Search

To assess suitability of Comprehensive Complication Index (CCIA total of 128 patients with bladder cancer (BCa) undergoing intracorporeal RARC with pelvic lymph node dissection between 2015 and 2021 were included in a retrospective bi-institutional study, which adhered to standardized reporting criteria. Thirty-day complications were captured according to a procedure-specific catalog. Each complication was graded by the CDC and the CCI381 complications were identified in 118 patients (92%). 55 (43%), 43 (34%), and 20 (16%) suffered from CDC grade I-II, IIIa, and ≥ IIIb complications, respectively. 16 (13%), 27 (21%), and 2 patients (1.6%) were reoperated, readmitted, and died within 30 days, respectively. 31 patients (24%) were upgraded to most severe complication (CCIThe CCI

To compare surgical, oncological and functional outcomes between obese vs. normal-weight prostate cancer (PCa) patients treated with robotic-assisted radical prostatectomy (RARP).We assessed 4555 consecutive RARP patients from a high-volume center 2008-2018. Analyses were restricted to normal-weight vs. obese patients (≥ 30 kg/mBefore matching, higher rates of pathological Gleason Grade group ≥ 4 (14 vs. 18%; p = 0.004) and pT3 stage (33 vs. 35%; p = 0.016) were observed in obese patients, with similar observations for surgery time, blood loss and 30-day wound- and surgical complication rates. For normal-weight vs. obese patients, BCR- and MP-free rates were 86 vs. 85% (p = 0.97) and 97.5 vs.97.8% (p = 0.8) at 48 months. Similarly, rates of erectile function at 36 months and urinary continence at 12 months were 56 vs. 49% (p = 0.012) and 88 vs. 85% (p = 0.003), respectively. Before and after propensity score matching, obesity had no effect on BCR or MP, but a negative effect on erectile function (matched HR 0.87, 95%CI 0.76-0.99; p = 0.029) and urinary continence recovery (matched HR 0.91, 95%CI 0.84-0.98; p = 0.014).Obesity did not represent a risk factor of BCR or MP after RARP despite higher rates of adverse pathological features. However, obesity was associated with higher risk of perioperative morbidity and impaired functional outcomes. Such information is integral for patient counselling. Thus, weight loss before RARP should be encouraged.

Background: Renal hematomas, although relatively rare, are potentially life-threatening complications after ureterolithotripsy. Case Presentation: We present four cases of renal hematomas that occurred in our department during the past decade (2008–2018). Unstable vital signs, increased inflammatory markers, fever, and flank pain were the commonest postoperative findings. Two patients were treated conservatively and had an uneventful recovery, whereas one patient underwent selective arterial embolization for bleeding control. The fourth patient was diagnosed with contralateral ureteral urothelial tumor and ultimately underwent contralateral radical nephroureterectomy. Conclusion: Application of safety measures during ureteroscopy may reduce the incidence of perirenal hematomas. Prompt diagnosis is based on a thorough clinical examination in combination with imaging to evaluate the location and extent of the hematoma.

The aim of this study was to assess whether age ≥75 years impairs surgical, functional, and oncological outcomes after robot-assisted radical prostatectomy (RARP).Patients with prostate cancer (PCa) were stratified in ≥75(RARP duration, blood loss, and 30d complication rates were similar between groups. For patients ≥75 vs.70 years, rates of erectile function after 36 and urinary continence after 12 months were 27 vs. 56% (Apart from erectile function, senior age has no significant effect on urinary continence recovery, BCR- or MP-free rates after RARP. Post-RARP QoL improved even in senior patients. Modern therapy of senior PCa patients should be based on individual counseling than just age.

Η λιθίαση της ουροδόχου κύστεως στις μέρες μας αποτελεί το 5% της λιθίασης του ουροποιητικού συστήματος στον δυτικό κόσμο, με τυπικά συμπτώματα τα δυσουρικά ενοχλήματα (επώδυνη, επιτακτική, διακοπτόμενη ούρηση) και την τελική αιματουρία. Συντηρητικές θεραπείες, διαδερμικές προσπελάσεις αλλά και ανοικτές χειρουργικές επεμβάσεις αντικαταστάθηκαν με την πάροδο του χρόνου από τη διουρηθρική κυστεολιθοτριψία. Σκοπός της μελέτης είναι η εξέταση της ασφάλειας και αποτελεσματικότητας μίας ελάχιστα επεμβατικής μεθόδου, της εξωσωματικής λιθοτριψίας (ESWL), στη θεραπεία της λιθίασης της ουροδόχου κύστεως. Συνολικά 47 ασθενείς υποβλήθηκαν σε ESWL με τη χρησιμοποίηση του ηλεκτρομαγνητικού Dornier Lithotripter S. Το μέγεθος του προστάτη και το υπόλειμμα ούρων υπολογίστηκαν υπερηχογραφικά. Επιτυχής ορίστηκε η θεραπεία σε περίπτωση απουσίας λίθου ή συγκρίματος μετά το πέρας 4 εβδομάδων. Ο μέσος όρος ηλικίας των ασθενών ανήλθε στα 69.1 έτη (34 – 93 ± 11.43), με τον μέσο όγκο προστάτη να καταγράφεται στα 50,1 cm3 (0-85 ± 15,81) και το υπόλειμμα ούρων στα 131 ml (50 – 190 ± 32,82). Το μέσο μέγεθος της λιθίασης διαπιστώθηκε στα 1.97 εκατοστά (1-4.5 ± 0.79), ενώ ο μέσος αριθμός κρουστικών κυμάτων κυμάνθηκε στα 2704.34 (1800 - 3000 ± 293.37) με μέση χρονική διάρκεια συνεδρίας τα 20.63 λεπτά (15 - 25 ± 2.63). Σε 2 ασθενείς απαιτήθηκε αναλγητική θεραπεία, με το VAS score να διαμορφώνεται στο 1.73 (0-4 ± 0.98). Το ποσοστό επιτυχίας άγγιξε το 76.5% (36/47) χωρίς να παρατηρηθούν σοβαρές επιπλοκές (Clavien-Dindo > 2). Η εξωσωματική λιθοτριψία αποτελεί μια ασφαλή και αποτελεσματική εναλλακτική θεραπευτική μέθοδο σε ασθενείς με λιθίαση ουροδόχου κύστεως, ειδικά σε ασθενείς υψηλού κινδύνου που δεν δύνανται να υποβληθούν σε χειρουργική αντιμετώπιση.

INTRODUCTION AND OBJECTIVE:To assess clinically meaningful improvement of preoperative lower urinary tract symptoms (LUTS) and associated quality of life (QoL) after robot-assisted radical prostate...

Bladder lithiasis accounts for around 5% of all urinary tract stones diseases with typical symptoms dysuria, hematuria, urgency and intermittent urination. therapy, percutaneous procedures, and open surgical treatments have been replaced by transurethral lithotripsy. The aim of this study is to investigate the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of vesical lithiasis. A total of 47 patients underwent ESWL for bladder calculi, using the electromagnetic Dornier Lithotripter S. Stone and prostate size as well as postvoid urine residual was determined with sonography. The success of the procedure was determined in the absence of stone fragments after 4 weeks. The mean age of patients was 69.1 years (34–93 ± 11.43) with a median prostate size at 50.1 cm3 (0–85 ± 15.81) and an average postvoid residual at 131 ml (50–190 ± 32.82). The mean size of lithiasis was found 1.97 cm (1–4.5 ± 0.79) and the median number of impact waves 2704.34 (1800–3000 ± 293.37) with the average duration of session 20.63 min (15–25 ± 2.63). Only two patients received analgesic treatment and the mean pain visual analog scale score was 1.73 (0–4 ± 0.98). The stone-free rate was found at 76.5% (36/47) and no severe complications (Clavien–Dindo >2) were observed. ESWL is a safe and efficient alternative for the management of vesical lithiasis, especially for high-risk patients that are not candidates for a more invasive treatment.