Using our prospectively derived database, we identified 17 patients with squamous-cell carcinoma involving the glans penis, who were treated using organ-sparing surgery between March 2003 and January 2008. Of them, two were treated with partial glansectomy with primary glans closure, and 15 underwent total glans amputation and reconstruction of a new glans using a split-thickness skin graft (STSG). These 15 patients represent the subject of our study (mean age 51 years, range 42 to 59 years). Overall, two patients had early partial loss of the graft and of them, one required surgical regrafting. Two late complications occurred, consisting of one meatal stenosis and one postoperative phimosis. At a mean follow-up of 36 months, functional results were extremely satisfactory. All patients maintained their erectile function with good vaginal penetration starting from 3 months after surgery, with a range between 2 and 6 months. Orgasm and ejaculation were preserved in all patients, although reduced glans sensitivity was reported by all patients. No local recurrences were reported.

Vardenafil enhanced power Doppler ultrasound enables excellent visualization of the microvasculature associated with cancer and can improve the detection rate compared to contrast enhanced power Doppler ultrasound and the random technique.

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ARTICLE IN PRESS M A N U S C R I P T A C C E P T E D ARTICLE IN PRESSAims. To investigate the incidence and long term effects on kidney function of obstructive and nonobstructive dilatation of the upper urinary tract in patients with ileal neobladder with refluxing ureterointestinal anastomoses.Methods We retrospectively analyzed a prospectively derived database of 110 patients with bladder cancer and who were treated with an ileal neobladder between 1996 and 2007 using refluxing endto-side ureterointestinal anastomoses on a short afferent limb. The mean follow up was 65 months.At every follow up visit the patients had an analysis of serum creatinine, urine culture, abdominal CT or ultrasonography, and, if there was dilatation of the upper urinary tract, 99mTc-DTPA renal scintigraphy was requested.Results. In all, 206 renoureteral units were included in the study. Overall, seven had anastomotic stricture and of those, three were symptomatic and were corrected; while four were asymptomatic and of those, only two, with preserved split GFR, were surgically treated, while the remaining two, with a poor split GFR, were followed up. The last 99mTc-DTPA showed a preserved split GFR in the reimplanted units and further split renal function decrease in untreated units. Nonobstructive dilatation of the upper urinary tract, caused by reflux, was diagnosed in 13 units. The dilatation was bilateral in three patients with recurrent UTIs and urosepsis, and the split GFR was bilaterally reduced at diagnosis with a further reduction at the last 99mTc-DTPA. The remaining seven units with sterile urine, showed a preserved split GFR during follow up.Conclusions. All strictures, regardless of their severity, should be immediately corrected. Reflux per se does not provoke renal impairment unless recurrent UTIs and urosepsis are present.

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INTRODUCTION AND OBJECTIVES: Although the efficacy of real-time tissue elastography (RTE) for prostate cancer detection has been reported, the procedure is highly operator dependent. We speculated that the use of a pressure device might decrease operator dependency and increase the detection rate of RTE. A pressure device driven water pressure was developed for this study, which we termed real-time balloon inflation elastography (RBIE), and the procedure investigated for its effectiveness in detecting prostate cancer. METHODS: From July, 2008 to February, 2009, 87 patients had abnormal digital rectal examination (DRE), PSA, and/ or TRUS findings, and were enrolled in this study. Their median age was 73 years -old (range 54-89), median PSA was 7.6 ng/mL (range 0.8-2606.0), and the median number of biopsy cores obtained from each was 8 (range 8-10). All patients were examined with MRI prior to prostate needle biopsy and a total of 733 specimens obtained by systemic biopsies were studied. The findings of RTE, RBIE, TRUS, PDUS, and MRI [T2WI, dynamic contrast enhanced images imaging (DCEI)] were compared with histopathological findings of the biopsy specimens.RESULTS: Prostate cancer was detected in 48 of 87 patients (55.2%), and 178 of 733 specimens (24.3%), of which 49, 56, and 73 specimens had Gleason scores of 5-6, 7, and 8-10, respectively. Clinical stage was T1c, T2a-c, T3a-b, and T4 in 6, 26, 10, and 6 cases, respectively. The sensitivity of RBIE, RTE, TRUS, PDUS, T2WI, and DCEI was 72.5%, 71.9%, 75.8%, 75.8%, 72.5%, and 71.3%, respectively, while specificity was 97.7%, 85.8%, 85.4% 86.6%, 89.7%, and 91.5%, respectively. Sensitivity and specificity of RBIE were both superior to those of MRI.CONCLUSIONS: RBIE is known to be a low cost and less invasive procedure, while its prostate cancer detection capability may be superior to that of MRI, which is expensive and time consuming.INTRODUCTION AND OBJECTIVES: Real-time sonoelastography (HI-RTE) has been proven capable to visualize prostate cancer (PCa) areas and therefore can be used for PCa detection. However, application and assessment of this novel technique has several limitations that are important to know for the design of future studies. We evaluated the role of HI-RTE limitations by applying this method to patients before undergoing radical retropubic prostatectomy (RRP) and comparing the results with whole mounted sections.METHODS: In this study 800 prostate sectors with biopsy proven PCa scheduled for RRP were included and underwent HI-RTE by 2 investigators. HI-RTE was done by using a transrectal ultrasound probe (EUB-7500HV Hitachi medical systems with EUP-V53W probe). Local elastography findings were compared with histology. Areas suspicious for PCa were depicted and documented blinded to the pathological reports. RRP specimens were serially step sectioned and whole mounted after a modified Stanford protocol, tumour areas were marked by felt pen and each prostate was divided into 16 sectors. Areas suspicious for PCa were correlated with the correspond...

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