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Raymond A Costabile

Publications and source records attributed to Raymond A Costabile.

6 recordsLinked to original sources
PubMed2006

Progression of renal tumors after laparoscopic radiofrequency ablation.

OBJECTIVES: To describe 2 patients with tumor progression after treatment with radiofrequency ablation (RFA). RFA is a minimally invasive, Food and Drug Administration-approved technique used to treat solid organ tumors. However, few studies of RFA treatment failure have been reported. METHODS: As a part of an institutional review board-approved protocol, nine renal tumors were ablated with RFA during a 2-year period. Patients enrolled on the protocol were assigned to one of two arms--ablate and resect and ablate and follow-up--depending on the patient's health, tumor characteristics, and tumor location and size. The average tumor size was 4.5 cm in the largest dimension, and the tumors were accessed percutaneously using computed tomography or ultrasound guidance, with direct laparoscopic visualization or through an open incision for concomitant nephrectomy. Postoperative follow-up examinations occurred at 3-month intervals for 2 years using serial computed tomography or magnetic resonance imaging. RESULTS: Two patients (22%) in the ablate and follow-up arm of the study experienced significant tumor progression less than 1 year after RFA. One tumor increased in size by 20% and the other quadrupled in size and developed a renocolic fistula. This is the first reported case of a renocolic fistula after RFA of a renal tumor. Both patients subsequently underwent radical nephrectomy with the final pathologic results showing renal cell carcinoma. CONCLUSIONS: Rapid tumor progression and renocolic fistula formation are possible complications of RFA. This treatment requires close and aggressive follow-up to ensure complete eradication of the renal lesion.

Aged↗
PubMed2006

How can we best characterize the relationship between erectile dysfunction and benign prostatic hyperplasia?

INTRODUCTION: Considerable epidemiological literature exists, showing a relationship between voiding dysfunction and sexual dysfunction. However, few basic science or prospective data are available to determine the nature of the relationship between benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and sexual dysfunction. METHODS AND DISCUSSION: A critical evaluation of the nature of the relationship between LUTS and erectile dysfunction (ED) must include a look at the nature of the data establishing the relationship, precise definitions of the disease states being evaluated, and adherence to established normative relationships. Criteria for causality will be utilized to best determine the relationship between LUTS and ED. This article will attempt to take a critical and provocative look at where we are presently in establishing a relationship between voiding dysfunction and sexual dysfunction in order to better direct research efforts through evidence-based studies. CONCLUSION: At present, the epidemiological data do not support a causal relationship based on Hill's criteria for causality between LUTS and ED but suggest a less rigorous association. Additional research is needed to better characterize this relationship.

Causality↗
PubMed2005

Time to development of symptomatic urinary calculi in a high risk environment.

PURPOSE: While seasonal variation of stone disease is well described, the time to formation of urinary calculi is unknown. Because southwestern Asia is a high risk environment for stone disease, the date of entry into this region is a definitive beginning to a period of increased risk of urinary calculi. The recent influx of Department of Defense personnel into southwestern Asia provided the opportunity to observe stone disease in a cohort of healthy personnel during a well-defined period of increased risk of stone formation. MATERIALS AND METHODS: A database was constructed for all patients presenting with symptomatic urinary calculi to a single military hospital deployed to Kuwait from March through August 2003. Patient demographics, stone characteristics and time to formation of symptomatic urinary calculi were evaluated. RESULTS: A total of 182 patients were diagnosed with 218 symptomatic stones. Mean time to formation of symptomatic urinary calculi was 93 days with a standard deviation of 42 days. CONCLUSIONS: This study provides unprecedented information about the development of symptomatic urinary calculi in a high risk environment. While unique aspects of the population, environment and medical system created a singular opportunity to study stone disease, the results of this study are applicable to the general population.

Adult↗