ABSTRACT
AIM: To evaluate our experience with the first cases of radical retropubic prostatectomy and to use the results for patient counseling and optimizing therapeutic decision. MATERIAL AND METHODS: In the interval January 2011 - December 2012, 23 patients aged 56-69 years (mean age 62.6 years) were treated by radical retropubic prostatectomy. The retrospective study included an analysis of the significant data in the case records, surgical protocols and outpatient postoperative check-ups, special attention being given to indications, intra- and early postoperative complications (within 30 days) and hospital stay. RESULTS: Preoperatively, prostate specific antigen (PSA) ranged between 4.5 and 27.2 ng/ml (mean 9.5 ng/ml), and Gleason score was 5 in one patient, 6 in 20, and 7 in 2 patients. Clinical stage was T1 in 5 patients (21.7%), T2 in 16 (69.6%) and T3 in 2 (8.7%). Mean intraoperative blood loss was 1214 ml (range 400-2500 ml), and 17 patients received blood transfusions. Postoperative complications included acute renal failure and extravasation of contrast medium during retrograde cystography in 3 cases each, urinary infection in 4 patients and wound dehiscence in 1 case. The average postoperative hospital stay was 19.57 days (range 13-43). CONCLUSIONS: Radical retropubic prostatectomy is a safe technique, involving a reduced risk of complications. For most patients with localized prostate cancer, radical prostatectomy is the best treatment option.
Subject(s)
Biomarkers, Tumor/blood , Prostate-Specific Antigen/blood , Prostatectomy , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/surgery , Aged , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Grading , Prostatectomy/adverse effects , Prostatectomy/methods , Prostatic Neoplasms/blood , Retrospective Studies , Risk Assessment , Risk Factors , Treatment OutcomeABSTRACT
OBJECTIVES: The study aimed to identify the complications recorded at the patients with obstructive renal failure treated with percutaneous nephrostomy (PCN). MATERIAL AND METHOD: The retrospective study investigated the data of 244 patients admitted in our department and treated with percutaneous nephrostomy for obstructive renal failure during January 2005 - December 2007. Demographical data, investigation, indication, complications and hospital stay were recorded. RESULTS: Median preoperative/discharge haematological values were hematocrit 27.4% comparing to 25.8% and haemoglobin 9.9g% comparing to 9.3g%. An anaemic syndrome was noted at admission time in 161 (65.9%) patients and at discharge time 202 (82.8%). 126 (51.6%) patients were treated with blood transfusion with an average dose of 2.47 red blood cell units per patient. In 25 (10.1%) patients the nefrostomy tube was clamped in order to control the postoperative bleeding. The median hospitalization time was 8.7 days with a median ICU stay of 3.3 days. The recorded mortality was 3.2% (8 patients) with an average time of 5.8 days between the operatory time and exitus time. CONCLUSIONS: The most frequent causes of obstructive renal failure necessiting percutaneous nephrostomy are malignancies. Preoperative anaemic syndrome is aggravated in the postoperative period and frequently need red blood cell administration. In experienced hands, PCN catheter placement is safe and usually successful.
Subject(s)
Acute Kidney Injury/etiology , Nephrostomy, Percutaneous/adverse effects , Ureteral Obstruction/complications , Acute Kidney Injury/mortality , Adult , Aged , Aged, 80 and over , Anemia, Iron-Deficiency/etiology , Anemia, Iron-Deficiency/therapy , Blood Transfusion , Female , Humans , Length of Stay , Male , Middle Aged , Postoperative Hemorrhage/etiology , Retrospective Studies , Romania/epidemiology , Rural Population/statistics & numerical data , Survival Rate , Treatment Outcome , Urban Population/statistics & numerical data , Ureteral Obstruction/mortality , Ureteral Obstruction/surgeryABSTRACT
Ureteroscopy is a well-established procedure, which has proven the efficiency for diagnostic purposes, but mostly for ureteric stone removal. The authors describe their strategy after ureteroscopic lithotripsy with Wolf 8 Ch semirigid ureteroscope. Insertion of a double J stent for 2-4 weeks was the rule when there was an important bleeding during the procedure, the fragments were big and could not be extracted, some fragments migrated in upper third of the ureter or renal pelvis, a perforation occurred or it was found a ureteral stenosis. If the stone can be extracted without any problems (in one piece) and the ureter is normal there is no need for ureteral stenting. Having in mind that many patients describe problems with the double J stent (pains, polakiuria, etc) we recommend to insert a stent at the end of ureteroscopy only for selected cases.
