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.

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.

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.

[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.

[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.

[6-year experience with extra peritoneal lumbar laparoscopic surgery: indications, complications, and results in a reference Southamerican center].

Objectives: To report the experience in lumbar extraperitoneal laparoscopy surgery obtained while perfectioning the technique over a six-year period.

Methods: We perform a prospective study with 168 cases of extra peritoneal laparoscopic surgery for the treatment of various kidney-ureter and adrenal diseases between 1999 and 2004. Operations were classified by organ and complexity (ablative or reconstructive).

Influence of asymptomatic histologic prostatitis on serum prostate-specific antigen: a prospective study.

Objectives: To determine the influence of asymptomatic inflammatory processes of the prostate on serum prostate-specific antigen (PSA) levels.

Methods: A total of 51 patients with no evidence of prostate cancer or clinical prostatitis were prospectively studied. All subjects underwent 10 to 12 sector transrectal-ultrasound guided needle biopsies of the prostate.

Prostate innervation and local anesthesia in prostate procedures.

The nerve supply of the human prostate is very abundant, and knowledge of the anatomy contributes to successful administration of local anesthesia. However, the exact anatomy of extrinsic neuronal cell bodies of the autonomic and sensory innervation of the prostate is not clear, except in other animals. Branches of pelvic ganglia composed of pelvic (parasympathetic) and hypogastric (sympathetic) nerves innervate the prostate.

Hand-assisted bilateral nephrectomy in a patient with adult polycystic kidney disease.

Context: Dominantly autosomal polycystic disease is characterized by multiple bilateral and non-functional cysts, which lead to progressive kidney failure.

Objective: Our objective was to report on a case of hand-assisted bilateral nephrectomy in a 28-year-old female patient with adult polycystic disease and recurring pyelonephritis in a kidney transplant program.

Case Report: A hand-assisted bilateral nephrectomy was performed through a supra-umbilical median incision of approximately 6 cm, and with 3 ports of 10 mm.

Preliminary experience with ureteral intussusception in exclusive retroperitoneoscopic nephroureterectomy: a simple and safe option for the resection of the distal ureter and bladder cuff.

Objective: To describe a surgical option in the resection of the distal third of the ureter and bladder cuff.

Material And Method: Three nephroureterectomies were performed by the extraperitoneal access. The first was performed in a patient with vesicoureteral reflux, recurrent urinary infection and chronic renal failure; and two nephroureterectomies were performed for the treatment of upper urinary tract transitional cell cancer.

Retroperitoneoscopic adrenalectomy in an infant with adrenocortical virilizing tumor.

Context: Adrenocortical virilizing tumors are rare in the pediatric age group. Laparoscopic surgery is the gold standard method for treatment of adrenal functional tumors under 6 cm in size, in adults. There has been very little use of laparoscopy in children and there is no report of its application in the treatment of adrenal carcinoma in childhood.

Ureterolithotripsy in the management of calcified double-J catheter.

Objective: The authors present their experience in the management of a rare complication observed during long-term use of a ureteral catheter. The calcification along the entire surface of the catheter followed by incrustation can make its removal by means of cystoscopy difficult, thus becoming a great challenge to the urologist.

Methods: The authors describe their experience in the management of this complication through the analysis of two illustrative cases.