The prostate-specific antigen (PSA) has been considered a useful tumor marker in monitoring responses, disease progression and recurrence after therapy in patients with prostatic cancer. However. The effect of digital rectal examination on serum PSA determination has remained controversial. The author. therefore. investigated the influence of examination on seurm PSA values. Blood samples were taken before (T0) and 5 minutes (T1), 1 hour (T2), 24 hours (Ts) and I week (T4) after digital rectal examination and the concentration of serum PSA was measured using a Tandeme radioimmunometric assay in 49 persons including 7 patients with prostatic cancer. 27 patients with BPH and 15 controls free of prostatic disorder, The following results were obtained. 1. In normal control group. the mean (+/-SD) PSA values before and 5 minutes, 1 hour. 24 hours and l week after digital rectal examination were 1.51+/-1.12, 2.12+/-1.57. 2.53+/-1.62, 2.39+/-1.41 and 1.97+/-1.20 (ng/ml) respectively. Although serum PSA values measured at 5 minutes. 1 hour, 24 hours and 1 week after digital rectal examination were significantly elevated (p<0.05), most of post-examination PSA values remained within the normal range. 2. In benign prostatic hyperplasia. statistically significant differences between PSA values before and 1 hour and 24 hours after digital rectal examination were observed (p<0.05), while in prostatic cancer group. there were no significant differences between paired pre-examination and post-examination mean PSA values. 3. There were statistically significant differences between PSA values before and 5 minutes, 1 hour, 24 hours and 1 week after rectal examination in normal-value group (<4.0 ng/ml) and between PSA values before and 1 hour after rectal examination in high-value group (>4.0 ng /ml). These results suggest that the evaluation of the concentration or PSA level for prostatic cancer suspected should be done before or immediately after prostatic manipulation.
Digital Rectal Examination* ; Disease Progression ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Recurrence ; Reference Values

No abstract available.
Erectile Dysfunction* ; Male

PURPOSE: The artificial erection is critical to chordee repair. We report the use of a natural erection induced by prostaglandin E(1)(PGE1) in the diagnosis and treatment of penile curvatu re as an alternative to artificial erection in children and adult patients. MATERIALS AND METHODS: Pharmacological erection was induced 14 children with a mean age of 5 years (range 1-10) and 8 adults with a mean age of 33 years (range 18-58) to diagnose and repair anomalies, such as simple penile curvature, chordee with or without hypospadias, webbed penis and Peyronie's disease. Alprostadil (1-16ng) as a agent for induce erection was used exclusively, but no agents were routinely given to reverse the erection was used exclusively, but no agents were routinely given to reverse the erections. The dose injected intracavernosally was dependent on the patient's age, penile size and response, and ranged from 0.5 to 10 micrograms. Time to and adequacy of erection, detumescence, changes in blood pressure and pulse rate were monitored. RESULTS: A dilatation of erectile tissue was achieved within 8 minutes and was judged adequate in 2 and excellent in 20. The mean duration of erection was 107 minutes, while a prolonged erection, for up to 2.5 hours, occured on 2 patients who were treated conservatively. Detumescence were occurred when the corpora were opened, but re-erected penis after closure of corpora in 7 cases who treated with Nesbit's corporeal plication or fibrous plaque excision and dermal graft. Although there were the impression of increased bleeding, there were no specific changes in blood pressure or pulse rate. CONCLUSIONS: Pharmacological erection in penile curvature is effective and reliable with no significant complications. Although PGE1 is expensive and induced slightly increased bleeding, pharmacological erection has the advantage of tumescence of the entire penis and consequently a constant and natural representation of chordee without corporeal or urethral injury. Therefore, the erection achieved by injecting PGE1 into the corpora cavemosa is a useful alternative to artificial erection in the diagnosis and treatment of penile anomalies.
Adult ; Alprostadil ; Blood Pressure ; Child ; Diagnosis ; Dilatation ; Female ; Heart Rate ; Hemorrhage ; Humans ; Hypospadias ; Male ; Penile Induration ; Penis ; Transplants

No abstract available.
Laparoscopy* ; Ureter*

No abstract available.
Urodynamics*

No abstract available.
Priapism*

No abstract available.
Priapism*

The bilateral vanishing testes syndrome is a rare condition in which the vanishing testes were once present but atrophied due to compromise in blood supply. We present a case of bilateral vanishing testes syndrome which was confirmed with laparoscopy and exploratory laparotomy following hormonal therapy The diagnosis of vanishing testes syndrome can be established by following criteria without surgical exploration. These criteria include a normal male phenotype with XY karyotype, absence of Mullerian structures on rectal examination or ultrasonography, elevated gonadotropins(FSH alone or FSH and LH), and no significant increase in serum testosterone after hCG stimulation. However, patients who do not fit these criteria should have laparoscopy or exploration to look for occult gonadal tissue and spermatic vessels.
Diagnosis ; Gonads ; Humans ; Karyotype ; Laparoscopy ; Laparotomy ; Male ; Phenotype ; Testis* ; Testosterone ; Ultrasonography

To evaluate the typical appearance and the influence in the image interpretation of the metallic artifact which is known as one of the patient-related field artifacts, we analysed the magnetic resonance (MR) images of 40 patients (the total number of metallic materials were 45) acquired at MR 1.5T unit. All patients were screened for the presence of metal. The metallic implants were surgical wires and clips, orthopedic devices, and the other miscellaneous materials. The artifacts produced by metallic objects can be seen on MRI as the focal loss of signal and/or the local distortion of the image. Regardless of their ferromagnetic properties, metallic implants created regional artifacts in their images. Ferromagnetic materials, such as a lead fragment, showed severe artifacts and nonferromagnetic metals showed mild to moderate artifacts. The conspicuity of artifact was related tot he composition, mass, shape, orientation, and the location of the metallic objects in the body. Under high magnetic field strength, there were no significant differences between the various pulse sequences. Artifacts are particularly prominent on gradient-echo images. Our findings indicate that MR imaging of patients with standard nonferromagnetic metallic materials can be successfully performed and usefully interpretated.
Artifacts* ; Humans ; Magnetic Fields ; Magnetic Resonance Imaging* ; Magnets ; Metals ; Orthopedics

Cryptorchidism or an undescended testis is one of the most common congenital anomalies found at birth and affects about 3% of full-term male newborns. A cryptorchid testis can be located anywhere between the abdominal cavity and just outside the scrotum, and 80% of undescended testes are palpable. Approximately three-fourths of cryptorchid testes will spontaneously descend, usually by 3 months of age. Children with retractile testes require annual follow-up until puberty or the testis is no longer retractile. Determination of whether the testis is present on physical examination is critically important because it guides further workup and treatment. Although radiological evaluation does not have a relevant role in the assessment of undescended testes and would not influence surgical management, many physicians have been performed it to verify the location and condition of cryptorchid testis. The efficacy of hormonal treatment is less than 20% and is significantly dependent on pretreatment testicular location. Therefore, surgical repositioning of the testis within the scrotal sac, i.e., orchiopexy, remains the gold standard for the management of undescended testes and it should be performed between 6 and 12 months of age because spontaneous descent occurs uncommonly thereafter, and in order to prevent the complications and long-term sequelae of cryptorchidism, such as testicular torsion, trauma, infertility, and testicular cancer. Recently, laparoscopy has attained its greatest degree of general acceptance, both diagnostically and therapeutically, in the realm of pediatric urology for the management of a nonpalpable testis.
Abdominal Cavity ; Child ; Cryptorchidism ; Follow-Up Studies ; Humans ; Infant, Newborn ; Infertility ; Laparoscopy ; Male ; Orchiopexy ; Parturition ; Physical Examination ; Puberty ; Scrotum ; Spermatic Cord Torsion ; Testicular Neoplasms ; Testis ; Urology