Urology News Feeds

Bladder diverticula are herniations of the bladder urothelium resulting in a thin diverticular wall consisting of mucosa, lamina propria, adventitia, and, in some instances, non-functioning detrusor muscle fibers. They can be congenital, or more commonly acquired. Bladder diverticula are often asymptomatic and are usually first noted as incidental findings on cystoscopy or radiographic imaging. However, large diverticula can be responsible for symptoms such as recurrent urinary tract infections, bladder stones, hematuria, and ureteral obstruction.

To determine the relationship between subcutaneous fat (SFA), visceral fat surface area (VFA), bladder wall fat distribution, and visceral adiposity index (VAI) as risk factors for overactive bladder (OAB) occurrence.

To measure differences in post-operative opioid usage and pain scores between pre- and post-Enhanced Recovery after Surgery (ERAS®) radical cystectomy (RC) patients in an effort to optimize outcomes.

To evaluate the feasibility and safety of performing Robotic-Assisted Laparoscopic Partial Nephrectomy (RAPN) as outpatient surgery in patients with renal masses.

To determine how effective routine post-operative blood work is in identifying complications after percutaneous nephrolithotomy (PCNL), the gold standard treatment for large volume stone disease. Although major complication rates are low, hemorrhagic and sepsis-related complications are serious and can occur. Routine post-PCNL complete blood count (CBC) is routinely performed by most endourologists but may be a low-value practice.

Extra-adrenal pheochromocytoma is called paraganglioma. Paraganglioma near the ureterovesical junction can be confused with urothelial carcinoma in a ureterocele. Urinary metanephrine can be an indicator for bladder paraganglioma. Metaiodobenzylguanidine scintigraphy (MIBG) is an excellent method not only for distinguishing bladder paraganglioma from other submucosal mesenchymal tumors but also for detecting multifocal lesions. In the present case, we did not perform a preoperative MIBG scan because the patient was asymptomatic and urinary metanephrine was negative.

To determine whether selection of treatment modality for urinary stone disease differs between primary and outreach healthcare centers, and if patient rurality predicts treatment modality.

Renal angiomyolipoma (AML) is a benign, mesenchymal tumor consisting of mature adipose tissue, thick-walled blood vessels, and spindle smooth muscle-like cells. Although the majority of AMLs arise sporadically, they are seen in 50-90% of patients with Tuberous Sclerosis Complex (TSC). In the absence of symptoms or concern for malignancy, AML is managed conservatively with the priority of maintaining kidney function. Tumors ≤4 cm typically undergo observation with annual imaging. Selective renal arterial embolization or partial nephrectomies are performed for indications such as hemorrhage, bleeding, and/or suspicion of malignancy.

The heterogenous nature of high-risk non-muscle invasive bladder cancer encompasses a wide range of tumor biologies with varying recurrence and progression risks. Radical cystectomy provides excellent oncologic outcomes but is often underutilized. Timing for these patients is critical, however, to its effectiveness. Certain unfavorable tumor characteristics predict worse outcomes and may help select the most appropriate patients for more aggressive initial therapy. This manuscript aims to outline factors that predict worse outcomes in high-risk non-muscle invasive bladder cancer and proposes which patients may benefit most from a timely radical cystectomy.

To the Editor: Guidelines on deferring surgeries during the COVID-19 pandemic have been based primarily on disease urgency, without addressing resource allocation specifically.1-5 We highlight resource stewardship issues, and share an easily-administered and highly-adaptable tool for surgical prioritisation depending on surgical acuity and resource utilisation, two key determinants of resource allocation in a pandemic.

Urologic and gynecologic surgeons are the top utilizers of robotic surgery; however, non-obstetrical robotic-assisted laparoscopic surgery (RALS) in pregnant patients is infrequent. A systematic literature review was performed to ascertain the frequency, indication and complications of RALS in pregnancy. Results showed thirty-eight pregnancies from eleven publications between 2008-2020. Five cases were for urologic indication and thirty-three for gynecologic indication. Minimal surgical alterations were required.

To compare two techniques—trocar and Seldinger—for performing percutaneous suprapubic cystostomy (SPC).

To reliably and quickly diagnose children with posterior urethral valves (PUV), we developed a multi-instance deep learning method to automate image analysis.

Application of the Single Port (SP) robotic platform [Intuitive®] is expanding.  Using two illustrative examples of bladder diverticula (BD) resulting from bladder outflow obstruction (BOO), we describe in this video our techniques utilising SP to treat BD via Extravesical (EV#1) and Transvesical (TV#2) approaches.

Nitrous oxide (N2O) is underutilized in ambulatory urology. Here, we review available data regarding application, efficacy, and side effect profile of N2O in ambulatory urologic procedures. Data were available from 11 studies. N2O has been described in the setting of transrectal ultrasound-guided prostate biopsies, flexible cystoscopy, ureteral stent placement, and extracorporeal shockwave lithotripsy in adult patients and catheterization in children. Studies showed significant improvements in peri-procedural pain and anxiety relative to alternative (or none) forms of analgesia.

The human spread of a novel beta-coronavirus, i.e. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan in December 2019.1 COVID-19 was then designated as the name of the disease resulting from this infection which is short for “Coronavirus Disease 2019”.1 COVID-19 has been declared as a pandemic by the World Health Organization (WHO) on March 11, 2020, which is also the date when the first confirmed case in Turkey has been announced by the Ministry of Health.

To study disease-specific knowledge and decisional quality in men with varicocele being counseled for infertility.

To determine if racial and/or socioeconomic factors influence advanced therapy utilization for refractory overactive bladder (OAB) amongst the commercially insured.

To investigate the prevalence and potential risk factors for postpartum voiding dysfunction (PPVD).

To examine the rates of surgical repair of comorbid rectal prolapse (RP) and pelvic organ prolapse (POP) over time in a large population-based cohort.