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European Urology Focus

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https://www.readbyqxmd.com/read/30448051/management-of-urosepsis-in-2018
#1
Gernot Bonkat, Tomasso Cai, Rajan Veeratterapillay, Franck Bruyère, Riccardo Bartoletti, Adrian Pilatz, Béla Köves, Suzanne E Geerlings, Benjamin Pradere, Robert Pickard, Florian M E Wagenlehner
Despite optimal treatment, urosepsis has still high morbidity and mortality rates. An updated definition and classification system for sepsis have recently been introduced. Management of urosepsis comprises four major aspects: (1) early diagnosis, (2) early empiric intravenous antimicrobial treatment, (3) identification and control of complicating factors, and (4) specific sepsis therapy. The quick sequential organ failure assessment is replacing the systemic inflammatory response syndrome scoring for rapid identification of patients with urosepsis...
November 14, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30442584/what-is-better-for-predicting-morbidity-of-robotic-partial-nephrectomy-a-score-or-your-clinical-judgement
#2
Zine-Eddine Khene, Benoit Peyronnet, Lucas Freton, Vivien Graffeille, Benjamin Pradere, Corentin Robert, Solène-Florence Kammerer-Jacquet, Grégory Verhoest, Nathalie Rioux-Leclercq, Shahrokh Shariat, Romain Mathieu, Karim Bensalah
BACKGROUND: Little is known about the predictive value of surgeon's judgement to estimate perioperative outcomes following robotic partial nephrectomy (RPN). OBJECTIVE: To evaluate the accuracy of surgeon's intuition to estimate perioperative outcomes of patients undergoing RPN and compare its predictive value with that of objective scoring systems. DESIGN, SETTING, AND PARTICIPANTS: We prospectively analysed 100 consecutive patients who underwent RPN...
November 12, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30425001/evaluation-of-urinary-renal-biomarkers-for-early-prediction-of-acute-kidney-injury-following-partial-nephrectomy-a-feasibility-study
#3
Brian R Lane, Stephen K Babitz, Katerina Vlasakova, Allen Wong, Sabrina L Noyes, William Boshoven, Pam Grady, Cindy Zimmerman, Susan Engerman, Maureen Gebben, Michael Tanen, Warren E Glaab, Frank D Sistare
BACKGROUND: Partial nephrectomy (PN) is the gold standard for the treatment of small renal masses. Urinary biomarkers (UBMs) may serve as early indicators of acute kidney injury (AKI) following PN. OBJECTIVE: To evaluate the timing, specificity, and sensitivity of several candidate UBMs after PN to determine the most promising UBMs in this setting. We hypothesize that some UBMs will have utility as early markers of AKI. DESIGN, SETTING, AND PARTICIPANTS: Twenty-two patients undergoing on-clamp robotic or open PN underwent paired urine collection via ureteral catheterization of the affected kidney and Foley catheterization for the unaffected kidney obtained preoperatively, after anesthesia, and at several points in time after renovascular occlusion...
November 10, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30415922/robotic-inferior-vena-cava-thrombectomy-are-we-entering-the-house-through-an-attic-window
#4
Selma Masic, Alexander Kutikov
While feasible, it is unclear whether robotic inferior vena cava thrombectomy affords significant benefits. Outcomes are acceptable in carefully selected patients, but the approach is not applicable to all-comers. Higher costs are a challenge for health care systems and the value proposition for this approach is undefined.
November 8, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30415921/building-on-a-solid-foundation-enhancing-bacillus-calmette-gu%C3%A3-rin-therapy
#5
REVIEW
Cyrill A Rentsch, Laurent Derré, Sarah G Dugas, Christian Wetterauer, Joël R Federer-Gsponer, George N Thalmann, Molly A Ingersoll
CONTEXT: More than 40 yr ago, bacillus Calmette-Guérin (BCG) was introduced as an adjuvant therapy following transurethral resection of papillary tumours and as a treatment for carcinoma in situ of the bladder. Some 30 yr after its introduction, BCG maintenance therapy was found to be superior to induction therapy alone, representing the most relevant clinical improvement to BCG therapy since its inception. OBJECTIVE: To review current efforts and future opportunities to improve BCG immunotherapy...
November 8, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30413390/early-catheter-removal-after-robot-assisted-radical-prostatectomy-results-from-a-prospective-single-institutional-randomized-trial-ripreca-study
#6
Giuliana Lista, Giovanni Lughezzani, Nicolò Maria Buffi, Alberto Saita, Elena Vanni, Rodolfo Hurle, Pasquale Cardone, Roberto Peschechera, Giovanni Forni, Massimo Lazzeri, Giorgio Guazzoni, Paolo Casale
BACKGROUND: The adoption of robotic technology in the treatment of prostate cancer (PCa) could lead to improvement in outcomes. OBJECTIVE: To evaluate feasibility, to compare functional outcomes, and to assess the economic benefits of removing catheter on the postoperative day (POD) 3 versus POD 5 after robot-assisted radical prostatectomy (RARP). DESIGN, SETTING, AND PARTICIPANTS: From September 2016 to May 2017, patients selected to undergo RARP for clinically localized PCa at a high-volume center were prospectively randomized into group 1 (POD 3; n=72) versus group 2 (POD 5, n=74)...
November 6, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30409684/focus-on-internal-urethrotomy-as-primary-treatment-for-untreated-bulbar-urethral-strictures-results-from-a-multivariable-analysis
#7
Guido Barbagli, Nicola Fossati, Francesco Montorsi, Sofia Balò, Claudio Rimondi, Alessandro Larcher, Salvatore Sansalone, Denis Butnaru, Massimo Lazzeri
BACKGROUND: The use of internal urethrotomy for treatment of urethral stricture remains a controversial topic in urology. OBJECTIVE: To investigate outcomes and predictors of failure for internal urethrotomy as primary treatment for untreated bulbar urethral strictures. DESIGN, SETTING, AND PARTICIPANTS: We performed a retrospective analysis of patients who underwent internal urethrotomy. Patients with bulbar urethral stricture who did not receive any previous treatment were included...
November 5, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30392867/another-therapeutic-role-for-intravesical-botulinum-toxin-patients-with-long-stay-catheters-and-refractory-bladder-pain-and-catheter-bypass-leakage
#8
Matthew J Young, Nadir I Osman, Laura Phillips, Altaf Mangera, Sheilagh V Reid, Richard D Inman, Christopher R Chapple
BACKGROUND: Botulinum neurotoxin (BotN) is used to treat detrusor overactivity (DO) refractory to medical treatment. Catheterised patients with symptoms of bladder spasm and catheter bypass leakage are challenging to manage and the efficacy of BotN is not established. OBJECTIVE: To review our experience using intravesical BotN to treat refractory bladder pain and catheter bypass leakage in patients with long-term indwelling catheters. DESIGN, SETTING, AND PARTICIPANTS: We carried out a review of data prospectively collected for patients with indwelling urethral or suprapubic catheters receiving BotN for the treatment of bladder spasms and catheter bypass leakage in a UK tertiary centre...
November 1, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30392866/differential-nocturnal-diuresis-rates-among-patients-with-and-without-nocturnal-polyuria-syndrome
#9
Thomas F Monaghan, Nicholas R Suss, Matthew R Epstein, Viktor X Flores, Zhan D Wu, Kyle P Michelson, François Hervé, Donald L Bliwise, Karel Everaert, Jeffrey P Weiss
BACKGROUND: The mechanism of nocturnal polyuria (NP), a leading cause of nocturia, is poorly understood. OBJECTIVE: To characterize NP in terms of diuresis rate changes before and after the first nocturnal awakening. DESIGN, SETTING, AND PARTICIPANTS: A frequency-volume chart (FVC) database of 773 entries from 440 veterans treated at a Veterans Affairs urology clinic was analyzed. The first FVCs completed by male patients aged ≥18 years with two or more nocturnal voids were included...
November 1, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30389312/performance-and-safety-of-the-artificial-urinary-sphincter-ams-800-for-non-neurogenic-women-with-urinary-incontinence-secondary-to-intrinsic-sphincter-deficiency-a-systematic-review
#10
REVIEW
Christine R Reus, Véronique Phé, Agnès Dechartres, Nuno R Grilo, Emmanuel J Chartier-Kastler, Pierre C Mozer
CONTEXT: The use of the artificial urinary sphincter (AUS) for female non-neurogenic severe stress urinary incontinence (SUI) due to sphincter deficiency is either not specifically registered and/or reimbursed in some countries worldwide, as opposed to males, in whom it is considered the gold standard. With waning popularity of synthetic midurethral slings for the treatment of SUI, evidence-based assessment of AUS performance and safety is mandatory for patient counselling. OBJECTIVE: To conduct a systematic review of studies evaluating short- to long-term AUS performance and safety outcomes in non-neurogenic adult females with severe SUI...
October 30, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30361146/the-association-of-robot-assisted-versus-pure-laparoscopic-radical-nephrectomy-with-perioperative-outcomes-and-hospital-costs
#11
Boris Gershman, Laura Bukavina, Zhengyi Chen, Badrinath Konety, Fredrick Schumache, Li Li, Alexander Kutikov, Marc Smaldone, Robert Abouassaly, Simon P Kim
BACKGROUND: Although robot assistance can facilitate the advantages of minimally invasive surgery, it is unclear whether it offers benefits in settings in which laparoscopic surgery has been established as the standard of care. OBJECTIVE: To examine the comparative effectiveness of robot-assisted laparoscopic radical nephrectomy (RALRN) and laparoscopic radical nephrectomy (LRN) using a nationwide data set. DESIGN, SETTING, AND PARTICIPANTS: 8316 adults who underwent RALRN or LRN for non-urothelial renal cancer from the Nationwide Inpatient Sample from 2010 to 2013...
October 22, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30337191/the-past-the-present-and-the-future-of-robotic-urology-robot-assisted-surgery-and-human-assisted-robots
#12
EDITORIAL
Alexandre Mottrie, Alessandro Larcher, Vipul Patel
No abstract text is available yet for this article.
October 15, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30327282/primary-penile-cancer-the-role-of-adjuvant-radiation-therapy-in-the-management-of-extranodal-extension-in-lymph-nodes
#13
Peter A S Johnstone, David Boulware, Rosa Djajadiningrat, Sarah Ottenhof, Andrea Necchi, Mario Catanzaro, Dingwei Ye, Yao Zhu, Nicola Nicolai, Simon Horenblas, Philippe E Spiess
BACKGROUND: In head and neck cancer, the presence of extranodal extension (ENE) in lymph nodes (LNs) has been shown prospectively to require adding chemotherapy to postoperative radiation therapy (RT). Limited data exist regarding ENE in LNs from primary penile cancer (PeCa). OBJECTIVE: To determine the association of RT and ENE in PeCa. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively analyzed the outcomes of 93 patients with pT1-4 N3 M0 (American Joint Committee on Cancer 7th edition) squamous cell carcinoma of the penis across four international centers...
October 13, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30327280/accuracy-and-variability-of-prostate-multiparametric-magnetic-resonance-imaging-interpretation-using-the-prostate-imaging-reporting-and-data-system-a-blinded-comparison-of-radiologists
#14
Nicholas A Pickersgill, Joel M Vetter, Gerald L Andriole, Anup S Shetty, Kathryn J Fowler, Aaron J Mintz, Cary L Siegel, Eric H Kim
BACKGROUND: Multiparametric (mp) magnetic resonance imaging (MRI) has become an important tool for the detection of clinically significant prostate cancer. However, diagnostic accuracy is affected by variability between radiologists. OBJECTIVE: To determine the accuracy and variability in prostate mpMRI interpretation among radiologists, both individually and in teams, in a blinded fashion. DESIGN, SETTING, AND PARTICIPANTS: A study cohort (n=32) was created from our prospective registry of patients who received prostate mpMRI with subsequent biopsy...
October 13, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30318465/management-of-urethritis-is-it-still-the-time-for-empirical-antibiotic-treatments
#15
REVIEW
Riccardo Bartoletti, Florian M E Wagenlehner, Truls Erik Bjerklund Johansen, Bela Köves, Tommaso Cai, Zafer Tandogdu, Gernot Bonkat
CONTEXT: Urethritis prevalence in Europe changed in the last years due to both the increase of migratory streams from North Africa and the more frequent exposition of males to relevant risk factors. Owing to these reasons, urethritis treatment should be optimized by accurate microbiological investigations to avoid the risk of persistence, recurrence, or reinfection. OBJECTIVE: The aim of this systematic review is to optimize the treatments for urethritis and investigate the applicability of nucleic acid amplification test (NAAT) as the primary microbiological investigation...
October 11, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30318464/urine-gene-expression-profiles-in-bladder-pain-syndrome-patients-treated-with-triamcinolone
#16
Laura Izquierdo, Laura Mateu, Juan José Lozano, Ruth Montalbo, Mercedes Ingelmo-Torres, Ascensión Gómez, Lluís Peri, Lourdes Mengual, Agustín Franco, Antonio Alcaraz
BACKGROUND: The pathogenesis of bladder pain syndrome (BPS) remains incompletely defined, and there is no standard treatment for BPS as yet. OBJECTIVE: To gain detailed insight into the disease pathobiology of BPS through comparative gene expression analysis of urine from BPS patients versus control individuals and, furthermore, to determine the efficacy of triamcinolone treatment in BPS patients in terms of the gene expression profiles in urine. DESIGN, SETTING, AND PARTICIPANTS: A prospective pilot study including 21 urine samples from patients with Hunner's lesions (n=6) and controls (n=9) between January and August 2017...
October 11, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30316826/clinical-profile-of-young-patients-with-erectile-dysfunction-preliminary-findings-of-a-real-life-cross-sectional-study
#17
Edoardo Pozzi, Paolo Capogrosso, Francesco Chierigo, Filippo Pederzoli, Eugenio Ventimiglia, Luca Boeri, Nicola Frego, Donatella Moretti, Federico Dehò, Francesco Montorsi, Andrea Salonia
BACKGROUND: Erectile dysfunction (ED) is an increasingly common complaint among men aged <40 yr. OBJECTIVE: To assess clinical factors potentially associated with impaired erectile function (EF) in a cohort of young men seeking first medical help for ED as their primary complaint. DESIGN, SETTING, AND PARTICIPANTS: Complete sociodemographic and clinical data for 307 consecutive patients aged <40 yr were analysed. Health-significant comorbidities were scored using the Charlson comorbidity index...
October 10, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30316824/role-of-bed-assistant-during-robot-assisted-radical-prostatectomy-the-effect-of-learning-curve-on-perioperative-variables
#18
Giancarlo Albo, Elisa De Lorenzis, Andrea Gallioli, Luca Boeri, Stefano P Zanetti, Fabrizio Longo, Bernardo Rocco, Emanuele Montanari
BACKGROUND: A remote interaction between a console surgeon (CS) and a bedside surgeon (BS) makes the role of the latter critical. No conclusive data are reported about the length of the learning curve of a BS. OBJECTIVE: To highlight the role of a BS during robot-assisted radical prostatectomy (RARP) and to analyze the effect of the learning curve of a BS on intra- and postoperative outcomes. DESIGN, SETTING, AND PARTICIPANTS: From June 2013 to September 2016, 129 RARPs were performed by one expert CS (>1000 RARPs) and two BSs (residents)...
October 10, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30309817/the-predictive-role-of-biomarkers-for-the-detection-of-acute-kidney-injury-after-partial-or-radical-nephrectomy-a-systematic-review-of-the-literature
#19
REVIEW
Alessandro Antonelli, Marco Allinovi, Andrea Cocci, Giorgio Ivan Russo, Riccardo Schiavina, Bernardo Rocco, Giovannialberto Pini, Antonio Celia, Antonio Galfano, Virginia Varca, Giorgio Bozzini, Carlo Ceruti, Francesco Greco, Paolo Verze, Antonio Luigi Pastore, Angelo Porreca, Andrea Minervini
CONTEXT: Postoperative acute kidney injury (AKI) is a serious complication after kidney surgery, associated with prolonged hospital stay, high morbidity, and mortality. Biomarkers represent a tool of increasing importance to identify renal impairment after partial nephrectomy (PN) or radical nephrectomy (RN) in order to optimize and anticipate the diagnosis of AKI. OBJECTIVE: The goal of this systematic review is to investigate current insights on the role of biomarkers in predicting renal impairment in patients undergoing PN or RN...
October 9, 2018: European Urology Focus
https://www.readbyqxmd.com/read/30309818/hoxa9-pcdh17-pou4f2-and-onecut2-as-a-urinary-biomarker-combination-for-the-detection-of-bladder-cancer-in-chinese-patients-with-hematuria
#20
Yishuo Wu, Guangliang Jiang, Ning Zhang, Shenghua Liu, Xiaoling Lin, Chelsea Perschon, S Lilly Zheng, Qiang Ding, Xiang Wang, Rong Na, Jishan Sun, Jianfeng Xu
BACKGROUND: DNA methylation biomarkers for bladder cancer (BCa) have not been evaluated extensively in the Chinese population. OBJECTIVE: To develop and validate a urinary biomarker combination of methylation assays in a group of Chinese patients with hematuria. DESIGN, SETTING, AND PARTICIPANTS: A total of 192 urine samples were collected and evaluated from patients with microscopic or gross hematuria, including 97 BCa patients and 95 controls with benign diseases...
October 8, 2018: European Urology Focus
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