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Biomedical subjects

Kostis Gyftopoulos

Publications and source records attributed to Kostis Gyftopoulos.

4 recordsLinked to original sources

Clinical correlation of prostatic lithiasis with chronic pelvic pain syndromes in young adults.

OBJECTIVE: To investigate the incidence, morphology and clinical presentation of prostatic calculi in a selected population of young adults and to examine any possible correlation with chronic prostatitis/chronic pelvic pain syndromes (CP/CPPS). METHODS: A population of 1374 young adults was screened with ultrasound imaging of the prostate and 101 cases with prostatic lithiasis were selected. Patients were divided in two groups, according to the type of prostatic calculi (type A: small, multiple or type B: larger, coarser calculi). Further evaluation included history and physical examination, recording of lower urinary tract symptoms and the Meares-Stamey test. RESULTS: Calculi were type A in 71.3% and type B in 28.7% of cases. Localization (central/periurethral) was not correlated with other parameters. Age was closely related to calculus burden ( p =0.034 ). Type B calculi were more often associated with symptoms and chronic prostatitis/CPPS (chi(2)-test, p=0.007 and 0.018 respectively). CONCLUSIONS: Small, multiple calcifications are a normal, often incidental ultrasonographic finding in the prostate and represent a result of age rather than a pathologic entity. However, larger prostatic calculi may be related to underlying inflammation and require further evaluation and possibly, treatment.

Adult↗

Effects of finasteride and cyproterone acetate on hematuria associated with benign prostatic hyperplasia: a prospective, randomized, controlled study.

OBJECTIVES: To evaluate the influence of two differently acting antiandrogens, finasteride (FIN) and cyproterone acetate (CPA), on the natural history of hematuria associated with benign prostatic hyperplasia (BPH) in a prospective, randomized, controlled study. METHODS: Forty-two patients with hematuria episodes due to BPH were randomly allocated to three subgroups of 14 patients each and treated daily with either 5 mg FIN or 100 mg CPA or were placed in a watchful waiting arm. Patients were evaluated at 3-month intervals, and 40 patients had at least 1 year of follow-up. RESULTS: Four patients in the FIN group (30%) and three in the CPA group (23%) presented with recurrent hematuria. In both groups, the bleeding episodes were treated conservatively and required no hospitalization. In the control group, 8 patients (57%) presented with recurrent bleeding; in 4, the bleeding was severe and required some form of intervention (catheterization or transurethral prostatectomy). When the frequency and severity of the hematuria episodes were analyzed over time, a statistically significant difference for FIN versus control was present at 9 and 12 months (analysis of variance, P = 0.035 and P = 0.009, respectively). A similar difference was evident for CPA versus control at 9 and 12 months (P = 0.028 and P = 0.008, respectively). No statistically significant difference was present between the FIN and CPA groups. Interestingly, no statistically significant effect in bleeding recurrence for both CPA and FIN over controls was present at 3 and 6 months of follow-up. CONCLUSIONS: Both FIN and CPA seem to exert a comparable control in hematuria recurrence in patients with BPH, thus confirming the rationale behind the use of antiandrogens for such a purpose. Our results support the hypothesis that any antiandrogen, irrespective of the mode of action, would alter the natural history of BPH-associated hematuria. Interestingly, our results indicate that the speed of action of FIN may not be as rapid as previously described.

Aged↗

Clinical and embryologic aspects of penile duplication and associated anomalies.

OBJECTIVES: To report 2 cases of penile duplication and review the literature in an attempt to categorize the associated anomalies in relation to the degree of penile duplication. Embryologic considerations of this rare anomaly are also reviewed. METHODS: We report 2 distinct cases of diphallia. In the first case, true complete penile duplication was associated with multiple malformations, including a cloacal anomaly, colon and bladder duplication, a horseshoe kidney, a bifid scrotum with undescended testes, a hypoplastic right leg, and a ventricular septum defect. The second patient presented with true, complete diphallia and bladder and urethral duplication but an absence of other anomalies. The patients were individually treated according to the concomitant malformations. A review of published reports allowed a classification of associated anomalies in 77 cases of diphallia, according to the degree of penile duplication. RESULTS: The first patient underwent a series of staged surgical repairs, including correction of the congenital heart anomaly, separation of the urogenital and gastrointestinal tract and resection of the duplicate terminal colon, excision of the smaller bladder and underdeveloped duplicate penis, bilateral orchiopexy, and hypospadias correction. The second patient underwent bladder fusion and excision of a urethrorectal fistula. Penile reconstruction was left for a later stage. An analysis of the cases available in published studies suggests that diphallia is often associated with a wide spectrum of anomalies that vary from severe malformations to less significant variations of human anatomy. CONCLUSIONS: Penile duplication is a rare anomaly. Thorough investigations are mandatory in all cases to reveal underlying congenital malformations that are potentially life threatening and require immediate surgical correction. Treatment should always be individualized according to the degree of penile duplication and the extent of the concomitant anomalies.

Abnormalities, Multiple↗

Retrocaval ureter and associated abnormalities.

OBJECTIVE: To investigate the association of retrocaval ureter with other congenital abnormalities. METHODS AND PATIENTS: Two new cases of retrocaval ureter are discussed and a detailed electronic search of the literature was mainly focused on the concomitant abnormalities. The first of our patients had also a glandular hypospadias and a supernumerary lumbar vertebra, while the second one had syndactylia (fixed toes) in both feet. Results. The review of the literature revealed that 21% of the cases of retrocaval ureter present with concomitant abnormalities mainly from the cardiovascular system and the genitourinary tract. CONCLUSION: Diagnosis of retrocaval ureter should increase the awareness of the responsible physician on the possibility of concomitant malformations where treatment could prevent future symptoms.

Abnormalities, Multiple↗