Authors from Serbia present a retrospective review of their experience in the treatment of the uncommon condition of vesico‐uterine fistula. They discovered 14 such cases, and present the results of surgery, with advice on how to optimise the results. OBJECTIVE To analyse the indications, diagnosis, major causes and basic principles of surgical treatment of vesico‐uterine fistulas (VUF). PATIENTS AND METHODS From 1970 to 2006, 14 patients underwent surgical repair of VUF in two Belgrade hospitals. The most common cause of a fistula was previous Caesarean section (13/14). The mean (range) age was 27 (22–38) years. Five women underwent transvesical fistula suture, and nine underwent a transperitoneal surgical approach with the interposition of a tissue flap; an omental flap in five and a peritoneal flap in four. RESULTS The mean (range) duration of surgery was 85 (70–120) min. The mean hospital stay was 14 (12–22) days. The urethral catheter was removed 10 days after surgery. One woman with no tissue flap repair relapsed and none of the women with a tissue flap repair relapsed. After surgery, eight patients became pregnant and underwent Caesarean section. CONCLUSION Successful closure of VUF requires accurate diagnostic evaluation, appropriate repair using techniques that utilize basic surgical principles, and the careful application of interposing tissue flaps.

The management of high-grade (HG) non-muscle-invasive bladder cancer (NMIBC) continues to be a serious clinical problem. The role of many factors related to efficacy of Bacillus Calmette-Guérin (BCG), which is the most useful intravesical agent for these tumors, is still unknown. This study investigated the prognostic value of tumor location in high-grade non-muscle-invasive bladder cancer. Seventy-four patients with HG non-muscle-invasive bladder cancer, without carcinoma in situ (CIS), were treated by transurethral resection of bladder tumor (TURBT). Twenty-eight patients received adjuvant BCG therapy after TURBT. The relation between tumor location and the recurrence capacity was estimated using a Cox regression model. Our results suggest that tumor location is an important prognostic factor for BCG-therapy response in patients with high-grade non-muscle-invasive bladder cancer. Tumors in the bladder neck might have a higher risk of recurrence after intravesical immunotherapy. In addition, tumors in the lateral and posterior bladder walls might be at higher risk of recurrence when treated by TURBT alone.

A case of an adenocarcinoma within a horseshoe kidney (HK) is presented. Male patient presented with a history of a painless hematuria. A contrast enhanced magnetic resonance (MR) scan showed a horseshoe kidney. A large soft tissue mass was also noted on the right side. Kidney was receiving supply from two arteries on the left side and one at the right side. Angiography of the right renal artery demonstrated hypervascular tumor staining. The kidney was approached through midline abdominal incision, and a right heminephrectomy was performed. The histopathology examination showed pT2, grade 2 renal cell carcinoma. To conclude, angiography is indispensable for guiding surgical interventions.

The tension--free vaginal tape procedure (TVT) has been regarded as a safe, minimally invasive method for the treatment of female stress urinary incontinence. In a prospective multicenter study we evaluated safety and efficacy of TVT procedure for the treatment of female stress incontinence. From 1998. to 2003, a total of 42 patients, mean age 60 years (range 34-76) with urodynamically verified stress urinary incontinence underwent the TVT procedure. The mean follow-up period was 28 months (range 14 to 32). Intra- and postoperative complications were few, including bladder perforations (4.7%), vaginal hematoma (2.4%), complete urinary retention (2.4%), transient urinary retention (19%) and urinary tract infection (7.1%). Postoperatively, voiding time and functional urethral length significant increased. The subjective and objective cure rates were 85.7% and 90.5%, respectively. We conclude that the TVT procedure is associated with high cure rate and low morbidity.

Perineal radical prostatectomy is valuable surgical procedure that provides good oncological results as well as urinary and sexual function.