A complex case of megalourethra and its repair.

Megalourethra is a rare malformation of the urethra caused by a lack of corpus sponigosum and in some cases corpora cavernosa in the region of the distal urethra. The absence of these structures causes a ballooning of the urethra despite there being no mechanical obstruction. A male child presented with so-called fusiform megalourethra, with absence of the corpora cavernosa and urethral duplication.

Serotonin used as prognostic marker of urological tumors.

Introduction: In regard to therapy and prognosis of urological tumors, specific tumor markers are lacking especially in renal and urinary bladder carcinoma. Our study examines the relevance of serum serotonin levels to urinary bladder, prostate, renal, and testicular carcinoma when it comes to prognosis and occurrence of these oncological conditions.

Materials And Methods: Serotonin levels were obtained in 109 patients presenting with urothelial carcinoma to the urinary bladder, adenocarcinoma of the prostate and renal cell carcinoma, as well as presenting with seminomatous and non-seminomatous testicular tumors.

Solitary metastasis of a Merkel cell tumor to the urinary bladder.

The primary Merkel cell carcinoma, a neuroendocrine tumor, mostly appears on skin areas exposed to light. Complete excision with a safety margin plus local lymphadenectomy is the basic therapy. In cases of relapse or metastasis, surgical treatment is also the first choice.

Polymorphisms of human estrogen receptor (ER) gene alpha and beta in prostate cancer PC-EW and PC-OR cell lines.

Background: Prostate cancer is the second leading cause of death among men in Western countries. Genetic alterations of the estrogen receptor gene are known to be indicative of a higher risk of this disease. The estrogen receptor gene is found as two subtypes, alpha and beta.

[Pasqualini's syndrome].

Introduction: Pasqualini's syndrome is an isolated, incretory functional disorder of the testes with a secondary Leydig cell insufficiency but, unlike Klinefelder's syndrome, with normal spermiogenesis and fertility. This unusual form of hypogonadism is caused by an inherent LH secretion disorder of the pituitary gland. The result of this is the secondary Leydig cell insufficiency and a corresponding peripheral androgen deficiency.

[Wilms' tumors in adults].

Wilms' tumors develop from persistent, primitive metanephrogenic stem cells. Their biology and etiology in adults is still unknown even though remnants of primitive metanephrogenic tissue, which tends to malignancy, is suspected, and there are very few scientific studies on the biology of Wilms' tumors in adults. Such a tumor occurs at a rate of 0.

[Endometriosis of the ureter and urinary bladder].

Endometriosis is a benign growth of ectopic endometrial mucous membrane which has maintained the histological characteristics and biological reactions of uterine mucous membrane. In only 1-2% of cases does it occur in the urinary system, most commonly in the urinary bladder. Such an endometriosis is often diagnosed very late due both to its commonly asymptomatic course and its rarity.

[Urethral duplication in a male child. Accessory urethra with a normotopic opening in a penopubic epispadias with dorsal penis deviation].

Urethral duplication is a rare deformity which can present in various forms, commonly together with other congenital malformations. The embryological genesis is unknown. The isolated deformity is most often found in young males, while for young females it is very rare.

Radiochemotherapy after transurethral resection for high-risk T1 bladder cancer: an alternative to intravesical therapy or early cystectomy?

Purpose: For high-risk T1 bladder cancer, the most important issue is how to restrict radical cystectomy to selective patients with a high likelihood of tumor progression and to choose an initial bladder-sparing approach in others without affecting survival. Radiotherapy or radiochemotherapy (RT/RCT) may help to strike a balance between intravesical treatment and early cystectomy.

Patients And Methods: Between 1982 and 2004, 141 patients with high-risk T1 bladder cancer (84 patients with T1 grade 3 [T1G3]; others with T1G1/2 and associated carcinoma-in-situ, multifocality, tumor diameter > 5 cm, or multiple recurrences) were treated with RT (n = 28) or platinum-based RCT (n = 113) after transurethral resection of bladder tumor (TURBT).

Clinical decisions for treatment of different staged bladder cancer based on multitarget fluorescence in situ hybridization assays?

Non-invasive methods for detecting genetic alterations of bladder cancer are increasingly becoming the focus of attention as diagnostic tools. The fluorescence in situ hybridization we performed to detect genetic alterations of chromosomes 3, 7, 9p21, and 17 (UroVysion Test) showed very high sensitivity, higher even than cytology, in detecting bladder tumors of varying differentiation (pTa-pT4). The use of this test in everyday clinical urology can be a very useful decision aid in treating problem cases.

Cowper's syringocele--a rare malformation of the male urethra. Erlangen experience in two example cases.

Cowper's syringocele is a cystic dilation of the male urethra which should be surgically treated when symptomatic. Two cases of syringocele, 1 adult and 1 juvenile, with obstructive micturition and microhematuria are reported. Both patients were treated using the transurethral surgical technique.

[Frasier syndrome: a rare syndrome with WT1 gene mutation in pediatric urology].

Introduction: Frasier syndrom is an autosomal dominant, hereditary disease characterized by nephropathy, gonadal dysgenesis and risk of gonadal blastoma in early childhood. To date, in many patients with Frasier syndrome WT1 mutations have been found, occurring exclusively as germ-line mutations of the alternative splicing donor site in intron 9. A Wilms tumor is seen only rarely in this clinical entity.

[Retroperitoneal ganglioneuroma].

The ganglioneuroma is a benign neuroblastal tumor. All neuroblastomas and ganglioneuromas derive from immature cells of the sympathetic nerve system. The ganglioneuroma is a very rare disease and effects newborns and infants more often than adolescents and adults.

Heterogeneity in prostate cancer: prostate specific antigen (PSA) and DNA cytophotometry.

Background: The heterogeneity in prostate cancer is the reason for the difficult diagnosis and prognosis of this tumor. In this study, we looked for a correlation between prostate specific antigen (PSA), tumor staging and DNA cytophotometry.

Materials And Methods: Twenty-two prostates (pT1-T4) from patients with prostate cancer, who underwent radical prostatectomy, were examined.

Does the distance to normal renal parenchyma (DTNRP) in nephron-sparing surgery for renal cell carcinoma have an effect on survival?

Background: The effect of the distance to normal renal parenchyma (DTNRP) on survival after nephron-sparing surgery (NSS) for renal cell cancer (RCC) was analyzed. Additionally, the role of T-classification, tumor diameter and tumor grading was considered.

Patients And Methods: NSS was performed on 126 patients with RCC between 1988 and 2000.

Radiochemotherapy after transurethral resection is an effective treatment method in T1G3 bladder cancer.

Aim: Conservative therapy using deep transurethral resection (TUR) followed by radiochemotherapy is a novel treatment strategy in stage TI grade 3 (TIG3) transitional cell carcinoma (TCC) of the bladder. The aim of this study was to present our long-term results of radiochemotherapy in T1G3 TCC patients.

Materials And Methods: A total of 64 patients with TIG3 TCC of the bladder underwent a TUR and a subsequent radiochemotherapy protocol at our institution.

Polymorphisms of human androgen receptor (hAR) gene in prostate cancer cell lines PC-EW and PC-OR.

Background: Prostate cancer is the leading tumor of the male in Western societies. Genetic alterations of the androgen receptor gene are known in the advanced metastatic disease. In this study, the androgen receptor gene was tested in two human prostate cancer cell lines, the androgen-sensitive PC-EW and the androgen-independent PC-OR.

Polymorphisms in the human progesterone receptor (PGR) gene of two human prostate adenocarcinoma cell lines.

Background: The incidence and mortality rate of prostate cancer has been steadily increasing in most countries worldwide. A potential implication of the progesterone receptor has been reported in prostatic carcinogenesis. In this study, an allele of human progesterone receptor gene (PROGINS), which was demonstrated to be associated with an increased risk of sporadic ovarian cancer, was tested in two human prostate cancer cell lines, PC-EW and PC-OR.

[Denys-Drash syndrome. Experience gathered in Erlangen illustrated by two case reports].

Denys-Drash syndrome is a rare symptom complex associated with obligatory childhood nephrotic syndrome, male pseudohermaphroditism, and Wilms' tumor. The etiology of Denys-Drash syndrome is attributed to a mutation of the WT1 gene. We report on two cases of Deny-Drash syndrome confirmed by genetic testing.

[Xanthogranulomatous pyelonephritis: presentation of an unusual case].

Introduction: Xanthogranulomatous pyelonephritis is a morphologically and clinically unique manifestation of chronic pyelonephritis with the formation of pus or granulomas. The most frequent predisposing factors for the development of xanthogranulomatous pyelonephritis are urinary obstruction (e. g.

Combined-modality treatment and organ preservation in bladder cancer. Do molecular markers predict outcome?

Purpose: In invasive bladder cancer, several groups have reported the value of organ preservation by a combined-treatment approach, including transurethral resection (TUR-BT) and radiochemotherapy (RCT). As more experience is acquired with this organ- sparing treatment, patient selection needs to be optimized. Clinical factors are limited in their potential to identify patients most likely to respond to RCT, thus, additional molecular markers for predicting treatment response of individual lesions are sorely needed.

Radiochemotherapy in locally invasive non-metastatic carcinoma of the bladder.

We therefore believe that our therapeutic concept is a true alternative to primary cystectomy, with comparable survival rates. We observed a high rate of functional organ preservation in long-term survivors (79% with complete remission (CR) after 5 years). Radiation bladders were rare at doses not exceeding 60 Gy.

Examination of tumorigenesis of precursor lesions in bladder cancer by in situ hybridization.

Through examinations using fluorescence in situ hybridization (FISH) of chromosomes 1 and 9, we tried to obtain more information on dysplasia and carcinoma in situ (Cis) in relation to the oncogenesis of bladder cancer. 63 paraffin sections (dysplasia grades I-III and Cis) were evaluated, and 8 negative sections functioned as a control group. For FISH, DNA samples of CEP 1 and 9 (alpha satellites) were chosen.

Clinical aspects for the use of DNA image cytometry in detection of bladder cancer: a valuable tool?

The employment of DNA flow or image cytometry for oncological diagnostic procedures is favored because of its high correlation to tumor biological behavior. Prognostic statements and therapeutic strategies therefore are based on the high validity of DNA cytometric measurements. Using 151 bladder washings from patients suspected of bladder cancer for this study, we examined the clinical value of various common methods of DNA single cell (SCI) and stemline interpretations (SLI).

Combined-modality treatment and selective organ preservation in invasive bladder cancer: long-term results.

Purpose: To evaluate our long-term experience with combined modality treatment and selective bladder preservation and to identify factors that may predict treatment response, risk of relapse, and survival.

Patients And Methods: Between 1982 and 2000, 415 patients with bladder cancer (high-risk T1, n = 89; T2 to T4, n = 326) were treated with radiotherapy (RT; n = 126) or radiochemotherapy (RCT; n = 289) after transurethral resection (TUR) of the tumor. Six weeks after RT/RCT, response was evaluated by restaging-TUR.