Atypical small acinar proliferation is a histopathological diagnosis of unspecified importance in prostate needle-biopsy reports,suggestive but not definitive for cancer.The terminology corresponds to some uncertainty...Atypical small acinar proliferation is a histopathological diagnosis of unspecified importance in prostate needle-biopsy reports,suggestive but not definitive for cancer.The terminology corresponds to some uncertainty in the biopsy report,as the finding might represent an underlying non-cancerous pathology mimicking cancer or an under-sampled prostate cancer site.Therefore,traditional practice favors an immediate repeat biopsy.However,in modern urological times,the need of urgent repeat biopsy is being challenged by some authors as in the majority of cases,the grade of cancer found in subsequent biopsy is reported to be low or the disease to be non-significant.On the other hand,high risk disease cannot be excluded,whereas no clinical or pathological factors can predict the final outcome.In this review,we discuss the significance of the diagnosis of atypical small acinar proliferation in the biopsy report,commenting on its importance in modern urological practice.展开更多
Dear editor,Premature ejaculation(PE)is a common male sexual dysfunction.It occurs in 4%e39%of men across studies in community samples[1].It is impossible to establish accurately the real prevalence of PE because it l...Dear editor,Premature ejaculation(PE)is a common male sexual dysfunction.It occurs in 4%e39%of men across studies in community samples[1].It is impossible to establish accurately the real prevalence of PE because it lacks a widely accepted definition.Furthermore,PE is frequently a self-reported,self-rated complaint,making it difficult to appreciate its real epidemiology.In addition,the fact that in some couples PE is diagnosed based on distress rather than as an objective symptom complicates the matter even further[2].Oral dapoxetine has been recommended as first-choice therapy for PE.When using this drug,side effects were uncommon,dose-dependent,including nausea,diarrhea,headache,and dizziness[1].Although since the early 1930s,many drugs have been used to treat PE such as topical local anesthetics and selective serotonin reuptake inhibitors.展开更多
Background:Percutaneous nephrolithotomy(PNL)is the gold standard to treat large or complex renal stones.Intrarenal pseudoaneurysm is a rare,yet clinically significant,complication of PNL.Case summary:A 58-year-old man...Background:Percutaneous nephrolithotomy(PNL)is the gold standard to treat large or complex renal stones.Intrarenal pseudoaneurysm is a rare,yet clinically significant,complication of PNL.Case summary:A 58-year-old man with a 3cm calculus in the lower calyx of the left kidney was operated on by PNL 3days before presentation to the emergency department.The patient presented with massive hematuria and dizziness.Upon presentation,the patient appeared uncomfortable and in distress.He was in hemorrhagic shock.The patient was resuscitated with intravenous fluids and blood transfusion.An urgent computed tomography scan showed multiple clots in the left renal pelvis and bladder with a retroperitoneal hematoma.The patient underwent angiography which revealed an inferior pole branch pseudoaneurysm.The pseudoaneurysm was treated by endovascular embolization with N-butyl-2-cyanoacrylate.No postoperative complications were seen.Conclusion:Selective renal artery embolization is an effective treatment for pseudoaneurysm post PNL with excellent outcomes.展开更多
文摘Atypical small acinar proliferation is a histopathological diagnosis of unspecified importance in prostate needle-biopsy reports,suggestive but not definitive for cancer.The terminology corresponds to some uncertainty in the biopsy report,as the finding might represent an underlying non-cancerous pathology mimicking cancer or an under-sampled prostate cancer site.Therefore,traditional practice favors an immediate repeat biopsy.However,in modern urological times,the need of urgent repeat biopsy is being challenged by some authors as in the majority of cases,the grade of cancer found in subsequent biopsy is reported to be low or the disease to be non-significant.On the other hand,high risk disease cannot be excluded,whereas no clinical or pathological factors can predict the final outcome.In this review,we discuss the significance of the diagnosis of atypical small acinar proliferation in the biopsy report,commenting on its importance in modern urological practice.
文摘Dear editor,Premature ejaculation(PE)is a common male sexual dysfunction.It occurs in 4%e39%of men across studies in community samples[1].It is impossible to establish accurately the real prevalence of PE because it lacks a widely accepted definition.Furthermore,PE is frequently a self-reported,self-rated complaint,making it difficult to appreciate its real epidemiology.In addition,the fact that in some couples PE is diagnosed based on distress rather than as an objective symptom complicates the matter even further[2].Oral dapoxetine has been recommended as first-choice therapy for PE.When using this drug,side effects were uncommon,dose-dependent,including nausea,diarrhea,headache,and dizziness[1].Although since the early 1930s,many drugs have been used to treat PE such as topical local anesthetics and selective serotonin reuptake inhibitors.
文摘Background:Percutaneous nephrolithotomy(PNL)is the gold standard to treat large or complex renal stones.Intrarenal pseudoaneurysm is a rare,yet clinically significant,complication of PNL.Case summary:A 58-year-old man with a 3cm calculus in the lower calyx of the left kidney was operated on by PNL 3days before presentation to the emergency department.The patient presented with massive hematuria and dizziness.Upon presentation,the patient appeared uncomfortable and in distress.He was in hemorrhagic shock.The patient was resuscitated with intravenous fluids and blood transfusion.An urgent computed tomography scan showed multiple clots in the left renal pelvis and bladder with a retroperitoneal hematoma.The patient underwent angiography which revealed an inferior pole branch pseudoaneurysm.The pseudoaneurysm was treated by endovascular embolization with N-butyl-2-cyanoacrylate.No postoperative complications were seen.Conclusion:Selective renal artery embolization is an effective treatment for pseudoaneurysm post PNL with excellent outcomes.
