Volume 18, Number 2Review ArticlesReducing Infectious Complications Following Transrectal Ultrasound-guided Prostate Biopsy: A Systematic ReviewSystematic ReviewClaus G RoehrbornJordon T WalkerNirmish SinglaA rise in antimicrobial resistant uropathogens has generated a global increase in infections following transrectal ultrasound-guided prostate biopsy (TRUS-Bx). We performed a systematic search of Ovid MEDLINE® and PubMed to comprehensively review strategies to mitigate infections. Of 1664 articles retrieved, 62 were included. The data suggest that augmented prophylaxis and povidone-iodine bowel preparation warrant consideration in regions with high rates of antimicrobial resistance. Transperineal biopsy may be a safer, equally effective alternative to TRUS-Bx in select cases. Recent international travel appears to increase patients’ risk for experiencing infections. These findings can aid clinicians in minimizing post-TRUS-Bx infectious complications. [Rev Urol. 2016;18(2):73-89 doi: 10.3909/riu0713] © 2016 MedReviews®, LLCUrinary tract infectionProstate biopsyTransrectal ultrasoundSystematic review
Volume 18, Number 4Case ReviewGossypiboma Manifesting as Urachal MassVitaly MargulisChristopher CefaluAhmed Q HaddadNirmish SinglaGossypiboma (retained surgical sponge) occurs between 1 in 1000 and 1 in 1500 of all intra-abdominal operations. Patients with gossypibomas may present asymptomatically or with nonspecific symptoms, such as abdominal pain or bloating; identification frequently relies on imaging. Results of imaging alone, however, may appear nonspecific, and the gossypiboma may mimic other masses, such as neoplasms, hematomas, or abscesses. They require surgical removal for definitive diagnosis and treatment. Herein we present an unusual case of gossypiboma masquerading as an urachal mass in a 75-year-old woman. Diagnostic evaluation, natural history, and prevention of retained surgical materials are discussed. [Rev Urol. 2016;18(4):239-241 doi: 10.3909/riu0703] © 2016 MedReviews®, LLCGossypibomaUrachal massSurgical errorsPatient safety
Volume 19, Number 1Case ReviewPenile Ossification: A Reconstructive ChallengeAllen F MoreyArthi SatyanarayanNirmish SinglaPenile ossification is a rare condition that occurs most commonly in acquired cases of penile deformity. We report the case of a 43-year-old man with Peyronie disease who was incidentally found to have significant ossified tissue in his penile corpora during complex placement of an inflatable penile prosthesis (IPP). His clinical course was later complicated by impending distal extrusion of his IPP laterally, necessitating corporoplasty. Penile ossification remains a poorly understood, unusual entity that may pose a reconstructive challenge for urologists. We discuss evaluation and management of this condition, focusing on important considerations for preoperative counseling and intraoperative pearls. [Rev Urol. 2017;19(1):64-67 doi: 10.3909/riu0722] © 2017 MedReviews®, LLCPeyronie’s diseasePenile ossificationInflatable penile prosthesisCorporoplasty
Volume 21, Number 2Reviews in UrologyMassive Intra-abdominal Germ Cell Tumors: A Case Series and Review of LiteratureDaniel G WongAditya BagrodiaNirmish SinglaIntra-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®, LLCTesticularSeminomaNonseminomatous
Volume 22, Number 2Case ReviewFirst Do No Harm: A Cautious, Risk-adapted Approach to Testicular Cancer PatientsDavid FetzerPayal KapurNirmish SinglaJohn LafinHersh M TrivediAditya BagrodiaCurrent guidelines regarding treatment for germ-cell tumors (GCTs) emphasizes cautious progression focusing on stage-specific treatments. Presented herein is the case of a 30-year-old man who, through monitoring of serum alpha-fetoprotein (AFP) levels and surveillance imaging, avoided excessive treatment. This case demonstrates how an experienced clinician, familiar with natural history of GCTs, can appropriately classify level of risk and allow a patient to preserve natural fertility. Furthermore, we highlight the potential for miRNA analysis in staging and management of GCTs. This case serves to underscore the importance of acting with caution in the pursuit of the best outcome for our patients. [Rev Urol. 2020;22(2):85–89] © 2020 MedReviews®, LLC