Urology News Feeds
To assess perioperative, clinical and functional outcomes following completely robotic ileal ureter.
Current Children’s Oncology Group studies on children with renal malignancy focus on minimizing side effects with a goal of decreasing long term complications. The goal of the present study is to evaluate the patterns of initial imaging in children with renal tumors.
To help rein in surgical spending, there is growing interest in the application of payment bundles to common outpatient procedures like ureteroscopy (URS) and shockwave lithotripsy (SWL). However, before urologists can move to such a payment system, they need to know where their episode costs are concentrated.
A limited diet can help a person reduce the symptoms of diarrhea. In this article, learn what foods to eat, what foods to avoid, and when to see a doctor.
Information underpinning our understanding about how bladder cancer treatments, in particular bladder removal, affect patient quality of life has grown significantly in the last several years. The number of citations on this topic listed in PubMed® between 2013 and 2017, for example, is more than double that in the 5 years between 2001 and 2005 (567 vs 274).1 Most of these gains followed the call by Porter and Penson for better measurement so that now research into QOL outcomes is more often based on reliable and representative assessments than it was before 2005.
Budendorf et al reported that prostate cancer can follow 2 hematogenous metastatic pathways, including backward venous spread to the spine, which occurs early, and dissemination through a lung passage, which happens later in the disease.1 Therefore, to identify early lumbar spine involvement sensitive and specific imaging techniques are necessary.
ObjectivesTo characterize the utilization of delayed phase computed tomography (CT) imaging in blunt renal trauma and determine if the omission of delayed phase CT imaging affected clinical outcomes in children.MethodsA prospectively collected trauma database was reviewed between 2006 and 2016 to identify patients ≤21 years of age with a diagnosis of renal injury from blunt trauma. Demographic characteristics, injury grade, injury severity score (ISS), non-kidney organ injuries, radiologic studies, and clinical course were reviewed.
Absorbable Hydrogel Spacer Use in Prostate Radiotherapy: A Comprehensive Review of Phase 3 Clinical Trial Published Data
To provide an update on SpaceOAR® System, a FDA approved hydrogel indicated to create distance between the prostate and rectum which has been studied in phase 2 and 3 clinical trials. Here we review and summarize these clinical results including: the safety of prostate-rectum spacer application technique, the implant quality and resulting rectal dose reduction, acute and long term rectal, urinary and sexual toxicity as well as patient reported outcomes.
Use of 99mTc-Sestamibi SPECT/CT in the Diagnosis of Hybrid Oncocytic/Chromophobe Tumor in a Pediatric Patient
The differential diagnosis of solid renal neoplasms in adolescence includes aggressive malignancy and indolent oncocytic tumors which are typically indistinguishable using conventional imaging. We report use of 99mTc-sestamibi single photon emission computed tomography/x-ray computed tomography (SPECT/CT) in characterizing enhancing renal neoplasms in a pediatric patient. Genetic testing suggested a hereditary syndrome associated with aggressive malignancy, while renal mass biopsy suggested an oncocytic tumor.
Comparative Effectiveness of Initial Surgery Versus Initial Systemic Therapy for Metastatic Kidney Cancer in the Targeted Therapy Era: Analysis of a Population-Based Cohort
To use econometric methods to assess comparative overall survival of mRCC patients managed with initial cytoreductive nephrectomy (CN) versus initial systemic therapy. Randomized data demonstrate improved survival for CN preceding cytokine-based therapy in metastatic renal cell carcinoma (mRCC). This benefit may be attenuated in the contemporary mRCC era given more effective systemic therapies.
Defining a cohort of men who may not require repeat prostate biopsy based on PCA3 score and MRI: The dual negative effect
Prostate Cancer (PCa) overdiagnosis and overtreatment is a concern for clinicians and policy makers. Multiparametric MRI (mpMRI) and the PCA3 urine test select for clinically significant cases. We explore how well the tests perform in combination for men with previous biopsies.
A Randomized Comparative Study Evaluating Various Cough Stress Tests and 24-Hour Pad Test with Urodynamics
The cough stress test (CST) is a common and accepted tool to evaluate stress urinary incontinence but there is no agreement on how the test should be conducted. We assessed the diagnostic ability of different CSTs performed varying patient’s position and bladder volumes using urodynamic stress urinary incontinence (USI) as the gold standard. The 24-hour pad test was also evaluated.
The effect of family assistance to wake children with monosymptomatic enuresis in alarm therapy: A pilot study
Alarm therapy is widely used as first-line treatment for nocturnal enuresis (NE). However, some children do not wake when nocturnal urination activates the alarm. It is currently unclear whether waking the child when the alarm is activated improves the efficacy of alarm therapy. This study aimed to investigate the efficacy of alarm therapy for NE when children do not wake in response to the sound and their parents do not wake them.
The best way to lower creatinine is to treat the underlying cause. There are also many diet and lifestyle changes that can help lower creatinine.
The authors analyzed longitudinal trends in urinary continence status among 5,250 patients with spina bifida participating in the National Spina Bifida Patient Registry. Overall the factors associated with continence status were not surprising (older age, female gender, use of bladder management, sacral lesion, ambulatory status and nonmyelomeningocele diagnosis). However, it is concerning that patients who were non-Hispanic black or Hispanic/Latino had lower odds of continence compared to their white counterparts.
The unfortunate reality is many patients requiring surgery have significant comorbidities. For established cardiovascular disease perioperative cessation of aspirin may increase thromboembolic complications (reference 25 in article). In the current study Otto et al found that continued low dose aspirin did not adversely affect bleeding or outcomes following standard percutaneous nephrolithotomy. They report similarly low transfusion rates in patients on continued aspirin and those not on therapy although each group additionally received heparin prophylaxis.
Frequently, manuscripts on the same topic are submitted to The Journal of Urology®. It is surprising how often what appear to be well done studies come to opposite conclusions. However, 2 retrospective studies published in this issue of The Journal (pages 000 and 000) reached nearly the same conclusions.1,2 The impact of prior transurethral procedures on subsequent complexity of urethral strictures was evaluated, and the authors of both studies concluded that the complexity of the stricture and difficulty performing urethroplasty were compounded by the prior procedures including urethrotomy and dilation.
Short-Term Clinical Efficacy of Electric Pudendal Nerve Stimulation on Neurogenic Lower Urinary Tract Disease: a Pilot Research
To compare the short-term efficacy of electrical pudendal nerve stimulation versus anogenital electrical stimulation for neurogenic lower urinary tract disease.
Navigation of fluorescence cameras during soft-tissue surgery – is it possible to use a single navigation setup for various open and laparoscopic urological surgery applications?
Providing real-time visualization, fluorescence imaging can guide surgeons during tissue resection. Unfortunately, tissue-induced signal-attenuation limits the value of this technique to superficial applications. By positioning the fluorescence camera via a dedicated navigation setup we reason the technology can be made compatible with deeper lying lesions, increasing its impact on clinical care. Such impact would benefit from the ability to implement the navigation technology in different surgical settings.
Modern medicine aspires to achieve personalized treatment in which diagnostic investigations and therapy are tailored toward the individual patient. In patients with nephrolithiasis this approach is more than ideological since uncovering the underlying genetic mutation can distinctly change the treatment strategy. For example restricting tanning bed use for a patient with identified CYP24A1 mutation is highly specific1 and is distinct from generic stone prevention advice focusing on fluid intake.