Prog Urol
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Penile trauma is uncommon, but can be serious due to its urinary and sexual complications. After reviewing the literature, the authors examined three types of trauma of particular interest because of the specificity of the lesions induced and their treatment. The circumstances of onset, the various lesions observed, the complementary investigations required, and the therapeutic modalities are studied for each type of trauma. ⋯ Strangulations can lead to ulceration of the skin and urethral fistula. The causes of strangulation are varied, including the very unusual case of strangulation by a hair in a young circumcised boy. Automutilations of the penis are rare, but, after psychiatric assessment, microsurgical reimplantation can be performed with good functional and aesthetic results.
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Urinary tract infection is frequent during pregnancy with a high potential risk for mother and child. Based on a review of the literature and a retrospective survey conducted in 20 representative French university hospitals during 1993, the authors propose a practical review designed to standardize the therapeutic approach to this disease. ⋯ They evaluate the need for complementary investigations in relation to the 3 clinical presentations encountered (asymptomatic bacteriuria, cystitis and acute pyelonephritis) taking into account their respective adverse effects. The therapeutic modalities of the three clinical forms are then described, including drainage of the urinary tract.
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Androgen-independent progression invariably occurs following castration of patients with prostate cancer. Animal model data suggest that androgen resistance may result from adaptive cell survival mechanisms activated by androgen withdrawal. If this is true, then re-exposure to, or low levels of, androgens may suppress or downregulate these mechanisms. ⋯ Serum and LNCaP tumour mRNA PSA levels remained below precastrate levels by 60 days post-castration in 75% of the IAS group, while serum PSA in all mice in the CAS group exceeded precastrate PSA by 28 days post-castration. Following castration, serum PSA levels increased 9-fold faster with CAS compared to IAS therapy. Observations using IAS in the LNCaP tumour model suggest that the onset of androgen-independent PSA gene regulation is prolonged 3-fold, perhaps due to androgen-induced differentiation and/or downregulation of androgen-suppressed gene expression.