| 1. |
- Agardh, Carl-David, et al.
(författare)
-
Influence of treatment with diethylstilbestrol for carcinoma of prostate on platelet aggregation and plasma lipoproteins
- 1986
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 28:6, s. 469-471
-
Tidskriftsartikel (refereegranskat)abstract
- Treatment of prostatic carcinoma with estrogens is accompanied by an increased risk for thromboembolic and cardiovascular complications. The underlying mechanisms are still unknown. Patients treated with diethylstilbestrol (DES) were compared with patients given no estrogen treatment regarding factors (platelet aggregation in vitro and plasma lipoproteins) that have been suggested to contribute to increased thrombogenesis and cardiovascular risk. The results do not show any increase in in vitro platelet aggregation in patients treated with DES compared with those given no treatment. This indicates that hyperaggregability does not contribute to the increased incidence in thromboembolic events seen in DES-treated patients. This is in contrast to the increased platelet aggregation previously described in patients treated with polyestradiolphosphate + etinylestradiol. The changes in plasma lipoproteins observed during DES-treatment are generally considered beneficial from an atherogenic point of view and do not appear to cause the elevated incidence of cardiovascular disease in these patients.
|
|
| 2. |
- Andersson, Karl-Erik, et al.
(författare)
-
Pharmacologic perspective on the physiology of the lower urinary tract
- 2002
-
Ingår i: Urology. - : Elsevier. - 0090-4295 .- 1527-9995. ; 60:5 Suppl 1, s. 13-20
-
Tidskriftsartikel (refereegranskat)abstract
- Myogenic activity, distention of the detrusor, and signals from the urothelium may initiate voiding. In the bladder, afferent nerves have been identified not only in the detrusor, but also suburothelially, where they form a plexus that lies immediately beneath the epithelial lining. Extracellular adenosine triphosphate (ATP) has been found to mediate excitation of small-diameter sensory neurons via P2X3 receptors, and it has been shown that bladder distention causes release of ATP from the urothelium. In turn, ATP can activate P2X3 receptors on suburothelial afferent nerve terminals to evoke a neural discharge. However, most probably, not only ATP but also a cascade of inhibitory and stimulatory transmitters and mediators are involved in the transduction mechanisms underlying the activation of afferent fibers during bladder filling. These mechanisms may be targets for future drugs. The central nervous control of micturition involves many transmitter systems, which may be suitable targets for pharmacologic intervention. gamma-Aminobutyric acid, dopamine, enkephalin, serotonin, and noradrenaline receptors and mechanisms are known to influence micturition, and potentially, drugs that affect these systems could be developed for clinical use. However, a selective action on the lower urinary tract may be difficult to obtain. Most drugs currently used for treatment of detrusor overactivity have a peripheral site of action, mainly the efferent (cholinergic) neurotransmission and/or the detrusor muscle itself. In the normal bladder, muscarinic receptor stimulation produces the main part of detrusor contraction, but evidence is accumulating that in disease states, such as neurogenic bladders, outflow obstruction, idiopathic detrusor instability, and interstitial cystitis, as well as in the aging bladder, a noncholinergic activation via purinergic receptors may occur. If this component of activation is responsible not only for part of the bladder contractions, but also for the symptoms of the overactive bladder, it should be considered an important target for therapeutic interventions.
|
|
| 3. |
- Baert, L, et al.
(författare)
-
Clinical Fluorescence Diagnosis of Human Bladder-carcinoma Following Low-dose Photofrin Injection
- 1993
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 41:4, s. 322-330
-
Tidskriftsartikel (refereegranskat)abstract
- A point-monitoring fluorescence diagnostic system based on a low-energy pulsed laser, fiber transmission optics, and an optical multichannel analyzer was used for diagnosis of patients with bladder malignancies. Twenty-four patients with bladder carcinoma, carcinoma in situ, and/or dysplasia were injected with hematoporphyrin derivative, Photofrin, 0.35 or 0.5 mg/kg body weight, forty-eight hours prior to the investigation. The ratio between the red sensitizer emission and the bluish tissue autofluorescence provided excellent demarcation between papillary tumors and normal bladder wall. Certain cases of dysplasia also could be differentiated from normal mucosa. Benign exophytic lesions such as malakoplakia appeared different from malignant tumors in fluorescence. Flat suspicious bladder mucosa such as seen in infectious diseases or after radiation therapy appeared normal on fluorescence.
|
|
| 4. |
- Björk, Thomas, et al.
(författare)
-
Alpha 1-antichymotrypsin production in PSA-producing cells is common in prostate cancer but rare in benign prostatic hyperplasia
- 1994
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 43:4, s. 427-434
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE. To investigate the distribution and production of alpha 1-antichymotrypsin (ACT) and prostate-specific antigen (PSA) in benign hyperplastic and malignant prostatic tissue, respectively. METHODS. Using monoclonal anti-ACT and anti-PSA IgGs for immunocytochemistry and alkaline phosphatase conjugated 30-mer oligodeoxynucleotide probes for nonradioactive in situ hybridization, tissue specimens were studied from 15 patients with benign prostatic hyperplasia after transurethral resection of the prostate (TURP) and from 9 patients with bladder cancer who underwent cystoprostatectomy. Cancer specimens were from 23 TURP patients and from ultrasound guided core biopsies in 14 patients. Prostate tumors were graded according to the Gleason system. RESULTS. We found no or only occasional small foci of immunostaining for ACT, and no ACT transcripts in the PSA-producing epithelium in areas with benign nodular hyperplasia. By contrast, a high proportion of cells expressed both ACT and PSA in prostate cancers with low Gleason score, as detected by immunocytochemistry and in situ hybridization. Poorly differentiated tumor cells manifested greater variation in immunostaining for both ACT and PSA. As compared to tumors of low Gleason score, high-score tumors less frequently manifested immunostaining for ACT than for PSA, and less frequently generated hybridization signals for both PSA and ACT transcripts. CONCLUSIONS. A significantly higher proportion of serum PSA has been reported to be complexed to ACT in patients with prostate cancer than in patients with benign prostatic hyperplasia. The presently reported lack of ACT production in PSA-containing BPH nodules may contribute to this by making conditions less optimal for complex formation between PSA and ACT. As opposed to this, production of both ACT and PSA in prostate cancers may enhance the complex formation between PSA and ACT.
|
|
| 5. |
- Tornblom, M, et al.
(författare)
-
Diagnostic value of percent free prostate-specific antigen: retrospective analysis of a population-based screening study with emphasis on men with PSA levels less than 3.0 ng/mL
- 1999
-
Ingår i: Urology. - 1527-9995 .- 0090-4295. ; 53:5, s. 945-950
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To retrospectively investigate the use of percent free prostate-specific antigen (PSA) compared with total PSA in serum as predictor of prostate cancer in men selected randomly from the general population who underwent biopsy on the basis of abnormal findings on digital rectal examination (DRE) or transrectal ultrasound (TRUS) and/or serum PSA levels greater than 10 ng/mL. METHODS: A single intervention, population-based screening study was undertaken in 1988 and 1989. Of the 2400 men aged 55 to 70 years invited to participate, 1782 men responded and were examined with DRE, TRUS, and PSA testing (Tandem-Hybritech). In 1995, frozen serum samples from 1748 men were analyzed for percent free PSA (Prostatus, Wallac OY). Five-year follow-up data on new cancers in the screened population were obtained from the Swedish Cancer Registry (SCR). RESULTS: Of the 1748 men, 367 underwent TRUS-guided biopsies because of abnormal findings on either DRE or TRUS or serum PSA levels of greater than 10 ng/mL. This resulted in the diagnosis of 64 cases of prostate cancer (3.7%). PSA levels of 3.0 ng/mL or greater were found in 55 (86%) of 64 cancer cases and in 399 (24%) of the 1684 benign cases. Among the 1294 men with PSA less than 3.0 ng/mL, 9 prostate cancers were diagnosed (14% of all prostate cancers). All 9 patients with cancer and with PSA less than 3.0 ng/mL had a percent free PSA of 18% or less. In the group of 1109 patients with PSA less than 3.0 ng/mL and a percent free PSA greater than 18%, 159 biopsies were performed because of abnormal DRE or TRUS. However, no prostate cancer was diagnosed in this category of patients. Five years after the screening intervention, 7 more cases of prostate cancer were clinically diagnosed in the screened population according to the SCR. CONCLUSIONS: The combination of PSA levels less than 3.0 ng/mL and percent free PSA greater than 18% defines a large part of the population at a very low risk of cancer of the prostate both at the time of screening and during the following 5 years. Men in this group may be spared DRE, and longer screening intervals may be considered. However, the risk of having prostate cancer is not negligible in men with PSA less than 3.0 ng/mL and percent free PSA of 18% or less. The results of this study indicate that biopsy should be recommended to men fulfilling these criteria, although these results should be confirmed in larger prospective studies because of the limited number of patients with prostate cancer in the present series.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
- Modiri, Ali-Reza, et al.
(författare)
-
Effect of muscarinic antagonists on micturition pressure measured by cystometry in normal, conscious rats
- 2002
-
Ingår i: Urology. - 0090-4295 .- 1527-9995. ; 59:6, s. 963-968
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To establish an in vivo model to screen new muscarinic antagonists for the treatment of overactive urinary bladder and to calculate the respective ID(50) values.METHODS: The conscious rat cystometry model was modified to determine a complete dose-response curve in each animal. Spontaneous micturition was induced by infusion of room-temperature saline into rat bladders at a constant rate of 12 mL/hr. Cumulative doses of muscarinic antagonists administered in the femoral vein caused dose-dependent inhibition of the urinary bladder contraction measured as the micturition pressure. In addition, the in vitro pK(B) values for atropine, PNU-200577 (DD01), tolterodine, oxybutynin, and terodiline were determined in carbachol-contracted rat bladder strips.RESULTS: The rank order of the in vivo ID(50) values were atropine (14 +/- 4 nmol/kg), PNU-200577 (22 +/- 12 nmol/kg), tolterodine (94 +/- 20 nmol/kg), oxybutynin (175 +/- 89 nmol/kg), darifenacin (236 +/- 144 nmol/kg), desethyloxybutynin (313 +/- 209 nmol/kg), propiverine (4561 +/- 2079 nmol/kg), and terodiline (18,339 +/- 5348 nmol/kg). Tolterodine and PNU-200577 caused a parallel shift of the in vitro concentration-response curve to the right and did not alter the maximal contraction. The ID(50) values correlated significantly with the in vitro rat pK(B) and human bladder pA(2) values.CONCLUSIONS: The present results suggest that the rat cystometry model can be used in in vivo screening for new muscarinic antagonists.
|
|
| 14. |
- Sandblom, Gabriel, et al.
(författare)
-
Long-term survival in a swedish population-based cohort of men with prostate cancer
- 2000
-
Ingår i: Urology. - 0090-4295 .- 1527-9995. ; 56:3, s. 442-447
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives. To study the long-term survival of patients with prostate cancer, determine the risk factors for prostate cancer death, and investigate the outcome of initially untreated localized prostate cancer and incidentally detected tumors.Methods. The survival of 813 patients in a population-based cohort of patients with prostate cancer in Linköping, Sweden, diagnosed from 1974 to 1986, was analyzed.Results. At 10, 15, and 20 years after diagnosis, the prostate cancer-specific survival rate of men with localized, initially untreated, prostate cancer was 85.0% (95% confidence interval [CI], 79.0% to 91.0%), 80.0% (95% CI, 72.5% to 87.5%), and 62.6% (95% CI, 43.0% to 82.2%). Age 70 years or older, advanced stage, and poor differentiation were risk factors associated with an increased risk of prostate cancer death. At 10 years, the prostate cancer-specific survival rate among men with localized tumors treated by expectancy was 90% (95% CI, 84% to 97%) for grade 1 tumors, 74% (95% CI, 60% to 89%) for grade 2 tumors, and 59% (95% CI, 29% to 90%) for grade 3 tumors. For patients with incidentally detected tumors, the grade of malignancy was a more important risk factor than tumor volume.Conclusions. Patients with localized tumors have a favorable prognosis, even without initial treatment. However, when deciding on therapy, the grade of malignancy should be taken into account, as it has a great influence on survival. We did not see a tendency toward increased mortality when the patients were followed up for longer than 10 years after diagnosis.
|
|
| 15. |
|
|
| 16. |
- Adolfsson, Per I, et al.
(författare)
-
Zinc Induces a Bell-shaped Proliferative Dose-response Effect in Cultured Smooth Muscle Cells From Benign Prostatic Hyperplasia.
- 2015
-
Ingår i: Urology. - : Elsevier BV. - 0090-4295 .- 1527-9995. ; 85:3, s. 704.e15-704.e19
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the effects of zinc (Zn(2+)) concentrations on cultured benign prostatic hyperplasia (BPH) smooth muscle cell (SMC) proliferation.METHODS: The effects of Zn(2+) were studied in primary cultures of human BPH SMC, stimulated with either 10-μM lysophosphatidic acid (LPA) or LPA in combination with 100-nM testosterone. Deoxyribonucleic acid replication and protein synthesis using [(3)H]-thymidine and [(35)S]-methionine incorporation were measured. Furthermore, studies were performed to evaluate if Zn(2+) could potentiate the inhibitory effect of phosphodiesterase-5 blockers, on BPH SMC proliferation.RESULTS: Zn(2+) generated a bell-shaped concentration response, both regarding deoxyribonucleic acid replication and protein synthesis in cultured BPH SMC. Below a threshold value (approximately 200 μM), a significant mitogenic effect was seen, whereas higher concentrations inhibited SMC proliferation after stimulation with LPA. This effect was even more pronounced after stimulation of LPA in combination with testosterone. Moreover, phosphodiesterase-5 inhibitors, that is, sildenafil blocked LPA-stimulated BPH SMC proliferation. This antiproliferative effect, was significantly potentiated by coincubation with Zn(2+) in an additative manner.CONCLUSION: The bell-shaped concentration response of Zn(2+) on cultured BPH SMC proliferation suggests that changes in prostate Zn(2+) concentrations, during aging, diet, or inflammatory conditions, may be of importance in the pathogenesis of BPH.
|
|
| 17. |
|
|
| 18. |
|
|
| 19. |
|
|
| 20. |
- Andersson, Karl-Erik
(författare)
-
New pharmacologic targets for the treatment of the overactive bladder: an update.
- 2004
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 63:3 Suppl 1, s. 32-41
-
Tidskriftsartikel (refereegranskat)abstract
- Although currently available antimuscarinic agents are the standard of care for overactive bladder (OAB), they are limited by certain side effects, particularly dry mouth and constipation. Research aimed at discovering new therapies for OAB has resulted in the identification of some promising drugs. Investigations of pharmacologic targets in the central nervous system (CNS) have yielded encouraging results with several agents, including tramadol and gabapentin. Further investigation may show that drugs acting at serotonergic and noradrenergic CNS sites are clinically useful as therapies for OAB. Some peripherally acting drugs, such as resiniferatoxin and botulinum toxin, have already been proved to be of clinical value. However, development of other agents that block afferent or efferent nerve impulses in the bladder through activity at vanilloid, purinergic, or opioid-like receptor sites may result in clinically useful drugs.
|
|
| 21. |
- Andersson, Karl-Erik
(författare)
-
Storage and voiding symptoms: pathophysiologic aspects.
- 2003
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 62:5 Suppl 2, s. 3-10
-
Tidskriftsartikel (refereegranskat)abstract
- Lower urinary tract symptoms (LUTS) can be categorized as storage, voiding, and postmicturition symptoms. Although often associated with benign prostatic hyperplasia (BPH), they may also occur in women. This observation, the beneficial effects of a-adrenoceptor (AR) antagonists in men with BPH and LUTS, and the frail correlation between LUTS, and prostatic enlargement and/or outflow obstruction have focused interest on the role of extraprostatic alpha-ARs in the pathogenesis of LUTS. It has been suggested that an upregulation of contraction-mediating alpha-ARs and a downregulation of relaxation-mediating beta-ARs can contribute to LUTS generation. However, recent investigations on human bladder tissue could not confirm such a change. Antimuscarinic agents are effective for treatment of the overactive bladder, which is characterized by urge, frequency, urge incontinence, and nocturia (ie, LUTS). This suggests that muscarinic receptors are involved in the pathogenesis of LUTS, and there is recent evidence implicating purinergic receptors. Structural changes in the bladder, such as smooth muscle hypertrophy and connective tissue infiltration, are associated with detrusor overactivity in about 50% to 66% of patients with BPH. However, it is unclear whether this is caused by bladder outlet obstruction because the symptoms may remain in up to 33% of the patients after surgical removal of the obstruction. When outflow obstruction is reversed in rats, there is a subset (20%) that continues to have overactive voiding, despite a reversal of the bladder hypertrophy, suggesting that changes within the central nervous system may be a contributing factor. LUTS can be caused by many, often overlapping, pathophysiologic mechanisms, which may contribute to individual variation in response to treatment.
|
|
| 22. |
|
|
| 23. |
- Aydogdu, Özgu, 1978, et al.
(författare)
-
Does the diameter of dextranomer microspheres affect the success in endoscopic treatment of vesicoureteral reflux?
- 2012
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 80:3, s. 703-6
-
Tidskriftsartikel (refereegranskat)abstract
- To evaluate whether the polymer microsphere diameter affects the success rate in the endoscopic treatment of vesicoureteral reflux.In our consecutive series, 56 patients underwent subureteral injection with Dexell and 60 patients were treated with Deflux. Patients were evaluated with pediatric lower urinary tract scoring system, uroflowmetry, and a residual urine volume and voiding diary at the time of injection and control. Patients with grade V reflux, duplex systems, paraureteral diverticula, or refractory lower urinary tract symptoms were excluded. The numbers of renal units with grade II-III vesicoureteral reflux were 78 and 73 in the first (Deflux) and second (Dexell) groups, respectively. The numbers of renal units with grade IV reflux were 24 and 17 in the first and second groups, respectively. The resolution rate was determined by voiding cystourethrogram at the third postoperative month. Postoperative febrile urinary tract infections and de novo scars in dimercaptosuccinic acid were noted. Groups were compared by the χ(2) test.Mean follow-up time and mean age of the children were not significantly different. The number of nondilating and dilating renal units was not significantly different. Resolution rates were similar between the groups (79.5 and 78%, respectively). There was no significant difference in terms of resolution rates when dilating and nondilating urinary systems were separately analyzed. The average volumes used per renal unit were 0.9 and 1.6 mL in the first and second groups, respectively (P < .005). Postoperative febrile urinary tract infection and de novo scar formation rates were similar.The diameter of dextranomer microsphere does not affect the short-term success rate in endoscopic treatment of vesicoureteral reflux. Multicentric, randomized and prospective studies are required for long-term clinical results.
|
|
| 24. |
- Aydogdu, Özgu, 1978, et al.
(författare)
-
Predictors of surgical outcome in children with vesicoureteral reflux associated with paraureteral diverticula.
- 2010
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 76:1, s. 209-14
-
Tidskriftsartikel (refereegranskat)abstract
- To retrospectively evaluate success rates of different surgical approaches in the treatment of paraureteral (Hutch) diverticula (PUD) associated with vesicoureteral reflux (VUR) and also to define preoperative objective criteria to predict the surgical outcome.Records of 51 patients who underwent surgical treatment for PUD were reviewed. Intravesical ureteroneocystostomy (UNC), subureteral injection, and extravesical UNC were performed in 23, 28, and 10 renal units, respectively. Records of patients were evaluated with particular emphasis on predictors of treatment outcome. Mean follow-up was 22.1 months (range, 3-46). Statistical significance was set at P <.05.Overall success rates were 91%, 79%, and 80% for intravesical UNC, subureteral injection, and extravesical UNC, respectively (P >.05). The mean PUD index for patients who underwent endoscopic treatment was significantly lower (P <.05). In the endoscopic group, reflux was detected at the late-filling or voiding phase of voiding cystourethrography (P <.005). In patients, who were diagnosed with video urodynamics, reflux began at higher bladder pressures and volumes in the injection group (P <.005). UNC was more frequently used in patients with the orifice at the neck or dome (P <.005).For injection in the lower PUD index, onset of reflux at late-filling or voiding phase on voiding cystourethrography, higher pressure and volume on video urodynamics, and C position orifice are positive predictive parameters for success. Bilateral reflux with high PUD index and grade 5 VUR are associated with failure of intravesical reimplantation. Presence of grade 5 VUR and an early onset of reflux outstand as negative predictive factors for unilateral extravesical UNC.
|
|
| 25. |
- Burgu, Berk, et al.
(författare)
-
Pelvic reduction during pyeloplasty for antenatal hydronephrosis: does it affect outcome in ultrasound and nuclear scan postoperatively?
- 2010
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 76:1, s. 169-74
-
Tidskriftsartikel (refereegranskat)abstract
- To compare ultrasound (US) scan and nuclear renography findings in patients who underwent pyeloplasty with and without pelvic reduction in a randomized prospective study.A total of 42 patients, all prenatally diagnosed with unilateral hydronephrosis, were included. Hydronephrosis was confirmed postnatally. Twenty patients were randomly selected to undergo pyeloplasty with pelvic reduction and 22 underwent pelvis-sparing pyeloplasty. Patients were evaluated with mercaptoacetyltriglycine-3 scans on the sixth month and US scans on the first, third, and sixth months, postoperatively. Mean follow-up was 37 +/- 5.6 weeks. Statistical analyses were performed using chi-square test and significance was set as P <.05. Power analyses were performed by the NCSS-PASS program. Power value of 0.84 was calculated for a sample size of 42.The anteroposterior pelvic diameter decreased significantly in the pelvic reduction group compared with pelvis-sparing group in the first- and third-month US scans. However, the difference was not significant in the sixth month. The improvements in the US findings for the pelvis-sparing group match with those of the pelvic reduction group later in the postoperative period. Pelvic reduction significantly improved the renal washout time (T(1/2)) in mercaptoacetyltriglycine-3 renography when compared with pyeloplasty group without reduction at postoperative sixth month. Differential renal function was found to be unaffected from pelvic reduction.Resolution of anteroposterior diameter in US scan is more prominent in the pelvic reduction group at earlier stages of the postoperative period. Although T(1/2) decreases more prominently in the pelvic reduction group, the utility of this procedure is still indecisive. This feature can reveal possible surgical failures earlier and strengthen the values of US and renography postoperatively.
|
|
| 26. |
|
|
| 27. |
|
|
| 28. |
|
|
| 29. |
|
|
| 30. |
- Damber, Jan-Erik, 1949, et al.
(författare)
-
The Effect of Baseline Testosterone on the Efficacy of Degarelix and Leuprolide: Further Insights From A 12-Month, Comparative, Phase III Study in Prostate Cancer Patients
- 2012
-
Ingår i: Urology. - : Elsevier BV. - 0090-4295 .- 1527-9995. ; 80:1, s. 174-180
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE To investigate the effects of baseline testosterone on testosterone control and prostate-specific antigen (PSA) suppression using data from a phase III trial (CS21) comparing degarelix and leuprolide in prostate cancer. METHODS In CS21, patients with histologically confirmed prostate cancer (all stages) were randomized to degarelix 240 mg for 1 month followed by monthly maintenance doses of 80 or 160 mg, or leuprolide 7.5 mg/month. Patients receiving leuprolide could receive antiandrogens for flare protection. Treatment effects on testosterone and PSA reduction, testosterone surge, and microsurges were investigated in 3 baseline testosterone subgroups: <3.5, 3.5-5.0, and >5.0 ng/mL. Data are presented for the groups receiving degarelix 240/80 mg (the approved dose) and leuprolide 7.5 mg. RESULTS Higher baseline testosterone delayed castration with both treatments. However, castrate testosterone levels and PSA suppression occurred more rapidly with degarelix irrespective of baseline testosterone. With leuprolide, the magnitude of testosterone surge and microsurges increased with increasing baseline testosterone. There was no overall correlation between baseline testosterone and initial PSA decrease in either treatment group, although PSA suppression tended to be slowest with leuprolide and fastest with degarelix in the high baseline testosterone subgroup. CONCLUSION Patients with high baseline testosterone may have greater risk of tumor stimulation (clinical flare) and mini-flares during gonadotrophin-releasing hormone agonist treatment and so the need for flare protection with antiandrogens in these patients is obvious, especially in metastatic disease. Although higher baseline testosterone delays castration, castrate testosterone and PSA suppression occur more rapidly with degarelix, irrespective of baseline testosterone, without the need for flare protection. UROLOGY 80: 174-181, 2012. (c) 2012 Elsevier Inc.
|
|
| 31. |
|
|
| 32. |
|
|
| 33. |
|
|
| 34. |
- Egevad, Lars, et al.
(författare)
-
Primary seminal vesicle carcinoma detected at transurethral resection of prostate
- 2007
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 69:4
-
Tidskriftsartikel (refereegranskat)abstract
- We present a case of primary seminal vesicle carcinoma detected at transurethral resection. The clinical presentation, radiologic findings, and pathologic features of these tumors are reviewed. Grossly, seminal vesicle carcinoma is poorly circumscribed and solid or solid/cystic and may be misinterpreted as an abscess or hemorrhage on radiologic examination. Although a definitive diagnosis often cannot be given until after complete resection, we describe the findings indicative of seminal vesicle origin, including papillary histologic architecture, sometimes with mucinous differentiation, and a characteristic immunophenotype positive for CA-125 and cytokeratin 7, but negative for prostate-specific antigen and cytokeratin 20. UROLOGY 69: 778.e11-78.e13, 2007.
|
|
| 35. |
- Egevad, L, et al.
(författare)
-
Reply by the Authors
- 2016
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 96, s. 179-180
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 36. |
|
|
| 37. |
- Elzanaty, Saad
(författare)
-
Time-to-Ejaculation and the Quality of Semen Produced by Masturbation at a Clinic.
- 2008
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 71:5, s. 883-888
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate the association between the length of time-to-ejaculation and semen parameters. METHODS: Ejaculates from 142 men under infertility assessment were analyzed according to the World Health Organization guidelines. Seminal neutral alpha-glucosidase (NAG), prostate-specific antigen (PSA), zinc, and fructose were also measured. Three groups according to the length of the time-to-ejaculation were defined: G(<10) (<10 minutes), G(10-15) (10 to 15 minutes), and G(>15) (greater than 15 minutes). RESULTS: Time to ejaculation showed negative significant correlation with sperm concentration (rho = -0.20, P = 0.02), total sperm count (rho = -0.20, P = 0.04), NAG (rho = -0.20, P = 0.01), and fructose (rho = -0.30, P = 0.02), respectively. No significant correlations existed among the time-to-ejaculation and age, sexual abstinence, semen volume, sperm motility, PSA, and zinc. There were negative significant associations among time-to-ejaculation and sperm concentration (beta = -3.0; P = 0.004), total sperm count (beta = -10; P = 0.02), total count of progressive motility (beta = -7.0; P = 0.02), and fructose (beta = -0.30; P = 0.02), respectively. No significant associations existed among the time-to-ejaculation and semen volume, motility grades, NAG, PSA, and zinc. G(<10) was characterized by higher sperm concentration, total sperm count, and total count of progressive motility compared with G(10-15) (mean difference = 33 x 10(6)/mL; P = 0.01), (mean difference = 96 x 10(6)/ejaculate; P = 0.50), (mean difference = 77 x 10(6)/ejaculate; P = 0.02), respectively, and G(>15) (mean difference = 50 x 10(6)/mL; P = 0.01), (mean difference = 176 x 10(6)/ejaculate; P = 0.02), (mean difference = 110 x 10(6)/ejaculate; P = 0.03), respectively. Fructose was significantly higher in G(<10) compared with G(>15) (mean difference = 5.0 mmol/L; P = 0.03). CONCLUSIONS: The time-to-ejaculation length was associated with semen parameters. These results might reflect the negative effect of acute stress during semen collection via masturbation at a clinic on semen parameters.
|
|
| 38. |
|
|
| 39. |
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
- Hautmann, Richard E., et al.
(författare)
-
Urinary diversion
- 2007
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 69:1, Supplement 1, s. 17-49
-
Forskningsöversikt (refereegranskat)abstract
- A consensus conference convened by the World Health Organization (WHO) and the Societe Internationale d'Urologie (SIU) met to critically review reports of urinary diversion. The world literature on urinary diversion was identified through a Medline search. Evidence-based recommendations for urinary diversion were prepared with reference to a 4-point scale. Many level 3 and 4 citations, but very few level 2 and no level 1, were noted. This outcome supported the clinical practice pattern. Findings of > 300 reviewed citations are Summarized. Published reports on urinary diversion rely heavily on expert opinion and single-institution retrospective case series: (1) The frequency distribution of urinary diversions performed by the authors of this report in > 7000 patients with cystectomy reflects the current status of urinary diversion after cystectomy for bladder cancer: ncobladder, 47%; conduit, 33%; anal diversion, 10%; continent cutaneous diversion, 8%; incontinent cutaneous diversion, 2%; and others, 0.1%. (2) No randomized controlled studies have investigated quality of life (QOL) after radical cystectomy. Such studies are desirable but are probably difficult to conduct. Published evidence does not Support an advantage of one type of reconstruction over the others with regard to QOL. An important proposed reason for this is that patients are subjected preoperatively to method-to-patient matching, and thus are prepared for disadvantages associated with different methods. (3) Simple end-to-side, freely refluxing ureterointestinal anastomosis to an afferent limb of a low-pressure orthotopic reconstruction, in combination with regular voiding and close follow-up, is the procedure that results in the lowest overall complication rate. The potential benefit of "conventional" antireflux procedures in combination with orthotopic reconstruction seems outweighed by the higher complication and reoperation rates. The need to prevent reflux in a continent cutaneous reservoir is not significantly debated, and this should be done. (4) Most reconstructive surgeons have abandoned the continent Kock ileal reservoir largely because of the significant complication rate associated with the intussuscepted nipple valve.
|
|
| 43. |
- Hautmann, Richard E, et al.
(författare)
-
Urinary diversion: how experts divert.
- 2015
-
Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 85:1, s. 233-238
-
Tidskriftsartikel (refereegranskat)abstract
- To determine the rates of the available urinary diversion options for patients treated with radical cystectomy for bladder cancer in different settings (pioneering institutions, leading urologic oncology centers, and population based).
|
|
| 44. |
|
|
| 45. |
- He, Leye, et al.
(författare)
-
Clinical Significance of IL-2, IL-10, and TNF-alpha in Prostatic Secretion of Patients With Chronic Prostatitis
- 2010
-
Ingår i: Urology. - : Elsevier BV. - 0090-4295 .- 1527-9995. ; 75:3, s. 654-657
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore the clinical significance of interleukin-2 (IL-2), interleukin-10 (IL-10), and tumor necrosis factor alpha (TNF-α) in expressed prostatic secretions (EPS) of patients with different types of chronic prostatitis (CP). Methods Fifty-seven CP patients and 12 healthy males (controls) were investigated. The CP patients were evaluated through routine examination of urine, EPS, 2 glasses urine culture, and the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score and classified by the NIH prostatitis diagnostic criteria. The levels of cytokines TNF-α, IL-10, and IL-2 in the EPS were measured by two-antibody enzyme-linked immunosorbent assay. Results CP patients fell into 3 groups: type II (n = 10), type IIIa (n = 26), and type IIIb (n = 21). EPS TNF-α and IL-10 levels were significantly higher in type II and type IIIa than in type IIIb and control groups. The levels of IL-2 were lower than control in all CP groups, but only type II was statistically different from the controls. In the CP patients, the level of TNF-α was positively related to the white blood cell counts (r = .77; P <.01), and the level of IL-10 was positively related to the NIH-CPSI scores (r = .55; P <.01). Conclusions Determination of variety expression of TNF-α, IL-10, and IL-2 in the EPS of CP patients may provide a potential indicator for clinical diagnosis classification and an indicator to evaluate the effect of treatment of CP.
|
|
| 46. |
|
|
| 47. |
|
|
| 48. |
|
|
| 49. |
- Ilicki, Jonathan, et al.
(författare)
-
Partial Segmental Thrombosis of the Corpus Cavernosum : A Case Report and a Review of the Literature
- 2012
-
Ingår i: Urology. - : Elsevier. - 0090-4295 .- 1527-9995. ; 79:3, s. 708-712
-
Forskningsöversikt (refereegranskat)abstract
- Partial segmental thrombosis of the corpus cavernosum (PSTCC) is a rare urological condition characterized by a painful, firm mass in the proximal part of the corpus cavernosum. The underlying pathophysiology of this condition is not fully understood. We present a case diagnosed by magnetic resonance imaging with complete clinical recovery after conservative treatment and novel associated findings, such as excessive alcohol intake. We also review the previous cases of PSTCC and propose a two hit model explaining PSTCC's etiology. UROLOGY 79: 708-712, 2012.
|
|
| 50. |
- Jancke, Georg, et al.
(författare)
-
Bladder Wash Cytology at Diagnosis of Ta-T1 Bladder Cancer Is Predictive for Recurrence and Progression
- 2012
-
Ingår i: Urology. - : Elsevier. - 0090-4295 .- 1527-9995. ; 80:3, s. 625-631
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE To evaluate the effect of the bladder wash cytology finding at the primary diagnosis of Stage Ta-T1 urinary bladder cancer on recurrence and progression. less thanbrgreater than less thanbrgreater thanMETHODS The clinical and pathologic characteristics of all patients with primary Stage Ta-T1 urinary bladder cancer were prospectively registered. The data were divided according to the bladder wash cytology results at diagnosis. Multivariate analyses were performed to determine the influence of bladder wash cytology on recurrence and progression. less thanbrgreater than less thanbrgreater thanRESULTS The analysis included 768 evaluable patients with a mean follow-up of 60 months. Recurrence was observed in 478 patients (62%) and progression in 71 (9%). High-grade malignant bladder wash cytology was predictive for recurrence and progression (P andlt; .001 and P = .036, respectively). Other factors affecting recurrence were missing bladder wash cytology data, tumors size 16-30 mm and andgt;30 mm, Stage T1 tumor category, and multiplicity (P = .008, P = .006, P andlt; .001, P = .002, and P andlt; .001, respectively). Progression was also associated with T1 tumor category, local recurrence, and primary concomitant carcinoma in situ (P andlt; .001, P andlt; .001, and P = .024, respectively). less thanbrgreater than less thanbrgreater thanCONCLUSION High-grade malignant bladder wash cytology at the primary diagnosis was predictive for recurrence and progression. This could be taken into account in designing future follow-up schedules.
|
|
