The Effect of Bisphosphonates on Bone Mineral Density in Metastatic Prostate Cancer Patients Who Are Treated with Anti-Androgen Drugs and Radiotherapy.

OBJECTIVE: To evaluate the potential effect of bisphosphonates on bone mineral density (BMD) in patients who are treated with anti-androgen drugs and radiotherapy for metastatic prostate cancer. MATERIALS AND METHODS: The data of 31 patients with metastatic prostate cancer who were treated with anti-androgen drugs and radiotherapy during a 1-year period were retrospectively reviewed. Patients were divided in 2 groups, in which 17 patients in group 1 were treated with zoledronic acid (4 mg/month, intravenous) and 14 patients in group 2 who did not receive zoledronic acid. BMD was measured before the treatment and at the end of the 1st year by dual energy X-ray absorptiometry. Statistical analyses were performed with the T test. RESULTS: Mean age of the patients was 71.42 ± 6.7(range 59-85) years. A significant increase was noted for pelvic bone, femoral neck, and lumbar vertebrae t scores when pretreatment and 1st year measurements were compared in group 1 (p < 0.05). In group 2 a significant decrease was noted for pelvic bone and femoral neck t scores at the end of the 1st year (p < 0.05). A significant increase was noted for pelvic bone and femoral neck follow-up in BMD values at the end of the 1st year compared to initial measurements in group 1. A significant decrease was noted for lumbar vertebrae follow-up in BMD values at the end of the 1st year when compared to initial values in group 2. CONCLUSION: Zoledronic acid significantly increases BMD and delays unfavorable outcomes for bones in men who are treated with anti-androgen drugs and radiotherapy for metastatic prostate cancer.

A unique case of bilateral synchronous testicular tumor with concomitant bilateral diffuse intratubular germ cell neoplasia: testis sparing surgery and local radiotherapy.

Synchronous bilateral testicular germ cell tumors (TGCTs) are seen in exteremely rare cases. Although there is still no standard therapy for bilateral TGCTs, bilateral orchiectomy is recommended as the gold standard treatment. Nevertheless, it has some long-term problems, such as infertility and psychosocial difficulties, and thus some clinicians prefer to perform testis-sparing surgery in appropriate cases. We reviewed the first case of bilateral synchronous TGCT with concomittant bilateral diffuse intratubular germ cell neoplasia in a young single patient, who was treated by a left radical orchiectomy and right testis sparing-surgery with following local radiotherapy to the right residual testicular tissue with previous semen cryopreservation to maintain the ability to father children. We supposed that testis-sparing surgery can be a feasible therapeutic alternative to radical orchiectomy in patients with bilateral TGCTs in terms of improving the quality of life and continuing fertility and normal hormonal status with no medications. However, while the long-term effects are not yet known, this type of treatment should be perpormed in carefully selected cases with longlife expectancy.

Long-term significance of the number of hours until surgical repair of penile fractures.

OBJECTIVES: We investigated whether a delay in time until surgery, in terms of hours, has any effect on the overall long-term results of surgical repair of penile fractures. METHODS: Between 2001 and 2009, we operated on 56 patients with penile fractures. We evaluated 43 patients sorted into 3 groups according to the time interval until surgery. We applied the validated Turkish version of the International Index of Erectile Function (IIEF) questionnaire 3 times: for the time period before the fracture, 1 year after the fracture, and at the time of the study. An erectile dysfunction score was calculated for every patient. RESULTS: Overall, the mean follow-up was 46.1 ± 19.2 months. The mean number of hours from trauma to surgery was 11.3 ± 8.5. There was no statistically significant difference between the 3 groups in terms of age and length of tears. The results of the IIEF questionnaires of each group for time periods and for individual patients in each separate group were statistically similar. CONCLUSIONS: Surgical repair has a good functional outcome and low complication rates in the long term. Neither serious deformities nor erectile dysfunction occur as a consequence of a delay in surgery in the long term in patients with no urethral involvement within a given period of time.