Can J Urol
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Biography Historical Article
A meaningful legacy: urologists as Nobel Prize laureates.
To review the careers of two urologists among Nobel Prize-winners in medicine, W. Forssmann and C. H. Huggins, and the significance of their contributions. ⋯ The distinguished accomplishments of these two great urologists exemplify the highest level of excellence in science for the entire surgical and urological community. Furthermore, today's breakthroughs in molecular medicine represent an extremely appealing challenge for the new generation of scientists and clinicians.
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To accommodate the small size of the infant urethra, finer, more flexible tubes are often used for urinary catheterization in the pediatric intensive care units. These tubes have the ability to knot in the bladder, occasionally requiring surgical removal. ⋯ Review of the literature from 1975 to 2000 identified 19 cases of urethral catheter knotting in the pediatric bladder with two reports of prostatic urethral involvement. Herein, we describe the first reported instance of catheter knotting within the penile urethra and describe the surgical technique employed for its removal.
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Practice Guideline Guideline
Adjuvant chemotherapy for deep muscle-invasive transitional cell bladder carcinoma - a practice guideline.
To examine the role of adjuvant chemotherapy in the treatment of patients with deep muscle-invasive transitional cell carcinoma (TCC) of the bladder who have undergone cystectomy. ⋯ As randomized trials have not proven a benefit in overall survival, adult patients with deep muscle-invasive TCC of the bladder should not be routinely offered adjuvant chemotherapy following cystectomy. Disease-free survival may be improved by adjuvant chemotherapy, but it is unclear whether this improvement compensates for the detrimental effects of chemotherapy. If a patient chooses adjuvant chemotherapy to improve disease-free survival they should be made aware of the lack of proven overall survival benefit, and a cisplatin-based combination chemotherapy regimen such as MVAC or CMV is recommended. RCTs of gemcitabine-cisplatin and dose-intensive MVAC plus G-CSF in the setting of metastatic TCC of the bladder provide indirect evidence that these regimens could offer equivalent benefit to MVAC and CMV but with less toxicity in patients with muscle-invasive disease. The use of these regimens in the adjuvant setting after cystectomy is currently being evaluated in a randomized trial (EORTC trial 30994).
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The Genito-Urinary Radiation Oncologists of Canada (GUROC) have produced a consensus statement on radiotherapy in prostate cancer. This paper summarizes the consensus statement with regard to risk grouping and the role of hormones and radiotherapy. Survival is the most important outcome in the assessment of patients treated with radiotherapy. ⋯ Adjuvant hormone treatment should not be routinely used in low- and intermediate-risk prostate cancer. Neoadjuvant hormone treatment is recommended prior to radiotherapy in patients with bulky tumors. The results of ongoing research will further clarify the use of hormone treatment with radiotherapy.