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A Rare Case of Ureteral IgG4 Disease Masquerading as Urothelial Carcinoma

Tue, 05/22/2018 - 00:00
The present paper described a rare case of ureteral IgG4-related disease (IgG4-RD) that mimicked urothelial carcinoma. An otherwise healthy patient presented with CT, ureteroscopic and biopsy findings that were suspicious of urothelial carcinoma. The patient received a right nephro-ureterectomy. Histopathology showed ureteral IgG4-RD, without evidence of urothelial carcinoma. Accurate diagnosis of this rare entity should be based on clinical, biochemical and histopathological findings.
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Extra-Adrenal Pheochromocytoma Associated with Segmental Renal Artery Compression and Pseudostenosis

Tue, 05/22/2018 - 00:00
Classically, pheochromocytomas and paragangliomas result in hypertension secondary to an excess release of catecholamines. However, when the tumor arises near the renal hilum, hypertension may occur secondary to renal artery stenosis, which can occur via several purported mechanisms. We describe an unusual case of a hereditary, extra-adrenal pheochromocytoma causing right lower pole renal artery pseudostenosis, pertinent radiologic signs, relevant surgical findings, and subsequent resolution after extirpative surgery.
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Characterization of Septal and Punctate Scarring in Peyronie's Disease

Tue, 05/22/2018 - 00:00
To characterize patients with isolated septal scarring (ISS) and punctate scarring (PS) in Peyronie's disease (PD) as well as highlight the importance of duplex ultrasonography in the work-up of patients with PD.
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Robotic Management of Recto-Urethral Fistulas after Focal Treatment for Prostate Cancer

Tue, 05/22/2018 - 00:00
To describe our management strategy for RUF after focal treatment for prostate cancer (PCa) using two cases as an example. Almost 50% of recto-urethral fistulas (RUF) are associated with energy treatment modalities for PCa. The adjacent damage to healthy tissue along with limited pliability of it makes the success of the repair troublesome. There is no standardized approach for these scenarios.
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Reply

Tue, 05/22/2018 - 00:00
An optimal definition for urethroplasty success should include both anatomic and functional outcomes.1 To objectively assess anatomic success, ideally all patients should undergo cystoscopy at follow up. However, previous data show that about half of the patients will not return for a cystoscopic follow-up at 1 year.2 Factors such as lack of symptoms, being remote from the clinic, lack of time, and unwillingness to undergo another cystoscopy are among the reasons for low follow-up rates.1 Lack of cystoscopic follow-up in 12 of 35 (34%) patients in our study is in line with this.
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Editorial Comment

Tue, 05/22/2018 - 00:00
The authors reviewed the quality of life as well as the occurrence or persistence of perineal pain in a series of men who are underwent urethroplasty, with primary anastomosis or using single-stage buccal graft repair, for bulbar urethral strictures.
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Reply

Tue, 05/22/2018 - 00:00
This retrospective study provides a window of a group of patients who rarely present to the large academic medical centers, where almost all prostate cancer research is carried out. Despite a dearth of literature regarding the majority black and low socioeconomic background patients in this study, physicians and allied health professionals who work in America's Essential Hospitals know that a substantial number present with remarkably elevated prostate-specific antigen (PSA) values.1 When patients do present, often it is via the Emergency Department, where the presentations are often signs and symptoms of disseminated prostate cancer.
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Editorial Comment

Tue, 05/22/2018 - 00:00
The authors describe their study on a group of predominantly lower socio-economic status African-American men who presented to their public hospital with PSAs > 100, and conclude that the lack of PSA screening may be exacerbating advanced disease in a similar population of men.
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Editorial Comment

Tue, 05/22/2018 - 00:00
In this video article, Wake et al described their workflow for creating a “novel” 3-dimensional (3D) printing and augmented reality methods aimed to facilitate surgical planning during robot-assisted partial nephrectomy.1 The feasibility of such technologies was demonstrated on the single case of a pelvic kidney with complex vascular anatomy affected by a renal mass. Nevertheless, authors stated that up to date they performed 15 cases using this technology, observing an influence on surgical decision-making.
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Three-dimensional Printing and Augmented Reality: Enhanced Precision for Robotic Assisted Partial Nephrectomy

Tue, 05/22/2018 - 00:00
To describe novel 3-dimensional (3D) printing and augmented reality (AR) methods of image data visualization to facilitate anatomic understanding and to assist with surgical planning and decision-making during robotic partial nephrectomy.
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Bladder Agenesis and Associated Pelvic Arterial Anomaly in Two Female Pediatric Patients

Mon, 05/21/2018 - 00:00
Bladder agenesis is an extremely rare congenital anomaly of the genitourinary tract. Two female patients with known diagnoses of bladder agenesis presented for pre-renal transplant evaluation and neobladder creation. Similar unique pelvic arterial malformations were identified through pre-operative imaging and intraoperative examination. With these similar findings, it could be proposed that such anatomical variants are products of the same insult or involve a causal relationship, with vascular aberrancies potentially provoking pelvic organ maldevelopment.
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Patient Compliance with Maintenance Intravesical Therapy for Non-Muscle Invasive Bladder Cancer

Mon, 05/21/2018 - 00:00
To assess patient adherence to intravesical instillation therapy for non-muscle invasive urothelial carcinoma outside of clinical trials.
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Simultaneous Bilateral Ureteral Calculi: A New Paradigm for Management

Mon, 05/21/2018 - 00:00
To define the need for emergent intervention between patients with SBUC compared to unilateral ureteral calculi (UUC). Patients with simultaneous bilateral ureteral calculi (SBUC) represent a potential urological emergency due to possible anuria and/or electrolyte imbalance. While conventional practice mandates immediate intervention in these patients, little data exist to define the rate of these events. METHODS: Records of all patients with ureteral stones treated ureteroscopically over an 11-year period were reviewed to identify those with SBUC.
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Association between Early Confirmatory Testing and the Adoption of Active Surveillance for Men with Favorable-Risk Prostate Cancer

Mon, 05/21/2018 - 00:00
To examine the relationship between the use and results of early confirmatory testing and persistence on active surveillance (AS).
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The Application of Suctioning Flexible Ureteroscopy with Intelligent Pressure-Control in Treating Upper Urinary Tract Calculi on Patients with a Solitary Kidney

Fri, 05/18/2018 - 00:00
The position of the end of the ureteral sheath during surgery should be determined based on the location of the stone and the range of flexible motion of the ureteroscope at the time of lithotripsy. In lithotripsy for ureteral calculus, the sheath should be as close as possible to be beneath the ureteral calculus; in lithotripsy for kidney stones, the front end of the sheath should be as close as possible to the outlet of the renal pelvis but should not limit the moving activity of the bendable part of the flexible ureteroscope.
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Endoscopic Injection of Low Dose Triamcinolone: a Simple, Minimally Invasive and Effective Therapy for Interstitial Cystitis with Hunner Lesions

Fri, 05/18/2018 - 00:00
To investigate the efficacy of low dose triamcinolone injection for effectiveness and durability in interstitial cystitis/bladder pain syndrome (IC/BPS) patients with Hunner Lesions (HL).
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Retrograde Ureteral Catheterization: a Possible New Treatment for Renal Fungal Balls in Very-Low-Birth-Weight Infants

Thu, 05/17/2018 - 00:00
Invasive candidiasis is a serious pathogen of late-onset sepsis in very-low-birth- weight (VLBW) infants. Kidney is the most common organ involved and it causes morbidity and mortality, especially when fungal balls are formed. We report a 34-day-old female infant (28 weeks, 1152 gm) with systemic fungal infection complicated obstructive uropathy. On sonography, the fungal balls filled the entire pelvis without hydronephrosis. Percutaneous nephrostomy was not feasible. In addition to systemic antifungals, we successfully performed cystoscopy-assisted retrograde ureteral catheterization (RUC) to decompress the pelvis, which also provided a route for local amphotericin B irrigation to achieve therapeutic concentration without nephrotoxicity.
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Modified Transanosphincteric (York Mason) Repair of Non-Radiated Rectourinary Fistulae: Patient-Reported Fecal Continence Outcomes

Thu, 05/17/2018 - 00:00
To review our experience with the modified York Mason (MYM) procedure in treatment of rectourinary fistulae (RUF), and to assess fecal continence using patient reported measures.
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Patency and Incontinence Rates after Robotic Bladder Neck Reconstruction for Vesicourethral Anastomotic Stenosis and Recalcitrant Bladder Neck Contractures: the TURNS Experience.

Thu, 05/17/2018 - 00:00
To review a robotic approach to recalcitrant bladder neck obstruction and assess success and incontinence rates.
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