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Objectives. To characterize observed differences in Gleason score between prostate biopsy and corresponding radical retropubic prostatectomy (RRP) specimens.Methods. One hundred consecutive clinically localized prostate cancers diagnosed by transrectal ultrasound-guided biopsy (TRUS-Bx) and treated with RRP were reviewed. All specimens were evaluated in blinded review by a single expert uropathologist...
Objectives. To compare four assays-the Abbott IMx, the Tosoh, the Chiron ACS PSA, and the Chiron ACS PSA 2 -in their ability to detect prostate-specific antigen (PSA) after radical prostatectomy.Methods. Serum samples were drawn on all men who had had a previous radical prostatectomy and who were seen in the urology clinic in March 1995. The results of each assay were compared using linear...
Objectives. During the last decade, vasoactive intracavernosal pharmacotherapy (VIP) has been used extensively for the treatment of erectile dysfunction. However, there is concern about high discontinuation rates and the possibility of long-term complications. Because of few long-term studies on VIP, we investigated efficacy, side effects, satisfaction index, and drop-out rate for injection therapy...
Objectives. To describe the optimal surgical management of the testes and mullerian duct structures in patients with persistent mullerian duct syndrome.Methods. We performed a comprehensive Medline literature search regarding the surgical management of persistent mullerian duct syndrome and extracted information regarding the etiology, pathogenesis, and treatment of this disorder. We specifically...
Objectives. To develop a procedure to be used to find, identify, and characterize the living prostate cancer cells in the blood of patients with prostate cancer.Methods. The procedure is based on a negative selection approach that removes most of the blood cells and collects the remaining prostate cancer cells, which are identified and characterized by fluorescent in situ hybridization with deoxyribonucleic...
A new surgical technique to treat retroperitoneal tumors with supradiaphragmatic vena caval invasion is described. In this technique, hepatic warm ischemia can be avoided with reversed hepatic outflow through the portal vein and neither hypothermic circulatory arrest nor cardiopulmonary bypass is necessary using centrifugal blood pump-driven bypass.
Objectives. The current need to evaluate necessity and cost of diagnostic and therapeutic procedures extends to transplant services. We reviewed our experience over the past 3 years as we have moved away from routine post-transplant nuclear medicine scans, ultrasounds, and cystograms.Methods. From January 1, 1992 to December 31, 1994, 252 kidney transplants were performed at Virginia Mason Medical...
Objectives. Current primary prostate cell culture techniques use an overnight digestion or extensive media preparation. In this report, we describe a method for the culture of benign and neoplastic cells from human prostatectomy specimens that is rapid and contains no undefined factors in the medium.Methods. Characterization of the human cultured prostate cells was performed using immunohistochemical...
A 12-year-old boy, examined after an episode of acute urinary retention, was found to have neurofibromatosis of the bladder neck and prostatic urethra. His symptoms of bladder outlet obstruction and radiographic findings of a dilated prostatic urethra mimicked posterior urethral valves. Complete urologic investigation, including cystourethroscopy, revealed that the dilatation of the prostatic urethra...
Objectives. We describe the expression of a potentially new tumor marker, human glandular kallikrein 2 (hK2), that may be useful as an adjunct to prostate-specific antigen (PSA) in the diagnosis and monitoring of prostate cancer.Methods. We evaluated 257 radical prostatectomy specimens removed at the Mayo Clinic with pathologic Stage T2 adenocarcinoma to compare the cytoplasmic expression of hK2,...
Objectives. Androgen ablation with luteinizing hormone-releasing hormone (LHRH) agonists, orchiectomy, or oral estrogens has significant untoward sexual side effects. We evaluated a combination of finasteride and flutamide as potency-sparing androgen ablative therapy (AAT) for advanced adenocarcinoma of the prostate. In addition, we evaluated whether finasteride provided additional intraprostatic...
Neurofibromatosis is a hamartomatous disorder of neural crest derivation characterized by cutaneous pigmentation and tumor formation in various tissues. Visceral involvement is typically insidious, progressive, and difficult to treat. Plexiform neurofibroma of the urinary tract is rare. Involvement of nearly every genitourinary structure by these lesions has been reported, with the bladder being most...
Objectives. Screening for prostate cancer to reduce the mortality and morbidity from this disease has become an important issue in recent years. Of all procedures used to diagnose prostate cancer, biopsy of the prostate is the cause of most complications. To evaluate the safety of the screening procedure, we have studied the complications and risk factors for complications within the screened population...
Objectives. Increasingly, nonpalpable prostate-specific antigen (PSA)-detected (Stage T1c) tumors are being treated with curative intent. Presently, only limited information is available regarding pathologic findings correlated with preoperative PSA levels. Herein, we report the characteristics of Stage T1c tumors in a contemporary surgical series.Methods. Clinical and pathologic results in 107 patients...
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