Urology News Feeds

Grand Rounds: Multimodal surgical management of severe scrotal lymphedema and buried penis

Urology (Gold Journal) In Press - Thu, 06/25/2020 - 00:00
A 42-year old man with a history of Type II diabetes mellitus, hypertensive disorder and hyperlipidemia presented with a 7-year history of progressive lymphedema and inflammation of the scrotum and penile shaft. He had no prior surgical history, was obese with an initial BMI of 44.77, and had also been a heavy smoker for 30 years. He had undergone an extensive workup at an outside facility which did not reveal any infectious etiologies. At time of initial consultation, severe scrotal and penile shaft lymphedema was observed, with the scrotum measuring approximately 20 cm by 20 cm with some mild erythema and the penis completely buried (Fig 1A, B).
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Gender Representation among Plenary Panel Speakers at the American Urological Association Annual Meeting

Urology (Gold Journal) In Press - Wed, 06/24/2020 - 00:00
To examine trends in the representation of women in plenary panels at the American Urological Association (AUA) Annual Meeting.
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A Rare Case of T-Cell Lymphoma Presenting with Bilateral Nephrolithiasis and Acute Renal Failure

Urology (Gold Journal) In Press - Wed, 06/24/2020 - 00:00
We present the rare case of a young boy who was found to have T-cell lymphoma after presenting with flank pain and bilateral nephrolithiasis. He initially underwent bilateral ureteral stent placement but returned with oliguria and acute renal failure. His subsequent workup revealed lymphoma involving both kidneys. He was started on chemotherapy for his lymphoma and dialysis for his renal failure. His stones ultimately dissolved with aggressive hydration and correction of serum uric acid levels. In this report, we discuss the identification and management of this rare condition.
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In support of a simple urethrocutaneous fistula closure technique following hypospadias repair

Urology (Gold Journal) In Press - Wed, 06/24/2020 - 00:00
To evaluate the success rates of a simple post-hypospadias urethrocutaneous fistula repair.
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A large paraprostatic mass in a man: rare presentation of aggressive angiomyxoma

Urology (Gold Journal) In Press - Wed, 06/24/2020 - 00:00
Aggressive angiomyxoma is a rare lesion with infiltrative growth and a tendency to recur locally. We present the images of a rare case of aggressive angiomyxoma in the pelvic region of a male patient presenting as a retrovesical, paraprostatic mass causing urinary symptoms.
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Re: Goel S, Pierce H, Pain K, Christos P, Dmochowski R, Chughtai B. Use of Botulinum Toxin A (BoNT-A) in Detrusor External Sphincter Dyssynergia (DESD): A Systematic Review and Meta-analysis. Urology. 2020. doi:10.1016/j.urology.2020.03.007

Urology (Gold Journal) In Press - Wed, 06/24/2020 - 00:00
Goel et al present an important systematic review of Botulinum toxin A in patients with detrusor external sphincter dyssynergia.1 However, the review fails to answer some questions that might be central to the lack of widespread adoption of this technique. After all, this was the first urological use of botulinum reported over three decades ago.2 Currently the molecule is sparingly used for this indication, at a handful of centers, and there is just one randomized trial on the subject.3 Compare this with usage of botulinum for overactive bladder and neurogenic detrusor overactivity, two other indications with rapid adoption and a large number of high quality studies.
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Single-Stage Double-Face Buccal Mucosal Graft Urethroplasty for Neophallus Anastomotic Strictures

Urology (Gold Journal) In Press - Tue, 06/23/2020 - 00:00
After gender-affirming phalloplasty the anastomosis between the perineal urethra (pars fixa) and the penile urethra is the most common site of stricture1. Excisional urethroplasty after phalloplasty is known to have high failure rates due to poor vascularization of neourethra2. Our objective is to demonstrate the feasibility of a single-stage repair of neophallus anastomotic strictures using a “double-face” urethroplasty technique.
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CHARACTERISTICS OF GENITOURINARY FISTULA IN KIGALI, RWANDA; 5- YEAR TRENDS

Urology (Gold Journal) In Press - Tue, 06/23/2020 - 00:00
To assess the characteristics of women presenting with genitourinary fistula over a 5-year period in Kigali, Rwanda. Genitourinary (GU) fistula is a devastating condition that can result from difficult vaginal deliveries or as a surgical complication. Rwanda has seen notable increases in cesarean section rates as a result of a successful universal health care system. It is unclear how the increase in cesarean section rates may influence the types of fistula diagnosed.
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Treatment Related Outcomes for Patients with Atypical Peyronie's Disease using Xiaflex Injections

Urology (Gold Journal) In Press - Tue, 06/23/2020 - 00:00
To evaluate the efficacy and safety of collagenase Clostridium histolyticum (CCH) for the management of penile deformities in patients presenting with different categories of atypical Peyronie's disease (PD).
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Outpatient Panniculectomy and Skin Graft for Adult Buried Penis.

Urology (Gold Journal) In Press - Tue, 06/23/2020 - 00:00
To demonstrate a technique for performing panniculectomy and skin graft for a patient with adult buried penis, highlighting a number of technical modifications that allow for the procedure to be performed as an outpatient.
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Letter to the Editor - Reply

Urology (Gold Journal) In Press - Mon, 06/22/2020 - 00:00
We thank the authors for their interest in our manuscript, and we acknowledge their concerns regarding the potential downstream effects of elevated sodium intake in our AA patients. While we agree that the recommendation of a low sodium diet (≤2300mg daily) is frequently offered to nephrolithiasis patients for conservative dietary management due to concern for the correlation between increased sodium intake and hypercalciuria, the two prospective studies in which low sodium diet was correlated to decreased urine calcium were performed in patients in hypercalciuric patients with elevated baseline 24-hr urine sodium.
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Development and Validation of a Male Anterior Urethral Stricture Classification System

Urology (Gold Journal) In Press - Sun, 06/21/2020 - 00:00
To develop and validate a clinical classification system for urethral stricture disease (USD) based on the retrograde urethrogram (RUG), physical exam, and stricture-specific patient history.
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Follow Up and Outcomes of Patients with Long Term Cutaneous Vesicostomies at a Single Institution

Urology (Gold Journal) In Press - Sat, 06/20/2020 - 00:00
To identify and describe the characteristics of a group of patients at our institution who are satisfied with cutaneous vesicostomy for long term bladder management and never undergo subsequent continence surgery.
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Grade IV Renal Laceration In A 13-Year Old Boy With Cross Fused Renal Ectopia

Urology (Gold Journal) In Press - Sat, 06/20/2020 - 00:00
A 13-year old boy presented with gross hematuria following a skateboarding accident and was found to have cross-fused renal ectopia of the left kidney with a grade IV right renal laceration and urinary extravasation. Despite a double-J ureteral stent, urinoma drain, and indwelling bladder catheter, his urinoma drain maintained high output. He underwent a ureteral stent exchange and upsizing. A percutaneous nephrostomy tube was subsequently placed for maximal urinary diversion, which led to the resolution his urinary leak.
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Cadaveric Laboratory Simulation Training of Male Stress Urinary Incontinence Treatment Improves Trainee Knowledge and Confidence

Urology (Gold Journal) In Press - Sat, 06/20/2020 - 00:00
To assess whether a focused, simulation training course can improve trainee surgical knowledge and confidence in the treatment of male stress urinary incontinence.
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Grand Rounds: Nested Variant Urothelial Carcinoma of the Bladder

Urology (Gold Journal) In Press - Fri, 06/19/2020 - 00:00
Papillary subtype urothelial carcinoma constitutes the majority of bladder cancers and upper tract urothelial cancers.1 Variant histologies including nested variant urothelial carcinoma (NVUC) present diagnostic challenges, are often under-reported, and portend a more aggressive clinical course.2 We present a case of newly diagnosed nested variant urothelial carcinoma of the bladder and highlight its clinical presentation, pathologic appearance, and treatment considerations. We further place this diagnosis in the context of a patient who is a poor surgical candidate and comment on the management of bladder cancers in this challenging population.
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Single-Port Robotic-Assisted Laparoscopic Sacrocolpopexy with magnetic retraction: A Video Demonstration

Urology (Gold Journal) In Press - Fri, 06/19/2020 - 00:00
Abdominal sacrocolpopexy is the gold standard for treatment of apical prolapse.1 Minimally invasive surgery offers many advantages over the open approach, including incision size, blood loss, post-operative pain while maintaining similar long-term outcomes.2,3
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Gender disparities in industry payments to urologists

Urology (Gold Journal) In Press - Fri, 06/19/2020 - 00:00
To analyze and compare industry payments to urologists in the Open Payments Database by gender. We hypothesized that industry payments might be greater to male vs women urologists.
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A Systematic Review and Meta-Analysis of Methods Used to Reduce Infectious Complications Following Transrectal Prostate Biopsy

Urology (Gold Journal) In Press - Fri, 06/19/2020 - 00:00
We reviewed and analyzed the most effective methods to reduce infectious complications (IC) after transrectal prostate biopsy (TRPB). We included only prospective randomized controlled trials in the analysis. The analysis neither demonstrated any superiority of fluoroquinolones over other antibiotic classes nor of targeted antibiotics over empiric regimens in men undergoing TRPB. However, longer course antibiotics (3 days or more) compared to single dose or day regimens, combination of fluoroquinolones with aminoglycosides compared to fluoroquinolones alone and povidone-iodine rectal cleansing compared to control significantly reduced IC following TRPB.
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