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Therapeutic Advances in Urology

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https://www.readbyqxmd.com/read/29623108/electrical-neuromodulation-in-the-management-of-lower-urinary-tract-dysfunction-evidence-experience-and-future-prospects
#1
REVIEW
Alejandro Abello, Anurag K Das
Lower urinary tract dysfunction (LUTD) is common and causes a spectrum of morbidity and decreased quality of life (QoL) for patients. LUTD can range from urinary retention to urge incontinence, and includes a variety of syndromes, with the most common and widely recognized being overactive bladder (OAB). The classic treatments of LUTD and OAB comprise different strategies including behavioral therapies, medications and minimally invasive or invasive surgical procedures. Generally, once patients have tried behavioral modifications and oral medical therapy, and have not experienced adequate relief of their symptoms, the next step is to consider minimally invasive therapies...
May 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29623107/intravesical-instillations-for-the-treatment-of-refractory-recurrent-urinary-tract-infections
#2
Sonia Dutta, Felicia Lane
Background: Treatment options for refractory recurrent urinary tract infections (UTI) are limited; therefore, we sought to determine if intravesical instillations with heparin effectively treat recurrent UTIs. Methods: Patients at an academic medical center who received intravesical instillations with heparin for recurrent UTIs/chronic cystitis between January 2011 and December 2015 were identified via International Classification of Diseases, Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) procedure codes...
May 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29560030/intralesional-collagenase-clostridium-histolyticum-in-the-management-of-peyronie-s-disease-current-best-practice
#3
REVIEW
Daniel J Cwikla, Faysal A Yafi
The use of Clostridium histolyticum collagenase (CCH) has become increasingly widespread for the treatment of Peyronie's disease (PD) in recent years. Numerous trials have confirmed both its safety and efficacy in appropriately selected patients with this condition. The purpose of this review is to examine pivotal trials demonstrating the efficacy of CCH, revisit viable candidates for treatment with intralesional injection therapy, and provide a summary of injection technique and appropriate management of patients receiving this treatment at the time of therapy and in follow up...
April 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29560029/contemporary-best-practice-urolithiasis-in-pregnancy
#4
REVIEW
Marie-Therese I Valovska, Vernon M Pais
Urolithiasis is the most common nonobstetric complication in the gravid patient. The experience can provoke undue stress for the mother, fetus, and management team. The physiologic changes of pregnancy render the physical exam and imaging studies less reliable than in the typical patient. Diagnosis is further complicated by the need for careful selection of imaging modality in order to maximize diagnostic utility and minimize obstetric risk to the mother and ionizing radiation exposure to the fetus. Ultrasound remains the first-line diagnostic imaging modality in this group, but other options are available if results are inconclusive...
April 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29662541/cabozantinib-in-the-treatment-of-advanced-renal-cell-carcinoma-in-adults-following-prior-vascular-endothelial-growth-factor-targeted-therapy-clinical-trial-evidence-and-experience
#5
REVIEW
Susanne Osanto, Tom van der Hulle
Cabozantinib is an oral multitargeted tyrosine kinase inhibitor (TKI) that potently inhibits MET and AXL, both associated with poor prognosis in renal cell carcinoma (RCC), next to vascular endothelial growth factor receptor 2, KIT, FLT3 and RET. Chronic treatment with vascular endothelial growth factor receptor (VEGFR)-targeting sunitinib upregulates MET and AXL in RCC, indicating that cabozantinib may be particularly effective in patients with advanced RCC whose disease progressed on prior VEGFR-targeted treatment...
March 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29662540/the-impact-of-comorbidities-sex-and-age-on-the-occurrence-of-acute-kidney-injury-among-patients-undergoing-nephron-sparing-surgery
#6
Elias Hellou, Zaher Bahouth, Edmond Sabo, Zaid Abassi, Ofer Nativ
Background: The aim of this study was to report the impact of patients' baseline characteristics on the incidence of acute kidney injury (AKI) after nephron-sparing surgery (NSS) for localized kidney cancer. Patients and methods: Data from our kidney cancer database were retrospectively extracted to include 402 patients who underwent NSS between March 2000 and June 2016, and had sufficient data. Definition of AKI was based on the postoperative serum creatinine levels and estimated glomerular filtration rate (eGFR) magnitude, which were measured during the 72 h after surgery...
March 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29662539/urogenital-tuberculosis-the-cause-of-ineffective-antibacterial-therapy-for-urinary-tract-infections
#7
Ekaterina Kulchavenya, Andrey Cherednichenko
Background: Urogenital tuberculosis (UGTB) is one of the great imitators; it is commonly masked by urinary tract infections (UTIs). We aimed to estimate how many UGTB patients were among patients with a long history of UTIs. Material and Methods: A total of 244 patients with recurrent UTIs and suspected UGTB were enrolled in an open, noncomparative prospective study. Their urine and expressed prostate secretion or ejaculate were cultured (a total of 1446 samples), and 421 isolates with growth of ⩾104 colony-forming units (CFU)/ml were investigated for drug resistance...
March 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29434675/best-practice-in-the-management-of-storage-symptoms-in-male-lower-urinary-tract-symptoms-a-review-of-the-evidence-base
#8
REVIEW
Mauro Gacci, Arcangelo Sebastianelli, Pietro Spatafora, Giovanni Corona, Sergio Serni, Dirk De Ridder, Stavros Gravas, Paul Abrams
Storage lower urinary tract symptoms (LUTS) are characterized by an altered bladder sensation, increased daytime frequency, nocturia, urgency and urgency incontinence. Some evidence underlines the role of metabolic factors, pelvic ischemia, prostatic chronic inflammation and associated comorbidities in the pathophysiology of storage LUTS. A detailed evaluation of the severity of storage LUTS, and the concomitance of these symptoms with voiding and postmicturition symptoms, is mandatory for improving the diagnosis and personalizing treatment...
February 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29434674/circulating-tumor-cells-in-genitourinary-tumors
#9
REVIEW
Francesco Massari, Vincenzo Di Nunno, Francesca Comito, Marta Cubelli, Chiara Ciccarese, Roberto Iacovelli, Michelangelo Fiorentino, Rodolfo Montironi, Andrea Ardizzoni
Management of advanced urogenital malignancies has profoundly changed in recent years due to the development of novel targeted drugs that have significantly improved patient's clinical outcomes. This process has been made possible mainly thanks to better knowledge of tumor genetic alterations and molecular altered pathways. Despite these remarkable results, several issues such as early detection of the disease as well as the research into early markers of recurrence or disease progression still remain an open challenge for clinical research...
February 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29434673/practical-differences-between-luteinizing-hormone-releasing-hormone-agonists-in-prostate-cancer-perspectives-across-the-spectrum-of-care
#10
REVIEW
Davide Meani, Mladen Solarić, Harri Visapää, Rose-Marie Rosén, Robert Janknegt, Majana Soče
Background: Androgen deprivation therapy (ADT) with luteinizing hormone-releasing hormone (LHRH) agonists is well established for the treatment of men with metastatic prostate cancer. As clear differences in efficacy, safety, or tolerability between the available LHRH agonists are lacking, the healthcare management team needs to look to practical differences between the formulations when selecting therapy for their patients. Moreover, as the economic burden of prostate cancer rises alongside earlier diagnosis and improved survival, the possibility for cost savings by using products with specific features is growing in importance...
February 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29434672/pharmacokinetic-and-pharmacodynamic-comparison-of-subcutaneous-versus-intramuscular-leuprolide-acetate-formulations-in-male-subjects
#11
Daniel Saltzstein, Neal D Shore, Judd W Moul, Franklin Chu, Raoul Concepcion, Stephan de la Motte, John A McLane, Stuart Atkinson, Alex Yang, E David Crawford
Background: The aim of this study was to compare the pharmacokinetics (PK) and pharmacodynamics (PD) of two distinct formulations of leuprolide acetate (LA); subcutaneous (SC) injection and intramuscular (IM) injection. Methods: A total of 32 healthy men were randomized to receive a single 7.5 mg injection of SC-LA ( n = 16) or IM-LA ( n = 16) in this phase I, open-label, parallel-group study. PK was assessed via LA concentrations, and PD via serum luteinizing hormone (LH) and testosterone (T) concentrations...
February 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29434671/validation-of-american-joint-committee-on-cancer-eighth-staging-system-among-prostate-cancer-patients-treated-with-radical-prostatectomy
#12
Omar Abdel-Rahman
Background: The objective in this paper was to validate the prognostic performance of the American Joint Committee on Cancer (AJCC) 7th and 8th systems among prostate cancer patients treated with radical prostatectomy. Methods: The surveillance, epidemiology and end results (SEER) database (2006-2014) was accessed through the SEER*Stat program and AJCC 7th and 8th editions were calculated utilizing T, N and M stages, histological grade group, as well as baseline prostatic-specific antigen (PSA)...
February 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29344095/metachronous-metastasis-of-renal-cell-carcinoma-to-the-urinary-bladder-a-case-report
#13
Ruben De Groote, Alessandro Larcher, Marijn Goossens, De Raeve Hendrik, Van Der Steen Kris, Vincent De Coninck, Geert De Naeyer, Peter Schatteman, Frederiek D'Hondt, Alexandre Mottrie
We report a case of intravesical metastasis of a clear cell renal cell carcinoma. In renal cell carcinoma 16% of patients present with metastatic disease. Renal cell carcinoma can metastasize to nearly every organ, although metastatic spread to the urinary bladder is rare, with fewer than 70 described cases. The route and pattern of metastatic spread is not yet fully understood and different pathways are suggested. Gross haematuria is the presenting symptom in the majority of cases. These intravesical metastases may be synchronous or metachronous and can be solitary or part of polymetastatic disease...
January 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29344094/robotic-prostatectomy-leading-to-a-delayed-mrsa-infected-lymphocele-a-case-report-and-review-of-the-literature
#14
Monica Kaminski, Rose Recco, Steven Siegel
Prostate cancer is the second leading cancer-related cause of death in the USA with the majority presenting as localized disease. In the last decade minimally invasive, robotic-assisted laparascopic, radical prostatectomy has become the most favored treatment choice. A complication that has been observed in 27% of patients is the formation of an asymptomatic lymphocele. It is a very rare complication for these to become infected, and when they do 80% have occurred 2-12 months post-procedure. In this case report the patient presented with fever and leukocytosis of unknown origin and was found to have a methicillin-resistant Staphylococcus aureus (MRSA) infected lymphocele over 2 years after a radical prostatectomy...
January 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29344093/current-best-practice-in-the-management-of-cystitis-and-pelvic-pain
#15
REVIEW
Jayne Louise Douglas-Moore, Jonathan Goddard
Bladder pain syndrome (BPS) is a difficult disorder to diagnose and subsequently manage despite having been recognized for more than 200 years according to references in medical literature. There are currently three widely accepted guidelines on BPS: the American Urological Association Guidelines; the Royal College of Obstetricians and Gynaecologists in conjunction with the British Society of Urogynaecologists Guidelines; and the European Association of Urology Guidelines. These guidelines have similarities to each other but also significant differences...
January 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29344092/engaging-the-primary-care-community-to-encourage-appropriate-prostate-cancer-screening
#16
Malhar P Patel, Ariel Schulman, Kevin P Shah, John B Anderson, Thomas J Polascik
Prostate-specific antigen (PSA) screening for prostate cancer remains a controversial topic, particularly in the primary care community. Our multidisciplinary prostate screening panel at Duke University Health System, USA created a nuanced PSA screening algorithm, implemented it into the Electronic Health Record of Duke Primary Care, and conducted outreach meetings with primary care practices to support its rollout. Through this project, we identified areas of concern among primary care clinicians regarding PSA screening that we structured into two major categories: ideological opposition and logistical opposition...
January 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29344091/the-correlation-between-gain-of-chromosome-8q-and-survival-in-patients-with-clear-and-papillary-renal-cell-carcinoma
#17
Reza Mehrazin, Essel Dulaimi, Robert G Uzzo, Karthik Devarjan, Jianming Pei, Marc C Smaldone, Alexander Kutikov, Joseph R Testa, Tahseen Al-Saleem
Background: The proto-oncogene c-MYC, located on chromosome 8q, can be upregulated through gain of 8q, causing alteration in biology of renal cell carcinoma (RCC). The aim of this study was to evaluate the prevalence of c-MYC through chromosome 8q gain and to correlate findings with cancer-specific mortality (CSM), and overall survival (OS). Methods: Cytogenetic analysis by conventional or Chromosomal Genomic Microarray Analysis (CMA) was performed on 414 renal tumors...
January 2018: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29383032/comparison-of-objective-and-subjective-factors-in-the-adherence-to-antimuscarinics-when-treating-overactive-bladder-in-employed-persons
#18
Kirill Vladimirovich Kosilov, Sergey Loparev, Irina Kuzina, Alexandra Prokofyeva
Background: This study examines subjective reasons for the refusal of treatment and the state of objective status markers of various factors influencing the resistance of patients when treating overactive bladder by antimuscarinic drugs (AMs). Methods: The socioeconomic and medical parameters were studied in 2465 patients aged 18-60 years (1446 women (58.7%), 1019 men (41.3%); mean age was 52.1) taking AMs during the year. The study control was carried out by studying passport data, employers' income certificates, patients' ambulatory medical records, the use of OABq-SF and MOS SF-36 questionnaires, voiding diaries and uroflowmetry...
December 2017: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/29383031/treatment-of-ulcerative-compared-to-non-ulcerative-interstitial-cystitis-with-hyperbaric-oxygen-a-pilot-study
#19
David L Wenzler, Farris Gulli, Maureen Cooney, Michael B Chancellor, Jason Gilleran, Kenneth M Peters
Background: The etiology of interstitial cystitis (IC) is often idiopathic but can be due to Hunner's ulcers. Hyperbaric oxygen (HBO) is used to treat ulcerative disease of the superficial skin. We hypothesized that HBO can treat ulcerative IC (UIC) but would be less efficacious for non-ulcerative IC (NIC). Methods: Patients with NIC and UIC enrolled in this study. Following informed consent, demographic information was collected. A visual analog pain scale and validated questionnaires were collected; each patient underwent cystoscopy prior to treatment...
December 2017: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/28588653/renal-cell-carcinoma-with-inferior-vena-cava-thrombus-extending-to-the-right-atrium-diagnosed-during-pregnancy
#20
REVIEW
Efe C Ghanney, Jaime A Cavallo, Matthew A Levin, Ramachandra Reddy, Jeffrey Bander, Maria Mella, Joanne Stone, Myron Schwartz, Kenneth Haines, Umesh Gidwani, Reza Mehrazin
Only one case of renal cell carcinoma (RCC) with inferior vena cava (IVC) tumor thrombus diagnosed and treated during pregnancy has been reported in the literature. In that report, the tumor thrombus extended to the infrahepatic IVC (level II tumor thrombus). In the present case, a 37-year-old woman with lupus anticoagulant antibodies was diagnosed with RCC and IVC tumor thrombus extending to the right atrium (level IV tumor thrombus) at 24 weeks of pregnancy. The fetus was safely delivered by cesarean section at 30 weeks of gestation...
December 2017: Therapeutic Advances in Urology
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