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Roeder F, Fastner G, Fussl C, Sedlmayer F, Stana M, Berchtold J, Jäger T, Presl J, Schredl P, Emmanuel K, Colleselli D, Kotolacsi G, Scherer P, Steininger P, Gaisberger C. First clinical application of image-guided intraoperative electron radiation therapy with real time intraoperative dose calculation in recurrent rectal cancer: technical procedure. Radiat Oncol 2023; 18:186. [PMID: 37950314 PMCID: PMC10638784 DOI: 10.1186/s13014-023-02374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 11/04/2023] [Indexed: 11/12/2023] Open
Abstract
Intraoperative radiation therapy (IORT) is a radiation technique applying a single fraction with a high dose during surgery. We report the first abdomino-pelvic application of an image-guided intraoperative electron radiation therapy with intraoperative real time dose calculation based on the individual intraoperative patient anatomy. A patient suffering from locoregionally recurrent rectal cancer after treatment with neoadjuvant re-chemoradiation was chosen for this approach. After surgical removal of the recurrence, an adequate IORT applicator was placed as usual. A novel mobile imaging device (ImagingRing, MedPhoton) was positioned around the patient covering the region to be treated with the IORT-applicator in place. It allowed the acquisition of three-dimensional intraoperative cone-beam computed tomography images suitable for dose calculation using an automated scaling (heuristic object and head scatter as well as hardening corrections) of Hounsfield units. After image acquisition confirmed the correct applicator position, the images were transferred to our treatment planning system for intraoperative dose calculation. Treatment could be accomplished using the calculated dose distribution. We herein describe the details of the procedure including necessary adjustments in the typically used IORT equipment and work flow. We further discuss the pros and cons of this new approach generally overcoming a decade long limitation of IORT procedures as well as future perspectives regarding IORT treatments.
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Affiliation(s)
- Falk Roeder
- Department of Radiation Therapy and Radiation Oncology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria.
| | - Gerd Fastner
- Department of Radiation Therapy and Radiation Oncology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Christoph Fussl
- Department of Radiation Therapy and Radiation Oncology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Felix Sedlmayer
- Department of Radiation Therapy and Radiation Oncology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
- Institute of Research and Development of Advanced Radiation Technologies (radART), Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg, Austria
| | - Markus Stana
- Department of Radiation Therapy and Radiation Oncology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Johannes Berchtold
- Department of Radiation Therapy and Radiation Oncology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Tarkan Jäger
- Department of Visceral and Thoracic Surgery, Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg, Austria
| | - Jaroslav Presl
- Department of Visceral and Thoracic Surgery, Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg, Austria
| | - Philipp Schredl
- Department of Visceral and Thoracic Surgery, Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg, Austria
| | - Klaus Emmanuel
- Department of Visceral and Thoracic Surgery, Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg, Austria
| | - Daniela Colleselli
- Department of Urology, Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg, Austria
| | - Gabriel Kotolacsi
- Department of Anesthesiology, Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg, Austria
| | - Philipp Scherer
- Department of Radiation Therapy and Radiation Oncology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Philipp Steininger
- Institute of Research and Development of Advanced Radiation Technologies (radART), Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg, Austria
| | - Christoph Gaisberger
- Department of Radiation Therapy and Radiation Oncology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
- Institute of Research and Development of Advanced Radiation Technologies (radART), Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg, Austria
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Pallauf M, Sevcenco S, Steiner C, Drerup M, Mitterberger M, Colleselli D, Lusuardi L, Kunit T. LithoVue™ for renal stone therapy - a perfect fit for high volume academic centers; a retrospective evaluation of 108 cases. BMC Urol 2020; 20:56. [PMID: 32423440 PMCID: PMC7236187 DOI: 10.1186/s12894-020-00624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/29/2020] [Indexed: 11/29/2022] Open
Abstract
Background Over the last few years the number of flexible ureterorenoscopies, used for renal stone treatment, has risen steadily. This was associated with an increase in costs for maintenance and repair of the fragile ureterorenoscopes used. To overcome this problem single-use devices have been introduced to the market. The aim of this study was to assess surgical outcome and workability for LithoVue™, a single-use flexible ureterorenoscope. Methods We retrospectively analyzed all flexible ureterorenoscopies performed at our department between January and October 2017. We included a total of 108 interventions for renal stone therapy, all performed using the single-use device LithoVue™. We assessed patients’ characteristics including stone size, count and location. We evaluated the surgical outcome, analyzing stone-free rates, reintervention rates, complication rates, as well as surgery time. Learning curve for single-use ureterorenoscopes was evaluated by comparing the surgical outcome between residents and consultants. Results The average time needed per intervention was 52,31 min ± 28,11. In 77 out of 108 (71,30%) patients we were able to remove all stones by a single intervention. In 8 patients (7,41%) intra- or postoperative complications occurred, none of which was graded higher than Clavien-Dindo III B. We did not find any statistical differences comparing the surgical outcome between residents and consultants. No technical difficulties occurred during surgery. Conclusion Single-use flexible ureterorenoscopes provide decent working properties resulting in good surgical outcome. Furthermore, they are proven to be easy to handle even for unexperienced surgeons, making them a feasible choice for high volume academic centers.
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Affiliation(s)
- Maximilian Pallauf
- Landeskrankenhaus Salzburg - Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Universitätsklinik für Urologie und Andrologie, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Sabina Sevcenco
- Abteilung für Urologie und Andrologie, Sozialmedizinisches Zentrum Ost - Donauspital, Langobardenstraße 122, 1220, Wien, Austria
| | - Christopher Steiner
- Landeskrankenhaus Salzburg - Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Universitätsklinik für Urologie und Andrologie, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Martin Drerup
- Landeskrankenhaus Salzburg - Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Universitätsklinik für Urologie und Andrologie, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Michael Mitterberger
- Landeskrankenhaus Salzburg - Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Universitätsklinik für Urologie und Andrologie, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Daniela Colleselli
- Landeskrankenhaus Salzburg - Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Universitätsklinik für Urologie und Andrologie, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Lukas Lusuardi
- Landeskrankenhaus Salzburg - Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Universitätsklinik für Urologie und Andrologie, Müllner Hauptstraße 48, 5020, Salzburg, Austria
| | - Thomas Kunit
- Landeskrankenhaus Salzburg - Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Universitätsklinik für Urologie und Andrologie, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
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Oberhammer L, Mitterberger MJ, Lusuardi L, Kunit T, Drerup M, Colleselli D, Griessner H, Hager M. Sporadic renal hemangioblastoma: A case report of a rare benign renal tumor. Clin Case Rep 2019; 7:2321-2326. [PMID: 31893050 PMCID: PMC6935610 DOI: 10.1002/ccr3.2466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/30/2019] [Accepted: 08/27/2019] [Indexed: 11/25/2022] Open
Abstract
In renal tumors, suspicious for renal cell carcinoma, where there is any doubt and discrepancy between morphology and immune profile, we recommend performing further immunohistochemical staining for pan-cytokeratin, S100, NSE, and inhibin-alpha. Thus, follow-up overtreatment can be avoided in cases of benign kidney tumors.
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Affiliation(s)
- Lukas Oberhammer
- Department of Urology and AndrologyUniklinikum SalzburgSalzburgAustria
| | | | - Lukas Lusuardi
- Department of Urology and AndrologyUniklinikum SalzburgSalzburgAustria
| | - Thomas Kunit
- Department of Urology and AndrologyUniklinikum SalzburgSalzburgAustria
| | - Martin Drerup
- Department of Urology and AndrologyUniklinikum SalzburgSalzburgAustria
| | | | - Hubert Griessner
- Department of Urology and AndrologyUniklinikum SalzburgSalzburgAustria
| | - Martina Hager
- Department of PathologyUniklinikum SalzburgSalzburgAustria
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Hurle R, Casale P, Lazzeri M, Paciotti M, Saita A, Colombo P, Morenghi E, Oswald D, Colleselli D, Mitterberger M, Kunit T, Hager M, Herrmann TRW, Lusuardi L. En bloc re-resection of high-risk NMIBC after en bloc resection: results of a multicenter observational study. World J Urol 2019; 38:703-708. [PMID: 31114949 DOI: 10.1007/s00345-019-02805-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To investigate the role of en bloc re-resection (EBRS) in patients who had undergone previous en bloc resection for high-risk non-muscle-invasive bladder cancer (NMIBC). METHODS An international, multicenter, observational retrospective analysis of prospectively collected data. Patients with a high-risk NMIBC who had previously undergone en bloc resection were scheduled for EBRS of the resected area after 40 days. The primary outcome was the presence of residual tumor or recurrence-free survival. RESULTS Overall, 78 patients underwent EBRS. Only five (6.41%) residual cancers were found: one patient had a pTa G3 (1.28%) cancer and four (5.13%) had a pTis. The detrusor muscle was preserved in all samples. Only one patient had a positive margin on EBRS. No procedure called for a conversion to traditional re-TURBT. No patient experienced bladder perforation or other intra-operative complications. The recurrence rate at the first follow-up cystoscopy (RRFF-C at 3 months) was 3.85% (three patients). The median follow-up period was 30.8 months (range 6.9-76.0 months). In univariate analysis, the only predictor of recurrence was grade. Overall we observed 11 recurrences. Only one tumor progressed to T2 MIBC. CONCLUSIONS The low rates of residual tumor, recurrence, and progression seem to raise doubts about the efficacy of EBRS in patients who have previously undergone en bloc resection. EBRS appears to be a feasible and safe procedure with a low rate of complications. However, further data will be needed before EBRS can be used in clinical trials or recommended as a treatment modality.
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Affiliation(s)
- Rodolfo Hurle
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Paolo Casale
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Massimo Lazzeri
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Marco Paciotti
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy.
| | - Alberto Saita
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Piergiuseppe Colombo
- Department of Pathology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Emanuela Morenghi
- Department of Biomedical Science, Humanitas University, via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
| | - David Oswald
- Department of Urology, Paracelsus Medical University, Salzburg, Austria
| | | | | | - Thomas Kunit
- Department of Urology, Paracelsus Medical University, Salzburg, Austria
| | - Martina Hager
- Department of Pathology, Paracelsus Medical University, Salzburg, Austria
| | - Thomas R W Herrmann
- Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland
| | - Lukas Lusuardi
- Department of Urology, Paracelsus Medical University, Salzburg, Austria
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Bretterbauer KM, Heidler S, Colleselli D, Huber ER, Remzi M, Eredics K, Madersbacher S, Hübner WA. Postmicturition Dribble: A Physiological Phenomenon? Urol Int 2019; 102:487-491. [PMID: 30731473 DOI: 10.1159/000496801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/03/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Postmicturition dribble (PMD) is a common condition in the male population. OBJECTIVES Despite its common occurrence, there are only a few studies on this topic so far. The aim of this study was to investigate possible physiological aspects of PMD. METHOD Seventeen men complaining of PMD and 10 healthy subjects were assessed via uroflometry, IPSS questionnaire, IIEF-5 questionnaire, and an adapted visual analogue scale (VAS) for ejaculation force -(0-10) and the amount of bother concerning PMD (0-10) were completed. In addition to that, a retrograde urethrography at 40 and 60 cm water column as pressure unit to measure the width of the bulbar urethra was performed, and the amount of PMD was measured with an adjusted pad test. RESULTS The PMD group showed a significantly worse IPSS score, a lower Qmax rate in uroflowmetry, a worse IIEF-5 score, and a worse VAS score concerning ejaculation force. In both groups, worse IPSS levels correlated with a low bulbar urethral diameter at 40 and 60 cm water column. -Another correlation was found between a high maximum urine flow rate and a larger bulbar urethral diameter at 40 and 60 cm. Both groups showed urine loss after micturition, with no bother (VAS 0) in the control group, whereas the PMD group showed a VAS of 6. CONCLUSIONS PMD should be regarded as a physiological occurrence in men rather than a disease by itself. Suffering is only to be expected in combination with other lower urinary tract symptoms.
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Affiliation(s)
| | - Stefan Heidler
- Department of Urology, Krankenhaus Mistelbach, Mistelbach, Austria,
| | - Daniela Colleselli
- Department of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Erik R Huber
- Department of Urology, Krankenhaus Korneuburg, Korneuburg, Austria
| | - Mesut Remzi
- Department of Urology, Krankenhaus Korneuburg, Korneuburg, Austria
| | - Klaus Eredics
- Department of Urology, Krankenhaus Mistelbach, Mistelbach, Austria
| | | | - Wilhelm A Hübner
- Department of Urology, Krankenhaus Korneuburg, Korneuburg, Austria
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Drerup M, Magdy A, Hager M, Colleselli D, Kunit T, Lusuardi L, Janetschek G, Mitterberger M. Non-ischemic laparoscopic partial nephrectomy using 1318-nm diode laser for small exophytic renal tumors. BMC Urol 2018; 18:99. [PMID: 30413201 PMCID: PMC6230292 DOI: 10.1186/s12894-018-0405-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 10/16/2018] [Indexed: 12/13/2022] Open
Abstract
Purpose Warm ischemia (WI) and bleeding constitute the main challenges for surgeons during laparoscopic partial nephrectomy (LPN). Current literature on the use of lasers for cutting and coagulation remains scarce and with small cohorts. We present the largest case series to date of non-ischemic LPN using a diode laser for small exophytic renal tumors. Methods We retrospectively evaluated 29 patients with clinically localized exophytic renal tumors who underwent non-ischemic laser–assisted LPN with a 1318-nm wavelength diode laser. We started applying the laser 5 mm beyond the visible tumor margin, 5 mm away from the tissue in a non-contact fashion for coagulation and in direct contact with the parenchymal tissue for cutting. Results The renal vessels were not clamped, resulting in a WIT (warm ischaemic time) of 0 min, except for one case that required warm ischemia for 12 min and parenchymal sutures. No transfusion was needed, with a mean Hemoglobin drop of 1,4 mg/dl and no postoperative complications. The eGFR did not significantly change by 6 months. Histologically, the majority of lesions (n = 22/29) were renal-cell carcinoma stage pT1a. The majority of malignant lesions (n = 13/22) had a negative margin. However, margin interpretation was difficult in 9 cases due to charring of the tumor base. A mean follow-up of 1.8 years revealed no tumor recurrence. The mean tumor diameter was 19.4 mm. Conclusion The 1318-nm diode laser has the advantages of excellent cutting and sealing properties when applied to small vessels in the renal parenchyma, reducing the need for parenchymal sutures. However, excessive smoke, charring of the surgical margin, and inability to seal large blood vessels are encountered with this technique.
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Affiliation(s)
- Martin Drerup
- Department of Urology, Paracelsus Medical University Salzburg, Muellner-Hauptstrasse 48, 5020, Salzburg, Austria
| | - Ahmed Magdy
- Department of Urology, Paracelsus Medical University Salzburg, Muellner-Hauptstrasse 48, 5020, Salzburg, Austria
| | - Martina Hager
- Department of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria.
| | - Daniela Colleselli
- Department of Urology, Paracelsus Medical University Salzburg, Muellner-Hauptstrasse 48, 5020, Salzburg, Austria
| | - Thomas Kunit
- Department of Urology, Paracelsus Medical University Salzburg, Muellner-Hauptstrasse 48, 5020, Salzburg, Austria
| | - Lukas Lusuardi
- Department of Urology, Paracelsus Medical University Salzburg, Muellner-Hauptstrasse 48, 5020, Salzburg, Austria
| | - Günter Janetschek
- Department of Urology, Paracelsus Medical University Salzburg, Muellner-Hauptstrasse 48, 5020, Salzburg, Austria
| | - Michael Mitterberger
- Department of Urology, Paracelsus Medical University Salzburg, Muellner-Hauptstrasse 48, 5020, Salzburg, Austria
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Griessner H, Kunit T, Colleselli D, Drerup M, Oberhammer L, Wolfgruber T, Lusuardi L, Mitterberger M. Pseudoaneurysma der bulbären Harnröhre nach traumatischer Katheterisierung. Urologe A 2018; 57:1357-1359. [DOI: 10.1007/s00120-018-0665-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Martini T, Wezel F, Löbig N, Mitterberger M, Colleselli D. [Systematic review on conservative treatment options in non-muscle-invasive bladder cancer patients refractory to Bacillus Calmette-Guérin instillation therapy]. Aktuelle Urol 2017; 48:314-328. [PMID: 28609792 DOI: 10.1055/s-0043-108944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background Adjuvant Bacillus Calmette-Guérin (BCG) intravesical instillation is the recommended standard treatment in patients with high-risk non-muscle-invasive bladder cancer (NMIBC). However, a significant proportion of patients fail treatment, and radical cystectomy (RC) is the subsequent gold standard. On the other hand, there is an unmet need for conservative alternatives for patients who are unfit or unwilling to undergo surgery. This study aimed to identify conservative treatment options in NMIBC patients after BCG failure. Material and Methods We performed a systematic search in the databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, including all randomised controlled trials (RCTs), quasi-RCTs and single-arm studies, in which patients with NMIBC were treated with second-line intravesical or systemic therapy after BCG failure. A minimum of eight patients were included in each treatment arm. Full papers were restricted to English language. Literature research and data analysis were assessed independently by two reviewers. Data on treatment response, recurrence, time to recurrence, progression and rate of cystectomy were collected and analysed. Results This systematic review included 42 publications with a total of 3521 patients (2371 BCG failures). Valrubicin, taxanes, gemcitabine, combination chemotherapy, thermochemotherapy, photodynamic therapy, combination of BCG and interferon and immunotherapies or targeted therapies were identified as conservative treatment options. For taxanes, gemcitabine and thermochemotherapy there is the highest evidence for a clinical meaningful response with minor toxicities. Conclusions Despite some promising response rates for taxanes, gemcitabine or thermochemotherapy, an evidence-based recommendation for treatment options superior to RC in patients failing BCG therapy cannot be made. The definition of BCG failure is still inconsistent and heterogeneous outcomes in patients with BCG failure have been reported. In order to identify effective conservative therapy options in patients failing BCG therapy, prospective trials with a standardised trial design are needed.
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Affiliation(s)
- Thomas Martini
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Deutschland
| | - Felix Wezel
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Deutschland
| | - Niklas Löbig
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Deutschland
| | - Michael Mitterberger
- Universitätsklinik für Urologie und Andrologie, Paracelsus Medizinischen Universität, Salzburg, Österreich
| | - Daniela Colleselli
- Universitätsklinik für Urologie und Andrologie, Paracelsus Medizinischen Universität, Salzburg, Österreich
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Martini T, Gilfrich C, Mayr R, Burger M, Pycha A, Aziz A, Gierth M, Stief CG, Müller SC, Wagenlehner F, Roigas J, Hakenberg OW, Roghmann F, Nuhn P, Wirth M, Novotny V, Hadaschik B, Grimm MO, Schramek P, Haferkamp A, Colleselli D, Kloss B, Herrmann E, Fisch M, May M, Bolenz C. The Use of Neoadjuvant Chemotherapy in Patients With Urothelial Carcinoma of the Bladder: Current Practice Among Clinicians. Clin Genitourin Cancer 2017; 15:356-362. [DOI: 10.1016/j.clgc.2016.09.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/07/2016] [Accepted: 09/11/2016] [Indexed: 11/26/2022]
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De Santis M, Bauernhofer T, Stoiber F, Höltl L, Sommerhuber A, Klocker J, Meran JG, Klikovich J, Colleselli D, Dittrich C, Pantel K, Riethdorf S. Circulating tumor cells (CTC) and HER-2 status on CTC and primary tumor in urothelial cancer (UC) patients refractory to platinum based chemotherapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.4520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Maria De Santis
- University of Warwick, Cancer Research Centre, Coventry, United Kingdom
| | - Thomas Bauernhofer
- Division of Clinical Oncology, Department of Internal Medicine, Medical University Graz, Graz, Austria
| | | | | | | | | | | | | | - Daniela Colleselli
- Department of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Christian Dittrich
- Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna), Kaiser Franz Josef-Spital, Vienna, Austria, Vienna, Austria
| | - Klaus Pantel
- Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine Riethdorf
- Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Magdy A, Drerup M, Bauer S, Colleselli D, Hruby S, Mitterberger M, Janetschek G. Natural Orifice Transluminal Endoscopic Surgery-Assisted Laparoscopic Transvesical Bladder Diverticulectomy: Feasibility Study, Points of Technique, and Case Series with Medium-Term Follow-Up. J Endourol 2016; 30:526-31. [PMID: 26732642 DOI: 10.1089/end.2015.0693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To demonstrate the feasibility of our novel natural orifice transluminal endoscopic surgery (NOTES)-assisted approach with medium-term follow-up. PATIENTS AND METHODS From March 2012, we included all patients who presented to our clinic with symptomatic or complicated retentive bladder diverticula secondary to long-standing infravesical obstruction. After managing the primary cause, we proceeded in all cases to our novel NOTES-assisted approach. We followed up the patients with abdominal ultrasonography at 6 weeks and 12 months postoperatively. Success was determined as subjective relief of the symptoms and objective disappearance of the diverticula in postoperative retrograde cystogram (RGC). RESULTS Between March 2012 and August 2014, eight diverticula were treated using our new technique. The surgery was uneventful. The mean operative time was 134.25 ± 44.92 minutes. Blood loss was minimal (>50 mL). Retrograde cystography was performed on the 10th postoperative day. The introduction of the needle holder through the urethral natural orifice (NOTES) facilitated a more optimal direction of the needle holder for suturing the bladder wall due to its parallel position in relation to the trigone and posterolateral walls. This renders this step easier compared with suturing the bladder wall through the transvesical laparoscopic ports. One case had a grade IIIa complication according to the Clavien-Dindo classification of surgical complications. The study is limited by the small number of cases. CONCLUSION Laparoscopic transvesical bladder diverticulectomy is a promising and safe procedure with good outcomes. Using the urethra (NOTES assisted) as an extra access to the bladder facilitates diverticular traction and bladder suturing without the need for extra ports. This technique can also be applied together with the novel T-laparoendoscopic single-site surgery approach.
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Affiliation(s)
- Ahmed Magdy
- 1 Department of Urology and Andrology, Paracelsus Medical University Salzburg , Salzburg, Austria .,2 Urology and Andrology Department, Faculty of Medicine, Menoufia University, Egypt
| | - Martin Drerup
- 1 Department of Urology and Andrology, Paracelsus Medical University Salzburg , Salzburg, Austria
| | - Sophina Bauer
- 1 Department of Urology and Andrology, Paracelsus Medical University Salzburg , Salzburg, Austria
| | - Daniela Colleselli
- 1 Department of Urology and Andrology, Paracelsus Medical University Salzburg , Salzburg, Austria
| | - Stephan Hruby
- 1 Department of Urology and Andrology, Paracelsus Medical University Salzburg , Salzburg, Austria
| | - Michael Mitterberger
- 1 Department of Urology and Andrology, Paracelsus Medical University Salzburg , Salzburg, Austria
| | - Günter Janetschek
- 1 Department of Urology and Andrology, Paracelsus Medical University Salzburg , Salzburg, Austria
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Bretterbauer KM, Colleselli D, Magdy A, Janetschek G, Mitterberger M. [An incidental finding of retrocaval extraadrenal pheochromocytoma]. Wien Med Wochenschr 2015; 165:406-9. [PMID: 26169994 DOI: 10.1007/s10354-015-0374-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 06/26/2015] [Indexed: 10/23/2022]
Abstract
As part of diagnostic work-up of a 71-year-old patient with resistant hypertension, an extraadrenal mass was found. After further imaging and biochemical evaluation an extraadrenal pheochromocytoma was diagnosed and after alpha-receptor blockade was removed via posterior approach laparoscopically in the course. The pheochromocytoma is a rare catecholamine-producing tumor with an incidence of 1-2 per 100 000. In about 1-25 % it is located extraadrenal. Establishing the diagnosis is dependent on the demonstration of significant catecholamine excess. Afterwards imaging with CT or MRI should be performed. After administration of alpha-blockers, the complete surgical resection is the treatment of choice.
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Affiliation(s)
| | - Daniela Colleselli
- University of Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Österreich
| | - Ahmed Magdy
- University of Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Österreich
| | - Günter Janetschek
- University of Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Österreich
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Lusuardi L, Hager M, Kloss B, Hruby S, Colleselli D, Zimmermann R, Janetschek G, Mitterberger M. Tissue effects resulting from eraser laser enucleation of the prostate: in vivo investigation. Urol Int 2013; 91:391-6. [PMID: 24107510 DOI: 10.1159/000353554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 05/31/2013] [Indexed: 11/19/2022]
Abstract
UNLABELLED BACKGROUND/AIMS/OBJECTIVES: To describe the depth of the laser coagulation zone in vivo based on histological examinations and the functional outcome of a 1,318-nm diode laser for enucleation in benign prostatic enlargement (BPE). METHODS A total of 20 patients with BPE were treated by laser Eraser® enucleation of the prostate (ELEP). Prostatic tissue wedges were evaluated to assess the depth of the ELEP coagulation zones. Additionally, patients were assessed preoperatively and 12 months postoperatively. RESULTS The coagulation zones were 0.36 ± 0.17 mm in epithelial tissue, 0.28 ± 0.15 mm in stromal tissue, and 0.25 ± 0.12 mm in mixed tissue. The coagulation area at the cutting edge completely sealed capillary vessels, reaching a depth of 0.35 ± 0.15 mm. The diameter of the coagulated vessels measured 1.75 ± 0.83 mm. Mean blood loss was 115.54 ± 93.12 ml, catheter time 1.35 ± 0.33 days, and hospital stay 1.89 ± 0.52 days. The International Prostate Symptom Score, maximal flow rate, and quality of life significantly improved 12 months after the procedure. CONCLUSIONS ELEP is safe and effective for BPE treatment and yields good results at a follow-up of 1 year. Because of the limited penetration depth, damage to the urinary sphincter is not expected.
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Affiliation(s)
- L Lusuardi
- Departments of Urology and Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
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Schätz T, Hruby S, Colleselli D, Janetschek G, Lusuardi L. A severe complication of mid-urethral tapes solved by laparoscopic tape removal and ureterocutaneostomy. Can Urol Assoc J 2013; 7:E598-600. [PMID: 24069104 DOI: 10.5489/cuaj.393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mid-urethral tapes are largely used to manage stress urinary incontinence (SUI). In certain cases, however, this procedure results in bothersome complications that lead to complete resection. We present the case of an 85-year-old woman who presented with ongoing suprapubic pain, hematuria, vaginal bleeding and recurrent urinary tract infections. The patient had undergone a tension-free vaginal tape (TVT) procedure in 1999 and a transobturator tape (TOT) placement in 2003 for SUI. Investigations revealed a urethral stone, erosion of both TOT and TVT and an urethra-vaginal fistula. Under local anesthesia the urethral stone was removed endoscopically and the TOT removed via a vaginal approach. Due to her comorbidity, she underwent a laparoscopic intraperitoneal removal of the TVT and a definitive ureterocutaneostomy to relieve her pain, inflammation and incontinence. This is the first ever presented case of erosion of mid-urethral tapes and incontinence treated with a laparoscopic resection of the tape and ureterocutaneostomy as definitive urinary diversion.
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Affiliation(s)
- Tobias Schätz
- Paracelsus Medical University Salzburg, Department of Urology and Andrology, Salzburg, Austria
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Seibold J, Selent C, Feil G, Wiedemann J, Colleselli D, Mundhenk J, Gakis G, Sievert KD, Schwentner C, Stenzl A. Development of a porcine animal model for urethral stricture repair using autologous urothelial cells. J Pediatr Urol 2012; 8:194-200. [PMID: 21398188 DOI: 10.1016/j.jpurol.2011.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 02/02/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To present a versatile large animal model for endoscopic stricture repair using autologous urothelial cells. MATERIALS AND METHODS 12 male minipigs were used. An artificial stricture model was established using suture-ligation, thermo-coagulation and internal urethrotomy. A vesicostomy served for urinary diversion. Stricture formation was confirmed radiologically and histologically. Autologous urothelial cells were harvested from bladder washings, cultivated and labeled. Internal urethrotomy was done in all, and the cultivated cells were injected into the urethrotomy wound. All animals were sacrificed after 4 or 8 weeks. Immunohistology was done to confirm the presence of autologous urothelial cells within the reconstituted urethra. RESULTS Stricture formation was verified with all three methods. Histologically, no significant differences in the severity of stricture development could be observed with regard to the method used. The autologous urothelial cells in the area of the urethrotomy could be detected in the urothelium and the corpus spongiosum until 8 weeks after re-implantation. CONCLUSIONS We created a reliable and reproducible porcine model for artificial urethral strictures. Autologous urothelial cells can be implanted into an artificial stricture after urethrotomy. These cells retain their epithelial phenotype and are integrated in the resident urothelium. Further comparative studies are needed to ultimately determine a superior efficacy of this novel approach.
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Affiliation(s)
- J Seibold
- Department of Urology, Eberhard-Karls University, Tuebingen, Germany
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Colleselli D, Hennenlotter J, Krueger S, Schilling D, Gakis G, Lichy M, Vogel U, Kuehs U, Schlemmer HP, Stenzl A, Schwentner C. 2309 IMPACT OF CLINICAL PARAMETERS ON THE DIAGNOSTIC ACCURACY OF ENDORECTAL COIL MAGNETIC RESONANCE IMAGING FOR THE DETECTION OF PROSTATE CANCER. J Urol 2011. [DOI: 10.1016/j.juro.2011.02.2555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Colleselli D, Schilling D, Gakis G, Todenhoefer T, Aufderklamm S, Alloussi S, Stenzl A, Schwentner C. 977 ENDOSCOPC INGUINOFEMORAL LYMPHADENECTOMY FOR GENITOURINARY MALIGNANCIES. J Urol 2011. [DOI: 10.1016/j.juro.2011.02.988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schwentner C, Hennenlotter J, Kuehs U, Sleiman H, Gakis G, Todenhoefer T, Colleselli D, Aufderklamm S, Schilling D, Stenzl A. 151 SECOND-LINE APPLICATION OF URINE-BASED MOLECULAR MARKERS IN TRANSITIONAL CARCINOMA DIAGNOSTICS -A CONTRIBUTION TO COST EFFECTIVENESS. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1569-9056(11)60154-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Colleselli D, Hennenlotter J, Schilling D, Krueger SA, Roethke M, Lichy MP, Vogel U, Kuehs U, Schlemmer HP, Stenzl A, Schwentner C. Impact of clinical parameters on the diagnostic accuracy of endorectal coil MRI for the detection of prostate cancer. Urol Int 2011; 86:393-8. [PMID: 21335950 DOI: 10.1159/000324098] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 12/28/2010] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Endorectal coil MRI (endoMRI) of the prostate is useful to evaluate tumor localization. There is little evidence on patient characteristics affecting its diagnostic performance. We evaluate the influence of clinical and histological parameters on the accuracy of endoMRI. METHODS Sixty-nine patients with prostate cancer were included. After virtually dividing the prostate into pixels of 1 cm2, results of endoMRI were compared with those from prostatectomy specimens' whole-mount sections. Univariate and multivariate analyses were performed to calculate the impact of clinical and histological parameters on the number of appropriately described pixels. RESULTS In 9, no tumor could be demonstrated by endoMRI. 48.3% of patients were staged correctly, 23.3% were over- and 28.3% understaged. Mean rates of correctly labeled pixels were 0.44 (± 0.04 SEM) for tumor and 0.90 (± 0.01) for benign segments. In univariate analysis, the rate of correctly labeled tumor segments showed significant positive correlations with Gleason score ≥7 and negative correlations with prostate weight and multifocality. The rate of correctly labeled benign segments showed significant negative correlation with tumor weight. All factors were independent variables in multivariate analysis. CONCLUSIONS The reliability of endoMRI depends on clinical parameters. Higher Gleason scores, unifocal tumors and smaller prostate volumes ameliorate endoMRI performance.
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Affiliation(s)
- Daniela Colleselli
- Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany
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Schwentner C, Seibold J, Colleselli D, Alloussi SH, Schilling D, Stenzl A, Radmayr C. Single-stage dorsal inlay full-thickness genital skin grafts for hypospadias reoperations: extended follow up. J Pediatr Urol 2011; 7:65-71. [PMID: 20172763 DOI: 10.1016/j.jpurol.2010.01.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Accepted: 01/29/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To report our extended experience with single-stage genital skin graft urethroplasty for complex hypospadias reoperations. MATERIALS AND METHODS Thirty-one patients with failed hypospadias surgery were included. The urethral plate had been removed or was scarred in all. After excision of fibrotic tissue a free full-thickness skin graft was quilted to the corpora cavernosa. The neourethra was then tubularized followed by glanuloplasty. Voiding cystograms, urethral ultrasound and flow measurements were performed in all. Outcome was considered a failure when postoperative instrumentation was needed. RESULTS Follow up was 78.45 +/- 18.18 months. Shaft skin was used in 13 and internal prepuce in 18. Average graft length was 3.66 +/-1.56cm. Eighteen patients required glanuloplasty. Initial graft healing was successful in all. There was no postoperative infection involving the inlay. We did not note complications from the graft donor sites. Four patients underwent redo surgery yielding a complication rate of 12.9%. Urethral stricture of the proximal anastomosis was most frequent. CONCLUSIONS This single-stage approach using dorsal inlay skin grafts is reliable, creating a substitute urethral plate in the long term. Complication rates are equivalent to those of staged strategies. This is a safe option for hypospadias reoperations if the urethral plate is compromised.
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Colleselli D, Stenzl A, Schwentner C. Re: Florian Jentzmik, Carsten Stephan, Kurt Miller, et al. Sarcosine in urine after digital rectal examination fails as a marker in prostate cancer detection and identification of aggressive tumours. Eur Urol 2010;58:12-8. Eur Urol 2010; 58:e51. [PMID: 20728983 DOI: 10.1016/j.eururo.2010.08.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 08/10/2010] [Indexed: 11/25/2022]
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Schwentner C, Seibold J, Colleselli D, Alloussi SH, Schilling D, Sievert KD, Stenzl A, Radmayr C. Dorsal Onlay Skin Graft Urethroplasty in Patients Older Than 65 Years. Urology 2010; 76:465-70. [DOI: 10.1016/j.urology.2010.01.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 01/01/2010] [Accepted: 01/11/2010] [Indexed: 11/28/2022]
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Seibold J, Werther M, Alloussi S, Gakis G, Schilling D, Colleselli D, Stenzl A, Schwentner C. Objective long-term evaluation after distal hypospadias repair using the meatal mobilization technique. ACTA ACUST UNITED AC 2010; 44:298-303. [PMID: 20450394 DOI: 10.3109/00365599.2010.482944] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Meatal mobilization (MEMO) by distal urethral preparation has been demonstrated to be an efficient surgical technique for the correction of distal hypospadias offering excellent short-term success rates. This study objectively evaluates individual patient satisfaction using a validated score in the long term. MATERIAL AND METHODS A total of 218 patients who underwent hypospadias repair using the MEMO technique was identified. Of these, 104 (mean age at time of surgery 4.9 years, range 2-28 years) had a minimum follow-up of 5 years and were eligible for the study. They were investigated by physical examination and self-assessment. An objective evaluation using the validated Hypospadias Objective Scoring Evaluation (HOSE) was done in all patients. RESULTS Mean follow-up was 6.3 (range 5-8) years. Ninety-nine patients participated in the investigation, an overall survey response rate of 95.2%. One urethrocutaneous fistula occurred, but no cases of stenosis were noted. One patient developed a mild penile deviation during the postoperative follow-up. Ninety-three out of 99 patients reached the maximum of 16 points (median 15, range 12-16) on the HOSE symptom score. CONCLUSION The MEMO technique demonstrates a surgical success rate of 97% after 2 years. Even in the long-term follow-up of a mean 6.3 years objective outcome data and individual patient satisfaction were excellent. MEMO is a reliable and versatile method for distal hypospadias repair, as reflected by high patient satisfaction.
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Affiliation(s)
- Joerg Seibold
- Department of Urology, Eberhard-Karls University, Tuebingen, Germany
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Schwentner C, Seibold J, Colleselli D, Alloussi SH, Gakis G, Schilling D, Sievert KD, Stenzl A, Radmayr C. Anterior urethral reconstruction using the circular fasciocutaneous flap technique: long-term follow-up. World J Urol 2010; 29:115-20. [PMID: 20379722 DOI: 10.1007/s00345-010-0548-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 03/30/2010] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The circular fasciocutaneous skin flap technique (FCF) yields excellent short-term results for complex anterior urethral reconstruction. We performed an observational retrospective and descriptive study to report our long-term experience. METHODS A total of 36 adults with anterior urethral strictures (AUS) exceeding 3 cm underwent single-stage urethroplasty using the FCF. Exclusion criteria were: lichen sclerosus, absence of the urethral plate and hypospadias. All had a minimum follow-up of 7 years. Mean age was 49.7 years. Radiological work-up was supplemented by urethral ultrasound showing a mean stricture length of 5.9 cm. A circumferential island of distal penile skin was mobilized on a vascularized pedicle and used for urethral reconstruction. Tube repairs were not included. Outcome was considered a failure when post-operative instrumentation was needed. The Mann-Whitney U test was used for statistical analysis. RESULTS Mean follow-up was 96.7 months (86-117). All received a ventral onlay repair secondary to stricturotomy. Complication rate was 8.3% (3/36): A flimsy stricture at the proximal anastomotic site occurred in 1 requiring optical urethrotomy. In 2 patients, glans dehiscence was noted. No penile skin necrosis was observed proximal to the flap-harvesting site. We did not observe neurovascular lower extremity complications. Long-term success rates exceeded 90%. CONCLUSIONS FCF-urethroplasty yields excellent long-term results with no late stricture recurrence. All complications occurred early after surgery underlining the durability of pedicled genital skin flaps. Despite extensive stricture, disease complication rates and morbidity were low. In case of paucity of local skin or lichen scleroses, oral grafts are required for optimal treatment.
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Affiliation(s)
- Christian Schwentner
- Department of Urology, Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Tuebingen, Germany.
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Schwentner C, Hennenlotter J, Kuehs U, Tews V, Colleselli D, Huber S, Schilling D, Sievert KD, Stenzl A. 1170 IMPACT OF INSTRUMENTED URINARY SAMPLING ON THE DIAGNOSTIC VALUE OF URINE TESTS (UROVYSIONR, UCYT+R) AND CYTOLOGY FOR TRANSITIONAL CELL CARCINOMA – RESULTS FROM A COHORT OF 2077 PATIENTS. J Urol 2010. [DOI: 10.1016/j.juro.2010.02.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schwentner C, Seibold J, Colleselli D, Mundhenk J, Schilling D, Stenzl A, Radmayr C. 1221 THE SINGLE STAGE DORSAL INLAY SKIN GRAFT FOR COMPLEX HYPOSPADIAS REOPERATIONS: LONG-TERM FOLLOW-UP. J Urol 2010. [DOI: 10.1016/j.juro.2010.02.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schwentner C, Hennenlotter J, Kuehs U, Sleiman H, Colleselli D, Huber S, Schilling D, Sievert KD, Stenzl A. 1171 COMBINATION OF URINE-BASED TUMOR MARKERS AND URINE CYTOLOGY IN THE DETECTION OF TRANSITIONAL CARCINOMA. J Urol 2010. [DOI: 10.1016/j.juro.2010.02.671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Colleselli D, Schilling D, Lichy MP, Hennenlotter J, Vogel UH, Krueger SA, Kuehs U, Schlemmer HP, Stenzl A, Schwentner C. Topographical Sensitivity and Specificity of Endorectal Coil Magnetic Resonance Imaging for Prostate Cancer Detection. Urol Int 2010; 84:388-94. [DOI: 10.1159/000300572] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 01/14/2010] [Indexed: 11/19/2022]
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Seibold J, Amend B, H. Alloussi S, Colleselli D, Todenhoefer T, Gakis G, Merseburger A, Sievert KD, Stenzl A, Schwentner C. Pediatric Urology Meatal mobilization (MEMO) technique for distal hypospadias repair: Technique, results and long-term follow-up. Cent European J Urol 2010. [DOI: 10.5173/ceju.2010.03.art4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Seibold J, Schwentner C, Schilling D, Anastasiadis A, Colleselli D, Stenzl A, Antwerpen C, Corvin S. Laparoscopic pyeloplasty is also successful in patients with duplicated collecting systems. Cent European J Urol 2010. [DOI: 10.5173/ceju.2010.01.art7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Massoner P, Colleselli D, Matscheski A, Pircher H, Geley S, Jansen Dürr P, Klocker H. Novel mechanism of IGF-binding protein-3 action on prostate cancer cells: inhibition of proliferation, adhesion, and motility. Endocr Relat Cancer 2009; 16:795-808. [PMID: 19509068 DOI: 10.1677/erc-08-0175] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
IGF-binding protein-3 (IGFBP-3) is a modulator of the IGF-signaling pathway and was described as an anti-cancer agent in prostate cancer. The molecular mechanisms underlying these effects remained, however, largely undefined. We analyzed the influence of recombinant IGFBP-3 on cell proliferation of PC3, Du145, and LNCaP prostate cancer cells. As expected, IGFBP-3 inhibited IGF-stimulated cell proliferation by blocking IGF-mediated proliferation signals, but we observed an IGF-independent inhibitory effect of IGFBP-3 on prostate cancer cell proliferation in long-term cultures. We further investigated the influence of IGFBP-3 on adhesion, motility, and invasion of prostate cancer cells using adhesion assays, live-cell imaging techniques, and matrigel invasion measurements. There was a clear inhibitory effect of IGFBP-3 on tumor cell adhesion to extracellular matrix components in the presence and absence of IGF, whereas cell-cell adhesion was not affected. The same inhibitory effect of IGFBP-3 was determined on cell motility when real-time cell movements were followed. In addition, IGFBP-3 was able to inhibit tumor cell invasion through matrigel. In summary, we show that IGFBP-3 inhibits proliferation, adhesion, migration, and invasion processes of prostate tumor cells. These newly described mechanisms of IGFBP-3 can be of importance for tumor progression and support a role of IGFBP-3 in therapeutic settings.
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Affiliation(s)
- Petra Massoner
- Department of Urology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
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Horstmann M, Patschan O, Hennenlotter J, Colleselli D, Feil G, Stenzl A. URINARY - BASED TUMOUR MARKERS EVALUATED EITHER BY WHITE LIGHT OR PHOTODYNAMIC TRANSURETHRAL RESECTION IN BLADDER CANCER. IS THERE ANY DIFFERENCE? J Urol 2009. [DOI: 10.1016/s0022-5347(09)61179-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schwentner C, Alloussi SH, Radmayr C, Colleselli D, Schilling D, Sievert KD, Stenzl A. Contemporary minimal-invasive nephron-sparing surgery. Cent European J Urol 2009. [DOI: 10.5173/ceju.2009.04.art2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Horninger W, Pelzer AE, Bektic J, Colleselli D, Schafer G, Bartsch G. TRANSURETHRAL RESECTION OF THE PROSTATE WITH THE “COAGULATING INTERMITTENT CUTTING DEVICE”(CIC): IMPACT ON HEMOSTATIC COMPLICATIONS – AN UPDATE ON A 7 YEAR EXPERIENCE. J Urol 2008. [DOI: 10.1016/s0022-5347(08)61967-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mitterberger M, Colleselli D, Pelzer AE, Horninger W, Bartsch G, Pallwein L, Frauscher F. CONTRAST ENHANCED COLOR DOPPLER TARGETED BIOPSY: VALUE OF BLOOD FLOW RATING SCALE FOR PROSTATE CANCER DETECTION. J Urol 2008. [DOI: 10.1016/s0022-5347(08)61981-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bektic J, Pelzer AE, Colleselli D, Schafer G, Bartsch G, Horninger W. PREDICTIVE VALUE OF PROSTATE SPECIFIC ANTIGEN VELOCITY IN THE DIAGNOSIS OF PROSTATE CANCER: RESULTS OF THE TYROL SCREENING PROJECT. J Urol 2008. [DOI: 10.1016/s0022-5347(08)62111-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mitterberger M, Pinggera GM, Colleselli D, Pelzer A, Horninger W, Strasser H, Bartsch G, Pallwein L, Gradl J, Aigner F, Frauscher F. CONTRAST ENHANCED COLOR DOPPLER TARGETED PROSTATE BIOPSY FOR PROSTATE CANCER DETECTION: RESULTS OF 2008 MEN. J Urol 2008. [DOI: 10.1016/s0022-5347(08)61888-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Colleselli D, Pelzer AE, Steiner E, Schafer G, Bektic J, Horninger W, Tewari AK, Bartsch G. OUTCOME OF RADICAL PROSTATECTOMY IN LOW, INTERMEDIATE AND HIGH RISK PROSTATE CANCER PATIENTS: A COMPARISON BETWEEN A SCREEN AND NON SCREEN POPULATION. J Urol 2008. [DOI: 10.1016/s0022-5347(08)62009-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pelzer AE, Colleselli D, Bektic J, Steiner E, Ramoner R, Mitterberger M, Schwentner C, Schaefer G, Ongarello S, Bartsch G, Horninger W. Pathological features of Gleason score 6 prostate cancers in the low and intermediate range of prostate-specific antigen level: is there a difference? BJU Int 2008; 101:822-5. [DOI: 10.1111/j.1464-410x.2008.07454.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bektic J, Pelzer AE, Colleselli D, Schafer G, Bartsch G, Horninger W. DISCREPANCIES IN GLEASON SCORING OF PROSTATE BIOPSIES AND RADICAL PROSTATECTOMY SPECIMENS AND THE PROGNOSTIC VALUE OF PSAV ON SCORING ACCURACY. TEN YEAR EXPERIENCE IN A SINGLE CENTRE. J Urol 2008. [DOI: 10.1016/s0022-5347(08)60155-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pallwein L, Mitterberger M, Gradl J, Aigner F, Colleselli D, Pelzer AE, Horninger W, Bartsch G, Frauscher F. MICROVASCULAR IMAGING (MVI) OF THE PROSTATE DURING CONTRAST-ENHANCED ULTRASOUND: INITIAL EXPERIENCE. J Urol 2008. [DOI: 10.1016/s0022-5347(08)61979-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mitterberger M, Colleselli D, Pelzer AE, Horninger W, Bartsch G, Strasser H, Pallwein L, Gradl J, Frauscher F. EVALUATION OF INVESTIGATOR DEPENDENCY IN TRANSRECTAL CONTRAST ENHANCED COLOR DOPPLER TARGETED BIOPSY. J Urol 2008. [DOI: 10.1016/s0022-5347(08)61982-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pelzer AE, Colleselli D, Bektic J, Schaefer G, Ongarello S, Schwentner C, Pallwein L, Mitterberger M, Steiner E, Bartsch G, Horninger W. Clinical and pathological features of screen vs non-screen-detected prostate cancers: is there a difference? BJU Int 2008; 102:24-7. [PMID: 18341623 DOI: 10.1111/j.1464-410x.2008.07566.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate the clinical and pathological characteristics of screen vs non-screen-detected prostate cancers, to determine if there is a difference in the same prostate-specific antigen (PSA) range. PATIENTS AND METHODS In all, 997 patients who had had a radical prostatectomy were evaluated; 806 were Tyrolean screening volunteers, and 191 were from outside Tyrol, representing the 'referred prostate cancer' group. PSA level, age, prostate volume and pathological characteristics were assessed, as was the amount of over- and under-diagnosis. RESULTS There were no statistically significant differences in patient age or PSA levels in the two groups. Even in the same PSA range there were statistically significantly more extraprostatic cancers in the referral group, at 31.7% and 17.4%, respectively. In the referred and screening groups there was over-diagnosis in 7.9% and 16.8%, and under-diagnosis in 40.8% and 27.8%, respectively. CONCLUSION This study suggests that screening volunteers have a statistically significantly higher rate of organ-confined prostate cancers, and a statistically significantly lower rate of extracapsular extension and positive surgical margins than their counterparts in the referral group even in the same PSA range. As the pathological stage and surgical margin status are significant predictors of recurrence, these findings support the concept of PSA screening.
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Mitterberger M, Colleselli D, Pelzer A, Horninger W, Bartsch G, Pallwein L, Gradl H, Aigner F, Frauscher F. CONTRAST ENHANCED COLOUR DOPPLER TARGETED PROSTATE BIOPSY FOR PROSTATE CANCER DETECTION: RESULTS OF 2008 MEN. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60023-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ukimura O, Mitterberger M, Okihara K, Miki T, Pinggera GM, Neururer R, Peschel R, Aigner F, Gradl J, Bartsch G, Colleselli D, Strasser H, Pallwein L, Frauscher F. Real-time virtual ultrasonographic radiofrequency ablation of renal cell carcinoma. BJU Int 2008; 101:707-11. [PMID: 18205858 DOI: 10.1111/j.1464-410x.2007.07324.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the usefulness of real-time virtual ultrasonography (RVS) as a new navigational tool for percutaneous radiofrequency ablation (RFA) of solid renal cell carcinoma (RCC). PATIENTS AND METHODS Ten patients with 13 RCCs were treated with percutaneous RFA using RVS, which displays ultrasonograms and corresponding multiplanar reconstruction images of computed tomography in parallel. RESULTS RVS allowed excellent anatomical visualization and precise navigation of RFA for RCC. All patients were treated successfully in one session with percutaneous RVS RFA. There were no significant complications, and none of the patients had a local tumour recurrence during the follow-up. CONCLUSION RVS for RFA of solid RCC is a new and promising alternative imaging method.
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Affiliation(s)
- Osamu Ukimura
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Pelzer AE, Colleselli D, Bektic J, Schaefer G, Ongarello S, Schwentner C, Aigner F, Mitterberger M, Steiner E, Bartsch G, Horninger W. Over-diagnosis and under-diagnosis of screen- vs non-screen-detected prostate cancers with in men with prostate-specific antigen levels of 2.0-10.0 ng/mL. BJU Int 2008; 101:1223-6. [PMID: 18190631 DOI: 10.1111/j.1464-410x.2007.07367.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate possible over- and under-diagnosis of prostate cancer in a screened vs a referral population in the same range of prostate-specific antigen (PSA). PATIENTS AND METHODS In all, 1445 patients undergoing radical prostatectomy and with a PSA level of <10 ng/mL were evaluated; 237 were from outside Tyrol (Austria) and represented the unscreened group, and 1208 were Tyrolean screening volunteers. Over-diagnosis was defined as a pathological stage of pT2a and a Gleason score of <7 with no positive surgical margins. Under-diagnosis was defined as a pathological stage of >or=pT3a or positive surgical margins. The chi-square test was used to assess the differences, with P < 0.05 considered to indicate statistical significance. RESULTS There were no significant differences in patient age or PSA levels between the study groups. There was over-diagnosis in the screening and referral groups in 17.4% and 8.9%, respectively, and under-diagnosis in 18.6% and 42.2%, respectively. CONCLUSION This study suggests that patients with prostate cancer participating in a screening programme are less likely to be under-diagnosed or have extracapsular disease than their counterparts in a referral population, even in the same PSA range, after radical prostatectomy. Furthermore, there was more under-diagnosis in the referral group than over-diagnosis in the screened group.
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Dalpiaz O, Kerschbaumer A, Mitterberger M, Pinggera GM, Colleselli D, Bartsch G, Strasser H. Female sexual dysfunction: a new urogynaecological research field. BJU Int 2008; 101:717-21. [PMID: 18190620 DOI: 10.1111/j.1464-410x.2007.07442.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To critically review published data on the urogynaecological aspects of female sexual dysfunction (FSD), as FSD is a developing multidisciplinary issue associated with several biological, medical and psychological factors. METHODS The reported prevalence of FSD is 19-50% and women with lower urinary tract symptoms or urinary incontinence (UI) not only complain of a deteriorating of quality of life but also of sexual life with an incidence as high as 26-47%. Furthermore, urogynaecological surgery represents an important but underestimated cause of FSD. Different databases (Pub Medical, Medline, serial titles, the Cochrane library and the NLM gateway database) were searched for the keywords 'sexuality; sexual function; urinary incontinence; pelvic organ prolapse; questionnaire; symptom severity; epidemiology; quality of life; instruments; sexual health; vagina; vaginal surgery; pelvic surgery'. RESULTS There is a lack of a standardized instrument for assessing FSD. Recent studies investigate the impact of UI on sexual function, but the pathophysiology has not been elucidated. Vaginal or pelvic surgery does not affect overall sexual satisfaction. CONCLUSIONS Our investigation highlights the need for studies to assess the anatomical, physiological and sensory mechanisms related to FSD. Specific questionnaire are needed to quantify the problem. In the definition, symptoms assessment and preoperative counselling is important, to make a distinction between overall sexual function and individual parameters, such as psychosocial context. Only in this way, will it be possible to identify new therapeutic targets. A definition of success in urogyneacological terms should include aspects of quality of life and quality of sexual life. Immediate research in this field is needed.
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Affiliation(s)
- Orietta Dalpiaz
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria.
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Mitterberger M, Pelzer A, Colleselli D, Bartsch G, Strasser H, Pallwein L, Aigner F, Gradl J, Frauscher F. Contrast-enhanced ultrasound for diagnosis of prostate cancer and kidney lesions. Eur J Radiol 2007; 64:231-8. [PMID: 17881175 DOI: 10.1016/j.ejrad.2007.07.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Revised: 07/30/2007] [Accepted: 07/31/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW Conventional ultrasonography of both, kidney and prostate, is limited due to the poor contrast of B-mode imaging for parenchymal disease and limited sensitivity of colour Doppler for the detection of capillaries and deep pedicular vessels. Contrast-enhanced ultrasound (CEUS) overcomes these limitations. RECENT FINDINGS CEUS investigates the blood flow of the prostate, allows for prostate cancer visualization and for targeted biopsies. Comparisons between systematic and CEUS-targeted biopsies have shown that the targeted approach detects more cancers with a lower number of biopsy cores and with higher Gleason scores compared with the systematic approach. Also the kidney offers promising applications as CEUS improves the detection of abnormal microvascular and macrovascular disorders. SUMMARY In recent literature CEUS has shown its value for diagnosis of both, prostate cancer and kidney lesions. This paper describes recent improvements and future perspectives of CEUS.
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Affiliation(s)
- Michael Mitterberger
- Department of Urology, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
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