Interstitial high-dose-rate brachytherapy as salvage treatment for locally recurrent prostate cancer after definitive radiation therapy: Toxicity and 5-year outcome.

Purpose: We report our results with interstitial high-dose-rate brachytherapy (HDR-BT) as a salvage therapy option after external beam therapy with or without BT. Emphasis was put on toxicity and 5-year outcome.

Methods And Materials: From 2003 to 2011, 29 patients with local failure after previous radiotherapy for prostate cancer were treated with salvage interstitial HDR-BT.

Reliability of dynamic sentinel node biopsy combined with ultrasound-guided removal of sonographically suspicious lymph nodes as a diagnostic approach in patients with penile cancer with palpable inguinal lymph nodes.

Introduction And Objectives: Dynamic sentinel node biopsy (DSNB) is considered "unsuitable" in patients with penile cancer and palpable inguinal lymph nodes. The aim of this study was to determine the diagnostic reliability of DSNB combined with ultrasound (US)-guided removal of additional suspicious lymph nodes as a minimally invasive diagnostic approach in these patients.

Material And Methods: A total of 23 consecutive patients with penile cancer and unilaterally or bilaterally palpable inguinal lymph nodes underwent DSNB according to the 2-day protocol.

Management of recurrent post-prostatectomy incontinence after previous failed retrourethral male slings.

Objective: Our objective was to establish the feasibility of combining 2 minimally invasive procedures in patients with failed primary treatment (male sling) in post-prostatectomy incontinence (PPI) patients.

Methods: From January 2007 to July 2008, 40 men with PPI were implanted with a suburethral tape (2 patients with Seratim, 3 with I-Stop and 35 with Advance). The median preoperative pad count was 4 (range 2-10).

Histological detection of minimal metastatic disease in inguinal non-sentinel lymph nodes in penile cancer.

Unlabelled: The aim of this study was to detect lymphatic spread by serial step-section technique in non-sentinel lymph nodes (NSLNs), which were earlier assessed as negative by histological examination.

Patients And Methods: Inguinal dissection specimens of 13 men with penile cancer were investigated. The LNs were sectioned at multiple levels (150 mum-intervals) and then H&E- and immuno-stained for cytokeratin (Lu-5).

Functional impact of the rhabdosphincter branch of the pelvic nerve on the membranous urethra in comparison to that of the pudendal nerve in male rabbits.

Introduction: The innervation of the membranous urethra (MU) is still under debate. We analysed the functional effects of electrostimulation of the rhabdosphincter branch of the pelvic nerve (RBP) on the MU in a standardized male rabbit model, paying attention both to the efferent and the possible afferent effects of stimulation.

Material And Methods: Six male rabbits (chinchilla bastards) were included in this study.

Should being aged over 70 years hinder penile prosthesis implantation?

Objective: To assess the satisfaction profiles following penile prosthesis surgery in patients with erectile dysfunction (ED) in their seventh decade of life.

Patients And Methods: In all, 174 patients received, for the first time, a penile prosthesis between 1990 and 2007 in our department. Among these, 35 patients were aged > or =70 years at prosthesis implantation.

Lymphatic spread in squamous cell carcinoma of the penis is independent of elevated lymph vessel density.

Objective: To examine the potential effect of tumour-induced lymphangiogenesis in squamous cell carcinoma of the penis as a possible mechanism responsible for lymphatic spread.

Patients And Methods: Specimens from 65 patients with invasive tumours (31 with and 34 without metastases) were evaluated for lymphatic vessel density (LVD) by the 'hot-spot' method as the density of lymphatic endothelium hyaluronan receptor (LYVE-1)-positive lymphatic vessels per unit area of tissue. LVD was examined in peritumoral, intratumoral and normal tissue areas.

Interobserver variation in grading and staging of squamous cell carcinoma of the penis in relation to the clinical outcome.

Objective: To examine interobserver variations in assessing grade and stage of penile squamous cell carcinoma (SCC).

Patients And Methods: We retrospectively reviewed the pathological features and clinical outcome in 75 patients with SCC of the penis, who were treated in participating urological centres between 1996 and 2005; the assessments of the local pathologists and the review pathologists were compared.

Results: There was conformity in tumour grade in 67% and the assessment of tumour stage conformed in 84%; the combination assessment of both grade and stage conformed in 56%.

Unilateral vs bilateral sacral neuromodulation in pigs with formalin-induced detrusor hyperactivity.

Objective: To investigate the efficacy of unilateral vs bilateral sacral neuromodulation (SNM) under standard experimental conditions by stimulating the dorsal sacral roots in pigs with formalin-induced detrusor hyperactivity.

Materials And Methods: After lumbosacral laminectomy in eight alpha-chloralose-anaesthetized Göttinger mini-pigs, the dorsal roots of the nerve S3 were inserted into separate compartments of a size-modified Brindley electrode. Detrusor hyperactivity was induced by intravesical instillation of a 0.

Ewing's sarcoma of the urogenital tract.

This article reviews the current available information on Ewing's sarcoma of the urogenital tract, focusing on the presentation, diagnosis, and therapeutic management of this uncommon entity. Because of the rapid local growth of these tumors, an immediate decision for treatment initiation is mandatory. The classical presentation depends mainly on the site of involvement of these tumors, involving a palpable mass, hematuria, and pain.

Endoscopic retrieval of a penile prosthesis' rear-tip extender.

Introduction: The renewal of penile prosthesis is a foreseeable intervention because of the limited survival time of the different implants. It usually becomes necessary simply for material fatigue after long-term regular use; in some cases, premature intervention might be necessary because of infection or other perioperative complications.

Aim: In the case presented here, the removal of a Dynaflex penile prosthesis showed a missing rear-tip extender on the right-hand tube.

Functional outcome following photoselective vaporisation of the prostate (PVP): urodynamic findings within 12 months follow-up.

Objectives: We determined the impact of potassium-titanyl-phosphate (KTP) laser therapy of the prostate on urodynamic results, voiding function, quality of life, and sexual function.

Design, Setting, And Participants: Forty-five patients complaining of symptomatic benign prostatic hyperplasia (BPH) and urodynamically proven obstructive voiding were included in the prospective study. Follow-up exams were repeated 3 mo and 12 mo after the treatment.

Lymph-node metastases in intermediate-risk squamous cell carcinoma of the penis.

Objective: To evaluate the metastatic risk of pT1 G2 squamous cell carcinoma (SCC) of the penis.

Patients And Methods: We retrospectively reviewed 20 patients with pT1 G2 penile SCC and determined their groin status at first presentation, their nodal status after inguinal lymph node dissection and their follow-up for at least 18 months.

Results: Four of the 20 patients had a clinically positive groin; three of these were found to have lymph node metastases.

Recovery of erectile function after nerve-sparing radical prostatectomy: improvement with nightly low-dose sildenafil.

Objective: To evaluate the effect of low-dose sildenafil for rehabilitating erectile function after nerve-sparing radical prostatectomy (NSRP), as the delay to recovery of erectile function after NSRP remains under debate.

Patients And Methods: Forty-three sexually active patients had a NSRP; at 7-14 days after surgery they had a Rigiscan (Dacomed Corporation, Minneapolis, MN, USA) measurement of nocturnal penile tumescence and rigidity (NPTR). To support the recovery of spontaneous erectile function, 23 patients with preserved nocturnal erections received sildenafil 25 mg/day at night.

Nocturnal tumescence: a parameter for postoperative erectile integrity after nerve sparing radical prostatectomy.

Purpose: The exact process and time required for rehabilitation of erectile function after nerve sparing prostatectomy remain unclear to date. Different theories of the pathophysiology of postoperative erectile dysfunction are currently being discussed. In a prospective study we performed recordings of nocturnal penile tumescence and rigidity during the acute phase after nerve sparing radical prostatectomy, ie in the first night after removal of the catheter, to assess the organic penile integrity.

Cortical representation of the urge to void: a functional magnetic resonance imaging study.

Purpose: The urge to void generally increases with bladder distention but the relationship between the 2 factors is complex. When the bladder is moderately filled, the desire to void can be called forth deliberately but it can also be suppressed. To elucidate human brain mechanisms that are active during such intentional modulations of the desire to void we performed functional magnetic resonance imaging in healthy volunteers.

Penile carcinoma (pT1 G2): surveillance or inguinal lymph node dissection?

Background: Due to the low incidence of squamous cell penile cancer and lack of well-designed studies, controversies persist over the therapeutic approach in patients with pT1 G2 carcinoma.

Patients And Methods: Between 1992 and 2003, 16 patients with T1 squamous penile cancer were treated in our institution either by surveillance or by inguinal lymph node dissection (ILND).

Results: A total of 8 primary lesions were classified as pT1 G2 carcinoma with 4 tumors developing early or delayed inguinal metastatic disease.

Methylene blue staining for nerve-sparing operative procedures: an animal model.

Objectives: To evaluate methylene blue fiber staining as a method of nerve fiber identification in an animal model, because the maintenance of organ function after surgery depends on exact intraoperative identification of the relevant nerve fibers.

Methods: Brindley electrodes were implanted bilaterally at S3 for sacral anterior root stimulation in six minipigs. For reference, stimulation-induced detrusor contractions were recorded urodynamically.

Effect of subthalamic deep brain stimulation on the function of the urinary bladder.

Detrusor hyperreflexia is a relevant clinical symptom for patients suffering from Parkinson's disease. In a series of 16 patients, we demonstrated that subthalamic deep brain stimulation has a significant and urodynamically recordable effect leading to a normalization of pathologically increased bladder sensibility.