Urinary incontinence

Ketamine-associated lower urinary tract destruction: a new radiological challenge Mason, K. et al. Clin. Radiol. 65, 795–800 (2010)

Small bladder volume, bladder wall thickening and perivesical inflammation are the key imaging features of ketamine abusers who present with urinary frequency, nocturia, dysuria, hematuria and incontinence. According to the UK team who used ultrasonography, CT and intravenous urography to examine 23 patients, early recognition of these harmful effects is essential if irreversible damage to the urinary tract is to be avoided.

Urinary incontinence

Overactive bladder drugs and constipation: a meta-analysis of randomized, placebo-controlled trials Meek, P. D. et al. Dig. Dis. Sci. doi:10.1007/s10620-010-1313-3

Pooling of data from 20,000 patients with overactive bladder has shown that use of anticholinergic drugs for at least 2 weeks is associated with a twofold increased risk of constipation. Odds ratios of the six medications analyzed were 3.0 for solifenacin, 2.9 for trospium, 2.3 for oxybutynin, 2.1 for fesoterodine, 1.9 for darifenacin and 1.4 for tolterodine. Different affinities for muscarinic receptors might account for the variation.

Prostate cancer

Phase II study of the human anti-epithelial cell adhesion molecule antibody adecatumumab in prostate cancer patients with increasing serum levels of prostate-specific antigen after radical prostatectomy Marschner, N. et al. Urol. Int. doi:10.1159/000318055

Adecatumumab can delay biochemical progression of prostate cancer after prostatectomy in men with a baseline PSA level less than 1 ng/ml whose tumors express high levels of the anti-epithelial cell adhesion molecule that is targeted by the drug. Patients randomized to the efficacious dose of 6 mg/kg reported diarrhea, nausea and chills during the 24-week trial.

Surgery

Visual enhancement of laparoscopic partial nephrectomy with 3-charge coupled device camera: assessing intraoperative tissue perfusion and vascular anatomy by visible hemoglobin spectral response Crane, N. J. et al. J. Urol. doi:10.1016/j.juro.2010.06.010

Images generated using a conventional 3-charge coupled device (CCD) camera can reliably distinguish between veins and arteries, and detect changes in tissue oxygenation, during laparoscopic partial nephrectomy. Manipulation of images collected during 10 procedures resulted in clear delineation of arteries as red and veins as blue, and dramatic color changes during the pre-clamp to post-clamp transition.