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To evaluate a novel sutureless tissue apposing vesicourethral anastomosis (VUA) device in a porcine model and compare it with standard laparoscopically sutured VUA.Thirty domestic pigs were divided into six groups. In groups 1, 2, and 3, a standard laparoscopic sutured running VUA was performed. In groups 4, 5, and 6, a novel device VUA was performed. In all cases, cystography was completed immediately...
To evaluate the prevalence of pelvic floor dysfunction in women with interstitial cystitis (IC).Women with IC and pelvic pain were referred to the Beaumont Women’s Initiative for Pelvic Pain and Sexual Health program. A comprehensive patient history and pelvic examination were completed by a certified women’s health nurse practitioner.Seventy women with a mean age of 45 years were evaluated. Of these...
Epidermolysis bullosa is a rare inherited bullous disorder of the skin that occasionally involves the urinary tract. We describe a child with a history of epidermolysis bullosa who presented with hematuria, urgency, and dysuria. On radiographic investigation, bladder wall lesions were found. On cystoscopy, these were bullous lesions on the urinary bladder that at biopsy were shown to have inflammatory...
To determine the influence of age on the outcomes of high-risk superficial bladder cancer treated with intravesical bacille Calmette-Guérin (BCG) therapy.A total of 805 patients with multiple or recurrent high-grade Ta, T1, and/or carcinoma in situ bladder cancer received BCG therapy. The endpoints were the initial response to BCG and cancer-free survival correlated with age among patients followed...
Emerging evidence supports a role for endothelin-1 (ET-1), endothelin A and B receptors (ET A and ET B , respectively), and neutral endopeptidase (NEP) in the progression of prostate carcinoma. In clinical trials for advanced prostate cancer, ET axis blockade significantly delayed the time to disease progression in a subset of patients. We examined ET axis expression in prostate cancer,...
The intraoperative complexity of laparoscopic partial nephrectomy (LPN) for upper pole renal tumors is recognized. We report on the technical feasibility and operative outcomes of LPN for upper pole tumors (UPLPN) and lower pole tumors (LPLPN), and open partial nephrectomy (UPOPN) for upper pole tumors.We retrospectively reviewed our database of LPNs performed by a single surgeon from October 2002...
To assess outcomes in hypospadias repair at our institution, as compared with the literature, with repair technique and surgeon considered as risk factors.The results of 299 primary hypospadias corrections were analyzed. All procedures were performed by three experienced pediatric urologists. Mean patient age at operation was 16.3 months. Follow-up was between 6 months and 5.5 years. Distal hypospadias...
To study the evolution of surgical margins in robotic prostatectomy (DVP), to ascertain the surgical volume necessary to provide quality cancer care.Clinicopathologic data on consecutive DVP patients were abstracted from our institutional database. The primary outcome evaluated was the presence of any positive surgical margin. Surgeon DVP volume was the unit of exposure. A logistic model was fit to...
We report the case of Kock pouch incontinence resulting from perforation of the efferent nipple valve by an unsuccessful catheterization attempt in a patient with a spinal cord injury. Continence was reestablished by surgical revision.
Scrotal defects resulting from many factors, including accidents, Fournier’s gangrene, and gunshot injuries, present difficulties in management and reconstruction. Antibiotic therapy must be given to all patients, and if necessary vigorous debridement must be performed. Because of the abundant vascularity of the region, local wound dressing results in dramatically rapid recovery of the wounds. In...
Lymph node dissection (LND) may improve accuracy of staging, decrease recurrence rates, and improve survival in patients with advanced renal cell carcinoma (RCC). Here we assess the feasibility and safety of laparoscopic LND.Data were analyzed for patients who underwent combined laparoscopic radical nephrectomy (LRN) with LND between July 1997 and September 2006. Demographics, operative data, pathologic...
To further elucidate the significance of the cyclic nucleotide-mediated signal transduction, we examined the in vitro functional responses of isolated seminal vesicle (SV) smooth muscle tissue to selective phosphodiesterase (PDE) inhibitors.Using the organ bath technique, the effects of increasing concentrations (1 nM to 10 μM) of the PDE inhibitors vinpocetine (PDE1 inhibitor), rolipram (PDE4 inhibitor),...
We report a case of large cell B-cell lymphoma of the kidney associated with humoral hypercalcemia of malignancy. A 70-year-old man presented with renal failure and hypercalcemia. After the workup, the patient was thought to have renal cell carcinoma and underwent radical nephrectomy. The pathologic evaluation showed a large cell lymphoma with a B-cell phenotype. Reevaluation of the patient’s serum...
To assess the prognostic effect of perineural invasion (PNI) for patients undergoing external beam radiotherapy for prostate cancer.We evaluated 657 consecutive patients who had undergone external beam radiotherapy for clinically localized prostate cancer. The clinical/treatment parameters used for analysis included PNI, clinical stage, biopsy Gleason score, pretreatment prostate-specific antigen,...
The Weck clip has emerged as an attractive option for laparoscopic vascular control. It is secure and easy to use. However, once fired, the clip can be difficult to remove. We describe a novel technique for the safe removal of misdirected Weck clips using the Harmonic scalpel.
To assess the expression of livin, a member of the inhibitor of apoptosis protein family, in renal cell carcinoma (RCC) and to determine its prognostic relevance.Immunohistochemical staining for livin was performed using paraffin-embedded tissues from 45 cases of RCC. Then we assessed anti-livin antibodies (Abs) in patient sera by enzyme-linked immunosorbent assay and Western blotting. Disease-specific...
The advent of molecularly targeted agents is rapidly changing the management of metastatic renal cell carcinoma. A case in which surgical metastatectomy was used in the setting of dramatic but incomplete disease response to sunitinib is presented. Some of the issues complicating operative intervention in the setting of multitargeted tyrosine kinase inhibitors are discussed.
To investigate the clinical significance of local assessment by endorectal magnetic resonance imaging (MRI) in prostate cancer patients with metastases.The local extent and tumor size were determined by endorectal MRI in 95 prostate cancer patients with metastases, and their clinical implications were assessed.The maximum diameter and tumor volume significantly correlated with the local extent of...
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