Retroperitoneoscopic renal biopsy: still a good indication!

The histological evaluation of the renal parenchyma is often essential in cases of several renal diseases and provides useful information in determining the prognosis and guiding treatment. In patients with contraindications to percutaneous kidney biopsy, retroperitoneal laparoendoscopic single-site surgery (LESS) is to be preferred as a minimally invasive technique. However, there are cases in which the LESS technique is difficult to perform, especially given that the learning curve is not optimal.

An objective comparison of novice trainees learning LESS versus traditional laparoscopy with the use of a pelvic trainer.

Objectives: To compare the differences between LESS and SL among a population of subjects inexperienced of both techniques.

Materials And Methods: Participants were randomly assigned to the LESS or SL arm of the course; between the population examined, none had previous laparoscopic experience. The trial consisted in performing three increasingly difficult exercises either with LESS or standard laparoscopy.

How effective is extracorporeal shock wave lithotripsy of ureteral stones with Dornier Lithotripter S EMSE 220F-XXP? A prospective and preliminary assessment.

Aim: To report our preliminary series with the Doli S EMSE 220F-XXP, the upgraded version of the previous Dornier Lithotripter S EMSE 220, for treatment of ureteral stones.

Methods: Since July 2006, a total of 200 patients with ureteral stones were submitted to shock wave lithotripsy (SWL) with Doli S EMSE 220F-XXP. Mean stone size was 9.

New trends in minimally invasive urological surgery: what is beyond the robot?

Purpose: To review the minimal-invasive development of surgical technique in urology focusing on nomenclature, history and outcomes of Laparo-Endoscopic Single-site Surgery (LESS), Natural Orifice Translumenal Endoscopic Surgery (NOTES) and Computer-Assisted Surgery (CAS).

Methods: A comprehensive literature search was conducted in order to find article related to LESS, NOTES and CAS in urology. The most relevant papers over the last 10 years were selected in base to the experience from the panel of experts, journal, authorship and/or content.

Retroperitoneal laparoendoscopic single-site surgery: preliminary experience in kidney and ureteral indications.

The advantages of retroperitoneoscopic technique are well known. We decided to combine this access with the emerging laparoendoscopic single-site surgery (LESS) technique. We present our preliminary data on 11 renoureteral procedures and describe our retroperitoneoscopic LESS technique.

Urinary incontinence and sport: first and preliminary experience with a combined pelvic floor rehabilitation program in three female athletes.

A relationship between sport or fitness activities and urinary incontinence (UI) previously has been described in women. We report our preliminary experience with the use of a complete pelvic floor rehabilitation program in three female athletes affected by UI. The athletes were submitted to a combined pelvic floor rehabilitation program, including biofeedback, functional electrical stimulation, pelvic floor muscle exercises, and vaginal cones.

Sexual function and quality of life in women with urinary incontinence treated by a complete pelvic floor rehabilitation program (biofeedback, functional electrical stimulation, pelvic floor muscles exercises, and vaginal cones).

Introduction: Urinary incontinence (UI) is a debilitating condition that can cause discomfort, embarrassment, loss of confidence; it can lead to withdrawal from social life, and adversely affects physical and mental health, sexual function and quality of life (QoL) in women.

Aim: The aim is to determine the impact of combined pelvic floor rehabilitation (PFR) on UI, female sexual dysfunction, and QoL.

Main Outcome Measures: Female Sexual Function Index questionnaire (FSFI) and King's Health Questionnaire (KHQ).

Potential effectiveness of pelvic floor rehabilitation treatment for postradical prostatectomy incontinence, climacturia, and erectile dysfunction: a case series.

Introduction: Radical prostatectomy is the treatment of choice for prostate cancer; although novel techniques have significantly reduced its side effects, the procedure can provoke urinary incontinence of various degrees and/or erectile dysfunction.

Aim: We evaluate the effect of a complete pelvic floor rehabilitation program on both incontinence and erectile dysfunction, including climacturia, in a preliminary case series.

Main Outcomes Measures: Pad usage and International Index of Erectile Function (IIEF-15) Questionnaire.

Dornier Lithotripter S 220 F EMSE: the first report of over 1000 treatments.

Objective: To assess the short-term efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) with the standard Dornier Lithotripter S 220 F EMSE in the treatment of a large population of 736 patients with renal and ureteral stones. This is the only report with more than 1000 treatments performed with this device.

Methods: Between January 2003 and July 2006, a total of 479 renal and 257 ureteral stones were treated with 1168 ESWL sessions.

Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial.

Transperineal prostate biopsy is a procedure that can be used to obtain histological samples from the prostate. To improve both the quality of the biopsy core samples and prostate cancer detection, we are currently performing a prospective, randomized trial comparing prostate biopsy samples obtained using an 18 G-needle to those obtained using a 16 G needle. The aim of this preliminary study was to evaluate pain and complication rates in both groups in order to assess whether performing a prostate biopsy with a larger calibre needle is a feasible procedure.

Laparoscopic simultaneous treatment of peripelvic renal cysts and stones: case series.

Introduction: Renal multiple peripelvic cysts are often symptomatic. Obstruction of renal hilum and the collecting system leads to hydronephrosis and could promote formation of stones. Managing both entities at the same time needs a new approach to minimize complications and improve success rates.

Biofeedback, electrical stimulation, pelvic floor muscle exercises, and vaginal cones: a combined rehabilitative approach for sexual dysfunction associated with urinary incontinence.

Introduction: Urinary incontinence (UI) is often associated with sexual dysfunction. We present our preliminary experience with a combined rehabilitative approach consisting of biofeedback, functional electrical stimulation, pelvic floor muscle exercises, and vaginal cones.

Aim: The potential impact of such practice on UI and sexual function was analyzed in our case series and discussed.

Retrospective descriptive analysis of the physiological kinetics of prostate-specific antigen in men older than 75 years.

Several studies have compared prostate-specific antigen (PSA) kinetics in men with and without cancer, but there has been no adequate analysis of the longitudinal variation in PSA. The aim of this study was to assess the fluctuations in PSA in a cohort of elderly men in an attempt to define a physiological pattern of PSA kinetics. We searched a specific cohort of patients aged > 75 years and with PSA value < 2.

Tumor seeding after open nephroureterectomy for ureteral transitional cell carcinoma.

Skeletal muscle metastases following cancer surgery are rare. Few cases of abdominal wall metastasis have been reported in the literature and attributed to tumor seeding after laparoscopic surgery or percutaneous nephrostomy. We report a case of abdominal tumor seeding after open nephroureterectomy managed by means of a surgical and medical approach.

Shockwave lithotripsy and protective role of inosine: early and late evaluation in an experimental model.

Purpose: Extracorporeal shockwave lithotripsy (SWL) is one of the most common treatments for urinary stones. Despite technological improvements, it may cause side effects varying from minor reversible microscopic damage to severe large renal hematomas. The aim of our experimental study is to assess the efficacy of inosine in avoidance of acute renal damage after SWL.

Muscle- and nerve-sparing bulbar urethroplasty: a new technique.

Background: To describe a new surgical technique for the repair of bulbar urethral strictures to preserve the bulbospongiosum muscle and its perineal innervation.

Objective: Surgical steps of muscle- and nerve-sparing bulbar urethroplasty are described. The outcome is provided regarding semen sequestration and postvoiding dribbling.

Squamous cell carcinoma of the prostate.

Primary squamous cell carcinoma of the prostate is an extremely uncommon malignancy, accounting for less than 0.2-1% of all prostatic cancers. We report one case of primary squamous cell carcinoma of the prostate.

Bulbar urethroplasty with dorsal onlay buccal mucosal graft and fibrin glue.

Objectives: We describe a new surgical technique with the use of fibrin glue for bulbar urethra reconstruction using a dorsal buccal mucosal onlay graft.

Methods: Six patients with a mean age of 43 yr underwent bulbar urethroplasty with dorsal onlay buccal mucosal graft and fibrin glue. The urethra was mobilised from the corpora cavernosa and opened along its dorsal surface.

Benign intratesticular schwannoma: a rare finding.

Schwannoma is a peripheral nerve tumour, occasionally located in the genitourinary tract. We described an extremely rare case of intratesticular neurinoma in a 79-year-old patient.

Bizarre leiomyoma of scrotum.

Genital leiomyomas of the scrotal skin are extremely rare benign tumors, originating from the tunica dartos of the scrotum. We report our experience with one patients with scrotal bizarre leiomyoma.

Non Hodgkin lymphoma of the ureter: a rare disease.

Non urotelial malignant neoplasm of the ureter has been rarely described, usually arising from muscular, vascular and nervous tissue. Primary lymphoma of the ureter is an uncommon finding; we report a case of primary Non Hodgkin Lymphoma of the ureter in young woman.

Color Doppler appearance of penile cavernosal-spongiosal communications in patients with severe Peyronie's disease.

Our objective was to investigate the prevalence and Doppler characteristics of penile cavernosal-spongiosal communications (CSC) in patients with severe Peyronie's disease. These vessels are either anastomoses connecting the cavernosal arteries with the urethral arterial network or afferent vessels to the corpus spongiosum. Twenty patients with severe Peyronie's disease underwent penile color Doppler US after intracavernous injection of prostaglandin E(1).

High-flow priapism: treatment and long-term follow-up.

Objectives: To determine the long-term follow-up of treatment of high-flow priapism, we reviewed the case records of 10 patients who were examined by the Urologic Clinic in Trieste from 1995 to 1998. High-flow or arterial priapism is a fairly rare dysfunction, generally resulting from penile or perineal trauma. In some cases, the etiology remains unknown.