How small can we go? Percutaneous nephrolithotomy using 6F nephroureteral catheter.

Objectives: To retrospectively examine our percutaneous nephrolithotomy pathway to determine the efficacy of a 6F antegrade nephroureteral catheter (NUC).

Methods: The records of 99 consecutive patients who underwent percutaneous nephrolithotomy from 1998 to 2000 were reviewed. All patients were admitted the day before percutaneous nephrolithotomy and underwent placement of a nephrostomy tube.

Corporoscopic-assisted removal of ruptured inflatable penile prosthesis.

Despite the recent availability of effective oral agents for treatment of erectile dysfunction, many patients do not respond to oral therapy and do not desire injection therapy. For some of these patients, inflatable prostheses remain an effective form of treatment for erectile dysfunction; however, prostheses are not without their own set of complications. The most common complications are infection and mechanical failure.

Percutaneous endoscopic cystostomy for bladder localization and exact placement of a suprapubic tube.

Purpose: We describe a new technique for exact positioning and placement of a suprapubic tube.

Materials And Methods: The bladder dome and its relative position on the lower abdomen are localized using a flexible cystoscope, light source and abdominal palpation.

Results: The technique has been successfully used in patients who require long-term urinary drainage.

The staging pelvic lymphadenectomy: implications as an adjunctive procedure for clinically localized prostate cancer.

Objectives: To evaluate the utility of staging pelvic lymphadenectomy and to identify factors associated with nodal metastases in which a node dissection would be of clinical benefit.

Patients And Methods: A retrospective analysis (1989-1993) was performed on 303 consecutive patients who underwent staging bilateral modified pelvic lymph node dissection for clinically localized prostate cancer. Multivariate logistic regression analysis was used to evaluate age, race, clinical stage, prostate-specific antigen (PSA) level and Gleason score for predicting nodal metastases.

Soft-tissue uptake of technetium-99m-MDP after prostate cryoablation.

Prominent soft-tissue uptake of 99mTc-methylene diphosphonate (MDP) within the prostate bed was found after cryoablation for prostate carcinoma. CT, MRI and sonographic studies demonstrated liquifactive necrosis of the prostate bed. The probable etiology for 99mTc-MDP uptake in this case is necrosis with subsequent neovascular hyperemia and microscopic calcium deposits.

Acute renal failure with thrombocytopenia after cryosurgery of the prostate.

We report three cases of transient acute renal failure accompanied by thrombocytopenia all occurring within 48 h of percutaneous transperineal cryoprostatectomy. Renal function spontaneously improved in all three patients, who currently have normal renal function and are voiding without difficulty. No known risk factor or specific etiology for the renal failure could be identified; therefore, we conclude that the renal failure is most likely secondary to the cryosurgery procedure, a common link shared by all three patients.

Phase I/II dose-escalation study of liarozole in patients with stage D, hormone-refractory carcinoma of the prostate.

Background: Liarozole binds to the cytochrome P-450-dependent hydroxylating enzymes involved in steroid biosynthesis and retinoic acid catabolism. This phase I study investigated the clinical/endocrine toxicity profile of liarozole and determined the maximally tolerated dose (MTD) in hormone-refractory prostate cancer patients.

Methods: Groups of five patients were treated with oral liarozole caplets, starting at 37.

CT of vesicocorporeal fistula with menouria: a complication of uterine biopsy.

Vesicouterine fistulas are a rare complication of obstetrical-gynecological interventions and are the least common of the acquired urogenital fistulas. They are almost solely associated with cesarean section. A case is reported in which a patient with adenomyosis and pelvic adhesions presented with menouria (vesical menstruation) after uterine biopsy.

Neuroblastoma as a prominent component of a mixed germ cell tumor of testis.

Background: Primitive neuroectodermal tissue in teratomas of testis has been reported in the literature. A mixed germ cell tumor of testis with a prominent neuroblastoma component dictating the clinical behavior was found to be unique.

Methods: Tissue sections were stained with hematoxylin and eosin, and immunohistochemical, ultrastructural, cytogenetic, and flow cytometric analyses were performed on the primitive neuroectodermal component of the testicular mass.

Use of endorectal surface coil magnetic resonance imaging for local staging of prostate cancer.

A total of 111 patients with clinically localized prostate cancer (stage A or B) underwent endorectal surface coil magnetic resonance imaging (MRI) for preoperative staging of the disease. Of the patients 43 with advanced disease on endorectal surface coil MRI (33 with stage C and 10 with stage D disease) received alternative therapy, as did 21 with stage B disease on MRI. The overall staging accuracy for the remaining 47 patients was 68%, with a 74% accuracy rate in staging advanced disease and a 91% accuracy rate for depiction of seminal vesicle involvement.

Multicenter, randomized, double-blind, placebo controlled study to investigate the effect of finasteride (MK-906) on stage D prostate cancer.

A total of 28 untreated patients with asymptomatic, stage D prostate cancer was randomized in a double-blinded fashion to receive finasteride (10 mg. per day), a 5 alpha-reductase inhibitor or placebo. Patients were evaluated at 3-week intervals by rectal examination, and serum prostate specific antigen (PSA) and prostatic acid phosphatase (PAP) levels, and at 6-week intervals by bone scan and transrectal ultrasound determinations of prostatic volume.

Quality of life and psychosocial status in stage D prostate cancer. Zoladex Prostate Cancer Study Group.

Inasmuch as treatments for advanced prostate cancer may have identical clinical outcomes but very different meanings to patients, we sought to compare the impact of surgical and medical castration (orchiectomy versus injected goserelin acetate Zoladex) on quality of life and psychosocial status. A total of 147 men with Stage D prostate cancer participated in the study: 115 selected treatment with goserelin acetate, and 32 chose orchiectomy. Quality of life, as measured by the Functional Living Index: Cancer (FLIC), improved at both the 3 and the 6 month follow-up in the goserelin acetate group (p = 0.

Staging of ureteral transitional cell carcinoma by CT and MRI.

Intravenous urography and retrograde pyelography are the primary radiologic studies for detecting ureteral carcinoma but give limited information regarding stage of disease. Computed tomography (CT) and magnetic resonance imaging (MRI) delineate the extent of ureteral carcinomas with a high degree of accuracy by depicting the periureteral fat and presence or absence of lymphadenopathy. In selected cases, CT and MRI are valuable for assessing the presence or absence of tumor in a ureteral stump and for the differential diagnosis of ureteral obstruction.

Treatment of recurrent urinary tract infection with norfloxacin versus trimethoprim-sulfamethoxazole.

Norfloxacin, a broad-spectrum antimicrobial analog of nalidixic acid, was evaluated by comparing it to trimethoprim-sulfamethoxazole in 93 office patients with recurrent urinary tract infections. In this prospective randomized study, norfloxacin and trimethoprim-sulfamethoxazole were given on the same dosage schedule with the former drug given as a 400-mg tablet twice daily and the latter drug given as a double strength tablet twice daily. Overall, 50 patients received norfloxacin and 43 patients received trimethoprim-sulfamethoxazole with a cure rate of 96 percent and 79 percent, respectively.

Vasovasostomy in dogs using the carbon dioxide milliwatt laser: Part II.

This is the second study of a two-prong investigation conducted to learn two different aspects of vasovasostomy in dog vas deferens by using the carbon dioxide milliwatt laser. This investigation involves the evaluation of patency and analysis of sperm. Six dogs underwent vasectomy, followed by vasovasostomies performed between 4 and 12 weeks later, utilizing two approximating sutures and welding with the carbon dioxide milliwatt laser.

Carbon dioxide milliwatt laser in the vasovasostomy of vas deferens in dogs: Part I.

This is the first arm of a two prong study conducted to learn two different aspects of vasovasostomy in dog vas deferens using the milliwatt carbon dioxide laser. The first study involved the evaluation of patency without collection of sperm. Six dogs were evaluated and all underwent vasectomy and subsequently had vasovasostomies performed between 4 and 12 weeks utilizing two approximating sutures and welding with the milliwatt carbon dioxide laser.

Endoscopy for removal of unusual foreign bodies in urethra and bladder.

Numerous reports have been published concerning intraurethral foreign bodies. Two patients required endoscopic intervention: one for the removal of screws from the urethra and the other for extraction of a calculus. The technique utilized the Wolf universal nephroscope and stone dislodger with 3 jaws, and its success prevented a more aggressive surgical approach.

The pH analysis of papaverine-phentolamine and prostaglandin E1 for pharmacologic erection.

Although papaverine-phentolamine preparations are being employed for pharmacologic erection programs across the nation, their chemical properties have not been described in the literature. We found that the pH of papaverine-phentolamine solution in all concentrations tested remained less than 4.0.

Patients' choice of treatment in stage D prostate cancer.

Given the current preference of many patients for an active role in decision-making regarding their care, the feasibility of patients making their own treatment choices was investigated, and the reasons for their selections were studied. Subjects comprised previously untreated Stage D prostate cancer patients for whom hormonal therapy was indicated. Thirteen institutions entered 159 patients into the study.

Congenital pelvic arteriovenous malformation with massive prostatic hemorrhage: a case report.

Congenital arteriovenous malformations in the true pelvis are extremely rare: only 7 cases have been described in male patients. We report on a patient who presented with massive hemorrhage after transrectal prostatic biopsy and transurethral resection of the prostate. Diagnosis was established by means of magnetic resonance imaging and confirmed by arteriography.

Venous intravasation of barium into the inferior mesenteric vein mimicking a coloureteral fistula: a case report and literature review.

Venous intravasation of barium following a barium enema is a rare event. We report a case of barium venous intravasation into the inferior mesenteric vein. Because of the close proximity to the course of the left ureter, this condition was interpreted initially as a coloureteral fistula.

Relative merits of MRI, transrectal endosonography and CT in diagnosis and staging of carcinoma of prostate.

Magnetic resonance imaging (MRI) and transrectal sonography of 27 patients with biopsy-proved carcinoma of the prostate were performed to compare the sensitivity of these modalities to each other for diagnosis and to computed tomography (CT) for staging. Sonography was superior to MRI for the detection of intraglandular carcinoma and capsular disruption. MRI was superior to both sonography and CT for evaluating seminal vesicle invasion, and slightly better than CT for detecting lymphadenopathy.