the development of excessive bladder excitability and overactivity by high amounts of extracellular ATP.

Intravesical drug delivery (IDD) refers to the administration of therapeutic agents directly into the urinary bladder through a catheter. Low permeability of the urinary bladder epithelium, poor retention of the therapeutic agents due to dilution and periodic urine voiding as well as frequent catheterizations (with potential risk of infections) are the major limitations of IDD used in the treatment of bladder-related disorders, such as bladder cancer. In this work, the mucoadhesive properties of polymeric materials based on chitosan, chitosan-gellan gum, and chitosan-Carbopol™ 940 containing sodium fluorescein (NaFI) were investigated for their potential application in intravesical drug delivery. The evaluation of mucoadhesive properties was carried out using an in vitro flow-through method with fluorescent detection that simulates the interaction conditions of polymers with the urinary bladder mucosa. Additionally, the release kinetics of NaFI from polymer compositions under conditions mimicking the physiological environment of the bladder was studied using a fluorescence spectrometry. The acquired data confirm the promise of using chitosan-based mucoadhesive polymers in developing systems for intravesical drug delivery, which could significantly enhance the efficacy of IDD therapy to treat urinary bladder-related disorders.

Four of seven Patagonian maras (Dolichotis patagonum) at a zoological institution developed acute neurologic signs that progressed to tetraparesis and death. All affected were young adult females (10 mon-5 yr old) that presented over 11 d. Clinical signs were rapidly progressive and unresponsive to supportive therapies. Two of the four individuals were found deceased 4 d after hospitalization. Two individuals were euthanized due to poor prognosis and decline after 6 and 8 d, respectively. Simultaneously, an additional mara developed mild and self-resolving clinical signs, including a kyphotic gait and paraparesis. On gross examination, there were widespread petechiae and ecchymoses of the skeletal muscle, myocardium, skin, pericardium, urinary bladder mucosa, and spinal cord. On histopathology, all animals had necrotizing myelitis and rhombencephalitis, with intranuclear viral inclusions in three individuals. Electron microscopy confirmed herpesviral replication and assembly complexes in neurons and oligodendrocytes. Consensus PCR performed on spinal cord, brainstem, or cerebellum revealed a novel Simplexvirus most closely related to Simplexvirus leporidalpha 4. The virus was amplified and sequenced and is referred to as Simplexvirus dolichotinealpha1. It is unknown whether this virus is endemic in Patagonian mara or whether it represents an aberrant host species. Clinicians should be aware of this virus and its potential to cause severe, rapidly progressive, life-threatening disease in this species.

Although blood urine is frequently observed in dromedary camels, little attention is gained and only it was reported as case reports. This study was carried out to examine dromedary camels suffering from red urine syndrome from the points of clinical, etiological, hematobiochemical, ultrasonographic, and pathological characteristics. Thirty-one camels with red urine and fifteen controls were enrolled. With a duration ranging from five days to nine months, clinical manifestations included weakness, red discoloration of the urine, dribbling of urine, straining during urination, and abdominal pain. Blood was sampled in ethylenediaminetetraacetic acid and plain tubes. The urine red color intensity was marked in 23 camels. In five camels discolored red urine was moderate while red urine was voided intermittently in the remaining three camels. The wide stance of the hind legs and pain reactions during urination were recorded in 18 camels. In all 31 camels, urine samples were centrifuged and sedimentation of red deposits was found. Nephrolithiasis was detected in three animals. One female camel had bilateral hydronephrosis. Hyperechoic urine was imaged within the renal pelvis in seven camels. In addition, hypoechoic fluid was imaged within the peritoneal cavity in 8 animals. A ruptured and collapsed urinary bladder was found in two male camels. In addition, bilateral pyelonephritis was found in another male camel. Abscessation of the left and right kidneys confirmed by ultrasound-guided aspiration was confirmed in 3 and 2 females, respectively. Peri-renal abscessation of the right kidney was detected in a female camel. A large, misshaped hypoechoic mass involving the right kidney was found in 1 female. A large mass king neoplasia was also imaged in a female camel distal to and compressing the left kidney, which proved histologically to be a leiomyoma. Moderate to severe thickening and corrugation of the urinary bladder mucosa were detected in 18 of the diseased camels. This study's syndrome of red urine in camels resulted mainly from hematuria. The existing etiologies were nephrolithiasis, cystitis, pyelonephritis, peri-renal and renal abscessation, and renal neoplasia. Ultrasonography was superior in assessing the renal parenchyma and urinary bladder for the verification of the existing nephrolithiasis, hydronephrosis, pyelonephritis, peri-renal and renal abscessation, cystitis, and ruptured or perforated bladder.

The 20-25% incidence of uterine myoma often experienced by women in childbearing age and 2% of these uterine myomas attach and grow in the uterine cervical area. The chief complain of cervical myom are lumps in the lower abdomen that are getting bigger and pressing on the urinary bladder cause difficulty in urinating and are accompanied by bloody urine, although the amount of menstrual blood is still within reasonable limits. Like uterine myomas, cervical myomas are not fused with the myometrial lining but are covered by thin connective tissue on the surface.The procedure of cervical myoma based on ACOG (American College of Obstetrics and Gynecology) is hysterectomy if the patient no longer wants to get pregnant, or myomectomy if the patient still wants to have children. Both of these actions have a very high risk in which vascularization in the pelvic area will be very complex, pressure on cervical myoma will have a high risk of injuring the urinary bladder mucosa and when setting aside the lower segment of the uterus there is a risk of injury. We present a 38-year-old woman with 30x 26 x 22 cm giant cervical myoma and secondary infertility that was treated with challenging laparotomi myomectomy in colaboration with urologist to preserve fertility. There was a tear in the upper part of the urinary bladder which was elongated with irregular edges measuring 12 x 5 cm after enucleation cervical myoma. The tear was repaired immediately and there are no complications in the form of vesico-vaginal fistulas or vesico-cervical postoperatively.

BackgroundTransitional cell carcinoma (TCC) is the most common neoplasia affecting the canine urinary bladder. Partial cystectomy, when used adjuctively with medical management, has been shown to meaningfully extend medial survival time. Surgical stapling devices have a wide variety of uses and advantages over traditional closure methods and, to date, investigation into their use in canine partial cystectomies has not been documented.ObjectiveTo determine the influence of three closure techniques on ex vivo leakage pressures and leakage location following canine partial cystectomy.MethodsSpecimens were assigned to one of three closure techniques: simple continuous appositional closure with 3‐0 suture, closure with a 60 mm gastrointestinal stapler with a 3.5 mm cartridge, and placement of a Cushing suture to augment the stapled closure, with each group containing 12 specimens. Mean initial leakage pressure (ILP), maximum leakage pressure (MLP), and leakage location at the time that ILP was recorded were compared between groups.ResultsOversewn stapled constructs leaked at significantly higher ILP (28.5 mmHg) than those in the sutured (17 mmHg) or stapled (22.8 mmHg) group, respectively. MLP was greater in the oversewn stapled construct group compared to other groups. Leakage was detected in 97% partial cystectomies, with leakage occurring from the needle holes in 100% of the sutured closure group, from the staple holes in 100% of the stapled only group, and from the incisional line in 83% and from bladder wall rupture in 8% of the augmented staple closure group. All closure methods withstood normal physiologic cystic pressures.ConclusionsPlacement of a Cushing suture to augment stapled closures improved the ability of partial cystectomies to sustain higher intravesicular pressures compared with sutured or stapled bladder closures alone. Further in vivo studies are required to determine the clinical significance of these findings and the role of stapling equipment for partial cystectomy, as well as the clinical significance of suture penetration through the urinary bladder mucosa during closure.

BackgroundFollicular cystitis is an uncommon inflammatory change in the urinary bladder wall characterized by the formation of tertiary lymphoid structures (TLSs) in the submucosa.ObjectivesTo characterize clinical and pathologic features of follicular cystitis in dogs and to explore in situ distribution and possible role of Escherichia coli as an associated cause.AnimalsEight dogs diagnosed with follicular cystitis and 2 control dogs.MethodsRetrospective descriptive study. Dogs diagnosed with follicular cystitis (macroscopic follicular lesions in the urinary bladder mucosa and histopathologic detection of TLSs in bladder wall biopsies) were identified from medical records. Paraffin embedded bladder wall biopsies were subject to in situ hybridization for E. coli 16SrRNA identification.ResultsFollicular cystitis was diagnosed in large breed (median weight 24.9 kg, interquartile range [IQR] 18.8‐35.4 kg) female dogs with a history of chronic recurrent urinary tract infections (UTIs; median duration of clinical signs 7 months, IQR 3‐17 months; median number of previous UTIs 5, IQR 4‐6). Positive E. coli 16SrRNA signal was detected within developing, immature and mature TLSs in 7/8 dogs, through submucosal stroma in 8/8 dogs and within the urothelium in 3/8 dogs.Conclusions and Clinical ImportanceChronic inflammation associated with an intramural E. coli infection in the urinary bladder wall represents a possible triggering factor for the development of follicular cystitis.

Cystitis Cystica and Cystitis Glandularis of the Urinary Bladder: A Review and Update

BackgroundCystitis glandularis a rare benign proliferative disease of the urinary bladder mucosa is usually a microscopic finding and manifests rarely as a large visible macroscopic lesion of urinary bladder. Only few cases of cystitis glandularis presenting as urinary bladder mass in female patients have been reported in the literature. We are reporting a case of cystitis glandularis presenting as a urinary bladder mass in a very young female patient.Case presentation.Our patient, a young female 25 years of age presented in the Urology OPD with complaints of irritative lower urinary tract symptoms for two years and intermittent hematuria for one year. On evaluation, she was found to have a urinary bladder mass. Transurethral resection of her urinary bladder mass was done and on histopathological examination, it came out to be cystitis glandularis.ConclusionClinical presentation of cystitis glandularis is variable. It may remain asymptomatic or could present as irritative lower urinary tract symptoms, hematuria, or mucus in the urine. It is normally a microscopic finding but could also present as an overt urinary bladder mass however this has been reported rarely in the literature.

A series of thermoresponsive diblock copolymer worm gels is prepared via reversible addition–fragmentation chain transfer (RAFT) aqueous dispersion polymerization of 2-hydroxypropyl methacrylate using a water-soluble methacrylic precursor bearing pendent cis-diol groups. Selective oxidation using an aqueous solution of sodium periodate affords the corresponding aldehyde-functional worm gels. The aldehyde groups are located within the steric stabilizer chains and the aldehyde content can be adjusted by varying the periodate/cis-diol molar ratio. These aldehyde-functional worm gels are evaluated in terms of their mucoadhesion performance with the aid of a fluorescence microscopy-based assay. Using porcine urinary bladder mucosa as a model substrate, we demonstrate that these worm gels offer a comparable degree of mucoadhesion to that afforded by chitosan, which is widely regarded to be a ‘gold standard’ positive control in this context. The optimum degree of aldehyde functionality is approximately 30%: lower degrees of functionalization lead to weaker mucoadhesion, whereas higher values compromise the desirable thermoresponsive behavior of these worm gels.

BackgroundCorynebacterium urealyticum urinary tract infections can result in a rarely reported condition called encrusting cystitis whereby plaque lesions form on and within the urinary bladder mucosa. Chronic lower urinary tract signs manifest subsequent to the infection-induced cystitis and plaque-induced decreased bladder wall distensibility. Because of the organism’s multidrug resistance and plaque forming capability, infection eradication can be difficult. While systemic antimicrobial therapy is the mainstay of treatment, adjunctive surgical debridement of plaques has been used with relative paucity in such cases, thereby limiting our understanding of this modality’s indications and success rate. Consequently, this report describes the successful eradication of Corynebacterium urealyticum encrusting cystitis utilizing a unique timeline of medical and surgical treatments. Additionally, this represents the first reported veterinary case of a vasovagal reaction due to bladder overdistension.Case presentationA 6-year-old female spayed Miniature Schnauzer was evaluated for lower urinary tract clinical signs and diagnosed with Corynebacterium urealyticum encrusting cystitis. The infection was persistent despite prolonged courses of numerous oral antimicrobials and urinary acidification. A unique treatment timeline of intravenous vancomycin, intravesical gentamicin, and mid-course surgical debridement ultimately resulted in infection resolution. During surgery, while the urinary bladder was copiously flushed and distended with saline, the dog experienced an acute vasovagal reaction from which it fully recovered.ConclusionsSurgical debridement of bladder wall plaques should be considered a viable adjunctive therapy for Corynebacterium urealyticum encrusting cystitis cases failing to respond to systemic antibiotic therapy. The timing in which surgery was employed in this case, relative to concurrent treatment modalities, may be applicable in future cases of this disease as dictated on a case-by-case basis. If surgery is ultimately pursued, overdistension of the urinary bladder should be avoided, or at least minimized as much as possible, so as to prevent the possibility of a vasovagal reaction.

<p><strong>Background:</strong> Cyclophosphamide disturbs the oxidant and antioxidant balance that is associated with several unwanted toxic effects and induction of secondary cancers. The aim of this study was to test the protective effects of Sulforaphane on the cyclophosphamide toxicity of rat urinary bladder.</p><p><strong>Methods:</strong> 32 male albino rats were divided into 4 groups, 8 animal each (n=8). Group I received saline intra-peritoneal, group II received 5 mg/kg sulforaphane for 5 days and then saline, group III received 0.9% saline intra-peritoneal for consecutive 5 days and a single dose of cyclophosphamide 200 mg/kg on the six-day, group IV received sulforaphane at a dose of 5 mg/kg for consecutive 5 days and a single dose of cyclophosphamide 200 mg/kg on the six day. On the seventh day of the experiment, the animals were sacrificed, and the urinary bladder samples were dissected for histopathological and immunohistochemical investigations and electron microscopic studies.</p><p><strong>Results</strong>: the mucosa of the urinary bladder of Sulforaphane treated group showed normal architecture while that of cyclophosphamides treated group showed features of degenerated and ulcerated lesions of the epithelial lining associated with hemorrhage. Theses lesions markedly decreased in the mucosa of urinary bladder of cyclophosphamides and sulforaphane treated group.</p><p><strong>Conclusions</strong>: The use of sulforaphane reduces the cyclophosphamide toxicity on the urinary bladder in the form of decreased vacuolation with decreased degeneration of the epithelial lining.</p>

The etiology and pathogenesis of painful bladder syndrome or interstitial cystitis is not fully understood. For a better understanding of the pathogenesis of the disease, experimental animal models have been created. It is assumed that the histopathological features of the inflammatory response of the bladder wall may play an important role in predictive modeling of the symptoms of interstitial cystitis. It was found that in samples of bladder preparations with interstitial cystitis, an increase in the number of functionally active mast cells, both partially and completely degranulated, is observed. However, there is no convincing evidence that mast cells can serve as cell markers for this disease. The aim of the investigation was to identify cells of inflammation in histological preparations of the urinary bladder mucosa in 3 experimental models of interstitial cystitis. The study was carried out on 37 female rabbits. Experimental animals were injected into the bladder cavity with protamine sulfate (1 st group); into the wall of the bladder urine taken from the bladder (2 nd group); into the wall of the bladder 0.9% NaCl solution (3rd group). The 4th group of animals was intact. 14 days after the injections, the animals were taken out of the experiment, cystectomy was performed, preparations of the bladder wall and histological sections were prepared. The average number of all types of leukocytes in the tissues of the urinary bladder wall of animals of the 1st group exceeded that in the remaining groups (p <0.001). Mast cells were detected in the preparations of the 1st and 2nd groups, in the 2nd group their number was 25 times higher than in the 1st group (p <0.001). In animals of the 1st group, inflammatory infiltration of the bladder wall with lymphocytes and neutrophils was noted. In 2nd group, infiltration of the bladder wall with inflammatory cells was associated with a large number of mast cells. In the preparations of animals of the 3rd group, edema, single lymphocytes and neutrophils were detected. The data obtained make a certain contribution to the study and understanding of the mechanisms of inflammatory processes in interstitial cystitis.

Introduction: Haemorrhagic cystitis (HC) can be chemically induced by cyclophosphamide (CYP) injection; it is mainly used as an immunosuppressive and antineoplastic drug. Tadalafil (TAD) a phosphodiesterase type-5 inhibitor has vasodilator, anti-inflammatory and anti-apoptotic effects. It is mainly used for the treatment of erectile dysfunction and pulmonary arterial hypertension.Aim of the work: This work aimed to verify the effect of tadalafil on apoptosis and proliferation on the injured bladder mucosa after chemically induced HC. Material and Methods: Thirty-six adult male albino rats were randomly divided into four groups; group I was the control group, group II was TAD-treated group, group III was CYP-treated group and group IV was TAD-CYP treated group. Groups III and IV were subdivided into two subgroups (a and b), subgroups IIIa and IVa were euthanized after one day while subgroups IIIb and IVb were euthanized after 10 days. Urinary bladder specimens were processed for light and electron microscopic examination and immunohistochemical analysis of caspase-3 and Ki-67. Results: Subgroup IIIa revealed haemorrhage and decrease of urothelium thickness with presence of denuded areas. Subgroup IIIb showed restoration of urothelium with focal denuded areas. Both subgroups showed a significant increase in apoptotic index while subgroup IIIb showed a significant increase in proliferative index. Subgroup IVa revealed a significant decrease in apoptosis associated with a significant increase in proliferation, thereby limiting cellular loss. Subgroup IVb; showed a significant decrease in both apoptosis and proliferation indicated prevention of the developed hyperplasia of the urothelium. By transmission electron microscopy, the terminal differentiation of superficial cells of group IV was expressed by presence of an angular contour.Conclusion: TAD-CYP co-treatment provides a positive impact on the apoptosis, proliferation, and the histological changes of HC on urinary bladder mucosa. Therefore, further studies are required to elucidate the protective effect of TAD on CYP-induced HC.

The present study was undertaken to evaluate the chemopreventive activity of myrtenal, a natural monoterpene, against bladder carcinoma in rats induced with N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) and promoted with γ-ionizing radiation (γ-IRR) as well as to assess the involvement of inflammation, apoptosis and oxidative damage in tumor development. Histopathological examination of rat bladder revealed the presence of noninvasive papillary transitional cell carcinoma (Grade 2) in sections from BBN group indicating the credibility of the applied carcinogenesis model. Myrtenal treatment caused improvement in urinary bladder mucosa with cells more likely in Grade 1. Administration of myrtenal to BBN-treated rats exhibited downregulation in the expressions of COX-2, NF-kB and STAT-3 associated with suppression of inflammatory cytokines levels of TNF-α and IL-6 as well as biomarkers of oxidative damage (MDA & NO). In addition, myrtenal treatment caused a significant increase in caspase-3 activity and Bax/Bcl-2 ratio. Data obtained suggested that the anti-inflammatory effect and the induction of apoptosis contributed largely to the beneficial antitumor effects of myrtenal in rats with BBN/γ-IRR-induced bladder carcinoma. Present findings, in addition to benefits described in other pathologies, indicated myrtenal as a potential adjuvant natural compound for the prevention of tumor progression of bladder cancer.

IntroductionUrinary incontinence is a troublesome complication following radical prostatectomy. Various robot-assisted radical prostatectomy (RARP). We describe our technique (Santosh-PGI) of urethral and urinary bladder mucosa coaptation for early continence following RARP.Material and methodsWe performed a prospective comparative study of patients planned for RARP between July 2018 and December 2019 at our centre. A total of 40 patients were enrolled in the study protocol. Following prostatectomy, patients were alternatively assigned into two groups. In one group, urethral and urinary bladder coaptation sutures were placed in a purse string manner using 3-0 Monocryl sutures and none in the another group. All patients underwent standard end to end vesico-urethral anastomosis as described by Van Velthoven. The urinary catheter was removed on day 10 after surgery. All patients were evaluated on day 1, 30 and 90 after catheter removal.ResultsThe two groups, each with 20 patients, were comparable in terms of age, clinical staging and D’Amico risk classification. The operative time, blood loss and surgical margin positivity were comparable. Following catheter removal, 75% of patients in Group A (Mucosal coaptation) and 50% in Group B (Standard technique) were continent (p = 0.264). At 30 and 90 days, 90% and 95% in Group A and 60% and 80% in Group B reported continence respectively (p-0.078). Four patients in group B reported bothersome incontinence at 90 days follow-up.ConclusionsUrethral and urinary bladder mucosal coaptation is a simple innovative technique for early continence following RARP.

45 patient with leukoplakia of the bladder were examined. The patients were divided into three pears depending on the biopsy data and the next treatment method. Each group received the appropriate treatment: I pear received conservative treatment; Group 1 underwent transurethral resection of altered areas of the urinary bladder mucosa; the group underwent transurethral coagulation of altered areas of the bladder mucosa. It was found that patients with the first stage of leukoplakia are shown conservative therapy, in the second and third stages of the process (transurethral resection, transurethral surgical treatment of electrocoagulation).