Bicalutamide 150 mg monotherapy may offer an important advantage compared to castration in terms of bone loss and body composition for patients who require long-term androgen deprivation for localized or locally advanced prostate cancer.
The recent increased use of steriods, immunosuppressive agents and cytotoxic drugs has been associated with a rise in the incidence of significant fungal disease. The first case of bilateral renal aspergillosis without disseminated involvement is reported. A multitherapeutic approach, including surgical evacuation of masses of hyphae, parenteral antimycotic chemotherapy and topical instillations of amphotericin B, were necessary to clear the kidneys. Newer systemic agents such as 5-fluorocytosine and rifampicin were also used. Treatment of fungal infections of the urinary tract is discussed.
Bilateral medial deviation of mid and distal portions of the ureters can occur as a normal finding in patients with psoas muscle hypertrophy. Two groups of patients are presented, both composed of young, healthy males. In 13 patients, the distance between the ureters at the narrowest point averaged 3.7 cm. Psoas muscle hypertrophy was evident radiographically and confirmed by ultrasound. In 20 patients with normal psoas muscles, the average minimum distance between the ureters was 7.1 cm. The importance of this observation is to avoid overdiagnosis of retroperitoneal disease in this group of young, muscular men. The differential diagnosis and severe examples of this normal variant are presented.
The patient with hematuria and clot retention who has an abnormality in urokinase-plasmin production or coagulopathy may have extraordinary clots. An understanding of the underlying disease and pathophysiology of clot formation will enable the urologist to better evaluate and treat this type of patient. Aberrations in urokinase-plasmin production or consumption occur in many disease states that may not be recognized generally.
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