Vol. 44 n. 5 Set . Oct, 2018

Volume 44 | number 5 | Set . Oct, 2018 -The September-October 2018 issue of the International Braz J Urol presents original contributions with a lot of interesting papers in different fields: Renal stones, Prostate Cancer, Renal Cell Carcinoma, Laparoscopy, Vaginal Prolapse, BPH…

Partial nephrectomy: three dimensional (3D) models from preoperative computed tomography is the future to identify the exact loction of the tumor

Vol. 44 (5): 857-858, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2018.05.01 EDITORIAL Luciano A. Favorito 1, 2, 3 1 Professor Titular, Unidade Urogenital da Univ. Est. do Rio de Janeiro – UERJ, RJ, Brasil; 2 Urologista do Hospital da Lagoa Federal, Rio de Janeiro , RJ, Brasil; 3 Editor Associado do International Braz J Urol The September-October 2018 issue of the International Braz J Urol presents original contributions with a lot of interesting papers in different fields: Renal stones, Prostate Cancer, Renal Cell Carcinoma, Laparoscopy, Vaginal Prolapse, BPH, Varicocele, Testicular Torsion, Renal Cystis, Basic Research, HPV, Bladder Cancer, Bladder augmentation and Overactive bladder. The papers come from many different countries such as Brazil, USA, China, Turkey, Korea, Spain, Mexico, Iran and Israel, and as usual the editor ́s comment highlights some papers. We decided to comment the paper about a very interesting topic: Clinical applications of personalized 3D kidney model. [Full text]   Related Post Prognostic role of preoperative albumin to globulin ratio in predictin... views 227 The fate of some urologic innovations from the last century views 158 Editorial Comment: The protective effect of Papaverine and Alprostadil... views 254 Bladder diverticula with more than 5 cm increases the risk of acute ur... views...

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HPV vaccination is fundamental for reducing or erradicate penile cancer | Opinion: YES

Vol. 44 (5): 859-861, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2018.05.02 DIFFERENCE OF OPINION Brunno Raphael Iamashita Voris 1, Carolina Del Negro Visintin 2, Leonardo O. Reis 1, 3, 4 1 Departamento de Urologia, Universidade Estadual de Campinas, Unicamp, Campinas, SP, Brasil; 2 Departamento de Ginecologia, Pontifícia Universidade Católica de Campinas, PUC -Campinas, SP, Brasil; 3 UroScience, Campinas, SP, Brasil; 4 Departamento de Urologia, Pontifícia Universidade Católica de Campinas, PUC – Campinas, SP, Brasil Keywords: Human papillomavirus 31; Penile Neoplasms; Vaccination, Male Penile cancer is a rare tumor in developed countries; since its diagnosis is made usually in a late stage, it presents high morbidity and mortality. It is more prevalent in developing countries in Asia, Africa and South America, particularly in non-circumcised males (1). More common histology type is penile squamous cell carcinoma – PSCC (95%) related to the infection by the Human Papillomavirus (HPV) (2). HPV-DNA is found in more than 20% of patients with penile tumor and in 90% of anal cancers (3). The number of new patients with PSCC is increasing worldwide, including developed European countries (Denmark, Netherlands, England), and has been worried many health care professionals around the World (4). [Full text]   Related Post Do we have enough evidences that make you safe to treat a man with hyp... views 158 Editorial Comment: Gastric Neobladders: surgical outcomes of 91 cases ... views 96 A rare case of spontaneous renal rupture caused by anca – associ... views 128 Focal therapy will be the next step on prostate cancer management? | O... views...

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HPV vaccination is fundamental for reducing or erradicate penile cancer | Opinion: NO

Vol. 44 (5): 862-864, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2018.05.03 DIFFERENCE OF OPINION Paulo Ornellas 1, Antonio Augusto Ornellas 2, 3 1 Departamento de Patologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil; 2 Departamento de Urologia, Instituto Nacional do Câncer (INCA), Rio de Janeiro, RJ, Brasil; 3 Instituto de Pós-Graduação Médica Carlos Chagas, Rio de Janeiro, RJ, Brasil Keywords: Human papillomavirus; Penile Neoplasms; Vaccination, Male Human papillomavirus (HPV) is a DNA virus that presents tropism for epithelial cells, causing infections of the skin and mucous membranes. It is transmitted by direct contact of a healthy skin or mucosa with an affected skin or mucosa. Until now, more than 200 types of HPVs have been discovered (1). Approximately 30 types infect the anal and genital mucosa. Types that can also be detected in the oral mucosa are classified according to risk of causing lesions or their potential for malignancy. Such as “low risk” are included types 6 and 11 (more incidents) and as “high risk” the types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 66 (2). Human papillomavirus (HPV), a sexually transmitted infection, is responsible for 99.7% of cases of cervical cancer (3) and 530,000 new cases of cervical cancer globally every year (4). In addition, HPV is also responsible for some head and neck cancers, penile cancers and the majority of anal cancers (5). The incidence of these cancers is on the rise. Globally, HPV types 16 and 18 are responsible for 38,000 (85%) new cases of head and neck cancers and 35,000 (87%) cases of anal cancers (4). [Full text]   Related Post Prognostic role of preoperative albumin to globulin ratio in predictin... views 227 A rare case of spontaneous renal rupture caused by anca – associ... views 128 Laparoscopic dismembered pyeloplasty combined with port entrance flexi... views 180 BPH treatment: laser for everyone | Opinion: YES views...

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5-alpha Reductase Inhibitors and risk of male breast cancer: a systematic review and meta-analysis

Vol. 44 (5): 865-873, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0531 REVIEW ARTICLE Jiamin Wang 1, Shankun Zhao 1, Lianmin Luo 1, Ermao Li 1, Xiaohang Li 1, ZhiGang Zhao 1 1 Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, Guangdong, China  ABSTRACT  Objective: To assess the relationship between 5α-reductase inhibitors (5ARIs) and the risk of male breast cancer (MBC). Material and Methods: We systematically searched Medline via PubMed, Embase and the Cochrane Library Central Register up to May 2017 to identify published articles related to 5ARIs and the risk of MBC. Results: Summary effect estimates were calculated by a random-effect model, and tests for multivariable-unadjusted pooled risk ratios (RR) and heterogeneity, as well as the sensitivity analyses were conducted to assess publication bias. All four studies were conducted in a quality assessment according to the Newcastle Ottawa Scale system. The strength of association between 5ARIs and the prevalence of MBC was evaluated by using summarized unadjusted pooled RR with a 95% confidence interval [CI]. Four studies involving 595.776 participants, mean age range from 60 to 73.2 years old, were included in a meta-analysis, which produced a summary unadjusted RR of the risk of MBC for the treatment of 5ARIs of 1.16 (95% CI 0.85-1.58, P=0.36) and the multivariable-adjusted RR is 1.03, (95% CI 0.75-1.41, p=0.86). There was no heterogeneity among included studies (I2=0%, P=0.49). Estimates of total effects were generally consistent with the sensitivity. Conclusion: We did not observe a positive association between the use of 5ARIs and MBC. The small number of breast cancer cases exposed to 5ARIs and the lack of na association in our study suggest that the development of breast cancer should not influence the prescribing of 5ARIs therapy.  Keywords: 5-alpha Reductase Inhibitors; Breast Neoplasms, Male; Meta-Analysis as Topic [Full Text]   Related Post Impact of intravesical hyaluronic acid treatment on bladder inflammati... views 134 Gastric neobladders: surgical outcomes of 91 cases using different tec... views 199 Laparoscopic management of paraganglioma in a pregnant woman: a case r... views 186 Female urinary incontinence and sexuality views...

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Incidence and treatment of malignant tumors of the genitourinary tract in renal transplant recipients

Vol. 44 (5): 874-881, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0471 ORIGINAL ARTICLE Juan Manuel Ochoa-Lopez 1, Bernardo Gabilondo-Pliego 1, Sylvain Collura-Merlier 1, Jaime O. Herrera-Caceres 1, Mariano Sotomayor de Zavaleta 1, Francisco Tomas Rodriguez-Covarrubias 1, Guillermo Feria-Bernal 1, Fernando Gabilondo-Navarro 1, Ricardo Alonso Castillejos-Molina 1 1 Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México ABSTRACT Purpose: To provide data of the incidence and management of common urological malignancies in renal transplant recipients. Materials and Methods: We conducted a retrospective analysis of a prospective database from August 1967 to August 2015. A descriptive analysis of the sample was performed. Results: Among 1256 consecutive RTR a total of 88 patients developed malignancies (7%). There were 18 genitourinary tumors in the 16 patients (20.45 % of all malignant neoplasms), incidence of 1.27%. The most common neoplasm encounter was renal cancer (38.8%), followed by urothelial carcinoma (33.3%). Median follow-up of transplantation was 197 months (R, 36-336). Mean time from RT to cancer diagnosis 89±70 months (R, 12-276). CsA and AZA was the most common immunosuppression regimen in 68.75%. Mean follow-up after diagnosis was 103±72 months (R 10-215). Recurrence free survival rate of 100%. Overall survival of 89.5% of the sample; there were two non-related cancer deaths during follow-up. Conclusions: The incidence of neoplasms in RTR was lower than in other series, with favorable functional and oncologic results after treatment. This suggests that actions to reduce the risk of these malignancies as well as a strict follow-up are mandatory for an early detection and treatment.   Keywords: Neoplasms; Urinary Tract; Kidney Transplantation [Full Text]   Related Post Emergency percutaneous nephrostomy versus emergency percutaneous nephr... views 126 Inflatable penile prosthesis as tissue expander: what is the evidence? views 173 Gastric neobladders: surgical outcomes of 91 cases using different tec... views 199 Serum tissue factor as a biomarker for renal clear cell carcinoma views...

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Objective value on ADC map to categorize the intensity of DWI restriction for prostate cancer detection on MRI

Vol. 44 (5): 882-891, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2018.0038 ORIGINAL ARTICLE Thais Caldara Mussi 1, Tatiana Martins 1, 2, Adriano Tachibana 1, Pedro Nogueira Mousessian 1, Ronaldo Hueb Baroni 1 1 Hospital Israelita Albert Einstein, São Paulo, SP, Brasil and 2 Ecoar Medicina Diagnostica, Belo Horizonte, MG, Brasil ABSTRACT Purpose: To identify objective and subjective criteria on multiparametric prostate MRI that can be helpful for prostate cancer detection. Materials and Methods: Retrospective study, IRB approved, including 122 patients who had suspicious lesion on MRI and who underwent prostate biopsy with ultraso­nography (US)/MRI imaging fusion. There were 60 patients with positive biopsies and 62 with negative biopsies. MRI of these patients were randomized and evaluated inde­pendently by two blinded radiologists. The following variables were analyzed in each lesion: morphology, contours, T2 signal, diffusion restriction (subjective impression and objective values), hyper-enhancement, contact with transition zone or prostatic contour, prostatic contour retraction, Likert and PIRADS classification. Results: Apparent diffusion coefficient (ADC) value was the best predictor of positivity for prostate cancer, with mean value of 1.08 (SD 0.20) and 1.09 mm2/sec (SD 0.24) on negative biopsies and 0.81 (SD 0.22) and 0.84 mm2/sec (SD 0.22) on positive biopsies for readers 1 and 2, respectively (p < 0.001 in both analysis). For the others categori­cal variables evaluated the best AUC for reader 1 was subjective intensity of diffusion restriction (AUC of 0.74) and for reader 2 was hyper-enhancement (AUC of 0.65), all inferior comparing to the value of ADC map. Interobserver agreement ranged from 0.13 to 0.75, poor in most measurements, and good or excellent (kappa > 0.6) only in lesion size and ADC values. Conclusions: Diffusion restriction with lower ADC-values is the best parameter to pre­dict cancer on MRI prior to biopsy. Efforts to establish an ADC cutoff value would improve cancer detection, especially for less experience reader.   Keywords: Magnetic Resonance Imaging; Prostatic Neoplasms; Prostate [Full Text]   Related Post Attenuation of partial unilateral ureteral obstruction -induced renal ... views 150 Evaluation of apoptosis indexes in currently used oral alpha-blockers ... views 188 Does the experience of the bedside assistant effect the results of rob... views 106 Synchronous abdominal tumors: is combined laparoscopic surgery in a si... views...

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Impact of 68GA-PSMA PET / CT on treatment of patients with recurrent / metastatic high risk prostate cancer – a multicenter study

Vol. 44 (5): 892-899, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0632 ORIGINAL ARTICLE Aline B. Mattiolli 1, Allan Santos1,2,3, Andreia Vicente 3, Marcelo Queiroz 3, Diogo Bastos 3, Daniel Herchenhorn 4, Miguel Srougi 3, Fabio A. Peixoto 5, Lisa Morikawa 4, 5, João Luiz Fernandes da Silva 3, Elba Etchebehere 1, 2, 3 1 Universidade Estadual de Campinas (UNICAMP), Campinas, Brasil; 2 Medicina Nuclear de Campinas, Campinas, SP, Brasil; 3 Hospital Sírio – Libanês, São Paulo, SP, Brasil; 4 Centro de Oncologia de D’Or, Rio de Janeiro, RJ, Brasil; 5 Grupo Américas Centro de Oncologia Integrado, Rio de Janeiro, RJ, Brasil ABSTRACT Purpose: The purpose of our study was to evaluate the clinical impact of 68Ga-PSMA PET / CT in the setting of biochemical recurrence of prostate cancer. Materials and Methods: We retrospectively evaluated 125 prostate cancer patients submitted to the 68Ga-PSMA PET / CT due to biochemical recurrence. The parameters age, Gleason score, PSA levels, and the highest SUVmax were correlated to potential treatment changes. The highest SUVmax values were correlated with age and Gleason score. The median follow-up time was 24 months. Results: 68Ga-PSMA PET / CT led to a treatment change in 66 / 104 (63.4%) patients (twenty-one patients were lost to follow-up). There was a significant change of treatment plan in patients with a higher Gleason score (P = 0.0233), higher SUVmax (p = 0.0306) and higher PSA levels (P < 0.0001; median PSA = 2.55 ng / mL). Conclusion: 68Ga-PSMA PET / CT in prostate cancer patients with biochemical recurrence has a high impact in patient management. Keywords: Prostatic Neoplasms; Tomography, X-Ray Computed; Positron-Emission Tomography [Full Text]   Related Post The diagnostic value of FNDC5/Irisin in Renal Cell Cancer views 168 Cystoscopy-assisted laparoscopy for bladder endometriosis: modified li... views 112 Dramatic polarization in genitourinary expert opinions regarding the c... views 77 Evaluation of urodynamic parameters after sling surgery in men with po... views...

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Dynamic 11C-Choline PET / CT for the primary diagnosis of prostate cancer

Vol. 44 (5): 900-905, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2018.0035 ORIGINAL ARTICLE Shay Golan 1, Meital Nidam 2, Hanna Bernstine 2, Jack Baniel 1, David Groshar 2 1 Institute of Urology, and 2 Department of Nuclear Medicine, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Sackler Faculty of Medicine, Israel   ABSTRACT Objectives: To test the ability of dynamic 11C-PET / CT to discriminate cancerous tissue from background tissue in patients with localized prostate cancer. Materials and Methods: Twenty-four consecutive patients with prostate cancer were prospectively evaluated with dynamic 11C-choline PET / CT prior to radical prostatectomy. The PET / CT scan was divided into 18 sequences of 5 seconds each, followed by 9 sequences of 60 seconds each. Whole-mount sections of harvested prostates served as reference standards. Volumes of interest were positioned on the dynamic PET / CT images and the following quantitative variables were calculated: perfusion coefficient (K1), washout constant (K2), area under the curve (AUC) at 175 and 630 seconds, and average and maximum standardized uptake values (SUVavg, and SUVmax). Wilcoxon signed-ranks test was used to compare benign and cancerous areas of the prostate. Results: Areas of cancerous tissue were characterized by higher SUVavg and SUVmax than areas of benign tissue (3.67 ± 2.7 vs. 2.08 ± 1.3 and 5.91 ± 4.4 vs. 3.71 ± 3.7, respectively, P < 0.001), in addition to a higher K1 (0.95 ± 0.58 vs. 0.43 ± 0.24, P < 0.001) and greater cumulative tracer uptake, represented by the AUC at 175 and 630 seconds (P <0.001). No associations were found between dynamic parameters and preoperative prostate specific antigen level or Gleason score. Conclusions: In this pilot study, 11C-choline PET / CT demonstrated increased tracer uptake with higher values of static and dynamic parameters in areas of prostate cancer compared to areas of benign tissue. Larger studies are warranted to validate these results and examine the potential applicability of 11C-choline dynamic PET / CT for the diagnosis of prostate cancer. Keywords: Positron-Emission Tomography; Tomography, X-Ray Computed; Prostatic Neoplasms [Full Text]   Related Post The association between the outcomes of extraperitoneal laparoscopic r... views 139 Analysis of the association between bladder carcinoma and arsenic conc... views 148 Impact of testicular sperm extraction and testicular sperm aspiration ... views 151 Moderate or severe LUTS is associated with increased recurrence of non... views...

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Analysis of the association between bladder carcinoma and arsenic concentration in soil and water in southeast Brazil

Vol. 44 (5): 906-913, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0543 ORIGINAL ARTICLE Jonathan Doyun Cha 1, Danilo Budib Lourenço 2, Fernando Korkes 1, 2 1 Departamento de Urologia, Faculdade de Medicina do ABC, SP, Brasil; 2 Departamento de Urologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil ABSTRACT In approximately 50% of cases of bladder carcinoma, an associated predisposing factor can be established. The main factors are exposure to tobacco, arsenic (As) ore and aromatic compounds. Arsenic is a metalloid with a low average concentration in the earth’s crust, and one of the most dangerous substances for human health. The present study aims to evaluate the incidence of hospitalization and mortality from bladder neoplasia and its possible association with As concentration in water and soil in two of the most critical regions of Brazil: the states of São Paulo and Minas Gerais. We have investigated bladder cancer hospitalization and mortality in the states of São Paulo and Minas Gerais during 2010-2014. Water and soil samples were analyzed and As concentrations were established. Data were obtained through the Department of Informatics of the Brazilian Unified Health System. Correlation was made with water samples from São Paulo and with data on soil analysis from Minas Gerais. The results revealed no direct association in the distinctive municipalities. Areas with high environmental As concentration had a low bladder cancer rate, while areas with normal as levels had similar cancer rates. The quantitative variables did not present a normal distribution (p < 0.05). In conclusion, we did not observe a correlation between as concentration in water or soil and bladder cancer’s hospitalization and mortality rates in the states of São Paulo and Minas Gerais. Keywords: Arsenic; Urinary Bladder; Neoplasms [Full Text]   Related Post Research prioritization of men’s health and urologic diseases views 128 Impact of intravesical hyaluronic acid treatment on bladder inflammati... views 134 An unusual cause of renal colic: ovarian teratoma views 123 A new material to prevent urethral damage after implantation of artifi... views...

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Gastric neobladders: surgical outcomes of 91 cases using different techniques

Vol. 44 (5): 914-919, September – October, 2018 doi: 10.1590/S1677-5538.IBJU.2017.0563 ORIGINAL ARTICLE Aloysio Floriano de Toledo 1, Carlos Eduardo Bastian da Cunha 1, Christian Heinz Steppe 1, Daniel Weissbluth de Toledo 1, Jorge Antonio Pastro Noronha 1, Gustavo Carvalhal 1 1 Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul – PUC, Porto Alegre, RS, Brasil ABSTRACT   Introduction: We report on the surgical results of a series of 91 patients who received gastric neobladders as urinary diversion after radical cystectomies performed for the treatment of muscle-invasive bladder cancers. Materials and Methods: We report on a retrospective case series of 91 patients who recei­ved gastric neobladders as urinary diversion after radical cystectomies performed for the treatment of muscle-invasive bladder cancers. Different techniques of gastric neoblad­ders were employed from 1988 to 2013 at a university hospital in the South of Brazil. Results: Initial outcomes utilizing Leong (Antral) and Nguyen-Mitchell (Wedge) tech­nique were unsatisfactory, yielding high pressure, low capacity reservoirs. Further devel­opments of these techniques, with the detubularized gastric neobladder and the “spheri­cal” gastric neobladders resulted in low pressure, high capacity reservoirs, with better surgical and urodynamic outcomes. Complication and perioperative mortality rates of our series of gastric neobladders were significantly higher than historical results of tech­niques using ileum or colon. Conclusions: Stomach is an exceptional option for the creation of neobladders after radical cystectomies, but due to the increased complication rates it should be reserved for specific situations (e.g., renal insufficiency, previous pelvic/abdominal radiotherapy, short bowel syndromes). Keywords: Surgical Procedures, Operative; Urinary Diversion; Cystectomy [Full Text]   Related Post Vitamin C inhibits crystallization of struvite from artificial urine i... views 206 Emergency percutaneous nephrostomy versus emergency percutaneous nephr... views 126 Predictors of surgical complications of nephrectomy for urolithiasis views 70 Dipyridamole reduces penile apoptosis in a rat model of post-prostatec... views...

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