Two-stage functional and aesthetic reconstructive surgery in melanoma in situ of the glans penis and urethra.

Melanoma in situ including glans penis and fossa navicularis is unique and represents a challenging dilemma since surgery should not be very aggressive. We present a case of melanoma in situ treated with a two-stage penile and urethral reconstructive surgery, with emphasis on functional and aesthetic results. At the first-stage surgery an anatomic glansectomy was perfomed, and combined preputial and full-thickness skin grafts were used to prepare the urethral plate and restore the aesthetic aspect of the corpora cavernosa.

Renal trauma in adolescent skateboarders.

Objective: Kidney is the most commonly injured organ of the genitourinary tract after trauma. Half of blunt renal injuries are caused by traffic accidents, but sport activities are also included as frequent causes. Skatebording is popular among young people but it deserves being considered a potential cause of severe injuries.

Fast-track surgery and technical nuances to reduce complications after radical cystectomy and intestinal urinary diversion with the modified Indiana pouch.

Objectives: With the purpose to reduce the complications of radical cystectomy and intestinal urinary reconstruction a perioperative protocol based on fast-track surgery principles and technical modifications of the original surgical technique was applied to patient candidates for etherotopic bladder substitution. Our protocol included pre-, intra-, and postoperative interventions. The technical variations of the modified Indiana pouch technique were focused on intestinal anastomosis to restore bowel continuity, uretero-colonic anastomoses, and capacity of the reservoir.

Prognostic significance of fluorescent in situ hybridisation in the follow-up of non-muscle-invasive bladder cancer.

Aim: To evaluate the potential contribution of a fluorescent in situ hybridization (FISH) as prognostic indicator of the risk of recurrence or progression in patients undergoing follow-up for non-muscle-invasive bladder cancer (NMIBC).

Patients And Methods: A total of 126 consecutive patients with a history of NMIBC being followed-up with urinary cytology and cystoscopy at a referral centre were studied. Patients with carcinoma in situ, or tumour stage higher than pT1 were excluded.

Short-time ureteral catheterization after operative ureteroscopic lithotripsy: an alternative to stent versus no stent evaluated in a retrospective study.

Objectives: Stent-less procedure following ureterolithotripsy needs a definition for patient selection and procedure criteria. To mediate stenting versus no stenting, a retrospective study was performed to evaluate the insertion of an ureteral open-tip catheter for 24 hours.

Material And Method: From 2002 to 2006 255 ureterolithotripsy were performed (176 male - 79 female, mean age 51.

The UroVysion F.I.S.H. test compared to standard cytology for surveillance of non-muscle invasive bladder cancer.

Objective: To evaluate the potential contribution of urinary fluorescent in situ hybridization in the prediction of the risk of recurrence and progression of men undergoing followup for NMIBC.

Materials And Methods: Patients with a history of NMIBC being followed with urinary cytology and cystoscopy were included in the study. Patients with Carcinoma in situ or tumour stage higher than pT1 were excluded from this analysis.

Pharmacokinetics and toxicity of an early single intravesical instillation of gemcitabine after endoscopic resection of superficial bladder cancer.

Background: The tolerability and plasma absorption of gemcitabine administered at 40 mg/ml after small and extensive endoscopic transurethral resection of bladder tumors (TURB) were evaluated.

Patients And Methods: Nine patients with a history of recurrent superficial bladder cancer were eligible for a single immediate, post TURB, intravesical instillation of gemcitabine. The endoscopic resection was small in 5 patients and extensive in 4.

Short-schedule intravesical gemcitabine with ablative intent in recurrent Ta-T1, G1-G2, low- or intermediate-risk, transitional cell carcinoma of the bladder.

Primary Objective: to assess ablative efficacy and tolerability of short-schedule intravesical gemcitabine for intact, low- and intermediate-risk, recurrent superficial bladder tumours.

Secondary Objective: to assess effect on prophylaxis.

Methods: Patients with a diagnosis of recurrence and a history of previous superficial, low- or intermediate-risk bladder tumours were selected for the study.

Results and complications with the mini-laparotomic incision in 52 consecutive radical retropubic prostatectomies.

Objectives: We describe a simple mono-institutional study to prospectively assess the benefits and complications of the mini-laparotomic incision for radical retropubic prostatectomy with the anatomic approach.

Methods: Radical retropubic prostatectomy with the anatomical approach, as described by Walsh, was performed through a 4 to 8 cm incision. Median operative time, body weight, prostate weight, pathologic stage, incidence of positive surgical margins, urinary continence, the need for post-operative analgesics, peri-operative complications, are the parameters we assessed.

Cancer detection with TRUS-guided 10-core biopsy of the prostate. an institutional assessment at the first, repeated and surgical specimen biopsy.

Objectives: We retrospectively investigated the results of the 10-core scheme that our institute has adopted for three years. The aim of this study is to evaluate the cancer detection rate in different sets of biopsies (first, second, third and surgical specimen biopsy).

Material And Methods: Patients with clinical suspicion of prostate cancer based on abnormal digital rectal examination, increase of PSA or hypoechoic lesion at transrectal ultrasound were subjected to a 10-core biopsy.

Still a place for the classical systematic sextant technique? Cancer detection rates and complications in 1025 consecutive prostatic biopsies.

Objectives: To verify if there might still be an indication to the sextant biopsy technique we reviewed the cancer detection rate obtained and the complications encountered during a five years interval, at our hospital.

Methods: From January 1997 to December 2002 we have submitted to prostatic biopsy a total of 1025 consecutive patients with a clinical suspect of prostate cancer. A total of six cores were obtained in all the patients with an additional core at suspect lesions.

Intravesical gemcitabine in recurrent superficial bladder carcinoma: preliminary results on ablative efficacy and tolerability.

Background: The ablative potential and toxicity of gemcitabine, administered intravesically in low stage and grade superficial transitional cell carcinoma (TCC), were evaluated.

Patients And Methods: Patients with a history of recurrent Ta-T1, GI-G2 bladder TCC were considered eligible for the study. Gemcitabine was administered intravesically at 40 mg/mL concentration (2000 mg in 50 ml saline) in one weekly instillation for 4 consecutive weeks.

Peri-operative management of ablative and reconstructive surgery for invasive bladder cancer in the elderly.

Introduction And Objectives: Radical cystectomy and urinary diversion for muscle invasive bladder cancer is a demanding surgical procedure usually followed by a variable period of inability. It might be even more delicate in the elderly. We describe our protocol of pre, intra, and post operative management aimed at minimising the impact of bladder cancer surgery.