The Journal of urology
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The Journal of urology · Aug 2001
Aging effects on contractility of longitudinal and circular detrusor and trigone of rat bladder.
Aging is associated with bladder dysfunction, including difficult voiding and urinary leakage. Voiding involves reduction in the bladder lumen in all dimensions brought about by contraction of the meshwork of longitudinal, circular and oblique layers of detrusor smooth muscles. Most in vitro physiological studies of the effects of aging on bladder function used the longitudinal detrusor. To understand the region specific effects of aging on bladder function the contractile responses of longitudinal and circular detrusor, and trigone segments of the bladder from young and old rats were monitored. ⋯ The reduction in contractions evoked by bethanechol suggests an age related reduction in muscarinic receptors in the longitudinal detrusor of aged rats. An increase in contractions evoked by electrical stimulation without a change in contractions evoked by bethanechol suggests a decrease in compliance caused by an increase in collagen in the circular detrusor of aged rats. A general decline in all contractile responses, including those evoked by high potassium, suggests reduced membrane depolarization in the trigone of aged rats. The effect of aging is specific to different regions and functional components of the bladder, probably due to changes in muscarinic receptors, collagen and depolarization.
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The Journal of urology · Aug 2001
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialRandomized comparative study of 3 versus 8-month neoadjuvant hormonal therapy before radical prostatectomy: biochemical and pathological effects.
A prospective phase 3 trial was initiated to determine whether 8 compared with 3-month neoadjuvant hormonal therapy reduces prostate specific antigen (PSA) recurrence rates after radical prostatectomy. Our interim analysis includes secondary end points of differences in biochemistry, pathology and adverse events between the 2 groups. ⋯ Ongoing biochemical and pathological regression of prostate tumors occurs between 3 and 8 months of neoadjuvant hormonal therapy, suggesting that the optimal duration of neoadjuvant hormonal therapy is longer than 3 months. Longer followup is needed to determine whether longer therapy alters PSA recurrence rates.
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The Journal of urology · Aug 2001
Long-term followup after laparoscopic nephropexy for symptomatic nephroptosis.
Symptomatic nephroptosis is a rare disease requiring surgical therapy only in select cases. Laparoscopic nephropexy has been reported as minimally invasive treatment for symptomatic patients. We evaluated our long-term outcome after laparoscopic fixation of the kidney with an alloplastic mesh graft. ⋯ Symptomatic nephroptosis is a bothersome disease requiring therapy only after thorough evaluation, including IVP and split renal scan with patients supine and upright. The good clinical outcome and highly satisfactory cosmetic result support laparoscopic nephropexy as the treatment of choice. Short-term and long-term results prove the efficacy of renal fixation with alloplastic mesh graft as minimally invasive therapy with a high success rate.
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We investigate the longitudinal recovery of quality of life after radical prostatectomy in men with localized prostate cancer. ⋯ Most quality of life recovery occurs early after radical prostatectomy, except in several domains, including urinary and sexual, which continue to improve even beyond 2 years postoperatively. Patients should be encouraged that recovery may continue for months or years after surgery.