Urology News Feeds
INTRODUCTION AND OBJECTIVE: Urosymphyseal fistula (UF) with osteomyelitis most commonly occurs as a result of prostate cancer and benign prostate hyperplasia (BPH) therapy. UF presentation typically includes debilitating pelvic pain exacerbated with ambulation. Traditional management required open surgical genitourinary (GU) reconstruction with pubectomy leading to significant morbidity. However, progressive utilization of robotic approaches and advances in holmium laser technology has led to a less invasive alternative.
A 78-year-old female was referred to urology for hematuria and dysuria. Her urine culture was negative, however, urine cytology showed malignant cells with scant cytoplasm and stippled chromatin (Figure 1). They were negative for pancytokeratin, CD45, and Melan A, thus making carcinoma, lymphoma or melanoma unlikely. Additional tissue procurement was requested. Cystoscopy revealed a 6 cm bladder mass composed of a small, blue cell tumor, with involvement of the muscularis propria. The tumor expressed skeletal muscle markers (desmin and myogenin) consistent with rhabdomyosarcoma (Figure 2).
Neoadjuvant cisplatin-based chemotherapy (NAC) followed by radical cystectomy (RC) or radiation therapy (RT) improves survival of patients with nonmetastatic, muscle-invasive bladder cancer (MIBC). The rationale dates to 1979 when George Prout, at the Massachusetts General Hospital in Boston, stated that MIBC is a systemic disease1. He based this on the undisputed evidence that despite local treatment with RC or RT, more than half of patients die of distant metastases. Systemic therapy, integrated with local therapy, would be necessary to cure more patients.
Congenital Giant Megaureter in a Sixteen-Year-Old Female Presenting with Abdominal Pain: A Case Report and Review of Literature
We describe a case of congenital giant megaureter (CGM) in a sixteen-year-old female. She presented with a five-day history of abdominal distention, right flank pain and tenderness. Right pyelonephritis was suspected. Computerized tomography (CT) showed a large cystic abdominal mass with no appreciably functioning left kidney causing secondary compression of the contralateral right ureter. A left upper nephroureterectomy was performed, draining over 3.5 L of fluid. Our experience suggests that CGM should be considered in the differential for pediatric patients presenting with a cystic abdominal mass.
Characterization of a Novel Implant Intended to Expand and Reshape the Prostatic Urethra for the Treatment of Benign Prostatic Hyperplasia: A Pre-Clinical Feasibility Study in the Canine Model
To evaluate the safety, feasibility, and tissue response of a novel device for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia, using the first-generation XFLO Expander System (Mercury Expander System).
Exploring Barriers to the Inclusion of Underrepresented Minorities in Urology: The Temporal and Financial Costs of Residency Interviews
To investigate whether interview travel cost and time differed for urology residency applicants from medical schools with higher versus lower proportions of students from groups underrepresented in medicine (URiMs).
Reply to Kokayi A, Warren H, Tranb M ‘s Letter to the Editor-Active Surveillance for Biopsy Proven Renal Oncocytomas: Outcomes and Feasibility. Urology 2021. doi: 10.1016/j.urology.2021.05.034. Online ahead of print.
We thank Kokayi et al. for their interest in our study on the feasibility and outcomes of active surveillance (AS) in renal oncocytoma recently published in Urology.1 We also read with great interest their results on the growth and renal function dynamics of renal oncocytomas in patients on AS.2 It is a great satisfaction to see that our institutions share common research topics in addition to similar conclusions.
Strategies to Optimize Nephrolithiasis Emergency Care (STONE): Prospective Evaluation of an Emergency Department Clinical Pathway
To convene a multi-disciplinary panel to develop a pathway for Emergency Department (ED) patients with suspected nephrolithiasis and then prospectively evaluate its effect on patient care.
To assess whether urology residency programs publish information about lactation accommodations online. Although residencies are required to provide lactation accommodations, there is limited data on whether programs disclose this information.
Voiding dysfunction is a significant cause of morbidity and quality-of-life impairment in both children and adults.1-3 Urodynamic studies (UDS) are commonly performed to diagnose and assess the presence and severity of lower urinary tract pathology. UDS can be invaluable in identifying which patients are at risk for harmful sequela of their voiding dysfunction such as renal damage, hydronephrosis, or recurrent urinary tract infections (UTIs).4, 5 For example, in patients with spina bifida, voiding dysfunction can result in permanent renal damage in up to 25% of patients,6 making UDS a very important and commonly used tool that guides clinical decision making in this population.
Antimicrobial selection for transurethral procedures across the United States: a state-by-state antibiogram evaluation
: To evaluate optimal regimens for perioperative antimicrobial prophylaxis in transurethral procedures by examining antimicrobial susceptibility patterns in the United States.
Real-world global outcomes of RIRS in anomalous kidneys: A high volume international multicenter study
To analyse the trends and outcomes of RIRS (retrograde intrarenal surgery) for treatment of urolithiasis in anomalous kidneys in a large international multicentre series.
Single-Port Mini-Pfannenstiel Robotic Pyeloplasty: Establishing a Non-Narcotic Pathway Along with A Same-Day Discharge Protocol
To analyze the feasibility of a same day discharge protocol following SP robotic pyeloplasty.
Intracorporeal versus Extracorporeal Neobladder after Robot-assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium
To compare perioperative and oncologic outcomes of intracorporeal (ICNB) and extracorporeal neobladder (ECNB) following robot assisted radical cystectomy (RARC) from a multi-institutional, prospectively maintained database, the International Robotic Cystectomy Consortium (IRCC).
Development and Usability Testing of a Mobile Application to Monitor Patient-Reported Outcomes after Stress Urinary Incontinence Surgery
To develop and perform a usability testing of a mobile application (app) with representative users of surgeons and female patients undergoing stress urinary incontinence (SUI) surgery.
Letter to the Editor-Active Surveillance for Biopsy Proven Renal Oncocytomas: Outcomes and Feasibility
We welcome this contribution to the growing body of evidence demonstrating the safety of active surveillance (AS) for biopsy-proven renal oncocytomas. The low median growth rate of 2.4 mm/year reported in this work is in keeping with our own series1 and that of others,2,3 in which no patient has developed metastases or disease-related mortality during median follow up of 29-34 months.
Objectives: To detect seed-based functional connectivity (FC) between various cortical sub-regions and the thalamus in lifelong premature ejaculation (LPE) patients and explore whether specific thalamocortical networks are significantly altered in PE patients compared to healthy controls (HCs)Methods: Fifty non-medicated LPE patients and 40 age-matched HCs underwent a resting-state functional MRI. FC was adopted to identify specific thalamocortical connectivity between the thalamus and six cortical regions of interest (i.e.
: To provide a scoping review of the economic burden of non-cancerous genitourinary conditions (NCGUCs).
Recently, genitourinary reconstruction has experienced a renaissance. Over the past several years, there has been an expansion of the literature regarding the use of buccal mucosa for the repair of complex ureteral strictures and other pathologies. The appendix has been an available graft utilized for the repair of ureteral stricture disease and has been infrequently reported since the early 1900s. This review serves to highlight the use of the appendix for reconstruction in urology, particularly focusing on the anatomy and physiology of the appendix, historical use, and current applications, particularly in robotic upper tract reconstruction.
Postoperative pain relief following lumbar Erector Spinae Plane Block in patients undergoing Percutaneous Nephrolithotomy: A randomized controlled trial
To test whether lumbar Erector Spinae Plane Block (ESPB) provides superior analgesia compared to placebo in patients undergoing Percutaneous Nephrolithotomy (PCNL), using reduction in postoperative opioid consumption, delay in rescue analgesia demand and reduction of pain scores as outcome measures.