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The
July – August 2003 issue of the International Braz J Urol presents
interesting contributions and the Editor will highlight some important
papers.
Doctors
Holzbeierlein and colleagues, from University of Kansas Medical Center,
Kansas City and Medical College of Wisconsin, Milwaukee, USA, authored
on page 291 a through presentation on case selection and outcome of radical
perineal prostatectomy in localized prostate cancer. It was emphasized
that proper patient selection is critical to the success of the procedure
and the minimization of complications. The authors concluded that radical
perineal prostatectomy has stood the test of time, with only a few technical
modifications since its original description more than 100 years ago.
The procedure offers outcomes similar to radical retropubic prostatectomy,
the standard approach for the treatment of localized prostate cancer.
Its advantages include decreased pain, blood loss, and convalescence,
the same arguments currently being made in favor of laparoscopic prostatectomy.
Doctors Srougi and co-workers, from Federal
University of São Paulo, Brazil, presented on page 336 a modification
of the radical cystectomy technique with preservation of sexual function
and urinary continence. The authors stated that the proposed maneuvers
allow the performance of radical cystectomy with integral preservation
of distal urethral sphincter and of cavernous neurovascular bundles, without
jeopardizing the oncological principles. Doctor Mark S. Soloway, from
University of Miami School of Medicine, Doctors John F. Ward and Horst
Zincke, from Mayo Medical School, Rochester, and Doctor James E. Montie,
from University of Michigan, Ann Arbor, USA, provided important editorial
comments that emphasize critical points and give adequate balance on this
proposed technique.
Doctors Der Horst and colleagues, from University
Hospitals of Kiel and University of Mannheim, Germany, presented on page
332 a 2 institutions work on a slightly modified technique of the original
Schroeder-Essed plication procedure for congenital penile deviation. The
modification of the technique with inverted sutures described previously
consisted of horizontal incisions in the tunica albuginea. The results
indicated that this simple modification offered good functional and cosmetic
results and most patients were satisfied with the penile angle correction
outcomes. Doctor Drogo Montague, from The Cleveland Clinic Foundation,
Ohio, USA, provided an editorial comment on this article, highlighting
critical points.
Doctors Tobias-Machado and colleagues from ABC Medical School, São
Paulo, Brazil, presented on page 313 a comparative randomized clinical
assay between ciprofloxacin, norfloxacin and chloramphenicol as antibiotic
prophylaxis in prostate biopsy. Two hundred and fifty-seven patients were
randomized in 4 groups: 1) single dose of ciprofloxacin 2 hours before
the procedure; 2) ciprofloxacin 3 days; 3) chloramphenicol 3 days; and
4) norfloxacin 3 days. The schemes using ciprofloxacin presented better
results in prophylaxis previously to prostate biopsy. The single dose
of ciprofloxacin is recommended due to its posologic ease and low cost,
associated with a therapeutic response equivalent to a 3-day regimen.
Doctors Paschoalin and colleagues from Ribeirão
Preto School of Medicine, São Paulo, Brazil, investigated on page
300 the prevalence of prostate carcinoma in a sample of volunteers known
to have a large proportion of Bantu African ancestors, and the performance
of total PSA (tPSA), PSA density (PSAD) and free-to-total PSA ratio (f/tPSA)
on the diagnosis. The authors found that tumor prevalence was higher in
Non-White than in White phenotype. Also, they proposed that the association
of tPSA at a cut-off level of 2.5 ng/ml with a PSAD of 0.08 or a f/tPSA
of 20% for biopsy indication deserves further investigations as an alternative
to tPSA cut-off level of 4 ng/ml.
Doctor Barros and associates, from Federal
University of Bahia, Brazil, analyzed on page 306 the prevalence of prostate
adenocarcinoma according to race in an university hospital. The authors
studied 580 patients with mean age of 60.7 ± 10.0 years, with 116
Whites (20.0%), 276 Mulattos (47.6%) and 188 Blacks (32.4%). Prostate
adenocarcinoma was found in 16.6% of patients aged between 40 and 79 years.
The authors did not find statistically significant influence of race in
the population with prostate adenocarcinoma. Dr. Gustavo F. Carvalhal,
from Catholic University, Rio Grande do Sul, Brazil, provided an interesting
editorial comment on racial implications in prostate cancer.
Dr. Francisco J. B. Sampaio
Editor-in-Chief
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