Modified inguinal lymphadenectomy causes a lower complication rate than complete inguinal lymphadenectomy. Bilateral modified inguinal lymphadenectomy performed at the same time as penectomy does not increase the complication rate. When frozen section analysis is negative bilaterally, 5.5% of inguinal regions might still harbor occult metastasis. Modified inguinal lymphadenectomy is recommended as a staging procedure in all patients with T2-3 penile carcinoma. A straight followup is required for 2 years since all recurrence was within this period.
Objective To present the results of a continent and nonre¯uxing transverse colonic urinary reservoir technique. Patients and methods Twenty patients who had received high doses of irradiation underwent construction of transverse colonic reservoir as a primary form of urinary diversion. Fourteen patients had a vesicovaginal ®stula after de®nitive radiation therapy for gynaecological tumours and six had radiation therapy for invasive bladder cancer as a de®nitive treatment. They were followed for a median (range) of 4.5 (1±8) years. Intravenous pyelography before diversion showed mild hydronephrosis in 10 patients. Results After diversion, hydronephrosis improved in four patients and no upper tract deteriorated. All but one of the pouchograms showed no ureteric re¯ux. All the patients required clean intermittent self-catheterization every 3±4 h. Persistent asymptomatic bacteriuria was present in 14 patients, although clinical urinary tract infections were not reported. A moderate metabolic acidosis was present in 12 patients, but none required treatment. The urodynamic evaluation revealed a median (range) reservoir capacity of 450 (350±600) mL, with no contractions or contractions of <35 cmH 2 O. Conclusion These results suggest that the Unicamp technique for constructing a transverse colonic reservoir is a safe and effective diversion, and is recommended as an alternative method for patients treated by pelvic irradiation.
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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