Purpose To determine if age should be considered a relative contraindication to surgery for safety reasons. Methods Renal cell carcinoma (RCC) patients who underwent nephrectomy from January 2007 to December 2017 were analyzed retrospectively. Patients were grouped into age<65 and age≥65 years. The demographic data, surgical outcomes, complication, hospital stay, blood loss, and survival were compared between the two groups. Results A total of 101 patients were included; 74 in the younger group, and 27 in the older group. Compared to the young group, lower BMI, higher anemia, higher ASA grade, and comorbidities were frequent in the elderly. The operative time, blood loss, and renal function decline were comparable between two age groups. The complication rates in the older and younger group were 22% and 12%, respectively. The survival time was shorter in older patients compared to the younger ones; hazard ratio 2.25; 95%CI 1.08–4.69, p -value=0.031. Conclusion Nephrectomy in elderly patients is safe and feasible and preoperative assessment along with diligent postoperative care may further increase survival. Age alone cannot be regarded as a contraindication for nephrectomy in RCC.

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Objectives To report outcomes of surgical treatment in patients with penile foreign body granuloma and compare surgical outcomes between single‐ and two‐stage scrotal flap reconstructions. Methods Medical records of patients with penile foreign body granuloma who underwent surgical treatment were reviewed. Patients with single‐ and two‐stage scrotal flap reconstructions were compared. Results Forty‐two patients underwent surgical treatment from January 1, 2018 to October 31, 2022. Twenty‐three patients underwent single‐stage reconstruction with bilateral scrotal flap while 12 patients underwent two‐stage repair with 19 operations. Five patients underwent circumcision; one had excision with primary closure. Another patient underwent reconstruction by penile skin preservation technique. There was no statistically significant differences between single‐ and two‐stage groups in wound infection (8.69% vs. 0%, RR 2.71, 95%CI; 0.14–52.29), wound dehiscence (21.74% vs. 8.33%, RR 2.61, 95%CI 0.34–19.87), reoperation rate (26.08% vs. 8.33%, RR 3.13, 95%CI; 0.42–23.10). Postoperative fever was significantly higher in single‐stage group (56.52 vs. 8.33%, RR 6.78, 95%CI; 1.01–43.83). Total length of hospital stay was shorter in single‐stage group (7.43 ± 3.19 days vs. 10.86 ± 1.57 days, MD −3.42, 95%CI; −5.28 to −1.57). Incidence of patients without Clavien–Dindo surgical complications was significantly lower in single‐stage group (43.48% vs. 83.33%, RR 0.53, 95%CI; 0.31–0.89). Conclusions Both single‐ and two‐stage techniques may be considered for penile foreign body granuloma reconstruction. Although the hospital stay was longer in two‐stage group, the complication rates were lower.

Background Emergency renal artery embolization (RAE) is a useful method in treating renal trauma and bleeding renal tumors. The aim of this study was to evaluate the clinical efficacy and safety of emergency RAE, and factors associated with RAE failure. Methods This retrospective study included patients treated with emergency RAE for acute renal hemorrhage between 1 January 2009 and 31 October 2019 in Srinagarind Hospital. The embolization was performed using coils, glues, and/or gel foams. Factors associated with unsuccessful outcomes were analyzed using univariate and multivariate regression analyses. Results A total of 94 patients were treated at the center during the study period with the clinical success rate of 91.5%. The most common cause of acute renal hemorrhage was iatrogenic injury (76.5%). Factors associated with unsuccessful RAE according to multivariate analyses were hypertension (adjusted odds ratio [AOR] 24.2) and ruptured tumor/aneurysm (AOR 26.8). Conclusion RAE is an effective procedure for acute renal hemorrhage. Hypertension and ruptured tumor/aneurysm were negative predictors for success.

555 Background: Penile cancer is relatively more common in Thailand compared to western countries. We report multidisciplinary treatment outcomes of penile squamous cell carcinoma at a regional center in northeast of Thailand. Methods: Using an institutional database, a total of 68 patients with squamous cell carcinoma of penis treated during 2009-2015 were identified. Patient demographics, pathological data, and treatment modality were reviewed. Survival data was calculated using the Kaplan-Meier method. Results: Median age was 53 years (25-89 years) and the median follow-time was 2.7 years. At presentation, 39 patients (57.4%) were node positive, and 9 (13.2%) had metastatic disease. Management was penile preserving surgery in 13 patients, partial penectomy in 36 patients, total penectomy in 15 patients, and palliative with radiation and/or chemotherapy in 4 patients. The 3-year overall survival for patients with N0-1 and N2-3 was 86% and 35% respectively. For those with high risk (N2/N3) non-metastatic disease, multimodality treatment improved overall survival significantly compared with surgery alone (13.7 mo vs 8.6 mo; HR 0.32, p-value = 0.04) Conclusions: Patients present with locally advanced disease had a poor prognosis. Multidisciplinary management improved overall survival N2/N3 patients.