1,721,063 research outputs found
Synchronous bilateral percutaneous nephrolithotomy (PCNL).
No full textBACKGROUND. The management of bilateral renal stones still represents a therapeutic challenge and synchronous bilateral percutaneous nephrolithotomy (PCNL) appears to be a well tolerated, safe and relatively rapid procedure with a favorable cost-benefit ratio. The purpose of the present study is to report our experience in the synchronous percutaneous treatment of bilateral renal stones. METHODS. We retrospectively evaluated clinical files from 4 consecutive patients (BS, BE, OCB, FL), who underwent a synchronous bilateral PCNL, performed by the same operator (ZF), for the management of renal persistent and/or recurrent stones after extracorporeal shock wave lithotripsy, or other surgical maneuvers. From each patient's file we recorded a clinical history, any peri- and post-operative complication, any therapeutic resolution employed and the outcomes in terms of stones persistence/recurrence. RESULTS. Overall, 3 men (BS, BE, FL) and 1 woman (OCB), their age ranging from 31 up to 76 years, consecutively underwent synchronous bilateral PCNL. In 75% of cases a calcium- oxalate nephrolithiasis was found. We did not find any peri- or post-operative complication. All patients were stone-free after a mean follow-up of 12 months (range: 3-24 months). CONCLUSIONS. Synchronous bilateral PCNL is a relatively safe procedure; it may be performed in selected patients without increasing the morbidity of this surgical maneuver. The simultaneous treatment of the contra-lateral kidney may be taken into account only when the PCNL of the first side has been performed quickly and easily without any peri-operative complication
Periorbital emphysema after laparoscopic nephrectomy: case report and literature review.
No full textA 40-year-old lady presented with marked swelling and inability to open her left eye immediately after laparoscopic nephrectomy for a left pyelonephritic kidney. A diagnosis of periorbital emphysema was made and within 7 days the emphysema spontaneously disappeared. Periorbital emphysema is a rare benign condition that may complicate a laparoscopic nephrectomy
Anatomy and nerve supply of the pelvic floor.
Full text linkIn order to guarantee urinary and fecal continence as well as correct pelvic statics, the perfect neuroanatomical integrity of the pelvic floor muscles is mandatory. As Dickinson stated: “There is no considerable muscle in the body whose form and function are more difficult to understand than those of the levator ani, and about which such nebulous impressions prevail”. Clinical implications of pelvic floor anatomy and nerve supply are evident: a denervation of this muscle group and the consequent muscle dysfunction could result in urinary and/or fecal incontinence, as well as pelvic organ prolapse
Second-line intravesical gemcitabine in high risk superficial bladder cancer: our experience.
No full textNefrolitotomia percutanea sincrona nel trattamento della urolitiasi bilaterale: esperienza personale.
No full textManagement of periurethral granuloma following injection with dextranomer/hyaluronic acid copolymer for stress urinary incontinence
No full textDescription of a case of periurethral granuloma after the injection of dextranomer/hyaluronic acid copolymer for stress urinary incontinenc
Predictive pathologic factors of lymph nodes involvement in the squamous cell carcinoma of the penis.
No full textOBJECTIVES: To evaluate the predictive role of primary tumor histopathological
features in predicting inguinal lymph nodes involvement in patients with penile
squamous cell carcinoma.
MATERIAL AND METHODS: We retrospectively analysed pathological records from 30
consecutive patients who underwent penectomy for invasive squamous cell carcinoma
of the penis. All histological specimens were reviewed by the same pathologist.
We considered the following histological parameters: histological grading, growth
pattern, deph invasion, tumour thickness, nuclear grading, poorly differentiated
cancer rate, vascular and lymphatic embolization, eosinophilic and mononuclear
infiltration and pathological stage.
RESULTS: Lymph nodes involvement occurred in 5 patients who underwent 'early'
lymphadenectomy and in other 4 ones during oncological surveillance. Lymph nodes
metastasis resulted significantly correlated with histological grading (p =
0.005), lymphatic (p = 0.005) and venous (p = 0.02) embolization, corpora
cavernosa (p = 0.03) and urethra (p = 0.03) infiltration. Histological grading
and lymphatic embolization were independent predictive variables of lymph nodes
involvement (p = 0.02).
CONCLUSIONS: The histological grading and lymphatic embolization have to be
considered as important parameters to select patients with penile squamous cell
carcinoma to undergo an 'early' lymphadenectomy
Residual prostatic tumour in the surgical bed following radical prostatectomy in organ-confined prostate cancer: possible prognostic significance.
No full textINTRODUCTION AND OBJECTIVES:
The aim of our study was to verify the impact of benign and malignant residual glandular tissue on surgical bed after radical prostatectomy, in terms of both biochemical and clinical disease progression, in a group of patients with pathologically organ-confined cancer of the prostate (PCa).
MATERIAL AND METHODS:
Files from 70 consecutive patients who undergone radical retropubic prostatectomy (RRP) for organ-confined PCa were retrospectively evaluated. During each intervention, after prostate removal, biopsies of the surgical bed were obtained from the following sites: urethral/periapical section margin, basal, left and right postero-lateral and under/retrotrigonal regions. No patient was been previously treated with either radiation or hormone therapy. We evaluated the relationship between the presence of either benign or malignant prostatic cells at surgical bed biopsies and the following parameters: postoperative serum PSA levels, definitive Gleason score, tumour staging, margin status.
RESULTS:
In all cases pathological stage was pT2NOMO, an immediate postoperative PSA zeroing occurred and surgical margins were negative. Surgical bed biopsies after prostate removal were positive for malignant cells in 5/70 cases (7.1%) and for benign prostatic cells in 16/70 patients (22.9%). Overall a biochemical disease progression was observed in 13/70 cases (18.6%): 1 case with surgical bed biopsies positive for cancer; 3 cases with biopsies positive for benign prostatic tissue; 9 patients with biopsies negative for prostatic tissue residuals. In this latter group 2 cases of disease progression were observed. Stratifying patients according to biopsy features, we did not find any significant difference between groups concerning preoperative PSA (p = 0.319), prostate weight (p = 0.158), pathological staging (p = 0.371), Gleason score (p = 0.457), follow-up (p = 0.144), biochemical progression rates (p = 0.553). At logistic regression model the only statistically significant association was between disease progression and preoperative PSA (p = 0.026). Stratifying patients with no malignant biopsies in two subgroups (presence and absence of residual benign prostate tissue) no statistically significant differences were detected in terms of disease relapse (p = 0.158).
CONCLUSIONS:
In patients with pathologically organ-confined PCa, minimal neoplastic tissue residuals might not significantly affect medium-long-term prognosis: 80% of patients with positive biopsy showed undetectable serum PSA levels after a median follow-up over 5 years. In contrast, surgical margins positive for benign prostatic glands was not significantly related to a possible disease relapse/progression
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