Benign prostatic hyperplasia: associated pathology.
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Hemorrhoids↗
Biomedical subjects
R M Scarpa
Publications and source records attributed to R M Scarpa.
Behaviour and urodynamic properties of orthotopic ileal bladder substitute after radical cystectomy.
The study included 18 men, submitted to urodynamic investigation 9-18 months after cystoprostatectomy for bladder cancer and bladder substitution with a detubularized ileal segment as described by Studer-Zingg. Sixteen patients were continent by day and 3 were incontinent during the night so as to require the use of a condom catheter. The residual urine was over 100 ml in 3 patients, while it was low or absent in the remainder. Micturition was performed by straining, and maximal flow rates were normal, although the pattern was intermittent. The incidence of nocturnal incontinence was 55.5%. Measurement of the urethral pressure profile revealed a shortened functional length, and low pressure was found in 3 patients, with a maximum urethral closure pressure < 45 cm H2O. During extramural ambulatory urodynamic monitoring, pressure values in the neobladder usually ranged below 20 cm H2O and exceeded 34 cm H2O in only 2 patients who complained of daytime and nocturnal incontinence. The urodynamic features of the neobladder in patients who underwent radical cystoprostatectomy and bladder replacement with a detubularized ileal segment indicate low pressure at high-level filling.
Aged↗
Urodynamic changes in benign prostatic hyperplasia patients treated by transurethral microwave thermotherapy.
Our study describes the results obtained in 44 patients with benign prostatic hyperplasia (BPH) who underwent transurethral microwave thermotherapy (TUMT) and their follow-up at 12 months. Prostatron, a prostatic TUMT device which comprised a microwave heat generator and a cooling system, was used at our centre. Forty-four out of the 60 patients given the treatment had a 12-month follow-up to be evaluated. The evaluation of subjective symptoms, according to the Boyarsky symptom score, demonstrated a significant rate of response (p < 0.0005). The analysis of pressure-flow recordings demonstrated a reduction of mean detrusor opening pressure (p < 0.0005), a reduction of detrusor pressure at maximum flow 12 months after treatment (p < 0.0005) and an improvement of mean values of maximum flow after treatment (p < 0.0005). This study shows that TUMT, though it cannot be considered an alternative to surgical or endoscopic therapy of BPH for severely obstructed patients, can produce improvement of both subjective and objective parameters of mild prostatic bladder outflow obstruction.
Aged↗
Metastatic renal cell cancer treated with recombinant alpha 2a interferon and vinblastine.
42 patients with advanced renal cell carcinoma were treated with a combination therapy with interferon alpha 2a (mean dosage 16 x 10(6) U i.m. 3 times/week) and vinblastine (0.1 mg/Kg every 21 days). 12 patients (28.5%) had a positive response. Of them 1 presented a complete response (2.38%), 5 a partial response (11.9%) and 6 a stable disease (14.2%). No significant side effects were observed apart from the flu-like syndrome (all patients) and a moderate leukopenia (45.2%). The median duration of responses was 10+ months (range 3-37 months). At 4-year follow-up the median survival time was 16.0 months (range 4-37 months).
Adult↗
[Ureteral lithotripsy with rigid ureteroscopy and pulsed dye laser].
Pulsed dye laser lithotripsy represents nowadays a new approach to ureteral stones. 27 patients were treated with a pulsed dye laser unit (Pulsolith TM) at our department from november 1989 to january 1990. 21 had a single stone and the remaining a multiple ureteral lithiasis. The pulsed dye laser operated at a wave length of 504 nm, energy ranged between 90 and 160 mj with pulse of 1,5 ms. A 320 theta diameter quartz fiber with Helium Neon red laser (to visualize the top of the fiber) introduced in a rigid 9.5 ureteroscope (Wolf) was used during the procedure. Spinal, peridural or general anesthesia was done in all patients and the time of the procedure ranged between 8-150 minutes. Fiber was inserted in a 4 Ch ureteral catheter which provided easier manipulation of the fiber. Complete fragmentation was achieved in 88.9% of the patients, and combined manoeuvres were requested in another 3.7%. Failures were 7.4%. Minimal lesions of the ureter, due to ureteroscope advancement subsided spontaneously after placement of double F catheter. Pulsed dye laser lithotripsy seems to be a safe and useful procedure for treatment of impacted ureteral calculi and seems to offer low morbidity in respect of ultrasonic or electrohydraulic procedures especially when the stone location does not permit an ESWL approach.
Coloring Agents↗
[Simple renal cysts, biochemical analysis of the cystic fluid, and comparison with blood parameters].
62 specimens of cystic fluid drawn back by ultrasound guided needle-aspiration in 37 males and 25 females were evaluated biochemical analysis including magnesium, calcium, phosphorus, chloride, uric acid, total protein, sugar, urea, creatinine, sodium, potassium, total cholesterol, AST, ALT, ALP, ACP, PAP, alpha-amilasys. In our study Cl, Na and sugar showed similar concentrations in the two fluids. Uric acid, and urea were more concentrated in the cystic fluid while Mg, Ca and total protein were more pronounced in the blood. The results obtained seem to indicate that simple renal cyst could originate from glomerular proximal tubulus part of the nephron as consequence of an obstructive cause.
Female↗
[Clinical observations about an oligomineral water from the "Funtana Piscamu" of San Leonardo di Siete Fuentes].
In this study we evaluated the effects induced by the administration of a natural oligomineral water "Funtana Piscamo" di San Leonardo di Siete Fuentes on patient with urinary stone disease. Urine from 30 stone formers attending our metabolic stone clinic were compared with freshly voided urine of 20 normal volunteers. A marked increase in urinary magnesium (p less than 0.001) and a change in the urinary Ca/Mg ratio (p less than 0.005) were the most striking features disclosed in patients with stone disease. This natural oligomineral water drawn from "Funtana Piscamu di San Leonardo di Siete Fuentes" seems to have a long-term efficacy in urinary stone prevention.
Adult↗
Serum and urine ferritin in patients with transitional cell carcinoma of the bladder.
Erythrocyte, serum and urine ferritin concentrations were evaluated in 20 patients suffering from transitional cell carcinoma of the urinary bladder and in 20 healthy men. No clinical or biochemical signs of liver disorders, chronic inflammatory states or infections were present in both the patients and the controls. Our results showed no significant difference in the erythrocyte ferritin concentration in both groups. On the contrary there was a statistically significant difference in mean serum (p less than 0.05) and urine (p less than 0.01) ferritin concentration between the two groups. The mean serum ferritin concentration in the patients was 102.23 +/- 63.38 ng/ml while it was 258.41 + 250.68 ng/ml in normal subjects. The mean urine ferritin concentration was 6.30 +/- 5.35 ng/ml in normal subjects and 22.66 +/- 25.59 ng/ml in patients with bladder cancer. Our data seem to demonstrate that the assessment of the ferritin either in the serum or preferably, in the urine, could become an interesting tumoral marker for bladder cancer.
Carcinoma, Transitional Cell↗
Evaluation of efficacy and tolerability of Nilutamide and Buserelin in the treatment of advanced prostate cancer.
Several different medical strategies have been proposed for the treatment of advanced prostatic cancer: androgen withdrawal by surgical castration on indirect suppression of androgen production by estrogen or estrogen-like substances, antiandrogen compounds or LH-RH analogues. The Authors evaluated in detail tolerability and efficacy of a combination therapy of a LHRH analogue (Buserelin) and a pure antiandrogen (Nilutamide) in a group of 15 patients with advanced prostate cancer (stage D) followed over a period of six months.
Aged↗
[Monitoring of erection function in patients with prostatic carcinoma treated with Casodex].
This study evaluates the sleep-related erections in 5 patients with locally advanced prostate cancer (T3NOMO) during 6 months treatment with Casodex by multinight continuous monitoring of penile tumescence and rigidity. Mean serum LH, Testosterone and Estradiol levels shown a no statistically significant increase at the six months control. We found no significant modifications in the number of NPT episodes, maximum penile circumference and rigidity time before and after therapy. Penile arterial flow and neurologic examination were also unmodified. All patients had a stable disease and unchanged performance status after 6 months. This pure antiandrogen in a men with prostate cancer does not seem to interfere with self reported libido and erectile capability.
Androgen Antagonists↗
[Qualitative analysis of 1447 patients with urinary calculi in the period 1979-1989 in Sardinia].
In this work we have examined the results obtained from the chemical analysis of 1447 urinary stones. The data concerning the frequency are distinguished according to the sex. Then we examined the difference between frequency of pure and mixed calculi in a sample, analyzing the results obtained by a subdivision in two periods of five years each. Our data are compared with those obtained in other regions of our country.
Female↗
Trisomy 7 in a case of transitional cell carcinoma of the kidney.
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Aged↗
The effect of flutamide on basal and ACTH-stimulated plasma levels of adrenal androgens in patients with advanced prostate cancer.
The effect of flutamide on basal and ACTH-stimulated plasma levels of adrenal androgens was investigated in 6 patients with untreated advanced prostate cancer, aged 52-75 yr. Flutamide was administered (250 mg three times daily) for 10 days; before and after treatment, a synthetic ACTH1-24 stimulation test (250 micrograms im, with blood sampling immediately before and 60 min after the stimulus) was performed. Basal plasma 17OH-pregnenolone (delta 5-17OHP), 170H-progesterone (delta 4-17OHP), androstenedione (A), dehydroepiandrosterone (DHEA) and its sulphate (DHEAS) were unchanged by flutamide treatment. In contrast, basal plasma testosterone (T) concentrations significantly increased (p less than 0.05). The response of cortisol delta 4-17OHP, delta 5-17OHP, A and DHEA to ACTH, as well as the ACTH-stimulated delta 5-17OHP/delta 4-17OHP, delta 5-17OHP/DHEA, delta 4-17OHP/A and DHEA/A ratios, were unchanged by flutamide treatment. These findings indicate that: a) Short-term flutamide administration enhances testicular steroidogenesis, via augmented LH pulse frequency; b) Adrenal steroidogenesis seems to be not affected by the drug, since ACTH-stimulated plasma levels of adrenal androgens and precursors/products ratios were unchanged.
Adrenal Glands↗
Cytogenetic investigation on 30 bladder carcinomas.
Cytogenetic study of 30 bladder carcinomas confirmed the heterogeneity and the complexity of the karyotypic picture in this type of tumor. Presence of numerical and/or structural chromosome aberrations was observed in all tumors. Clonal abnormalities were found in 19 cases. Chromosomes most frequently involved in changes were chromosome #1, #3 and #11(36.6%, 26.6%, and 20% of the cases respectively). Trisomy 7 and monosomy 9 were the sole abnormalities in one case each.
Chromosome Aberrations↗
Short term effects of flutamide administration on hypothalamic-pituitary-testicular axis in man.
The effect of short term administration of flutamide on the hypothalamic-pituitary-gonadal axis was studied in six patients with advanced prostate cancer (C2 stage). Flutamide significantly increased LH pulse frequency in all patients (p less than 0.05 by Wilcoxon's test). The FSH pulse analysis disclosed a similar pattern of LH. Plasma IC-T clearly increased following flutamide therapy; mean IC-T values were 2.67 +/- 0.47 ng./ml. and 4.67 +/- 0.62 ng./ml. before and after flutamide administration, respectively (p less than 0.05 by paired Student's t test). Our study demonstrates that flutamide acts in humans as a selective and specific antiandrogen compound.
Aged↗
Transitional cell carcinoma of the bladder in a young man. A multidisciplinary approach.
A multidisciplinary diagnostic approach to a case of bladder carcinoma in a 19-year-old male smoker is presented. The transitional cell carcinoma was submitted to conventional histological examination, flow cytometry and cytogenetic analysis. Serum and urine tumour markers were also investigated. The tumour was diploid, with an increased proliferative phase, and a chromosome marker was found. A net decrease in serum and urine ferritin concentrations was noted after transurethral resection of the neoplasm and its low malignancy was confirmed at follow-up.
Adult↗
Percutaneous drainage of utricular cyst under ultrasound guidance.
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Cysts↗
The effect of androgen blockade on pulsatile gonadotrophin release and LH response to naloxone.
In order to clarify the effects of androgen blockade on the hypothalamic-pituitary-testicular axis in man, four patients with advanced prostate cancer, not previously treated, were given oral flutamide, 250 mg three times daily for 9 days. Before, and 7, 8 and 9 days after starting flutamide treatment, on separate days, the following tests were performed: a gonadotrophin pulsatility study, with 20 min interval blood sampling for 12 h, a naloxone test and a GnRH test. Flutamide induced a significant increase in both LH and FSH pulse frequency, while pulse amplitudes and plasma integrated concentrations (IC) of LH and FSH were unaffected. Plasma integrated concentrations of testosterone and oestradiol rose significantly, while that of prolactin was unaffected. The increase in plasma LH concentration induced by naloxone injection was abolished by flutamide treatment. On the other hand, the small FSH response to naloxone was unaffected by flutamide treatment. Response to GnRH was unaffected by flutamide. These results suggest that flutamide exerts effective androgen blockade at the hypothalamic level, since, despite increased plasma testosterone concentrations, gonadotrophin pulse frequency increased and the LH response to naloxone was abolished.
Anilides↗