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Muhammad H Alkazemi, Steven Brousell, Joseph Fantony, Matvey Tsivian, Judd W Moul
No abstract text is available yet for this article.
July 12, 2018: Urology
Daniel A Wollin, Rajan T Gupta, Brian Young, Eugene Cone, Adam Kaplan, Daniele Marin, Bhavik N Patel, Maciej A Mazurowski, Charles D Scales, Michael N Ferrandino, Glenn M Preminger, Michael E Lipkin
OBJECTIVE: To compare the accuracy of plain abdominal radiography (KUB) with digital tomosynthesis (DT) to non-contrast computed tomography (NCCT), the gold standard imaging modality for urinary stones. Due to radiation and cost concerns, KUB is often used for diagnosis and follow-up of nephrolithiasis. Digital tomosynthesis, a novel technique that produces high-quality radiographs with less radiation/cost than low-dose NCCT, has not been assessed in this situation. MATERIALS AND METHODS: Seven fresh tissue cadavers were implanted with stones of known size/composition and imaged with KUB, DT and NCCT...
July 10, 2018: Urology
Michael Benson, Sang Lee, Ratul Bhattacharya, Valentino Vasy, Jamshed Zuberi, Sayeeda Yasmeen, Mutahar Ahmed, Moneer K Hanna
OBJECTIVE: To discuss the presenting features, imaging findings and recommended management of patients with Metanephric adenoma (MA) focusing on the diagnostic challenges and indications for follow up. MATERIALS AND METHODS: In this case report, we present a case of a 10-year-old female with MA who eventually underwent nephron sparing surgery with a partial nephrectomy. We performed a literature review of previous cases of metanephric adenoma and their respective management and follow-up...
July 10, 2018: Urology
Albert H Kim, Badrinath Konety, Zhengyi Chen, Fredrick Schumacher, Alexander Kutikov, Marc Smaldone, Robert Abouassaly, Abhinav Khanna, Simon P Kim
OBJECTIVE: To evaluate the comparative effectiveness of local versus systemic therapy among patients diagnosed with non-metastatic clinical T4 prostate cancer. METHODS: Using the National Cancer Database (NCDB) men with clinical T4N0-1M0 prostate cancer from 2004 to 2013 were identified. Local therapy was defined as radiation (RT with ADT), surgery (radical prostatectomy with ADT), or combined radiation plus surgery (radical prostatectomy plus RT with ADT). Systemic therapy was defined as ADT or chemotherapy alone...
July 7, 2018: Urology
Parth K Modi, Samuel R Kaufman, Ji Qi, Brian R Lane, Michael L Cher, David C Miller, Brent K Hollenbeck, Vahakn B Shahinian, James M Dupree
OBJECTIVE: To better describe the real-world use of active surveillance. Active surveillance is a preferred management option for low-risk prostate cancer, yet its use outside of high-volume institutions is poorly understood. We created multiple claims-based algorithms, validated them using a robust clinical registry, and applied them to Medicare claims to describe national utilization. MATERIALS AND METHODS: We identified men with prostate cancer from 2012-2014 in a 100% sample of Michigan Medicare data and linked them with the Michigan Urologic Surgery Improvement Collaborative (MUSIC) registry...
July 7, 2018: Urology
Cheng-Ling Lee, Hann-Chorng Kuo
OBJECIVE: To investigate therapeutic results of tailoring medication for lower urinary tract symptoms (LUTS) in men according to initial treatment results and International Prostate Symptom Score (IPSS) - voiding to storage subscore (V/S) ratio. METHODS: Men with mild-to-moderate LUTS were initially treated for 1 month with doxazosin 4mg daily for IPSS-V/S >1 or tolterodine 4mg daily for IPSS-V/S ≤1. They then underwent the Global Response Assessment (GRA) to tailor their medication by changes in IPSS-V/S, uroflow, and GRA, which were compared at baseline, 1, and 3 months post-treatment...
July 7, 2018: Urology
Garrido-Abad Pablo, Sinués-Ojas Bryan, Conde-Caturla Pablo, García-Martín Luis, Fernández-Arjona Manuel
OBJECTIVE: To describe micro-ureteroscopy, a novel minimally invasive approach for treating distal ureteral lithiasis. MATERIAL AND METHODS: Seven female patients with distal ureteral stones ≤ 10 mm were operated by microureteroscopy. The micro-ureteroscope consist on a 4.85 Fr (16-gauge) sheath, a 0.9 mm diameter flexible optic system and a 3-arm luer-lock adapter to connect the sheath and insert the optics. Patients are placed in lithotomy position. Under sedative anesthesia and antimicrobial coverage we performed micro-ureteroscopy in patients with distal ureteral stones, describing key steps and perioperative and postoperative outcomes...
July 7, 2018: Urology
Nannan Thirumavalavan, Jason M Scovell, Adithya Balasubramanian, Taylor P Kohn, Byung Ji, Asad Hasan, Alexander W Pastuszak, Larry I Lipshultz
OBJECTIVES: To determine if subclinical varicocele repair produces similar results to palpable varicocele repair. METHODS: Retrospective review was performed on 190 infertile men who underwent a microsurgical varicocele repair by two surgeons from 2009 to 2017. Improvement in total motile sperm count (TMC) that enables men limited to in vitro fertilization (IVF) or intrauterine insemination (IUI) to undergo IUI or natural conception ('upgrade') is clinically meaningful...
July 4, 2018: Urology
Pubali Mitra, Biswanath Maity, Dilip Kumar Pal, Madhusudan Das
OBJECTIVE: To investigate the potential contribution of PTH (parathyroid hormone) gene polymorphisms in kidney stone disease (KSD), a global clinical problem impacting major burden on public health care system worldwide. METHODS: A case-control study was performed in West Bengal (India) with 152 patients reported with calcium-rich stone in kidney and 144 corresponding normal healthy individuals as controls. To identify genetic variants of PTH, the entire coding region, exon-intron boundaries and a few hundred nucleotides downstream the exon 3 (3'UTR region) was bi-directionally sequenced for all the study participants...
July 1, 2018: Urology
Raul I Clavijo, Himanshu Arora, Eric Gibbs, Samuel Cohen, Anthony Griswold, Emre Bakircioglu, Guney Bademci, Mustafa Tekin, Ranjith Ramasamy
In this case report we describe our investigation into the genetic cause of infertility due to idiopathic non-obstructive azoospermia in a consanguineous Turkish family. We extracted DNA from blood and applied whole exome sequencing (WES) on four infertile brothers in this family diagnosed with oligo- and azoospermia. Standard bioinformatics analysis pipelines were run including alignment to the reference genome, variant calling, and quality control filtering. Potentially pathogenic variants were identified and prioritized using genetic variant annotation software and public variant frequency databases, followed by validation with Sanger sequencing...
June 29, 2018: Urology
Matias Ignacio Gonzalez, Maria Ercilia Zubieta, Jorge Horacio Jaunarena, Gabriel Andres Favre, Juan Carlos Tejerizo
OBJECTIVE: To review surgical outcomes in urinary undiversions and describe short and long-term complications. METHODS: Retrospective review of patients who underwent urinary undiversion in our institution between May 2010 and May 2016. Complications were graded according to the Clavien classification. All patients completed the Patient Global Impression of Improvement questionnaire (PGI-I) to indicate overall satisfaction with urinary undiversion. RESULTS: Median time from the cystectomy to undiversion was 29 months (range 11-53 months)...
June 29, 2018: Urology
Kymora B Scotland, Nir Kleinmann, Dillon Cason, Logan Hubbard, Ryuta Tanimoto, Kelly A Healy, Scott G Hubosky, Demetrius H Bagley
OBJECTIVES: To evaluate the effectiveness of ureteroscopy (URS) with laser ablation as an alternative treatment for UTUC lesions larger than 2 cm. Traditionally, patients with large upper tract urothelial carcinoma (UTUC) are treated with radical nephroureterectomy (RNU). However, in patients with pre-existing renal disease, a solitary kidney, or those who decline RNU, management of UTUC may prove challenging METHODS: An institutional database review identified 80 patients with biopsy proven low grade UTUC who had at least one lesion larger than 2 cm...
June 29, 2018: Urology
Amin Katherine A, Vertosick Emily A, Stearns Gillian, Fathollahi Ali, Sjoberg Daniel D, Donat S Machele, Herr Harry, Bochner Bernard, Dalbagni Guido, Sandhu Jaspreet S
OBJECTIVE: To determine predictors of symptomatic uretero-enteric anastomotic strictures (UAS) formation following radical cystectomy (RC) and urinary diversion (UD). MATERIALS AND METHODS: 2,888 consecutive patients who underwent open RC at our institution from 1995-2014 were included for analysis. Data was collected from institutional databases and individual medical records. Symptomatic benign UAS was defined as percutaneous nephrostomy tube insertion for rising creatinine or unilateral hydronephrosis comparing pre- and post-operative imaging...
June 29, 2018: Urology
Armando J Lorenzo, Mandy Rickard, Luis H Braga, Yanbo Guo, John-Paul Oliveria
OBJECTIVE: To explore the potential value of utilizing a commercially available cloud based machine learning platform to predict surgical intervention in infants with prenatal hydronephrosis (HN). MATERIALS AND METHODS: A prospective prenatal HN database was uploaded into Microsoft® Azure Machine Learning Studio. Probabilistic principal component analysis was employed for data imputation. Multiple clinical variables were included in two-class decision jungle and neural network for model training, using surgical intervention as the primary outcome...
June 29, 2018: Urology
Philip Dundee, Tobias Gross, Diarmaid Moran, Andrew Ryan, Zita Ballok, Justin Peters, Anthony Costello
OBJECTIVES: To assess the performance of Ga-PSMA PET for positive lymph nodes on imaging after curatively intended radical prostatectomy. PATIENTS AND METHODS: Seventeen patients with biochemical recurrence after radical prostatectomy undergoing robot assisted salvage lymphadenectomy for positive lymph nodes on imaging were included in this single surgeon study. The performance of Ga-PSMA PET was assessed on a per patient, per lesion, per landing site and per laterality level using sensitivity, specificity, negative and positive predictive value analysis...
June 28, 2018: Urology
Paholo G Barboglio Romo, John T Stoffel
No abstract text is available yet for this article.
June 28, 2018: Urology
Justin S Han
No abstract text is available yet for this article.
June 28, 2018: Urology
Arun Rai, Jason M Scovell, Ang Xu, Adithya Balasubramanian, Ryan Siller, Taylor Kohn, Young Moon, Naveen Yadav, Richard E Link
OBJECTIVES: To test a novel visuospatial testing platform improve trainee ability to convert two-dimensional (2D) to three-dimensional (3D) space. METHDOS: Medical students were recruited from Baylor College of Medicine and McGovern Medical School (Houston, TX). We 3D reconstructed three partial nephrectomy cases using a novel, rapid and highly accurate edge-detection algorithm. Patient-specific reconstructions were imported into the dV-Trainer (Mimics Technologies, Seattle, WA) and used to generate custom 3D printed physical models...
June 27, 2018: Urology
Wesley R Baas, Michael J Butcher, Aye Lwin, Bradley Holland, Michelle Herberts, Joseph Clemons, Kristin Delfino, Stanley Althof, Tobias S Kohler, Kevin T McVary
OBJECTIVE: To quantify reports made to the Food and Drug Administration Adverse Event Reporting System (FAERS), create a demographic of patient reports, and examine the cluster of symptoms to correlate consistency of post-finasteride syndrome (PFS) complaints. PFS is a provisional diagnosis encompassing a cluster of sexual, physical, and psychological/neurologic symptoms associated with 5-alpha reductase inhibitor (5ARI) use that emerge or continue after discontinuation of medication...
June 27, 2018: Urology
Daniel C Rosen, Muthumeena Kannappan, David J Paulucci, Alp Tuna Beksac, Kyrollis Attallah, Ronney Abaza, Daniel D Eun, Akshay Bhandari, Ashok K Hemal, James Porter, Ketan K Badani
OBJECTIVE: To explore whether variation of warm ischemia time (WIT) is associated with functional and perioperative outcomes following robotic partial nephrectomy (RPN). MATERIALS AND METHODS: 668 patients, each with two kidneys, undergoing RPNs for a cT1 tumor, were identified from a U.S. multi-institutional database. The associations between WIT, normal excisional volume loss (EVL), and surgical and renal function outcomes, including AKI at discharge and percent change in eGFR at up to 24 months post-RPN, were evaluated using Spearman's rank correlation test as well as multivariable models controlling for tumor, surgeon, and patient characteristics...
June 27, 2018: Urology
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