Urology Clinic of Lake Charles, LA

Dr. Reed Fontenot, Jr.
Dr. Stacy McBroom
Dr. John Upshaw

News

July 18, 2008
Computerized Tomography Findings In Pediatric Renal Trauma - Indications For Early Intervention?
UroToday.com - The study out of Children's Hospital of Pittsburgh evaluated CT scans for blunt renal trauma to see if they correlated with the need for operative intervention when urinary extravasation was present.

A total of 17 patients with grade IV blunt renal trauma and urinary extravasation were identified between 2000 and 2007. Each CT scan was reviewed to determine location, size and number of sites of extravasation, as well as the presence of contrast material in the ipsilateral ureter. These were then compared to the findings at the time of surgery - whether surgey included stent placement, percutaneous urinoma drainage, angiographic embolization and nephrectomy. Read entire article here.

July 15, 2008
Increased Risk Of Kidney Stone Disease Due To Global Warming, Predicts UT Southwestern Researchers
Global warming is likely to increase the proportion of the population affected by kidney stones by expanding the higher-risk region known as the "kidney-stone belt" into neighboring states, researchers at UT Southwestern Medical Center and UT Dallas have found.

Dehydration is one of the risk factors linked to kidney-stone disease, and the paper suggests global warming will exacerbate this effect. The researchers predict that by 2050, higher temperatures will cause an additional 1.6 million to 2.2 million kidney-stone cases, representing up to a 30 percent growth in some areas. Read entire article here.

Information
Prostate cancer is the second leading cause of death among men. In 2002 it is estimated that 30,200 men will die from prostate cancer and 189,000 men will be diagnosed (American Cancer Society Facts & Figures 2002). The incidence of prostate cancer increases with age with 75% of all prostate cancers being diagnosed in men over the age of 65.

Prostate Cancer Management
The critical focus for the treatment of prostate cancer is to treat those cancers where it is necessary, and not to treat those that do not need it.

Decisions about the best management of prostate cancer can be complex and depend upon the:

Pathology of the cancer (unlike other cancers, prostate cancer often progresses very slowly)
Stage of the disease (non-metastatic (localized or locally advanced), metastatic or hormone refractory)
Age and general health of the patients at diagnosis
The impact that treatment can have on quality of life, including sexual activity.
Patient's preference for treatment
PSA at diagnosis

Please visit the National Prostate Cancer Coalition for more information.

August is National Immunization Awareness Month
Vaccine-preventable disease levels are at or near record lows. However, we cannot take high immunization coverage levels for granted. To continue to protect America's children and adults, we must obtain maximum immunization coverage in all populations, establish effective partnerships, conduct reliable scientific research, implement immunization systems, and ensure vaccine safety.
Read more ....

Testicular Cancer

Overview

Testicular cancer develops in the testicles (testes), the male reproductive glands. The testicles are located in the scrotum (membranous pouch below the penis) and are suspended from the body by the spermatic cord. They produce sperm (male reproductive cells) and testosterone. Testicular cancer is treated successfully in more than 95% of cases.

Anatomy

The testicles are primarily made up of a mass of seminiferous tubules in which sperm develop. The tubules are lined with Sertoli cells, which protect and supply nutrients to developing sperm. Sertoli cells also secrete the hormone inhibin, which is involved in the regulation of sperm production.

Leydig cells, located in tissue between the seminiferous tubules, secrete testosterone and androsterone. These hormones stimulate the development of male sex organs, beard growth, muscle mass, and deepening of the voice.

Types

Most (95%) testicular cancer originates in undeveloped cells (germ cells) that produce sperm. These tumors, called germ cell tumors (GCTs), are most common in men between the ages of 20 and 40 and are curable in more than 95% of cases. There are two main types: seminomas and nonseminomas. A third type, called stromal tumors, develops in the supporting tissues of the testicle.

Approximately 40% of GCTs are seminomas, which are classified as either typical or spermatocytic. Typical seminomas account for 90% of this type. They often cause unilateral (on one side) testicle enlargement or more often a painless lump in the testicle. Spermatocytic seminomas grow slowly, usually do not spread to other parts of the body (metastasize), and are most common around age 65.

Nonseminomas account for 60% of GCTs and develop in younger men (usually between 15 and 35). Most nonseminomas contain cells from at least two subtypes, including the following:

Choriocarcinoma (rare; aggressive; likely to metastasize)
Embryonal carcinoma (accounts for 20% of cases; likely to metastasize)
Teratoma (usually benign in children; rarely metastasize)
Yolk sac carcinoma (most common in young boys; rare in men)

Testicular cancer may also develop in the supportive, hormone-producing tissue of the testicles (stroma). This type accounts for 4% of testicular cancer in men and 20% in boys. Types of stromal tumors include Leydig cell tumors and Sertoli cell tumors.

Seventy-five percent of Leydig cell tumors develop in men and 25% develop in boys. Most tumors of this type are benign and are treated successfully with surgery. If the tumor metastasizes, it often does not respond well to radiation or chemotherapy and the prognosis is poor.

Sertoli cell tumors develop in Sertoli cells that nourish the sperm-producing germ cells. These tumors are usually benign; metastatic tumors of this type are rare, yet resistant to treatment.

Secondary tumors in the testicles usually migrate from the lymph or lymph nodes. Testicular lymphoma is more common than primary testicular cancer in men over 50. Other cancers (e.g., prostate, lung, skin) may also spread to the testicles.