Multiple mask and boundary scoring R-CNN with cGAN data augmentation for bladder tumor segmentation in WLC videos.

Automatic diagnosis systems capable of handling multiple pathologies are essential in clinical practice. This study focuses on enhancing precise lesion localization, classification and delineation in transurethral resection of bladder tumor (TURBT) to reduce cancer recurrence. Despite deep learning models success, medical applications face challenges like small and limited datasets and poor image characterization, including the absence lack of color/texture modeling. To address these issues, three solutions are proposed: (1) an improved texture-constrained version of the pix2pixHD cGAN for data augmentation, addressing the tradeoff of generating high-quality images with enough stochasticity using the Fréchet Inception Distance (FID) measure. (2) Introducing the Multiple Mask and Boundary Scoring R-CNN (MM&BS R-CNN), a new mask sub-net scheme where multiple masks are generated from the different levels of the mask sub-net pipeline, improving segmentation accuracy by including a new scoring module to refine object boundaries. (3) A novel accelerated training strategy based on the SGD optimizer with the second momentum. Experimental results show significant mAP improvements: the data generation scheme improves by more than 12 %; MM&BS R-CNN proposed architecture is responsible for an improvement of about 1.25 %, and the training algorithm based on the second-order momentum increases mAP by 2-3 %. The simultaneous use of all three proposals improved the state-of-the-art mAP by 17.44 %.

Paratesticular Cellular Angiofibroma (CAF): A Rare Case Report.

Cellular angiofibromas (CAFs) are infrequent and benign soft-tissue tumors that primarily affect the genitourinary region in both genders. The authors report the case of a 71-year-old male patient who exhibited progressively increasing swelling in both testicles, with greater prominence noted on the left side. Initial findings from physical examination and scrotal ultrasound indicated the possibility of bilateral hydrocele, so the patient was recommended surgical intervention of the left more prominent side. Intraoperatively, a left paratesticular mass was identified and subsequently excised. Histopathological analysis confirmed the diagnosis of cellular angiofibroma. Surgeons should be cognizant of this tumor type to optimize treatment strategies, as local excision demonstrates a potential to preserve the testicle and yield favorable outcomes. Although occurrences of local recurrence are extremely rare, long-term follow-up is imperative.

Testicular prostheses - impact on quality of life and sexual function.

Orchiectomy is the recommended treatment for many testicular conditions. However, testicular prosthesis placement is not always performed for different reasons. In this study, we aimed to evaluate patients' opinions and the impact on sexual function and quality of life. This retrospective observational single-center study included patients who underwent orchiectomy between January 2014 and December 2020 at the Department of Urology, Braga's Hospital (Braga, Portugal), where testicular implants were always available and the decision to undergo the procedure was made fully independent of cost. Patients completed four questionnaires that assessed demographic data, satisfaction, self-esteem, and sexual function. Of the 96 patients who underwent orchidectomy, 59 replied to the questionnaires, and of these patients, 86.4% decided to undergo silicone-based testicular prostheses implantation. The remaining 13.6% refused the implant based on concerns about complications (37.5%), because they felt that it was unnecessary (37.5%), or because it was not offered by the doctor (25.0%). Overall, 96.1% of these patients were satisfied with the implant; however, 25.5% classified it as "too firm". No statistically significant differences were found in sexual function (all P > 0.05). However, it can be observed that there are more patients with prostheses presenting normal sexual activity compared to patients without prostheses (74.0% vs 50.0%), and none of them reported severe erectile dysfunction (0 vs 16.7%). Regarding self-esteem, both patients with and without prostheses present very similar average scores with no statistically significant differences. The present study highlights the highest level of satisfaction among patients who received testicular prostheses. Testicular prostheses implantation is a safe procedure that does not hamper sexual function after orchiectomy.

Citrus flavanone metabolites significantly modulate global proteomic profile in pancreatic ß-cells under high-glucose-induced metabolic stress.

Hesperidin and narirutin are the major citrus flavanones. Several studies have associated these compounds with pancreatic ß-cell survival through their capacity to reduce oxidative stress, inflammation, and inhibit apoptosis. However, the molecular mechanisms of action of flavanones in pancreatic ß-cells under high-glycemic stress is still largely unknown. Therefore, this study aimed to decipher molecular mechanisms of flavanone metabolites in pancreatic ß-cells treated with high glucose concentration using untargeted shotgun proteomics. We identified 569 proteins differentially expressed in cells exposed to hesperetin 7-glucuronide (H7G) and 265 in cells exposed to 3-(4'-hydroxyphenyl) propanoic acid (PA). Comparison of global proteomic profiles suggest that these metabolites could counteract changes in protein expression induced by high glucose stress. The bioinformatic analyses suggested that H7G and PA modulated the expression of proteins involved in cell adhesion, cell signaling, metabolism, inflammation, and protein processing in endoplasmic reticulum (ER) pathways. Taken together, this study suggests that H7G and PA can modulate the expression of proteins that may prevent dysfunction of pancreatic ß-cells under stress induced by high glucose.

Citrus flavanone metabolites protect pancreatic ß-cells against cholesterol stress through a multi-proteomic mechanism.

Citrus flavanones may improve oxidative stress and insulin resistance induced by western diets. However, there is a paucity of studies investigating the change in protein expression levels. This study evaluated the protection and the mechanisms of action of citrus flavanone metabolites, hesperetin 7-glucuronide (H7G) and 3-(4'-hydroxyphenyl) propanoic acid (PA), on pancreatic ß-cell function under oxidative stress induced by cholesterol using the global proteomics approach. Cholesterol induced changes in the global proteomic profile in the pancreatic ß-cell line Min6. On the other hand, proteomics analysis identified 254 proteins differentially expressed with H7G and 352 with PA treatments, most of them were opposite to the changes induced by cholesterol. Bioinformatics analysis showed that these proteins are implicated in cell functions like cell signaling (insulin signaling, p30MAPK signaling, and others), metabolism (glucokinase and glutathione metabolisms), and inflammation pathways (TNF-α and NF-κB pathways). Also, the results of molecular docking suggest that H7G and PA could bind to putative transcription factors (PPAR-γ, STAT-3, CREB1, NF-κB, NFYA) and cell signaling proteins (IKK, RAS, Pi3K, ERK), which results in changes in protein expression observed. Altogether, these data suggest that the treatment with H7G and PA protects pancreatic ß-cells against stress induced by cholesterol through multi-proteomic mechanisms of action.

Laparoscopic treatment of entero-neobladder fistula after radical cystectomy.

Entero-neovesical fistula is a rare complication of orthotopic ileal neobladder after radical cystectomy occurring in <2% of cases. Surgical treatment is usually required and includes open resection of the affected bowel tract and reconstitution of bowel transit. Here we present a case of a laparoscopic treatment of entero-to-neobladder fistula 8 years after laparoscopic radical cystectomy to demonstrate the feasibility and safety of minimally invasive treatment (Supplementary Video). To the best of our knowledge, this is the first report of minimally invasive treatment of entero-neobladder fistula.

Detection of bladder cancer with feature fusion, transfer learning and CapsNets.

This paper confronts two approaches to classify bladder lesions shown in white light cystoscopy images when using small datasets: the classical one, where handcrafted-based features feed pattern recognition systems and the modern deep learning-based (DL) approach. In between, there are alternative DL models that had not received wide attention from the scientific community, even though they can be more appropriate for small datasets such as the human brain motivated capsule neural networks (CapsNets). However, CapsNets have not yet matured hence presenting lower performances than the most classic DL models. These models require higher computational resources, more computational skills from the physician and are more prone to overfitting, making them sometimes prohibitive in the routine of clinical practice. This paper shows that carefully handcrafted features used with more robust models can reach similar performances to the conventional DL-based models and deep CapsNets, making them more useful for clinical applications. Concerning feature extraction, it is proposed a new feature fusion approach for Ta and T1 bladder tumor detection by using decision fusion from multiple classifiers in a scheme known as stacking of classifiers. Three Neural Networks perform classification on three different feature sets, namely: Covariance of Color Histogram of Oriented Gradients, proposed in the ambit of this paper; Local Binary Patterns and Wavelet Coefficients taken from lower scales. Data diversity is ensured by a fourth Neural Network, which is used for decision fusion by combining the outputs of the ensemble elements to produce the classifier output. Both Feed Forward Neural Networks and Radial Basis Functions are used in the experiments. Contrarily, DL-based models extract automatically the best features at the cost of requiring huge amounts of training data, which in turn can be alleviated by using the Transfer Learning (TL) strategy. In this paper VGG16 and ResNet-34 pretrained in ImageNet were used for TL, slightly outperforming the proposed ensemble. CapsNets may overcome CNNs given their ability to deal with objects rotational invariance and spatial relationships. Therefore, they can be trained from scratch in applications using small amounts of data, which was beneficial for the current case, improving accuracy from 94.6% to 96.9%.

Do all patients with suspicious prostate cancer need Multiparametric Magnetic Resonance Imaging before prostate biopsy?

OBJECTIVES: Multiparametric magnetic resonance imaging (mpMRI) is a useful tool to diagnose prostate cancer (PCa) but its cost is not negligible. In order to reduce costs and minimize time to diagnosis, it is necessary to establish which patients benefit the most from doing mpMRI prior to prostate biopsy (PB). Our aim was to test if mpMRI still predicts PCa and clinically significant PCa (csPCa) in patients with high clinical suspicion of cancer, defined as prostate specific antigen (PSA) > 10 ng/ml, PSA-Density (PSAD) > 0.15 ng/ml/cc or suspicious digital rectal examination (DRE). MATERIALS AND METHODS: We retrospectively collected data on 206 patients who underwent mpMRI before PB at our Department from January 2017 to July 2018. mpMRI results were classified using Prostate Imaging Reporting and Data System (PI-RADS) version 2. In primary analysis, we evaluated the association of mpMRI with PCa and csPCa and stratified this model for low and high clinical suspicion of cancer. In secondary analysis, we determined the rate of negative PB results in patients with high suspicion of cancer and compared theses rates with those obtained if only those with PI-RADS 3-5 would be biopsied. RESULTS: In primary analysis and overall, mpMRI was predictive of PCa and csPCa. In stratified analysis, mpMRI was still significantly associated with csPCa in patients with PSA > 10 ng/ml and PSAD > 0.15 ng/ml/cc, but not in those with suspicious DRE. In secondary analysis, negative result rates were lower if only patients with PI-RADS 3-5 were biopsied, even in subgroups with high suspicion of cancer based on PSA and PSAD. In patients with suspicious DRE, however, the rate of negative results did not change significantly if only patients with PI-RADS 3-5 were biopsied. CONCLUSIONS: mpMRI is still useful in predicting csPCa in patients with PSA > 10 ng/mL and PSAD > 0.15 ng/ml/cc. If DRE is suspicious, though, mpMRI might be no longer useful in the prediction of PCa.

Reconstruction of the Denonvillier's fascia and posterior ligament of the external urethral sphincter: Assessment of its effect on urinary continence after laparoscopic radical prostatectomy.

OBJECTIVES: Some studies have shown that rhabdosphincter reconstruction provides an earlier return to continence after radical prostatectomy. We aim to study the impact of this procedure in urinary continence along with comparing two specific surgical techniques for posterior reconstruction. MATERIALS AND METHODS: We studied a group of patients who were submitted to LRP with No Rhabdosphincter Reconstruction (NRR) and another group with Posterior Reconstruction of the Rhabdosphincter (PRR). The latter was further divided into two groups: "Rocco type stitch" group and "Bollens type stitch" group. We used three questionnaires (IIEF-5, ICIQ-SF and IPSS) to assess urinary continence and erectile function 90 days after surgery. RESULTS: Patients of PRR group had a better full continence rate than patients of NRR group at 90 days (96.6% vs 33.3%, p < 0.001). Concerning urinary incontinence (p = 0.116), lower urinary tract symptoms (p = 0.543) and postoperative complication rates (p = 0.738), our results suggested that there were no differences between the techniques studied. CONCLUSIONS: Posterior reconstruction of the rhabdosphincter has significant benefits for urinary continence recovery on patients undergoing radical prostatectomy. No differences were observed in continence recovery between the two techniques analyzed. Additionally, reconstruction of the rhabdosphincter appears to be a safe procedure with no increased risk of postoperative complications.

Digital informed consent on radical prostatectomy surgery - A turning point on patient communication means.

To the Editor, Radical Prostatectomy (RP) is one of the preferred treatments for localized prostatic cancer and although surgical complications have been reduced over the years, urinary incontinence and erectile dysfunction are still common and significantly impact the patient's life. Therefore, adequate patient education and counselling before RP is essential. Informed Consent (IC) is a crucial element of doctor-patient interaction, and it must ensure that patients receive and understand all the information regarding their diseases and treatments. Implicit in providing IC is assessing the patient's understanding, since accessible communication enables them to make informed decisions consciously and autonomously about their health status [...].

Can narration and guidance in video-enhanced learning improve performance on E-BLUS exercises?

INTRODUCTION: This study aimed to compare trainees' laparoscopic performance concerning the peg-transfer (PT) and needle-guidance (NG) exercises after watching the original European Basic Laparoscopic Urologic Skills (E-BLUS) video or after watching a video-mentored tutorial (VMT) with 'tips and tricks', narration and didactic illustrations. MATERIAL AND METHODS: An experimental, unblinded, parallel, 2-intervention, 2-period randomized trial with an allocation ratio of 1:1 was conducted. Forty-two participants were randomized into 2 groups. Prior to task initiation, Group 1 watched the VMT in both trials and Group 2 watched, firstly, the original E-BLUS examination video and, in the second trial, the VMT. Each participant performed 2 trials for each exercise. Outcome measures were task time and total number of errors. RESULTS: In the first period, participants who visualized the PT and NG VMT had fewer errors than participants who visualized the E-BLUS video (p = 0.001 and p = 0.014, respectively). In the second period, after watching the VMT, a decrease in the total number of errors in PT and NG exercises was observed in the participants who previously watched the E-BLUS video (p = 0.001 and p = 0.002, respectively). In the second period, a decrease in median task time was observed for Group 1 and 2 after watching the PT VMT (p ≤0.001 and p = 0.003, respectively) and NG VMT (p = 0.005 and p = 0.01, respectively). CONCLUSIONS: The use of VMT can lead to a smaller number of errors and, if coupled with deliberate practice, could lead to a shorter task time in exercise performance among participants with no previous laparoscopic experience.

Citrus flavanone metabolites protect pancreatic-ß cells under oxidative stress induced by cholesterol.

Cholesterol is one of the triggers of oxidative stress in the pancreatic-ß cell, generating high levels of reactive oxygen species, which leads to impairment of insulin synthesis and secretion. Bioactive compounds, such as citrus flavanones, which possess anti-inflammatory and antioxidant activities, could reduce oxidative stress in ß-cells and improve their function. We describe for the first time the protective effects of the phase-II flavanone metabolites [naringenin 7-O-glucuronide, hesperetin 3'-O-glucuronide, and hesperetin 7-O-glucuronide], and two flavanones-catabolites derived from gut microbiota metabolism [hippuric acid and 3-(4-hydroxyphenyl)propionic acid], on pancreatic ß-cell line MIN6 under oxidative stress, at physiologically relevant concentration. Cholesterol reduced cell viability in a dose and time-dependent manner, with an improvement in the presence of the metabolites. Moreover, flavanone metabolites attenuated oxidative stress by reducing levels of lipid peroxides, superoxide anions, and hydrogen peroxide. In response to the reduction of reactive oxygen species, a decrease in superoxide dismutase and glutathione peroxidase activities was observed; these activities were elevated by cholesterol. Moreover, all the flavanone metabolites improved mitochondrial function and insulin secretion, and reduced apoptosis. Flavanone metabolites were found uptake by ß-cells, and therefore could be responsible for the observed protective effects. These results demonstrated that circulating phase-II hesperetin and naringenin metabolites, and also phenolics derived from gut microbiota, protect pancreatic-ß cells against oxidative stress, leading to an improvement in ß-cell function and could be the bioactive molecules derived from the citrus consumption.

Efficacy and safety of renal drainage options for percutaneous nephrolithotomy.

BACKGROUND: Percutaneous nephrolithotomy (PCNL) is the gold-standard for treatment of renal stones larger than 20 mm. Traditionally, a nephrostomy tube (NT) is placed, causing discomfort and prolonged hospitalization but some surgeons prefer the tubeless technique (TL). Simultaneously, the effectiveness of ureteral stents after PNCL is doubtful. We investigated the safety of the TL technique as well as that of the single loop (SL) over double loop (DL) stents. METHODS: Three hundred and twenty-one individuals submitted to PCNL in a single center were retrospectively reviewed. Statistical analysis was performed to compare procedures regarding safety and effectiveness (stone size, residual stones, operative time, peri- and post-operative complications, need for blood transfusion and length of hospital stay) between two groups regarding presence or absence of NT placement (NT [N.=198] vs. TL [N.=123]); and according to the type of stent used (SL [N.=74] vs. DL [N.=247]). RESULTS: NT was associated with a higher complications rate compared to the TL (30.3% and 13%, respectively; P=0.001) and longer hospitalization (4 vs. 2 days; P=0.001). Regarding ureteral stents, they cause similar morbidities (20.7% and 24.4%; P=0.881), and median length of stay (3 days; P=0.947). NT and DL were more frequent in patients with higher stone burden. CONCLUSIONS: Tubeless PCNL encompasses lower morbidity and should be considered as an option for select patients, particularly with less stone burden and uncomplicated procedures. Regarding ureteral stents, SL is a safe option and does not require further procedures for removal.

Efficacy and safety of a combined anesthetic technique for transrectal prostate biopsy: a single center, prospective, randomized study.

INTRODUCTION: A transrectal ultrasound-guided (TRUS) biopsy is the gold standard for diagnosis of prostatic neoplasia. This exam is associated with pain and discomfort, and numerous methods of analgesia during this procedure have been described. There is still no consensus among urologists about the pain control technique that should be performed, even though the periprostatic basal nerve block is the most studied technique. The main objective of this study is to evaluate the benefit of adding local periapical prostatic anesthesia to the traditional periprostatic basal nerve block during TRUS biopsy. MATERIAL AND METHODS: A total of 70 patients with indication for TRUS biopsy were enrolled in this study. Patients were randomized into 2 groups. Group 1 received a periprostatic basal nerve block. Group 2 received both periapical prostatic and periprostatic basal nerve blocks . The pain experienced during different moments of the procedure (introduction of the probe, anesthesia administration, removal of cores and 30 minutes after biopsy) was assessed using visual analog scales of one to ten. The rate of complications at 30 days post-biopsy was also assessed. RESULTS: The difference in pain during the distinct moments of the TRUS biopsy was not significant between the two groups. There were no significant differences concerning age, level of total prostate-specific antigen (PSA) and prostate volume in both groups. There were also no statistically significant differences between the groups regarding the occurrence of complications and pathological findings. CONCLUSIONS: The administration of concurent periprostatic basal and periapical nerve blocks has no significant benefits as compared to a periprostatic basal nerve block alone.

Assessment of the Performance of Solid Phase Extraction Based on Pipette Tip Employing a Hybrid Molecularly Imprinted Polymer as an Adsorbent for Enantioselective Determination of Albendazole Sulfoxide.

Herein, an organic-inorganic hybrid molecularly imprinted polymer (MIP) was successfully synthesized with albendazole sulfoxide (ABZSO) as a template and 3-(trimethoxysilyl)propyl methacrylate, a bifunctional group compound, as a single cross-linking agent. In this study, a simple method using HPLC-DAD was developed for the determination of ABZSO enantiomers in human urine using pipette tip-based molecularly imprinted polymer solid phase extraction (PT-MIP-SPE). Enantioseparation with satisfactory retention times (5.17 and 7.09 min), acceptable theoretical plates (N = 4,535 and 5,091) and strong resolution (Rs = 5.45) was performed with an Agilent® Eclipse Plus C18 (100 mm × 4.6 mm, 3.5 µm) coupled with a Chiralpak® IA column (100 mm × 4.6 mm, 3 µm), a mixture with ethanol:water (50:50, v/v) as the mobile phase, temperature at 40°C, flow rate at 0.9 mL min-1 and λ = 230 nm. Thereafter, certain parameters affecting the PT-MIP-SPE were investigated in detail and the better conditions were: 300 µL of water as washing solvent, 500 µL of ethanol:acetic acid (9:1, v/v) as eluting solvent, 20 mg of MIP, 500 µL of human urine at pH 9 and no addition of NaCl. Recoveries/relative standard deviation (RSD%) for (R)-(+)-ABZSO and (S)-(-)-ABZSO were 78.2 ± 0.2% and 69.7 ± 1.7%, respectively.

Late presentation of vesicoureteral reflux: An unusual cause of pyelonephritis in adults.

INTRODUCTION: Vesicoureteral reflux (VUR) corresponds to the reflux of urine from the bladder into the upper urinary system. It can be a congenital or an acquired anomaly and although its incidence is high in children it is uncommon in the adult life. One of its presentations in the adult population is the presence of recurrent Pyelonephritis. CASE PRESENTATION: Here we report a case of an adult patient with repetitive uncomplicated pyelonephritis caused by VUR. VUR was successfully managed endoscopically with subureteral injection of a bulking agent. A literature review of adult presenting VUR was performed. DISCUSSION: The first presentation of VUR in the adult life is rare. One of the most typical presentation is the presence of recurrent uncomplicated Pyelonephritis. Although no guidelines exists to study the presence of VUR in adult patients with Pyelonephritis, in the presence of several recurrent episodes of Pyelonephritis we should think in VUR as a possible cause. Even in adults, endoscopic management of VUR is an effective treatment with low morbidity. CONCLUSION: VUR can first present in the adult life, with recurrent episodes of UTI. The diagnosis is a suspicious one and is confirmed by VUCG. VUR in adults can be effectively managed with endoscopic injection of bulking agents.

Evaluation of physicochemical properties as supporting information on quality control of raw materials and veterinary pharmaceutical formulations.

This study aimed to show that the physicochemical proprieties obtained by Fourier transform infrared spectroscopy (FTIR), thermogravimetry (TG), and scanning electronic microscopy (SEM) can be useful tools for evaluating the quality of active pharmaceutical ingredients (APIs) and pharmaceutical products. In addition, a simple, sensitive, and efficient method employing HPLC-DAD was developed for simultaneous determination of lidocaine (LID), ciprofloxacin (CFX) and enrofloxacin (EFX) in raw materials and in veterinary pharmaceutical formulations. Compounds were separated using a Gemini C18 (250 mm × 4.6 mm, 5 µm) Phenomenex® column, at a temperature of 25 °C, with a mobile phase containing 10 mM of phosphoric acid (pH 3.29): acetonitrile (85.7:14.3, v/v) and a flow rate of 1.5 mL/min. Physicochemical characterization by TG, FTIR, and SEM of raw materials of LID, CFX, and EFX provided information useful for the evaluation, differentiation, and qualification of raw materials. Finally, the HPLC method was proved to be useful for evaluation of raw material and finished products, besides satisfying the need for an analytical method that allows simultaneous determination of EFX, CFX, and LID, which can also be extended to other matrices and applications.

[Smoking Cessation after Bladder Cancer Diagnosis]. / Cessação Tabágica após o Diagnóstico de Cancro da Bexiga.

INTRODUCTION: Smoking is an important risk factor for the development, recurrence and progression of bladder cancer. Our aim was to analyze smoking habits after diagnosis in bladder cancer patients. Additionally, we evaluated patient knowledge about smoking as a risk factor and the urologist role in promoting abstinence. MATERIAL AND METHODS: A cross-sectional, observational and descriptive study was performed in bladder cancer patients, diagnosed between January 2013 and September 2015 (n = 160) in Braga Hospital, in Portugal. RESULTS: Smoking history was present in 71.9% of the sample, with 21.9% current smokers, (40.7% of abstinence after diagnosis). Smoking was acknowledged as a risk factor by 74.4% of the sample, with only 51.3% of ever smokers and 24.4% of non-smokers recognizing smoking as the leading risk factor (p = 0.008). The presence of other household smokers were significantly higher in patients who continued smoking (40%) than in ex-smokers after diagnosis (4.2%) (p = 0.005). The majority of smokers at diagnosis (83.1%) were advised to quit by their urologist, but only one smoker (1.7%) was offered any specific intervention to aid in cessation. DISCUSSION: Smoking is not recognized as the leading risk factor for bladder cancer. This limited awareness, associated with the known difficulties in quitting smoking and the observed lack of smoking cessation interventions, may account for the high current smoking prevalence, albeit in line with other studies. CONCLUSION: This study highlights the need for efficient smoking cessation programs directed to bladder cancer patients.

Introdução: O tabagismo é um importante fator de risco para o desenvolvimento, recorrência e progressão do cancro da bexiga. Este estudo pretendia analisar os hábitos tabágicos após o diagnóstico em doentes com cancro da bexiga. Adicionalmente, foi avaliado o reconhecimento do tabagismo como fator de risco e a atuação médica na promoção da cessação tabágica. Material e Métodos: Estudo transversal, observacional e descritivo realizado em doentes com cancro da bexiga, diagnosticados entre janeiro de 2013 e setembro de 2015 (n = 160) no Hospital de Braga. Resultados: História tabágica estava presente em 71,9% da amostra, com 21,9% de tabagismo atual (40,7% de abstinência após o diagnóstico). O tabagismo foi reconhecido como fator de risco por 74,4% dos doentes, mas apenas 51,3% dos doentes com história tabágica e 24,4% dos não fumadores referem o tabagismo como a principal causa etiológica (p = 0,008). A presença de outros fumadores em casa foi significativamente maior em doentes que mantiveram tabagismo (40%) do que em ex-fumadores após o diagnóstico (4,2%) (p = 0,005). A maioria dos fumadores (83,1%) refere ter sido aconselhada a deixar de fumar, mas apenas um (1,7%) recebeu apoio específico para a cessação. Discussão: O tabagismo não é adequadamente reconhecido como a principal etiologia de cancro da bexiga. Este desconhecimento, aliado à reconhecida dificuldade na abstinência tabágica e ao défice de estratégias promotoras de cessação tabágica observados, poderá justificar a elevada prevalência de fumadores atuais, todavia, em linha com outros estudos. Conclusão: Este estudo evidencia a necessidade de programas de cessação tabágica eficientes dirigidos a pacientes com cancro da bexiga.