A 32-year-old woman was admitted to our department for hematuria and dysuria.Computed tomography (CT) and cystoscopy revealed a 2-cm pedunculated tumor with rich blood supply and a smooth surface in the bladder trigone. We performed a transurethral resection of bladder tumor. The pathologic diagnosis was alveolar soft part sarcoma (ASPS). CT, bone scintigraphy, positron emission tomography, and pelvic magnetic resonance imaging revealed no other lesions; thus, she was diagnosed as having a primary bladder ASPS. Postoperative follow-up with regular cystoscopies and CTs over 10 years have shown no local recurrence or metastasis.Primary ASPS of the bladder is exceedingly rare, and this case is the 8th case (the 2nd case in Japan) reported in literature.

Background: Evaluation of the benefits to postoperative outcomes of introducing robot-assisted radical cystectomy (RARC) to enhanced recovery after surgery (ERAS) is limited, especially in RARC with extracorporeal urinary diversion (eRARC). We assessed whether eRARC, when added to ERAS, provided additional efficacy in terms of patient outcomes during its initial implementation. Methods: We retrospectively identified 143 patients undergoing radical cystectomy with urinary diversion between June 2010 and December 2021 at a single center. The patients were assigned to three groups based on the type of surgical procedures and perioperative recovery protocols used. Length of hospital stay (LOS) and 90-day postoperative complication rates were compared between the groups. Regression analyses were performed to evaluate how ERAS and eRARC affected outcomes. Whereas, multivariate analysis was used to detect LOS predictors. Results: The median LOS was shorter with ERAS and eRARC (28.0 vs. 20.0 vs. 17.0 days, P < 0.001). In the linear regression model, ERAS was associated with a significantly shorter LOS (10.4 days, P < 0.001); eRARC was also associated with a shorter LOS, but the difference was nonsignificant (4.10 days, P = 0.14). Neither ERAS nor eRARC was associated with a significant improvement in complications. Following multivariate analysis, ERAS was found to be independently associated with shorter LOS (OR 0.23, P < 0.001), but eRARC showed no such association (OR 0.29, P = 0.096). Conclusion: ERAS was significantly associated with shorter LOS. Although a desirable trend was evident, eRARC did not contribute to additional efficacy. Neither ERAS nor eRARC improved complications.

A 50-year-old man was admitted to our hospital for urinary retention. Computed tomography revealed a spherical intravesical foreign body, measuring 1.7cm in diameter, and cystoscopy revealed glass ball in the bladder. Considering the shape of the object and the possibility of self-insertion, we used a flexible cystoscope, foreign body forceps, and a transvaginal echo probe cover to remove the intravesical foreign body. The end of the echo probe cover was grasped with the foreign body forceps, and a glass ball was inserted into the probe cover and extracted manually with a scooping action similar to using a landing net. No intraoperative hemorrhage was observed, and the glass ball was safely removed with good visual field.The patientʼs postoperative courses was uneventful, and he has shown no recurrence one year postoperatively.