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The clinical utility of positron emission tomography (PET) in renal cell carcinoma (RCC) has not been determined. We describe a case in which metastatic RCC undetected by traditional staging methods was accurately staged by PET. A 77-year-old man presented with a 20-lb weight loss and bilateral renal masses. Plain radiographs, bone scintigraphy, and alkaline phosphatase were normal. PET imaging confirmed...
Objectives. To investigate the prevalence of the microsatellite instability related to mismatch repair (MMR) gene defects using a panel of six microsatellite markers, as recommended by a recent workshop on microsatellite instability in colon cancer, because it is still unclear whether abnormalities in DNA MMR genes are involved in transitional cell carcinoma (TCC) of the bladder.Methods. Three mononucleotide...
Objectives. To determine the long-term success rate for the modified Pereyra bladder neck suspension and to identify preoperative characteristics that create differences in surgical outcome. We attempted retrospectively to separate those patients with what we now recognize was significant intrinsic sphincter deficiency (ISD) before routine use of Valsalva leak point pressures (VLPPs) was available...
Objectives: To evaluate the 1-year safety and effectiveness of transurethral vaporization of the prostate (TUVP) compared with transurethral resection of the prostate (TURP) in alleviating outflow obstruction.Methods: Two experienced surgeons performed 26 TUVPs and 28 TURPs. The intraoperative blood loss was measured by photometry and fluid absorption by the ethanol method. The treatments were evaluated...
Objectives. Retroperitoneal lymph node dissection (RPLND) after primary chemotherapy is an accepted therapeutic approach for metastatic nonseminomatous germ cell testicular cancer. Because of the intense desmoplastic reaction and adherence to venous and arterial walls, accurate imaging of the retroperitoneal vasculature and its relation to residual tumor is essential. We report our experience with...
Objectives. To compare the analysis of urine after prostatic massage (VB3) with expressed prostatic secretions (EPS) to assess the significance of leukocyte analysis in VB3 and to give a first hint of the diagnosis of inflammatory chronic pelvic pain syndrome (CPPS) when EPS cannot be obtained.Methods. Three hundred twenty-eight men (mean age 38 years, range 18 to 70) with expressible prostatic secretions...
We describe the application of a retubularized ileal stoma (Monti procedure) to an ileocecal pouch in a patient with a spinal cord injury who required a continent urinary diversion. When constructing a continent diversion with an ileocecal pouch, this technique seems a good choice, with significant advantages over the other alternatives.
Objectives. To determine the parent perception of discomfort (PPD) in children receiving local anesthesia for the lysis of labial adhesions, meatotomy, and newborn circumcision; the parents' perceived outcome of these procedures; and the overall satisfaction of parents when these procedures are performed in the office.Methods. A confidential phone survey was given to 99 parent participants whose children...
The differential diagnosis of recurrent bacteriuria includes a host of conditions very familiar to urologists. Ureterorectal fistula represents an unusual clinical entity that can cause recurrent bacteriuria. We present a patient who ultimately proved to have such a fistula. We review the available literature and comment on the significance of this condition.
Objectives. Radical, full-thickness resection of the bladder wall and overlying bladder tumor is a management option in highly selected patients with muscle invasive bladder cancer. The consequences of iatrogenic ureteral injury in patients whose tumor involves the ureteral orifice and intramural ureter have not been reported. This report details an experience with 4 patients who underwent full-thickness...
Objectives. To report the initial clinical experience with laparoscopic augmentation enterocystoplasty using the ileum, sigmoid, or right colon.Methods. Three patients with functionally reduced bladder capacities due to neurogenic causes underwent laparoscopic enterocystoplasty: ileocystoplasty (n = 1), sigmoidocystoplasty (n = 1), and cystoplasty with cecum and proximal ascending colon (n = 1). In...
Objectives. To determine whether outcome differences between African-American men (AAM) and white men with prostate cancer (PCa) will still be present if we control for stage in a large cohort of men. It is well established that AAM have a worse outcome from PCa than white men.Methods. We examined 848 consecutive patients who underwent radical prostatectomy at Wayne State University, Karmanos Cancer...
Objectives. To demonstrate the incidence of positive urinary nuclear matrix protein 22 (NMP22) values associated with renal cell carcinoma (RCC) of the kidney. Currently, urinary NMP22 is used to detect recurrent transitional cell carcinoma of the bladder.Methods. From May 1997 to March 1998, urinary NMP22 values were obtained from 65 patients who had undergone either computed tomography scanning...
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