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Abdominal hernias are not rare in women with urinary incontinence, but incisional bladder hernia is uncommon. The presenting symptoms in the rare cases reported included suprapubic discomfort, irritative voiding symptoms, and urinary incontinence. We present a patient with bladder herniation and severe mixed urinary incontinence. The pathophysiology of the urinary symptoms and the surgical alternatives...
Objectives. To evaluate pretreatment serum prostate-specific antigen (PSA) as an outcome predictor of targeted microwave thermotherapy.Methods. Seventy-one patients with lower urinary tract symptoms of benign prostatic hyperplasia underwent targeted transurethral microwave thermotherapy using the Targis system. Outcomes 12 months after treatment were evaluated by the International Prostate Symptom...
Objectives. To assess the effectiveness and tolerability of transdermal estrogen in men with hot flushes after hormonal therapy for prostate cancer.Methods. Twelve men with moderate to severe hot flushes were randomized to receive either low-dose (0.05 mg) or high-dose (0.10 mg) estrogen patches applied twice weekly for 4 weeks. After a 4-week washout period in which no treatment was given, each patient...
Objectives. To correlate the clinical outcomes of 148 patients with clear cell renal carcinoma treated at a single institution with a variety of other factors.Methods. Cases were derived from a consecutive series of nephrectomy specimens obtained from 1980 to 1994. A retrospective review of clinical records was performed, with tobacco use, alcohol use, recurrence, and survival noted.Results. The median...
Objectives. To present the preliminary results of renal ablative cryosurgery in selected patients.Methods. Seven patients were treated, all of whom had small peripheral tumors and chose not to undergo partial or radical nephrectomy. Four patients underwent a rib-sparing flank incision; the remaining three underwent laparoscopy. All tumors were biopsied before cryoablation. Intraoperative ultrasound...
Objectives. Little is known about the attitudes of men unselected for a family history for prostate cancer concerning genetic testing for prostate cancer risk or genetic testing for inherited cancer predisposition. To explore this, we examined the interest in molecular testing for hereditary prostate cancer (HPC) predisposition among a self-selected cohort of 342 men presenting for prostate cancer...
Objectives. Use of external beam radiation fields that conform to the shape of the target improves biochemical control in prostate cancer by facilitating dose escalation through increased sparing of normal tissue. By correcting potential organ motion and setup errors, ultrasound-directed stereotactic localization is a method that may improve the accuracy and effectiveness of current conformal technology...
Objectives. To examine the outcomes of patients with newly diagnosed metastatic renal cell carcinoma (RCC) who underwent initial nephrectomy as a component of therapy, because the role of nephrectomy in the treatment of patients with metastatic RCC is uncertain.Methods. A retrospective review of 63 patients who underwent radical nephrectomy with or without additional surgical procedures in the setting...
A 63-year-old man with bilateral adrenal tumors was treated for hypertension and diabetes mellitus. Endocrinologic examination during follow-up revealed the production of cortisol to be independent of the regulation of the hypothalamo-pituitary-adrenal axis. Therefore, he was diagnosed as having subclinical Cushing syndrome, and these tumors were removed. Adrenocorticotropic hormone-independent macronodular...
Objectives. The traditional treatment for a painful varicocele consists of conservative measures followed by varicocelectomy. We report our results with microsurgical subinguinal varicocele ligation to treat pain.Methods. From 1996 to 1999, a total of 119 men underwent subinguinal microsurgical varicocele ligation for painful varicocele. The diagnosis of varicocele was based on the findings of both...
Objectives. The mucosal collar was designed to achieve a cosmetically normal-appearing, circumcised phallus during hypospadias surgery. The original technique has been modified and refined since its introduction by Firlit in 1987. Herein, we provide a detailed description of the procedure as it is now performed.Methods. From 1987 to 1998, more than 500 mucosal collars were created by the senior author...
Objectives. To perform an in vitro study analyzing the possibilities in therapeutic strategies for an effective treatment of cystine stones.Methods. Artificial stones made of cystine [Bon(n)-Stones] with a ball-shaped size of 0.9 cm in diameter were used. Chemolysis of artificial cystine stones with different solvents (artificial urine, physiologic sodium chloride solution, acetylcysteine, tris-(hydroxymethylene)-aminomethane...
Objectives. Ileal and sigmoid augmentation are equally effective at increasing bladder capacity and compliance. Therefore, knowledge of the incidence of major complications, including perforation, small bowel obstruction (SBO), anastomotic complications, calculus formation, and indications for revision may be useful in choosing the ideal segment. We compared the complications of ileocystoplasty and...
Objectives. The biologic mechanism for the increased proportion of noncomplexed (''free'') prostate-specific antigen (PSA) found in the serum of patients with benign prostate disease is unknown. We recently reported that most of the PSA found in benign, hyperplastic, and cancerous prostatic tissue is in the free form. To determine whether specific molecular forms of free PSA are associated differentially...
Objectives. Fas/APO-1 is an apoptosis-signaling cell-surface receptor belonging to the tumor necrosis factor receptor family. The Fas-Fas ligand system plays an important role in cytotoxic T-lymphocyte-mediated or natural killer cell-mediated cytotoxicity against tumor cells. Soluble Fas (sFas), generated by alternative splicing, has been reported to antagonize the interaction of cell-surface Fas...
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