Biomedical subjects
Publications and source records attributed to G Sakkas.
We present a case of prostatic urethral nephrogenic adenoma incidentally diagnosed in a patient treated with ESWL for ureteral stone disease, and we comment on this unusual urothelial lesion.
Transurethral radiofrequency thermotherapy for symptomatic benign prostatic hyperplasia was performed in 50 selected patients, using the THERMEX II device. High surgical risk patients were included, among them 13 previously catheterized ones, because of unresolved retention for more than 6 months. The treatment consisted of a three-hour single session at 47 degrees C. Follow-up studies were carried out at 1, 3, 6 and 12 months using Madsen score, maximum flow rate, residual urine volume determinations and prostate bulk measurement by transrectal ultrasound. Subjective and objective improvement (of more than two parameters) was noticed in 62% of the patients. Prostatic volume did not change. In the retention group 54% of the patients remained free of catheter. Postoperative histology in 8 cases that failed to respond, revealed focal haemorrhagic and necrotic changes in periurethral glandular tissue. This is a promising method for selected high risk patients that achieves reasonable but not comparable results to TURP and requires further investigation in larger patient groups with BPH.
Laser surgery is currently considered as an effective alternative in the treatment of several urological diseases. We report on our three-year experience treating recurrent superficial low grade bladder carcinoma in 80 patients using Neodymium: YAG (Nd:YAG) laser. A decrease in local tumour recurrence rate (11%) was observed, but the overall not treated area recurrence was 45%. No complications were noted when the procedure was carried out on outpatient basis. Furthermore, we have been treating successfully urogenital condylomata using Nd:YAG and carbon dioxide (CO2) lasers in 364 patients. In addition we describe the use of Nd:YAG laser in the percutaneous treatment of a patient with bilateral transitional cell carcinoma of the renal pelvis.
In an attempt to evaluate renal injury relative to open surgery, percutaneous nephrolithotripsy (PCN) and extracorporeal shock wave lithotripsy (ESWL) were studied in 52 patients with renal calculus disease. Preoperative and postoperative urinary levels of N-acetyl-glycosaminidase (NAG), a sensitive marker of renal tubular damage, were studied. No significant changes were noted in posttreatment urinary NAG values among patients who underwent ESWL or PCN. Although statistically nonsignificant, a constant mild increase of urinary NAG was observed after PCN, that has to be evaluated with long-term follow-up studies. The shock wave number or power in cases treated with ESWL as well as the number of renal punctures in the PCN group did not change the effect on renal tubular function. Diabetics and patients with chronic renal disease treated by ESWL did not show any significant change in posttreatment urinary NAG levels. In contrast to that, all patients treated by open surgery had significant, intense and prolonged increase of the postoperative NAG values, especially those treated by ischaemic nephrolithotomy. Comparing the three different therapeutic modalities, open surgical procedures had the most significant effect on renal function and this difference was statistically significant. We therefore suggest that ESWL does not endanger renal function, while open surgery must be reserved for selected cases.
We present a case of carcinosarcoma of the bladder, the first in our experience. This tumour is generally considered to be a rare one, has uncertain aetiology and poor prognosis. At present, radical cystectomy is the treatment of choice.
Melanosis of the prostate gland is a rare pathological finding. Its clinical significance is unknown and the histogenesis is occult. It is found in benign prostatic hyperplasia or carcinoma of the prostate. We present such a case and review the literature.
The authors describe a case of inverted papilloma. It is relatively rare and generally appears as a benign tumour.