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Urology (Gold Journal) In Press - Mon, 09/04/2017 - 05:00
To describe the technique of transrectal biopsy with a new device that fuses multiparametric magnetic resonance (mpMRI) and ultrasound images in real time to guide target biopsies and to evaluate our initial experience.
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Author Reply, Re: Leapman et al.: Up and Away: Five Decades of Urologic Investigation in Microgravity (Urology 2017;106:18-25)

Urology (Gold Journal) In Press - Mon, 09/04/2017 - 05:00
The authors concur with the sentiments expressed from the University of Washington group, and feel the technological benefit to US citizens, and to mankind in general, has been substantial from research and development efforts supporting human spaceflight. NASA and other space agencies typically publish a summary of “spin-off” technologies that have resulted from space engineering, scientific and medical R&D, in partnership with industry and academia.1 Estimates indicate an approximately 9:1 (est.
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Health Related Quality of Life Following Radical Cystectomy: Comparative Analysis from the Medicare Health Outcomes Study

Health related quality of life (HRQOL) after radical cystectomy (RC) and ileal conduit is not well quantified at the population level. We evaluated HRQOL in patients with bladder cancer (BC) compared with non-cancer controls (NCC) and colorectal cancer (CRC) patients using SEER-Medicare Health Outcomes Survey (MHOS) data.
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Editorial Comment

Although urodynamic testing remains the gold standard for identifying and treating children with lower urinary tract dysfunction, especially those with neurological impairment, the evaluation is still fraught with artifacts the way it is presently conducted. Developing techniques for measuring important parameters, ie functional bladder capacity and maximum detrusor pressure, may reduce inaccurate data obtained from standard UDS, and consequently improve timing and efficacy of therapy. Although initially proposed 2 decades ago (reference 7 in article),1 Hidas et al have demonstrated the importance and feasibility of home monitoring of bladder pressure to improve management of children with neurogenic dysfunction on CIC in the modern era.
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Sleep problems are associated with development and progression of lower urinary tract symptoms (LUTS): Results from REDUCE

Though LUTS and sleep problems often co-occur, whether sleep disturbances are linked with LUTS development and progression is unknown. We examined the relationship between sleep problems measured by the Medical Outcomes Study Sleep Scale (MOS-Sleep) 6-item survey and LUTS development and progression in the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study.
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Does early PSADT (ePSADT) after Radical Prostatectomy, Calculated prior to PSA Recurrence, Correlate with Prostate Cancer Outcomes? —A Report from the SEARCH Database Group

Short PSA doubling time (PSADT) following recurrence after radical prostatectomy (RP) portends a poor prognosis. PSADT is traditionally calculated using PSA values >0.2ng/ml. We determined if early PSADT (ePSADT), calculated from the first detectable post-operative PSA up to and including the first recurrence value, correlates with prostate cancer outcomes.
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Incidence, clinicopathologic risk factors, management and outcomes of non-muscle invasive recurrences after complete response to tri-modality therapy for muscle-invasive bladder cancer

To describe the incidence, clinicopathologic risk factors, management, and outcomes of non-muscle invasive bladder cancer (NMIBC) recurrences after complete response (CR) to tri-modality therapy (TMT) for muscle-invasive bladder cancer (MIBC).
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Reply

Urology (Gold Journal) In Press - Fri, 09/01/2017 - 05:00
We are pleased that the editorial acknowledges that a select population of patients with primary low-volume metastatic renal cell carcinoma (mRCC) that cannot be completely resected may benefit from a period of observation after cytoreductive nephrectomy (CN) before further progression requires medication. Synchronous mRCC is considered to have a more aggressive behavior than metachronous metastatic disease that develops with a latency after nephrectomy in patients with previously nonmetastatic RCC.
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Editorial Comment

Urology (Gold Journal) In Press - Fri, 09/01/2017 - 05:00
In an era of burgeoning systemic therapy options in metastatic renal cell carcinoma (mRCC), there has been increasing attention to the option of initial active surveillance. A prospective trial by Rini et al. reported on 48 patients who underwent surveillance prior to initiation of systemic therapy in the setting of asymptomatic mRCC. In that study, the median time on surveillance prior to initiation of systemic therapy was 14.9 months 1.
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Depressive Symptoms and Low Sexual Desire After Radical Prostatectomy: Early and Long-Term Outcomes in a Real-Life Setting

To assess the rate of and predictors of depressive symptoms (DS) and sexual desire (SD) impairment in patients who underwent either open (ORP) or robot-assisted (RARP) radical prostatectomy.
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Long-term Anti-tumor Activity and Safety of Enzalutamide Monotherapy in Hormone-naïve Prostate Cancer: 3-year, Open-label, Follow-up Results

A phase 2 study of enzalutamide monotherapy in patients with hormone-naïve prostate cancer demonstrated high prostate-specific antigen response rates at 25 weeks, 1 year and 2 years, with minimal effects on total body bone mineral density and favorable safety. This follow-up analysis evaluated enzalutamide’s anti-tumor activity and safety at 3 years.
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Editorial Comment

This study represents an interesting appraisal of the practice patterns of urologists and gynecologists regarding the use of slings. Although it has some limitations, the study nevertheless instigates consideration of some interesting points.
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Editorial Comment

This initial report comparing matched cohorts undergoing robotic and open surgery for level I-II IVC tumor thrombi indicates superior outcomes of robotic surgery in most aspects, including operative time, blood loss, transfusions, complications, hospital stay and oncologic outcomes. And that, too, for similar sized caval thrombi (4.7 vs 4.5 cm) and kidney tumors (7.3 vs 8.4 cm). These data represent progress.
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Reply by Authors

It is true that studying military health care delivery entails unique sources of bias. One example well summarized in the comment is that military retirees may use TRICARE as secondary or backup insurance. Such men would have been excluded from our study if their annual PCP visit were covered by another insurance. As stated, their exclusion could lead to artificially low screening rates and introduce bias if they differ systematically from those who use TRICARE as primary insurance.
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Editorial Comment

As a retired Army urologist this study is most interesting, especially since I may be part of the study cohort, having been covered by TRICARE in 2010. The findings that more men cared for in military hospitals and clinics had a screening PSA paid by TRICARE compared to men cared for in the private/fee for service setting does not surprise me at all. For military retirees like me TRICARE can be the primary or secondary coverage.
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FDA approves new antibacterial drug

MedicalNewsToday - Thu, 08/31/2017 - 13:00
The U.S. Food and Drug Administration has approved Vabomere for adults with complicated urinary tract infections (cUTI), including a type of kidney infection, pyelonephritis, caused by specific...
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FDA approves new antibacterial drug

MedicalNewsToday - Thu, 08/31/2017 - 13:00
The U.S. Food and Drug Administration has approved Vabomere for adults with complicated urinary tract infections (cUTI), including a type of kidney infection, pyelonephritis, caused by specific...
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Study highlights new link between gene fusion and bladder and brain cancer

MedicalNewsToday - Thu, 08/31/2017 - 07:00
A study by the University of Warwick sheds new light on gene fusion in bladder and brain cancer.
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Study highlights new link between gene fusion and bladder and brain cancer

MedicalNewsToday - Thu, 08/31/2017 - 07:00
A study by the University of Warwick sheds new light on gene fusion in bladder and brain cancer.
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Where Do TRUS- and MRI Guided Biopsies Miss Significant Prostate Cancer?

Urology (Gold Journal) In Press - Wed, 08/30/2017 - 05:00
To identify the location of missed sPCa lesions by transrectal ultrasound-guided (TRUSbx) and multiparametric MRI-guided biopsies (mpMRIbx) in men undergoing repeat biopsies.
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