Current understanding of hypospadias: relevance of animal models

Hypospadias is a congenital abnormality of the penile urethra with an incidence of approximately 1:200-1:300 male births, which has doubled over the past three decades. The aetiology of the overwhelming majority of hypospadias remains unknown but appears to be a combination of genetic susceptibility and prenatal exposure to endocrine disruptors. Reliable animal models of hypospadias are required for better understanding of the mechanisms of normal penile urethral formation and hence hypospadias. Mice and/or rats are generally used for experimental modelling of hypospadias, however these do not fully reflect the human condition. To use these models successfully, researchers must understand the similarities and differences between mouse, rat and human penile anatomy as well as the normal morphogenetic mechanisms of penile development in these species. Despite some important differences, numerous features of animal and human hypospadias are shared: the prevalence of distal penile malformations; disruption of the urethral meatus; disruption of urethra-associated erectile bodies; and a common mechanism of impaired epithelial fusion events. Rat and mouse models of hypospadias are crucial to our understanding of hypospadias to ultimately reduce its incidence through better preventive strategies

Patients with a negative cystoscopy and negative Nmp22® Bladderchek® test are at low risk of missed transitional cell carcinoma of the bladder: a prospective evaluation

OBJECTIVES: Urine based tumor markers have uncertain utility in diagnosis or surveillance of patients with bladder cancer while cytology is commonly used. We evaluated whether cytology provides additional diagnostic information in patients with a negative NMP22® BladderChek® test (BladderChek) and negative cystoscopy. MATERIALS AND METHODS: We performed subset analyses of 2 large prospective multi-center databases evaluating BladderChek for UCB detection and surveillance. These cohorts were analyzed for presence of cancer and result of urine cytology in setting of a negative cystoscopy and negative BladderChek. Subsequently, we prospectively performed cystoscopy, cytology and BladderChek on 434 patients at our institution being evaluated for UCB. RESULTS: In the detection database (n = 1331), 1065 patients had a negative cystoscopy and BladderChek. There were 3 cancers (stages Ta, Tis and T1) and cytology was atypical in one and reactive in two. In the surveillance cohort (n = 668) patients, 437 patients had negative cystoscopy and BladderChek. Cancer was found in 2 patients (stages Tis and Ta). The patient with Tis has dysplastic cytology and Ta tumor had reactive cytology. In our cohort of 434 patients, 288 pts had negative cystoscopy and BladderChek. One cancer was missed, a Ta ureteral urothelial carcinoma with a reactive cytology. CONCLUSIONS: In patients with negative cystoscopy and BladderChek, very few cancers are missed and cytology was not effective in detection. Use of a point-of-care test in conjunction with cystoscopy in lieu of cytology could decrease cost, provide immediate results, improve negative predictive value and reduce the uncertainty that results from inconclusive cytologic results

A Randomized Controlled Study of Writing Interventions on College Women’s Positive Body Image

College women are at risk for body dissatisfaction, but enhancing the positive aspects of body image can serve as a protective factor. Self-compassion has been associated with body appreciation and may protect against negative body image. This study tested the effect of a self-compassion writing intervention on positive body image and affect and explored self-compassion as a mediator between writing group and positive body image. We used a randomized controlled design to compare self-compassion writing (n = 51), traditional expressive writing (n = 50), and control writing (n = 51) interventions in college women. Participants were mostly European-American (82%) with a mean age of 19. Participants wrote online for 20 min once a week for three consecutive weeks. Results indicated that negative and positive affect decreased for all three groups. There were no differences between groups on positive body image or affect; however, the self-compassion writing group reported greater increases in self-compassion (F = 3.48, p \u3c 0.05, ηp2 = 0.05). Moreover, mediator models revealed that the effect of group (self-compassion vs. traditional/control writing) on body appreciation and body image quality of life was mediated by self-compassion. Overall, the findings indicate that self-compassion writing increased self-compassion, and greater increases in self-compassion were associated with greater increases in positive body image and positive affect