Urology News Feeds

Urological Complications Following Pelvic Radiotherapy

Urology (Gold Journal) In Press - Fri, 07/20/2018 - 00:00
Radiotherapy is widely used as a curative treatment for pelvic malignancies. The location of these organs leads to unavoidable exposure of the bladder, urethra and distal ureters to radiation and may cause subsequent development of radiation cystitis, fistulas, strictures and secondary malignancy. As cancer survival improves, an ever-increasing number of patients are living with the long-term complications of radiotherapy. Symptoms are not only debilitating for the patient but also pose a treatment challenge to the urologist.
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Bilateral single-session versus staged mini-percutaneous nephrolithotomy for renal stones: a comparative study

Urology (Gold Journal) In Press - Fri, 07/20/2018 - 00:00
To compare safety and efficacy of bilateral single-session mini-percutaneous nephrolithotomy (BSS-Mini-PNL) vs staged-Mini-PNL.
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Direct lateral access to renal artery during transperitoneal laparoscopic partial nephrectomy: surgical technique and comparative outcomes

Urology (Gold Journal) In Press - Fri, 07/20/2018 - 00:00
To describe a novel technique of laparoscopic partial nephrectomy (LPN) with direct lateral access (DLA) to renal artery and to report our early outcomes with this technique.
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Intraurethral Erythropoietin to Prevent Fibrosis and Improve Urethral Healing: An Experimental Study in a Rat Model

Urology (Gold Journal) In Press - Fri, 07/20/2018 - 00:00
To determine the effects of intraurethral erythropoietin (EPO) on an experimentally induced urethral injury in a rat model in respect of wound healing enhancement and the prevention of spongiofibrosis
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Prostate Artery Embolization for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Results from a Prospective FDA-Approved Investigational Device Exemption Study

Urology (Gold Journal) In Press - Fri, 07/20/2018 - 00:00
To evaluate the safety and efficacy of prostate artery embolization(PAE) for lower urinary tract symptoms(LUTS) attributed to benign prostatic hyperplasia(BPH).
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A Prediction Model using Machine Learning Algorithm for Assessing Stone-Free Status after Single-Session Shockwave Lithotripsy to Treat Ureteral Stones

The aim of this study was to develop and validate a decision support model using machine learning algorithm to predict treatment success after single-session SWL in ureteral stone patients.
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Acute Kidney Injury after Partial Nephrectomy in Solitary Kidneys: Impact on Long-term Stability of Renal Function

Acute kidney injury (AKI) often leads to chronic kidney disease (CKD) in the general population. The long-term functional impact of AKI observed after partial nephrectomy (PN) has not been adequately studied.
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Oncologic and functional outcome of partial gland ablation with HIFU for localized prostate cancer

We assessed the outcomes of high-intensity focused ultrasound for the primary treatment of localized prostate cancer in a retrospective series. This represents one of the largest published series of intermediate and high-risk patients.
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Impact of Potassium Citrate vs. Citric Acid on Urinary Stone Risk in Calcium Phosphate Stone Formers

No medication has been shown to be effective at preventing recurrence of calcium phosphate urinary stones. Potassium citrate may protect against calcium phosphate stones by enhancing urine citrate excretion and lowering urine calcium, but it raises urine pH which increases calcium phosphate saturation and may negate the beneficial effects. Citric acid can potentially raise urine citrate but not pH, and thus may be a useful countermeasure against calcium phosphate stones. We aimed to assess whether these two agents can significantly alter urine composition and reduce calcium phosphate saturation.
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Editorial Comment

This post hoc analysis of the well-known dietary trial of Borghi et al (reference 15 in article) addresses a knowledge gap regarding whether urinary supersaturation indexes predict kidney stone recurrence. It is important to note that in the original study the 24-hour urine parameters dramatically improved after intervention at week 1 and the improvements were generally sustained in the following years.
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Predictors of Scholarly Productivity, Pursuit of Fellowship, and Academic Practice Among Urology Residents Using Medical Student Application Materials

Urology (Gold Journal) In Press - Thu, 07/19/2018 - 00:00
To evaluate predictors of urology resident scholarly productivity, pursuit of fellowship, and an academic career using medical student application materials.
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Translabial ultrasound evaluation of pelvic floor structures and mesh in the urology office and intraoperative setting

Urology (Gold Journal) In Press - Thu, 07/19/2018 - 00:00
Translabial ultrasound (TUS) can provide an inexpensive alternative imaging modality for evaluating pelvic floor structures and synthetic slings as mesh can be difficult to identify on pelvic exam or cystoscopy, patients may be unable to provide an accurate history of previous pelvic surgery, and cross-sectional imaging with computed tomography and magnetic resonance imaging can be inadequate for evaluating synthetic slings.
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Single-stage abdominoplasty using groin flaps without osteotomies: management of exstrophy-epispadias complex.

Urology (Gold Journal) In Press - Thu, 07/19/2018 - 00:00
The optimal treatment for children born with exstrophy-epispadia complex is still a matter of debate1,2,3. We demonstrate the Single-Stage Abdominoplasty using Groin Flap technique to close the abdominal wall of children with classic bladder exstrophy (CBE) without osteotomy neither radical soft tissue mobilization. Advantages over current techniques are less risk of penile tissue loss and avoidance of osteotomies.
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Evaluating Outcomes of Differential Surgical Management of Non-functioning Upper Pole Renal Moieties in Duplex Collecting Systems

Urology (Gold Journal) In Press - Thu, 07/19/2018 - 00:00
To evaluate the management and clinical outcomes of non-functioning upper pole moieties treated with either upper pole heminephrectomy or upper pole preservation with lower ureteral reconstruction at a single tertiary institution.
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The Prognostic Value of PIK3CA Copy Number Gain in Penile Cancer

Urology (Gold Journal) In Press - Thu, 07/19/2018 - 00:00
To determine whether phosphatidylinositol-4,5-bisphosphate 3- kinase, catalytic subunit alpha (PIK3CA) copy number gain in penile cancer has prognostic value and association with histopathological parameters, HPV and clinical outcome.
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Hypospadias—Nature and Nurture

Hypospadias is one of the most common conditions encountered and arguably one of the most challenging anomalies to be treated by pediatric urologists. The parental stress associated with this disorder naturally leads parents to ask 2 age-old questions: “Why did this happen?” and “Could this happen again in subsequent offspring?”
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Reply by Authors

For several decades it has been appreciated that multi-agent cisplatin based chemotherapy leads to a pathological complete response in about 30% to 40% of patients with muscle invasive urothelial cancer of the bladder and such a response confers a highly favorable prognosis. Ironically proving that a pathological complete response has occurred requires surgical removal of the bladder and the potential morbidity associated with the procedure.
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Editorial Comment

Muscle invasive bladder cancer is a challenging disease to treat. Balancing long-term disease control while minimizing short-term and long-term morbidity and maximizing quality of life is difficult when your tools are relatively toxic systemic chemotherapy, radiation therapy and radical cystectomy. Historically the urological community has been slow to consider alternate treatments compared to radical cystectomy as reflected in the relatively low use of neoadjuvant chemotherapy and trimodal therapy.
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Editorial Comment

In the current NCDB derived study short-term and long-term outcomes after chemotherapy of MIBC were evaluated in patients who did not undergo cystectomy or radiation after bladder tumor TUR. During a 10-year period 1,538 patients underwent chemotherapy alone after TUR while 17,866 underwent undergone cystectomy with or without chemotherapy. The authors noted that patients who did not undergo cystectomy had lower 30 and 90-day mortality rates than those who underwent cystectomy. The noncystectomy group was older, less insured, more likely to be African American, less likely to receive care at an academic facility and most importantly had poorer overall survival than patients who underwent cystectomy.
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Editorial Comment

Systemic chemotherapy prior to radical cystectomy has been shown to improve survival in MIBC with the best outcomes in patients who achieve a complete pathological response (pT0) (reference 8 in article). The current data from Audenet et al suggest that chemotherapy alone in select patients without cystectomy may result in up to 36% 5-year survival. The implication is that cystectomy can be safely delayed or even eliminated in some individuals with MIBC. However, these results must be interpreted with caution.
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