Three-dimensional ultrasound guidance for percutaneous drainage of prostatic abscesses.

Objectives: To evaluate the feasibility and effectiveness of three-dimensional ultrasound-guided transperineal puncture and drainage of prostatic abscesses.

Methods: Between 1985 and 2003, a prostatic abscess was diagnosed in 22 patients. One of the therapeutic modalities used to drain the abscesses was transperineal puncture under three-dimensional ultrasound guidance.

Screening for prostate cancer: updated experience from the Tyrol study.

The aim of the Tyrol study was to monitor the impact of screening in a natural experiment by comparing prostate cancer mortality in Tyrol, where prostate-specific antigen (PSA) testing was introduced at no charge, with the rest of Austria, where it was not strictly organized and not free of charge. In 1993, PSA testing was made freely available to men between the ages of 45 and 75 years in the Federal State of Tyrol, Austria. At least 70% of all of the men in this age range have been tested at least once during the first 10 years of the study.

The influence of left renal vein entrapment on outcome after surgical varicocele repair: a color Doppler sonographic demonstration.

Objective: To evaluate the impact of left renal vein entrapment on outcome after surgical varicocele repair using color Doppler sonography.

Methods: Eighty-four men had varicoceles on color Doppler sonography (2 right sided, 74 left sided, and 8 bilateral), which were diagnosed on the basis of a venous diameter of 3 mm or greater and venous retrograde flow in the pampiniform plexus of veins during the Valsalva maneuver or when changing from a supine to an upright position. Diagnosis of the left renal vein entrapment was based on the following criteria: antero-posterior diameter of greater than 1 cm and peak velocity of less than 15 cm/s for the left renal vein at the mid portion and anteroposterior diameter of less than 0.

Changes of renal blood flow in nephroptosis: assessment by color Doppler imaging, isotope renography and correlation with clinical outcome after laparoscopic nephropexy.

Objective: Previously, we have detected changes in renal blood flow secondary to nephroptosis by assessing the renal resistive index (RI) using color Doppler imaging (CDI). The aim of the current study was to compare two diagnostic methods, CDI and isotope renography (IRG), for detection of renal blood flow impairment in patients with nephroptosis.

Methods: 26 patients with nephroptosis and flank pain underwent CDI and isotope renography (IRG) before and after laparoscopic nephropexy.

Prenatal puncture of a unilateral hydronephrosis leading to fetal urinoma and postnatal nephrectomy.

Fetal pelvicaliceal dilatation due to ureteropelvic junction obstruction is the most common cause of antenatal hydronephrosis; it rarely leads to a spontaneous rupture resulting in urinoma formation. Antenatal intervention has been recommended only in those cases of large urinomas that seem to interfere with the function of other organ systems (eg, pulmonary hypoplasia secondary to diaphragmatic elevation). We report the case of a fetal intervention (transuterine puncture) in a unilateral massive hydronephrosis leading to a perirenal urinoma and the preterm birth of a female infant.

Serum pro-prostate specific antigen preferentially detects aggressive prostate cancers in men with 2 to 4 ng/ml prostate specific antigen.

Purpose: Pro forms of prostate specific antigen (PSA) have been reported to be more cancer specific markers of prostate cancer than total PSA and they also may preferentially detect the more aggressive forms of the disease.

Materials And Methods: Research immunoassays with high specificity for pro-PSA forms were used to study 1091 retrospective serum specimens, including 555 with 2 to 4 and 536 with 4 to 10 ng/ml PSA, from men enrolled in prostate cancer screening studies who underwent prostate biopsy.

Results: In the 2 to 4 ng/ml PSA range the ratio of pro- to free-PSA (percent pro-PSA) using a cutoff of 1.

Prostate cancer cells generated during intermittent androgen ablation acquire a growth advantage and exhibit changes in epidermal growth factor receptor expression.

Background: Intermittent androgen ablation is a palliative treatment option for advanced prostate cancer which is associated with less side effects, improved quality of life of patients, and reduced costs. Regulation of growth and survival of prostate cancer cells during intermittent androgen withdrawal has not been studied in appropriate models yet.

Methods: Two cycles of androgen withdrawal and supplementation were performed in human prostate cancer cells LNCaP in vitro.

Long-term results of laparoscopic retroperitoneal lymph node dissection: a single-center 10-year experience.

Objectives: To evaluate the feasibility, morbidity, and long-term oncologic efficacy of laparoscopic retroperitoneal lymph node dissection (L-RPLND) in patients with nonseminomatous germ cell tumor (NSGCT).

Methods: L-RPLND was performed 188 times in 185 patients; 114 procedures were performed for Stage I NSGCT and 6 procedures for tumor marker-negative clinical Stage IIA disease. In the case of positive lymph nodes, adjuvant cisplatin-based chemotherapy was administered.

Complication rate of transrectal ultrasound guided prostate biopsy: a comparison among 3 protocols with 6, 10 and 15 cores.

Purpose: We assessed the complication rate of ultrasound guided prostate biopsies performed at a single center in a screening population. Moreover the impact of different biopsy protocols comprising varying numbers of biopsy cores on the complication rate was evaluated.

Materials And Methods: A total of 5957 biopsies performed in 4303 clinically healthy men between January 1993 and August 2002 was evaluated retrospectively.

Genetic aberrations in prostate carcinoma detected by comparative genomic hybridization and microsatellite analysis: association with progression and angiogenesis.

Background: In spite of increasing knowledge about the tumor biology of prostate cancer (PC), molecular events involved in tumor progression are not well characterized. There is evidence that a number of genetic alterations play a role in tumor progression and in addition, angiogenesis also contributes. In this study, comparative genomic hybridization (CGH), a sensitive method for detecting regional DNA copy number abnormalities, and microsatellite analysis was used to identify frequent genome changes in PC.

Radical retropubic prostatectomy in men younger than 45 years diagnosed during early prostate cancer detection program.

Objectives: To evaluate the incidence and outcome of prostate cancer in men younger than 45 years of age treated with radical retropubic prostatectomy after screening in an early prostate cancer detection program.

Methods: Our study group comprised 19,302 men younger than 45 years old who participated in this program. The indications for prostate biopsy were a prostate-specific antigen (PSA) level of 1.

Clinical and pathologic features of prostate cancer detected after repeat false-negative biopsy in a screening population.

Background: The present study was designed to investigate whether the clinical or pathologic features of prostate cancer (PCa) are related to the number of repeat biopsies required to establish the diagnosis of PCa.

Methods: Between February 1993 and August 2000, 653 patients were evaluated in this retrospective study. All patients underwent transrectal ultrasound-guided biopsy of the prostate prior to radical retropubic prostatectomy.

Long-term androgen-ablation causes increased resistance to PI3K/Akt pathway inhibition in prostate cancer cells.

Background: In advanced stages of prostate cancer, the phosphatidylinositol-3' kinase (PI3K)/Akt signaling cascade, one of the major survival pathways in the cell, is frequently constitutively activated due to mutation or loss of the tumor suppressor protein phosphatase and tensin homolog deleted on chromosome 10 (PTEN). Using cell culture models representing different tumor stages, we explored the effect of inhibition of this survival pathway on the induction of apoptosis.

Methods: Inhibition of the survival kinase Akt and induction of apoptosis was analyzed in androgen-insensitive DU145 and PC-3 cells, in androgen-responsive LNCaP, and in androgen-independent long-term androgen-ablated LNCaP-abl cells representing therapy-resistant prostate cancer cells.

Long-term morbidity and mortality of transurethral prostatectomy: a 10-year follow-up.

Background: Long-term complication and reoperation rates in 1,211 patients undergoing TURP for symptomatic BPH between 1988 and 1991 were evaluated after a follow-up of at least 10 years.

Methods: Of the 1,211 patients who underwent TURP, 577 (47.6%) were available for follow-up.

Membrane properties of single muscle cells of the rhabdosphincter of the male urethra.

Background: The electrophysiological properties of myoblast cultures established from the human and porcine rhabdosphincter (RS) and porcine lower limb muscle (LLSKM) were studied to elucidate their potential for tissue engineering applications in the lower urinary tract.

Methods: Muscle biopsies were collected from the prostatic part of the RS, the RS of male pigs, and the porcine LLSKM. Ion channels were studied by means of the patch-clamp technique.

Androgen receptor regulation by physiological concentrations of the isoflavonoid genistein in androgen-dependent LNCaP cells is mediated by estrogen receptor beta.

Objectives: Isoflavonoids are discussed for use in chemoprevention and treatment of prostate cancer. We investigated the potential of genistein to modulate androgen receptor (AR) expression and transcriptional activity in the human androgen-sensitive prostate cancer cell line LNCaP.

Materials And Methods: AR expression at mRNA and protein level was analyzed by real-time RT-PCR and immunoblot, respectively.

Chemotherapeutic prevention studies of prostate cancer.

Purpose: Despite advances in the detection and management of prostate cancer, this disease remains a major cause of morbidity and mortality in men. Increasing attention has focused on the role of chemoprevention for prostate cancer, ie the administration of agents that inhibit 1 or more steps in the natural history of prostate carcinogenesis. We review prostate cancer chemoprevention studies in Europe.

Identification of genes involved in estrogenic action in the human prostate using microarray analysis.

Estrogens have profound effects on the developing prostate and are suspected to contribute to the development of benign prostatic hyperplasia, but the mechanism by which this hormone elicits its regulatory function still remains largely unknown. Using complementary RNA microarrays comprising approximately 10,000 oligonucleotide gene targets we compared differences in mRNA expression of estradiol-treated and untreated prostatic stromal cells in vitro. Based on a threshold of greater than twofold change, 228, 241, and 464 of the expressed genes were found to be regulated by estradiol after 10, 24, and 48 h of treatment, respectively.

Safer transurethral resection of the prostate: coagulating intermittent cutting reduces hemostatic complications.

Purpose: Transurethral resection of the prostate (TURP) is still the gold standard for the surgical treatment of symptomatic benign prostatic hyperplasia. However, the associated morbidity and blood loss remain concerns. A coagulating intermittent cutting (CIC) device with constant voltage pulses and controlled pulse intervals was recently developed.

Stromal testis tumors in infants. a report of two cases.

Gonadal stroma tumors account for 8% of pediatric testicular tumors and are therefore exceedingly rare. They generally exhibit a benign behavior. We report two consecutive cases of gonadal stroma tumors in infants.

Volume indexes of total, free, and complexed prostate-specific antigen enhance prediction of extraprostatic disease extension in men with nonpalpable prostate cancer.

Objectives: To analyze the ability of volume-adjusted total, complexed, and free prostate-specific antigen (PSA) to predict organ-confined cancer at radical prostatectomy in patients with nonpalpable disease.

Methods: Collected sera were assayed for total PSA (tPSA), complexed PSA (cPSA), and free PSA (fPSA) in 78 men who underwent radical prostatectomy with nonpalpable prostate cancer. The pathologic results (organ-confined versus extraprostatic extension [EPE]), tPSA, cPSA, fPSA/tPSA ratio, cPSA/tPSA ratio, fPSA/cPSA ratio, tPSA density (tPSAD), cPSA density (cPSAD), and fPSA density (fPSAD) were compared by the Mann-Whitney U test and receiver operating characteristic curves.

Management of adult Leydig-cell testicular tumors: assessing the role of laparoscopic retroperitoneal lymph node dissection.

Background And Purpose: Leydig-cell tumors represent <5% of malignant testicular tumors in adults. Orchiectomy is curative in approximately 90% of cases; however, the remaining men can develop metastases refractory to chemotherapy and radiation. We evaluated the role of laparoscopic retroperitoneal lymph node dissection (RPLND) in adult Leydig-cell tumors.

The intravesical ureter in children with vesicoureteral reflux: a morphological and immunohistochemical characterization.

Purpose: We investigated intravesical ureteral endings using immunohistochemical methods to study general morphology, smooth muscle architecture and collagen composition in children with vesicoureteral reflux.

Materials And Methods: Samples were obtained from 29 ureterorenal units in children with a mean age of 52.3 months undergoing reflux surgery.

Long-term outcome of laparoscopically managed nonpalpable testes.

Purpose: We evaluated laparoscopic diagnostic findings in 108 impalpable testes, and analyzed the success rate and long-term outcome of either direct laparoscopic orchiopexy or the 2-stage Fowler-Stephens procedure.

Materials And Methods: A total of 84 children with 108 impalpable testes and a mean age of 1.9 years underwent laparoscopy between 1992 and September 2000.

Serum pro prostate specific antigen improves cancer detection compared to free and complexed prostate specific antigen in men with prostate specific antigen 2 to 4 ng/ml.

Purpose: Pro prostate specific antigen (pPSA) is a precursor form of PSA enriched in tumor compared to benign prostate tissues that may be a more specific serum marker for prostate cancer. Serum pPSA was measured in the clinically relevant early detection PSA range of 2 to 10 ng/ml.

Materials And Methods: Research use immunoassays were used to measure native and truncated forms of pPSA.