Urology News Feeds

Focal Laser Ablation of Prostate Cancer: Feasibility of MRI/US Fusion for Guidance

Focal laser ablation (FLA) is a potential treatment for some men with prostate cancer (CaP). As currently practiced, FLA is performed by radiologists in a MRI unit (in-bore). We evaluated the safety and feasibility of performing FLA in a urology clinic (out-of-bore), using magnetic resonance imaging-ultrasound (MRI/US) fusion for guidance.
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Severity of Preoperative Proteinuria is a Risk Factor for Overall Mortality in Patients Undergoing Nephrectomy

Chronic kidney disease may adversely affect survival following nephrectomy. Proteinuria is increasingly used as a marker for kidney disease. However, the relationship between preoperative proteinuria and survival following nephrectomy remains incompletely characterized. We sought to evaluate the association of preoperative proteinuria with overall and cancer-specific survival using our institutional nephrectomy registry.
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Safety of Mesh Use in Vaginal Cystocele Repair: Analysis of National Patient Characteristics and Complications

The use of mesh in vaginal cystocele repair has declined. We analyzed the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database to compare outcomes of repairs with and without mesh.
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Editorial Comment

OAB is a highly prevalent condition, impacting approximately 16% of adults in the United States and significantly reducing quality of life.1 The recommended treatment options are well described in the AUA (American Urological Society)/SUFU (Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction) OAB guidelines, including tier 1—behavioral therapy, tier 2—oral medications (antimuscarinics and β3-agonists) and tier 3—onabotulinumtoxinA, sacral neuromodulation and PTNS.2 The lack of long-term persistence of the oral medications is well documented.
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Editorial Comment

Despite evidence of benefit1 tibial nerve stimulation is not widely performed with current technology since the delivery of therapy is often resource intensive and the response is hard to predict. Percutaneous delivery of therapy and application of therapy by the patient potentially could revolutionize the use of tibial nerve stimulation. Needle-free (transcutaneous) stimulation, in which an implant is placed adjacent to the target site, thereby enabling the patient to self-administer tibial nerve stimulation, could clearly have a great impact.
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Overactive bladder: Symptoms, myths, and misconceptions

MedicalNewsToday - Thu, 04/06/2017 - 05:00
In this article learn about overactive bladder. What is it, what are the symptoms and who does it affect? Is it the same as stress urinary incontinence?
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The Relationship between Diabetes, Diabetes Severity, Diabetes Biomarkers and the Presence of Lower Urinary Tract Symptoms: Findings From the National Health and Nutrition Examination Survey (NHANES)

Urology (Gold Journal) In Press - Thu, 04/06/2017 - 00:00
To characterize the associations between diabetes mellitus (DM) and lower urinary tract symptoms (LUTS). This study focuses on the relationships between specific diabetic characteristics (e.g. severity, biomarkers) and the prevalence of LUTS.
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From Galen's Urine to Harvey's Blood

Urology (Gold Journal) In Press - Thu, 04/06/2017 - 00:00
“If Harvey had a foothold on Galen's shoulder, he was nevertheless gazing off in a different direction.”
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Differences in Cavernosal Artery Parameters According to Different Anatomic Sampling Locations during the Diagnosis of Vascular Erectile Dysfunction Using Duplex Ultrasound

Urology (Gold Journal) In Press - Thu, 04/06/2017 - 00:00
Objective.To establish a standard location for examining penile cavernosal arteries (CAs) using dynamic duplex Doppler ultrasound (PDDU) examination in the diagnosis of non-arterial erectile dysfunction (ED) or arterial insufficiency.Materials and Methods.Two groups of 105 patients each were enrolled. The first group (age 56.3 ± 6.0 years) displayed clinical patterns of arterial insufficiency; the second group (age 35.2 ± 4.7 years) displayed clinical patterns of non-arterial ED. The patients had their peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI = PSV-EDV/PSV x 100) and acceleration time of the cavernosal arteries measured using PDDU at the crura and at the midpoint between the penoscrotal junction and the coronal sulcus (mid penis).
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Trans-scrotal Near Infrared Spectroscopy as a Diagnostic Test for Testis Torsion in Pediatric Acute Scrotum: A Prospective Comparison to Gold Standard Diagnostic Test Study

A rapid test for testicular torsion in children may obviate delay for testicular ultrasound. This study assessed testicular tissue percent saturation of oxygen (%StO2) measured by trans-scrotal near-infrared spectroscopy (NIRS) as a diagnostic test for pediatric testicular torsion.
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Functional Outcomes Following Nerve-Sparing Prostatectomy Augmented with Seminal Vesicle Sparing Compared to Standard Nerve-Sparing Prostatectomy: Results from a Randomized Controlled Trial

Seminal vesicle sparing may reduce the risk of neurovascular bundle injury and improve functional outcomes after prostatectomy. While several observational studies have reported better functional outcomes following seminal vesicle sparing approaches, evidence from randomized trials is lacking. We conducted a randomized controlled trial comparing functional and cancer control outcomes between nerve-sparing prostatectomy augmented with seminal vesicle sparing (NSP+SVS) and standard nerve-sparing prostatectomy (NSP).
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Reply by Authors

Our study suggests that urinary levels of IL-6 combined with bedside estimation of WBCs is a promising tool to differentiate ABU from a suspected episode of UTI. It also suggests that IL-6 could serve as a marker of treatment or a wait and see approach in suspected UTI cases. The added value of IL-6 in diagnosing UTI was recently tested in a pilot trial in an ABU prone nursing home population, resulting in a 20% reduction in antibiotic treatments without documented side effects (reference 25 in article).
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Editorial Comment

Hooton et al confirmed that colony counts of E. coli as low as 10 to 102 cfu/ml in midstream urine were sensitive for presence of E. coli in catheter urine and, thus, diagnostic for lower UTI in symptomatic women.1 However, in the same study no bacteriuria was found in catheter urine in 26% of symptomatic patients. On the contrary, in women with ABU recurrent symptomatic infections may even be prevented if left untreated.2 Thus, the clinical diagnosis of lower UTI has become much more important and a specific questionnaire was established.
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Editorial Comment

For many years the inappropriate use of antibiotics has been recognized as a major problem, leading to higher health care costs as well as increased antimicrobial resistance.1 On the other hand, no markers predicting the transition from ABU to symptomatic UTI have been available.2 Distinguishing ABU that does not require treatment from symptomatic UTIs may be a key to success for improving antibiotic stewardship (reference 7 in article). A biomarker that could indicate the time to begin antibiotic therapy is highly desirable.
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Editorial Comment

Urology (Gold Journal) In Press - Wed, 04/05/2017 - 00:00
The authors provided an interesting look at the academic profile of the current urologic chairs in the United States.1 I am impressed by the academic productivity as measured by the number of published manuscripts as well as the impact these articles have had in promoting overall urologic scientific discovery. Scientific impact as measured by H-factor was higher for urology chairs compared to other departments such as orthopedic surgery and radiation oncology. It would be interesting if the authors had been able to compare and contrast the temporal changes in the academic and demographic characteristics of chairs over the last several decades.
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Editorial Comment

Urology (Gold Journal) In Press - Wed, 04/05/2017 - 00:00
Accurate risk calculators for predicting the presence of significant prostate cancer at the time of prostate biopsy. Avoiding overdiagnosis and overtreatment is especially important given the increased awareness of prostate biopsy complications and the preventative task force's recommendations on prostate-specific antigen (PSA) screening.1
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Post Ritual Circumcision Bleeding – Characteristics and Treatment Outcome

Urology (Gold Journal) In Press - Tue, 04/04/2017 - 00:00
To report the characteristics, treatment, and short term outcome of neonatal post-circumcision bleeding, and identify predictors of surgical treatment.
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