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Directory of Authors from the Journal and their last article.

Afaf AmartiView Articles

Volume 9, Number 1Reviews in Urology

Solitary Fibrous Tumor of the Kidney: A Case Report and Review of the Literature

Case Review

Imane KamaouiAfaf AmartiSanae BennisLaila ChbaniHinde El FatemiTaoufik HarmouchFadl TaziKaoutar Znati

A solitary fibrous tumor (SFT) is an unusual spindle cell neoplasm that usually occurs in the pleura but has recently been described in diverse extrapleural sites. Urogenital localization is rare, and only 19 cases of SFT of the kidney have been described. We report a case of a large SFT clinically thought to be renal cell carcinoma arising in the kidney of a 70-year-old man. The tumor was well circumscribed and composed of a mixture of spindle cells and dense collagenous bands, with areas of necrosis or cystic changes noted macroscopically and microscopically. Immunohistochemical studies revealed reactivity for CD34, CD99, and Bcl-2 protein, with no staining for keratin, S-100 protein, or muscle markers, confirming the diagnosis of SFT. This tumor is benign in up to 90% of cases. The immunohistochemical study is the key to diagnosis. [Rev Urol. 2007;9(1):36-40]

KidneyImmunohistochemical studyRenal neoplasmSpindle cells

Ahmed AbrofView Articles

Volume 16, Number 4Review Articles

Post–Radical Prostatectomy Incontinence: Etiology and Prevention

Prevention Update

Nikhil VasdevGregory BousteadKimberley HoylandAhmed Abrof

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 prostatectomyUrinary incontinenceUrethral length

Ahmed Q HaddadView Articles

Volume 18, Number 4Case Review

Gossypiboma Manifesting as Urachal Mass

Nirmish SinglaAhmed Q HaddadChristopher CefaluVitaly Margulis

Gossypiboma (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®, LLC

GossypibomaUrachal massSurgical errorsPatient safety

Aidan KennedyView Articles

Volume 23, Number 3Prostate Cancer

Incorporation of IsoPSA Into Clinical Practice in the Management of Elevated Prostate-Specific Antigen Based on Current Guidelines

Aidan KennedyJason Hafron

Prostate cancer is a highly prevalent malignancy among men worldwide. Optimal management depends on early detection and accurate surveillance. Several screening and surveillance tools are available to men with prostate cancer, including prostate-specific antigen (PSA) testing, digital rectal examination, prostate biopsy, imaging modalities, and a plethora of biomarkers. Prostate-specific antigen, though widespread in its use, is limited in its specificity. Many adjunctive tests to PSA have been developed. One such test is IsoPSA (Cleveland Diagnostics), a novel PSA assay that focuses on structural differences among PSA isoforms to aid in detecting clinically significant prostate cancer. With an improved understanding of the capability and uses of IsoPSA, physicians can enhance patient outcomes through more accurate risk assessment and save costs by reducing the number of unnecessary prostate biopsies and imaging generated resulting from a nonspecific elevation in serum PSA. This review describes the performance and use of IsoPSA.

Prostatic neoplasmsBiomarkerProstate-specific antigen (PSA)Prostate-specific antigenBiomarkers

Áine GogginsView Articles
Ajay NehraView Articles

Volume 9, Number 4Review Articles

Extending the Rationale of Combination Therapy to Unresponsive Erectile Dysfunction

Treatment Update

Rajeev KumarAjay NehraDiedre NienowChristopher Reece

Combination therapies aim to overcome the limitations of individual drugs by selecting diverse targets of action to enhance effectiveness synergistically. This article reviews the principles of combination therapy and its applications for benign prostatic hyperplasia and overactive bladder. It then examines pathophysiological, pharmacological, and clinical evidence for currently available drug and device combinations for erectile dysfunction that has not responded to first-line, single-agent therapy. [Rev Urol. 2007;9(4):197-206]

Benign prostatic hyperplasiaOveractive bladderErectile dysfunctionCombination therapyIntracavernosal therapyIntraurethral therapy

Akira FurutaView Articles

Volume 9, Number 3Review Articles

Advances in the Understanding of Stress Urinary Incontinence and the Promise of Stem-Cell Therapy

Treatment Update

Michael B ChancellorNaoki YoshimuraAkira FurutaLesley K Carr

The middle urethra and external urethral sphincter are the focus in management of stress urinary incontinence, and recent cellular-therapy research suggests a new paradigm in treatment. Cell-based therapies are most often described as using autologous multipotent stem cells procured from bone marrow in procedures that may be painful, require anesthesia, and yield low numbers of mesenchymal stem cells upon processing. In contrast, muscleand adipose-derived stem cells can be obtained easily in large quantities under local anesthesia. Instead of lifting the urethra with a sling or bulking up the urethral sphincter with collagen, we now have the potential to restore function with the use of autologous stem cells. [Rev Urol. 2007;9(3):106-112]

Urinary incontinenceUrethral sphincterMuscle-derived stem cells

Akshay SoodView Articles

Volume 18, Number 1Review Articles

Contemporary Role of the Decipher® Test in Prostate Cancer Management: Current Practice and Future Perspectives

Management Update

Deepansh DalelaBjörn LöppenbergAkshay SoodJesse SammonFiras Abdollah

We performed a systematic literature search to identify original articles and editorials about the Decipher® Prostate Cancer Test (GenomeDx Biosciences, San Diego, CA) to provide an overview of the current literature and its present role in urologic clinical practice. The Decipher test, which uses the expression of 22 selected RNA markers (from a total of over 1.4 million), showed a very high discrimination in predicting clinical metastasis (0.75-0.83) and cancer-specific mortality (0.78) in external validation studies, outperforming all routinely available clinicopathologic characteristics. Further, the timing of postoperative radiotherapy (adjuvant vs salvage) may be guided based on Decipher scores. The Decipher test was also the only independent predictor of clinical metastasis in patients with biochemical recurrence after surgery. The Decipher Genomic Resource Information Database (GRID) is a novel research tool that captures 1.4 million marker expressions per patient and may facilitate precision-guided, individualized care to patients with prostate cancer. In this era of precision medicine, Decipher, along with the Decipher GRID platform, is a promising genomic tool that may aid in managing prostate cancer patients throughout the continuum of care and delivering appropriate treatment at an individualized level. [Rev Urol. 2016;18(1):1-9 doi: 10.3909/riu0706] © 2016 MedReviews®, LLC

Prostate cancerDecipher® Prostate Cancer TestGenomic classifierNeoplasm recurrenceLocal/surgeryTreatment outcome

Al BarqawiView Articles
Alan D KayeView Articles

Volume 15, Number 4Review Articles

Anesthetic Challenges in Robotic-assisted Urologic Surgery

Management Review

Richard L HsuAlan D KayeRichard D Urman

Robotic-assisted surgery has evolved over the past two decades with constantly improving technology, assisting surgeons in multiple subspecialty disciplines. The surgical requirements of lithotomy and steep Trendelenburg positions, along with the creation of a pneumoperitoneum and limited access to the patient, all present anesthetic management challenges in urologic surgery. Patient positioning requirements can cause significant physiologic effects and may result in many complications. Good communication among team members and knowledge of the nuances of robotic surgery have the potential to improve patient outcomes, increase efficiency, and reduce surgical and anesthetic complications. [Rev Urol. 2013;15(4):178-184 doi: 10.3909/riu0589] © 2014 MedReviews®, LLC

Robotic surgeryUrologic surgeryAnesthesia complicationsPneumoperitoneumPeripheral nerve injuryPatient positioning

Alan J WeinView Articles
Alan M QadriView Articles
Alan W PartinView Articles
Alan W ShindelView Articles

Volume 18, Number 3Original Research

Health Economic Impact and Prospective Clinical Utility of Oncotype DX® Genomic Prostate Score

Michael J KemeterPhillip G FebboDavid AlbalaRuixiao LuVincy JohnDylan StoyBela DenesMarybeth McCallAlan W ShindelFrank Dubeck

Prostate cancer (CaP) will be diagnosed in approximately 181,000 American men in 2016. Despite the high number of deaths from CaP in the United States, the disease has a protracted natural history and many men diagnosed with CaP will not die of the disease regardless of treatment. Unfortunately, identification of men with truly indolent/nonaggressive CaP is challenging; limitations of conventional diagnostic modalities diminish the ability of physicians to accurately stage every case of CaP based on biopsy results alone. The resulting uncertainty in prognosis may prompt men with low-risk CaP to proceed to morbid and expensive treatments for an unclear survival benefit. Incorporation of the Genomic Prostate Score (GPS) as part of the decision algorithm for patients with National Comprehensive Cancer Network very low-risk and low-risk cancer led to a substantial increase in uptake of active surveillance and substantial cost savings. GPS provides physicians and patients with an additional tool in assessing personalized risk and helps guide individual decision making. [Rev Urol. 2016;18(3):123-132 doi: 10.3909/riu0725] © 2016 MedReviews®, LLC

Prostate cancerOncotype DX® GPSGenomic testingHealth economicsClinical utility

Alana C DesaiView Articles

Volume 15, Number 2Case Review

Endoscopic Management of Genitourinary Foreign Bodies

Joseph B SongYoussef S TanaghoMohammed HaseebuddinBrian M BenwayAlana C DesaiSam B BhayaniRobert S Figenshau

Retrieval of foreign bodies from the genitourinary system, most commonly inserted for sexual satisfaction or as a result of a psychiatric illness, can pose a significant surgical challenge. Due to their breadth of size, shape, and location within the genitourinary system, endoscopic management can be difficult. Here, we review the management of four cases of foreign object insertion into the genitourinary system and their outcomes and management. [Rev Urol. 2013;15(2):84-91 doi: 10.3909/riu0571] © 2013 MedReviews®, LLC

Foreign body insertionSoundingGenitourinary foreign objectEndoscopic extraction

Albaha BarqawiView Articles
Albert C LeungView Articles
Alberto TrucchiView Articles
Aldo Franco De RoseView Articles

Volume 19, Number 4Case Review

Cycling Trauma as a Cause of Arterial Priapism in Children and Teenagers

Aldo Franco De RoseIrene ParaboschiGuglielmo ManticaAlexander SzpytkoHilgard AckermannGiovanni De CaroCarlo TerroneGirolamo Mattioli

Bicycle riding has multiple beneficial cardiovascular effects; however, it is a well-documented source of significant urologic injuries. Priapism is a rare condition in children, and occurs primarily because of congenital hematologic diseases or adverse drug reactions. A pediatric clinical case and literature review of a high-flow priapism secondary to cycling trauma is described here to highlight their etiopathologic correlation. Bicycle riding trauma is a rare but possible cause of high-flow priapism in children, and a high index of suspicion should ensure appropriate management. [Rev Urol. 2017;19(4):273–277 doi: 10.3909/riu0768] © 2018 MedReviews®, LLC

PediatricTraumaPriapismCycling

Alessandra HandisuryaView Articles