{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:44:37Z","timestamp":1792601077224,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":167,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Phalloplasty in transgender men is frequently complicated by a neourethral stricture, precluding standard transurethral access for bladder tumor resection. We describe the first reported case of a transcystostomal bladder tumor resection in a transgender man after a radial forearm free flap (RFFF) phalloplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Surgical Technique<\/jats:title>\n                    <jats:p>A 65\u2010year\u2010old transgender man, 23\u2009years after an RFFF phalloplasty, presented with gross hematuria and a 15\u2010mm posterior bladder tumor. A 7.95\u2009Fr flexible ureteroscope reached the bladder but with markedly limited maneuverability. A two\u2010stage transcystostomal approach was used: a 14\u2009Fr suprapubic cystostomy (SPC) was placed 1\u2009month before resection for tract maturation, followed by balloon dilation and insertion of a 24\u2009Fr resectoscope. The modified Valdivia position enabled simultaneous transcystostomal and transurethral access with gravity\u2010assisted irrigation drainage. Complete tumor resection was achieved without complications, and pathology confirmed noninvasive papillary urothelial carcinoma (pTa, low\u2010grade) with negative margins. A single immediate intravesical instillation of pirarubicin was administered. Surveillance cystoscopy via the cystostomy tract at 3 and 6\u2009months revealed no recurrence; the patient continues to void while standing with the cystostomy catheter capped.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The two\u2010stage transcystostomal approach, combining prior SPC placement, balloon tract dilation, and the modified Valdivia position, enabled safe oncological control while preserving phallic anatomy and standing voiding function. This technique offers a reproducible option for bladder tumor resection in patients with functionally inadequate transurethral access after phalloplasty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70330","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:12:31Z","timestamp":1781763151000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcystostomal Bladder Tumor Resection in a Transgender Man After Phalloplasty"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0163-1906","authenticated-orcid":false,"given":"Takatoshi","family":"Moriwake","sequence":"first","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Tominaga","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nariaki","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Urology Miyakekai Good Life Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama 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Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Sadahira","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Katayama","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama 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