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- Late presentation of vesicoureteral reflux: An unusual cause of pyelonephritis in adultsPublication . Pereira, B; Macedo, C; Anacleto, S; Gonçalves, M; Lima, E; Carvalho-Dias, EINTRODUCTION: Vesicoureteral reflux (VUR) corresponds to the reflux of urine from the bladder into the upper urinary system. It can be a congenital or an acquired anomaly and although its incidence is high in children it is uncommon in the adult life. One of its presentations in the adult population is the presence of recurrent Pyelonephritis. CASE PRESENTATION: Here we report a case of an adult patient with repetitive uncomplicated pyelonephritis caused by VUR. VUR was successfully managed endoscopically with subureteral injection of a bulking agent. A literature review of adult presenting VUR was performed. DISCUSSION: The first presentation of VUR in the adult life is rare. One of the most typical presentation is the presence of recurrent uncomplicated Pyelonephritis. Although no guidelines exists to study the presence of VUR in adult patients with Pyelonephritis, in the presence of several recurrent episodes of Pyelonephritis we should think in VUR as a possible cause. Even in adults, endoscopic management of VUR is an effective treatment with low morbidity. CONCLUSION: VUR can first present in the adult life, with recurrent episodes of UTI. The diagnosis is a suspicious one and is confirmed by VUCG. VUR in adults can be effectively managed with endoscopic injection of bulking agents.
- Penile fracture: review of 7 casesPublication . Cabral-Ribeiro, J; Sousa, L; Silva, C; Mendes, V; Garcia, P; Santos, A
- [Smoking Cessation after Bladder Cancer Diagnosis]Publication . Mota, P; Sousa, PM; Botelho, F; Carvalho-Dias, E; Cordeiro, A; Torres, JP; Morais, N; Anacleto, S; Lima, EINTRODUCTION: Smoking is an important risk factor for the development, recurrence and progression of bladder cancer. Our aim was to analyze smoking habits after diagnosis in bladder cancer patients. Additionally, we evaluated patient knowledge about smoking as a risk factor and the urologist role in promoting abstinence. MATERIAL AND METHODS: A cross-sectional, observational and descriptive study was performed in bladder cancer patients, diagnosed between January 2013 and September 2015 (n = 160) in Braga Hospital, in Portugal. RESULTS: Smoking history was present in 71.9% of the sample, with 21.9% current smokers, (40.7% of abstinence after diagnosis). Smoking was acknowledged as a risk factor by 74.4% of the sample, with only 51.3% of ever smokers and 24.4% of non-smokers recognizing smoking as the leading risk factor (p = 0.008). The presence of other household smokers were significantly higher in patients who continued smoking (40%) than in ex-smokers after diagnosis (4.2%) (p = 0.005). The majority of smokers at diagnosis (83.1%) were advised to quit by their urologist, but only one smoker (1.7%) was offered any specific intervention to aid in cessation. DISCUSSION: Smoking is not recognized as the leading risk factor for bladder cancer. This limited awareness, associated with the known difficulties in quitting smoking and the observed lack of smoking cessation interventions, may account for the high current smoking prevalence, albeit in line with other studies. CONCLUSION: This study highlights the need for efficient smoking cessation programs directed to bladder cancer patients.
- A curious cause of pseudo-haematuria: a neglected vaginal pessaryPublication . Cabral-Ribeiro, J; Leite, C
- Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)Publication . Lima, E; Rodrigues, PL; Mota, P; Carvalho, N; Dias, E; Correia-Pinto, J; Autorino, R; Vilaça, JLBACKGROUND: Puncture of the renal collecting system represents a challenging step in percutaneous nephrolithotomy (PCNL). Limitations related to the use of standard fluoroscopic-based and ultrasound-based maneuvers have been recognized. OBJECTIVES: To describe the technique and early clinical outcomes of a novel navigation system for percutaneous kidney access. DESIGN, SETTING, AND PARTICIPANTS: This was a proof-of-concept study (IDEAL phase 1) conducted at a single academic center. Ten PCNL procedures were performed for patients with kidney stones. SURGICAL PROCEDURE: Flexible ureterorenoscopy was performed to determine the optimal renal calyx for access. An electromagnetic sensor was inserted through the working channel. Then the selected calyx was punctured with a needle with a sensor on the tip guided by real-time three-dimensional images observed on the monitor. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoints were the accuracy and clinical applicability of the system in clinical use. Secondary endpoints were the time to successful puncture, the number of attempts for successful puncture, and complications. RESULTS AND LIMITATIONS: Ten patients were enrolled in the study. The median age was 47.1 yr (30-63), median body mass index was 22.85kg/m2 (19-28.3), and median stone size was 2.13cm (1.5-2.5cm). All stones were in the renal pelvis. The Guy's stone score was 1 in nine cases and 2 in one case. All 10 punctures of the collecting system were successfully completed at the first attempt without X-ray exposure. The median time to successful puncture starting from insertion of the needle was 20 s (range 15-35). No complications occurred. CONCLUSIONS: We describe the first clinical application of a novel navigation system using real-time electromagnetic sensors for percutaneous kidney access. This new technology overcomes the intrinsic limitations of traditional methods of kidney access, allowing safe, precise, fast, and effective puncture of the renal collecting system. PATIENT SUMMARY: We describe a new technology allowing safe and easy puncture of the kidney without radiation exposure. This could significantly facilitate one of the most challenging steps in percutaneous removal of kidney stones.
- Tumor germinativo do testículoPublication . Sousa, L; Cabral-Ribeiro, J; Vila Mendes, M; Ribeiros dos Santos, A; Mendes, J; Pardal, F
- Malakoplakia vesicalPublication . Ribeiro dos Santos, A; Pardal, F; Cabral-Ribeiro, J; Sousa, L; Mendes, J; Vila Mendes, M
- Polipose linfomatosa múltiplaPublication . Cabral-Ribeiro, J; Toscano, A; Antunes, C; Manso, F; Capelo, C
- Fístulas enterovesicais. Revisão a propósito de dois casos clínicos.Publication . Cabral-Ribeiro, J; Silva, C; Sousa, L; Mesquita Robrigues, A; Ribeiro dos Santos, A
- Síndroma de Fraley por aneurisma da artéria renal segmentar.Publication . Cabral-Ribeiro, J; Sousa, L; Mendes, V; Ribeiro dos Santos, A