A rare case of testicular metastasis of bladder transitional cell carcinoma.

Metastases from bladder transitional cell carcinoma (TCC) to the testis are very rare. These are usually found on autopsy and occur in advanced or metastatic bladder cancers. More common, known primary tumors that metastasize to the testis include prostate, lungs, melanoma, gastro-intestinal tract and the kidney.

Diethylstilboestrol for the treatment of prostate cancer: past, present and future.

The aim of this review was to discuss the most recent data from current trials of diethylstilboestrol (DES) to identify its present role in advanced prostate cancer treatment as new hormonal therapies emerge. The most relevant clinical studies using DES in castration-refractory prostate cancer (CRPC) were identified from the literature. The safety, efficacy, outcomes and mechanisms of action are summarized.

Urodynamics in the octogenarian female: is it worthwhile?

Introduction And Hypothesis: We hypothesized that urinary symptoms in elderly females correlate poorly with urodynamic diagnosis, which would impact on management.

Methods: Charts of 53 consecutive females over age 80 undergoing multichannel urodynamics according to the International Continence Society standards were retrospectively analyzed.

Results: Median age was 83 years.

A contemporary standard for morbidity and outcome after radical cystectomy.

Objective: To report the temporal changes in peri-operative outcome over an extended period in patients undergoing radical cystectomy (RC) for all causes, irrespective of the previous treatment or pathology; and to establish a current standard of peri-operative outcome for RC by analysis of contemporary operative mortality rates (2000-5) factored for risk factors that might predict outcome.

Patients And Methods: All patients undergoing RC between 1970 and 2005 were analysed; this was an unselected single-centre series and included patients previously treated by definitive radiotherapy, chemotherapy, and cases of RC where the primary tumour involved the bladder but was not of bladder origin.

Results: In all, 846 patients had a RC, of whom 647 had a bladder primary tumour and 199 a primary tumour elsewhere (gynaecological, colorectal and others).

Phimosis as a presenting feature of diabetes.

Objective: To determine the prevalence of diabetes in men presenting with phimosis, and to establish the incidence of undiagnosed diabetes in men presenting with acquired or life-long phimosis.

Patients And Methods: We prospectively collected data on 100 men (mean age 38.5 years, range 17-82) who presented to our department with phimosis during 2006.

Factors affecting successful outcome from ICSI in men following previous vasectomy.

There are conflicting reports as to whether the interval between vasectomy and surgical sperm retrieval (SSR) for intra-cytoplasmic sperm injection (ICSI) is related to clinical pregnancy (CPR), and live birth (LBR), rates. This study aimed to evaluate factors that may influence the outcome of ICSI in males with secondary azoospermia due to previous vasectomy. We analysed the medical records of 198 azoospermic males following vasectomy who underwent percutaneous epididymal sperm aspiration (PESA) and/or testicular sperm extraction (TeSE), between 1997 and 2005 by a single urologist, and whose sperm was subsequently frozen for use in an IVF treatment programme on their partner's behalf.

Validation of the CR-POSSUM risk-adjusted scoring system for major colorectal cancer surgery in a single center.

Purpose: Scoring systems to predict mortality from surgery are important tools used to give information to the operator and patient and in the auditing of clinical practice. This study was designed to validate the recently developed the Colorectal Physiologic and Operative Severity Score for the Enumeration of Mortality and Morbidity (CR-POSSUM) scoring system in a single center for colorectal cancer surgery. We also analyzed whether albumin may have a role in the CR-POSSUM model.

The use of prostate-specific antigen testing in men presenting with haematuria.

Objectives: To analyse prostate-specific antigen (PSA) levels and clinical outcome in men presenting with haematuria, to develop an evidence-base for the use of PSA testing in this setting, as haematuria is a known complication of locally invasive prostate cancer, and so PSA levels are often measured in patients presenting with haematuria.

Patients And Methods: We reviewed the records of 637 men presenting with haematuria to our urology department between April 2002 and June 2005.

Results: Of 373 men aged 50-79 years, 278 (75%) had their PSA level measured, and 50 were abnormal.

Sperm retrieval rates in subgroups of primary azoospermic males.

Objectives: Men presenting with primary infertility and azoospermia may be offered surgical sperm retrieval (SSR) as a prelude to intracytoplasmic sperm injection (ICSI). We evaluated sperm retrieval rates in subgroups of men with azoospermia, based on obstructive aetiology, testicular volume and FSH.

Methods: 106 patients with primary infertility underwent clinical evaluation and SSR with percuataneous epididymal aspiration (PESA) and/or testicular sperm extraction (TeSE) by a single urologist over a five year period.