Abstract: A new edition of the TNM was recently released that includes modifications for the staging system of kidney cancers. Specifically, T2 cancers were subclassified into T2a and T2b (< or =10 cm vs >10 cm), tumors with renal vein involvement or perinephric fat involvement were classified as T3a cancers, and those with adrenal involvement were classified as T4 cancers.
Abstract: In 1995 a penile dermal flap was described as an ideal operation for penile curvature due to Peyronie's disease. We report our experience with penile dermal flaps in patients with penile curvature due to Peyronie's disease.
Abstract: We report the case of a 76 ys-old woman with overactive bladder syndrome, determined by an histological exam of interstitial cystitis with plasma cell infiltration. To the best of our knowledge, in literature only a similar case has been described. The patient has been treated with corticosteroid therapy allowing a transitory benefit; despite this fact, after side effects have been shown, this therapy has been interrupted leading to the worsening of the previous sintomatology. Therefore the patient has undergone to radical cystectomy with orthotopic ileal neobladder. The phlogistic infiltration of the bladder wall is represented by the plasma cells for over 90% of the whole population. In addition, blood specimen was positive for perinuclear antineutrophil cytoplasmic antibodies (p-ANCA). All these elements could hint at a chronic cystitis due to autoimmune aetiology.
Abstract: As in men, female urethral stricture disease is often treated with repeat urethral dilation or internal urethrotomy but not always with good results. In nonresponsive cases surgical treatment may be useful but only a few cases are reported in the literature. We present our single institution experience with urethral reconstruction in 6 patients using an alternative vaginal inlay flap technique inspired by the Orandi technique.
Abstract: The aim of this observational study was to investigate the occurrence of postoperative delirium (POD) in elderly patients undergoing urological surgery and to identify those factors associated with delirium. Ninety consecutive patients (81 males and 9 females; average age of 74.3±0.40 years), undergoing urological surgery in University-Hospital Urological Clinic were selected. Personal, medical, cognitive and functional data, biochemical parameters, preoperative medications, conduct of surgery and anesthesia and details of hemodynamic control were collected as predictors of delirium. After surgery, the subjects were divided on the basis of delirium onset within a week observation period. Delirium was diagnosed by the Confusion Assessment Method. Delirium started the first post-operative day (2F; 6M) and lasted 3.0±0.8 days. Subjects with POD were significantly older, had a previous history of delirium, were more impaired in the instrumental activities of daily living and had poorer clock drawing test (CDT) score. Interestingly, a significantly greater number of hypotensive events were recorded during anesthesia. Age, cognitive and functional status, previous history of delirium and hypotensive episodes intrasurgery are the best predictor of POD in this setting. Our findings have implications in preventing delirium in elderly by an early and targeted evaluation.
