Christos Kalaitzis

• Democritus University of Thrace

Backround To describe and analyze our experience with secondary (redo) laparoscopic pyeloplasty (rLP) in managing recurrent ureteropelvic junction obstruction (UPJO) following primary pyeloplasty, and to compare our outcomes with those reported in the existing literature. Methods A retrospective analysis was conducted on patients who underwent rLP...

Müllerianosis of the urinary bladder is a rare pathological condition involving ectopic Müllerian-derived tissues within the bladder. Despite its benign nature, due to its ability to mimic malignant conditions such as bladder carcinoma, diagnosis might be challenging. In this review, data from 36 cases across 32 studies were an- alyzed, focusing on...

Spermatic cord sarcomas comprise a rare genitourinary malignancy that presents a challenging diagnostic and therapeutic pathway. They represent less than 5% of all soft-tissue sarcomas and less than 2% of malignant urologic tumours. The most commonly reported subtypes are liposarcoma, leiomyosarcoma, and rhabdomyosarcoma, with other rare variants i...

The diagnostic complexities posed by lesions within the urinary bladder underscore the need for personalised management approaches. Endocervicosis, a rare condition stemming from Müllerian tissue, is characterised by the benign infiltration of endocervical glands, predominantly affecting the urinary bladder. Despite the absence of definitive sympto...

This article reports a case of a 40-year-old woman with a history of myelomeningocele and neurogenic urinary incontinence who developed erosion and fistula formation following the placement of an artificial urinary sphincter (AUS) when she was 18 years old. The patient had a long-standing history of urinary incontinence that was unresponsive to pri...

Hereditary papillary renal cell carcinoma (HPRCC) is a rare form of kidney cancer that is inherited in an autosomal dominant manner with incomplete penetrance. HPRCC is caused by activating mutations in the MET proto-oncogene and is characterized by the tendency to develop multiple tumors in both kidneys. Detection of HPRCC tumors in imaging studie...

The extravesical spread of gas into the extraperitoneal space is an unusual complication of emphysematous cystitis and rarely, can reach remote areas of the body. Herein, we present the case of an immunosuppressed woman with emphysematous cystitis and extensive spread of extraperitoneal free gas up to the mediastinum.

Abdominal flank bulging is a known sequela after flank incision performed for a variety of renal, vascular, and neurosurgical procedures. The incidence of incisional flank bulge in renal surgery ranges from 3 to 49%, and although it is not considered a major complication, it has a negative effect on the quality of life of the patients. Damage to th...

Objective Two conventional approaches for vesicovaginal fistula (VVF) repair are transabdominal repair for supratrigonal VVF and transvaginal approach for low lying fistulae. Laparoscopic surgery was introduced to duplicate the surgical steps of the transabdominal approach with reduction in morbidity. We report a series of patients treated with a m...

Purpose To evaluate urinary stones using small-angle X-ray scattering (SAXS) and nitrogen porosimetry (NP). Traditionally, stones are categorized as hard or soft based on their chemical composition. We hypothesized that stone hardness is associated not only with its chemical composition but also with its internal architecture. SAXS and NP are well-...

Background: Kidney stone analysis techniques are well established in the field of materials characterization and provide information for the chemical composition and structure of a sample. Nanomedicine, on the other hand, is a field with an increasing rate of scientific research, a big budget and increasingly developing market. The key scientific...

Objective: To present a prospectively studied series of patients who underwent second-look flexible nephroscopy combined with Ho:YAG laser lithotripsy under local anesthesia for residual stone removal after percutaneous nephrolithotomy (PCNL). Materials and methods: Thirty consecutive eligible patients who underwent a PCNL procedure in the previ...

Objective: Ureteroscopic lithotripsy (URS) and Extracorporeal shock wave lithotripsy (ESWL) are highly effective for the treatment of uretral lithiasis and remain the treatment option for the majority of patients for more than two decades. In the present study we aimed to evaluate the levels of serum tumor necrosis factor A (TNFa) and interleucin...

Objective: Extracorporeal shock wave lithotripsy (ESWL) is highly effective for the treatment of uretral lithiasis and remains the first treatment option for the majority of patients when ureteral lithiasis can not be treated otherwise for more than two decades. In the present study we aim to evaluate the levels of serum tumor necrosis factor a (T...

Objective To describe the radiological findings and the clinical importance of megacalycosis. Materials and methods On the basis of a case report and literature review, diagnostic criteria and clinical significance of megacalycosis are presented. Result Megacalycosis is mostly asymptomatic and is usually discovered either accidentally or as a res...

The purpose of this study is to compare the perioperative total prostate specific antigen (tPSA) levels among coronary artery bypass grafting (CABG) patients with and without extracorporeal circulation (ECC), to investigate the changes overtime of tPSA in each group separately and to determine the effect of body core temperature on tPSA levels. A p...

Blunt penile trauma during sexual activity, although highly underreported due to the associated patient embarrassment, constitutes a real urological emergency requiring immediate attention and possibly early surgical intervention. We report a case of a 58-year old man who presented with penile pain following excessive masturbation. Although there w...

Introduction. Ureteroscopic lithotripsy (URS) although highly effective for the treatment of ureteral stones is associated with certain complications, the more common of which are postoperative fever and infection. In the present study we aimed to evaluate the levels of serum cytokines in patients undergoing ureteroscopic lithotripsy and investigat...

Introduction. Mucinous adenocarcinoma of the prostate is a rare variant of prostate cancer. Its malignant potential and the clinical course of the affected patients remain, by and large, controversial. No data exist about the course of metastatic mucinous adenocarcinoma of the prostate. Case Presentation. This case report describes the excellent c...

To prospectively evaluate the efficacy and safety of a perimeatal-based penile skin flap for neourethral coverage after repair of distal hypospadias with tubularized incised plate urethroplasty (TIPU). In 12 New Zealand white rabbits a ventral urethral defect was created and reconstruction was accomplished with continuous suture. An epithelialized...

Obstructive uropathy due to ureteral stones can cause renal infection and, if left untreated, can cause impairment of renal function. Endoscopic surgery such as ureteroscopy (URS) and laser lithotripsy are the primary therapeutic approach. Cytokines as non invasive markers may have a role to diagnose ureteral damage and infection. We aimed to evalu...

Changes in the expression of the mismatch repair (MMR) genes hMSH2, hMLH1, hMSH6 and hPMS2 reflect dysfunction of the DNA repair system that may allow the malignant transformation of tissue cells. The aim of the present study was to address the mRNA expression profiles of the mismatch DNA repair system in cancerous and precancerous urothelium. This...

Introduction. In cases of anatomic or functional single kidney with urothelial tumours of the upper urinary tract, the endoscopic laser ablation has proven efficacious. Based on the knowledge that low-grade, low-stage upper tract transitional cell carcinomas rarely progress to invasive lesions, indications for endoscopic laser ablation have expande...

The aim of the study was to evaluate the predictive values of two novel urinary markers for bladder cancer: survivin and soluble-Fas (s-Fas). The study included 84 individuals divided in two groups. The first group contained 47 patients, who underwent transurethral bladder tumor resection and the second, control, group 20 patients with non-malignan...

Objective: The most appropriate technique for excising the distal ureter and bladder cuff during laparoscopic nephroureterectomy is still debated. We report our experience with a pure laparoscopic transvesical method that duplicates the long-standing open transvesical approach. Materials and methods: Seven men and three women diagnosed with uppe...

Lymphatic drainage of the testes is known to follow a predictable pathway that usually involves the retroperitoneal, paraaortic, paracaval and interaortocaval nodal chains. Herein we report the case of a 41 years old man with a stage I testicular seminoma, with an unexpected inguinal lymph node metastasis. During his routine follow-up visit, 6 mont...

Cisplatin-based radio-chemotherapy is an effective alternative to cystectomy. The position of cisplatin has been challenged by novel drugs, while altered radiotherapy fractionation is also tested against conventional radiotherapy (RT). This study focuses on liposomal doxorubicin (LDox) in combination with an aggressive radiotherapy scheme (HypoARC)...

One of the most difficult, time-consuming, and at the same time critical steps of laparoscopic pyeloplasty is ureteral spatulation. We describe a reproducible technique that greatly simplifies this surgical step. Using standard laparoscopic scissors, the ureter is partially cut just inferior to the ureteropelvic junction (UPJ) at a point where a no...

High levels of beta human chorion gonadotropin in patients with pure seminoma of the testis are very rare. In such cases it is the question, whether these tumours can be effectively treated adjuvant such as pure seminomas or whether they must be considered as non-seminomatous tumours and whether extreme elevated beta human chorion gonadotropin has...

Penile carcinoma usually occurs in older than 40 years men with an incidence in western communities of 0.5 to 1.6 per 100,000 men per year while in developing countries the rate is much higher in men. Extensive lymph node dissection of lymphatic inguinal metastases evident by inguinal lymphoscintigraphy (ILS) induces improved overall survival. A 75...

Aims and background Evidence from the literature suggests that osteonecrosis of the jaw is emerging as a serious complication of treatment with bisphosphonates for patients with advanced prostate cancer. Methods and study design This study is a series of 60 patients with osseous metastases from prostate cancer under complete androgen deprivation t...

Evidence from the literature suggests that osteonecrosis of the jaw is emerging as a serious complication of treatment with bisphosphonates for patients with advanced prostate cancer. This study is a series of 60 patients with osseous metastases from prostate cancer under complete androgen deprivation therapy. All patients also received bisphosphon...

To describe the treatment modalities of symptomatic ovarian vein syndrome in pregnancy. In our study, we included 12 pregnant women with right ureter and kidney dilatation; caused by ureteric obstruction. In 11 out of 12, we insert a DJ stent and in one woman we applied percutaneous nephrostomy, because of intermittent abdominal pain, resistant on...

Occasionally during percutaneous surgery, significant contrast extravasation obscures the field, making fluoroscopic access no longer feasible. Herein, we describe a salvage technique. The cystoscopically placed, open-end ureteral catheter is exchanged with an angled-tip angiographic catheter. With the aid of a guidewire and under fluoroscopic guid...

The aim of the present study was to define the role of sodium balance and sodium sensitivity in the maintenance of two-kidney, one-clip renovascular hypertension in rats. Six months after induction of hypertension, systolic blood pressure, sodium balance, water intake and urine excretion were measured under normal conditions, after nephrectomy of t...

The incidence of bladder cancer has demonstrated a rapid increase during the last decades. The aim of this study is to determine the clinical value of serum tissue polypeptide antigen (TPA) as a tumour marker for urinary bladder cancer in comparison with conventional urine cytology. Urine and blood samples were obtained from a total of 108 patients...

New targeted agents have become the mainstream of treatment in metastatic renal cell carcinoma (mRCC) and substituted the previous cytokine-based therapies. Vascular endothelial growth factor (VEGF) pathway is the principle target for drugs like sunitinib, sorafenib and bevacizumab. As VEGF is regulating dendritic cell (DC) function, inhibition of...

Introduction: Neuroendocrine cells of the prostate are regulatory cells containing biogenic amines and certain neuropeptides such as chromogranin A (CgA). In the present study we evaluated the usefulness of serum CgA for monitoring prostate cancer progression. CgA levels were correlated to serum Prostate Specific Antigen (PSA) levels, bone scan fin...

The urethra is a usual site of introduction of foreign bodies for autoerotic stimulation. We present an unusual case of bladder perforation caused by foreign body that was self-inserted in the urethra and consequently slipped inside the bladder in a 29-year-old female patient with psychiatric disease. The patient was referred to our department for...

SUMMARY. Late relapse of testicular germ cell tumour is uncommon, especially with skeletal metastases. It appears that late relapse of non-seminomatous germ cell tumours presents with more aggressive biological features and is clinically distinct from early relapse. This report describes the case of a non-seminomatous germ cell tumour which recurre...

We report the case of a male patient with a left renal pelvic stone 2.5 cm in maximum diameter and a large upper pole intrarenal arterial aneurysm on the same side. The stone was treated with percutaneous nephrolithotomy (PCNL). This procedure was feasible even in this difficult clinical setting. Puncture of a calyx located at a safe distance from...

Prostate adenocarcinomas (PAC) consist mainly of tumour cells of luminal immunophenotype and scattered neuroendocrine (NE) cells. NE cells are defined by chromogranin A (CgA) immunoreactivity. T he aim of this study is the evaluation of CgA serum levels in monitoring prostate cancer (PC) patients under complete androgen deprivation (CAD) in compari...

Late relapse of a testicular germ cell tumour is an uncommon occurrence. We report a case of osteolytic bone metastasis appearing 23 years after the initial treatment of a metastatic testicular mixed tumour (choriocarcinoma and embryonal carcinoma). This is one of the longest periods of recurrence reported for testicular germ cell tumours. A 52-yea...

Background: The aim of the study was to evaluate a technique of retrograde double pigtail stent placement using a flexible cystoscope and fluoroscopic control in outpatients under local anesthesia. Patients and Methods: Seventy consecutive patients (79 ureters) requiring stent placement or replacement were included in the study. The procedures were...

Since the early 1990s, mitoxantrone has been used as a chemotherapeutic agent for adjuvant intravesical treatment following transurethral resection of superficial transitional cell carcinomas of the bladder. Although its efficacy as adjuvant intravesical therapy remains questionable and its use has not gained wide acceptance, the safety profile of...

We present comparative short-term experience with the transvaginal (TVT) and the transobturator (TVT-O) approaches for the treatment of stress urinary incontinence (SUI). We studied 315 women with SUI, treated with a tension-free tape placement. The TVT approach was applied in 265 women, while 50 women were treated by the TVT-O approach. The mean o...

Prostate cancer (PCa) is the second leading cause of death in men aged 40 years and older ]and prognostic indices are useful in suggesting its proper treatment. The aim of this study was to evaluate the prognostic value of Gleason score (GS), TNM staging system, initial serum prostate specific antigen (PSA) and bone scintigraphy (BS) in patients wi...

Benign prostate hyperplasia (BPH) is common in elderly men. Nevertheless, the pathophysiology of low urinary tract symptoms (LUTS) may not be due only to BPH. Many men with LUTS are submitted to unnecessary medications or surgical interventions because their symptoms have not been correctly evaluated. Can diagnostic test such as serum prostate anti...

We present our initial experience with the use of the squamous cell carcinoma (SCC) antigen (SCCAg) in 16 men with penile SCC (SCC group), in four men with condyloma acuminatum (benign group), and in 32 blood donors (control group). The SCCAg levels were measured at presentation and every 6 months (upper limit was 2 ng/mL). The mean follow-up time...

Aristotle (384-322bc) was one of the leading intellectual figures of all time. In his work he systematised a massive amount of knowledge on a diverse range of subjects, including medicine. This article discusses the observations and hypotheses of this great philosopher on semen and infertility, as they are presented in his work Generation of Animal...

To elucidate the role of the eicosanoids prostaglandin E(2) (PGE(2)), 6-keto-prostaglandin F(1a) (PGF(1a)) and thromboxane B(2) (TXB(2)) in the maintenance of two-kidney, one-clip renovascular hypertension in rats. The right renal artery was constricted by a silver clip in 63 male Sprague-Dawley rats to induce hypertension, while a sham operation w...

To evaluate effectiveness and safety of intracorporeal holmium:YAG (Ho:YAG) laser lithotripsy of ureteral calculi. Between October 2003 and September 2005, 45 patients (age range 27-74, mean age 51.5 years) with 49 ureteral stones (measuring 4-28 mm in size) were treated with Ho:YAG laser lithotripsy. The locations of the stones in the ureter were:...

Indinavir, a protease inhibitor that is commonly used to treat HIV infection, may cause crystal formation within the renal tubules when urine pH is above 3.5. Crystallization in the urine may lead to intrarenal crystal deposition and acute renal failure (ARF). To establish the beneficial urological management of acute renal failure caused by indina...

The aim of this study was to investigate the expression of bcl-2 and p53 oncoproteins in a series of transitional cell bladder carcinomas and its relation to traditional prognostic indicators and patients' survival. Specimens from 59 patients who underwent transurethral resection from March 1992 to February 1997 were included in this study. Tumors...

To evaluate the genetic instability of 11 fertile and 25 infertile men. The methodology of sister chromatid exchanges (SCEs) was applied to cultures of peripheral blood lymphocytes, and the levels of SCEss were analyzed as a quantitative index of genotoxicity, along with the values of the mitotic index (MI) and the proliferation rate index (PRI) as...

Ureterosciatic herniation is a rare cause of ureteral obstruction. Sciatic hernia is a well-defined anatomic defect that is the result of atrophy or abnormal development of piriform muscle. Patients with sciaitic hernias commonly present with symptoms of flank, abdominal, pelvic, lower back or thigh pain. The hernia sack can contain small bowel, ur...

To assess the surgical technique of Mainz II urinary diversion and to discuss its simplicity, quickness of performance, short postoperative period, few postoperative complications, as well as its effectiveness allowing patients to have a very good quality of life. Over the last six and a half years, 47 patients aged between 65 and 76 years (mean ag...

We have analyzed data collected over a 26-year period for influences of new diagnostic imaging techniques (ultrasound, computed tomography, and magnetic resonance imaging) on the size, stage, and other parameters of renal cell carcinomas at the time of first diagnosis. We reviewed retrospectively the records of 203 patients who underwent operations...

Our experiences of managing nocturnal enuresis in Greek children at our Outpatient Clinics of Pediatric Urology are described. Between March 2001 and October 2003, 142 children with primary nocturnal enuresis (93 boys and 49 girls), aged 7-18 years old (mean: 9.0+/-0.5) were included in this prospective study. Initially, behavioral conditioning the...

We aimed to assess the feasibility, safety, and outcome of the sigmoidorectal (Mainz II) pouch for urinary diversion in patients with invasive bladder cancer. Twenty-nine patients (25 men and four women), aged 65-76 years, who had undergone radical cystectomy and the sigmoidorectal pouch procedure for invasive bladder cancer were included in this s...

We present our experience in the treatment of enuresis at the Pediatric Urology Outpatient Office over a period of four years. We report pertinent epidemiological data, diagnostic workup, as well as routine treatment protocol. Between April 1998 and May 2002, 142 healthy children, aged between 6.5 and 18 years (mean: 9 +/- 0.5 years), were referred...

To define the role of the renal nerves of the contralateral kidney in the maintenance of two-kidney, one-clip (2K-1C) renovascular hypertension in rats. The contralateral kidney of 2K-1C rats was denervated 6 months after induction of hypertension and 4 weeks after nephrectomy of the clipped kidney. Blood pressure, sodium and potassium balance and...

The approximate incidence of indinavir urolithiasis in HIV positive patients receiving the drug is 10%. The exact mechanism of lithogenesis is still unknown. Pure indinavir stones are radiolucent on plane abdominal X-ray or CT scan. Indinavir urolithiasis can be associated with acute unilateral renal colic or severe azotaemia. 20 HIV patients were...

We report on a 20-year-old man presenting with priapism while receiving oral acenocoumarol for the treatment of deep vein thrombosis. To the authors' knowledge, it is the first reported case of acenocoumarol-associated priapism.

Target The approximate incidence of indinavir urolithiasis in HIV positive patients receiving the drug is 10%. The exact mechanism of lithogenesis is still unknown. Pure indinavir stones are radiolucent on plane abdominal X-ray or CT scan. Indinavir urolithiasis can be associated with acute unilateral renal colic or severe azotaemia. Material and m...

A new technique for percutaneous nephrostomy needle guidance is presented. It was applied in a patient with a solitary pelvic kidney, where ultrasound guidance was not feasible because of a very narrow puncture window. Typical intravenous urography was not useful, owing to poor opacification of the collecting system. We describe how the use of digi...

Indinavir sulfate is a protease inhibitor used of the treatment of primary HIV infection either as monotherapy or as part of antiretroviral treatment schemes. Approximately 10% of all patients develop urolithiasis with radiolucent stones consisting of indinavir. We present our results of the treatment in 11 HIV positive patients (9 men, 2 women), w...