Urology News Feeds

The Kinetics of Sperm Return and Late Failure Following Vasovasostomy or Vasoepididymostomy: A Systematic Review

Vasovasostomy (VV) and vasoepididymostomy (VE) are technically challenging microsurgical reconstructive procedures necessary for men with obstructive azoospermia at the level of the vas deferens or epididymis. Patency rates following VV or VE have been widely described in the literature. However, few reports have discussed the timing of sperm return to the ejaculate following reconstruction as well as the proportion of men that develop late failure following VV or VE. Therefore, the objective of this article is to review the rates and predictors associated with late failures and the timing of sperm returning to the ejaculate following VV and VE.
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Patterns of Relapse and Implications for Post-Nephrectomy Surveillance for Patients with High-Risk Non-Clear Cell Renal Cell Carcinoma: Subgroup Analysis of the Phase 3 ECOG-ACRIN E2805 Trial

The natural history of non-clear cell renal cell carcinomas (non-ccRCC) following surgery with curative intent remains poorly defined, with post-operative surveillance informed by guidelines largely intended for clear cell RCC (ccRCC). We evaluated the patterns of relapse and potential implications for post-nephrectomy surveillance for patients with non-ccRCC enrolled in the largest randomized trial of adjuvant anti-angiogenic therapy for high-risk RCC (E2805).
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Waiting for Godot: What to Do When a Patient with a Sacral Neuromodulation Device Needs Magnetic Resonance Imaging

In this issue of The Journal Guzman-Negron et al (page 0000) address an important clinical concern and represents a nice movement from bench to in vivo study.1 The authors previously reported insignificant heating of a full InterStim™ system and a 5 cm lead in a phantom model and significant heating in the presence of an intact lead without a IPG (implantable pulse generator).2 This led to a prospective study of a group of patients using the same MRI machine, which showed no significant acute patient harm, clinical deterioration or damage to the implanted devices.
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Enhanced Recovery after Surgery Protocols in Pediatric Urology: How Are we Doing, and What Should we be Doing?

Enhanced recovery after surgery (ERAS) protocols have been used for adult colorectal surgery since the late 1990s, with significant evidence supporting improved patient outcomes including reduced hospital stay, lower complication rates, quicker return of bowel function and increased patient satisfaction.1 Since many of the changes have improved quality and outcomes for the patient, and decreased overall hospital costs, the ERAS principles have gained popularity in adult urological cancer surgery.
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Re: Efficacy and Safety of Sacral and Percutaneous Tibial Neuromodulation in Non-Neurogenic Lower Urinary Tract Dysfunction and Chronic Pelvic Pain: A Systematic Review of the Literature

M. Tutolo, E. Ammirati, J. Heesakkers, T. M. Kessler, K. M. Peters, T. Rashid, K. D. Sievert, M. Spinelli, G. Novara, F. Van der Aa and D. De Ridder
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Hydronephrosis After Pyeloplasty: “Will It Go Away?”

Urology (Gold Journal) In Press - Fri, 08/17/2018 - 00:00
To identify attributes of pediatric patients with hydronephrosis due to ureteropelvic junction obstruction (UPJO) and of their surgical encounters which are predictive of resolution of dilatation in order to provide more effective counseling about expected outcomes. This study was inspired by the suggestion in recent literature that greater than 20% improvement in anteroposterior diameter (APD) of the renal pelvis after pyeloplasty is indicative of resolution of obstruction. The remaining dilatation, however, is often distressing to caregivers, and there are no data to guide clinicians in counseling about its likelihood to resolve.
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Bladder Neck Contracture is Often a Misused Term

Urology (Gold Journal) In Press - Fri, 08/17/2018 - 00:00
The importance of correctly distinguishing between bladder neck contracture (BNC) and vesicourethral anastomosis (VUAS) cannot be understated1. We appreciate the previous authors’ response in emphasizing this distinction and detailing the prevalence of its misuse in the literature. As we continue to develop innovate methods to manage a complex problem, it is important to accurately distinguish between these two disease processes. As seen in our study, it is not uncommon for a urologist to manage both these disease processes.
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The stability of physician-specific episode costs for urological cancer surgery: Implications for Urologists under the Merit-Based Incentive Program (MIPS)

Urology (Gold Journal) In Press - Fri, 08/17/2018 - 00:00
To evaluate the stability of physician-specific episode payments for prostatectomy, nephrectomy, and cystectomy in the context of value-based purchasing programs, such as the Merit-Based Incentive Payment System (MIPS).
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EXCISION AND PRIMARY ANASTOMOSIS RECONSTRUCTION FOR TRAUMATIC STRICTURES OF THE PENDULOUS URETHRA

Urology (Gold Journal) In Press - Fri, 08/17/2018 - 00:00
To present a multi-institutional experience with functional and patient-reported outcomes among men undergoing excision and primary anastomosis (EPA) urethroplasty for pendulous urethral strictures.
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Impact of Post-hospital Syndrome on Penile Prosthesis Outcomes: A Period of Global Health Risk

Post-hospital syndrome is an acquired, transient period of health vulnerability following an inpatient admission. This study aims to assess the impact of a preoperative hospitalization on outcomes following penile prosthesis surgery and to optimize surgical timing following an inpatient admission.
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Editorial Comment

In this ex vivo study Hale et al explored MRI/US FBx characteristics that are technical (rigid and elastic registration) and human (experienced and novice users). They measured RE, defined as the distance between fiducial markers reproducing a lesion at MRI and at US.
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Editorial Comment

The use of MRI defined targets to increase the accuracy of prostate biopsy is of great interest. One of the challenges in the adoption of a MRI guided pathway is identification of the MRI target during a transrectal ultrasound guided biopsy procedure. Hale et al report an assessment of the relative accuracy of software assistance for this using rigid or elastic registration with novice and experienced operators.
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Re: Screening for Asymptomatic Bacteruria at One Month after Adult Kidney Transplantation: Clinical Factors and Implications

Y. S. B. Goh, Z. Deng, P. S. C. Cheong, L. Raman, T. H. A. Goh, A. Vathsala and H. Y. Tiong
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Re: Germline DNA-Repair Gene Mutations and Outcomes in Men with Metastatic Castration-Resistant Prostate Cancer Receiving First-Line Abiraterone and Enzalutamide

E. S. Antonarakis, C. Lu, B. Luber, C. Liang, H. Wang, Y. Chen, J. L. Silberstein, D. Piana, Z. Lai, Y. Chen, W. B. Isaacs and J. Luo
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Re: Circulating microRNAs and Treatment Response in the Phase II SWOG S0925 Study for Patients with New Metastatic Hormone-Sensitive Prostate Cancer

H. H. Cheng, M. Plets, H. Li, C. S. Higano, C. M. Tangen, N. Agarwal, N. J. Vogelzang, M. Hussain, I. M. Thompson, Jr., M. Tewari and E. Y. Yu
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