Urology
Objectives. To characterize nitric oxide synthase (NOS), which catalyzes nitric oxide (NO) production, in the human prostate using biochemical and immunohistochemical techniques.Methods. NOS catalytic assay and NOS immunohistochemistry were performed on histologically verified nonmalignant prostate tissue obtained from the peripheral and transition zones of seven radical prostatectomy specimens...
Objectives. To evaluate long-term efficacy and safety of terazosin, a selective alpha 1 blocker, in the treatment of benign prostatic hyperplasia (BPH).Methods. This was a long-term (42 months), open-label, multicenter study with patients evaluated at 1- to 6-month intervals. Twenty-three outpatient clinics throughout the United States and Canada participated in the study. A total of 494...
Objectives. To determine whether nitric oxide (NO) is a mediator of prostatic smooth muscle activity.Methods. Pharmacologic experiments using electrical field stimulation (EFS) were performed on strips of human and canine prostate.Results. EFS alone elicited frequency-dependent contractions in preparations of human and canine prostates. The greatest contractile activity was achieved at 30 Hz....
Objectives. Because repetitive hematuria home screening with a chemical reagent strip can detect early stage bladder cancer (BC) in asymptomatic middle-aged and elderly men, the ability of this screening to effect earlier detection and reduce BC mortality was investigated.Methods. Grades, stages, and outcomes of BCs detected by hematuria screening in 1575 men were compared with those of all newly...
Objectives. To assess the variability of membranous folds in the posterior urethra and their relationship to urethral obstruction.Methods. Endoscopic video recordings of 19 boys with a membranous lesion in the posterior urethra were obtained over a 2.5-year period. Six had an endoscopy after a prenatal diagnosis of obstructive uropathy and 13 boys presented with either a urinary tract infection...
Objectives. To review our experience with ureteropelvic junction obstruction in a duplicated renal collecting system.Methods. The records of 7 patients with ureteropelvic junction obstruction in a duplex collecting system were reviewed. In addition to routine demographics, each case was reviewed for presenting symptoms, site of obstruction, and type of surgical treatment.Results. Three of the...
Objectives. To evaluate the safety, feasibility, and efficacy of transurethral ablative prostatectomy (TURAPY), a radiofrequency method of thermal tissue ablation of benign prostatic hyperplasia (BPH).Methods. Twenty men, ages 55 to 81 years (mean, 67), with symptomatic BPH and with peak flow rate 12 mL/s or less, were treated with the TURAPY device (Direx Medical Systems). A 2 cm long heating element...
Insertion of semirigid penile prosthesis is a surgical option to correct male erectile dysfunction. Postoperative infection of penile prosthesis necessitates removal and drainage of corporeal chambers. We describe a technique to drain infected corporeal cavities with T-tubes.
Herein we report the initial experience with a completely extraperitoneal laparoscopic approach to bladder diverticulectomy combined with a drainage procedure (transurethral incision of the prostate).
Objectives. The objective of this study was to define the actual mechanism of neodymium: yttrium-aluminum-garnet (Nd:YAG) laser prostatectomy achieved with the previously described contact-free beam technique using the Ultraline delivery system at high-power settings.Methods. Transurethral Nd:YAG laser application was performed with the Ultraline side-firing laser fiber in canine and human prostates...
We present the open surgical repair of complete obstruction of the bladder neck unresponsive to endoscopic management. By combining abdominal and perineal dissection, partial pubectomy, and omental wrapping, repeat anastomosis is possible without the need for bladder tubularization. Two patients have been repaired successfully. Although both men presented with indwelling suprapubic tubes and a...
Objectives. The use of external percutaneous nephrostomy drainage in patients with end-stage ureteral obstruction in whom ureteral stenting has failed presents significant compromises in the patient's quality of life. Toward this end, we present the initial experience in the United States with an intracorporeal nephrovesical stent.Methods. We performed successful subcutaneous urinary diversion in...
Objectives. An evolving technology for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia (BPH) is the use of the side-firing neodymium: yttrium-aluminum-garnet (Nd:YAG) laser to achieve prostatic tissue ablation. The purpose of this study was to determine the short-term efficacy of this procedure in both an objective and subjective manner.Methods. We examined this...
Objectives. To understand the comparability of serum prostate-specific antigen (PSA) determinations across assays and storage time.Methods. Serum PSA levels were determined for men aged 40 to 79 years from the clinical subset of the Olmsted County Study of Urinary Symptoms and Health Status Among Men on fresh samples and after a median of 32 months on banked samples, frozen at -70 o C. ...
Objectives. To compare the outcome of patients with T3a and T3c adenocarcinoma of the prostate and determine the utility of these substages as defined in the current American Joint Committee on Cancer and the International Union Against Cancer (AJCC/UICC) staging system.Methods. An analysis was performed of patients with T3 (clinical) prostate cancer treated with definitive irradiation at the Fox...
Laparoscopic nephrolithotomy was used as an alternative to open surgery in a patient who had failed extracorporeal shock-wave lithotripsy and whose anteriorly located stone-bearing calix precluded percutaneous extraction. Endocavitary ultrasonography and color Doppler render the procedure safe and effective; localization of the stone, selection of an optimal nephrotomy site away from large vessels...
Objectives. The objective of this study was to evaluate the effect of finasteride (10 mg/d) or placebo on serum prostate-specific antigen (PSA) and recurrence rates in men with detectable PSA levels after radical prostatectomy.Methods. A total of 120 men, 48 to 89 years old, previously treated with radical prostatectomy for prostate cancer within the past 10 years, with serum PSA levels between...
Objectives. To evaluate disease outcome using serum prostate-specific antigen (PSA) as an outcome measure in patients with T1 or T2 prostate cancer treated with radiation therapy in the PSA era.Methods. We reviewed the outcome for 461 patients with T1 (n = 205) or T2 (n = 256) prostate cancer followed for a median of 31 months after radiation therapy as the sole initial treatment. Univariate and...
Objectives. To determine the frequency of abnormal p53 expression and to characterize confirmed p53 mutations in tumors from patients with clinically localized adenocarcinoma of the prostate.Methods. p53 protein nuclear accumulation was determined immunohistochemically in the initial diagnostic tumor specimens from 37 patients with clinically localized prostate carcinoma. Two primary antibodies...