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Glycosaminoglycan Therapy for Bladder Diseases: Emerging New Treatments.
No full textDamage to the urothelial gycosaminoglycan (GAG) barrier layer is thought to underlie the pathogenesis of several chronic bladder pathologies, including interstitial cystitis/painful bladder syndrome (IC/PBS), chemical or radiation cystitis, and recurrent urinary tract infections (UTIs). Penetration of urinary constituents
into the bladder wall causes C-fiber activation, mast cell activation, and histamine release. The resulting smooth muscle contraction, neurogenic inflammation, and hypersensitivity translate into the urinary urgency and frequency and chronic
pelvic pain that are characteristic symptoms of several chronic bladder conditions. Protecting the urothelium or promptly restoring the GAG layer to prevent the cycle of inflammation and hypersensitization is the basis for the clinical use of intravesical
instillations of sodium hyaluronate–chondroitin sulfate (HA-CS; Ialuril1;IBSA Institut Biochimique SA, Lugano, Switzerland).
In an experimental animal model, HA-CS instillations counteracted the increase of micturition frequency and threshold pressure, and they increased the bladder compliance, following urothelial damage induced by protamine sulfate and potassium
chloride. In the clinical setting, patients with IC/PBS receiving intravesical HA-CS experienced significantly fewer micturitions, increased voiding volumes, symptomatic improvement with respect to pain and urgency/frequency symptom scores, and improved quality of life. In patients with recurrent UTIs, urinary
intravesical HA-CS prompted an almost 90% reduction of episodes per patient per year versus 10% in the control group and, compared with the control group, patients in the HA-CS group lasted 3.5-fold longer between episodes.
The potential role of intravesical HA-CS as GAG replacement therapy in other chronic and challenging bladder conditions, including overactive bladder, calculi, and urothelial cancer, is being investigated. Urothelial damage is the central theme of many chronic bladder pathologies. Intravesical instillation of the sodium hyaluronate 1.6%–chondroitin sulfate 2% combination has proved to be a useful treatment approach for the protection and
replacement of this GAG barrier laye
Immunostaining for placental alkaline phosphatase on fine-needle aspiration specimens to detect noninvasive testicular cancer: a prospective evaluation in cryptorchid men
No full textOBJECTIVE:
To assess, in a 12-year prospective study, the potential for early detection of testicular carcinoma in situ (CIS) by immunocytochemistry, using anti-placental alkaline phosphatase (PLAP) monoclonal antibodies on testicular fine-needle aspiration cytology (FNAC) specimens taken from a group of formerly cryptorchid patients, as such men are at greater risk of developing testicular cancer.
PATIENTS AND METHODS:
Sixty-eight men who had had orchidopexy at the Urological Department of the University of Padova between 1975 and 1983 were evaluated first in 1993, by a protocol including a history, physical examination, testicular ultrasonography and serum tumour markers, to eliminate the presence of testicular cancer. In 57 of the 68 men, specimens taken from bilateral testicular FNAC were stained immunocytochemically using anti-PLAP monoclonal antibodies. After 8 years, the same protocol was repeated on the 57 men, and the follow-up was prolonged until March 2005 for men with previous positive PLAP immunostaining.
RESULTS:
In 1993, six of the 57 men, (10.5%) had unilateral positive immunostaining for PLAP. By 2001, none of these men had developed testicular cancer, while of the other 51 men, only one developed a nonseminomatous tumour. The uninterrupted surveillance of PLAP-positive men showed no overt cancer until March 2005.
CONCLUSION:
The present findings do not seem to confirm the reliability of PLAP immunostaining of testicular specimens from FNAC for detecting CIS. These findings might depend on the geographical variability of both CIS and testicular cancer incidence, as well as on the variable relationship between CIS and successive occurrence of invasive testis cancer
[Mitoxantrone chemoprophylaxis for multirecurrent multifocal superficial bladder tumours: results of a phase 2 controlled study].
No full textLa diagnostica urologica delle disfunzione erettile. In Foresta C, Scandellari C: La disfunzione erettile. sintomo o malattia?
No full textSignificato prognostico e diagnostico dellâ€TMagoaspirato testicolare nel recupero di spermatozoi in soggetti affetti da azoospermia non-ostruttiva
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Testicular fine needle aspiration as a diagnostic tool in nonobstructive azoospermia
No full textAIM:
To report the fine needle aspiration cytology (FNAC) of the testes used as a diagnostic tool in non-obstructive azoospermic patients.
METHODS:
One hundred and twenty-five non-obstructive azoospermic male candidates to intracytoplasmic sperm injetion (ICSI) were analysed for follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone and inhibin B plasma levels. They were classified into three groups on the basis of FNAC: 1) Sertoli cell-only syndrome (SCOS) (70); 2) severe hypospermatogenesis (42); and 3) maturation arrest (13). Then, all men underwent testicular sperm extraction (TESE) for sperm recovery for ICSI.
RESULTS:
Mature spermatozoa were detected by FNAC in 24 of 42 men with severe hypospermatogenesis and nine of 13 men with maturation arrest; while they were retrieved by TESE in 29 of 70 men with SCOS, 35 of 42 men with severe hypospermatogenesis (including the 24 by FNAC) and 10 of 13 men with maturation arrest (including the nine by FNAC). The sensitivity and specificity of FNAC were 44.6 % and 100 %, respectively. There was no difference on testicular volume and hormonal parameters in men with and without sperm retrieved.
CONCLUSION:
These findings suggest that FNAC may be a simple and valid diagnostic parameter in non-obstructive azoospermic men and it may represent a valid positive prognostic parameter for sperm recovery at TESE
Successful repair of iatrogenic rectourinary fistulas using the posterior sagittal transrectal approach (York-Mason): 15-year experience.
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