A congenital anterior urethrocutaneous fistula in a boy whose mother was exposed to ionizing radiations: case report and literature review.

Anterior congenital urethrocutaneous fistula is a rare anomaly that may present in an isolated fashion or in association with other anomalies of the genital urinary tract or anorectal malformations. A case of congenital anterior urethrocutaneous fistula nonassociated with other congenital anomalies in a 3-year-old male whose mother has been exposed to Chernobyl's nuclear fallout is described. The patient was successfully operated with no recurrence. We report a review of the literature about etiology and surgical strategy including the role of ionizing radiations. The congenital anterior urethrocutaneous fistula represents a rare malformation. The etiopathogenesis is unknown.

The use of mannitol in partial and live donor nephrectomy: an international survey.

PURPOSE: Animal studies have shown the potential benefits of mannitol as renoprotective during warm ischemia; it may have antioxidant and anti-inflammatory properties and is sometimes used during partial nephrectomy (PN) and live donor nephrectomy (LDN). Despite this, a prospective study on mannitol has never been performed. The aim of this study is to document patterns of mannitol use during PN and LDN. MATERIALS AND METHODS: A survey on the use of mannitol during PN and LDN was sent to 92 high surgical volume urological centers. Questions included use of mannitol, indications for use, physician responsible for administration, dosage, timing and other renoprotective measures. RESULTS: Mannitol was used in 78 and 64 % of centers performing PN and LDN, respectively. The indication for use was as antioxidant (21 %), as diuretic (5 %) and as a combination of the two (74 %). For PN, the most common dosages were 12.5 g (30 %) and 25 g (49 %). For LDN, the most common doses were 12.5 g (36.3 %) and 25 g (63.7 %). Overall, 83 % of centers utilized mannitol, and two (percent or centers??) utilized furosemide for renoprotection. CONCLUSIONS: A large majority of high-volume centers performing PN and LDN use mannitol for renoprotection. Since there are no data proving its value nor standardized indication and usage, this survey may provide information for a randomized prospective study.

Prulifloxacin versus levofloxacin in the treatment of chronic bacterial prostatitis: a prospective, randomized, double-blind trial.

Ninety-six patients with chronic bacterial prostatitis (CBP) and evidence of infection were randomized to receive a 4-week oral course of either prulifloxacin (a new fluoroquinolone) 600 mg or levofloxacin 500 mg once daily. They were evaluated with the Meares-Stamey test and the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) at baseline and one week after therapy completion. Patients with microbiological eradication were evaluated again with the Meares-Stamey test 6 months after therapy completion. The microbiological eradication rate was 72.73% for prulifloxacin and 71.11% for levofloxacin (p=0.86) and the reduction in the NIH-CPSI was 10.75 and 10.73, respectively (p=0.98). Safety was comparable, with 18.18% adverse events for prulifloxacin and 22.22% for levofloxacin (p=0.79). Thus, a 4-week course of prulifloxacin 600 mg once daily is at least as effective and safe as levofloxacin 500 mg once daily in the treatment of CBP.

Value of image fusion in the staging of prostatic carcinoma.

PURPOSE: We assessed the value of image fusion in the staging of prostatic cancer in a series of 32 patients who underwent preoperative evaluation with transrectal colour-Doppler ultrasonography (TRUS) and magnetic resonance imaging (MRI). MATERIALS AND METHODS: Colour-Doppler TRUS exams were performed using a 7.5-MHz biplanar probe. MRI exams were done with a scanner operating at 1.5 Tesla (T) using an endorectal coil. All patients underwent radical prostatectomy within 2 weeks from the imaging assessment. Whole-mount sections were prepared from the surgical specimens and were subsequently digitised by using a high-resolution scanner. The Digital Imaging and Communications in Medicine (DICOM) TRUS and MR images as well as the digitised pathological images were transferred to a graphic workstation to perform image fusion. RESULTS: Image fusion was technically possible in 25/32 cases in which axial TRUS images were available. The following fusion images were obtained: TRUS + pathological sections; MRI + pathological sections; TRUS + MRI + pathological sections. The final pathological staging concerning the T status was: four pT2b, fourteen pT2c, three pT3a and four pT3b. The three types of image fusion led to the following results: TRUS + pathological sections, correct staging in 20/25 cases (accuracy 80%); MRI + pathological sections, correct staging in 22/25 cases (accuracy 88%); TRUS + MRI + pathological sections, correct staging in 23/25 cases (accuracy 92%). CONCLUSIONS: Our study suggests that by using image fusion between colour-Doppler TRUS and endorectal MRI, it is possible to improve the accuracy of pathological staging in patients who are candidates for radical prostatectomy.

Testicular metastasis as isolated recurrence after radical prostatectomy. A first case.

Prostate cancer synchronously or metachronously metastasizing to the testis is a rare finding. We herein report on the first case of a solitary testicular metastasis from an organ-confined prostate cancer, diagnosed 6 months after a radical prostatectomy, without evidence of previous or concomitant biochemical and local recurrence.