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Editorial Comment

Urology (Gold Journal) In Press - Fri, 05/26/2017 - 00:00
Suppose I could share with you a new technology or a method that would: increase the efficiency of your practice, decrease your overhead expenses, increase your productivity, increase patient access to your practice, enhance your patient satisfaction scores, improve patient education, enhance office morale, and possibly decrease litigation, would you be interested in implementing this new concept or idea? I am sure most of you will say yes; sign me up. Well that option has been nicely described by Langston et al who have described how non-physician providers (NPP) can accomplish many of these goals and objectives.
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Reply

Urology (Gold Journal) In Press - Fri, 05/26/2017 - 00:00
We noted in our study the controversial nature of asymptomatic urachal lesions and agree that there is little known on whether these lesions will become symptomatic or develop malignant potential. The few asymptomatic patients in our series represent a minority of such cases seen in our practice. Parents were counseled as to the pros and cons of surgical intervention as well as observation, and these parents selected surgery. We are in agreement that longer-term data are needed regarding nonoperative management; however, our policy is to offer all treatment options to patients with enlarging or symptomatic urachal anomalies.
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Editorial Comment

Urology (Gold Journal) In Press - Fri, 05/26/2017 - 00:00
As noted by the authors, the indications for surgical excision of urachal anomalies are controversial. Consensus regarding conservative management of asymptomatic patients appears to be growing. There is also increasing evidence but no long-term data that a non-operative approach may be acceptable for many symptomatic lesions as well (at least initially).
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a Novel Robotic Technique

Urology (Gold Journal) In Press - Fri, 05/26/2017 - 00:00
To reduce the risk of symptomatic lymphocele after robotic pelvic lymph node dissection (PLND), we present a novel technique (P.L.E.A.T.): the peritoneum is ‘pleated’ along its midline, leaving two lateral openings and allowing lymphatic fluid to drain away from the pelvis and into the abdomen.
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Factors Associated with Erectile Dysfunction and the Peyronie's Disease Questionnaire in Patients with Peyronie's Disease

Urology (Gold Journal) In Press - Fri, 05/26/2017 - 00:00
To elucidate patient characteristics that impact symptom-related bother and erectile function in patients with Peyronie's disease (PD).
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Reply to Letter to the Editor

Urology (Gold Journal) In Press - Fri, 05/26/2017 - 00:00
As presented in this Letter to the Editor, we strongly agree with the authors that the 2012 USPSTF Statement against PSA based screening for prostate cancer has led to significant confusion within the medical community, especially among our primary care provider (PCP) colleagues. The Grade D recommendation served not only to raise question among PCPs about the practice of using PSA based screening but took one step further by actually recommending against that lab work.
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Re: George A Turini III, Annie Gjelsvik, Joseph F Renzulli II, The State of Pre-Screening Discussions About PSA Testing Following Implementation of the 2012 USPSTF Task Force Statement, (2017), http://dx.doi.org/doi: 10.1016/j.urology.2016.12.069

Urology (Gold Journal) In Press - Fri, 05/26/2017 - 00:00
We read the article with great interest. The authors analyzed the occurrence of pre-screening discussions (also called ‘shared decision-making’) that patients received from their providers prior to PSA testing, and found a declining rate between 2012 and 2014. As outlined in this article, the majority of screening is done by primary care providers and not by urologists. From the prospective of primary care, even after more than 25 years since the introduction of routine PSA screening for prostate cancer (PCa) there is still no clarity about the usefulness and desirability of this test.
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Memokath Stent Failure in Recurrent Bulbar Urethral Strictures: Results from an Investigative Pilot Stage 2a Study

Urology (Gold Journal) In Press - Fri, 05/26/2017 - 00:00
To evaluate the efficacy of the Memokath stent in managing recurrent bulbar urethral strictures.
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Outcomes of a cohort of prenatally diagnosed and early-enrolled patients with congenital solitary functioning kidney

To evaluate the clinical course of prenatally diagnosed and early-enrolled patients with congenital solitary functioning kidney (CSFK) and to identify the risk factors for renal injury.
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The impact of prostate cancer zonal origin on pathological parameters at radical prostatectomy and subsequent biochemical failure

To assess the impact of prostatic zone tumour origin on the pathological prognostic features and subsequent biochemical outcomes after radical prostatectomy.
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Prostate Cancer Antigen 3 (PCA3) Score Does Not Predict for Adverse Pathologic Features at Radical Prostatectomy or for Progression-Free Survival in Clinically-Localized, Intermediate- and High-Risk Prostate Cancer

Urology (Gold Journal) In Press - Thu, 05/25/2017 - 00:00
To evaluate whether pre-operative urinary prostate cancer antigen 3 (PCA3) scores predict for adverse pathologic features (APFs) and/or progression-free survival (PFS) in men with intermediate- or high-risk prostate cancer (PCa) undergoing radical prostatectomy (RP).
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Natural History of Low Stage Urethral Strictures

Urology (Gold Journal) In Press - Thu, 05/25/2017 - 00:00
To determine the natural history and rate of progression of incidental wide-caliber, anterior urethral strictures in men utilizing a validated stricture staging system.Subjects and Methods: Men with incidental findings of anterior US on cystoscopy performed for urologic conditions other than US were retrospectively reviewed from 2001 through 2016. Diagnosis of US on cystoscopy was made according to a validated staging system: Stage 0 - no stricture; Stage 1 - wide caliber stricture; Stage 2 - requires gentle dilation with a flexible cystoscope; Stage 3 - impassable stricture with a visible lumen; Stage 4 - no visible lumen.
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Recent changes in prostate cancer screening practices and prostate cancer epidemiology

Prostate-specific antigen (PSA) based screening for prostate cancer has had a significant impact on the epidemiology of the disease. Its use has been associated with a significant reduction in prostate cancer mortality, but has also resulted in the overdiagnosis and overtreatment of indolent prostate cancer, exposing many men to the harms of treatment without benefit. The U.S. Preventive Service Task Force (USPSTF) issued a recommendation against screening men over 75 in 2008, and against routine screening for all men in 2012, indicating that, in their interpretation, the harms of screening outweigh the benefits.
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Morbidity and Mortality of Locally Advanced Prostate Cancer: A Population-Based Analysis Comparing Radical Prostatectomy Versus External Beam Radiation

The management of locally advanced prostate cancer (PCa) remains controversial. We sought to compare the effect of primary external beam radiation therapy (EBRT) vs. radical prostatectomy (RP) for locally advanced PCa.
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Clinical Outcomes and Testosterone Levels Following Continuous Androgen Deprivation in Patients with Relapsing or Locally Advanced Prostate Cancer: A Post Hoc Analysis of the ICELAND Study

Lower serum testosterone levels correlate with improved cause-specific survival and longer time to progression in the first year of continuous androgen deprivation in men with prostate cancer. ICELAND was a large, European study demonstrating the efficacy of leuprorelin (Eligard®) during continuous androgen deprivation. This post hoc analysis investigated serum testosterone levels within the first year of continuous androgen deprivation for survival and time to progression.
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Novel Use of Fluorescence Lymphangiography during Robotic Groin Dissection for Penile Cancer

Urology (Gold Journal) In Press - Wed, 05/24/2017 - 00:00
To describe a novel technique of robotic inguinal lymphadenectomy with near infrared fluorescence imaging (NIRF) using indocyanine green (ICG) to facilitate lymph node identification during robotic groin dissection for penile cancer.
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Natural Orifice Transluminal Endoscopic Partial Prostatectomy: a Real Time Image Guided Focal Extirpative Feasibility Study

Urology (Gold Journal) In Press - Wed, 05/24/2017 - 00:00
To assess the feasibility of focal endoscopic excision of PCa under guidance of real time magnetic resonance imaging/ultrasound fusion (MUF).
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Benign Large Cell Calcifying Sertoli Tumor of the Testis in a 13 Year Old Male Treated with Partial Orchiectomy

Urology (Gold Journal) In Press - Wed, 05/24/2017 - 00:00
Large cell calcifying Sertoli cell tumors of the testis (LCCSCT) is an exceptionally rare lesion, found sparsely in any medical literature. There is a correlation between this entity and Peutz−Jeghers syndrome and Carney's complex (40% of tumors). The remaining 60% of tumors are sporadic.A 13 year old male underwent a left partial orchiectomy. Intra-op frozen section was used. Pathology revealed a benign large cell calcifying sertoli cell tumor with negative margins. To our knowledge there is not a case in the literature of a LCCSCT being treated with partial orchiectomy in a pubertal male with a normal contralateral testis.
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Remote Development of Tumor-to-Tumor Metastasis of Breast Adenocarcinoma in a Renal Oncocytoma

Urology (Gold Journal) In Press - Wed, 05/24/2017 - 00:00
Tumor-to-tumor metastasis (TTM) is a rare phenomenon where a focus of distinct metastatic disease is discovered with a second primary tumor. While renal cell carcinoma is the most frequent recipient of metastatic tumor cells, oncocytomas have also previously been described. We present the case of a patient with incidentally detected mammary adenocarcinoma within an oncocytoma 16 years following primary treatment. The mass was treated with partial nephrectomy, with the surgical pathology specimen showing clear delineation of the pleomorphic lobular carcinoma and oncocytoma cells.
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Effect of Prior Focal Therapy on Perioperative, Oncologic and Functional Outcomes of Salvage Robotic Assisted Radical Prostatectomy

To assess the impact of focal therapy (FT) on perioperative, oncologic, and functional outcomes in men who underwent salvage robotic-assisted radical prostatectomy(S-RARP) compared to primary RARP (P-RARP).
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