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- Egevad, Lars, et al.
(författare)
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Primary seminal vesicle carcinoma detected at transurethral resection of prostate
- 2007
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Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 69:4
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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.
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- Elzanaty, Saad
(författare)
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Time-to-Ejaculation and the Quality of Semen Produced by Masturbation at a Clinic.
- 2008
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Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 71:5, s. 883-888
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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.
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- Hautmann, Richard E., et al.
(författare)
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Urinary diversion
- 2007
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Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 69:1, Supplement 1, s. 17-49
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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.
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- Mattiasson, Anders, et al.
(författare)
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Five-year follow-up of feedback microwave thermotherapy versus TURP for clinical BPH: a prospective randomized multicenter study.
- 2007
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Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 69:1, s. 91-96
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Tidskriftsartikel (refereegranskat)abstract
- To compare the efficacy and safety of transurethral microwave thermotherapy (TUMT) with ProstaLund Feedback Treatment, using the CoreTherm device, with transurethral resection of the prostate (TURP) 5 years after treatment. METHODS This prospective, randomized, multicenter study was conducted at 10 centers in the United States and Scandinavia. A total of 154 patients with benign prostatic hyperplasia were randomized to TUMT or TURP in a 2:1 ratio. Patients were followed up at 3, 6, 12, 24, 36, 48, and 60 months after treatment. The intermediate results at 12 and 36 months have been previously reported. The treatment outcome at 5 years was evaluated with the International Prostate Symptom Score (IPSS), quality of life question (QOL), peak urinary flow rate (Qmax), postvoid residual urine volume, and prostate volume. The CoreTherm device differs from other microwave devices in that the intraprostatic temperature is constantly measured during the procedure to guide the treatment. RESULTS Of the 154 patients, 66% completed the 60 months of follow-up. Statistically significant improvements in the TUMT and TURP groups were observed for IPSS, QOL, and Qmax at 60 months. The average values for the TUMT group were an IPSS of 7.4, QOL score of 1.1, and Qmax of 11.4 mL/s. The values for the TURP group were IPSS of 6.0, QOL score of 1.1, and Qmax of 13.6 mL/s. No statistically significant differences were found in any of these variables between the two treatment groups. In the TUMT group, 10% needed additional treatment versus 4.3% in the TURP group. CONCLUSIONS The clinical outcome 5 years after TUMT using the CoreTherm device was comparable to the results seen after TURP. The safety of TUMT using the CoreTherm device compared favorably with that of TURP. (c) 2007 Elsevier Inc.
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- Månsson, Åsa, et al.
(författare)
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Patient-assessed outcomes in Swedish and Egyptian men undergoing radical cystectomy and orthotopic bladder substitution--a prospective comparative study.
- 2007
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Ingår i: Urology. - : Elsevier BV. - 1527-9995 .- 0090-4295. ; 70:6, s. 1086-1090
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To compare two patient populations with assumed cultural differences undergoing radical cystectomy and orthotopic bladder substitution to determine whether these translate into differences in the answers to self-report instruments. METHODS: The questionnaires Functional Assessment of Cancer Therapy-Bladder Cancer (FACT-BL), consisting of a general version (FACT-G) and a bladder cancer specific module, and Hospital Anxiety and Depression Scale (HADS) were used preoperatively and 3 and 12 months postoperatively to assess patient well-being, urologic symptoms, depression, and anxiety in 29 and 32 Swedish and Egyptian male patients, respectively. RESULTS: Significant differences were found between the two groups. Higher FACT-G scores (ie, better outcomes) were obtained in the Swedish patients, both preoperatively and 3 months postoperatively, but not after 12 months. Differences were also seen in the urogenital assessment provided by the FACT-BL module. HADS revealed more depression among the Egyptian patients throughout the study period. Also, anxiety was more common preoperatively and 3 months postoperatively in the Egyptian patients, but not after 12 months. CONCLUSIONS: Swedish men scored better than Egyptian men on the FACT-BL and HADS, although the latter improved with time after surgery. These results show that patient-assessed outcomes differ in patients from different sociocultural backgrounds. This should be recognized when analyzing results from comparative studies. Also, the use of culture-fair instruments is important when assessing patients with different sociocultural backgrounds.
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