Objectives: Analyze the oncologic and functional outcomes in patients affected by low risk prostate cancer underwent prostate cryotherapy. Materiasl and methods: It’s a prospective tricentric study of 434 patients treated with prostate cryoablation for low risk prostate cancer. By low risk we refer to the D'Amico’s risk classification. Two cycles of freezing/thawing are run for each patient following the technique described by Onik. Results: For the 434 patients, the median age was 66 years with a standard deviation of ± 6.68, the average PSA was 6.17 ng/d/L, the median 5.55 with a standard deviation of ± 2.13, the mean prostate volume was 35.59 cc, the median 34.00 cc, with a standard deviation of ± 7.89. Biochemical failure occurred in 67 patients (15.4%). Pre-operative erectile function in men was distributed as follows: severe in 95 patients (19.2%), moderate in 95 (19.2%), medium-moderate in 180 (36.4%), mild in 92 (18.6%), with no dysfunction in 32 (6.5%) patients. Post-operative erectile function, measured 1 month after cryotherapy, was distributed as follows: severe in 321 (65%) patients, moderate in 69 (14%), medium-moderate in 79 (16%), mild in 23 (4.7%), and no dysfunction in only 2 patients (0.4%). Post-operative erectile function after 3 months was distributed as follows: severe in 233 (47.2%) patients, moderate in 66 (13.4%), medium-moderate in 122 (24.7%), mild in 65 (13.2%), and no dysfunction in 8 patients (1.6%). Urinary incontinence was present in 21 patients (4.8%) after 3 months while it dropped to 13 patients (2.9%) after 6 months. Conclusions: Cryotherapy in the treatment of prostate cancer remains a viable alternative. The availability of new cryoprobes and the use of new diagnostic means such as fusion magnetic resonance will make this more precise and more effective method.
Objective: Clinical presentation of ureteral stones during pregnancy is generally with renal colic pain. The aim of this study is to present our experience in the management of renal colic during pregnancy in emergency settings. Materials and methods: 208 pregnant patients who presented to emergency department with renal colic pain and underwent ureteroscopy (URS) due to failed conservative therapy were enrolled in the study. Urinary tract stones were diagnosed either with ultrasound (US) examination or during URS. Laser lithotripsy and double J (DJ) stent placement were routinely done in all patients with ureteral stones. The incidence of infective complications and premature uterine contractions (PUC) due to URS were compared. Results: No stone was identified in 36.1% (n = 75) of patients with using US and diagnostic URS. Of the remaining 133 patients, 30 (22.6%) had no stone at US but stones were diagnosed during diagnostic URS. The type of anesthesia had no significant effect on PUC. An increased risk of sepsis and PUC was found in patients with fever at the initial presentation. Interestingly, PUC was more frequent in patients with lower serum magnesium levels. There was a significant correlation with time delay until the intervention and the risk of urosepsis and PUC, individually. Conclusions: Ureteroscopy is a safe option for evaluation of pregnant patients with unresolved renal colic. According to the current findings, timing of the operation is the most important factor affecting the septic risks and abortion threat. Surgical intervention with URS must be planned as soon as possible.KEY WORDS: Pregnancy; Urinary calculi; Renal colic. 0.02-0.53%, complicating from 1:200 to 1:2000 pregnancies, and urolithiasis may also be a contributing factor in up to 40% of premature births (2). Several elements are capable of increasing the risk of urolithiasis and hydronephrosis during pregnancy, including the mass-effect of gravid uterus, reduced peristalsis and dilation of the urinary tract due to elevated progesterone levels, and increased risk of infection and electrolyte imbalance (decreased secretion of urinary stone inhibitors, such as citrate and magnesium) (3). Renal colic is the most common non-obstetric cause of abdominal pain and subsequent hospitalization during pregnancy (3). The clinical presentation of ureteral stones during pregnancy is primarily after 20 weeks of gestation; alongside renal colic, tenderness, fever, dull aching pain and hematuria (4). As is the case with the general population, a conservative approach that makes use of analgesia and monitoring for spontaneous passage is often the most appropriate initial treatment for acute renal colic in the pregnant patient. However, if spontaneous passage does not occur or if complications develop, placement of a ureteral stent or a percutaneous nephrostomy is necessary. In such cases, ureteroscopy (URS) has also become a reasonable alternative due to patients' low tolerance for these devices (5). The aim of this study is to present our experience...
Spontaneous subcapsular renal hematoma is a rare condition in clinical practice. It is caused by renal cysts, benign and malignant renal tumors, vascular lesions, and antiplatelet or anticoagulant therapy. In this paper we report an unusual case of rupture of a renal cyst of a 66-year-old male patient during an aortic and iliac endovascular procedure for a massive calcified atheroma above the iliac bifurcation. We suspected that the bolus of high weight molecular heparin given during the procedure caused the rupture of the cyst. According to the literature, this is the first case of renal cyst rupture during an endovascular aortic procedure after administering a high weight molecular heparin bolus.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.