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Objectives. There has been an enormous amount of interest as to whether sperm counts are declining over time. We sought to compare a contemporary group of fertile men to those from the MacLeod study of 1951 to ascertain whether sperm counts in fertile men have changed over time.Methods. We obtained sperm count data from 374 fertile men who banked sperm in Minnesota prior to vasectomy from 1971 to...
Sarcoma of the penis is rare. We report an angiosarcoma that was essentially an incidental finding, despite the presence of metastatic lesions, in a 46-year-old man who presented with hematemesis and melena. The diagnosis of the primary lesion was confirmed by histology, and the presence of secondary lesions by fine needle aspiration cytology. The patient was given one dose of chemotherapy, but died...
Objectives. To study the efficacy and safety of a new transurethral microwave thermotherapy device (the Urowave) in the treatment of men with clinical benign prostatic hyperplasia (BPH) in a randomized, double-blind, sham-controlled trial.Methods. A total of 220 patients (mean age 66.2 years) with clinical BPH, an American Urological Association symptom index (AUA SI) of 13 points or more, and a peak...
Objectives. To evaluate morbidity and quality of life (QOL) in patients with continent urinary diversion.Methods. Morbidity and neobladder function were analyzed in 56 consecutive patients with bladder substitutions. QOL assessment was performed using the Sickness Impact Profile (SIP), supplemented with a detailed voiding and continence questionnaire.Results. Mean age was 44.7 years. Mean follow-up...
Intra-abdominal testicular neoplasms are difficult to diagnose, with open surgical exploration and excision the traditional mode of therapy. We report a patient with an intra-abdominal seminoma resected laparoscopically. In patients who present without evidence of retroperitoneal adenopathy, laparoscopy can be used for diagnosis, and with minimally invasive surgical techniques, to resect these tumors.
Objectives. To determine if proteins known to be expressed by both benign and malignant prostate epithelium can be recognized by T cells from patients with prostate cancer. We examined 7 HLA-A2 patients with prostate cancer for evidence of T cell reactivity with prostate-specific antigen (PSA).Methods. Four peptides derived from PSA were chemically synthesized and shown to bind to HLA-A2. As a control,...
Aspergillus is ubiquitous worldwide. It is found primarily in soil, dust, vegetation, and decaying matter. While disseminated aspergillosis affects the testis only 1% of the time, testicular aspergillosis in the absence of disseminated disease is exceedingly rare, as demonstrated in the present case report. .
Objectives. A 6-month pilot teleconsultative project linking Georgetown University Medical Center (GUMC) in Washington, DC, and City Hospital in Martinsburg, West Virginia, 90 miles away, was designed to assess the effectiveness of telemedicine on the clinical decision-making process for patients with urolithiasis.Methods. The telemedicine system designed and tested for this project was based on a...
Objectives. To investigate the effects of oral oxybutynin chloride (OC) on standard urodynamic measures in children with myelomeningocele (MMC) and detrusor hyperreflexia.Methods. Forty-one MMC children with detrusor hyperreflexia (19 boys and 22 girls, aged 2 months to 15 years; mean 4.9 years) were evaluated urodynamically before and within 3 months after initiation of oral OC therapy (0.2 to 0...
Perineal needle tract seeding of prostate cancer is an unusual complication of perineal prostate biopsy. We report a case with the longest known interval from biopsy to perineal recurrence-14 years. The prostate-specific antigen did not become detectable until 12 years after biopsy and no other metastases were apparent, suggesting that the patient's perineal disease was an isolated recurrence. Immunohistochemical...
We report a case of partial ejaculatory duct obstruction secondary to a mullerian duct cyst presenting with failure to fertilize and early demise of sperm during in vitro fertilization.
Objectives. To study the patient outcomes of various approaches on 14 consecutive patients who had laparoscopic adrenalectomy surgery between October 1995 and March 1997.Methods. The patients comprised 5 men and 9 women (mean age 46.2 years, range 32 to 61) with varying diagnoses. Eleven patients had Conn's syndrome, 1 had Cushing's syndrome, 1 had a nonfunctioning adrenal adenoma, and 1 had an adrenal...
Objectives. Although prostate-specific antigen (PSA) has revolutionized the detection of prostate cancer, it has definite limitations with respect to its clinical sensitivity and specificity. Because a substantial number (20% to 40%) of men undergoing radical prostatectomy have a PSA level of 4.0 ng/mL or less, any new test offering diagnostic improvement must perform well in patients whose PSA level...
Objectives. Two new methods for the detection of transitional tumor cells in bladder wash (karyometry: QUANTICYT) and voided urine material (BARD BTA test) were compared with bladder wash cytology for the prediction of histology and tumor recurrence.Methods. Bladder wash material and voided urine were sampled from 138 patients. Bladder wash karyometric (BWK) image analysis and the BTA test were applied...
Although most patients suffering from pain related to upper urinary tract stones feel the discomfort on the same side as the stone, rarely it is perceived on the opposite side. We sought to identify the prevalence of this clinical scenario and to review possible explanations. The charts and x-rays of all patients with unilateral, symptomatic, radiologically identifiable upper urinary tract stones,...
Objectives. To assess the safety and efficacy of the Alexandrite laser for intracorporeal lithotripsy of renal and ureteral stones in conjunction with ureterorenoscopy or percutaneous nephrostolithotomy.Methods. We retrospectively analyzed the records of 137 patients with 169 calculi in 143 renoureteral units who were treated with the Alexandrite laser via a retrograde (91.5%) or antegrade (8.5%)...
Objectives. Recently, it was confirmed that angiogenesis is important in the development and spread of a variety of human cancers, including prostate cancer (PCa). Tumor neovascularization is thought to be controlled by chemical signals, known as angiogenic factors (AF). To date, little is known regarding the existence and role of AF in PCa. We previously reported on vascular endothelial growth factor...
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