International braz j urol : official journal of the Brazilian Society of Urology
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The purpose of this study is to determine if body mass index (BMI) and stone skin distance (SSD) affect stone free rate (SFR) in obese and morbid obese patients who underwent flexible URS for proximal ureteral or renal stones < 20 mm. ⋯ Ureteroscopy should be considered as a first-line of treatment for renal/proximal stones in obese and morbid obese patients. URS may be preferable to SWL in obese patients independently of the SSD, BMI or the location of proximal stones.
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Case Reports
Pure laparoscopic radical heminephrectomy for a large renal-cell carcinoma in a horseshoe kidney.
Horseshoe Kidneys are the most common renal fusion anomaly. When surgery is contemplated for renal-cell carcinoma in such kidneys, aberrant vasculature and isthmusectomy are the major issues to consider. We describe a case of a pure laparoscopic radical heminephrectomy with hand-sewn management of the isthmus for a 11 cm tumour in a horseshoe kidney. ⋯ Laparoscopic oncologic surgery in patients with horseshoe kidneys can be technically challenging. The presence of a large cancer in a horseshoe kidney should not preclude a purely laparoscopic approach. With the aid of a Satinsky clamp, the isthmus can be sharply divided and sutured in a fashion similar to the open technique. To our knowledge, this report represents the largest cancer (11 cm) removed laparoscopically in the context of a horseshoe kidney.
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Randomized Controlled Trial
Comparison of postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol for circumcision: a prospective randomized study.
To evaluate the postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol administration following circumcision. ⋯ Penile block and caudal block provide similar pain scores and painless postoperative periods after circumcision under general anesthesia. Intravenous paracetamol is insufficient at the early postoperative period. The three procedures were shown to be safe for analgesia following circumcision.
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To evaluate acute toxicity and symptoms palliation of a weekly hypofractionated 3DCRT schedule as radical treatment in elderly patients with organ confined bladder cancer cT1-2N0. ⋯ The incidence of patient-reported acute toxicity following weekly hypofractionated external 3DCRT is low while the symptom palliation compares very favorably with other reported outcomes.