RESUMEN
Review of the treatment of localized prostate cancer. The major attention is devoted to the surgical treatment. The radical retropubic prostatectomy is used most frequently. Problems of the indication, anatomical foundations and the technique of the surgery are discussed. The radical perineal prostatectomy is used less frequently. The radiation therapy is an alternative to the surgical treatment. The radiation therapy is recommended by urologists in patients, for whom is this treatment considered as more advantageous.
Asunto(s)
Neoplasias de la Próstata/cirugía , Terapia Combinada , Humanos , Masculino , Prostatectomía , Neoplasias de la Próstata/radioterapiaRESUMEN
The method of preventive hemostasis as suggested by authors is capable of safely arresting the blood leakage into the operation field from spatium Retzii especially in radical retropubic surgery. Retropubic radical surgery requires haemostasis of the dorsal penile veins. In extracapsular prostatectomy, adequate haemostasis permits a safe well controllable urethroyesical anastomosis, diminishing blood loss, shortening the operation time and reducing the risk of postoperative stricture and incontinence development. In cystoprostatectomy, preventive haemostasis reduces the blood loss due to protracted haemorrhage taking place during the neovesica construction and shortens the operation period. In looking for a method of effective preventive ligature of the venae dorsales penis we made use of the technique as described by Berger and Ireton (1). In our opinion, that method is rather complicated requiring and presents requirements for a special instrumentarium and therefore, we regard it as impracticable. Based on the principles of the above technique we elaborated a method of preventive haemostasis using a wire loop to compress both these superficial and the subfascial dorsal penile veins (2), which appears easy to perform with the ordinary equipment of any surgical and urological department.
Asunto(s)
Hemostasis Quirúrgica/métodos , Pene/irrigación sanguínea , Prostatectomía/métodos , Humanos , Ligadura , Masculino , VenasRESUMEN
Described report case of the patient after left nephrectomy, performed 18 years ago, for adenocarcinoma. Recently he has a simultaneous carcinoma of the bladder and the left ureter. Carcinoma of the bladder was treated with transurethral resection and electrocoagulation. Once checked, the hemorrhage was found from the left ureter, later, papilocarcinoma was diagnosed and the urethrectomy with the resection of the part of the wall of the bladder in the region of the estuary. Patient was in good condition 5 months after the operation. There is a review of others report cases.
Asunto(s)
Neoplasias Renales , Neoplasias Primarias Secundarias , Neoplasias Ureterales , Neoplasias de la Vejiga Urinaria , Adenocarcinoma/cirugía , Anciano , Carcinoma Papilar/patología , Carcinoma Papilar/terapia , Humanos , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Masculino , Neoplasias Primarias Secundarias/patología , Neoplasias Ureterales/patología , Neoplasias Ureterales/terapia , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/terapiaRESUMEN
At the urological department of the First Surgical Clinic, Faculty of general Medicine Charles University in Prague from January 1977 to December 1986 922 men were operated on account of benign obstruction of the cervix. Ninety-one patients, i.e. 9.8%, with some common signs were subjected to clinical analysis. The criterium for inclusion in the group was the finding of a not enlarged, through on palpation frequently altered prostate, the finding of a histological, endoscopic, X-ray and urodynamic examination. The common sign of these patients was the presence of the disease in young age, a prolonged persistence (up to 20 years) and the frequent presence of supravesical congestion, sometimes with a diverticulum of the urinary bladder. The cause of the disease was dyssynergy, urethrovesical hypertrophy of the poesterior commissure, atrophy of the prostate, subtrigonal hyperplasia of the prostate and a secondary contracture. A transurethral operation was performed in 64 patients, a transvesicalar one in 24 and in three a XY plastic operation was made.