Our goal is to describe our experience in the difficulties encountered during radical
cystectomy for muscle invasive bladder cancer in patients with contemporary pelvic
kidney. Two patients with muscle invasive bladder cancer and contemporary pelvic
kidney were subjected to radical cystectomy and extended lymphadenectomy with
conversion to an ileal pouch. In both cases, lymphadenectomy was the first step after
entering the true pelvis. In order to proceed to the cystoprostatectomy, careful
dissection of the ectopic renal vessels and proper mobilization of the kidney were
performed. In both cases, an ileal pouch was our choice. The pelvic kidney is the most
common sight of renal ectopia. The etiology is the aborted ascent of the fetal kidney
from its initial position in the pelvis. This is the first case series describing radical
cystectomy for muscle invasive urothelial carcinoma of the bladder in patients with a
pelvic kidney.
The coagulation pathway seems to be activated in urological malignancies. Specific panels of coagulation factors might play a role as screening or prognostic tools in earlier stages of renal, prostate and bladder cancer. Further research should also focus on their role in the association of cancer with thromboembolic events.
Purpose: We aimed to thoroughly search and identify studies referring to risk factors associated with postoperative delirium (POD) in patients undergoing open as well as en-doscopic urological surgery. Methods: The review after a systematic literature search included 5 studies. Results: The incidence of POD was reported to be between 7.8 and 30% depending on the type of the urologic surgery, while in the majority of the studies the onset happened on the first postoperative day and the symptoms lasted 3 ± 0.8 days. Seventeen different risk factors for POD were identified and presented in detail. Conclusion: The Mini-Mental State Examination score and older age were significantly associated with the development of POD. However, the Confusion Assessment Method is very well validated against the diagnosis of delirium from the specialists.
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