Cardiovascular and metabolic syndrome risk among men with and without erectile dysfunction: case-control study.

Context And Objective: Erectile dysfunction has been associated with cardiovascular diseases. The aim here was to evaluate cardiovascular risk through the Framingham Risk Score (FRS) criteria, C-reactive protein (CRP) assays and presence of metabolic syndrome (MS) in men with and without erectile dysfunction diagnosed within a healthcare program.

Design And Setting: A retrospective case-control study was conducted.

Robotic assisted radical prostatectomy: a different treatment for prostate cancer?

Considering the Health Care System in Brazil, a developing country, and public healthcare policies, robotic surgery is a reality to very few citizens. Therefore, robotic assisted radical prostatectomy is far removed from the daily practice of the vast majority of Brazilian urologists. Scientific evidence of the superiority of robotic assisted radical prostatectomy does not presently justify public investments for widespread development of robotic centers.

Her-2/neu expression in prostate adenocarcinoma: a systematic review and meta-analysis.

Purpose: HER-2/neu has been linked to the clinical progression of hormone independent prostate cancer. We performed a meta-analysis to investigate the prognostic impact of HER-2/neu over expression in patients with prostate adenocarcinoma, and its correlation with other pathological and clinical variables.

Materials And Methods: We searched the MEDLINE, Embase, CancerLit and ASCO abstract databases for published studies of HER-2/neu protein expression in primary prostate cancer tissue with a median followup of greater than 2 years and data on survival in patients with and without HER-2/neu over expression.

Parachute technique for partial penectomy.

Purpose: Penile carcinoma is a rare but mutilating malignancy. In this context, partial penectomy is the most commonly applied approach for best oncological results. We herein propose a simple modification of the classic technique of partial penectomy, for better cosmetic and functional results.

Patient position and semi-rigid ureteroscopy outcomes.

Introduction: Two positions have been reported for ureteroscopy (URS): dorsal lithotomy (DL) position and dorsal lithotomy position with same side leg slightly extended (DLEL). The aim of the present study was to compare the outcomes associated with URS performed with patients in DL vs. DLEL position.

Video-assisted double-barreled wet colostomy: a new minimally invasive simultaneous diversion to patients after pelvic radiation therapy.

Introduction: A wet colostomy can be done when the simultaneous diversion of fecal and urine streams are necessary. Laparoscopic access is gaining space in urinary diversion procedures. The aim of the present study was to present the technique and results of the first case reported of a video-assisted double-barreled wet colostomy.

Video-assisted colonic conduit: a new minimally invasive urinary diversion to patients after pelvic radiotherapy.

Purpose: To report preliminary results of the first case of video-assisted colonic conduit. A 42-year-old woman had undergone external beam radiotherapy for squamous cell carcinoma of the cervix and developed a vesicovaginal fistula with small capacity bladder. Intraoperative option for urinary diversion was colonic conduit.

Comparative results of two techniques to treat stress urinary incontinence: synthetic transobturator and aponeurotic slings.

Introduction And Hypothesis: This study aims to analyze comparatively the efficacy and safety of synthetic transobturatory and aponeurotic retropubic slings, in the treatment of stress urinary incontinence (SUI) in women.

Methods: Patients were separated in a randomized way. Twenty-one patients were submitted to the operatory correction by the transobturatory sling technique, whereas 20 patients were operated by the retropubic sling technique.

Prospective comparative study between retroperitoneoscopic and hand-assisted laparoscopic approach for radical nephrectomy.

Objective: No consensus has yet been established regarding the best minimally invasive access for radical ablation of renal tumors. Our objective was to prospectively compare the surgical results and oncologic management of two currently used endoscopic techniques.

Materials And Methods: Over a four-year period, 50 patients with renal tumors and clinical stage T1b-T2, smaller than 12 cm, underwent a radical nephrectomy at two reference institutions, 25 underwent retroperitoneoscopic radical nephrectomy (RRN) and 25 a hand-assisted laparoscopic radical nephrectomy (HALRN).

Male infertility related to an aberrant karyotype, 46,XY,9ph,9qh+.

Objective: To report a man with primary infertility and variant karyotype.

Design: Case report.

Setting: Private practice.

Can video endoscopic inguinal lymphadenectomy achieve a lower morbidity than open lymph node dissection in penile cancer patients?

Background And Purpose: Radical lymphadenectomy improves survival in penile cancer patients, but the morbidity of the classic open procedure exceeds 50%. We report the updated results of Video Endoscopic Inguinal Lymphadenectomy (VEIL), an original minimally invasive procedure recently reported for extended inguinal node dissection in clinical settings.

Patients And Methods: Fifteen consecutive patients who underwent the VEIL technique were prospectively followed and included in this study.

Extensive ureteral stricture after percutaneous nephrolithotomy.

Objective: To present a previously unreported long term complication of percutaneous nephrolithotomy for exclusive renal stone.

Methods/results: A 30-years-old woman underwent percutaneous nephrolithotomy for a obstructive pelvic stone, through inferior calix access achieving a stone free status. During the procedure occurred an inadvertent pelvis perforation, but the early evolution was otherwise uneventful.

Video endoscopic inguinal lymphadenectomy: a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma.

Purpose: Video endoscopic inguinal lymphadenectomy is a recently described lymphadenectomy with the same template of the open technique but performed with laparoscopic instruments under video guidance. It was developed to decrease procedure related morbidity while maintaining good oncological results. We report our initial results in a trial comparing video endoscopic inguinal lymphadenectomy with standard inguinal lymphadenectomy.

Video endoscopic inguinal lymphadenectomy (VEIL): initial case report and comparison with open radical procedure.

Objectives: Inguinal metastases are one of the major determinants of mortality in patients with penile cancer. In high risk patients, while prophylatic inguinal lymphadenectomy may offer survival advantages, it still carries a relatively high morbidity. We describe in this paper the first report of the Video Endoscopic Inguinal Lymphadenectomy (VEIL) in the clinical practice, a technique which aims at reducing the morbidity of the procedure without compromising the cancer control or reducing the template of the dissection.

[Laparoscopic adrenalectomy: a prospective study comparing transperitoneal and retroperitoneal approaches].

Objectives: A prospective protocol was used to compare transperitoneal and retroperitoneal laparoscopic access for treatment of adrenal lesions.

Methods: Forty patients (19 male and 21 female) were submitted to laparoscopic adrenalectomy. Patients were operated by two surgeons.

Vesical explosion during transurethral resection of the prostate: report of a case.

Objective: Vesical perforation during transurethral resection of the prostate (TURP) is usually related to high increases in intravesical pressure. However, it may rarely be related to explosion precipitated by the contact of the electrocautery with some gases produced during the resections. The authors present a case of vesical explosion, discuss its mechanism and suggest some measures for prevention.

Video endoscopic inguinal lymphadenectomy (VEIL): minimally invasive resection of inguinal lymph nodes.

Objectives: Describe and illustrate a new minimally invasive approach for the radical resection of inguinal lymph nodes.

Surgical Technique: From the experience acquired in 7 operated cases, the video endoscopic inguinal lymphadenectomy (VEIL) technique was standardized in the following surgical steps: 1) Positioning of the inferior member extended in abduction, 2) Introduction of 3 work ports distal to the femoral triangle, 3) Expansion of the working space with gas, 4) Retrograde separation of the skin flap with a harmonic scalpel, 5) Identification and dissection of the long saphenous vein until the oval fossa, 6) Identification of the femoral artery, 7) Distal ligature of the lymph node block at the femoral triangle vertex, 8) Liberation of the lymph node tissue up to the great vessels above the femoral floor, 9) Distal ligature of the long saphenous vein, 10) Control of the saphenofemoral junction, 11) Final liberation of the surgical specimen and endoscopic view showing that all the tissue of the region was resected, 12) Removal of the surgical specimen through the initial orifice, 13) Vacuum drainage and synthesis of the incisions.

Comments: The VEIL technique is feasible and allows the radical removal of inguinal lymph nodes in the same limits of conventional surgery dissection.

Prospective randomized controlled trial comparing three different ways of anesthesia in transrectal ultrasound-guided prostate biopsy.

Purpose: To make an objective controlled comparison of pain tolerance in transrectal ultrasound-guided prostatic biopsy using intrarectal topic anesthesia, injectable periprostatic anesthesia, or low-dose intravenous sedation.

Materials And Methods: One hundred and sixty patients were randomized into 4 groups: group I, intrarectal application of 2% lidocaine gel; group II, periprostatic anesthesia; group III, intravenous injection of midazolam and meperidine; and group IV, control, patients to whom no sedation or analgesic was given. Pain was evaluated using an analogue pain scale graded from 0 to 5.

[Laparoscopic retroperitoneal adrenalectomy as a minimally invasive option for the treatment of adrenal tumors].

Objectives: The excision of the adrenal gland by laparoscopic approach is the gold standard for the treatment of adrenal tumors smaller than 6 cm. Most Brazilian centres favour the transperitoneal approach. The objective of the present prospective study was to show the intraoperative and postoperative results of patients undergoing adrenal laparoscopic surgery through a lateral retroperitoneal approach performed by an individual surgeon.

Hand-assisted laparoscopic nephrectomy as a minimally invasive option in the treatment of large renal specimens.

Introduction: We describe our experience with hand-assisted laparoscopy (HAL) as an option for the treatment of large renal specimens.

Materials And Methods: Between March 2000 and August 2004, 13 patients candidate to nephrectomies due to benign renal conditions with kidneys larger than 20 cm were included in a prospective protocol. Unilateral nephrectomy was performed in cases of hydronephrosis (6 patients) or giant pyonephrosis (4 patients).

Laparoscopic surgery for treatment of incisional lumbar hernia.

Objective: To present results obtained with laparoscopic correction of incisional lumbar hernia in patients with minimum follow-up of 1 year.

Materials And Methods: We prospectively studied 7 patients diagnosed with incisional lumbar hernia after physical examination and computerized tomography. We used laparoscopic transperitoneal access through 3 ports.

Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique.

Objective: To describe surgical and functional results with extraperitoneal laparoscopic radical prostatectomy with duplication of the open technique, from the experience obtained in the treatment of 28 initial cases.

Materials And Methods: In a 36-month period, we prospectively analyzed 28 patients diagnosed with localized prostate cancer undergoing extraperitoneal laparoscopic radical prostatectomy.

Results: Mean surgical time was 280 min, with mean blood loss of 320 mL.

Retroperitoneoscopic surgery with extracorporeal uretero-ureteral anastomosis for treating retrocaval ureter.

We present a case of retrocaval ureter featuring laparoscopic technique treatment using extraperitoneal access and extracorporeal suture of the ureteral stumps. Surgical time was 130 minutes, and the anastomosis was performed in 40 minutes. There were no intra- or postoperative complications, and the patient was discharged from hospital on the second postoperative day.