Urology News Feeds

Standard test may miss urinary infection in symptomatic women

MedicalNewsToday - 3 hours 59 min ago
New research suggests that the majority of women with symptoms of urinary tract infection probably are infected, despite negative result on standard test.
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Higher prostate cancer risks for black men may warrant new approach to screening

MedicalNewsToday - 10 hours 59 min ago
In two independent studies, scientists at the University of Basel have demonstrated that both the structure of the brain and several memory functions are linked to immune system genes.
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Three – piece penile prosthesis implantation in refractory ischemic priapism – Tips and Tricks

Urology (Gold Journal) In Press - Thu, 04/27/2017 - 00:00
Implantation of a penile prosthesis in a patient with significant corporal fibrosis can pose a significant challenge to the surgeon necessitating the knowledge of specific techniques used to dilate and close aggressively scarred corpora. The objective of our instructional video is to discuss two techniques used to approach corporal fibrosis: proper and safe use of cavernotomes for dilation and use of narrower prostheses.
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Evolution of Surgical Professional Organizations: a Case Study of Thomas Moore, Graceland, and the American Urological Association

Urology (Gold Journal) In Press - Thu, 04/27/2017 - 00:00
Thomas D. Moore of Memphis, Tennessee began service to the American Urological Association (AUA) as its secretary in 1942 at the annual meeting June 1-4 in New York City. A successful community urologist, he was well regarded by his peers nationally, as evidenced by appointment to this important but uncompensated position and later election to AUA presidency in 1950. Moore was the last AUA secretary to house the association's national headquarters in a clinical office. His home during most of these years was on farmland his wife Ruth had inherited from her aunt Grace Toof, and on which, in 1939, the Moores built a house that became known as Graceland.
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Pursuing Novel Ideas – Confessions of Lost Opportunities!

Urology (Gold Journal) In Press - Thu, 04/27/2017 - 00:00
Old ideas long forgotten in medicine are sometimes resurrected years later as novel new concepts. The question is why a discarded idea needs reinventing if it was sound to begin with? Perhaps ahead of its time once, new knowledge, better treatments and more favorable culture willing to look at old ideas disguised as new are only some explanations. I suspect, however, another major factor is the principals involved conjuring up a truly novel idea simply did not pursue it vigorously enough to a logical verifiable (or falsifiable) conclusion.
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Indocyanine Green (ICG) Angiography-Assisted Laparo-Endoscopic Single-Site (LESS) Varicocelectomy

Urology (Gold Journal) In Press - Thu, 04/27/2017 - 00:00
To study the efficacy of a new laparoscopic varicocelectomy technique using indocyanine green (ICG) angiography.
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Editorial Comments

Urology (Gold Journal) In Press - Thu, 04/27/2017 - 00:00
The authors of this prospective case-crossover study and several other studies have shown an increased risk of nonarteritic anterior ischemic optic neuropathy (NAION) associated with phosphodiesterase type 5 inhibitor (PDE5i) use. Several reports, conversely, have denied any such relationship, resulting in controversy as to whether there is a cause-and-effect relationship between PDE5i and NAION. The most common argument put forward by skeptics is that the incidence of development of NAION among millions of persons using these drugs is so small that it is hard to imagine that there is any such relationship between the two.
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Reply by Authors

We understand the view of Shah and Ioffe regarding the Prostate Health Index, that biopsy pathology is not the ideal end point for studies of prostate cancer markers.1 Biopsy pathology and the alternative suggested by Shah and Ioffe, ie radical prostatectomy pathology, are surrogate end points. This is why we have examined the value of the kallikrein panel for the clinically significant end point of long-term metastasis in men followed without screening or biopsy. We found that in men with increased prostate specific antigen (PSA) the panel had predictive discrimination of 0.87 for the long-term prediction of metastasis, compared to 0.81 for PSA alone.
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Reply by Authors

The most important principle of surgical prophylaxis is that it should prevent serious infection. To achieve this it should cover the potential pathogens and be present in adequate concentrations at the time of the procedure. Unfortunately the convenience of fluoroquinolones and the current AUA (American Urological Association) recommendations1 encourage the use of these agents, which are often administered for several days (reference 5 in article) and are much more likely to generate resistance than a single dose of carbapenem (reference 23 in article).
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Editorial Comment

An antimicrobial used for surgical prophylaxis should be administered for the shortest effective duration to minimize adverse effects, cost and the development of resistance.1 Ertapenem, a broad-spectrum agent from the carbapenem class for surgical prophylaxis, would seem to violate this principle.
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Reply by Authors

As noted in the discussion section, we are aware of the research of Shepard et al, in which they did not find a correlation between SWS and bladder compliance (reference 26 in article). The reasons for the discrepancy between our results and those obtained in their series are not entirely clear and deserve further investigation. Key differences in the methods between these 2 studies include variability between devices by manufacturer, the location of measurements on the bladder wall and the measurements of SWS at specific well-defined bladder volumes.
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Editorial Comment

Because urodynamic testing is invasive, there has been great interest in finding another modality for evaluating bladder compliance. Ultrasound SWE measures tissue fibrosis in situ. Since bladder fibrosis can cause poor compliance, this technology seems promising and may be a significant advance. The authors obtained SWS in 23 pediatric patients undergoing concurrent urodynamics. They found a significant correlation between bladder compliance and mean SWS of the anterior bladder wall.
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Re: Properties of the 4-Kallikrein Panel Outside the Diagnostic Gray Zone: Meta-Analysis of Patients with Positive Digital Rectal Examination or Prostate Specific Antigen 10 ng/ml and Above

It is well documented that transrectal ultrasound guided prostate biopsy underestimates grade and stage in 35% to 50% of prostate cancer cases.1–4 Hence, the conclusions of this study based on prostate biopsies is inaccurate. We believe that the gold standard for investigating the accuracy of the 4-kallikrenin panel should be based on prostatectomy pathology rather than prostate biopsy grade.
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Editorial Comment

This retrospective study of almost 700,000 Navy personnel in a 10-year period examined stone disease among pilots. The issue deserves special attention. In civilians stones cause morbidity and pain (reference 3 in article) but among military pilots stones can be career and life altering. Currently Navy pilots can be grounded for even asymptomatic stones. This implies significant military costs and exposure of young, healthy individuals to potentially unnecessary surgery (reference 22 in article).
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Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging to Identify Clear Cell Renal Cell Carcinoma in cT1a Renal Masses

Detection of small renal masses is increasing with the use of cross-sectional imaging, although many incidental lesions have negligible metastatic potential. Among malignant masses, clear cell renal cell carcinoma is the most prevalent and aggressive subtype, and a method to identify such histology would aid in risk stratification. Our goal was to evaluate a likelihood scale for multiparametric magnetic resonance imaging in the diagnosis of clear cell histology.
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Evaluation of urinary aquaporin-2 and plasma copeptin as biomarkers of effectiveness of desmopressin acetate for the treatment of monosymptomatic nocturnal enuresis

Desmopressin is a synthetic V2-specific analog of antidiuretic hormone (arginine vasopressin), widely used as a first-line treatment for monosymptomatic nocturnal enuresis. However, no biomarkers to predict desmopressin effectiveness have yet been established. Because arginine vasopressin is unstable, we prospectively measured the major urine concentration factors aquaporin-2 and copeptin (as a surrogate marker for vasopressin) in patients with monosymptomatic nocturnal enuresis, and evaluated whether they are useful for predicting desmopressin treatment outcome.
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Role of Preoperative Testicular Shear-Wave Elastography in Predicting Improvement of Semen Parameters after Varicocelectomy for Male Patients with Primary Infertility

Urology (Gold Journal) In Press - Wed, 04/26/2017 - 00:00
To evaluate the role of preoperative testicular Shear wave elastography in prediction of improvement of semen analysis parameters after subinguinal microsurgical varicocele ligation in patients with primary infertility and clinically detectable varicocele.
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Dietary Sodium Restriction Reduces Nocturnal Urine Volume and Nocturnal Polyuria Index in Renal Allograft Recipients with Nocturnal Polyuria

Urology (Gold Journal) In Press - Wed, 04/26/2017 - 00:00
To investigate whether sodium restriction alters nocturnal urine volume (NUV) and the ratio of NUV to 24-hr urine of renal allograft recipients (RAR).
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AZFa Microdeletions: Occurrence in Chinese Infertile Males and Novel Deletions Revealed by Semiconductor Sequencing

Urology (Gold Journal) In Press - Wed, 04/26/2017 - 00:00
To evaluate the frequency of AZFa microdeletions among infertile males, and establish a new high-throughput sequencing method to detect novel deletion types.
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Long-Term Health Related Quality of Life Outcomes Following Radical Cystectomy

Urology (Gold Journal) In Press - Wed, 04/26/2017 - 00:00
To evaluate the long-term (>5 years) health-related quality of life outcomes following radical cystectomy, comparing Indiana pouch (IP), neobladder (NB), and ileal conduit (IC).
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