The study will provide information on patients' quality of life and its variations over time in relation to the treatments received for the prostate cancer.

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SummaryNo conflict of interest declared. MATERIALS AND METHODSThe clinical presentation may have a wide range of symptoms. such as perineal pain, emptying phase symptoms and intermittent haemospermia, epididymitis; the physical examination may be negative and in some cases the rectal exam reveal a cystic mass in the area of seminal vescicles. Transrectal or abdominal ultrasonography, CT scan and MRI (Figures 1-1a-2-2a) are the diagnostic tools indicated for the diagnosis; seldom vesiculography and semen analysis may be useful in cases with ejaculatory duct obstruction. Uroflussometry may show obstruction and endoscopic view can show bulging of the bladder wall with dislocation of the ureteric virtual orifice, in cases with large cysts. ROBOTIC TECHNIQUEA standard transperitoneal approach could be carried with six trocars in "W" configuration if a four arms robot is used, but four or five access are also described. Moderate Trendelemburg position was obtained. The bladder was drained with a Foley catheter. The posterior surface of the bladder was approached by transverse peritoneal incision between the bladder and the rectum and a cleavage plane was developed. Left vas deferens, seminal vesicle and cyst were identified (Figures 3-3a). Then the cyst was gently dissected from the bladder wall, resected and the communication with the seminal vesicle closed with 4/0 absorbable suture (Figures 4-4a). The peritoneal layers were sutured and no drain was left.No complications were observed. Foley catheter was removed on day one. Postoperative hospital stay was two days. After one year follow-up total relief of symptoms without complications was shown.CT scan and postoperative flowmetry showed normal findings.

<b><i>Background:</i></b> Although TURB of tumor (TURBT) by itself can eradicate a non-muscle-invasive bladder cancer (NMIBC) completely, these tumors commonly recur and can progress to MIBC. It is, therefore, necessary to consider adjuvant therapy in most patients. The primary objective of the present study was to report our experience with EMDA/MMC and BCG, considering efficacy, progression, and recurrence, as adjuvant therapy in NMIBC patients; the secondary objective was to assess the efficacy of EMDA/MMC versus BCG as a comparative treatment. <b><i>Methods:</i></b> Between April 2016 and February 2020, a series of 216 patients, with a diagnosis of intermediate- and high-risk NMIBC after TURBT, underwent adjuvant intravesical therapy. In 26 cases with a failure of the treatment, in patients unfit and unwilling for radical cystectomy, a repeated intravesical therapy was performed (2 had a twice repetition). Out of 244 adjuvant therapies, 140 EMDA/MMC and 104 BCG treatments were done. The following data were collected for each patient: baseline demographics and clinical data and perioperative and postoperative data. Overall patients’ adjuvant intravesical therapies were included in a prospectively maintained institutional database, and a retrospective chart review was performed. We collected data on 2 main outcomes, recurrence-free survival (defined as a negative cystoscopy, cytology, and/or histology at the evaluation time point) and progression-free survival (defined as a negative cystoscopy or a nonprogressive tumor recurrence). <b><i>Results:</i></b> The NMIBC progression rate was higher in BCG than EMDA/MMC but not statistically significant (respectively, 4.2% vs. 2.5%; <i>p</i> = 0.703). In the overall population, the risk of NMIBC recurrence was higher after BCG than EMDA/MMC (<i>p</i> = 0.025). In the subgroups of 59 paired patients with similar characteristics, no difference was observed between groups in NMIBC progression and recurrence. <b><i>Conclusions:</i></b> Our findings suggest that EMDA/MMC and BCG are safe and reproducible approaches as adjuvant treatment in NMIBC. EMDA/MMC permits to achieve a fine oncological management as adjuvant treatment in NMIBC, which is not less than that obtained with BCG.

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