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 ....

Upper Tract Tumors

Overview

Upper tract tumors develop in the renal pelvis (tissue in the kidneys that collects urine) and the ureters (tubes that carry urine from the kidneys to the bladder). Cancer that originates in the upper urinary tract accounts for less than 1% of cancers of the genitourinary system (reproductive and urinary systems). Upper tract tumors are often associated with bladder cancer.

Types

More than 90% of renal pelvis tumors develop in transitional epithelial cells (surface lining cells). This type is called transitional cell carcinoma (TCC). TCC often develops in multiple areas of the upper urinary tract.

Fewer than 10% of renal pelvis tumors are squamous cell carcinomas, which develop in flat surface cells that line the renal pelvis. Adenocarcinoma, which develops in glandular cells, is extremely rare. These types of renal pelvis tumors are associated with inflammation caused by chronic urinary tract infections and kidney stones.

Incidence and Prevalence

According to the American Cancer Society, incidence of upper tract tumors is about 1-2 cases per 100,000 people each year. Renal pelvis tumors are more common in men and in Caucasians. Peak incidence occurs in the 60- to 70-year age group. The highest incidence is in Balkan countries such as Bulgaria, Greece, Yugoslavia, and Romania.

Bilateral (occurring on both sides) upper tract tumors occur in less than 2% of cases.

Causes and Risk Factors

The cause of upper tract tumors is unknown. A personal history of bladder cancer is the primary risk factor. Smoking cigarettes is also a major risk factor. Smoking may contribute to as many as 60-80% of cases. Other risk factors include the following:

Age
Balkan descent
Chronic urinary tract infections
Family history of transitional cell carcinoma
Genetic mutation of the p53 gene
Overuse of analgesics that contain phenacetin
Recurrent kidney stones
Use of chemotherapy drugs cyclophosphamide and ifosfamide

People who work in chemical, petroleum, aniline dye, and plastics industries, and those exposed to coal, tar, and asphalt, also have an increased risk for upper tract tumors. Consuming more than seven cups of coffee a day may slightly increase the risk for the condition.

Signs and Symptoms

Blood in the urine (hematuria) is the most common symptom. Hematuria may be gross (visible to the naked eye) or microscopic (visible upon examination with a microscope). Other symptoms include bladder irritation, constipation, and pelvic pain.