Urological Science RSS feed: Current Issue. The Urological Science ( Urol Sci ) is the official peer- reviewed publication of the Taiwan Urological Association. The journal is published quarterly by Elsevier and is indexed in Chemical Abstracts Service, PASCAL, Scopus, EMBase, and ScienceDirect. The Urol Sci aims to publish high-quality scientific research in the field of urology, with the goal of promoting and disseminating medical science knowledge to improve global health. http://www.urol-sci.com/?rss=yesElsevier Inc.en © 2011 Published by Elsevier Inc. Urological Science1879-5226224December 2011 © 2011 Published by Elsevier Inc. healthpermissions@elsevier.comhttp://www.urol-sci.com/article/PIIS1879522611000388/abstract?rss=yesAbstract: Both lower urinary tract symptoms (LUTSs) and erectile dysfunction (ED) are highly prevalent, frequently coassociated, and significantly contribute to the overall quality of life. Numerous cross-sectional epidemiological studies have reported a clear and clinically significant association between LUTSs and ED in aging men worldwide. LUTSs were also demonstrated to be an independent risk factor for ED after controlling for age, comorbidities, and lifestyle factors. Four main pathophysiological mechanisms, including the nitric oxide (NO)/NO synthase (NOS) theory, autonomic hyperactivity, the Rho-kinase activation pathway, and pelvic atherosclerosis, currently support the relationship. New approaches were recommended to evaluate and manage both conditions and select treatment options. In addition to well-known treatment effects of α1-blockers and phosphodiesterase (PDE)-5 inhibitors, α1-blockers can also be beneficial in the treatment of ED, while PDE-5 inhibitors can be beneficial in the treatment of LUTSs. Combination therapy with both agents can improve LUTSs and/or ED via different mechanisms of action. Testosterone replacement therapy (TRT) with or without PDE-5 inhibitors was also reported to improve erectile function and LUTSs in hypogonadal men. Additional studies of combination therapy for LUTSs, ED, and other comorbidities are needed to establish new approaches to achieve optimal management of these conditions in aging men.Lower urinary tract symptoms and erectile dysfunctionChun-Hou Liao, Han-Sun Chiang, Po-Jen Hsiao10.1016/j.urols.2011.06.001Urological Science 22, 4 (2011)2011-11-10Urological Science2011-11-10224S1879-5226(11)X0005-2Mini- Review135140http://www.urol-sci.com/article/PIIS187952261100039X/abstract?rss=yesAbstract: Objective: One of the most common forms of bladder dysfunction is related to the development of unstable bladder contractions (bladder overactivity). Solifenacin is a relatively new, selective, antimuscarinic agent that has been shown to be particularly useful in the treatment of overactive bladder (OAB) dysfunctions in both men and women. Experimentally, we have demonstrated that OAB and obstructive bladder dysfunction are associated with the generation of free radicals and oxidative damage to the bladder. The hypothesis tested was that solifenacin + coenzyme Q10 + α-lipoic acid (CoQ + LA) would be more effective in the treatment of OAB than either would be individually.Materials and methods: Forty-eight male White New Zealand rabbits were separated into 8 groups of 6 rabbits each. The following oral treatments were given to each group: Groups 1 and 5, vehicle (saline); Groups 2 and 6, solifenacin; Groups 3 and 7, CoQ + LA; Groups 4 and 8, solifenacin + CoQ + LA. After three weeks of treatment (by oral gavage), the rabbits in Groups 1–4 received partial outlet obstruction as detailed above. The rabbits continued their treatments for four weeks following surgery. At the end of this four-week period, immediately following urodynamic and physiological studies, the bladder was excised and the muscle and mucosa were separated and frozen for biochemical research.Results: The following marker enzymes were quantitated: choline acetyltransferase, citrate synthase, catalase, superoxide dismutase, and malondialdehyde (MDA, marker for lipid peroxidation). Solifenacin had no effect on citrate synthase activity of the bladder smooth muscle. However, pretreatment with both the antioxidants or the combination of solifenacin + antioxidants protected the citrate synthase activity such that it remained at control values. Partial outlet obstruction (PBOO) resulted in a 60% decrease in choline acetyltransferase activity (ChAT) activity, while solifenacin had no effect on reduced ChAT activity. Both the antioxidant and combination therapy resulted in maintaining ChAT activity at control values. PBOO resulted in a significant increase in MDA of both the muscle and mucosa. For both tissues, all treatments resulted in a significantly lower MDA content. In general, the results demonstrate the combination of solifenacin + antioxidants was more effective than either solifenacin or antioxidants alone.Conclusion: The addition of the antioxidants CoQ + LA works synergistically with solifenacin in the treatment of obstructive bladder dysfunction and OAB.Effect of solifenacin plus and minus antioxidant supplements on the response to experimental outlet obstruction and overactive bladder dysfunction in rabbits—Part 2Turgut Topol, Catherine Schuler, Robert E. Leggett, Tasmina Hydery, Sandra Benyamin, Robert M. Levin10.1016/j.urols.2011.04.001Urological Science 22, 4 (2011)2011-11-21Urological Science2011-11-21224S1879-5226(11)X0005-2Original Articles141146http://www.urol-sci.com/article/PIIS1879522611000406/abstract?rss=yesAbstract: Objective: Today, the role of inflammation in the pathophysiology of benign prostatic hyperplasia (BPH) has become quite evident. Numerous markers have been found which suggests a role of non-bacterial inflammation in the prostate. Despite the recommendation of anti-inflammatory drugs for BPH, research on the effectiveness of such drugs is scant. Hence, the present study examined the effectiveness of celecoxib in treating patients with BPH.Materials and Methods: This single-blind randomized control trial was conducted on 160 patients referred to a urology clinic from 2006 to 2007. Patients were aged ≥50 years, had obstructive and irritative symptoms of BPH, and had American Urological Association (AUA) scores ranging 7–25. They were randomly assigned to control (treated with 2 mg terazosin) and celecoxib (2 mg terazosin with 200 mg celecoxib) groups and underwent 12 weeks of treatment.Results: The baseline measures for the severity of symptoms, postvoiding residual urine (PVR), prostate volume, and prostate-specific antigen (PSA) level did not significantly differ between the two groups. The severity of symptoms and PVR significantly decreased after treatment in both groups. However, the prostate volume and PSA level significantly dropped as well in the celecoxib group. The overall severity of symptoms, irritative symptoms, and prostate volume decreased more in the celecoxib group than in the control group.Conclusion: The present study showed that combination therapy with celecoxib and terazosin can significantly decrease irritative symptoms of BPH and prostate volume as well. Therefore, it seems that adding anti-inflammatory drugs to routine treatment for BPH could be more effective than routine therapy.Effect of celecoxib on benign prostatic hyperplasia: Results of a preliminary studyDavood Goodarzi, Ali Cyrus, Hamid Reza Khoddami Vishteh, Hassan Solhi, Mahdi Shirinkar10.1016/j.urols.2011.07.001Urological Science 22, 4 (2011)2011-11-23Urological Science2011-11-23224S1879-5226(11)X0005-2Original Articles147150http://www.urol-sci.com/article/PIIS1879522611000418/abstract?rss=yesAbstract: Objective: Photoselective vaporization of the prostate (PVP) is an easy-to-learn procedure which shows promise as an alternative to transurethral resection of the prostate (TURP) in treating acute urinary retention with benign prostatic hyperplasia (BPH). In this retrospective study, we evaluated the safety and efficacy of PVP in patients with urinary retention due to BPH.Materials and Methods: In total, 48 male patients aged 60–87 (mean, 72) years were included in the study. Preoperative data, postoperative outcomes, and complications were recorded in patients with a history of urinary retention before surgery.Results: The average prostate volume was 59.2 (range, 41.71–120.1) mL. The respective preoperative prostate-specific antigen (PSA) level was 10.4 ng/mL, and the operative time was 45 (range, 30–90) min. The total applied laser energy ranged 60–120 (mean, 90 ± 25) kJ. The maximal urinary flow rate after surgery 14 mL/s, and the postvoided residual urine volume was 132 mL. Recorded surgical complications were hematuria in 10.4% and transient urinary retention in 8.3%.Conclusion: PVP can improve the uroflow and peak flow rate in patients with urinary retention due to BPH with minimal postoperative discomfort and a low rate of complications.The outcome of a photoselective vaporization prostatectomy using a high-performance system to treat benign prostatic hyperplasia with acute urinary retentionYi-Hsiang Lin, Shao-Ming Chen, Phei-Lang Chang, Chien-Lun Chen, Ke-Hung Tsui10.1016/j.urols.2011.06.002Urological Science 22, 4 (2011)2011-10-31Urological Science2011-10-31224S1879-5226(11)X0005-2Original Articles151153http://www.urol-sci.com/article/PIIS187952261100042X/abstract?rss=yesMost renal traumas are blunting injuries, the majority of which are caused by traffic accidents. Typical symptoms are flank pain, a possible flank mass, and hematuria. In the presence of renal trauma, computed tomography (CT) is the examination of choice for assessing and categorizing renal injury. Renal injuries are classified into five grades of severity according to the American Association of Surgeons on a trauma organ injury severity scale. Surgical treatment or conservative treatment depends on the extent of the renal injury, associated injuries, and the clinical condition of the patient. Follow-up CT examinations are important if severe renal injuries are treated conservatively to observe the condition of recovery of the renal injuries, and also follow up the occurrence of complications.Renal traumaJia-Hwia Wang10.1016/j.urols.2011.06.003Urological Science 22, 4 (2011)2011-11-14Urological Science2011-11-14224S1879-5226(11)X0005-2Practical Uroradiology154156http://www.urol-sci.com/article/PIIS1879522611000431/abstract?rss=yesExamples of tubulocystic carcinoma of the kidney were introduced in an abstract presented at the Annual Meeting of the United States and Canada Academy of Pathology and also in the Armed Forces Institute of Pathology Atlas of Tumor Pathology, Series III, in 1994. However, the morphological features of this rare distinctive renal tumor were described in 1955 by Masson, who designated the lesion a “Bellinian epithelioma” because he regarded it as a neoplasm originating in the collecting ducts of Bellini. The first detailed report of the clinical and pathological details of tubulocystic carcinoma were published in 1997. The authors described the neoplasm as a “low-grade mucinous tubulocystic renal carcinoma of possible collecting duct origin”. The cases were initially considered to be derived from the collecting duct; however, since those reported tumors were of a low-grade malignancy, the behavior of which significantly differed from the classical highly aggressive collecting duct carcinomas, the term “low-grade collecting duct carcinoma” was coined for this peculiar renal tumor.Tubulocystic carcinoma of the kidneyShih-Hao Liu, Yen-Hwa Chang, Chin-Chen Pan10.1016/j.urols.2011.06.004Urological Science 22, 4 (2011)2011-11-11Urological Science2011-11-11224S1879-5226(11)X0005-2Practical Uropathology157159http://www.urol-sci.com/article/PIIS1879522611000443/abstract?rss=yesAbstract: Extrapulmonary small-cell carcinoma (EPSCC) is a rare small-cell carcinoma (SCC). It is recognized as a clinicopathological entity distinct from SCCs of the tracheobronchial tree. EPSCCs account for about 2.5% of all SCCs. SCCs of the kidney are an even rarer neoplasm. Abdominal pain and hematuria are the major clinical symptoms. Many cases are already advanced disease at diagnosis and have poor prognoses. Platinum-based chemotherapy seems to be beneficial for overall survival. We describe an 82-year-old male patient who was seen at the emergency room due to complaints of gross hematuria and right-flank pain. Computed tomography showed a large right renal tumor. Treatment modalities, pathologic features, survival outcome of this case, and a review of similar cases in the literature are presented and discussed. To the best of our knowledge, this is the 21st case of SCC of the kidney reported in the literature to date. It is also the first report in Taiwan of a primary SCC of the kidney with the tumor thrombus extending to the inferior vena cava which required a right radical nephrectomy.Small-cell carcinoma of the kidney: Report of a case and review of the literatureYi-Hong Cheng, Yi-Chia Lin, Chung-Hsin Yeh, Thomas I.S. Hwang, Hung-En Chen10.1016/j.urols.2011.08.011Urological Science 22, 4 (2011)2011-11-07Urological Science2011-11-07224S1879-5226(11)X0005-2Case Reports160162http://www.urol-sci.com/article/PIIS1879522611000455/abstract?rss=yesAbstract: Emphysematous cystitis (EC) is a potentially fatal disease if treatment is delayed. A high index of suspicion is crucial for an early diagnosis of the disorder, which typically occurs in patients with poorly controlled diabetes. Although gas in the bladder is suggestive of EC, other differential diagnoses include a postoperative state, an enterovesical fistula and urological instrumentation. We report on a 73-year-old female diabetic patient who had undergone major surgery for an obstructive common bile duct stone 3 weeks prior to the onset of EC. She presented with an initial picture of severe sepsis, possibly due to a postoperative infection of the urinary and/or biliary tract. She responded well to prompt therapy with antibiotics, adequate drainage of the urinary and biliary tracts, and good glycemic control. She was discharged on hospital day 7 and remained stable during the 3-month follow-up period.Emphysematous cystitis onset after common bile duct stone surgerySheng-Hsuan Chen, Hui-Ming Chung, Tser-Min Wu10.1016/j.urols.2011.01.001Urological Science 22, 4 (2011)2011-10-31Urological Science2011-10-31224S1879-5226(11)X0005-2Case Reports163165http://www.urol-sci.com/article/PIIS1879522611000467/abstract?rss=yesAbstract: Adrenocortical oncocytomas are very rare, with only 47 cases reported in the English literature. They are usually benign and nonfunctional. Herein, we report on a 30-year-old female patient presenting with extreme weight gain (17 kg in a year), moon face, buffalo hump, central obesity and edema in both legs. Computed tomography revealed a 3.2 cm solid left adrenal tumor. A clipless laparoscopic adrenalectomy was performed. Pathology revealed an adrenocortical oncocytoma.Functional adrenal oncocytoma presenting as Cushing’s syndrome: Case report and literature reviewYung-Shu Lee, Wun-Rong Lin, Chi-Kuan Chen, Yi-Wei Pai, Marcelo Chen10.1016/j.urols.2011.02.001Urological Science 22, 4 (2011)2011-11-16Urological Science2011-11-16224S1879-5226(11)X0005-2Case Reports166168http://www.urol-sci.com/article/PIIS1879522611000601/abstract?rss=yesAuthor Index10.1016/S1879-5226(11)00060-1Urological Science 22, 4 (2011)2011-12-01Urological Science2011-12-01224S1879-5226(11)X0005-2IIIhttp://www.urol-sci.com/article/PIIS1879522611000613/abstract?rss=yesKeyword Index10.1016/S1879-5226(11)00061-3Urological Science 22, 4 (2011)2011-12-01Urological Science2011-12-01224S1879-5226(11)X0005-2IIIIVhttp://www.urol-sci.com/article/PIIS1879522611000625/abstract?rss=yesTitle Index10.1016/S1879-5226(11)00062-5Urological Science 22, 4 (2011)2011-12-01Urological Science2011-12-01224S1879-5226(11)X0005-2VVIhttp://www.urol-sci.com/article/PIIS1879522611000637/abstract?rss=yesPlease read this issue of Urological Science and return the postage-paid reply slip with your answers by February 29, 2012. A score of 80% or better will earn three CME credits.CME Test10.1016/S1879-5226(11)00063-7Urological Science 22, 4 (2011)2011-12-01Urological Science2011-12-01224S1879-5226(11)X0005-2VIIVIII