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Reply: Transperineal Prostate Biopsy is Associated With Lower Tissue Core Pathogen Burden Relative to Transrectal Biopsy: Mechanistic Underpinnings for Lower Infection Risk in the Transperineal Approach
We appreciate the insight of Dr. Harrington et al. regarding the successful implementation of topical rectal antiseptic (TRS) into their transrectal prostate biopsy protocol, and commend them for the associated reduction in infectious complications over the decade of their experience. Their study, a retrospective review of nearly 1200 men who underwent transrectal biopsy of the prostate, compared a cohort that received TRS with antibiotic prophylaxis relative to a cohort that received antibiotic prophylaxis but no TRS.
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RE: “Transperineal Prostate Biopsy is Associated With Lower Tissue Core Pathogen Burden Relative to Transrectal Biopsy: Mechanistic Underpinnings for Lower Infection Risk in the Transperineal Approach”
Dear Editor,
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Robot-assisted laparoscopic calyceo-pyelostomy for vascular compression of the upper calyx (Fraley Syndrome)
Fraley's Syndrome is a rare anatomic vascular malformation described in 1966 where an aberrant crossing vessel compresses the upper infundibulum and leads to upper calyx massive dilation. It is mostly asymptomatic and the diagnosis often missed; however, surgery is usually required for symptomatic cases. Open surgery is still frequently used while minimally invasive management is anecdotal in the literature. We report the first robot-assisted calyceo-pyelostomy.
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Do parameatal urethral cysts in children need surgical excision?
: To examine pathophysiology of parameatal urethral cyst (PUC) with comparison between the surgical excision group and the spontaneous resolution group.
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Prenatally diagnosed posterior urethral valves: ethical dilemmas of fetal intervention
Although anhydramnios due to in utero renal failure has traditionally been considered lethal, in utero interventions offer the potential for pulmonary survival. As fetal interventions become more common, questions arise about how to identify and counsel eligible candidates. In this report we describe the presentation and management of a 17-year-old pregnant female who presented from out-of-state with severe lower urinary tract obstruction (LUTO) with associated anhydramnios, focusing on the ethical questions that this case raised.
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Association Between Private Equity Acquisition of Urology Practices and Physician Medicare Payments
To assess whether private equity acquisitions of urology practices were associated with changes in Medicare payments and patient volume.
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Establishment of mini-pig model of ureteral stricture by electrocoagulation under ureteroscopy
: To establish a mini-pig model of ureteral stricture by using electrocoagulation under ureteroscopy.
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“Labia majora fasciocutaneous flap reconstruction in complex urogynecological fistulas with vaginal deficit - A versatile approach”
To appraise the pivotal points of different modifications of labia majora fasciocutaneous flap in combating the challenges of complex urogynecological fistula repair in the form of seven cases.
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Periurethral and intravenous injections of adipose-derived stem cells to promote local tissue recovery in a rat model of stress urinary incontinence
: To compare the effects of periurethral and intravenous injection of adipose-derived stem cells (ADSCs) on voiding function and tissue recovery in a stress urinary incontinence (SUI) rat model.
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Management of chyluria by laparoscopic ligation of renal lymphatic vessels
A 74-year-old male was admitted due to chyluria for 60 years without scrotal or lower extremity edema. He had received an open cystotomy and clot aspiration one week before admission for acute urine retention and failure of catheterization at another hospital. He was probably infected by filariasis because filariasis had been reported as an epidemic disease in his growing town located in the southwest of China approximately 50 years ago. The patient was underweight and diagnosed with hypoproteinemia.
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Pulsed electromagnetic field therapy for pain management in interstitial cystitis/bladder pain syndrome: A proof-of-concept case series
: To evaluate the efficacy of pulsed electromagnetic field (PEMF) therapy for symptom and pain management in women with non-bladder centric interstitial cystitis/bladder pain syndrome (IC/BPS).
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The preliminary exploration of what role miRNAs derived from urinary exosomes play in kidney stone formation
To identify dysregulated miRNAs derived from urinary sEVs and to explore the potential roles sEVs miRNAs play in nephrolithiasis.
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Men with Chronic Orchialgia Exhibit Differential Neuroinflammatory Gene Expression relative to Asymptomatic Controls
To identify differences in neuroinflammatory gene expression in individuals with chronic orchialgia (CO) compared to asymptomatic controls.
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Scrotal fetus in fetu in a newborn: A rare case report
Fetus in fetu is a rare phenomenon of infancy, separate from conjoined twins, teratomas, and acardiac twins. The pathogenesis is not well understood but has been theorized to originate from either the involution of a twin or the differentiation of a teratoma. While the majority of these are found in the retroperitoneum, the presence of a fetus in fetu within the scrotum is exceedingly rare. We present the diagnosis and management of a case of fetus in fetu in the scrotum of a newborn male including radiologic imaging and pathologic examination.
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Management of Inpatient macroscopic haematuria: a typical urology emergency with a high mortality
To review the in-patient (IP) management patterns and 30-day outcomes of patients admitted with macroscopic haematuria (MH) over a 1-year-period in a single-institution, aiming to clarify management for such cases in the future.
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Resection of Pubic Symphysis and Cystectomy Significantly Improves Short-Term Patient-Reported Physical Functioning among Patients with Pubovesical Fistula and Pubic Bone Osteomyelitis
To investigate the impact of extirpative surgery for pubic bone osteomyelitis with pubovesical fistula on prostate cancer survivors’ physical and mental health.
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Collateral Damage from Fetal Interventions: Increasing the Complexity of Complex Patients
Fetal interventions are often key to fetal survival and growth; however, they can often have complications causing significant morbidity and mortality. This case highlights not only a complication of fetal surgery, but also a very unusual diagnosis. We present the case of a male fetus who was diagnosed with urethral atresia and subsequently underwent two vesicoamniotic shunt placements. At birth, he was diagnosed with Megacystis Microcolon Intestinal Hypoperistalsis Syndrome and was noted to have rectovesical and vesicocutaneous fistulae likely iatrogenically created from shunt placement.
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Abdominal Evisceration: A Rare Complication of In Utero Vesicoamniotic Shunting
Vesicoamniotic shunting (VAS) is one of the most common surgical options in selected cases of severe fetal obstructive uropathy. Abdominal evisceration (AE) secondary to VAS has been reported in only eight cases. A pregnant woman underwent VAS due to lower urinary tract obstruction with severe oligohydramnios. AE was observed at birth. Subsequently, he underwent abdominal surgical repair and urethral dilations due to segmental urethral atresia. At 21-months-follow-up, the patient is breathing spontaneously, undergoing peritoneal dialysis, voiding small amounts of urine, and being fed via G-tube.
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Bilateral Ureterovesical Junction Obstruction Resulting in Anuria in a Three-Week-Old Infant
Bilateral megaureter with ureterovesical junction obstruction is exceedingly rare. We present a case of a 3-week-old boy who presented in acute renal failure and found to have bilateral megaureter. He was initially decompressed with bilateral percutaneous nephrostomy tubes and once stable underwent bilateral ureterostomy. At 6 months old, renal ultrasound showed stable mild right sided hydronephrosis.
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Opioid and Multimodal Analgesia Use Following Urological Trauma
: To examine opioid use following Urological trauma. Increased opioid use is associated with inferior outcomes and risk of dependence, particularly in vulnerable populations. In contrast, multimodal analgesia following trauma allows decreased pain and readmission. Currently there is a paucity of data describing opioid usage following urological trauma. The purpose of this study was to assess utilization of opioids and multimodal pain regimens following urologic trauma.
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