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Therapeutic Advances in Urology

Brian L Meyerson, Justin Streicher, Abhinav Sidana
No abstract text is available yet for this article.
November 2018: Therapeutic Advances in Urology
Amy Marcia Pearlman, Vaidehi Mujumdar, Kara Elizabeth McAbee, Ryan Patrick Terlecki
Background: Reconstruction for complex urethral strictures may necessitate grafting. Buccal mucosal graft (BMG) harvest involves additional morbidity, making 'off-the-shelf' options attractive. Multiple extracellular matrices (ECMs) have been used with varying degrees of success. We reviewed our experience with MatriStem (ACell, Inc., Columbia, MD, USA) to assess safety and clinical/histologic outcomes. Methods: All patients undergoing acellular matrix-based reconstruction were included...
November 2018: Therapeutic Advances in Urology
Daniele Castellani, Roberto Starnari, Lucia Faloia, Massimo Stronati, Alfredo Venezia, Luca Gasparri, Redi Claudini, Alessandro Branchi, Marina Giampieri, Marco Dellabella
Background: Radical cystectomy (RC) is the gold standard therapy in nonmetastatic muscle-invasive bladder cancer and is usually performed under general anesthesia (GA). GA is high risk in most older patients due to comorbidities. Continuous spinal anesthesia (CSA) may be an alternative solution to reduce postoperative morbidity in elderly. The aim of this study was to assess the feasibility, morbidity, and mortality of RC performed under CSA in octogenarian patients. Methods: We retrospectively reviewed data of five frail patients aged ⩾80 who underwent RC in CSA...
November 2018: Therapeutic Advances in Urology
Piotr Zareba, Jehonathan H Pinthus, Paul Russo
The appropriate role of lymph node dissection (LND) in the management of patients with renal cell carcinoma (RCC) is still a matter of debate. There is ample evidence that LND is the most accurate modality for staging the regional lymph nodes (LNs), which may harbor metastatic disease in greater than one-third of patients with high-risk RCC. The presence of LN metastases is an independent negative prognostic factor in this disease and accurate determination of LN status not only helps with patient counselling regarding prognosis and tailoring of postoperative surveillance schedules, but it also identifies patients at high risk of systemic disease recurrence who may qualify for clinical trials of adjuvant systemic therapies...
November 2018: Therapeutic Advances in Urology
Jennifer Westwood, Robert Geraghty, Patrick Jones, Bhavan P Rai, Bhaskar K Somani
Rezum is a minimally invasive transurethral water vapour therapy for benign prostatic enlargement which uses thermal energy for treatment. The short-term results show it to have good outcomes with a potential for outpatient-based treatment preserving sexual function. This review serves to provide an overview of the technique and evaluate its safety and efficacy.
November 2018: Therapeutic Advances in Urology
Taylor Peak, Andrew Chapple, Grayson Coon, Ashok Hemal
Background: To utilize a semi-competing risk model to predict perioperative and oncologic outcomes after radical cystectomy and to compare the findings with the univariate Cox regression model. Methods: We reviewed the Institutional Review Board approved database of radical cystectomy of 316 patients who had undergone robot-assisted radical cystectomy (RARC) or open radical cystectomy between 2006 and 2016. Demographic data, perioperative outcomes, complications, metastasis, and survival were analyzed...
November 2018: Therapeutic Advances in Urology
Michele Marchioni, Petros Sountoulides, Maida Bada, Sebastiano Rapisarda, Cosimo De Nunzio, Fabiola Raffaella Tamburro, Luigi Schips, Luca Cindolo
Background: To assess the efficacy and safety of treatment with abiraterone acetate (AA) in chemotherapy-naïve men with metastatic castration-resistant prostate cancer (mCRPC) in the 'real-life' setting. Methods: Data acquisition on the outcomes of the use of AA in chemotherapy-naive patients with mCRPC was performed by a MEDLINE comprehensive systematic literature search using combinations of the following key words: 'prostate cancer', 'metastatic', 'castration resistant', 'abiraterone', 'real life', and excluding controlled clinical trials (phase II and III studies)...
October 2018: Therapeutic Advances in Urology
Tomer Erlich, Noam D Kitrey
The kidneys are the most vulnerable genitourinary organ in trauma, as they are involved in up to 3.25% of trauma patients. The most common mechanism for renal injury is blunt trauma (predominantly by motor vehicle accidents and falls), while penetrating trauma (mainly caused by firearms and stab wound) comprise the rest. High-velocity weapons impose specifically problematic damage because of the high energy and collateral effect. The mainstay of renal trauma diagnosis is based on contrast-enhanced computed tomography (CT), which is indicated in all stable patients with gross hematuria and in patients presenting with microscopic hematuria and hypotension...
October 2018: Therapeutic Advances in Urology
Ivy Y Ge, Helene B Fevrier, Carol Conell, Malika N Kheraj, Alexander C Flint, Darvin S Smith, Lisa J Herrinton
Background: Risk of community-acquired Clostridium difficile infection (CA-CDI) following antibiotic treatment specifically for urinary tract infection (UTI) has not been evaluated. Methods: We conducted a nested case-control study at Kaiser Permanente Northern California, 2007-2010, to assess antibiotic prescribing and other factors in relation to risk of CA-CDI in outpatients with uncomplicated UTI. Cases were diagnosed with CA-CDI within 90 days of antibiotic use...
October 2018: Therapeutic Advances in Urology
Matthew R Macey, Ryan C Owen, Sherry S Ross, R Matthew Coward
A varicocele is an abnormal dilation of the pampiniform plexus of veins in the scrotum which begins at puberty in approximately 15% of males. Although common in the general population and often asymptomatic, varicoceles are associated with gonadal dysfunction including testicular atrophy, infertility, and hypogonadism in a subset of men diagnosed later in life. Because of the high prevalence and uncertain pathogenesis, definitive management guidelines for varicoceles diagnosed in the pediatric and adolescent population remain poorly defined...
September 2018: Therapeutic Advances in Urology
Yoshihisa Matsukawa, Shun Takai, Tsuyoshi Majima, Yasuhito Funahashi, Masashi Kato, Tokunori Yamamoto, Momokazu Gotoh
Background: The aim of this research was to investigate intermediate-term effects of silodosin on lower urinary tract functions and symptoms in patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) according to prostate size, using urodynamics. Methods: A total of 70 untreated outpatients with a prostate volume <40 ml [small prostate (SP) group] and 70 with prostate volume ⩾40 ml [large prostate (LP) group] were prospectively enrolled and treated by monotherapy with silodosin for 24 months...
September 2018: Therapeutic Advances in Urology
Ekaterina Kulchavenya
Background: Acute uncomplicated cystitis in women is one of the most frequently diagnosed bacterial infections. Methods: In a pilot, open, noncomparative prospective study, 29 nonpregnant, sexually active women with acute uncomplicated cystitis were enrolled. The mean age was 28.9 ± 4.3, range 22-36 years. All patients received unique therapy: the nonsteroidal anti-inflammatory drug (NSAID) ketoprofen, 100 mg once a day for 5 days, and Canephron, 2 dragees three times a day for 1 month...
September 2018: Therapeutic Advances in Urology
Karl-Erik Andersson, Nurul Choudhury, Jean-Nicolas Cornu, Moses Huang, Cees Korstanje, Emad Siddiqui, Philip Van Kerrebroeck
Urgency is the prevalent and most bothersome symptom of overactive bladder (OAB) and the treatment of urgency is the primary objective in the management of OAB. Urgency has a major impact on other symptoms of OAB and culminates in an increased frequency of micturition and reduced volume voided, which may contribute to shorter intervals between the need to void. Antimuscarinic agents and mirabegron, a β3 -adrenoceptor agonist, constitute the main oral pharmacotherapeutic options for the treatment of urgency and other OAB symptoms...
August 2018: Therapeutic Advances in Urology
Darryl Ethan Bernstein, Brett Sydney Bernstein
Since prehistoric times, our understanding of urology has rapidly expanded. Whilst primitive urologists began by using urine as a therapeutic substance, modern urologists may find themselves removing a kidney remotely by driving a robotic arm, with seven degrees of movement, while using image overlay-augmented reality. This review provides an insight into the potential status of urological technology in 20 years' time, assessed through an analysis of developments in imaging, diagnostics, robotics and further technologies...
August 2018: Therapeutic Advances in Urology
Giacomo Maria Pirola, Giovanni Saredi, Ricardo Codas Duarte, Lorraine Bernard, Andrea Pacchetti, Lorenzo Berti, Eugenio Martorana, Giulio Carcano, Lionel Badet, Hakim Fassi-Fehri
Background: The aim of our study was to compare perioperative and functional outcomes of two different prostatic laser enucleation techniques performed in two high-volume centers: 100 W holmium laser enucleation of the prostate (HoLEP) (Lyon, France) and 110 W thulium laser enucleation of the prostate (ThuLEP) (Varese, Italy). Materials and Methods: A nonrandomized, observational, retrospective and matched-pair analysis was performed on two homogeneous groups of 117 patients that underwent prostate laser enucleation in the HoLEP or ThuLEP centers between January 2015 and April 2017, following the classical 'three lobes' enucleation technique...
August 2018: Therapeutic Advances in Urology
F Johannes P van Valenberg, Dalit Strauss-Ayali, Yael Agmon-Gerstein, Astar Friedman, Harm C Arentsen, H Ewout Schaafsma, J Alfred Witjes, Egbert Oosterwijk
Background: We investigated a thermoreversible hydrogel that is highly viscous at body temperature, while fluid-like at a low temperature, thus aiming for a slow and prolonged intravesical drug release. Our study purposed to assess antitumor efficacy of mitomycin C (MMC) mixed with hydrogel in an orthotopic rat bladder cancer model. Methods: Bladders of female Fischer F344 rats were grafted with 1.5 × 106 AY-27 urothelial carcinoma cells. On day 5, tumor presence was assessed by cystoscopy and rats were divided into six groups (five treatment, one control, n = 10/group)...
July 2018: Therapeutic Advances in Urology
Esther Han, Laura Nguyen, Larry Sirls, Kenneth Peters
Introduction: Over the last 100 years, the terminology and diagnosis criteria for interstitial cystitis have evolved. Many therapeutic options have changed, but others have endured. This article will review the idea of separating 'classic' Hunner lesion interstitial cystitis (HL IC) from non-Hunner lesion interstitial cystitis and bladder pain syndrome (N-HL IC/BPS) and their respective treatment algorithms. Methods/Results: A literature search was performed to identify articles and research on HL IC and N-HL IC/BPS including definitions, etiological theories, and treatments...
July 2018: Therapeutic Advances in Urology
Lorenzo Angelini, Gianni Bisogno, Ciro Esposito, Marco Castagnetti
The latest multimodal protocols for treatment of bladder/prostate rhabdomyosarcoma (RMS) have shifted the goal of treatment from patient survival to bladder preservation. Consistently, partial resections, such as radical prostatectomy (RP), are favoured when surgery is deemed necessary. We sought to determine the oncological risks - that is, failure to achieve disease control - and the possible benefits in terms of urinary continence associated with RP in RMS patients based on a review of our experience and the data reported in the literature...
June 2018: Therapeutic Advances in Urology
Samih Taktak, Patrick Jones, Ahsanul Haq, Bhavan Prasad Rai, Bhaskar K Somani
Aquablation is a minimally invasive surgical technology for benign prostate enlargement, which uses high-pressure saline to remove parenchymal tissue through a heat-free mechanism of hydrodissection. Early results show this to be a promising surgical strategy with a strong morbidity profile and reduced resection time. This review serves to provide an overview of the technique and evaluate its safety and efficacy.
June 2018: Therapeutic Advances in Urology
Désirée Louise Draeger, Karl-Dietrich Sievert, Oliver W Hakenberg
Background: The experience of stress in patients with cancer through helplessness and the suppression of emotions correlates with unfavorable disease prognosis. Significant distress can reduce survival probability as well as subjectively perceived poor quality of life. Currently, there are few data on psychological stress in patients with renal cancer and most studies focus on survival time. The aim of the study was to evaluate the psychosocial stress of patients with renal cancer with screening questionnaires for an inpatient psychosocial treatment program...
June 2018: Therapeutic Advances in Urology
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