Investigative urology

Abstract

a pure Gleason score of 4 + 4 = 8. Each core should be assigned a separate Gleason score, especially in cases with high Gleason score cancer on at least 1 core. Editorial CommentIn our Institution each core with prostate cancer is assigned a separate Gleason score, e.g., slide #1: normal prostatic tissue; slide #2: focal atrophy; slide #3: adenocarcinoma Gleason 4 + 4 = 8; slide #4: adenocarcinoma Gleason 3 + 3 = 6; slide #5: focal atrophy; and, slide #6: normal prostatic tissue. This paper answers a frequent question by the urologist. Why assign each core separately instead of an overall Gleason score? In our example the overall Gleason score would be 4 + 3 = 7. Kunz and Epstein answer this question. A Gleason score of 4 + 4 = 8 with pattern grade 3 in other cores had a more advanced stage than a pure Gleason score of 4 + 3 = 7 (p=0.008) and the group with a Gleason score of 4 + 4 = 8 and Gleason pattern grade 3 on other cores had a higher overall grade on radical prostatectomy than the group with a pure Gleason score of 4 + 3 = 7 (p=0.001). The authors conclude that each core should be assigned a separate Gleason score, especially in cases with high Gleason score cancer on at least one core. We fully agree with this conclusion and highly recommend urologists to ask from their pathologists to grade separately each core in case the pathology report is given as an overall Gleason score. Dr. Athanase Billis Full-Professor of Pathology State University of Campinas, UnicampCampinas, São Paulo, Brazil J Urol. 2003; 170: 2086-90 Purpose: Previous studies have demonstrated that in vivo and in vitro ischemia of the bladder results in decreased contractile responses. However, to our knowledge the effect of reperfusion following ischemia of the bladder is not known. INVESTIGATIVE UROLOGY _____________________________________________________ Reperfusion injury of the rat bladder is worse than ischemiaMaterials and Methods: Adult male rats were subjected to bilateral bladder ischemia and varying periods of reperfusion. In vivo ischemia was created for 4 hours by reversibly clamping the 2 vesical arteries for 4 hours. Reperfusion was produced by removing the clamps and allowing the animals to recover for 1 day, 1 week or 1 month after surgery. Following recovery bladders strips were studied using field stimulation (FS), carbachol and KCl. The maximal contractile response and rate of response generated were recorded digitally and analyzed.Results: The maximal responses to FS, carbachol and adenosine triphosphate (ATP) were not decreased by 4-hour ischemia alone, whereas the response to KCl was decreased significantly. The contractile responses