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Author Reply: Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications
The authors bring up a relevant point, in that structured followup of patients after a midurethral sling procedure is lacking. It is challenging to do, as most patients do well post-operatively, and wonder why they must attend repeated physician's appointment. However, if a “higher-risk” group could be identified, that would make systematic followup more significant for physicians, cost-effective for the medical system and pertinent to the patient. In our previous work, we found that a large number of women have their midurethral sling complication treated a different physician, highlighting a potential problem with accessing their prior surgeon.
Clinical Experience with Penile Traction Therapy among Men Undergoing Collagenase Clostridium Histolyticum for Peyronie's Disease
To evaluate the outcomes in men undergoing Collagenase Clostridium histolyticum (CCH) with concurrent penile traction therapy (PTT) for the treatment of Peyronie's Disease (PD).
Re: Punjani Et Al: Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications (Urology 2017;99:42-48)
We read this manuscript with great interest. While the mid-urethral sling is considered by many to be the gold standard treatment for SUI, it is also associated with notable mesh-related complications. Research has sought to evaluate predictive factors for MUS complications. The majority of available investigation focuses on risk factors for post-operative voiding dysfunction, de novo irritative symptoms, or surgical failure.1-3 While this data is important, similar investigation is lacking to help understand risk factors for the most severe adverse events following MUS, including urethral/bladder perforation and fistula.
Re “Assessment and Treatment of Asymptomatic Bacteriuria Necessary for Reducing the Risk of Postoperative Symptomatic Urinary Tract Infections after Urologic Surgical Procedures?
We read the article with great interest published in your esteemed journal titled “Is Preoperative Assessment and Treatment of Asymptomatic Bacteriuria Necessary for Reducing the Risk of Postoperative Symptomatic Urinary Tract Infections After Urologic Surgical Procedures?” by Tommaso Cai et al1
Does Implementing an Enhanced Recovery after Surgery Protocol Increase Hospital Charges? Comparisons From a Radical Cystectomy Program at a Specialty Cancer Center
OBJECTIVETo compare perioperative charges induced at initial phase of a standardized enhanced recovery after surgery (ERAS) program from a tertiary, referral center.METHODSA multidisciplinary ERAS protocol was implemented in our department in July 2015. The subsequent year all patients were treated according to this protocol (ERAS group). They were compared in terms of real in-hospital charges per surgical episode with a control group consisting of consecutive patients prior to start of ERAS. Individual charges were analyzed per each sample population and compared with the Wilcoxon rank and t tests.
Causes and Clinical Features of Infertile Men with Non-Obstructive Azoospermia and Histopathological Diagnosis of Hypospermatogenesis
To analyze the causes and the clinical features of infertile men with non-obstructive azoospermia (NOA) and hypospermatogenesis (HS).
A 48-year-old Chinese woman presenting with continuing dull pain in the right lower back and abdomen was found to have a tumor with extensive osseous metaplasia in the the upper-middle pole of the right kidney. The exsected neoplasm specimen revealed a 29×26mm hard tumor with dense ossification. Histopathological examination of the tumor contained lamellar bone forming trabeculae intermingled and showed spherical or polygonal epithelial cells which contained slightly irregular nuclei with small nucleoli and abundant pink to clear cytoplasm.Clear cell renal cell carcinoma with extensive osseous metaplasia is a very rare occurrence.
William U. Shipley, M.D., Wendy Seiferheld, M.S., Himanshu R. Lukka, M.D., Pierre P. Major, M.D., Niall M. Heney, M.D., David J. Grignon, M.D., Oliver Sartor, M.D., Maltibehn P. Patel, M.D., Jean-Paul Bahary, M.D., Anthony L. Zietman, M.D., Thomas M. Pisansky, M.D., Kenneth L. Zeitzer, M.D., Colleen A.F. Lawton, M.D., Felix Y. Feng, M.D., Richard D. Lovett, M.D., Alexander G. Balogh, M.D., Luis Souhami, M.D., Seth A. Rosenthal, M.D., Kevin J. Kerlin, M.D., James J. Dignam, Ph.D., Stephanie L. Pugh, Ph.D., and Howard M.
Padeliporfin Vascular-Targeted Photodynamic Therapy Versus Active Surveillance in Men with Low-Risk Prostate Cancer (Clin1001 PCM301): an Open-Label, Phase 3, Randomised Control Trial.
A-R Azzouzi, S Vincendeau, E Barret, A Cicco, F Kleinclauss, H van der Poel, C Stief, J Rassweiler, G Salomon, E Solsona, A Alcaraz, T Tammela, D Rosario, F Gomez-Veiga, G Ahlgren, F Benzaghou, B Gaillac, B Amzal, F Debruyne, G Fromont, C Gratzke, M Emberton, on behalf of the PCM301 Study Group.
A looping vas deferens may be present in up to 20% of undescended testes located within or proximal to the inguinal canal. This associated abnormality is vulnerable to transection during orchidopexy. We present an example of a very long looping vas to emphasize the importance of inspection for this anomaly, and demonstrate the extreme extent that a looping vas may extend. Identification of the vas amongst cord structures may provide false reassurance of normal ductal anatomy. Examination for a looping vas by inspecting structures caudal to the testis should occur at an early opportunity during orchidopexy to avoid inadvertent transection.
The Utility of the Kidneys-Ureters-Bladder (KUB) Radiograph as the Sole Imaging Modality and Its Combination with Ultrasonography for the Detection of Renal Stones
To investigate the efficacy of plain radiography and ultrasonography each as the sole imaging tool as well as combined, for detecting renal stones using unenhanced computed tomography as a standard reference. Ultrasonography and plain radiography of the kidneys, ureters, and bladder are often used for urinary tract stone detection, but the effectiveness of each method used alone, or the two methods used together, remains controversial.
Unexplained Bone Pain is an Independent Risk Factor for Bone Metastases in Newly Diagnosed Prostate Cancer: a Prospective Study; Methodological Issues
We, meticulously and enthusiastically, read the article authored by Zacho and colleagues published in the Journal of Urology in 2017.1 The authors purposed to examine the association between bone pain and bone metastases in newly diagnosed prostate cancer. They concluded that unexplained bone pain was a strong independent risk factor for bone metastasis. However, despite the fact that the current study makes valuable contributions to the area, it seems that some methodological issues should have been taken into account so as to ascertain the conclusion.
Incidental Malignancies identified during staging for Prostate Cancer with Ga -PSMA HBED-CC PET imaging
The rapid uptake of 68Ga Prostate-Specific Membrane Antigen (PSMA) HBED-CC PET imaging for prostate cancer staging has led to concerns regarding its specificity, with uptake in both malignant and non-malignant tissues. We describe three separate malignancies identified on 68Ga PSMA HBED-CC PET imaging. The misnomer of “prostate specific membrane antigen” is demonstrated by this case and highlights the importance of continued investigation of the potential role for 68Ga PSMA HBED-CC PET in other malignancies.
Polyorchidism is a rare congenital anomaly with less than 200 case reports in literature. Triorchidism – three testicles – is the most common presentation. We present an unusual case of a patient who was diagnosed with five testicles by magnetic resonance imaging. To the best of our knowledge, this rare presentation has not previously been reported in the medical literature.
Reply to Letter-to-the-Editor: Unexplained Bone Pain is an Independent Risk Factor for Bone Metastases in Newly Diagnosed Prostate Cancer: a Prospective Study, Published in Urology. 2017 Jan;99:148-154
We appreciate the interest for the study and the special interest in the applied data analysis. The points raised have merits and we are thankful for the comments.
Robotic Surgery in Uro-Oncology: a Systematic Review and Meta-Analysis of Randomised Controlled Trials
Robotic surgery represents a new horizon in minimally-invasive urological surgery. This systematic review of the literature and meta-analysis examines the effectiveness of robotic surgery compared with laparoscopic or open surgery for major uro-oncological procedures. 25 articles reported findings from 8 trials of prostatectomy (4 trials) and cystectomy (4 trials) including 1033 participants. Robotic surgery is comparable to laparoscopic or open surgery for oncological outcomes, overall complications, and provides somewhat better functional outcome, when compared to laparoscopic and open surgery.
Serum microRNA Expression Profiling: Potential Diagnostic Implications of a Panel of Serum microRNAs for Clear Cell RCC
To study the expression profiles of 5 microRNAs in tissue and serum of patients with clear cell RCC (ccRCC) and evaluate their diagnostic and prognostic potential.
Prospective Case-Crossover Study Investigating the Possible Association Between Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) and Phosphodiesterase Type 5 Inhibitor (PDE5i) Exposure
To evaluate association between intermittent phosphodiesterase type 5 inhibitor (PDE5i) exposure and risk of acute Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) using a case-crossover design.
Structural Variations of the Prostatic Urethra Within the Prostate Predict the Severities of Obstructive Symptoms: a Prospective Multicenter Observational Study
To describe distinctive morphologic variations of the prostate associated with the prostatic urethra, and to determine whether structural changes of the urethra within the prostate resulting from gland enlargement, rather than prostrate volume itself, lead to male lower urinary tract symptom (LUTS).
To evaluated the urethral mobilization procedure as the main technique in management of glanular, coronal, subcoronal, and distal penile hypospadias.