The effect of high grade prostatic intraepithelial neoplasia on serum total and percentage of free prostate specific antigen levels.

PURPOSE: It is established that the percentage of free prostate specific antigen (PSA) in serum is low in patients with prostate cancer. An unanswered question is whether a low percentage of free PSA can be explained by high grade prostatic intraepithelial neoplasia alone. We compared the percentage of free PSA in men with high grade prostatic intraepithelial neoplasia alone, prostate cancer, benign prostatic hyperplasia (BPH) and a normal prostate (that is normal digital rectal examination and PSA less than or equal to 2.5 ng./ml.). MATERIALS AND METHODS: From October 1994 through December 1997, 48 men were diagnosed with high grade prostatic intraepithelial neoplasia without concomitant prostate cancer. Of these men 43 with a mean age plus or minus standard deviation of 67.4 +/- 7.8 years comprised our study group. To date none has been diagnosed with cancer during followup. Serum free and total PSA levels were measured, and the percentage of free PSA was calculated. The percentage of free PSA in the 43 men was compared to that in 50 with prostate cancer (mean age 65.4 +/- 7.8 years), 50 with biopsy proved BPH (67 +/- 7) and 43 with a normal prostate (61 +/- 8). RESULTS: There was no significant difference in mean total serum PSA in patients with high grade prostatic intraepithelial neoplasia, prostate cancer or BPH. The percentage of free PSA was significantly lower in patients with prostate cancer (14.9 +/- 6.5%) than those with high grade prostatic intraepithelial neoplasia (20.8 +/- 7.1%), BPH (20.1 +/- 7.3%) or a normal prostate (27.7 +/- 12.2%). There was also no significant difference in the percentage of free PSA between men with high grade prostatic intraepithelial neoplasia (20.8 +/- 7.1%) and those with BPH (20.1 +/- 7.3%). Additionally, men with a normal prostate had a higher percentage of free PSA (27.7%) than those with BPH (20.1%), high grade prostatic intraepithelial neoplasia (20.8%) or prostate cancer (14.9%). CONCLUSIONS: The percentages of free PSA in men with high grade prostatic intraepithelial neoplasia and BPH are similar, and significantly higher than those found in men with prostate cancer.

Mitrofanoff gastrico continente modificado: tecnica de decio streit / Modifying continence gastric Mitrofanoff

Desde enero de 1994 hasta setiembre de 1995 utilizamos el estómago como técnica alternativa para reconstrucciones vesicales en 23 oportunidades; 15 correspondieron a gastrocistoplastias y 8 a neovejigas gástricas. Empleamos la gastrostomía modificada en 5 casos (3 gastrocistoplastias y 2 neovejigas gástricas). La gastrostomía modificada por nosostros es un procedimiento inédito correspondiente a una variante de la gastrostomía clásica en neovejigas gástricas o gastrocistoplastias que garantiza una perfecta irrigación del segmento cateterizable y disminuye el tiempo operatorio. En nuestra casuística las edades oscilaron entre 2 y 58 años con seguimiento postoperatorio de 40 días a 12 meses. De los 5 casos, todos obtuvieron continencia total(AU)

Mitrofanoff gastrico continente modificado: tecnica de decio streit / Modifying continence gastric Mitrofanoff

Desde enero de 1994 hasta setiembre de 1995 utilizamos el estómago como técnica alternativa para reconstrucciones vesicales en 23 oportunidades; 15 correspondieron a gastrocistoplastias y 8 a neovejigas gástricas. Empleamos la gastrostomía modificada en 5 casos (3 gastrocistoplastias y 2 neovejigas gástricas). La gastrostomía modificada por nosostros es un procedimiento inédito correspondiente a una variante de la gastrostomía clásica en neovejigas gástricas o gastrocistoplastias que garantiza una perfecta irrigación del segmento cateterizable y disminuye el tiempo operatorio. En nuestra casuística las edades oscilaron entre 2 y 58 años con seguimiento postoperatorio de 40 días a 12 meses. De los 5 casos, todos obtuvieron continencia total