[Urinary problems and prostate-specific antigen in a Norwegian normal population]. / Vannlatingsplager og prostataspesifikt antigen i en norsk normalpopulasjon.

BACKGROUND: Measurements of PSA in serum is crucial in the diagnostic work-up of prostatic diseases. MATERIAL AND METHODS: We have studied the distribution of PSA values in an unselected population of 609 men, and the relation between PSA level and urinary symptoms, age and prostate volume. RESULTS: 87 (14%) men had a PSA concentration at or above the reference value of 4.0 ng/ml. Prostate cancer was verified in 14 (16%) of these men. The probability of having PSA equal to or above 4.0 ng/ml was 12 times greater for men with a prostate volume of 40 cm3 or less than for men with a prostate volume less than 20 cm3. Mean PSA values were higher in men with severe than with mild urinary symptoms, but symptoms were poor predictors of PSA levels. Age was not associated with an increase in PSA level independent of prostate volume. INTERPRETATION: Absence of urinary symptoms does not exclude elevated PSA values and thus not cancer. Most men with PSA equal to or above 10.0 ng/ml will have prostate cancer, but enlarged prostate without cancer can also give elevated PSA values.

Lower urinary tract symptoms, prostate volume and uroflow in norwegian community men.

OBJECTIVE: To describe lower urinary tract symptoms, prostate volume and peak urinary flow rate, and investigate the relationships among urological variables in a community sample of Norwegian men. MATERIALS AND METHODS: A cross-sectional study of 611 men, aged 55-70 years, who underwent a clinical urological examination including uroflowmetry, residual urine measurement, and transrectal ultrasonography of the prostate. All the men completed a questionnaire which included the International Prostate Symptom Score (IPSS). RESULTS: Severe symptoms were reported by 5%, while 23.6% reported moderate symptoms, and the overall median IPSS was 4 (q1 = 25th percentile, 1; q3 = 75th percentile, 9). The median peak flow rate was 15 ml/s (q1 = 11; q2 = 22) while median prostate volume was 30 cm(3) (q1 = 23; q3 = 38), with little variation evident across the narrow age range of 55-70 years. A positive modest correlation (r = 0.176) was found between IPSS and prostate volume, and a negative correlation between IPSS and peak flow rate (r = -0.278). There was a modest correlation between body mass index (BMI) and prostate size, but no significant correlation between BMI and IPSS. CONCLUSION: In this population-based study, moderate lower urinary tract symptoms were reported by 24% and severe symptoms by 5% of community men. The distribution of lower urinary tract symptoms, prostate volume and peak urinary flow rate in Norwegian men is comparable to that described in similar studies conducted in Spain, Holland and USA.

[Penis fracture]. / Penisfraktur.

Fracture of the penis is a rare condition caused by blunt trauma to the erect penis resulting in tearing of the tunica albuginea. The injury occurs mainly during sexual intercourse or as a result of forceful manipulation. Two cases are described. Diagnosis is based on the patient's narrative and the clinical findings. One patient was treated by immediate surgery, while the other was treated by corrective surgery for his disabling posttraumatic penile deformity. Based on available literature and our own observations we recommend immediate surgical repair in order to avoid serious complications.

Sexual function after transurethral prostatectomy.

The potency of 98 men who underwent transurethral resection for benign prostatic enlargement was assessed before and after operation in a prospective study. Preoperatively, 38 could not maintain their erections long enough to achieve coitus. Three months after operation a decrease in erectile ability had been experienced by three of the remaining 60 patients, while two reported an improvement. At the six-month follow-up two of these patients stated that they had recovered their preoperative potency, while the third patient still experienced reduced erectile function. Examination showed normal penile blood pressure but testing with papaverine showed reduced tumescence.

Blood transfusion and survival following surgery for renal carcinoma.

The effect of peri-operative blood transfusion on survival after surgery for renal carcinoma was studied in 201 patients. In addition to blood transfusion, several other factors were included in a multivariate analysis. Using Cox's proportional hazards model, transfusion of more than 4 units of blood was found to be an independent prognostic factor in addition to tumour stage, erythrocyte sedimentation rate and macrohaematuria.

Orchidectomy or LHRH-analogue? Which do the patients prefer and what treatment would Norwegian urologists prefer if they had advanced cancer of the prostate?

Since January 1989, we have carried out a prospective study about whether patients prefer orchidectomy or medical castration with luteinising hormone releasing hormone analogues for the treatment of prostatic cancer. When the preliminary results were presented, 40 Norwegian urologists were asked which treatment they would prefer if they had advanced cancer of the prostatic gland. Most patients and urologists (65-70%) favoured medical castration.

[Perinephritic abscess]. / Perinefrittisk abscess.

In spite of technical advances in diagnostic radiology the recognition of a perinephric abscess is still a challenge to even the most experienced urologist. Untreated perinephric abscesses result in considerable mortality. We present ten years experience from 17 patients. All underwent open drainage procedures. In our case this still seems to be the treatment of choice for the majority of these patients. Percutaneous drainage is an alternative to surgery, and is particularly suitable for the high risk patient.