TVT-Secur is a minimally invasive, safe and easy surgical technique for stress urinary incontinence in females. To compare this procedure to other tension-free techniques longer and more detailed followup is necessary in more patients. However, this tape may be associated with fewer complications.
SummaryBackground:Mucinous adenocarcinoma of the urinary bladder is a rare primary urologic disease, poorly responsive to radiation or chemotherapy as first-line treatment.Case Report:After trans-urethral resection of the bladder, a 62-year-old woman was diagnosed with mucinous adenocarcinoma of the urinary bladder. An upper gastro-intestinal endoscopy and a colonoscopy excluded any primary site of origin from those gastro-intestinal tracts. After whole-body CT staging scans, an anterior pelvectomy was performed, confirming a mucinous adenocarcinoma of the bladder, with no extra-vesical spreading. Some onco markers were sampled before surgery, and Ca 19-9 showed very high values, with a decreasing trend after pelvectomy. Six month after surgery, bilateral inguinal lymph node dissection was performed because of bilateral palpable masses – histologic examination showed a single metastatic node. The patient also received external radiotherapy of the inguinal area. Twenty-eight months after pelvectomy, the patient appears healthy.Conclusions:Early radical surgery with or without adjuvant radio-chemo-therapy appears to be the best option for mucinous adenocarcinoma of the bladder, and a good outcome is likely to be related with a confined disease and small tumor size. In addition, Ca 19-9 sampling proves to be useful in tumors that produce markers.
The malignant lymphomas rarely occur in the genito-urinary tract and particularly penis lymphomas are extremely uncommon. Frequently they do not have any specific symptoms and the diagnosis is delayed even in presence of a penis node. In our hospital we observed two patients affected by Non-Hodgkin Lymphoma (NHL), one of them with a primitive disease. Both cases were sexually active men who did not accept a radical surgery. A conservative polichemotherapy treatment by ciclophosphamide, vincristine and prednisone has been proposed and performed for both cases and a complete resolution of disease was demonstrated. At the same time we assessed the erectile function by the IIEF score, before and after treatments.
Cystitis often appears even in absence of bacteria colonization. Trigonitis and interstitial inflammation are the most common morphological features of abacterial cystitis in young and post menopausal women. Arterial obstructive disease and bladder ischemia might play an important role in bladder dysfunction. Activated inflammatory cells produce ROS (radicals of oxygen), NF kB seems involved in ROS synthesis. Clinical studies have indicated that high CO 2 levels can impact upon peripheral tissue, reducing ischaemia, responsible of recurrent inflammation and consequently reducing oxydative phenomena. PRP (platelet-rich plasma) is a volume of fractionated plasma from the patient's own blood that contains platelet concentrate rich of alpha granules. PRP interacts tissue repair mechanisms by placing supra-physiological concentrations of autologous platelets at the site of tissue damage. This study proposes a single PRP transvaginal injection followed by 10 weekly applications of carboxytherapy, using subcutaneous injections of sterile CO2 gas. We have selected 6 Women (50-75 years), affected by recurrent abacterial cystitis with Pain and urge incontinence. All patients showed a subjective sensible reduction of symptoms. After 2 months all patients have neither inflammatory symptoms nor endoscopic evidence of trigonitis. Preliminary qualitative results could encourage the use of carboxytherapy and PRP in treatment of abacterial and interstitial cystitis.
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