Penile preservation for male urethral cancer

Tumors of the male urethra are rare, comprising<1% of urologic malignancies. This is a report of a 44-year-old man presented with a 4-month history of gross initial hematuria and dysuria. After examining the patient, we found a firm mass extending 1 cm within the proximal bulbar urethra and a pathologic report of moderately differentiated squamous cell carcinoma. He underwent excision of the involved urethra followed by end-to-end bulbar urethroplasty. External beam radiation was performed at the dose of 6000 Rad, in 33 courses. The patient was followed by surveillance protocol and, no evidence of urethral or bladder tumor was found in the 2-year follow-up with bi-annual cystoscopic examination

[Safety and efficacy of anticholinergic and alpha-blocker combination therapy in treatment of benign prostatic hyperplasia]

Although voiding symptoms are classically related to BPH, as many as 50% of patients can experience irritative symptoms. We compared safety and efficacy of combination therapy using alpha-blocker with anticholinergic agents with tamsulosin alone. We compared anticholingergic and alpha-blocker combination therapy versus alpha-blocker alone in BPH patients with dominant irritative symptoms in a clinical trial during 2006. Eighty four patients who fulfilled the inclusion/exclusion criteria were randomly divided into two groups of tamsulosin monotherapy versus tamsulosin and an anticholinergic agent combination therapy. Therapeutic efficacy and safety were analyzed using international prostate symptom score [IPSS] and residual urine volume. Total IPSS was significantly improved in both groups. We considered significant improvements in total IPSS were also seen for the combination therapy group [P=0.0008 within group], but not for the monotherapy group. At the end of treatment, median PVR was not significantly higher for the co-therapy group [51.6 mL] than for the monotherapy group [47.0 mL] [P=0.173]. There was no retention in either group. Combination of alpha-blocker and anticholinergics in BPH patients with dominant irritative symptoms is a reasonable and safe therapeutic option without any increase in urinary retention rate

Synchronous contra lateral transitional cell carcinoma [TCC] of the kidney and bladder

Synchronous upper urinary tract tumor and superficial bladder tumor are uncommon. This is a report of a 62- year- old man presented with episode of painless gross hematuria and flank pain. We worked him up and found a left renal mass and bladder lesion. He underwent nephrectomy and TUR-BT, and the pathology report of both showed a high grade urothelial transitional cell carcinoma. The patient was followed by surveillance protocol for ureter stump. Our report included an uncommon case of high grade synchronous upper urinary tract and bladder transitional cell carcinoma

Tamsulosin and spontaneous expulsion of ureteral stones

ureteral stones have a high rate of spontaneous expulsion, especially when they are smaller than 6 mm. some medications including corticosteroids, Ca channel blockers and alpha-blocker have been used by some to enhance spontaneous stone passage. In this paper we evaluate the effect of Tamsulosin in spontaneous stone passage in a clinical trial study. We performed clinical trial study of 100 renal colic patients with lower ureteral stones and stone size less than 7 mm determined by CT scan, KUB or ultrasonography of UVJ region who didn't have UTI, intractable pain or any indications of immediate intervention during January 2006 and April 2007.50 of the patients got only standard regime of analgesics and 50 of them got standard regime and Tamsulosin [0.4 mg/d]. The stone expulsion rate was 60% [30/50 patients] for group A and 86% [43/50] for group B [P=0.01] with a mean expulsion time of 8.1 +/- 2.2 [range 3.5-12] and 5.1 +/- 2.7 days [range 1.8-10.5] [P=0.005]. Tamsulosin increase spontaneous stone passage and decrease expulsion time and analgesic use significantly

[ unusual case of transitional cell carcinoma of renal pelvis presenting with brain metastases]

Transitional cell carcinoma of renal pelvis presenting with brain metastases is a very rare case which should be diagnosed and treated in order to prevent further damages. We report a rare case, who had presented with a constellation of neurological symptoms [due to multiple brain metastases], but without any urological symptoms. During evaluation of patient, we found transitional cell carcinoma [TCC] of left renal pelvis, for which palliative radical nephroureterectomy was performed. Although transitional cell carcinoma of renal pelvis presenting with brain metastases is a very rare case, but the patient was managed with gamma knife stereotactic radiosurgery for the metastatic lesions. Afterward he received four cycles of paclitaxel and carboplatin chemotherapy. The patient is alive with stable disease at 32-months' follow-up