1,720,976 research outputs found
How to manage a partial detachment of the ureter during robotic radical prostatectomy?
No full textThe management of a ureteral orifice injury occurring during robotic radical prostatectomy (RARP) represents a challenge for urologists. Several techniques have been proposed to treat an intraoperative injury, but intraoperative positioning of a DJ stent represents the most common treatment in cases of a partial injury of the ureteral orifice. We present a technique to ensure the successful outcome in cases of a partial detachment of the ureter during RARP. When the orifice is identified after the incision of the bladder neck and it appears very close to the anastomosis line setting up a partial detachment of the ureter, before implanting a DJ stent, one tip could be to perform a small incision of the anterior wall of the orifice to spatulate it and then proceeding to a short slip of the ureter: the eversion of the mucosa - creating a sort of "folded shirt cuff"- allows the fixation of the ureter to the bladder wall. We successfully performed this technique in two cases of RARP
Metabolic syndrome and stone disease
No full text: Metabolic syndrome is a clustering of several pathological medical conditions including hypertension, impaired glucose tolerance/diabetes, abdominal obesity and dyslipidemia. In the last two decades, MetS has reached an epidemic stage, with an estimated prevalence in the range of 30% among the American adult population and a constant increase for all age categories. The incidence of nephrolithiasis between different geographical areas, ranging 1% to 13%; however, a worldwide increase has been recently reported. There is consistent evidence in the literature both about the association between metabolic syndrome/metabolic syndrome traits and kidney stones. Conversely, less is known about the underlying mechanisms and the complex interplay between metabolic syndrome traits. In this work, we sought to review the literature and to summarize the available evidence regarding the association between metabolic syndrome and nephrolithiasis, the biological mechanisms linking metabolic syndrome and its trait to stone formation, and stone composition in individuals affected by metabolic syndrome. In conclusion, we would like to stress the concept of "appropriate" dietary habits and lifestyle as a key concept in the prevention of both metabolic syndrome and nephrolithiasis
Urethral fixation technique improves urinary continence recovery in men undergoing open radical cystectomy and ileal orthotopic neobladder
No full textBACKGROUND: We assessed urinary continence recovery and perioperative complications in patients operated on
with the novel urethral fixation technique during open radical cystectomy (RC) with ileal orthotopic neobladder (IONB).
METHODS: A retrospective cohort of 82 consecutive male patients undergoing open RC with IONB between 07/2013
and 06/2020 was analyzed. A study group of 48 patients operated on with the urethral fixation technique was compared
with a control group of 34 patients receiving standard neovesico-urethral anastomosis. In the study group, the urethral
stump was fixed to the dorsal median raphe posteriorly and to the medial portion of levator ani muscle postero-laterally in
order to avoid urethral retraction/deviation. Urinary continence recovery and perioperative complications were assessed
and compared between the two groups.
RESULTS: The two groups were comparable with regard to demographic, clinical and pathological variables. At the median follow-up of 36 months, 42 (87.5%) patients in the study, and 22 (64.7%) in the control group during daytime, and
32 (66.7%) patients in the study, and 15 (44.1%) patients in the control group during nighttime used no pads or a safety
pad (P=0.01 and P=0.04, respectively). Ninety-day postoperative complications were observed in 14 (29.2%) patients in
the study, and in 10 (29.4%) cases in the control group (P=0.77).
CONCLUSIONS: In our exploratory case-control study of male patients undergoing open RC with IONB, we observed a
significant improvement in daytime and nighttime urinary continence recovery with no increase in perioperative compli- cations using the novel urethral fixation technique compared to the standard neovesical-urethral anastomosis
Peripheral primitive neuroectodermal tumor of seminal vesicles: is there a role for relatively aggressive treatment modalities?
Full text linkA 50 year old white man received an incidental ultrasound diagnosis of hypoechoic mass interesting the right seminal vesicle. A CT scan showed the presence of a 7.8 cm roundish cyst, originating from the right seminal vesicle. He had been followed by the removal of the right seminal vesicle and both the cystic lesion. The histological findings of the specimen documented the presence of small round cells compatible with Ewing’s sarcoma/PPNET. The patient received also adjuvant chemotherapy and radiation treatment. After 10 years, the follow-up is still negative
Measuring the Quality of Diagnostic Prostate Magnetic Resonance Imaging: A Urologist's Perspective
No full textFocus on the quality of magnetic resonance imaging (MRI) by radiologists is welcome, but the clinical impacts that arise from MRI scans still need urological expertise. The urologist perspective is required in a multidisciplinary team setting when making decisions on whether to repeat a scan or perform a biopsy. This can ensure effective use of the prostate MRI diagnostic pathway in delivering desired clinical benefits for patients
An unusual cystic presentation of ductal carcinoma of the prostate
No full textA 74-year-old male came to our clinic for rectal tenesmus, lower urinary tract symptoms and a previous episode of acute retention of urine. Computed tomography (CT) and magnetic resonance imaging (MRI) scan of abdomen showed a multiloculated, cystic formation of 12 cm in the pelvic cavity to the left, with compression of the prostate, bladder, sigmoid and rectum, and its extension imprinted the back of the pubis and back bladder. Saturation prostate biopsy was negative for carcinoma. The histology of transurethral resection of bladder formation revealed flogistic tissue. Cistoprostatectomy and ureteroileal pouch with Wallace anastomosis, removal of the rectum and colostomy with Hartmann pouch were performed. The histopatology showed a ductal carcinoma of the prostate
Time of catheterization as an independent predictor of early urinary continence recovery after radical prostatectomy
No full textThe purpose of the present study was to investigate the potential impact of catheter removal time on immediate and early urinary continence recovery in a series of patients who underwent radical prostatectomy (RP)
Combined robotic-assisted retroperitoneoscopic partial nephrectomy and extraperitoneal prostatectomy. First case reported.
Full text linkA 54-year-old man with a history of prostate cancer and clear cell renal cell carcinoma of the left kidney underwent concomitant robot-assisted laparoscopic partial nephrectomy and radical prostatectomy. We report, to our knowledge, the first case of a concomitant retroperitoneal robotic-assisted partial nephrectomy and extraperitoneal radical prostatectomy
Role of contrast-enhanced ultrasound in assessing indeterminate renal lesions and Bosniak ≥2F complex renal cysts found incidentally on CT or MRI
Full text linkTo investigate the impact of contrast-enhanced ultrasound (CEUS) in reclassifying incidental renal findings categorized as indeterminate lesions (IL) or Bosniak ≥ 2F complex renal cysts (CRC) on CT or MRI
Correlation between pathologic features and perfusion CT of renal cancer: a feasibility study.
No full textOBJECTIVES:
The computerized tomography with perfusion technique (pCT) has proved to have some potentialities in the oncologic field as a possible tool to identify neoangiogenesis in vivo. The purpose of the present job is to test the correlations existing between perfusion data and pathologic features in the evaluation of vascularization in kidney cancer.
METHODS:
6 patients with clinical diagnosis of renal tumor awaiting surgical treatment underwent preoperatively pCT scans. Axial images encompassing the greatest diameter of the cancer were compared with the respective histological sections.
RESULTS:
A correlation between tumor histological subtype and perfusion index was observed and shown. Moreover, clear cell RCC of different Fuhrman grades showed statistically significant differences in perfusion values (T test). Specifically, high perfusion indexes were associated with high density of microvessels with abnormal architecture at the microscopic evaluation of tumor specimen. Conversely, lower perfusion index were detected in tumors with lower microvascular density.
CONCLUSIONS:
pCT scans can provide significant data on tumor angiogenesis and, eventually, suggest tumor histological subtype. The possibility of identifying preoperatively tumor histotype can be of particular relevance in patients with small renal tumors, suitable for minimally-invasive surgery or active surveillance program
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