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Current Opinion in Urology

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https://www.readbyqxmd.com/read/28632505/obesity-and-prostate-cancer
#1
Marco Bandini, Giorgio Gandaglia, Alberto Briganti
PURPOSE OF REVIEW: To investigate the association between obesity and prostate cancer (PCa). RECENT FINDINGS: Obesity has been proposed to be involved in the pathogenesis of PCa through different biological mechanisms that include deregulation of the insulin axis, sex hormone secretion, adipokines signaling, and oxidative stress. Hypertrophic peritumoral adipocytes may also facilitate the local spread of PCa through the chemo-attraction of tumor cells. Clinical studies demonstrate that obesity might have clinical implications also in disease detection and management...
June 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28614086/the-present-and-future-of-prostate-cancer-histopathology
#2
Jesse K McKenney
PURPOSE OF REVIEW: The present review describes recent changes in the histologic grading of prostatic adenocarcinoma and emerging data suggesting areas for further grade optimization. RECENT FINDINGS: The grading of prostatic adenocarcinoma has evolved over time, and optimization for active surveillance management has been one major driving force. Recent changes include adoption of the Grade Group system, which stratifies patients into one of five prognostic groups...
June 12, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28614085/a-multiparametric-approach-to-improve-upon-existing-prostate-cancer-screening-and-biopsy-recommendations
#3
Brian T Helfand, Carly A Conran, Jianfeng Xu, William J Catalona
PURPOSE OF REVIEW: To provide an overview of how genetic, serum, and urine biomarkers can help identify men at high risk for prostate cancer (PCa) and aggressive disease and men who would benefit from prostate biopsy. RECENT FINDINGS: Screening for PCa is controversial because of concerns about overdiagnosis and overtreatment of nonlife-threatening tumors. Therefore, an approach to screening that includes a detailed family history with genetic testing of risk single nucleotide polymorphisms and high-penetrance genetic variants should be considered...
June 12, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28604411/metabolic-syndrome-and-voiding-dysfunction
#4
Omar Al Hussein Alawamlh, Bashir Al Hussein Al Awamlh, Richard K Lee
PURPOSE OF REVIEW: The metabolic syndrome (MetS) is an ever growing pandemic consisting of a constellation of abnormalities. Many hypotheses have been put forth to establish a link between this syndrome and voiding dysfunction. We created a layout of the possible, probable, and proven relationships connecting the MetS with voiding dysfunction in men. RECENT FINDINGS: There has been growing interest in the relationship linking MetS and voiding dysfunction, with or without benign prostatic hyperplasia, during the past several years...
June 9, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28590268/ar-v7-liquid-biopsy-for-treatment-stratification-in-prostate-cancer-how-close-are-we
#5
Claire Fletcher
PURPOSE OF REVIEW: Recent clinical introduction of the novel antiandrogen, Enzalutamide (Enza), CYP17 inhibitor, Abiraterone (Abi), and the second-generation chemotherapeutic, Cabazitaxel, has increased survival of patients with advanced, metastatic castration-resistant prostate cancer (mCRPC). However, de novo and acquired resistance rates are high. A liquid biopsy that can rapidly, sensitively and robustly identify which patients will respond to treatment in a minimally invasive manner is urgently required to permit switch to a potentially more efficacious drug regimen, thus increasing survival whilst avoiding debilitating side effects associated with unnecessary treatment...
June 5, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28562371/the-role-of-the-multiparametric-mri-in-the-diagnosis-of-prostate-cancer-in-biopsy-na%C3%A3-ve-men
#6
Adrian Rhudd, Jean McDonald, Mark Emberton, Veeru Kasivisvanathan
PURPOSE OF REVIEW: To review the role of prebiopsy multiparametric MRI in biopsy-naïve men for the detection of clinically significant prostate cancer. RECENT FINDINGS: Recent level 1 evidence shows that multiparametric MRI has high sensitivity and negative predictive value for the detection of clinically significant prostate cancer in biopsy-naïve men. Concurrent developments include important work in the standardization of MRI reporting. The low specificity and positive predictive value of MRI means that biopsy is still necessary following MRI...
May 29, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28570290/secondary-data-analysis-techniques-for-comparing-interventions-and-their-limitations
#7
Alexander P Cole, Quoc-Dien Trinh
PURPOSE OF REVIEW: Secondary data analysis has become increasingly common in health services research, specifically comparative effectiveness research. While a comprehensive study of the techniques and methods for secondary data analysis is a wide-ranging topic, we sought to perform a descriptive study of some key methodological issues related to secondary data analyses and to provide a basic summary of techniques to address them. RECENT FINDINGS: In this study, we first address common issues seen in analysis of secondary datasets, and limitations of datasets with respect to bias...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28505039/patient-reported-outcome-measures-in-urology
#8
Gopal L Narang, Stephanie C Pannell, Aaron A Laviana, Kathy H Y Huen, Jason Izard, Angela B Smith, Jonathan Bergman
PURPOSE OF REVIEW: Many urologic treatments have similar clinical outcomes, necessitating alternative methods to discriminate between options. Patient-reported outcome measures (PROMs) have become the new standard for evaluating the patient experience, and their use has drastically increased over the past decade. The purpose of this review is to discuss the status of PROMs in urology, highlight commonly used tools and address their future direction. RECENT FINDINGS: An increasing number of urology-specific PROMs tools have been developed and validated...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28505038/editorial
#9
Domenico Veneziano
No abstract text is available yet for this article.
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28505037/getting-ready-for-the-first-robotic-prostatectomy-from-basics-to-real-practice
#10
Christian Wagner, Victor Srougi, Rafael Sanchez-Salas
PURPOSE OF REVIEW: Robot-assisted radical prostatectomy (RARP) has been embraced by urologists and has become a treatment standard in many countries already. Learning how to perform a RARP is challenging and has not yet been standardized. The current review summarizes the latest concepts regarding the most effective way of training for RARP. RECENT FINDINGS: The strategy to learn RARP should comprise didactic activities, skills lab training, participating in surgeries and mentorship...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28459792/collaborative-quality-improvement
#11
Amy N Luckenbaugh, David C Miller, Khurshid R Ghani
PURPOSE OF REVIEW: Quality improvement collaboratives were developed in many medical and surgical disciplines with the goal of measuring and improving the quality of care provided to patients. The aim of this review is to provide an overview of surgical quality improvement collaboratives, and in particular those aimed at improving urological care. RECENT FINDINGS: Quality improvement collaboratives collect high-quality data using standardized methodologies, and use the data to provide feedback to physicians and practices, and then implement processes to improve patient outcomes...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28459791/healthcare-policy-and-urologic-practice
#12
Daniel Pitts, Jesse D Sammon
PURPOSE OF REVIEW: Healthcare policy is currently a topic of national debate, with numerous implications for the practice of urology. RECENT FINDINGS: Healthcare policy has broad reaching effects, both predicted and unforeseen. The effects of healthcare policy are manifested through clinical practice guidelines, payment reform and the overall structure of the healthcare system. This review describes each of these topics and their impact on clinical practice, with a specific focus on urology and urologic practice...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28445190/cognitive-learning-and-its-future-in-urology-surgical-skills-teaching-and-assessment
#13
Somayeh B Shafiei, Ahmed A Hussein, Khurshid A Guru
PURPOSE OF REVIEW: The aim of this study is to provide an overview of the current status of novel cognitive training approaches in surgery and to investigate the potential role of cognitive training in surgical education. RECENT FINDINGS: Kinematics of end-effector trajectories, as well as cognitive state features of surgeon trainees and mentors have recently been studied as modalities to objectively evaluate the expertise level of trainees and to shorten the learning process...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28441271/alternative-payment-models-and-urology
#14
Deborah R Kaye, David C Miller, Chad Ellimoottil
PURPOSE OF REVIEW: The Medicare Access and CHIP Reauthorization Act (MACRA) is a historic bill that was recently passed that establishes how quality measurement and practice patterns will affect physician reimbursement. Alternative payment models (APMs) are an essential component of MACRA and Medicare's vision of paying for high-value care. This review describes APMs in the context of MACRA and their impact on urology. RECENT FINDINGS: The majority of urologists will be affected by MACRA...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28441270/improving-quality-through-clinical-registries-in-urology
#15
Mark D Tyson, Daniel A Barocas
PURPOSE OF REVIEW: In this review, we highlight the use of clinical registries for quality improvement and research purposes in urology. We focus on national and regional clinical database registries, such as the National Surgical Quality Improvement Programme, the Cancer of the Prostate Strategic Urologic Research Endeavor, the Michigan Urological Surgery Improvement collaborative and the American Urological Association Quality Registry programme. RECENT FINDINGS: It is widely known that claims-based and institutional databases are limited in their capacity to provide granular, real-time data for quality improvement purposes...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28426464/comparative-effectiveness-in-urology-a-state-of-the-art-review-utilizing-a-systematic-approach
#16
Jathin Bandari, Charles B Wessel, Bruce L Jacobs
PURPOSE OF REVIEW: Comparative effectiveness research plays a vital role in healthcare delivery by guiding evidence-based practices. We performed a state-of-the-art review of comparative effectiveness research in the urology literature for 2016, utilizing a systematic approach. Seven high-impact papers are reviewed in detail. RECENT FINDINGS: Across the breadth of urology, there were several important studies in comparative effectiveness research, of which we will highlight two randomized controlled trials and five observational trials: radiotherapy, prostatectomy, and active monitoring have equivalent mortality outcomes in patients with localized prostate cancer; the ideal modality of patient education is yet to be determined, and written education has minimal effect on patient perception of prostate specific antigen screening; robotic prostatectomy is associated with higher perioperative complication rates on a population basis; racial disparities exist in incontinence rates after treatment for localized prostate cancer, but not in irritative, bowel, or sexual function; androgen deprivation therapy is associated with higher fracture, peripheral artery disease, and cardiac-related complications than bilateral orchiectomy; robotic and open cystectomy offer comparable cancer-specific mortality and perioperative outcomes; and bonuses for low-cost hospitals can inadvertently reward low-quality hospitals...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28406847/nontechnical-skill-training-and-the-use-of-scenarios-in-modern-surgical-education
#17
Oliver Brunckhorst, Muhammad S Khan, Prokar Dasgupta, Kamran Ahmed
PURPOSE OF REVIEW: Nontechnical skills are being increasingly recognized as a core reason of surgical errors. Combined with the changing nature of surgical training, there has therefore been an increase in nontechnical skill research in the literature. This review therefore aims to: define nontechnical skillsets, assess current training methods, explore assessment modalities and suggest future research aims. RECENT FINDINGS: The literature demonstrates an increasing understanding of the components of nontechnical skills within surgery...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28406846/the-value-of-simulation-based-training-in-the-path-to-laparoscopic-urological-proficiency
#18
Ben S E P Van Cleynenbreugel, Ali S Gözen, Theodoros Tokas
PURPOSE OF REVIEW: Numerous factors have reduced the training opportunities of surgical residents in the operating room. There is also the question of patient's safety. This gives a need for increased training opportunities outside the operating room. We look if there is an added value in simulation-based training (SBT) in the acquisition of laparoscopic skills. RECENT FINDINGS: Incorporating SBT into the medical students curriculum reduces surgical complication rates in the operating room...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28403125/low-vs-high-fidelity-the-importance-of-realism-in-the-simulation-of-a-stone-treatment-procedure
#19
Piyush Sarmah, Jim Voss, Adrian Ho, Domenico Veneziano, Bhaskar Somani
PURPOSE OF REVIEW: Simulation training for stone surgery is now increasingly used as part of training curricula worldwide. A combination of low and high fidelity simulators has been used with varying degrees of 'realism' provided by them. In this review, we discuss low and high fidelity simulators used for ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) stone procedures with their advantages, disadvantages and future direction for endourological simulation surgery. The final goal will be to understand whether or not 'realism' has to be considered as a critical element in simulation for this field...
July 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28376513/the-role-of-environmental-stress-on-lower-urinary-tract-symptoms
#20
Melissa T Sanford, Larissa V Rodriguez
PURPOSE OF REVIEW: Lower urinary tract symptoms (LUTS) have been associated with comorbid conditions such as anxiety and depression. In addition, stress appears to influence the development or exacerbation of LUTS. This article seeks to review literature regarding the role of environmental stress on LUTS, focusing on findings presented in the last year. RECENT FINDINGS: Numerous authors have published on the impact early childhood experiences, acute and chronic stress, and psychiatric illness play in the development of LUTS...
May 2017: Current Opinion in Urology
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