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Skin Diseases Erythema Multiforme Rarely, bullae develop on preexisting maculo- papular lesions, giving rise to the bullous form of Erythema multiforme is an acute or subacute self- the disease. In the oral cavity small vesicles limiting disease that mainly involves the skin and develop that rupture and leave an eroded surface mucous membranes. Lesions obscure, a plethora of different agents, such as may be seen anywhere in the mouth, but the lips drugs, infections, radiation, endocrine factors, and the anterior part of the mouth are most com- neoplasia, collagen diseases, and physical factors monly involved (Fig. The occurs chiefly in young adults between 20 and 40 diagnosis is primarily based on clinical criteria. Men are more frequently affected the differential diagnosis includes stomatitis than women. The disease affects mainly the skin and has a sudden onset with the occurrence of red medicamentosa, Stevens-Johnson syndrome, toxic macules and papules in a symmetrical pattern on epidermal necrolysis, pemphigus, bullous and ero- sive lichen planus, cicatricial pemphigoid, bullous the palms and soles and less commonly on the face, neck, and trunk. These lesions are small and pemphigoid, primary herpetic gingivostomatitis, may increase in size centrifugally, reaching a and recurrent aphthous ulcers. A histopathologic examina- periphery remains erythematous, but the center tion of the lesions is suggestive of the disease. Stevens-Johnson Syndrome extremely painful erosions covered by grayish- white or hemorrhagic pseudomembranes (Fig. The lips usually show characteristic bloody severe form of erythema multiforme that predom- crusting. The dromal systemic illness (fever, cough, weakness, ocular lesions consist of conjunctivitis, but corneal malaise, sore throat, arthralgias, myalgias, ulceration, anterior uveitis, or panophthalmitis diarrhea, etc. Stevens-Johnson syndrome, widespread erosions covered by hemorrhagic crusting on the lips and tongue. They may be either pathogenesis of the disease still remains unclear, the typical maculopapular eruption of erythema and an underlying immune mechanism seems multiforme, but more commonly are bullous or most probable. The mortality rate of the conjunctivae, and erythema, which begins on untreated patients ranges from 5 to 15%. Diag- the face and extremities and rapidly extends to the nosis is based mainly on clinical criteria. In the oral mucosa there is severe inflammation, vesiculation, and Laboratory findings. Histopathologic examination painful widespread erosions, primarily on the lips, is supportive of the diagnosis. Large doses of systemic steroids and Similar lesions may be seen on the eyelids, con- antibiotics if considered necessary. A great variety of etiologic factors have been incriminated, but mainly drugs, such as antibiot- ics, sulfonamides, sulfones, nonopiate analgesics, nonsteroidal anti-inflammatory agents, and anti- epileptic drugs, are thought to be responsible for the disease. Viral, bacterial, and fungal infection, malignant diseases, and radiation have also been 22. Toxic epidermal necrolysis, characteristic detachment of epidermis, resembling scalding. Toxic epidermal necrolysis, severe erosions covered by hemorrhagic crusting on the lips. Pemphigus be involved, but the soft palate, buccal mucosa, and lower lip predominate. Lesions on other Pemphigus is a chronic autoimmune bullous dis- mucosal surfaces (conjunctivae, larynx, nose, ease that affects the skin and mucous membranes pharynx, genitals, anus) may eventually develop and has a reasonable prognosis. On the skin, a high incidence in Mediterranean races (Jews, bullae that rupture easily, leaving eroded areas, Greeks, Italians) without, however, usually are seen and exhibit a tendency to enlarge as the exhibiting any familial distribution. When the disease is confined to immunologic criteria, four varieties of pemphigus the oral mucosa, diagnosis usually may be delayed can be recognized: pemphigus vulgaris, pemphi- for 6 to 11 months due to the nonspecific nature of gus vegetans, pemphigus foliaceus, and pemphi- oral lesions and the low index of suspicion. The differential diagnosis of oral lesions includes cicatricial pemphigoid, bullous pemphigioid, der- Pemphigus Vulgaris matitis herpetiformis, erythema multiforme, ero- sive and bullous lichen planus, herpetic gingivo- Pemphigus vulgaris is the most common form of stomatitis, aphthous ulcers, and amyloidosis. It has been reported that in more than 68% of the Pemphigus Vegetans cases the disease presents initially in the oral cavity, where it may persist for several weeks, Pemphigus vegetans is a rare variant of pemphigus months, or even years before extending to other vulgaris. Clinically, bullae that rapidly rupture leav- tical to those of pemphigus vulgaris, but the ing painful erosions are seen (Fig. They denuded areas soon develop hypertrophic granu- show little evidence of healing, extend peripher- lations. They may occur in any part of the body, ally, and the pain may be so severe that dysphagia but are more common in the intertriginous areas. A characteristic feature Lesions are rare in the mouth, but vegetating of the oral lesions of pemphigus is the presence of lesions may form at the vermilion border and small linear discontinuities of the oral epithelium angles of the lips (Fig. The course and surrounding an active erosion, resulting in epithe- prognosis are similar to those of pemphigus vul- lial disintegration. Treatment of all forms of pemphigus includes systemic corticosteroids in high doses, Pemphigus foliaceus represents a superficial, less azathioprine, cyclosporine, and cyclophos- severe but rare variant of pemphigus. The lesions may spread to involve the entire skin, resembling Pemphigus very rarely affects persons less than 20 a generalized exfoliative dermatitis. It is now well documented that mucosa is rarely affected with small superficial pemphigus vulgaris, foliaceus, and erythematosus erosions (Fig. It has been reported that in 13 of 14 young patients with Pemphigus Erythematosus pemphigus vulgaris (93%) the disease began in the Pemphigus erythematosus is a rare superficial va- oral cavity and the female to male ratio was 1. The disease is clinically charac- sions are seen, which may persist and exhibit a terized by an erythematous eruption similar to tendency to enlarge (Fig. The clinical and that of lupus erythematosus and by superficial laboratory features of juvenile pemphigus are bullae concomitant with crusted patches, resem- similar to those seen in pemphigus of the adults. Sometimes, the differential diagnosis includes other bullous the disease coexists with lupus erythematosus, diseases affecting children, such as herpetic gin- myasthenia gravis, and thymoma. The oral givostomatitis, juvenile bullous pemphigoid, mucosa is very rarely affected with small erosions juvenile dermatitis herpetiformis, erythema mul- (Fig. Pemphigus erythematosus, characteristic erythema and superficial crusting lesions on the "butterfly" area of the face. Paraneoplastic Pemphigus spaces and along the basement membrane zone are common findings, and circulating "pemphigus- Paraneoplastic pemphigus is a rare recently like" antibodies at high titer are also present. All described autoimmune variant of pemphigus reported patients with paraneoplastic pemphigus characterized by skin and mucosal lesions in have had poor prognoses. The differential diagnosis includes other forms of the clinical features of the disease are charac- pemphigus, erythema multiforme, cicatricial and terized by a) polymorphous skin lesions often bullous pemphigoid. Helpful laboratory tests include painful, treatment-resistant erosions of the oral histopathologic examination, direct and indirect mucosa and the vermilion border of the lips immunofluorescence. Systemic corticosteroids in association and C3 deposition in epidermal intercellular with the treatment of underlying neoplasm. Cicatricial Pemphigoid involving the gingiva, although ultimately other sites in the oral cavity may be involved. The Cicatricial pemphigoid, or benign mucous mem- mucosal lesions are recurrent vesicles or small brane pemphigoid, is a chronic bullous disease of bullae that rupture, leaving a raw eroded surface autoimmune origin that preferentially affects mu- that finally heals by scar formation (Fig. Frequently, occurs more frequently in women than in men the disease affects exclusively the gingiva in the (1. The oral mucosa is invariably affected and, in 95% of ocular lesions consist of conjunctivitis, symble- the cases, the mouth is the initial site of involve- pharon, trichiasis, dryness, and opacity of the ment. The most consistent oral lesions are those cornea frequently leading to complete blindness 208 22. Less commonly, other mucosae the differential diagnosis includes pemphigus vul- (genitals, anus, nose, pharynx, esophagus, larynx) garis, bullous pemphigoid, linear IgA disease, are involved (Fig. Skin lesions occur in bullous and erosive lichen planus, dermatitis her- about 10 to 20% of the cases and consist of bullae petiformis, erythema multiforme, Stevens-John- that usually appear on the scalp, face, and neck son syndrome, and lupus erythematosus. Helpful laboratory tests include histopathologic examination and direct immuno- fluorescence of oral mucosa biopsy specimens. Skin Diseases Childhood Cicatricial Pemphigoid Laboratory tests to confirm the diagnosis are direct and indirect immunofluorescence and his- Cicatricial pemphigoid is a chronic autoimmune topathologic examination. However, at least eight well-documented cases of cicatricial pem- phigoid of childhood have been recorded so far. Five of the patients were girls and three were Bullous Pemphigoid boys, aged 4 to 18 years. All patients except one Bullous pemphigoid is a chronic autoimmune had oral lesions, and in four, desquamative ging- mucocutaneous bullous disease that affects ivitis was the cardinal manifestation of the disease women more frequently than men (1. However, well- mucosa, eyes, genitalia, anus, and skin are identi- documented cases have been described in child- cal to those seen in cicatricial pemphigoid of adult- hood. Clinically, the cutaneous lesions begin as a the differential diagnosis includes juvenile bul- nonspecific generalized rash and ultimately large, lous pemphigoid, juvenile pemphigus, childhood tense bullae develop that rupture, leaving dermatitis herpetiformis, childhood linear IgA denuded areas without a tendency to extend disease, childhood chronic bullous disease, and peripherally.

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Prostate cancer is characterized by epigenetic silencing of 14-3- 3sigma expression. Prostate specific antigen velocity in men with total prostate specific antigen less than 4 ng/ml. Invasive urodynamic studies are well tolerated by the patients and associated with a low risk of urinary tract infection. Monotherapy versus combination drug therapy for the treatment of benign prostatic hyperplasia. Lower urinary tract symptoms suggestive of benign prostatic obstruction-Triumph: the role of general practice databases. A demographic profile of patients undergoing transurethral resection of the prostate for benign prostate hyperplasia and presenting in acute urinary retention. An endourologic approach to complete ureteropelvic junction and ureteral strictures. Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms-long-term follow-up of a placebo- controlled, double-blind, multicenter trial. 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Molecular cloning, enzymatic characterization, developmental expression, and cellular localization of a mouse cytochrome P450 highly expressed in kidney. Drug treatments for lower urinary tract symptoms secondary to bladder outflow obstruction: focus on quality of life. A systematic review of Cernilton for the treatment of benign prostatic hyperplasia. Alfuzosin for treatment of lower urinary tract symptoms compatible with benign prostatic hyperplasia: a systematic review of efficacy and adverse effects. Doxazosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects. Detrusor instability with equivocal obstruction: A predictor of unfavorable symptomatic outcomes after transurethral prostatectomy. The history of endocrine therapy of benign and malignant diseases of the prostate. Lower urinary tract reconstruction for spina bifida - does it improve health related quality of life. Cytoplasmic induction and over-expression of cyclooxygenase-2 in human prostate cancer: implications for prevention and treatment. Prevalence of lower urinary tract symptoms and urinary incontinence in the elderly: recent data from Austria. Long-term outcome of transrectal high- intensity focused ultrasound therapy for benign prostatic hyperplasia. Survey on the Italian outpatient urologists regarding the management of benign prostatic hyperplasia. A role of intravesical capsaicin instillation in benign prostatic hyperplasia with overactive bladder symptoms: the first reported study in the literature. The 3-dimensional structure of isolated and small foci of prostatic adenocarcinoma: the morphologic relationship between prostatic adenocarcinoma and prostatic intraepithelial neoplasia. A simple technique for calculation of the volume of prostatic adenocarcinomas in radical prostatectomy specimens. Differential expression of the ccn3 (nov) proto-oncogene in human prostate cell lines and tissues. Nuclear chromatin texture analysis of nonmalignant tissue can detect adjacent prostatic adenocarcinoma. Urinary incontinence and voiding dysfunction after radical retropubic prostatectomy (prospective urodynamic study). Photoselective potassium-titanyl-phosphate laser vaporization of the benign obstructive prostate: observations on long-term outcomes. Elevated resistin is related to inflammation and residual renal function in haemodialysed patients. Prostate cancer vs hyperplasia: relationships with prostatic and adipose tissue fatty acid composition. Trabeculation of urinary bladder by ultrasound in patients with benign prostatic hyperplasia. Acinetobacter infections in patients with human immunodeficiency virus infection: microbiological and clinical epidemiology. Cost effectiveness of treatment for benign prostatic hyperplasia: an economic model for comparison of medical, minimally invasive, and surgical therapy. Virtual reality surgical simulation for lower urinary tract endoscopy and procedures. Tretinoin prevents age-related renal changes and stimulates antioxidant defenses in cultured renal mesangial cells. Drug Insight: 5alpha-reductase inhibitors for the treatment of benign prostatic hyperplasia. Prostate volume and serum prostate-specific antigen as predictors of acute urinary retention. Relationship among serum testosterone, sexual function, and response to treatment in men receiving dutasteride for benign prostatic hyperplasia. Eosinophilic crystals as a distinctive morphologic feature of a hyaline droplet nephropathy in a mouse model of acute myelogenous leukaemia. A phase I trial of etanidazole and hyperfractionated radiotherapy in children with diffuse brainstem glioma. Relief by botulinum toxin of voiding dysfunction due to benign prostatic hyperplasia: results of a randomized, placebo-controlled study. Management of bladder, prostatic and pelvic floor disorders with botulinum neurotoxin. Expression of Lewis carbohydrate antigens and chromogranin A in human prostatic cancer. Laparoscopic prostatectomy with vascular control for benign prostatic hyperplasia. Intravesical prostatic protrusion is better than prostate volume in predicting the outcome of trial without catheter in white men presenting with acute urinary retention: a prospective clinical study.

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Muscle systems of the lower urinary tract of the male rhesus monkey (Macaca mulatta): histomorphology and 3-dimensional reconstruction. Urtica dioica agglutinin: separation, identification, and quantitation of individual isolectins by capillary electrophoresis and capillary electrophoresis-mass spectrometry. In vivo proton magnetic resonance spectroscopy of diseased prostate: spectroscopic features of malignant versus benign pathology. Management of benign prostate hyperplasia: an overview of alpha- adrenergic antagonist. Markers of bone turnover for the management of patients with bone metastases from prostate cancer. Percutaneous endoscopic trigonoplasty in children: long-term outcomes and modifications in technique. No change in calculated creatinine clearance after tenofovir initiation among Thai patients. Isoflavones and the prevention and treatment of prostate disease: is there a role. Applications of Fourier transform infrared microspectroscopy in studies of benign prostate and prostate cancer. Irrigation fluid absorption during transurethral resection of the prostate: spinal vs. Evaluation of infectious etiology and prognostic risk factors of febrile episodes in neutropenic cancer patients. Clinical correlation of prostatic lithiasis with chronic pelvic pain syndromes in young adults. Effectiveness of lidocaine lubricant for discomfort during pediatric urethral catheterization. The role of a lipido-sterolic extract of Serenoa repens in the management of lower urinary tract symptoms associated with benign prostatic hyperplasia. Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms. Distribution of chronic prostatitis in radical prostatectomy specimens with up-regulation of bcl-2 in areas of inflammation. Usefulness of procalcitonin and C-reactive protein rapid tests for the management of children with urinary tract infection. Does the prostatic vascular system contribute to the development of benign prostatic hyperplasia. A prospective randomized trial comparing transurethral prostatic resection and clean intermittent self-catheterization in men with chronic urinary retention. Simultaneous extraperitoneal laparoscopic radical prostatectomy and intraperitoneal inguinal hernia repair with mesh. Quantitative and qualitative assessment of flowmetrograms in patients with prostatodynia. The lipidosterolic extract of Serenoa repens in the treatment of benign prostatic hyperplasia: a comparison of two dosage regimens. Pharmacokinetics of clarithromycin in the prostate: implications for the treatment of chronic abacterial prostatitis. Pharmacokinetics of intravenously administered pefloxacin in the prostate; perspectives for its application in surgical prophylaxis. A slight decrease in renal function further impairs bone mineral density in primary hyperparathyroidism. Ultrasound screening of asymptomatic siblings of children with vesicoureteral reflux: a long-term followup study. Holmium laser enucleation of the prostate for glands larger than 100 g: an endourologic alternative to open prostatectomy. Holmium laser resection v transurethral resection of the prostate: results of a randomized trial with 2 years of follow-up. Holmium laser versus transurethral resection of the prostate: a randomized prospective trial with 1-year followup. Lower urinary tract injury during gynecologic surgery and its detection by intraoperative cystoscopy. Interleukin-8 is a paracrine inducer of fibroblast growth factor 2, a stromal and epithelial growth factor in benign prostatic hyperplasia. Analysis and reliability of data from 24-hour frequency-volume charts in men with lower urinary tract symptoms due to benign prostatic hyperplasia. Dutasteride improves objective and subjective disease measures in men with benign prostatic hyperplasia and modest or severe prostate enlargement. Accuracy of prostate volume measurements using transrectal multiplanar three-dimensional sonography. Hemodynamic interaction study between the alpha1- blocker alfuzosin and the phosphodiesterase-5 inhibitor tadalafil in middle-aged healthy male subjects. Combined effect of terazosin and finasteride on apoptosis, cell proliferation, and transforming growth factor-beta expression in benign prostatic hyperplasia. Induction of apoptosis in human prostate stromal cells by 4-hydroxytamoxifen: an alternative therapy for benign prostate hyperplasia. Lower urinary tract symptoms and erectile dysfunction are highly prevalent in ageing men. Outcome of transurethral prostatectomy for the palliative management of lower urinary tract symptoms in men with prostate cancer. Case-control prostate cancer screening studies should not exclude subjects with lower urinary tract symptoms. A trial study: the effect of low dose human chorionic gonadotropin on the symptoms of benign prostatic hyperplasia. Re: Transurethral resection of prostate and suprapubic ballistic vesicolithotripsy for benign prostatic hyperplasia with vesical calculi (Kamat et al; J Endourol 2003; 17:505-510) and Per-urethral endoscopic management of bladder stones: does size matter. Retroperitoneal laparoscopic radical nephrectomy and nephroureterectomy and comparison with open surgery. Effect of lower infundibulopelvic angle, lower infundibulum diameter and inferior calyceal length on stone formation. The presence and structure of circulating immune complexes in patients with prostate tumors. Saw palmetto berry extract inhibits cell growth and Cox-2 expression in prostatic cancer cells. Doxazosin gastrointestinal therapeutic system: a review of its use in benign prostatic hyperplasia. Urothelial cancer of the bladder in an area of former coal, iron, and steel industries in Germany: a case-control study. The role of combination therapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia. Initial experience with laparoscopic ipsilateral ureteroureterostomy in infants and children for duplication anomalies of the urinary tract. First-line treatment for symptomatic benign prostatic hyperplasia: is there a particular patient profile for a particular treatment. Tadalafil for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. A prospective pilot study to validate the management protocol for patients presenting with acute urinary retention: a community-based, nonhospitalised protocol. Periprostatic nerve blockage reduces postoperative analgesic consumption and pain scores of patients undergoing transurethral prostate resection. Comparison of tamsulosin and naftopidil for efficacy and safety in the treatment of benign prostatic hyperplasia: a randomized controlled trial. Positive bladder cooling reflex in patients with bladder outlet obstruction due to benign prostatic hyperplasia. Prognostic value of pressure- flow study in surgical treatment of benign prostatic obstruction. Benign hyperplasia of the human prostate is associated with tissue enrichment in chondroitin sulphate of wide size distribution. Predictive factors for nocturia in elderly men: a cross-sectional study in 21 general practices. Evaluation of the fibroblast growth factor system as a potential target for therapy in human prostate cancer. Transurethral ethanol injection therapy for prostatic hyperplasia: 3-year results. Ethanol injection therapy of the prostate for benign prostatic hyperplasia: preliminary report on application of a new technique.

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The potential value of (Myo)fibroblastic stromal reaction in the diagnosis of prostatic adenocarcinoma. Assessing the risk of unsuspected prostate cancer in patients with benign prostatic hypertrophy: a 13-year retrospective study of the incidence and natural history of T1a-T1b prostate cancers. Comparisons of urodynamic findings and voiding habits in patients with concomitant benign prostatic hyperplasia and detrusor overactivity presenting with or without the symptom of urgency. The effect of psychological motivation on volumes voided during uroflowmetry in healthy aged male volunteers. A systematic review of holmium laser prostatectomy for benign prostatic hyperplasia. Possible autocrine loop of the epidermal growth factor system in patients with benign prostatic hyperplasia treated with finasteride: a placebo-controlled randomized study. The relationship between obesity and transforming growth factor beta on renal damage in essential hypertension. Detection of chlamydial antigenic material in ovarian, prostatic, ectopic pregnancy and semen samples of culture-negative subjects. A new prostatic stent for the treatment of benign prostatic hyperplasia in high-risk patients. Report of a case of a woman with multiple urinary tract infections and two sons with posterior urethral valves. Temperature-controlled radiofrequency energy delivery for gastroesophageal reflux disease: the Stretta procedure. Long-term pooled analysis of multicenter studies of cooled thermotherapy for benign prostatic hyperplasia results at three months through four years. The role of the lymphatic system and its specific growth factor, vascular endothelial growth factor C, for lymphogenic metastasis in prostate cancer. Influence of catheter on urinary flow during urodynamic pressure-flow study in men with symptomatic benign prostatic hyperplasia. Initial clinical experience with the selective phosphodiesterase-I isoenzyme inhibitor vinpocetine in the treatment of urge incontinence and low compliance bladder. Terminal loop cutaneous ureterostomy in renal transplantation: an under utilized urinary diversion technique. Vesicoureteral reflux in hospitalized children with urinary tract infection: the clinical value of pelvic ectasia on renal ultrasound, inflammatory responses and demographic data. Effects of branded versus generic terazosin hydrochloride in adults with benign prostatic hyperplasia: a randomized, open-label, crossover study in Taiwan. Transurethral microwave thermotherapy for symptomatic benign prostatic hyperplasia: long-term durability with Prostcare. Transurethral microwave thermotherapy for symptomatic benign prostatic hyperplasia: short-term experience with Prostcare. 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Change in International Prostate Symptom Score, prostrate-specific antigen and prostate volume in patients with benign prostatic hyperplasia followed longitudinally. Resistance index in benign prostatic hyperplasia using power Doppler imaging and clinical outcomes after transurethral vaporization of the prostate. Zone-dependent expression of estrogen receptors alpha and beta in human benign prostatic hyperplasia. The use of voiding studies (flowmetry and urodynamics) in the assessment and follow-up of patients. A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia. Early treatment of benign prostatic hyperplasia: implications for reducing the risk of permanent bladder damage. The relation of lower urinary tract symptoms with life-style factors and objective measures of benign prostatic enlargement and obstruction: an Italian survey. Invasive and minimally invasive treatment modalities for lower urinary tract symptoms: what are the relevant differences in randomised controlled trials. Long-term results of contact laser versus transurethral resection of the prostate in the treatment of benign prostatic hyperplasia with small or moderately enlarged prostates. Hybrid laser treatment compared with transurethral resection of the prostate for symptomatic bladder outlet obstruction caused by a large benign prostate: a prospective, randomized trial with a 6-month follow-up. Should high-grade prostatic intraepithelial neoplasia change our approach to infravesical obstruction. Prevalence of lower urinary tract symptoms in a community-based survey of men in Turkey. Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention. Free and total prostate-specific antigen levels in saliva and the comparison with serum levels in men. Power Doppler ultrasonography of the feeding arteries of the prostate gland: a novel approach to the diagnosis of prostate cancer. Cells in various benign and malignant conditions of the human prostate express different antigenic phenotypes. Apoptotic regression of prostatic tissue induced by short- term doxazosin treatment in benign prostatic hyperplasia. A new suture technique for anastomosis in radical retropubic prostatectomy and early removal of urethral catheter. Results of the ureteral reimplantation with serous-lined extramural tunnel in orthotopic ileal W-neobladder. Effects of transurethral prostate resection and transurethral laser prostatectomy on plasma hormone levels. Comparative results of shockwave lithotripsy for renal calculi in upper, middle, and lower calices. Reduction in glucocorticoid receptors in renal biopsies of patients with lupus nephritis. Successful renal transcatheter arterial embolization in three patients with symptomatic hydronephrosis due to ureteral obstruction. Urethral stent (Angiomed-Memotherm) implantation in high-risk patients with urinary retention. Patient and kidney survival by dialysis modality in critically ill patients with acute kidney injury. Characterization and functional relevance of cyclic nucleotide phosphodiesterase isoenzymes of the human prostate. Possible role of bioactive peptides in the regulation of human detrusor smooth muscle - functional effects in vitro and immunohistochemical presence. Distribution and functional significance of phosphodiesterase isoenzymes in the human lower urinary tract. Effects of simultaneous transurethral resection of prostate and solitary bladder tumors smaller than 3 cm on oncologic results. Possible contribution of prostatic anterior fibromuscular stroma to age-related urinary disturbance in reference to pressure-flow study. Preoperative administration of chlormadinone acetate reduces blood loss associated with transurethral resection of the prostate: a prospective randomized study. Urodynamic findings in primary progressive multiple sclerosis are associated with increased volumes of plaques and atrophy in the central nervous system. Ciprofloxacin for 2 or 4 weeks in the treatment of febrile urinary tract infection in men: a randomized trial with a 1 year follow-up.

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A comparison of fluid absorption during transurethral resection and transurethral vaporization for benign prostatic hyperplasia. Transurethral prostatic resection or laser therapy for men with acute urinary retention: the ClasP randomized trial. Anemia after kidney transplantation is not completely explained by reduced kidney function. Stromal and acinar components of the transition zone in normal and hyperplastic human prostate. Laser ablation of the prostate versus transurethral resection of the prostate in men with benign prostatic hyperplasia. The usefulness of prostate specific antigen density as a screening method for prostatic carcinoma. Change in urinary symptoms and quality of life in men with benign prostatic hyperplasia after transurethral resection of prostate. Reduction of length of hospital stay after transurethral resection of prostate by early catheter removal: a retrospective analysis. Long-term effects of angiotensin-converting enzyme inhibition and metabolic control in hypertensive type 2 diabetic patients. Rehabilitation outcomes following traumatic spinal cord injury in a tertiary spinal cord injury centre: a comparison with an international standard. Beneficial effect of intranasal desmopressin for men with benign prostatic hyperplasia and nocturia: preliminary results. Incidence and severity of vesicoureteral reflux in children related to age, gender, race and diagnosis. Safety and efficacy of transurethral resection of the prostate under sedoanalgesia. Evaluation of nuclear matrix protein-22 as a clinical diagnostic marker for bladder cancer. Correlation between serum prostate specific antigen and prostate volume in Taiwanese men with biopsy proven benign prostatic hyperplasia. Clinical study of benign prostatic disease, current concepts and future prospects: randomized controlled trials versus real life practice. 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Successful voiding after trial without catheter is not synonymous with recovery of bladder function after colorectal surgery. Prenatal diagnosis of cystic bladder distension secondary to obstructive uropathy. Comparison of ofloxacin and norfloxacin concentration in prostatic tissues in patients undergoing transurethral resection of the prostate. The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia. Hemolysis in transurethral resection of the prostate using distilled water as the irrigant. Lower urinary tract symptoms and uroflow in a community-based sample of Taiwanese men. Hepsin and maspin are inversely expressed in laser capture microdissectioned prostate cancer. Clinical investigation on the correlation between lower urinary tract infection and cystitis glandularis. Is surveillance necessary for inverted papilloma in the urinary bladder and urethra. Diagnosing symptomatic urinary tract infections in infants by catheter urine culture. Pediatric transperitoneal laparoscopic partial nephrectomy: comparison with an age-matched group undergoing open surgery. Endoscopic puncture of ureterocele as a minimally invasive and effective long-term procedure in children. The impact of polymorphism on prostate specific antigen gene on the risk, tumor volume and pathological stage of prostate cancer. Human kallikrein-2 gene polymorphism is associated with the occurrence of prostate cancer. Pilot study of transperineal injection of dehydrated ethanol in the treatment of prostatic obstruction. Results of holmium laser resection of the prostate for benign prostatic hyperplasia. Nephroureterectomy for transitional cell carcinoma - the value of pre-operative histology. Peripheral hypoechoic lesions of the prostate: evaluation with color and power Doppler ultrasound. Is the higher prevalence of benign prostatic hyperplasia related to lower urinary tract symptoms in Korean men due to a high transition zone index. Expression of senescence-associated beta-galactosidase in enlarged prostates from men with benign prostatic hyperplasia. Prostate carcinoma risk subsequent to diagnosis of benign prostatic hyperplasia: a population-based cohort study in Sweden. Superficial transitional cell carcinoma of the ureteral orifice: higher risk of developing subsequent upper urinary tract tumors. A comparison of sonourethrography and retrograde urethrography in evaluation of anterior urethral strictures. Expression of vascular endothelial growth factor in primary superficial bladder cancer. Initiation of nonselective alpha1-antagonist therapy and occurrence of hypotension-related adverse events among men with benign prostatic hyperplasia: a retrospective cohort study. Prostate tissue and leukocyte levels of n-3 polyunsaturated fatty acids in men with benign prostate hyperplasia or prostate cancer. Microsatellite alterations in urinary sediments from patients with cystitis and bladder cancer. Risk assessment of renal cortical scarring with urinary tract infection by clinical features and ultrasonography. Double-blind randomized comparison of single-dose ciprofloxacin versus intravenous cefazolin in patients undergoing outpatient endourologic surgery. Combination of ballistic lithotripsy and transurethral prostatectomy in bladder stones with benign prostatic hyperplasia: report of 120 cases. Toxicological effects of in utero and lactational exposure of rats to a mixture of environmental contaminants detected in Canadian Arctic human populations. Change in International Prostate Symptom Score after transurethral prostatectomy in Taiwanese men with benign prostate hyperplasia: use of these changes to predict the outcome. Botulinum toxin type A improves benign prostatic hyperplasia symptoms in patients with small prostates. Sustained beneficial effects of intraprostatic botulinum toxin type A on lower urinary tract symptoms and quality of life in men with benign prostatic hyperplasia. Intraprostatic injection of botulinum toxin type-A relieves bladder outlet obstruction in human and induces prostate apoptosis in dogs. Dual effects of ouabain on the regulation of proliferation and apoptosis in human prostatic smooth muscle cells. Long-term follow-up study to evaluate the efficacy and safety of the doxazosin gastrointestinal therapeutic system in patients with benign prostatic hyperplasia with or without concomitant hypertension. Relationship between serum prostate-specific antigen and prostate volume in Korean men with benign prostatic hyperplasia: a multicentre study.

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Rather, by providing context and understanding, we hope that the information provided in this Handbook and on the website will empower the patient to be a better partner in his or her own care and will facilitate constructive conversations between patient and physician. Anyone relying on information obtained from Google™ Translate does so at his or her own risk. Medical, Research and Support Council Links to each member can be found at hlrccinfo. Please contact your local group and your tax advisor for specific information on guidelines for tax deductibility of donations. There is a 50% risk of passing this on and the severity of the disease can vary a lot from person to person. Both men and women tend to develop benign skin leiomyomas (or skin bumps ) in their twenties. Be sure to read the Handbook section Suggested Screening Guidelines for more information. Unlike some other cancers, there is no curative treatment for kidney cancer once it metastasizes, although life may be extended with the latest class of drugs. We expect that more will be opened in the future, possibly at other locations around the world. There are controversies over how to screen children so please read more about this in the Handbook. It is a newly identified condition (2001) and is currently being studied at several locations around the world. Although it is sometimes difficult to come to terms with a new diagnosis, we provide you and your family with information to protect yourselves and future generations. We also encourage you to reach out to us and ask for support – or offer it to another member. In recent years, scientists have used the work of the Genome Project to help identify new connections between physical symptoms that used to be viewed as isolated or random. There is considerable variation in symptoms from family to family and among members of the same family. For example, if your parent had kidney cancer, it does not mean you will develop a kidney tumor. So far, researchers have not been able to find any patterns that would allow one to predict which symptoms a person will develop based on the particular genotype they have. All people have two copies of the fumarate hydratase gene, one from their mother and one from their father. The other is altered, meaning that it has a change in Page 12 it and does not work very well. When a person has only one working copy of the gene, their cells make less fumarase than normal, but enough to be healthy. However, fibroids are very common in the general population and are rarely diagnostically useful on their own. However, the incidence of kidney tumors in the European group is reported as much lower. Some laboratories that can test for fumarase activity find difficulties because of problems in calculating and interpreting the results. Examples are benign adrenal tumors and Leydig testicular cancer which develops in the Leydig cells - - the cells in the testes that release the male hormone, testosterone. It gives family members who do not have symptoms the ability to discover whether they have the gene alteration by a simple blood test. As we learn more, the exact alteration in your gene will become increasingly important to your own health maintenance. Things to keep in mind regarding genetic testing: It may complicate your ability to obtain life or health insurance. The results may be difficult to interpret, and it is best to undertake genetic testing through a genetic professional (geneticist or genetic counselor) who can help you understand the results and their implications for yourself and your family. If you have your children tested before their age of consent and they are found positive there are implications for future life or health insurance, and mortgage applications as well as the start of a life-long screening process. This is a difficult decision to make between health safety and financial implications. The actual risk figure depends on the closeness of the relationship starting as high as 50% with a first degree relative (parent, child or sibling). The alteration cannot however skip generations so the more genetic testing a family has Page 16 the more precise the risk figure will be for each individual ranging from 0% to 50%. In other words, if one of your parents is at risk, but tests negative, then you will not be at risk. It is important to keep in mind that your family members may be overwhelmed when they receive this information. It can sometimes take several months to obtain genetic testing results, but once one genetic alteration is identified within the family, testing of additional family members is faster and less costly. Periodic screening with scans will catch a tumor early, so that it can be treated. Life and Health Insurance A useful link describing the general implications for insurance (applies to all genetic conditions not just to Birt-Hogg-Dubé) is. Many states have enacted state laws to protect their citizens from genetic discrimination by health insurers. Health insurance protection: Group and individual health insurers may not use your genetic information to set eligibility, premium or contribution amounts; Health insurers may not request or require that you take a genetic test. Employment protection: Employers may not use your genetic information to make decisions involving hiring, firing, job assignments and promotions; Employers may not request, require or purchase genetic information about you or one of your family members. Employers with fewer than 15 employees and the military are not required to abide by the employment protections. Page 18 Having Children Deciding whether to have children when there is a 50% chance of inheriting a problem is a difficult decision to make. Before making any decision you may wish to speak with a geneticist or genetic counselor about possible testing options and their implications. Just as uterine leiomyomas grow from smooth muscle of the uterus, cutaneous leiomyomas are rare benign tumors that grow from smooth muscles in the skin. The arrectores pilorum (singular arrector pili, also called piloerectus muscles) are small smooth muscles that are attached to hair follicles. These are the muscles that allow your hairs to stand up when you are cold or fearful. They tend to grow anywhere on the body and limbs, but rarely on the face, hands or feet. These bumps can be very small, but sometimes large, can range in color from skin-colored to light brown to red, and tend to grow in mosaic clusters, but can also be solitary. Some people have a single leiomyoma, but many people develop small clusters of leiomyomas. A smaller percentage of people develop wide distribution of leiomyomas over a chest or back ( segmental distribution ). Once a leiomyoma appears, it does not normally go away and others may appear over the following years. A skin biopsy involves minor surgical removal of some of the skin bump, after which the tissue is sent to a pathology lab. An anesthetic agent is injected under the skin around the leiomyoma and once the area is numb, a small sample of tissue is taken. Slides are prepared from the tissue and examined under a microscope by a pathologist to determine whether the diagnosis is piloleiomyoma or some other type of growth. The exact cause of pain has not been understood, but there is a thought that the leiomyoma has trapped nerve cells. The variation is not just from patient to patient, but also within one patient and can increase over time. Some patients find a cold sensitivity to such an extent that they even consider moving to a warmer country. Some find that if a pain develops in one leiomyoma it acts as a trigger to all the others to become also painful for hours or days at a time. Sometimes a leiomyoma that grows initially without having any pain symptom can start to become irritable and painful. When pain does occur most patients describe it as excruciating, like having a knifepoint stab.

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General anesthesia keeps patients from feeling pain during surgery or other procedures. Gleason score: A system of grading prostate cancer cells based on how they look under a microscope. Gleason scores range from 2 to 10 and indicate how likely it is that a tumor will spread. A low Gleason score means the cancer cells are similar to normal prostate cells and are less likely to spread; a high Gleason score means the cancer cells are very different from normal and are more likely to spread. They can cause a fever and other problems, depending on where the infection occurs. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation. It is used in microsurgery, photodynamic therapy, and for a variety of diagnostic purposes. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). A medical oncologist often is the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists. When cancer cells metastasize and form secondary tumors, the cells in the new tumor are like those in the original (primary) tumor. One nanogram weighs a billion times less than one gram, and almost a trillion times less than a pound. It contains a tube called the urethra, which carries semen and urine to the outside of the body. It may include information about allergies, illnesses and surgeries, and dates and results of physical exams, tests, screenings, and immunizations. It may also include information about medicines taken and about diet and exercise. The prostate surrounds the part of the urethra (the tube that empties the bladder) just below the bladder, and produces a fluid that forms part of the semen. Proteins are the basis of body structures such as skin and hair and of substances such as enzymes, cytokines, and antibodies. In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Since screening may find diseases at an early stage, there may be a better chance of curing the disease. Semen is made up of sperm from the testicles and fluid from the prostate and other sex glands. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores. Skin cancer that forms in melanocytes (skin cells that make pigment) is called melanoma. Skin cancer that forms in basal cells (small, round cells in the base of the outer layer of skin) is called basal cell c a rcinoma. Skin cancer that forms in squamous cells (flat cells that form the surface of the skin) is called squamous cell carcinoma. Skin cancer that forms in neuroendocrine cells (cells that release hormones in response to signals from the nervous system) is called neuroendocrine carcinoma of the skin. Most skin cancers form in older people on parts of the body exposed to the sun or in people who have weakened immune systems. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain. It is needed to develop and maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. Testosterone may also be made in the laboratory and is used to treat certain medical conditions. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. For more information, or to order free copies of this booklet: C a l l 1 - 8 0 0 - 4 - C A N C E R (1 - 8 0 0 - 4 2 2 - 6 2 3 7) or visit Some data have suggested that there is decreased risk among the Asians compared Ageing; to the western white population. Lifestyle changes including exercise and diet are important strategies in controlling Inflammation this common ailment. Observational studies comparing black, Asian and white men have produced variable results. These and other findings suggest an autosomal dominant pattern of inheri- tance [13]. Physician-diagnosed diabetes, increased serum insulin and elevated fasting plasma glucose have been associated with increased prostate size and increased risk of prostate 2. With respect underlying pathophysiology between these two conditions to micronutrients, higher circulating concentrations of have been hypothesized but there is no indication that one vitamin E, lycopene, selenium and carotene have been condition precedes the other [31]. The underlying causes of prostatic magnitude of the protective effect increasing with higher inflammation remains unclear although there are several levels of activity [18]. In the Olmsted cohort, men who reported the Baltimore Longitudinal Study of Aging. However, in their study of men from a urology men than in their Caucasian or Hispanic counterparts? Clinical and biological characteristics of familial ageing population in almost all societies, it is inevitable benign prostatic hyperplasia. Familial aggregation of bothersome benign prostatic Apart from medications, one important strategy is advice hyperplasia symptoms. This may help to reduce the need for perplasia and lower urinary tract symptoms: new approaches surgery with its many possible side effects and long term to old problems. Dietary patterns, supplement use, and the risk of symptomatic benign prostatic hyperplasia: results from Conflicts of interest the Prostate Cancer Prevention Trial. Intake of selected micronutrients and the risk of surgi- cally treated benign prostatic hyperplasia: a case-control study from Italy. Association between physical activity, lower Ms Mei Ying Ng assisted in the editing of the manuscript. Lipids, lipopro- References teins and the risk of benign prostatic hyperplasia in commu- nity dwelling men. Alcohol consumption is associated with a human benign prostatic hyperplasia with age. Relationship of serum sex-steroid hormones and pros- population of healthy aging men: the Krimpen Study. Asymptomatic inflam- prostatic hyperplasia: clinical connections, emerging etiolog- mation and/or infection in benign prostatic hyperplasia. Obesity increases and physical activity decreases lesions, incidental carcinoma in histologically confirmed lower urinary tract symptom risk in older men: the osteopo- benign prostatic hyperplasia: a retrospective analysis. Biomarkers of systemic inflammation and risk of incident, behaviors and the risk of symptomatic benign prostatic hy- symptomatic benign prostatic hyperplasia: results from the pros- perplasia: results from the prostate cancer prevention trial. Protective association between nonsteroidal anti prostatic hyperplasia/lower urinary tract symptomsewhat do inflammatory drug use and measures of benign prostatic hy- we know? Statin use and decreased risk of a prospective cohort study of air force veterans. Urology 2006; benign prostatic enlargement and lower urinary tract symp- 68:1198e205. Indications for and use of nonsteroidal gender, lifestyle and medical comorbidities. Eur Urol 2003;44: the risk of benign prostatic hyperplasia-related outcomes and 588e94. Erectile dysfunction and lower urinary tract testosterone and lower urinary tract symptoms in men.

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Role of connective tissue growth factor in fibronectin synthesis in cultured human prostate stromal cells. Intakes of energy and macronutrients and the risk of benign prostatic hyperplasia. Single-voxel oversampled J-resolved spectroscopy of in vivo human prostate tissue. Reflux nephropathy in infancy: a comparison of infants presenting with and without urinary tract infection. Potential adverse effects of a low-dose aspirin-diuretic combination on kidney function. Testosterone levels in benign prostatic hyperplasia: sexual function and response to therapy with dutasteride. Day-case local anaesthetic radiofrequency thermal ablation of benign prostatic hyperplasia: a four-year follow-up. Urinary flow disturbance as an early sign of autonomic neuropathy in diabetic children and adolescents. Videourodynamics in the diagnosis of urinary tract abnormalities in a single center. Pelvi-ureteric junction obstruction in children: the role of urinary transforming growth factor-beta and epidermal growth factor. Development of an immunoassay for serum caveolin-1: a novel biomarker for prostate cancer. Apoptotic impact of alpha1-blockers on prostate cancer growth: a myth or an inviting reality. Association between serum adiponectin levels and arteriolosclerosis in IgA nephropathy patients. Electromyographic study of the striated urethral sphincter in type 3 stress incontinence: evidence of myogenic-dominant damages. Down-regulated expression of prostasin in high- grade or hormone-refractory human prostate cancers. Expression of sulfotransferase 1E1 in human prostate as studied by in situ hybridization and immunocytochemistry. Does lower-pole caliceal anatomy predict stone clearance after shock wave lithotripsy for primary lower-pole nephrolithiasis. Prospective randomized study of transurethral vaporization resection of the prostate using the thick loop and standard transurethral prostatectomy. Changes of serum prostate-specific antigen following high energy thick loop prostatectomy. Intraprostatic tissue infection in catheterised patients in comparison to controls. Epigenetic regulation of human bone morphogenetic protein 6 gene expression in prostate cancer. Colonic adenocarcinoma metastatic to the urinary tract versus primary tumors of the urinary tract with glandular differentiation: a report of 7 cases and investigation using a limited immunohistochemical panel. The direct costs of nosocomial catheter-associated urinary tract infection in the era of managed care. Long-term results of high-power holmium laser vaporization (ablation) of the prostate. A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). Are clinical characteristics of familial benign prostatic hyperplasia different than in sporadic cases. Serum concentrations of sex hormones in men with severe lower urinary tract symptoms and benign prostatic hyperplasia. Case report: Incidental primary transitional cell carcinoma of the prostate treated with transurethral prostatectomy only. Effects of combined androgen blockade on bone metabolism and density in men with locally advanced prostate cancer. Change in the ratio of free-to-total prostate-specific antigen during progression of advanced prostate cancer. Immunohistochemical finding of alpha-1-antichymotrypsin in tissues of benign prostatic hyperplasia and prostate cancer. A novel form of prostate-specific antigen transcript produced by alternative splicing. Is the short-term outcome of transurethral resection of the prostate affected by preoperative degree of bladder outlet obstruction, status of detrusor contractility or detrusor overactivity. Urodynamic effects of terazosin treatment for Japanese patients with symptomatic benign prostatic hyperplasia. Correlation between hypoechoic nodules on ultrasonography and benign hyperplasia in the prostatic outer gland. Does benign prostatic hyperplasia originate from the peripheral zone of the prostate? Helical computed tomography angiography in the evaluation of Chinese living renal donors. Benign prostatic hyperplasia in elderly Thai men in an urban community: the prevalence, natural history and health related behavior. Association of prostatic inflammation with down- regulation of macrophage inhibitory cytokine-1 gene in symptomatic benign prostatic hyperplasia. The use of refluxing ureter in the creation of a Mitrofanoff channel in children undergoing bladder augmentation: is a formal reimplantation necessary. The timing of primary neurosurgical repair significantly affects neurogenic bladder prognosis in children with myelomeningocele. Effect of spinal cord abnormalities on the function of the lower urinary tract in patients with anorectal abnormalities. The economics of benign prostatic hyperplasia and lower urinary tract symptoms in the United States. Gunshot wound injuries of the prostate and posterior urethra: reconstructive armamentarium. K+, Na+, Mg2+, Ca2+, and water contents in human skeletal muscle: correlations among these monovalent and divalent cations and their alterations in K+ -depleted subjects. Outcomes of surgical treatment for upper urinary tract transitional cell carcinoma: comparison of retroperitoneoscopic and open nephroureterectomy. Detrusor underactivity: Clinical features and pathogenesis of an underdiagnosed geriatric condition. A modern rationale for the use of phenoxybenzamine in urinary tract disorders and other conditions. Impact of prostate-specific antigen level and prostate volume as predictors of efficacy in photoselective vaporization prostatectomy: analysis and results of an ongoing prospective multicentre study at 3 years. Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia: 12-month results from the first United States multicenter prospective trial. A hybrid technique using bipolar energy in transurethral prostate surgery: a prospective, randomized comparison. Urinary incontinence in both sexes: prevalence rates and impact on quality of life and sexual life. Prevalence of the overactive bladder syndrome by applying the International Continence Society definition. Microwave thermotherapy for benign prostatic hyperplasia with the Dornier Urowave: response durability and variables potentially predicting response. Interstitial laser coagulation for management of benign prostatic hyperplasia: long-term follow-up. Association of lower urinary tract symptoms with erectile dysfunction in Japanese men. Evidence that chlormadinone acetate exhibits antiandrogenic activity in androgen-dependent cell line. Spinal fusion and instrumentation for paediatric neuromuscular scoliosis: retrospective review.


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