Urology News Feeds

Re: Men’s Sexual Response to Female Partner’s Intranasal Oxytocin Administration for Hypoactive Sexual Desire Disorder: An Open Prospective Cohort Study

D. A. Muin, S. Sheikh Rezaei, M. Tremmel-Scheinost, M. Salama, A. Luger, M. Wolzt, P. W. Husslein and M. Bayerle-Eder
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Reply by Authors

Prostate cancer screening and treatment indeed remain moving targets. PSA screening in particular will continue to be controversial until the development of a more sensitive test to identify men with high risk disease. Nevertheless, current and changing professional guidelines for the early detection of prostate cancer emphasize the balance of clinical judgment and patient preference. Such recommendations are not informed by the broader debate about health care access. Is the early diagnosis of prostate cancer a right or a privilege for those who can afford it? It is our position that access to screening should not be predicated on income, although this is a hotly debated political question without easy resolution.
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Editorial Comment

Medicaid expansion under ACA sought to improve health insurance coverage for low income adults (reference 2 in article). Six states and jurisdictions implemented Medicaid expansion early in 2010 and 2011.
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Reply by Authors

Ayubi and Safiri note the issue of sparse data in our multivariable analysis. We cannot deny the paucity of data in the field of exstrophy-epispadias repair. We agree with the questions raised in their letter. The analysis of orthopedic surgeon type included only 8 osteotomies performed by general orthopedic surgeons, of which only 1 procedure did not fail. From a statistical standpoint if data are sparse and more than 1 variable is going to be included, glmnet in R software (R Project for Statistical Computing, http://www.R-project.org) should be used to perform the analysis since the stepwise method as discussed in the letter would not alleviate the problem of correlated variables included in our study.
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Re: Failed Primary Bladder Exstrophy Closure with Osteotomy: Multivariable Analysis of a 25-Year Experience

The authors of this study aimed to identify factors contributing to failed primary exstrophy closure with osteotomy. One important finding was that osteotomy performed by general orthopedic surgeons had significantly higher odds of failure in univariable (OR 28.18, 95% CI 3.20–248.42) and multivariable (OR 23.47, 95% CI 1.45–379.19) models, which is problematic. Scientists have indicated that large effect size estimates, such as OR with a substantially wide CI, do not indicate a strong association and may be only biased effect size estimates because of the sparse data bias.
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Author Reply

Urology (Gold Journal) In Press - Wed, 09/27/2017 - 00:00
The main objective of this video was to illustrate a step-by-step combined 1-section approach. We believe that it is very useful for endourologists who are starting their experience with encrusted ureteral catheters. In our service, we also remove encrusted ureteral stents in 1 single procedure when patient's condition allows it. However, in some cases, the large amount of encrusted stones precludes a single successful surgery. According to Borboroglu and Kane,1 multiple procedures (average of 4.2 procedures per patient) are necessary to remove severely encrusted ureteral stents.
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Editorial Comment

Urology (Gold Journal) In Press - Wed, 09/27/2017 - 00:00
This is a case report with a short video describing one-step removal of a retained, calcified ureteral stent. There are numerous articles in the literature relating similar methods,1-4 and the techniques in this article are routinely employed at many tertiary referral institutions including the one at which I practice. Although there is a diagram with 5 gradations of stent encrustation, the urologist not accustomed to removing retained stents might find it helpful if there was a clear explanation as-to when one would make a cystotomy to remove the lower stent portion, when one can disintegrate the bladder portion of the encrustation trans-urethrally, when a ureteroscopic or shock wave lithotripsy would be likely to succeed for removal of the upper portion of the stent, and when a percutaneous approach would be best (for the upper portion).
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Multicenter Analysis of Patient Reported Outcomes Following Artificial Urinary Sphincter Placement for Male Stress Urinary Incontinence

Patient-centered data regarding functional and quality of life improvements after AUS placement is lacking. We analyzed the degree of benefit from AUS placement utilizing the ISI, a validated patient reported outcome measure assessing severity and bother of urinary incontinence and the IIQ-7, a validated patient reported outcome measure assessing the impact and emotional distress of urinary incontinence.
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Laparoscopic retroperitoneal lymph-node dissection (L-RPLND) in clinical stage I non-seminomatous germ-cell tumors of the testis (NSGCTT): safety and efficacy analyses in a high-volume center

Prognosis of stage I NSGCTT is very favorable. Early and late side effects of treatment may condition quality of life and survival. We determine tolerability, safety and efficacy of L-RPLND in stage I NSGCTT in a high-volume center.
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A Thematic Analysis of Online Discussion Boards for Vasectomy

Urology (Gold Journal) In Press - Wed, 09/27/2017 - 00:00
To examine posts on Internet discussion groups related to vasectomies, and identify common ideas through a structured theme analysis.
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Effect of Stone Size and Composition on Ultrasonic Propulsion Ex Vivo

Urology (Gold Journal) In Press - Wed, 09/27/2017 - 00:00
To evaluate in more detail the effectiveness of a new designed more efficient ultrasonic propulsion for large stones and specific stone compositions in a tissue phantom model. In the first clinical trial of noninvasive ultrasonic propulsion, urinary stones of unknown compositions and sizes up to 10 mm were successfully repositioned.
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Evaluating the Role of Postoperative Oral Antibiotic Administration in Artificial Urinary Sphincter and Inflatable Penile Prosthesis Explantation: a Nationwide Analysis

Urology (Gold Journal) In Press - Wed, 09/27/2017 - 00:00
To determine whether postoperative oral antibiotics are associated with decreased risk of explantation following artificial urinary sphincter (AUS) or inflatable penile prosthesis (IPP) placement.Although frequently prescribed, the role of postoperative oral antibiotics in preventing AUS or IPP explantation is unknown.
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Eleven ways to help prevent kidney stones

MedicalNewsToday - Tue, 09/26/2017 - 09:00
Kidney stones are crystalized minerals that form in the kidneys. They can cause a lot of pain and discomfort. We look at 11 ways to prevent kidney stones.
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Reply by Authors

Heilbrun and Powell correctly observe that race was associated with several differences in clinical and pathological characteristics as presented in table 1 in the article. It is noteworthy that AA patients were younger at diagnosis (which should predict less upgrading), had greater PSA and PSA density (which should predict more upgrading), and were more likely to have clinical stage T1c disease (which predicts less upgrading). We shared the concern that a degree of collinearity would exist among these predictor variables and investigated how this factor might impact estimates of the regression coefficients.
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Reply by Authors

The goal of our review was to provide a summary of issues specifically related to pediatric fertility preservation, and hence the focus on oncology and DSD (also known as intersex) populations, whose only chance of future fertility may be via fertility preservation during childhood or adolescence. Mosiello et al highlight another important group of individuals, ie patients with congenital urological abnormalities that result in anatomical fertility challenges (ie spina bifida, bladder exstrophy, posterior urethral valves and anorectal malformations).
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Reply by Authors

We fully agree with the comment that disparities between the treated and untreated groups in our registry might underscore some inherent limitations, ie the absence of a placebo control and randomization. However, we attempted to use propensity matching to adjust for a number of factors, which would have reduced potential confounding.
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Editorial Comment

Haider et al detail the results of an observational registry study of outcomes in men with symptomatic hypogonadism, comparing 7-year outcomes in those on testosterone therapy vs those not treated. They report several interesting findings, including significant improvement in voiding function, erectile function and quality of life, in men on testosterone therapy vs those not treated.
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