[Show abstract][Hide abstract] ABSTRACT: Bipolar technology offers a new perspective in the treatment of BPH.
Purpose: To present our experience with the TURis system (Olympus, Tokyo,
Materials and Methods: From February 2011 till December 2013 in a
prospective study, 93 patients were treated for BPH. They were evaluated
with IPSS, QoL, uroflow (Qmax) and residual urine (RU), pre-operatively, as
well as 6 and 9 months post-operatively. Based on the prostate volume the
patients were divided into two groups: group A (n=48) with prostates ≥ 75cc
and group B (n=45) with smaller prostate glands. All patients underwent
bipolar TURP or/and plasma vaporization.
Results: The postoperative improvement for IPSS, QoL, Qmax and RU was -
47.41%, -56.67%, 101.07% and -65.97% respectively (p<0.001).The
postsurgical improvement for group A was -52.46%, -47.57%, 157.68% and
-65.03% for IPSS, QoL, Qmax and RU respectively, and -45.41%, -60.60%,
116.08% and -65.82% for group B respectively as well. The operation time
was longer in group A (88.76 min vs 54.23 min, p<0.001) in comparison with
group B. The former group also had higher infection and stricture formation
rates, however, there was no statistical difference between the two groups.
Conclusions: Treatment with the TURis constitutes an effective technique
and can be offered to large prostates with results equivalent to those in small
ones. Regarding safety, large adenomas treated with TURis are not at a
higher risk for urethral stricture but their odds to develop urogenital infections
are relatively higher compared to the smaller adenomas.
Full-text · Article · Nov 2015 · Advances in Urology
[Show abstract][Hide abstract] ABSTRACT: Our objective is to describe a novel ligamentolysis approach using a subcoronal incision technique and to determine its safety and efficacy. During the last 7 years, 82 consecutive patients had penile augmentation surgery. Ligamentolysis, through a lower abdominal incision (V-Y plasty) in the first 35 males, was performed (Group A), followed by circumcision ligamentolysis in the next 47 males (Group B). The operation time, complications, and the preoperative and postoperative values of penile length and girth along with the self-esteem and relations questionnaire score as well as satisfaction score was calculated before and after the surgery, and a comparison was conducted between the groups. The mean age at presentation was 32 years (range: 18-56 years). Seventy-nine patients suffered from penile dysmorphophobia, and three patients had micropenises (length, <7.5 cm). The mean surgical times were 150.7 and 125.2 min for Groups A and B, respectively (P=0.005). Postoperatively, four Group A patients and three Group B patients (11% versus 6%, respectively) experienced penile retraction (P=0.453). Hypertrophic scars were observed in 18 men (51%) in the former group. In the circumcision group, no major wound complications were recorded. The length and girth improvements between the groups were similar. In terms of satisfaction and SEAR improvement, the resulting difference for both variables favored the circumcision group (P=0.007 and <0.001, respectively). With strict selection criteria, the circumcision ligamentolysis procedure compared to the V-Y plasty demonstrated improved results in terms of safety, operation time, retraction rate and cosmetic appearance without any compromise in the gained penile size.
Full-text · Article · Aug 2013 · Asian Journal of Andrology
[Show abstract][Hide abstract] ABSTRACT: A 62-year old male patient presented complaining of intermittent macroscopic hematuria. The ultrasonographic investigation revealed a hydronephrosis of remarkable degree with indiscrete renal parenchyma. The abdominal computed tomography scan identified a ureteral lesion with proximal dilatation, hydronephrosis and a functionless ipsilateral renal unit. The retrograde urography showed a 4-cm lesion with multiple filling defects and a smooth contour. The endoscopic examination showed an exophytic lesion, highly suspicious for malignancy. Urine cytology revealed atypia. Right nephroureterectomy was performed and the pathology revealed a ureteral inverted papilloma (UIP). Polymerase chain reaction examination for the presence of human papilloma virus, using GP5+/6+ consensus primers, was negative. The presence UIP should be considered in patients with urotheleal lesions in the ureter when the diagnostic workup for malignancy is inconclusive. The clinical course of the disease seems to be favorable.
No preview · Article · Dec 2012 · Canadian Urological Association journal = Journal de l'Association des urologues du Canada
[Show abstract][Hide abstract] ABSTRACT: Herein, we report on our experience with six patients (0.3%) diagnosed with lymphoepithelioma-like bladder carcinoma (LELBC) over the past 15 years at our department. The mean age of the patients with LELBC was 73 years (range 69-80 years). All patients had at least pT2 disease. The primary treatment was transurethral resection of the bladder tumor, radical cystectomy (RC), and radiotherapy (RT) in one, two, and three patients, respectively. After a mean follow-up of 31 months (range 13-72 months), three patients are still alive. The predominant subtype was diagnosed in four patients, three of whom are alive at the time of writing, compared with the two patients in whom the focal subtype was diagnosed, both of whom are dead. Two of the living patients were treated with a bladder-preservation strategy. Our experiences suggest that RC may not be necessary in muscle invasive disease and that RT and chemotherapy may be reliable treatment options. The pathology report may be useful in selecting patients suitable for bladder-preservation treatment.
Preview · Article · Aug 2011 · International Journal of Urology
[Show abstract][Hide abstract] ABSTRACT: Neuroendocrine small cell carcinoma of the urinary tract is rarely encountered and very few cases have been reported in the literature. Herein we describe a case of small cell malignancy located contemporarily in the ureter and the bladder.