Vol. 44 n. 1 Jan . Feb, 2018

Volume 44 | number 1 | January . February, 2018 -Int Braz J Urol Annual Report – 2017

REPLY BY THE AUTHORS: Re: An unanswered question in pediatric urology: the post pubertal persistence of prepubertal congenital penile curvature correction by tunical plication

Vol. 44 (2): 413-414, March – Abril, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0055.2 LETTER TO THE EDITOR Unsal Ozkuvanci 1, Orhan Ziylan 1, M. Irfan Donmez 1, Omer Baris Yucel 1, Tayfun Oktar 1, Haluk Ander 1, Ismet Nane 1 1 Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey   No abstract available [Full Text] Related Post Best videos of the year in 2017 views 116 Serum tissue factor as a biomarker for renal clear cell carcinoma views 107 The impact of metformin use on the risk of prostate cancer after prost... views 118 Re: Artificial urinary sphincter for urinary incontinence after radica... views...

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Int Braz J Urol Annual Report – 2017

Vol. 44 (1): 1-1, January – February, 2018 doi: 10.1590/S1677-5538.IBJU.2018.0001 EDITORIAL in This Issue Sidney Glina 1 1 Professor Titular Disciplina de Urologia da Faculdade de Medicina do ABC, Santo André, SP, Brasil   Traditionally, every year, the International Brazilian Journal of Urology evaluates its reviewers and selects the most efficient along the previous year, Evaluation is based on the number of performed reviews, time for conclusion and quality of work (1). In 2017, the five most efficient reviewers were: Fabio Vicentini (Hospital das Clinicas da Faculdade de Medicina da USP, SP, Brasil), Eduardo Kaiser Ururahy Nunes Fonseca (Hospital Israelita Albert Einstein SP, Brasil), Victor Srougi (Faculdade de Medicina de Sao Paulo, SP, Brasil), Elcio Silva (Clinica Dr. Elcio Dias Silva, Campinas, SP, Brasil) and Kemal Sarica (Kartal Dr. Lufi Kirdar Training and Research Hospital Istanbul, Turkey). [Read more] Related Post Editorial Comment: Laparoscopic pectopexy: initial experience of singl... views 108 Re: Simplified Fournier’s gangrene severe index score (SFGSI) views 127 Editorial Comment: Feasibility of Robot – assisted Segmental Ure... views 117 Biochemical recurrence after radical prostatectomy: what does it mean? views...

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Best videos of the year in 2017

Vol. 44 (1): 2-3, January – February, 2018 doi: 10.1590/S1677-5538.IBJU.2018.0001 EDITORIAL Philippe E. Spiess 1,2 1 – Section Editor, International Brazilian Journal of Urology Senior Member, 2 Department of GU Oncology, Assistant Chief of Surgical Services Moffitt Cancer Center This year has been another memorable year for the International Brazilian Journal of Urology with quality international submissions to the video section from across the World. It highlights the commitment by the urology community in continually striving to improve the outcomes of surgical patients. We should never accept that good is good enough particularly with the plethora of surgical tools at our disposal. In this regard, it gives me a distinct pleasure to introduce the three best videos for 2017. These selections were made based on their novelty and potential to favorably impact the surgical care of urological patients. Making these selections is always challenging, being that all accepted videos are already of an incredibly high quality; hence, I would like to congratulate all authors for accepted videos over the past year and look forward to receiving your future submissions in the months to years to come. The selection of best videos of the year are as follows: [Read more] Related Post Editorial Comment: The protective effect of Papaverine and Alprostadil... views 195 Do we have enough evidences that make you safe to treat a man with hyp... views 107 Can hydrophilic coated catheters be beneficial for the public healthca... views 119 Do we have enough evidences that make you safe to treat a man with hyp... views...

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Do we have enough evidences that make you safe to treat a man with hypogonadism one year after a radical prostatectomy for prostate cancer? | Opinion: YES

Vol. 44 (1): 4-7, January – February, 2018 doi: 10.1590/S1677-5538.IBJU.2018.0003 DIFFERENCE OF OPINION Luiz Otavio Torres 1 1 President Elect of the International Society of Sexual Medicine (ISSM) Testosterone Replacement Therapy (TRT) was – during the last 7 to 8 decades – associated with triggering or worsening of a prostate cancer. A meta-analysis in 2005 of 19 randomized controlled trials showed no statistically significant difference in the diagnosis of prostate cancer in men using TRT or placebo (1). A pooled-analysis of 18 population-based longitudinal studies comprising 3886 men with prostate cancer (PCa) and 6438 matched controls showed no association between endogenous androgen levels and the risk of developing PCa (2). [Read more]   Related Post Impact on sexual function of surgical treatment in rectal cancer views 112 Prostate Cancer – Local Treatment after Radiorecurrence: HIFU – High-I... views 141 Biochemical recurrence after radical prostatectomy: what does it mean? views 154 Radical Cystectomy is the best choice for most patients with muscle-in... views...

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Do we have enough evidences that make you safe to treat a man with hypogonadism one year after a radical prostatectomy for prostate cancer? | Opinion: Not Yet

Vol. 44 (1): 8-13, January – February, 2018 doi: 10.1590/S1677-5538.IBJU.2018.0004 DIFFERENCE OF OPINION Marcelo Langer Wroclawski 1, 2, Flavio Lobo Heldwein 3, 4 1 Hospital Israelita Albert Einstein, São Paulo, SP, Brasil; 2 Faculdade de Medicina do ABC, Santo André, SP, Brasil; 3 Universidade do Sul de Santa Catarina, SC, Brasil; 4 Universidade Federal de Santa Catarina, SC, Brasil Prostate cancer (PCa) is a heterogeneous disease. After almost a decade of contradictory screening recommendations made by expert and advisory panels (1), prostate cancer has risen again as the second leading cause of cancer death in American males (2). PCa is androgen dependent. Research on biological effects of testosterone and its relationship with PCa awarded Butenandt with the Nobel Prize in Chemistry in 1939, and Huggins with The Nobel Prize in Physiology or Medicine in 1966 (3, 4). In 1941, Huggins and Hodges observed that castration could cause a decrease of PCa serum marker activity and that administration of exogenous testosterone propionate resulted in its increase. Indeed, different research groups repeatedly showed that PCa culture cells are stimulated by administration of testosterone and that deprivation induces apoptosis (5, 6). These traditional assumptions are the base of metastatic PCa treatment until nowadays. [Read more]   Related Post Super-selective robot-assisted partial nephrectomy using near-infrared... views 93 Prostate Cancer – Local Treatment after Radiorecurrence: HIFU – High-I... views 141 Most of patients with localized prostate cancer will be treated in the... views 107 Magnetic resonance imaging and clinical findings in seminal vesicle pa... views...

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Biochemical recurrence after radical prostatectomy: what does it mean?

Vol. 44 (1): 14-21, January – February, 2018 doi: 10.1590/S1677-5538.IBJU.2016.0656 REVIEW ARTICLE Rafael Tourinho-Barbosa 1,2, Victor Srougi 1,3, Igor Nunes-Silva 1, Mohammed Baghdadi 1, Gregory Rembeyo 1, Sophie S. Eiffel 1, Eric Barret 1, Francois Rozet 1, Marc Galiano 1, Xavier Cathelineau 1, Rafael Sanchez-Salas 1 1 Department of Urology, Institut Montsouris, Université Paris-Descartes, Paris, France; 2 Divisão de Urologia, Faculdade de Medicina ABC, São Paulo, Brasil; 3 Divisão de Urologia, Universidade de São Paulo, São Paulo, Brasil ABSTRACT Background: Radical prostatectomy (RP) has been used as the main primary treatment for prostate cancer (PCa) for many years with excellent oncologic results. However, approximately 20-40% of those patients has failed to RP and presented biochemical recurrence (BCR). Prostatic specific antigen (PSA) has been the pivotal tool for recurrence diagnosis, but there is no consensus about the best PSA threshold to define BCR until this moment. The natural history of BCR after surgical procedure is highly variable, but it is important to distinguish biochemical and clinical recurrence and to find the correct timing to start multimodal treatment strategy. Also, it is important to understand the role of each clinical and pathological feature of prostate cancer in BCR, progression to metastatic disease and cancer specific mortality (CSM). Review design: A simple review was made in Medline for articles written in English language about biochemical recurrence after radical prostatectomy. Objective: To provide an updated assessment of BCR definition, its meaning, PCa natural history after BCR and the weight of each clinical/pathological feature and risk group classifications in BCR, metastatic disease and CSM.   Keywords: Prostatic Neoplasms; Prostate-Specific Antigen; Prostatectomy [Full Text] Related Post Impact on sexual function of surgical treatment in rectal cancer views 112 Clinical features of carriers of reciprocal chromosomal translocations... views 135 Magnetic resonance imaging and clinical findings in seminal vesicle pa... views 120 Int Braz J Urol Annual Report – 2017 views...

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Tissue-based molecular markers in upper tract urothelial carcinoma and their prognostic implications

Vol. 44 (1): 22-37, January – February, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0204 REVIEW ARTICLE Ricardo L. Favaretto 1, Stenio C. Zequi 1, Renato A. R. Oliveira 1, Thiago Santana 1, Walter H. Costa 1, Isabela W. Cunha 2, Gustavo C. Guimarães 1 1 Departamento de Cirurgia Pélvica, Serviço de Urologia AC Camargo Cancer Center, São Paulo, Brasil, São Paulo, Brasil; 2 Departamento de Patologia, AC Camargo Cancer Center, São Paulo, Brasil ABSTRACT Upper tract urothelial carcinoma (UTUC) is a rare and aggressive disease that is associated with high rates of recurrence and death. Radical nephroureterectomy (RNU) with excision of the bladder cuff is considered the standard of care for high-risk UTUC, whereas kidney-sparing techniques can be indicated for select patients with low-risk disease. There is a significant lack of clinical and pathological prognostic factors for stratifying patients with regard to making treatment decisions. Incorporation of tissue-based molecular markers into prognostic tools could help accurately stratify patients for clinical decision-making in this heterogeneous disease. Although the number of studies on tissue-based markers in UTUC has risen dramatically in the past several years—many of which are based on single centers and small cohorts, with a low level of evidence—many discrepancies remain between their results. Nevertheless, certain biomarkers are promising tools, necessitating prospective multi-institution studies to validate their function. Keywords: Carcinoma; Biomarkers; Prognosis [Full Text]   Related Post Retroperitoneal access for robotic renal surgery views 117 The demographic features, clinical outcomes, prognosis and treatment o... views 97 Impact of local treatment on overall survival of patients with metasta... views 91 Super-selective robot-assisted partial nephrectomy using near-infrared... views...

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Serum tissue factor as a biomarker for renal clear cell carcinoma

Vol. 44 (1): 38-44, January – February, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0007 ORIGINAL ARTICLE Daniel D’Oliveira Silva 1, Jorge A. P. Noronha 1, Bartira E. Pinheiro da Costa 2, Pedro Caetano Edler Zandona 1, Gustavo F. Carvalhal 1 1 Departamentos de Urologia, Pontifícia Universidade Católica, Porto Alegre, RS, Brasil; 2 Instituto de Pesquisas Biomédicas (BEP), Pontifícia Universidade Católica, Porto Alegre, RS, Brasil   ABSTRACT Purpose: to determine the usefulness of serum TF as a potential marker for patients with clear cell RCC. Materials and Methods: prospective study of 30 patients with clear cell RCC submit­ted to nephrectomy and 16 controls without clear cell RCC treated surgically for other conditions. TF is a endothelium marker that was correlated with worse prognosis in a variety of solid tumors including RCC. Serum TF was collected before surgery at the operating room and in the postoperative setting after at least four weeks. Serum samples were analyzed with a commercial ELISA kit for human TF (R&D Systems®). Results: Mean preoperative serum TF levels in clear cell RCC patients and in controls were 66.8 pg/dL and 28.4 pg/dL, respectively (p<0.001). Mean postoperative serum TF levels in clear cell RCC patients were 26.3 pg/dL. In all patients with clear cell RCC postoperative serum levels of TF were lower, with a mean reduction of 41.6 pg/dL in the postoperative setting (p<0.001). Linear regression revealed that tumor size was cor­related with the postoperative reduction of serum TF levels (p=0.037). Conclusions: We have shown a 3-fold reduction in the median preoperative serum levels of TF in patients with clear cell RCC after surgery. We have also shown a differ­ence of the same magnitude in the serum levels of TF compared with those of a control group of patients with benign diseases. TF appears to be a useful serum marker for the presence of clear cell RCC. Further studies are needed to validate these findings. Keywords: Kidney Neoplasms; Thromboplastin; Biomarkers [Full Text]   Related Post Simultaneous treatment of parapelvic renal cysts and stones by flexibl... views 128 Myiasis associated with penile carcinoma: a new trend in developing co... views 129 Protective effects of Tadalafil and darbepoetin against ischemia ̵... views 105 Minimally invasive treatment of female stress urinary incontinence wit... views...

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The demographic features, clinical outcomes, prognosis and treatment options for patients with sarcomatoid carcinoma of the urinary bladder: a single centre experience

Vol. 44 (1): 45-52, January – February, 2018 doi: 10.1590/S1677-5538.IBJU.2016.0347 ORIGINAL ARTICLE Simon Paul Robinson 1, Assad Farooq 2, Marc Laniado 3, Hanif Motiwala 3 1 Frimley Health Foundation Trust – Urologia, Wexham Street, Slough, United Kingdom, UK; 2 Heatherwood and Wexham Park Hospitals NHS Trust, Wexham Park Hospital Wexham Slough, Slough, United Kingdom, UK; 3 Department of Urology, Heatherwood and Wexham Park Hospitals NHS Trust – Slough, Berkshire, United Kingdom, UK ABSTRACT Introduction: Carcinosarcoma of the bladder is a very rare neoplasm. The pathogenesis of carcinosarcomas is not clearly understood and remains a subject of debate. Whilst there is some research conceptualizing the histopathological findings of bladder car­cinosarcomas, the demographic features, clinical outcomes, prognosis and treatment options remain unclear. Materials and Methods: We analyzed 12 consecutive cases of patients with sarco­ma-toid bladder cancer who were treated surgically at a single Urology Department be-tween 1999 and 2015. Radiology, pathology and surgical reports were reviewed to determine the pathological staging at the time of cystectomy. These were directly compared with 230 patients having cystectomies for urothelial cell carcinoma. The sarcomatoid patients, were compared to patients with urothelial cell cancers. The other histological sub types, squamous cell (17), neuroendocrine (9), metastatic (7), mixed (4), adenocarcinoma (3), were not included. Results and conclusion: Carcinosarcoma of the urinary bladder is often described in the literature as a highly malignant neoplasm that is rapidly lethal. We found that the sarcoma does not offer a worse prognosis than conventional high-grade urothelial car-cinoma. There is no significant difference in grade, stage, positive surgical margin rate, nodal involvement, associated prostate cancer or incidence rates of progression, all cause or disease specific mortality. There was a barely significant difference in car­cinoma in-situ. However, carcinosarcomas are three times the volume of urothelial cell tumors which may contribute to its reputation as an aggressive tumour (44cc v 14cc). Sarcomatous elements do not appear, from our small study, to bestow a worse prognosis. Keywords: Urinary Bladder; Sarcoma; Carcinoma [Full Text] Related Post Differences in the percutaneous nephrolithotomy practice patterns amon... views 194 Synchronous abdominal tumors: is combined laparoscopic surgery in a si... views 108 A Safe teaching protocol of LRP (laparoscopic radical prostatectomy) views 128 Myiasis associated with penile carcinoma: a new trend in developing co... views...

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Super-selective robot-assisted partial nephrectomy using near-infrared flurorescence versus early-unclamping of the renal artery: results of a prospective matched-pair analysis

Vol. 44 (1): 53-62, January – February, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0311 ORIGINAL ARTICLE Cecilia Lanchon 1, 2, Valentin Arnoux 1, Gaëlle Fiard 1, 2, Jean-Luc Descotes 1, 2, Jean-Jacques Rambeaud 1, Jean-Benjamin Lefrancq 1, Delphine Poncet 1, Nicolas Terrier 1, Camille Overs 1, Quentin Franquet 1, Jean-Alexandre Long 1, 2 1 Department of Urology, Grenoble University Hospital, Grenoble, France; 2 UJF-Grenoble 1, CNRS, INSERM, TIMC-IMAG UMR 5525, 38041 Grenoble, France   ABSTRACT   Introduction: Super-selective clamping of tumor-specific segmental arteries was developed to eliminate ischemia of the remnant kidney while limiting hemorrhage during partial nephrectomy. The objective is to evaluate the benefice of super-selective clamping on renal functional outcome, compared to early-unclamping of the renal artery. Materials and Methods: From March 2015 to July 2016, data from 30 patients undergoing super-selective robot-assisted PN (RAPN) for a solitary tumor by a single surgeon were prospectively collected. Tumor devascularization was assessed using indocyanine green near-infrared fluorescence. A matched-pair analysis with a retrospective cohort undergoing early-unclamping was conducted, adjusting on tumor complexity and preoperative eGFR. Perioperative, oncologic and functional outcomes using DMSA-renal scintigraphy were assessed. Multivariate analysis was performed to identify predictors of postoperative renal function and de novo chronic kidney disease (CKD). Results: Super-selective RAPN was successful in 23/30 patients (76.7%), 5 requiring secondary main artery clamping due to persistent tumor fluorescence. Matched-pair analysis showed similar operating time, blood loss, positives margins and complication rates. Super-selective clamping was associated with an improved eGFR variation at discharge (p=0.002), 1-month (p=0.01) and 6-month post-op (-2%vs-16% p=0.001). It also led to a better relative function on scintigraphy (46%vs40% p=0.04) and homolateral eGFR (p=0.04), and fewer upstaging to CKD stage ≥3 (p=0.03). On multivariate analysis, super-selective clamping was a predictor of postoperative renal function. Conclusion: Super-selective RAPN leads to an improved preservation of renal function and a reduced risk of de novo CKD stage≥3, while keeping the benefit of main artery clamping on perioperative outcomes. Keywords: Nephrectomy; Kidney; Ischemia [Full Text] Related Post Effect of platelet-rich plasma on polypropylene meshes implanted in th... views 103 Laparoscopic management of recurrent ureteropelvic junction obstructio... views 82 Do we have enough evidences that make you safe to treat a man with hyp... views 107 99mTc-DTPA Diuretic Renography with 3 hours late output fraction in th... views...

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