Transurethral Ultrasonography Research Articles

PREDICTION OF HYPOECHOIC LESIONS ON ULTRASOUND OF PROSTATE CANCER BASED ON PSA INTERVAL AND GLEASON GROUP

Objective: To evaluate hypoechoic lesion in transrectal ultrasonography of prostate (TRUS-P) predictive value on prostate cancer based on PSA Interval and Gleason Group. Material & Methods: An observational analytic study with a cross-sectional design take place from January 2015 to December 2018 analyzing patients who had undergone TRUS-P Biopsy at Hasan Sadikin Hospital. Patients are divided into several subgroups according to different PSA levels. A p-value < 0.05 was considered statistically significant. PPV, NPV, and Youden’s index were all indexes reflecting the performance of a diagnostic test. Results: There were 35 cases (49.3%) with a visible hypoechoic lesion in TRUS and 36 cases (41.7%) without a visible hypoechoic lesion. In our study, 23.9% of the patients with hypoechoic lesions were diagnosed with prostate cancer on TRUSP-Biopsy. The results of the analysis with Youden’s index show that PSA at intervals of 10-20 is the best predictor of diagnostic values. Then we analyzed the overall detection rate based on PSA interval. Patients with PSA > 20 ng/ml, hypoechoic lesions were significantly associated with Gleason Group. Conclusion: We concluded in our study that the hypoechoic lesion in transurethral ultrasonography of prostate could improve the predictive efficacy for diagnosing prostate cancer.

An update on the diagnosis and management of ejaculatory duct obstruction.

Ejaculatory duct obstruction (EDO) remains a rare but surgically correctable cause of male sexual dysfunction and male infertility due to obstructive azoospermia, diagnosed in up to 5% of infertile men. EDO should, therefore, be considered within the list of differential diagnoses for men undergoing infertility investigations, with work up including clinical examination, transurethral ultrasonography, semen analysis, chromotubation, seminal vesiculography and seminal vesicle aspiration. Obstruction can be limited to the distal ends of the ducts or it can extend proximally to include the terminal portions of the vasa deferentia, with the site and length of the obstruction having implications for surgical intervention. Early endoscopic treatment can reverse symptoms and prevent the progression of partial obstruction to bilateral, complete obstruction, and transurethral resection of the ejaculatory duct remains the main treatment option for EDO. Alternative treatment options include endoscopic laser-assisted resection of the ducts, antegrade seminal-vesicle lavage to relieve EDO secondary to inspissated material or calculi, or dilatation of the ejaculatory ducts using 9F seminal vesicoscopy or balloon.

1384: Transurethral Ultrasonography Guided Injection of Autologous Myo- and Fibroblasts Versus Transurethral Endoscopic Injection of Collagen in Treatment of Urinary Incontinence in Women

You have accessJournal of UrologyPodium 41, Tuesday, May 22, 2007, 10:00 am - 12:00 pm1 Apr 20071384: Transurethral Ultrasonography Guided Injection of Autologous Myo- and Fibroblasts Versus Transurethral Endoscopic Injection of Collagen in Treatment of Urinary Incontinence in Women Hannes Strasser, Michael Mitterberger, Rainer Marksteiner, Eva Margreiter, Ferdinand Frauscher, Germar M. Pinggera, and Georg Bartsch Hannes StrasserHannes Strasser More articles by this author , Michael MitterbergerMichael Mitterberger More articles by this author , Rainer MarksteinerRainer Marksteiner More articles by this author , Eva MargreiterEva Margreiter More articles by this author , Ferdinand FrauscherFerdinand Frauscher More articles by this author , Germar M. PinggeraGermar M. Pinggera More articles by this author , and Georg BartschGeorg Bartsch More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)31598-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1384: Transurethral Ultrasonography Guided Injection of Autologous Myo- and Fibroblasts Versus Transurethral Endoscopic Injection of Collagen in Treatment of Urinary Incontinence in Women." The Journal of Urology, 177(4S), pp. 456–457 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 177Issue 4SApril 2007Page: 456-457 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Hannes Strasser More articles by this author Michael Mitterberger More articles by this author Rainer Marksteiner More articles by this author Eva Margreiter More articles by this author Ferdinand Frauscher More articles by this author Germar M. Pinggera More articles by this author Georg Bartsch More articles by this author Expand All Advertisement PDF DownloadLoading ...

Changes in the Serum Prostate-specific Antigen Level One Year after Transurethral Resection of the Prostate

Purpose: We wanted to investigate how transurethral resection of the prostate (TURP), for treating patients with benign prostate hyperplasia (BPH), affected the serum prostate-specific antigen (PSA) levels. Materials and Methods: The serum PSA levels were measured before and 12 months after operation in 57 patients who underwent TURP for BPH. The total prostate weight, as measured by transurethral ultrasonography (TRUS), and the weight of the surgical specimen were examined in relation to the pretreatment PSA value and the changes in the PSA levels after the operation. Results: The preoperative mean PSA density was 0.10±0.08ng/ml/cc. The postoperative serum PSA levels were decreased significantly after TURP (p=0.002). Removal of 1g of BPH tissue reduced the serum PSA levels by an average of 0.22±0.4ng/ml. The changes in the serum PSA level one year after TURP correlated with the resected chip weights [Y=0.406+0.176x (r=0.526, p<0.05)]. Conclusions: TURP caused a long term decrease in the serum PSA level. One year after TURP, the PSA levels should be expected to decrease according to the resected chip weights. (Korean J Urol 2007;48:691-695) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Early detection of prostate cancer: evaluating the diagnostic performance of prostate specific antigen by comparing with histological technique among africans.

This study was conducted to investigate the diagnostic performance characteristics of prostate specific antigen (PSA) by comparing serum PSA value with histological findings in patients suspevted of having prostate cancer in Aminu Kano Teaching Hospital. Nigeria. Clinical and Laboratory records were examined and collated for serum PSA values, together with histological findings of biopsy specimen, clinical diagnosis, age of patients, and mode of presentation. The serum PSA values were determined by ELECSYS 1010 autoanalysers Roche, Germany based on electrochemiluminescence immunoassay technique. The results show that serum PSA values increase with age in the assymptomatic non-cancer patients who came for medical check up but were within normal limit. In prostatic disease conditions PSA values were raised in benign prostatic hyperplasia 35.957± 4.0315ng/ml, in undifferentiated carcinoma 56.22±4.295ng/ml and adenocarcinoma >100ng/ml as compared to the normal range (0-4ng/ml). These cases were confirmed by histological diagnosis. It is concluded that PSA evaluations is a sensitive marker for prostate cancer but because of various other conditions that affect serum PSA concentration, other methods of investigations such as Digital Rectal examination, Trans Urethral Ultra-Sonography and histological examination should be combined to confirm diagnosis. Prognosis of patients will be better if early diagnosis is made.

TRANSURETHRAL INCISION FOR HEMATOSPERMIA CAUSED BY EJACULATORY DUCT OBSTRUCTION

Hematospermia is supposed to be derived from pathological conditions in the seminal vesicle, prostate, testis, epididymis, or urethra. A recent advance in diagnostic procedures has demonstrated the seminal vesicle, the prostate, and midline cyst as potential sources of hematospermia. The authors describe a case of hematospermia caused by ejaculatory duct obstruction, in which a transurethral technique was successful. A 51-year-old male was referred to the authors' clinic with a chief complaint of hematospermia. Transurethral ultrasonography showed a cystic lesion surrounded with hyperechoic area in the middle of the prostate. Vasography demonstrated the distal dilation of the ejaculatory duct. Magnetic resonance imaging demonstrated a high signal intensity area in the middle of the prostate. Urethrocystoscopy showed an enlarged cystic lesion with an orifice at the prostatic urethra, which was incised endoscopically. There was no complication observed postoperatively. Seven months after the technique, hematospermia resolved completely. A midline cyst should be considered a cause of hematospermia and the incidence of such cysts may be higher than that previously recognized. The transurethral technique is expected to be a successful treatment approach.

Urinary symptoms, quality of life and sexual function in patients with benign prostatic hypertrophy before and after prostatectomy: a prospective study.

To evaluate urinary symptoms, sexual dysfunction and quality of life in patients with benign prostatic hypertrophy (BPH) before and after open prostatectomy, using the International Prostate Symptom Score (IPSS), the International Continence Society (ICS)-"BPH" (ICS-male, ICS-sex and ICS-QoL) and International Index of Erectile Function (IIEF) questionnaires. Sixty men with BPH (mean age 68 years) underwent a digital rectal examination, transurethral ultrasonography, measurement of total prostatic specific antigen serum level and uroflowmetry. Their urinary symptoms, sexual function and quality of life were fully evaluated using the IPSS, ICS-"BPH" and IIEF before and 6 months after suprapubic prostatectomy. The body mass index (BMI) was also calculated for each patient. Univariate analysis was used to examine the relationship between symptom scores and age, tobacco use, alcohol intake and BMI. In a univariate analysis, age was the most important prognostic factor for both urinary and sexual symptoms. Prostatectomy resulted in a significant improvement in obstructive (mean 9.68 to 3.38) and irritative symptom (6.70 to 3.06), and quality-of-life scores (3.41 to 1.34). ICS-male scores were both significantly decreased, the mean voiding score from 13.72 to 10.28 and the incontinence score from 10.43 to 7.81. There was also a significant decrease in the ICS-QoL symptom score (from 9.20 to 7.27). Comparative results between IIEF and ICS-sex showed no improvement in sexual scores after open surgery, but there was a significant increase in sexual desire and overall satisfaction (both P = 0.035). The combined use of the IPSS, ICS-"BPH" and IIEF allows an evaluation of the relationship between age, prostatic symptoms and sexual dysfunction. Age may be considered both a direct and indirect (BPH-related) prognostic factor for sexual activity. Suprapubic prostatectomy resolves obstructive symptoms, and maintains sexual desire, overall sexual satisfaction and an improvement in quality of life. However, irritative symptoms, erection, orgasm and sexual intercourse satisfaction are not significantly altered.

Bladder carcinoma evaluated by transvaginal ultrasonography.

Transvaginal ultrasonography is a less invasive examination method than transrectal and transurethral ultrasonography for women. However, in spite of the use of transrectal and transurethral ultrasound for the detection of a bladder tumor being well known to urologists, we found no previous studies on transvaginal ultrasonography as a method to evaluate bladder carcinoma. We report a case in which transvaginal ultrasonography contributed to the screening and evaluation of bladder carcinoma.

The efficacy of re-TUR after 3 weeks of initial TUR treatment for locally advanced bladder cancer

Radical cystectomy was usually performed for the patient with advanced bladder cancer. The choice of surgical procedure whether bladder preserved therapy or radical cystectomy has sometime plagued us in bladder cancer treatment. Because we don't have clear guideline for the treatment of locally advanced bladder cancer (T2-T3a N0M0). We devised a radical treatment for the patients with locally advanced bladder cancer without radical cystectomy. We performed re-TUR treatment after 3 weeks of initial TUR for 13 patients with grade 2 and locally advanced bladder cancer diagnosed with pelvic CT scan, transurethral ultrasonography or bimanual examination under the anesthesia. We could successfully preserve all cases of bladder with the use of this devised TUR (periods 9-45 months median 22 months). This method has significantly reduced the cystectomy rate in such locally advanced cases compared with the cystectomy rate prior to 1993 (p < 0.001). This method has significance on treatment for locally advanced papillary bladder cancer as bladder preserving therapy with careful observation.

Comparison of prostatic volume and dimensions by transrectal and transurethral ultrasonography.

To compare the volumes and dimensions of the prostate gland as measured by transrectal and transurethral ultrasonography (TRUS and TUUS) and to study the prostatic changes that occur in the presence of an urethral instrument. Twenty men (mean age 71 years, range 43-85) with symptoms of prostatic enlargement underwent TRUS and the dimensions and volumes of their prostates were obtained by the dimensional method and by step planimetry. Within 24 h, all the men were examined cystoscopically under sedoanalgesia and underwent TUUS. Their prostatic volumes and dimensions were again measured by the dimensional method and by step planimetry. Step planimetry was carried out using a specially designed indexer firmly attached to the examination couch or operating table. All the static images and planimetry slices were video recorded for later computer enhancement and to study the three-dimensional changes occurring in the prostate. The volumes and dimensions obtained by TRUS and TUUS were compared. Volumes obtained by transurethral step planimetry were 22% greater than those from transrectal planimetry. Although there was a good correlation (r = 0.984) between transurethral planimetry and the volumes derived using the transurethral dimensions with the prolate ellipsoid formula, the latter produced values 17% and 25% lower by the transurethral and transrectal routes, respectively. These volume estimates varied widely, indicating that the simple addition of a constant to the prolate ellipsoid formula would not correct the volume. Three-dimensional changes of the prostate occurred with TRUS and TUUS: with TUUS, the craniocaudal and anteroposterior diameters were significantly larger (by 7% and 18%, respectively) while the transverse diameter was smaller by 20%. The estimated volumes and dimensions of the prostate differed when measured by TRUS and TUUS and three-dimensional changes in the prostate occurred in the presence of an urethral instrument.

Transurethral Ultrasonographic Assessment of Bladder Carcinoma: Its Value and Limitation

Purpose We assess the value and limitation of transurethral ultrasonography in the diagnostic evaluation of bladder carcinoma. Materials and Methods A total of 115 patients underwent the procedure, either at the same setting as transurethral resection (76) or 2 weeks before radical cystectomy (39). The results were compared with the pathological findings of transurethral and cystectomy specimens. Results The correlation between transurethral ultrasonography and pathological staging was 100 percent in tumors without muscle invasion (stages Ta and T1), 95.7 percent and 96.8 percent in muscle invasive tumors (stages T2 and T3a, respectively), and 70 percent in tumors with extravesical spread. Conclusions Transurethral ultrasonography is most valuable in determining the stage of tumor confined to the bladder wall. Also, it is of value in detecting tumors in a diverticulum, and monitoring the distensibility of the bladder wall and transurethral resection of disease. The main limitations are the inabilities to discriminate between stages Ta and T1 tumors, and to detect involvement of the pelvic lymph nodes.

NEOPLASMS OF THE BLADDER, PROSTATE, AND TESTIS

As a group, carcinomas of the urinary bladder, prostate, and testis account for more than one third of all cancers occurring in men. Computed tomography is the imaging procedure of choice for postorchiectomy staging of testicular cancers. Transrectal ultrasonography and magnetic resonance imaging play important roles in the staging of prostate cancer. Magnetic resonance imaging, computed tomography, and transurethral ultrasonography are all capable of providing important information in the staging of bladder cancer. Carefully designed clinical trials will be needed to provide a sound scientific basis for guiding the judicious use of imaging tests for staging bladder and prostate cancer in the future.

STAGING OF ADVANCED BLADDER CANCER: Current Concepts and Pitfalls

Data presented in the preceding paragraphs should highlight to the reader several important features of clinical bladder cancer staging. Irrespective of the staging level being addressed, the available techniques uniformly have limitations, as well as advantages and disadvantages with respect to each other. A common shortcoming of both plain and cross-sectional techniques employing conventional X-rays is their lack of specificity. Every radiographic finding has an associated differential diagnosis in which neoplasia-related change is but one of many possibilities. Solitary abnormalities on bone scan or chest film serve as an excellent examples of this dilemma. The specificity of conventional imaging techniques is further compromised by attempts to increase sensitivity. As long as nonspecific anatomic changes are used as discriminating criteria, increases in test sensitivity will always occur at the price of specificity. It is hoped that advances in PET scanning and the use of isotope-labeled, tumor-selective monoclonal antibodies will overcome the limitations of currently available techniques. The significance of the limitations of a given test depends to some degree on whether the test is being used for clinical decision making or for patient stratification in a clinical trial. As an example, an aggressive transurethral resection of bladder tumors provides excellent information for clinical management but may introduce bias into multicenter studies in which this technique is not uniformly practiced. Similarly, the results of bimanual examination under anesthesia are important in the reference framework of the managing physician but are a poor quantifier of disease extent in multi-investigator clinical trials. Which staging studies are indicated and their optimal sequence for performance are influenced by pre-existing clinical information. Recognizing this, the staging algorithm in Figure 6 is intended to serve only as a guide to assist the clinician in the evaluation of patients with bladder neoplasms. As clarifications, several points concerning this algorithm merit mention. The literature suggests that as a single study, transurethral ultrasonography provides excellent local staging information. However, given that it is not widely available, the authors have chosen not to incorporate it into the staging schema. Optimally, it would be used immediately prior to transurethral resection of bladder tumors and bimanual examination. In addition, the algorithm lists MRI interchangeably with CT. While MRI appears to have slightly better sensitivity and specificity for both local and regional tumor stage relative to CT, its benefits are to some degree offset by its greater cost and the need to image the patient in multiple planes for lengthy intervals.(ABSTRACT TRUNCATED AT 400 WORDS)

Transurethral ultrasonography, fiberoptic cystoscopy and bladder washout cytology in the evaluation of bladder tumours.

The impact of transurethral ultrasonography, fiberoptic cystoscopy and bladder washout cytology on assessment of bladder tumours was investigated in this study. Transurethral ultrasonography had an accuracy rate of 96.5% in diagnosing and staging bladder tumours. The accuracy rates of fiberoptic cystoscopy and washout cytology were 90.9% and 73.7%, respectively, in diagnosis. The efficacy of transurethral ultrasonography was found to be high enough for routine employment in the evaluation of the bladder tumours. Fiberoptic cystoscopy in conjunction with washout cytology as a combination relatively easy to perform can be used especially for follow-up purposes of the bladder tumours.

Transurethral Ultrasound-Guided Laser-Induced Prostatectomy (Tulip Procedure): A Canine Prostate Feasibility Study

We describe the TULIP procedure, a new system to relieve bladder outlet obstruction caused by benign prostatic hyperplasia. This device is composed of a real-time 7.5MHz ultrasound transducer coupled to a Nd:YAG laser with a 1.064μm wavelength that fires through an intact intraprostatic balloon. A series of feasibility studies in 21 canine prostate glands was performed with a follow-up time to 3 months. Results indicate that the Nd:YAG laser in the 20 to 40W range at a pull rate of approximately 1mm. per second is an effective means of removing substantial amounts of canine benign prostatic hyperplasia. Transurethral ultrasonography was a reliable means of identifying essential landmarks and of controlling the laser. Prostatectomy by laser coagulation necrosis resulted in no bleeding or postoperative obstruction. Intraoperative irrigation fluids were not required, eliminating systemic volume related problems.

A Case of Vesical Paraganglioma Behind the Symphysis Pubis

We report on a 15-year-old boy with a vesical paraganglioma behind the symphysis pubis. Magnetic resonance imaging and transurethral intravesical ultrasonography were helpful in the preoperative localization of the lesion.

Efficacy of Gadolinium-Diethylenetriaminepentaacetic Acid-Enhanced Magnetic Resonance Imaging for differentiation between Superficial and Muscle-Invasive Tumor of the Bladder: A Comparative Study with Computerized Tomography and Transurethral Ultrasonography

Gadolinium-labeled diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) was evaluated in an effort to clarify whether MRI could replace or be proved to be superior to computerized tomography (CT) and/or transurethral ultrasonography. A total of 57 bladder cancer patients was evaluated. MRI was performed with a superconducting magnet operating at 1.5 Tesla. The images acquired were multisections, having a fast spin-echo pulse sequence of less than a 14-second breath holding. Serial scans were performed before and immediately after Gd-DTPA venous injection. The findings on different imaging techniques were compared with the histological stagings. A proper diagnosis was made in 42 of 57 cases (73.7%) by Gd-DTPA-enhanced MRI, in 27 of 57 (47.4%) by CT and in 31 of 57 (54.4%) by transurethral ultrasonography when comparing the histological findings. The sensitivity and specificity for differentiating superficial and muscle-invasive tumor of each imaging method were, respectively, 96.2 and 83.3% in Gd-DTPA-enhanced MRI, 96.0 and 58.3% in CT, and 88.0 and 66.7% in transurethral ultrasonography. These data suggest that the staging of bladder cancer by Gd-DTPA-enhanced MRI appears to be superior and more accurate than the staging obtained by CT and transurethral ultrasonography. Key Words: bladder, carcinoma, bladder neoplasms, magnetic resonance imaging, ultrasonic diagnosis

経尿道的超音波断層法による前立腺癌の浸潤度判定

Transurethral ultrasonography was used to demonstrate the local extension of prostatic cancer in 18 patients undergoing radical prostatectomy. By ultrasonography, capsular penetration of the carcinoma was judged from irregularity and protrusion of the capsule. Infiltration to the seminal vesicle was determined by asymmetry on the echogram. The ultrasound staging was compared to the pathological findings of the step sectioned specimens obtained by total prostatectomy. The accuracy of transurethral ultrasonography in demonstrating the local extension was 94%. The accuracy rates in detecting capsular penetration and depicting seminal vesicle infiltration were 94% and 72%, respectively. The local extension of prostatic cancer has been evaluated by transrectal and transabdominal scannings. Ultrasonography is considered to be more reliable than digital rectal examination, CT or MRI in the preoperative staging of the prostatic cancer. The present study revealed that transurethral ultrasonography had advantage in demonstrating the capsule of the prostate for the following reasons; 1) there is no interposing tissue between the probe and prostate because the probe is inserted into the prostatic urethra, 2) the prostate is observed without deformity caused by the balloon in the rectum, and 3) the beam hits the capsule perpendicularly. The prostatic cancer at the portion of capsular penetration was hypoechoic or anechoic pathologically, these areas corresponded to homogeneous and large cancer nodules. Transurethral ultrasonography is valuable in demonstrating local extension of the prostatic cancer, in particular capsular penetration.

Transrectal Ultrasonography for Staging Tumors of the Urinary Bladder

Transurethral ultrasonography appears to help the urologist stage transitional cell tumors of the bladder. On the basis of the depth of invasion, one can determine whether transurethral resection of tumors will be adequate or whether segmental resection or cystoprostatectomy is required. The adequacy of transurethral resection of tumors can be monitored by comparing the depth of resection with the initial ultrasound examination. Pelvic lymph nodes cannot be assessed by transurethral ultrasound, and therefore CT, MRI, or lymphangiography must be used as well. Currently, CT scanning is the preferred modality because it is noninvasive, simple, inexpensive, and widely available. Other pelvic disorders, including gynecologic disease and neoplasms of gastrointestinal, neural, or bony origin, also may be assessed by transurethral ultrasonography, although experience with its use for these purposes is limited.

Urologic cancer.

Cancer prevention and risk reduction in patients with carcinomas of the urinary tract are most easily identified by smoking cessation. Recent assessments of patients with bladder carcinomas show a high percentage of active smokers. Urologic surgeons and those dealing with cancers of the genitourinary tract should recognize such an important factor. In other lifestyle guidelines, the American Cancer Society suggests that those who significantly reduce the fat content of their diet with weight reduction will generally reduce risk factors in a number of cancers, including prostate cancer. Many new diagnostic tests have been introduced since the 1980 conference. Transrectal ultrasonography as a preoperative staging technique has been received with some enthusiasm. Currently, a national program for the testing of the detection of prostate cancer by ultrasound compared with other physical examinations and marker antigens, such as prostate antigen, is underway. The evaluation of renal masses continues to be improved by the use of ultrasonography and computed tomography (CT) scanning. Currently, magnetic resonance imaging (MRI) techniques are believed to have added some improved assessment for particularly large tumors and the question of their vascular extension. Occasionally observed lesions of the adrenal gland without hormonal expression in patients continue to be noticed during evaluations for frequently unrelated diagnoses. The management of such lesions less than 3.5 cm in diameter is believed to be conservative based on their size. Preoperative staging of the bladder has improved with transurethral ultrasonography use and the follow-up with patients has developed more frequently with the widely available urinary cytology. Fine needle aspiration of the prostate gland, lymph nodes, and other urinary tumor masses is increasing in diagnostic use. Flow cytometry has been applied to all lesions of the urinary tract and continues to be a field of clinical investigation. The field of biologic markers in diagnosis, detection, and follow-up evaluation of patients with carcinomas of the urinary tract is a most interesting and progressive one. Currently, the most widely accepted new innovation is the prostate antigen, which was developed by members of the National Prostatic Cancer Project between 1975 and 1986. Other markers offer potential added value in more accurate and earlier diagnosis and detection and correlation with prognostic factors concerning individual groups of patients. Progress in the detection, diagnosis, and management of genitourinary cancer is being achieved, and prevention, although perhaps simplistic in design, can be more readily applied.