A. Cisternino

Lymphatic and vascular embolizations are independent predictive variables of inguinal lymph node involvement in patients with squamous cell carcinoma of the penis.

The objective of the current study was to identify independent clinical and pathologic variables that were predictive of lymph node involvement in patients with squamous cell carcinoma of the penis in a multicenter series with the intent to select patients who were suitable to undergo immediate inguinal lymphadenectomy.

Long-term follow-up of a neoadjuvant chemohormonal taxane-based phase II trial before radical prostatectomy in patients with non-metastatic high-risk prostate cancer

To assess the feasibility and activity of a neoadjuvant treatment combining a luteinizing hormone‐releasing hormone (LHRH)‐analogue, estramustine and docetaxel before radical retropubic prostatectomy (RRP) in patients with high‐risk prostate cancer.

Obstructive Primary Bladder Neck Disease: Evaluation of the Efficacy and Safety of α1-Blockers

Objective: The efficacy and safety of using α1-adrenergic blockers for treating primary bladder neck obstruction in young and middle-aged men was assessed as the first therapeutic step, before surgery, in a symptomatic non-neurogenic selected group of patients. Materials and Methods: From January 1995 to December 2001, primary bladder neck obstruction was diagnosed in 41 men whose average age was 43 years. All of them were evaluated by a complete clinical history, American Urological Association (AUA) symptom score index, physical examination, uroflowmetry, transabdominal ultrasound prostatic volume determination, ultrasound post-void residual determination, videourodynamics including pressure-flow analysis and upper urinary tract screening with renal ultrasound or an excretory urogram. A full daily dose of α1-adrenergic blockers (alfuzosin or tamsulosin) was administered for at least 6 months. Successful treatment was defined as improved symptoms, voiding diary, maximum flow rate and pressure-flow parameters. Patients who did not gain improvement of symptoms with pharmacological treatment were offered surgery. Results: Overall, pharmacological treatment was successful in 29/41 patients (70.7%) whereas bladder neck endoscopic incision was mandatory in 12/41 (29.3%). Conclusions: α1-Blockers were effective and safe for treating young and middle-aged men with symptomatic bladder neck obstruction.

Urological Manifestations of Acute Appendicitis: Report of Two New Cases

Clinical manifestations of acute appendicitis are variegated and urologic symptoms may be the first manifestation of the disease. In 1985 we reported on 2 cases of acute appendicitis who presented with irritative bladder symptoms. Here we describe 2 new cases come to our observation because of hematuria and irritative bladder symptoms. A brief review of the literature is also carried out.

Page kidney : a curable form of arterial hypertension : case report and review of the literature

A case report of arterial hypertension which occurred 5 years after a blunt renal trauma is presented. The physiopathology of this type of hypertension along with the diagnostic features and the therapeutic aspects are extensively discussed. The sudden appearance of hypertension in a young patient following trauma must suggest a Page kidney as one of the diagnostic possibilities.

Predictive medicine in non-malignant urological disorders

The potential of disease prediction in non-malignant disorders should not be undervalued. Such disorders present several characteristics which make them suitable for disease prediction: they can be wide-spread, strongly affect the patients’ quality of life, lead to a heavy burden on social health expenses and have a protracted clinical course. Moreover, people who present a high risk for non-malignant disease can be successfully introduced to long-term preventive measures such as lifestyle modifications, dietary changes and improvement in hygienic conditions. There is a growing demand for developing predictive medical strategies in urology. While urological cancers are the main focus of interest, we analyse the potentialities and challenges of predictive medicine in non-malignant urological disorders, with particular attention to benign prostate hyperplasia and urolithiasis.

IS PERCUTANEOUS NEPHROLITHOTOMY A SAFE AND EFFECTIVE PROCEDURE FOR TREATMENT OF RENAL STONES IN CHILDREN

MATERIAL & METHODS: Percutaneous nephrolithotomy (PCNL) was performed in 30 children 1 to 17 years old (median age 12), including 14 boys (46.6%) and 16 girls (53.3%). There was a single obstructing calculus in 20 patients, while 10 had multiple calculi. The procedure was performed in 1 stage in 28 patients, and it was staged with preliminary nephrostomy in two cases. Complete anatomical and metabolic evaluation was performed in all cases. Patients were followed 1, 3 and 6 months postoperatively with a plain abdominal x-ray and renal ultrasound.

Lymphatic and vascular embolizations are independent predictive variables of inguinal lymph node involvement in patients with squamous cell carcinoma of the penis: Gruppo Uro-oncologico del Nord-est

The objective of the current study was to identify independent clinical and pathologic variables that were predictive of lymph node involvement in patients with squamous cell carcinoma of the penis in a multicenter series with the intent to select patients who were suitable to undergo immediate inguinal lymphadenectomy.

The Hereditary Renal Cancer Syndromes

Although the majority of renal cell carcinomas (RCC) are sporadic, hereditary types of kidney cancer such as Von Hippel-Lindau (VHL) disease and hereditary papillary renal carcinoma syndromes are thought to account for approximately 4% of kidney cancers. A germline mutation seems to predispose to the development of specific histologic types of RCC. Hereditary kidney cancers are bilateral multifocal kidney tumors that, in some instances, occur at a younger age than do sporadic renal cancers. A better knowledge of the genetic basis of renal carcinogenesis has been useful in identifying genetic causes of renal tumorigenesis, such as inactivation of the VHL tumor suppressor gene in clear cell carcinoma. Moreover, the genes responsible for hereditary renal cancer syndromes seems to play a role in the development of sporadic counterparts. Knowledge of genetic cancer syndromes may allow clinicians to screen and counsel family members, identify those patients at risk for multiple cancer development, and give the chance to intervene therapeutically when cancers are still treatable by identifying localized tumors through early screening. This article reviews the current status and recent advances in the field of familial kidney cancer syndromes.

Simultaneous Surgical Treatment of Abdominal Aortic Aneurysm (AAA) and Invasive Transitional Cell Carcinoma

A prospective case-control study on simultaneously occurring abdominal aortic aneurysm (AAA) and invasive transitional cell carcinoma of the bladder (TCCB) was carried out to evaluate short- and long-term mortality and morbidity of the one-stage surgical treatment. Methods From January 1995 to December 2000 16 patients presented a concomitant AAA and TCCB. A standard operative protocol included AAA graft replacement before bladder resection and urinary reconstruction. Control patients (16 AAA and 16 TCCB alone) matched according to time of intervention, type of vascular and urinary procedure and pathologic staging. Results No vascular complications and graft infections were observed. Systemic and urologic complications were similar in study and control groups. One patient simultaneously treated for AAA and TCCB died of MI 32 days after surgery after an uncomplicated postoperative period. Estimated 6–year survival rate was 68% in AAA and TCCB patients simultaneously treated, 93% and 54% in matched control patients undergoing AAA and TCCB treatment alone respectively. Conclusions The present study shows that the one-stage is a safe approach to simultaneous occurring AAA and TCCB. Long-term survival of treated patients is dependent upon cancer progression. Whenever endovascular treatment is not advisable, the simultaneous surgical treatment of coexisting AAA and TCCB is recommended in highly specialized centers.