Rat penis as a replantation model.

The aim of this study is to assess the feasibility of rat penile replantation as a new microsurgical training model. The study was performed in 2 parts. ANATOMIC STUDIES: Fifteen Wistar albino rats were used to study and document the penile vascular anatomy. In 5 rats, dissections were performed after colored silicone injections, while 5 rats were operated under anesthesia to develop the strategy of flap elevation. In the remaining 5 rats, microangiographic study was performed with silicone-lead oxide mixture. FLAP STUDIES: As flap studies in 5 rats, penis were elevated based on right-side internal pudendal artery and internal pudendal vein and resutured. In 6 rats, penis were elevated as free flaps, and in 3 rats the penis were implanted in right thigh of the rats being the femoral artery and vein recipient. In the remaining 3 rats, penis were resutured in their original place, with saphenous artery and vein being the recipient and rerouted to the pubic region. At postoperative fifth day, the penis were examined for viability, and selected ones were histologically examined. Rat penis has a dual blood supply from bilateral internal pudendal arteries. Venous drainage is via both crural veins and dorsal vein. One side of the internal pudendal artery and anastomotic vein (branch of pudendal plexus) may be used as the vascular pedicle of the flap. Rat penis may be successfully elevated as a free flap and also may be replanted in its original place.

Transrectal sonographic features of prostatic intraepithelial neoplasia: correlation with pathologic findings.

PURPOSE: This study was conducted to evaluate the transrectal sonographic (TRUS) features of prostatic intraepithelial neoplasia (PIN) by comparing the histopathologic results with TRUS findings in patients who had undergone TRUS-guided prostate biopsy. METHODS: From an initial set of 307 patients who underwent TRUS-guided prostate biopsy, TRUS findings for 44 patients whose pathologic results were consistent with PIN were reviewed retrospectively. Among these 44 patients, 12 had only PIN, 20 PIN associated with prostatitis, and 12 PIN associated with prostate cancer foci. After exclusion of the foci that included PIN associated with prostatitis and PIN associated with prostate cancer at the same site, the pathologic results for the core specimens from the 100 PIN foci were correlated with TRUS findings according to their location. The sonographic features sought were hypoechoic areas and regions of heterogeneous echogenicity. RESULTS: Positive TRUS findings were detected in 43% of PIN and 36% of high-grade PIN (HGPIN) focise. For the HGPIN foci with positive TRUS findings, the detected sonographic features were clusters of millimetric hypoechoic foci (CMHF) (53%), hypoechoic areas with well-defined borders (27%), and heterogeneous echogenicity (20%) (not significant). The sensitivity of the presence of CMHF for the diagnosis of HGPIN was only 19%. CONCLUSIONS: TRUS-detected CMHF may indicate HGPIN. Because of the limited sensitivity of this finding, TRUS detection of CMHF does not warrant biopsy, although these lesions warrant close monitoring.

Long-term results of Anderson-Hynes pyeloplasty in 180 adults in the era of endourologic procedures.

INTRODUCTION: The aim of the present study wasto evaluate the long-term results of adult open pyeloplasties performed by the Anderson-Hynes technique in the era of new endourologic procedures. MATERIALS AND METHODS: The medical records of 180 adult patients who underwent Anderson-Hynes pyeloplasty with a diagnosis of ureteropelvic junction (UPJ) obstruction, were retrospectively reviewed. Pre- and postoperative results were compared with clinical, radiologic and radionuclide studies. The mean age of the patients was 33.2 (16-65) years. The minimum clinical follow-up time was 12 months and the mean time from the operation was 9.4 years (between 1 and 17 years). RESULTS: Success was defined as resolution of symptoms and decrease in pyelocaliceal volume and calicectasis. The overall success rate was 91.1%. The success rate was between 93.1 and 100% in patients with grades I-III and 62.5% in patients with grade IV hydronephrosis and contribute to renal function less than 25%. The pyelocaliceal volume returned to normal in 39 (21.7%) patients, significantly decreased in 82 (45.5%), and the flow of contrast media from renal pelvis to ureter improved in 43 (23.9%) and did not change or increased in 16 (8.9%). The failure happened in the first 3 months in 57% of patients and in long-term follow-up in 43% of patients. CONCLUSION: Despite newer endoscopic techniques, Anderson-Hynes pyeloplasty, with an over 90% success rate remains the gold standard in the treatment of primary UPJ obstruction.

Invasive bladder carcinoma in a patient with Behçet's disease.

We present here a case of invasive bladder carcinoma in a 51-year-old man with Behçet's disease (BD). A radical cystoprostatectomy was performed and postoperative chemotherapy was administered to treat lymph node metastasis. However, the patient died 6 months after the operation. Malignancies associated with BD are very uncommon. The incidence, diagnosis and management of our case is discussed in the present paper.