Priapism can be successfully treated by unilateral or bilateral percutaneous transcatheter occlusion of the internal pudendal arteries. Occlusion should be reversible in order to avoid impotence. Embolization with an autologous clot satisfies this requirement because of clot lysis and consequent vessel recanalization. This treatment is the most specific therapy in 'high-flow' priapism. The authors describe extensively 5 cases which demonstrate the feasibility of the method by which sexual potency is preserved.

Adult↗

PubMedDate not supplied

Roach's mathematical equations in predicting pathological stage in men with clinically localized prostate cancer.

AIMS AND BACKGROUND: The therapeutic choice in patients with clinically localized prostate cancer depends on preoperative clinical stage. Diagnostic instruments currently available for such an evaluation--considered separately--have not shown enough efficacy. Roach has recently introduced three simple mathematical equations that--on the basis of prostate-specific antigen and the biopsy Gleason score--are aimed at calculating the definitive pathological stage. We retrospectively analyzed our radical prostatectomy data base to assess the accuracy of the equations in predicting the final stage in patients with clinically localized prostate cancer. METHODS STUDY DESIGN: The study included 173 patients who had undergone radical retropubic prostatectomy at our Institution. Patients were divided into 25 groups, depending on preoperative PSA and the biopsy Gleason score. The risk of extracapsular neoplastic growth, seminal vesicle involvement and lymph node involvement was calculated for each group by means of Roach's equations. On the basis of definitive histological examinations, we compared the expected risk to the observed risk. RESULTS: The observed risk fell within the interval of expected risk in 16 of 17 groups (94%) regarding the evaluation of extracapsular growth, in 15 of 17 (88%) regarding the analysis of seminal vesicle involvement, and in 14 of 17 (82%) regarding the evaluation of lymph node involvement. Therefore, the observed event was in agreement with the expected event in 45 of 51 groups (88%). CONCLUSIONS: The equations represent a practical and effective instrument for preoperative clinical staging in patients with localized prostate cancer. By means of these mathematical formulas, one can assess the correct prognosis and--above all--plan the best therapeutic approach.

Aged↗

PubMedDate not supplied

[Monodose aztreonam in the prevention of infection after extracorporeal shockwave lithotripsy. Theoretical premises].

A series of 905 patients suffering from renal calculosis and treated with ESWL is considered and the indications for antibiotic treatment with prophylactic or prolonged aztreonam reviewed: 1) for calculi with sterile urine or occasionally infected with I.S.T. less than 200, monodose prophylaxis is certainly advantageous; 2) for calculi with sterile urine or occasionally infected with I.S.T. between 200 and 500, prolonged antibiotic cover is useful; 3) for calculi with chronic infection or with I.S.T. greater than 500, prolonged target antibiotic therapy is necessary; 4) aztreonam is an effective drug for both monodose prophylaxis and for cover treatment. In more complex cases, an antibiogram indication is necessary.

Aztreonam↗