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Directory of Authors from the Journal and their last article.

A Ibn SellamView Articles

Volume 13, Number 3Case Review

An Unusual Presentation of Primary Male Genital Tuberculosis

Imane KamaouiMohamed AmineBrahim EddafaliA Ibn SellamZakaria DahamiSaid Mohamed MoudouniIsmail Sarf

Urogenital tuberculosis is a rare disease; however, it is the second most common location for tuberculosis after the lung. Currently, incidence of urogenital tuberculosis is increasing due to factors such as a higher prevalence of immunosuppression (especially that caused by human immunodeficiency virus infection) and drug abuse. Herein a new case of male genital primary tuberculosis is reported presenting as a scrotal tumor; the originality of this observation lies in its unusual pseudotumor form. [Rev Urol. 2011;13(3):176-178 doi: 10.3909/riu0525] © 2011 MedReviews®, LLC

Urogenital tuberculosisEpididymal tuberculosisMale genital tuberculosis

A J FarhaView Articles

Volume 22, Number 3Case Review

From Radical to Partial Nephrectomy in the Setting of Solitary Functioning Kidney: Neoadjuvant Treatment of Renal Cell Carcinoma

David D WatsonNicole G FarhaK James KallailShaker DakhilA J Farha

Immunotherapy has revolutionized the treatment of metastatic renal cell carcinoma (RCC). This case evaluates the use of neoadjuvant immunotherapy for localized RCC in a patient with solitary functioning kidney. A retrospective chart review was conducted between September 2019 and January 2020 on a single patient. Before treatment, the tumor was 7 cm × 8 cm × 8.5 cm. The patient trialed nivolumab + ipilimumab then cabozantinib. The tumor shrunk to 6.3 cm × 5.5 cm and was removed via partial nephrectomy. This case demonstrates the efficacy of immunotherapy in neoadjuvant treatment of RCC. Expansion of guidelines could allow for patients with RCC to undergo partial nephrectomy. [Rev Urol. 2020;22(3):126-129] © 2020 MedReviews®, LLC

Renal cell carcinomaImmunotherapyNeoadjuvant immunotherapySolitary kidney

A Karim KaderView Articles

Volume 22, Number 4Review Articles

Low Penetrance Germline Genetic Testing: Role for Risk Stratification in Prostate Cancer Screening and Examples From Clinical Practice

Management Update

Gerald L AndrioleFranklin GaylisKelly K BreePaul DatoChristopher J KaneA Karim Kader

Broad-based prostate-specific antigen (PSA) screening has saved lives but at a substantial human and financial cost. One way of mitigating this harm, while maintaining and possibly improving the benefit, is by focusing screening efforts on men at higher risk. With age, race, and family history as the only risk factors, many men lack any reliable data to inform their prostate cancer (PCa) screening decisions. Complexities including history of previous negative biopsies, interpretation of negative and/or equivocal mpMRI findings, and patient comorbidities further compound the already complicated decisions surrounding PCa screening and early detection. The authors present cases that provide real-world examples of how a single nucleotide polymorphism–based test can provide patients and providers with personalized PCa risk assessments and allow for development of improved risk-stratified screening regimens. [Rev Urol. 2020;22(4):152–158] © 2021 MedReviews®, LLC

Prostate cancer screeningRisk stratificationSomatic DNA testGermline DNA testsSingle nucleotide polymorphism DNA test

A MouzannarView Articles

Volume 21, Number 4Case Review

Using 17-OHP as Serum Biomarker to Monitor Therapy in Patients With Hypogonadotropic Hypogonadism

A MouzannarM NarasimmaP PatelR Ramasamy

Exogenous testosterone administration decreases intratesticular testosterone (ITT) significantly, an essential hormone for spermatogenesis. Therefore, treatment of patients with hypogonadotropic hypogonadism (HH) who desire infertility can be challenging. These patients are treated with recombinant follicle-stimulating hormone (FSH), clomiphene citrate, and human chorionic gonadotropin (hCG) to increase their ITT. However, there is no approved serum biomarker for ITT and it can only be measured via invasive testicular biopsy or aspiration. Previous authors have speculated that serum 17-hydroxyprogestrone (17-OHP) can be used as serum biomarker for ITT. In our case report, we demonstrate increase in 17-OHP associated with spermatogenesis after commencing treatment for infertility in patient with HH. [Rev Urol. 2019;21(4):180–182] © 2020 MedReviews®, LLC

BiomarkerInfertility17-HydroxyprogesteronIntratesticular testosteroneHypogonadotropic hypogonadism

A Scott PolackwichView Articles

Volume 18, Number 1Case Review

Adenomatoid Tumor of the Testis Arising From the Tunica Albuginea

Andrew Y SunA Scott PolackwichEdmund S Sabanegh

Adenomatoid tumors are the most common paratesticular tumor. Although they primarily arise from the epididymis, they can rarely occur as an isolated intratesticular mass. These tumors are benign and surgical excision is curative. We present a case of a 36-year-old man diagnosed with an intratesticular adenomatoid tumor. [Rev Urol. 2016;18(1):51-53 doi: 10.3909.riu0690] © 2016 MedReviews®, LLC

Testicular neoplasmAdenomatoid tumor

Aaron BergerView Articles
Aaron E KatzView Articles
Aaron M BernieView Articles

Volume 17, Number 4Review Articles

Can Serum Testosterone Be Used as a Marker of Overall Health?

Health Screening Update

Michael A MederosAaron M BernieJason M ScovellRanjith Ramasamy

Low serum testosterone has been associated with obesity, type 2 diabetes, metabolic syndrome, and atherosclerosis. Individuals with these comorbidities are at increased risk of premature death and other adverse health effects. Clinical data portend low testosterone as a risk factor for developing these conditions which are supported by the hypogonadal-obesity-adipocytokine hypothesis. The authors support comprehensive evaluation for these comorbid conditions in men found to have low serum testosterone. [Rev Urol. 2015;17(4):226-230 doi: 10.3909/riu0674] © 2016 MedReviews®, LLC

DiabetesAndrogen deficiencyAging maleComorbiditiesCardiovascular disease

Aaron S. DahmenView Articles

Volume 23, Number 1Prostate Cancer

Contemporary Approaches to Diagnosing Prostate Cancer

Ashley E. RossAlon LazarovichAaron S. DahmenAbhinav SidanaJack MillotJonathan E. ShoagHangcheng FuJohn Eifler

The diagnosis of prostate cancer (PCa) has changed substantially over the last decade. An increased understanding of disease behavior has led to the development of more specific biomarkers that may limit the numbers of prostate biopsies performed as well as the overdiagnosis of low-grade disease. We have concurrently seen the refinement of imaging techniques such as multiparametric magnetic resonance imaging (mpMRI), which can also limit overdiagnosis and aid in the discovery of clinically significant disease. We now have various options for performing ultrasound-guided biopsies, including transperineal and transrectal approaches. In this article, we gather perspectives on contemporary pathways toward the diagnosis of PCa from experts practicing in large urology practice groups and academia.

Prostatic neoplasmsBiomarkersMagnetic resonance imaging (MRI)

Abbott OncologyView Articles
Abdelhak KhalloukView Articles

Volume 11, Number 4Case Review

Concurrent Bilateral Renal Angiomyolipoma and Renal Cell Carcinoma in a Patient With Tuberous Sclerosis Complex

Abdelhak KhalloukYounes AhallalMohamed Jamal El FassiMohamed Fadl TaziSoufiane MellasMbarek Doublali

Renal angiomyolipomas (AMLs) are often associated with tuberous sclerosis. These tumors are predominantly benign, although malignant forms do exist and are known to be associated with renal cell carcinoma. This case report describes a patient with tuberous sclerosis and massive bilateral AML. Total right nephrectomy was performed; histopathologic examination revealed the coexistence of AML and clear cell renal carcinoma in the same kidney. Because differentiation between renal cell carcinoma and AML with minimal or no fat component can be difficult, an accurate diagnosis is critical in the management of renal AML.[Rev Urol. 2009;11(4):216-218 doi: 10.3909/riu0436]© 2009 MedReviews®, LLC

Renal cell carcinomaAngiomyolipomaTuberous sclerosis

Abdul Rouf KhawajaView Articles

Volume 17, Number 4Case Review

Effectiveness of Antegrade Access in Bladder Tumors With Inaccessible Urethra

Abdul Rouf KhawajaTanveer Iqbal DarSajad MaikJavaid MagrayAshiq BhatArif Hameed BhatMohdSaleem WaniBaldev Singh Wazir

Inaccessible urethra with no retrograde endoscopic access due to multiple/diffuse strictures or multiple urethrocutaneous fistulas with acute urinary retention due to posturethral instrumentation (transurethral resection of bladder tumor [TURBT], or TURBT with transurethral resection of the prostate [TURP]), is a rare entity. Management of such a case with a bladder tumor for TURBT/surveillance cystoscopy poses a great challenge. The authors present 12 cases of bladder tumor with inaccessible urethra, 10 cases due to multiple strictures (post-TURBT and/or TURP), and 2 cases due to urethrocutaneous fistulas (post-TURBT), who presented to our emergency department with acute urinary retention. Emergent suprapubic catheterization was used as a temporary treatment method. [Rev Urol. 2015;17(4):241-245 doi: 10.3909/riu0677] © 2016 MedReviews®, LLC

Bladder tumorsSuprapubic cystostomyInaccessible urethraTract seedling

Abhejit RajagopalView Articles

Volume 23, Number 4Prostate Cancer

Deep Learning for Magnetic Resonance Imaging–Based Radiation Therapy for Prostate Cancer: Current Status

Jessica E. ScholeyAbhejit RajagopalJulian HongPeder LarsonKe Sheng

Magnetic resonance imaging (MRI) is increasingly being used for external beam radiation therapy in the treatment of prostate cancer because of its excellent soft tissue contrast and ability to provide functional and physiologic information about tumor behavior. At the same time, deep learning has seen widespread applications in medical imaging, including for MRI-based classification and synthesis. Deep learning–based approaches are being incorporated into the MRI-guided clinical external beam radiation therapy workflow for patient simulation, contouring of targets and critical structures, treatment planning, and treatment delivery. In this review, we examine the current status of deep learning for MRI-guided prostate external beam radiation therapy.

Artificial intelligenceProstatic neoplasmsRadiotherapyMagnetic resonance imaging (MRI)Deep Learning

Abhinav SidanaView Articles

Volume 23, Number 1Prostate Cancer

Contemporary Approaches to Diagnosing Prostate Cancer

Ashley E. RossAlon LazarovichAaron S. DahmenAbhinav SidanaJack MillotJonathan E. ShoagHangcheng FuJohn Eifler

The diagnosis of prostate cancer (PCa) has changed substantially over the last decade. An increased understanding of disease behavior has led to the development of more specific biomarkers that may limit the numbers of prostate biopsies performed as well as the overdiagnosis of low-grade disease. We have concurrently seen the refinement of imaging techniques such as multiparametric magnetic resonance imaging (mpMRI), which can also limit overdiagnosis and aid in the discovery of clinically significant disease. We now have various options for performing ultrasound-guided biopsies, including transperineal and transrectal approaches. In this article, we gather perspectives on contemporary pathways toward the diagnosis of PCa from experts practicing in large urology practice groups and academia.

Prostatic neoplasmsBiomarkersMagnetic resonance imaging (MRI)

Abhishek TripathiView Articles

Volume 23, Number 4Case Review

Exceptional Response to Radiation Therapy to the Primary Tumor in a Patient With de Novo Metastatic Prostate Cancer With High Tumor Mutation Burden

Benjamin MercierAndrew TamDaniela V. CastroSalvador Jaime-CasasAbhishek TripathiYun Rose LiRegina Barragan-Carrillo

We present the case of a patient diagnosed with de novo, low-volume metastatic prostate cancer who received first-line treatment with androgen-deprivation therapy in combination with darolutamide. The patient presented with symptoms derived from local growth from the primary tumor and received pelvic radiation therapy to the primary tumor and pelvic nodes. He experienced complete tumor regression, with high serum prostate-specific antigen declining to nondetectable levels. Next-generation genomic analysis indicated high tumor mutation burden and high microsatellite status instability. Here, we contextualize this patient’s case regarding the importance of precision genomics in radiation oncology and its potential importance for optimizing treatment.

Prostatic neoplasmsRadiation therapyNeoplasm metastasisAndrogen antagonistsprostate neoplasmcastration resistant

Adam JM KernView Articles
Adam KernView Articles
Adam S KibelView Articles

Volume 16, Number 4Review Articles

A Guide for Clinicians in the Evaluation of Emerging Molecular Diagnostics for Newly Diagnosed Prostate Cancer

Diagnosis Update

Michael J KemeterPhillip G FebboSteven E CanfieldAdam S KibelH Jeffrey LawrenceJudd W Moul

Prostate-specific antigen (PSA) screening is associated with a decline in prostate cancerrelated mortality. However, screening has also led to overdiagnosis and overtreatment of clinically insignificant tumors. Recently, certain national guidelines (eg, US Preventive Services Task Force) have recommended against PSA screening, which may lead to a reverse-stage migration. Although many prostate tumors are indolent at presentation, others are aggressive and are appropriate targets for treatment interventions. Utilization of molecular markers may improve our ability to measure tumor biology and allow better discrimination of indolent and aggressive tumors at diagnosis. Many emerging commercial molecular diagnostic assays have been designed to provide more accurate risk stratification for newly diagnosed prostate cancer. Unfamiliarity with molecular diagnostics may make it challenging for some clinicians to navigate and interpret the medical literature to ascertain whether particular assays are appropriately developed and validated for clinical use. Herein, the authors provide a framework for practitioners to use when assessing new tissue-based molecular assays. This review outlines aspects of assay development, clinical and analytic validation and clinical utility studies, and regulatory issues, which collectively determine whether tests (1) are actionable for specific clinical indications, (2) measurably influence treatment decisions, and (3) are sufficiently validated to warrant incorporation into clinical practice. [Rev Urol. 2014;16(4):172-180 doi: 10.3909/riu0644] © 2014 MedReviews®, LLC

Prostate cancerBiomarkerClinical utilityGenomic prostate scoreAdverse pathologyClinical validationMolecular diagnostics

Aditya BagrodiaView Articles

Volume 21, Number 2Reviews in Urology

Massive Intra-abdominal Germ Cell Tumors: A Case Series and Review of Literature

Nirmish SinglaAditya BagrodiaDaniel G Wong

Intra-abdominal testes are at increased risk of malignant transformation and can manifest as large abdominal masses with a wide variation in presenting symptoms. In the setting of cryptorchid or nonpalpable testes, large abdominal masses are highly suspect for germ cell tumors. Without standard guidelines, management can vary extensively. Surgical management may not be trivial and can entail a major abdominal operation in the context of a multimodal approach. The use of biopsy and serum tumor markers may effectively guide sequence of management based upon expected histology. In advanced cases, neoadjuvant chemotherapy may be pursued, and retroperitoneal lymph node dissection may be accomplished at the time of orchiectomy to minimize morbidity. The development of these massive late stage tumors reaffirms current guidelines on the early correction of cryptorchidism. [Rev Urol. 2019;21(2/3):136–140] © 2019 MedReviews®, LLC

TesticularSeminomaNonseminomatous

Adrian DobsView Articles