[Imaging capabilities in upper urothelial malignancies differentiation].

UNLABELLED: Aim of our study is to analyze sensitivity and specificity of imaging procedures in characterization upper urothelial malignancies, according to algorithm suggested by American Urology Association. MATERIAL AND METHODS: We analyzed 242 patients with kidney tumor masses who had been operated during 2006/2007 at Urological clinic in Belgrade. Due to pathohistological exam 210 patients had kidney parenchyma and 32 patients upper urothelial kidney tumor. RESULTS: According to tumor stage, computed tomography was sufficient and definitive diagnostic tool concerning both renal epithelial and upper urothelial malignancy. Only in four cases 1.60% (4/242; CT in 3/4, MRI 1/4) preoperative site of origin was different from histopathology findings. This mislead to inappropriate surgery plan. CONCLUSION: Familiarity with limitations and capabilities of imaging modalities is crucial for appropriate diagnosis. It should respect algorithm but has to be individual adapted.

[A new generation of urethral stents--Allium in the therapy of symptomatic prostatic enlargement of various etiology].

A number of urethral stents made of different materials, with different time of indwelling and different designs, primarily based on the vascular stent concept, have been applied in the clinical practice so far. According to the published studies, urethral stents have justified their clinical application, however with certain limitations. Within an attempt to overcome the limitations, a covered, temporary urethral stent was initially designed by Daniel Yachie and Ijko Markovi in Allium corporation from Israel. With its triangular shape, the stent is a replica of the obstructive prostatic urethral lumen. In has been applied in a series of 14 patients with lower urinary tract symptoms caused by the obstruction at the level of the prostatic urethra. The subjects were averagely aged 77.4 +/- 5.1 years. Allium prostatic stent remained in place in the patients for 4.93 +/- 3.17 months, at the average.

[Differential diagnosis of changes in kidney tumors of a small size].

The paper is aimed at presenting several patients treated at the CCS Institute of Urology and Nephrology using the retrospective analysis, in whom differentiation of the kidney tumor change nature and size smaller than 3 cm were decisive for further treatment. Similar cases were not reported or were reported exceptionally rarely in the literature. The diagnosis was established based on ultrasound examination, intravenous urography, computed tomography, magnetic resonance imaging as well as angiography, percutaneous biopsy and pathohistological analysis of the surgical preparation.

Interventional radiology methods of treating ureteral strictures developed on anastomoses after the radical cystectomy in Mainz pouch II and ileal conduit derivation.

UNLABELLED: OBJECTIVE of this work is to evaluate interventional radiology modalities such as balloon catheter dilation (BCD) and stent insertion, as minimally invasive methods in treatment uretero-enteral anastomotic strictures. MATERIAL AND METHOD: Retrospective study enrolled 26 patients (pts) in whom percutaneous BCD (17 pts) and metal stent implantation (9 pts) were done. Study was conducted from June 2005 till August 2007 and included total amount of 470 pts operated during 4 year period from 2003 till 2007. In 26 pts 35 ureteral units were treated, all of them in ambulatory conditions under oral analgosedation, monitored by fluoroscopy. Percutaneous BCD or stent implantation was performed in 24 pts and in 2 pts combined antegrade-retrograde approach for stent delivery, was applied. In all cases percutaneous nephrostomy (PCN) was left for 7 days period after procedure but in 6 units (5 pts) it remained permanent solution. First check up was done 7 days after by contrast media injection through nephrostomy tube prior to its extraction. Second control was done 30 days after by ultrasound exam and the last control (3 months after) by intravenous urography (IVU). RESULTS: In our specimen 17pts had strictures unilaterally (65.4%) and in 9 pts (34.6%) it occurred bilaterally. First check up revealed 82.7% success of BCD, in 17.3% BCD was repeated with the final success rate of 73.5% (19/26). In four pts (26.5%) after BCD reobliteration happened and PCN was left. Patent ureteral lumen was observed in 6 pts (85.7%) with stent inserted while one pt underwent surgical reintervention. No significant difference between BCD and stent insertion success rate was noticed, based upon morphological parameters (ureteral lumen diameter, pelvicaliceal system dilatation) and serum creatinin level. CONCLUSION: BCD and stent insertion showed satisfactory results (following 3 months) in ureteroenteral anastomotic stricture recanalization. They include ambulatory conditions, ability to repeat procedure, without complications -excluding restenosis which finally can be surgically treated.