Purpose To evaluate the clinical outcome of a cohort of localized prostate cancer patients treate with 125-I permanent brachytherapy at the São José Hospital – CHLC, Lisbon.Materials and Methods A retrospective analysis was carried out on 429 patients with low and intermediate-risk of prostate adenocarcinoma, according to the recommendations of the EORTC, who underwent 125I brachytherapies in intraoperative dosimetry “real-time” system between September 2003 and September 2013.Results The mean follow-up was 71.98 months. Biochemical relapse of disease by rising PSA (Phoenix criterion) was observed in 18 patients (4.2%). Through the application of Kaplan-Meier survival curves in this sample, the rate of survival at 6 years without biochemical relapse was higher than 95%. By Iog rank test comparing biochemical relapse with initial PSA (15-10 and <10) and Gleason values (7 and <7), there was no statistical difference (P=0.830) of the initial PSA in the probability of developing biochemical relapse. In relation to Gleason score, it was noted a statistical difference (P<0.05), demonstrating that patients with Gleason 7 are more likely to develop biochemical relapse.Conclusions Brachytherapy as monotherapy is at present an effective choice in the treatment of localized prostate adenocarcinoma. Biochemical relapses are minimal. The initial PSA showed no statistically difference in the rate of relapses, unlike the value Gleason, where it was demonstrated that patients with Gleason 7 have a higher probability of biochemical relapse. Cases with PSA bounce should be controlled before starting a salvage treatment.
CESA/VASA é uma nova técnica que tem como objetivo principal o tratamento curativo da incontinência urinária de urgência, patologia conhecida como bexiga hiperativa idiopática. A técnica consiste numa abordagem cirúrgica abdominal (aberta ou laparoscópica) com a aplicação de uma fita (CESA/VASA) que se fixa ao colo uterino ou à cúpula vaginal, sendo inserida no lugar onde existiam os ligamentos útero-sagrados (ligamentoplastia), e fixada ao osso sacro. Isto faz com que, graças à tensão e suporte desenvolvidos pela fita aplicada, a bexiga volte à sua posição anatómica habitual. Este caso retrata uma doente, 72 anos, com queixas de incontinência urinária mista. Efetuou vários tipos de medicação (anti-muscarínicos e mirabegron) sem grandes melhorias. Realizou estudo urodinâmico que confirma a presença de incontinência urinária de esforço e bexiga hiperativa.Foi submetida a colocação de fita CESA por via laparoscópica + sling sub-uretral (TOT) por via transvaginal. Cirurgia e pós-operatório sem intercorrências. Após quatro semanas da intervenção, a doente foi reavaliada afirmando estar assintomática.
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