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1.
Urol Int ; 67(1): 41-5, 2001.
Article in English | MEDLINE | ID: mdl-11464114

ABSTRACT

OBJECTIVE: To compare secretory immunity in cecal and ileal orthotopic neobladders, and to detect its permanence over time. PATIENTS AND METHODS: IgA was studied in the urine of 33 patients with ileocecourethrostomy (ICUS) and 13 patients with ileal reservoir (IR). The mean follow-up was 55 months. Results were compared in terms of the type of operation, a healthy control group, and the time since surgery. RESULTS: Urinary IgA levels were significantly higher in ICUS and IR patients than in normal controls. No significant differences in IgA concentrations were detected in patients with different reservoirs and with regard to time. CONCLUSION: Both the reservoirs maintain the function of producing IgA. In particular no differences were detected over time and urine could be a permanent antigenic stimulus. IgA could be considered an adjunctive factor for upper urinary tract protection. For this reason we prefer to use a simple, indirect antireflux mechanism, thus avoiding direct manipulation of the uretero-intestinal anastomosis.


Subject(s)
Immunoglobulin A, Secretory/physiology , Urinary Reservoirs, Continent , Aged , Cecum/surgery , Follow-Up Studies , Humans , Ileum/surgery , Male , Middle Aged , Time Factors
2.
Urology ; 54(4): 629-35, 1999 Oct.
Article in English | MEDLINE | ID: mdl-10510919

ABSTRACT

OBJECTIVES: To compare acid-base and electrolyte balance in ileocecal and ileal neobladders. METHODS: Acid-base and electrolyte balance were studied in 45 patients with an ileocecourethrostomy and 18 patients with an ileal reservoir. The mean follow-up was 51 months. Results were compared with regard to both the type of operation and the time since surgery. RESULTS: No significant differences were found with regard to either the type of operation or the length of follow-up. A preserved renal function is important in maintaining a healthy status. CONCLUSIONS: The use of 35 to 40 cm of ileum or 10 cm of cecum with the ileocecal junction seems to be safe even after a long follow-up. The length rather than the kind of bowel used for bladder replacement appears to be important in safeguarding hydroelectrolyte and acid-base homeostasis. This is particularly true in the presence of preserved renal function.


Subject(s)
Acid-Base Equilibrium , Cecum/surgery , Ileum/surgery , Urinary Reservoirs, Continent/physiology , Water-Electrolyte Balance , Aged , Follow-Up Studies , Humans , Male , Middle Aged
3.
J Urol ; 160(5): 1655-7, 1998 Nov.
Article in English | MEDLINE | ID: mdl-9783925

ABSTRACT

PURPOSE: We compare the absorption of D-xylose and vitamin B12, and the metabolic status in ileocecal and ileal orthotopic neobladders. MATERIALS AND METHODS: D-xylose plasma levels after an oral load, body composition, plasma vitamin B12, acid base and electrolyte balance were studied in 33 patients with an ileocecal reservoir and 13 patients with an ileal reservoir. Mean followup was 55 months. Results of both types of operation and a healthy control group were compared. RESULTS: Plasmic levels of D-xylose and vitamin B12 were significantly lower in the ileal reservoir than in ileocecal reservoir group and normal controls. CONCLUSIONS: Despite an acceptable body composition, intestinal malabsorption could be present in patients with an ileal reservoir but the ileocecal tract appears to be safe.


Subject(s)
Cecum/surgery , Ileum/surgery , Urinary Reservoirs, Continent , Vitamin B 12/metabolism , Xylose/metabolism , Aged , Follow-Up Studies , Humans , Male , Middle Aged , Nutritional Status , Urologic Surgical Procedures/methods
4.
Eur J Surg Oncol ; 24(2): 131-3, 1998 Apr.
Article in English | MEDLINE | ID: mdl-9591029

ABSTRACT

AIMS: To identify the most appropriate surgical strategy for carcinoma of the urachus. METHODS: Analysis of a case of adenocarcinoma of the urachus and an examination of the current literature were carried out. CONCLUSIONS: Partial cystectomy is considered the most appropriate surgical strategy but the need for close follow-up is underlined.


Subject(s)
Adenocarcinoma/surgery , Urachus/surgery , Urologic Neoplasms/surgery , Adult , Female , Humans
5.
Minerva Urol Nefrol ; 49(2): 103-6, 1997 Jun.
Article in Spanish | MEDLINE | ID: mdl-9281079

ABSTRACT

The authors report a case of renal leiomyosarcoma and a review of the literature, underlining the difficulties of making a correct differential diagnosis with the benign neoplasms of the kidney and in performing correct surgical therapy.


Subject(s)
Kidney Neoplasms/diagnosis , Leiomyosarcoma/diagnosis , Humans , Kidney Neoplasms/pathology , Leiomyosarcoma/pathology , Male , Middle Aged
6.
Scand J Urol Nephrol ; 31(6): 579-81, 1997 Dec.
Article in English | MEDLINE | ID: mdl-9458521

ABSTRACT

A very rare case of perirenal myelolipoma and the problems of differential diagnosis are reported. The non-specificity of, and sometimes even the lack of, radiological and haematological data prevents physicians from preoperatively excluding a malignant neoplasm with a certain degree of confidence. Surgical exploration remains a compulsory step in myelolipoma management and its simple removal seems to be the therapy of choice.


Subject(s)
Adrenal Gland Neoplasms/diagnosis , Kidney Neoplasms/diagnosis , Myelolipoma/diagnosis , Adrenal Gland Neoplasms/pathology , Aged , Diagnosis, Differential , Humans , Kidney Neoplasms/pathology , Male , Myelolipoma/pathology
7.
Arch Ital Urol Androl ; 69(5): 283-6, 1997 Dec.
Article in Italian | MEDLINE | ID: mdl-9477611

ABSTRACT

The aim of the study was to evaluate the usefulness of ferritin as an early marker in the diagnosis of renal cell carcinoma (RCC). The Authors dosed the pre-operative concentration of ferritin in the sera of 22 patients (16 males and 6 females) affected by stage I-II, according to Robson's classification, RCC. Plasma concentrations of ferritin were matched for the presence of tumor and for the tumor volume. The results did not evidence any relationship between plasma concentration of ferritin and the presence of renal cancer. In the same way a linear correlation did not show any significant relationship between serum concentration of ferritin and tumor diameter. Ferritin does not seem to be a usefull marker in the early diagnosis of renal cell carcinoma.


Subject(s)
Biomarkers, Tumor , Carcinoma, Renal Cell/diagnosis , Ferritins/blood , Kidney Neoplasms/diagnosis , Adult , Aged , Aged, 80 and over , Carcinoma, Renal Cell/blood , Carcinoma, Renal Cell/surgery , Female , Humans , Kidney Neoplasms/blood , Kidney Neoplasms/surgery , Male , Middle Aged , Nephelometry and Turbidimetry , Nephrectomy , Time Factors
8.
Urology ; 50(6): 888-92, 1997 Dec.
Article in English | MEDLINE | ID: mdl-9426719

ABSTRACT

OBJECTIVES: To compare the plasma levels of vitamin B12 and folic acid following resection of ileocecal or ileal segments used for orthotopic bladder substitution. METHODS: Hemoglobin, hematocrit, and plasma levels of vitamin B12 and folic acid were measured in 34 patients with ileocecourethrostomy (ICUS) and in 16 patients with ileal reservoir (IR), with a mean follow-up of 59.8 +/- 41.9 months. The results were compared with regard to both the type of operation and the length of time since surgery. RESULTS: The level of folic acid was normal in all patients. The mean level of vitamin B12 in the ICUS group was 413.67 +/- 160.45 ng/mL compared to 257.63 +/- 121.36 for the IR group. This difference was statistically significant. In the IR group, 18.75% of the patients had a level of vitamin B12 below normal. CONCLUSIONS: There is a tendency for vitamin B12 levels to fall in patients in whom the ileum is used. Resection of the ileocecal segment including the junction does not alter the level of vitamin B12.


Subject(s)
Folic Acid/blood , Urinary Diversion/methods , Vitamin B 12/blood , Aged , Carcinoma/blood , Carcinoma/surgery , Cecum/surgery , Cystectomy , Hematocrit , Hemoglobins/analysis , Humans , Ileum/surgery , Middle Aged , Postoperative Period , Statistics, Nonparametric , Time Factors , Urinary Bladder Neoplasms/blood , Urinary Bladder Neoplasms/surgery , Urinary Diversion/statistics & numerical data
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