Metastatic renal cell carcinoma management.

Purpose: To assess the current treatment of metastatic renal cell carcinoma, focusing on medical treatment options.

Material And Methods: The most important recent publications have been selected after a literature search employing PubMed using the search terms: advanced and metastatic renal cell carcinoma, anti-angiogenesis drugs and systemic therapy; also significant meeting abstracts were consulted.

Results: Progress in understanding the molecular basis of renal cell carcinoma, especially related to genetics and angiogenesis, has been achieved mainly through of the study of von Hippel-Lindau disease.

Localized renal cell carcinoma management: an update.

Objective: To review the current modalities of treatment for localized renal cell carcinoma.

Materials And Methods: A literature search for keywords: renal cell carcinoma, radical nephrectomy, nephron sparing surgery, minimally invasive surgery, and cryoablation was performed for the years 2000 through 2008. The most relevant publications were examined.

Appendix interposition for total left ureteral reconstruction.

Introduction: Appendix interposition has been described as an option for surgical reconstruction of partial and total ureteral defects both in children and adults. However, to our knowledge, appendix interposition for a total left ureteral reconstruction has never been described.

Case Report: We report the first case of total left ureteral reconstruction with cecal appendix to connect the renal pelvis of a native kidney to the urinary bladder in a 3-month-old child with ureteral necrosis following pyeloplasty.

Use of the gamma probe in sentinel lymph node biopsy in patients with prostate cancer.

Objective: To describe the reproducibility of the sentinel lymph node technique in patients with prostate cancer and verify if there is improved accuracy over modified lymphadenectomy.

Material And Methods: Twenty-three patients with biopsy proven prostate cancer were enrolled in this study. Lymphoscintigraphy was performed after the transrectal administration of Tc sulfur colloid guided by ultrasound, with one injection in each prostate lobe.

Diabetes mellitus is associated with subnormal serum levels of free testosterone in men.

Objective: To evaluate the relationship between diabetes mellitus (DM) and serum levels of free (FT) and total (TT) testosterone.

Patients And Methods: A cross-sectional study was carried out including 746 men, of whom 116 (15.6%) were diabetics.

Intracavernosal etilefrine self-injection therapy for recurrent priapism: one decade of follow-up.

Recurrent idiopathic priapism is a rare condition that, if not properly treated, may lead to impaired quality of life and erectile dysfunction. Treatment can be achieved by prevention of priapism episodes with systemic therapy or by early intervention with intracavernosal self-injection of sympathomimetic agents. We describe a case of a young patient with recurrent idiopathic priapism who has used etilefrine self-injection for the past 10 years with good efficacy and libido and erectile function preservation.

Value of prostate specific antigen in predicting the existence of bone metastasis in scintigraphy.

Objective: Evaluate the ability of serum concentration of prostate specific antigen (PSA) between 2 cutting points to predict the existence of bone metastasis confirmed by bone scintigraphy in man with prostate cancer.

Materials And Methods: Two hundred and fourteen consecutive patients with prostate cancer were evaluated during the present study in the period from 1998 to 2001. From all patients, PSA serum concentrations and bone scintigraphy were obtained.

Glycosylated haemoglobin levels and the severity of erectile function in diabetic men.

Objective: To evaluate the association between the levels of glycosylated haemoglobin (HbA1c) and the severity of erectile dysfunction (ED) in men with diabetes mellitus (DM).

Patients And Methods: This cross-sectional study included sexually active men with a diagnosis of DM attending a urological medical centre from January 2000 to December 2001. The 115 men with ED (95%) completed the International Index of Erectile Function questionnaire, and fasting serum glucose and HbA1c serum levels were measured.

Urethral catheter removal 7 or 14 days after radical retropubic prostatectomy: clinical implications and complications in a randomized study.

Purpose: To evaluate the hypothesis that a 7-day period of indwelling catheter after radical retropubic prostatectomy is effective and safe without the need of performing cystography.

Methods: In the period from January of 2000 to July of 2002, 73 patients underwent radical retropubic prostatectomy, and these patients were prospectively randomized in 2 groups: Group 1-37 patients who had the urethral catheter removed 7 days after the procedure, and Group 2-36 patients who had the catheter removed 14 days after the surgery. The 2 groups were similar, the surgeons and the technique were the same, and no cystography was performed to evaluate the presence of leaks.

The relationship of serum testosterone to erectile function in normal aging men.

Purpose: We evaluated the variation in serum testosterone in normal aging men and its relationship with erectile function.

Materials And Methods: In a study that was not community based and during a free screening program for prostate cancer 1,071 men were invited to complete a sexual activity questionnaire, that is the abridged 5-item version of the International Index of Erectile Function (IIEF-5), as a diagnostic tool for erectile dysfunction. Possible scores on the IIEF-5 are 1 to 25 and erectile dysfunction was classified into 5 categories based on the scores, namely severe-1 to 7, moderate-8 to 11, mild to moderate-12 to 16, mild-17 to 21 and none-22 to 25.