Serum isoform [-2]proPSA derivatives significantly improve prediction of prostate cancer at initial biopsy in a total PSA range of 2-10 ng/ml: a multicentric European study.

Background: Strategies to reduce prostate-specific antigen (PSA)-driven prostate cancer (PCa) overdiagnosis and overtreatment seem to be necessary.

Objective: To test the accuracy of serum isoform [-2]proPSA (p2PSA) and its derivatives, percentage of p2PSA to free PSA (fPSA; %p2PSA) and the Prostate Health Index (PHI)-called index tests-in discriminating between patients with and without PCa.

Design, Setting, And Participants: This was an observational, prospective cohort study of patients from five European urologic centers with a total PSA (tPSA) range of 2-10 ng/ml who were subjected to initial prostate biopsy for suspected PCa.

[Limits of laparoscopic surgery in the treatment of renal tumors].

Laparoscopic radical nephrectomy is considered to be the technique of choice in the mangement of stage T1 and T2 renal cancer, though increased mastery of this alternative type of surgery has served to expand its indications. In any case, these procedures have a series of limitations which are tied to the intrinsic characteristics of laparoscopic surgery, and which are associated with the patient and tumor characteristics, and the experience of the surgeon. The present study discusses the different indications and establishes the current limits of laparoscopic surgery applied to the management of renal tumors.

[Non-sparing surgery of a transplanted kidney].

There is an increasement on the incidence of tumours within the population of renal transplanted, from three to five times over general population. Related to urological tumours, it emphasizes an increase in the incidence of the renal carcinoma, around 4,7% against 3% on general population. In this case, we present a 56-year-old patient, who suffered a renal transplant 8 years ago.

[Robotic radical prostatectomy: first 100 patients in Fundació Puigvert].

Objective: We present the 100 first robotic radical prostatectomy with Da Vinci (RRPdaV), corresponding to the first experience in Spain.

Methods: We reviewed the first 100 patients that underwent transperitoneal RRPda performed in Fundació Puigvert between July 2005 and January 2007. All cases were performed by 5 surgeons, being the learning curve for all of them.

[Arterial embolization in the treatment of renal trauma of a horseshoe kidney].

Objectives: To report one case of renal trauma in a patient with horseshoe kidney treated conservatively by superselective embolization.

Methods: We report the case of a 19 year old male presenting at the emergency room with macroscopic hematuria and severe abdominal pain after a motor vehicular accident.

Results: IV contrast CT scan showed a horseshoe kidney with a fracture in the area between the lower pole of the left kidney and the isthmus, with active bleeding and a big retroperitoneal hematoma extended to pelvis.

Gastric cancer in augmentation gastrocystoplasty.

A 27-year-old man operated for myelomeningocele in the neonatal period and for augmentation gastrocystoplasty at age 13 years for voiding dysfunction, was diagnosed with gastric adenocarcinoma on the stomach side of bladder augmentation. A radical cystectomy and an ileal conduit procedure were performed and the pathologist confirmed a poorly differentiated gastric adenocarcinoma. Urologists should be aware of this potential degeneration, and long-term follow-up is mandatory to detect malignization of these cystoplasties.