Læknablaðið : fylgirit - 01.06.2009, Blaðsíða 29

2 7 T H CONGR SCAND ASSOC UROL
F Y L GIR I T 6 1
<0.001). The mean renal axis angle of right kidneys was found
16,04° which was more acute than left kidneys (18,5°,p=0,001).
Conclusions: High success rate in left kidneys despite
unfavorable anatomy like acute IPA and narrow IW and low
success rate in right kidneys despite favorable anatomy but
more acute renal axis in our study suggest that renal axis
angle may influence the stone clearance after SWL. More acute
renal axis probably rotate caliceal structures and the resulting
anatomy can behave as an unfavorable one. So renal axis and
stone side should also be taken into account for stone clearance
after SWL treatment of LCS.
59 Aspects on the relation between diet and upper
urinary tract stone disease
PJS Osther, SS Osther
Department ofUrology, Fredericin Hospital, Fredericia, Denmark
palle.joem.osther@slb.regionsyddnnmark.dk
Introduction: The exact role of the diet in the pathophysiology
of calcium oxalate (CaOx) stone formation remains to be
elucidated. The aim of the present study was to analyse the
relation between diet and stone risk in recurrent male CaOx
stone formers and healthy males while maintained on free-
choice diet.
Material and methods: 118 recurrent male CaOx stone formers
and 122 healthy males were included. The participants were
asked to keep a 7-day food record. 24-h urines were sampled
on a week-day. The risk of CaP and CaOx crystallisation were
estimated.
Results: There were no differences in fluid intake and dietary
intake of minerals and major nutrients between stone formers
and healthy subjects. Risk of CaOx and CaP crystallization were
significantly higher in the stone formers compared to controls.
Performing a multivariate analysis the characteristic of the male
stone formers that most clearly distinguished them from the
healthy men was a high level of urine calcium for any given
level of citrate.
Conclusion: There seems to be no major differences in the
dietary habits of CaOx stone formers and healthy males. Thus,
a 'western' diet alone does not seem to cause stone formation.
The stone formers must have some metabolic abnormality to
account for their susceptibility to form calculi. The differences
between male stone formers and healthy males in the present
study may be indicative of an altered metabolic response to
protein catabolism.
60 Our experience with the continent neo-urachus
FE Martins, RN Rodrigues, AF Sandul, TM Lopes
Department of Urology, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
faemartins@gmail.com
4 patients. We also demonstrate the procedure in a step-by-step
manner.
Results: Since April 2006, 4 patients (1 male and 3 females)
have undergone this procedure in our department. 2 patients
developed swelling and serous discharge from the wound that
healed after approximately 2 weeks and medical treatment. In
the remaining 2, the healing process occurred uneventfully. All
patients are performing CISC without problem.
Discussion: Although our experience is limited and long-term
results are still unavailable, this procedure appears to be a
promising alternative to urethral self-catheterization in well-
selected patients, due to its easier abdominal access . Moreover,
it avoids all the inconveniences of an intra-abdominal bowel
operation.
Conclusion: The described technique is a feasible, simple,
surgical procedure, with a high level of acceptance by patients
in well-selected cases. It has limited complications.
61 Penile carcinoma: organ sparing surgery using
disassembly technique
FE Martins, JP Marcelino, AF Sandul, TM Lopes
Department ofUrology, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
faemartins@gmail.com
Introduction: Penile carcinoma is uncommon, but when
diagnosed, it is psychologically devastating to the patient and
often present a challenge to the urologist. We present organ-
sparing surgery based on penile disassembly technique in a 38-
year-old patient with carcinoma of the penile glans.
Methods: Biopsy previously performed confirmed stage 1
squamous cell carcinoma. Penile disassembly starts with
urethral mobilization. The urethra is lifted together with Bucks
fascia. Dorsally, the neurovascular bundle is dissected by blunt
and sharp maneuvers. The glans with urethra ventrally and
neurovascular bundle dorsally are completely separated from
corpora cavernosa. Neurovascular bundle is divided 2cm under
the glans cap. The glans is removed after division of the urethra.
Biopsy of the margins confirmed that the resection had been
adequate. Urethra is spatulated 4cm in length and fixed to the
corpora cavernosa. The spatulated portion is used for new
glans construction. At proximal level, each corpora cavernosa is
fixed to the skin using U-shaped suture in order to avoid post-
operative retraction of the penis. Reconstruction of the penile
skin is performed as in circumcision.
Results: Six months after surgery good appearance is achieved.
Erectile function is completely preserved.
Conclusion: Organ sparing surgery is the method of choice
in treatment of low stage, low grade penile carcinoma. It is
most important for young patients who desire to maintain a
functioning penis. The penile disassembly technique is a radical
but very useful approach for satisfactory outcome.
Introduction: We present our experience with the use of a
continent neo-urachus-like tract as described by Rackley et al in
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