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Directory of Authors from the Journal and their last article.

Erica SternView Articles

Volume 22, Number 4Review Articles

Contemporary Management of Bulbar Urethral Strictures

Management Review

Andrew J CohenRoss S LiaoErica SternJames E Wright

Urethral stricture disease (USD) is a progressive scar-forming disease commonly encountered by urologists and is challenging to manage. USD most frequently occurs in the bulbar urethra. Patients typically present with chronic obstructive voiding symptoms but may develop recurrent urinary tract infections, detrusor failure, or renal disease. The authors review the pathophysiology, diagnostic workup, and evidence-based management of bulbar urethral strictures (BUS). There are multiple surgical options to treat BUS. Endoscopic techniques (eg, dilation and urethrotomy) are suitable for the initial management of short strictures but new evidence-based guidelines recommend against repeated endoscopic treatment. Urethroplasty is the gold standard treatment for BUS of all lengths, with anastomotic techniques appropriate for strictures <2 cm and tissue substitution performed for longer strictures. New techniques, such as non-transecting urethroplasty, lack long-term data but may represent a paradigm shift in the field. Future treatments may utilize tissue-engineered grafts and agents that inhibit inflammation and scar formation. [Rev Urol. 2020;22(4):139–151] © 2021 MedReviews®, LLC

UrethroplastyBulbar urethral strictureUrethrotomyUrethral dilationBuccal graft non-transecting

Erik PasinView Articles

Volume 10, Number 1Review Articles

Superficial Bladder Cancer: An Update on Etiology, Molecular Development, Classification, and Natural History

Treatment Update

Richard J CoteDavid Y JosephsonAnirban P MitraErik PasinJohn P Stein

Superficial “non–muscle-invasive” bladder tumors represent a heterogeneous group of cancers, including those that are (1) papillary in nature and limited to the mucosa, (2) high grade and flat and confined to the epithelium, and (3) invasive into the submucosa, or lamina propria. The goal of treatment is 2-fold: (1) to reduce tumor recurrence and the subsequent need for additional therapies and the morbidity associated with these treatments and (2) to prevent tumor progression and the subsequent need for more aggressive therapy. This update reviews important contemporary concepts in the etiology, molecular mechanisms, classification, and natural history of superficial bladder cancer. [Rev Urol. 2008;10(1):31-43]

Transitional cell carcinomaBladder neoplasmsNon–muscle-invasive tumorMolecular mechanismsGenitourinary tumors

Erika B BuntView Articles

Volume 19, Number 1Review Articles

Urinary Tract Stone Development in Patients With Myelodysplasia Subjected to Augmentation Cystoplasty

Management Update

Dean G AssimosCourtney L ShephardGuaqiao WangBetsy D HopsonErika B Bunt

Patients with myelodysplasia who have undergone augmentation cystoplasty are at risk for urinary tract stones. We sought to determine the incidence and risk factors for stone development in this population. The charts of 40 patients with myelodysplasia who have undergone augmentation cystoplasty were reviewed. None had a prior history of urinary tract stones. All patients were seen on an annual basis with plain abdominal imaging, renal ultrasonography, and laboratory testing. Statistical analysis included a multivariable bootstrap resampling method and Student’s t-test. Fifteen (37.5%) patients developed stones, 14 with bladder stones and 1 with a solitary renal stone, at a mean of 26.9 months after augmentation. Five (33.3%) developed recurrent bladder stones. The patient with a renal stone never developed a bladder stone. The mean follow-up for the stone formers was 117.2 months and for non–stone formers was 89.9 months. The stone incidence per year was 6.8%. Risk factors included a decline in serum chloride after augmentation (P = .02), female sex, younger age at time of augmentation, longer time period since augmentation, and bowel continence. A significant proportion of patients with myelodysplasia subjected to augmentation cystoplasty develop urinary tract stones, predominantly in the bladder. Dehydration may play a role in development of lower urinary tract stones as the decline in serum chloride suggests contraction alkalosis, which could lead to constipation and improved bowel continence. Therefore, improved hydration should be a goal in this cohort. [Rev Urol. 2017;19(1):11-15 doi: 10.3909/riu0741] © 2017 MedReviews®, LLC

NephrolithiasisSpina bifidaNeurogenic bladderaugmentationcystoplasty

Erika BracamonteView Articles

Volume 16, Number 2Case Review

Immunoglobulin G4–related Retroperitoneal Fibrosis of the Pelvis

Anthony DyerPeter M SadowErika BracamonteMatthew Gretzer

Retroperitoneal fibrosis (RPF) is a rare disease characterized by the replacement of normal tissue with fibrosis and/or inflammation. In this case, a 68-year-old man presented with RPF in the pelvis, a rare location for this disease. Biopsies were performed, which showed elevated levels of C-reactive protein, erythrocyte sedimentation rate, and, most importantly, immunoglobulin G4 (IgG4). It has been postulated that IgG4-related sclerosing disease is a systemic disease. Treatment has been successful with systemic corticosteroids. [Rev Urol. 2014;16(2):92-94 doi: 10.3909/riu0594] © 2014 MedReviews®, LLC

Retroperitoneal fibrosisSerum immunoglobulin G4

Erika FerrozzoView Articles

Volume 23, Number 1Meet The Expert

Meet the Expert: Erika Ferrozzo, MHA

David M. AlbalaErika Ferrozzo

In-office dispensaries (IODs) are frequently discussed but rarely implemented in urology private group practices. In this interview, Erika Ferrozzo, MHA, CEO of the Idaho Urologic Institute and a member of the LUGPA Executive Leadership Program’s class of 2023, explains how the Idaho Urologic Institute identified an opportunity that helped its patients experience improved adherence and ease of access to treatment and that earned the practice a year-over-year $250 000 increase in net revenue.

UrologyGroup practiceequipment and supplies

Ernest R SosaView Articles
Esther UdojiView Articles

Volume 17, Number 2Case Review

Long-term Survival From Muscle-invasive Bladder Cancer With Initial Presentation of Symptomatic Cerebellar Lesion: The Role of Selective Surgical Extirpation of the Primary and Metastatic Lesion

Ganesh K KarthaJoseph SanfrancescoEsther UdojiHemant Chaparala (4)Donna HanselJ Stephen Jones

A 59-year-old man was diagnosed with urothelial carcinoma involving an isolated cerebellar metastasis after presenting to the emergency department for headache complaints. After selective surgical excision of the symptomatic brain lesion and delayed cystectomy due to intractable hematuria, he survived 11 years without evidence of recurrence or subsequent systemic chemotherapy. He eventually expired after delayed recurrence in the lung, supraclavicular lymph node, and brain. To our knowledge, this is the only case of prolonged survival from urothelial carcinoma after selective surgical extirpation of the primary and metastatic lesion without subsequent systemic chemotherapy. [Rev Urol. 2015;17(2):106-109 doi: 10.3909/riu0643] © 2015 MedReviews®, LLC

Urothelial carcinomaBladder cancerMetastasisCystectomy

Ethan J HalpernView Articles

Volume 8, Supplement 1Review Articles

Contrast-Enhanced Ultrasound Imaging of Prostate Cancer

Prostate Cancer Imaging

Ethan J Halpern

Ultrasound imaging of the prostate is commonly used to assess the size of the gland and for needle placement during systematic biopsy. Ultrasound evaluation of prostate cancer is limited by difficulty in distinguishing benign from malignant tissue. Although Doppler techniques may provide some improvement in the detection of prostate cancer, targeted biopsy based on conventional ultrasound with Doppler is not sufficient to replace systematic biopsy. Contrast-enhanced ultrasound imaging techniques that employ microbubble contrast agents represent an innovative approach to imaging of the neovascularity associated with prostate cancer. This review describes the application of contrast-enhanced ultrasound to improve detection and assessment of prostate cancer. [Rev Urol. 2006;8(suppl 1):S29-S37]

Prostate cancerDopplerUltrasoundMicrobubble contrast agents

Evan R GoldfischerView Articles
Ezequiel BecherView Articles

Volume 21, Number 2Review Articles

Prostate Cancer Screening and Management in Solid Organ Transplant Candidates and Recipients

Management Review

Herbert LeporEzequiel BecherAlex Wang

The number of solid organ transplantations is increasing worldwide. Major medical advances have allowed for incremented survival in this population, which, because approximately 50% of recipients are over age 50 years, makes for an increasingly older population of transplant survivors. This article discusses controversies and current guidelines related to prostate cancer (PCa) screening, detection, and treatment for men in the general population. The relevant literature is reviewed in order to provide insights on how to optimize PCa screening, detection, and treatment pre– and post–solid organ transplantation. There is compelling evidence that immunosuppression does not increase the risk for the development or progression of PCa following solid organ transplantation. Therefore, PCa screening, detection, or treatment should not be influenced by the impact of immunosuppression on the biology of the disease. Prostate-specific antigen (PSA) appears to be as reliable for PCa screening of transplant candidates and recipients as it is for the general population. There is no consensus on how or when it should be implemented. Evidence is also equivocal as to the suggested waiting time between treatment and transplantation. Surgery and radiation therapy appear to be safe and provide good outcomes for managing PCa in solid organ transplant candidates and recipients. However, certain precautions should be taken with this vulnerable population, especially for kidney transplant patients given the pelvic location of the renal graft. Partial gland ablation of PCa should be considered in appropriate candidates. [Rev Urol. 2019;21(2/3):85–92] © 2019 MedReviews®, LLC

F PouliotView Articles

Volume 11, Number 2Meeting Reviews

Best of the 2009 AUA Annual Meeting

Highlights From the 2009 Annual Meeting of the American Urological Association, April 25-30, 2009, Chicago, IL

Dean G AssimosEllen ShapiroAlan W PartinMichael B ChancellorStacy LoebJ Curtis NickelClaus G RoehrbornMichael K BrawerNaoki YoshimuraArie S BelldegrunB ShuchF Pouliot

Prostate cancer screeningObesityBenign prostatic hyperplasiaLower urinary tract symptomsVesicoureteral refluxNephrolithiasisStress urinary incontinenceInflammationSilodosinHormonal therapyTumor markersTMPRSS2ERG4-Kallikrein panelBotulinum toxin type AMale voiding dysfunctionBenign prostatic specific antigenRoux-en-Y gastric bypass surgeryGenitourinary pain indexUPOINT clinical phenotype systemNephron-sparing surgeryWatchful waitingLaparoscopy for adrenal cortical carcinomaPartial adrenalectomyUrethral traumaPediatric urethral strictureEnteric urologic surgery

Fadi N JoudiView Articles

Volume 22, Number 2Review Articles

The Role of Multiparametric MRI and MRI-targeted Biopsy in Detecting Clinically Significant Prostate Cancer in the Community Setting: A Retrospective Study

Original Research

Kenneth E SchmankeJordan J StiversonRosalee E ZackulaSerge G SrourMatthew P LierzFadi N Joudi

Multiparametric MRI and the Prostate Imaging-Reporting and Data System (PI-RADS) have emerged as tools to reveal suspicious prostate lesions and MRI-targeted biopsy has shown potential to avoid repeat prostate biopsies and miss fewer significant cancers. This retrospective study sought to assess the differences in diagnostic yield and sampling efficiency between MRI-targeted and standard biopsies in a community urology practice. We concluded that MRI-targeted biopsy was more efficient than a standard biopsy, although neither technique achieved a superior diagnostic yield of clinically significant cancer in our community setting. We recommend that a standard biopsy be performed alongside targeted biopsy. [Rev Urol. 2020;22(2):57–66] © 2020 MedReviews®, LLC

Health services researchProstatic neoplasmsImage-guided biopsyMultiparametric MRIAmbulatory care facilities

Fadl TaziView 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

Fairooz F KabbinavarView Articles

Volume 14, Number 3Review Articles

Systemic Therapy for Metastatic Renal Cell Carcinoma: A Review and Update

Management Update

Karim ChamieJoshua E LoganEdward N RampersaudGeoffrey A SonnDennis J SlamonFairooz F KabbinavarArie S BelldegrunAllan J Pantuck

An in-depth understanding of metastatic renal cell carcinoma (mRCC) is important so that practitioners can make informed evidenced-based decisions with patients to optimize not only quantity of life but quality of life as well. Therefore, this review focuses on the biology of mRCC as it relates to targets for therapy, as well as on the small molecules rationally designed with these targets in mind. In addition, anticipated emerging therapies are highlighted, including the new tyrosine kinase inhibitors axitinib and tivozanib, as well as new immune-based therapies such as dendritic cell-based vaccines and antibodies. We also briefly review recent reports from the emerging field of predicting drug response based on molecular markers. And finally, management of metastatic non-clear cell RCC histologies are discussed focusing on available evidence to direct decision making when assessing therapeutic options. [Rev Urol. 2012;14(3/4):65-78 doi: 10.3909/riu0562] © 2013 MedReviews®, LLC

Metastatic renal cell carcinomaTyrosine kinase inhibitorsDendritic cell-based vaccines

Farhang RabbaniView Articles
Farshid SadeghiView Articles
Federico SergiView Articles

Volume 15, Number 3Review Articles

Bladder Cancer After Radiotherapy for Prostate Cancer

Systematic Review

Francesca SurianoEmanuela AltobelliFederico SergiMaurizio Buscarini

External beam radiotherapy (EBRT) is frequently used in the management of prostate cancer (PCa) as definitive, postoperative, or salvage local treatment. Although EBRT plays a central role in the management of PCa, complications remain a troubling by-product. Several studies have demonstrated an association between radiotherapy and elevated risk of acute and late toxicities. A secondary malignancy induced by initial therapy represents one of the most serious complications related to definitive cancer treatment. The radiation-related secondary primary malignancy risk increases with increasing survival time. Transitional cell carcinoma of the bladder is the most frequent secondary primary malignancy occurring after radiotherapy and is described as more aggressive; it may be diagnosed later because some radiation oncologists believe that the hematuria that occurs after prostate EBRT is normal. Some patients treated for localized PCa will subsequently develop invasive bladder cancer requiring surgical intervention. Patients with PCa treated with EBRT should be monitored closely for the presence of bladder cancer. [Rev Urol. 2013;15(3):108-112 doi: 10.3909/riu0577] © 2013 MedReviews®, LLC

Prostate cancerBladder cancerRadiotherapyExternal beam radiotherapy

Fergus V CoakelyView Articles

Volume 8, Supplement 1Review Articles

Magnetic Resonance Imaging and Spectroscopy of Prostate Cancer

Prostate Cancer Imaging

Peter R CarrollFergus V CoakelyJohn Kurhanewicz

Magnetic resonance imaging may improve the staging of prostate cancer compared with clinical evaluation alone, computerized tomography, or transrectal ultrasound, and it allows simultaneous and detailed evaluation of prostatic, periprostatic, and pelvic anatomy. Endorectal magnetic resonance imaging and magnetic resonance spectroscopic imaging (endoMRI/MRSI) allow better visualization of the zonal anatomy of the prostate and better delineation of tumor location, volume, and extent (stage). Metabolic criteria used to identify and localize prostate cancer with endoMRI/MRSI have been standardized, thus improving the accuracy of the examination and limiting interobserver variations in interpretation. Evidence is now emerging that endoMRI/MRSI may also be helpful in assessing response to prostate cancer treatment, most commonly with radiation and/or androgen-deprivation therapy. [Rev Urol. 2006;8(suppl 1):S4-S10]

Prostate cancerMagnetic resonance imagingMagnetic resonance spectroscopyEndorectal MRI

Fernand LabrieView Articles
Fernando de MiguelView Articles