1,721,002 research outputs found
27. LAPAROSCOPIC RADICAL PROSTATECTOMY: SURGICAL MARGIN ASSESSEMENT S. Galli, A. Simonato, A. Gregori, A. Lissiani A, Bozzola, F. Gaboardi ABSTRACTS EUROPEAN UROLOGY XVIIITH CONGRESS E.A.U. madrid March 12-15, 2003. Eur Urol Supplements Vol 2 N1, 41, 2003
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Ruolo dell’analisi Doppler associata a somministrazione di furosemide nello studio dei pazienti con idronefrosi e calcolosi ureterale
No full textEGFr and c-erB2mRNA expression in urinary bladder superficial carcinomas.
No full textAIM: The biological behaviour of superficial type transitional carcinomas of the urinary bladder can not be predicted. To try to differentiate those tumors that will present aggressive behaviour with infiltrative recurrences from those that will not, we studied, at the mRNA level, the expression of two membrane proteins, EGFr and c-erbB2, and of k-ras oncogene. METHODS: The mRNAs relative quantitation as performed, after RT-PCR, from histological sections cut from formalin-fixed and paraffin-embedded tissues. Twenty-three patients with urinary bladder transitional carcinoma have been studied for EGF-receptor, c-erbB2 and k-ras oncogene. The expression has been correlated with the outcomes of the follow-up period (infiltrative or superficial recurrences). RESULTS: The mRNA or EGFr was in average more expressed in tumors that continue to be superficial in the relapses, but for c-erbB2 the level of mRNA was similar in both, the more and less aggressive groups. The expression of k-ras was higher in cases associated with more infiltrative tumor relapses. CONCLUSIONS: In this preliminary study we did not identify any specific marker that can clearly predict the prognosis of superficial type transitional carcinoma of the urinary bladder; only k-ras expression is connected in some cases with the aggressiveness of the tumors. The expression of EGFr gave us intriguing results, it is in fact higher in the superficial carcinomas that do not tend to become infiltrative of the urinary bladder wall
Two-stage transperineal management of posterior urethral strictures or bladder neck contractures associated with urinary incontinence after prostate surgery and endoscopic treatment failures
No full textAbstract
OBJECTIVES:
The treatment of posterior urethral strictures or bladder neck contracture associated with severe urinary incontinence after prostate surgery and failure of endoscopic treatments is controversial. We report our experience with a transperineal approach in two steps: end-to-end urethroplasty/anastomosis and subsequent artificial urinary sphincter implantation.
METHODS:
Between September 2001 and January 2005, we observed six patients (58-68 yr old), with a combination of severe urinary incontinence and posterior urethral stricture with anastomotic bladder neck contracture after prostate surgery. In all cases, repeated endoscopic treatments of the strictures failed. The patients underwent transperineal end-to-end urethroplasty or anastomosis followed by transperineal artificial urinary sphincter placement after 6 mo.
RESULTS:
After the first surgical step, all patients were completely incontinent with absence of urethral strictures and complete anastomotic healing in all cases. Therefore, all patients underwent artificial urinary sphincter insertion. After a mean follow-up of 38 mo (range: 18-57 mo), five patients are continent with no postvoid residual urine and a perfectly functioning device. One artificial urinary sphincter was removed due to urethral erosion.
CONCLUSIONS:
In patients with posterior urethral strictures or bladder neck contractures associated with severe urinary incontinence, an artificial urinary sphincter implantation as a second step allows verification of the outcome of a previous end-to-end urethroplasty or anastomosis and utilizes a dedicated operative field to reduce the risks of prosthesis implants
Two-Stage Transperineal Management of Posterior Urethral Strictures or Bladder Neck Contractures Associated with Urinary Incontinence after Prostate Surgery and Endoscopic Treatment Failures
No full textObjectives: The treatment of posterior urethral strictures or bladder neck contracture associated with severe urinary incontinence after prostate surgery and failure of endoscopic treatments is controversial. We report our experience with a transperineal approach in two steps: end-to-end urethroplasty/anastomosis and subsequent artificial urinary sphincter implantation.Methods: Between September 2001 and January 2005, we observed six patients (58-68 yr old), with a combination of severe urinary incontinence and posterior urethral stricture with anastomotic bladder neck contracture after prostate surgery. In all cases, repeated endoscopic treatments of the strictures failed. The patients underwent transperineal end-to-end urethroplasty or anastomosis followed by transperineal artificial urinary sphincter placement after 6 mo.Results: After the first surgical step, all patients were completely incontinent with absence of urethral strictures and complete anastomotic healing in all cases. Therefore, all patients underwent artificial urinary sphincter insertion. After a mean follow-up of 38 mo (range: 18-57 mo), five patients are continent with no postvoid residual urine and a perfectly functioning device, one artificial urinary sphincter was removed due to urethral erosion.Conclusions: In patients with posterior urethral strictures or bladder neck contractures associated with severe urinary incontinence, an artificial urinary sphincter implantation as a second step allows verification of the outcome of a previous end-to-end urethroplasty or anastomosis and utilizes a dedicated operative field to reduce the risks of prosthesis implants. (c) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved
Changes of renal RI in response to hydration and diuretic administration in normal subjects and in patients with small ureteral stone
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Oncologic Outcome and Continence Recovery after Laparoscopic Radical Prostatectomy: 3 Years' Follow-Up in a "Second Generation Center"
No full textObjectiues: Laparoscopic radical prostatectomy in major centers guarantees oncologic and functional results equal to open procedures. In our institution this operation was introduced in 2001 after an adequate training in laparoscopic surgery. We report the oncologic and functional results after 3 years of experience.Methods: We considered our first 150 patients that had undergone transperitoneal laparoscopic radical prostatectomy. The following parameters were prospectively collected and analyzed: pathological findings, surgical margins, surgical time, blood loss, hospital stay, catheterization, complications, oncologic follow-up and continence.Results: Single positive surgical margins were observed in 26 patients (17.3%) and multiple positive margins in 15 patients (10%). The rates of positive margins in organ confined tumors (pT2a/b) were 11.3%. Preoperative PSA > 10 ng/ml (Chi-square p < 0.01), pathological stage > pT2 (Chi-square p < 0.001) and Gleason score > 6 (Chi-square p < 0.01) were significantly correlated with positive margins. Major complications occurred in 16 patients (10.7%). The total recurrence rate is 11.7%. The continence rate at 12 months is 91.7%. with 44.3% of patients completely continent at the moment of catheter removal.Conclusions: Laparoscopic radical prostatectomy in now a well codified operation that, after an adequate training, could be learned and reproduced safely. Actually this is our first choice surgical approach in patients with localized prostate cancer. (c) 2006 Elsevier B.V. All rights reserved
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