Posts made in January, 2016

Forming a stone in pelviureteric junction obstruction: Cause or effect?

Vol. 43 (1): 13-19, January – February, 2017

doi: 10.1590/S1677-5538.IBJU.2015.0515


Theodora Stasinou 1, Andreas Bourdoumis 2, Junaid Masood 3

1 South Manchester University Hospitals NHS Foundation Trust, Manchester, UK; 2 North Manchester General Hospital, Acute Pennine Hospitals NHS Trust, Manchester, UK; 3 Homerton University Hospital NHS Foundation Trust, London, UK


Objectives: To investigate a possible causal relationship for stone formation in pelvi­ureteric junction obstruction and to outline management options.

Materials and Methods: A literature search and evidence synthesis was conducted via electronic databases in the English language using the key words pelviureteric junction obstruction; urolithiasis; hyperoxaluria; laparoscopic pyeloplasty; flexible nephros­copy; percutaneous nephrolithotomy, alone or in combination. Relevant articles were analysed to extract conclusions.

Results: Concomitant pelviureteric junction obstruction (PUJO) and renal lithiasis has been reported only scarcely in the literature. Although PUJO has been extensively studied throughout the years, the presence of calculi in such a patient has not received equal attention and there is still doubt surrounding the pathophysiology and global management.

Conclusions: Metabolic risk factors appear to play an important role, enough to justify metabolic evaluation in these patients. Urinary stasis and infection are well known fac­tors predisposing to lithiasis and contribute to some extent. The choice for treatment is not always straightforward. Management should be tailored according to degree of obstruction, renal function, patient symptoms and stone size....

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Female urinary incontinence and sexuality

Vol. 43 (1): 20-28, January – February, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0102


Renato Lains Mota 1

1 Departamento de Urologia, Centro Hospitalar de Lisboa Ocidental, EPE e Universidade Lusófona de Lisboa, Portugal


Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most preva­lent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females.

This article is a review of both the concepts of female urinary incontinence and its im­pact on global and sexual quality of life. Nowadays, it is assumed that urinary inconti­nence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chro­nicity of incontinence, namely urge urinary incontinence.

Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the im­pact among female sexual function. Unfortunately, there are sparse articles that evalu­ate the benefits of female sexual function with drug management of incontinence.


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Predictive role of Trimprob associated with multiparametric MRI in the diagnosis of prostate cancer

Vol. 43 (1): 29-35, January – February, 2017

doi: 10.1590/S1677-5538.IBJU.2015.0714


Gustavo Cardoso Guimaraes 1, Walter Henriques da Costa 1, Renato Almeida Rosa 1, Stênio Zequi 1, Ricardo Favaretto 1

1 Núcleo de Urologia, Departamento de Cirurgia Pélvica, AC Camargo Cancer Center, SP, Brasil


Objectives: to evaluate the predictive value of TRIMprob test to detect prostate cancer (PCa) in patients referred to prostate biopsy (PB).
Material and Methods: Patients with PSA <10ng/mL and rectal exam without findings suggestive of prostate cancer were selected for TRIMprob evaluation.
Exam was performed by a single operator through transperineal approach.
Patients admitted for the study were submitted to TRIMprob and multiparametric magnetic resonance (mpMRI) and posteriorly to PB.
Results: In total, 77 patients were included. TRIMprob showed evidences of PCa in 25 (32.5%) and was negative in 52 patients (67.5%). The rate of detection of prostate cancer at biopsy was higher in patients with positive TRIMprob (16/25; 64.0%) than in patients with negative TRIMprob (11/52; 21.1%; p<0.001). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TRIMprob were respectively 61.5%, 82.0%, 64.0%, 80.3% and 74.0%. ROC curve showed the following areas under the curve values for TRIMprob, mpMRI and combination of TRIMprob + mpMRI: 0.706; 0.662 and 0.741 respectively. At combined analysis, when both TRIMprob and mpMRI were negative for prostate cancer, accuracy was 96.3% or only 1 in 27 PB was positive (3.7%).
Conclusions: Trimprob had similar predictive value for PCa in patients submitted to PB as mpMRI. Combined TRIMprob and mpMRI showed higher accuracy than when performed...

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Lack of evidence of HPV etiology of prostate cancer following radical surgery and higher frequency of the Arg/Pro genotype in Turkish men with prostate cancer

Vol. 43 (1): 36-46, January – February, 2017

doi: 10.1590/S1677-5538.IBJU.2015.0429


Merve Aydin 1, Aliseydi Bozkurt 2, Aytekin Cikman 1, Baris Gulhan 1, Mehmet Karabakan 2, Aysun Gokce 3, Murat Alper 3, Murat Kara 1

1 Department of Medical Microbiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey; 2 Department of Urology, Erzincan University, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey; 3 Department of Pathology, Dıskapı Training and Research Hospital, Ankara, Turkey


Objectives: The aim of this study was to assess the possible role of HPV in the devel­opment of prostate cancer (PCa) and investigate the distribution of the p53 codon 72 polymorphism in PCa in a Turkish population.

Materials and methods: A total of 96 tissues, which had been obtained using a radical surgery method, formalin-fixed and parafin-embedded, were used in this study. The study group consisted of 60 PCa tissues (open radical prostatectomy) and the control group contained 36 benign prostatic hyperplasia tissues (BPH) (transvesical open pros­tatectomy). The presence of HPV and the p53 codon 72 polymorphism was investigated in both groups using real-time PCR and pyrosequencing.

Results: The results of the real-time PCR showed no HPV DNA in any of the 36 BPH tis­sue samples. HPV-DNA was positive in only 1 of the 60 PCa samples (1.7%). The HPV type of this sample was identified as HPV-57. The distribution of the three genotypes, Arg/Arg, Arg/Pro and Pro/Pro was found to be 45.6, 45.6, and 8.8% in the PCa group and 57.1%, 34.3% and 8.6% in the control group, respectively. Compared with the control group, patients with PCa had a higher...

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Editorial Comment: Lack of evidence of HPV etiology of prostate cancer following radical surgery and higher frequency of the Arg/Pro genotype in Turkish men with prostate cancer

Vol. 43 (1): 47-47, January – February, 2017

doi: 10.1590/S1677-5538.IBJU.2015.0429.1


Jose Pontes Jr.

1 Departamento de Urologia Hospital das Clincas da FMUSP, Instituto Central São Paulo, SP, Brasil

The authors retrospectıvely evaluated the presence of HPV and the p53 polymorphism distribution by RT-PCR in a series of 60 surgical specimens of localized prostate cancer and 36 BPH samples.

They found HPV in only one prostate cancer case and no HPV in BPH cases. They also demonstrated that Ar72Pro polymorphism and the Proline allele were more frequently found in cancer. They concluded that there is no association between prostate cancer and HPV and also postulate that the Proline allele can be a risk factor for the development of PCa in the Turkish population.

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