“Psoas Hitch” procedure

U 51-godišnjega bolesnika učinjena je transuretralna resekcija urotelijalnoga karcinoma završnoga dijela lijevoga mokraćovoda. U sljedećoj fazi odstranjen je donji dio lijevoga mokraćovoda s pripadajućim dijelom mokraćnoga mjehura te je na toj strani postavljena perkutana nefrostoma. Radi postizanja boljega kapaciteta mokraćnoga mjehura, učinjena je transuretralna resekcija prostate i u posljednjoj fazi učinjen je ”psoas hitch” postupak s ureteroneocistostomijom.In 51-year-old patient urothelial carcinoma of the terminal left ureter was resected transurethrally. In the next phase, a distal part of the left ureter with a ”cuff” of the bladder was removed, and ipsilateral percutaneous nephrostomy introduced. Better bladder capacity was achieved by transurethral resection of the prostate, and in the last phase left-sided ”psoas hitch” procedure with ureteroneocystostomy was performe

Prevention and early detection of prostate cancer

This Review was sponsored and funded by the International Society of Cancer Prevention (ISCaP), the European Association of Urology (EAU), the National Cancer Institute, USA (NCI) (grant number 1R13CA171707-01), Prostate Cancer UK, Cancer Research UK (CRUK) (grant number C569/A16477), and the Association for International Cancer Research (AICR

Serum antibodies against genitourinary infectious agents in prostate cancer and benign prostate hyperplasia patients: a case-control study

<p>Abstract</p> <p>Background</p> <p>Infection plays a role in the pathogenesis of many human malignancies. Whether prostate cancer (PCa) - an important health issue in the aging male population in the Western world - belongs to these conditions has been a matter of research since the 1970 s. Persistent serum antibodies are a proof of present or past infection. The aim of this study was to compare serum antibodies against genitourinary infectious agents between PCa patients and controls with benign prostate hyperplasia (BPH). We hypothesized that elevated serum antibody levels or higher seroprevalence in PCa patients would suggest an association of genitourinary infection in patient history and elevated PCa risk.</p> <p>Methods</p> <p>A total of 434 males who had undergone open prostate surgery in a single institution were included in the study: 329 PCa patients and 105 controls with BPH. The subjects' serum samples were analysed by means of enzyme-linked immunosorbent assay, complement fixation test and indirect immunofluorescence for the presence of antibodies against common genitourinary infectious agents: human papillomavirus (HPV) 6, 11, 16, 18, 31 and 33, herpes simplex virus (HSV) 1 and 2, human cytomegalovirus (CMV), Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Neisseria gonorrhoeae and Treponema pallidum. Antibody seroprevalence and mean serum antibody levels were compared between cases and controls. Tumour grade and stage were correlated with serological findings.</p> <p>Results</p> <p>PCa patients were more likely to harbour antibodies against Ureaplasma urealyticum (odds ratio (OR) 2.06; 95% confidence interval (CI) 1.08-4.28). Men with BPH were more often seropositive for HPV 18 and Chlamydia trachomatis (OR 0.23; 95% CI 0.09-0.61 and OR 0.45; 95% CI 0.21-0.99, respectively) and had higher mean serum CMV antibody levels than PCa patients (p = 0.0004). Among PCa patients, antibodies against HPV 6 were associated with a higher Gleason score (p = 0.0305).</p> <p>Conclusions</p> <p>Antibody seropositivity against the analyzed pathogens with the exception of Ureaplasma does not seem to be a risk factor for PCa pathogenesis. The presence or higher levels of serum antibodies against the genitourinary pathogens studied were not consistently associated with PCa. Serostatus was not a predictor of disease stage in the studied population.</p

The MTOPS Study: New findings, new insights, and clinical implications for the management of BPH. Eur Urol Supp 2006; 5: 628–633

Introduction The relationship between benign prostatic hyperplasia (BPH) and age has been clearly established and studies indicate that approximately 50% of men are estimated to have pathologic BPH in their sixth decade of life Article info Keywords: Benign prostatic hyperplasia Combination therapy Doxazosin Finasteride Medical Therapy of Prostatic Symptoms (MTOPS) Please visit www.eu-acme.org to read and answer the EU-ACME questions on-line. The EU-ACME credits will then be attributed automatically. Abstract Benign prostatic hyperplasia (BPH) affects an increasing number of men as they age and can progress in a certain proportion, resulting in serious complications such as acute urinary retention (AUR) and BPH-related surgery. The Medical Therapy of Prostatic Symptoms (MTOPS) Study was a large-scale, long-term study with a recruitment of 3047 men with BPH and a mean follow-up period of 4.5 yr. The study found that combination therapy with a selective type 2 5a-reductase inhibitor (finasteride) and an a 1 -blocker (doxazosin) provided benefits over either drug as monotherapy in terms of reduction in the risk of clinical progression. Data from the MTOPS Study corroborate earlier evidence of the prognostic power of baseline prostate-specific antigen (PSA) levels and prostate volume. Patients with higher PSA values and prostate volumes have worse outcomes as seen in deteriorating symptom scores, development of AUR, and the need for invasive surgery. Recent analyses of the MTOPS Study have been conducted to identify which patients should be considered for combination therapy. Findings suggest that patients with BPH with a prostate volume !25 ml and a PSA of !1.5 ng/ml may benefit from combination therapy. In addition, analysis of the placebo arm of the study reveals that patients with a baseline prostate volume of !31 ml and a PSA of !1.5 ng/ml are at a significantly greater risk of clinical progression. As such, combination therapy is strongly indicated in this patient group