Urology News Feeds

Re: Malte Rieken, Shahrokh F. Shariat, Luis A. Kluth, et al. Association of Cigarette Smoking and Smoking Cessation with Biochemical Recurrence of Prostate Cancer in Patients Treated with Radical Prostatectomy. Eur Urol. In press. http://dx.doi.org/10...

Refers to article:

Association of Cigarette Smoking and Smoking Cessation with Biochemical Recurrence of Prostate Cancer in Patients Treated with Radical Prostatectomy

Malte Rieken, Shahrokh F. Shariat, Luis A. Kluth, Harun Fajkovic, Michael Rink, Pierre I. Karakiewicz, Christian Seitz, Alberto Briganti, Morgan Rouprêt, Wolfgang Loidl, Quoc-Dien Trinh, Alexander Bachmann and Gholamreza Pourmand

Accepted 20 May 2015

Footnotes

a Department of Urology, University Hospital “Carl Gustav Carus,” Technische Universität Dresden, Dresden, Germany

b Department of Medical Statistics and Biometry, University Hospital “Carl Gustav Carus,” Technische Universität Dresden, Dresden, Germany

Corresponding author. Department of Urology, University Hospital “Carl Gustav Carus,” Technische Universität Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany. Tel. +49 351 4587462; Fax: +49 351 4584333.

Article information

PII: S0302-2838(15)00754-X
DOI: 10.1016/j.eururo.2015.08.011
© 2015 European Association of Urology, Published by Elsevier B.V.

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EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis

Abstract Context

Low-dose computed tomography (CT) has become the first choice for detection of ureteral calculi. Conservative observational management of renal stones is possible, although the availability of minimally invasive treatment often leads to active treatment. Acute renal colic due to ureteral stone obstruction is an emergency that requires immediate pain management. Medical expulsive therapy (MET) for ureteral stones can support spontaneous passage in the absence of complicating factors. These guidelines summarise current recommendations for imaging, pain management, conservative treatment, and MET for renal and ureteral stones. Oral chemolysis is an option for uric acid stones.

Objective

To evaluate the optimal measures for diagnosis and conservative and medical treatment of urolithiasis.

Evidence acquisition

Several databases were searched for studies on imaging, pain management, observation, and MET for urolithiasis, with particular attention to the level of evidence.

Evidence synthesis

Most patients with urolithiasis present with typical colic symptoms, but stones in the renal calices remain asymptomatic. Routine evaluation includes ultrasound imaging as the first-line modality. In acute disease, low-dose CT is the method of choice. Ureteral stones <6 mm can pass spontaneously in well-controlled patients. Sufficient pain management is mandatory in acute renal colic. MET, usually with α-receptor antagonists, facilitates stone passage and reduces the need for analgesia. Contrast imaging is advised for accurate determination of the renal anatomy. Asymptomatic calyceal stones may be observed via active surveillance.

Conclusions

Diagnosis, observational management, and medical treatment of urinary calculi are routine measures. Diagnosis is rapid using low-dose CT. However, radiation exposure is a limitation. Active treatment might not be necessary, especially for stones in the lower pole. MET is recommended to support spontaneous stone expulsion.

Patient summary

For stones in the lower pole of the kidney, treatment may be postponed if there are no complaints. Pharmacological treatment may promote spontaneous stone passage.

Take Home Message

Low-dose computed tomography has became the method of choice for detection of ureteral calculi, but limitations and radiation exposure have to be considered. Conservative management of urinary stones is an option and spontaneous passage of ureteral stones can be facilitated by medical expulsive therapy. This article summarises the current recommendations of the EAU Guideline Panel on Urolithiasis on imaging, pain management and observational/medical management for urolithiasis.

Keywords: Urinary calculi, Ureteroscopy, Percutaneous nephrolithotomy, Medical expulsive therapy, Stone surgery, Shock wave lithotripsy, Computed tomography, Chemolitholysis, EAU guidelines.

Footnotes

a Department of Urology, Rudolfstiftung Hospital, Vienna, Austria

b Department of Urology, Region Hospital, České Budějovice, Czech Republic

c Department of Urology, Dr. Lutfi Kirdar Kartal Research and Training Hospital, Istanbul, Turkey

d Department of Urology, Medical University Vienna, Vienna, Austria

e Second Department of Urology, Sismanoglio Hospital, Athens Medical School, Athens, Greece

f Department of Urology, Technical University Munich, Munich, Germany

g Department of Urology, Sindelfingen-Böblingen Medical Centre, University of Tübingen, Sindelfingen, Germany

Corresponding author. Department of Urology, Klinikum Sindelfingen-Böblingen, University of Tübingen, Arthur-Gruber-Strasse 70, 71065 Sindelfingen, Germany. Tel. +49 703 19812501; Fax: +49 703 1815307.

Article information

PII: S0302-2838(15)00699-5
DOI: 10.1016/j.eururo.2015.07.040
© 2015 European Association of Urology, Published by Elsevier B.V.

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Re: Orazio Caffo, Ugo De Giorgi, Lucia Fratino, et al. Clinical Outcomes of Castration-resistant Prostate Cancer Treatments Administered as Third or Fourth Line Following Failure of Docetaxel and Other Second-line Treatment: Results of an Italian...

Refers to article:

Clinical Outcomes of Castration-resistant Prostate Cancer Treatments Administered as Third or Fourth Line Following Failure of Docetaxel and Other Second-line Treatment: Results of an Italian Multicentre Study

Orazio Caffo, Ugo De Giorgi, Lucia Fratino, Daniele Alesini, Vittorina Zagonel, Gaetano Facchini, Donatello Gasparro, Cinzia Ortega, Marcello Tucci, Francesco Verderame, Enrico Campadelli, Giovanni Lo Re, Giuseppe Procopio, Roberto Sabbatini, Maddalena Donini, Franco Morelli, Donata Sartori, Paolo Zucali, Francesco Carrozza, Alessandro D’Angelo, Giovanni Vicario, Francesco Massari, Daniele Santini, Teodoro Sava, Caterina Messina, Giuseppe Fornarini, Leonardo La Torre, Riccardo Ricotta, Michele Aieta, Claudia Mucciarini, Fable Zustovich, Sveva Macrini, Salvatore Luca Burgio, Sandra Santarossa, Carmine D’Aniello, Umberto Basso, Sara Tarasconi, Enrico Cortesi, Consuelo Buttigliero, Fiorella Ruatta, Antonello Veccia, Vincenza Conteduca, Francesca Maines and Enzo Galligioni

Accepted 8 October 2014

July 2015 (Vol. 68, Issue 1, pages 147 - 153)

Footnotes

a School of Medicine, I-Shou University, Kaohsiung City, Taiwan

b Division of Urology, Department of Surgery, E-Da Hospital, Kaohsiung City, Taiwan

c Division of Urology, E-Da Cancer Hospital, Kaohsiung City, Taiwan

4 Fl. Bldg. C, 1, Yi-Da road, Yan-Chao District, 82457, Kaohsiung County, Taiwan. Tel. +886 7 6150011 extension 2975; fax: +886 7 6150982.

Article information

PII: S0302-2838(15)00760-5
DOI: 10.1016/j.eururo.2015.08.017
© 2015 European Association of Urology, Published by Elsevier B.V.

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Re: Raj Satkunasivam, Sheaumei Tsai, Sumeet Syan, et al. Robotic Unclamped “Minimal-margin” Partial Nephrectomy: Ongoing Refinement of the Anatomic Zero-ischemia Concept. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2015.04.044

Refers to article:

Robotic Unclamped “Minimal-margin” Partial Nephrectomy: Ongoing Refinement of the Anatomic Zero-ischemia Concept

Raj Satkunasivam, Sheaumei Tsai, Sumeet Syan, Jean-Christophe Bernhard, Andre Luis de Castro Abreu, Sameer Chopra, Andre K. Berger, Dennis Lee, Andrew J. Hung, Jie Cai, Mihir M. Desai and Inderbir S. Gill

Accepted 30 April 2015

Footnotes

a Cleveland Clinic, Cleveland, OH, USA

b Loyola University, Chicago, IL, USA

c Fox Chase Cancer Center, Philadelphia, PA, USA

Corresponding author. Center for Urologic Oncology, Room Q10-120, 9500 Euclid Avenue, Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH, 44195, USA. Tel. +1 216 444 5595; Fax: +1 216 636 0770.

Article information

PII: S0302-2838(15)00764-2
DOI: 10.1016/j.eururo.2015.08.021
© 2015 European Association of Urology, Published by Elsevier B.V.

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Re: Richard J. Sylvester, Willem Oosterlinck, Sten Holmang, et al. Systematic Review and Individual Patient Data Meta-analysis of Randomized Trials Comparing a Single Immediate Instillation of Chemotherapy After Transurethral Resection with...

Refers to article:

Systematic Review and Individual Patient Data Meta-analysis of Randomized Trials Comparing a Single Immediate Instillation of Chemotherapy After Transurethral Resection with Transurethral Resection Alone in Patients with Stage pTa–pT1 Urothelial Carcinoma of the Bladder: Which Patients Benefit from the Instillation?

Richard J. Sylvester, Willem Oosterlinck, Sten Holmang, Matthew R. Sydes, Alison Birtle, Sigurdur Gudjonsson, Cosimo De Nunzio, Kikuo Okamura, Eero Kaasinen, Eduardo Solsona, Bedeir Ali-El-Dein, Can Ali Tatar, Brant A. Inman, James N’Dow, Jorg R. Oddens and Marek Babjuk

Accepted 28 May 2015

Footnotes

a Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

b Department of Surgery, University of Arizona, BCG Oncology, Phoenix, AZ, USA

Corresponding author. 1515 Holcombe Boulevard, Unit 1373, Houston, TX 77030, USA. Tel. +1 713 792 3250; Fax: +1 713 794 4824.

Article information

PII: S0302-2838(15)00762-9
DOI: 10.1016/j.eururo.2015.08.019
© 2015 European Association of Urology, Published by Elsevier B.V.

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Signs and Symptoms of Detrusor Underactivity: An Analysis of Clinical Presentation and Urodynamic Tests From a Large Group of Patients Undergoing Pressure Flow Studies

Abstract Background

The clinical diagnosis of detrusor underactivity (DU) is hampered by the need for invasive pressure flow studies (PFS) in combination with a lack of knowledge of the associated signs and symptoms. This has contributed to a lack of awareness of DU and underactive bladder, and to the assumption that symptoms are always due to bladder outlet obstruction (BOO).

Objective

To investigate the signs and symptoms recorded in a large urodynamic database of patients who met the diagnoses of DU, BOO, and normal, to identify the clinical features associated with DU.

Design, setting, and participants

From the database of 28 282 adult PFS records, 1788 patients were classified into: (1) those with DU without BOO; (2) those with BOO without DU; and (3) those with normal PFS.

Results

Patients with DU reported a statistically significantly higher occurrence of decreased and/or interrupted urinary stream, hesitancy, feeling of incomplete bladder emptying, palpable bladder, and absent and/or decreased sensation compared with patients with normal PFS. Other differences were found between men with DU and BOO, and between women with DU and normal PFS.

Conclusions

There are signs and symptoms that can distinguish DU patients from patients with normal PFS and further distinguish between DU and BOO, which is traditionally invasively diagnosed. This is a first step to better understand the clinical presentation of DU patients, is consistent with the recent underactive bladder working definition, and justifies further exploration of the signs and symptoms of DU.

Patient summary

The clinical diagnosis of detrusor underactivity is hampered by the need for invasive urodynamics in combination with a lack of knowledge of the associated signs and symptoms. This study has shown that there are signs and symptoms that can distinguish men and women patients with DU from patients with either normal urodynamic studies or with BOO.

Take Home Message

This study has shown that there are signs and symptoms that can distinguish patients with detrusor underactivity from patients with normal pressure flow studies, and further distinguish between detrusor underactivity and bladder outlet obstruction – an invasively diagnosed condition.

Keywords: Bladder, Bladder Outlet Obstruction, Database, Detrusor, Signs, Symptoms, Underactive, Urodynamics.

Footnotes

a Bristol Urological Institute, Southmead Hospital, Bristol, UK

b Astellas Pharma Europe B.V., Leiden, The Netherlands

Corresponding author. Bristol Urological Institute, Southmead Hospital, Bristol BS10 5NB, UK. Tel. +44 0 117 414 7942; Fax: +44 0 117 414 9474.

Article information

PII: S0302-2838(15)00757-5
DOI: 10.1016/j.eururo.2015.08.014
© 2015 European Association of Urology, Published by Elsevier B.V.

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UDP-glucuronosyltransferase Enzymes in Prostate Cancer Progression: Is Only Androgen Catabolism Involved?

Footnotes

a Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

b Department of Medicine, University of Washington, Seattle, WA, USA

Corresponding author. Department of Medicine, University of Washington, Harborview Research and Training Bldg, Box 359625, 325 9th Avenue, Seattle, WA 98104, USA. Tel. +1 253 2506749.

Article information

PII: S0302-2838(15)00768-X
DOI: 10.1016/j.eururo.2015.08.025
© 2015 European Association of Urology, Published by Elsevier B.V.

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CDK4/6-inhibition controls proliferation of bladder cancer and transcription of

The retinoblastoma (RB) signaling network is frequently altered in advanced bladder cancer (BLCA). We investigated the potential of CDK4/6 as a therapeutic target and determined biomarkers for patient stratification.
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Evaluating the Role for Operative Repair of Extraperitoneal Bladder Rupture Following Blunt Pelvic Trauma

Catheter drainage has become a standard management of extraperitoneal bladder rupture from blunt trauma. However, data are lacking critically comparing outcomes between operative and non-operative management. This study aims to evaluate management strategies and identify risk factors for complications.
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The role of glomerulations in Bladder Pain Syndrome – A review

Glomerulations as a diagnostic marker for bladder pain syndrome/interstitial cystitis (BPS/IC) was first popularized by Messing & Stamey in 1978. Later this was included in the NIDDK criteria for research and consequently used by many urologists as a default diagnostic criterion. Today, the connection between glomerulations and BPS/IC is much debated, as research has found glomerulations in asymptomatic populations.This paper systematically looks at the available research to see if there is valid data to support the use of glomerulations as a marker for BPS/IC.
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Native Nephrectomy with Renal Transplantation is Associated with a Decrease in Hypertension Medication Requirements in Autosomal Dominant Polycystic Kidney Disease

To assess hypertensive control following native nephrectomy and renal transplantation in patients with Autosomal Dominant Polycystic Kidney Disease(ADPKD).
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Mini-percutaneous nephrolithotomy versus retrograde intrarenal surgery for renal stones larger than 10 mm: a prospective randomized controlled trial

Urology (Gold Journal) In Press - Wed, 08/26/2015 - 00:00
To compare mini-percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) in the management of renal stones larger than 10 mm in a single session.
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Editorial Comment

Neuromodulation via sacral nerve stimulation (ie InterStim®) has been performed by our group and others in the pediatric population for more than 10 years. This method has produced amazing subjective clinical results in patients who have failed all other treatment modalities. Many of the patients have been living with these problems for years.
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Reply to Michael Froehner, Rainer Koch, Manfred P. Wirth's Letter to the Editor re: Malte Rieken, Shahrokh F. Shariat, Luis A. Kluth, et al. Association of Cigarette Smoking and Smoking Cessation with Biochemical Recurrence of Prostate Cancer in...

Refers to article:

Association of Cigarette Smoking and Smoking Cessation with Biochemical Recurrence of Prostate Cancer in Patients Treated with Radical Prostatectomy

Malte Rieken, Shahrokh F. Shariat, Luis A. Kluth, Harun Fajkovic, Michael Rink, Pierre I. Karakiewicz, Christian Seitz, Alberto Briganti, Morgan Rouprêt, Wolfgang Loidl, Quoc-Dien Trinh, Alexander Bachmann and Gholamreza Pourmand

Accepted 20 May 2015

Footnotes

a Department of Urology, University Hospital Basel, Basel, Switzerland

b Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA

c Department of Urology, Medical University of Vienna, Vienna, Austria

d Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA

Corresponding author. Department of Urology, University Hospital Basel, Spitalstrasse 21, Basel, 4031, Switzerland.

Article information

PII: S0302-2838(15)00755-1
DOI: 10.1016/j.eururo.2015.08.012
© 2015 European Association of Urology, Published by Elsevier B.V.

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External validation of CROES nephrolithometry as a preoperative predictive system for percutaneous nephrolithotomy outcomes

To externally validated CROES nephrolithometry and to evaluate the predictive accuracy of the nomogram.
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New study indicates magnetic stimulation effective in reducing bedwetting

MedicalNewsToday - Sun, 08/23/2015 - 17:00
Bedwetting, or nocturnal enuresis, causes distress in children and young adults, as well as for their parents or caregivers.
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Reply from Authors re: Adri C. Voogd, Rob H.A. Verhoeven. Treatment of the Primary Tumour in the Presence of Metastases: Lessons from Breast Cancer. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2015.06.024Reply from Authors re: Alfred I....

Refers to article:

Treatment of the Prostate in the Presence of Metastases: Lessons from Other Solid Tumors

Alfred I. Neugut and Edward P. Gelmann

Footnotes

a Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK

b Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden

c Martini Clinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

Corresponding author. Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden. Tel. +46 739660771.

Article information

PII: S0302-2838(15)00691-0
DOI: 10.1016/j.eururo.2015.07.032
© 2015 European Association of Urology, Published by Elsevier B.V.

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Do Ultrasensitive PSA Measurements Have a Role in Predicting Long-Term Biochemical Recurrence-Free Survival in Men Following Radical Prostatectomy?

The purpose of this study was to evaluate an ultrasensitive PSA assay in prostate cancer patients following radical prostatectomy (RP) to predict long-term biochemical recurrence (BCR)-free survival.
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Wolf Piranha Versus Lumenis Versacut Prostate Morcellation Devices: A Prospective Randomized Trial

Holmium laser enucleation of the prostate (HoLEP) for the management of benign prostatic hyperplasia (BPH) involves two steps: enucleation and morcellation. Few prostate morcellation devices (PMD) are available. Our aim is to compare the Wolf Piranha and Lumenis VersaCut PMDs.
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