RESUMO
The authors present several less usual reconstructions of ureters after the primary iatrogenic lesions. The appropriate ureteric capacity to drain the urine after previous injury is quite demanding and hence before the definitive decision is made the wholesome health status of the patient is to be considered and all possible solutions should be weighted. The efficient primary urinary diversion above the lesion is unavoidable. The genuine reconstruction could be deferred by several weeks or months in the view that in some cases the least invasive (endourologic) methods can completely avoid the need of open surgery in difficult adhesions after previous major surgery.
Assuntos
Abdome/cirurgia , Complicações Intraoperatórias , Ureter/lesões , Ureter/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Derivação Urinária/métodosRESUMO
The prostate grows and functions within a multihormonal environment. It consists of androgens, oestrogens, gonadotrophins, gonadotrophin-releasing hormones and gestagens. Growth factors are produced under the influence of androgen stimulation. We show all possibilities of androgen deprivation of advanced and metastatic prostate cancer.
Assuntos
Antineoplásicos Hormonais/uso terapêutico , Carcinoma/terapia , Orquiectomia , Neoplasias da Próstata/terapia , Antagonistas de Androgênios/uso terapêutico , Androgênios/fisiologia , Carcinoma/fisiopatologia , Humanos , Masculino , Neoplasias da Próstata/fisiopatologiaRESUMO
The method of choice in the surgical treatment of neurogenic dysfunctions of the lower urinary pathways is to use the ureteral wall for augmentation of the urinary bladder. The advantage of the method is that it rules out risks and complications encountered in techniques using an excluded intestinal or gastric segment (mucus formation, metabolic disorders, malignant transformation, uroinfection, urolithiasis). The author presents the case-history of a 28-year-old man with a neurogenic bladder due to surgery of meningomyelocele during childhood.
Assuntos
Ureter/cirurgia , Bexiga Urinaria Neurogênica/cirurgia , Bexiga Urinária/cirurgia , Adulto , Humanos , MasculinoRESUMO
Extracorporeal lithotripsy is a modern noninvasive method for the treatment of urolithiasis. The morphological and functional state of the urinary pathways, the localization of concrement and their size and number call in 35% of the patients for additive and auxiliary operations. Such comprehensive treatment can be provided by departments where all methods for the treatment of lithiasis are readily available. Repeated lithotripsy and combined therapeutic methods of more complicated conditions protract hospitalization and reduce the number of patients. The authors tested in more than 2500 lithotripsies the possibility to apply this treatment in the great majority of lithiases. However, because of the limited capacity they had to reduce the spectrum of indications to a minimum. Retardation of treatment by a protracted waiting period could damage the patient and it is then better to indicate another therapeutic approach; or to provide adequate treatment. We hope that patients who will need treatment after a year's time, will have the opportunity to be treated sooner by lithotriptors which should be installed before long in other departments.