1/5. A case of nephrogenic diabetes insipidus caused by obstructive uropathy due to prostate cancer.Nephrogenic diabetes insipidus (DI) secondary to chronic urinary tract obstruction is a rare disease. The exact cause is unknown but it is likely that increased collecting duct pressures cause damage to the tubular epithelium, resulting in insensitivity to the action of arginine-vasopressin (AVP). A 77-year-old man complaining of polyuria and polydipsia was treated with alpha glucosidase inhibitor under the impression of polyuria due to diabetes mellitus. But his symptoms did not improve. water deprivation and AVP administration study revealed that the patient had nephrogenic DI. urinary tract obstruction due to an enlarged prostate was suggested as a principal cause of nephrogenic DI. The patient underwent transurethral resection of the prostate and bilateral subcapsular orchiectomy. After surgery, the urine osmolarity was normalized and the patient became symptom-free. We report a case of nephrogenic DI due to obstructive uropathy which was cured by surgery eliminating obstruction.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/5. diagnosis and management of incidental ureterocele during the treatment of clinically localized prostate cancer.Two instances of simultaneous diagnosis of prostate cancer and ureterocele were recently identified. In one patient an ectopic ureterocele in a duplex system with an obstructed upper pole was unroofed at the time of radical prostatectomy. Surgical excision of the ureterocele wall provided decompression of the obstructed system. In a second patient, bilateral intravesical ureteroceles associated with normal renal units were left untreated. Complications were not associated with the untreated ureteroceles. On rare occasions a ureterocele may be discovered incidentally during the evaluation of patients with prostate cancer. When radical prostatectomy is planned, treatment of the ureteroceles should be determined by the ureterocele's size, anatomic configuration, and location and by the degree of obstruction of the affected renal unit. Surgical excision of the ureterocele at the time of radical prostatectomy may be the best approach for patients requiring treatment.- - - - - - - - - - ranking = 1.5keywords = cancer (Clic here for more details about this article) |
3/5. Immunosuppressive acidic protein in patients with testicular cancer.serum immunosuppressive acidic protein was compared to lactic dehydrogenase as a marker for testicular cancer in 54 patients with testicular cancer, 62 with benign urological diseases and 203 healthy controls. The mean value of serum immunosuppressive acidic protein in patients with testicular cancer (598 /- 293 micrograms. per ml.) was statistically higher than that in patients with benign disease (429 /- 163 micrograms. per ml.) and healthy controls (368 /- 73 micrograms. per ml.). There were statistically significant differences in serum immunosuppressive acidic protein levels between controls and patients with stage 2 (p less than 0.0001) or stage 3 (p less than 0.001) testicular cancer, and between those with stage 1 and stage 2 (p less than 0.0001) or stage 3 (p less than 0.001) disease, respectively. The usefulness of immunosuppressive acidic protein as a marker for testicular cancer also was compared to that of lactic dehydrogenase. Immunosuppressive acidic protein and lactic dehydrogenase levels were elevated almost equally in patients with stage 2 or 3 disease (range 71 to 92 per cent). However, immunosuppressive acidic protein levels were elevated in only 3 of 25 patients with stage 1 cancer (12 per cent), compared to 11 of 25 (44 per cent) with elevated lactic dehydrogenase levels. Immunosuppressive acidic protein was correlated better with tumor stage. In conclusion, serum immunosuppressive acidic protein determinations may be useful in patients with testicular cancer for staging, monitoring treatment results and predicting recurrence.- - - - - - - - - - ranking = 378.03808472417keywords = testicular cancer, cancer (Clic here for more details about this article) |
4/5. Nondilated obstructive uropathy.Four patients presented with severe renal failure secondary to urinary tract obstruction, yet ultrasonography and/or computed tomography revealed only minimal dilatation in 1 patient and no dilatation in the other three. Two patients had prostate cancer, one had bladder cancer, and one had retroperitoneal fibrosis. In all cases, relief of obstruction led to a dramatic improvement in renal function. These cases, and others in the literature, illustrate that in certain settings severe urinary tract obstruction may be present in the absence of dilatation and hence may be missed by noninvasive imaging techniques. Nondilated obstructive uropathy should be suspected in any elderly patient who presents with the acute onset of oliguria in the absence of an identifiable cause, especially if there is a previous history of malignancy in the pelvis. Left undiagnosed, this potentially reversible cause of renal failure can lead to end-stage renal disease.- - - - - - - - - - ranking = 0.5keywords = cancer (Clic here for more details about this article) |
5/5. disseminated intravascular coagulation in the urologic patient.Gram-negative septicemia and metastatic prostatic cancer are frequent causes of disseminated intravascular coagulation. The clinical manifestations of this condition as well as the laboratory data vary considerably, depending on the patient's compensatory mechanisms in relation to the magnitude and duration of the thromboplastin or endotoxin release. Treatment centers primarily on correcting the underlying disorder. Secondly, deficient clotting factors and platelets should be replaced in the appropriate patient. Heparinization is often unnecessary. The use of drugs that inhibit the protective fibrinolytic mechanism is contraindicated in disseminated intravascular coagulation.- - - - - - - - - - ranking = 0.25keywords = cancer (Clic here for more details about this article) |