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We agree with the comments. As noted, there is growing awareness about other important side effects of ADT, which may be less familiar to urologists. These side effects include liver disease as well as important effects on cognition and even mood disorders (reference 3 in article).
Using SEER data with Medicare linkage Gild et al assembled a large study cohort from which they advance the persuasive argument that ADT is associated with significant risks to liver health. In the absence of a significant prospective study SEER with Medicare linkage likely represents the best data source to study this question in an American population.
NAFLD is the most common cause of liver disease in Western countries. Gild et al analyzed SEER-Medicare linkage observational data to determine the association between primary ADT and the potential subsequent development of NAFLD in patients with prostate cancer. While acknowledging the known limitations of administrative data, using restricting criteria for the cohort to overcome potential comorbidities and treatment related confounders, and applying using propensity core adjustments, the authors found that ADT is associated with a greater risk of liver disease, particularly NAFLD.
Vesico - vaginal fistulae (VVF) are the most common type of urinary tract fistulae. 1 These fistulae (VVF) represent a complication that generally occurs after an iatrogenic injury during hysterectomy and lower segment cesarean section, obstructed labor, radiation necrosis, pelvic malignancies as well as other radical pelvic surgery. 1 The incidence varies between 0.3 and 2%.2 Due to its iatrogenic nature, and symptomatology VVF is associated with considerable emotional and psychologic distress.
Validation of the Chronic Orchialgia Symptom Index For Men with Chronic Orchialgia/Chronic Scrotal Contents Pain
To prospectively validate the Chronic Orchialgia Symptom Index (COSI), a newly created instrument with 12 questions in 3 domains (pain, sexual symptoms (SS) and quality of life(QOL)).
A Simplified Adult Acquired Buried Penis Repair Classification System with an Analysis of Perioperative Complications and Urethral Stricture Disease,,✯✯✯
To propose a simple classification system for buried penis repairs and present an analysis of perioperative data based on category.
Health Education and Symptom Flare Management Using a Video-Based m-Health System for Caring Women with IC/BPS
To assess effectiveness of the video-based m-health system providing videos dictated by physicians for health education and symptom self-management for patients with IC/BPS.
Comparison between two different en bloc Thulium laser enucleation of the prostate: does technique influence complications and outcomes?,
: To evaluate whether two similar en bloc thulium laser enucleation of the prostate (ThuLEP) techniques can influence surgical complications and outcomes.
INFECTION RETARDANT COATINGS IMPACT ON BACTERIAL PRESENCE IN PENILE PROSTHESIS SURGERY: A MULTICENTER STUDY
To investigate patients for positive culture rates with or without IRC PPs and to examine changes in culture positive isolates found in patients presenting overt clinical infection.
Angiomyxomas are rare soft tissue neoplasms rich in myxoid matrix and blood vessels that typically present as nodules on the trunk, head, and limbs in adults. They are classified as either cutaneous or aggressive based on histological findings and extent of local growth. There are less than 150 reported cases in the literature. In this case report we describe the first paratesticular case of a cutaneous angiomyxoma in a pediatric patient, who presented with a transilluminating paratesticular mass consistent with a hydrocele, but showed solid and vascular features on ultrasound.
Nephrolithiasis in a 17 Year Old Male with Seckel Syndrome and Horseshoe Kidneys: Case Report and Review of the Literature
We report the case of a 17 year old male with Seckel syndrome and horseshoe kidneys which had a 7 mm kidney stone in the lower pole calyx of the right moiety. The patient had a history of rotoscoliosis with 60° dextroconvex curvature and hepatic steatosis. Attempted ureteroscopy was unsuccessful due to stone location and anatomy. Percutaneous nephrolithotomy was ultimately required. This case highlights the difficulties of endoscopic treatments of renal calculi in patients with abnormal renal anatomy and dysmorphia.
Vesicoureteral reflux (VUR) is one of the original conditions (along with hypospadias, cryptorchidism and hydronephrosis) that helped define the field of pediatric urology. There were a variety of open surgical options for VUR and one of the earliest concerns was trying to determine where these procedures fit into possible treatments versus observation on antibiotic prophylaxis and spontaneous resolution. To help answer this question, the International Reflux Study (IRS) was conducted, and the IRS grading system was created and remains an internationally accepted standard today.
Volume 199, Number 5, Page 1202: Sentence 2 in Results in the Abstract should read: The 111 men treated with unilateral nerve sparing and the 75 treated with a nonnerve sparing procedure were grouped together.
Aggressive Renal Angiomyolipoma in a Patient with Tuberous Sclerosis Resulting in Pulmonary Tumor Embolus and Pulmonary Infarction,
Renal angiomyolipoma (AML) is the most commonly encountered mesenchymal tumor of the kidney which can present spontaneously or in association with tuberous sclerosis complex. Rarely, renal AMLs may demonstrate aggressive features such as renal vein invasion. This common entity and its uncommon complications are diagnosed based on physical examination and computed tomography results. Here we report imaging findings of a renal AML with renal vein and inferior vena cava invasion resulting in pulmonary tumor embolus and pulmonary infarction.
Analysis of National Trends in Hospital Acquired Conditions Following Major Urological Surgery Before and After Implementation of the Hospital Acquired Condition Reduction Program,,✰✰✰
To define the rates of common Hospital Acquired Conditions (HACs) in patients undergoing major urological surgery over a period of time encompassing the implementation of the Hospital Acquired Condition Reduction program, and to evaluate whether implementation of the HAC reimbursement penalties in 2008 was associated with a change in the rate of HACs.
Long term cancer-specific anxiety in men undergoing active surveillance for prostate cancer: findings from a large prospective cohort
Active surveillance is the preferred management of men with low-risk prostate cancer. Cancer-specific anxiety during active surveillance remains understudied. We sought to report long-term anxiety for men on active surveillance to determine if interventions need to be tailored to improve adherence.
The institutional learning curve for MRI-US Fusion-Targeted Prostate Biopsy: Temporal improvements in cancer detection over four years
While MRI-Ultrasound Fusion-targeted biopsy (MRF-TB) allows for improved detection of clinically significant prostate cancer (csPCa), concerning numbers of clinically significant disease are still missed. We hypothesize that a number of these are due to the learning curve associated with MRF-TB. We report results of repeat MRF-TB in men with continued suspicion for cancer and the institutional learning curve in detection of csPCa over time.
Enhanced Recovery After Surgery (ERAS) Protocol, Pediatric Urologic Augmentation and Diversion Surgery Using Small Bowel
Enhanced Recovery after Surgery protocols aim at improving recovery following urologic augmentation and diversion surgery. With regard to the positive experiences in adult patients, we aimed at evaluating safety and outcomes after implementation of an Enhanced Recovery after Surgery protocol in children undergoing augmentation and diversion surgery using small bowel.
The authors have studied MRI scans of men prior to laser enucleation of the prostate gland. They have measured the distance from the verumontanum to the distal end of the prostatic adenoma, as well as the distance from the prostate adenoma to the apex of the prostate. They note a correlation between the length of the urethra from the verumontanum to the prostate adenoma to the overall prostate volume in patients over the age of sixty nine.1