Decreased renal function is prevalent in patients with small unilateral renal tumors even with a normal contralateral kidney. Ablative or extirpative nephron sparing techniques are effective for preserving renal function in these patients.

and 47% had invasive disease ( ≥ pT2). Lowgrade and high-grade cancers were present in 33% and 67% of patients, respectively.• Positive, atypical and negative urine cytology was noted in 40%, 40% and 20% of cases. Positive urinary cytology had sensitivity and PPV of 56% and 54% for high-grade and 62% and 44% for muscleinvasive UTUC.• Inclusion of atypical cytology with positive cytology improved the sensitivity and PPV for high-grade (74% and 63%) and muscle-invasive (77% and 45%) UTUC. Restricting analysis to patients with selective ureteral cytologies further improved the diagnostic accuracy when compared with bladder specimens (PPV > 85% for highgrade and muscle-invasive UTUC). CONCLUSIONS• In this cohort of patients with UTUC treated with radical surgery, urine cytology in isolation lacked performance characteristics to accurately predict muscleinvasive or high-grade disease.• Improved surrogate markers for pathological grade and stage are necessary, particularly when considering endoscopic modalities for UTUC. KEYWORDS transitional cell carcinoma, radical nephroureterectomy, urothelial carcinoma, cytologyWhat's known on the subject? and What does the study add? Accurate preoperative staging for upper-tract urothelial carcinoma (UTUC) lesions is presently limited. Urinary cytology has shown promise for characterizing pathological features of bladder cancer. The role of cytology for UTUC is at present poorly defined.In this large multi-institutional cohort of patients, urinary cytology was limited in its ability to accurately predict the grade and stage of upper-tract lesions. Selective ureteral sampling improved the diagnostic accuracy of cytology when compared to bladder specimens. Improved preoperative surrogate markers for staging UTUC remain necessary.Study Type -Therapy (case series) Level of Evidence 4 OBJECTIVE• To evaluate the diagnostic accuracy of urine cytology for detecting aggressive disease in a multi-institutional cohort of patients undergoing extirpative surgery for upper-tract urothelial carcinoma (UTUC). METHODS• We reviewed the records of 326 patients with urinary cytology data who underwent a radical nephroureterectomy or distal ureterectomy without concurrent or previous bladder cancer.• We assessed the association of cytology (positive, negative and atypical) with final pathology. Sensitivity and positive predictive value (PPV) of a positive ( ± atypical) cytology for high-grade and muscle-invasive UTUC was calculated. RESULTS• On final pathology, 53% of patients had non-muscle invasive disease (pTa, pTis, pT1)

Preoperative evaluation for hydronephrosis, ureteroscopic grade and cytology can identify patients at risk for advanced upper tract urothelial carcinoma. Such knowledge may impact surgery choice and extent as well as the need for perioperative chemotherapy regimens.

The TAP procedure is a safe and effective means of correcting penile curvature, with similar overall outcomes between patients with PD and chordee. Shortening of the penis does commonly occur but is dependent on direction and degree of curvature, as well as the length of the phallus.

Renal function preservation and complications were similar for robotic, laparoscopic, and open partial nephrectomy.