392 Background: Industrial byproducts and environmental pollutants (IBP/EP) are associated with the development of urothelial carcinoma (UC). While tobacco exposure (TE) is the major risk factor for UC, the interaction between sources of IBP/EP and incidence of UC in surrounding communities has been infrequently explored. We seek to identify high-density microregions of UC prevalence and spatially-related industrial and environmental risk factors. Methods: We queried a multi-institutional database for patients diagnosed with UC between 2008-2018. Geocoded addresses and ArcGIS software were used to calculate the Getis-Ord-Gi* statistic and perform hotspot analysis on the census-block level to identify UC hotspots. Demographics, clinicopathologic disease characteristics, and proximity to sources of IBP/EP were compared using Pearson’s chi-square and Student’s T-test. Univariate analyses and multivariable multilevel logistic random-intercept regression models were fitted to test the association between patient and census block-level factors and living in a UC hot spot. Results: Of 5,080 patients meeting inclusion/exclusion criteria, 148 patients (2.9%) were associated with one of three UC hotspots. In univariate analyses, hotspot patients were less likely to be tobacco users (OR 0.24, p=0.004) or of white race (OR 0.10, p<0.001) and less likely to have higher income (OR 0.73, p=0.005). They were more likely to be associated with IBP/EP exposure (OR 8.24, p=0.001) (Table). Multivariable analysis confirmed increased likelihood of residing in a UC hotspot and proximity to high-traffic density (OR >999, p=<0.001) and sites of IBP/EP contamination (OR 106.90, p=0.009), with decreased likelihood of tobacco use (OR 0.11, p=0.045) and white race (OR 0.02, p=0.004). Conclusions: Patients residing in geospatial hotspots of UC prevalence are less likely to be white, higher income or tobacco users and more likely to reside in proximity to sources of IBP/EP. Further research is necessary to investigate the interplay between socioeconomic status, race and environmental risk factors in order to better identify at-risk populations and improve screening, referral, diagnosis and timely intervention. [Table: see text]

Purpose:The interaction between sources of industrial byproducts and environmental pollutants (IBP/EP) and the prevalence of urothelial carcinoma (UC) in surrounding communities has been infrequently explored. The purpose of this research is to identify microregional UC hotspots and associated industrial and environmental risk factors.Materials and Methods:We retrospectively queried a multi-institutional database for UC patients diagnosed between 2008 and 2018. Addresses were geocoded and used to perform hotspot analysis on the census block level. Demographic and clinicopathological characteristics, census data and proximity to sources of IBP/EP were compared between patients who did vs did not reside in a hotspot. Associations were tested using multilevel logistic regression models using 95% confidence intervals.Results:A total of 5,080 patients met inclusion criteria and 148 (2.9%) were identified as living in 1 of 3 UC hotspots. In univariate analyses, race, tobacco and alcohol use, household income, IBP/EP exposure and proximity to traffic, industrial discharge and airports were significantly associated with UC hotspots. Multivariable analysis demonstrated that polycyclic aromatic hydrocarbon exposure (OR: 48.09, p ≤0.001) and proximity to high-density traffic (OR: >999, p ≤0.001) increased the odds of living in a hotspot. Patients living in a hotspot were significantly less likely to be white (OR: 0.06, p ≤0.001) or tobacco users (OR: 0.39, p=0.031) on multivariate analysis.Conclusions:Spatially related clusters of UC may be associated with locoregional environmental exposures rather than tobacco exposure and may also be correlated with socioeconomic disparities. Geospatial analysis can help to identify at-risk populations, offering the opportunity to better focus preventive and diagnostic interventions.

CONCLUSIONS: HNB products produce carcinogenic BoE with a strong link to bladder cancer. Long-term implications of risk to these carcinogens are unknown but concerning, given the similarities to combustible cigarette smoke and its established relationship with bladder cancer.

We present three cases of urethral prolapse in prepubertal females in Senegal who presented with vulvar bleeding. Careful gynecologic and urologic physical exams were performed and revealed urethral origin and prolapse. Conservative versus surgical approaches were taken in different patients, but ultimately, each patient received a urethral meatoplasty. Surgical excision of these masses yielded a full recovery in the patients. A careful review of the literature was then undertaken and showed that surgical excision or ligation of the prolapse is preferable to more conservative treatment. The case series article discusses the rare occurrence of urethral prolapse, as well as the epidemiology and prognostic and therapeutic implications of urethral prolapse in prepubertal females. Introduction. Urethral prolapse is a rare condition occurring mostly in young black females. It can be worrying to the parents as it often causes vulvar bleeding. Case Presentation. We present three cases of urethral prolapse in prepubertal females who presented with vulvar bleeding. Physical exams were performed and revealed urethral origin and prolapse. Each patient underwent a urethral meatoplasty and subsequently experienced a full recovery after respective follow-up of 2 years, 1 year, and 1 year. Conclusion. Urethral prolapse is a rare condition which can be managed successfully by surgery. Plain Language Summary. This case report on pediatric urethral prolapse showcases the different presentations and modalities of treatment, as the literature does not show that a specific treatment is always undertaken. In some countries, there are strong social considerations and they demonstrate difficulty separating sexual abuse from genitourinary pathologies, which are important to address in the treatment of these conditions.