Urological Science - Articles in Press

A rare, highly aggressive primitive neuroectodermal tumor of the kidney: Case report and literature review - Corrected Proof

Chia-Cheng Su, Chien-Liang Liu, Ching-Nan Lin, Ying-Huei Lee, Kun-Hung Shen — 2012-05-14

Abstract: We report a case of a 14-year-old boy who initially suffered from a sudden onset of abdominal pain for 2 weeks with a protrusive soft mass over the left upper abdomen. No obvious symptomatic symptoms or body weight loss were observed. However, early lung metastasis was detected after an initial computed tomographic examination. Even after we performed salvage en bloc resection of the huge retroperitoneal tumor after primary neoadjuvant chemotherapy, the final outcome was still poor. A diagnosis according to radiologic findings was uncharacteristic. Finally, a pathologic diagnosis based on histologic and immunohistochemical results revealed a rare renal peripheral primitive neuroectodermal tumor.

Renal arteriovenous malformation - Corrected Proof

Jia-Hwia Wang — 2012-05-14

Congenital renal arteriovenous malformations (AVMs) are abnormal communications between the renal arterial and venous systems through a vascular nidus that forms a cluster of multiple, enlarged, tortuous arteriovenous communications. They are uncommon, with a prevalence of < 1% among the general population. The clinical presentation, diagnostic imaging examinations, and management of renal AVMs are described below.

Tissue-engineered constructs for urethral regeneration - Corrected Proof

Kuo-Liang Chen, Hsi-Chin Wu, Chao-Hsiang Chang — 2012-05-14

Abstract: Those who have urethral injury, long-distance urethral stricture, hypospadias, or epispadias need tissue for urethral repair. Tissue engineering is one of the solutions for urethroplasty. Three components essential for tissue engineering are cells, scaffolds, and bioactive factors. Several animal studies of tissue-engineered urethras have been conducted and progressed to human clinical trials by 1999. These studies have shown that the maximum distance for normal tissue regeneration in tubularized urethral replacement with unseeded matrices is 0.5cm. Although autologous tissue-engineered tabularized urethras have been successful in clinical trials, this method could be an alternative treatment for urethral reconstruction.

Ketoconazole in Taiwanese castration-resistant prostate cancer patients: Evaluation of response rates, durations, and predictors - Corrected Proof

Bing-Juin Chiang, Yeong-Shiau Pu, Hong-Jeng Yu, Chao-Yuan Huang — 2012-05-14

Abstract: Background/purpose: To evaluate the efficacy of ketoconazole in castration-resistant prostate cancer.Materials and methods: We reviewed the medical records of consecutive patients with pathologically confirmed prostate cancer from May 2006 to December 2008. The inclusion criteria were: (1) receiving 200 or 400 mg ketoconazole three times daily and replacement doses of prednisolone; (2) antiandrogen withdrawal for at least 2 months before ketoconazole treatment; and (3) no prior cytotoxic agents or other CYP17 inhibitors. Treatment consisted of ketoconazole at 200 mg three times daily (Group A) and 400 mg three times daily (Group B). Patients' characteristics, time to prostate-specific antigen (PSA) progression, duration of PSA response, and adverse events were evaluated.Results: Of the 37 patients in Group A, 14 (37.8%) experienced a PSA response. Of the seven patients in Group B, four (57.1%) experienced a PSA response. Median durations of time to progression in those who experienced a > 50% PSA decline were 7.5 and 11.5 months in Group A and Group B, respectively. Median duration of PSA response was 5.5 and 9.0 months in Group A and Group B, respectively. There was no difference in the PSA response or time to progression between the two groups. Orchiectomy had a borderline unfavorable effect on the PSA response rate (p = 0.067).Conclusion: The present study demonstrated that ketoconazole contributed to the PSA response in patients with castration-resistant prostate cancer. The efficacy and toxicity profiles were comparable to those in previous studies. Orchiectomy had a borderline unfavorable effect on PSA response rate. Further studies are required to confirm the efficacy of ketoconazole therapy in surgically castrated patients.

Holmium laser-assisted endoscopic extraction of a fishhook from the male urethra - Corrected Proof

Hui-Ming Chung, Sheng-Hsuan Chen — 2012-05-11

Abstract: A man 37 years of age presented with frequency and dysuria. Rigid cystoscopy revealed the presence of a fishhook in the anterior urethra. Initial attempts to remove the fishhook in one piece by forceps or a basket were unsuccessful. The fishhook was cut into two pieces using a holmium laser via a 9-Fr ureteroscope and removed by forceps. The anterior urethra experienced a minor tear during the procedure. He voided well without significant urethral stricture 6 months postoperatively. An open urethrotomy is usually indicated for unsuccessful endoscopic removal of foreign bodies from the male urethra, which often leads to recurrent urethral stricture. The novel use of a holmium laser to facilitate the endoscopic removal of a fishhook from the male urethra may reduce the risk of postoperative urethral stricture.

Ureteroscopic manipulation of ureteral calculi: Experience in a regional hospital - Corrected Proof

Yi-Chang Li, Ying-Sheng Pan, Shih-Liang Chen, Chia-Yen Chang — 2012-05-11

Abstract: Objective: We report our experience in the treatment of ureteral calculi by ureteroscopic stone manipulation (URS-SM).Materials and methods: In 2009, 420 patients with ureteral calculi underwent a total number of 438 URS-SMs with a lithoclast, holmium laser, or both. All patients were evaluated by plain radiography, sonography, and excretory urography prior to the operation. Follow-up studies included plain film and sonography that were done immediately and 2 weeks after the operation.Results: The overall stone-free rate was 95.4%. According to the location of the stones, respective success rates for upper, middle, and lower ureteral stones were 88.4%, 97%, and 100%. The most common cause of failure was stone migration (4.5%).Conclusion: Ureteroscopic lithotripsy is a trustworthy procedure for treating ureteral calculi of different sizes at all levels, and it can be efficaciously and safely performed in expert hands.

Prognostic significance of genetic polymorphisms on prostate-specific antigen recurrence after a radical prostatectomy - Corrected Proof

2012-05-11

Abstract: Approximately one-third of patients with prostate cancer show prostate-specific antigen (PSA) recurrence (biochemical failure) after a radical prostatectomy and are prone to developing metastasis with significant mortality. Although several clinicopathologic indicators, such as the PSA level, Gleason score, pathologic stage, and surgical-margin status, are used to predict outcomes after a curative-intended radical prostatectomy for localized prostate cancer, new biomarkers are still required to improve the prognosis and plan appropriate adjuvant therapy, particularly for patients at high risk of recurrence. DNA-based genetic biomarkers have several advantages over clinicopathologic indicators because they can be preoperatively examined, are easily evaluated, and can be interpreted more objectively without individual bias. In this study, the literature was reviewed from the PubMed database using the keywords “genetic polymorphisms” and “radical prostatectomy” from 1985 to April 2011. The results showed that genetic variants discovered from genome-wide association studies (such as rs1447295, rs1447295, rs6983561, rs13254738, Broad11934905, rs6983267, and rs7000448 at 8q24, rs7920517 and rs10993994 at 10q11, rs10486567 in the 7JAZF1, rs198977 in the KLK2, rs9282861 in the SULT1A1, and rs1536889 in the TLR4 gene) and single-nucleotide polymorphisms (SNPs) in important pathways (RUNX1, FGFR4, EGFR, VEGF, TNFRSF11B, vitamin D receptor, p53, WNT, inflammatory, androgen synthesis, and metabolism pathways) on prostate cancer occurrence and progression could serve as biomarkers to predict PSA recurrence after a radical prostatectomy. Including the genetic information might improve predictions of PSA recurrence after a radical prostatectomy. Future studies can be dedicated to confirming these findings in other ethnic cohorts and clarifying the roles of these SNPs/genes in the course of prostate cancer progression after a radical prostatectomy through functional analyses.

Practical urodynamics in children, part 2: Normal uroflowmetry curve is not a guarantee of normal voiding function - Corrected Proof

Stephen Shei-Dei Yang, Shang-Jen Chang — 2012-05-11

Since uroflowmetry and postvoiding residual (PVR) urine tests are noninvasive and relatively inexpensive, they are regarded as first-line screening tools for evaluating pediatric voiding function. The International Children's Continence Society states that bell-shaped uroflowmetry curves usually imply normal voiding function in children. Herein, we present a girl with voiding dysfunction who had a normal bell-shaped uroflowmetry curve because of abdominal straining.