Urology News Feeds

Testosterone therapy for high-risk prostate cancer survivors: a systematic review and meta-analysis

Urology (Gold Journal) In Press - Fri, 09/21/2018 - 00:00
A systematic review and meta-analysis was performed to determine the relationship between testosterone therapy and risk of recurrence in testosterone-deficient survivors of curatively treated high-risk prostate cancer. Primary outcome was the risk of biochemical recurrence (BCR) in 109 high-risk patients in 13 included studies (1997-2017). Biochemical and symptomatic effects of therapy were also reviewed. The BCR rate was 0.00 (0.00-0.05), lower than the expected rate for high-risk prostate cancer survivors, suggesting that testosterone therapy may not increase their BCR risk.
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Surgical Outcomes of Three vs Four Arm Robotic Partial Nephrectomy: Is the Fourth Arm Necessary?

Urology (Gold Journal) In Press - Fri, 09/21/2018 - 00:00
To compare the cost, efficacy, and safety of 3-arm versus 4-arm technique in robotic partial nephrectomy (RPN). Surgeons may either elect to utilize three versus four robotic instruments depending on preference. The purpose of this study is to compare the outcomes between the two techniques.
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The History of Urology at the Minneapolis Veterans Affairs Health Care System

Urology (Gold Journal) In Press - Fri, 09/21/2018 - 00:00
The Veterans Health Administration (VHA) is the largest health care system in the United States, serving more than 8.9 million Veterans each year.1 It is estimated that sixty percent of all medical residents train within the 168 Veterans Affairs (VA) Medical Centers, making the VA the largest provider of healthcare training in the United States.1 Within the VA system, the Minneapolis VA Health Care System is one of the largest training programs. Many leaders in Urology have trained or served at the Section of Urology within the Minneapolis VA.
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Non-neuropathic Neuropathic Bladder: Is it Really Non-neuropathic?

Hinman Syndrome is a rare disease with urodynamic findings and clinical course that resemble neuropathic bladder and no neuropathic etiology. Diffusion Tensor Imaging (DTI) is a special magnetic resonance imaging (MRI) technique that has recently been used for peripheral nerves but shown to be applicable for evaluation of lumbosacral plexus. Our aim was to evaluate the lumbosacral plexus using DTI, which was not previously performed in Hinman Syndrome.
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Radical prostatectomy after vascular-targeted photodynamic therapy (VTP) with TOOKAD® : feasibility, early and intermediate results

and objectives: vascular-targeted photodynamic therapy with TOOKAD® (VTP) is a new therapeutic option for localized prostate cancer (PCa) management. The objectives are to assess the feasibility of radical prostatectomy (RP) after VTP and describe functional and oncological outcomes.
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Editorial Comment

It is exciting to see studies such as this one in which elegant technology was applied to improve medical decision making by using presumably more accurate means of prediction. In this case the example is machine learning to predict stone-free status after single session shock wave lithotripsy to treat ureteral stones. If the idea of seeing what machine learning can do for decision making does not excite you, just watch AlphaGo (DeepMind, London, United Kingdom) on Netflix®!
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Editorial Comment

The authors attempted to develop and validate a decision support model to predict treatment success after a single session of lithotripsy in patients with ureteral stones. They included 15 factors in decision making. While the stone characteristics included in the model, such as stone bulk, density and depth from the skin, have been significant in impacting fragmentation following lithotripsy, renal function, too, is a logical inclusion. However, the impact of patient characteristics like age, gender or body mass index on fragmentation following lithotripsy have been variable.
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Reply by Authors

It is unfortunate that Gold and Ende have misinterpreted the findings of our study in an attempt to support the integral theory. We believe the integral theory has no scientific validity and consider it a fallacy.
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Re: Correlations between Sonographic and Urodynamic Findings after Mid Urethral Sling Surgery

We congratulate the authors for accurately obtaining and presenting these data in clear, easy to understand images. Unfortunately their conclusion, ie the data support the notion that the mid urethral sling mechanism of action is dynamic urethral compression, is incorrect.
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Reply by the Authors: Shock-wave Lithotripsy for Pediatric Patients: Which Nomogram Can Better Predict Postoperative Outcomes?

Urology (Gold Journal) In Press - Thu, 09/20/2018 - 00:00
The prediction of the success rate of SWL is an important issue, especially for pediatric patients. Therefore, clinicians should use these nomograms more often in daily practice to improve surgical planning. In our study, we compared the accuracy of the Onal and Dogan nomograms. We demonstrated that both nomograms are effective and independent predictors of stone-free rate. We used objective variables such as gender, age, stone size, number of stones, stone localization, and history of previous treatment.
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Comparison of Post-Radical Cystectomy Ileus Rates Using GIA-80 versus GIA-60 Intestinal Stapler Device

Urology (Gold Journal) In Press - Thu, 09/20/2018 - 00:00
To assess the impact on recovery of bowel function using an 80 mm versus 60 mm gastrointestinal anastomosis (GIA) stapler following radical cystectomy and urinary diversion (RC/UD) for bladder cancer.
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Deputy Editor of Female Urology, Urodynamics, Incontinence, and Pelvic Floor Reconstructive Surgery: Craig Comiter

Urology (Gold Journal) In Press - Thu, 09/20/2018 - 00:00
Dr. Comiter received his undergraduate degree from Harvard College, and his medical degree from Harvard Medical School. He stayed in Boston for his residency, serving as resident in general surgery at the Brigham and Women's Hospital, and then completed his urology residency at the Harvard Program in Urology. In 1998, Dr. Comiter served as Clinical Instructor and Fellow in Neurourology and Urodynamics at the University of California in Los Angeles.
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Editorial Comment

This rapid review with practice recommendations on the treatment and prevention of recurrent lower urinary tract infections in women is timely as the number of women affected by this condition, especially the older group, is rapidly growing in all of our practices. The authors should be congratulated for their large and detailed search of the best available literature on this topic and for offering a succinct algorithm of the favored alternatives for rUTI prevention and treatment. Notably, a quick glance at reference 3 pointing out the lack of consensus in the definition of rUTIs, and at the quality rating (AMSTAR 2) column in table 3 documenting the “low or critically low” level of evidence in the presented data in 20 of 23 reviews, should be more than sufficient to convince the reader and the international scientific community of the vast gaps in knowledge of rUTIs.
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Editorial Comment

Recurrent lower urinary tract infections in women are a frustrating problem for patient and provider. Patients suffer with these infectious episodes, often at inconvenient times, and have very bothersome symptoms. Repeat courses of antibiotics put them at risk for yeast vaginitis and gastrointestinal disturbances including C. difficile colitis. These women also suffer from constant worry about when their next infection is going to strike.
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Editorial Comment

Urinary stone disease is a growing and important public health problem in the United States. Tundo et al report the results of a cross-sectional analysis of data from the 2007 to 2012 NHANES, the gold standard for nationally representative health estimates. Focusing on younger adults, the authors compared the prevalence of self-reported stone disease by gender, finding an equal prevalence of stones (approximately 1/16) among men and women. These findings persisted after controlling for important potential confounders.
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Distal urethroplasty and glanuloplasty procedure can be suitable for all types of glanular / subcoronal hypospadias

Urology (Gold Journal) In Press - Wed, 09/19/2018 - 00:00
To correct all types of glanular/subcoronal hypospadias, we performed surgery named the distal urethroplasty and glanuloplasty procedure (DUG procedure). We analyzed cases that we have experienced.
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What can make urination painful?

MedicalNewsToday - Tue, 09/18/2018 - 20:00
There are many possible causes of painful urination, or dysuria, including bacterial infections and health conditions that place extra pressure on the bladder. Fortunately, most of these potential causes are highly treatable. Learn more about 10 causes of dysuria here, as well as when to see a doctor.
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Active surveillance for localized prostate cancer. Nationwide, observational study

The objective of this study was to investigate nationwide survival outcomes in men with localized prostate cancer managed on active surveillance.
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