Factors affecting urinary continence and sexual potency recovery after robotic-assisted radical prostatectomy.

Introduction: Robot-assisted radical prostatectomy (RARP) is the most recent surgical technique for localized prostate cancer. The Da Vinci (Intuitive Surgical, Sunnyvale, CA) system was first introduced in Brazil in 2008, with a fast growing number of surgeries performed each year.

Objective: Our primary endpoint is to analyze possible predictors of functional outcomes, related to patient and tumor features.

Comparative and prospective analysis of three different approaches for live-donor nephrectomy.

Purpose: Living donor nephrectomy is usually performed by a retroperitoneal flank incision. Due to the significant morbidity and long recovery time for a flank incision, anterior extra peritoneal sub-costal and transperitoneal video-laparoscopic methods have been described for donor nephrectomy. We prospectively compare the long-term results of donors as well as functional recipients submitted to these three approaches.

Prostate cryoablation: prospective analysis comparing high- and low-risk prostate cancer outcomes.

Aim: To evaluate percutaneous cryotherapy as a primary treatment option for prostate cancer, comparing different risk groups.

Patients And Methods: Forty-seven prostate cryoablation procedures were performed on 44 patients. Patients median age was 70.

A prospective study evaluating the efficacy of the artificial sphincter AMS 800 for the treatment of postradical prostatectomy urinary incontinence and the correlation between preoperative urodynamic and surgical outcomes.

Objectives: We have evaluated prospectively the long-term efficacy of the artificial urinary sphincter (AUS) AMS 800 for the treatment postradical prostatectomy urinary incontinence (PRPUI) patients. We also evaluated the correlation between preoperative urodynamic findings and surgical outcomes.

Methods: From May 1997 to April 2003, 40 consecutive patients with PRPUI caused by intrinsic sphincter deficiency (ISD) were treated with the AMS 800.

Percutaneous prostate cryoablation as treatment for high-risk prostate cancer.

Purpose: To evaluate percutaneous cryotherapy as a primary treatment option for high-risk prostate cancer patients.

Patients And Methods: From October 2000 to February 2005, 21 high-risk (Gleason e.8 and/or PSA > 10 and/or stage > T2a) prostate cancer patients underwent 24 percutaneous prostate cryoablation procedures.

Late hormonal levels, semen parameters, and presence of antisperm antibodies in patients treated for testicular torsion.

In spite of prompt diagnosis and either orchiectomy or preservation of the affected testis, infertility remains a significant sequel to testicular torsion. The objective of this study was to evaluate the late endocrine profile, seminal parameters, and antisperm antibody levels after testicular torsion. We also analyzed the impact of orchiectomy or detorsion on the organ fate.

Surgical treatment of lymphedema of the penis and scrotum.

Purpose: Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region.

Prospective study evaluating efficacy and safety of Adjustable Continence Therapy (ProACT) for post radical prostatectomy urinary incontinence.

Objectives: To examine a new prosthesis, the Adjustable Continence Therapy (ProACT), to determine its ability to treat effectively post radical prostatectomy urinary incontinence. Urinary incontinence is one of the most significant complications of radical prostatectomy. Although the artificial urinary sphincter (AUS) is considered the standard treatment for this condition, many men seek a simpler and less expensive treatment option.

A cost-effective technique for pure laparoscopic live donor nephrectomy.

Objective: Compare two different techniques for laparoscopic live donor nephrectomy (LDN), related to the operative costs and learning curve.

Materials And Methods: Between April/2000 and October/2003, 61 patients were submitted to LDN in 2 different reference centers in kidney transplantation. At center A (CA), 11 patients were operated by a pure transperitoneal approach, using Hem-O-Lok clips for the renal pedicle control and the specimens were retrieved manually, without using endobags.

Semen analysis in fertile patients undergoing vasectomy: reference values and variations according to age, length of sexual abstinence, seasonality, smoking habits and caffeine intake.

Context And Objective: Recent studies have shown regional and population differences in semen characteristics. The objective was to establish reference values for semen analysis and to verify the effect that age, length of sexual abstinence, seasonality, smoking habits and coffee consumption have on fertile individuals' semen characteristics.

Design And Setting: Prospective study in the Urology Division, Hospital das Clínicas, Universidade de São Paulo.

Assessment of sexual function in patients undergoing vasectomy using the international index of erectile function.

Introduction: The present study aims to prospectively compare the sexual function in males before and after vasectomy surgery using the international index of erectile function (IIEF).

Materials And Methods: From October to December 2002, sixty-four patients who were candidates for male sterilization in the vasectomy program of the Urology Section at the General Hospital of the University of São Paulo were included. The same investigator applied the IIEF before and 90 days after the surgery.

Treatment of simple renal cysts with single-session percutaneous ethanol sclerotherapy without drainage of the sclerosing agent.

Purpose: To evaluate percutaneous single-session sclerotherapy with ethanol without drainage of the sclerosing agent in symptomatic simple renal cysts that require treatment.

Patients And Methods: A prospective series of 30 consecutive patients with symptomatic simple renal cysts with volume of 280.3 +/- 365.

Is it worthwhile to operate on subclinical right varicocele in patients with grade II-III varicocele in the left testicle?

Purpose: To determine whether repair of subclinical varicoceles in the right testicle results in significant seminal improvement in patients with clinical left varicocele.

Methods: Patients were divided into two groups: Group I (unilateral varicocelectomy) and Group II (bilateral varicocelectomy-subclinical left varicocele). The mean sperm concentration before treatment was higher in Group I (21.

Relationship between the number of veins ligated in a varicocelectomy with testicular volume, hormonal levels and semen parameters outcome.

Purpose: Correlate semen analysis, hormones, and testicular volume with the number of veins ligated.

Methods: Patients were divided into three groups: Group 1 (< or = 5 veins), Group 2 (6-10 veins), and Group 3 (> 10 veins). We evaluated testicular volume, hormonal levels, sperm concentration, and motility before and after the surgical procedure.

Surgical complications after renal transplantation in grafts with multiple arteries.

Introduction: Renal transplantation with multiple arteries appears, in literature, associated to a major index of surgical complications. This study compared the surgical complications and short-term outcome renal transplants with multiple arteries and single artery grafts.

Materials And Methods: The data of 64 renal transplants with multiple arteries performed between January 1995 and December 1999 were compared to the ones of 292 transplants with single renal artery.

Ocular metastasis as first presentation of renal cell carcinoma: report of 2 cases.

Authors report the cases of 2 patients who had an ocular lesion as the first sign leading to diagnosis of renal cell carcinoma, an uncommon presentation of this neoplasm. The first patient was a 59-year-old man presented with a mass in the right eye. The histological and immunohistochemical profile of the biopsy showed a probable renal cell carcinoma.

The laparoscopic management of intersex patients: the preferred approach.

Unlabelled: In the world's largest series of patients with intersex treated by laparoscopy, authors from Sao Paulo found that this technique allowed easy identification and removal of gonads. They also found that other organs could be removed and genitoplasty performed.

Objective: To present possibly the largest series of the use of laparoscopy for treating intersex patients.

Endopyelotomy with the Acucise catheter.

Objectives: Determine the efficiency of the Acucise catheter in the treatment of ureteropelvic junction (UPJ) obstruction.

Materials And Methods: Between May 1997 and April 1999, 30 patients with primary or secondary ureteropelvic junction obstruction were treated using Acucise endopyelotomy catheter. The diagnosis was based on intravenous urography and diuretic renography.

Laparoscopic nephrectomy in live donor.

Objective: To present the initial experience of videolaparoscopic nephrectomy in live renal donor.

Materials And Methods: In the period from April 2000 to August 2003, 50 left nephrectomies in live donor were performed by videolaparoscopy for transplantation. Twenty-eight patients were male (56%) and 22 female (44%).

Testicular growth, sperm concentration, percent motility, and pregnancy outcome after varicocelectomy based on testicular histology.

Objective: To evaluate the outcome following surgery in two different patterns of testicular histology in patients with varicocele.

Design: Prospective study.

Setting: Academic medical center.

Effects of medical therapy, alcohol, smoking, and endocrine disruptors on male infertility.

Infertility affects up to 15% of the sexually active population, and in 50% of cases, a male factor is involved, either as a primary problem or in combination with a problem in the female partner. Because many commonly encountered drugs and medications can have a detrimental effect on male fertility, the medical evaluation should include a discussion regarding the use of recreational and illicit drugs, medications, and other substances that may impair fertility. With the knowledge of which drugs and medications may be detrimental to fertility, it may be possible to modify medication regimens or convince a patient to modify habits to decrease adverse effects on fertility and improve the chances of achieving a successful pregnancy.

Semen profile, testicular volume, and hormonal levels in infertile patients with varicoceles compared with fertile men with and without varicoceles.

Objective: To assess semen analysis, testicular volume, and hormone levels in fertile and infertile patients with varicoceles and fertile men without varicoceles.

Design: Retrospective study.

Setting: Academic medical center.

The best infertility treatment for vasectomized men: assisted reproduction or vasectomy reversal?

In men with prior vasectomy, microsurgical reconstruction of the reproductive tract is more cost-effective than sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection if the obstructive interval is less than 15 years and no female fertility risk factors are present. If epididymal obstruction is detected or advanced female age is present, the decision to use either microsurgical reconstruction or sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection should be individualized. Sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection is preferred to surgical treatment when female factors requiring in vitro fertilization are present or when the chance for success with sperm retrieval and intracytoplasmic sperm injection exceeds the chance for success with surgical treatment.