Urology News Feeds
Considering the enormous investment in efforts to improve NMIBC treatment beyond 3-week maintenance BCG immunotherapy, the existence of an effective, inexpensive, safe and readily available technique such as PPD testing sounds too good to be true. Surprisingly it is not. In earlier centuries medical students were taught that the immune response after sensitization is accelerated and heightened. In my first study of BCG there was no significant inhibition of chemically induced bladder cancer without prior sensitization.
As pointed out, women who present with MUS complications generally have multiple complaints. Therefore, a single outcome measure (pain or incontinence) is clearly insufficient to capture the real clinical outcome in these multisymptomatic cases. To tackle this unusual situation in the field of female pelvic medicine and reconstructive surgery we evaluated different multidomain outcome tools and found the UDI-6, possibly supplemented by information on sexual function and urinary tract infections, is relevant and practical.
In this complicated retrospective review Shakir et al characterized presenting symptoms and outcomes in a select group of patients who elected to undergo SSR at a single center using the UDI-6 questionnaire as well as the presence or absence of recurrent UTIs, urinary incontinence and dyspareunia. The authors were attempting to address the lack of uniformity in reporting MUS complications (reference 7 in article). They found that there were many different presenting symptoms and the UDI-6 correlated with symptom improvement irrespective of presenting complaints.
To determine whether an enhance recovery protocol for radical cystectomy patient affected the length of stay or the number and type of readmissions that occurred after hospital discharge.
Preclinical Animal Studies of Intravesical Recombinant Human Proteoglycan 4 as a Novel Potential Therapy for Diseases Resulting From Increased Bladder Permeability
To test in an animal model the hypothesis that recombinant human proteoglycan 4 (rhPRG4; lubricin), a highly O-glycosylated mucin-like glycoprotein, may be a novel surface-active therapeutic for treating bladder permeability with comorbid bowel permeability. Previously we showed that inducing bladder permeability in rats with dilute protamine sulfate (PS) produced colonic permeability and visceral hypersensitivity, suggesting increased bladder permeability could represent an etiologic factor in both interstitial cystitis-bladder pain syndrome and irritable bowel syndrome.
Assessment of Discomfort and Pain in Patients Undergoing Fusion Magnetic Resonance Imaging-guided vs TRUS-guided Prostate Biopsy
To investigate patient pain perception from receiving magnetic resonance imaging fusion-guided prostate biopsy (FBx) in addition to transrectal ultrasound-guided template biopsy (TBx) vs pain from standard TBx alone.
In his 1914 novel The World Set Free, British science fiction writer, H.G. Wells, portrays a war of our world in which Earth's major cities are destroyed by atomic bombs.1 No serious scientist of the time believed this was possible, as evidenced by no less than the 1908 Nobel laureate in chemistry, Sir Ernest Rutherford, who as late as 1933 lectured to the effect that the energy locked within the atomic nucleus which he himself had discovered would never be available for mankind to use.2 A young Hungarian physicist traveled to London to meet Wells, and was intrigued by the author's ideas.
Re: Brassetti et al.: Prostate-specific Antigen Density Is a Good Predictor of Upstaging and Upgrading, According to the New Grading System: The Keys We Are Seeking May Be Already in Our Pocket (Urology 2018;111:129-136)
I read this publication with interest, but caution that the conclusions may not be robust due to methodological flaws which are common across many radical prostatectomy (RP) papers investigating the utility of prostate specific antigen density (PSAD), most of which fail to include an internal reference for correlation of the prostate volume estimate. Highlighting this flaw may serve as a template for future PSAD studies that involve RP specimens.
Ovarian epithelial type tumors of the testis have been a rare clinical entity. Its awareness and management remain a clinical challenge. We described the case of an 18-year-old, obese male patient who presented with scrotal enlargement. He underwent eversion of tunica vaginalis and resection of epididymal mass. The histology of the resected sample showed an ovarian epithelial type borderline tumor. We believe our case helps to strengthen awareness and management of this rare disease.
To examine how Medicare reimbursement for prostate biopsies was allocated to physicians, ambulatory surgery centers (ASCs), and hospitals from 2012 to 2015.
To review the pioneering contributions of Dr. Robert Gibbons of Virginia Mason Medical Center to the evolution and development of the modern ureteral stent.
We appreciate the concerns raised by X regarding the statistical methods reported in our manuscript.
To evaluate the association of clinical factors on outcomes in patients with spinal cord injury (SCI) undergoing ureteroscopy. Immobility, recurrent urinary tract infection, and lower urinary tract dysfunction contribute to renal stone formation in patients with SCI. Ureteroscopy is a commonly utilized treatment modality; however, surgical complication rates and outcomes have been poorly defined. Evidence guiding safe and effective treatment of stones in this cohort remains scarce.
Prostate biopsy is one of the most common procedures performed by urologists with an estimated >2 million performed in the United States and Europe every year,1,2 and is the gold standard for the diagnosis of prostate cancer. The majority of prostate biopsies in the United States are done in the office setting using the ultrasound probe through a transrectal approach. The proximity of the posterior prostate to the anterior rectal wall provides easy access the peripheral zone which is known to harbor >70% of malignancies.
Delayed Posterior Urethroplasty Following Pelvic Fracture Urethral Injury: Do We Have to Wait 3 Months?
To compare outcomes with early vs delayed reconstruction following pelvic fracture urethral injury (PFUI) to determine if a traditional 3-month delay is necessary. This delay has been advocated to allow resolution of traumatic inflammation and hematoma but has never been validated. We proceed to reconstruction at 3-6 weeks if the associated injuries are stable, the perineum is soft on rectal palpation, and the fracture is stable for lithotomy positioning.
Pheochromocytoma and paraganglioma (PPGL) are rare autosomal dominant disorders derived from the neural crest chromaffin tissues of the autonomic nervous system. The succinate dehydrogenase complex subunit D (SDHD) gene has been implicated as one of the pathogenic genes. Although more than 100 SDHD mutations have been reported, the phenotype-genotype association remains unclear.
Inverted papilloma of the prostatic urethra is an especially rare finding. A 75-year-old man with urinary retention wished to proceed with a holmium laser enucleation of the prostate (HoLEP) and was found to have a mass arising from his prostate vs bladder on preoperative imaging. Cystourethroscopy revealed the mass arising from the median lobe of the prostate. After transurethral resection and frozen analysis confirmed the benign pathology of an inverted papilloma, the patient subsequently underwent a successful HoLEP during the same surgical setting.
Spina bifida has traditionally been regarded as a pediatric health issue with little regard to adult consequences of the disorder. The congenital neurologic and urologic anomalies, as well as sequelae of bladder management, can have a profound impact on adult male sexual function. Abnormalities in testicular descent, development, and function; fertility; penile sensation; erectile function; ejaculatory function; and orgasmic function are common. Prostate cancer has been diagnosed in men with spina bifida, but little data are available to guide screening, diagnosis, and treatment efforts.
A 49-year-old man presented to the urology clinic with 1-year history of abdominal swelling and lower urinary tract symptoms, including incomplete bladder emptying and urinary urgency and frequency. Additionally, he complained of thin, loose stools for the past few months but had never had a colonoscopy or other work-up. Immediately on physical exam, a palpable suprapubic mass and a small umbilical hernia were noted with no obvious umbilical abnormalities or drainage.
To compare complication rates, perioperative outcomes, and survival after radical cystectomy (RC) in patients with prior abdominal or pelvic radiation therapy (RT) vs those without an RT history.