From August 8 to 10, 2013, more than 120 leading clinicians, researchers, patient advocates, and industry representatives convened in Snowmass Village, Colorado, for the 8th Annual Bladder Cancer Advocacy Network-Think Tank (BCAN-TT). This year׳s meeting engaged participants representing more than 60 institutions from across the United States, Canada, and Europe. Bladder cancer is the sixth most common cancer in the United States. In 2013, there were an estimated 72,500 new cases and more than 15,000 deaths from this malignancy . With no major changes in these statistics over the past 30 years, there continues to be a tremendous need for more glucose transport proteins cancer research. Since 2006, the BCAN-TT has focused on creating collaborative opportunities for researchers, practitioners, advocates, and industry partners to move the field forward.
Understanding sex disparities in bladder cancer
Sexual dysfunction in bladder cancer: Expanding the conversation
Targeting novel pathways in bladder cancer
Clinical Trials Working Group
Translational Science Working Group
NMIBC Working Group
Standardization of Care Working Group
Survivorship Working Group
Patient-Centered Outcomes and Policy Working Group (formerly Health Services Research and Health Policy Working Group)
Upper Tract Disease Working Group
Radical cystectomy (RC) and urinary diversion (UD) are the gold-standard treatments for muscle-invasive bladder cancer (BCa) . Despite advances in anesthesia, surgical techniques, and perioperative care, postoperative morbidity within 3 months of surgery is greater than 60% in the contemporary series . Long-term complications related to the UD can also lead to significant morbidity. For example, the incidence of benign ureterointestinal anastomotic (UIA) strictures following RC and UD is reported at 1% to 13% [3–7]. Although most UIA strictures become clinically evident between 7 and 18 months postoperatively [5,7,8], patients occasionally present after more than 10 years from their initial surgery . Patients with UIA strictures can present with nephrolithiasis, recurrent pyelonephritis, asymptomatic worsening hydronephrosis, or even more insidiously with impaired renal function. The pathophysiology of UIA stricture formation is likely secondary to ischemia and inflammation, resulting in fibrosis and ureteral obstruction; however, the exact etiology of UIA strictures remains elusive.
Meticulous surgical technique, preservation of periureteral adventitia and blood supply, avoidance of electrocautery, and excision of the distal or compromised ureter before anastomosis are common strategies employed to mitigate the risks of UIA stricture formation . Additionally, a running end-to-side Bricker UIAs , a postoperative urinary tract infection (UTI) , and an antirefluxing technique [3,4,11] are potential risk factors for UIA stricture formation. By contrast, Anderson et al.  were unable to identify any patient- or disease-specific factor to be associated with UIA stricture formation in a cohort of 478 patients from their institution.
Materials and methods
We obtained approval from our institutional review board before initiating this analysis. A prospective database was reviewed for patients undergoing RC with ileal conduit or ileal orthotopic neobladder UD by 2 surgeons (G.D.S. and N.D.S.) from 2007 to 2012. Both the surgeons have extensive experience in urologic oncology and large practices in BCa resection. An orthotopic neobladder was constructed as a Studer pouch or a modified Hautmann pouch with an isoperistaltic afferent limb. A permanent distal ureteral specimen is routinely sent intraoperatively but frozen sections are not. All UIAs were performed in a similar Bricker end-to-side tension-free technique using 4-0 polyglactin sutures on CV-23 needles. The decision to perform a running vs. interrupted UIA or to excise additional ureter was at the discretion of the surgeon. Our technique for running UIA has been previously described . A single 4-0 monofilament traction suture is placed at the 12-o’clock position to avoid unnecessary manipulation and to ensure correct orientation. The left ureter is tunneled through a wide channel created beneath the sigmoid mesentery by grasping the traction suture with a large right-angled clamp. All anastomoses were stented with either 5-F feeding tubes or 7-F single J stents and tested for water tightness upon completion by irrigating the conduit or the afferent limb with a bulb syringe. Stents were removed following tolerance of oral diet (G.D.S) or approximately 2 weeks postoperatively (N.D.S). The length of the ureter resected was defined as the length of the ureter in the cystectomy specimen plus the length of the distal ureter submitted separately for pathologic analysis. It is a routine practice for our pathologists to quantify the length of the ureter in the specimens and to comment on the presence of dysplasia or neoplasia in the distal ureter on the final pathologic report.