Urology News Feeds

Re: Imaging Appearance of Fibrosing Diseases of the Retroperitoneum: Can a Definitive Diagnosis be Made?

R. H. Cohan, K. L. Shampain, I. R. Francis, M. S. Davenport, J. S. Wolf, Jr., W. Marder and R. D. Swartz
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Re: A Cost Comparison for Telehealth Utilization in the Kidney Transplant Waitlist Evaluation Process

R. C. Forbes, D. B. Rybacki, T. B. Johnson, A. Hannah-Gillis, D. Shaffer and D. A. Hale
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The Impact of Microsurgical Repair of Subclinical and Clinical Varicoceles on Total Motile Sperm Count: Is There a Difference?

Urology (Gold Journal) In Press - Wed, 07/04/2018 - 00:00
To determine if subclinical varicocele repair produces similar results to palpable varicocele repair.
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Assessing the learning curve of Holmium Laser Enucleation of Prostate (HoLEP). A systematic review.

Urology (Gold Journal) In Press - Wed, 07/04/2018 - 00:00
We systematically assessed the learning curve of Holmium laser enucleation of the prostate using the available literature to identify, as our primary outcome, the average number of cases required to reach competency. A computerised search of PubMed and Scopus for articles published from inception through to January 2018 was performed including twenty-four studies with a total of 5173 patients. Even though different outcome measures require varying case-loads to reach a plateau, Holmium laser enucleation of prostate has an acceptable learning curve with a proposed figure approximating 25-50 cases, with a structured mentorship programme aiding for faster progress.
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Re: Robotic Ureteral Reconstruction Using Buccal Mucosa Grafts: A Multi-Institutional Experience

L. C. Zhao, A. C. Weinberg, Z. Lee, M. J. Ferretti, H. P. Koo, M. J. Metro, D. D. Eun and M. D. Stifelman
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This Month in Pediatric Urology

Hypospadias represents one of the most common congenital anomalies encountered by pediatric urologists. Tremendous advances have occurred in the last few decades regarding surgical techniques but we still have only a vague understanding of the underlying risk factors. The exact genetic factors that create familial risk and the added impact of environmental endocrine disruptors and potential multi-generational epigenetic effects are still incompletely understood. We know that future male siblings of index patients with hypospadias are at increased risk but little information exists regarding the future risks when hypospadias is documented in the family history of previous generations.
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The Impact of Surgical Sequence on Stricture Recurrence after Anterior One-Stage Buccal Mucosal Graft Urethroplasty: Comparative Effectiveness of Initial, Repeat, and Secondary Procedures

We aimed to compare the results of initial buccal mucosal graft urethroplasty to repeat and secondary cases (previous urethroplasty of any technique other than buccal mucosal graft urethroplasty).
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cT1a renal masses < 2 versus > 2 cm managed with Robotic Partial Nephrectomy: a propensity-score matched comparison of perioperative Outcomes

To perform a single center evaluation comparing the perioperative, pathological and functional outcomes of robotic partial nephrectomy (RPN) for T1a renal masses < 2 cm vs T1a renal masses > 2 cm.
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The Value of Urinary BDNF Levels on Assessment of the Botulinum Toxin Type A Treatment for Neurogenic Detrusor Overactivity in Children with Myelodysplasia

Urinary cytokines are proposed to predict the urodynamic findings and outcome of intradetrusor botulinum neurotoxin type A injection (iBoNT-Ai) in children with myelodysplasia. The relationship between urinary brain-derived neurotrophic factor (BDNF) and neurogenic and non-neurogenic detrusor overactivity (NDOA) has been shown, as well. In this prospective study, we aimed to investigate the effect of iBoNT-Ai on urine BDNF levels in children with NDOA due to myelodysplasia.
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Diagnostic value of anteroposterior diameter of renal pelvis for predicting postnatal surgery: A systematic review and meta-analysis

To evaluate the diagnostic value of anteroposterior diameter (APD) of fetal renal pelvis in predicting postnatal surgery.
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Epidural Analgesia Decreases Narcotic Requirements in Low Level Spina Bifida Patients Undergoing Urologic Laparotomy for Neurogenic Bladder and Bowel

Concern of anatomical anomalies and worsening neurologic symptoms has prevented widespread use of epidural catheters in patients with low level spina bifida (LLSB). We hypothesize that thoracic epidural placement in the T9-T10 interspace is safe and decreases narcotic requirements in LLSB patients following major open lower urinary tract reconstruction (LUTR).
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Multiparametric MRI Features Identify Aggressive Prostate Cancer at the Phenotypic and Transcriptomic Level

Multiparametric magnetic resonance imaging (mpMRI) is a diagnostic tool for prostate cancer with limited data on prognostic use. We sought to determine whether mpMRI can predict aggressive prostate cancer features.
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Editorial Comment

Bladder cancer has a marked male incidence of uncertain etiology.1 Mouse models show that androgen receptor and androgens convey an increased risk of bladder cancer after exposure to a carcinogen.2 Intriguingly an observational (not randomized) analysis of the PLCO (Prostate, Lung, Colorectal, and Ovarian) cancer screening trial showed a lower incidence of bladder cancer in men receiving finasteride (reference 5 in article).
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Reply by Authors

We appreciate the suggestion regarding further adjustments to visceral fat area and subcutaneous fat area with the addition of volumetric measurement (VAT and SAT). A single slice VFA/SFA measurement was chosen for our study since previously published data regarding increased risk of nephrolithiasis and visceral obesity were based on single slice measurements.7–9 When we conducted our analysis, no previous studies existed examining the relationship between volumetric abdominal adipose tissue measurements and nephrolithiasis risk.
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Reply by Authors

The comments by Temiz help to highlight the role of CSA as a predictor of post-nephron sparing renal function. It is known that the main variable affecting postoperative renal function is preserved renal volume.1 To date, there is no evidence that surgical approach (open, laparoscopic or robotic) has any effect on renal function after partial nephrectomy.2 Since the primary outcome of our study was renal function, we did not see any compelling reason to do a subgroup analysis based on surgical approach.
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Re: Comparison of Pathological and Oncologic Outcomes of Favorable Risk Gleason Score 3 + 4 and Low Risk Gleason Score 6 Prostate Cancer: Considerations for Active Surveillance

As a genitourinary pathologist, I agree that Gearman et al have presented evidence that Grade Group 2 cancer should be a soft contraindication for active surveillance. However, a growth pattern (architecture) of cancer glands, called the cribriform pattern, within Gleason grade 4 disease should be a hard contraindication.
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Re: Computerized Tomography Based Diagnosis of Visceral Obesity and Hepatic Steatosis is Associated with Low Urine pH

We read this article with interest and propose further adjustments to the visceral fat area (VFA) and subcutaneous fat area (SFA) reported by the authors. For each computerized tomogram (CT) a single axial area measurement was obtained at L3-L4 in females regardless of body mass index (BMI), L2-L3 in males with BMI less than 40 kg/m2 and L1-L2 in males with BMI greater than 40 kg/m2 for visceral fat area and subcutaneous fat area. However, we maintain that a single axial area measurement was insufficient and inadequate to express visceral or subcutaneous fat area.
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Re: External Validation of Contact Surface Area as a Predictor of Postoperative Renal Function in Patients Undergoing Partial Nephrectomy

Haifler et al state that tumor contact surface area (CSA) correlates with renal functional outcome and can be used for the establishment of renal functional risk. In fact, almost all features of kidney cancer are associated with renal functional changes after partial nephrectomy. The results of the study are consistent with previous relevant reports, as stated by the authors. I would like to highlight some issues on this subject.
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Effectiveness and complications of the AMS AdVance™ Male Sling System for the treatment of stress urinary incontinence: a prospective multicenter study

Urology (Gold Journal) In Press - Mon, 07/02/2018 - 00:00
To evaluate the effectiveness and tolerance of the AdVance™ Male Sling System for the treatment of male stress urinary incontinence in patients after prostatic surgery.
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