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N/A, Narrative Medicine Article

A case report of a 51-year-old man with left renal tumor and level II vena cava tumor thrombus (thrombus extending >2 cm above the renal vein, but below the hepatic veins) in a rare anatomical variant of renal vein. In nonmetastatic patients, aggressive surgical resection is widely accepted as the standard management option, but some doubts about the best practice in these patients are relevant. Surgical approach on those patients is a challenge for the surgeons, and anatomical variants make the procedure even more difficulty.

To compare the quality of robotic prostatectomy surgical videos on the popular website YouTube with more curated, professional sources using the Global Evaluative Assessment of Robotic Skills (GEARS) criteria.

To use data from a large, prospectively- acquired regional collaborative database to compare the risk of infectious complications associated with three American Urologic Association- recommended antibiotic prophylaxis pathways, including culture-directed or augmented antibiotics, following prostate biopsy.

To report our findings in patients with determination of testicular tumor markers from the vena spermatica during inguinal orchiectomy.

Splenogonadal fusion (SGF) is a rare congenital anomaly in which there is abnormal adhesion between splenic tissue and gonads. Several patients with cryptorchidism associated with this anomaly have undergone orchiectomy because of the suspicion of tumors. Preoperative computed tomography (CT) is useful in differentiating between SGF and tumors, and in evaluating the vasculature of the SGF. We report a boy with an abdominal testis associated with SGF. Based on the CT findings, we successfully performed Fowler-Stephens orchiopexy.

A supernumerary testis is a rare finding with limited description in the literature. Presentations of supernumerary testes vary and often involve initial discovery intraoperatively or in association with a separate condition. In this case report, we describe our experience of a patient with ultrasound imaging concerning for a left paratesticular mass. The patient was taken to the operating room where the mass was found to be an atrophic, supernumerary testis. We also address the specific anatomy encountered in our case and discuss both the intraoperative and post-operative management that resulted, in addition to reviewing relevant literature.

To evaluate outcomes for patients with local recurrence (LR) of clinically localized renal cell carcinoma (RCC) without concurrent systemic metastasis from our institution, an event that occurs rarely (1-3%) after surgery. LR may be a harbinger of poor outcomes, and the best management of these patients is unclear.

In recent years, robot-assisted laparoscopic procedures have gradually replaced standard laparoscopic procedures in the realm of pediatric urology. The potential advantages of the robot-assisted technique include a higher degree of dexterity, three-dimensional visualization and reproducibility. Although laparoscopic orchiopexy is considered to be the gold standard approach in cases of intra-abdominal testes, it can be technically challenging. A crucial point in decision-making is choosing between preservation of testicular blood vessels or sacrificing the vessels in order to achieve sufficient length, as with the one and two-stage Fowler-Stephens orchiopexy (FSO).

To quantify and describe urologic adverse events and symptoms after vaccination with the Pfizer-BioNTech and Moderna COVID-19 vaccines.

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, benign neoplasm with a predilection for children that predominantly involves the craniofacial region. Here we report two cases of MNTI involving epididymis, placing emphasis on the sonographic features. Both appeared to be hypoechoic, regular shaped masses with abundant blood supplies. The unique sonographic features and age of predilection make it possible to diagnose MNTI within the scrotum by ultrasonography.

To characterize the presentation, patterns of care, and outcomes of radiation-associated muscle-invasive bladder cancer (RA-MIBC) compared to primary (non-radiation associated) MIBC. RA-MIBC has been suggested to represent a more aggressive disease variant and be more difficult to treat compared to primary (non-radiation associated) MIBC.

To assess both the safety and efficacy, in terms of symptomatic improvement, of botulinum toxin injections distributed in the bowel patch and the bladder remnant of failed augmented bladders.

To review the rates of persistent and de novo stress urinary incontinence (SUI) following urethral diverticulum (UD) repairs performed without concomitant SUI surgical procedures.

To describe the X-Capsular Incision for Tumor Enucleation (X-CITE) technique to resect endophytic renal tumors while preserving the overlying renal parenchyma.

We thank the authors for sharing their insight on our work. The Prostate, Lung, Colorectal and Ovarian cancer (PLCO) trial had important shortcomings directly affecting the interpretation of the trial, including the under-representation of African American (AA) men. As the authors allude to, this was one of the key findings of our study.1 We agree with the authors that the USPSTF recommendations decreased the nationwide prostate-specific antigen (PSA) screening rates2 and potentially led to men being diagnosed later with more aggressive prostate cancer (PCa).

Multiparametric magnetic resonance imaging (mpMRI) has enhanced the risk stratification for men with suspected prostate cancer1 and inevitable implementation challenges around pathway modification, capacity and quality control are well rehearsed.2 Use of pre-biopsy prostate mpMRI is now well-established following publication of multiple Level 1 evidence trials,1 however, views of men undergoing this pathway have not yet been explored, in-depth.

To establish predictive factors of patients who failed intracavernosal injection therapy and ultimately required corporoglandular shunting during first-time ischemic priapism episodes.

We agree with Dalela et al. that The Prostate, Lung, Colorectal and Ovarian cancer (PLCO) trial underestimates the effectiveness of Prostate Specific Antigen (PSA) based prostate cancer (PCa) screening because the PLCO trial enrolled 4.4% African-American (AA) men compared to 14.7% in the US population (metropolitan areas over 30%). Studies have shown that AA men have earlier onset and more aggressive prostate cancers. Unfortunately, based on the PLCO trial, the United States Preventive Services Task Force (USPSTF) has recommended against prostate cancer screening by issuing a Grade D (2012) and Grade C (2018).

Testicular Adrenal Rest Tumors (TART), also known as Testicular Tumors of the Androgenital Syndrome, are benign tumors found in the testes of patients with congenital adrenal hyperplasia (CAH). While considered benign, they are significant in that they can proliferate within the rete testis and cause infertility. We present a patient who appeared to have findings consistent with TART and is in the process of malignancy rule out.