Testicular cancer

Marital status independently predicts testis cancer survival—an analysis of the SEER database Abern, M. R. et al. Urol. Oncol. doi:10.1016/j.urolonc.2010.03.005

Married men, particularly Caucasians, are more likely to survive testis cancer. These two factors emerged as independent predictors of a more-favorable outcome during analysis of data from more than 20,000 patients. Independent predictors of death were older age, higher disease stage, lymphoid histology and nonseminomatous germ cell tumor (NSGCT). Further, men with stage I or II NSGCT who underwent retroperitoneal lymph node dissection fared better.

Surgery

Detrusor activity is impaired during thoracic epidural analgesia after open renal surgery Wuethrich, P. Y. et al. Anesthesiology 112, 1345–1349 (2010)

Standard thoracic postoperative epidural analgesia (insertion at T7–8 or T8–9) has striking effects on bladder function. Comparison of urodynamic studies performed on 13 men prior to, and 2 or 3 days after, open kidney surgery revealed marked detrusor weakness and a change in postvoid residual volume from a median of 25 ml to 420 ml. All had had normal lower urinary tract function prior to surgery.

Incontinence

Adverse events of intravesical botulinum toxin A injections for idiopathic detrusor overactivity: risk factors and influence on treatment outcome Kuo, H.-C. et al. Eur. Urol. doi:10.1016/j.eururo.2010.09.007

A team based in Taiwan has identified four parameters which increase the likelihood of acute urinary retention and straining to void after intravesical injection of botulinum toxin A for refractory idiopathic detrusor overactivity. Data were collected from 217 patients. Treatment was successful in 66%. The four risk factors are male gender, baseline postvoid residual volume >100 ml, botulinum toxin A dose >100 U, and comorbidities.

Incontinence

Concordance between one-hour pad test and subjective assessment of stress incontinence Liebergall-Wischnitzer, M. et al. Urology doi:10.1016/j.urology.2010.05.048

The utility of the 1 h pad test for assessment of urinary incontinence has been confirmed. More than 700 pad test results from women participating in two clinical trials were compared with subjective estimates of leakage reported by the women in quality-of-life questionnaires. A significant correlation was found, both prior to and after noninvasive interventions (that is, circular muscle exercises and pelvic floor muscle training).