Introdução: A hiperplasia prostática benigna (HPB) é uma das doenças que mais comumente afeta o homem adulto, gerando importante prejuízo na qualidade de vida destes. Atualmente, existem diversos tratamentos para a HPB, incluindo os medicamentos, endoscópicos e minimamente invasivos. Porém a cirurgia aberta, na forma da prostatectomia, ainda possuem seu espaço no tratamento de pacientes selecionados, principalmente nos serviços públicos de saúde. Revisão: Objetivou comparar, com base na literatura, as cirurgias de prostatectomia transvesical e prostatectomia a Millin para o tratamento da HPB, no que diz respeito a vantagens/desvantagens, indicações e complicações pós-operatórias. Discussão: Com base na literatura, não se pode afirmar a superioridade de uma das técnicas. Elas apresentam suas vantagens e desvantagens, sendo a escolha entre elas, principalmente, uma decisão do cirurgião com base em sua experiência. Considerações finais: Em países subdesenvolvidos, como no Brasil, a prostatectomia aberta ainda tem importante papel no tratamento de pacientes com próstatas volumosas. Permanece importante o estudo, discussão, aprimoramento e disseminação da técnica de prostatectomia aberta aos residentes de urologia em formação.
Few cases of paratesticular liposarcomas have been described in literature and they are considered as rare tumors, especially when they are larger than 10 cm, called giant tumors. We describe the case of a 52-year-old patient diagnosed with a painless mass in the scrotum, initially submitted to magnetic resonance imaging, which revealed a large paratesticular mass. Subsequently, he underwent left radical orchiectomy, which revealed a well-differentiated, “lipoma-like,” “giant” paratesticular liposarcoma. We discussed the workup and current management of this pathology.
Urothelial carcinoma of the upper urinary tract is a rare and potentially aggressive disease. It rarely affects the ureter and is quite uncommon in the ureteral stump of a patient who has already undergone nephrectomy for benign disease. We, herein, describe a case of a male patient who underwent total left nephrectomy owning to renal exclusion. After three years, owning to an episode of hematuria, he was diagnosed with a urothelial tumor of the ureteral stump, and he underwent ureterectomy and excision of the bladder cuff. The involvement of the ureteral stump by urothelial tumor is an extremely rare event and is normally associated with poor prognosis owning to the delay in diagnosis inherent to atypical presentation. The most common symptom is hematuria. Pain is uncommon because of the absence of a renal unit and consequently, hydronephrosis. Although rare, we must remember the possibility of the appearance of primary tumors in the ureteral stump and maintain a high degree of diagnostic suspicion to avoid diagnosis in advanced stages.
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