"Non-metastatic, Castration-resistant Prostate Cancer: Diagnostic and Treatment Recommendations by an Expert Panel from Brazil".

Introduction: Non-metastatic, castration-resistant prostate cancer (nmCRPC) is an important clinical stage of prostate cancer, prior to morbidity and mortality from clinical metastases. In particular, the introduction of novel androgen-receptor signaling inhibitors (ARSi) has changed the therapeutic landscape in nmCRPC. Given recent developments in this field, we update our recommendations for the management of nmCRPC.

Consensus on Screening, Diagnosis, and Staging Tools for Prostate Cancer in Developing Countries: A Report From the First Prostate Cancer Consensus Conference for Developing Countries (PCCCDC).

Purpose: To generate and present the survey results on critical issues relevant to screening, diagnosis, and staging tools for prostate cancer (PCa) focused on developing countries.

Methods: A total of 36 of 300 questions concern the main areas of interest of this paper: (1) screening, (2) diagnosis, and (3) staging for various risk levels of PCa in developing countries. A panel of 99 international multidisciplinary cancer experts voted on these questions to create recommendations for screening, diagnosing, and staging tools for PCa in areas of limited resources discussed in this manuscript.

Consensus on Prostate Cancer Treatment of Localized Disease With Very Low, Low, and Intermediate Risk: A Report From the First Prostate Cancer Consensus Conference for Developing Countries (PCCCDC).

Purpose: A group of international urology and medical oncology experts developed and completed a survey on prostate cancer (PCa) in developing countries. The results are reviewed and summarized, and recommendations on consensus statements for very low-, low-, and intermediate-risk PCa focused on developing countries were developed.

Methods: A panel of experts developed more than 300 survey questions of which 66 questions concern the principal areas of interest of this paper: very low, low, and intermediate risk of PCa in developing countries.

Comparison beetwen open and laparoscopic radical cistectomy in a Latin American reference center: perioperative and oncological results.

Objectives: To evaluate the differences of peri-operatory and oncological outcomes between Laparoscopic Radical Cystectomy and Open Radical Cystectomy in our center.

Materials And Methods: Overall, 50 patients were included in this non randomized match-pair analysis: 25 patients who had undergone Laparoscopic Radical Cystectomy for invasive bladder cancer (Group-1) and 25 patients with similar characteristics who had undergone Open Radical Cystectomy (Group-2). The patients were operated from January 2005 to December 2012 in a single Institution.

Penile cancer: organ-sparing surgery.

Purpose Of Review: Penile cancer is a devastating disease, usually diagnosed late, that requires wide excisions, which causes alterations in self-esteem and body image, affecting sexual and urinary functions, which compromise quality of life. Recently, an increasing interest in penile-sparing surgeries (PSSs) has emerged, aiming to spare patients from these complications.

Recent Findings: Several options of PSS have been popularized for selected cases (Ta-1, Tis and some T2), such as wide local excision, circumcision, partial penectomy, total or partial glansectomies with or without glans-resurfacing procedures, as well as new glans reconstructions using spatulated urethral advances or free skin grafts.

Clinical use of a cordless laparoscopic ultrasonic device.

Objective: On April 25, 2012, the first laparoscopic cordless ultrasonic device (Sonicision, Covidien, Mansfield, Massachusetts) was used in a clinical setting. We describe our initial experience.

Methods: The cordless device is assembled with a reusable battery and generator on a base hand-piece.

The S.T.O.N.E. Score: a new assessment tool to predict stone free rates in ureteroscopy from pre-operative radiological features.

Objective: To develop a user friendly system (S.T.O.

Determinants of holmium:yttrium-aluminum-garnet laser time and energy during ureteroscopic laser lithotripsy.

Objective: To evaluate the association of preoperative noncontrast computed tomography stone characteristics, laser settings, and stone composition with cumulative holmium:yttrium-aluminum-garnet (Ho:YAG) laser time/energy.

Materials And Methods: We retrospectively reviewed patients who underwent semirigid/flexible ureteroscopy and Ho:YAG laser lithotripsy (200 or 365 μm laser fiber; 0.8-1.

Laminar and turbulent surgical plume characteristics generated from curved- and straight-blade laparoscopic ultrasonic dissectors.

Objective: To characterize laparoscopic ultrasonic dissector surgical plume emission (laminar or turbulent) and investigate plume settlement time between curved and straight blades.

Materials And Methods: A straight and a curved blade laparoscopic ultrasonic dissector were activated on tissue and in a liquid environment to evaluate plume emission. Plume emission was characterized as either laminar or turbulent and the plume settlement times were compared.

Histopathologic findings of small renal tumor biopsies performed immediately after cryoablation therapy: a retrospective study of 50 cases.

Objectives: To evaluate the histopathology of small renal tumor biopsies following cryoablation.

Methods: We retrospectively evaluated small renal tumor biopsy specimens after cryoablation treatment for renal cell carcinoma and determined the ability to differentiate tumor types, effect on nuclear grading, immunohistochemical staining, and if the number of freeze cycles affected interpretation.

Results: Of the biopsy specimens, 66% were diagnostic of tumor and 34% showed normal renal parenchyma.

Outcomes of intracorporeal lithotripsy of upper tract stones is not affected by BMI and skin-to-stone distance (SSD) in obese and morbid patients.

Purpose: The purpose of this study is to determine if body mass index (BMI) and stone skin distance (SSD) affect stone free rate (SFR) in obese and morbid obese patients who underwent flexible URS for proximal ureteral or renal stones < 20 mm.

Materials And Methods: A retrospective chart review was performed of consecutive patients that underwent flexible URS. Inclusion criteria were: proximal ureteral stones and renal stones less than 20 mm in the preoperative computed tomography (CT).

Extending boundaries in minimally invasive procedures with simultaneous bilateral video endoscopic inguinal lymphadenectomy (veil) for penile cancer: initial Denver health medical center and ABC school of medicine experience and surgical considerations.

Purpose: To report the surgical technique, procedural outcomes, and feasibility of simultaneous bilateral Video Endoscopic Inguinal Lymphadenectomy (VEIL) in the management of patients with indication for inguinal lymphadenectomy.

Surgical Technique: VEIL was applied in all patients using the oncological landmarks (the adductor longus muscle medially, the sartorius muscle laterally and the inguinal ligament superiorly). A 1.

Early scrotal approximation after hemiscrotectomy in patients with Fournier's gangrene prevents scrotal reconstruction with skin graft.

Objective: We report the outcomes of an early loose closure of the scrotum with a modified U-stitch to minimize use of split thickens skin graft for patients with hemiscrotal tissue loss after surgical debridement.

Methods: From January 2006 to August 2011, 28 male patients presented with Fournier's gangrene, requiring major urological surgical care and scrotal debridement at Denver Health Medical Center. Surgical outcomes were compared between patients receiving a novel U-Stitch approximation and those treated by traditional management.

Early effectiveness of endoscopic posterior urethra primary alignment.

Background: Posterior urethra primary realignment (PUPR) after complete transection may decrease the gap between the ends of the transected urethra, tamponade the retropubic bleeding, and optimize urinary drainage without the need of suprapubic catheter facilitating concurrent pelvic orthopedic and trauma procedures. Historically, the distorted anatomy after pelvic trauma has been a major surgical challenge. The purpose of the study was to assess the relationship of the severity of the pelvic fracture to the success of endoscopic and immediate PUPR following complete posterior urethral disruption using the Young-Burgess classification system.

Robotic partial adrenalectomy using indocyanine green dye with near-infrared imaging: the initial clinical experience.

Objective: To present the initial clinical experience with robot-assisted partial adrenalectomy using indocyanine green dye with near-infrared fluorescence (ICG-NIRF) imaging.

Methods: Three consecutive patients with solitary adrenal masses with worrisome features were referred for treatment. The preoperative workup included dedicated axial imaging and adrenal function studies.

Idiopathic scrotal calcinosis: A rare entity and a review of the literature.

Scrotal calcinosis is a rare condition with presentation including intradermal nodules varying in size and number. Differentials include calcification of epidermal or pilar cysts noted by the presence of keratinaceous debris. We present 2 cases of scrotal calcinosis at our institution.

Laparoscopic ureteroneocystostomy for ureteral injuries after hysterectomy.

Objectives: To examine the feasibility of early laparoscopic ureteroneocystostomy for ureteral obstruction due to hysterectomy injury.

Methods: We retrospectively reviewed a 10-y experience from 2 institutions in patients who underwent early (<30 d) or late (>30 d) laparoscopic ureteroneocystostomy for ureteral injury after hysterectomy. Evaluation of the surgery included the cause of the stricture and intraoperative and postoperative outcomes.

Cell-free plasma DNA as biochemical biomarker for the diagnosis and follow-up of prostate cancer patients.

The aim of this study was to evaluate the diagnostic and potential prognostic value of cell-free plasma DNA (CF-pDNA) in patients with suspected or histologically proven prostate cancer (PCa). We included 133 men with a diagnosis of PCa and 33 controls. PCa patients had blood samples prospectively drawn every 3 months for 2 years.

Initial brazilian experience in the treatment of localized prostate cancer using a new generation cryotechnology: feasibility study.

Introduction: The objective of our study is to present the first Brazilian cryoablation experience in the treatment of low and intermediate risk localized prostate cancer using 3rd generation cryoablation and real-time biplanar transrectal ultrasonography.

Materials And Methods: Ten Brazilian patients underwent primary cryoablation for localized prostate cancer between October 2010 and June 2011. All patients consented for whole gland primary cryotherapy.

Comparison of surgical plume among laparoscopic ultrasonic dissectors using a real-time digital quantitative technology.

Background: This study aimed to analyze the effect of surgical plume generation from various ultrasonic dissectors on laparoscopic visibility, including the first cordless ultrasonic dissector, using a novel real-time digital quantification technique.

Methods: The Covidien Cordless Sonicision, the Harmonic ACE, and the Olympus SonoSurg were applied to bovine liver with industry-specified settings. Consecutive activations were digitally captured from a laparoscope positioned to replicate the clinical setting.

Biophysiologic considerations in cryoablation: a practical mechanistic molecular review.

Cryotherapy techniques date back as far as the mid-1800s, when James Arnott demonstrated the effectiveness of salt/ice mixtures in palliation of breast, uterine, and skin cancers. Subsequent advances saw the use of liquid air and solid carbon dioxide in the treatment of various conditions, particularly benign dermatologic lesions (1). Cooper and Lee introduced the first automated cryosurgical apparatus cooled by circulating liquid nitrogen in 1961 and initially used it for treating neuromuscular disorders (2).

Spleen preserving distal pancreatectomy in an isolated blunt pancreatic trauma.

Blunt isolated pancreatic trauma is uncommon, accounting for 1%-4% of high impact abdominal injuries. In addition, its diagnosis can be difficult; physical signs may be poor and laboratory findings nonspecific, resulting in delayed treatment. Preserving the spleen during distal pancreatectomy (DP) is controversial.