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Prostate cancer is the most common male malignancy. Radiation therapy and radical prostatectomy are the main curative treatment options for organ confined disease. Despite the good long-term oncologic outcomes, roughly 40% of patients undergoing surgery develop biochemical recurrence, manifested as a rising prostate-specific antigen (PSA). Those patients are at higher risk of developing a local or distant recurrence. The diagnosis of a nodal recurrence is challenging. This report is about a 66-year-old male, who had a radical prostatectomy in 2006. Postoperatively, the PSA was never undetectable. Radiotherapy was delivered in 2007, but the PSA rose again. Anti-androgen therapy was started, but he developed painful mastodynia. A (11C) choline PET-CT showed an enlarged suspicious lymph node at the left common iliac and a salvage pelvic lymphadenectomy was performed. Postoperatively, the PSA remained undetectable for the last 5 years. The use of lesion - targeted therapy for oligometastatic disease is a new concept in urology, aiming at reducing the tumor burden. Therefore, even though this surgical approach might not be associated with a durable response over time, the tumor load is decreased and further cancer progression might be delayed, allowing to postpone the delivery of hormone therapy., (© 2014 S. Karger AG, Basel.)

Objective: Identification of patients in whom the perineal route is the optimal approach to perform radical prostatectomy., Material and Methods: During 1992-1999, 376 patients with prostate cancer underwent radical perineal prostatectomy. Four patients were identified in whom the perineal approach was indicated because of previous bilateral groin hernia repair using synthetic meshes. In addition, 1 patient underwent perineal prostatectomy elsewhere for similar reasons., Results: The perineal approach offered an uneventful surgical solution for an adequate and straightforward radical perineal prostatectomy without complications and without biochemical recurrence during the follow-up., Conclusion: Radical perineal prostatectomy is suggested to be the optimal approach in patients with previous bilateral groin hernia repair using synthetic, nonabsorbable meshes., (Copyright 2001 S. Karger AG, Basel)

Renovascular hypertension, caused by fibromuscular dysplasia, mainly affects young women in the third decade of life. Percutaneous transluminal angioplasty is the treatment of choice for solitary lesions with a complete functional result in 40-50% of the cases. Multiple stenoses, involving intrarenal arterioles, cannot be treated by dilatation and are mostly treated by nephrectomy. Nevertheless, those vascular stenoses are often limited to a particular renal segment so that unaffected segments could be spared. Two patients were treated with a partial nephrectomy. The short-term results are promising. We suggest that this treatment modality could be offered as a rational and effective solution to well-selected cases, with multiple, regionally limited arterial stenoses.

We describe the results after implantation of a urethral stent in 6 patients with recurrent urethral strictures. Four patients had strictures located in close vicinity to the external sphincter. In 3 of these 4 patients open urethroplasty procedures had failed. The treatment was successful in 5 of the 6 patients with a follow-up of 6-10 months. However, in 1 patient who had a complex stricture close to the sphincter, dense fibrotic strictures recurred at the proximal end of the stent where a short segment of the stricture was left uncovered in order to preserve continence. We conclude that implantation of the stent is a valuable treatment for complex strictures in the vicinity of the sphincter on condition that the stent covers the whole stricture.