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Váradi M, Horváth O, Fazekas T, Csizmarik A, Módos O, Széles Á, Kenessey I, Reis H, Oláh C, Hadaschik B, Krafft U, Ting S, Furka A, Nyirády P, Szarvas T. Molecular analysis of urothelial carcinoma to predict the efficacy of immune checkpoint inhibitor therapy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01202-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Szarvas T, Csizmarik A, Váradi M, Fazekas T, Hüttl A, Nyirády P, Hadaschik B, Grünwald V, Tschirdewahn S, Shariat SF, Sevcenco S, Maj-Hes A, Kramer G. The prognostic value of serum MMP-7 levels in prostate cancer patients who received docetaxel, abiraterone, or enzalutamide therapy. Urol Oncol 2020; 39:296.e11-296.e19. [PMID: 33046366 DOI: 10.1016/j.urolonc.2020.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/06/2020] [Accepted: 09/12/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The rapidly changing treatment landscape in metastatic castration-resistant prostate cancer (mCRPC) calls for biomarkers to guide treatment decisions. We recently identified MMP-7 as a potential serum marker for the prediction of response and survival in mCRPC patients who received docetaxel (DOC) chemotherapy. Here, we aimed to test this finding in an independent patient cohort and in addition to explore the prognostic potential of serum MMP-7 in abiraterone (ABI) or enzalutamide (ENZA) treated patients. METHODS AND MATERIALS MMP-7 levels were measured in 836 serum samples from 320 mCRPC patients collected before and during DOC (n = 95), ABI (n = 140), or ENZA (n = 85) treatment by using the ELISA method. Results were correlated with clinical and follow-up data. RESULTS MMP-7 baseline levels were similar between the 3 treatment groups. In the ABI and ENZA cohorts, baseline MMP-7 levels were lower in patients with prior radical prostatectomy (P = 0.058 and P = 0.041, respectively). Baseline MMP-7 levels above the median were associated with shorter overall survival for the DOC (P = 0.001) and ENZA (P = 0.006) cohorts. Multivariable analyses in the DOC and ENZA cohorts revealed that high pretreatment MMP-7 level is an independent risk factor for patients' survival. In addition, in DOC-treated patients with high baseline MMP-7 level, marker decrease at the third DOC cycle was associated with improved survival. Patients with high baseline MMP-7 levels had better survival when treated with ABI compared to DOC or ENZA. CONCLUSIONS We confirmed the prognostic value of pretreatment MMP-7 serum level and its changes as independent predictors of survival in DOC-treated mCRPC patients. In addition, high MMP-7 was a negative predictor in ENZA-treated but not in ABI-treated patients. These results warrant further research to confirm the predictive value of serum MMP-7 and to explore the potential mechanistic involvement of MMP-7 in DOC and ENZA resistance of mCRPC patients.
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Affiliation(s)
- T Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary; Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - A Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - M Váradi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - T Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - A Hüttl
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - P Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - B Hadaschik
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - V Grünwald
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - S Tschirdewahn
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - S F Shariat
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - S Sevcenco
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - A Maj-Hes
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - G Kramer
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
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Krafft U, Tschirdewahn S, Hess J, Harke NN, Hadaschik BA, Nyirády P, Szendröi A, Szücs M, Módos O, Olah C, Székely E, Reis H, Szarvas T. STIP1 Tissue Expression Is Associated with Survival in Chemotherapy-Treated Bladder Cancer Patients. Pathol Oncol Res 2019; 26:1243-1249. [PMID: 31250373 DOI: 10.1007/s12253-019-00689-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/16/2019] [Indexed: 12/23/2022]
Abstract
To optimize treatment decisions in advanced bladder cancer (BC), we aimed to assess the therapy predictive value of STIP1 with regard to cisplatin therapy. Cisplatin-based chemotherapy represents the standard first-line systemic treatment of advanced bladder cancer. Since novel immunooncologic agents are already available for cisplatin-resistant or ineligible patients, biological markers are needed for the prediction of cisplatin resistance. STIP1 expression was analyzed in paraffin-embedded bladder cancer tissue samples of 98 patients who underwent adjuvant or salvage cisplatin-based chemotherapy by using immunohistochemistry. Furthermore, pre-chemotherapy serum STIP1 concentrations were determined in 48 BC patients by ELISA. Results were correlated with the clinicopathological and follow-up data. Stronger STIP1 nuclear staining was associated with worse OS in both the whole patient group (p = 0.034) and the subgroup of patients who received at least 2 cycles of chemotherapy (p = 0.043). These correlations remained significant also in the multivariable analyses (p = 0.035 and p = 0.040). Stronger STIP1 cytoplasmatic immunostaining correlated with shorter PFS both in the whole cohort (p = 0.045) and in the subgroup of patients who received at least 2 cycles of chemotherapy (p = 0.026). Elevated STIP1 serum levels were associated with older patient's age, but we found no correlation between STIP1 serum levels and patients' outcome. Our results suggest that tissue STIP1 analysis might be used for the prediction of cisplatin-resistance in BC. In contrast, pretreatment STIP1 serum levels showed no predictive value for chemotherapy response and survival.
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Affiliation(s)
- U Krafft
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - S Tschirdewahn
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - J Hess
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - N N Harke
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - B A Hadaschik
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - P Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - A Szendröi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - M Szücs
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - O Módos
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - C Olah
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - E Székely
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - H Reis
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany. .,Department of Urology, Semmelweis University, Budapest, Hungary.
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Szarvas T, Jardin-Watelet B, Bourgoin N, Hoffmann MJ, Nyirády P, Oláh C, Széll T, Csizmarik A, Hadaschik B, Reis H. High-soluble CGA levels are associated with poor survival in bladder cancer. Endocr Connect 2019; 8:625-633. [PMID: 30999279 PMCID: PMC6510714 DOI: 10.1530/ec-19-0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/17/2019] [Indexed: 11/26/2022]
Abstract
Recently, a neuroendocrine-like molecular subtype has been discovered in muscle-invasive urothelial bladder cancer (BC). Chromogranin A (CGA) is a widely used tissue and serum marker in neuroendocrine tumors. Our aim was to evaluate serum CGA (sCGA) concentrations and their associations with clinical and follow-up data in BC and renal cell carcinoma (RCC). sCGA concentrations were analyzed in the following cohorts: (1) BC training set (n = 188), (2) BC validation set (n = 125), (3) RCC patients (n = 77), (4) healthy controls (n = 97). CGA immunohistochemistry and RT-qPCR analyses were performed in 20 selected FFPE and 29 frozen BC tissue samples. Acquired data were correlated with clinicopathological parameters including comorbidities with known effect on sCGA as well as with patients' follow-up data. sCGA levels were significantly higher in BC but not in RCC patients compared to healthy controls. High sCGA levels were independently associated with poor overall and disease-specific survival both in the BC training (P < 0.001, P = 0.002) and validation set (P = 0.009, P = 0.017). sCGA levels were inversely correlated with glomerulus filtrating rate (GFR) and linearly correlated with creatinine clearance and urea concentrations. These correlations were not related to the prognostic value of sCGA. Tissue CGA levels were low to absent independently of sCGA concentrations. Our results demonstrate elevated levels and an independent prognostic value for sCGA in BC but not in RCC. Despite the significant correlation between sCGA and GFR, the prognostic relevance of sCGA seems not related to impaired renal function or other comorbidities.
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Affiliation(s)
- T Szarvas
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Urology, Semmelweis University, Budapest, Hungary
- Correspondence should be addressed to T Szarvas:
| | - B Jardin-Watelet
- Thermo Fisher Scientific Cezanne SAS, Clinical Diagnostics Division, Nimes, France
| | - N Bourgoin
- Thermo Fisher Scientific Cezanne SAS, Clinical Diagnostics Division, Nimes, France
| | - M J Hoffmann
- Department of Urology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - P Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - C Oláh
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - T Széll
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - A Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - B Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - H Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Modos O, Szarvas T, Reis H, Niedworok C, Rübben H, Szendröi A, Szasz AM, Hollosi P, Baghy K, Kovalszky I, Okon K, Golabek T, Chlosta P, Shariat SF, Peyronnet B, Mathieu R, Nyirády P. Mutation analysis of EGFR signal transduction pathway in urachal carcinoma. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1569-9056(15)30251-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rencz F, Kovács Á, Gulacsi L, Majoros A, Nyirády P, Tenke P, Németh Z, Nagy GJ, Nagy J, Buzogány I, Böszörményi-Nagy G, Brodszky V. Health-Related Quality Of Life And Subjective Happiness Of Patients With Benign Prostatic Hyperplasia: First Results Of A Cross-Sectional Survey From Hungary. Value Health 2014; 17:A471-A472. [PMID: 27201353 DOI: 10.1016/j.jval.2014.08.1339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- F Rencz
- Corvinus University of Budapest, Budapest, Hungary
| | - Á Kovács
- Corvinus University of Budapest, Budapest, Hungary
| | - L Gulacsi
- Corvinus University of Budapest, Budapest, Hungary
| | - A Majoros
- Semmelweis University, Budapest, Hungary
| | - P Nyirády
- Semmelweis University, Budapest, Hungary
| | - P Tenke
- Jahn Ferenc South-Pest Hospital and Clinic, Budapest, Hungary
| | - Z Németh
- Jahn Ferenc South-Pest Hospital and Clinic, Budapest, Hungary
| | - G J Nagy
- Saint Borbala Hospital of Tatabánya, Tatabánya, Hungary
| | - J Nagy
- Szentgotthárd Clinic, Szentgotthárd, Hungary
| | - I Buzogány
- Péterfy Sándor Hospital, Budapest, Hungary
| | | | - V Brodszky
- Corvinus University of Budapest, Budapest, Hungary
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Törzsök P, Riesz P, Kenessey I, Szekely E, Somoracz A, Nyirády P, Romics I, Schaff Z, Lotz G, Kiss A. 7117 POSTER Claudins and Ki-67 – Potential Markers to Differentiate Low and High Grade Transitional Cell Carcinomas of the Urinary Bladder. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72032-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- S Lovász
- Urological Department, Semmelweis University, Budapest, Hungary.
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Kiss A, Nyirády P, Pirót L, Merksz M. Combined use of perimeatal-based flap urethroplasty (Mathieu) with midline incision or urethral plate in hypospadias repair. Eur J Pediatr Surg 2003; 13:383-5. [PMID: 14743325 DOI: 10.1055/s-2003-44727] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Perimeatal-based flap urethroplasty is commonly used for the primary correction of distal hypospadias. The Mathieu repair provides excellent function and satisfactory cosmetic results, but the risk of devascularisation of the neourethral flap is an inherent problem of this technique. The midline incision of the urethral plate is part of the Snodgrass method, which offers good urethral calibre and tension-free closure. Our aim was to test the effectiveness of the use of the perimeatal-based flap combined with a midline incision of the urethral plate in hypospadias repair. 19 boys, aged 20 months to 5 years, with distal hypospadias, underwent a one-stage repair using the above-described modification of the Mathieu technique. The meatal-based flap with a midline incision of the urethral plate was similar in all cases. The hypospadias repair was successful in all patients, only one boy developed a urethrocutaneous fistula which required subsequent operation. There was no postoperative scarring, chordee or urethral stricture during follow-up. Hypospadias repair using a perimeatal-based skin flap and combined with an incision of the urethral plate reduces complication rates and offers good cosmetic results.
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Affiliation(s)
- A Kiss
- Department of Urology, Heim Pál Children's Hospital, Budapest, Hungary.
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Abstract
METHODS Haemodynamic changes were measured noninvasively using impedance cardiography (ICG) in 30 ASA I children during laparoscopic varicocelectomy under general anaesthesia. After induction and intubation, mechanical ventilation was started, then pneumoperitoneum (PP) was created. During the course of anaesthesia, values of endtidal CO2 pressue (PECO2), peak inspiratory airway pressure (PIP), heart rate (HR), mean arterial blood pressure (MABP), stroke volume index (SVI), cardiac index (CI) and systemic vascular resistance index (SVRI) were recorded at 1 min intervals. We analysed four periods: T1, before induction; T2, after induction; T3, during PP; T4, after desufflation of PP until awake. RESULTS After induction of anaesthesia a significant reduction of HR, MABP and CI was recorded. Creating PP together with the use of a 15 degrees head down tilt resulted in a further drop in CI, mainly caused by the reduction of SVI, and an elevation of MABP and SVRI. We measured a 25% total decrease of CI. CONCLUSION Our patients tolerated this significant reduction of cardiac output well. We have demonstrated that ICG can be used to track the haemodynamic changes caused by PP in children, and suggest that this type of monitoring is useful in this group of age during laparoscopy.
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Affiliation(s)
- A Kardos
- Paedriatic Intensive Care Unit, Heim Pál Hospital for Sick Children, Ullöi str. 89, 1086 Budapest, Hungary.
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Kiss A, Csontai A, Pirót L, Nyirády P, Merksz M, Király L. The response of balanitis xerotica obliterans to local steroid application compared with placebo in children. J Urol 2001; 165:219-20. [PMID: 11125410 DOI: 10.1097/00005392-200101000-00062] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We evaluated the clinical effectiveness of topical steroid application for balanitis xerotica obliterans in children and analyzed the association of any clinical response with histological findings. MATERIALS AND METHODS Our double-blind, placebo controlled, randomized study included 40 boys in whom balanitis xerotica obliterans was diagnosed clinically by cicatricial phimosis. The severity of phimosis was graded into 4 groups. Patients were randomized to receive the topical application of 0.05% mometasone furoate or placebo. After 5 weeks phimosis severity was reevaluated and all patients underwent circumcision. Surgical specimens were histologically typed as an early, intermediate or late form of balanitis xerotica obliterans. RESULTS Seven patients were withdrawn from the study. In the steroid group 7 boys had clinical improvement and 10 had no change. Histological study showed an early, intermediate and late form of balanitis xerotica obliterans in 5, 5 and 7 cases, respectively. Of cases with clinical improvement 5 were the early and 2 the intermediate type. In the placebo group 5 cases worsened clinically and 11 did not change. Histological evaluation revealed an early, intermediate and late form of balanitis xerotica obliterans in 3, 7 and 6 boys, respectively. Of the 5 cases with histological worsening, disease was the early, intermediate and late type in 2, 2 and 1, respectively. CONCLUSIONS Applying a potent topical steroid affects improvement in balanitis xerotica obliterans in the histologically early and intermediate stages of disease, and may inhibit further worsening in the late stage.
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Affiliation(s)
- A Kiss
- Departments of Urology and Pathology, Heim Pál Children's Hospital, Budapest, Hungary
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Nyirády P, Merksz M, Pirót L, Altorjay A, Pelényi A, Kiss A, Csontai A. [Laparoscopic intervention in pediatric urology]. Orv Hetil 1999; 140:1403-6. [PMID: 10489767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The authors summarise the short history of the laparoscopy, and main steps of its use in international and Hungarian practice of urological surgery. They evaluate the possibility of laparoscopy in paediatric urological practice. Finally, they present their experience with this minimally invasive technique from 1995. Between October 1995 and September 1998, 83 laparoscopic procedures were performed. In 59 patients the vena testicularis were ligated by laparoscopy and in 22 patients 24 non palpable testes were diagnosed and operated. In 9 of the cases laparoscopic orchidopexy was performed. The authors demonstrate their operative technique. All laparoscopic interventions were tolerated well by children and they were treated without any complication. Postoperative pain medication were given for 5 children. The operative time for varix ligation ranged from 15 and 20 minutes, and for laparoscopic orchidopexy from 30 and 40 minutes. The recurrence rate of varicocele was found to be 1.5%, and postoperative hydrocele developed in one patient (1.5%).
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Affiliation(s)
- P Nyirády
- Urológiai-sebészeti osztály, Fövárosi Onkormányzat Heim Pál Gyermekkórháza, Budapest
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Nyirády P, Pirót L, Altorjay A, Pelényi A, Merksz M, Kiss A, Csontai A. Laparoscopic varicocele operation: a chance to prevent the recurrence. Acta Chir Hung 1998; 37:201-4. [PMID: 10379372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
There are recurrences and postoperative hydrocele of varicocele after any kind of surgical treatment. Laparoscopic clipping and dissection of internal spermatic vessels was performed without any complication in 73 children to treat varicocele in our department between 1995 and 1998. We have used a new method to detect etiological factors at laparoscopic surgery. The well-known Linton and Trendelenburg test was adapted to detect incidental collateral veins in 73 patients. Using these test, collateral veins were detected in 16 boys. The testicular artery identified in most of the cases as a pulsatile vessel. The operating time was 10-25 minutes. Laparoscopic varicocelectomy is a safe, effective treatment causing minimal discomfort and allowing patients an early to return to activity. These results suggest this technique a viable alternative to open ligation in paediatric urological practice.
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Affiliation(s)
- P Nyirády
- Department of Urology, Heim Pál Children's Hospital, Budapest, Hungary
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