Adam Luchey

In Vitro Regulation of Cell Growth and Angiogenesis by Inositol Hexaphosphate in Bladder Cancer

Background: Inositol Hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate that is found in food sources high in fiber content. We hypothesized that IP6 would inhibit the cell growth rate of bladder cancer in vitro. Methods: T24 and TCCSUP bladder cancer cell lines were treated with titrating doses of IP6 (0.3, 0.6 and 0.9 mM/well). Cell viability and vascular endothelial growth factor levels were measured. Results: Significant reductions (p < 0.001) in cellular growth were noted in both cell lines at all doses and time points tested, with the exception of 0.3 mM IP6 at 24 hours in the T24 cell line. The percent inhibition of vascular endothelial growth factor was significantly higher than that observed in the TCCSUP cell line at 48 and 72 hours with 0.3 mM IP6 (p < 0.001). The T24 cells exhibited the same level of inhibition at 24 and 48 hours with 0.6 mM dose of IP6 and at 72 hours with the 0.3 mM dose (p < 0.001). Conclusions: In vitro treatment of bladder cancer with the common dietary polyphosphorylated carbohydrate IP6 significantly decreased cellular growth by anti-angiogenic mechanisms. We feel that this data warrants further investigation and consideration for initiation of clinical trials to evaluate the safety and clinical utility of this agent.

PD44-07 FEMALE SEXUAL DYSFUNCTION: A WEST VIRGINIA UNIVERSITY CLINICAL EXPERIENCE

INTRODUCTION AND OBJECTIVES: Female lower urinary tract symptoms (LUTS) affect quality of life and sexual activity. This study aimed to evaluate the influences of LUTS on sexual well-being in Japanese women, as little is known on this topic. METHODS: We investigated 514 women recruited between August 6 and August 17, 2007, from the outpatient departments (except the departments of pediatrics, psychiatry and ophthalmology) at our hospital, regardless of the reason for visiting. All participants were asked to answer a standardized self-reported questionnaire. Using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the overactive bladder symptom score (OABSS), we evaluated urinary symptoms, including stress urinary incontinence, urgency, day time frequency, and nocturia. To assess satisfaction with sexual function, we asked the question “If you were to spend the rest of your life with your sexual function the way it is today, how would you feel about this?”, with answer choices of “very satisfied”, “somewhat satisfied”, “neither satisfied nor dissatisfied”, “somewhat dissatisfied” and “very dissatisfied”, from part of a questionnaire from the Global Study of Sexual Attitudes and Behaviors (GSSAB) study. The top two categories for each aspect were collapsed to identify positive answers as being very or somewhat satisfied with the level of sexual function. We analyzed relationships between dissatisfaction with sexual function and other variables, including age, stress urinary incontinence, urgency (1⁄4 once a day), daytime frequency ( 8 times/day), and nocturia (1⁄4 once a night). The chi-square test and logistic regression models were used for statistical analyses. Values of P<0.05 were considered statistically significant. RESULTS: A total of 360 individuals completed the questionnaire (response rate, 70.0%). The mean ( standard deviation) age of respondents was 48.3 13.2 years. Prevalences of stress urinary incontinence, urgency, daytime frequency, and nocturia were 35.4%, 3.1%, 39.6%, and 55.0%, respectively. Overall, the prevalence of dissatisfaction with sexual function was 55.4%. In univariate analysis, age, urgency, and nocturia were associated with dissatisfaction with sexual function. In multivariate analysis, a significant correlation was found between dissatisfaction with sexual function and both age (odds ratio (OR), 1.05; p<0.001) and urgency (OR, 9.19; p1⁄40.047). CONCLUSIONS: Our study confirmed age and urgency as independent risk factors for dissatisfaction with sexual function. These results suggest that urgency can offer a predictor of sexual dysfunction among Japanese women.

Chemoprevention and Novel Treatments of Non-Muscle Invasive Bladder Cancer

The Cancer Journal for Clinicians reports there will be 69,250 newly diagnosed cases of bladder cancer in 2011, with 52,020 being men and 17,230 being women with an increase by 50% of annual cases since 1985. Approximately 1 in 5 of those who develop bladder cancer will die due to the disease (relative mortality 20.8%, [Siegel et al., 2011, Golijanin et al., 2006]). Bladder cancer has become the second most prevalent cancer after cancer of the prostate in middle-aged to elderly male individuals. Many patients do not die from their disease, but typically have multiple recurrences (Pelucchi et al., 2006). This lends to a fiveyear cost to Medicare attributed to bladder cancer of over one billion dollars (Yabroff et al., 2008). Tobacco use and exposure to aromatic amines are well established etiologic contributors to bladder cancer and by eliminating or reducing contact with these substances has been shown to reduce such risk. BCG (bacillus Calmette-Guerin) has become the standard of care in the treatment of carcinoma in situ as well as high grade T1 (invasion into the lamina propria) and when not appropriate, Mitomycin-C, has been proven to be an acceptable, albeit, less effective alternate. The goal of this chapter will be to describe novel agents that may show promise in the treatment of bladder cancer. This will include descriptions of the agents, their respective mechanism of action (e.g. molecular/biochemical pathways, cell cycle interaction, necrosis), clinical data, combinations of combinations of regimens and mode of delivery. and mode of delivery. A second goal of this chapter will be to consider whether any of these novel agents may have a role in the prevention of bladder cancer.

Treatment of the Duplicated Ureter Injured Intraoperatively, Application of Kidney Transplant Techniques to the Urology Reconstruction Setting: Case Report and Review of the Literature

Clinically significant iatrogenic ureteral injuries, excluding ureteroscopy, are likely underreported but considered a rare occurrence in pelvic surgery. An intraoperative consult for double ureter injury has never been documented in the medical literature. Presented herein is a case of a 53-year-old female undergoing conversion from a laparoscopic to open sigmoid resection for diverticular disease. There was an injury to a pelvic left ureter, which was then identified intraoperatively as left double ureter. Reconstruction was performed with left double side-to-side stented ureteroureterostomy followed by ureteroneocystotomy.