BRCA1 mutations and prostate cancer in Poland.

Evidence to date that BRCA1 mutation carriers are at an increased risk of prostate cancer is mixed - both positive and negative studies have been published. To establish whether or not inherited variation in BRCA1 influences prostate cancer risk we genotyped 1793 men with prostate cancer in Poland and 4570 controls for three founder mutations (C61G, 4153delA and 5382insC). A BRCA1 mutation was present in 0.45% of the cases and 0.48% of the controls (odds ratio=0.9; P=1.0). The odds ratios varied substantially by mutation. The 5382insC mutation is the most common of the three founder mutations. It was detected only in one case (0.06%), whereas it was seen in 0.37% of controls (P=0.06). In contrast, the 4153delA was more common in prostate cancer cases (0.22%) than in controls (0.04%) (odds ratio=5.1; 95% confidence interval: 0.9-27.9; P=0.1). The C61G mutation was also found in excess in cases (0.17%) compared with controls (0.07%) (odds ratio=2.6; 95% confidence interval: 0.5-12.7; P=0.5). Eight men with prostate cancer carried a mutation. Only one of these carried the 5382insC mutation, compared with 17 of 22 individuals with mutations in the control population (P=0.003). These data suggest that the 5382insC mutation is unlikely to be pathogenic for prostate cancer in the Polish population. The presence of one of the other alleles was associated with an increased risk for prostate cancer (odds ratio=3.6; 95% confidence interval: 1.1-11.3; P=0.045); in particular for familial prostate cancer (odds ratio=12; 95% confidence interval: 2.9-51; P=0.0004). We consider that the risk of prostate cancer in BRCA1 carriers varies with the position of the mutation.

[One-stage urethroplasty for penoscrotal hypospadias using Denis Browne (Michalowski's modification) technique in a 50-year-old man]. / Jednoetapowa operacja spodziectwa mosznowo-kroczowego sposobem denisa browne'a w modyfikacji Michalowskiego u 50-letniego mezczyzny.

Authors present a case of 50-year-old man with penoscrotal hypospadias in whom using one-stage techniques repair urethra was reconstructed with good functional and cosmetic effect.

Bladder outlet obstruction in women: difficulties in the diagnosis.

OBJECTIVE: To identify the difficulties in diagnosing bladder outlet obstruction in women. MATERIAL AND METHODS: 53 women with a mean age of 37.2 (range 16-70) with chronic lower urinary tract symptoms and no neurogenic or organic diseases were examined. The prevalent symptoms were frequency (96%), urgency (92%) and nocturia (75%), and the mean duration of symptoms was 3.8 years. After pressure-flow studies and voiding cystourethrography were conducted, patients either underwent bladder neck or urethral incisions based on their diagnosis. These patients were subsequently subjected to follow-up uroflow studies. RESULTS: Abnormal uroflow curves were observed in 19 of 53 women. In 10 of them (52.6%), bladder outlet obstruction based on pressure-flow results was confirmed. Voiding cystourethrography results from these 19 women confirmed that 17 patients had bladder neck obstruction, while the remaining 2 had urethral obstruction. 16 of 19 were treated endoscopically, with 14 patients undergoing bladder neck incisions through the 5- and 7-o'clock positions and 2 patients having a distal urethral incision through the 12-o'clock position. In all of these 16 cases, there were both a statistical increase in the maximum flow rate (Qmax) as well as an improvement in the flow curves. Symptomatic improvement was observed in 12 of the 16 women subjected to surgical intervention. CONCLUSION: Bladder outlet obstruction exists in women with lower urinary tract symptoms. Pressure-flow studies and voiding cystourethrography are reliable modalities for confirming bladder outlet obstruction. Bladder outlet obstruction can be functionally or structurally caused.

[Treatment of condylomata acuminata with the neodymium laser]. / Leczenie klykcin konczystych za pomoca lasera neodymowego.

The effectiveness of neodymium laser therapy was presented in the treatment of urogenital condyloma acuminata in 55 patients (51 men and 4 women). The patients were followed up 14 days, 4 weeks, 3 months and 6 months after the laser treatment. The main localization of condyloma acuminata was foreskin and glans penis. The cure rate after the 1st session of treatment was 76%, 8.5% of patients required 3 sessions of the laser therapy. After 6 months 7 patients discontinued the follow-up, 89.6% (43 patients) were cured, 2 had the scars of foreskin and 3 suffered from recurrences. Neodymium laser treatment of urogenital condyloma is a safe treatment and no major side effects were encountered.

A case of lichen planus of the penis mimicking leukoplakia lesions: a review of differential diagnosis.

We describe a case of a 50-year-old man with lesions localized in the region of urethral meatus and on the epithelium of the foreskin. The lesions were observed as the white spots with flat or somewhat depressed surface, locally similar to leukoplakia, lichen sclerosus atrophicus or cicatrix, without any subjective symptoms. Cystoscopy, micturition urography and biopsy were performed by urologist. The diagnosis of lichen planus Wilsoni was made based on the biopsy examination. We obtained great improvement of lesions through the applied local therapy

[Ureter injury as a gynecologic surgery complication--prospects for conservative treatment]. / Uszkodzenie moczowodu jako powiklanie operacji ginekologicznej--mozliwosci leczenia zachowawczego.

There we presented three cases of ureteral injury after gynecological operations. In two cases partial ureteral obstruction was treated by creating percutaneous renal fistula. In the latter case, in spite of conservative treatment (double J catheter), a uretero-vaginal fistula was detected.