Induction and maintenance adjuvant topical MMC for endoscopically resected UTUC is feasible, well tolerated and shows promising intermediate term data on recurrence, progression, and nephroureterectomy-free survival.
Our data provide preliminary clinical rationale for the second-line TT for refractory and recurrent, endoscopically managed papillary UTUC in patients ineligible for or refusing nephroureterectomy. However, refractory upper tract CIS appears to have poor response to salvage TT.
In the setting of an infected inflatable penile prosthesis (IPP), removal of the reservoir is a surgical challenge. We describe a novel technique for IPP reservoir removal at the time of IPP explantation utilizing laparoscopic instruments. We present two cases of infected IPPs requiring complete removal of all components of the implant. The corporal cylinders and scrotal pump were removed via a single penoscrotal incision. Through the same incision, a lighted, hand-held retractor was used for visibility, and laparoscopic instruments were utilized to dissect the tissue surrounding reservoir and the attached tubing until free. Then, a completely intact reservoir was easily removed. Infected IPP reservoirs were successfully removed in this fashion without any complication. This new technique not only facilitated the safe removal of the reservoir, but also enhanced surgical efficiency by eliminating the need for additional incisions. We performed a review of current literature concerning techniques and indications for removal of IPPs and the reservoir. In the setting of an infected penile prosthesis, all components of the implant should be removed. Removal of the reservoir has been surgically difficult due to its location, either deep in the space of Retzius or high in the abdomen between the muscular fascias. Our new technique provides an innovative solution for reservoir removal with the use of laparoscopic instruments via a single penoscrotal incision. We have found that this technique overcomes the challenge of a cumbersome blind dissection and the need for the second incision.
In the current era, the ureteroscopy (URS) has become a powerful tool to diagnose and treat patients with upper tract urothelial carcinoma (UTUC). However, there is concern that it may have a negative impact on the patients. We aim to investigate whether the URS before RNU for UTUC has impact on oncologic outcomes.METHODS: We performed a systematic literature search of PubMed, Embase, and Cochrane library for citations published prior to June 2016, describing URS performed among patients with UTUC and conducted a standard meta-analysis of survival outcomes.RESULTS: Our meta-analysis included eight eligible studies containing 2998 patients. The results were as follows: cancer-specific survival(CSS) (Hazard Ratio(HR) ¼ 0.74, 95% confidence interval(CI):
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