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Essential Urology

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157 papers 100 to 500 followers
By Axel Cayetano Urology Resident
https://www.readbyqxmd.com/read/27878331/fluoroscopy-versus-ultrasound-for-image-guidance-during-percutaneous-nephrolithotomy-a-systematic-review-and-meta-analysis
#1
REVIEW
Qiang Liu, Liang Zhou, Xiang Cai, Tao Jin, Kunjie Wang
This meta-analysis aims to compare the safety and efficacy of fluoroscopy versus ultrasound guidance during the access to the renal collecting system. A systematic literature review was performed in September 2016. Outcomes were explored using review manager v5.0. 18 studies with 2919 patients were included in the final analysis. There was no significant difference in stone-free rate (RR: 1.0; 95% CI, 0.98 to 1.05; p = 0.41), operation time (MD: 1.75; 95% CI, -9.15 to 12.65; p = 0.75), hospital stay (MD: -1...
November 22, 2016: Urolithiasis
https://www.readbyqxmd.com/read/27908363/definition-of-successful-treatment-and-optimal-follow-up-after-urethral-reconstruction-for-urethral-stricture-disease
#2
REVIEW
Bradley A Erickson, George M Ghareeb
The definition of a successful urethroplasty, the lack of need for a secondary procedure, is outdated and must be amended to incorporate objective and subjective outcomes. Success is assigned if a flexible cystoscope can traverse the reconstructed urethra without force. Functional success is assigned if patient-reported outcome measures reveal improvement in voiding symptoms and urinary quality of life. Optimal follow-up strategy allows determination of anatomic and functional outcomes, protects genitourinary health, and prevents excessive invasive testing, unnecessary cost, discomfort, anxiety, and risk...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28053945/treatment-of-leukocytospermia-in-male-infertility-a-systematic-review
#3
REVIEW
Jae Hung Jung, Myung Ha Kim, Jiye Kim, Soon Koo Baik, Sang-Baek Koh, Hyun Jun Park, Ju Tae Seo
Male factors account for 20% to 50% of infertility cases, and infection in the genitourinary tract may play a contributing role in up to 15% of male infertility. Leukocytospermia is a well-known indicator of infection or inflammation in the male sex glands and the urogenital tract. Although great deal of effort has been expended to elucidate definite management strategies in infertile men with leukocytospermia, the gold standard of treatment remains unclear. Until recently, broad spectrum antibiotics and antioxidants have been used in the treatment of leukocytospermia for male infertility to eliminate infection and reduce reactive oxygen free radicals produced inside cellular mitochondria as a result of inflammation...
December 2016: World Journal of Men's Health
https://www.readbyqxmd.com/read/28124111/percutaneous-nephrolithotomy-technique
#4
Thomas Knoll, Francisco Daels, Janak Desai, Andras Hoznek, Bodo Knudsen, Emanuele Montanari, Cesare Scoffone, Andreas Skolarikos, Keiichi Tozawa
Percutaneous nephrolithotomy (PCNL) is considered to be the first line of treatment for large renal stones. Though PCNL comes with higher morbidity, its efficacy is unbeaten by other minimally invasive modalities. However, potential complications, such as bleeding, occur. Improved skills and modifications of the procedure may reduce the probability of adverse outcomes. This article discusses the current trends and standards in PCNL technique with special focus on all important steps as positioning, access, instruments, dilation, disintegration, and exit, including outcomes, complication management, and training modalities...
January 25, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28196724/persistence-and-adherence-with-mirabegron-versus-antimuscarinic-agents-in-patients-with-overactive-bladder-a-retrospective-observational-study-in-uk-clinical-practice
#5
Christopher R Chapple, Jameel Nazir, Zalmai Hakimi, Sally Bowditch, Francis Fatoye, Florent Guelfucci, Amine Khemiri, Emad Siddiqui, Adrian Wagg
BACKGROUND: Persistence with antimuscarinic therapy in overactive bladder (OAB) is poor, but may be different for mirabegron, a β3-adrenoceptor agonist with a different adverse event profile. OBJECTIVE: To compare persistence and adherence with mirabegron versus tolterodine extended release (ER) and other antimuscarinics in routine clinical practice over a 12-mo period. DESIGN, SETTING, AND PARTICIPANTS: Retrospective, longitudinal, observational study of anonymised data from the UK Clinical Practice Research Datalink GOLD database...
February 11, 2017: European Urology
https://www.readbyqxmd.com/read/28146658/radiation-with-or-without-antiandrogen-therapy-in-recurrent-prostate-cancer
#6
RANDOMIZED CONTROLLED TRIAL
William U Shipley, Wendy Seiferheld, Himanshu R Lukka, Pierre P Major, Niall M Heney, David J Grignon, Oliver Sartor, Maltibehn P Patel, Jean-Paul Bahary, Anthony L Zietman, Thomas M Pisansky, Kenneth L Zeitzer, Colleen A F Lawton, Felix Y Feng, Richard D Lovett, Alexander G Balogh, Luis Souhami, Seth A Rosenthal, Kevin J Kerlin, James J Dignam, Stephanie L Pugh, Howard M Sandler
Background Salvage radiation therapy is often necessary in men who have undergone radical prostatectomy and have evidence of prostate-cancer recurrence signaled by a persistently or recurrently elevated prostate-specific antigen (PSA) level. Whether antiandrogen therapy with radiation therapy will further improve cancer control and prolong overall survival is unknown. Methods In a double-blind, placebo-controlled trial conducted from 1998 through 2003, we assigned 760 eligible patients who had undergone prostatectomy with a lymphadenectomy and had disease, as assessed on pathological testing, with a tumor stage of T2 (confined to the prostate but with a positive surgical margin) or T3 (with histologic extension beyond the prostatic capsule), no nodal involvement, and a detectable PSA level of 0...
2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27958393/a-contemporary-update-on-fournier-s-gangrene
#7
REVIEW
Judith C Hagedorn, Hunter Wessells
Despite advances in the evaluation, treatment, and pathophysiological understanding of necrotizing soft-tissue infections, Fournier's gangrene remains a life-threatening urological emergency. Although the condition can affect patients of any age and gender, it might be more prevalent in some high-risk groups with certain comorbidities. Several prognostic and diagnostic tools have been developed to assist with clinical decision-making once the diagnosis is made - primarily based on the physician's physical exam and potentially supported by laboratory and imaging findings...
December 13, 2016: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28075168/transurethral-resection-of-prostate-and-bleeding-a-prospective-randomized-double-blind-placebo-controlled-trial-to-see-efficacy-of-short-term-use-of-finasteride-and-dutasteride-on-operative-blood-loss-and-prostatic-micro-vessel-density
#8
Ankur Bansal, Aditi Arora
OBJECTIVE: To evaluate the effects of short term use of finasteride and dutasteride on the amount of intraoperative blood loss and microvessel density (MVD) of prostatic stromal and suburethral tissues in the patients with benign prostatic hyperplasia (BPH) prior to transurethral resection of prostate (TURP). METHODS: The study involved 450 male patients who planned to have TURP and were prospectively randomized into 3 groups (150 patients each). Group 1 received placebo, group 2 received finasteride 5 mg/day and group 3 received dutasteride 0...
January 11, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28114785/pelvic-phlebolith-a-trivial-pursuit-for-the-urologist
#9
Angus Chin On Luk, Paul Cleaveland, Louise Olson, Donald Neilson, Shalom Srirangam
OBJECTIVE: Pelvic phleboliths are commonly encountered on plain and CT imaging and remain a source of frustration when attempting to differentiate them from ureteral calculi. Given their frequency, surprising little is known about their significance. We review the literature on pelvic phleboliths, specifically in relation to their history, demography, clinical significance, and methods to distinguish them from ureteral calculi. METHODS: A comprehensive literature search was performed for all articles concerning pelvic phleboliths...
January 23, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28089304/management-of-prostate-cancer-in-elderly-patients-recommendations-of-a-task-force-of-the-international-society-of-geriatric-oncology
#10
REVIEW
Jean-Pierre Droz, Gilles Albrand, Silke Gillessen, Simon Hughes, Nicolas Mottet, Stéphane Oudard, Heather Payne, Martine Puts, Gilbert Zulian, Lodovico Balducci, Matti Aapro
CONTEXT: Prostate cancer is the most frequent male cancer. Since the median age of diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if treatment is to be tailored to individual circumstances including comorbidities and frailty. OBJECTIVE: To update the 2014 International Society of Geriatric Oncology (SIOG) guidelines on prostate cancer in men aged >70 yr. The update includes new material on health status evaluation and the treatment of localised, advanced, and castrate-resistant disease...
January 11, 2017: European Urology
https://www.readbyqxmd.com/read/28196723/diagnostic-performance-of-prostate-imaging-reporting-and-data-system-version-2-for-detection-of-prostate-cancer-a-systematic-review-and-diagnostic-meta-analysis
#11
REVIEW
Sungmin Woo, Chong Hyun Suh, Sang Youn Kim, Jeong Yeon Cho, Seung Hyup Kim
CONTEXT: In 2015, the updated Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) for the detection of prostate cancer (PCa) was established. Since then, several studies assessing the value of PI-RADSv2 have been published. OBJECTIVE: To review the diagnostic performance of PI-RADSv2 for the detection of PCa. EVIDENCE ACQUISITION: MEDLINE and EMBASE databases were searched up to December 7, 2016. We included diagnostic accuracy studies that used PI-RADSv2 for PCa detection, using prostatectomy or biopsy as the reference standard...
February 11, 2017: European Urology
https://www.readbyqxmd.com/read/28145037/ureteric-stent-dwelling-time-a-risk-factor-for-post-ureteroscopy-sepsis
#12
Amihay Nevo, Roy Mano, Jack Baniel, David A Lifshitz
OBJECTIVES: To evaluate the association between stent dwelling time and sepsis after ureteroscopy, and identify risk factors for sepsis in this setting. PATIENTS AND METHODS: The prospectively collected database of a single institution was queried for all patients who underwent ureteroscopy for stone extraction between 2010 and 2016. Demographic, clinical, preoperative and operative data were collected. The primary study endpoint was sepsis within 48 h of ureteroscopy...
February 1, 2017: BJU International
https://www.readbyqxmd.com/read/28058776/guideline-of-guidelines-non-muscle-invasive-bladder-cancer
#13
LETTER
Solomon L Woldu, Aditya Bagrodia, Yair Lotan
Non-muscle-invasive bladder cancer (NMIBC) represents the vast majority of bladder cancer diagnoses, but this definition represents a spectrum of disease with a variable clinical course, notable for significant risk of recurrence and potential for progression. Management involves risk-adapted strategies of cystoscopic surveillance and intravesical therapy with the goal of bladder preservation when safe to do so. Multiple organizational guidelines exist to help practitioners manage this complicated disease process, but adherence to management principles among practising urologists is reportedly low...
March 2017: BJU International
https://www.readbyqxmd.com/read/28181381/changes-in-penile-length-after-radical-prostatectomy-investigation-of-the-underlying-anatomical-mechanism
#14
Yoshifumi Kadono, Kazuaki Machioka, Kazufumi Nakashima, Masashi Iijima, Kazuyoshi Shigehara, Takahiro Nohara, Kazutaka Narimoto, Kouji Izumi, Yasuhide Kitagawa, Hiroyuki Konaka, Toshifumi Gabata, Atsushi Mizokami
OBJECTIVE: To measure changes in penile length (PL) over time before and after radical prostatectomy (RP), and to investigate the underlying mechanisms for these changes. PATIENTS AND METHODS: The stretched PL (SPL) of 102 patients was measured before, 10 days after, and at 1, 3, 6, 9, 12, 18 and 24 months after RP. The perpendicular distance from the distal end of the membranous urethra to the midline of the pelvic outlet was measured on mid-sagittal magnetic resonance imaging (MRI) slice at three time points: preoperatively; 10 days after RP; and 12 months after RP...
February 8, 2017: BJU International
https://www.readbyqxmd.com/read/26597613/use-of-ureteral-access-sheaths-in-ureteroscopy
#15
REVIEW
Adam G Kaplan, Michael E Lipkin, Charles D Scales, Glenn M Preminger
The ureteral access sheath (UAS) facilitates the use of flexible ureteroscopy, enabling improved minimally invasive management of complex upper urinary tract diseases. The UAS, which comes in a variety of diameters and lengths, is passed in a retrograde fashion, aided by a hydrophilic coating and other features designed to confer smooth passage into the ureter with sufficient resistance to kinking and buckling. Use of a UAS has the advantage of enabling repeated passage of the ureteroscope while minimizing damage to the ureter, thus improving the flow of irrigation fluid and visualization within the urethra with reductions in operative times, which improves both the effectiveness of the surgery and reduces the costs...
March 2016: Nature Reviews. Urology
https://www.readbyqxmd.com/read/25100183/ureteral-strictures-revisited%C3%A2-trying-to-see-the-light-at-the-end-of-the-tunnel-a-comprehensive-review
#16
REVIEW
Stavros I Tyritzis, Nils Peter Wiklund
A ureteral stricture is a rather rare urological event defined as a narrowing of the ureter causing a functional obstruction and renal failure, if left untreated. The aim of this review article is to summarize and discuss current knowledge on the incidence, pathogenesis, management, and follow up of proximal, mid, and distal ureteral strictures.
February 2015: Journal of Endourology
https://www.readbyqxmd.com/read/26895782/optimal-management-of-distal-ureteric-strictures-following-renal-transplantation-a-systematic-review
#17
Justin Kwong, Danielle Schiefer, Ghaleb Aboalsamh, Jason Archambault, Patrick P Luke, Alp Sener
Our objective was to define optimal management of distal ureteric strictures following renal transplantation. A systematic review on PubMed identified 34 articles (385 patients). Primary endpoints were success rates and complications of specific primary and secondary treatments (following failure of primary treatment). Among primary treatments (n = 303), the open approach had 85.4% success (95% CI 72.5-93.1) and the endourological approach had 64.3% success (95% CI 58.3-69.9). Among secondary treatments (n = 82), the open approach had 93...
May 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/24109196/management-of-urolithiasis-in-pregnancy
#18
REVIEW
Michelle Jo Semins, Brian R Matlaga
Kidney stones are very common and unfortunately do not spare the pregnant population. Anatomical and pathophysiological changes occur in the pregnant female that alter the risk for development of nephrolithiasis. Acute renal colic during pregnancy is associated with significant potential risks to both mother and fetus. Diagnosis is often challenging because good imaging options without radiation use are limited. Management of diagnosed nephrolithiasis is unique in the pregnant population and requires multi-disciplinary care...
September 30, 2013: International Journal of Women's Health
https://www.readbyqxmd.com/read/27906777/asymptomatic-bacteriuria-to-screen-or-not-to-screen-and-when-to-treat
#19
Tommaso Cai, Bela Koves, Truls E Bjerklund Johansen
PURPOSE OF REVIEW: Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary treatment. The purpose of this review is to outline and evaluate the most recent literature on the management of ABU. RECENT FINDINGS: The role of ABU management has been evaluated in several patient subgroups: healthy patients without identified risk factors, pregnant women, postmenopausal women, women with recurrent UTI, patients with diabetes, elderly institutionalized patients, patients with renal transplants, patients with indwelling catheters and prior to surgery...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27860090/guideline-of-guidelines-priapism
#20
REVIEW
Asif Muneer, David Ralph
No abstract text is available yet for this article.
November 14, 2016: BJU International
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