The potential value of power Doppler ultrasound imaging compared with grey-scale ultrasound findings in the diagnosis of local recurrence after radical prostatectomy.

AIM: To determine the value of power Doppler ultrasound (PDUS) imaging during transrectal ultrasonography (TRUS) in detecting local recurrence after radical retropubic prostatectomy (RRP). MATERIALS AND METHODS: Eighteen patients were evaluated in whom local recurrence of prostate cancer was suspected on the basis of elevated serum prostate-specific antigen (PSA) levels (above 0.4 ng/ml) after RRP with no evidence of metastatic disease. Grey-scale TRUS and PDUS-guided biopsies of the vesicourethral anastomosis (VUA) and perianastomotic soft tissues were obtained after TRUS examinations of the prostatic fossa. The ability to detect locally recurrent prostate cancer using grey-scale TRUS alone was compared with TRUS combined with PDUS. RESULTS: Fifteen of the 18 patients (83%) had positive biopsies for local recurrent tumour at histological examination. TRUS alone detected grey-scale abnormalities in 15 of 18 patients (83%), of whom 14 (77%) had positive TRUS-guided biopsies. PDUS during TRUS showed hypervascularity in 14 of 18 patients (77%). Biopsies of these hypervascular regions were positive in all patients (100%). The sensitivity and specificity of TRUS alone in detecting recurrent tumour were 93 and 67%, respectively, with a positive predictive value (PPV) of 93% and a negative predictive value (NPV) of 67%. TRUS combined with PDUS had a sensitivity and specificity of 93 and 100%, respectively, with a PPV and a NPV of 100 and 75%, respectively.

Women with low libido: correlation of decreased androgen levels with female sexual function index.

The aim of the present study was to investigate a possible correlation between decreased androgen levels and female sexual function index (FSFI) in women with low libido and compare these findings with normal age-matched subjects. In total, 20 premenopausal women with low libido (mean age 36.7; range 24-51 y) and 20 postmenopausal women with low libido (mean age 54; 45-70 y), and 20 premenopausal healthy women (mean age 32.2; range 21-51 y) and 20 postmenopausal healthy women (mean age 53.5; range 48-60 y) as controls were enrolled in the current study. Women with low libido had symptoms for at least 6 months and were in stable relationships. All premenopausal patients had regular menstrual cycles and all postmenopausal patients and controls were on estrogen replacement therapy. None of the patients were taking birth control pills, corticosteroids or had a history of chronic medical illnesses. All completed the FSFI and Beck's Depression Inventory (BDI) questionnaires. Hormones measured included: cortisol; T3, T4 and TSH; estradiol; total and free testosterone; dehydroepiandrosterone sulfate (DHEA-S); sex hormone binding globulin (SHBG). We performed statistical analysis by parametric and nonparametric comparisons and correlations, as appropriate. We found significant differences between the women with low libido and the controls in total testosterone, free testosterone and DHEA-S levels and full-scale FSFI score for both pre- and postmenopausal women (P<0.05). In addition, decreased total testosterone, free testosterone and DHEA-S levels positively correlated with full-scale FSFI score and FSFI-desire, FSFI-arousal, FSFI-lubrication and FSFI-orgasm scores (P<0.05). Our data suggest that women with low libido have lower androgen levels compared to age-matched normal control groups and their decreased androgen levels correlate positively with female sexual function index domains.

Bladder leiomyoma: a rare cause of urinary stress incontinence.

Lejomyoma of the bladder is an uncommon lesion and usually present as small intramural or submucosal lesions. Preoperative evaluation based on careful physical and radiologic examinations must rule out malignant and other lesions. It is readily and successfully treated in most cases with transurethral or open resection. The prognosis of this tumor is excellent and no malignant degeneration has been reported. The most common presentations are obstructive voiding symptoms, irritative symptoms, and hematuria. Occasionally, it may be a cause of urinary stress incontinence. Although this condition is rare, it should be considered in the causes of urinary stress incontinence.

Sarcoma developing in a burn scar: case report and review of the literature.

The development of malignancy in burn scars is a well known entity. However, burn scar sarcomas are rarely seen. This report presents the first case of a leiomyosarcoma arising in a burn scar of scalp in the English literature.

Systemic absorption of gentamicin in penile prosthesis operations.

Irrigation with antibiotic solutions is frequently used in penile prosthesis surgery to avoid infection. We carried out a prospective study to determine the degree of absorption of gentamicin after intracavernous irrigation in 10 patients who underwent penile implantation surgery. All obtained values were below the toxic level of 10 micrograms/ml and decreased gradually within a few hours. We concluded that highly concentrated gentamicin solutions could be used with safety for intracavernous irrigation.

Eosinophilic cystitis induced by mitomycin-C.

Eosinophilic cystitis is an unusual form of cystitis which is characterized by irritative voiding symptoms and haematuria. In the report herein two adult cases of eosinophilic cystitis treated with intravesical Mitomycin-C instillations for prophylaxis of bladder carcinoma are presented and the literature is reviewed.