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These authors have conducted an analysis of testosterone (T) levels in men with urethral stricture disease. Their results are very provocative insofar as demonstrating a clear link between hypoandrogenism (defined as <300 ng/dL) and longer stricture length. As these investigators note, there are no putative pathophysiologic mechanisms for stricture development. While there are some limitations to this research, like only 1 serum T draw and lack of a central laboratory, this work augments the previous observations by this group linking a low T with risk of artificial sphincter erosion.
The Adverse Survival Implications of Bland Thrombus in Renal Cell Carcinoma with Venous Tumor Thrombus
To characterize the presence of bland (non-tumor) thrombus in advanced renal cell carcinoma and assess the impact of this finding on cancer-specific survival.
Prostate Specific Antigen Density (PSAD) reliably predicts upgrading and upstaging in men candidate to surgery for prostate cancer (PCa) and helps selecting patients suitable for active surveillance. Above all, it is basically inexpensive, being the ratio of pre-operative Prostate Specific Antigen (PSA) and prostate volume (PV), routinely assessed at the time of ultrasound-guided biopsy.
Nephrogenic diabetes insipidus (NDI), a rare cause of polyuria and polydipsia in children, is usually managed with medications and careful monitoring of water intake. We present a child who was incidentally found to have right hydronephrosis secondary to ureteropelvic junction obstruction, and was subsequently also diagnosed with NDI. After being medically managed, he underwent open right pyeloplasty. His polydipsia abated within one month of surgery, and he has done well off of medications since that time.
Reply to Letter-to-the-Editor, Re: Linder Et Al: Autologous Transobturator Urethral Sling Placement for Female Stress Urinary Incontinence: Short-Term Outcomes
We appreciate these authors' interest in our use of a transobturator approach to autologous urethral sling placement.1 As detailed in our previous publication, we use absorbable polyglactin (Vicryl) sutures for sling attachment, with two trocar passes on each side to allow for a tissue bridge over which the sutures are secured.1, 2 The authors specifically query whether use of an absorbable suture may impact long-term efficacy of the autologous transobturator (ATO) sling technique. While we recognize that intuitively, given that the suture material dissolves the fixation of the sling could change, we would respectfully submit that this has not been our clinical experience, likely due to fibrosis of sling in the periurethral and paravaginal tissues.
Re: Linder et al.:Autologous Transobturator Urethral Sling Placement for Female Stress Urinary Incontinence: Short-Term Outcomes (Urology. 2016 Jul;93:55-9)
We have read with great interest the study entitled ‘Autologous Transobturator Urethral Sling Placement for Female Urinary Incontinence: Short-term outcomes’ by Linder et al. (1). The authors evaluated the outcomes of 33 patients who had been performed autologous transobturator (ATO) mid-urethral sling with rectus fascia and concluded that the technique of ATO urethral sling placement was safe and a promising procedure with short-term outcomes. In the literature, this technique described by Linder in 2014 was the first report about usage of autologous fascia at transobturator tape surgery (2).
ObjectivesTo validate the newly designed Ultra-Sound guided Suprapubic Catheter Insertion Trainer (US-SCIT) model against the real life experience, by enrolling participants with prior confidence in the technique of US-guided Supra-Pubic Catheter (SPC) insertion.MethodsThe US-SCIT was self-constructed from common disposables and equipment found in the Emergency Department (ED). A validation questionnaire was completed by all participants, after SPC insertion on the US-CIT model.ResultsFifty participants enrolled in the study.
Reduced Risk of Sepsis after Prostate Biopsy Using a Cephalosporin/Fluoroquinolone Antibiotic Regimen and Isopropyl Alcohol Needle Washing
To compare 3 prophylactic regimens to assess their impact on post-biopsy sepsis incidence.
The ability to create 3D renderings from multi-detector CT data enables a global overview of complex anatomy and disease processes which can be difficult to appreciate on 2D images. As such, 3D CT has become an invaluable adjunct for diagnosis and treatment planning of many urologic conditions. A newly available method of 3D visualization, known as cinematic rendering, uses a complex lighting model to create photorealistic images and holds promise for improved discrimination of tumors and cancer staging in genitourinary imaging.
and Objectives: Overactive bladder (OAB) imposes a significant socioeconomic burden on the healthcare system. It is a commonly held belief that increased fluid intake (eight glasses of water a day) is beneficial for one’s health; however, increased fluid intake exacerbates OAB symptoms. Thus, it is imperative that clinicians appropriately educate patients for whom increased water intake may be detrimental (women with OAB), in contrast to patients with comorbidities that necessitate increased water intake (nephrolithiasis).
3-year treatment outcomes of water vapor thermal therapy (Rezūm System) compared to doxazosin, finasteride and combination drug therapy for men with benign prostatic hyperplasia: cohort data from the Medical Therapy of Prostatic Symptoms (MTOPS) Trial
This evaluation of long-term outcomes of treatment for lower urinary tract symptoms due to benign prostatic hyperplasia compares a one-time water vapor thermal therapy procedure with daily medical therapy in cohorts from the Medical Therapy of Prostatic Symptoms (MTOPS) study.
Cystic renal cell carcinoma: a report on outcomes of surgery and active surveillance in patients retrospectively identified on pretreatment imaging
To evaluate the outcomes of surgical intervention and active surveillance in patients diagnosed with cystic renal cell carcinoma at our hypothesized radiologic cutoff of >50% cystic.
Acute prostatitis is a sudden inflammation of the prostate gland. It is a rare type of prostatitis, which is a common prostate problem.
There are many reasons for rectal bleeding after wiping. We look at 11 causes here, along with the treatment options there are for each one.
Hassan et al assessed the risk of locally aggressive behavior of pure GS6 prostate cancer in RP specimens. They found that it was not rare for pure GS6 PCa to show extraprostatic extension and yet not lymph node metastasis.
Is Gleason 6 (Grade group I) cancer really cancer? Those who argue that the label “cancer” is inappropriate cite the generally indolent clinical behavior of the disease and the virtual lack of demonstrable lymph node or distant metastasis in men with pure 3+3 tumors. In this retrospective review Hassan et al (page 000) from Baltimore, Maryland compared the pathological features after radical prostatectomy in 3,291 men with Gleason 3+3 (Grade group I) and 4,202 men with 3+4 (Grade group II) cancer.
The authors applied the power of large distributed groups of people around the country to accomplish the task of sampling and identifying biomarkers of urothelial inflammation. The research group used social media and machine learning to solve urological challenges. This article represents yet another application of using crowdsourcing to rapidly and expansively drive participation for a study that would take years by conventional recruitment means.
In this issue of The Journal Pradère et al (page 0000) compare and contrast 3 clinical practice guidelines for the surgical management of urolithiasis.1 These guidelines include those from SIU (Société Internationale d’Urologie)/ICUD (International Consultation on Urology Diseases) in 2014,2 AUA (American Urological Association)/ES (Endourological Society) in 20162,3 and EAU (European Association of Urology) in 2017.4 There are 2 interesting aspects to this report. The first is the highlighting of the commonalities and the differences among the 3 guidelines.
Prevalence and Characteristics of Urinary Incontinence in a Treatment-Seeking Male Prospective Cohort – Results from the LURN Study
Male urinary incontinence (UI) is thought to be infrequent. We sought to describe the prevalence of UI in a male treatment-seeking cohort enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN).