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European Urology Focus

Charlotte T J Michels, Carl J Wijburg, Erik Leijte, J Alfred Witjes, Maroeska M Rovers, Janneke P C Grutters
BACKGROUND: Open radical cystectomy (ORC) is regarded the standard treatment for muscle-invasive bladder cancer, but robot-assisted radical cystectomy (RARC) is increasingly used in practice. However, it is unclear whether RARC provides value for money. OBJECTIVE: To identify the main evidence gaps and main drivers of cost-effectiveness, comparing RARC to ORC. DESIGN, SETTING, AND PARTICIPANTS: A decision analytical model was developed to study the 30d and 90d postoperative complications with RARC versus ORC and their related cost in bladder cancer patients...
May 18, 2018: European Urology Focus
Hans Albin Gritsch
This manuscript reviews the outcomes of a European clinical trial to evaluate the effects of living kidney donation on adrenal function. The study shows that left-sided donor nephrectomy is associated with transiently reduced adrenocortical responsiveness, which returns to baseline after 28 d.
May 17, 2018: European Urology Focus
Nadir I Osman, Christopher R Chapple
Currently, underactive bladder, the symptom-based correlate of the urodynamic diagnosis of detrusor underactivity, has no effective drug treatments. Use of sympathomimetics, targeting cholinergic receptors, is not supported by current evidence. Several potential targets are the subject of ongoing investigation.
May 15, 2018: European Urology Focus
Manuela Tutolo, Enrico Ammirati, Frank Van der Aa
We reviewed the available studies on efficacy and safety of percutaneous tibial nerve stimulation (PTNS) and sacral nerve modulation (SNM) for overactive bladder (OAB) symptoms not responsive to conservative treatments. We limited our search to randomized trials, in English, with at least 20 adult patients, and 6 mo and 12 wk of follow-up for SNM and PTNS, respectively, published between January 1998 and December 2017. Therapeutic success ranges from 61% to 90% for SNM and from 54% to 79% for PTNS. Both techniques are effective and safe, with no life-threatening adverse effects...
May 14, 2018: European Urology Focus
Myong Kim, Myungchan Park, Sahyun Pak, Seung-Kwon Choi, Myungsun Shim, Cheryn Song, Hanjong Ahn
BACKGROUND: The applicability of the sphincter complex integral theory to robotic-assisted radical prostatectomy (RARP) is unclear, with little known about the long-term effect of sphincter complex integrity on continence. OBJECTIVE: To determine whether the preoperative anatomical and functional features of the sphincter complex and the degree of nerve-sparing affect long-term continence after RARP. DESIGN, SETTING, AND PARTICIPANTS: Prospective study of 529 patients who underwent RARP at a single tertiary center...
May 11, 2018: European Urology Focus
Malte Rieken, Stephen A Kaplan
Transurethral resection of the prostate remains the reference technique for patients with a prostate <100ml. Endoscopic enucleation is a safe and effective alternative, while photoselective vaporization of the prostate appears to be the treatment of choice for patients on anticoagulation medication.
May 10, 2018: European Urology Focus
Richard Lee, Claus Roehrborn
Transurethral resection of the prostate (TURP) is considered the gold standard for minimally invasive treatment of lower urinary tract symptoms due to benign prostate enlargement of <80ml. Although durable and effective, TURP carries the risk of significant side effects, including infection and bleeding, and the risk of dilutional hyponatremia. The Aquabeam system uses high-velocity water jets to robotically ablate prostatic tissue under real-time ultrasound guidance, with hemostasis achieved via a catheter balloon tamponade and a novel traction device or electrocautery...
May 7, 2018: European Urology Focus
Marc A Dall'Era, Ralph deVere-White, Danielle Rodriguez, Rosemary Cress
BACKGROUND: Screening for prostate cancer (PCa) has dramatically declined in the United States (US) since the United States Preventive Services Task Force recommended against routine prostate-specific antigen (PSA)-based PCa screening in all men in 2012. This led to dramatic reductions in the diagnosis of localized disease across all clinical risk groups. OBJECTIVE: In light of decreased PSA screening for men in the US, we sought to study trends in newly diagnosed metastatic PCa incidence and how this may vary by race and age...
May 4, 2018: European Urology Focus
Koichi Kido, Shingo Hatakeyama, Atsushi Imai, Hayato Yamamoto, Yuki Tobisawa, Tohru Yoneyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Shigeyuki Nakaji, Chikara Ohyama
BACKGROUND: Nocturia has been reported to be associated with sleep disturbance. However, whether nocturia or sleep disturbance has a more negative influence on the quality of life (QOL) of individuals remains unclear. OBJECTIVE: To compare the impact of nocturia and sleep disturbance on QOL. DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional study including 3992 adults who participated in the Iwaki Health Promotion Project between 2011 and 2015 in Hirosaki, Japan...
May 4, 2018: European Urology Focus
Kush Panara, John M Masterson, Luis F Savio, Ranjith Ramasamy
CONTEXT: Male factor infertility plays a significant role in infertility. Many factors have been associated with male infertility; however, the link between many sports and recreational factors and male reproduction remains poorly characterized. OBJECTIVE: To evaluate the current literature regarding the impact of many common sports and recreational factors on male reproduction. EVIDENCE ACQUISITION: A comprehensive PubMed and Embase search for relevant articles published between 1970 and 2017 was performed by combining the following search terms: male, sports (including individual sports), traumatic brain injury, sauna, hot tub, fertility, erectile dysfunction, varicocele, environment, cell phone, and laptop computer...
May 3, 2018: European Urology Focus
Malte Rieken, Richard K Lee
No abstract text is available yet for this article.
May 2, 2018: European Urology Focus
Kathleen Hwang, David Guo
Many common sports and sports-related behaviors and practices represent potential sources of male infertility. Clinicians should be aware of these associations in the evaluation of idiopathic infertility in men.
May 2, 2018: European Urology Focus
Robert J Ellis, Yeoungjee Cho, Sharon J Del Vecchio, Megan McStea, Christudas Morais, Jeff S Coombes, Simon T Wood, Glenda C Gobe, Ross S Francis
CONTEXT: Most practice decisions relevant to preserving kidney function in patients managed surgically for kidney tumours are driven by observational studies. A wide range of outcome measures are used in these studies, which reduces comparability and increases the risk of reporting bias. OBJECTIVE: To comprehensively and succinctly describe the outcomes used to evaluate kidney function in studies evaluating surgical management of kidney tumours. EVIDENCE ACQUISITION: Electronic search of the PubMed database was conducted to identify studies with at least one measure of kidney function in patients managed surgically for kidney tumours, published between January 2000 and September 2017...
May 1, 2018: European Urology Focus
Julian Marcon, Giuseppe Magistro, Christian G Stief, Tobias Grimm
CONTEXT: There is growing interest in minimally invasive (MI) treatment options for male lower urinary tract symptoms (LUTS). Among these options, the temporary implantable nitinol device (TIND; Medi-Tate, Or Akiva, Israel) is a novel instrument used to alleviate symptoms by creating incisions in the prostate via mechanical stress. OBJECTIVE: To review recent data for TIND as an MI procedure to improve LUTS. EVIDENCE ACQUISITION: Medline, PubMed, the Cochrane Database, and Embase were screened for clinical trials, randomized controlled trials, and review articles on the use of TIND in patients with male LUTS...
April 26, 2018: European Urology Focus
Marcus J Drake
Urodynamics can distinguish bladder outlet obstruction from detrusor underactivity. Clear identification of the mechanism of a man's voiding symptoms can help give the best chance of good outcome from surgery. Publication of results from the UPSTREAM study will help in establishing the exact place for urodynamic testing in male lower urinary tract symptoms.
April 25, 2018: European Urology Focus
Kenneth Hiew, Claire A Hart, Adnan Ali, Tony Elliott, Vijay Ramani, Vijay Sangar, Maurice Lau, Satish Maddineni, Mick Brown, Noel Clarke
BACKGROUND: Docetaxel chemotherapy is a standard of care for metastatic castrate-resistant prostate cancer (mCRPC): 40-50% of patients achieve a biochemical response. However, there is a lack of response predictive biomarkers. OBJECTIVE: To assess lactate dehydrogenase (LDH) as a docetaxel response biomarker in mCRPC and to examine the association of LDH with genomic alterations in primary diagnostic biopsies. DESIGN, SETTING, AND PARTICIPANTS: Clinical and associated primary tumour-targeted next-generation sequencing data from matched training (n=150) and test (n=120) cohorts of progressive mCRPC patients receiving docetaxel therapy were analysed...
April 23, 2018: European Urology Focus
Alexander Bachmann, Leonid M Rapoport, Christian Wetterauer
In 2018, owing to the variety of true minimally invasive and effective treatment modalities available, early surgery in patients suffering from lower urinary tract symptoms due to benign prostatic enlargement is a valid, safe, and effective option compared to long-term less effective medical treatment.
April 18, 2018: European Urology Focus
Stavros Gravas, Iason Kyriazis, Adam P Klausner
It is well known that lower urinary tract symptoms (LUTS) have a multifactorial etiology. Therefore, there is an increased need for improved diagnostics for the optimal assessment of patients with LUTS in order to identify the various causes of symptoms and improve disease phenotyping. Research has focused on the development of improved urodynamic technologies and the development of noninvasive tests that could replace urodynamic studies. This mini-review will present the most recently published studies on the topic including new technologies in the diagnosis of bladder outlet obstruction, novel metrics for bladder sensation, analysis of filling phase rhythm, measurement of detrusor wall tension, and brain imaging during urodynamic studies...
April 14, 2018: European Urology Focus
Benoit Peyronnet, Benjamin M Brucker, Martin C Michel
CONTEXT: Pharmacological treatment is a cornerstone in the management of patients with lower urinary tract symptoms (LUTS). OBJECTIVE: To review emerging evidence in the medical treatment of LUTS. EVIDENCE ACQUISITION: An Embase/Pubmed-based literature search was conducted in December 2017, screening for randomized controlled trials (RCTs), prospective and retrospective series, animal model studies, and reviews on medical treatment of LUTS...
April 14, 2018: European Urology Focus
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