Urology News Feeds

Author Reply: Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications

Urology (Gold Journal) In Press - 23 hours 8 min ago
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.
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Clinical Experience with Penile Traction Therapy among Men Undergoing Collagenase Clostridium Histolyticum for Peyronie's Disease

Urology (Gold Journal) In Press - 23 hours 8 min ago
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).
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Re: Punjani Et Al: Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications (Urology 2017;99:42-48)

Urology (Gold Journal) In Press - 23 hours 8 min ago
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.
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Intermediate-Term Outcomes of Men with Very Low/Low and Intermediate/High Risk Prostate Cancer Managed by Active Surveillance

To compare intermediate-term clinical outcomes among men with favorable risk and intermediate/high risk prostate cancer (PCa) managed with active surveillance (AS).
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Comparison of biochemical recurrence free survival after radical prostatectomy triggered by grade reclassification on active surveillance, and men newly diagnosed with similar grade disease

Comparison of biochemical recurrence between men in active surveillance undergoing radical prostatectomy triggered by grade reclassification, and men diagnosed with similar grade disease undergoing immediate radical prostatectomy.
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Anti-aging peptide recovers fur growth, kidney health in mice

MedicalNewsToday - Thu, 03/23/2017 - 11:00
New study reveals how a peptide targeted senescent cells - known to play a role in aging - to restore fitness, fur growth, and kidney function in old mice.
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Survival of children receiving dialysis varies widely across Europe

MedicalNewsToday - Thu, 03/23/2017 - 02:00
All European Union Member States have made commitments towards reducing inequalities in access to health care and in health outcomes.
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Editorial Comment

It is critical to determine which men truly harbor indolent disease when deciding which men are suitable candidates for active surveillance for low risk prostate cancer. This is especially important for African American men, who have been shown to present with earlier, aggressive disease and are more likely to experience upgrading and biochemical failure after treatment when initially eligible for active surveillance.1,2 A plethora of serum, urine and tissue based tests add incremental value to the predictive ability of the known risk factors of PSA, Gleason sum and clinical tumor classification.
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Editorial Comment

Urologists performing PN by any approach face similar challenges, which must be articulated to the patient prior to the operation. Potential adverse events include bleeding, urinary fistula formation, infection and conversion to RN (reference 18 in article) if for technical reasons PN cannot be executed. This group of high volume robotic surgeons reports their RN conversion rate of 3.1% and the patients most likely to require conversion due to worse baseline kidney function, larger tumor size and greater tumor complexity.
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Editorial Comment

Robotic partial nephrectomy has advanced significantly. Early in its evolution cautious application dictated that complex tumors were avoided. Now with experience there are few, if any, tumors not amenable to RPN when OPN is possible, although not for all surgeons and institutions.
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Re “Assessment and Treatment of Asymptomatic Bacteriuria Necessary for Reducing the Risk of Postoperative Symptomatic Urinary Tract Infections after Urologic Surgical Procedures?

Urology (Gold Journal) In Press - Thu, 03/23/2017 - 00:00
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
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Does Implementing an Enhanced Recovery after Surgery Protocol Increase Hospital Charges? Comparisons From a Radical Cystectomy Program at a Specialty Cancer Center

Urology (Gold Journal) In Press - Thu, 03/23/2017 - 00:00
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.
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Causes and Clinical Features of Infertile Men with Non-Obstructive Azoospermia and Histopathological Diagnosis of Hypospermatogenesis

Urology (Gold Journal) In Press - Wed, 03/22/2017 - 00:00
To analyze the causes and the clinical features of infertile men with non-obstructive azoospermia (NOA) and hypospermatogenesis (HS).
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Clear Cell Renal Cell Carcinoma with Extensive Osseous Metaplasia: Report of a Rare Case

Urology (Gold Journal) In Press - Wed, 03/22/2017 - 00:00
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.
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Radiation with or Without Antiandrogen Therapy in Recurrent Prostate Cancer

Urology (Gold Journal) In Press - Wed, 03/22/2017 - 00:00
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.
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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.

Urology (Gold Journal) In Press - Wed, 03/22/2017 - 00:00
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.
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Interpreting patient-reported urinary and sexual function outcomes across multiple validated instruments

Comparing patient-reported outcomes such as urinary and erectile function across institutions is critical for prostate cancer research and quality assurance. Such comparisons are complicated by the use of different questionnaires. We aimed to develop a method to convert scores between four commonly used instruments.
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Clinical Outcomes in Patients with Panurothelial Carcinoma Treated with Radical Nephroureterectomy Following Cystectomy for Metachronous Recurrence

We report pathologic, functional, and oncologic outcomes in patients treated with radical nephroureterectomy following radical cystectomy.
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Robotic Intracorporeal Continent Cutaneous Diversion

Robotic intra-corporeal urinary diversion has mostly been utilized for ileal conduit or orthotopic neobladder diversion. Herein, we present the initial series, detailed technique and outcomes of robotic intra-corporeal Indiana pouch, with minimum 1-year follow-up.
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Beware the Looping Vas Deferens in Orchidopexy

Urology (Gold Journal) In Press - Tue, 03/21/2017 - 00:00
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.
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