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Current Opinion in Urology

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https://www.readbyqxmd.com/read/28505039/patient-reported-outcome-measures-in-urology
#1
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...
May 12, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28505038/editorial
#2
Domenico Veneziano
No abstract text is available yet for this article.
May 12, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28505037/getting-ready-for-the-first-robotic-prostatectomy-from-basics-to-real-practice
#3
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...
May 12, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28459792/collaborative-quality-improvement
#4
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...
April 28, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28459791/healthcare-policy-and-urologic-practice
#5
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...
April 28, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28445190/cognitive-learning-and-its-future-in-urology-surgical-skills-teaching-and-assessment
#6
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...
April 25, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28441271/alternative-payment-models-and-urology
#7
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...
April 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28441270/improving-quality-through-clinical-registries-in-urology
#8
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...
April 22, 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
#9
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...
April 19, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28406847/nontechnical-skill-training-and-the-use-of-scenarios-in-modern-surgical-education
#10
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...
April 12, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28406846/the-value-of-simulation-based-training-in-the-path-to-laparoscopic-urological-proficiency
#11
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...
April 12, 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
#12
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...
April 11, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28376513/the-role-of-environmental-stress-on-lower-urinary-tract-symptoms
#13
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
https://www.readbyqxmd.com/read/28376512/improving-the-evaluation-and-diagnosis-of-clinically-significant-prostate-cancer
#14
Oleksandr N Kryvenko, Jonathan I Epstein
PURPOSE OF REVIEW: This chapter describes important changes in the clinical practice and pathological interpretation of prostate cancer (PCa) that stratify PCa into insignificant and significant disease to allow for better patient management and treatment decisions. RECENT FINDINGS: Among the most important changes over the last half a decade has been the change in PCa grading. A new grading system has been developed that is more patient-centric with more accurate stratification according to risk of disease progression...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28319478/recent-developments-of-the-pelvic-floor-and-lower-urinary-tract-symptoms
#15
Karl-Dietrich Sievert
No abstract text is available yet for this article.
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28319477/emerging-techniques-in-truly-minimal-invasive-treatment-options-of-benign-prostatic-obstruction
#16
Karl-Dietrich Sievert, Thomas Kunit
PURPOSE OF REVIEW: Benign prostatic enlargement is a common age-related condition, affecting over 50% of men aged more than 60 years. Side effects of medical therapy and significant morbidity of transurethral resection of the prostate and open surgery led to the development of so-called minimally invasive procedures, with the aim to be efficient but with less morbidity and shorter or no hospitalization. For this review, a systematic literature was performed. We report recent results in different treatment options for benign prostate hypoplasia (BPH) and recommend the best minimal-invasive treatment for BPH...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28306604/role-of-mri-in-low-risk-prostate-cancer-finding-the-wolf-in-sheep-s-clothing-or-the-sheep-in-wolf-s-clothing
#17
Ivo G Schoots, Caroline M Moore, Olivier Rouvière
PURPOSE OF REVIEW: In men on active surveillance for localized prostate cancer, MRI and MRI-targeted biopsies can be used prior to confirmatory or surveillance biopsy, to detect individuals with high-grade cancer (the wolf in sheep's clothing). However, some men will have low-risk disease despite adverse MRI findings (the sheep in wolf's clothing). We review the value addition of MRI-targeted biopsies in comparison to systematic transrectal ultrasound-guided biopsies, using pathological reclassification as an end-point...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28306603/current-treatment-of-pelvic-organ-prolapse-correlated-with-chronic-pelvic-pain-bladder-and-bowel-dysfunction
#18
Bernhard Liedl, Klaus Goeschen, Leopold Durner
PURPOSE OF REVIEW: The purpose of this review is to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction and pelvic organ prolapse (POP) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments. RECENT FINDINGS: In this review, we provide evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28267057/female-pelvic-floor-biomechanics-bridging-the-gap
#19
Deanna C Easley, Steven D Abramowitch, Pamela A Moalli
PURPOSE OF REVIEW: The pelvic floor is a complex assembly of connective tissues and striated muscles that simultaneously counteracts gravitational forces, inertial forces, and intra-abdominal pressures while maintaining the position of the pelvic organs. In 30% of women, injury or failure of the pelvic floor results in pelvic organ prolapse. Surgical treatments have high recurrence rates, due, in part, to a limited understanding of physiologic loading conditions. It is critical to apply biomechanics to help elucidate how altered loading conditions of the pelvis contribute to the development of pelvic organ prolapse and to define surgeries to restore normal support...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28267056/active-surveillance-for-low-risk-prostate-cancer
#20
Laurence Klotz
PURPOSE OF REVIEW: The approach of active surveillance for low-risk prostate cancer has evolved in many ways since its introduction 20 years ago. There is a great deal of ongoing research addressing the molecular genetics and clinical outcome of low-risk disease, the use of MRI and biomarkers, and the role of lifestyle and dietary modifications. The major developments in the field are reviewed in this article. RECENT FINDINGS: Low risk and many cases of low-intermediate risk prostate cancer are indolent, have little or no metastatic potential, and do not pose a threat to the patient in his lifetime...
May 2017: Current Opinion in Urology
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