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Nikhil Vasdev

All articles from this author are listed below.

Volume 15, Number 2 Review Articles

The Use of Vacuum Erection Devices in Erectile Dysfunction After Radical Prostatectomy

Management Update

James Adshead Kimberley Hoyland Nikhil Vasdev

The risk of postoperative erectile dysfunction (ED) following radical prostatectomy (RP) is reported to be between 14% and 89%. With an increase in the detection of prostate cancer in younger men, there is a greater emphasis on the appropriate management of ED following RP. A number of options are available to manage ED after RP, including phosphodiesterase-5 inhibitors, intracorporeal injections, intraurethral alprostadil, and vacuum erection devices (VEDs). Penile rehabilitation programs are increasingly used to facilitate the return of natural postoperative erections; the VED is an ideal therapy given that it increases blood flow and oxygenation to the corpora to reverse the changes that result in ED after RP. [Rev Urol. 2013;15(2):67-71 doi: 10.3909/riu0574] © 2013 MedReviews®, LLC

Radical prostatectomy Erectile dysfunction Penile rehabilitation Vacuum erection device

Volume 15, Number 1 Review Articles

Physiologic and Anesthetic Considerations in Octogenarians Undergoing Laparoscopic Partial Nephrectomy

Management Review

Naeem A Soomro Elizabeth Todd Nikhil Vasdev

The number of small renal tumors detected is increasing as imaging becomes both more available and advanced, and as the population ages, with a greater proportion of patients in their 80s emerging with small and treatable renal tumors. The technique of laparoscopic partial nephrectomy is emerging and becoming ever more popular in some centers, and is potentially a safer alternative for the elderly due to improved postoperative pain, shorter hospital stay with faster return to preoperative activities, and lower rates of morbidity and mortality. We present a systematic review of the physiologic and anesthetic considerations in octogenarians undergoing the procedure, highlighting special considerations and the need for expertise throughout the multidisciplinary team when dealing with these patients, in order to minimize risk and optimize outcome. [ Rev Urol. 2013;15(1):23-31 doi: 10.3909/riu0565] © 2013 MedReviews®, LLC

Renal cell carcinoma Radical nephrectomy Laparoscopic partial nephrectomy Renal tumor Octogenarian

Volume 16, Number 4 Review Articles

Post–Radical Prostatectomy Incontinence: Etiology and Prevention

Prevention Update

Ahmed Abrof Kimberley Hoyland Gregory Boustead Nikhil Vasdev

All patients undergoing a radical prostatectomy (RP) using any surgical approach, be it open, laparoscopic, or robotic, are at risk of developing postprostatectomy urinary incontinence. This side effect of RP has an effect on the patient’s quality of life and can be associated with moderate to severe postoperative morbidity. The authors present a review of the etiology and prevention strategies of postprostatectomy urinary incontinence. Based on the current literature, the authors conclude that there is a paucity of studies that can accurately answer the exact anatomic and physiologic etiologies of postprostatectomy urinary incontinence. The aim of urologic surgeons performing RP should be to reduce the rate of postoperative incontinence rather than attempting to treat it once it has occurred. Further studies aimed at providing a detailed anatomic map of the pelvic anatomy related to continence will help to improve surgical techniques and reduce postoperative urinary incontinence following RP. [Rev Urol. 2014;16(4):181-188 doi: 10.3909/riu0606] © 2014 MedReviews®, LLC

Radical prostatectomy Urinary incontinence Urethral length

Volume 16, Number 1 Review Articles

The Physiologic and Anesthetic Considerations in Elderly Patients Undergoing Robotic Renal Surgery

Management Review

Anna Sau Kuk Poon James M Adshead Gregory Boustead Gowrie Mohan Damian Hanbury Tim Lane Nikhil Vasdev

A number of patients are diagnosed with renal malignancies incidentally worldwide. Once a diagnosis of a renal malignancy is established, after a careful evaluation, patients can be offered a robotic nephrectomy or partial nephrectomy. We present a review of the physiologic and anesthetic considerations in elderly patients who are being considered for robotic renal surgery. [Rev Urol. 2014;16(1):1-9 doi: 10.3909/riu0591] © 2014 MedReviews®, LLC

Robotic partial nephrectomy Robotic radical nephrectomy Physiologic considerations Anesthetic considerations

Volume 21, Number 1 Review Articles

Immunotherapy in Urological Tumors

Treatment Review

Nikhil Vasdev Oliver Jones Narin Suleyman Anand Sharma

The past decade has seen significant improvement in our understanding of tumor biological features, which has led to use of anti-programmed-death 1 (PD-1) and anti-PD ligand-1 (PD-L1) agents and cytotoxic T lymphocytes antigen 4 (CTLA-4) inhibitors in a multitude of cancers. These immunotherapeutic agents have shown activity in melanoma, lung, head and neck, colorectal, urological, and other cancers. This article details the use of immunotherapy agents in urothelial, renal, prostate, and testicular tumors. [Rev Urol. 2019;21(1):15–20] © 2019 MedReviews®, LLC

Immunotherapy Cytokines urological tumors immune checkpoint inhibitors recombinant BCG cell wall-derived therapies