Bladder cancer can be classified histologically as urothelial ornon-urothelial. Urothelial cancer has a propensity for divergentdifferentiation, which has increasingly been recognized in recentyears due to heightened awareness and improved immunohistochemistrytechniques. Furthermore, the recent World HealthOrganization classification of urothelial cancers improved clarityon this issue, with its listing of 13 histologic variants of urothelialcancer. The divergent differentiation patterns include, amongstothers, squamous, glandular, micropapillary, nested, lymphepithelioma-like, plasmacytoid and sarcomatoid variants of urothelialcancer. Attempts to quantify the amount of divergent differentiationpresent, such as using the nonconventional differentiationnumber, have been made recently, which will improve the abilityto compare publications from different centres. Genetic-basedstudies have indicated that the histologic variants of urothelialcancer arise from a common clonal precursor. Mostly, the currentevidence suggests that urothelial cancer with divergent differentiationhas a worse prognosis when compared with pure urothelialcancer. This article will review the current literature on varianthistologies of urothelial cancer, and well as new developmentsin pure squamous cell carcinoma, small cell carcinoma and adenocarcinomaof the bladder.

We determined the use of the Clavien-Dindo classification in urological articles. We also assessed the recent trend in the use of different postoperative complication reporting classifications by authors in major journals from 2010 to 2012. We reviewed all articles from 5 major urological journals published between January 2010 and October 2012. All studies reporting surgical outcomes were included in analysis and individually assessed after retrieving the full text. We recorded the use of complication classifications with particular emphasis on the Clavien-Dindo classification. A total of 907 articles mentioned surgical outcomes, of which 137 reported no complications. A descriptive classification was the most common method (483 of 770 articles or 62.7%), followed by the Clavien-Dindo classification (256 of 770 or 33.3%). Use of the Clavien-Dindo classification in articles from all 5 journals that discussed surgical outcomes increased from 21.4% in 2010 to 50.2% in 2012. Of the 770 articles 287 (37.3%) used any standardized criteria for surgical outcome reporting in 2010 to 2012. Of the 287 articles that reported surgical outcomes the Clavien-Dindo classification was used in 256 (89.5%). Increasing use of classification systems was seen in the most recently published articles. When a system was adopted by authors, the Clavien-Dindo classification was used most frequently. While there has been increased use of standardized reporting systems in articles mentioning surgical complications, there is room for increased implementation.