Objective. To analyze the penile and urethral meatus biometry and its correlation with meatoplasty during endoscopic resections. We also propose a new classification for urethral meatus morphology. Materials and Methods. We prospectively studied 105 patients who underwent prostate and bladder transurethral resections. We performed standardized measurement of penile and urethral meatus biometry followed by penile photo in the front position. The need to perform meatoplasty or dilatation during resectoscope introduction was registered. Data were analyzed comparing the correlation between two groups: without intervention (Group A) and with intervention (Group B). Results. We observed in Group A and Group B, respectively, the average length of urethral meatus of 1.07 cm versus 0.75 cm (p < 0.001) and average width of urethral meatus of 0.59 cm versus 0.38 cm (p < 0.001). Considering the morphology of the urethral meatus, we propose a new classification, in the following groups: (a) typical; (b) slit; (c) point-like; (d) horseshoe; and (e) megameatus. The point-like meatus was the one that most needed intervention, followed by the slit and the typical meatus (p < 0.001). Conclusions. Point-like and slit-shaped urethral meatus, as well as reduced length and width of the urethral meatus, are the determining factors.

Objective : to verify the association of success rate of percutaneous lithotripsy, Guy score and size of the stone. Methods: one hundred patients submitted to percutaneous nephrolithotripsy were evaluated. All stones were classified according to Guy Score. Patient free of stone was considered when residual fragments were ≤2mm. Results: according to guy Score, 54% were score 1 (Group 1), 18% score 2 (Group 2), 15% score 3 (Group 3), and 13% score 4 (Group 4). Success was observed in 77.77% in Group 1, 27.77% in group 2, 26.6% in Group 3, and 7.69% in Group 4. In patients with Guy score 1, there was statistical significance of prediction of free stone rate when evaluated according to the size of the stone. Among groups 2, 3 and 4 there was no statistical significance, but it was observed a trend in relation to stone size, the bigger the higher the chance of residual fragments. Conclusion: nephrolithometry by Guy Score and size of the stone are single predictors of success of percutaneous nephrolithotripsy. Stone size may influence success rate of patients with Guy Score 1.

We present a male patient, 52 years old, with acute renal failure due to giant bladder stone. In first presentation with acute renal failure, tomography has shown a bladder stone with 10 cm in its largest diameter associated with bilateral ureterohydronephrosis. It was initially treated by bladder catheterization and indicated emergency dialysis and subsequently submitted to surgical treatment through open cistolitotomy. During the procedure it was possible to observe the giant calculus, adhered to the trigone of the bladder, occluding his neck. After the vesical catheter was deployed, the patient had clinical and laboratory improvement during hospitalization. The association between giant bladder stones and urologic kidney failure is a rare condition and once removed the causative factor, we expect the return to normal limits. Studies with higher levels of evidence are needed to increase knowledge about the subject.

Background: Prostate cancer is the second most common type of cancer in man and the second in cancer-specific deaths in this population in the world. Most of the causes of death related to prostate cancer are due to its distant metastases, with the most common sites being: skeleton, distant lymph nodes, liver and lung. Renal metastasis is rare, and studies suggest infiltration due to arterial microembolization of the tumor. A key point in this scenario is the clinical suspicion of differential diagnoses, to offer the patient an effective therapy in such a specific case. Aim: To report a case of a patient with prostate cancer undergoing partial nephrectomy whose histopathological report revealed a metastatic lesion of that primary site. Case Presentation: 74 years old man, referred in May 2015 due to high PSA level and lumbago. PSA 323.11 ng/dl, rectal examination cT3a; biopsy was performed and histopathological study reported bilateral prostate adenocarcinoma, Gleason's score 8 (4 + 4). Patient's staging showed multiple secondary implants on skeletal scintigraphy. Tomography revealed solid exophytic lesion in the lower pole of the right kidney (4.7 × 3.6 cm); prostate without cleavage planes with seminal vesicles and pelvic node enlargement. Hormone therapy was initiated, PSA levels dropped to 9.51 ng/dl and total testosterone < 50 ng/dl. Partial nephrectomy was planned, initially by laparoscopy, but converted to laparotomy in December 2015. Procedure lasting 3 hours, minimal blood loss, no perioperative complications, discharged on the 3rd postoperative day. Histopathological report described undifferentiated malignant neoplasm, requiring immunohistochemistry that confirmed prostate adenocarcinoma. Patient remains hormone therapy, with no progression of the disease so far. Conclusion:How to cite this paper: Sobrinho, U