Urology News Feeds
Impact of strength and nature of patient health values on compliance and outcomes for physiotherapy treatment for pelvic floor dysfunction
To determine whether patient values impact on compliance and outcome for physiotherapy treatment for pelvic floor dysfunction. Although studies have related ‘health values’ to behaviours in the laboratory, or to behaviours such as exercise, there have been no studies of the impact of patient values on actual medical treatments.
How many cores should be obtained during saturation biopsy in the era of multiparametric magnetic resonance? Experience in 875 patients submitted to repeat prostate biopsy
To evaluate the number of needle cores combined with multiparametric magnetic resonance imaging (mpMRI) findings needed to diagnose all clinically significant cases of prostate cancer (csPCa) in men subject to transperineal saturation biopsy (SPBx; 30 cores).
Posterior urethral valves (PUVs) present clinically across a varied spectrum, ranging from severe obstruction with massive distension of the bladder and upper urinary tracts in the fetus, to a much more indolent course with minor secondary changes in the young or older child. Type III (diaphragm) PUVs are relatively uncommon, and are associated with difficulty in passing a transurethral catheter into the bladder as well as smooth dilation of the bladder. 1,2 The following case examines the unusual experiences of both diagnosing PUVs in a teenager, and capturing visual evidence of type III valves during cystourethroscopy.
Menkes disease, or Kinky Hair Syndrome, is a rare disorder of copper metabolism that causes fatal neurodegenerative disease in infancy.1, 2 This X-linked disorder results from mutations in the ATP7A gene.2 Along with neurological decline, characteristic coarse appearance of the hair is seen.1, 2 Urological issues are prevalent in this patient population, with bladder diverticula being the most common.3, 4 Herein, we describe a unique male patient with genetic mosaicism and osseous metaplasia found in a ruptured bladder diverticulum.
Antibiotic Prophylaxis Prescribing Patterns of Pediatric Urologists for Children with Vesicoureteral Reflux and other Congenital Anomalies of the Kidney and Urinary Tract
To determine pediatric urologists’ antibiotic prophylaxis prescribing practices for children with vesicoureteral reflux (VUR) and other congenital anomalies of the kidney and urinary tract (CAKUT).
We thank you for bringing to our attention your study which suggests that pressure regulating balloon (PRB) exchange can be done safely in the carefully selected patient. At our institution, we have overfilled the PRB beyond the index volume in two patients in an attempt to increase the pressure delivered by the PRB to improve continence. While we have not seen erosion in these two patients, we have not broadly adopted this technique due to concern over the long-term effect of overfilling the reservoir on the longevity of the silicone used to construct the PRB and the vascularity of the urethra.
Letter to the Editor: Predictors of Device-Related Complications After Exchange of the Pressure Regulating Balloon in Men with an Artificial Urinary Sphincter
In a recent issue of Urology, Loh-Doyl et al report their results after changing the pressure regulating balloon (PRB) of an artificial urinary sphincter (AUS) to manage recurrence of incontinence due to urethral atrophy.1 As the authors stated, there is a paucity of available data about outcomes after changing PRB with the intention of improving incontinence as the first revision step. However, the authors’ statement that this technique was first described by Moses et al2 is wrong. Indeed Maillet et al3 in 2004 already stated that there were three techniques available to treat urethral atrophy and recurrent urinary incontinence: replacing the cuff by a smaller one, replacing the pressure regulating balloon by a bigger one or over-pressurizing the system under systematic preoperative urethral pressure profile control.
To compare the outcomes of patients who underwent early repair (≤7 days) of iatrogenic ureteral injury with ureteroneocystostomy and compare them to those repaired in a delayed fashion (> 7 days).
Percutaneous Transgluteal Ureteral Stump Access: A Novel Approach to Hybrid Management of Ureteral Stump Syndrome
Duplicated collecting systems with minimal-to-no function of the upper moiety are often treated surgically with upper pole heminephrectomy and ureterectomy. Complications associated with the ureteral stump can occur and are collectively known as ureteral stump syndrome. We present a case of ureteral stump syndrome treated with percutaneous transgluteal access into the stump which aided in identification of an ectopic ureteral opening that could not be identified by surgical means alone.
To examine urological transfers and rate of tertiary center interventions from four geographically distinct academic medical centers.
Algorithms Using Previous Resistance, Prior Antimicrobial Prescriptions and Patient Place of Residence Enhance Empiric Therapy for Women with Uncomplicated Urinary Tract Infections
To evaluate how previous antimicrobial resistance, prior prescription data and patient place of residence (ZIP code) can guide empiric therapy for uncomplicated urinary tract infections (UTI).Guidelines recommend empiric antimicrobial selection for women with symptoms of uncomplicated UTIs, most commonly trimethoprim-sulfamethoxazole (SXT), nitrofurantoin (NIT) or ciprofloxacin (CIP). Previous antimicrobial resistance and prior prescription data are potential predictors of resistance in subsequent urine cultures for UTIs.
A Systematic Review and Evidence-Based Analysis of Ingredients in Popular Male Fertility Supplements
To study the level of evidence available for ingredients of popular over-the-counter male fertility supplements.
To characterize the status of mentorship programs for Urology residencies in the United States, highlight the importance of mentorship in the career of an urology resident, and identify the obstacles of implementing a mentorship program.
To describe a novel technique of using peripheral nerve neuromodulation (PNNM) for the treatment of refractory, mesh-induced chronic pelvic pain. Chronic pelvic pain associated with mesh can be a debilitating complication and there is currently no consensus on treatment. PNNM has been shown to be successful in the treatment of post-traumatic neuralgias but has yet to be studied in mesh complications.
Electromagnetic Guided Percutaneous Renal Access Outcomes Among Surgeons and Trainees of Different Experience Levels: A Pilot Study
To determine feasibility of an electromagentic (EM) guidance system (Auris Health, Redwood City, CA) in obtaining percutaneous renal access among urologists and trainees of different experience levels. EM-guidance is appealing for access as it allows real time, three-dimensional targeting without radiation. Few studies have explored this for percutaneous nephrolithotomy (PCNL) and none have assessed its potential to decrease the learning curve in obtaining access using traditional techniques.
To assess and analyze the contemporary causes of inhospital deaths of spina bifida patients.
Metastasis of prostate cancer (PCa) to renal pelvis is extremely rare. A 64-year-old man was hospitalized for increased prostate specific antigen (PSA) after radical prostatectomy. 68Ga-PSMA-11 PET/CT showed hydronephrosis caused by a mass in the left renal pelvis without significant uptake of PSMA tracer. The histopathology indicated metastatic PCa with a Gleason score of 5+5 but negative for prostate specific membrane antigen (PSMA) following nephroureterectomy. Although metastasis to renal pelvis is rare, the occurrence possibility could not be ignored when with hydronephrosis is found in prostate cancer patients.
Pediatric extrarenal malignant rhabdoid tumors (MRTs) are rare, aggressive tumors with a poor prognosis (20% 5-year survival). There are currently fewer than 10 published case reports of primary MRT of the bladder. We report the case of an 18 month-old female with an isolated MRT of the bladder which was initially misdiagnosed as an inflammatory myofibroblastic tumor on biopsy. We review the history, tumor biology, histology, and current management of extrarenal MRT, along with lessons learned from the difficulty with the patient's initial diagnosis.
Prostatic artery embolization in non-index benign prostatic hyperplasia patients: Single center outcomes for urinary retention and gross prostatic hematuria
To present outcomes for prostatic artery embolization (PAE) to treat urinary retention and gross prostatic hematuria in non-index benign prostatic hyperplasia (BPH) patients.
Is primary realignment appropriate for the initial management of straddle injuries to the bulbar urethra?
To compare the clinical courses of patients with straddle injuries to the bulbar urethra based on the initial management strategy for urinary drainage, mainly suprapubic tube placement (SPT) and primary realignment (PR), and to examined whether PR has a beneficial effect on subsequent urethroplasty with regards to surgical and patient-reported outcomes.