Urology
Objectives. To demonstrate the effectiveness of an extravesical approach to refluxing ureters associated with paraureteral diverticula.Methods. Over a 39-month period, 23 children underwent repair of Hutch diverticula with refluxing ureters using an extravesical approach. Seventeen had unilateral reflux with an ipsilateral diverticulum, 4 had bilateral reflux with a unilateral diverticulum, and...
The management of the testicles in the prune belly syndrome can be problematic after the neonatal period. Lapraoscopic orchidopexy has been used for the intra-abdominal testis with success. A case of bilateral laparoscopic orchidopexy in a child with prune belly syndrome is presented. The testes were brought to the scrotum without division of the spermatic vessels, taking advantage of the extensive...
Objectives. To evaluate short-term and long-term variability between prostate-specific antigen (PSA) measurements to determine the most appropriate PSA sampling interval and rate of PSA change (PSA velocity) to distinguish between men with and without prostate cancer.Methods. Retrospective study of PSA variability and PSA velocity in three groups of men without a diagnosis of prostate cancer and...
Objectives. To evaluate and characterize erectile manifestations associated with sickle cell disease using nocturnal penile tumescence testing with polysomnography (NPT/PSG) and magnetic resonance imaging (MRI) of the penis.Methods. Six variably potent men with sickle cell disease, of whom 5 reported a history of priapism, underwent comprehensive evaluations of erectile function. Evaluations involved...
Objectives. A case report is presented of 2 patients whose levels of serum prostate-specific antigen (PSA) improved after the withdrawal of a steroidal antiandrogen.Methods. Two cases with prostate cancer had been treated with surgical castration and the steroidal antiandrogen chlormadinone acetate (CMA), and, on disease progression, the administration of CMA was terminated.Results. Following withdrawal...
Objectives. Recurrent incontinence after implantation of an artificial urinary sphincter (AUS) may be due to urethral atrophy. Treatment options consist of decreasing the cuff size, increasing the balloon pressure, implanting a double-cuff system, or proximal cuff repositioning. The first three options may increase the risk of erosion. Increasing the balloon pressure does not effectively increase...
Objectives. Androgen deprivation therapy before and during radiation therapy could, by reducing tumor volume, increase local tumor control, disease-free survival, and overall survival in patients with locally advanced adenocarcinomas of the prostate.Methods. In a randomized controlled clinical trial, patients with large T2, T3, and T4 prostate tumors, but no evidence of osseous metastasis, were...
Cardiopulmonary bypass, temporary cardiac arrest, and exsanguination have facilitated the surgical resection of renal tumors with intracaval thrombi that extend above the hepatic veins or into the atrium. The bloodless field provided by this approach enables the surgeon to utilize a flexible cystoscope to ensure that the caval thrombus has been removed entirely from the hepatic veins.
Objectives. To assess the usefulness of color Doppler ultrasound in evaluating the newborn with suspected antenatal testis torsion.Methods. Nine newborns with 10 antenatally torsed testes were examined using color Doppler and gray-scale ultrasound.Results. Each examination revealed lack of intratesticular blood flow on the affected side and normal flow within the contralateral testis. In addition,...
Objectives. To determine the time course of histologic resolution of prostate cancer following radiotherapy (RT) and to correlate biopsy results with clinical outcome.Methods. Since July 1990, all patients treated with radical external beam RT for prostate cancer at the General Division of the Ottawa Regional Cancer Centre have had systematic transrectal ultrasound (TRUS) and TRUS-guided biopsies...
A complete workup for a 36-year-old man with unexplained inguinal adenopathy and an indurated, enlarged penis and scrotum included urine cultures for bacteria, fungi, and acid-fast bacilli; scrotal ultrasound; computed tomography of the abdomen and groin; a retrograde urethrogram; a cystogram; duplex penile Doppler blood flow studies; and a surgical inguinal lymph node dissection. Pathologic examination...
Objectives. To evaluate and compare the safety and effectiveness of two noncontact laser regimens for the treatment of human benign prostatic hyperplasia (BPH), and to assess the impact of the spatial distribution of the laser-induced lesions on treatment outcome.Methods. This was a prospective, double-blind, randomized study that included 29 patients with BPH (both the patients and the study physician...
Cryoablation of the prostate has been shown to be a useful tool in the eradication of prostate cancer. Sloughing of necrotic tissue per urethra was one of the major complications of prostate cryosurgery during its initial application and led to ts disuse by urologists. A catheter was then needed until sloughing was complete and the patient again able to void. In a previous report, we have demonstrated...
Objectives. This study was undertaken to characterize adenosine 3'5'-cyclic monophosphate (cAMP) and guanosine 3'5'-cyclic monophosphate (cGMP) phosphodiesterases (PDEs) in porcine detrusor smooth muscle and to define their possible role in tension regulation.Methods. PDEs were isolated from porcine detrusor homogenate by Q-Sepharose anion exchange and calmodulin affinity chromatography. The effects...
Prostate-specific antigen (PSA) is the clinically most useful tumor marker for prostate cancer. Although false-positive elevations have been reported due to disease processes outside the prostate gland with the use of the polyclonal assay, such false-positive test results have been exceedingly rare with the use of the monoclonal assay. We report the case of a patient diagnosed with a B-cell lymphoma...
Objectives. To evaluate the long-term results of the UroLume endourethral prosthesis for the treatment of recurrent bulbar urethral strictures.Methods. In a multicenter, prospective study 175 patients with recurrent bulbar urethral strictures were enrolled in a Food and Drug Administration (FDA) trial of the UroLume endourethral prosthesis. One hundred thirty-nine patients were available for follow-up...
Objectives. The aim of this study was to evaluate efficacy and safety of transurethral evaporation of the prostate (TUEP) using neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in prostate glands of various sizes.Methods. One hundred consecutive patients with benign prostatic hyperplasia (BPH) and prostate volumes less than 40 cc (group I, n = 41), 41 to 80 cc (group II, n = 39), and more than 80...