Encrusted alkaline cystitis and malacoplakia

Urinary infection due to urea splitting bacteria leads to a rise in urinary pH, favouring the precipitation of calcium salts and struvita crystals. If deposited on the surface of a bladder with chronic inflammation or some other previous lesion, may produce an alkaline encrusted cystitis, now a rare condition. In the case here presented, occurred in a 69-year-old male. Corynebacterium urealyticum grown in the urine, and some foci of malakoplakia were found in the area of encrustation endoscopically excised. This case seems to be the third example of alkaline encrusted cystitis associated with malakoplakia reported in the bibliography. These two conditions share similar clinical signs and may probably have a common aetiopathogenesis.     

Radical prostatectomy. The surgical complications

Study of 165 patients with prostate adenocarcinoma who underwent radical prostatectomy using a retropubic approach. Mean PSA is 19 ng/ml, mean age 63 years and median follow-up 26 months. 22 patients (13.2%) reported complications during the first month post-surgery, primarily urinary fistula of more than 5 days long in 5 patients and rectal injury in 3.49 patients (29%) reported complications after the first month, mainly urinary incontinence in 26 cases and stenosis of the urethrovesical juncture in 15. The group with early complications showed no significant differences compared to those who had none, neither in PSA (p = 0.3) or a worse pathological stage (p = 0.1), and no evidence is shown in terms of biochemical progression or in disease free progression (p = 1). Patients with urethrovesical juncture stenosis have higher mean PSA (p = 0.01), greater biochemical progression (p = 0.006), worse Gleason (p = 0.03 = and worse progression free survival (p = 0.01). Patients with stress incontinence showed no differences compared to the other groups relative to the studied factors.     

The management of urinary candidiasis in cystectomized patients

Presentation of eight cases of urinary candidiasis in patients who underwent radical cystectomy and were managed using by-pass of the urinary tract, oral antifungal therapy and solutions in the way of intermittent instillation through nephrostomy catheters.     

Total Corporal Contouring with Megaliposuction (120 Consecutive Cases)

The purpose of this study is to present the authors' long-term experience with total corporal contouring with megaliposuction. The evolution of body reshaping in one operative setting including simultaneous head and neck contouring, upper and lower extremity recontouring, and creation of an aesthetic trunk and abdominal form is discussed. Patient evaluation, operative techniques, postoperative management, and long-term results are emphasized. From February 1994 to February 1997, 120 consecutive patients underwent total corporal contouring with tumescent (Hunstad formula)-technique, classic liposuction. There were 10 males and 110 females. The average age of all patients was 28 years. Preoperative evaluation emphasized corporal shape and proportions. No other open procedures were performed simultaneously in these patients. The authors' postoperative regimen is discussed. The average amount of aspirated material in these series was 14,000 ml (range, 8000–20,000 ml). No blood transfusions were required. Complications included only hypopigmentation (N= 2) and postoperative seromas requiring aspiration (N= 12). Follow-up examination took place at 3 months to 3 years, with an average of 14 months. All patients underwent a metamorphosis from an amorphic shape to one that follows the normal body contours and profiles. The goals of megaliposuction are no longer just to reduce body fat and body mass. Individually planned surgery for these patients should be based upon obtaining normal symmetrical body proportions. Total corporal contouring and reshaping can now be safely performed, offering hope and predictable outcomes to this patient population. Patient evaluation, operative technique, postoperative care, and long-term results are presented.