Validation of the Brazilian version of the Expanded Prostate Cancer Index Composite (EPIC) for patients submitted to radical prostatectomy

Objectives: Validation of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire translated to Portuguese. This is an evaluation tool of the effects of treatment on quality of life of patients with prostate cancer.Materials and Methods: in order to translate and validate, several recommended methodological techniques in the literature were included: initial translation, synthesis of translation, board committee review and back translation. Sample included 40 patients with localized prostate cancer submitted to surgical retropubic radical prostatectomy from 2008 to 2010.Results: the internal consistency analysis of the scales of the questionnaire resulted in alpha Cronbach coefficients very good (> 0.9) and good (> 0.8) to 8 of 14 domains. the higher coefficients (0.94) were assigned to sexual score, subscales incontinence and sexual function. Post-operatory follow-up ranged from 3 to 35 months, median 18.7 months.Conclusions: the Brazilian version of EPIC is reliable and valid, and is a useful tool to evaluate the impact of retropubic radical prostatectomy on quality of life of Brazilian patients with localized prostate cancer, in national and internationals studies.Universidade Federal de São Paulo, Escola Paulista Med, EPM UNIFESP, Dept Urol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, EPM UNIFESP, Dept Urol, São Paulo, BrazilWeb of Scienc

Glutamine/Glutamate Metabolism Studied with Magnetic Resonance Spectroscopic Imaging for the Characterization of Adrenal Nodules and Masses

Purpose. To assess glutamine/glutamate (Glx) and lactate (Lac) metabolism using proton magnetic resonance spectroscopic imaging (1H-MRS) in order to differentiate between adrenal gland nodules and masses (adenomas, pheochromocytomas, carcinomas, and metastases). Materials and Methods. Institutional review board approval and informed consent were obtained. A total of 130 patients (47 men) with 132 adrenal nodules/masses were prospectively assessed (54 +/- 14.8 years). A multivoxel system was used with a two-dimensional point-resolved spectroscopy/chemical-shift imaging sequence. Spectroscopic data were interpreted by visual inspection and peak amplitudes of lipids (Lip), choline (Cho), creatine (Cr), Lac, and Glx. Lac/Cr and Glx/Cr were calculated. Glx/Cr was assessed in relation to lesion size. Results. Statistically significant differences were observed in Glx/Cr results between adenomas and pheochromocytomas (P < 0.05), however, with a low positive predictive value (PPV). Glx levels were directly proportional to lesion size in carcinomas. A cutoff point of 1.44 was established for the differentiation between carcinomas larger versus smaller than 4 cm, with 75% sensitivity, 100% specificity, 100% PPV, and 80% accuracy. Lac/Cr results showed no differences across lesions. A cutoff point of -6.5 for Lac/Cr was established for carcinoma diagnosis. Conclusion. Glx levels are directly proportional to lesion size in carcinomas. A cutoff point of -6.5 Lac/Cr differentiates carcinomas from noncarcinomas.Universidade Federal de São Paulo, Dept Diagnost Imaging, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Endocrinol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Urol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Diagnost Imaging, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Endocrinol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Urol, BR-04024002 São Paulo, BrazilWeb of Scienc

Optic-Guided Vaginal Repair of Vesicovaginal Fistula Editorial Comment

Universidade Federal de São Paulo, Dept Urol, BR-04532080 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Urol, BR-04532080 São Paulo, BrazilWeb of Scienc

Contemporary evaluation and treatment of chronic unilateral hematuria and upper tract urothelial tumours

Universidade Federal de São Paulo, Dept Urol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Urol, São Paulo, BrazilWeb of Scienc

Contemporary Different Patterns of Indications and Outcomes for the Surgical Management of Renal Tumors in an Academic Center

Purpose: Inconsistencies have been pointed out in the treatment of small renal tumors by laparoscopists, as many would remove the entire kidney unnecessarily, whereas open surgeons are more likely to perform partial nephrectomy. Thus, we compared the practice and outcomes between two groups of surgeons treating renal tumors.Materials and Methods: We reviewed the renal cancer database from our institution from January 2000 to October 2006 for data retrieval and analysis. the patients treated by the laparoscopy staff (LS) and the oncology staff (OS) were divided into two groups for comparison. Data were collected for age, gender, type of surgery performed, time of operation, length of stay in the hospital, complications, histological evaluation, operation room time, hospital stay time, complications rate, and overall survival.Results: A total of 240 patients were evaluated, 149 in the LS group (62%) and 91 in the OS group (38%), and the results have been summarized. Fifty percent of all procedures were open; however, in the OS group 100% of the surgeries were open and in the LS group 19% of the cases were open. Interestingly, only 9% of the surgeries in the OS group were nephron sparing, whereas in the LS group 60% of the patients had their kidneys spared. OS treated a higher percentage of locally advanced tumors.Conclusions: Laparoscopists performed a more variety of surgical approaches including open procedures and performed much more nephron sparing surgeries than the oncologists. Open surgery still plays an important role for locally advanced disease and hilar tumors.Universidade Federal de São Paulo, Div Urol, BR-01239040 São Paulo, BrazilUniversidade Federal de São Paulo, Div Urol, BR-01239040 São Paulo, BrazilWeb of Scienc