Urology News Feeds

Predictors of Renal Functional Improvement after Pyeloplasty in Ureteropelvic Junction Obstruction: Clinical Value of Visually Assessed Renal Tissue Tracer Transit in Tc-Mercaptoacetyltriglycine Renography

Urology (Gold Journal) In Press - Mon, 06/05/2017 - 00:00
To determine the clinical value of visually assessed renal tissue transit time (TTT) in 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) renography for patients undergoing pyeloplasty
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Home urodynamic pressures and volume measurement for the neurogenic bladder: Initial validation study

To evaluate the ability of a bladder pressure/volume diary (PVD) to identify patients at risk for elevated intravesical pressures.
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Patient-Reported Outcome Measurement System (PROMIS) Pain Intensity and Pain Interference in Patients with Urolithiasis: Initial Report

Health related quality-of-life is increasingly important in quality improvement efforts for medical conditions but has proved challenging to measure for urolithiasis given the distinct chronic and acute phases of this disease. We evaluated the utility of using the Patient-Reported Outcomes Measurement System (PROMIS®) to assess patient experience through stages of the acute stone episode.
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CT-based Diagnosis of Visceral Obesity and Hepatic Steatosis is Associated with Low Urine pH

Uric acid nephrolithiasis is associated with elevated visceral fat area (VFA) in kidney stone formers (KSF). Hepatic steatosis has also been linked to visceral obesity and nephrolithiasis. We evaluated the association of NCCT-based diagnosis of visceral obesity and hepatic steatosis with 24-hour urine parameters and stone composition in KSF.
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Editorial Comment

Health literacy is largely unstudied in surgical populations. Kappa et al report an association between health literacy and postoperative resource use in patients treated with radical cystectomy. Health literacy is important for patients who undergo cystectomy due to the need to process large volumes of information related to urinary diversion self-management. This study suggests that those with lower health literacy may require extra help upon hospital discharge. The authors also found that female gender, older age, medical complexity and poor social support are associated with post-discharge resource use.
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Variable Resource Utilization in the Prenatal and Postnatal Management of Isolated Hydronephrosis

Urology (Gold Journal) In Press - Fri, 06/02/2017 - 00:00
To characterize contemporary resource utilization and medical outcomes for infants with ANH and their mothers from a national claims database. We hypothesize that management of isolated hydronephrosis (IHN) varies widely, with decreased imaging following the 2010 Society for Fetal Urology (SFU) Consensus Statement.
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The Beneficial Effect of Fesoterodine, a Competitive Muscarinic Receptor Antagonist on Erectile Dysfunction in Streptozotocin-Induced Diabetic Rats

Urology (Gold Journal) In Press - Thu, 06/01/2017 - 00:00
To investigate the possible role of fesoterodine (a competitive muscarinic receptor antagonist) on erectile dysfunction (ED) in streptozotocin-induced diabetic rats.
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Renal Transplantation Using Stone-Bearing Deceased Donor Kidneys—Experience of a Transplant Center in China

Urology (Gold Journal) In Press - Thu, 06/01/2017 - 00:00
To evaluate the outcomes of transplantation of deceased donor stone-bearing kidneys.
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Serous carcinoma of the testicle and paratesticular tissue: Case Report and Literature Review

Urology (Gold Journal) In Press - Thu, 06/01/2017 - 00:00
Ovarian-type epithelial lesions of the testicle and paratesticular tissue are uncommon, especially invasive serous adenocarcinoma with just 18 cases reported in the literature. While the majority of these tumors occur in adults with an age range from 16 to 87 years, just one patient was less than 10 years old. Herein, we report only the second case of invasive serous adenocarcinoma occurring in first decade of life, that of a 7 year-old boy. Additionally, clinical presentation, imaging, histopathology, immunohistochemistry, and clinical follow-up of invasive serous adenocarcinoma of the testicle are discussed along with review of the literature.
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The Impact of Age on Urethroplasty Success

Urology (Gold Journal) In Press - Thu, 06/01/2017 - 00:00
To determine if age is an independent predictor of surgical success in patients undergoing urethroplasty. Urethroplasty performed by excision and primary anastomosis depends on vascular collateralization. Successful augmented urethroplasty depends on graft neovascularization. Older patients have more comorbid conditions including peripheral vascular disease associated with reduced penile blood flow.
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Improving Teamwork: Evaluating Workload of Surgical Team during Robot-Assisted Surgery

Urology (Gold Journal) In Press - Thu, 06/01/2017 - 00:00
To investigate the cognitive and physical workload experienced by each operating room team member for different types of urological procedures.
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Reply by Authors

Denize et al appropriately highlight the potential role of MRI and targeted biopsy during AS protocols. We agree that MRI may have an important role in AS and that improvements in imaging have promise for improving the care of AS patients. In the Canary PASS cohort MRI is currently used based on local provider preference, and we closely record MRI use and MRI related outcomes. Few of our PASS centers were using MRI before 2014, when data for the present analysis were frozen, and we expect growing MRI related data in forthcoming Canary PASS studies.
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Re: Timing of Adverse Prostate Cancer Reclassification on First Surveillance Biopsy: Results from the Canary Prostate Cancer Active Surveillance Study

In this article the authors underscore the great variability in schedules for first surveillance biopsies during active surveillance (AS) for localized prostate cancer (PCa). In the Canary Prostate Cancer Active Surveillance Study (PASS) median time from PCa diagnosis to first AS histological evaluation was 11 months (IQR 7.8 to 13.8). Reclassification rates were 24% before 8 months, 19% between 8 and 13 months and 22% after 13 months. As suggested by Klotz,1 active surveillance is now more often proposed for selected patients with localized PCa, while those who have a prostate specific antigen (PSA) doubling time of 3 years or less are offered radical treatment.
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Author Reply

Urology (Gold Journal) In Press - Thu, 06/01/2017 - 00:00
We strongly agree that the findings from this study should be thoughtfully applied and integrated into the surgical decision-making process. Now that we know that we can successfully measure frailty via the Timed Up and Go Test (TUGT) in the busy clinical setting, the next task is to use this information for both risk stratification and modification in the perioperative setting.
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Frailty is an important determinant of

Urology (Gold Journal) In Press - Thu, 06/01/2017 - 00:00
Frailty is an important determinant of outcomes among older adults undergoing surgical procedures. For example, in a cohort comprising older surgical patients—nearly half of whom underwent major urological procedures—the odds of a surgical complication doubled among individuals with intermediate or higher frailty scores.1 The rapidly aging demography of the United States heightens the exigency of frailty in these vulnerable adults. For these reasons, the American College of Surgeons created the Coalition for Quality in Geriatric Surgery project, including guidelines for preoperative assessment of older adults.
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Reply

Urology (Gold Journal) In Press - Thu, 06/01/2017 - 00:00
Radical prostatectomy is a technically challenging operation and men go into surgery with expectations of achieving control of their cancer while maintaining their quality of life with respect to outcomes.1 There has been an increasing trend toward active surveillance for low and select low intermediate risk patients.2 Active surveillance protocols require repeated biopsies to monitor disease burden and pathological grade. Although the risk of disease progression during active surveillance is small, some men will go on to receive a radical prostatectomy.
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Editorial Comment

Urology (Gold Journal) In Press - Thu, 06/01/2017 - 00:00
This administrative database study from Ontario assessing the impact of multiple transrectal ultrasound-guided prostate biopsies (TRUS-Bx) prior to radical prostatectomy (RP)1 highlights several important points.
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New genomic analysis promises benefit in female urinary incontinence

MedicalNewsToday - Wed, 05/31/2017 - 02:00
Urinary incontinence in women is common, with almost 50% of adult women experiencing leakage at least occasionally.
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Reply by Authors

The point of this study was to correlate MRI findings with actual tumors seen on the whole mount specimen. Biopsy method was not part of the study and had no influence on our findings.
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Editorial Comment

Since the FDA notifications on transvaginal mesh for prolapse repair in 2008 and 2011 (reference 8 in article), multiple manufacturers have voluntarily removed their products from the market. Theofanides et al report the safety of mesh for cystocele repair using data from the ACS NSQIP database. Patients treated with mesh based repair were older and more ill. They also experienced higher rates of surgical complications and even mortality, although fortunately at relatively low rates! This study serves as further warning for caution with mesh use.
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