Objective Ureteropelvic junction obstruction (UPJO) is a common cause of symptomatic ureteral obstruction. The aim of this study is to assess the outcome of laparoscopic pyeloplasty in patients with UPJO. Patients and Methods Medical reports of 47 UPJO patients treated with laparoscopic pyeloplasty were retrospectively analysed. All patients were recruited from our center in the period 2004–2011. Results We evaluated 47 patients. Mean age was 36 years and mean hospital stay 3.6 days. 42 (79%) of the patients had pain and 46 (98%) were diagnosed with hydronephrosis. 19 patients (40%) had a renal function below 40% of the affected kidney and 49% had impaired renal scan drainage. Postoperative significant improvement in pain score and renal scan drainage was found in 92% and 47% of the patients, respectively. Improvement of renal function > 10% was found in 11 patients (23%); the function remained stable in 31 patients (66%) and deteriorated > 10% in 5 patients (11%). We found no correlation between sex or age and the outcome. Conclusion Laparoscopic pyeloplasty for UPJO leads to relief of pain and preserved or improved renal function in the majority of the patients. Overall laparoscopic pyeloplasty is an efficient treatment for UPJO.
ObjectiveTo determine whether preoperative staging of high-risk prostate cancer with 18F-sodium-fluoride (18F-NaF) positron emission tomography (PET) reduces the risk of skeletal metastases.DesignNationwide, population-based cohort study using real-world data.SettingThe study used national health registries, including all sites in Denmark from 2011 to 2018.ParticipantsNewly diagnosed high-risk prostate cancer patients who underwent radical prostatectomy from 2011 to 2018. Patients were stratified into two groups according to the preoperative imaging modality of either 18F-NaF PET or bone scintigraphy.Main outcome measuresThe risk of skeletal-related events (SREs) as a proxy for skeletal metastases following radical prostatectomy. The secondary endpoint was overall survival.ResultsBetween 1 January 2011 and 31 December 2018, 4183 high-risk patients underwent radical prostatectomy. Of these patients, 807 (19.3%) underwent 18F-NaF PET and 2161 (51.7%) underwent bone scintigraphy. The remaining 30% were examined by a different imaging method or did not undergo imaging. Using the inverse probability of treatment weighting to control potential confounding, the HR of experiencing an SRE for patients in the 18F-NaF PET group versus the bone scintigraphy group was 1.15 (95% CI 0.86 to 1.54). The 3-year survival rates were 97.4% (95% CI 96.1 to 98.7) and 97.1% (95% CI 96.4 to 97.9) for patients receiving 18F-NaF PET and bone scintigraphy, respectively.ConclusionPatients with high-risk prostate cancer undergoing preoperative staging with 18F-NaF PET did not display a lower risk of developing SREs after prostatectomy compared with patients undergoing bone scintigraphy. The survival rates were similar between the two groups.
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