OBJECTIVE We reviewed our surgical experience on genitourinary tuberculosis in the past 20 years in order to evaluate if any change in the incidence and management of this disease has occurred. PATIENTS AND METHODS From 1980 to 1999, at our Institution, 102 patients underwent surgery for genitourinary tuberculosis. We recorded the data and the surgical procedure of these subjects and compared patients treated in period 1980-1989 to those submitted to surgery in the period 1990-1999. RESULTS The overall incidence of surgical management of genitourinary tuberculosis in the past 20 years was 0.50% (102 cases on a total of 20,299 urological surgical procedures). In the decade 1980-1989 the incidence was 0.67% (70 cases out of 10,428 patients) and in the decade 1990-1999 it was 0.32% (32 cases out of 9,871 patients). Nephrectomy was the most prevalent surgical procedure performed in both decades. CONCLUSIONS Despite the availability of effective antimycobacteric drugs, surgery continues to play a role in the management of genitourinary tuberculosis. This disease is very slow to progress with minimal and subtle symptoms, often resulting in irreversible damage of the organs involved by the time a diagnosis is established.
Abstract We present a case of ureteral metastasis from a primary breast cancer where the disease recurred with an episode of renal colic 7 years after diagnosis. A surgical operation was performed to remove the terminal ureter and the perimeatal area of the urinary bladder. Urological and radiological outcome was satisfactory after a 2‐year follow up.
Recent evidence has shown that positive results may be observed for fluorodeoxyglucose‑positron emission tomography (FDG‑PET) in undifferentiated, biologically aggressive and metastatic tumors. The present study describes a case series of six patients with normal prostate‑specific antigen (PSA) serum levels who underwent FDG‑PET due to other causes. Positive PET results were observed at the prostate and the patients were subsequently diagnosed with high‑risk prostate cancer. Clinical, anamnestic, laboratory and instrumental data were collected from six asymptomatic patients with total serum PSA levels of <4 ng/ml who had undergone FDG‑PET due to other causes. The FDG‑PET and prostate biopsy were positive for prostate cancer. All the patients were treated with radical intent. The median age was 66 years (range, 52‑72 years), the median total PSA value was 2.4 ng/ml (range, 1.5‑3.9 ng/ml) and the body mass index was 26.4 (range, 21.8‑30.2). Three of the six patients underwent FDG‑PET due to a clinical suspicion of multiple myeloma, while three patients were examined for other oncological diseases. The pathological analysis at the prostate biopsy revealed three patients with a Gleason score of 6, two with a score of 7 (4+3) and one with a score of 8 (4+4). Five of the six patients were treated by radical prostatectomy and one by radiotherapy. The pathological analysis revealed one patient of pT2a stage, three of pT2c and one of pT3b. No patients demonstrated lymph node invasion. The definitive Gleason score was 3+3 in one patient, 4+3 in one patient, 4+4 in two patients and 5+3 in one patient. Following a median follow‑up time of six months (range, 1‑12 months), five of the six patients underwent FDG‑PET again, which revealed negative results. At the end of this study, these patients were alive without evidence of disease. By contrast, one patient demonstrated positive FDG‑PET results. In conclusion, FDG‑PET has been used to characterize prostate cancers in patients with apparently normal PSA levels.
<i>Introduction:</i> The study of the psychological impact in patients diagnosed with cancer is an important topic. Cancer diagnosiscan induce feelings of anxiety, depression, fear of recurrence and produce treatment side effects. Men and women tend to differ in their way of dealing with emotional distress and physical illness. The aim of this study is to investigate and evaluate the prevalence and detection of psychological disease in patients with genitourinary tumors and outline the eventual gender differences. <i>Materials and Methods:</i> State-Trait Anxiety Inventory, Self-Rating Depression Scale and Illness Behavior Questionnaire were administered to 60 patients with genitourinary neoplasm. <i>Results:</i> Most patients show symptoms of depression and anxiety during the hospitalization. We have observed a significant gender differences in the psycho-emotional assessment. <i>Conclusion:</i> Our study confirms the importance to make available for the patients a proper and continuous support in pre- and postsurgery period to prevent the generation of psychological disorders.
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