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Current Opinion in Urology

Philipp Dahm, Jae H Jung
No abstract text is available yet for this article.
March 13, 2018: Current Opinion in Urology
Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
Shamar Young, Jafar Golzarian
PURPOSE OF REVIEW: Over the last several years prostate artery embolization (PAE) has been developed as a minimally invasive technique for the treatment of benign prostatic hyperplasia induced lower urinary tract symptoms. This review aims to elucidate the data available on this developing technique and identify areas requiring further investigation. RECENT FINDINGS: Recent studies have demonstrated that PAE is able to deliver excellent clinical outcomes in terms of International Prostate Symptom Score, quality-of-life score, maximum urinary flow rate, post-void residual, and prostate volume reduction...
March 13, 2018: Current Opinion in Urology
Giuseppe Magistro, Philipp Weinhold, Christian G Stief, Christian Gratzke
PURPOSE OF REVIEW: The main objective of novel minimally invasive treatment options is to provide relief of bothersome lower urinary tract symptoms (LUTS) equally effective to current standard techniques, but with a more favorable safety profile. Here we present the first clinical experience with the prostatic urethral lift (Urolift) and the convective water vapor energy ablation (Rezūm). RECENT FINDINGS: Urolift offers rapid and durable relief of LUTS with complete preservation of sexual function...
March 13, 2018: Current Opinion in Urology
Bente T Jensen, Susanne V Lauridsen, Jørgen B Jensen
PURPOSE OF REVIEW: Whether prehabilitation in radical cystectomy adds to the effort of reducing postoperative morbidity and impairments in the survivorship phase has until recently received limited attention. This narrative review aims to summarize the current evidence base on prehabilitaion interventions focusing on the efficacy of procedure-specific interventions and the influence on postoperative outcomes. RECENT FINDINGS: Given the oncological risk, there is a relative short window to intervene and proactively optimize the patient before radical cystectomy...
March 13, 2018: Current Opinion in Urology
Tim Large, Amy E Krambeck
PURPOSE OF REVIEW: Holmium laser enucleation of the prostate (HoLEP) has been a mainstay therapy for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH) for nearly 20 years. We briefly review current and sentinel publications that provide outcomes data after HoLEP. RECENT FINDINGS: Current literature continues to support HoLEP as a versatile and durable surgical option for men with LUTS secondary to BPH. Despite evidence supporting durable symptom relief beyond 10 years even in large prostate glands, HoLEP is still not widely available to all patients...
March 13, 2018: Current Opinion in Urology
Joseph Acquaye, Michael S Borofsky
PURPOSE OF REVIEW: As benign prostatic hypertrophy (BPH) becomes a more common disease, there has been a dramatic rise in the number of investigational procedures being developed to manage it. We seek to present an overview of the most recently developed treatments and present clinical data related to application wherever available. RECENT FINDINGS: As a greater number of treatments become available for BPH, improved diagnostic testing could prove beneficial in helping guide patient selection...
March 9, 2018: Current Opinion in Urology
Matthew G Crockett, Marcus J Drake
PURPOSE OF REVIEW: Benign prostatic obstruction (BPO) is a common cause of lower urinary tract symptoms (LUTS) in elderly men. However, such symptoms are often caused by primary detrusor overactivity or underactivity. Surgical management where BPO is absent or merely incidental has a lower chance of success, and exposes the patient to the potential complications of surgery. This review discusses the diagnostic challenges facing this common presentation. RECENT FINDINGS: Most evidence comes from small, historical prospective cohort studies...
March 9, 2018: Current Opinion in Urology
Joo Yong Lee, Kang Su Cho
PURPOSE OF REVIEW: The use of 5-alpha reductase inhibitors (5ARIs) for the treatment of benign prostatic hyperplasia (BPH) and other diseases has been proposed and studied. However, the controversy about its benefits and harms for other diseases has persisted. In this review, we will discuss the newly identified effects of 5ARIs based on recently published studies. RECENT FINDINGS: These drugs are currently recommended in clinical guidelines for BPH. However, the reporting of adverse effects, including sexual dysfunction as well as neurologic, endocrine, and cardiovascular effects, have been controversial...
March 9, 2018: Current Opinion in Urology
Randy Vince, Lance J Hampton, Mihai D Vartolomei, Shahrokh F Shariat, Francesco Porpiglia, Riccardo Autorino
PURPOSE OF REVIEW: Robotic assisted simple prostatectomy (RASP) represents a minimally invasive evolution of traditional open simple prostatectomy for the surgical treatment of severe lower urinary tract symptoms (LUTS) because of benign prostatic enlargement (BPE). Aim of the present review is to summarize the most recent evidence on this novel procedure, and to better define its current role in the surgical armamentarium for the treatment of BPE. RECENT FINDINGS: Several studies demonstrated that RASP can be safely and effectively performed in centers with sufficient expertise...
March 9, 2018: Current Opinion in Urology
Livio Mordasini, Marco Moschini, Agostino Mattei, Christophe Iselin
PURPOSE OF REVIEW: GreenLight photoselective vaporization (GL-PV) is now established in the treatment of benign prostatic enlargement. The present review outlines the available technical armamentarium and summarizes the current best evidence on functional and safety outcomes. Moreover, future technical developments and refinements are presented. RECENT FINDINGS: GL-PV has evolved to be the most commonly performed procedure, second to conventional transurethral resection of the prostate (TURP) for surgical management of benign prostatic obstruction (BPO)...
March 9, 2018: Current Opinion in Urology
Janet E Baack Kukreja
PURPOSE OF REVIEW: Venous thromboembolism (VTE) is a common complication during the perioperative period for major urologic oncology operations. The present review focuses on the risk factors, the mechanisms of hypercoagulability in this patient population, and the timing and prevention of VTE. RECENT FINDINGS: Although the vast majority of patients undergoing major urologic oncology operations do not develop VTEs, when they do develop they can be fatal. The risk factors for VTEs are important to identify in this patient population...
February 19, 2018: Current Opinion in Urology
Pietro Grande, Riccardo Campi, Morgan Rouprêt
PURPOSE OF REVIEW: Hospital and surgical volumes, as well as complications, are considered to influence intra and postoperative results in most surgical operations. This trend is also seen in uro-oncologic surgery. The objective of this review is to critically analyze the most recent literature to give a comprehensive overview on whether surgical and hospital volumes have an impact, and whether regionalization of the procedure should be advised. RECENT FINDINGS: Uro-oncologic surgery has recently become more regionalized, and data coming from different population-based analyses appear to support this trend...
February 15, 2018: Current Opinion in Urology
Alex Gomelsky, Emily F Kelly, David C Dalton
PURPOSE OF REVIEW: Although alpha-adrenergic antagonists (α-blockers) are effective for relieving voiding lower urinary tract symptoms (LUTS) in men, storage symptoms often persist. The aim of this manuscript is to evaluate the efficacy and safety of combination therapy with α-blockers and muscarinic receptor antagonists (anticholinergics). RECENT FINDINGS: High-quality evidence confirms that the addition of an anticholinergic improves micturition diary parameters, such as daytime and nocturnal frequency and urgency incontinence episodes, as well as total and storage subset scores on the International Prostate Symptom Score...
February 9, 2018: Current Opinion in Urology
Alexa R Meyer, Mohamad E Allaf, Steven P Rowe, Michael A Gorin
PURPOSE OF REVIEW: To explore the role of molecular imaging in the characterization of renal masses. RECENT FINDINGS: Incidentally detected renal masses exhibit variable malignant potential related to their underlying histology. Patients presenting with a renal mass should undergo individual risk stratification including characterization of their tumor histology. At the present time, anatomical imaging techniques are unable to reliably distinguish between the various renal tumor subtypes...
January 11, 2018: Current Opinion in Urology
Benjamin Namdarian, Prokar Dasgupta
PURPOSE OF REVIEW: The purpose of this review is to summarize the status of robotic surgery currently, contextualizing the advances and improvements we can expect in the immediate future. Robotics continues to demonstrate increased utility and expansion in medicine, particularly surgery. When coupled with the imminent expiry of Intuitive patents in the next few years, it is timely to consider what we can expect to see from new platforms; what new features might we anticipate and what technology will be available to enhance and improve patient care...
January 4, 2018: Current Opinion in Urology
Franck Bruyère, Nicolas Doumerc
PURPOSE OF REVIEW: Kidney transplantation is the preferred modality for the treatment of patients with end-stage renal disease. Robot-assisted kidney transplantation (RAKT) has been in use since 2002 to reduce morbidity in open kidney transplantation. The aim of this review is to highlight the most relevant publications on this challenging surgical topic. RECENT FINDINGS: Recent publications suggest that minimally invasive techniques in kidney transplantation, including RAKT, have shown promising results particularly with regard to complications and recovery, reducing postoperative pain and analgesic requirement with a better cosmetic result...
January 4, 2018: Current Opinion in Urology
Beat Foerster, Shoji Kimura, Mihai D Vartolomei, Mohammad Abufaraj, Kilian Gust, Harun Fajkovic, Shahrokh F Shariat, Christian Seitz
PURPOSE OF REVIEW: Various ischemia type during partial nephrectomy for renal cell cancer (RCC) resulted in different postoperative functional outcomes. Our objective was to systematically review the contemporary literature on robot-assisted partial nephrectomy (RPN) and investigate the association of ischemia type and tumor complexity with postoperative functional outcomes of the operated kidney and overall. RECENT FINDINGS: Forty-five of the 99 reports identified were selected for qualitative analysis...
December 22, 2017: Current Opinion in Urology
Justin Ferdinandus, John Violet, Shahneen Sandhu, Michael S Hofman
PURPOSE OF REVIEW: Prostate-specific membrane antigen (PSMA) theranostics offers a new approach for a personalized and targeted treatment for metastatic prostate cancer. Lutetium-177-labelled PSMA-ligands (Lu-PSMA) is a radionuclide therapy that is directed to PSMA expressing prostate cancer. Clinical experience with Lu-PSMA in men with advanced prostate cancer is growing. The purpose of this review is to outline the mechanism of action of this therapy, summarize recent efficacy and toxicity data and highlight future direction and challenges in establishing Lu-PSMA treatment as part of routine clinical practice...
December 22, 2017: Current Opinion in Urology
Matthias N van Oosterom, Henk G van der Poel, Nassir Navab, Cornelis J H van de Velde, Fijs W B van Leeuwen
PURPOSE OF REVIEW: To provide an overview of the developments made for virtual- and augmented-reality navigation procedures in urological interventions/surgery. RECENT FINDINGS: Navigation efforts have demonstrated potential in the field of urology by supporting guidance for various disorders. The navigation approaches differ between the individual indications, but seem interchangeable to a certain extent. An increasing number of pre- and intra-operative imaging modalities has been used to create detailed surgical roadmaps, namely: (cone-beam) computed tomography, MRI, ultrasound, and single-photon emission computed tomography...
December 22, 2017: Current Opinion in Urology
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