Authors

Main Content

Top Content

Directory of Authors from the Journal and their last article.

Guaqiao WangView Articles

Volume 19, Number 1Review Articles

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

Management Update

Dean G AssimosGuaqiao WangCourtney L ShephardBetsy 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

Guglielmo ManticaView Articles

Volume 19, Number 4Case Review

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

Irene ParaboschiGirolamo MattioliCarlo TerroneGiovanni De CaroHilgard AckermannAlexander SzpytkoGuglielmo ManticaAldo Franco De Rose

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

Guilherme GodoyView Articles

Volume 11, Number 4Review Articles

Focal Therapy: A New Paradigm for the Treatment of Prostate Cancer

Treatment Update

Guilherme GodoyBasir TareenSamir S Taneja

Focal therapy has been proposed in recent years as a means of bridging the gap between radical prostatectomy and active surveillance for treatment of prostate cancer. The rationale for focal therapy comes from its success in treating other malignancies. One of the challenges in applying such an approach to the treatment of prostate cancer has been the multifocal nature of the disease. This review addresses the selection of potentially ideal candidates for focal therapy and discusses which modalities are currently being used and proposed for focal therapy. Setting and meeting guidelines for oncologic efficacy is a challenge we must embrace to safely deliver this potentially revolutionary approach to treating men with prostate cancer.[Rev Urol. 2009;11(4):203-212 doi: 10.3909/riu0475]© 2009 MedReviews®, LLC

Prostatic neoplasmsFocal therapyProstate-specific antigenProstatectomyPhotodynamic therapyUltrasound, high-inten sity focused, transrectalCryosurgery

Gülistan GümrükçüView Articles

Volume 17, Number 3Case Review

Retroperitoneal Ancient Schwannoma: A Case Report

Cevdet KayaGülistan GümrükçüSelahattin ÇalIiskan

Schwannomas are extremely rare tumors that are composed of Schwann cells. Retroperitoneal localization comprises 0.7% to 2.6% of all schwannomas. Patients usually present with nonspecific symptoms. There are no pathognomonic features on radiologic evaluation. Preoperative biopsy is not recommended because of complication risks; however, surgery is necessary for diagnosis and treatment. Although most schwannomas are benign tumors, those that are associated with von Recklinghausen disease are malignant. Schwannomas exhibit regions of high and low cellularity, termed Antoni A and Antoni B areas, with a diffuse positivity of S100 protein on pathologic evaluation. If there are degenerative changes, such as cyst formation, hemorrhage, calcification, and hyalinization, these tumors are termed ancient schwannomas. We present a case of retroperitoneal ancient schwannoma. [Rev Urol. 2015;17(3):190-193 doi: 10.3909/riu0638] © 2015 MedReviews®, LLC

Retroperitoneal schwannomaNeurilemmomaSchwannomaRetroperitoneal tumor

Guru SonpavdeView Articles

Volume 12, Number 1Review Articles

Emerging Vaccine Therapy Approaches for Prostate Cancer

Treatment Update

David M SpencerJonathan M LevittGuru SonpavdeKevin M Slawin

Prostate cancer vaccines attempt to induce clinically relevant, cancer-specific systemic immune responses in patients with prostate cancer and represent a new class of targeted, nontoxic therapies. With a growing array of vaccine technologies in preclinical or clinical development, autologous antigen-presenting cell vaccines loaded with the antigen, prostate acid phosphatase, and poxvirus vaccines targeting prostate-specific antigen have recently demonstrated a significant survival benefit in randomized trials of patients with metastatic castration-resistant prostate cancer, whereas others have failed to demonstrate any benefit. The combination of vaccines with chemotherapy, radiotherapy, and other biologic agents is also being evaluated. Efforts to optimize vaccine approaches and select ideal patient populations need to continue to build on these early successes.[Rev Urol. 2010;12(1):25-34 doi:10.3909/riu0437]

Prostate cancerImmunotherapyVaccine

Guy VallancienView Articles
H Ballentine CarterView Articles

Volume 8, Number 3Review Articles

The Importance of Pelvic Lymph Node Dissection in Men With Clinically Localized Prostate Cancer

Diagnostic Review

Mohamad E AllafH Ballentine CarterAlan W Partin

Despite advances in noninvasive staging, pelvic lymph node dissection (PLND) remains the most accurate means of detecting lymph node metastases in men with clinically localized prostate cancer. Nomograms exist that can identify patients at low risk for lymphatic metastases according to preoperative information. In general, it seems reasonable to omit PLND in men with a biopsy Gleason sum of 6 or less and a prostate-specific antigen level of 10 ng/mL or less. Ultimately, however, this decision should be made according to physician and patient preference, considering the low contemporary morbidity associated with PLND. When PLND is performed, studies suggest that an extended dissection maximizes the detection rate of nodal involvement. Retrospective data indicate that an extended dissection might play a therapeutic role in a subset of patients with a limited lymph node burden. However, this might be an artifact of stage migration, and prospective studies are needed to evaluate this further. [Rev Urol. 2006;8(3):112-119]

Prostate cancerNomogramsRadioimmunoscintigraphyLymphadenectomyClinical stagingMagnetic resonanceimagingAlgorithms

H Barton GrossmanView Articles

Volume 10, Number 4Review Articles

Bacillus Calmette-Guérin Failures and Beyond: Contemporary Management of Non–Muscle-Invasive Bladder Cancer

Management Review

Richard E GreenbergMichael S CooksonH Barton GrossmanMichael A O'DonnellThomas E Keane

In the United States, bacillus Calmette-Guérin (BCG) is the treatment most used for superficial bladder cancer. Patients with carcinoma in situ (CIS) treated with intravesical BCG plus interferon have a 60% to 70% chance of a complete and durable response if they were never treated with BCG or if they failed only 1 prior induction or relapsed more than a year from induction. Intravesical gemcitabine is safe, but its usefulness for BCG-refractory patients is unclear. Valrubicin, approved for intravesical treatment of BCGrefractory CIS of the bladder, has efficacy and acceptable toxicity. Cystectomy should be considered in high-risk, non–muscle-invasive cancer, particularly if intravesical therapy failed. [Rev Urol. 2008;10(4):281-289]

Bacillus Calmette-GuérinBladder cancerCystectomyGemcitabine

H Henry LaiView Articles
H Jeffrey LawrenceView Articles

Volume 16, Number 4Review Articles

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

Diagnosis Update

Judd W MoulH Jeffrey LawrenceSteven E CanfieldPhillip G FebboMichael J KemeterAdam S Kibel

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

Hakan ÖztürkView Articles

Volume 17, Number 3Case Review

Treatment of Colonic Injury During Percutaneous Nephrolithotomy

Hakan Öztürk

Colonic injury during percutaneous nephrolithotomy (PCNL) persists despite the advances in technical equipment and interventional radiology techniques. According to the Clavien-Dindo classification of surgical complications, colonic injury is regarded as a stage IVa complication. Currently, the rate of colonic injury ranges between 0.3% and 0.5%, with an unremarkable difference in incidence between supine and prone PCNL procedures. Colon injury is the most significant complication of PCNL. Colonic injury can result in more complicated open exploration of the abdomen, involving colostomy construction. The necessity of a second operation for the closure of the colostomy causes financial and emotional burden on the patients, patients’ relatives, and surgeons. Currently, the majority of colonic injuries occurring during PCNL are retroperitoneal. The primary treatment option is a conservative approach. It must be kept in mind that the time of diagnosis is as important as the diagnosis itself in colonic injury. Surgeons performing PCNL are advised to be conservative when considering exploratory laparotomy and colostomy construction during treatment of colonic injury. We present the case of a 49-year-old woman who underwent left prone PCNL that resulted in retroperitoneal colonic injury, along with a review of the current literature. [Rev Urol. 2015;17(3):194-201 doi: 10.3909/riu0641] © 2015 MedReviews®, LLC

Percutaneous nephrolithotomyPreventionUrolithiasisColonic injuryClavienComplicationManagement

Haluk AkpinarView Articles

Volume 12, Number 4Review Articles

Metabolic Syndrome and Urologic Diseases

Mangement Review

Ilya GorbachinskyHaluk Akpinar

Metabolic syndrome (MetS) is a complex entity consisting of multiple interrelated factors including insulin resistance, central adiposity, dyslipidemia, endothelial dysfunction and atherosclerotic disease, low-grade inflammation, and in males, low testosterone levels. MetS has been linked to a number of urologic diseases including nephrolithiasis, benign prostatic hyperplasia and lower urinary tract symptoms, erectile dysfunction, male infertility, female incontinence, and prostate cancer. This article reviews the relationships between MetS and these entities. Urologists need to be cognizant of the impact that MetS has on urologic diseases as well as on overall patient health.[Rev Urol. 2010;12(4):e157-e180 doi: 10.3909/riu0487]© 2010 MedReviews®, LLC

ObesityMetabolic syndromeBenign prostatic hyperplasiaNephrolithiasisHypogonadismCardiovascular diseaseInsulin resistanceEndothelial dysfunction

Hangcheng FuView 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)

Hann-Chorng KuoView Articles
Hans LiljaView Articles
Hari K KoulView Articles

Volume 8, Number 4Review Articles

Penile Rehabilitation After Radical Prostatectomy: Important Therapy or Wishful Thinking?

Management Update

Hari K KoulJoseph E Dall'EraRandall B MeachamJesse N Mills

On the basis of data accumulated thus far, it is reasonable to discuss the implementation of a “penile rehabilitation” program with patients undergoing radical prostatectomy. Central to discussions of penile rehabilitation after radical prostatectomy is evidence demonstrating significant fibrotic changes in the corpus cavernosum that occur postoperatively. Several studies have been published evaluating the efficacy of various pro-erectogenic agents. The limited data regarding intracavernous injections and vacuum constriction devices suggest that an increased percentage of treated patients experienced a return of natural erections compared with patients who received no treatment. Longer, prospective, randomized, placebo-controlled studies will be needed to confirm the utility of these treatments. Data from contemporary studies evaluating the chronic use of oral phosphodiesterase type 5 inhibitors suggest a beneficial effect on endothelial cell function among men suffering from erectile dysfunction due to a variety of causes. Limited data suggest that this effect might be seen among post-prostatectomy patients, implying a possible role for these agents in enhancing the return of sexual function in such individuals. [Rev Urol. 2006;8(4):209-215]

Radical prostatectomyErectile dysfunctionPenile rehabilitationPDE-5 inhibitorsHypoxiaIntracorporeal injectionVacuum constriction device

Hari KoulView Articles
Hari Siva Gurunadha Rao TunuguntlaView Articles
Hari TunuguntlaView Articles

Volume 17, Number 3Review Articles

Conservative Management of Urinary Incontinence in Women

Izak FaienaMarc CalabreseNeal PatelJaspreet S PariharHari Tunuguntla

Urinary incontinence in women has a high prevalence and causes significant morbidity. Given that urinary incontinence is not generally a progressive disease, conservative therapies play an integral part in the management of these patients. We conducted a nonsystematic review of the literature to identify high-quality studies that evaluated the different components of conservative management of stress urinary incontinence, including behavioral therapy, bladder training, pelvic floor muscle training, lifestyle changes, mechanical devices, vaginal cones, and electrical stimulation. Urinary incontinence can have a severe impact on our healthcare system and patients’ quality of life. There are currently a wide variety of treatment options for these patients, ranging from conservative treatment to surgical treatment. Although further research is required in the area of conservative therapies, nonsurgical treatments are effective and are preferred by some patients. [Rev Urol. 2015;17(3):129-139 doi: 10.3909/riu0651] © 2015 MedReviews®, LLC

Urinary incontinenceWomenConservative management

Harin Padma-NathanView Articles