— 2019-3 — Summary
Prevention for recurrent lower urinary tract infections
DOI: 10.22591/magyurol.2019.3.ganyeczm.106
Authors:
Ganyecz Máté dr., Köves Béla dr., Tenke Péter dr.
Jahn Ferenc Dél-pesti Kórház, Urológia osztály, Budapest (osztályvezető: Tenke Péter dr.)
Summary
Half of women suffer from acute lower urinary tract infection at least once in their lifetime and 20% of cases develop recurrent urinary tract infection. The disease has a detrimental impact on patient’s quality of life; and 60% of patients have some degree of depression that can be reduced by up to 30-40% with appropriate preventive treatment. In developed countries, this disease represents a significant financial burden on the health care system and on the other hand result in a high number of days off work. In the case of recurrent cystitis, it is not sufficient to treat the current infection a greater emphasis should be placed on the appropriate prophylaxis. From the options of the preventive methods, non-antibiotic-based methods should always be preferred, and antibiotic prophylaxis is only recommended in case of failure.
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Laparoscopic renal dissection and left side nephroureterectomy for ureteral tumour in a horseshoe kidney – Case report
DOI: 10.22591/magyurol.2019.3.csicsenkovp.103
Authors:
Csicsenkov Péter dr., Domján Zsolt dr.
Szent János Kórház és Észak-budai Egyesített Kórházak, Urológiai osztály, Budapest (osztályvezető: Domján Zsolt dr.))
Summary
Introduction: Horseshoe kidney is the most common renal fusion anomaly. The incidence of horseshoe kidney is approximately 1 in 500 in the normal population with a male preponderance of 2:1. Upper urinary tract urothelial carcinoma is relatively uncommon, accounting for less than 5% of all urothelial carcinomas. It is associated with high mortality and morbidity.
Case report: The authors would like to present a single case of a laparoscopic dissection and left side nephroureterectomy in a patient who was investigated for painless haematuria and later on diagnosed for left side ureteral cancer.
The case was considered worth of presentation because a full thickness renal parenchyma was successfully dissected with minimal invasive way, but the authors had to work out a special safe technique.
Conclusion: There are only a few publications about laparoscopic horseshoe kidney dissections due to cancer, and this article can be considered as the first case reported in Hungary.
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Tumour in the renal graft after transplantation
DOI: 10.22591/magyurol.2019.3.kissz.98
Authors:
Kiss Zoltán dr., Berczi Csaba dr., Berczi Adrienne, Flaskó Tibor dr.
Debreceni Egyetem Általános Orvostudományi Kar, Urológiai Tanszék, Debrecen (igazgató: Flaskó Tibor dr.)
Summary
Introduction: The administered immunosuppressive treatment increases the incidence of malignant tumours after organ transplantation. Occurrence of renal cancers is higher after kidney transplantation than in normal population. These tumours mainly occur in the own kidney of the recipients, while in 10% they developed in the graft. The authors report their experience with treatment of tumour in renal graft in their three cases.
Case presentation: Case 1: Kidney transplantation was performed 20 years ago in a 46-year-old male patient. The routine ultrasound examination showed a 2 cm tumour in the graft which was confirmed by the abdominal MR scan. The patient underwent partial nephrectomy. Histology proved pT1a, renocellular carcinoma. The dose of immunosuppressive drugs was reduced after surgery. No recurrence was observed in the 2-year follow-up period.
Case 2: Renal transplantation was done 13 years ago in a 65-year-old female patient. Ultrasound and CT scan of the graft described a 35 mm tumour at the upper pole of the kidney. Partial nephrectomy was performed. Histological examination showed pT1a, renocellular carcinoma. Following surgery, the dose of immunosuppressive drugs was reduced. There was no tumour recurrence during the 17 months’ follow-up.
Case 3: In the 62-year-old male patient, kidney transplantation was carried out 10 years earlier. During the follow-up, the ultrasound showed a 2.5 cm tumour in the graft, which was confirmed by CT. Partial resection was performed and a multifocal tumour was removed. The histology proved papillary carcinoma. Following surgery, everolimus treatment was started instead of tacrolimus. There was no tumor recurrence during the 2 months follow-up.
Discussion: After kidney transplantation, in case with tumour in the renal graft organ sparing surgery is recommended. In the described cases, tumour resection was also performed. The organ sparing surgery provides adequate oncological efficacy with preservation the function of the transplanted kidney.
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Life with prostate cancer – the patient’s perspective
DOI: 10.22591/magyurol.2019.3.birok.91
Authors:
Biró Krisztina dr.1, Kun Eszter2, Dobi Etelka3
1Országos Onkológiai Intézet, Budapest (főigazgató főorvos: Polgár Csaba dr.)
2Szinapszis Kft., Budapest (ügyvezető: Szabó András dr.)
3Janssen-Cilag Kft., Magyarország
Summary
Prostate cancer continues to be one of the most common cancers diagnosed in men. Due to early detection, radical interventions and the emerging modern treatments, life expectancy has significantly improved in recent years. In light of the excellent survival rates for prostate cancer, quality of life became a primary concern, and several studies addressed long-term physical, psychosocial, and economic effects of cancer treatment. We measured patient-reported outcome by asking 61 prostate cancer patients online, about their own experience during and following their treatment. Although most of them reported that they received adequate information about the diagnosis and the treatment options, some of them missed a more detailed discussion about possible complications, side effects and available clinical trials. Only 28% heard about the beneficial effect of exercise and lifestyle changes. and only 8% was briefed, that his case was assessed by a multidisciplinary team, although the positive impact of the multidisciplinary discussion is well documented.