Giant multilocular prostatic cystadenomas (GMPC) are very rare benign tumors that originate from the prostate with extensive spread into the pelvis. The lesion may present as large abdominal mass causing obstructive voiding dysfunction and usually not invading adjacent structures. All of the previously reported patients with GMPC underwent open surgery. Although the natural history of prostatic cystadenoma remains unknown, complete surgical excision may not always be necessary. We report the case of a 74-year-old male who presented a retrovesical recurrence of prostatic cystoadenoma after 16 years, treated with a laparoscopic approach. To our knowledge this is the first case of laparoscopic management of GMPC. In this article we review the current literature about this rare tumor and discuss the diagnostic and management dilemmas posed by this rare pathologic condition. We believe that physicians should at least be aware of the existence of this disease in the differential diagnosis of pelvic cavity tumours and, considering the benignity of GMPC, they should propose--as first--a minimally invasive approach.
A 32-year-old man with azoospermia is presented. Transperineal echographically guided vesiculography of the vas deferens showed absence of the ejaculatory duct and presence of a cystic müllerian duct in which both enlarged seminal vesicles joined. Transurethrally, by means of a contact tip over the verumontanum a new channel was created by neodymium:YAG laser irradiation at 25 watts every 2 seconds. The patient had 32.10(6) spermatozoa per ml. with good quality on semen analysis 10 months later.
— The Authors describe the endourologic treatment of prostatic cancer. Nowadays the possibilities for the treatment of localized prostatic cancer include: radical prostatectomy, nerve sparing prostatectomy, radiotherapy and TURP plus Nd:YAG laser irradiation. All these modalities of treatment are discussed and the indications for endoscopic treatment in the early stage of a prostatic tumour are reported according to results in literature. The Authors summarize their experience with TURP plus Nd:YAG laser in 48 patients with early prostatic cancer, incidental prostatic cancer and PIN 2–3. According to the Authors this method of treatment presents results comparable to those of radical prostatectomy but without impotence or incontinence.
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