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https://www.readbyqxmd.com/read/28441271/alternative-payment-models-and-urology
#1
Deborah R Kaye, David C Miller, Chad Ellimoottil
PURPOSE OF REVIEW: The Medicare Access and CHIP Reauthorization Act (MACRA) is a historic bill that was recently passed that establishes how quality measurement and practice patterns will affect physician reimbursement. Alternative payment models (APMs) are an essential component of MACRA and Medicare's vision of paying for high-value care. This review describes APMs in the context of MACRA and their impact on urology. RECENT FINDINGS: The majority of urologists will be affected by MACRA...
April 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28440360/anorectal-malformation-as-a-cause-of-recurring-perineal-abscesses-value-of-anorectal-endosonography-and-magnetic-resonance-imaging-a-case-report
#2
Małgorzata Kołodziejczak, Giulio A Santoro, Jacek Sobocki, Tomasz Szopiński, Anna Wiączek, Iwona Sudoł-Szopińska
Malformations of the rectum and urinary tract frequently coexist, and the prevalence of urogenital defects in patients with a rectal defect ranges from 20 to 54%. In most patients, anorectal malformations are diagnosed and treated surgically in early childhood. In this report, we present a case of a 52-year-old male with a history of urological operations in infancy due to a congenital urethral malformation and multiple recurrent episodes of perineal abscesses with urinary retention. Anorectal endosonography and magnetic resonance imaging revealed the presence of a large cystic lesion adjacent to the rectal wall which became smaller at the level of the puborectalis...
April 22, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/28440233/-clinical-cytology-for-endoscopists-a-practical-guide
#3
REVIEW
Michael Hocke, Theodoros Topalidis, Barbara Braden, Christoph F Dietrich
Clinical cytology was originally used by clinicians to provide rapid diagnosis. However, with advancing medical subspecialization, few clinicians interpret cytology themselves these days, for example, gynecologists, hematologists, urologists, and occasional gastroenterologist (mainly in Asian countries). Cytological assessment enjoyed a renaissance with the development of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA). Subsequently, pathologists, most of them more experienced in histology, had to take over...
March 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28437672/eosinophilic-funiculitis-initially-diagnosed-as-irreducible-inguinal-hernia-a-case-report
#4
Kohei Yamada, Akashi Ikubo, Shota Ikeda, Satoko Koga, Yasuhiro Tsuru, Hideo Kuroki, Naohiko Koya, Ryuichiro Samejima, Masashi Sakai, Masanobu Tabuchi, Seiji Yunotani, Shinichi Kido, Kazushige Nishimura, Hiroyuki Meiri
BACKGROUND: Most groin masses are first suspected to be groin hernias. More than 80% of bulging groin lesions are reportedly diagnosed as hernias by ultrasonography. Establishment of the correct diagnosis of hernia among all differential diagnoses is not easy. We herein describe a very rare case of groin eosinophilic funiculitis that presented as an irreducible groin hernia. CASE PRESENTATION: A 59-year-old man presented to our hospital with suspicion of a right groin hernia...
April 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28437028/esut-educational-video-on-fluoroscopic-guided-puncture-in-pcnl-all-techniques-step-by-step
#5
Iason Kyriazis, Evangelos Liatsikos, Odysseas Sopilidis, Panagiotis Kallidonis, Andreas Skolarikos
OBJECTIVE: Kidney puncture during percutaneous nephrolithotomy (PCNL) is regarded as one of the most demanding aspects of the procedure and only a minority of urologists perform this step without assistance by a radiologist. Currently a wide variation of fluoroscopic guided techniques is available in clinical practice. In this work we describe the most common fluoroscopic guided access techniques in a step-by-step manner aiming to assist on the standardization of their technique and terminology...
April 24, 2017: BJU International
https://www.readbyqxmd.com/read/28436366/analysis-of-preoperative-antibiotic-prophylaxis-in-stented-distal-hypospadias-repair
#6
Jacob Smith, Ashay Patel, Ismael Zamilpa, Shasha Bai, Jeffrey Alliston, Stephen Canon
INTRODUCTION: Surgical site infection [SSI] is a risk for any surgical procedure, including hypospadias repair. Prophylactic antibiotic therapy for patients having surgery is often effective in preventing SSIs, but with increasing rates of antibiotic resistance, this practice has been questioned. The objectives of this study are 1) to assess the incidence of SSIs in patients following stented, distal hypospadias repair and 2) to observe for any potential difference in the incidence of SSIs for patients with and without preoperative antibiotic utilization in this setting...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28436364/upper-pole-urologist-obtained-percutaneous-renal-access-for-pcnl-is-safe-and-efficacious
#7
Amar P Patel, Don Bui, John Pattaras, Kenneth Ogan
INTRODUCTION: Interventional radiologist may be hesitant to obtain upper pole access for percutaneous nephrolithotomy (PCNL) due to a higher complication rate. Renal access gained by urologists may achieve higher stone-free rates with similar complication rates. We evaluate our institution's contemporary results of percutaneous renal access in the upper pole for nephrolithotomy by urologists, which we believe both safe and efficacious. MATERIALS AND METHODS: This retrospective chart review included all PCNL's performed by fellowship-trained endourologists from 2003 to 2014 at a single institution...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28435035/the-expanding-role-of-advanced-practice-providers-in-urologic-procedural-care
#8
Joshua P Langston, Richard Duszak, Venetia L Orcutt, Heather Schultz, Brad Hornberger, Lawrence C Jenkins, Jennifer Hemingway, Danny R Hughes, Raj S Pruthi, Matthew E Nielsen
OBJECTIVE: To understand the role of Advanced Practice Providers (APPs) in urologic procedural care, and its change over time. As the population ages and the urologic workforce struggles to meet patient access demands, the role of APPs in the provision of all aspects of urologic care is increasing. However, little is currently known about their role in procedural care. MATERIALS AND METHODS: Commonly performed urologic procedures were linked to Current Procedural Terminology (CPT) codes from 1994 to 2012...
April 20, 2017: Urology
https://www.readbyqxmd.com/read/28434984/the-nonpalpable-testis-a-narrative-review
#9
REVIEW
Courtney L Shepard, Kate H Kraft
PURPOSE: While the nonpalpable testis represents only a small portion of all cryptorchid testes, it remains a clinical challenge for pediatric urologists. Many controversies about the best evaluation and management exist. This narrative review serves as an update on what is known about the nonpalpable testis: etiology, pre-operative evaluation, the best surgical management, novel techniques, and ongoing controversies. MATERIALS AND METHODS: A Pubmed® and MEDLINE® search limited to January 2000 to January 2017 was performed using relevant key terms...
April 20, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28432607/impact-of-the-medical-specialty-on-knowledge-regarding-multidrug-resistant-organisms-and-strategies-toward-antimicrobial-stewardship
#10
Steffen Lebentrau, Christian Gilfrich, Malte W Vetterlein, Harald Schumacher, Philipp J Spachmann, Sabine D Brookman-May, Hans M Fritsche, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Matthias May
PURPOSE: Evidence is scarce on subject-specific knowledge of multidrug-resistant organisms and rational use of antibiotics. We aimed at evaluating attitude, perception, and knowledge about multidrug-resistant organisms (MDRO) and antibiotic prescribing among urologists versus other medical specialties. METHODS: Within the MR2-study (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria), a questionnaire was conducted targeting general surgeons, internists, gynecologists, and urologists in 18 German hospitals...
April 21, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28431538/a-prospective-and-randomized-comparison-of-rigid-ureteroscopic-to-flexible-cystoscopic-retrieval-of-ureteral-stents
#11
Dehui Lai, Meiling Chen, Shifang Zha, Shawpong Wan
BACKGROUND: Flexible cystoscopy has become an accepted alternative for stent retrieval. However, it is associated with higher cost. Some reports have described experiences of using rigid ureteroscope to retrieve ureteral stents. We compared rigid ureteroscopic to flexible cystoscopic retrieval of ureteral stents in a prospective and randomized clinical trial. METHODS: Three hundred patients treated with ureteral stents between July 2012 and July 2013 were accrued in this study...
April 21, 2017: BMC Urology
https://www.readbyqxmd.com/read/28427985/ureter-injury-as-a-complication-of-oblique-lumbar-interbody-fusion-a-case-report
#12
Hyeong-Jin Lee, Jin-Sung Kim, Kyeong-Sik Ryu, Choon Keun Park
BACKGROUND: Oblique lumbar interbody fusion is a commonly used surgical method of achieving lumbar interbody fusion. There have been some reports about complications of oblique lumbar interbody fusion at the L2-3 level. But to our knowledge, there have been no reports about ureter injury during oblique lumbar interbody fusion. We report a case of ureter injury during oblique lumbar interbody fusion to share our experience. CASE DESCRIPTION: A 78-year-old male patient presented with a history of lower back pain and neurogenic intermittent claudication...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28424869/review-on-diagnosis-and-management-of-urolithiasis-in-pregnancy-an-esut-practical-guide-for-urologists
#13
REVIEW
Bhaskar K Somani, Athanasios Dellis, Evangellos Liatsikos, Andreas Skolarikos
PURPOSE: Management of urolithiasis in pregnancy can be challenging for most urologists with diagnostic and treatment dilemma to ensure the best outcome for both mother and fetus. We wanted to review the literature for urolithiasis in pregnancy with a practical management guide for urologists. METHODS: A non-systematic review of literature was carried out for all English language literature using Medline. To ensure a more comprehensive search, the review of diagnosis and management of pregnant patients with urolithiasis was carried out separately, by two authors independently...
April 19, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28418183/evaluation-of-gender-based-disparities-from-initial-hematuria-presentation-to-upper-tract-urothelial-carcinoma-diagnosis-analysis-of-a-nationwide-insurance-claims-database
#14
Meera R Chappidi, Max Kates, Jeffrey J Tosoian, Michael H Johnson, Noah M Hahn, Trinity J Bivalacqua, Phillip M Pierorazio
OBJECTIVE: To investigate the duration from initial hematuria presentation to upper tract urothelial carcinoma (UTUC) diagnosis and the effect of gender on this duration. PATIENTS AND METHODS: Patients with hematuria claims in the year prior to UTUC diagnosis were identified in the MarketScan database (2010-2014). Delayed diagnosis was defined as >90 days from hematuria presentation to UTUC diagnosis. Multivariable Poisson regression models were used to determine factors associated with delayed UTUC diagnosis...
April 18, 2017: BJU International
https://www.readbyqxmd.com/read/28417430/the-emergence-of-kidney-stone-disease-during-childhood-impact-on-adults
#15
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/28417428/outcomes-of-minimally-invasive-inguinal-hernia-repair-at-the-time-of-robotic-radical-prostatectomy
#16
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
#17
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/28413533/persistent-l5-lumbosacral-radiculopathy-caused-by-lumbosacral-trunk-schwannoma
#18
Guive Sharifi, Amin Jahanbakhshi
Schwannomais, usually, benign tumor of nerve sheath that occurs evenly along the spinal cord. Intra-pelvic schwannoma is very rare entity that may arise from lumbosacral nerve roots or from sciatic nerve. Radicular pain of the lower limb as a presenting symptom of pelvic schwannoma is extremely rare. In the current report, the patient is presented with a right sided L5 radicular pain typical of lumbar discopathy. Interestingly, a herniated lumbar disc was noted on lumbosacral magnetic resonance imaging (MRI)...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28411921/salvage-surgery-after-renal-mass-ablation
#19
REVIEW
Brian W Cross, Daniel C Parker, Michael S Cookson
Thermal ablative techniques represent treatment options for patients with small renal masses who are not candidates for surgery. The oncologic efficacy of ablation has not been compared in a randomized fashion with nephron-sparing surgery, and the urologist must be knowledgeable regarding the workup and treatment of patients with suspected residual or recurrent tumor following these therapies. Surveillance of patients with tumor recurrence after ablation may be indicated in select circumstances. When patients are deemed appropriate for salvage therapy, most undergo a repeat course of the same ablative modality...
May 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28411919/complications-of-renal-surgery
#20
REVIEW
William T Berg, Jeffrey J Tomaszewski, Hailiu Yang, Anthony Corcoran
The incidence of the small renal mass continues to increase owing to the aging population and the ubiquity imaging. Most of these tumors are stage I tumors. Management strategies include surveillance, ablation, and extirpation. There is a wide body of literature favoring nephron-sparing approaches. Although nephron-sparing surgery may yield decreased long-term morbidity, it is not without its drawbacks, including a higher rate of complications. Urologists must be attuned to the complications of surgery and develop strategies to minimize risk...
May 2017: Urologic Clinics of North America
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