Objectives: To assess epidemiologic characteristics of penile cancer in Brazil. Materials and Methods: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of sexually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service), as well as the time between the appearance of the symptoms and the diagnosis, the pathological characteristics of the tumor (histological type, degree, localization and size of lesion, stage of disease), the type of treatment performed and the present state of the patient. Results: 283 new cases of penile cancer in Brazil were recorded. The majority of these cases occurred in the north and northeast (53.02%) and southeast (45.54%) regions. The majority of patients (224, or 78.96%) were more than 46 years of age while only 21 patients (7.41%) were less than 35 years of age. Of the 283 patients presenting penile cancer, 171 (60.42%) had phimosis with the consequent impossibility to expose the glans. A prior medical history positive for HPV infection was reported in 18 of the 283 cases (6.36%). In 101 patients (35.68%) tobacco smoking was reported. The vast majority of the cases (n = 207; 73.14%) presented with tumors localized in the glans and prepuce. In 48 cases (16.96%) the tumor affected the glans, the prepuce and the corpus penis; in 28 cases (9.89%) the tumor affected the entire penis. The majority of the patients (n = 123; 75.26%) presented with T1 or T2; only 9 patients (3.18%) presented with T4 disease. Conclusion: Penile cancer is a very frequent pathology in Brazil, predominantly affecting low income, white, uncircumcised patients, living in the north and northeast regions of the country.

Although the results of renal and intrarenal anatomy in pigs could not be completely transposed to humans, many similarities in the pig and human intrarenal arteries support its use as the best animal model for urological procedures.

No abstract

Penile fracture is an entity of eminently clinical diagnosis, which management should be surgical and immediate, avoiding thus complications related to erectile dysfunction. When suspecting an associated urethral injury, Urethrocystogram is recommended. In cases where there is diagnostic uncertainty, ultrasound and/or MRI may be used to reveal the condition.

We present detailed anatomic findings on collecting system anatomy and renal morphometry in the pig and compare these findings with previous findings in humans. We studied three-dimensional polyester resin corrosion endocasts of the pelviocaliceal system obtained from 100 kidneys (50 pigs). Eighty kidneys were evaluated morphometrically, considering length, cranial pole width, caudal pole width, thickness, and weight. The pig collecting system was classified into two major groups (A and B). Group A (40%) was composed of kidneys in which the mid-zone is drained by calices dependent on the cranial or the caudal caliceal group or both. Group B (60%) kidneys have the mid-zone drained by calices independent of the polar groups. Group B includes two subtypes (B-I and B-II). The pig collecting system showed only angles smaller than 90 degrees between the caudal (lower) infundibulum and the renal pelvis. Renal morphometric measurements revealed the following means: length 11.8 cm, cranial pole width 5.64 cm, caudal pole width 5.35 cm, thickness 2.76 cm, and weight 98 g. As in human kidneys, one may group the pig collecting system into two groups. Nevertheless, in pigs, we did not find a subdivision of Group A. The incidence of collecting systems in Groups A and B and the subtypes of Group B in pigs are different from those in humans. Also different from humans, in pigs, we found only angles smaller than 90 degrees between the caudal (lower) infundibulum and the renal pelvis. Except for the length, the means of the other morphometric measurements of the pig kidney are smaller than those of humans. From an anatomic standpoint, despite the differences pointed out, we conclude that the pig kidney is a good animal model for endourologic research and training.

The detailed findings of canine intrarenal anatomy (collecting system and arteries) are presented. Ninety-five three-dimensional endocasts of the kidney collecting system together with the intrarenal arteries were prepared using standard injection-corrosion techniques and were studied. A single renal artery was observed in 88.4% of the casts. The renal artery divided into a dorsal and a ventral branch. Using the branching pattern of the ventral and dorsal divisions of the renal artery, the vessels were classified in type I or type II. Type I presented a cranial and a caudal artery, whereas type II presented a mesorenal and a caudal artery. Cranial branches of dorsal and ventral arteries supplied the cranial pole in 90.5% of the specimens. Caudal branches of the dorsal and the ventral divisions of the renal artery irrigated both the caudal pole and the mid-zone of the kidney in 95.8% and 98.9% of the cases, respectively. In all casts, caudal branches of both dorsal and ventral arteries supplied the caudal pole. Therefore, the caudal branches of the ventral and dorsal divisions of the renal artery are of utmost importance in the kidney arterial supply. Although many results of renal and intrarenal anatomy in dogs may not be completely transposed to humans, the anatomical relationship between arteries and the collecting system in the cranial pole of the dog kidney is similar to those in man. This fact supports the use of the dog as an animal model for urologic procedures at the cranial pole. Anat Rec,

In an attempt to determine the best route to puncture and access the kidney collecting system we studied 62, 3-dimensional polyester resin endocasts of the pelvicaliceal system together with the intrarenal vessels. A retrograde pyelogram was obtained, and the arterial and venous trees were injected with red and blue resins, respectively. When the resin was still in the gel state, the kidneys were positioned at 30 to 45 degrees and the collecting system was punctured under radioscopy. Since the resin is not opaque to x-ray the operator was not able to visualize the vessels while puncturing. After puncture, the needle was maintained in place, the contrast medium was removed and the pelvicaliceal system was filled with yellow resin. After the resin had set, the renal organic matter was corroded in acid and the endocast was obtained (with the needle in the original position). This type of preparation allowed us to examine the needle tract and the vessels damaged during the puncture. In the same kidney we punctured the superior pole, mid kidney and inferior pole. In some cases we also punctured the renal pelvis. We performed 104 punctures through an infundibulum, 39 through a fornix of a calix and 12 through the renal pelvis. Due to a high percentage of vascular lesions, intrarenal access through an infundibulum should be avoided. Also, renal pelvis puncture should be avoided. Regardless of the kidney region, puncture through a fornix of a calix was safe.

To help endourologists perform endopyelotomy safely and efficiently with a reduced risk of vascular complications, we analyzed the vascular relationships to the ureteropelvic junction in 146, 3-dimensional endocasts of the kidney collecting system together with the intrarenal arteries and veins. There was a close relationship between a prominent vessel (artery and/or vein) and the anterior surface of the ureteropelvic junction in 65.1% of the cases, including the inferior segmental artery with a tributary of the renal vein in 45.2% and an artery or vein in 19.9%. In the remaining 34.9% of the cases the anterior surface of the ureteropelvic junction was free of vessels. There was a direct relationship between a prominent vessel (artery and/or vein) and the posterior surface of the ureteropelvic junction in 6.2% of the cases, including an artery and vein in 2.1%, and just an artery in 1.4%. In all cases (3.5%) of an artery crossing at the posterior surface of the ureteropelvic junction, this vessel was the posterior segmental artery (retropelvic artery). In 2.7% of the cases the relationship of the prominent vessel was just with a posterior tributary of the renal vein, and in 20.5% a vessel crossed lower than 1.5 cm. above the posterior surface of the ureteropelvic junction. Among these latter cases the vessel was an artery (posterior segmental artery) in 6.8%. In the remaining 73.3% of the cases the posterior surface was free of vessels up to 1.5 cm. above the ureteropelvic junction. Due to the anatomical findings, we advise that posterior and posterolateral incisions at the ureteropelvic junction be avoided, and that deep incision alongside the ureteropelvic junction stenotic wall be done only laterally.