Urology News Feeds

Efficacy of Bacillus Calmette-guerin Strains for the Treatment of non-muscle Invasive Bladder Cancer: a Systematic Review and Network Meta-analysis

To determine the efficacy of genetically distinct Bacillus Calmette-Guérin (BCG) strains in preventing disease recurrence for patients with non-muscle invasive bladder cancer (NMIBC).
Categories: Urology News Feeds

The Risk of Chronic Kidney Disease Associated With Urolithiasis and its Urological Treatments: a Review

Urolithiasis can impair kidney function. This literature review focuses on the risk of kidney impairment in stone formers, the specific conditions associated with this risk and the impact of urological surgery.
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Human Penile Transplantation: An Emerging Therapy for Genitourinary Reconstruction

Reconstruction of complex functional structures is increasingly being performed with vascularized composite allo-transplantation (VCA). Penile transplantation is a novel VCA treatment option for severe penile tissue loss and disfigurement. Three allogeneic human penile transplantations have been reported. We review these cases as well as penile transplant indications, pre-clinical models, and immunosuppression therapy.
Categories: Urology News Feeds

Intermediate Term Outcomes and Complications of Long-segment Urethroplasty with Lingual Mucosa Grafts

We evaluated the outcomes and donor site complications of male patients with complex urethral strictures (CUS) that underwent urethroplasty by using with long-strip oral mucosal grafts (OMGs). The study analyzed whether lingual mucosa graft (LMG) is a good substitute for repairing long segment urethral strictures.
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Bosniak classification for complex renal cysts re-evaluated - a systematic review

To systematically evaluate the Bosniak classification, with malignancy rates of each Bosniak category, and to assess the effectiveness related to surgical treatment and oncological outcome, based on recurrence and/or metastasis.
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Future Directions of Research and Care for Urinary Incontinence in Women: Findings from the National Institute of Diabetes and Digestive and Kidney Diseases’ (NIDDK) Summit on Urinary Incontinence Clinical Research in Women

Female urinary incontinence (UI) is prevalent, costly, and morbid. Participants in an NIDDK-sponsored summit reviewed findings from NIH-funded clinical research in UI and discussed the future of UI research.
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KIUrologyX: Urology As You Like It—A Massive Open Online Course for Medical Students, Professionals, Patients, and Laypeople Alike

Take Home Message

KIUrologyX is a massive open online course in clinical urology that allows a broad range of people access to important clinical knowledge. It is a course that can be made available to an unlimited number of students, professionals, patients, and their kin.

Footnotes

a Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, Sweden

b Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden

Corresponding author. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, Stockholm 17177, Sweden. Tel. +46 73 7121366.

Article information

PII: S0302-2838(17)30129-X
DOI: 10.1016/j.eururo.2017.02.034
© 2017 European Association of Urology, Published by Elsevier B.V.

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Re: Rodolfo Montironi, Silvia Gasparrini, Roberta Mazzucchelli, et al's Letter to the Editor re: Karim A. Touijer, James A. Eastham. The Sentinel Lymph Node Concept and Novel Approaches in Detecting Lymph Node Metastasis in Prostate Cancer. Eur Urol...

Refers to article:

The Sentinel Lymph Node Concept and Novel Approaches in Detecting Lymph Node Metastasis in Prostate Cancer

Karim A. Touijer and James A. Eastham

November 2016 (Vol. 70, Issue 5, pages 738 - 739)

Refers to article:

Re: Karim A. Touijer, James A. Eastham. The Sentinel Lymph Node Concept and Novel Approaches in Detecting Lymph Node Metastasis in Prostate Cancer. Eur Urol 2016;70:738–9: Sentinel Lymph Nodes in Adipose Tissue Surrounding the Prostate Gland and Seminal Vesicles as Observed in Virtual Whole-mount Histologic Slides

Rodolfo Montironi, Silvia Gasparrini, Roberta Mazzucchelli, Francesco Massari, Liang Cheng, Antonio Lopez-Beltran, Francesco Montorsi and Marina Scarpelli

Accepted 11 August 2016

February 2017 (Vol. 71, Issue 2, pages e73 - e75)

Footnotes

Pathology Department, Medical College of Wisconsin, Milwaukee, WI, USA

Pathology Department, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA. Tel. +1 414 8058463; Fax: +1 414 8058463.

Article information

PII: S0302-2838(17)30128-8
DOI: 10.1016/j.eururo.2017.02.033
© 2017 European Association of Urology, Published by Elsevier B.V.

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Procedure-specific Risks of Thrombosis and Bleeding in Urological Non-cancer Surgery: Systematic Review and Meta-analysis

Refers to article:

Validation of an Age-adjusted Prostate Cancer–Specific Comorbidity Index

Michael Froehner, Rainer Koch, Matthias Hübler and Manfred P. Wirth

Accepted 23 October 2015

May 2016 (Vol. 69, Issue 5, pages 764 - 766)

Abstract Context

Pharmacological thromboprophylaxis involves a trade-off between a reduction in venous thromboembolism (VTE) and increased bleeding. No guidance specific for procedure and patient factors exists in urology.

Objective

To inform estimates of absolute risk of symptomatic VTE and bleeding requiring reoperation in urological non-cancer surgery.

Evidence acquisition

We searched for contemporary observational studies and estimated the risk of symptomatic VTE or bleeding requiring reoperation in the 4 wk after urological surgery. We used the GRADE approach to assess the quality of the evidence.

Evidence synthesis

The 37 eligible studies reported on 11 urological non-cancer procedures. The duration of prophylaxis varied widely both within and between procedures; for example, the median was 12.3 d (interquartile range [IQR] 3.1–55) for open recipient nephrectomy (kidney transplantation) studies and 1 d (IQR 0–1.3) for percutaneous nephrolithotomy, open prolapse surgery, and reconstructive pelvic surgery studies. Studies of open recipient nephrectomy reported the highest risks of VTE and bleeding (1.8–7.4% depending on patient characteristics and 2.4% for bleeding). The risk of VTE was low for 8/11 procedures (0.2–0.7% for patients with low/medium risk; 0.8–1.4% for high risk) and the risk of bleeding was low for 6/7 procedures (≤0.5%; no bleeding estimates for 4 procedures). The quality of the evidence supporting these estimates was low or very low.

Conclusions

Although inferences are limited owing to low-quality evidence, our results suggest that extended prophylaxis is warranted for some procedures (eg, kidney transplantation procedures in high-risk patients) but not others (transurethral resection of the prostate and reconstructive female pelvic surgery in low-risk patients).

Patient summary

The best evidence suggests that the benefits of blood-thinning drugs to prevent clots after surgery outweigh the risks of bleeding in some procedures (such as kidney transplantation procedures in patients at high risk of clots) but not others (such as prostate surgery in patients at low risk of clots).

Take Home Message

Although inferences are limited owing to low-quality evidence, our results suggest that extended prophylaxis is likely to be warranted for some procedures (eg, kidney transplantation procedures in high-risk patients) but not others (transurethral resection of the prostate and reconstructive female pelvic surgery in low-risk patients).

Keywords: Baseline risk, Bleeding, Modeling, Reporting, Risk of bias, Thromboprophylaxis, Urology, Venous thromboembolism.

Footnotes

a Departments of Urology and Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

b Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada

c Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada

d School of Medicine, University of Toronto, Toronto, ON, Canada

e Department of Medicine, University of Toronto, Toronto, ON, Canada

f Department of Epidemiology and Biostatistics, Imperial College London, London, UK

g Department of Urogynaecology, St Mary's Hospital, London, UK

h Department of Surgery, Division of Urology, Woodstock General Hospital, Woodstock, ON, Canada

i Department of Surgical, Oncological, and Gastroenterological Sciences, Urology Clinic, University of Padua, Padua, Italy

j Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy

k Department of Oncology, McMaster University, Hamilton, ON, Canada

l Faculty of Pharmacy, University of Waterloo, Kitchener, ON, Canada

m Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA

n Institute of Clinical Medicine, University of Oslo, Oslo, Norway

o Department of Haematology, Oslo University Hospital, Oslo, Norway

p Department of Medicine, McMaster University, Hamilton, ON, Canada

q McMaster Department of Surgery Division of Urology, Hamilton, ON, Canada

Corresponding author. Department of Urology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, Helsinki 00029, Finland. Tel. +358 50 5393222.

Article information

PII: S0302-2838(17)30114-8
DOI: 10.1016/j.eururo.2017.02.025
© 2017 European Association of Urology, Published by Elsevier B.V.

Categories: Urology News Feeds

Tackling Lupus and its renal complications with novel small molecule drug candidate

MedicalNewsToday - Wed, 03/08/2017 - 08:00
Lupus, a chronic autoimmune disease, has proved difficult to treat, but a new international study co-led by a Rush University Medical Center researcher suggests that a drug starting through the...
Categories: Urology News Feeds

“Gotta Catch 'em All”, or Do We? Pokemet Approach to Metastatic Prostate Cancer

Take Home Message

Metastasis-directed therapy is of interest for the management of oligometastatic prostate cancer. Improved imaging may help with patient selection, but the approach to metastatic prostate cancer of “catching 'em all”, or “Pokemet”, must be considered experimental.

Footnotes

a Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia

b Australian Prostate Cancer Research Centre, Epworth Healthcare, Richmond, Australia

c The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia

d Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

e Institut de Recherche Clinique, Cliniques Universitaires Saint-Luc, Brussels, Belgium

Corresponding author. Division of Cancer Surgery, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia. Tel. +61 399368032; Fax: +61 39429 4683.

Article information

PII: S0302-2838(17)30131-8
DOI: 10.1016/j.eururo.2017.02.036
© 2017 European Association of Urology, Published by Elsevier B.V.

Categories: Urology News Feeds

Re: J. Alfred Witjes, Thierry Lebret, Eva M. Compérat, et al. Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer. Eur Urol 2017;71:462–75

Refers to article:

Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer

J. Alfred Witjes, Thierry Lebret, Eva M. Compérat, Nigel C. Cowan, Maria De Santis, Harman Maxim Bruins, Virginia Hernández, Estefania Linares Espinós, James Dunn, Mathieu Rouanne, Yann Neuzillet, Erik Veskimäe, Antoine G. van der Heijden, Georgios Gakis and Maria J. Ribal

Accepted 13 June 2016

March 2017 (Vol. 71, Issue 3, pages 462 - 475)

Footnotes

Department of Urology, Clinical Hospital Sveti Duh, Zagreb, Croatia

Corresponding author. Department of Urology, Clinical Hospital Sveti Duh, Sveti Duh 64, 10000 Zagreb, Croatia. Tel. +385 1 3712147; Fax: +385 1 3712027.

Article information

PII: S0302-2838(17)30126-4
DOI: 10.1016/j.eururo.2017.02.031
© 2017 European Association of Urology, Published by Elsevier B.V.

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Surgical outcomes of primary and recurrent female urethral diverticula

Urology (Gold Journal) In Press - Tue, 03/07/2017 - 00:00
To evaluate the surgical outcomes of female urethral diverticulectomy.
Categories: Urology News Feeds

Reply

Urology (Gold Journal) In Press - Tue, 03/07/2017 - 00:00
We appreciate the recognition and support of establishing a cure paradigm for men who present with low-volume metastatic disease that is beyond the limits of curability with any single treatment. Our pilot study shows that an aggressive multi-modal treatment strategy applied with curative intent is both feasible and safe, and that each modality—systemic therapy, surgery, and radiation therapy—plays a key role in eliminating the disease.
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Editorial Comment

Urology (Gold Journal) In Press - Tue, 03/07/2017 - 00:00
The treatment of oligometastatic prostate cancer is in rapid evolution. In the report by O'Shaughnessy et al, oligometastatic patients were treated with androgen deprivation therapy (ADT) monotherapy, or a combined modality approach involving ADT + surgery for the primary tumor and lymph nodes, or ADT + surgery + hypofractionated stereotactic body radiation (SBRT) to metastases.1 Based on the results of surgery, in some cases conventional fractionation was given to the prostate bed +/− pelvic/para-aortic nodes.
Categories: Urology News Feeds

FDA approves first treatment for frequent urination at night due to overproduction of urine

MedicalNewsToday - Mon, 03/06/2017 - 08:00
The U.S. Food and Drug Administration has approved Noctiva (desmopressin acetate) nasal spray for adults who awaken at least two times per night to urinate due to a condition known as nocturnal...
Categories: Urology News Feeds