Accuracy of the CUETO, EORTC 2016 and EAU 2021 scoring models and risk stratification tables to predict outcomes in high-grade non-muscle-invasive urothelial bladder cancer.

Purpose: Non-muscle-invasive bladder cancers (NMIBC) constitute 3-quarters of all primary diagnosed bladder tumors. For risk-adapted management of patients with NMIBC, different risk group systems and predictive models have been developed. This study aimed to externally validate EORTC2016, CUETO and novel EAU2021 risk scoring models in a multi-institutional retrospective cohort of patients with high-grade NMIBC who were treated with an adequate BCG immunotherapy.

Troubleshooting Complex Vascular Cases in the Kidney Transplant Recipient: Vascular Anomalies, Challenging Vessel Diseases, and Procedural Disasters.

Purpose Of Review: To update the most relevant literature regarding complex cases during kidney transplant setting that recipient presents by himself, especially during implantation surgery due to vascular diseases and/or urinary tract anomalies.

Recent Findings: Increasing age of donors and recipients is leading to an increased complexity of kidney transplant implantation surgery. In addition, the high peripheral vascular disease prevalence worldwide increases difficulty of surgery and decreases long-term outcomes as well.

Troubleshooting Complex Vascular Cases in the Kidney Graft: Multiple Vessels, Aneurysms, and Injuries During Harvesting Procedures.

Purpose Of The Review: To update the most relevant literature regarding complex vascular cases in kidney transplant setting involving the graft, especially during the harvesting procedure and back-table preparation from the subsequent implant.

Recent Findings: Challenging situations affecting the kidney graft such as multiple vessels, renal artery aneurysms, kidney anatomical anomalies, or major injuries do not contraindicate the transplant, but require an exhaustive graft viability assessment and several bench surgery techniques. Graft vessel conditioning in the back-table might include simple anastomosis between them, enlarging with venous patch or reconstruction with donor or synthetic grafts.

[Intraoperative neurophysiological monitoring in radical prostatectomy and pudendal nerve surgical releasing.].

Objective: Intraoperative neurophysiological monitoring (INM) allows obtaining real-time information on the functional integrity of nervous system structures. The objective of this article is to present the role of clinical neurophysiology in Urology in the identification and preservation, on the one hand, of the prostate neurovascular bundles in radical prostatectomy (RP), and of the pudendal nerve in the release of this in Pudendal Nerve Entrapment Syndrome (PNS).

Methods: A bipolar laparoscopic probe was used for intraoperative stimulation for both the identification in PNS and neurovascular bundles in RP, obtaining response at the external anal sphincter in the first one; and intracavernous pressure in the second through needle electrodes.

Novel Mapping Method for the Intraoperative Neurophysiologic Monitoring of Sexual Function During Prostate Surgery.

Purpose: The occurrence of urinary incontinence and erectile dysfunction after surgical treatment for prostate cancer is a significant and lingering problem. The aim of this study is to revise and improve older techniques of intraoperative cavernous nerve mapping already in use to improve accuracy and reliability.

Methods: We prospectively studied this technique in 12 patients suffering from prostate cancer.

Surgical technique for the treatment of renal cell carcinoma with inferior vena cava tumor thrombus: tips, tricks and oncological results.

Renal cell carcinoma represents 3 % of all cancers. Around 4-10 % of cases present with inferior vena cava involvement, generally with tumor thrombus. Clinical and preoperative stage will be classified depending of the thrombus extension.

Orthotopic kidney transplant: a valid surgical alternative for complex patients.

Kidney transplant is the best alternative of treatment for patients with end-stage renal disease (ESRD). At present, a significant part of patients admitted to waiting list are older and have previous transplants or severe vascular atheromatosis. In these cases, orthotopic kidney transplant (OKT) could be an option.

Contrast-enhanced ultrasound (CEUS): an excellent tool in the follow-up of small renal masses treated with cryoablation.

Strict imaging follow-up is mandatory after cryoablation of small renal masses (SRMs). Although it uses ionizing radiation and nephrotoxic iodinated contrast, computed tomography (CT) is still the gold standard test. Contrast-enhanced ultrasound (CEUS) is a novel technique that informs in real time about renal perfusion avoiding radiation and nephrotoxicity.

Prostate cancer in Spain: from guidelines to clinical practice.

Objective: • To determine how closely practice in prostate cancer (PCa) follows European Association of Urology (EAU) guidelines.

Materials And Methods: • This project involving 242 experts comprised four phases: (1) selection of controversial topics by a panel of experts; (2) preparation of case descriptions and associated questionnaires; (3) determination of their face validity; and (4) completion (November 2007 to January 2008). • The primary endpoint was percentage agreement with the recommendations given by the EAU guidelines.

Optical quality and intraocular scattering in a healthy young population.

Background: We objectively assessed the optical quality and intraocular scattering by means of parameters provided by a clinical double-pass system in healthy young subjects and thereby we obtained new reference data for clinical diagnosis. We calculated normal values of neural contrast sensitivity function (nCSF) from the measured modulation transfer function (MTF) and the contrast sensitivity function (CSF).

Methods: Eligible subjects were healthy adults aged from 18 to 30 years with a logMAR visual acuity (VA) of 0.

Very early serum creatinine as a surrogate marker for graft survival beyond 10 years.

Background: Available studies of early serum creatinine (SCr) as a surrogate marker for long-term graft loss are multicenter, registry-based or limited to 5- to 7-year survival.

Methods: This was a single-center observational retrospective study. SCr during the first year post-kidney transplant as an independent variable in determining long-term (>10-year) graft survival in 754 first cadaver kidney transplants was assessed with univariate and multivariate models.

Uneventful thoracic healing with everolimus after aortic valve replacement.

Impaired wound healing problems constitute a frequent severe adverse event associated to de novo use of proliferation signal inhibitors sirolimus or everolimus in kidney, heart, and lung transplantation. No published experience on the best practice to manage these drugs in patients scheduled for elective thoracic surgery is available. Herein we present a renal allograft recipient with recurrent cutaneous neoplasia who was maintained on everolimus plus prednisone undergoing aortic valve replacement.

Lumbar bone mineral density in renal transplant patients on neoral and tacrolimus: a four-year prospective study.

Background: This prospective study was designed to investigate the long-term evolution of bone mineral density (BMD) in kidney transplant recipients.

Methods: In 86 patients with functioning grafts, 65 on tacrolimus-based immunosuppression and 21 on cyclosporine-based immunosuppression, laboratory parameters and BMD measurements in lumbar spine (L2-L4) and femoral neck (FN) were performed by DEXA in the first month after transplantation (baseline) and yearly thereafter up to the fourth year.

Results: BMD did not change at 12 months in lumbar spine nor in the FN.

Clinical outcomes and C2 cyclosporin monitoring in maintenance renal transplant recipients: 1 year follow-up study.

Background: Cyclosporin A (CsA) concentration monitoring with 2 h post-dosing levels (C2) correlates with the incidence of rejection and graft outcome in de novo renal transplant patients. The advantages of this policy beyond the first 12 months remain a matter of debate. The purpose of the present work was to evaluate the C2 target ranges on CsA monitoring after the first year in stable kidney transplant patients.