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This case is the first reported presentation of obstructive anuria due to extrinsic ureteral compression in a patient with dermatomyositis. Further evaluation revealed disseminated sigmoid colon adenocarcinoma. Conservative treatment of ureteral obstruction by internal double-J stents achieved appropriate palliation.
Because tissue samples obtained ureteroscopically are small, the techniques for biopsy and for handling and processing the samples are crucial. Our aim is to describe the biopsy technique in great detail so other centers can reproduce it. Patients were evaluated by retrograde ureteropyelography and ureteroscopy for diagnosis. The entire collecting system was examined using a combination of small-diameter...
Objectives. The effects of finasteride on prostate-specific antigen (PSA) variability and usefulness in prostate cancer detection were examined.Methods. Percent change and crossover of PSA levels between the low (1.0 to 3.9 ng/mL) and high (4.0 to 10.0 ng/mL) ranges were evaluated in 72 men with benign prostatic hyperplasia (BPH) and 77 men with both BPH and prostate cancer (PCa) treated with finasteride...
Neonatal renal vein thrombosis (RVT) is a well described entity that typically presents after a variety of neonatal stresses. Prenatal RVT is a less common entity found incidentally on prenatal imaging. We report a case of neonatal RVT and a probable prenatal RVt.
Objectives. Patients with large bladder calculi (4 cm or larger) have traditionally been managed with open cystolithotomy. Endoscopic management with cystolitholapaxy or electrohydraulic lithotripsy risks complications. In an effort to spare patients the morbidity of open cystolithotomy, the results of holmium:yttrium-aluminum-garnet (YAG) laser cystolithotripsy for bladder calculi 4 cm or larger...
Objectives. To refine the clinical and radiologic description of an unusual benign disease, cystic pyeloureteritis (CPU), consisting of the appearance of suburothelial cysts that raise the mucosa layer of the urothelium. We also studied its relationship with various types of inflammation, including chronic infection, that may be the stimulus for the appearance of CPU.Methods. We compiled 34 cases...
Objectives. Prior investigations evaluating the presence of human papillomavirus (HPV) in prostatic tissue by polymerase chain reaction (PCR) technology have yielded detection rates of 0% to 100%. Contamination by viral DNA from prostatic urethral colonization or less than optimal laboratory conditions have been suggested to explain this discrepancy. In addition, the various investigations have...
Objectives. To evaluate three popular storage media and the effect of 24-hour cold storage on bladder tissue.Methods. Guinea pig bladders were stored in three solutions: UW solution (a media used for transplant organs), Reznikoff solution (cell culture medium), and Krebs' solution with and without aeration.Results. Cell potassium and sodium concentrations and total tissue water (a measurement of...
Objectives. During a prospective randomized study of prostatic and periprostatic heating during transurethral electrosurgical treatment, energy utilization was studied with respect to electrode configuration and prostate size.Methods. Patients were stratified for gland volume (transrectal ultrasound [TRUS] 50 cc or less and more than 50 cc) and randomized to treatment either with loop resection...
Objectives. We calculated the annual hazard rate (HR) for prostate cancer recurrence after radical prostatectomy (RP) to elucidate the pattern of treatment failure over time and to assess the efficacy of definitive therapy.Methods. We calculated the progression-free probabilities (PFP) and HRs after RP for a cohort of 611 consecutive men with clinically localized (cT1-2, NX, MO) prostate cancer...
Objectives. Snodgrass recently described a form of urethral tubularization with longitudinal incision of the urethral plate to create an elliptical meatus. To prevent fistulae, a transverse island of dorsal subcutaneous tissue was used to cover the repair. The generation of this flap may compromise blood supply to the skin that is used in the skin closure, and predispose to penile torsion. We...
Objectives. To compare the Bard BTA test, a simple latex-agglutination test for cancer of the bladder (BC) that can be performed in less than 3 minutes in the urologist's office, with voided urine or bladder wash cytology in the diagnosis of subjects suspected of having BC on the basis of symptoms or recent abnormal cystoscopy or intravenous urography.Methods. The study was performed at three medical...
We describe an alternative method of double J stent placement for ureteral transection following the failure of traditional antegrade and retrograde approaches. Cystoscopically, a guidewire was placed across the distal ureteral segment and was advanced into a urinoma cavity at the level of the transected ureter. Subsequently, an antegrade approach was used to place a gooseneck snare through the...
Objectives. To determine the efficacy of pentosan polysulfate (Elmiron) compared to placebo in the treatment of interstitial cystitis.Methods. The data sources used were MEDLINE, Excerpta Medica, and International Pharmaceutical Abstracts databases, and the manufacturer. Bibliographies of articles obtained were reviewed. The keywords used were pentosanpolysulfate, pentosanpolysulfate sodium, and...
Objectives. We investigated the symptomatic and urodynamic effects of several noninvasive and minimally invasive treatment modalities to quantify these effects and to compare subjective and objective results within groups with various degrees of obstruction.Methods. In a prospective study at one center, 487 patients who completed a full screening program including urodynamic investigation started...
Hippocrates, who is generally considered a focal point for the start of western medical tradition, left behind a corpus of medical writings that constituted the first recorded comprehensive health system. The pivotal point of the Hippocratic corpus was the Hippocratic Oath, which outlined the duties of healers of his school, but demarcated lithotomy as a practice that was off limits to his fellow...
Objectives. Managed care organizations (MCOs) are developing population-based approaches to illnesses with large numbers of patients, wide variations in care and outcomes, and high costs. This is the first survey that evaluates current prostate cancer approaches by MCOs.Methods. Case studies and a survey of corporate medical directors at large MCOs were conducted.Results. Two approaches, broadly...
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