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Objectives. To identify the rates of decline in health-related quality of life during the year before death in men with prostate cancer.Methods. We studied men in a subset analysis within a longitudinal, observational cohort of patients with metastatic prostate cancer at the University of California, Los Angeles, Center for Health Sciences. The analysis included 23 patients who died and had submitted...
Objectives. To determine the value of the before and after treatment level of prostate-specific antigen (PSA) to predict the time to androgen-independent progression (AIP) in patients with advanced prostate cancer who received androgen-deprivation therapy (ADT) at the time of recurrence or progression.Methods. The records of 153 patients with advanced or metastatic prostate cancer who were treated...
Objectives. To describe a simplified technique and results of pubovaginal sling lysis by incision of the sling in the midline by way of a transvaginal approach.Methods. We reviewed the charts of 19 women who underwent pubovaginal sling lysis for obstruction. Patients presenting with retention, incomplete emptying or storage, or voiding symptoms suggesting obstruction after pubovaginal sling placement...
Introduction. To describe an open technique for the cryosurgical ablation of small renal tumors using multiple ultrathin cryoprobes. Renal cryosurgery is an evolving surgical technique, and uncertainties exist regarding the ideal approach to freezing renal tumors.Technical Considerations. Using an open surgical approach, a 3-cm upper pole renal mass was ablated using five, state-of-the-art, 1.5-mm...
Objectives. To investigate the role substance P (SP) plays in prostatic inflammation, we evaluated SP immunoreactivity within the spinal cord after irritation of the prostate. Because alpha-adrenergic blockade attenuates nociceptor-induced pain, the effects of an alpha-adrenergic blocker on SP immunoreactivity were also evaluated. SP is considered a mediator of nociception in the spinal cord. Immunoreactivity...
Objectives. To assess the secular trends in postbiopsy complications and to identify the risk factors for complications.Methods. Olmsted County residents who underwent a prostate biopsy between 1980 and 1997 were identified. All community medical records for the study subjects were reviewed to identify prostate biopsy-related complications, including gross hematuria, infection, pain, hematospermia,...
Nineteen cases of breast cancer metastatic to the bladder and diagnosed in living patients have been identified in the English literature. Most patients were symptomatic with evidence of disseminated disease at the time of diagnosis. Metastasis usually occurred many years after diagnosis, and the prognosis was poor. The definitive modality for diagnosis in all cases was cystoscopy, which demonstrated...
Objectives. To evaluate the therapeutic efficacy of bacille Calmette-Guerin (BCG) for carcinoma in situ (CIS) of the urothelium involving the upper urinary tract when the vaccine was administered by way of the bladder using vesicoureteral reflux created by a double-pigtail (DP) catheter.Methods. Thirteen upper urinary tracts of 9 patients with cytologically diagnosed CIS, with concomitant bladder...
Objectives. To assess the significance of asymptomatic residual stone fragments of less than 4 mm (clinically insignificant residual fragments [CIRFs]) after extracorporeal shock wave lithotripsy (ESWL).Methods. Eighty-one patients were followed up for 6 to 60 months (mean 15) after ESWL to determine the fate of the CIRFs.Results. Of the 81 patients, 6 were lost to follow-up, leaving 75 patients....
Objectives. To evaluate adhesion formation after urologic laparoscopy, a multi-institutional review was conducted among adult patients who underwent a second procedure after an initial transperitoneal laparoscopic procedure. Adhesion formation after abdominal surgery remains a major cause of postoperative morbidity. Peritoneal adhesions result in hospitalizations and interventions that result in healthcare...
Recurrent priapism in young men is a potentially devastating condition that may result in irreversible penile fibrosis. Hormonal manipulation using estrogens and gonadotropin-releasing hormone analogues has been successful in treating episodes of priapism refractory to other treatment forms, but it is associated with significant adverse effects, in particular the loss of libido and erectile function...
Objectives. To determine whether an additional subclassification of the assessed clinical stage for prostate cancer before biopsy increases our ability to predict the biopsy outcome. A suspicious digital rectal examination (DRE) and/or a suspicious transrectal ultrasound (TRUS) investigation increases the likelihood of prostate cancer given a certain prostate-specific antigen level.Methods. Biopsies...
A child with neurogenic bladder and bowel underwent an antegrade continence enema procedure for fecal incontinence and severe constipation. She subsequently demonstrated an improvement in her neurogenic bladder and urinary incontinence.
Objectives. To evaluate the efficacy of a 7F tail stent with an 18F Councill nephrostomy tube and compare it to a 24F re-entry Malecot nephrostomy tube after percutaneous nephrolithotomy.Methods. Forty patients were prospectively randomized to receive either a 24F re-entry Malecot nephrostomy tube (group A, n = 20) or a 7F tail stent with an 18F Councill nephrostomy tube (group B, n = 20) for postoperative...
Objectives. To determine whether the expression level of clusterin in transitional cell carcinoma (TCC) of the bladder could be used as a predictor of tumor recurrence and prognosis.Methods. Total RNA samples were extracted from 89 specimens of TCC of the bladder, and the expression level of clusterin mRNA in these specimens was measured by Northern blot analysis. The results were evaluated with respect...
Constricting devices placed on the penis present a challenge to urologists. Various nonmetallic and metallic objects are placed on the penis to increase sexual performance or because of autoerotic intentions. We describe five different cases of strangulating objects (wedding ring, metal plumbing cuff, bull ring, hammer- head, and plastic bottle neck) and demonstrate that each case needs individual...
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