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Current Urology Reports

Farnoosh Nik-Ahd, A Lenore Ackerman, Jennifer Anger
PURPOSE OF REVIEW: There are an estimated 33 million men and women with overactive bladder (OAB) in the USA. Despite the prevalence of OAB, it remains a frequently misdiagnosed condition. OAB has shared symptomatology with other common urologic conditions, namely recurrent urinary tract infections (UTIs). Here, we will review key distinguishing features of OAB that aid in establishing an accurate diagnosis and recent advances in OAB management. RECENT FINDINGS: Recent studies have shown that among women presenting with lower urinary tract symptoms, the majority were diagnosed with UTIs and treated without performing a urine culture as routine care...
September 13, 2018: Current Urology Reports
Cara E Morin, Morgan P McBee, Andrew T Trout, Pramod P Reddy, Jonathan R Dillman
PURPOSE OF REVIEW: In this article, we describe the basics of how magnetic resonance urography (MRU) is performed in the pediatric population as well as the common indications and relative performance compared to standard imaging modalities. RECENT FINDINGS: Although MRU is still largely performed in major academic or specialty imaging centers, more and more applications in the pediatric setting have been described in the literature. MRU is a comprehensive imaging modality for evaluating multiple pediatric urologic conditions combining excellent anatomic detail with functional information previously only available via renal scintigraphy...
September 11, 2018: Current Urology Reports
Toya S Pratt, Anne M Suskind
PURPOSE OF REVIEW: This review will highlight our current understanding of age-related changes in bladder function and propose important clinical considerations in the management of overactive bladder (OAB) specific to older women. RECENT FINDINGS: Frailty, functional and cognitive impairment, multimorbidity, polypharmacy, estrogen deficiency, and remaining life expectancy are important clinical factors to consider and may impact OAB symptom management in older women...
September 10, 2018: Current Urology Reports
Patricia M Zahner, Laura L Giusto, Howard B Goldman
PURPOSE OF REVIEW: Third-line therapies for patients with overactive bladder (OAB) can improve symptoms for those who have failed conservative therapies. Options include percutaneous tibial nerve stimulation (PTNS), cystoscopic injection of onabotulinumtoxinA (BTX-A), and sacral neuromodulation (SNM). This paper aims to review the current literature on the treatment of patients with idiopathic OAB who have undergone BTX-A injections and have not responded or have undesirable side effects from the therapy...
September 8, 2018: Current Urology Reports
Rose Leu, Gillian L Stearns
PURPOSE OF REVIEW: Adherence to anticholinergic medications is known to be a problem in patients with overactive bladder, with only 13.2% of patients continuing anticholinergic therapy beyond 1 year D'Souza et al. (J Manag Care Pharm. 14:291-301, 2008). RECENT FINDINGS: Prior to the advent of third line therapies such as onabotulinumtoxin A, refractory overactive bladder (OAB) was managed with augmentation cystoplasty, a lengthy surgery with associated side effects including lifetime need for self-catheterization, ileus, and metabolic disturbances...
September 7, 2018: Current Urology Reports
Aaron D Coleman, Janeen L Arbuckle
PURPOSE OF REVIEW: Abnormal development of the uterus, cervix, and proximal 2/3 of the vagina results in Müllerian duct anomalies. Because of the close embryologic relationship between the developing female genital and urinary tracts, abnormalities of the urinary tract often accompany Müllerian duct anomalies. Magnetic resonance imaging (MRI) is the current gold standard-imaging modality in the evaluation of the anomalies of the female reproductive tract. This article discusses the imaging evaluation of Müllerian duct and accompanying urinary tract anomalies with a particular focus on the MRI findings...
September 6, 2018: Current Urology Reports
Nadir Zaidi, Dominique Thomas, Bilal Chughtai
PURPOSE OF REVIEW: To review the most up-to-date diagnosis and treatment of chronic prostatitis. We conducted a review of the literature based on the diagnosis and treatment of chronic prostatitis. RECENT FINDINGS: The use of advanced phenotyping, links to lifestyle, and multimodal approaches has helped to enhance the treatment of chronic prostatitis and its negative effects on quality of life. Chronic prostatitis is a common and complex condition that requires a multimodal approach to treat symptoms...
August 31, 2018: Current Urology Reports
Akbar N Ashrafi, Nima Nassiri, Inderbir S Gill, Mittul Gulati, Daniel Park, Andre L de Castro Abreu
PURPOSE OF REVIEW: Contrast-enhanced transrectal ultrasound (CeTRUS) is an emerging imaging technique in prostate cancer (PCa) diagnosis and treatment. We review the utility and implications of CeTRUS in PCa focal therapy (FT). RECENT FINDINGS: CeTRUS utilizes intravenous injection of ultrasound-enhancing agents followed by high-resolution ultrasound to evaluate tissue microvasculature and differentiate between benign tissue and PCa, with the latter demonstrating increased enhancement...
August 28, 2018: Current Urology Reports
Soo Jeong Kim, Omar Al Hussein Alawamlh, Bilal Chughtai, Richard K Lee
PURPOSE OF REVIEW: Transurethral resection of the prostate (TURP) is the standard surgical therapy for lower urinary tract symptoms (LUTS) due to prostatic enlargement. Following TURP, LUTS may persist in a proportion of patients. Persistent LUTS necessitates proper evaluation and management. In this review, we sought to describe the prevalence, pathophysiology, and predictors of LUTS following TURP, as well as the recommended evaluation and management. RECENT FINDINGS: Among the different techniques utilized for TURP, the prevalence of postoperative LUTS is similar...
August 20, 2018: Current Urology Reports
C R Powell
PURPOSE OF REVIEW: Sacral neuromodulation (SNM) is being used to treat lower urinary tract symptoms (LUTS) with growing popularity among clinicians in multiple specialties. As this therapy becomes more common in the USA and Europe, urologists will encounter more patients implanted with SNM generators. RECENT FINDINGS: Over time, it has recently been understood that up to 53% will develop pain at the implant site as reported by Groen et al. (J Urol 186:954, 2011) and 3-38% will lose effective stimulation as reported by Al-zahrani et al...
August 20, 2018: Current Urology Reports
Andrew Rabley, Tina O'Shea, Russell Terry, Sharon Byun, M Louis Moy
PURPOSE OF REVIEW: The purpose of this article is to review the available data regarding the application and therapeutic outcomes of laser therapy for the treatment of genitourinary syndrome of menopause (GSM). RECENT FINDINGS: There have been several studies regarding the use of laser therapy for the treatment of GSM. Most of these studies show a trend toward safe and effective treatment in the short term (less than or equal to 12 weeks). However, these studies are lacking in randomization, blinding, placebo, and comparison groups...
August 17, 2018: Current Urology Reports
Shane Pearce, Siamak Daneshmand
PURPOSE OF REVIEW: Endoscopy coupled with targeted resections represents a cornerstone in the diagnosis, staging, and treatment of patients with bladder cancer. Direct visualization can be challenging and imprecise due to patient-, tumor-, and surgeon-specific factors. We will review contemporary endoscopic technologies and techniques used to improve our ability to safely identify and resect malignant lesions in patients with bladder cancer. RECENT FINDINGS: Enhanced endoscopic imaging technology may improve detection rates for bladder cancer throughout the upper and lower urinary tract, which may lead to improvements in recurrence and progression rates for non-muscle invasive bladder cancer (NMIBC)...
August 17, 2018: Current Urology Reports
Yuval Freifeld, Lakshmi Ananthakrishnan, Vitaly Margulis
PURPOSE OF REVIEW: To summarize the literature providing the basic genetic and clinical characteristics of renal cell carcinoma (RCC) familial syndromes, as well as to describe associated unique imaging characteristics and appropriate imaging protocols. RECENT FINDINGS: At least 5-8% of RCC cases are associated with hereditary syndromes. These patients are prone to developing multiple renal tumors or associated malignancies and require more intense diagnostic and follow-up imaging studies...
August 16, 2018: Current Urology Reports
Lai Xu, Russell K Pachynski
PURPOSE OF REVIEW: Androgen deprivation therapy (ADT) has been the standard-of-care (SOC) for metastatic hormone-sensitive prostate cancer (mHSPC) since the middle of the twentieth century. Recently, several practice-changing trials have added new therapy options for these patients. Here we review these studies and discuss guidelines on treatment decision-making. RECENT FINDINGS: A trio of studies (GETUG-AFU15, STAMPEDE, CHAARTED) combining docetaxel chemotherapy with ADT all showed clinical benefit of the addition...
August 13, 2018: Current Urology Reports
Christine W Liaw, Jared S Winoker, Reza Mehrazin
PURPOSE OF REVIEW: To review the growth kinetics of small renal masses and available imaging modalities for mass characterization and surveillance, highlight current organizational recommendations for the active surveillance of small renal masses, and discuss the most recently reported oncological outcomes of patients as they relate to various surveillance imaging protocols and progression to delayed intervention. RECENT FINDINGS: Overall, organizational guideline recommendations are broad and lack specifics regarding timing and modality for follow-up imaging of small renal masses...
August 13, 2018: Current Urology Reports
James T Kearns, Daniel W Lin
PURPOSE OF REVIEW: Prostate cancer remains a significant public health burden. In order to decrease the morbidity and mortality associated with prostate cancer, serum prostate-specific antigen (PSA) screening has been used since the 1990s. However, there is concern for overdiagnosis of prostate cancer with widespread PSA screening, which could lead to overtreatment and its attendant morbidities. RECENT FINDINGS: In order to avoid unnecessary biopsy and downstream effects including treatment of insignificant prostate cancer, a number of tests have been proposed to improve upon PSA screening...
August 13, 2018: Current Urology Reports
Amelia Pietropaolo, Patrick Jones, Mike Moors, Brian Birch, Bhaskar K Somani
PURPOSE OF REVIEW: Intravesical antibiotics (IVA) has been used for prophylaxis and treatment of recurrent urinary tract infections (rUTIs). However, there is a lack of comprehensive evidence and consensus on its use. We conducted a systematic review to collect all available data about the effectiveness of IVA in prevention and treatment of rUTIs and to give an overview on the outcomes to date. METHODS: A systematic review was carried out for all English language articles from inception to August 2017, according to the Cochrane and PRISMA standards using MEDLINE, Scopus, Biomed Central, EMBASE, CINAHL, and Web of Science with references cross-checked and individual urology journals hand-searched...
August 9, 2018: Current Urology Reports
Ravindra Sahadev, Victoria Maxon, Arun Srinivasan
PURPOSE OF REVIEW: Traditional management of pediatric urolithiasis has been associated with a significant amount of radiation exposure. The steady increase in pediatric urolithiasis in recent years has raised concerns of long-term consequences in this special population. This review seeks to highlight the newer insights towards eliminating radiation exposure in pediatric urolithiasis from contemporary literature. RECENT FINDINGS: Establishing a clinical care pathway restricting usage of computed tomography in emergency rooms in suspected pediatric urolithiasis can eliminate unnecessary radiation exposure...
August 9, 2018: Current Urology Reports
Andrew J Gunn, Anand R Patel, Soroush Rais-Bahrami
PURPOSE OF REVIEW: To provide the technical aspects of, clinical indications for, status of the current literature on, and emerging concepts in trans-arterial embolization (TAE) for renal cell carcinoma. RECENT FINDINGS: TAE has been evaluated in several retrospective series as a neoadjuvant therapy prior to surgical resection of RCC to reduce tumor vascularity and minimize intra-operative blood loss. TAE has also been examined retrospectively as a neoadjuvant therapy prior to the percutaneous ablation of RCC to reduce blood loss and procedural complications...
August 8, 2018: Current Urology Reports
Felix Cheung, Jaspreet S Sandhu
PURPOSE OF REVIEW: Urinary dysfunction is a common entity in patients undergoing radical pelvic surgery for non-urologic malignancies. These dysfunctions may manifest as lower urinary tract symptoms (LUTS) or signs such as urinary retention or leakage. Review of current literature is performed to describe the differing urinary dysfunctions that manifest after colorectal resection, hysterectomy, and sacrectomy. RECENT FINDINGS: Conventional radical surgery for pelvic malignancies often will result in debilitating functional problems...
August 6, 2018: Current Urology Reports
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