Urology
Objectives. To determine the long-term safety and efficacy of the Titan endoprosthesis as a therapeutic alternative in the management of men with bladder outlet obstruction.Methods. One hundred forty-four patients (mean age, 73.5 years +/- 4.2) had placement of the Titan stent. The stents were inserted under direct vision and expanded to 33 F using balloon catheter. Of the 144 patients, 59 (41%) were...
Objectives. To assess the effects of finasteride, a 5-alpha-reductase inhibitor, and of classic antiandrogens on the growth rate of the LnCap human prostate carcinoma cell line, derived from a primary and well-differentiated neoplasm.Methods. Cell proliferation experiments in vitro with and without the antiandrogens cyproterone acetate, hydroxyflutamide, and finasteride in the 0.0001 to 10.0 μM range...
Objectives. To review the selection criteria and perioperative morbidity in patients undergoing living-related donor nephrectomy.Methods. Retrospective chart review.Results. Six hundred eighty-one patients underwent living donor nephrectomy during a 20-year period without any mortality. The postoperative morbidity included pneumothorax requiring a chest tube in 7%, urinary tract infection in 5%, wound...
Objectives. Laser tissue welding in genitourinary reconstructive surgery has been shown in animal models to decrease operative time, improve healing, and decrease postoperative fistula formation when compared with conventional suture controls. Although the absence of future material is the ultimate goal, this has not been shown to be practical with current technology for larger repairs. Therefore,...
Objectives. To compare the normal sheep bladder at 6 and 12 months with bladders subjected to either an autoaugmentation gastrocystoplasty or a clam demucosalized gastrocystoplasty.Methods. Twenty male lambs aged between 8 and 10 weeks had an autoaugmentation gastrocystoplasty in which de-epithelialized stomach muscle was added to an intact urothelium. The functional, radiologic, and histologic outcomes...
Objectives. To present the preliminary results of a novel technique of ureteroneocystostomy with a new principle (extravesical seromuscular tunnel).Methods. The new technique was applied in the left ureter of 12 mongrel dogs. The dogs were stratified into three groups (4 dogs each) according to the length of the extravesical travesical seromuscular tunnel. Tunnel lengths of 3, 2, and 1 cm were used...
Objectives. To review a contemporary series of rectal injuries occurring during radical perineal prostatectomy.Methods. Of 81 patients who underwent radical perineal prostatectomy, 9 (11 %) sustained a full-thickness laceration of the anterior rectal wall. All 9 patients had a preoperative bowel preparation, although only 1 received a complete oral lavage regimen. All received prophylactic perioperative...
Objectives. Apomorphine has been reported to be effective in causing erections in animals and man when administered parenterally. The side effects, notably nausea, have seriously limited its clinical usefulness. We formulated apomorphine for controlled sublingual absorption and herein report on four preliminary studies evaluating efficacy and side effects in men with no documentable organic cause...
Objectives. To evaluate the current indications and outcome of open stone surgery in a tertiary endourology unit.Methods. A 3-year retrospective review (1990 to 1993) of all endoscopic and open stone surgery was undertaken.Results. Twenty-five open procedures were performed on 20 patients of a total of 799 stone treatment procedures (3.13%). The most common indications for open stone surgery included...
Objectives. The prevalence of pelvic lymph node metastases in men with clinically localized prostate cancer has decreased dramatically over the past decade, possibly due to efforts at early detection. With a significantly lower incidence of pelvic node involvement, it may be possible to identify a segment of patients for whom pelvic lymph node dissection (PLND) may be omitted. This study was conducted...
We report a primary squamous cell carcinoma of the prostate that developed in a 57-year-old man, 3 years after treatment with leuprolide and flutamide for Stage D1 adenocarcinoma of the prostate. This is the first case that describes this transformation from adenocarcinoma to squamous cell carcinoma following the use of luteinizing hormone agonists.
Laser treatment of men with BPH remains in its infancy. To date, a large number of techniques and devices have been developed and investigated to varying degrees. Each laser system that is utilized in a unique fashion must be evaluated individually, since tissue effects may vary significantly with minor changes in technique or technology. Over all, it appears that the majority of men treated by laser...
We present an interesting application of laparoscopy in a man who was otherwise not a candidate for radiotherapy because of an adherent loop of small bowel in the proposed treatment field. Laparoscopic enterolysis was performed and the involved segment was displaced out of the pelvis; a synthetic mesh was placed to serve as a sling to prevent caudal migration back into the pelvis. The patient had...
Objectives. The objective of this study was to define optimal treatment parameters and quantitative dosimetry for neodymium:yttrium-aluminum-garnet (Nd:YAG) laser coagulation prostatectomy utilizing the ProLase II side-firing laser delivery system.Methods. Transurethral Nd:YAG laser application was performed with the ProLase II side-firing laser fiber in adult human prostates prior to planned radical...
Objectives. Genomic imprinting is a newly discovered mechanism in genetics that is involved in tumorigenesis. H19 is an imprinted gene in the human, expressed from the maternal allele. It is extensively transcribed in fetal life but is not translated and functions as an RNA molecule. It has been suggested as a candidate tumor suppressor gene. We studied the expression of H19 in human cancer arising...