Background : We assessed the incidence of micro-metastases at surgical margins (SM) and pelvic lymph nodes (LN) in patients submitted to radical retropubic prostatectomy (RP) after neoadjuvant therapy (NT) or to RP alone. We compared traditional staging to molecular detection of PSA using Taqman-based quantitative real-time PCR (qrt-PCR) never used before for this purpose.
Although surgery is considered the ultimate treatment for hydrocele, sclerotherapy can be a valuable alternative, avoiding postoperative complications such as bleeding, hematoma, wound infections and anesthesia related problems mostly in the elderly. It's also a cost-saving procedure when used in out-patients practice. We treated 50 patients using a 2.5% phenol solution for sclerotherapy. The treatment was successful in 96% of patients, with a mean follow-up of 15.5 months. Only minor complications such as scrotal pain and 1 hematocele occurred. Phenol sclerotherapy nowadays seems to be the best choice for out-patient management of hydrocele in selected cases.
The Infrequent Voider Syndrome or Lazy Bladder Syndrome in children is characterized by a large capacity bladder, frequently associated with a significant volume of residual urine.
Usually these patients arrive at medical examination with a history of recurrent urinary infections but without anomalies in the upper urinary tract. We report about a young girl affected by one-sided 2° degree vesico-ureteral reflux due to Lazy Bladder Syndrome that had never been diagnosed before. This patient has been submitted to a prompt bladder training and seems presently to have at last gained a physiological micturition after 9 months of follow-up, without actual evidence of vesicoureteral reflux.
Therefore we must stress that it is prominently important considering about infrequent micturition in a paediatric case history or a large capacity bladder, possible presence of bladder dysfunction and vesicoureteral reflux too.
— Chronic lower urinary tract dysfunction not responsive to conventional therapies can be treated by sacral root neuromodulation. Before implantation of a permanent stimulator, the effect is tested by temporary implantation of a wire electrode connected to an external stimulator (PNE). We report our experience with 19 PNE and 2 permanent implants with a follow-up of 12 and 6 months, very good results and no serious side effects. A short excursus follows about PNE and the permanent implant technique and above all indications of this technique and patient selection. From our clinical experience and data, patients with excellent response to PNE, who have urethral or detrusorial instability, would appear to respond best after permanent implant.
In our Department of Urology, from June ‘88 to February ‘92, 135 patients, with superficial transitional cell papillary carcinoma of the bladder, T1G2, were treated with intravesical antiblastic instillations, after therapeutic transurethral resection. 45 patients (33%) were treated with Mitomycin C; 40 patients (30%) were treated with Doxorubicin; 50 patients (37%) were treated with B.C.G. Pasteur. In the Mitomycin Ck group (follow-up 6.’88 ÷ 2.’92), only 20 patients out of 45 (i.e. 44%) were free of tumor at 30.5 months. Of the 16 patients with unifocal carcinoma, 12 patients (i.e. 75%) had no recurrences at 31.2 months, while of the 29 patients with multifocal carcinoma only 8 patients (i.e. 25%) were free of tumor at 29.1 months. In the Doxorubicin group, (follow-up 10.’89 ÷ 2.’92) 33 patients out of 40 (i.e. 82%) were free of tumor at 16.5 months. Of the 15 patients with unifocal carcinoma, 13 (i.e. 86%) had no recurrences at 17 months, while of the 25 patients with multifocal carcinoma 20 (i.e. 80%) were free of tumor at 18.4 months. As to the B.C.G. group (follow-up 11.’89 ÷ 2.’92), 35 patients out of 50 (i.e. 70%) were free of tumor at 13 months. Of the 6 patients with unifocal carcinoma 5 (i.e. 83%) had no recurrences at 7 months, while of the 44 patients with multifocal carcinoma 30 (i.e. 68%) were free of tumor at 13 months. In conclusion, the above reported data show that the best results were obtained in patients treated with Doxorubicin instillations, without significant difference between the results of unifocal and of multifocal carcinoma. Intermediate results were obtained in patients treated with B.C.G., with a moderate but significant difference between unifocal and multifocal carcinoma. The patients treated with Mitomycin C yielded the worst results, and the difference between unifocal and multifocal carcinoma was substantial
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