Computerized transrectal ultrasound of the prostate in a multicenter setup (C-TRUS-MS): detection of cancer after multiple negative systematic random and in primary biopsies.

Objective: To improve prostate cancer diagnostic imaging, a computer-based analysis of the transrectal ultrasound signal (C-TRUS) was developed. Until recently, the C-TRUS existed only as a stand-alone device. Now, C-TRUS was developed into a network-compatible module (C-TRUS-MS).

Treatment outcomes and resource use of patients with neurogenic detrusor overactivity receiving botulinum toxin A (BOTOX) therapy in Germany.

Purpose: To evaluate treatment outcomes and resource consumption of patients with neurogenic detrusor overactivity (NDO) before and after botulinum toxin A (Botox) therapy in Germany.

Methods: In a multi-center, cross-sectional, retrospective cohort study, data of patients with NDO 12 months before and after the first Botox therapy were analyzed.

Results: 214 patients (mean age 38 +/- 14.

Urodynamic changes and response rates in patients treated with permanent electrodes compared to conventional wire electrodes in the peripheral nerve evaluation test.

Objectives: Sacral neuromodulation having become established as an essentially effective new therapeutic modality, both in patients with anticholinergic-therapy refractory overactive bladder (OAB) and with chronic urinary retention. It is important to establish which patients might profit from this kind of therapy in order to ensure, by means of a peripheral nerve evaluation (PNE) test, that the implantation of a permanent stimulating device is effective. In a retrospective study we compared the urodynamic outcome of two different techniques (implantation of the permanent neurostimulation electrodes so-called "two-stage-implantation" vs.

[Botulinum toxin for the treatment of overactive bladder--an overview].

This article shall give a state-of-the-art review about the treatment of neurogenic and idiopathic detrusor overactivity with botulinum toxin injections into the detrusor muscle. We searched PubMed for original articles up to December 2006. Abstracts published at international congresses were also considered if they provided substantial new information.

Improved sensory gating of urinary bladder afferents in Parkinson's disease following subthalamic stimulation.

In addition to motor symptoms, patients with Parkinson's disease (PD) show deficits in sensory processing. These deficits are thought to result from deficient gating of sensory information due to basal ganglia dysfunction in PD. Deep brain stimulation of the subthalamic nucleus (STN-DBS) has been shown to improve sensory deficits in PD, e.

[Dysfunctions of artificial urinary sphincters (AMS 800) and their management via a transscrotal access. Optimum procedure illustrated by reference to clinical examples].

Background: The introduction of a transscrotal access for implantation of an artificial urinary sphincter (AUS) offers an alternative to the perineal approach for dealing with post-prostatectomy incontinence. Should a revision be necessary, the entire implant can be explored via this access and only one incision is needed. The aim of our study was to present the advantage of the transscrotal approach in different malfunctions of AUSs (AMS 800).

[30 Years of sentinel lymph node diagnostic in penile carcinoma: development of a diagnostic procedure and current results].

Cabanas, working 30 years ago, was the first to use the term "sentinel lymph node" in urology. His definition of the sentinel lymph node was based on typical anatomical patterns and therefore could not do justice to any individual variability in lymphatic drainage. This meant that application of the technique yielded high false-negative rates, and because of this it was largely abandoned.

[Mesonephroid carcinoma of the urinary bladder (clear cell carcinoma). Two case reports and review of the literature in a rare variation of the primary adenocarcinoma].

Mesonephroid adenocarcinoma of the bladder may be a malignant form of nephrogenic adenoma or nephroid metaplasia. The lesion is extremely rare in the urinary bladder, and to our knowledge 19 cases have been reported in the literature. We report two cases of mesonephroid adenocarcinoma of the bladder which were treated by radical cystectomy.

[Botulinum toxin A injection for treatment-refractory giggle incontinence].

A 20-year-old woman reported about giggle incontinence despite antimuscarinic therapy. Therefore we injected botulinum toxin A into the detrusor muscle. The effect of botulinum toxin A appeared about 1 week after injection and no more leakage was observed even during vigorous laughter.

[Botulinum toxin for the treatment of neurogenic detrusor hyperactivity. Consensus paper on use for neurogenic bladder dysfunction].

Due to elevated intravesical storage pressures, neurogenic bladder dysfunction carries a high risk of renal damage. Thus, the goals of neurourologic treatment are reduction of intravesical storage pressure and intermittent bladder emptying in order to protect renal function and to achieve continence. If anticholinergic medication is either ineffective or intolerable, several open and controlled studies showed that the injection of botulinum toxin A into the detrusor muscle is a minimally invasive, safe, and effective treatment option.

Subthalamic stimulation modulates cortical control of urinary bladder in Parkinson's disease.

Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective therapy for off-period motor symptoms and dyskinesias in advanced Parkinson's disease. Clinical studies have shown that STN-DBS also ameliorates urinary bladder function in Parkinson's disease patients by delaying the first desire to void and increasing bladder capacity. This study aimed at investigating the effect of STN-DBS on the neural mechanisms underlying cerebral bladder control.

[Use of permanent electrodes in the peripheral nerve evaluation test (PNE-Test) in comparison to conventional wire electrodes].

Purpose: Prior to implantation of a chronic sacral neurostimulator, it is important to establish which patients might profit from this kind of therapy in order to ensure, by means of a PNE (peripheral nerve evaluation) test, that the implantation of a permanent stimulating device is effective. In this study we compared the two different techniques used in our department (implantation of the permanent neurostimulation electrodes, the so-called "two-stage-implantation" vs. conventional PNE).

Systemic nitric oxide augmentation leads to a rapid decrease of the bladder outlet resistance in healthy men.

Objective: We examined the immediate effect of a systemic nitric oxide augmentation on the bladder outlet resistance in healthy men.

Methods: Eleven healthy male volunteers with a mean age of 25.5 yr were included in the study.

Systemic augmentation of nitric oxide: is there an immediate effect on the urinary flow rate in healthy men?

Introduction: Nitric oxide (NO) is an important neurotransmitter in the lower urinary tract. Data from experimental studies in animals and humans suggest that NO donors like isosorbide dinitrate could be used to lower the infravesical resistance. Despite the potentially significant clinical benefit of such an effect, it has hardly been studied in vivo in men.

Understanding detrusor sphincter dyssynergia--significance of chronology.

Objectives: To evaluate in patients with spinal cord injury (SCI) and detrusor sphincter dyssynergia (DSD) whether the onset of external urethral sphincter (EUS) contractions precedes or follows the onset of bladder contractions and to address the issue of potential therapeutic approaches based on the understanding of DSD chronology.

Methods: A retrospective review of video-urodynamic recordings of patients with SCI that demonstrated both untreated neurogenic overactive bladder and DSD, from January 2002 to December 2003, was performed. Delay A was defined as the period between the onset of an EUS pressure increase and the onset of a bladder pressure increase and delay B as the period between the onset of a urethral sphincter pressure increase and the moment at which the bladder pressure increase reached 10 cm H2O greater than the baseline value.

Conditioning stimulus can influence an external urethral sphincter contraction evoked by a magnetic stimulation.

Aims: To study the effect of a conditioning stimulus on an external urethral sphincter (EUS)contraction evoked by a magnetic stimulation at different time intervals.

Methods: Seven healthy male volunteers underwent EUS pressure measurement. At baseline, magnetic stimulation of the lumbosacral spinal cord above the motor threshold was performed and evoked EUS pressure responses were recorded.

["Second line" polychemotherapy in metastatic urothelial cancer of the renal pelvis. Persisting partial remission by 18 treatment cycles of gemcitabine/paclitaxel after 24 treatment cycles gemcitabine/cisplatin "stable disease"].

Moderate activity of systemic chemotherapy for advanced urothelial cancer has been reported for more than 30 years. Only with the advent of potent combination therapy in the mid-1980s have clinically significant response rates and prolonged survival been documented. Due to the small number of cases and poor prognosis, knowledge is scant about the therapeutic effect of "second-line" polychemotherapy in metastatic upper tract urothelial cancer.

The effect of tamsulosin on the resting tone and the contractile behaviour of the female urethra: a functional urodynamic study in healthy women.

Aims: The aim of this functional urodynamic experiment was to study the effect of the selective alpha1(A)-blocker tamsulosin on the urethral pressure in healthy human females and assessed first the resting urethral pressure and second the urethral contractility in response to magnetic stimulation of the sacral roots.

Methods: 11 healthy female subjects gave their written informed consent and were included. A microtip pressure transducer catheter was inserted into the bladder and three baseline urethral pressure profiles were obtained.

The effect of nitric oxide on the resting tone and the contractile behaviour of the external urethral sphincter: a functional urodynamic study in healthy humans.

Aims: This functional urodynamic study assessed the effect of the nitric oxide donor isosorbide dinitrate on the external urethral sphincter and hypothesised first that nitric oxide could lower the resting sphincter pressure, second that nitric oxide could influence the sphincter contractility during magnetic stimulation, and third that nitric oxide could induce a faster external urethral sphincter fatigue during continuous magnetic stimulation.

Methods: Eight healthy males gave their written informed consent and were included. A 2-channel microtip pressure transducer catheter was inserted into the urethra measuring the bladder and the external urethral sphincter pressure.