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Regarding: Almassi N, Gorin M, Purysko as, Rowe Sp, Kaouk J, Allaf M, Campbell Sc, Rhee a: Use of 99mTc-Sestamibi Single-Photon Emission Computed Tomography / X-Ray Computed Tomography in the Diagnosis of Hybrid Oncocytic/Chromophobe Tumor in a...
A recent reassessment of the pathology for the case described in this report has facilitated new perspectives, and our objective is to provide an update that should be informative (1). The patient was a 12-year-old girl with 2 right lower pole renal tumors, both relatively small (≤ 2.0 cm) and solid, and only demonstrating modest enhancement. Genetic testing revealed a defect in the fumarate hydratase (FH) gene, which is commonly altered in the hereditary leiomyomatosis RCC (HLRCC) syndrome, where aggressive renal tumors are typically seen.
Proteomic Signatures of Sperm Mitochondria in Varicocele: Clinical Utility as Biomarkers of Varicocele-Associated Infertility
Varicocele may disrupt testicular microcirculation and induce hypoxia-ischemia related degenerative changes in testicular cells and spermatozoa. Superoxide production at low oxygen concentrations exacerbates oxidative stress in men with varicocele. Therefore, the present study was designed to study the role of mitochondrial redox regulation and its possible involvement in sperm dysfunction in varicocele-associated infertility.
Small benign testicular masses are often misinterpreted as germ cell tumors, and immediate inguinal orchiectomy is performed. We aimed to analyse the diagnostic and therapeutic work-up of testicular masses in order to improve preoperative stratification algorithms.
The Bladder Utility Symptom Scale (BUSS): A Novel Patient-Reported Outcome Instrument in Bladder Cancer
Health-related quality of life (HRQOL) is important in bladder cancer care and clinical decision-making because patients must choose between diverse treatment modalities with unique morbidities. A patient-reported outcome (PRO) measure of overall HRQOL for bladder cancer regardless of disease severity and treatment could benefit clinical care and research.
When new technology comes along, it is natural and appropriate to question whether the added cost and effort needed to use it add value to patient treatment. This is especially true when a new test challenges an established standby like PSA, which is generally recognized to be an imperfect test for screening but is nonetheless widely used and considered the standard to which newer tests are compared. Second generation PSA based screening tests like PHI, IsoPSA™ and the OPKO Health 4Kscore have been shown to be more accurate to predict high grade cancer and reduce the need for prostate biopsies in those with low scores.
To compare prostate volume and PSA levels with bacterial growth in prostate tissue cultures.
The effect of vasectomy reversal on prostate cancer risk: International meta-analysis of 684,660 men with vasectomies
Evidence on the effect of vasectomy on prostate cancer is conflicting, with the issue of detection bias a key criticism. We examine the effect of vasectomy reversal on prostate cancer risk in a cohort of vasectomised men; evidence of a protective effect would be consistent with a harmful effect of vasectomy on prostate cancer risk, while nullifying the issue of detection bias.
A 17-gene Genomic Prostate Score assay provides independent information on adverse pathology in the setting of combined mpMRI fusion-targeted and systematic prostate biopsy
Multiparametric MRI (mpMRI) and biopsy-based molecular tests such as the 17-gene Oncotype DX® Genomic Prostate Score™ (GPS) assay are increasingly used to improve risk stratification in men with clinically localized prostate cancer (PCa). The GPS assay was previously shown to be a significant independent predictor of adverse pathology (AP) at radical prostatectomy (RP) in men diagnosed with systematic biopsies only. We therefore investigated the ability of GPS to predict AP in the setting of MRI-guided prostate biopsy.
We agree with the comments. Although voiding symptoms are more common in men with LUTS/BPH, storage symptoms are more troubling, interfere considerably with the activities of daily life and adversely affect QOL.1 Thus, research focusing on the treatment outcomes of storage symptoms of BPH surgeries has significant clinical implications in men with LUTS/BPH. In our long-term followup study we noted that the improvement in storage symptoms was maintained throughout long-term followup after PVP using the 120 W Greenlight HPS or HoLEP without a significant difference between the 2 laser prostatectomies.
Cho et al present a comparison of 5-year storage symptoms following PVP and HoLEP. The study is relevant as storage symptoms affect patient bother and QOL. The study shows similar improvement in storage symptoms for PVP and HoLEP, which was maintained at 5 years. This might lead one to conclude that overall outcomes are equivalent. However, in nearly every parameter, including maximal Qmax, PSA reduction, overall voiding symptoms on the I-PSS, the QoL index and the re-treatment rate, HoLEP had superior long-term outcomes.
Usefulness of Preoperative Ultrasound for the Evaluation of Testicular Rupture in the Setting of Scrotal Gunshot Wounds
A scrotal gunshot wound may result in testicular injury, necessitating urgent scrotal exploration and attempted testicular salvage. Scrotal ultrasound is highly sensitive and specific for testicular rupture in the setting of blunt scrotal trauma but it has been poorly studied in the setting of scrotal gunshot wounds. Our objective was to determine the accuracy of scrotal ultrasound to identify testicular rupture following a scrotal gunshot wound.
Intra-Detrusor Injections of Botulinum Toxin Type a in Children with Spina Bifida: a Multicenter Study
To assess the effectiveness of Intradetrusor injections of botulinum toxin type A (IDBTX-A) in children with spina bifida.
The patient is a 55-year-old man with a history of Crohn's disease requiring multiple small bowel resections and a history of uric acid stones. He developed bilateral staghorn calculi and has undergone numerous interventions including 3 left percutaneous nephrolithotomies (PCNL's), 2 right PCNL's, and multiple ureteroscopies with holmium laser lithotripsy (URS/HLL). His most recent procedure, performed at our institution, was a right PCNL in 2013.
Sexual Quality of Life after Treatment of Stress Urinary Incontinence with Adjustable Tension-Free Mesh System in Women Who Were Sexually Active Prior to Surgery
To assess the sexuality and quality of life of sexually active women with stress or mixed urinary incontinence (SUI/MUI) after surgery with adjustable tension-free suburethral mesh system (TOA/TVA).
Tumor Contact Surface Area as a Predictor of Functional Outcomes after Standard Partial Nephrectomy: Utility and Limitations
To evaluate contact surface area (CSA) between the tumor and parenchyma as a predictor of ipsilateral parenchyma and function preserved after partial nephrectomy (PN). Previous studies suggested that CSA is a strong predictor of functional outcomes but the limitations of CSA have not been adequately explored.
A look at mucus in urine, which is usually a symptom of an underlying condition. Included is detail on when to see a doctor and signs of bladder cancer.
Multiple regions of interest on multi-parametric magnetic resonance imaging are not associated with increased detection of clinically significant prostate cancer on fusion biopsy
To determine the association between multiple regions of interest (ROI) on pre-biopsy magnetic resonance imaging (MRI) and the detection of clinically significant prostate cancer (CSPC) in men undergoing MRI ultrasound fusion biopsy (Fbx).
Perioperative Immunonutrition Modulates Inflammatory Response after Radical Cystectomy: Results of a Pilot Randomized Controlled Clinical Trial
Poor preoperative nutritional status is associated with higher complication rates in bladder cancer patients after radical cystectomy (RC). Given the short lag time between diagnosis and RC, we compared a short-term Specialized IMmunonutrition (SIM) to a standard oral nutrition supplement (ONS) on the acute inflammatory response and arginine status in RC patients.
The optimal duration of test stimulation for stage 1 SNM is an arbitrary number. Prolonged staged evaluation, which has been hypothesized to improve long-term success while reducing the duration of test stimulation, could minimize risks of infection and optimize patient satisfaction.1,2 The authors concluded that the mean time to 50% or greater improvement in all patients was 3.3 days with no difference in time to success between those with OAB and NOR, and all patients reached 50% improvement within 9 days.
What Impacts the All Cause Risk of Reoperation after Pelvic Organ Prolapse Repair? A Comparison of Mesh and Native Tissue Approaches in 110,329 Women
Several factors are hypothesized to impact the risks of mesh-augmented pelvic organ prolapse (POP) repair including, 1) characteristics of the material itself, 2) surgical experience, and 3) patient selection. We present a large population-based approach to explore their impact on outcomes and to describe an ideal mesh usage strategy.