Substitution Urethroplasty With Buccal Mucosal Graft in the Management of Stricture of Vesicourethral Anastomosis or Membranous Urethra: Single-institution Long-term Experience With Perineal Approach and Endourethroplasty.

OBJECTIVE: To present long-term experience with buccal mucosa posterior urethroplasty (BMPU) for refractory posterior urethral stenosis (PUS) or vesicourethral anastomosis stenosis (VUAS) either by perineal approach (PA) or by endourethroplasty (EUP). MATERIALS AND METHODS: A single-center retrospective study of 38 consecutive patients operated on between 1999 and 2022. BMPU consisted of the transfer of onlay or tubular buccal mucosa grafts into dilated and/or incised strictures through an open or endourological approach. If VUAS or PUS recurred with short stenosis within the first 12 months after surgery, it was transected by a cold-knife direct vision internal urethrotomy (DVIU), referred to as an "auxiliary" DVIU. The primary outcome was 3-year stricture recurrence-free survival (SRFS). RESULTS: BMPU by perineal approach and EUP were performed in 27 (71%) and 11 (29%) patients, respectively. The 3-year SRFS was 65% for the whole cohort, with rates of 63% for the perineal approach and 73% for endourological approach. With permitted auxiliary DVIU, 3-year SRFS for the whole cohort was 81%. De novo incontinence occurred in 2 out of 18 preoperatively continent patients. Limitations include the retrospective nature of the single-center study and a small, heterogenous cohort of patients. CONCLUSION: We present 2 techniques of substitution urethroplasty with BMG in the management of PUS and VUAS with a low rate of recurrence or de novo incontinence. A novel endourological approach (EUP) is a promising minimally invasive alternative to the perineal approach.

Determination of common urine substances as an assay for improving prostate carcinoma diagnostics.

Recently, interest in the identification of non-invasive markers for prostate carcinoma detectable in the urine of patients has increased. In this study, we monitored the abundance of potential non-invasive markers of prostate carcinoma such as amino acid sarcosine, involved in the metabolism of amino acids and methylation processes, ongoing during the progression of prostate carcinoma. in addition, other potential prostate tumor markers were studied. The most significant markers, prostate-specific antigen (PSA) and free PSA (fPSA), already used in clinical diagnosis, were analyzed using an immunoenzymometric assay. Whole amino acid profiles were also determined to evaluate the status of amino acids in patient urine samples and to elucidate the possibility of their utilization for prostate carcinoma diagnosis. To obtain the maximum amount of information, the biochemical parameters were determined using various spectrophotometric methods. All results were subjected to statistical processing for revealing different correlations between the studied parameters. We observed alterations in most of the analyzed substances. Based on the results obtained, we concluded that the specificity of prostate carcinoma diagnosis could be improved by determination of common urine metabolites, since we compiled a set of tests, including the analysis of sarcosine, proline, PSA and uric acid in the urine. These metabolites were not observed in the urine obtained from healthy subjects, while their levels were elevated in all patients suffering from prostate carcinoma.

Caveolin-1 as a potential high-risk prostate cancer biomarker.

Current diagnostic techniques of prostate cancer cannot efficiently distinguish the latent and low-risk forms from the high-risk significant forms of prostate cancer. Caveolin-1 (Cav-1), except other functions, plays an important role in cell transformation and the process of tumorigenesis. Furthermore, Cav-1 is involved in metastatic processes. It has also been shown that Cav-1 expression is induced under stress conditions, such as oxidative stress. The present study focused on the determination of prognostic markers of aggressive (high-grade) forms of prostate cancer. We determined serum Cav-1 and serum markers of antioxidant activity-glutathione (GSH), 2,2-diphenyl-1-picrylhydrazyl (DPPH), Trolox equivalent antioxidant capacity (TEAC), ferric-reducing antioxidant power (FRAP), N,N-dimethyl-1,4-diaminobenzene (DMPD), free radicals method (FRK) and blue chromium peroxide (Cro) in 97 serum samples (82 prostate cancer patients and 15 controls). We found insignificant differences in Cav-1 between the sera of patients and controls (5.69 in the cancer group vs. 5.42 ng/ml in the control group). However, we found a significant (p<0.004) 2.8-fold elevation of Cav-1 in high tumour stages (TNM T4) compared to lower stages and a significant positive association with histological grading (r=0.29, p=0.028). We also found that in patients with high serum Cav-1 the antioxidant capacity of the body is reduced. These findings indicate that Cav-1 may be an interesting tool for the prediction of disease burden.