Urology News Feeds
While much surgery is performed for the anticipated subjective benefit of patients, assessment of treatment success by the patients themselves has received little attention in pediatric urology research. Indeed, the notion that people with spina bifida are bothered by incontinence at all was established only recently.1 The authors should be commended for this important study of decisional regret at 4 years after a MACE procedure (reported by parents of those younger than 13 years old and by patients age 13 years or older).
In the PRIDE study, a randomized, prospective, intensive behavioral therapy program, the effect of weight loss by exercise and diet on urinary incontinence was studied in women (reference 4 in article). The control arm received a short instructional program. Significant improvement in UI occurred at the 6-month interval with significant weight loss and quality of life improvement. At 12 and 18 months objective measures of UI were not maintained but subjects reported subjective UI improvement, better quality of life and maintained weight loss.
This review focuses on the emerging field of fertility in pediatric urology. Pediatric urologists are accustomed to thinking in terms of survival, quality of life and continence,1 while sexual aspects including fertility have been neglected for a long time. Therefore, this article is useful, presenting fertility preservation options as well as ethical and research issues. Nevertheless, we wonder if the authors missed some populations that could benefit from fertility preservation.
Re: Pathological and Biochemical Outcomes among African-American and Caucasian Men with Low Risk Prostate Cancer in the SEARCH Database: Implications for Active Surveillance Candidacy
In this study Leapman et al analyze upgrading diagnostic biopsy Gleason scores after pathological review of radical prostatectomy specimens in 895 men with low risk prostate cancer in the SEARCH (Shared Equal Access Regional Cancer Hospital) database. Low risk was defined as Gleason pattern 3 + 3 or less on diagnostic biopsy, prostate specific antigen (PSA) 10 ng/ml or less and clinical stage T2a or less.
Low-Intensity Extracorporeal Shock Wave Therapy for Erectile Dysfunction: a Systematic Review and Meta-Analysis
To use systematic review and meta-analysis to assess the efficacy of low-energy extracorporeal shockwave therapy (LI-ESWT) for erectile dysfunction (ED) was undertaken with a meta-analysis to identify the efficacy of the treatment modality.
Is Cryotherapy a Genuine Rival to Robotic Assisted Partial Nephrectomy in the Management of Suspected Renal Malignancy? a Systematic Review and Meta-Analysis
We systematically reviewed world literature and compare oncological outcomes, morbidity, renal function and peri-operative outcome between cryotherapy (CA) and robotic assisted partial nephrectomy (RAPN) for suspected renal malignancy. There was a statistically significant difference for “recurrence rates” between the 2 techniques, favouring the RAPN cohort. There was no statistically significant difference in overall and ≥Clavien 3a complication rates between the 2 techniques. The quality of evidence for recurrence rates, overall complication and ≥Clavien 3a were ‘moderate’, ‘low’ and ‘very low’ respectively on GRADE approach.
Targeted prostate biopsy using magnetic resonance imaging (MRI) guidance is improving accuracy of prostate cancer (CaP) diagnosis. This new biopsy technology is especially important for men undergoing active surveillance, improving patient selection for enrollment and enabling precise longitudinal monitoring. MRI/US fusion biopsy allows for three functions not previously possible with US-guided biopsy: targeting of suspicious regions, template-mapping for systematic sampling, and tracking of cancer foci over time.
Suprapubic catheters are a type of catheter that empties urine from the bladder via an incision in the belly. Learn how to use and care for one.
To explore the long-term outcomes and indications for cystectomy in bladder exstrophy patients. Although rare, cystectomy is the final surgical alternative to bladder repair among these patients with a poor quality bladder template.
We appreciate the editorial comments that highlight the importance of our work.1 Although there is an epidemiological association between testosterone level and erectile dysfunction, no study so far has shown that increasing testosterone level results in improvement in erectile function, especially in eugonadal men, which constituted half of this study. It is well established that increasing serum testosterone level is not a successful treatment modality for erectile function unless the man's total testosterone is low (less than 300 ng/dL).
Innovative ideas are often met with skepticism. It is important that physicians are open to new concepts; yet it is equally important that we challenge ourselves before embracing new approaches, interventions, and strategies. It is important that data support such innovations.
Growth Kinetics of Small Renal Masses on Active Surveillance: Variability and Results from the DISSRM Registry
Active surveillance (AS) is emerging as a safe and effective strategy for the management of small renal masses (SRMs; ≤4cm). We characterize growth rates (GRs) and their pertinence to clinical outcomes in a prospective multi-institutional study of patients with SRMs.
As outlined in this review, adjuvant therapy for locally advanced renal cell carcinoma has remained the elusive holy grail and has been the subject of much research. Unfortunately all prior research had been negative, until recent developments again focused the spotlight on this important endeavor. Two recently completed phase III trials address the question of the role of targeted therapy with tyrosine kinase inhibitors in the adjuvant setting. The ASSURE trial, which examined the benefit of sunitinib or sorafenib vs placebo for 1 year, failed to reveal a benefit in DFS or OS (reference 39 in article).
The progressive development of FT in recent years has brought new frontiers to be overcome in the treatment of prostate cancer. Although short-term functional and oncologic outcomes are promising in this scenario, long-term outcomes provided by randomized, controlled trails are still lacking. Consistent evidence favoring one energy type vs another is still an open field for prospective studies.
In the recently updated AUA/ASTRO/SUO localized prostate cancer guidelines active surveillance was designated as an acceptable form of management for favorable intermediate risk prostate cancer.1 What is the evidence basis to support active surveillance for favorable intermediate risk prostate cancer and in what clinical context should this care option be considered?
Active surveillance (AS) has become a widely accepted management strategy for favorable risk (very low to low risk) prostate cancer as evidenced by increasing clinical uptake and endorsement by several influential clinical guidelines. For example, recent AUA (American Urological Association) guidelines recommend active surveillance as the best available care option for very low risk and a preferable care option for low risk cancers.1 The National Comprehensive Cancer Network® and the American Society of Clinical Oncology have similarly endorsed use of AS in the low risk population.
What is papillary urothelial carcinoma? What are the signs of papillary urothelial carcinoma, what are the causes, and what are the risk factors?
To assess the differences between the male and female urology resident applicant pool. Urology is a competitive field with a selective match process. Women have historically been a minority in medicine. While this has equalized, women continue to be underrepresented in urology.
Ureteroscopy with Holmium:YAG Laser Lithotripsy for Ureteral Stones in Preschool Children: Analysis of the Factors Affecting the Complications and Success
To evaluate the factors that may affect the efficacy and safety of ureteroscopy with holmium:YAG (Ho:YAG) laser lithotripsy in the management of ureteral stones in preschool children.
Clinical and Urodynamic Results of Repeated Intradetrusor Onabotulinum Toxin a Injections in Refractory Neurogenic Detrusor Overactivity: Up to Five Injections in a Cohort of Children with Myelodysplasia
To determine the efficacy and safety of repeated intradetrusor onabotulinum toxin A (onaBoNT-A) injections in children with neurogenic detrusor overactivity due to myelodysplasia.