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Choi BH, You S, Park CS, Cho EH, Park TD, Kim S, Kim YJ, Lee T, Kim J. Differential perturbation of the interstitial cystitis-associated genes of bladder and urethra in rat model. Cell Cycle 2017; 16:749-758. [PMID: 28278053 DOI: 10.1080/15384101.2017.1295184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Interstitial cystitis (IC) is a chronic bladder dysfunction characterized as urinary frequency, urgency, nocturia, and pelvic pain. The changes in urethra may wind up with the bladder changes in structure and functions, however, the functions of the urethra in IC remains elusive. The aim of this study was to understand the perturbed gene expression in urethra, compared with urinary bladder, associated with the defected urodynamics. Using female IC mimic rats, a comprehensive RNA-sequencing combined with a bioinformatics analysis was performed and revealed that IC-specific genes in bladder or urethra. Gene ontology analysis suggested that the cell adhesion or extracellular matrix regulation, intracellular signaling cascade, cardiac muscle tissue development, and second messenger-mediated signaling might be the most enriched cellular processes in IC context. Further study of the effects of these bladder- or urethra-specific genes may suggest underlying mechanism of lower urinary tract function and novel therapeutic strategies against IC.
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Affiliation(s)
- Bo-Hwa Choi
- a Department of Pharmacology , Hypoxia-Related Disease Research Center, Inha Research Institute for Medical Sciences, Inha University College of Medicine , Incheon , South Korea
| | - Sungyong You
- b Departments of Surgery and Biomedical Sciences , Cedars-Sinai Medical Center , Los Angeles , CA , USA
| | - Chang-Shin Park
- a Department of Pharmacology , Hypoxia-Related Disease Research Center, Inha Research Institute for Medical Sciences, Inha University College of Medicine , Incheon , South Korea
| | - Eun-Ho Cho
- b Departments of Surgery and Biomedical Sciences , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,c University of California , Los Angeles , CA , USA
| | - Taeeun D Park
- b Departments of Surgery and Biomedical Sciences , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,d University of California , Berkerly , CA , USA
| | - Sungsoo Kim
- e Department of Biochemistry and Molecular Biology , Medical Research Center for Bioreaction to Reactive Oxygen Species and Biomedical Science Institute, School of Medicine, Kyung Hee University , Seoul , South Korea
| | - Young-Ju Kim
- a Department of Pharmacology , Hypoxia-Related Disease Research Center, Inha Research Institute for Medical Sciences, Inha University College of Medicine , Incheon , South Korea.,f Department of Urology , Inha University College of Medicine , Incheon , South Korea
| | - Tack Lee
- f Department of Urology , Inha University College of Medicine , Incheon , South Korea
| | - Jayoung Kim
- b Departments of Surgery and Biomedical Sciences , Cedars-Sinai Medical Center , Los Angeles , CA , USA.,c University of California , Los Angeles , CA , USA
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Mishra NN. Clinical presentation and treatment of bladder pain syndrome/interstitial cystitis (BPS/IC) in India. Transl Androl Urol 2016; 4:512-23. [PMID: 26816851 PMCID: PMC4708552 DOI: 10.3978/j.issn.2223-4683.2015.10.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease characterized by pelvic pain urgency and frequency. Patients with severe symptoms lead a very miserable life. North American, European and Asian guidelines have been recently promulgated but they differ on many important issues. There is no consensus on its name, definition, investigations and management. Indian guidelines have also been developed and they give more importance to the symptoms in relation to micturition. Though initially believed to be rare or non-existent in India the situation has changed. In Indian patients the presentation is more or less same as the rest of the world but a large percentage have obstructive symptoms and unusual urinary symptoms. Anal discomfort is also common. In India the commonest investigation in all cases of lower urinary tract (LUT) dysfunction is ultrasonography of kidney ureter and bladder with measurement of the post void residual urine volume. Cystoscopy is also done in all the cases to rule out presence of tuberculosis or carcinoma in situ. Bladder pain syndrome/interstitial cystitis (BPS/IC) is not considered to be a clinical disease as it is difficult to rule out all differential diagnosis only from history. Hunner’s lesion is very rare. Cystoscopy with hydro distension, oral therapy, intravesical therapy and surgical therapy form the back bone of management. It is difficult to know which treatment is best for a given patient. A staged protocol is followed and all the treatment modalities are applied to the patients in a sequential fashion—starting from the non-invasive to more invasive. Intravesical botox has not been found to be effective and there is no experience with interstim neuromodulation.
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Chen JL, Chen SF, Kuo HC. Clinical assessment and management of patients with National Institutes of Health categories IIIA and IIIB chronic prostatitis/chronic pelvic pain syndrome. Tzu Chi Med J 2014. [DOI: 10.1016/j.tcmj.2014.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lee SWH, Liong ML, Yuen KH, Liong YV, Krieger JN. Chronic prostatitis/chronic pelvic pain syndrome: role of alpha blocker therapy. Urol Int 2007; 78:97-105. [PMID: 17293646 DOI: 10.1159/000098064] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This article reviews the rationale and data supporting alpha blocker therapy for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), the most common and difficult prostatitis syndrome. METHODS Systematic review identified ten clinical trials evaluating alpha blocker therapy for patients with CP/CPPS, including five open-label or small prospective studies and five double-blinded and placebo-controlled clinical trials. RESULTS Encouraging results in uncontrolled and small clinical trials led to the development of reasonably powered, double-blinded, placebo-controlled, randomized clinical trials evaluating terazosin, doxazosin, tamsulosin, and alfuzosin. CONCLUSIONS Current data suggest that treatment-naïve and/or newly diagnosed patients appear more likely to respond than long-term, chronic refractory patients. Longer courses of treatment (12 weeks to 6 months) appear superior to shorter courses, and less selective agents appear superior to more selective alpha1 blockers. These observations outline important questions that must be answered to define optimal treatment strategies for patients with CP/CPPS.
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Affiliation(s)
- Shaun Wen Huey Lee
- Department of Urology, University of Washington School of Medicine, Seattle, Wash. 98195, USA
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Dimitrakov JD, Kaplan SA, Kroenke K, Jackson JL, Freeman MR. Management of chronic prostatitis/chronic pelvic pain syndrome: an evidence-based approach. Urology 2006; 67:881-8. [PMID: 16698346 PMCID: PMC1463048 DOI: 10.1016/j.urology.2005.12.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2005] [Revised: 10/25/2005] [Accepted: 12/06/2005] [Indexed: 12/11/2022]
Affiliation(s)
- Jordan D Dimitrakov
- Harvard Urological Diseases Research Center, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA.
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7
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Lee C, Seong B. Urodynamic Findings of Chronic Nonbacterial Prostatitis Patients with Urinary Symptoms. Korean J Urol 2006. [DOI: 10.4111/kju.2006.47.3.268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Changug Lee
- Department of Urology, Hanil General Hospital, Seoul, Korea
| | - Bongmo Seong
- Department of Urology, Hanil General Hospital, Seoul, Korea
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Cheah PY, Liong ML, Yuen KH, Teh CL, Khor T, Yang JR, Yap HW, Krieger JN. Reply by the authors. Urology 2005. [DOI: 10.1016/j.urology.2005.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schneider H, Wilbrandt K, Ludwig M, Beutel M, Weidner W. Prostate-related pain in patients with chronic prostatitis/chronic pelvic pain syndrome. BJU Int 2005; 95:238-43. [PMID: 15667647 DOI: 10.1111/j.1464-410x.2005.05373.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pontari MA. Chronic prostatitis/chronic pelvic pain syndrome in elderly men: toward better understanding and treatment. Drugs Aging 2004; 20:1111-25. [PMID: 14651434 DOI: 10.2165/00002512-200320150-00004] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most common of the prostatitis syndromes. It is characterised by pelvic pain, with or without voiding symptoms. CP/CPPS accounts for 2 million office visits in the US alone. Recent epidemiological studies have shown that CP/CPPS can affect men at any age, including those in their 80s. The aetiology is unknown but proposals include infectious, autoimmune, neurologic and psychiatric causes. Men with CP/CPPS are much more likely to have had a past medical history of cardiovascular, neurologic, psychiatric or infectious disease (particularly sinusitis) as compared with asymptomatic individuals. Although leucocytes are commonly found in the prostatic fluid of these men, they do not correlate with the symptoms. The clinical evaluation now includes a validated, self administered symptom score, the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), which was designed as an outcome measure for treatment trials. This can aid in diagnosis and follow-up of patients' response to therapy. Treatment for CP/CPPS is empiric and limited by a lack of randomised, placebo-controlled clinical trials. Antimicrobials are commonly used to treat the symptoms of CP/CPPS. However, the finding that asymptomatic men have equal or greater numbers of bacteria which localise to the prostatic fluid, compared with men with CP/CPPS, has raised doubts about the contribution of infection to the symptoms. Other commonly used drugs include alpha-adrenoceptor antagonists, anti-inflammatory drugs, tricyclic antidepressants and anticholinergic agents. The adverse effects of these medications are a concern in older men with CP/CPPS. Other therapies available include minimally invasive procedures such as microwave thermotherapy and transurethral needle ablation, and now neuromodulation devices.Although much progress has been made, particularly in the last 7 years, considerable work still remains to be done to determine the aetiology and pathogenesis of CP/CPPS, and to develop mechanism based therapy that is shown to be effective in controlled trials.
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Affiliation(s)
- Michel A Pontari
- Department of Urology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA
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Jakobsson L, Lovén L, Hallberg IR. Micturition Problems in Relation to Quality of Life in Men With Prostate Cancer or Benign Prostatic Hyperplasia. Cancer Nurs 2004; 27:218-29. [PMID: 15238809 DOI: 10.1097/00002820-200405000-00007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of the study was to investigate men with prostate cancer and benign prostatic hyperplasia (BPH) in comparison with men from the general population in aspects of presence and frequency of micturition problems in remembrance of prior to treatment and currently. Further, the aim was to investigate the impact of micturition problems on quality of life and the association with micturition problems, and quality of life and sense of coherence (SOC). The samples consisted of 155 men with prostate cancer, 131 with BPH, and 129 from the general population. Micturition problems were assessed with study-specific questions, modified International Prostate Symptom Score (IPSS), quality of life questionnare (QLQ C-30), and SOC questionnaires. Parametric and nonparametric statistics were applied. Most troublesome urinary problems were leakage, feelings of discomfort, and disrupted urinary function and frequency. Men with urological diagnosis had more micturition problems, fatigue, and sleeping difficulties than men from the general population, but the cancer diagnosis did not add to the problems. Role and social functioning (prostate cancer), emotional functioning (BPH), and grade of fatigue (general population) showed itself vital for overall quality of life. Thus, help in solving issues of micturition problems, fatigue, and sleeping disturbances may contribute to maintenance of role, social, and emotional aspects of life.
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Affiliation(s)
- Liselotte Jakobsson
- Department of Health Sciences, Kristianstad University College, Kristianstad, Sweden.
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Affiliation(s)
- Daniel A Shoskes
- Department of Urology, Section of Renal Transplantation, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL 33331, USA.
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Eisenberg ER, Moldwin RM. Etiology: where does prostatitis stop and interstitial cystitis begin? World J Urol 2003; 21:64-9. [PMID: 12774174 DOI: 10.1007/s00345-003-0337-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2003] [Accepted: 04/04/2003] [Indexed: 11/24/2022] Open
Abstract
Male chronic pelvic pain syndrome (MCPPS) and interstitial cystitis (IC) patients show striking similarities in clinical presentation, diagnostic evaluation, purported pathogenesis, and even response to therapy. This makes the distinction between them very difficult. This review aims to show just how easy it is for the clinician to miss the features of IC in the MCPPS patient (and conversely). Misdiagnosis can result in the rejection of various potentially helpful therapies while accurate early diagnosis will lead to appropriate therapies and a better quality of life for the patient.
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Affiliation(s)
- Evan R Eisenberg
- Deptartment of Urology, 270-05 76th Avenue, New Hyde Park, NY 11040, USA.
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Terazosin Therapy For Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Randomized, Placebo Controlled Trial. J Urol 2003. [DOI: 10.1016/s0022-5347(05)63960-2] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Krieger JN, Ross SO, Penson DF, Riley DE. Symptoms and inflammation in chronic prostatitis/chronic pelvic pain syndrome. Urology 2002; 60:959-63. [PMID: 12475649 DOI: 10.1016/s0090-4295(02)01963-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To evaluate the possibility that patients with inflammatory and noninflammatory chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) might present with different symptoms. Patients with CP/CPPS present with characteristic symptoms without bacteriuria. The new National Institutes of Health consensus suggests that CP/CPPS can be divided into inflammatory and noninflammatory categories. METHODS Standardized symptom surveys were completed by 130 subjects who met the criteria for CP/CPPS after clinical examination and urethral, urine, expressed prostatic secretion (EPS), and seminal fluid analysis evaluations. RESULTS When classified by either EPS or postprostatic massage urine (VB3) findings, subjects with and without inflammation had similar symptoms. However, when classified using the combination of EPS, VB3, and seminal fluid analysis, subjects with inflammatory CP/CPPS had more severe (P <0.02) and more frequent symptoms, in particular, difficulty reaching erection (P <0.01), weak urinary stream (P <0.01), urinary frequency (P = 0.03), and penile pain (P = 0.04). CONCLUSIONS The increased severity and frequency of symptoms among patients with inflammatory CP/CPPS provide empirical support for the new consensus classification on the basis of the combination of EPS, VB3, and seminal fluid analysis findings.
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Affiliation(s)
- John N Krieger
- Department of Urology, School of Medicine, University of Washington, Seattle, Washington, USA
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Ku JH, Kim ME, Jeon YS, Lee NK, Park YH. Impact of urinary symptoms on bothersomeness and quality of life in young men. Urology 2002; 60:442-8. [PMID: 12350481 DOI: 10.1016/s0090-4295(02)01765-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To examine the impact of urinary symptoms on bothersomeness and quality of life among young men in a community. METHODS The National Institutes of Health-Chronic Prostatitis Symptom Index was used to identify men with urinary symptoms. The questionnaire also queried about sociodemographic characteristics. A total of 15,264 men without pain or discomfort suggestive of prostatitis were included in this study. RESULTS Of the 15,264 subjects, 43.6% reported that they experienced urinary symptoms. With regard to symptom severity, 3.4% did not believe their bladder emptied fully after urinating more than one time in five, and 9.7% had to urinate again within 2 hours more than one time in five. Men in major towns had more severe symptoms, including incomplete emptying and frequency, than those in other areas. Men with a high educational level were less likely to report that they experienced severe frequency. Multivariate logistic regression analyses indicated that urinary symptoms significantly affected bothersomeness and quality of life of young men. CONCLUSIONS In a community-based population of healthy 20-year-old Korean men, the prevalence of urinary symptoms was 43.6%. The results of the study indicated that demographic variables might influence the prevalence of urinary symptoms in young men. In addition, our findings suggest that young men with urinary symptoms experience a negative impact on their quality of life.
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Affiliation(s)
- Ja Hyeon Ku
- Department of Urology, Military Manpower Administration, Taejeon, South Korea
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Abstract
Few clinical conditions encountered by the urologist cause more patient and clinician frustration than interstitial cystitis and male chronic pelvic pain syndrome, also know as nonbacterial prostatitis. This frustration is fueled by the chronicity of often disabling urogenital (and often associated systemic) symptoms coupled with delayed care, misdiagnosis, and suboptimal clinical responses. Basic research and therapeutic trials for these syndromes have historically taken two separate paths. However, mounting evidence suggests that significant overlap may exist between them in epidemiology, pathophysiology, and even therapy. This discussion reviews some of the common features of these clinical problems and makes a case that they might in fact represent different manifestations of the same disease process.
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Affiliation(s)
- Robert M Moldwin
- Department of Urology, Long Island Jewish Medical Center, 170-5 76th Avenue, New Hyde Park, NY 11040, USA.
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Lovejoy B. Diagnosis and management of chronic prostatitis by primary care providers. JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS 2001; 13:317-21; quiz 322-4. [PMID: 11930605 DOI: 10.1111/j.1745-7599.2001.tb00042.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe the etiology, clinical manifestations, differential diagnosis, and treatment of chronic bacterial and chronic abacterial prostatitis (CBP and CAP respectively) in the primary care setting. DATA SOURCES Selected research, clinical guidelines, and research-based articles in the scientific literature. CONCLUSIONS Most cases of CBP can be appropriately diagnosed and treated in the primary care office. In the case of a diagnosis of CAP, initial therapy can be started by the nurse practitioner (NP) with referral to a urologist for refractory cases. IMPLICATIONS FOR PRACTICE Complete eradication of pathogens in CBP is not always possible. Assisting patients to carefully follow their treatment regimens, including completion of all antibiotic therapy, will reduce the frequency and severity of symptoms. Successful management of chronic prostatitis symptoms can result in an improved quality of life and an increased ability to perform activities of daily living for patients. Chronic abacterial prostatitis may require referral to a urologist or mental health professional for co-management of symptoms.
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Affiliation(s)
- B Lovejoy
- University Medical Associates-Baker Place, Omaha, NE 68104, USA.
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KRIEGER JOHNN, RILEY DONALDE, VESELLA ROBERTL, MINER DAVIDC, ROSS SUSANO, LANGE PAULH. BACTERIAL DNA SEQUENCES IN PROSTATE TISSUE FROM PATIENTS WITH PROSTATE CANCER AND CHRONIC PROSTATITIS. J Urol 2000. [DOI: 10.1016/s0022-5347(05)67145-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- JOHN N. KRIEGER
- From the Department of Urology, University of Washington, School of Medicine, Seattle, Washington
| | - DONALD E. RILEY
- From the Department of Urology, University of Washington, School of Medicine, Seattle, Washington
| | - ROBERT L. VESELLA
- From the Department of Urology, University of Washington, School of Medicine, Seattle, Washington
| | - DAVID C. MINER
- From the Department of Urology, University of Washington, School of Medicine, Seattle, Washington
| | - SUSAN O. ROSS
- From the Department of Urology, University of Washington, School of Medicine, Seattle, Washington
| | - PAUL H. LANGE
- From the Department of Urology, University of Washington, School of Medicine, Seattle, Washington
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