Antibiotic prophylaxis for transrectal prostate biopsy.

Background: Transrectal prostate biopsy (TRPB) is a well established procedure used to obtain tissue for the histological diagnosis of carcinoma of the prostate. Despite the fact that TRPB is generally considered a safe procedure, it may be accompanied by traumatic and infective complications, including asymptomatic bacteriuria (bacteria in the urine), urinary tract infection (UTI), transitory bacteremia (bacteria in the blood), fever episodes, and sepsis (pathogenic microorganisms or their toxins in the blood). Although infective complications after TRPB are well known, there is uncertainty about the necessity and effectiveness of routine prophylactic antibiotics and their adverse effects, as well as a clear lack of standardization.

Upper-pole access for percutaneous nephrolithotomy.

Although the supracostal approach is thought to increase the difficulties and patient morbidity of PCNL, it facilitates the management of certain urinary infirmities, such as UPJ obstruction, staghorn stone, upper pole stone, proximal ureteral abnormalities, impacted UPJ stone and upper calix diverticulum. Hereby the authors briefly comment on the technical aspects of the supracostal approach, and also discuss the possible complications of this technique and how to avoid them.

Proximal ureteral calculi: shock wave or ureterolithotripsy?

Objective: To compare the success rates and efficiency of ureterolithotripsy (URL) and extracorporeal shock wave lithotripsy (SWL) for proximal ureteric stones. CASUISTRY AND METHODS: A prospective non-randomized study was performed between 1999 and 2004. Of a total of 235 patients, 121 underwent SWL and 114 had ureteroscopy with ultrasonic lithotripsy.

Transverse colon for continent urinary diversion: experimental study comparing two techniques.

Objectives: Patients who have undergone pelvic radiotherapy can develop urinary complications such as actinic cystitis or fistulas and ultimately need urinary diversion, for which several techniques have been described. The purpose of this experimental study was to compare 2 different types of continent urinary diversion with the colonic pouch.

Methods: Sixteen dogs of both sexes, weighing 20-25 kg were divided into 3 groups: the pilot group consisted of 6 dogs used to standardize the technique.

Primary leiomyosarcoma of the inferior vena cava: How should it be treated and the vein anatomy re-established?

Retroperitoneal sarcomas are responsible for 10-15% of all sarcomas in soft tissue. Leiomyosarcoma of the inferior vena cava has a slow growth rate, and the initial symptoms are related to the affected segment of the vein. A 56-year-old woman with leiomyosarcoma of the middle segment of the inferior vena cava underwent en-block resection of the affected segment of the vena cava and the right kidney.

New method for minimally invasive urodynamic assessment in men with lower urinary tract symptoms.

Objectives: Urodynamic studies are considered the reference standard to diagnose bladder outlet obstruction. However, the procedure is invasive, expensive, and time-consuming. The purpose of this study was to evaluate a new minimally invasive urodynamic assessment model and compare the results with those of conventional urodynamic evaluation.

Primary invasive versus progressive invasive transitional cell bladder cancer: multicentric study of overall survival rate.

Introduction And Objective: When feasible, the treatment for all-invasive bladder cancer is radical cystectomy. The aim of the present study was to analyze the prognostic difference, disease-specific survival rate, of muscle-invasive transitional cell cancer of the bladder (TCCB) for progressive invasive TCCB.

Patients And Methods: A retrospective multicentric analysis was performed studying a total of 242 patients who underwent radical cystectomy for invasive TCCB from 1993 to 2005.

Arteriovesical fistula as a complication of a gunshot wound to the pelvis: treatment dilemma.

The case is reported of an arteriovesical fistula after a gunshot wound to the pelvis in a 29-year-old man. It developed 20 days after an exploratory laparotomy with primary suture of the bladder. The patient presented with intermittent gross hematuria and diagnosis was made through cystoscopy and arteriogram.

Adjustable continence therapy for the treatment of urinary incontinence after radical cystectomy and orthotopic neobladder in women.

The management of urinary incontinence after radical cystectomy and orthotopic neobladder reconstruction is a very challenging situation. We report on a patient that developed a neobladder-urethro-vaginal fistula successfully treated but resulting in severe urinary incontinence that was cured after the periurethral insertion of adjustable silicone balloons.

Laparoscopic ileocystoplasty: an experimental study in pigs.

Background And Purpose: Bladder dysfunction may lead to urinary incontinence and progressive kidney deterioration. When clinical treatment fails, bladder augmentation is the operation of choice in most cases. The purpose of this study was the standardization of the technique of videolaparoscopic ileocystoplasty in a porcine model and demonstration of a tutor-supervised learning curve.

Is the minimally invasive treatment as good as transurethral resection for benign prostatic hyperplasia?

Despite the development of new technologies, transurethral resection of the prostate (TURP) is still considered the gold standard for surgical treatment of the benign prostate hyperplasia (BPH). In general, new minimally invasive treatments have not demonstrated better outcomes than TURP in evidence based medicine trials published to date, and should be reserved for patients who prefer to avoid surgery, who are unsuitable candidates for surgery or who no longer respond favorably to medication. TUMT and TUNA appears to be more effective than medical therapy but less effective than TURP.

Experimental animal model for training transobturator and retropubic sling techniques.

Introduction: Suburethral slings have become the treatment of choice for stress urinary incontinence. However, the lack of experimental models for surgical training is a problem for beginners. We present a model for sling training and evaluate its acceptance by surgeons who have had prior experience.

Macroplastique implantation system for female stress urinary incontinence: long-term follow-up.

Purpose: To evaluate the 60-month outcome of the Macroplastique Implantation System (MIS) for the treatment of female stress urinary incontinence (SUI) caused by intrinsic sphincter deficiency evaluated by objective and subjective measures, including Quality of Life (QoL) impact.

Patients And Methods: Twenty-one women, mean age 47.4 years, with urodynamically diagnosed intrinsic sphincter deficiency were enrolled.

Open surgical treatment of right-sided adrenal carcinomas >15 cm.

Introduction: Adrenal carcinomas are rare and are associated with a very poor prognosis. The incidence is estimated to be 1 in 1.7 million which represents 0.

[Early versus delayed physiotherapy in the treatment of post-prostatectomy male urinary incontinence].

Objectives: To analyze the importance of the starting time for pelvic floor physiotherapy in patients with post radical prostatectomy urinary incontinence.

Methods: Between May 2003 and February 2004 18 patients with the diagnosis of post radical prostatectomy urinary incontinence underwent physiotherapy of the pelvic floor. Each patient received 12 sessions using kinesotherapy and electric stimulation on a weekly basis.

Renal medullary carcinoma. Case report and review of the literature.

Young patients with sickle cell trait or disease present a higher risk for renal medullary carcinoma, an aggressive renal tumor, with dismal prognosis, with a median survival of 4 months from the time of diagnosis. We report a 26-year-old patient with a 2-month history of bone pain at the right iliac crest, loss of weight, recurrent macroscopic hematuria and abdominal mass. Imaging studies demonstrated a 10-cm mass in the right kidney.

Split technique in horseshoe kidney transplantation.

Background/aims: Nowadays, owing to a greater number of patients waiting for a kidney donation and to a shortage of organs donated, more suitable organ acceptance criteria have been formulated. Horseshoe kidney transplantations have become feasible giving good allograft outcomes. The aim of this paper is to illustrate the split technique in horseshoe kidney transplantation and to report long-term results.

Videolaparoscopic orchiectomy and nephrectomy: training model in rats.

Objective: Videolaparoscopic surgery conducted on small animals has proved to be of great importance for the improvement of surgical skills. This is a report utilizing an experimental model for laparoscopic orchiectomy and nephrectomy in training courses for urologists.

Material And Methods: Of 350 American Wistar rats enrolled, 319 animals underwent laparoscopic orchiectomy and nephrectomy under intraperitoneal general anesthesia.

Massive prolapse of the urethral mucosa following periurethral injection of calcium hydroxylapatite for stress urinary incontinence.

The injection of bulking agents into the urethral submucosa is designed to create artificial urethral cushions that can improve urethral coaptation and hence restore continence. Ideally, a urethral bulking agent should be non-immunogenic and biocompatible, leading to minimal inflammatory and fibrotic response. The authors present a case report of a granulomatous reaction leading to urethral prolapse, 3 months after the transurethral injection of calcium hydroxylapatite.

Continent urinary diversion in patients with pelvic irradiation: an alternative utilizing transverse colon reservoir.

The use of radiation therapy in pelvic malignancies increases the risk of urinary complications, sometimes being necessary urinary diversion. The risk of utilizing previously irradiated bowel should be avoided. The use of transverse colon is a safe and effective alternative.

Transobturator SAFYRE sling is as effective as the transvaginal procedure.

Introduction: SAFYRE is a monofilament polypropylene mesh held between two self-anchoring silicone columns that associates universal approach with readjustability. This unique feature allows for comparing two different approaches, i.e.

Intravesical calculus secondary to ethanol gel injection into the prostate.

A 78-year-old man with coagulopathy and lower urinary tract symptoms secondary to benign prostatic hyperplasia underwent transurethral prostate ethanol gel injection. Six months after the injection, the patient presented with irritative symptoms and hematuria. Ultrasonography revealed a 5-cm intravesical calculus.

Comparative study of percutaneous access for staghorn calculi.

Objectives: To compare the success and complication rates of staghorn calculi treated through the upper pole calix, lower/middle calices, and multiple access.

Methods: Between January 1995 and December 2000, the records of 119 patients with staghorn calculi who underwent percutaneous nephrolithotomy were retrospectively reviewed. The mean stone burden was 6.

Treatment of intrinsic sphincter deficiency using the Macroplastique Implantation System: two-year follow-up.

Purpose: To evaluate the 24-month outcome of the Macroplastique Implantation System (MIS) for the treatment of stress urinary incontinence (SUI) using objective and subjective measures, including quality-of-life (QoL) impact.

Patients And Methods: Twenty-one consecutive women with a mean age of 47.4 years and a mean body mass index 26.