Influence of polyunsaturated fatty acids on urologic inflammation.

Purpose: Studies demonstrate that polyunsaturated fatty acids, fish oils, and alpha-linoleic acid are beneficial anti-inflammatory agents, which suppress inflammatory mediators and their activity.

Methods: This review focuses on the effects of omega-3 fatty acids (O-3FAs) on three primary urologic organs (bladder, kidney, and prostate) and associated conditions such as urolithiasis, kidney transplantation, interstitial cystitis/bladder pain syndrome, bladder cancer, prostate cancer (CaP), and chronic prostatitis/chronic pelvic pain syndrome.

Results: The following themes emerged: the potential influence of O-3FA in suppressing urologic inflammation; the supportive role of O-3FA in therapeutic interventions; pro-inflammatory mechanisms of omega-6 fatty acids (O-6FAs) associated with disease progression; and the importance of the optimal ratio of O-6FAs/O-3FAs.

Debulking nephrectomy followed by a "watch and wait" approach in metastatic renal cell carcinoma.

Objective: Debulking nephrectomy has been shown to improve survival in metastatic renal cell carcinoma and is now a standard procedure. However, it remains controversial if debulking nephrectomy should routinely be followed by interferon. We report on the clinical course of metastatic renal cell carcinoma patients after debulking nephrectomy who did not receive routine systemic anticancer therapy.

Urethroplasty for anterior urethral strictures in a community-based urology practice.

Introduction: The outcome of urethroplasty for the anterior urethral stricture is superior to internal urethrotomy. However, the excellent results are often reported by tertiary medical centres and most urologists in general urological practice do not offer urethroplasty. We review the results of our institution to ascertain whether equivalent results are achievable in a district hospital urology service.

Botulinum toxin type A for refractory neurogenic detrusor overactivity in spinal cord injured patients in Singapore.

Introduction: Managing neurogenic detrusor overactivity (NDO) successfully in spinal cord-injured patients is a challenge. The aims of preserving kidney function by achieving safe bladder pressures with anticholinergic medication often leave a significant proportion of patients with side effects. Botulinum toxin type A has been shown to be a promising alternative.

Urodynamic studies in the evaluation of young men presenting with lower urinary tract symptoms.

Aim: To evaluate the usefulness of urodynamic study in young men with lower urinary tract symptoms (LUTS).

Methods: We reviewed the charts of 50 men with LUTS aged 50 years and below. Those with neurological diseases, urethral trauma or strictures were excluded.

Outcomes following revisions and secondary implantation of the artificial urinary sphincter.

Purpose: Durable success with the artificial urinary sphincter (AUS) is common but device revision and replacement are often needed for various reasons. We examined indications and outcomes following these secondary procedures with comparisons to outcomes after primary procedures.

Materials And Methods: The medical records of all patients undergoing primary and secondary bulbar urethral AUS implantation and revision from January 1990 to September 2002 were reviewed for various demographic and surgical variables.

Laparoscopic drainage of nocardial adrenal abscess in an HIV positive patient.

We report a rare case of a nocardial adrenal abscess in an HIV patient that underwent the first drainage of adrenal abscess by laparoscopy. Adrenal abscesses are exceedingly rare in adults and prove to be a diagnostic challenge. Laparoscopic adrenal exploration is both a diagnostic and therapeutic modality with low perioperative morbidity that should be considered in the management of indeterminate adrenal masses and abscesses.

Preoperative urodynamic evaluation may predict voiding dysfunction in women undergoing pubovaginal sling.

Purpose: We determine which urodynamic parameters can best predict postoperative voiding dysfunction following pubovaginal sling surgery.

Materials And Methods: The records of 98 consecutive women who had undergone pubovaginal sling surgery with allograft fascia lata between July 1998 and July 2000 were reviewed. Urodynamic and followup data were sufficient for evaluation for 73 patients.

Transcorporal artificial urinary sphincter cuff placement in cases requiring revision for erosion and urethral atrophy.

Purpose: A distal cuff location is often required in patients undergoing artificial urinary sphincter reimplantation after previous erosion or in those requiring revision because of urethral atrophy at the original cuff site. Dissecting the urethra at a more distal site increases the risk of urethral injury and erosion, and often the urethral circumference is so small that a 4 cm. cuff is too large.