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Current Urology

Rafal Turo, Ewere Hadome, Pavlo Somov, Bushra Hamid, Dev Mohan Gulur, Bo Adrian Pettersson, Ninaad Shashank Awsare
The first uretero-arterial fistula (UAF) was reported in 1908 by Moschcowitz. In 2009, a systematic review identified 139 cases. Since then a further 23 cases were described with 19 cases originating from a single center. It has been recognized as a very rare condition in the past. However, more recently, the increasing incidence of UAF has led us to believe that this condition is more frequent than previously described. Aging population, improved cancer survival and extensive multimodal pelvic cancer treatments have been recognized as culprits for the increased incidence of UAFs...
October 2018: Current Urology
Sandra Baleato-González, Maria Gabriela Tirapu-de-Sagrario, Elena Pintos-Martínez, Roberto García-Figueiras
The peripheral primitive neuroectodermal tumor (pPNET) is a rare malignant tumor originating from neuroectoderm that usually occurs in children or adolescent and is frequently located in the extremities, chest cavity, pelvic cavity and chest wall. We present a rare case of an 84-year-old man with a history of pPNET in the scrotal sac, to our knowledge not previously published in the literature. The presence of a large irreducible mass in the inguinal sac forced to exclude a tumor. Ultrasound and MRI are very useful modalities to assess the location of the mass, its dependency from any organ and the tumoral internal structure...
October 2018: Current Urology
Andrew J Gunn, Benjamin J Mullenbach, May M Poundstone, Jennifer B Gordetsky, Edgar S Underwood, Soroush Rais-Bahrami
This report describes the technical aspects of trans-arterial embolization (TAE) of renal cell carcinoma prior to percutaneous ablation. All patients (n = 11) had a single renal mass (mean tumor diameter = 50.2 mm; range: 28-84 mm). Selective TAE was performed via the common femoral artery. Embolic materials included: particles alone (n = 4), coils alone (n = 1), particles + ethiodized oil (n = 2), particles + coils (n = 1), ethiodized oil + ethanol (n = 2), and particles + ethanol (n = 1). All embolizations were technically successful and no complications have been reported...
October 2018: Current Urology
Kei Nagase, Shohei Tobu, Shuhei Kusano, Kohei Takahara, Kazuma Udo, Mitsuru Noguchi
Recently, metabolic syndrome (MetS) has become an important public health problem, and its prevalence is increasing. MetS is associated with multifactorial diseases. No reports have suggested a relationship between bladder cancer and high blood pressure, and hyperlipidemia has been reported as a possible risk factor. In the present study, we investigated the relationships between the stage and degree of malignancy of bladder cancer and MetS. Furthermore, we investigated the influence of the components of MetS on the results...
October 2018: Current Urology
Rabea A Gadelkareem
Introduction: Surgical fires are unique topics that belong to surgical never events and deserve urological attention. Materials and Methods: A retrospective search of our hospital records was done for the states of electrosurgical never events in the period from July 2001 to June 2016. The included events were classified according to the site of occurrence in relation to the patient's body and possibilities of human involvement. The events were studied for the type, extent, damages, personnel involvements, complications, and management...
October 2018: Current Urology
Alireza Aminsharifi, Dariush Irani, Hossein Amirzargar
Aims: To compare the outcome of shock wave lithotripsy (SWL) on post-percutaneous nephrolithotomy (PCNL) residual fragments (RFs) versus primary stones of the same size through a matched pair study. Methods: Patients with a single 5-15 mm fragment 3 months after PCNL were enrolled (study group n = 59). The control group (n = 67) consisted of all adult patients with a single 5-15 mm renal stone. Results: The success rate of SWL was significantly higher in the study group (81...
October 2018: Current Urology
Jennifer L Saluk, Robert H Blackwell, William S Gange, Matthew A C Zapf, Anai N Kothari, Paul C Kuo, Marcus L Quek, Robert C Flanigan, Gopal N Gupta
Introduction: Radical cystectomy for bladder cancer is associated with high rates of readmission. We investigated the LACE score, a validated prediction tool for readmission and mortality, in the radical cystectomy population. Materials & Methods: Patients who underwent radical cystectomy for bladder cancer were identified by ICD-9 codes from the Healthcare Cost and Utilization Project State Inpatient Database for California years 2007-2010. The LACE score was calculated as previously described, with components of L: length of stay, A: acuity of admission, C: comorbidity, and E: number of emergency department visits within 6 months preceding surgery...
October 2018: Current Urology
Athanasios Skarmoutsos, Ioannis Skarmoutsos, Ioannis Katafigiotis, Elisavet Tataki, Athina Giagini, Christos Alamanis, Ioannis Anastasiou, Anastasios Angelou, Mordechai Duvdevani, Nikolaos Sitaras, Constantinos Constantinides
Introduction: Although the prostate specific antigen revolutionized the diagnosis of prostate cancer (PCa), it has its limitations. We prospectively examined the potential use of the platelet-derived growth factor-BB (PDGF-BB) as a urine biomarker for the early diagnosis of PCa. Materials and Methods: The urine samples of 118 patients were collected after a prostatic massage and all the patients subsequently underwent ultrasound-guided transrectal biopsy. PDGF-BB was detected in the urine by enzyme-linked immunosorbent assay...
October 2018: Current Urology
Jason Gandhi, Steven J Weissbart, Albert N Kim, Gunjan Joshi, Steven A Kaplan, Sardar Ali Khan
Background: Intravesical prostatic protrusion (IPP) is a manifestation of benign prostatic hyperplasia marked by overgrowth of the prostatic median lobe into the bladder, producing bladder outlet obstruction and related storage and voiding symptoms. Methods: A MEDLINE® database search of the current literature was guided using combination of "prostate" with the following terms: intravesical prostatic protrusion, bladder trabeculation, bladder outlet obstruction, lower urinary tract symptoms, alpha blockers, transrectal ultrasonography, and prostatectomy...
October 2018: Current Urology
Prasan I Panagoda, Nikhil Vasdev, Shan Gowrie-Mohan
Introduction: Bladder cancer is the seventh most common cancer in the UK. Transurethral resection of bladder tumor (TURBT) is a relatively common procedure used to treat cancer of the bladder. A serious complication of TURBT is bladder perforation, the risk of which is greatly increased in the presence of an "obturator jerk". Methods: A literature search was performed on PubMed using the following search criteria "obturator nerve block", "obturator nerve block in transurethral resection of bladder tumor", "adductor spasm during transurethral resection of bladder tumor", "bi-polar diathermy obturator nerve", and "transvesical obturator nerve block"...
October 2018: Current Urology
Li Rebekah Feng, Simeng Suy, Sean P Collins, Jonathan W Lischalk, Berwin Yuan, Leorey N Saligan
Background: Prostate cancer survivors commonly experience late-onset lower urinary tract symptoms following radiotherapy. We aimed to compare lower urinary tract symptoms in patients treated with stereotactic body radiotherapy (SBRT) to those treated with a combination of lower dose SBRT and supplemental intensity-modulated radiotherapy (SBRT + IMRT). Methods: Subjects with localized prostate carcinoma scheduled to receive SBRT or a combination of SBRT and IMRT were enrolled and followed for up to 2 years after treatment completion...
June 2018: Current Urology
Melissa L Dawson, Meagan S Cramer, Dana R Thompson, Babak Vakili
Background/Aims: The rate of urinary tract infection (UTI) after pelvic reconstructive surgery ranges from 9 to 48% and the most common uropathogen is Escherichia coli ( E. coli ). The aim of the study is to identify the predominant uro-pathogen from urine cultures in women undergoing pelvic reconstructive surgery. Methods: A retrospective review was conducted on women who underwent pelvic reconstructive surgery at a tertiary care center from July 2013 to June 2015...
June 2018: Current Urology
Yair Feld, Shai Golan, Ilan Leibovitch
Background: Transurethral resection of the prostate is the most common procedure for the treatment of benign prostatic hyperplasia (BPH). Although effective, transurethral resection of the prostate can be associated with side effects including prolonged recovery, storage and voiding symptoms, risk of acute urinary retention. Objectives: In this study, we describe a new minimally invasive device for the treatment of lower urinary track symptoms due to BPH, implanting a nitinol C shape ring in a circular incision in the prostatic tissue, surrounding the urethra, done by electrocuting blade over a dilatation balloon...
June 2018: Current Urology
Takeshi Hara, Takeshi Ogata, Hiroko Wada, Takayuki Yabuki, Susumu Kanazawa
Introduction: Gadobutrol (Gd-DO3A-butrol) (Gadovist®) is a macrocyclic gadolinium-based contrast agent for magnetic resonance imaging (MRI) formulated at 1.0 mmol Gd/ml. Gadobutrol's higher concentration compared to other contrast agents (0.5 mmol Gd/ml) is associated with higher T1 relaxivity. We examined whether gadobutrol increases the accuracy of prostate cancer detection using dynamic contrast-enhanced MRI. Materials and Methods: Multiparametric MRI was performed in 379 patients: 94 patients received 1 M gadobutrol while 285 randomly received equivalent doses of 0...
June 2018: Current Urology
David Curry, Ajay Pahuja, Willie Loan, Ali Thwaini
Introduction: To describe oncological outcomes, effects on renal function and complications with radiofrequency ablation (RFA) of T1 renal tumors in an 8-year experience. Materials and Methods: A retrospective study of RFA in 89 consecutive patients between 2005 and 2013 was undertaken. Those with metastatic disease, incomplete follow-up, genetic pre-disposition to renal tumors and biopsy proven benign pathology were excluded, with 79 patients meeting inclusion criteria...
June 2018: Current Urology
Ahmed Adam, Jayveer Sookram, Amit Sattish Bhattu, Reubina Wadee, Marlon Perera, Nathan Lawrentschuk
Background: To assess if trans-urethral snare of bladder tumor (TUSnBT) with subsequent stone basket retrieval can be used as an effective, time-saving adjunct resection technique for papillary bladder lesions. Methods: Via standard cystoscopy, TUSnBT was performed using a standard endoscopic polypectomy snare with subsequent tumor extraction utilizing a standard stone retrieval basket, when lesions were more than 10 mm in diameter. Smaller lesions were removed with the polypectomy snare...
June 2018: Current Urology
Daniël F Osses, Joost J van Asten, Jasper D Tijsterman
Introduction: Purpose of this study is to evaluate the detection rates of prostate cancer (PCa) for cognitive-targeted biopsy (CTB) in comparison with magnetic resonance imaging (MRI)-guided biopsy (MRGB) related to prostate imaging reporting and data system (PI-RADS) score, lesion location and lesion volume. Furthermore, the addition of systematic transrectal ultrasound-guided biopsy (TRUS-GB) to CTB is evaluated. Materials and Methods: We included all patients with cancer-suspicious lesions on 3-Tesla multiparametric MRI who underwent either CTB and additional TRUS-GB or only MRGB (in-bore) in Haga Teaching Hospital between January 2013 and January 2015...
June 2018: Current Urology
Robert H Blackwell, Anai N Kothari, Arpeet Shah, William Gang, Marcus L Quek, Fred A Luchette, Robert C Flanigan, Paul C Kuo, Gopal N Gupta
Objective: To describe the long-term incidence of adhesive bowel obstruction following major urologic surgery, and the effect of early surgery on perioperative outcomes. Methods: The Healthcare Cost and Utilization Project State Inpatient Databases for California and Florida (2006-2011) were used to identify major urologic oncologic surgery patients. Subsequent adhesive bowel obstruction admissions were identified and Kaplan-Meier time-to-event analysis was performed...
June 2018: Current Urology
Eva Browne, Usman Haroon, Niall F Davis, James C Forde
New oral anticoagulants (NOACs) are increasingly replacing the use of warfarin in clinical practice. Their use has now also been extended to thromboprophylaxis in many orthopedic surgeries. This, in addition to an increasingly aging population with many complex comorbidities means that these medications will be ever more frequently encountered by urologists. Thus, a clear understanding of the mechanism of action of NOACs, their time to peak action and half-life is essential for the purpose of managing these patients perioperatively...
June 2018: Current Urology
Jeremy M West, Andrew J Goates, James A Brown
Intermittent testicular torsion presents with recurrent episodes of severe unilateral testicular pain with resolution of symptoms between episodes. We present a case of a 26-year-old man with a 14-year history of intermittent testicular pain presenting to the urology clinic for elective surgical evaluation. He reported monthly symptoms for many years and had learned to manually reduce the torsion with each episode. Diagnosis of intermittent testicular torsion was made based on patient history and treatment with bilateral orchiopexy resulted in complete symptom resolution and without any loss of testicular function...
March 2018: Current Urology
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