Background/Objectives: Transurethral resection of bladder tumors (TURBT) is the standard for diagnosing and treating non-muscle-invasive bladder cancer. For lateral bladder wall tumors, obturator nerve stimulation can trigger sudden adductor contractions, raising the risk of perforation, hemorrhage, incomplete resection, and poor specimen quality. We evaluated the impact of obturator nerve block (ONB) on specimen quality and perioperative complications. Methods: In this single-center retrospective study, patients with lateral wall tumors treated by TURBT between October 2022 and December 2024 were divided into an ONB group (spinal anesthesia plus ONB) and a non-ONB group (spinal anesthesia alone). Specimen quality, perioperative complications, and 12-month recurrence were analyzed. Results: Of 219 patients (135 ONB, 84 non-ONB), high-quality specimens were more frequent with ONB (71.1% vs. 35.7%, p < 0.001). No perforations occurred with ONB versus 5 (6.0%) without (p = 0.008); hematuria (11.1% vs. 28.6%, p = 0.002) and 12-month recurrence (4.4% vs. 16.7%, p = 0.005) were also lower. Conclusions: ONB added to spinal anesthesia during TURBT for lateral wall tumors was associated with improved specimen quality and fewer perioperative complications. The lower recurrence rate should be considered hypothesis-generating, given the retrospective design and lack of multivariate adjustment; prospective studies are needed.

Background: Kimura disease (KD) is a rare benign disorder usually presenting in young Asian males as a subcutaneous mass in the head and neck. Common histological findings include lymphoid follicular hyperplasia, eosinophilic infiltrates, and vascular proliferation. Non-endemic presentations, particularly in women, are rare. Methods: We report a case of isolated retroauricular KD in a 28-year-old White woman with a 3-year history of an isolated, enlarging, mildly painful retroauricular mass, accompanied by peripheral eosinophilia and elevated serum immunoglobulin E (IgE) levels. The mass was resected, imaging showed no other sites of concern, and there was no recurrence. Results: Histopathologically, eosinophilic microabscesses, prominent vascular proliferation, and lymphoid follicular hyperplasia with CD20⁺ B cells, CD3⁺ T cells, and preserved CD23⁺ follicular dendritic networks were identified. Conclusions: A diagnosis of angiolymphoid hyperplasia with eosinophilia (ALHE) was excluded, and a final diagnosis of KD was established.

Background/Objectives: Transurethral resection of bladder tumors (TURBT) is the standard for diagnosing and treating non-muscle-invasive bladder cancer. For lateral bladder wall tumors, obturator nerve stimulation can trigger sudden adductor contractions, raising the risk of perforation, hemorrhage, incomplete resection, and poor specimen quality. We evaluated the impact of obturator nerve block (ONB) on specimen quality and perioperative complications. Methods: In this single-center retrospective study, patients with lateral wall tumors treated by TURBT between October 2022 and December 2024 were divided into an ONB group (spinal anesthesia plus ONB) and a non-ONB group (spinal anesthesia alone). Specimen quality, perioperative complications, and 12-month recurrence were analyzed. Results: In this retrospective cohort of 219 patients (135 ONB, 84 non-ONB), high-quality specimens were more frequent with ONB (71.1% vs. 35.7%, p < 0.001). No perforations occurred with ONB versus 5 (6.0%) without (p = 0.008); hematuria (11.1% vs. 28.6%, p = 0.002) and 12-month recurrence (4.4% vs. 16.7%, p = 0.005) were also lower. Conclusions: ONB added to spinal anesthesia during TURBT for lateral wall tumors was associated with improved specimen quality and fewer perioperative complications. The lower recurrence rate should be considered hypothesis-generating, given the retrospective design and the small number of recurrence events; prospective studies are needed.

Background/Objectives: Non-muscle-invasive bladder cancer (NMIBC) recurs frequently, and clinicopathological tools predict recurrence imperfectly. We assessed whether six preoperative blood-count-derived inflammatory indices (SII, SIRI, PIV, NLR, PLR, and LMR) are associated with adverse histology and 12-month recurrence and whether SIRI adds prognostic information to established risk factors. Methods: We retrospectively analysed 180 consecutive NMIBC patients treated by transurethral resection of bladder tumour (TURBT) and immediate instillation. Indices were modelled per 1-SD in logistic (adverse histology: high grade, T1 or carcinoma in situ) and Cox (recurrence) models adjusted for established risk factors. Results: Adverse histology occurred in 121 patients (67.2%); 88 recurred (12-month Kaplan–Meier estimate: 49.2%). All six indices were univariably associated with both endpoints, with similar effects (SIRI: adverse histology OR: 2.35, 95% CI: 1.41–3.90; recurrence HR: 1.41, 1.19–1.67). After adjustment, SIRI was not independently associated with adverse histology (OR: 1.69, 0.92–3.11) or recurrence (HR: 1.10, 0.86–1.40) and did not improve discrimination (ΔC: 0.001, −0.006 to 0.016). Results were robust across sensitivity analyses, including propensity weighting for BCG (limited by positivity violations). Conclusions: SIRI added no demonstrable independent prognostic value. Given modest overfitting (optimism-corrected calibration slope: 0.79), neither the indices nor the model should be used clinically without external validation and recalibration.