Selection process for the new Editor-in-Chief of the International Brazilian Journal of Urology

Second brazilian consensus on the treatment of advanced prostate cancer – a SBOC-SBU-SBRT panel review

Vol. 45 (x): 2019 April 4.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0798 ORIGINAL ARTICLE Andre Deeke Sasse 1, Rodolfo Borges dos Reis 2, Lucas Mendes Nogueira 3, Fernando Cotait Maluf 4, Daniel Herchenhorn 5, Oren Smaletz 6, Volney Soares Lima 7, Fabio Schutz 4, Diogo Bastos 8, Evanius Garcia Wiermann 9, Igor Alexandre Protzner Morbeck 10, Leo-nardo Fontes Jardim 8, Vinicius Carrera Souza 9, Icaro Thiago Carvalho 6, Elton Trigo Tei-xeira Leite 11, Archimedes Nardozza Jr. 12, Antonio Carlos Lima Pompeo 13, Francisco Bre-tas 14, Marcos Lima de Oliveira Leal 15, Marcus Vinicius Sadi 12, Jose Ricardo Tuma da Ponte 16, Gustavo Carvalhal 17 1 Grupo SONHE, Oncologia, Campinas, SP, Brasil; 2 Departamento de Urologia, Universi-dade de São Paulo- USP, Campus de Ribeirão Preto, Ribeirão Preto, SP, Brasil; 3 Divisão de Urologia e Departamento de Cirurgia Hospital das Clínicas, Universidade Federal de MG – UFMG, Belo Horizonte, MG, Brasil; 4 Hospital Beneficência Portuguesa de São Pau-lo, SP, Brasil; 5 Rede D’Or São Luiz, Rio de Janeiro, Brasil; 6 Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, Brasil; 7 Oncocentro, Belo Horizonte, MG, Brasil; 8 Departamento de Oncologia, Instituto do Câncer do Estado de São Paulo – ICESP, SP, Brasil; 9 Sociedade Brasileira de Oncologia Clinica – SBOC, Belo Horizonte, MG, Bra-sil; 10 Clinica AMO, Salvador, Bahia, Brasil; 11 Hospital Sírio-Libanês, São Paulo, SP, Brasil; 12 Departamento de Urologia e Cirurgia, Universidade Federal de São Paulo – UNIFESP, São Paulo, SP, Brasil; 13 Faculdade de Medicina do ABC, Urologia, Santo André, Brasil; 14 Hospital Mater Dei, Belo Horizonte, MG, Brasil; 15 Departamento de Urologia, Universidade Federal da Bahia – UFBA, Salvador, Bahia, Brasil; 16 Departamento de Urologia, Universi-dade do Estado do Pará – UEPA, Belém, PA, Brasil; 17 Divisão de Urologia e Departamento de Cirurgia, Pontifícia Universidade Católica do Rio Grande do Sul – PUC RS, Porto Ale-gre, RS, Brasil   ABSTRACT Prostate cancer is the second most common cancer and the fifth leading cause of cancer deaths. In Brazil, it is likewise the second most common cancer among men, second only to non-melanoma skin cancers. The aim of this consensus is to align different opinions and interpretations of the medical literature in a practical and patient-oriented approach. The first Brazilian Con-sensus on the Treatment of Advanced Prostate Cancer was published in 2017, with the goal of reducing the heterogeneity of therapeutic conduct in Brazilian patients with metastatic prostate cancer. We acknowledge that in Brazil the incorporation of different technologies is a big challenge, especially in the Sistema Único de Saúde (SUS), which allows for the disparity in the options available to patients treated in different institutions. In order to update the recommendations and to make them objective and easily accessible, once more a panel of specialists was formed in order to discuss and elaborate a new Brazilian Consensus on Advanced Prostate Cancer. This Consensus was written through a joint initiative of the Brazilian Society of Clinical Oncology (SBOC) and the Brazilian Society of Urology (SBU) to support the clinical decisions of physicians and other health professionals involved in the care of patients with prostate cancer. Keywords: Prostatic Neoplasms; Therapeutics; Consensus [Full...

read more

Penile skin flap: a versatile substitute for anterior urethral stricture

Vol. 45 (x): 2019 April 4.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0652 SURGICAL TECHNIQUE Wissem Hmida 1, Mouna Ben Othmen 1, Amidou Bako 1, Mehdi Jaidane 1, Faouzi Mosbah 1 1 Department of Urology, Sahloul Hospital Sousse, Sousse, Tunísia ABSTRACT Purpose: Penile skin fl ap uretroplasty is a useful technique for a long urethral stricture due to the ample length and surgical handling characteristics. We investigated the surgical technique and initial results of uretroplasty for anterior urethral strictures using a dorsal penile skin flap. Patients and methods: From January 2003 to January 2018, a total of 77 patients underwent substitution urethroplasty using dorsal penile skin fl ap for bulbar urethral strictures in our institution. All patients were assessed preoperatively, and followed postoperatively by physical examination, urinalysis, retrograde and voiding urethrography, urofl owme-try and post-void residual urine measurement. Success was defi ned as no requirement of additional urethral instru-mentation. Results: The mean age was 45 years (10-87). The mean stricture length was 5cm (3-10cm). The mean fl ap length was 6cm. Urinary fi stula was the most common postoperative complication. The mean follow-up was 60 months (6-120). The overall success rate was 88%. Recurrent strictures were found in 4 patients (5%) at 1 year. At 3 year follow-up, 5 (7%) more patients had recurrences. All recurrences were managed by internal urethrotomy. Conclusions: Substitution urethroplasty using penile skin fl ap appear to be a safe and effi cient technique for the treatment of a long and complex anterior urethral stricture. It provides encouraging cosmetic and functional results. Keywords: Penis; Urethral Stricture; Bulbourethral Glands [Full...

read more

Spontaneous gas in a retroperitoneal mass: check the testis!

Vol. 45 (x): 2019 March 3.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0606 RADIOLOGY PAGE Jérémy Dana 1, Florian Maxwell 1, 2, David. Eiss 3, Laurence Rocher 1, 2, 4 1 Department of Diagnostic & Interventional Radiology, Hôpitaux Universitaires Paris Sud, Site Bicêtre, Le Kremlin-Bicêtre, France; 2 Faculté Paris Sud, Le Kremlin-Bicêtre, France; 3 IR4M, CNRS, imagerie par résonance magnétique médicale et multi-modalités, CNRS Université Paris Sud, Orsay Cedex, France; 4 Department of Diagnostic & Interventional Radiology, Hôpital Necker, Paris, France ABSTRACT Testicular germ cell tumor is the most common cancer in 20-to 35-years-old men. There are known risk factors such as undescended testicle(s) and history of testicular cancer. Most lesions are germ cell tumors with two main subtypes: seminomas and non-seminomatous germ cell tumors. [Full...

read more

Intraoperative serious complications of laparoscopic urological surgeries: a single institute experience of 4,380 procedures

Vol. 45 (x): 2019 April 4.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0601 ORIGINAL ARTICLE Ju Guo 1, Zhigang Zeng 1, Runfu Cao 1, Jieping Hu 1 1 Department of Urology, The First Affi liated Hospital of Nanchang University, Nanchang, Jiangxi, China ABSTRACT This study aimed to share a single institute experience of 4,380 procedures about in-traoperative serious complications of laparoscopic urological surgeries. From January 2005 to December 2013, 4,380 cases of laparoscopic urological surgeries were recruited in our department. The distribution, incidence, and characteristics of intraoperative serious complications were retrospectively sorted out and analyzed. The surgeries were divided into three groups: very diffi cult (VD), diffi cult (D), and easy (E). The com¬plication at Satava class II was defi ned to be serious. One hundred thirty one cases with intraoperative serious complications were found (3.0%). The incidence of these complications was signifi cantly increased along with the diffi culty of the surgeries (P<0.05). The highest morbidity of serious complication belonged to total cystectomy with a ratio of about 17% as compared with other surgeries (P<0.05). The types of these complications included small vascular injury demanding blood transfusion (101 cases, 77.1%), large vascular (venous and artery) injury (16 cases), hypercapnia & acidosis (8 cases), and organ injury (6 cases). The cases of conversion to open surgery were 37 (≤1%). There was no signifi cant difference in the rates of conversion to open surgery among the three groups (P>0.05). The overall tendency of the intraoperative serious complications was decreasing with the time from 2005 to 2013. In conclusion, through standardized training including improving the surgical technique, being familiar with the anatomic relationship, and constantly summarizing the experience and lessons, laparoscopic surgery could be safe and effective with not only minimal invasion but also few complications. Keywords: Urology; Laparoscopy; Intraoperative Complications [Full...

read more

Vol. 45 N. 02, 2019

Vol. 45 N. 02, 2019

Int Braz J Urol. Vol. 45 N. 02 – 2019 Download the PDF file . EDITORIAL IN THIS ISSUE 208 | The future of inguinal Lymphadenecotmy in penile cancer: laparoscopic or robotic? Luciano Favorito [view article] DIFFERENCE OF OPINION 210 | Super active surveillance for low-risk prostate cancer | Opinion: Yes Leonardo O. Reis, Danilo L. Andrade, Fernando J. Bianco Jr. [view article] 215 | Super active surveillance for low-risk prostate cancer | Opinion: No Saum Ghodoussipour, Amir Lebastchi, Peter Pinto, Andre Berger [view article]  REVIEW ARTICLE 220 | Role of Adiponectin in prostate cancer Xiaobo Hu, Cong Hu, Caiping Zhang, Min Zhang, Shiyin Long, Zhaohui Cao [view article]  ORIGINAL ARTICLE 229 | The TNM 8th edition: Validation of the proposal for organ – confined (pT2) prostate cancer Athanase Billis, Leandro L. L. Freitas, Larissa B. E. Costa, Icleia S. Barreto, Luis A. Magna, Wagner E. Matheus, Ubirajara Ferreira [view article] 237 | Salvage radiotherapy for biochemical recurrence after radical prostatectomy: does the outcome depend on the prostate cancer characteristics? Gustavo Arruda Viani, Ana Carolina Hamamura, Alexandre Ciuffi Correa, Felipe Teles de Arruda [view article] 246 | Can expressed prostatic secretions affect prostate biopsy decision of urologist? Osman Ergün, Erdem Çapar, Yunus Emre Göğer, Ayşe Gül Ergün [view article] 253 Safety and effectiveness evaluation of open reanastomosis for obliterative or recalcitrant anastomotic stricture after radical retropubic prostatectomy Carlos Roberto Giúdice, Patricio Esteban Lodi, Ana Milena Olivares, Ignacio Pablo Tobia, Gabriel Andrés Favre [view article] 262 | Robot assisted radical prostatectomy in kidney transplant recipients: surgical, oncological and functional outcomes of two different robotic approaches Francesco Alessandro Mistretta, Antonio Galfano, Ettore Di Trapani, Dario Di Trapani, Andrea Russo, Silvia Secco, Matteo Ferro, Gennaro Musi, Aldo Massimo Bocciardi, Ottavio de Cobelli [view article] 273 | Is moderate hypofractionation accepted as a new standard of care in north america for prostate cancer patients treated with external beam radiotherapy? Survey of genitourinary expert radiation oncologists Shearwood McClelland III, Kiri A. Sandler, Catherine Degnin, Yiyi Chen, Arthur Y. Hung, Timur Mitin [view article] 288 | Prostate brachytherapy with iodine-125 seeds: analysis of a single institutional cohort Elton Trigo Teixeira Leite, João Luis Fernandes da Silva, Eduardo Capelletti, Cecilia Maria Kalil Haddad, Gustavo Nader Marta [view article] 299 | Small cell bladder cancer: should we consider prophylactic cranial irradiation? Tara Nikonow Morgan, Robert M. Turner II, Julian Baptiste, Timothy D. Lyon, Jodi K. Maranchie, Ronald L. Hrebinko, Benjamin J. Davies, Jeffrey R. Gingrich, Bruce L. Jacobs [view article] 306 | Moderate or severe LUTS is associated with increased recurrence of non – muscle – invasive urothelial carcinoma of the bladder Austin Lunney, Allan Haynes, Pranav Sharma [view article] 315 | Can Neutrophil-to-Lymphocyte ratio predict the response to BCG in high-risk non muscle invasive bladder cancer? Marco Racioppi, Luca Di Gianfrancesco, Mauro Ragonese, Giuseppe Palermo, Emilio Sacco, Pier Francesco Bassi [view article] 325 | Initial experience of video endoscopic inguinal Lymphadenectomy in a center located at northeast brazilian region Aurus Dourado Meneses, Pablo Aloisio Lima Mattos, Walberto Monteiro Neiva Eulálio Filho, Taíla Sousa de Moura Fé, Rodolfo Myronn de Melo Rodrigues, Marcos Tobias-Machado [view article] 332 | Clinicopathological characteristics of surgically treated localized renal masses in patients previously exposed to chemotherapy Efrat Tsivian, Matvey Tsivian, Christina Sze, Ariel Schulman, Thomas J. Polascik [view article] 340 |...

read more

Non-functional paraganglioma of urinary bladder managed by transurethral resection

Vol. 45 (x): 2019 April 4.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0604 ORIGINAL ARTICLE Baochao Zhang 1, Zhenrui Fu 1, Liwei Liu 1, Baomin Qiao1, Chunyu Liu 1 1 Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China ABSTRACT Purpose: As a rare bladder tumor, paraganglioma of the urinary bladder (PUB) is frequently misdiagnosed as bladder cancer, particularly for the non-functional type. To date, transurethral resection remains a controversial treatment for non-functional PUB. This study aimed to identify the clinical features, pathological characteristics, prognosis, and safe/effective treatment of non-functional PUB using transurethral resection of the bladder tumor (TURBT). Materials and Methods: The clinical records, radiological data, pathological characteristics and follow-up times were retrospectively reviewed in 10 patients with clinically and pathologically proven non-functional PUB in our hospital from January 2008 to November 2016. All patients underwent TURBT treatment. Results: The incidence of non-functional PUB in patients with bladder cancer was 0.17%. The mean age at diagnosis was 44.5 ± 13.6 years (range, 29-70 years), and the patient population had a female: male ratio of 3: 2. No patients had excess catecholamine (CA) whilst four patients had painless hematuria. All neoplasms were completely resected via TURBT. The majority of samples were positive for immunohistochemical markers including chromogranin A (CgA) and Synaptophysin (Syn), but were negative for cytokeratins (CKs). Only a single recurrence was observed from the mean follow-up period of 36.4 ± 24.8 months. Conclusion: Complete TURBT is a safe and effi cient treatment that serves both diagnostic and therapeutic purposes. Histopathological and immunohistochemistry examinations are mandatory for diagnostic confi rmation. Long-term follow-up is recommended for patients with non-functional PUB. Keywords: Paraganglioma; Urinary Bladder; Transurethral Resection of Prostate [Full...

read more

Predictors of complication after adrenalectomy

Vol. 45 (x): 2019 March 3.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0482 ORIGINAL ARTICLE Victor Srougi 1, Joao A. B. Barbosa 1, Isaac Massaud 1, Isadora P. Cavalcante 2, Fabio Y. Tanno 1, Madson Q. Almeida 2, Miguel Srougi 1, Maria C. Fragoso 2, José L. Chambo 1 1 Divisão de Urologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil; 2 Divisão de Endocrinologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil ABSTRACT Purpose: To investigate risk factors for complications in patients undergoing adrenalectomy. Materials and Methods: A retrospective search of our institutional database was performed of patients who underwent adrenalectomy, between 2014 and 2018. Clinical parameters and adrenal disorder characteristics were assessed and correlated to intra and post-operative course. Complications were analyzed within 30-days after surgery. A logistic regression was performed in order to identify independent predictors of morbidity in patients after adrenalectomy. Results: The fi les of 154 patients were reviewed. Median age and Body Mass Index (BMI) were 52-years and 27.8kg/m2, respectively. Mean tumor size was 4.9±4cm. Median surgery duration and estimated blood loss were 140min and 50mL, respectively. There were six conversions to open surgery. Minor and major post-operative complications occurred in 17.5% and 8.4% of the patients. Intra-operative complications occurred in 26.6% of the patients. Four patients died. Mean hospitalization duration was 4-days (Interquartile Range: 3-8). Patients age (p=0.004), comorbidities (p=0.003) and pathological diagnosis (p=0.003) were independent predictors of post-operative complications. Tumor size (p<0.001) and BMI (p=0.009) were independent predictors of intra-operative complications. Pathological diagnosis (p<0.001) and Charlson score (p=0.013) were independent predictors of death. Conclusion: Diligent care is needed with older patients, with multiple comorbidities and harboring unfavorable adrenal disorders (adrenocortical carcinoma and pheocromocytoma), who have greater risk of post-operative complications. Patients with elevated BMI and larger tumors have higher risk of intra, but not of post-operative complications. Keywords: Adrenalectomy; Morbidity; Pathology [Full...

read more

Predicting urine output after kidney transplantation: development and internal validation of a nomogram for clinical use

Vol. 45 (x): 2019 March 3.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0701 ORIGINAL ARTICLE Aderivaldo Cabral Dias Filho 1,2, João Ricardo Alves 1, Pedro Rincon Cintra da Cruz 1,3, Viviane Brandão Bandeira de Mello Santana 4, Cassio Luis Zanettini Riccetto 2 1 Unidade de Urologia e Transplante Renal, Instituto Hospital de Base do Distrito Federal (IHB), Brasília, DF, Brasil; 2 Divisão de Urologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brasil; 3 Divisão de Urologia, Hospital Universitário de Brasília (HUB), Brasília, DF, Brasil; 4 Unidade de Nefrologia e Transplante Renal, Instituto Hospital de Base do Distrito Federal (IHB), Brasília, DF, Brasil ABSTRACT Purpose: To analyze pre-transplantation and early postoperative factors affecting post-transplantation urine output and develop a predictive nomogram. Patients and Methods: Retrospective analysis of non-preemptive first transplanted adult patients between 2001-2016. The outcomes were hourly diuresis in mL/Kg in the 1st (UO1) and 8th (UO8) postoperative days (POD). Predictors for both UO1 and UO8 were cold ischemia time (CIT), patient and donor age and sex, HLA I and II compatibility, pre-transplantation duration of renal replacement therapy (RRT), cause of ESRD (ESRD) and immunosuppressive regimen. UO8 predictors also included UO1, 1st/0th POD plasma creatinine concentration ratio (Cr1/0), and occurrence of acute cellular rejection (AR). Multivariable linear regression was employed to produce nomograms for UO1 and UO8. Results: Four hundred and seventy-three patients were included, mostly deceased donor kidneys’ recipients (361, 70.4%). CIT inversely correlated with UO1 and UO8 (Spearman’s p=-0.43 and -0.37). CR1/0 inversely correlated with UO8 (p=-0.47). On multivariable analysis UO1 was mainly influenced by CIT, with additional influences of donor age and sex, HLA II matching and ESRD. UO1 was the strongest predictor of UO8, with significant influences of AR and ESRD. Conclusions: The predominant influence of CIT on UO1 rapidly wanes and is replaced by indicators of functional recovery (mainly UO1) and allograft’s immunologic acceptance (AR absence). Mean absolute errors for nomograms were 0.08 mL/Kg h (UO1) and 0.05 mL/Kg h (UO8). Keywords: Kidney Transplantation; Nomograms; Delayed Graft Function [Full...

read more

Synchronous presentation of muscle-invasive urothelial carcinoma of bladder and peritoneal malign mesothelioma

Vol. 45 (x): 2019 March 3.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0815 CHALLENGING CLINICAL CASES Cem Basatac 1, Fatma Aktepe 2, Sezer Sağlam 3, Haluk Akpınar 1 1 Department of Urology, Istanbul Bilim University, Istanbul, Turkey; 2 Department of Pathology, Group Florence Nightingale Hospitals, Istanbul, Turkey; 3 Department of Medical Oncology, Istanbul Bilim University, Istanbul, Turkey ABSTRACT Introduction: Cancer is one of the most important leading cause of death in man and woman in the world. The occurrence of new cancer has become more frequent in recent years due to strict screening protocols and occupational and environmental exposure to carcinogens. The incidence of secondary malignancies has also increased due to close medical follow-up and advanced age. Herein, we report a case and its management diagnosed as synchronous peritoneal malignant mesothelioma and muscleinvasive urothelial carcinoma. Case Description: A 71-year-old male presented with macroscopic hematuria and abdominal distension increasing gradually. A contrast enhanced computerized tomography demonstrated bladder mass and diffuse ascites with nodular peritoneal thickening and umbilical mass. He was treated with the multidisciplinary team working including urologist, medical oncologist and general surgeon. Conclusions: To our knowledge, this is the fi rst case of peritoneal malign mesothelioma with synchronous muscle-invasive urothelial carcinoma. Because of the rarity of this condition, there is still no consensus on the defi nitive treatment protocols, yet. Individualized treatment with multidisciplinary close follow-up might improve the survival outcomes. Keywords: Mesothelioma; Peritoneum; Neoplasms [Full...

read more

Testicular mixed germ cell tumor presenting with seizure as the initial symptom: a case report and literature review

Vol. 45 (x): 2019 March 3.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0523 CHALLENGING CLINICAL CASES Syuan-Hao Syu 1, Chia-Lun Chang 2, Hung-Jen Shih 1, 3 1 Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan;  2 Department of Hematology, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan; 3 Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan ABSTRACT Most patients with testicular germ cell tumor present with a painless scrotal mass. We report a 19-year-old patient who presented with neurological complains. Rapid clinical progression to coma was noted during the staging work up. A diagnosis of testicular mixed germ cell tumor with multiorgan metastasis (lymph node, lung, liver and brain) was made. Patients with brain metastasis should receive chemotherapy alone or combined with surgery or radiotherapy. Because the clinical symptoms deteriorated quickly, surgery was used upfront followed by chemotherapy and radiotherapy for the brain tumor. After the first stage of treatment, the clinical symptoms, tumor markers and imaging findings were improved. The residual brain tumor was eliminated by chemotherapy, and only sparse degenerated tumor cells were noted in the brain tissue. Longer follow up is required to assess the impact of our treatment strategy. Keywords: Testis; Testicular Germ Cell Tumor 1 [Supplementary Concept]; Neoplasm Metastasis [Full...

read more