IntroductionTo determine the effectiveness and safety of extended pelvic lymphadenectomy compared with standard lymphadenectomy in the overall, cancer-specific survival and biochemical recurrence-free survival of patients with localized prostate cancer who underwent radical prostatectomy.Material and methodsClinical trials and cohort studies were included without language restrictions with the following participants: men older than 40 years of age diagnosed with localized prostate cancer who received radical prostatectomy plus pelvic lymphadenectomy. Standard vs. extended pelvic lymphadenectomy were compared. The primary outcomes were overall and cancer-specific survival. A search strategy in MEDLINE, EMBASE, CENTRAL, LILACS, and other databases was conducted to obtain published and unpublished literature. The risk of bias was evaluated with the Cochrane Collaboration tool. The statistical analysis was performed in STATA 14.ResultsSix studies were included, of which only one was experimental; the other studies were cohort studies. The surgical technique was robot-assisted in three studies. Two studies only had information concerning the adverse effects. It was not possible to include one clinical trial that met the criteria because an erratum was published in which falsification of the experimental data was proven. There was a biochemical recurrence-free survival hazard ratio (HR) = 0.62 and a 95% confidence interval (CI) (0.36 to 0.87).ConclusionsAccording to current literature, a mild difference was evident favoring the extended lymphadenectomy in biochemical recurrence-free survival. Additionally, there was no evidence to draw a conclusion regarding the overall survival since we did not find any studies concerning this outcome.
Conclusión: La cirugía reconstructiva uretral es el procedimiento de elección para el manejo de la estrechez uretral. Un factor de riesgo importante para la aparición de recurrencias es la realización de procedimientos mínimamente invasivos previo a la cirugía reconstructiva.
Asymptomatic microscopic haematuria, defined as the presence of three or more red blood cells per high-power field on microscopic examination of the urinary sediment, with no of infection, is a warning sign of disease of the kidney disease or the urinary tract. Among the most common causes include, urinary tract infection, benign prostatic hyperplasia, and urolithiasis, but there is also a likelihood that a patient with microscopic haematuria may have a neoplasm. The risk of urological malignancy increases in men over 35 years, people with a history of smoking, and exposure to environmental or occupational dyes, glues, benzene, etc. Its evaluation includes the study of erythrocyte dysmorphia, proteinuria, serum creatinine, or hypertension. An assessment of the entire urinary tract is required, with CT being the best tool for identifying lesions of the upper urinary tract. The lower urinary tract is best explored with cystoscopy. Urine cytology is not recommended for routine study of asymptomatic microscopic haematuria. In this review, an approach is presented on the diagnosis, evaluation and follow-up of patients with asymptomatic microscopic haematuria that enables it to be within everyone's reach.
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