[Prostatic neuroendocrine carcinoma with priapism : a case report].

An 84-year-old man presented with priapism in May, 2009. At 79 years old, he was diagnosed with stage C prostate cancer and then, was treated with hormonal therapy. The serum level of prostate-specific antigen (PSA) was within the normal range (0.02 ng/ml). Penile caverno-dorsal vein shunt (Barry shunt) and caverno-spongiosum shunt (Quackels shunt) were performed for the purpose of managing local symptoms. Following operation, the penile pain was mitigated. Postoperative computed tomography (CT) revealed the enlarged prostate and multiple metastases to lungs and multiple bone metastases. Histological examination of the prostatic needle biopsy revealed poorly differentiated neuroendocrine carcinoma of the prostate.

Upregulation of heme oxygenase and collagen type III in the rat bladder after partial bladder outlet obstruction.

The objective of the study was to evaluate possible changes of the gene expression and localization of the enzymes, heme oxygenase and nitric oxide synthase (NOS), with reference to increase of collagen type III in response to the partial obstruction of the bladder. Following initial obstruction, whole rat bladders were removed for real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. Real-time RT-PCR demonstrated significantly enhanced expression of HO (p < 0.01) and collagen type III (p < 0.001) gene on postoperative day 14. Enhanced expression of NOS gene was seen only on postoperative day 4 (p < 0.01). Immunohistochemistry revealed that immunoreactivity to HO-1 had much in common in neural cells and fibers, although immunoreactivity to HO-2 and iNOS was relatively weak. This study suggested gene expression of HO, especially HO-1, was more dramatically changed than NOS, and was upregulated simultaneously with increase of collagen type III after obstruction. HO systems could be involved in the pathogenesis of bladder dysfunction related to increase of collagen type III after obstruction.

[Primary squamous cell carcinoma of the prostate: a case report].

The patient was a 72-year-old man who visited our hospital with a chief complaint of pollakisuria. Digital rectal examination suggested prostatic carcinoma, but prostate specific antigen level was within normal limits. Transperineal needle biopsy was performed and histology was squamous cell carcinoma. Because of the urinary retention, transurethral resection of the prostate was performed and histological examination revealed squamous cell carcinoma. In spite of radiotherapy and chemotherapy with cis-platinum, the progression of cancer continued. The patient died about 13 months after the diagnosis.

Ultrasonic measurement of bladder weight as a novel urodynamic modality.

Although pressure-flow studies (PFS) are currently recognized as the gold standard for the diagnosis of infravesical obstruction, their clinical use is limited, due to the invasive nature of procedure. Recently, we developed a new urodynamic parameter, ultrasound estimated bladder weight (UEBW), which was calculated from the bladder wall thickness measured ultrasonically and intravesical volume. Our comparative study between UEBW and PFS showed that UEBW diagnosed infravesical obstruction with a diagnosis accuracy of 73% using a cut-off value of 35 gm. UEBW could also be used as a reliable tool in monitoring therapeutic effects on BPH patients in terms of the relief of obstruction. In addition, UEBW is of clinical use in the management of neurogenic bladder dysfunction, in which there was a significant negative correlation noted between UEBW and bladder compliance. Consequently, UEBW could be a reliable predictor for a low-compliant bladder. Since UEBW can be obtained non-invasively, it is readily applicable to pediatric urology. In healthy children, UEBW increased significantly with age. For the evaluation of UEBW in an individual child patient, the deviation from age-matched UEBW, obtained from the formula of the linear correlation between UEBW and age, was employed. In our recent studies, the deviation from age-matched UEBW is likely to be used as a predictor for bladder dysfunction in children, such as secondary vesicoureteral reflux and a low-compliant bladder. In conclusion, UEBW is promising as a non-invasive urodynamic modality capable of evaluating bladder hypertrophy with its functional abnormalities.