Inadvertent foley catheterization of the ureter.

We present a case of an 83-year-old woman with multiple sclerosis and chronic indwelling urethral catheter who was found to have a ureteral injury after inadvertent placement of a foley catheter into the proximal right ureter. Cystoscopy and retrograde ureteral stenting was attempted, but unsuccessful. The patient ultimately underwent successful antegrade ureteral stenting and nephrostomy placement.

Favorable risk factors in patients with positive surgical margin after robot-assisted radical prostatectomy.

Introduction: Positive surgical margin (PSM) has classically been associated with biochemical recurrence (BCR) following radical prostatectomy (RP) and immediate adjuvant radiotherapy has been advocated based on two large randomized prospective clinical studies. However, a significant percentage of patients with PSM never experience BCR. This study evaluated factors potentially affecting risk of BCR among the patients with PSM after robot-assisted radical prostatectomy (RARP).

Prostate-specific antigen density toward a better cutoff to identify better candidates for active surveillance.

Objective: To investigate the impact of prostate-specific antigen density (PSAD) on existing prostate cancer (PCa) active surveillance (AS) protocols.

Methods: Prospectively maintained database on men with PCa who underwent radical prostatectomy was reviewed retrospectively. Demographic data and pathologic characteristics of patients who fulfilled the AS inclusion criteria under the National Comprehensive Cancer Network (NCCN), Prostate Cancer Research International Active Surveillance (PRIAS), and University of California, San Francisco (UCSF) guidelines were examined.

Concern for overtreatment using the AUA/ASTRO guideline on adjuvant radiotherapy after radical prostatectomy.

Background: Recently, three prospective randomized trials have shown that adjuvant radiotherapy (ART) after radical prostatectomy for the patients with pT3 and/or positive margins improves biochemical progression-free survival and local recurrence free survival. But, the optimal management of these patients after radical prostatectomy is an issue which has been debated continuously. The object of this study was to determine the necessity of adjuvant radiotherapy (ART) by reviewing the outcomes of observation without ART after radical prostatectomy (RP) in patients with pathologic indications for ART according to the American Urological Association (AUA)/American Society for Radiation Oncology (ASTRO) guideline.

Comprehensive analysis of sexual function outcome in prostate cancer patients after robot-assisted radical prostatectomy.

Purpose: The recovery of potency following radical prostatectomy is complex and has a very wide range. In this study, we analyzed in detail the precise pattern of recovery of potency following robot-assisted radical prostatectomy (RARP).

Materials And Methods: Prospectively collected database of patients with a minimum follow-up of 1 year after RARP were evaluated retrospectively.

Absence of prostatic growth in large cohort of adult female patients with congenital adrenal hyperplasia.

Purpose: In girls with congenital adrenal hyperplasia the degree to which excess androgen exposure leads to the development of prostatic tissue is largely uncharacterized, except in rare case reports of prostatic growth and adenocarcinoma. Such growth yields concern for future malignant degeneration.

Materials And Methods: Chart review identified 43 adult women with congenital adrenal hyperplasia who had been longitudinally followed from birth, of whom 11 were available for history and physical examination, laboratory testing for androgen metabolites, and pelvic magnetic resonance imaging.

Cholestasis induced nephrotoxicity: the role of endogenous opioids.

Aims: Elevated levels of endogenous opioids play a pivotal role in several deleterious consequences of cholestasis. Renal dysfunction occurs in cholestasis but its exact mechanism is still unknown. In this study, we investigated the role of endogenous opioids in cholestasis induced nephrotoxicity.

miR-21: an androgen receptor-regulated microRNA that promotes hormone-dependent and hormone-independent prostate cancer growth.

Androgen receptor (AR)-mediated oncogenic pathways have not been fully elucidated. In this study, we used high-throughput microarray analysis on two AR-positive prostate cancer (CaP) cell lines to identify 16 AR-responsive microRNAs (miRNA). We focused on miR-21 because of its previously reported oncogenic activity in other cancers.

Bladder neck transection for intractable pediatric urinary incontinence.

Purpose: We report the indications, technique and outcome of a large series of children who underwent bladder neck transection for intractable urinary incontinence.

Materials And Methods: We retrospectively reviewed demographics, operative details, complications and outcomes of 76 patients (47 males, 29 females) who underwent bladder neck closure at our institution between 1996 and 2006. Mean patient age at the time of the procedure was 12 years, 10 months.

Complications of complex lower urinary tract reconstruction in patients with neurogenic versus nonneurogenic bladder--is there a difference?

Purpose: The complications of lower urinary tract reconstruction have been well documented in children with neurogenic bladders. While most series include small numbers of nonneurogenic diagnoses, this group is typically underrepresented. Despite a number of fundamental anatomical and functional differences, a direct comparison of surgical complications of lower urinary tract reconstruction in patients with neurogenic vs nonneurogenic bladders has not been performed.

Prostate screening in patients with 46,XY disorders of sex development--is it necessary?

Purpose: We used current methods of screening for prostate cancer, digital rectal examination and serum prostate specific antigen as an initial assessment of risk in a young group of adult 46,XY patients affected by disorders of sex development.

Materials And Methods: Adult intersex patients older than 21 years, under long-term followup at the Pediatric Endocrinology Clinic of the Johns Hopkins Hospital, with a diagnosis of male psuedohermaphroditism and raised as male or female were included in analysis. After written consent all participants underwent digital rectal examination and blood sampling for prostate specific antigen and testosterone measurements.

Transurethral autologous myoblast injection for treatment of urinary incontinence in children with classic bladder exstrophy.

Purpose: The application of autologous myoblasts is an area of active research that may represent an improved alternative for the treatment of urinary incontinence. In this study we investigated the effectiveness of autologous myoblast injection for the treatment of urinary incontinence in children with classic bladder exstrophy.

Materials And Methods: Seven boys and 1 girl with persistent urinary incontinence were entered in the study.

Role of endogenous cannabinoids in ischemia/reperfusion injury following testicular torsion in rats.

Objectives: The role of endogenous cannabinoids in ischemia/reperfusion induced germ cell apoptosis in rats was investigated.

Methods: Baseline group was for basal normal values. The Sham operated group served as a control group.

Dose-dependent modulation of systemic lipid peroxidation and activity of anti-oxidant enzymes by vitamin E in the rat.

The objective of this work was to examine the time-dependent pro-oxidant versus antioxidant effect of various doses of vitamin E used commonly in experimental studies. Erythrocyte activity of superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT) and plasma lipid peroxidation levels were investigated following biweekly intramuscular administration of 100, 300 and 600 mg/kg of vitamin E at a baseline time point, and additionally at 2, 4 and 6 weeks after initiating treatment. Vitamin E had an antioxidant effect when administered at low doses over short time periods, and increased the activity of antioxidant enzymes.

Protective effects of sildenafil administration on testicular torsion/detorsion damage in rats.

Purpose: We assessed the effectiveness of sildenafil administration during ischemic period in a rat model of testicular torsion/detorsion (T/D).

Material And Methods: Sprague-Dawley rats were divided into four groups (n = 10). In those animals that underwent T/D, right testes were rotated 720 degrees for 1 h.

Salutary effects of N-acetylcysteine on apoptotic damage in a rat model of testicular torsion.

Introduction: Numerous studies performed in recent years have shown protective effects of N-acetylcysteine (NAC) on cardiac and renal tissue damage following ischemia/reperfusion injury. We assessed the effectiveness of systemic administration of NAC, at a therapeutic dose, in a rat model of a 1-hour 720-degree testicular torsion/detorsion.

Materials And Methods: Sprague-Dawley rats were divided into five groups, 14 animals in each: group 1 animals underwent sham operation as the control group; group 2 rats underwent torsion/detorsion and received saline injection, and the animals in groups 3, 4, and 5 received intraperitoneal injections of 150 mg/kg NAC 30 min before torsion, after torsion, and after detorsion, respectively.

Comparison of different techniques for hemostasis in a rabbit model of hypospadias repair.

Purpose: We compared the cellular and ultrastructural changes in the urethral wall following application of different hemostasis techniques in a rabbit model of hypospadias surgery.

Materials And Methods: Rabbits were allocated into 5 groups. In group 1 animals underwent surgery without application of any hemostasis technique; in group 2 continuous penile tourniquet was applied for 30 minutes; in group 3, 3 intermittent periods of 10-minute penile tourniquet were applied with 3-minute intervals of reperfusion; in group 4 epinephrine was injected to maintain a 30-minute period of hemostasis; and in group 5 epinephrine vehicle (normal saline) was injected during the procedure.

Proximal hypospadias with severe chordee: single stage repair using corporeal tunica vaginalis free graft.

Purpose: We report the results of corporeal tunica vaginalis free graft for single stage correction of severe chordee in children with proximal hypospadias.

Materials And Methods: A total of 18 children with proximal hypospadias and severe chordee underwent tunica vaginalis free graft for correction of chordee and urethroplasty. The graft was anastomosed to the ventral surface of the corpus cavernosum to correct severe penile curvature without dorsal plication of the corpus cavernosum.

Evolution of endoscopic management of ectopic ureterocele: a new approach.

Purpose: We report the evolution of endoscopic treatment of ectopic ureteroceles from the unroofing technique to a novel approach using concomitant ureterocele double puncture and intraureterocele fulguration. We also compare the results of different endoscopic modalities at a single center.

Materials And Methods: We reviewed the records of 46 children with ectopic ureteroceles who were treated endoscopically between 1995 and 2005.

Time-dependent neovasculogenesis and regeneration of different bladder wall components in the bladder acellular matrix graft in rats.

Objectives: To determine the time-dependent regeneration of different cellular components in the bladder acellular matrix graft (BAMG) and the involvement of hematopoietic stem cells in BAMG vascular regeneration.

Methods And Materials: Thirty-three male Sprague Dawley rats underwent partial cystectomy and the acellular matrices were grafted to the remaining host bladder. At 4, 7, 14, 30, 60, 90, and 180 d after grafting, animals were sacrificed and their bladders were excised and paraffin-embedded.

Smooth muscle cell apoptosis and defective neural development in congenital ureteropelvic junction obstruction.

Purpose: We assessed the smooth muscle cell apoptosis along with changes in cellular and extracellular components of the ureteropelvic junction in 23 patients with unilateral obstruction and compared them with 25 autopsies from ureteropelvic junction regions of age matched cadavers.

Materials And Methods: Tissue specimens obtained from pyeloplasty were divided into 3 sections-renal pelvis above the obstruction, obstructed ureteropelvic junction and ureter below the obstructed region. For the control group the normal ureteropelvic junctions of age matched infants were autopsied.

ATP-sensitive potassium channels mediate the anti-ischemic properties of ischemic and pharmacologic preconditioning in rat random-pattern skin flap.

Ischemic preconditioning (IPC) and pharmacologic preconditioning by morphine and adenosine may significantly decrease the amount of necrosis in rat random pattern skin flaps. We examined the role of ATP-sensitive potassium channels (K(ATP) channels) in mediating these protective phenomenon by using glibenclamide a nonspecific blocker of these channels. We also investigated whether administration of diazoxide an opener of the K(ATP) channels could mimic the same protective effect.

Chronic morphine treatment induces oxidant and apoptotic damage in the mice liver.

Recently many researchers have proposed a protective role for morphine against tumor growth and metastasis, especially through induction of apoptosis in tumoral cells. These findings may lead to underestimation of cytotoxic effects of opioid drugs which are usually expected only at high doses. The present study was conducted to clarify whether repeated morphine administration, which is commonly used for relief from chronic pain, would interfere with liver antioxidant defence and hepatocytes vitality.

Effect of morphine on ischemia-reperfusion injury: experimental study in testicular torsion rat model.

Objectives: To investigate the effects of morphine on reperfusion injury due to testicular torsion-detorsion (T/D).

Methods: We divided 36 adult male Sprague-Dawley rats into six groups. Testicular ischemia was achieved by twisting the right testis 720 degrees counterclockwise for 1 hour, and reperfusion was allowed for 4 hours after detorsion.

Serum and CSF vitamin A concentrations in idiopathic intracranial hypertension.

Background: Elevated serum retinol, CSF retinol, and serum retinol binding protein (RBP) levels have been found in some patients with idiopathic intracranial hypertension (IIH), but serum and CSF retinol levels have not been studied in matched serum and CSF samples in patients with IIH.

Objective: To determine whether serum and CSF vitamin A concentrations are associated with IIH.

Methods: The serum and CSF retinol concentrations were prospectively assessed in 20 patients with IIH and 20 control subjects.