Objective To explore the causes and treatment of difficulty of urination after suprapubic prostatectomy. Methods 56 cases with difficulty of urination after suprapubic prostatectomy were reviewed.The causes of difficulty of urination were bladder outlet stricture,urethral stricture,relapse of BPH and other nonsurgical causes. Results 48 cases were surgically managed,and the success rate was 94%.The follow up time was 2～84 months with a mean of 38 months,all of them urinate normally except in 3 suprapubic cystostomy has been mandatory. Conclusions Correct presurgical diagnosis,adequate surgical treatment and postsurgical management are key points in preventing postsurgical difficulty of urination.

Objective To explore the management of T 1G 3 transitional cell carcinoma of urinary bladder. Methods 67 cases of T 1G 3 transitional cell carcinoma,average age of 63,were treated with TURBt.Followed by intravesical bacillus Calmette-Guerin instillation in 59 cases and mitomycin C instillation in other 8 cases. Results Within median 47 (range 12～78) months follow-up,28 cases had recurrence.20 cases had tumors progressed to muscle invasion(T 2 or higher).16 cases had received total cystectomy and 4 cases had long-distance metastasis. 9 cases died from the tumor. Conclusions Patients who have T 1G 3 transitional cell carcinoma initially should be treated by TURBt and intravesical BCG instillation and followed rigorously.When the tumor recurs and progresses into muscle invasion,total cystectomy is preferred.

Objective To compare the long-term outcomes in patients with newly diagnosed stage T1G3 bladder cancer treated with bladder preserving approach and intravesical instillation or im-mediate cystectomy.Methods of 113 patients with a median age of 64 years (range 27 to 88) diag-nosed with T1G3 bladder cancer from January 1993 to February 2007,81 cases were treated by tran-sureteral resection with additional intravesieal instillation and 32 were treated with immediate cystecto-my.Differences between the 2 groups in 5-year overall survival and tumor specific survival were calcu-lated using the Kaplan-Meier survival function and analyzed by the log rank test.Results of 81 pa-tients treated with organ preserving approach and postoperative intravesical instillation,53 patients developed local recurrence and 21 patients underwent deferred cysteetomy in a median 64 (range 6-140) months follow-up.The overall and tumor specific survival at 5 years was 64.2% (52/81) and 77.8%(63/81),and in those who had deferred cystectomy it was 61.9% (13/21) and 76.2% (16/21),respectively.Of the 32 patients treated with immediate cystectomy,the 5-year overall and tumor specific survival was 59.4%(19/32) and 75.0%(24/32) within a median follow-up of 62(range 4-141)months.There was no statistical difference of the 5-year overall and tumor specific survival be-tween patients treated with bladder preserving approach or immediate cystectomy.Conclusion Blad-der preserving approach and immediate eystectomy might have similar 5-year overall and tumor specific survival for primary T1G3 bladder cancers.

Objective To investigate the effects of nephroblastoma overexpressed (NOV) on proliferation,adhesion,migration and invasion of remal cell curcinomai (RCC) cells. Methods We constructed a NOV expression plasmid and transfected the plasmid into RCC cell line 786-O and analyzed the effects of NOV expression on proliferation,adhesion,migration and invasion of RCC cells by growth curve assay,WST-1 assay,cell adhesion assay,matrigel invasion assay and transwell migration assay. Results The stable NOV transfected 786-O cells (786-O-NOV) showed decreased growth rate,at 48 h and 72 h,the proliferation activities of 786-O-NOV cells were inhibited by 29.14％ and 32.46％ the proliferation activities of empty vector cells were inhibited by 9.25％ and - 8.16％,respectively,compared to 786-O cells (P ＜0.05); while the 786-O cells transfected with empty vector (786-O-mock) had no difference with 786-Ocells.Adhesion assay indicated significantly increased adhesion of 786-O-NOV cells to fibronectin (0.26 ±0.03) and laminin (0.28 ±0.04),compared to 786-O cells (0.15 ±0.01,0.12±0.10) and 786-O-mock cells (0.14 ±0.02,0.13 ± 0.08).Invasion assay displayed that the numbers of cells penetrated through matrigel membrane were significantly higher in 786-O-NOV cells (240.25 ± 23.12) compared to 786-O cells ( 56.16 ± 6.25 ) and 786-O-mock cells ( 50.28 ± 7.13 ).Migration assay displayed that the numbers of cells passed through polycarbonate filters were significantly higher in 786-O-NOV cells (267.25 ± 20.94) compared to 786-O cells ( 66.10 ± 5.68 ) and 786-O-mock cells ( 56.28 ± 4.11 ).Conclusion NOV exhibits anti-proliferative effects on RCC cells; however,it promotes adhesion,migration and invasion of RCC cells.

For invasive bladder cancer, radical cystectomy and rectal substitution for sigmoid skin fistulas were commonly used in some medical centers. There is no report on the feasibility of sigmoid colon retraction except nephroureterectomy for patients with recurrent ureteral tumors after operation. We presented a case of recurrent ureteral tumors after rectal substitution bladder surgery for bladder cancer. Finally, left ureteral resection + sigmoid colon return + right ureteral skin stoma was successfully performed.The patient was followed up for 1 year without recurrence.