Urology News Feeds

Why does my urine smell like popcorn?

MedicalNewsToday - Fri, 05/25/2018 - 13:00
The odor of a person's urine can say a lot about their health. Various factors can make urine smell like popcorn, including pregnancy, diabetes, and a high level of ketones in the bloodstream. In this article, we look at the reasons why urine may smell like popcorn and explain when a person should see their doctor.
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Growing Teratoma Syndrome of Testicular Origin

Urology (Gold Journal) In Press - Fri, 05/25/2018 - 00:00
A 20-year-old Hispanic male semi-professional soccer player with no prior medial history presented to the emergency department with one month of abdominal distension, and four days of left lower extremity swelling. During initial interview, the patient offered that his testicle had been enlarged for approximately 4-6 years, without any workup or intervention. A firm non-tender abdomen, enlarged left hemi-scrotum, and left lower extremity swelling was noted on physical examination. A left supraclavicular lymph node was also palpable.
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Combined Bladder Neck Reconstruction and Continent Stoma Creation as a Suitable Alternative for Continence in Bladder Exstrophy: a Preliminary Report

Urology (Gold Journal) In Press - Fri, 05/25/2018 - 00:00
To explore the use of concomitant BNR and creation of a continent stoma (CS) in patients that are not quite eligible for BNR, but still strongly desire volitional voiding.
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Bladder spasms: Everything you need to know

MedicalNewsToday - Thu, 05/24/2018 - 13:00
When the bladder contracts involuntarily, causing pain and urine leakage, this is called a bladder spasm. Here, learn why these spasms occur and how to identify them. We describe underlying illnesses, other symptoms, means of prevention, and treatments, including medication, surgical intervention, and home remedies.
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Can BPH cause kidney failure?

MedicalNewsToday - Wed, 05/23/2018 - 19:00
Benign prostatic hyperplasia (BPH) refers to enlargement of the prostate that is unrelated to cancer. Because of the positions of the prostate and kidneys, an enlarged prostate can cause kidney, or renal, failure. Knowing the symptoms can ensure quick treatment. Learn about the links between renal failure and BPH here.
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Reply by Authors

We agree with the points regarding the continued (and successful) role of conservative management, the use of hematoma diameter as a continuous variable and the need for a clinically relevant nomogram to enhance clinical decision-making. However, we disagree with the statement that ureteral stenting is “less relevant in relation to acute management of renal trauma.” Ureteral stenting represents a clinically relevant intervention for renal trauma, especially given that the AAST Organ Injury Scale specifies collecting system injury as an important factor stratifying renal trauma management.
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Reply by Author

There seems to be signaling that Rezūm therapy at 3-year followup has lower rates of surgical repeat treatment than some of the other minimally invasive therapies for benign prostatic hyperplasia. In addition, I agree that the definition of repeat treatment is narrow. Most patients would suggest that if they are still on a medication years after therapy, they are still on “treatment.” Ultimately the experience in the urological community, governed partly by safety and efficacy as well as reimbursement, will determine the long-term future of any minimally invasive therapy.
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Re: Perinephric Hematoma Size is Independently Associated with the Need for Urological Intervention in Multisystem Blunt Renal Trauma

This article is a timely and apt report on imaging specifics associated with urological interventions after renal trauma. As more renal injuries are managed nonoperatively, the importance of injury specifics beyond those captured by the AAST (American Association for the Surgery of Trauma) Organ Injury Scale becomes more apparent. Of 328 patients eligible for this study 194 (59%) had high grade renal injuries and only 7 (4%) underwent nephrectomy. This rate is low compared to a recent multi-institutional study showing a nephrectomy rate of 13% at level 1 United States trauma centers.
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Re: Editorial Comment on Three-Year Outcomes of the Prospective, Randomized Controlled Rezūm System Study: Convective Radiofrequency Thermal Therapy for Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia

This editorial comment by Kaplan on our report of long-term outcomes of a randomized controlled trial (RCT) of water vapor thermal therapy for lower urinary tract symptoms/benign prostatic hyperplasia suggests limitations to the credibility of the data presented.1 These putative reservations can be easily addressed.
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Re: Variations in the Arterial Blood Supply to the Penis and the Accessory Pudendal Artery: A Meta-Analysis and Review of Implications in Radical Prostatectomy

We read with great interest this systematic review and meta-analysis of arterial blood supply to the penis and the accessory pudendal artery (APA). We recently reviewed our video and surgical files regarding 210 extraperitoneal laparoscopic radical prostatectomies performed between June 2006 and August 2017 by the same surgeon, and our results regarding the incidence and laterality of APAs were similar to those reported by the authors and other laparoendoscopic surgeons.
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This Month in Adult Urology

Large administrative databases increasingly are the source of information used in medical publishing. Inevitably, the reliability of the findings depends on the accuracy of the analyzed data. Errors in decimal point placement on recorded prostate specific antigen (PSA) values used in SEER (Surveillance, Epidemiology, and End Results) data called into question some studies in which PSA was an important variable. Similar issues with the VACCR (Veterans Affairs Central Cancer Registry) are reported by Guo et al (page 000) from Stanford, California.
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Editorial Comment

This article identifies errors in PSA values in the VACCR, a massive national cancer registry, compared to the gold standard of the medical record values. The PSA value in more than 25% of patients was found to be misclassified when using registry data alone.
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A Rare Case of Ureteral IgG4 Disease Masquerading as Urothelial Carcinoma

Urology (Gold Journal) In Press - 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

Urology (Gold Journal) In Press - 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

Urology (Gold Journal) In Press - 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

Urology (Gold Journal) In Press - 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

Urology (Gold Journal) In Press - 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

Urology (Gold Journal) In Press - 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

Urology (Gold Journal) In Press - 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

Urology (Gold Journal) In Press - 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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