Pathological stage of the penile tumor, vascular invasion and greater than 50% poorly differentiated cancer were independent prognostic factors for inguinal lymph node metastasis. Prophylactic lymphadenectomy in compliant patients with pT1 lesions without vascular invasion and 50% or less poorly differentiated cancer does not appear warranted.

Modificações da junção ure t rovesical e u retra proximal após a ciru rgia de alça sem tensão em mulheres de 45 a 72 anos U re t h rovesical junction and pro x i m a l u rethra changes following tension-fre e vaginal tape surg e ry in women aged 45 to 72 years old Abstract Objectives: to describe the ure t h rovesical junction and proximal urethra changes following Te n s i o nf ree Vaginal Tape (TVT) pro c e d u re for stress urinary incontinence treatment (SUI).Methods Conclusions: TVT s u rg e ry used for tre a t i n g women with stress urinary incontinence significantly reduces the vertical mobility of the ure t h ro v e s i c a l junction (p=0,005) and proximal urethra (p=0,02). Key word s U r i n a ry incontinence, stress, Surg e ry, Women Resumo Objetivos: descrever as modificações da junção u re t rovesical e uretra proximal decorrentes do uso do Te n s i o n -F ree Vaginal Tape (TVT), empregado no tratamento da incontinência urinária de esforço ( I U E ) .Métodos

Pathological stage of the penile tumor, vascular invasion and greater than 50% poorly differentiated cancer were independent prognostic factors for inguinal lymph node metastasis. Prophylactic lymphadenectomy in compliant patients with pT1 lesions without vascular invasion and 50% or less poorly differentiated cancer does not appear warranted.

Introduction: Prostate cancer has high prevalence and mortality among men. Some of the findings on prostate biopsy may be related to the prognosis of the disease. Objective: To evaluate the association between the percentage of fragments affected by cancer in the prostate biopsy and the pathological staging in the surgical specimen. Materials and methods: Selected 159 patients underwent radical prostatectomy (RP) between 2003 and 2009. Data was collected on age, digital rectal exam, prostate-specific antigen (PSA), Gleason score, number of biopsy fragments, number of fragments affected by tumor, and tumor extension in the surgical specimen. Statistical analysis with Student's t-test, chi-squared test, and multiple logistic regression evaluated the association of percentage of affected fragments (PAF) with tumor extension and its predictive value. Results: The patients mean age and PSA were respectively 64 years and 8.5 ng/ml. Histopathologic evaluation of surgical specimens revealed 20.8% of patients with extraprostatic disease, 8.2% with seminal vesicle invasion and 35.8% with positive margins. We found that patients with extraprostatic disease, positive surgical margins, and seminal vesicle invasion had a higher mean PAF. PAF was divided into three groups: less than 34%, 34% to 50%, and greater than 50%, and the higher the PFA, the larger the increase in pathological changes. Conclusion: PAF in biopsy is a simple and practical parameter, which should be used as a predictor of pathological stage in RP specimen.

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O objetivo do presente estudo foi realizar uma revisão sistemática de estudos que avaliaram a associação do percentual de fragmentos acometidos por câncer na biópsia prostática com a extensão tumoral na peça cirúrgica. Com base em estratégia de revisão sistemática do programa de pós-graduação da Universidade Federal de Pernambuco, foram identificadas 979 publicações nas bases de dados: PubMed, Lilacs, SciELO e Medline; entre as quais, por um conjunto de critérios de inclusão/exclusão, foram selecionados 20 artigos publicados entre 2000 e 2009. Em 13 artigos, o percentual de fragmentos acometidos foi considerado como um excelente preditor do estadiamento cirúrgico. Em dois trabalhos na literatura, os autores sugeriram dois pontos de corte diferentes (“cut-off”), de 33% e 37,5%, no percentual de fragmentos acometidos para a estratificação de doença extraprostática em baixo e alto riscos. Concluiu-se que o percentual de fragmentos acometidos na biópsia prostática é uma ferramenta importante na avaliação prognóstica do paciente, e deve ser utilizada em conjunto com as outras ferramentas já consagradas para oferecer a melhor opção terapêutica.

Introduction:Penile cancer is a malignant disease that has an uneven geographical distribution. Brazil is one of the countries with the highest incidence of penile cancer, although epidemiological studies are rare. Poor hygiene, the presence of phimosis, HPV infection, and low socioeconomic status seem to be some important risk factors. The objective of this study is to know the clinical and epidemiological data on new cases of penile cancer in the state of Pernambuco, located in the northeast region of Brazil, and contribute to the national study of the Brazilian Society of Urology. Methods:We selected from a plethora of new penile cancer cases diagnosed from August 2008 to June 2009, at the department of urology of 5 referral hospitals of the National Health System. Interviews were conducted with a clinical, epidemiological questionnaire adapted from the questionnaire used by the SBU in the first epidemiological study of penile cancer. All patients gave written, informed consent for inclusion in the sample. This study was approved by the ethics committees of the institutions involved. Results:In 11 months of the study, 32 new cases of penile cancer were enrolled and analyzed in 5 referral hospitals in Pernambuco. The average age of lesion diagnosis was 59.2 years (SD ± 14.3 years), with 50% of cases diagnosed in patients over 60 years. Regarding schooling, 92% were illiterate or had only a primary level of schooling, and none advanced beyond the second grade. Assessing the antecedents and habits, it was found that 8 patients (32%) had at least 1 case of a lifelong STD, 14 patients (56%) reported a history of phimosis, and only 4 (16%) underwent circumcision, 3 of which during adulthood. Smoking was an addiction reported by 56.2% of patients. The average time between the appearance of the lesion and the diagnosis of penile cancer was higher than 10 months. Conclusion:Penile cancer in referral hospitals of Pernambuco usually involves men older than 60 years, with low education, a history of smoking, uncircumcised genitalia, and with delayed access to specialized medical care. It is necessary to create campaigns for the prevention and guidance of this most affected population.