Urology News Feeds

Reducing Readmissions following Radical Cystectomy: Moving Beyond Enhanced Recovery

Urology (Gold Journal) In Press - Mon, 04/06/2020 - 00:00
To assess readmission outcomes of a traditional ER pathway as well as a targeted post-discharge intervention aimed at reducing hospital readmissions following RC.
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Adopting for Supine Percutaneous Nephrolithotomy: Analyzing the Learning Curve of Tertiary Academic Center Urology Team

Urology (Gold Journal) In Press - Sun, 04/05/2020 - 00:00
To evaluate the effect of learning curve on supine mini-percutaneous nephrolithotomy (PNL) outcomes.
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Occult nodal metastases in patients down-staged to non-muscle invasive disease following neoadjuvant chemotherapy

Urology (Gold Journal) In Press - Sun, 04/05/2020 - 00:00
To evaluate the risk of occult nodal metastasis in patients with muscle invasive bladder cancer who exhibit a complete or partial clinical response to neoadjuvant chemotherapy (NAC) and assess a potential role for “bladder sparing” management given that the gold standard treatment, radical cystectomy (RC), is associated with high morbidity.
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Do Best Practice Alerts Reduce CAUTIs? The Influence of an Electronic Medical Record Embedded Best Practice Alert on Rate of Hospital Acquired Catheter Associated Urinary Tract Infections

Urology (Gold Journal) In Press - Sun, 04/05/2020 - 00:00
To understand if an electronic medical record embedded best practice alert decreased our hospital's Catheter associated urinary tract infections (CAUTIs) and catheter utilization (CU) rates.
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Re: It's All Relative: Assessing Online Search Interest in Genitourinary Cancer Awareness Campaigns

Urology (Gold Journal) In Press - Sun, 04/05/2020 - 00:00
Patel and colleagues measured the Google Trends relative search volume (RSV) of prostate, testicular, and breast cancers to evaluate the success of men's health awareness campaigns to generate online interest. Based on significantly higher RSV for “breast cancer” during breast cancer awareness month relative to male cancers, they suggest that men's health awareness campaigns did not increase online search interest in prostate and testicular cancer. While we support using RSV to characterize online search patterns, we believe the conclusions about the failure of men's cancer awareness campaigns warrant additional context.
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Alvimopan is Associated with a Reduction in Length of Stay and Hospital Costs for Patients Undergoing Radical Cystectomy

Urology (Gold Journal) In Press - Sun, 04/05/2020 - 00:00
To evaluate the impact of alvimopan in patient undergoing radical cystectomy (RC) for bladder cancer. We hypothesize that alvimopan can decrease cost for RC by reducing length of stay (LOS).
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Cleveland Clinic Akron General Urology Residency Program's COVID-19 Experience

Urology (Gold Journal) In Press - Thu, 04/02/2020 - 00:00
The current COVID-19 pandemic has proposed challenges to urology residency programs all over the nation, resulting in alterations in surgical volumes and academic curriculums. In this review, we propose a structured academic outline allowing for the preservation of the academic vitality. Additionally, we offer a model that optimizes resident coverage at hospitals, the preservation of surgical skills, and the designation of daily reserves as the pandemic worsens.
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Sterilization of Men with Developmental Disabilities: A Historical Perspective and Modern Conundrum

Urology (Gold Journal) In Press - Sat, 03/21/2020 - 00:00
The development of the vasectomy as a form of permanent sterilization was first described in the 1900’s.1 However, the indications for vasectomy were vastly different than those in contemporary practice. Initial series were performed on institutionalized persons including criminals, the “mentally defective,” and the “insane”.2 This practice became widespread and ushered in the Eugenics Movement of the early 20th century, aiming to ensure the health of the human race by eliminating “defective genes”.
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Laparoscopic repair of ureteral diverticulum caused by ureterosciatic hernia

Urology (Gold Journal) In Press - Sat, 03/21/2020 - 00:00
Ureterosciatic hernia and ureteral diverticulum are rare conditions. Only a few cases with surgical management for these conditions have been reported. We report a case of ureteral diverticulum due to ureterosciatic hernia in an 85-year-old woman admitted for septic shock. Computed tomography and retrograde ureterography revealed obstructive ureterosciatic hernia. During intraoperative laparoscopic mesh repair for the hernia after urosepsis treatment, we noted ureteral diverticulum that was also detected endoscopically at the herniated ureter wall.
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International Publication Patterns on Operative Management of Wilms Tumor: A Review by Surgeon Specialty and Surgical Modality

Urology (Gold Journal) In Press - Sat, 03/21/2020 - 00:00
To review the temporal trends in the published literature of the surgical management of Wilms tumor (WT) relative to surgical modality and authorship by surgeon specialty (pediatric urology [PU] vs. pediatric surgery [PS]).
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Early Increased Urinary IL-2 and IL-10 Levels were Associated with Development of Chronic UTI in a Murine Model

Urology (Gold Journal) In Press - Thu, 03/19/2020 - 00:00
To analyze factors during early stage of urinary tract infection (UTI) that are associated with development of chronic UTI.
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Detection and Treatment of Persistent Mullerian Duct Syndrome with Transverse Testicular Ectopia

Urology (Gold Journal) In Press - Wed, 03/18/2020 - 00:00
The coexistence of persistent Mullerian duct syndrome (PMDS) with transverse testicular ectopia (TTE) is extremely rare. Due to a lack of distinctive clinical features in the early stages, PMDS coexists with TTE is usually diagnosed when patients are examined for other diseases, including cryptorchidism and inguinal hernia.We present a case of a 51-year-old man who presented with a recurrent left indirect inguinal hernia for 2 years and right congenital cryptorchidism. The patient was diagnosed as PMDS with TTE by preoperative magnetic resonance imaging and underwent laparoscopic resection of the right transverse ectopic testis and Mullerian duct residues.
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Arterioureteral fistula in the setting of an indwelling ureteral stent, ileal conduit and history of pelvic radiation

Urology (Gold Journal) In Press - Wed, 03/18/2020 - 00:00
Arterioureteral fistulas (AUF) are rare, life-threatening developments that often cause episodes of acute hemorrhage requiring immediate surgical intervention. While significant blood loss leading to hemodynamic instability is a severe manifestation of AUFs, this is an uncommon initial presentation. In a majority of patients, the only presenting symptom of an AUF is intermittent hematuria, ranging from microscopic hematuria to massive hemorrhage.1 Hematuria is a nonspecific symptom with a broad differential diagnosis which can often time delay the recognition and management of this urologic emergency.
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Bilateral synchronous testicular germ cell tumors in children: Case report and review of the literatüre

Urology (Gold Journal) In Press - Wed, 03/18/2020 - 00:00
Bilateral testicular tumors are very rare in pediatric patients and only a few case reports have been reported. These patients have a high risk of sterility due to bilateral orchiectomy and subsequent gonadotoxic treatments. Therefore, if possible, testis-sparing surgery should be performed in patients with benign masses and testicular tissue preservation may be recommended in order to maintain fertility in later life. We present a 23 months-old-boy with synchronous bilateral testicular tumor managed with unilateral orchiectomy and testis-sparing surgery and testicular tissue cryopreservation performed to the controlateral side.
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Retinoblastoma in Infancy with Subsequent Bladder Leiomyosarcoma in Adulthood: Genomic Considerations

Urology (Gold Journal) In Press - Wed, 03/18/2020 - 00:00
Hereditary retinoblastoma is attributed to germline mutation in an RB1 tumor suppressor gene followed by somatic mutation in the other allele. This report details a case of leiomyosarcoma of the bladder in a 24-year-old man with a history of retinoblastoma treated by enucleation and radiotherapy in infancy. Leiomyosarcoma is the most common secondary soft tissue malignancy in retinoblastoma survivors; however, leiomyosarcoma of the bladder in retinoblastoma survivors is very rare. Survivors of hereditary retinoblastoma should be monitored closely for secondary malignancies, and there should be an increased suspicion of malignancy.
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Local Recurrence of Prostate Cancer to the Intersphincteric Space: A Case Report

Urology (Gold Journal) In Press - Wed, 03/18/2020 - 00:00
The patient is an otherwise-healthy 69-year-old Caucasian male with a history of prostate cancer who underwent uncomplicated robot-assisted laparoscopic prostatectomy (RALP). Following the prostatectomy, his tumor was histologically assessed a Gleason score of 4 + 3, with areas of cribriform pattern, pathologic stage T2 (tumor confined within the prostate) and was removed with free surgical margins (R0). One year later, the patient presented to a genitourinary cancer clinic with biochemical recurrence with elevated prostate-specific antigen (PSA) levels from postoperatively undetectable to 0.17 ng/mL at a one-year follow-up and 0.37 ng/mL six months later.
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Laying the Foundation for Bladder Health Promotion in Women and Girls

Urology (Gold Journal) In Press - Tue, 03/17/2020 - 00:00
Prevention strategies have been effective in many areas of human health, yet have not been utilized for lower urinary tract symptoms (LUTS) or bladder health (BH). This commentary outlines LUTS prevention research initiatives underway within the NIH-sponsored Prevention of Lower Urinary Tract Symptoms Research Consortium (PLUS). Prevention science involves the systematic study of factors associated with health and health problems, termed protective and risk factors, respectively. PLUS is enhancing traditional prevention science approaches through use of: 1) a transdisciplinary team science approach, 2) both qualitative and quantitative research methodology (mixed methodology), and 3) community engagement.
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Ventral Buccal Mucosa Graft Urethroplasty with Gracilis Muscle Flap for High Risk, Long Segment Urethral Strictures: A 20-Year Experience

Urology (Gold Journal) In Press - Tue, 03/17/2020 - 00:00
To evaluate our 20-year experience of urethroplasty with ventral buccal mucosa graft (BMG) and gracilis muscle flap coverage for long segment urethral strictures unfit for standard repair due to a compromised graft bed and poor vascular supply.
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Use of Botulinum Toxin A (BoNT-A) in Detrusor External Sphincter Dyssynergia (DESD): A Systematic Review and Meta-Analysis

Urology (Gold Journal) In Press - Tue, 03/17/2020 - 00:00
We performed a systematic review to examine the efficacy and outcomes of Botulinum Toxin A (BoNT-A) as the primary intervention strategy for patients with detrusor sphincter dyssynergia (DESD). Eleven studies were included in the analysis (n=353; 16% female, 84% male). BoNT-A was effective in 60 – 78% of patients for reducing post-void residual, mean detrusor pressure, detrusor leak point pressure, and mean urethral pressure 1 month after injection. Most patients required reinjection after an average of 4-9 months.
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Contrast-Enhanced Urodynamic Vector Projectile Imaging (CE-UroVPI) for Urethral Voiding Visualization: Principles and Phantom Studies

Urology (Gold Journal) In Press - Tue, 03/17/2020 - 00:00
To devise a new urodynamic imaging framework that can provide time-resolved visualization of urinary flow and urethral deformation during the initiation phase of voiding.
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