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[Comparison of the effectiveness between long-term instillation of mitomycin C and short-term prophylaxis with MMC or bacille Calmette-Guérin. Study of patients with non-muscle-invasive urothelial cancer of the urinary bladder].

BACKGROUND: Adjuvant instillation therapy with chemo- or immunotherapeutic agents is an integral component in the treatment of non-muscle-invasive bladder cancer. There is, however, no general consensus on the choice of medication and the optimal duration of therapy. This multicenter trial compared a long-term treatment regimen with mitomycin C (MMC) with two short-term treatment approaches with MMC or bacille Calmette-Guérin (BCG) for intermediate-/high-risk bladder tumor after transurethral resection. In patients with low-risk bladder tumors, the effectiveness of six weekly MMC instillations

Pembrolizumab monotherapy for the treatment of high-risk non-muscle-invasive bladder cancer unresponsive to BCG (KEYNOTE-057): an open-label, single-arm, multicentre, phase 2 study.

BACKGROUND: Standard treatment for high-risk non-muscle-invasive bladder cancer is transurethral resection of bladder tumour followed by int … rate (absence of high-risk non-muscle-invasive bladder cancer or progressive disease), assessed by cystoscopy and urine cytology approximately 3 months after the first dose of study drug. Patient follow-ups were done every 3 months for the first 2 years and every 6 months thereafter for up to 5 years. Efficacy was assessed in all patients who received at le …

Overlooked Factors Causing Renal Damage in Vesicoureteric Reflux!

INTRODUCTION: Vesicoureteric reflux (VUR), recurrent urinary tract infection (RUTI), febrile urinary tract infection (FUTI), renal scarring, … atinine clearance, USG Renometry, DTPA renal scan, uroflowmetry, and urodynamic study (UDS). Repeat cystoscopy, if necessary, was done following UDS for secondary bladder neck incision (BNI) or for repeat BNI if necessary. RESULTS: Mean duration of follow-up was 7.2 years (range 3-14 years). Out of 170 renal units, 132 renal units had VUR without VUJO, i.e. …

Management and outcome of TaG3 tumours of the urinary bladder in the nationwide, population-based bladder cancer database Sweden (BladderBaSe).

Purpose: To investigate the management of TaG3 tumours of the urinary bladder using nationwide population-based data in relation to the prevailing guidelines, patients' characteristics, and outcome.Materials and methods: The Bladder Cancer Data Base Sweden (BladderBaSe), including data from the Swedish National Register for Urinary Bladder Cancer (SNRUBC), was used to study all patients with TaG3 bladder cancer diagnosed from 2008 to 2014. Patients were divided into the following management groups: (1) transurethral resection (TUR) only, (2) TUR and intravesical instillation therapy (IVIT), (3

Radical radiotherapy in older patients with muscle invasive bladder cancer.

BACKGROUND: Muscle invasive bladder cancer (MIBC) is prevalent in the older patients, who are a vulnerable population with multiple co-morbidities and at increased risk of complications. Radical cystectomy is often not suitable, hence radical radiotherapy (RT) is an alternative option. We reviewed the outcomes of older patients treated with RT with or without concurrent chemotherapy (CRT) at our institution. METHODS: We retrospectively reviewed patients aged 65 years and above treated with radical RT for MIBC at our institution between March 2002 to January 2017. Data was collected from insti

Update of the ICUD-SIU consultation on upper tract urothelial carcinoma 2016: treatment of low-risk upper tract urothelial carcinoma.

INTRODUCTION: The conservative management of upper tract urothelial carcinoma (UTUC) has historically been offered to patients with imperative indications. The recent International Consultation on Urologic Diseases (ICUD) publication on UTUC stratified treatment allocations based on high- and low-risk groups. This report updates the conservative management of the low-risk group. METHODS: The ICUD for low-risk UTUC working group performed a thorough review of the literature with an assessment of the level of evidence and grade of recommendation for a variety of published studies in this diseas

Early clean intermittent catheterization may not prevent dimercaptosuccinic acid renal scan abnormalities in children with spinal dysraphism.

OBJECTIVES: To determine whether early initiation of clean intermittent catheterization is associated with increased renal preservation in children with spinal dysraphism based on dimercaptosuccinic acid (DMSA) renal scans. METHODS: A retrospective review was performed of 100 patients from a pediatric spinal defects clinic from June 2007 to October 2011 who were followed with routine studies including DMSA scans, voiding cystourethrograms, renal/bladder ultrasounds, and urodynamics. DMSA scans were reviewed for evidence of renal cortical loss as defined by presence of scarring or difference i

Tumor recurrence in prostatic urethra following simultaneous resection of bladder tumor and prostate: a comparative retrospective study.

OBJECTIVES: To evaluate the effect on the oncological outcomes and recurrences at the prostatic urethra of simultaneous transurethral resection of bladder tumor (TURBT) and benign prostatic hyperplasia (TURP). METHODS: The records of 85 men (group 1) who had undergone simultaneous TURBT and TURP at our clinic between 1986 and 2006 and fulfilled the inclusion criteria were retrospectively analyzed and compared with those of 85 men (group 2) who had undergone TURBT only during the same period. Clinicopathologic parameters, recurrence and progression rates, and recurrence rates in the bladder ne

Is efficacy of repeated intradetrusor botulinum toxin type A (Dysport) injections dose dependent? Clinical and urodynamic results after four injections in patients with drug-resistant neurogenic detrusor overactivity.

OBJECTIVE: To assess the effects of two different doses of botulinum toxin A (Dysport: 500 and 1,000 IU) injected repeatedly into the bladder for the treatment of neurogenic detrusor overactivity (NDO) in terms of safety, durability, and improvement of continence status and urodynamic parameters. PATIENTS AND METHODS: In this study we analyzed the effects of successive doses of 500 or 1,000 IU of Dysport, endoscopically injected into the detrusor muscle. Clinical, urodynamic, and satisfaction assessments were performed at baseline and 6 weeks after each injection. The results of injections an

Reverse transcriptase-polymerase chain reaction assays for prostate cancer.

RT-PCR, if targeted against a prostate-specific marker, can be a highly specific and sensitive assay to detect the presence of occult prosta … ipulation does, in fact, appear to affect the RT-PCR assay. Although digital rectal examination and cystoscopy do not seem sufficiently invasive to release prostate cells into the circulation, a small number of individuals undergoing transrectal ultrasound biopsy will experience this phenomenon. This observation provides a cautionary note relative to timing …

Risk of percutaneous renal biopsy of native kidneys in the evaluation of acute kidney injury.

BackgroundPercutaneous renal biopsy (PRB) of native kidneys (NKs) to better understand and treat acute kidney injury (AKI) is being advocated, but little is known about the risk of complications.MethodsWe performed a retrospective study of PRB of NKs in 955 adults from 1991 to 2015 at an academic medical center with real-time ultrasound and automated biopsy needles. Patients undergoing PRB for evaluation of AKI (n = 160) were compared with 795 patients biopsied for other reasons (not-AKI) for postbiopsy complications [need for transfusion of packed red blood cells (PRBCs), an interventional ra

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… Complication intervention AKI Not-AKI P-value n 160 795 Transfusion alone, n 13 36 Total transfusions, n (%) 16 (10.0) 42 (5.3) 0.02 Cystoscopy, n (%) 0 2 (0.25) 1.0 Radiologic embolization, n (%) and transfusion, n 3 (1.9) 8 (1.0) 0.41 3 6 Hematuria with obstruction, n (%) 0 1 (0.13) 1.0 Readmitted … Complication intervention | AKI | Not-AKI | P-value n | 160 | 795 | Transfusion alone, n | 13 | 36 | Total transfusions, n (%) | 16 (10.0) | 42 (5.3) | 0.02 Cystoscopy, n (%) | 0 | 2 (0.25) | 1.0 Radiologic embolization, n (%) and transfusion, n | 3 (1.9) | 8 (1.0) | 0.41 | 3 | 6 | Hematuria with …

Sacrospinous hysteropexy with a low weight transvaginal polypropylene mesh for treatment of complete uterovaginal eversion.

INTRODUCTION: Pelvic Organ Prolapse (POP) is a common condition in elderly resulting from the weakening of the organ suspension elements of … acement therapy. Transvaginal ultrasound and the Pap smear screening were done with normal results. Cystoscopy wasn´t employed at anytime of this procedure. Hydrodissection of vaginal wall was followed by longitudinal incision from the level of bladder neck to the cervix. Notice that the ideal dissection should maintain the vaginal thickness, and address the …

Editorial: Bio-Pathological Markers in the Diagnosis and Therapy of Cancer.

Identifying novel biomarkers with diagnostic, prognostic and predictive value in terms of therapeutic response is a current topic in the clinical practice of oncologists, pathologists and medical researchers in general [...].

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… Russo et al. compared the previously reported rates of sensitivity and specificity and the oncologic outcomes of different techniques such as photodynamic diagnosis (PDD) fluorescence, narrow-band imaging (NBI) and white light cystoscopy (WLC) in visualizing and sampling non-muscle invasive bladder cancer … Performance of Narrow Band Imaging (NBI) and Photodynamic Diagnosis (PDD) Fluorescence Imaging Compared to White Light Cystoscopy (WLC) in Detecting Non-Muscle Invasive Bladder Cancer: A Systematic Review and Lesion-Level Diagnostic Meta-Analysis. …

Novel Short PEG Chain-Substituted Porphyrins: Synthesis, Photochemistry, and In Vitro Photodynamic Activity against Cancer Cells.

This work presents the synthesis and characterization of metal-free, zinc (II), and cobalt (II) porphyrins substituted with short PEG chains. The synthesized compounds were characterized by UV-Vis, 1H and 13C NMR spectroscopy, and MALDI-TOF mass spectrometry. The origin of the absorption bands for tested compounds in the UV-Vis range was determined using a computational model based on the electron density functional theory (DFT) and its time-dependent variant (TD-DFT). The photosensitizing activity was evaluated by measuring the ability to generate singlet oxygen (ΦΔ), which reached values up

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… It should also be emphasized that exposure to blue light has been used for the blue-light cystoscopy (BLC), also known as fluorescence cystoscopy or photodynamic diagnosis, which enables imaging of the urinary bladder [ 69 ]. … Hexaminolevulinate Blue-Light Cystoscopy in Non-Muscle-Invasive Bladder Cancer: Review of the Clinical Evidence and Consensus Statement on Appropriate Use in the USA Nat. Rev. Urol. 2014 11 589 596 10.1038/nrurol.2014.245 25245244 70. Caputo E. Maiorana L. Vasta V. Pezzino F.M. Sunkara S. Wynne K. …

Decreased sensory receptors P2X3 and TRPV1 in suburothelial nerve fibers following intradetrusor injections of botulinum toxin for human detrusor overactivity.

PURPOSE: Botulinum neurotoxin type A (BoNT/A) is effective in the treatment of intractable detrusor overactivity (DO). In addition to its known inhibitory effect on presynaptic release of acetylcholine by motor terminals, there is increasing evidence that BoNT/A may affect sensory fibers. We investigated a possible effect of BoNT/A on human bladder afferent mechanisms by studying the sensory receptors P2X3 and TRPV1 in biopsies from patients with neurogenic or idiopathic DO. MATERIALS AND METHODS: A total of 38 patients (22 with neurogenic DO, 16 with idiopathic DO) with intractable DO were t

Re-operative urethroplasty after failed hypospadias repair: how prior surgery impacts risk for additional complications.

PURPOSE: The primary aim of this report was to compare urethroplasty complications for primary distal and proximal repairs with those after 1, 2, 3, and 4 or more re-operations. METHODS: Prospectively collected data on consecutive hypospadias repairs (tubularized incised plate (TIP), inlay, two-stage graft) from 2000 to 2015 were reviewed. Isolated fistula closures were excluded. Extracted information included patient age, meatal location, repair type, primary vs. re-operative surgery, number of prior operations, any testosterone use, glans width, and urethroplasty complications. Pre-operativ

Urinary morbidity following ultrasound-guided transperineal prostate seed implantation.

PURPOSE: To assess the urinary morbidity experienced by patients undergoing ultrasound-guided, permanent transperineal seed implantation for … ients received 120 Gy and 90 Gy, respectively for 125I or 103Pd. All patients underwent postimplant cystoscopy and placement of an indwelling Foley catheter for 24-48 h. Follow-up was at 5 weeks after implant, every 3 months for the first 2 years, and then every 6 months for subsequent years. Patients completed AUA urinary symptom scoring questionnaires at i …

Hemorrhagic Renal Cyst, a Case Report.

HISTORY OF PRESENT ILLNESS: A 73-year-old male presented with one day of hematuria associated with urinary frequency and acute on chronic ab … renal cyst. The patient was discharged and recommended to follow-up with urology for an outpatient cystoscopy and repeat renal ultrasound in 3 months to evaluate for a possible neoplasm. TOPICS: Renal cyst, hemorrhagic cyst, hematuria, bedside ultrasound, POCUS.

Evaluation of Urinalysis-Based Screening for Urothelial Carcinoma in Patients With Lynch Syndrome.

BACKGROUND: Approximately 5% to 10% of patients with Lynch syndrome develop urothelial carcinoma. Current screening recommendations vary and … patients (9.3%) had microscopic hematuria and were further evaluated with urine cytology, imaging, cystoscopy, and/or Urology consultation. None of the 19 patients with microscopic hematuria had urothelial carcinoma. During the same study period, 5 of 204 (2.4%) patients with Lynch syndrome were diagnosed with urothelial cancer, and all presented with sympt …