Proximal ureteral stone treatment requires multiple procedures until complete stone-free status is achieved. Laparoscopic ureterolithotomy is associated with higher success rates and fewer surgical procedures, but with more postoperative pain, longer procedures and a longer hospital stay. Although it is associated with the highest success rates for large proximal ureteral calculi, laparoscopic ureterolithotomy remains a salvage, second line procedure, and it seems more advantageous than open ureterolithotomy. At less well equipped centers, where semirigid ureterolithotripsy or extracorporeal shock wave lithotripsy is not available, it remains a good treatment option.

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Percutaneous access to the kidney has gained widespread use during the last decades. Iatrogenic colon injury is an uncommon but serious complication. Diagnosis is sometimes delayed, and treatment strategies are still controversial, including conservative management, colostomy, or primary repair. The aim of this review is to identify optimal diagnostic and treatment options for such injuries.

Giant prostatic hyperplasia is a rare condition characterized by very high volume benign prostatic enlargement (>500g). Few cases have been reported so far and most of them are associated with severe lower urinary symptoms. We report the first case of asymptomatic giant prostatic hyperplasia in an elderly man who had a 720g prostate adenoma, sudden gross hematuria and hypovolemic shock. The patient was successfully treated with open transvesical prostatectomy and had an uneventful postoperative recovery.

Considering the Health Care System in Brazil, a developing country, and public healthcare policies, robotic surgery is a reality to very few citizens. Therefore, robotic assisted radical prostatectomy is far removed from the daily practice of the vast majority of Brazilian urologists. Scientific evidence of the superiority of robotic assisted radical prostatectomy does not presently justify public investments for widespread development of robotic centers. Maybe over time and with reductions in costs, robotic technology will become a more established practice, as observed in other countries, and more feasible for the Brazilian urological community.

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Introdução A endometriose é uma doença multifocal caracterizada pelo crescimento anormal de tecido endometrial fora da cavidade uterina, de progressão rápida e imprevisível. Os principais sítios de lesão são os ovários, ligamentos útero-sacros e redondo e fundo de saco de Douglas. A patogênese desta afecção é desconhecida, mas algumas teorias têm sido propostas. Estas incluem a menstruação retrógrada, disseminação do tecido endometrial durante cirurgia, remanescentes embrionários, metaplasias, metástases linfáticas e hematogênicas 1,2 . O acometimento do trato urinário é raro e ocorre em 1-2% dos casos, sendo a bexiga acometida em 80% das vezes. O primeiro caso de endometriose vesical foi descrito em 1921 1,2 . Em 1960, revisando 6.107 casos de endometriose dentro de grandes séries desde 1925, Abeshouse e Abeshouse 3 encontraram apenas 67 casos de endometriose vesical, que correspondia a apenas 1,1% dos possíveis sítios de instalação desta patologia. Nessa extensa revisão, foram descritos 6 casos de endometriose renal (0,1%), 15 de acometimento ureteral (0,24%) e 3 em topografia uretral (0,05%). O quadro clínico é variado, podendo apresentar-se como hematúria cíclica, dor pélvica e sintomas vesicais irritativos. Os principais diagnósticos diferenciais incluem angiomas, papilomas, lesões inflamatórias inespecíficas como a cistite eosinofílica, cistite intersticial e a cistite cística, malacoplaquia, tuberculose e carcinoma vesical [1][2][3][4][5] . O diagnóstico preciso é necessário para instituirmos a terapêutica apropriada.