4 7What ' s known on the subject? and What does the study add? In patients treated with radical cystectomy, pelvic lymph node dissection may have a benefi cial effect on cancer control outcomes.We examined the effect of pelvic lymph node dissection on stage-specifi c cancer control outcomes. OBJECTIVE• To examine the effect of stage-specifi c pelvic lymph node dissection (PLND) on cancer-specifi c (CSM) and overall mortality (OM) rates at radical cystectomy (RC) for bladder cancer. METHODS• Overall, 11 183 patients were treated with RC within the Surveillance, Epidemiology, and End Results database.• Univariable and multivariable Cox regression analyses tested the effect of PLND on CSM and OM rates, after stratifying according to pathological tumour stage. RESULTS• Overall, PLND was omitted in 25% of patients, and in 50, 35, 27, 16 and 23% of patients with respectively pTa/is, pT1, pT2, pT3 and pT4 disease ( P < 0.001).• For the same stages, the 10-year CSM-free rates for patients undergoing PLND compared with those with no PLND were, respectively, 80 vs 71.9% ( P = 0.02), 81.7 vs 70.0% ( P < 0.001), 71.5 vs 56.1% ( P = 0.001), 43.7 vs 38.8% ( P = 0.006), and 35.1 vs 32.0% ( P = 0.1).• In multivariable analyses, PLND omission was associated with a higher CSM in patients with pTa/is, pT1 and pT2 disease (all P ≤ 0.01), but failed to achieve independent predictor status in patients with pT3 and pT4 disease (both P ≥ 0.05).• Omitting PLND predisposed to a higher OM across all tumour stages (all P ≤ 0.03). CONCLUSIONS• Our results indicate that PLND was more frequently omitted in patients with organ-confi ned disease.• The benefi cial effect of PLND on cancer control outcomes was more evident in these patients than in those with pT3 or pT4 disease.• PLND at RC should always be considered, regardless of tumour stage. KEYWORDSlymphatic metastasis , lymph node excision , neoplasm staging , SEER program , survival analysis , urinary bladder neoplasms Study Type -Therapy (cohort) Level of Evidence 2b

Emergency department visits for priapism are relatively uncommon and occur more frequently during the summer months. The majority of patients are treated and released expediently. Predictors of hospital admission included comorbidity profile, insurance, hospital location and emergency department volume.

3 0 1What ' s known on the subject? and What does the study add? Married individuals have lower morbidity and mortality rates for all major causes of death. Cancer-specifi c survival is better in married patients with testis cancer, prostate cancer, breast cancer, cervical cancer, as well as head and neck cancers.We have found the effect of marital status on outcomes after radical cystectomy to be variable, depending on gender and the outcome addressed. Being married is predictive of lower all-cause mortality for both men and women relative to their separated, divorced or widowed (SDW) or never-married counterparts. It is also predictive of lower bladder-cancer-specifi c mortality relative to SDW individuals. Marriage also exerts a protective effect on men regarding non-organ-confi ned disease, with those never having married having signifi cantly higher rates. OBJECTIVES• To examine the effect of marital status (MS) on the rate of non-organ-confi ned disease (NOCD) at radical cystectomy (RC) • To assess the effect of MS on the rate of bladder-cancer-specifi c mortality (BCSM) and all-cause mortality (ACM) after RC for urothelial carcinoma of the urinary bladder (UCUB). MATERIALS AND METHODS• A total of 14 859 patients, who underwent RC for UCUB, were captured within the Surveillance, Epidemiology, and End Results database, between 1988 and 2006.• Logistic regression analysis was used to assess the rate of NOCD (T 3-4 /N I-3 /M 0 ) at RC and Cox regression analyses were used to assess BCSM and ACM.• Analyses were stratifi ed according to gender; covariates included socio-economic status, tumour stage, age, race, tumour grade and year of surgery. RESULTS• Never-married males had a higher rate of NOCD at RC (odds ratio = 1.22, P = 0.004), an effect not found in nevermarried females.• Separated, divorced or widowed (SDW) males (hazard ratio [ HR ] = 1.18, P = 0.005) and females (HR = 1.16, P = 0.002) had higher rates of BCSM than their married counterparts.• SDW and never-married males had higher rates of ACM than their married counterparts (HR = 1.22, P < 0.001 and HR = 1.26, P < 0.001, respectively).• SDW and never-married females also had higher rates of ACM than married females (HR = 1.24, P < 0.001 and HR = 1.22, P = 0.01, respectively). CONCLUSIONS• For both men and women, being SDW conveyed an increased risk of BCSM after RC.• SDW and never marrying had a deleterious effect on ACM.• Unfavourable stage at RC was also seen more commonly in never-married males.

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