RESUMO
Potentially curative salvage options for biochemical failure after primary prostatic radiotherapy include salvage radical prostatectomy, brachytherapy, high-intensity focused ultrasound and cryotherapy. Salvage cryoablation for recurrent prostate cancer after irradiation failure is currently a well-established therapeutic option, since technical improvements have permitted better oncologic outcomes and lower complications rates over the years. This article reviews surgical technique, oncologic and functional outcomes, as well as morbidity and complications of salvage cryotherapy for local recurrence after external beam radiotherapy or brachytherapy for prostate cancer.
Assuntos
Criocirurgia , Neoplasias da Próstata/terapia , Terapia de Salvação/métodos , Biópsia por Agulha Fina , Braquiterapia/efeitos adversos , Criocirurgia/efeitos adversos , Disfunção Erétil/etiologia , Humanos , Masculino , Recidiva Local de Neoplasia , Dor/etiologia , Seleção de Pacientes , Prognóstico , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Estreitamento Uretral/etiologia , Incontinência Urinária/etiologiaRESUMO
Treatment of urinary calculi in caliceal diverticular is indicated when they are symptomatic. Minimally invasive techniques, in particularly laparoscopic approach, occupy an increasingly important place in the urological therapeutic armamentarium and have changed from an open surgical approach to endoscopic treatment for the management of symptomatic caliceal diverticular calculi. Herein, we report the case of a woman with symptomatic calculi in an upper caliceal diverticular managed by retroperitoneal laparoscopic approach.
Assuntos
Divertículo/cirurgia , Cálculos Renais/cirurgia , Cálices Renais/cirurgia , Laparoscopia/métodos , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To develop a convenient technique for dividing the bladder neck during radical retropubic prostatectomy. METHOD: Before opening the bladder, we created a plane that separates the anterior surface of the seminal vesicles from the posterior wall of the bladder and ran an umbilical tape through the plane. The posterior bladder neck wall was later divided using this tape as a guide mark. RESULTS AND CONCLUSION: The posterior bladder neck was divided in a single, easy, and swift maneuver (less than 2 min) in 350 patients with no subsequent complications.
Assuntos
Prostatectomia/métodos , Glândulas Seminais/cirurgia , Bexiga Urinária/cirurgia , Ducto Deferente/cirurgia , Humanos , Masculino , Neoplasias da Próstata/cirurgiaRESUMO
The authors report two rare cases of neoplastic vesical malakoplakia, one with an enterovesical fistula and the other with extravesical pelvic extension. The symptoms are non-specific and the diagnosis remains histological. Medical treatment, based on the suspected infectious physiopathogenesis of the disease, consists of variable combinations of antibiotics, cholinergics and vitamin C. It must be sufficiently prolonged and conservative in view of its usual efficacy, even in neoplastic forms.
Assuntos
Malacoplasia/patologia , Doenças da Bexiga Urinária/patologia , Adulto , Idoso , Feminino , Seguimentos , Granuloma/patologia , Humanos , Doenças do Íleo/patologia , Fístula Intestinal/patologia , Doenças Ureterais/patologia , Fístula da Bexiga Urinária/patologia , Fístula Urinária/patologiaRESUMO
Ultrastructural and morphometric abnormalities of Syrian hamster cardiomyopathy were compared to those observed in two different models of cardiac hypertrophy produced by mechanical overload (abdominal aortic stenosis, 60-day duration) or by isoproterenol injection during 15 days in normal Syrian hamsters of the same strain. Aspects of increased protein synthesis were observed in all three groups of animals. This was the only abnormality observed in the aortic stenosis group. Cardiomyopathy was different from the two other types of overload by the existence of large calcium deposits inside of the myocytes, by the presence of thin filaments and amorphous material accumulation suggesting abnormal synthesis and by a significant reduction of myofibrils at the heart-failure phase. Nuclear abnormalities with nuclear constrictions suggesting a division process and an increased number of myocytes with two nuclei were present in both spontaneous cardiomyopathy and isoproterenol-induced cardiopathy. Therefore, Syrian hamster cardiomyopathy appears to be different from cardiopathy induced by hemodynamic overload but, in spite of specific aspects, resembles that induced by isoproterenol injections, strengthening the hypothesis of a pathogenic role of catecholamines in the Syrian hamster cardiomyopathy.
Assuntos
Cardiomiopatias/patologia , Circulação Coronária , Doença das Coronárias/patologia , Miocárdio/ultraestrutura , Animais , Estenose da Valva Aórtica/patologia , Baixo Débito Cardíaco/patologia , Cardiomegalia/patologia , Cricetinae , Hemodinâmica , Isoproterenol/farmacologia , Mesocricetus , Microscopia Eletrônica , Valores de ReferênciaRESUMO
The authors report a case of pelvic lipomatosis in a 62 year old man associated with venous obstruction (third case reported in the literature), diagnosed after bilateral ureteric obstruction, and review of the literature on this subject. The diagnosis was suggested by the radiological triad of hyperlucency of the pelvis on plain abdominal X-ray, "hot air balloon" appearance of the bladder on IVU and a rigid and ascended rectosigmoid on barium enema, and was confirmed by CT and MRI. Treatment combining corticosteroids and urinary tract disinfection was partially effective. A double J ureteric stent resolved the problem of persistent right ureteric obstruction.