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Objectives. The vacuum erection device (VED) is usually well tolerated and very effective for patients with erectile dysfunction. When used correctly, VEDs carry low morbidity and few recognized complications. We report on 5 patients who developed unusual complications associated with VED use, including two previously unreported complications of urethral bleeding and capture of scrotal tunica within...
Objectives. Neuroendocrine differentiation (NED) is a common feature in adenocarcinoma of the prostate. Several studies suggest that NED may have a major impact on cancer progression as neuroendocrine (NE) secretory products have been shown to possess growth stimulatory effects. NED has also been proposed to constitute part of the mechanism by which a prostate cancer cell progresses toward androgen...
Objectives. To evaluate the response of prostatic stromal cells in vitro to the action of the agonist norepinephrine and to examine the role of cell density in this response.Methods. Stromal cells isolated from transurethral chippings of patients with benign prostatic hyperplasia (BPH) were seeded onto tissue culture dishes either at high density (9 x 10 3 cells/cm 2 ) or at low density...
Objectives. Vascular closure staple (VCS) clips made of titanium were initially developed for microvascular anastomoses with little knowledge of their effectiveness in larger tubular tissue structures. This study compares VCS clips and sutures in the closure of longitudinal ureterotomy incisions.Methods. In 9 pigs, 1-cm-long anterior, longitudinal ureterotomy incisions were randomly assigned to closure...
Objectives. To evaluate the incidence and outcome of cardiac arrhythmias associated with an external fixed-rate generator and the Medstone lithotripter with regard to stone location, anesthesia type, patient age, and gender.Methods. Data were obtained on 933 patients who underwent shock wave lithotripsy (SWL) with the Medstone lithotripter. Patients were randomly divided into two study groups, including...
Objectives. To better define the techniques of nerve-sparing prostate dissection that would result in preservation of erectile function, we characterize the effects of physical pressure on the prostate and cavernous nerve, electrical stimulation of the cavernous nerve, and pharmacologic manipulations on intracavernous pressure (ICP) in normal and diabetic rats.Methods. Fischer-34 rats, both normal...
Objectives. Extracorporeal shock wave lithotripsy (ESWL) for the treatment of lower caliceal stones (LCS) tends to have a poor success rate, prompting many urologists to advocate alternative treatment modalities. This study attempts to identify variables that may influence the outcome of ESWL treatment for LCS to help in selecting patients that are likely to benefit from the treatment.Methods. One...
Objectives. To evaluate the impact of magnetic resonance imaging (MRI) in renal transplant recipients whose ultrasound (US) examinations of the native kidneys have met the criteria of acquired cystic kidney disease (ACKD).Methods. The US scans of 840 renal allograft recipients were prospectively studied. In addition, 46 of 169 patients diagnosed with ACKD by US scans underwent MR examination. MRI...
Objectives. To investigate the correlation of epidermal growth factor receptor (EGFR) expression and its ligands EGF and transforming growth factor-alpha (TGF-α) with disease outcome in a cohort of patients with superficial bladder cancer.Methods. Tumor samples of 21 patients with transitional cell carcinoma of the bladder were analyzed by immunohistochemistry for expression of EGFR, EGF, and TGF-α...
Intractable, therapy-resistant priapism in a patient with sickle cell disease is presented. The patient was managed with insertion of an inflatable penile prosthesis. He consequently maintained potency and remains free of priapitic episodes. To our knowledge, immediate penile prosthesis insertion for management of priapism has not been reported. We discuss the indications and advantages of this approach...
Objectives. Multiple conservative therapies for the treatment of Peyronie's disease have been offered with variable and poor response rates. Calcium channel blockers have been shown in vitro and in vivo to inhibit secretion and synthesis of extracellular matrix, including collagen, glycosaminoglycans, and fibronectin, as well as causing increased collagenase and anti transforming growth factor-beta...
Objectives. To compare our results of preoperative corporal cavernosography and retrograde urethrography in penile fractures with the clinical and intraoperative findings.Methods. From January to October 1996, 7 cases of penile fracture were diagnosed at our inner city trauma center. All cases were associated with sexual activity and patients underwent preoperative retrograde urethrography and corpus...
Objectives. Metachronous metastasis of renal cell carcinoma to the contralateral adrenal gland is very rare. We review our experience with 5 such patients and compare it with reports in the literature.Methods. The records of all 350 patients who underwent nephrectomy for renal cell carcinoma in our center between 1975 and 1992 were reviewed. Five patients were found to have had solitary metachronous...
The uroflowmeter is perhaps the most important and certainly the most commonly used urodynamic instrument currently employed in urologic practice. The modern uroflowmeter was invented by Willard M. Drake, Jr., in 1946 at the Jefferson Medical College. The original manuscript, entitled ''The uroflometer: an aid to the study of the lower urinary tract,'' appeared in Journal of Urology in 1948. Drake...
Objectives. The efficacy and safety of levofloxacin and lomefloxacin in complicated urinary tract infections (UTIs) were compared in a randomized, open-label, multicenter study.Methods. Outpatients were randomized to receive levofloxacin (250 mg once daily) for 7 to 10 days or lomefloxacin (400 mg once daily) for 14 days. Three hundred thirty-six patients (171 with levofloxacin, 165 with lomefloxacin)...
Objectives. To describe the occurrence of a physician-assigned diagnosis of prostatitis in a community-based cohort.Methods. A sampling frame of all Olmsted County, Minnesota, male residents was used to randomly select a cohort of men between 40 and 79 years old by January 1, 1990, to participate in a longitudinal study of lower urinary tract symptoms. The 2115 participants (response rate 55%) completed...
Teratoma with malignant transformation is defined as the emergence of a non-germ cell tumor from a teratoma. Although extremely rare in extraovarian sites, cases have been reported that involve primary extragonadal germ cell tumors with transformation to variants of sarcoma. We report a 54-year-old man who was found to have adenocarcinoma arising within a mature teratomatous retroperitoneal metastasis...
Objectives. To review the trends in prostate cancer (PC) incidence and mortality rates in Denmark during a 50-year period.Methods. A population-based register study was performed of all new cases of PC recorded in the Danish Cancer Registry from 1943 to 1992.Results. The age-standardized incidence rate for PC increased from 11.5/100,000 in 1943 to 1947 to 30.9/100,000 in 1988 to 1992. Age-specific...
Objectives. A reference range of prostate-specific antigen (PSA) values compatible with cure following radiotherapy (RT) for prostate cancer (PCa) has yet to be established. Various thresholds, as low as 0.5 ng/mL, have been used to define biochemical disease-free status. We report PSA profiles in 118 patients who were systematically biopsied following standard RT, with a minimum 4-year follow-up...
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