Zabiegowe metody leczenia kamicy moczowej

Częstość występowania i nawrotowy charakter czynią z kamicy moczowej chorobę o wymiarze społecznym. Większość tworzących się w układzie moczowym złogów ma niewielkie rozmiary i może być leczona zachowawczo. Jednak niewielka część kamieni, ze względu na wielkość lub lokalizację, będzie wymagała postępowania zabiegowego, najczęściej z wykorzystaniem technik minimalnieinwazyjnych, czyli endoskopii, laparoskopii lub kruszenia falą generowaną poza ustrojem chorego (SWL). W artykule omówiono najważniejsze nowoczesne sposoby usuwania kamieni z układu moczowego, z podaniem głównych wskazań do ich stosowania, uzupełniając przykładami klinicznymi

Asymptomatic bladder leiomyoma: a report of three cases treated with minimal invasive techniques and a review of literature

We report a rare case of metastatic gastric cancer from invasive carcinoma of the breast (BC) as the first symptom of disease-mimicking primary gastric linitis plastica

Laparoendoscopic single-site transvesical removal of mid-urethral polypropylene sling eroded into the bladder

Complications of mid-urethral sling procedure such as erosion into the bladder are not very common. However, whenthey occur, removal of the tape may be necessary. To date, this complication has usually been managed by retropubicexploration or operative cystoscopy, which can often be associated with disproportionate morbidity or even failure. Wepresent 2 cases of a laparoendoscopic single-site surgery (LESS) approach for removal of polypropylene tape erodedinto the bladder. We report two female patients aged 41 years and 47 years who underwent treatment with this noveltechnique. A TriPort® single-site access system was placed through the apex of the bladder under cystoscopic control.Carbon dioxide was used for insufflations of the bladder. A combination of straight and articulating laparoscopic instrumentswas used to dissect and completely remove the foreign body. Both patients were managed adequately in themanner presented above. The length of the skin incision was 20 mm. Time of intervention was 35 min and 40 min.No blood loss or complications occurred. A Foley 18 F catheter was left for seven days and the patients were dischargedon the 1st postoperative day. The follow-up period (4 months and 7 months) showed no events related to the method.Removal of foreign bodies of the bladder through a single transvesical laparoscopic port is technically feasible. This procedureoffers excellent visualization inside the bladder, especially near the bladder neck where polypropylene tapesoften reside, and provides patients with a minimally invasive approach through a single small incision

Thrombosis of the deep dorsal penile vein and corpora cavernosa of the penis as the first symptoms of colon cancer. Case report and literature review

The case describes an 86-year-old man with thrombosis of the deep dorsal vein and corpora cavernosa of the penis who developed symptoms 4 months before hospitalisation. An accurate imaging diagnostics supplemented with a biopsy of the corpus cavernosum confirmed the initial diagnosis. Moreover, an adenocarcinoma of the hepatic flexion of the colon with numerous metastatic lesions, including those to the crus of penis were found. Diagnostic and therapeutic difficulties were described and the results obtained were discussed in the context of available literature

Laparoscopic nephron sparing surgery on a patient with extreme body deformation due to cerebral palsy. Is this justified when the tumor biopsy is unavailable?

Abdominal surgery on patients with significant body malformation is often a challenge for an operative team. Particularly, when patient presents lesions suspected for malignancy but benign disease cannot be excluded. In the reported case the patient suffered from cerebral palsy and had extreme spinal distortion with significant displacement of internal organs. Solid renal mass was detected incidentally, but because of body deformation the biopsy to asses pathological status could not be performed. The decision to perform surgery was made and the patient underwent successful laparoscopic partial nephrectomy. Pathology examination of the specimen revealed renal cell carcinoma grade 2

Initial Experience of Clinical Use of [99mTc]Tc-PSMA-T4 in Patients with Prostate Cancer. A Pilot Study

Numerous different molecules of prostate-specific membrane antigen (PSMA) ligands are used to detect prostate cancer (PCa); most approaches utilize gallium PET and a few reports describe the role of SPECT/CT. [99mTc]Tc-PSMA-T4 is a new radiopharmaceutical designed for the diagnosis of patients with PCa. We conducted a single site, prospective, preliminary case series study that included 31 patients with PCa; all had undergone clinical, biochemical or imaging examination and exhibited clear or suspicious active disease or clinical/biochemical recurrence of PCa. Whole-body (WB) SPECT/CT after i.v. administration of [99mTc]Tc-PSMA-T4 was utilized; acquisition images were obtained at three time points. The clinical value of the images was assessed in regard to the evaluation of tumor extent in patients with confirmed PC that qualified for initial therapy and the evaluation of tumor recurrence; both provided encouraging results. The late acquisition of WB-SPECT resulted in better lesions delineation. The results of the analysis of the sensitivity/specificity were: 92%/100% in cases of primary cancer, 83%/100% in terms of pelvic lymph nodes disease, 100%/95% in other lymph nodes and soft tissue involvement, respectively, and bone mets were both 100%. An oncotropic SPECT [99mTc]Tc-PSMA-T4 can help in selecting a rational therapeutic strategy for a patient with an initial diagnosis of PCa by assessing the extent of cancer and also after complex radical or palliative therapy in case of biochemical recurrence for re-staging

Changing patterns of urologic emergency visits and admissions during the COVID-19 pandemic : a retrospective, multicenter, nationwide study

INTRODUCTION: We aimed to examine the change in the number and severity of visits to the emergency departments (EDs) and subsequent admissions for urgent urologic conditions in the early stage of the coronavirus disease 2019 (COVID-19) pandemic in Poland. MATERIAL AND METHODS: We evaluated data from 13 urologic centers in Poland and compared the number of visits to the EDs and subsequent admissions before and after the advent of COVID-19 in 2020, and before and after the escalating national restrictions. Furthermore, data on types of urologic complaints, crucial laboratory parameters, and post-admission procedures were analyzed. RESULTS: In total 1,696 and 2,187 urologic visits (22.45% decrease) and 387 and 439 urologic urgent admissions (11.85% decrease) were reported in given periods in 2020 and 2019, respectively. The year-over-year difference in daily mean visits was clear (36.1 vs. 46.5; p < 0.001). Declines were seen in all complaints but device malfunction. In 2020 daily mean visits and admissions decreased from 40.9 and 9.6 before lockdowns to 30.9 (p < 0.001) and 6.9 (p = 0.001) after severe restrictions, respectively. There was a trend towards more negative laboratory parameter profiles in 2020, with patients who visited the EDs after severe restrictions having twice as high median levels of C-reactive protein (15.39 vs. 7.84, p = 0.03). CONCLUSIONS: The observed declines in ED visits and admissions were apparent with the significant effect of national lockdowns. Our results indicate that some of the patients requiring urgent medical help did not appear at the ED or came later than they would have done before the pandemic, presenting with more severe complaints