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Current Urology Reports

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https://www.readbyqxmd.com/read/28444639/metformin-and-prostate-cancer-a-new-role-for-an-old-drug
#1
REVIEW
Jessica Whitburn, Claire M Edwards, Prasanna Sooriakumaran
PURPOSE OF REVIEW: Since epidemiological studies first demonstrated a potential positive effect of metformin in reducing cancer incidence and mortality, there has been an increased interest in not only better understanding metformin's mechanisms of action but also in exploring its potential anti-cancer effects. In this review, we aim to summarise the current evidence exploring a role for metformin in prostate cancer therapy. RECENT FINDINGS: Preclinical studies have demonstrated a number of antineoplastic biological effects via a range of molecular mechanisms...
June 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28417431/robotic-kidney-transplantation-an-update
#2
REVIEW
V Sankaran, S Sinha
PURPOSE OF REVIEW: Over the last decade, there have been advances in kidney transplantation with introduction of minimally invasive surgery. Robotic surgery is becoming increasingly common across the specialities. There is now increasing experience in robotic kidney transplantation, though it remains a niche procedure. Initial reports suggest that this is a safe, feasible operation when performed by teams familiar with robotic surgery. There have been a few modifications to the initially described procedure, as a result of increasing experience...
June 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28417430/the-emergence-of-kidney-stone-disease-during-childhood-impact-on-adults
#3
REVIEW
Jeremy R Bonzo, Gregory E Tasian
PURPOSE OF REVIEW: The goal of this chapter is to review the recent epidemiologic trends of kidney stone disease and discuss the impact of the increasing incidence of nephrolithiasis among children on adults with respect to extra-renal manifestations, surgical management, and secondary prevention. RECENT FINDINGS: Among pediatric patients, kidney stone disease has been increasing at a rate of approximately 5-10% annually. Kidney stone disease has been associated with increased risks of coronary heart disease, chronic kidney disease, hypertension, and decreased bone mineral density, which is concerning for patients diagnosed at a young age...
June 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28417429/approach-to-androgen-deprivation-in-the-prostate-cancer-patient-with-pre-existing-cardiovascular-disease
#4
REVIEW
Alyssa K Greiman, Thomas E Keane
PURPOSE OF REVIEW: Androgen deprivation therapy (ADT) is a mainstay of treatment for advanced prostate cancer. Several studies have reported an association between ADT and an increase in cardiovascular events, especially in those receiving gonadotropin-releasing hormone (GnRH) agonists compared to GnRH antagonists. We review the body of literature reporting the association of ADT and cardiovascular morbidity, and discuss the proposed mechanism of cardiovascular disease due to ADT including metabolic changes that may promote atherosclerosis and local hormonal effects that may increase plaque rupture and thrombosis...
June 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28417428/outcomes-of-minimally-invasive-inguinal-hernia-repair-at-the-time-of-robotic-radical-prostatectomy
#5
REVIEW
Francois G Soto-Palou, Ricardo F Sánchez-Ortiz
Abdominal straining associated with voiding dysfunction or constipation has traditionally been associated with the development of abdominal wall hernias. Thus, classic general surgery dictum recommends that any coexistent bladder outlet obstruction should be addressed by the urologist before patients undergo surgical repair of a hernia. While organ-confined prostate cancer is usually not associated with the development of lower urinary tract symptoms, a modest proportion of patients treated with radical prostatectomy may have coexisting benign prostatic hyperplasia with elevated symptom scores and hernias may be incidentally detected at the time of surgery...
June 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28417427/extraperitoneal-robot-assisted-radical-prostatectomy-indications-technique-and-outcomes
#6
REVIEW
Alice Semerjian, Christian P Pavlovich
PURPOSE OF REVIEW: Extraperitoneal robot-assisted radical prostatectomy (eRARP) is an alternative to the more commonly employed transperitoneal RARP (tRARP) for treatment of clinically localized prostate cancer. The purpose of this review is to discuss indications in which eRARP would be a more favorable approach in comparison to tRARP. In addition, we will discuss the safety and technique of eRARP. RECENT FINDINGS: Recently published work has highlighted the outcomes and safety of eRARP in comparison to tRARP; specifically that eRARP is not inferior to tRARP...
June 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28401476/robotic-buccal-ureteroplasty-a-review-of-the-current-literature
#7
REVIEW
Benjamin Waldorf, Ziho Lee, Laura Kidd, Joshua Kaplan, Andrew Harris, Michael Metro, Jeffrey Liu, Daniel Eun
PURPOSE OF REVIEW: This study aimed to provide an overview of the literature on buccal mucosal ureteroplasty for ureteral stricture disease, with a specific focus on the application of the robotic platform to buccal ureteroplasty. RECENT FINDINGS: In our review, we highlight the results of Zhao et al. from the New York University School of Medicine Department of Urology, as well as our own results from Temple University Hospital. Zhao et al. published the first series of four patients who underwent robotic buccal ureteroplasty...
May 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28324275/the-impact-of-blue-light-cystoscopy-on-the-diagnosis-and-treatment-of-bladder-cancer
#8
REVIEW
Eugene J Pietzak
Photodynamic diagnostic technique with blue light cystoscopy (BLC) takes advantage of the preferential uptake and accumulation of protoporphyrins in neoplastic tissue which emit a red fluorescence when illuminated with blue light (360-450 nm wavelengths). This allows enhanced visualization of small papillary tumors and flat carcinoma in situ lesions that might have been missed on white light cystoscopy (WLC). There is compelling evidence that the ability of BLC to detect these additional tumors translates into improved recurrence rates compared to WLC...
May 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28315171/the-dilemma-of-adolescent-varicoceles-do-they-really-have-to-be-repaired
#9
REVIEW
Bryan S Sack, Mattias Schäfer, Michael P Kurtz
The primary indication for varicocele repair in adults, that of failed paternity, must be substituted in the adolescent population with surrogate parameters of testicular size differential and semen analysis. Making recommendations based on these two parameters is incredibly difficult because studies often have contradictory findings, different patient populations, and lack of long-term follow up of the key endpoint, paternity. Therefore, it is not a surprise that recommendations for adolescent varicocele repair are general (with some exceptions) and necessarily so because of limitations in quality of evidence...
May 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28303512/robot-assisted-simple-prostatectomy-expanding-on-an-established-operative-approach
#10
REVIEW
Ross Cockrell, David I Lee
PURPOSE OF REVIEW: The leading cause of voiding dysfunction in older men is benign prostatic obstruction. In the setting of a grossly enlarged prostate (>80cm(3)), an open simple prostatectomy has been the gold standard for surgical treatment. Here, we will discuss the minimally invasive robot-assisted approach and compare it to the classic open approach and holmium laser enucleation of the prostate. RECENT FINDINGS: Literature on robot-assisted simple prostatectomy, in concurrence with our institutional experience, has shown an overall lower morbidity, shorter hospital stay, and decreased indwelling catheter time, with equivalent functional outcomes compared to open simple prostatectomy...
May 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28299630/the-role-of-interventional-radiology-techniques-in-the-management-of-renal-angiomyolipomas
#11
REVIEW
Ryan M Kiefer, S William Stavropoulos
PURPOSE OF REVIEW: Although benign, renal angiomyolipoma (AML) may lead to serious complications without appropriate management. The purpose of this review is to describe the role of and evidence for interventional radiology techniques in the management of patients with AML. RECENT FINDINGS: For patients with renal masses and non-diagnostic imaging studies, image-guided percutaneous biopsy is found to be highly accurate and useful in directing patient management...
May 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28285380/urological-outcomes-of-myelomeningocele-and-lipomeningocele
#12
REVIEW
Yvonne Y Chan, Samantha K Sandlin, Eric A Kurzrock
PURPOSE OF REVIEW: Spina bifida is caused by incomplete neural tube closure during the first trimester. This condition may lead to bowel and bladder dysfunction as well as truncal weakness and motor anomalies. Presentations vary between myelomeningoceles and lipomeningoceles and may result in different outcomes. This review seeks to explore our current understanding of the variations in outcomes between individuals with myelomeningocele and lipomeningocele. RECENT FINDINGS: Prenatal intervention has become a standard of care for prenatal diagnoses of myelomeningocele and has been shown to reduce shunt placement and improve motor skills...
May 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28283915/management-of-voiding-dysfunction-after-female-neobladder-creation
#13
REVIEW
Nathan Y Hoy, Joshua A Cohn, Casey G Kowalik, Melissa R Kaufman, W Stuart Reynolds, Roger R Dmochowski
PURPOSE OF REVIEW: Functional complications after orthotopic neobladder urinary diversion (ONB), including urinary incontinence and urinary retention, present unique challenges. The purpose of this review is to outline contemporary treatment options for voiding dysfunction after ONB in females. RECENT FINDINGS: Meticulous surgical technique in the form of urethral nerve-sparing has been shown to play an important role in maintaining continence, as has sparing the uterus when possible...
May 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28283914/transurethral-resection-of-bladder-tumors-improving-quality-through-new-techniques-and-technologies
#14
REVIEW
Daniel Zainfeld, Siamak Daneshmand
PURPOSE OF REVIEW: Cystoscopy with transurethral resection of bladder tumors (TURBT) is essential in the diagnosis of bladder cancer as well as the management of non-muscle-invasive disease yet remains a comparatively imprecise procedure secondary to variability among patients, tumors, and surgeons alike. We will review evolving technologies and techniques used to enhance safety and efficacy of TURBT performance and education in the management of bladder cancer. RECENT FINDINGS: Though a generally safe procedure, efficacy of TURBT in terms of complete tumor excision, appropriate pathologic diagnosis, and absence of complications can vary significantly with direct impact on patient outcomes...
May 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28271355/to-dust-or-not-to-dust-a-systematic-review-of-ureteroscopic-laser-lithotripsy-techniques
#15
REVIEW
Javier E Santiago, Adam B Hollander, Samit D Soni, Richard E Link, Wesley A Mayer
PURPOSE OF REVIEW: This review discusses factors affecting outcomes during ureteroscopy (URS) with laser lithotripsy (LL), explores specific clinical challenges to the efficacy of URS LL, and reviews the available literature comparing the dusting and basketing approaches to URS LL. RECENT FINDINGS: Data show high stone-free rates with URS LL in all locations of the urinary tract and with all stone types and sizes. Recent data comparing LL with dusting versus basketing suggest higher rates of residual fragments with dusting but less utilization of ureteral access sheaths and potentially shorter operative times...
April 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28251485/endoscopic-treatment-of-upper-tract-urothelial-carcinoma
#16
REVIEW
Daniel P Verges, Costas D Lallas, Scott G Hubosky, Demetrius H Bagley
PURPOSE OF REVIEW: This study aims to make the reader be aware of recent trends regarding the endoscopic management of upper tract urothelial carcinoma (UTUC) via review of the urologic literature over the past 5 years. Given the rare incidence of this disease, and the lack of level 1 evidence, systematic reviews and meta-analyses were also evaluated. Studies of importance are also considered and outlined in the annotated reference section. RECENT FINDINGS: The PubMed database was queried using the following medical subject headings (MeSH terms): "carcinoma, transitional cell," "ureter," "ureteral neoplasms," "kidney pelvis," "endoscopy," "laser therapy," "ureteroscopy," "urologic surgical procedures," and "ureteroscopes...
April 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28251484/update-on-renal-mass-biopsy
#17
REVIEW
Miki Haifler, Alexander Kutikov
Renal masses are diagnosed with an increasing frequency. However, a significant proportion of these masses are benign, and the majority of malignant tumors are biologically indolent. Furthermore, renal tumors are often harbored by the elderly and comorbid patients. As such, matching of renal tumor biology to appropriate treatment intensity is an urgent clinical need. Renal mass biopsy is currently a very useful clinical tool that can assist with critical clinical decision-making in patients with renal mass...
April 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28247328/prone-versus-supine-percutaneous-nephrolithotomy-what-is-your-position
#18
REVIEW
Roshan M Patel, Zhamshid Okhunov, Ralph V Clayman, Jaime Landman
PURPOSE OF REVIEW: Percutaneous nephrolithotomy (PCNL) is the gold standard surgical procedure for treating large, complex renal stones. Due to its challenging nature, PCNL has undergone many modifications in surgical technique, instruments, and also in patient positioning. Since the first inception of PCNL, prone position has been traditionally used. However, alternative positions have been proposed and assessed over the years. This is a comprehensive review on the latest developments related to positioning in the practice of PCNL...
April 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28247327/extracorporeal-shock-wave-therapy-current-perspectives-and-future-directions
#19
REVIEW
Andrew C Lawler, Eric M Ghiraldi, Carmen Tong, Justin I Friedlander
PURPOSE OF REVIEW: Since its introduction, extracorporeal shock wave lithotripsy (ESWL) has undergone a variety of changes; however, it remains one of the most utilized treatment modalities for urolithiasis. The goal of this review is to provide the practicing urologist an update on contemporary trends, new technologies, and related controversies in utilizing ESWL for stone treatment. RECENT FINDINGS: ESWL use has come under scrutiny with a shift in focus to cost-effectiveness and healthcare outcomes...
April 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28247326/reconstructive-management-options-of-delayed-complications-following-bladder-outlet-surgery
#20
REVIEW
Nora Baker, Carmen Tong, Jay Simhan
PURPOSE OF REVIEW: Technological advancements in urologic endoscopy within the last decades have improved outcomes following bladder outlet reduction surgery while minimizing risks of short- and intermediate-term complications. This review aims to examine late complications of endoscopic reduction of the prostate and the various treatment options available. RECENT FINDINGS: Urinary incontinence, ejaculatory dysfunction, urethral strictures, bladder neck contractures, and fistula formations are the most common delayed complications following bladder outlet reduction surgery...
April 2017: Current Urology Reports
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