RESUMO
The purpose of this study was to evaluate fertility after different types of post-chemotherapy retroperitoneal lymph node dissection (RPLND). During 1980-1994, 192 patients with metastatic testicular cancer underwent post-chemotherapy RPLND with a gradual shift from modified bilateral template RPLND to nerve-sparing RPLND. Modified bilateral template RPLND was done in 92% of the patients operated during 1980-1984 as compared to 16% during 1989-1994. Pre- and post-treatment fertility was assessed by microscopic sperm analysis, determination of serum FSH and information on ejaculation and paternity. There was no significant difference of the survival rates between the three treatment periods. Antegrade ejaculation was preserved in 11% of the patients after modified bilateral template RPLND as compared to 89% after the nerve-sparing operation technique. The median ejaculatory volume decreased post-operatively, serum FSH increased and sperm density remained unchanged. Fifty-six patients attempted fatherhood after their treatment, and 27 fathered at least one child after an observation-time of 55 months, nine of them by assisted fertilization. Patients with initially advanced testicular cancer but limited residual retroperitoneal masses after induction chemotherapy can safely undergo limited post-chemotherapy RPLND as a part of multimodality treatment. After nerve-sparing RPLND antegrade ejaculation is preserved in 89% of the patients though the ejaculatory volume decreases after RPLND. Post-treatment fatherhood can be achieved in at least 50% of the patients attempting paternity.
Assuntos
Ejaculação , Neoplasias Testiculares , Adolescente , Adulto , Antineoplásicos/uso terapêutico , Terapia Combinada , Humanos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Orquiectomia , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia , Resultado do TratamentoAssuntos
Anestesia Epidural , Anestesia Obstétrica , Cesárea , Pai , Feminino , Humanos , Masculino , GravidezRESUMO
Ii is shown from statistical data reported to the Swedish Cancer Registry that in cases of prostatic carcinoma the long-term T-year survival rate is the final outcome of a complex interplay of multiple factors including diagnostic technology and techniques for staging and grading. Assessment of the value of specific therapy is not possible except in controlled clinical trials. The T-year survival rate per se does not give an accurate estimate of the effect of treatment.
Assuntos
Neoplasias da Próstata/epidemiologia , Adulto , Idoso , Biópsia por Agulha , Técnicas Citológicas , Humanos , Masculino , Métodos , Pessoa de Meia-Idade , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/mortalidade , Sistema de Registros , Risco , Suécia , Fatores de TempoAssuntos
Íleo/cirurgia , Derivação Urinária/métodos , Adulto , Animais , Cães , Endoscopia , Feminino , Humanos , Íleo/patologia , Mucosa Intestinal/patologia , Mucosa Intestinal/ultraestrutura , Rim/diagnóstico por imagem , Rim/fisiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Qualidade de Vida , Radiografia , Doenças da Bexiga Urinária/reabilitação , Doenças da Bexiga Urinária/cirurgia , Urina/análise , UrodinâmicaRESUMO
PIP: An analysis is presented of early somatic complications of abortion that occurred in 322 women, aged 14-49. Definitions for the types of complications that were analyzed are given (e.g., fever, incomplete evacuation). The frequency of complications was then analyzed with respect to the age, gestational period, and previous parity of the patients. The frequency of complications was 12.4%, for serious complications 4.0%. Complications were significantly more frequent in the 15-19 year age group and in multiparas. The frequency of complications is compared with other studies of the same nature. An analysis of the cost of these abortions to the state is presented.^ieng