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Permanent Urology Job in Erie Pennsylvania with Saint Vincent Health Center
PRIVATE PRACTICE Saint Vincent Health System A brief summary of the features of this position, the hospital and the community follows: This 4-person group is based mainly at Saint Vincent Health
Permanent Urology Job in Southwest Kansas with Rural Health Education & Services
KRC.0908.2302.03C Urologist position available at a 99-bed acute care facility accredited by the Joint Commission on Accreditation of Healthcare Organizations, which offers traditional comprehensive
Permanent Urology Job in Northwest Kansas with Rural Health Education & Services
KRC.0508.0801.31 Urologist position available to join 3 physician urology group for a 190+ bed, state of the art medical center and wellness facility. There are currently 90 physicians on their active

Urology / Nephrology News From Medical News Today

Kidneys For Transplant Function Earlier And Last Longer When Preserved In A Machine Compared To The Traditional Box Of Ice
Tue, 06 Jan 2009 06:00:00 -0800
Results from a landmark trial published in the New England Journal of Medicine, show that in transplanted kidneys preserved and transported in a specially designed machine (LifePort Kidney Transporter) the odds for experiencing a delay in recovery of kidney function are 43% lower, and that these kidneys are 48% less likely to fail within a year compared to those stored in the traditional box of ice (cold storage)(1).
2nd Eastern Mediterranean Meeting Of The European Association Of Urology Expected To Highlight Cystectomy
Tue, 06 Jan 2009 01:00:00 -0800
Because the 1st Eastern Mediterranean Meeting (EMM), which was held in Antalya (TR) in 2007, was a great success the 'second edition' will be organised on 23 and 24 January 2009 in the Pyramisa hotel in Cairo (EG). Approximately 250 participants from the eastern Mediterranean area are expected to participate.
Urodynamix Technologies Ltd. Receives FDA 510(k) Clearance For UroNIRS 2000™ Bladder Monitor System
Tue, 06 Jan 2009 00:00:00 -0800
Urodynamix Technologies Ltd. (TSX-V:URO) today announced that it has obtained 510(k) clearance from the U.S. Food and Drug Administration to market the UroNIRS 2000™ Bladder Monitor System - a second generation non-invasive medical device that uses near infrared spectroscopy (NIRS) to aid in the diagnosis of lower urinary tract symptoms (LUTS) in a urology office setting.

BMC Urology - Latest articles

Correlation of three immunohistochemically detected markers of neuroendocrine differentiation with clinical predictors of disease progression in prostate cancer
M Hammad Ather, Farhat Abbas, Nuzhat Faruqui, Mohammad Israr and Shahid Pervez Tue, 30 Dec 2008 00:00:00 -0000
Background: The importance of immuno-histological detection of neuroendocrine differentiation in prostatic adenocarcinoma with respect to disease at presentation and Gleason grade is gaining acceptance. There is limited literature on the relative significance of three commonly used markers of NE differentiation i.e. Chromogranin A (CgA), Neuron specific enolase (NSE) and Synaptophysin (Syn). In the current work we have assessed the correlation of immuno-histological detection of neuroendocrine differentiation in prostatic adenocarcinoma with respect to disease at presentation and Gleason grade and to determine the relative value of various markers. Material and Methods: Consecutive samples of malignant prostatic specimens (Transurethral resection of prostate or radical retropubic prostatectomy) from 84 patients between January 1991 and December 1998 were evaluated by immunohistochemical staining (PAP technique) using selected neuroendocrine tumor markers i.e. Chromogranin A (CgA), Neuron specific enolase (NSE), and Synaptophysin (Syn). According to the stage at diagnosis, patients were divided into three groups. Group (i) included patients who had organ confined disease, group (ii) included patients with locally invasive disease, and group (iii) with distant metastasis. NE expression was correlated with Gleason sum and clinical stage at presentation and analyzed using Chi-Square test and one way ANNOVA. Results: The mean age of the patients was 70 + 9.2 years. Group I had 14 patients, group II had 31 patients and group III had 39 patients. CgA was detected in 33 cases, Syn in 8 cases, and NSE in 44 cases. Expression of CgA was seen in 7% of group I, 37% in group II and 35% of group III patients (p 0.059). CgA (p 0.024) and NSE (p 0.006) had a significantly higher expression with worsening Gleason grade. Conclusion: CgA has a better correlation with disease at presentation than other markers used. Both NSE and CgA had increasing expression with worsening histological grade this correlation has a potential for use as prognostic indicator. Limitations in the current work included small number and retrospective nature of work. The findings of this work needs validation in a larger cohort.
Prostate Cancer - To screen, or not to screen, is that the question?
Charles J Rosser Tue, 23 Dec 2008 00:00:00 -0000
There continues to be controversy regarding serum Prostate-Specific Antigen (PSA) and prostate cancer screening. We anxiously await the results of two large prospective randomized clinical trials (Prostate, Lung, Colon, and Ovary -PCLO screening trial in the US and European Randomized Study of Screening for Prostate Cancer-ERSPC in Europe) assessing the benefits of prostate cancer screening. However the true question to answer may be which cancer to treat and when should we treat it.
The prognostic relevance of interactions between venous invasion, lymph node involvement and distant metastases in renal cell carcinoma after radical nephrectomy
Dragomir P Zubac, Leif Bostad, Tomas Seidal, Tore Wentzel-Larsen and Svein A Haukaas Fri, 19 Dec 2008 00:00:00 -0000
Background: To investigate a possible prognostic significance of interactions between lymph node invasion (LNI), synchronous distant metastases (SDM), and venous invasion (VI) adjusted for mode of detection, Eastern Cooperative Oncology Group performance status (ECOG PS), erythrocyte sedimentation rate (ESR) and tumour size (TS) in 196 patients with renal cell carcinoma treated with radical nephrectomy. Methods: Median follow-up was 5.5 years (mean 6.9 years; range 0.01-19.4). The mode of detection, ECOG PS, ESR and TS were obtained from the patients' records. Vena cava invasion and distant metastases were detected by preoperative imaging. The surgical specimens were examined for pathological stage, LNI and VI. Results: The univariate analyses showed significant impact of VI, LNI, SDM, ESR and TS (p<0.001), as well as mode of detection (p=0.003) and ECOG PS (p=0.002) on cancer specific survival. In multivariate analyses LNI was significantly associated with survival only in patients without SDM or VI (p<0.001) with a hazard ratio of 9.0. LNI lost its prognostic significance when SDM or VI was present. Conclusions: Our findings underline the prognostic importance of the status of the lymph nodes. LNI, SDM, ESR, and VI were independently associated with cancer specific survival after radical nephrectomy. LNI provided the strongest prognostic information for patients without SDM or VI whereas SDM and VI had strongest impact on survival when there was no nodal involvement.
Transurethral resection of the prostate In Northern Nigeria, problems and prospects
S U Alhasan, S A Aji, A Z Mohammed and S Malami Sat, 06 Dec 2008 00:00:00 -0000
Background: Benign prostatic hyperplasia (BPH) is the commonest disease of the urinary tract afflicting the ageing male and is the commonest neoplastic disease in men aged 50 years and above. Transurethral prostatectomy (TURP) is the ultimate treatment of choice for benign prostatic hyperplasia (BPH) due mainly to the preference of minimally invasive surgery, long term relief of symptoms and cost effectiveness1. It is however not available to the majority of Nigerians in need of prostatic surgery in Public Health Institutions. Methods: The records of patients who underwent prostatectomy in Aminu Kano Teaching Hospital, over the period June 2001 to July 2007 were examined. The bio data of patients and laboratory investigations performed were retrieved. Results: Five Hundred and forty two patients were operated upon, out of which 40 were excluded due to open prostatectomy (22 cases), bladder neck stenosis (16) or bladder tumour around the trigone (2). The age range of the patients was 47-110 years with a mean of 67.2 years. 289 patients (80.1%) had urethral catheter in situ at presentation and 11 (3%) patients had SPC of which only 3 (0.85%) had combined urethral stricture and BPH. Only 131 (26%) had their PSA measured which ranged from 2-100 ng/ml out of which 39(29.8% n=131) patients had more than 4ng/ml and cancer of the prostate and 1(0.8%, n=131) patient had a PSA level of 4ng/ml and malignant prostate. Hospital stay was 1-32 days (mean 7.9) and the mean follow up period was 5.6 months (range 0-60) and there were 17.5% complications comprising of urinary tract infection (UTI) 7.2%, Orchitis 2.2%, urinary incontinence 0.6%, atonic bladder 1%, erectile dysfunction 0.6%, cerebrovascular accident 0.4%, myocardial infarction 0.4%, deep vein thrombosis 0.4% and disseminated intravascular coagulopathy (DIC) 0.6% and 1.2% mortality. The cost of treatment inclusive of pre-admission investigations was US$ 615.00 (range US$ 300-1,300) Conclusion: Despite advances in minimally invasive therapy for LUTH/BPH, TURP is the optimum treatment of choice for the ageing male of sub-Saharan Africa. It is however not available to the majority of patients in this region due to poor health allocation and inadequate facilities.
The trends in prostate specific antigen usage amongst United Kingdom urologists – a questionnaire based study
Helena P Burden, Chris R Davis, Sophie Tate, Raj Persad, Chris H Holmes and Kate Whittington Thu, 20 Nov 2008 00:00:00 -0000
Background: Worldwide, the use of prostate specific antigen (PSA) testing as a screen for prostate cancer is contentious. Whilst there is no National UK Screening programme, many men undergo opportunistic screening. This study investigates UK urologist's usage of PSA and the awareness surrounding the Department of Health (DoH) PSA guidelines. Methods: Urologists were sent a questionnaire regarding PSA cut-off values. Results: Of the 733 urologists eligible to participate in this study 346 returned completed questionnaires giving a response rate of 47%. The most commonly generally used age-related PSA cut-off values (36% of respondents) are – 3.5 ng/ml for 50 – 59 year olds, 4.5 ng/ml for 60 – 69 year olds and 6.5 ng/ml for over 70 year olds. Two-thirds (58%, 200/346) of respondents were aware of the DoH PSA guidelines but only 20% (n = 69/346) follow these guidelines. The majority of respondents (68%, n = 234/346) used higher PSA cut-offs than recommended by the DoH. The level of compliance showed marked regional variation with a range from 7% to 44% (median 19%). In addition, it was apparent that lower PSA cut-off values were used in private practice as opposed to the National Health Service. Conclusion: A nationwide lack of agreement on PSA cut-off values may generate a variable standard of care both regionally and in NHS versus private practice. Generally, higher PSA cut-off values are being used than recommended by the DoH guidance.
The influence of high and low levels of estrogen on diurnal urine regulation in young women
Charlotte Graugaard-Jensen, Gitte M. Hvistendahl, Jorgen Frokiaer, Peter Bie and Jens Christian Djurhuus Wed, 19 Nov 2008 00:00:00 -0000
Background: Sex hormones have a pronounced effect on arginine vasopressin (AVP), and therefore on the diurnal water homeostasis. Low and high levels of plasma-estradiol as seen in the follicular phase of the menstrual cycle may therefore alter the diurnal regulation of urine production. Furthermore the structural resemblance of oxytocin to vasopressin has led to speculations about the possible antidiuretic properties of oxytocin under normal physiological conditions. To elucidate the influence of high and low p-estradiol on the regulation of the diurnal urine production, 15 normal menstruating women (21-33 y) underwent two circadian in-patient investigations, both situated in follicular phase. Methods: Admitting the participants solely in the follicular phase resulted in high and low plasma-estradiol whereas plasma-progesterone was similar. Urine and blood samples were taken at predetermined time points to determine plasma AVP, plasma oxytocin, plasma aldosterone, plasma natriuretic peptide (ANP), urinary solute excretions, and urinary excretions of prostaglandin E2 (PGE-2) and aquaporin-2 (AQP-2). Blood pressure was measured every hour. Results: Plasma AVP, plasma aldosterone and plasma ANP were unaffected by the different levels of estradiol. All had marked circadian variations whereas oxytocin did not display any circadian rhythm. High estradiol resulted in lower p-osmolality and p-sodium reflecting a downward resetting of the osmoreceptors. Oxytocin did not correlate with either diuresis or urine osmolality. The diurnal urine production was similar in the two groups as were urine osmolality, excretion of PGE-2 and AQP-2. AQP-2 does not have a circadian rhythm and is not significantly correlated to either AVP or oxytocin under normal physiological conditions. Conclusion: High and low level of estradiol has no influence on the circadian rhythm of AVP or the subsequent urine production. High p-estradiol resets the osmoreceptors for AVP release. Furthermore it appears that oxytocin under normal physiological conditions do not contribute to the overall antidiuretic effect.

Current Opinion in Urology - Current Table Of Contents

Editorial introductions.
Page: viiiDOI: 10.1097/MOU.0b013e32831e44da
Tailoring treatment in benign prostatic hyperplasia management.
Page: 1DOI: 10.1097/MOU.0b013e32831743e7Authors: de la Rosette, Jean JMCH
Watchful waiting in benign prostatic hyperplasia.
Page: 3DOI: 10.1097/MOU.0b013e32831a6ec6Authors: Wiygul, Jeremy; Babayan, Richard K
Phosphodiesterase 5 inhibitors in the management of benign prostatic hyperplasia and erectile dysfunction: the best of both worlds.
Page: 7DOI: 10.1097/MOU.0b013e328316c357Authors: Wong, Peter; Lawrentschuk, Nathan; Bolton, Damien M
Muscarinic receptor antagonists for overactive bladder treatment: does one fit all?.
Page: 13DOI: 10.1097/MOU.0b013e32831a6ff3Authors: Witte, Lambertus PW a,b; Mulder, Wilhemina MC a; de la Rosette, Jean JMCH b; Michel, Martin C a
Perspective of Botox for treatment of male lower urinary tract symptoms.
Page: 20DOI: 10.1097/MOU.0b013e328316c33fAuthors: Ilie, Cristian P a; Chancellor, Michael B b

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