Brazilian consensus on vesicoureteral reflux-recommendations for clinical practice.

INTRODUCTION: Vesicoureteral Reflux (VUR) is characterized by a retrograde flow of urine from the bladder into the ureters and kidneys. It is one of the most common urinary tract anomalies and the major cause of urinary tract infection (UTI) in the first years of life. If not properly diagnosed and treated can lead to recurrent UTI, renal scar and, in severe cases, to end stage renal disease. Despite recent advances in scientific and technological knowledge, evaluation and treatment of VUR is still controversial and there is still considerable heterogeneity in evaluation methods and therapeutic approaches. The aim of the present consensus is to give a practical orientation on how to evaluate and treat VUR. METHODS: The board of Pediatric Urology of the Brazilian Society of Urology joined a group of experts and reviewed all important issues on Vesicoureteral Refl ux evaluation and treatment and elaborated a draft of the document. On November 2017 the panel met to review, discuss and write a consensus document. RESULTS AND DISCUSSION: Vesicoureteral Reflux is a common and challenging problem in children. Children presenting with Vesicoureteral Reflux require careful evaluation and treatment to avoid future urinary tract infections and kidney scars. The panel addressed recommendations on up to date choice of diagnosis evaluation and therapies.

Brazilian consensus in enuresis-recomendations for clinical practice.

INTRODUCTION: Enuresis, defined as an intermittent urinary incontinence that occurs during sleep, is a frequent condition, occurring in about 10% of children at 7 years of age. However, it is frequently neglected by the family and by the primary care provider, leaving many of those children without treatment. Despite of many studies in Enuresis and recent advances in scientific and technological knowledge there is still considerable heterogeneity in evaluation methods and therapeutic approaches. MATERIALS AND METHODS: The board of Pediatric Urology of the Brazilian Society of Urology joined a group of experts and reviewed all important issues on Enuresis and elaborated a draft of the document. On September 2018 the panel met to review, discuss and write a consensus document. RESULTS AND DISCUSSION: Enuresis is a multifactorial disease that can lead to a diversity of problems for the child and family. Children presenting with Enuresis require careful evaluation and treatment to avoid future psychological and behavioral problems. The panel addressed recommendations on up to date choice of diagnosis evaluation and therapies.

Tratamento do carcinoma renal metastático / Treatment of the metastic renal cell carcinoma

O carcinoma de células renais (COR) é a sétíma principal causa de câncer, respondendo por 3por cento dos tumores malignos no homem. Em um terço dos casos se apresenta como doença avançada e até 50por cento dos pacientes tratados cirurgicamente terão recidiva tumoral Acomete os homens duas vezez mais frequentemente que as mulheres e é mais comum entre a quinta e a sétima década de vida. O CCR teve sua incidência aumentada a partir da década de 70 devido ao uso rotineiro do ultra-som e aumento dos fatores de risco na população como fumo, obesidade e hipertensão. Pacientes com CCR metastático não tratados têm uma sobrevida média de seis a dez meses e apenas 10por cento a 20por cento estarão vivos após dois anos. Atualmente, com um melhor estudo da biologia e história natural do CCR, muitos avanços têm ocorrido nas áreas da genética molecular e ímunologia. Os autores fazem uma revisão das atuais modalidades terapêuticas do CCR avançado.