"Non-metastatic, Castration-resistant Prostate Cancer: Diagnostic and Treatment Recommendations by an Expert Panel from Brazil".

Introduction: Non-metastatic, castration-resistant prostate cancer (nmCRPC) is an important clinical stage of prostate cancer, prior to morbidity and mortality from clinical metastases. In particular, the introduction of novel androgen-receptor signaling inhibitors (ARSi) has changed the therapeutic landscape in nmCRPC. Given recent developments in this field, we update our recommendations for the management of nmCRPC.

Wünderlich Syndrome in Renal Transplant Recipients: A Case Report and Literature Review.

Background: Wünderlich syndrome, or spontaneous atraumatic renal hemorrhage, is a clinical entity rarely described in the native kidney of patients who have undergone renal transplant. Although its manifestation is quite similar in reported cases, it may present few symptoms, from bleeding of unidentified etiology to dramatic pictures associated with hypovolemic shock. There are few reports of spontaneous hemorrhage of a native kidney after kidney transplantation.

Rate of spontaneous voiding recovery after acute urinary retention due to bed rest in the hospital setting in a nonurological population clinical study of the relationship between lower limbs and bladder function.

Objectives: To understand the clinical relationship between lower limbs functions and the recovery of spontaneous voiding after an acute urinary retention (AUR) in older patients admitted to hospitals for non-urological causes using clinical parameters.

Materials And Methods: 56 adult patients (32 men; mean age: 77.9 ± 8.

Can We State Stable Bladder? How Many Repetitions Should We Do for an Appropriate Demonstration of Involuntary Detrusor Contraction?

Aims: Involuntary Detrusor Contraction (IDC) may alter therapeutic plans; therefore, urodynamic demonstration (UD) is pivotal. We explore if same session repetitions enhance its demonstration and minimize false-negative results.

Methods: Two hundred fifty two women (mean age 47 ± 5.

One hundred cases of SUI treatment that failed: a prospective observational study on the behavior of patients after surgical failure.

Objectives: Determine what happens to patients after unsuccessful SUI operations and to explore the reasons why these patients change doctors.

Materials And Methods: One hundred consecutive failed patients treated for SUI were interviewed about the exams requested after persistence of the incontinence as well as the reasons they abandoned their primary doctors through a structured questionnaire.

Results: Among the patients with cases of anterior colporrhaphy, bladder suspensions or slings, 34.

Urodynamic after-contraction waves: a large observational study in an adult female population and correlation with bladder and ureter emptying functions in women.

Objective: To evaluate different patterns of after-contraction (A-C) waves detected during urodynamic evaluation in women.

Patients And Methods: 4,110 women were prospectively observed regarding the presence of A-C waves upon urodynamic evaluation. Intravenous pyelography and ultrasound were requested.

Involuntary detrusor contraction is a frequent finding in patients with recurrent urinary tract infections.

Objective: To check whether subtle voiding dysfunction is related to recurrent urinary tract infection (rUTI).

Methods: 254 consecutive patients with at least four episodes of urinary tract infection (UTI) were studied. At least three repeat urodynamic evaluations with an additional ice water test to maximize the detection of involuntary detrusor contraction (IDC) were used.

Impact of Urodynamic Learning on the Management of Benign Prostatic Hyperplasia Issue on Young and Senior Urologists and Reasons to Attend a Voiding Dysfunction Course.

Objectives: The aims of this study were to compare the impact of urodynamic training on the young urologists after fellowship training as well as on senior urologists who attend regular courses on the management of benign prostatic hyperplasia (BPH) and their capacity to do and interpret urodynamic studies.

Methods: Sixty-four consecutive young urologists admitted to fellowship program on voiding dysfunctions and 110 senior urologists attending to periodical meetings were interviewed before and after the 3-day-courses regarding their ability to set, interpret and do urodynamic studies. They were also questioned on the reasons that led them to attend the courses and how they use the new concepts to manage BPH.

Slings may not fail as frequently as believed for stress urinary incontinence: the misinterpretation of postoperative voiding dysfunction as failure based on patient report.

Objective: : Sling operations may obstruct the urethra, promoting voiding dysfunction and secondary urine leakage that are incorrectly attributed to surgical failure.

Methods: : We prospectively evaluated the evolution of urinary symptoms in the postoperative follow-up of 108 polypropylene sling cases. Patients presented for follow-up at 1, 3, 6, 12, 18, 24, 36, and 48 months for review of individual urinary symptoms.

Valsalva leak point pressure to determine internal sphincter deficiency in stress urinary incontinence.

Introduction: Valsalva leak point pressure (VLPP) represents the global competence of the conjunctive forces around the urethra to support increased pressure from the abdominal cavity with transmission to the bladder. Assessment of VLPP has prognostic meaning, but measurement techniques are still subject to controversy.

Patients And Methods: One hundred and eight consecutive women with no genital prolapse or bladder hyperactivity exclusively presenting with urinary stress incontinence were submitted to VLPP determination during urodynamic evaluation using a rectal and urethral catheter.

The percentage of positive biopsy cores as a predictor of disease recurrence in patients with prostate cancer treated with radical prostatectomy.

Objective: To analyse the prognostic value of the percentage of positive biopsy cores (PPBC) in determining the pathological features and biochemical outcome of patients with prostate cancer treated by radical prostatectomy, as published data evaluating the prognostic value of PPBC in such patients have limitations.

Patients And Methods: A group of 534 patients with clinically localized prostate cancer was selected. The PPBC was defined as the number of positive biopsy cores/total number of biopsy cores x 100, and grouped into categories of <25%, 25.

Deep-seated sarcomas of the penis.

Mesenchymal neoplasias represent 5% of tumors affecting the penis. Due to the rarity of such tumors, there is no agreement concerning the best method for staging and managing these patients. Sarcomas of the penis can be classified as deep-seated if they derive from the structures forming the spongy body and the cavernous bodies.

Localized prostatic cancer in patients submitted to renal transplant.

Objective: An attempt is made to evaluate the incidence of prostate cancer in patients who have previously undergone a kidney transplant surgery and to determine the best therapeutic approach to this target group.

Material And Methods: All kidney transplant male patients over 40 years of age were studied with respect to diseases unrelated to the transplants, which later affected them, mainly focusing on neoplastic disease and, more specifically, prostate cancer.

Results: Of 397 kidney-transplanted patients, 146 (37%) were males, at least 40 years old.

International Prostate Symptom Score--IPSS-AUA as discriminat scale in 400 male patients with lower urinary tract symptoms (LUTS).

Objective: This study analyzed the total symptom score, irritative and obstructive domains of IPSS questions regarding quality of life and the urodynamic diagnosis in 400 men with LUTS.

Materials And Methods: Four hundred consecutive male patients were prospectively enrolled after being submitted to full urodynamic evaluation and IPSS. Obstructed and non-obstructed patients were compared regarding the symptoms score and quality of life.

Alternative grafting technique for patients unsuited to heterotopic transplantation due to diseased pelvic conditions.

Introduction: An alternative technique for kidney transplantation is presented for patients in whom the use of pelvic vessels is precluded.

Patients And Methods: Of 482 cases of kidney or pancreas-kidney transplants, 4 were unsuited to heterotopic grafting, 1 due to multiple operations in the fossae and the 3 others due to extensive vascular occlusive disease. The patients were studied preoperatively by magnetic resonance angiography, which revealed extensive occlusive disease of the distal aorta and/or iliac vessels.

Pubo-fascial versus vaginal sling operation for the treatment of stress urinary incontinence: a prospective study.

Aims: To compare the long-term results of stress urinary incontinence (SUI) treatment involving the fascial or vaginal sling operations.

Material And Methods: Two-hundred-thirty-two women were consecutively submitted to fascial or vaginal sling operations due to urodynamic proven SUI. The fascial group had a median age of 47.

A randomized and prospective study on the value of antibiotic prophylaxis administration in transurethral resection of the prostate.

Context: Antibiotic prophylaxis in transurethral resection of the prostate is a regular practice in urology. However, its prophylactic effect can be questioned when the antiseptic surgical technique is used. Nonetheless, urine culture-oriented antibiotic therapy is the gold standard for avoiding improper medication usage and bacterial resistance.