Przydatność badań ultrasonograficznych w rozpoznawaniu i w ocenie odległych wyników leczenia operacyjnego zwężenia podmiedniczkowego moczowodu u noworodków

Background: Pyeloureteral stricture in neonates requires early diagnosis and treatment for the reason that leads to infections, formation of concrements and destruction of renal parenchyma. Aim: Evaluation of usefulness of ultrasound examinations in diagnosis of neonatal pyeloureteral stricture and their value in postoperative follow-up. Material/Methods: The study comprised of 54 newborns (33 boys and 29 girls) with pyloureteral stricture diagnosed by ultrasound, including 52 (96%) of unilateral (27 left and 25 right sided) and 2 cases of bilateral stricture. In 15 (28%) neonates high-grade pelvic dilatation was found. Results: Operative treatment with use of Anderson-Hynes method was applied in 6(11%) of children in first month of life, in 21 (39%) of children between 2 and 6 month of life and in 27(50%) in second half of first year of life. Long-term follow-up was performed in 46 children of mean age 7,8 years using abdominal ultrasound. The very good result of surgical intervention was noted in 50% of children, good effect in 43,5% and poor outcome in 3 children: 1 with large pelvic dilatation and two cases with lack of renal function confirmed by scintigraphy. Conclusions: Abdominal ultrasound in neonates allow not only to make early diagnosis of pyeloureteral stricture but also provide quick and proper qualification to operative treatment. Abdominal ultrasound, among other ways of imaging, as a safe and useful, should be method of choice in follow-up after operative treatment of pyeloureteral stricture in children. Follow-up using abdominal ultrasound in children after Anderson-Hynes operation confirm beneficial effects of such treatment on reconstruction of dynamics of upper urinary tract, prevention of deformation of pyelocaliceal system and damage of renal parenchyma

Prognostic value of radical cystoprostatectomy in men with bladder cancer infiltrating prostate versus co-existing prostate cancer: a research study

<p>Abstract</p> <p>Background</p> <p>The aim of the following study is to evaluate the advancement of incidentally diagnosed prostate cancer in specimen after cystoprostatectomies caused by muscle-invasive bladder cancer. Secondly we assessed the survival in patients after radical cystoprostatectomy whose postoperative specimen was characterized by the presence of co-existing prostate cancer or prostate infiltration by urothelial bladder cancer.</p> <p>Methods</p> <p>Between 1993 and 2009 a total of 320 patients with muscle-invasive bladder cancer underwent cystoprostatectomy. The first analyzed group consisted of 52 patients with bladder cancer infiltrating prostate, while the second group consisted of 21 patients with co-existing prostate cancer. In all patients cancer specific survival and progression were analyzed. Average follow up was 75.2 months (range: 0 - 181).</p> <p>Results</p> <p>Cancer-specific survival was significantly shorter in group I (p = 0.03). Neoplastic progression in patients from group I was observed in 42.2% of patients, while in patients from group II in 23.6% of patients (p = 0.04). No statistical difference was observed in the percentage of positive lymph nodes between the groups (p = 0.22). The median Gleason score in patients with co-existing prostate cancer was equal to 5. The stage of prostate cancer pT₂/pT₃was equal to 20 (96%)/1 (4%) patients. 12 (57%) prostate cancers were clinically insignificant. Biochemical recurrence occurred in 2 (9%) patients.</p> <p>Conclusions</p> <p indent="1">1. Incidentally diagnosed prostate cancer in specimen after cystoprostatectomies is frequently clinically insignificant and characterized by low progression.</p> <p indent="1">2. Patients with bladder cancer infiltrating prostate are characterized by higher percentage of progression and death in comparison with patients with co-existing prostate cancer.</p