Early hypofractionated salvage radiotherapy for postprostatectomy biochemical recurrence.

Background: Postprostatectomy adjuvant or salvage radiotherapy, when using standard fractionation, requires 6.5 to 8 weeks of treatment. The authors report on the safety and efficacy of an expedited radiotherapy course for salvage prostate radiotherapy.

Effects of solifenacin on overactive bladder symptoms, symptom bother and other patient-reported outcomes: results from VIBRANT - a double-blind, placebo-controlled trial.

Aim: The aim of this study was to evaluate the efficacy of solifenacin on symptom bother using the Overactive Bladder Questionnaire (OAB-q).

Methods: In VIBRANT, a double-blind, US-based trial, patients with OAB for > or = 3 months received flexibly dosed solifenacin or placebo for 12 weeks. At baseline and 4-week intervals, patients completed the OAB-q [symptom bother and health-related quality of life (HRQL) scales] and 3-day bladder diaries; other patient-reported outcome measures were also assessed at baseline and week 12.

Salvage hypofractionated radiotherapy for biochemically recurrent prostate cancer after radical prostatectomy.

Purpose: To evaluate whether hypofractionation is well tolerated and to preliminarily assess biochemical control of this regimen in a postprostatectomy, salvage setting.

Methods And Materials: A retrospective analysis was performed in 50 patients treated between May 2003 and December 2005 with hypofractionated radiotherapy for biochemical recurrence after radical prostatectomy. Radiotherapy was prescribed to the prostatic fossa to 65-70 Gy in 26-28 fractions of 2.

Long-term outcome of hematuria home screening for bladder cancer in men.

Background: The objectives of this study were to determine whether bladder cancer (BC) screening in healthy men could lead to earlier detection and reduced BC mortality compared with unscreened men and to determine long-term outcomes of a geographically defined, unscreened population with newly diagnosed BC.

Methods: In 1987 and from 1998 to 1992, 1575 men ages 50 years and older who were solicited from well patient rosters in clinics in and around Madison, Wisconsin, tested their urine repetitively with a chemical reagent strip for hemoglobin. Participants who had positive test results underwent standard urologic evaluation.

Single-dose oral ciprofloxacin versus placebo for prophylaxis during transrectal prostate biopsy.

Objectives: To determine whether antimicrobial prophylaxis could prevent infections after transrectal needle biopsy of the prostate using automated biopsy devices.

Methods: We conducted a prospective, randomized, double-blind, multicenter trial in which a total of 537 patients received either oral ciprofloxacin 500 mg or placebo before transrectal needle biopsy of the prostate. Repeated urine cultures and urinalysis were obtained at 2 to 6 days after biopsy and 9 to 15 days after biopsy.

Hematuria home screening: repeat testing results.

To determine at what interval screening should be repeated to detect bladder cancer before it becomes muscle invasive 856 men who had 14 negative daily home tests for hematuria with a chemical reagent strip 9 months previously performed repeat tests. Of these men 50 (5.8%) had at least 1 positive test during the second 14-day screening period and 38 were evaluated, 15 of whom (39.

Comparison of bladder cancer outcome in men undergoing hematuria home screening versus those with standard clinical presentations.

Objectives: Because repetitive hematuria home screening with a chemical reagent strip can detect early stage bladder cancer (BC) in asymptomatic middle-aged and elderly men, the ability of this screening to effect earlier detection and reduce BC mortality was investigated.

Methods: Grades, stages, and outcomes of BCs detected by hematuria screening in 1575 men were compared with those of all newly diagnosed BCs in men age 50 years or older reported to the Wisconsin cancer registry in 1988. BC grades and stages were assigned by review of all pathology slides/blocks, and causes of deaths were determined from cancer registry records.

Home screening for hematuria: results of a multiclinic study.

The majority of urinary tract tumors cause bleeding in the urine. A program designed to detect hematuria before it is grossly apparent may contribute to earlier detection and more successful treatment of these malignancies. To test this hypothesis a hematuria home screening study was conducted.

Laparoscopic management of lymphocele after pelvic lymphadenectomy and radical retropubic prostatectomy.

A new method of managing pelvic lymphoceles after urologic procedures is described. A patient with a symptomatic pelvic lymphocele after pelvic lymph node dissection and radical retropubic prostatectomy was treated laparoscopically. Technical aspects of laparoscopic marsupialization of lymphoceles are described, and the laparoscopic approach is compared with other modalities available for treating lymphoceles.

A multicenter, double-blind, trimethoprim-sulfamethoxazole controlled study of enoxacin in the treatment of patients with complicated urinary tract infections.

In a double-blind, randomized, controlled trial, 249 patients with complicated urinary tract infections received either 400 mg. enoxacin or 160 mg. trimethoprim plus 800 mg.

Exchange/retrograde ureteral stent set.

Once in position, ureteral stents are relatively inaccessible. A ureteral stent set was developed that allows for retrograde study of the collecting system or exchange of the stent with or without the assistance of a cystoscope. This has proved to be useful for opacification of the collecting system during extracorporeal shock wave lithotripsy or percutaneous nephrolithotomy, or after ureteroscopy.

Acute lobular nephronia.

Acute lobular nephronia is an unusual form of localized renal infection, which has a characteristic computerized tomographic and ultrasonographic appearance, and should be distinguished from abscess or other renal masses. Treatment is nonoperative, consisting of intensive antibiotic therapy.

Hemorrhagic angiomyolipoma: demonstration by computed tomography.

Preoperative tissue specific diagnosis of renal angiomyolipomas is now frequently made by computed tomography (CT). Although hemorrhage of these hypervascular tumors is a common cause for presentation, it is rarely recognized preoperatively. We present two cases of large, solitary angiomyolipoma complicated by perinephric and intratumoral hemorrhage demonstrated by CT.

Pseudotumor of kidney.

Pyelocancerous backflow during retrograde pyelography is a roentgen sign indicating renal tumors. An example of a pseudotumor (renal hematoma caused by anticoagulation) is presented which displayed this type of backlfow, demonstrating the nonspecificity of the sign. The diagnostic, especially radiographic, findings of intrarenal hematoma are discussed.

Congenital bladder duplication and diverticulum.

Evaluation of urinary infection in a 5-month-old male infant revealed duplication of the prostatic urethra and bladder. Associated anomalies were a right bladder diverticulum, left vesicoureteral reflux and bowel duplication.

Retroperitoneal seminoma.

A case of retroperitoneal seminoma is discussed, emphasizing the importance of diagnosing the primary lesion. Although the testes were normal to palpation and exploration a focus of seminoma was recognized in the left testicle. We prefer radical treatment of this potentially curable disease.

Familial Kallmann syndrome with unilateral renal aplasia.

On the basis of studies in two brothers and their double first cousin, the Kallmann syndrome (KS) is discussed as an X-linked syndrome of anosmic hypogonadotropic hypogonadism. The anosmia is thought to represent agenesis or hypoplasia of the olfactory lobes, the mildest form of the alobar holoprosencephaly developmental field defect; this is supported by the finding of hypotelorism in two of the patients and their mother. The endocrine defect is thought to represent a hypothalamic abnormality of the luteinizing hormone releasing hormone; borderline normal intelligence may represent another pleio-tropic CNS manifestation of the KS gene.