Urology
MD, Hospital Prof. Doutor Fernando Fonseca, EPE
Selected publications from PubMed
Early complications within 30 days after radical cystectomy: The top seven complications and their predictors.
Duarte S, Felício E, Bernardo G, Gaboleiro F, Pita A, Carmali D, Furtado A, Pinheiro A, Barcelos A, Ramos S, Ferrito F
Investig Clin Urol. 2026 May;67(3):254-262 doi: 10.4111/icu.20250687.
Spontaneous Bladder Rupture during Vaginal Delivery.
Carmali D, Quiterres J, Duarte S, Barcelos A, Ramos SA, Nunes IG, Pita A, Gaboleiro F, Felício E, Bernardo G, Meira M, Branco R, Furtado A, Bruno D, Santos AP, Ferreira AP, Ferrito F
Case Rep Urol. 2026;2026:8756601 doi: 10.1155/criu/8756601.
The role of psoas muscle index in predicting outcomes after radical cystectomy.
Duarte SL, Alexandre J, Felício EM, Bernardo GS, Gaboleiro FA, Pita AJ, Carmali D, Furtado AM, Pinheiro AM, Barcelos AP, Ramos SA
Indian J Urol. 2026 Jan-Mar;42(1):43-50 doi: 10.4103/iju.iju_385_25.
The role of transurethral resection of prostate (TURP) in patients with underactive bladder: 12 months follow-up in different grades of detrusor contractility.
Lebani BR, Barcelos ADS, Gouveia DSES, Girotti ME, Remaille EP, Skaff M, Almeida FG
Prostate. 2023 Jun;83(9):857-862 doi: 10.1002/pros.24526.
Satisfaction with testicular prosthesis: a Portuguese questionnaire-based study in testicular cancer survivors.
Ramos SA, Pinheiro AM, Barcelos AP, Cardoso AP, Varregoso J
Rev Int Androl. 2022 Apr-Jun;20(2):110-115 doi: 10.1016/j.androl.2020.10.006.
Penile cancer is an uncommon tumor, with an incident of 1/100,000 in developed countries. There are many associated risk factors, such as phimosis, chronic penile inflammation, HPV, smoking, among others. The only protective factor is neonatal circumcision. HPV is associated with 1/3 of invasive penile cancer. Squamous cell carcinoma is the most common histological subtype. 80% of penile cancer is curable if diagnosed early. However, there is significant delay in seeking health care, with some patients coming with more than 1 year’s delay. Physical examination of the penile lesion and groin for inguinal lymph node disease is vital for diagnostic evaluation and future patient management. Penile ultrasound and MRI are valid options to stage corporal invasion and CT or PET/CT to stage lymph node involvement when indicated. Local treatment is the treatment to the primary lesion and its recurrence does not significantly influence long-term survival. Therefore, if possible, penile preservation treatments should be offered. There are many options to achieve better cosmetic and functional outcomes, depending on the degree of invasiveness. The number and the extent of lymph node involvement is the main prognostic factor, and thus correct staging and treatment is mandatory. When nodes are not palpable, staging surgery might be needed. When nodes are palpable, radical inguinal lymphadenectomy is indicated. It is associated with relevant morbidity; however, the fear of complications should not delay a potentially life-saving surgery. Penile cancer treatment has a significant negative impact on quality of life and sexual function. Penile sparing treatment seems to have better results than more invasive options.
Published
Nov 2021
Non-muscle invasive bladder cancer (NMIBC) represents 75% of bladder cancer. It commonly recurs and may progress to muscle invasive (MIBC). BCG immunotherapy is an adjuvant treatment recommended in intermediate and high-risk NMIBC. Treatment failure with intravesical BCG immunotherapy is defined as any high-grade recurrence during or after BCG treatment. BCG-unresponsive is defined as all BCG-refractory (recurrence during BCG treatment) and some BCG-relapsing (recurrence after completion of treatment) papillary recurrence after 6 months and for Cis recurrence after 12 months. BCG-unresponsive bladder cancer is unlikely to respond to further BCG treatment: therefore BCG is not useful. Radical cystectomy is the standard and preferred treatment option; however, it is associated with significant morbidity and mortality. Therefore, many patients are unwilling or unable to undergo the procedure. Until 2020, valrubicin was the only drug approved by the FDA, with disappointing results on its trial. Pembrolizumab was approved by the FDA in 2020 based on KEYNOTE 057 results, making it the second drug approved in this setting. Many other treatments, such as sequential intravesical gemcitabine and docetaxel instillations, hyperthermic intravesical chemotherapy, radiofrequency-induced thermo-chemotherapy effect (RITE), intravesical nadofaragene firadenovec gene therapy, oportuzumab monatox have been studied on this setting. These last two treatments are the most promising and are awaiting FDA review for approval.
Published
May 2021
In recent years, the principles of open Simple Prostatectomy, performed to treat Benign Prostatic Hyperplasia in prostates larger than 80 mL, have been successfully transferred to laparoscopic and robot-assisted approaches, with the advantage of allowing faster recovery and reduced blood loss. Despite these advantages, most patients require continuous bladder irrigation in the postoperative period and will have ejaculatory dysfunction as result of the removal of the prostatic urethra, affecting patients’ quality of life. The laparoscopic simple prostatectomy with prostatic urethra preservation is the solution to overcome and solve these complications related to traditional surgical techniques and even transurethral endoscopic enucleations.
Published
Apr 2021
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