Association between the evidence of human papilloma virus infection in bladder transitional cell carcinoma in men and cervical dysplasia in their spouses

Cervical cancer is one of the most common tumors in women. One of its risk factors is direct contact with viruses, in particular human papillomavirus [HPV]. Recent studies have shown a prevalence of 2%-35% for HPV in cases with bladder cancer. In addition, some malignancies of the urogenital organs in males may promote the probability of cervical cancer in their spouses. In this study, the relationship between cervical dysplasia in women and evidence of HPV infection in tissue specimens obtained from their spouses' bladders has been investigated. This cross-sectional study was conducted on 82 male patients with bladder tumors and their spouses between February 2004 and February 2007 in Tehran. We gathered data related to the histopathology of the transitional cell carcinoma [TCC] in men and Pap smear tests of their spouses. Tissue specimens of patients with bladder TCC were analyzed for HPV infection using polymerase chain reaction [POR]. HPV-positive specimens were tested for subtypes 16 and 18. In 24 [29.3%] men, bladder tumor samples were positive for HPV infection. Of these, we found HPV-18 infection in 9 [37.5%], while 3 [12.5%] were infected with HPV-16. In the spouses of those men with HPV-infected bladder tumors, 4 [4.9%] cases had cellular dysplasia noted on their Pap smear tests. We found no dysplasia in those women whose husbands had bladder TCC, but no HPV infection [P = 0.006]. It is possible to decrease the incidence of bladder TCC in men and cervical cancer in women through public education regarding the methods of transmission and avoidance of risky sexual behaviors

Ureteral calculi in children: What is best as a minimally invasive modality?

Minimally invasive treatment of ureteral calculi in children is a challenging topic. In an evidence-based review, we evaluated the efficacy and safety of extracorporeal shock wave lithotripsy [SWL] and ureteroscopic modalities for this group of patients. In this study, we performed a comprehensive systematic review on articles appeared in the PubMed from 1998 to March 2008. We selected all papers addressing SWL or ureteroscopic management of the ureteral calculi in children and determined the level of evidence of the presenting data. Thirty-nine articles were reviewed and 24 with valid information on SWL or ureteroscopic management of the pediatric ureteral calculi were analyzed. Six articles [25%] were randomized controlled trials and 18 [75%] were retrospective case-controls or case series. The following data were extracted from the 24 articles: in SWL groups, overall success rate was 84.1% [range, 71% to 100%] for the upper ureteral calculi and 76.2% [range, 19% to 91%] for the lower ureteral calculi. Only 61% of the patients had only 1 treatment course, while 8% and 31% of the cases required 2 and more than 2 sessions of treatment, respectively. With ureteroscopic management, the overall success rates were 93.2% [range, 81% to 100%] and 74.4% [range, 20% to 100%] in the lower and upper ureteral calculi, respectively. The main limitations of the series on minimally invasive treatment of pediatric ureteral calculi are lack of powerful randomized controlled trials or prospective data and insufficient patients numbers. Therefore, it is difficult to draw absolute conclusions about successful treatment based on current knowledge

Diagnosis of bladder cancer by urine survivin, an inhibitor of apoptosis a preliminary report

Survivin is an inhibitor of apoptosis that is expressed in undifferentiated tissues like tumors. Detection of survivin in urine has been proposed as a diagnostic marker for bladder cancer. We evaluated the urine samples of patients with bladder cancer for survivin and compared them with healthy controls. The urine specimens of 20 patients with transitional cell carcinoma [TCC] of the bladder [group 1] and 18 controls without cancer [group 2] were collected before cystoscopy and assessed for survivin by reverse transcriptase polymerase chain reaction. All patients except 1 in group 1 were men. Urine specimens were positive for survivin in 18 [90%] and 9 [50%] patients of groups 1 and 2, respectively [P = .007]. Sixteen patients with TCC had urine cytology, of which 6 [37.5%] were positive. Urine survivin was positive in all 10 patients with negative cytology. Nine patients in this group had low-grade tumors. Urine survivin seems to have a higher sensitivity than urine cytology, especially in low-grade bladder cancer. The quantitative measurement of survivin in urine by advanced techniques may provide a better diagnostic and prognostic tool. However, the clinical use of survivin and its association with different stages and grades of TCC still requires more studies