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Directory of Authors from the Journal and their last article.

James M McKiernanView Articles

Volume 9, Supplement 2Review Articles

High-Risk, Clinically Localized Prostate Cancer: Is Monotherapy Adequate?

Androgen-Independent Prostate Cancer

James M McKiernanMark H Katz

High-risk, clinically localized prostate cancer represents a diverse disease entity. Patients who are considered to be at highest risk for biochemical failure after localized treatments may not be at significant risk for diseasespecific mortality. In this review, an attempt will be made to define high-risk status and help identify patients at high risk for mortality after a diagnosis of localized prostate cancer. Subsequently, a review of monotherapy approaches as well as previously successful strategies utilizing multimodality therapy for high-risk disease will be presented. Finally, a synopsis will be given of several ongoing randomized clinical trials using the most effective systemic therapies in the adjuvant setting following thorough local treatments such as radical prostatectomy. This review will provide a glimpse into the future and describe the tools that it is hoped will improve further upon the results of surgical monotherapy for high-risk, localized prostate cancer. [Rev Urol. 2007;9(suppl 2):S19-S27]

Prostate cancerRadical prostatectomyHigh-risk, localized prostate cancerMortality riskMultimodality therapy

James S WysockView Articles
James T TrusslerView Articles

Volume 22, Number 4Case Review

Cryptozoospermia Associated With Genital Tucking Behavior in a Transwoman

Robert J CarrasquilloJames T Trussler

Transwomen may elect to pursue fertility preservation prior beginning hormonal treatment or proceeding with gender-affirming surgery. To date, there has been little research specifically investigating factors influencing fertility and preservation thereof among transwomen. Here, we review the case of a transwoman who engaged in genital tucking behavior presenting with severe oligospermia, and we review the literature regarding transgender fertility preservation and the role of the heat stress hypothesis with regards to this common behavior. [Rev Urol. 2020;22(4):170–173] © 2021 MedReviews®, LLC

James WysockView Articles

Volume 20, Number 4Review Articles

Focal Ablation of Prostate Cancer

Treatment Update

Samuel GoldJames WysockHerbert Lepor

The challenge to the urology community is to reduce the risks of screening and treatment by reducing the number of men undergoing unnecessary biopsy and whole-gland curative treatment of low-risk disease. There is compelling evidence that focal ablation of prostate cancer is truly minimally invasive and offers major functional advantages over whole-gland treatment. [Rev Urol. 2018;20(3):145–157 doi: 10.3909/riu0809] © 2019 MedReviews®, LLC

Prostate cancer screeningHigh-intensity focused ultrasoundIrreversible electroporationFocal ablationProstate cancer treatmentVascular targeted photodynamic therapy

Jamie A KanofskyView Articles

Volume 9, Number 3Case Review

Spontaneous Renal Artery Dissection

Case Review

Jamie A KanofskyHerbert Lepor

Spontaneous renal artery dissection (SRAD) is a rare event, and thus may be a challenge for physicians to diagnose and treat. We report a case of SRAD in a healthy 56-year-old male who presented with flank pain, fever, and elevated white blood cell count. The patient was initially diagnosed with nephrolithiasis versus pyelonephritis and was admitted for observation. Multiple imaging modalities, including non-contrast computed tomography (CT), magnetic resonance imaging (MRI) with gadolinium, CT angiogram, and intraoperative angiogram, were used to make the final diagnosis of SRAD. The patient was treated with endovascular stent placement and is currently free of pain with normal laboratory values and blood pressure. [Rev Urol. 2007;9(3):156-160]

KidneyRenal arteryDissectionAngiogramEndovascular stenting

Janak SinghView Articles

Volume 16, Number 3Case Review

Occult Renal Cell Carcinoma Manifesting as Nasal Mass and Epistaxis

Rajeev MathurVishwas BahetiJanak SinghSher Singh Yadav

Metastasis of renal cell carcinoma (RCC) to the nasal cavity and paranasal sinuses is rare, with fewer than 50 cases described in the literature. Nasal metastasis as the initial presentation of RCC is even rarer. Metastases to the nasal cavity usually represent advanced disease with poor outcome. The authors report a case of metastatic RCC presenting with right nasal cavity mass and epistaxis, followed by a brief review of the relevant literature. [Rev Urol. 2014;16(3):145-148 doi: 10.3909/riu0607] © 2014 MedReviews®, LLC

Renal cell carcinomaNasal metastasisEpistaxis

Jared BrandenbergerView Articles

Volume 19, Number 3Case Review

Surgical Solution to an Intracorporeal Nickel Allergy

Paul KozlowskiAndrew StammJared Brandenberger

A previously healthy 30-year-old man with a symptomatic varicocele underwent gonadal vein embolization using nickel vascular plugs. He developed a painful hypersensitivity to his nickel plugs and elected to pursue laparoscopic excision and proximal gonadal vein ligation. In the operating room, the gonadal vein was isolated from the ureter, and ligated proximal to the cephalad plug and distal to the caudal coil. His pain is completely resolved 5 months after surgery. Metal allergies are well documented in orthopedics and cardiology implants, but there are a limited number of case reports of metal allergies after varicocele embolization. Interestingly, nickel is the most common type of metal hypersensitivity. [Rev Urol. 2017;19(3):195–197 doi: 10.3909/riu0769] © 2017 MedReviews®, LLC

VaricoceleMetal allergyNickelCoil embolizationGonadal vein

Jared M BieniekView Articles

Volume 16, Number 2Case Review

Solitary Candida albicans Infection Causing Fournier Gangrene and Review of Fungal Etiologies

Joel M SumfestJared M BieniekTiffany A Perkins

Polymicrobial bacterial infections are commonly found in cases of Fournier gangrene (FG), although fungal growth may occur occasionally. Solitary fungal organisms causing FG have rarely been reported. The authors describe a case of an elderly man with a history of diabetes who presented with a necrotizing scrotal and perineal soft tissue infection. He underwent emergent surgical debridement with findings of diffuse urethral stricture disease and urinary extravasation requiring suprapubic tube placement. Candida albicans was found to be the single causative organism on culture, and the patient recovered well following antifungal treatment. Fungal infections should be considered as rare causes of necrotizing fasciitis and antifungal treatment considered in at-risk immunodeficient individuals. [Rev Urol. 2014;16(2):95-98 doi: 10.3909/riu0595] © 2014 MedReviews®, LLC

Fournier gangreneFournier’s Gangrene Severity IndexCandida albicans

Jason D EngelView Articles

Volume 10, Number 4Review Articles

Renewing Intimacy: Advances in Treating Erectile Dysfunction Postprostatectomy

Expert Commentary

Jason D EngelAndrew R McCulloughHerbert Lepor

Erectile dysfunction following prostatectomy is almost universal. Herbert Lepor, MD, Professor and Martin Spatz Chairperson of Urology and Professor of Pharmacology at New York University School of Medicine and cofounder of Reviews in Urology; Andrew McCullough, MD, Director of the Sexual Health and Male Fertility and Microsurgery Programs at New York University School of Medicine; and Jason D. Engel, MD, Vice Chairman of Urology and Director of Urologic Robotic Surgery at George Washington University Hospital, discuss treatment options for erectile dysfunction postprostatectomy. [Rev Urol. 2008;10(4):245-253]

Jason HafronView 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

Jason M ScovellView Articles

Volume 16, Number 3Review Articles

Management of Erectile Dysfunction in the Hypogonadal Man: A Case-Based Review

Management Review

Jason M ScovellLarry I LipshultzJason R KovacNathan A WilkenRanjith Ramasamy

Erectile dysfunction (ED) has emerged as an important marker of cardiovascular and overall health, independent of other known conventional risk factors. ED often precedes coronary artery disease in half of affected subjects, and could indicate the presence of cardiovascular pathology. The pathophysiology and role of androgens in sexual function are described, along with the relevant literature on the effects of aging in erectile and gonadal function. The concept of testosterone supplementation (TST) in men with ED is reviewed. The authors utilize clinical vignettes to discuss the appropriate management of two clinical cases of men at different life stages who have ED in the setting of hypogonadism and propose a treatment algorithm. In patients of all ages, proper identification of the underlying pathophysiology of decreased libido and erectile function is paramount in choosing between the use of TST, phosphodiesterase type 5 inhibitors, or both, in the management of these disorders. [Rev Urol. 2014;16(3):105-109 doi: 10.3909/riu0623] © 2014 MedReviews®, LLC

HypogonadismErectile dysfunctionTestosterone supplementationPhosphodiesterase

Jason R KovacView Articles

Volume 16, Number 3Review Articles

Management of Erectile Dysfunction in the Hypogonadal Man: A Case-Based Review

Management Review

Jason M ScovellLarry I LipshultzJason R KovacNathan A WilkenRanjith Ramasamy

Erectile dysfunction (ED) has emerged as an important marker of cardiovascular and overall health, independent of other known conventional risk factors. ED often precedes coronary artery disease in half of affected subjects, and could indicate the presence of cardiovascular pathology. The pathophysiology and role of androgens in sexual function are described, along with the relevant literature on the effects of aging in erectile and gonadal function. The concept of testosterone supplementation (TST) in men with ED is reviewed. The authors utilize clinical vignettes to discuss the appropriate management of two clinical cases of men at different life stages who have ED in the setting of hypogonadism and propose a treatment algorithm. In patients of all ages, proper identification of the underlying pathophysiology of decreased libido and erectile function is paramount in choosing between the use of TST, phosphodiesterase type 5 inhibitors, or both, in the management of these disorders. [Rev Urol. 2014;16(3):105-109 doi: 10.3909/riu0623] © 2014 MedReviews®, LLC

HypogonadismErectile dysfunctionTestosterone supplementationPhosphodiesterase

Jason ShelnuttView Articles
Jaspreet S PariharView Articles

Volume 16, Number 3Review Articles

Role of Chemokines in Renal Cell Carcinoma

Systematic Review

Jaspreet S PariharHari Siva Gurunadha Rao Tunuguntla

With new frontiers of pharmaceutical therapies focusing on tumor growth and angiogenesis, understanding the interaction between immune system and tumor microenvironment has become ever more important. Chemokines and chemokine receptors appear to play an integral role in tumor characteristics. Evidence suggests CXCR4, CXCL5, CXCR7, and stromal derived factor-1 appear to be crucial in survival, growth, and metastasis of renal cell carcinoma. As the role of chemokines in renal cancer is becoming more evident, further research will lead to a better understanding of tumor biology and the development of new therapeutic targets to help improve survival. [Rev Urol. 2014;16(3):118-121 doi: 10.3909/riu0608] © 2014 MedReviews®, LLC

Renal cell carcinomaCytokinesChemokineOncocytoma

Javaid MagrayView Articles

Volume 17, Number 4Case Review

Effectiveness of Antegrade Access in Bladder Tumors With Inaccessible Urethra

MohdSaleem WaniBaldev Singh WazirArif Hameed BhatAshiq BhatJavaid MagraySajad MaikTanveer Iqbal DarAbdul Rouf Khawaja

Inaccessible urethra with no retrograde endoscopic access due to multiple/diffuse strictures or multiple urethrocutaneous fistulas with acute urinary retention due to posturethral instrumentation (transurethral resection of bladder tumor [TURBT], or TURBT with transurethral resection of the prostate [TURP]), is a rare entity. Management of such a case with a bladder tumor for TURBT/surveillance cystoscopy poses a great challenge. The authors present 12 cases of bladder tumor with inaccessible urethra, 10 cases due to multiple strictures (post-TURBT and/or TURP), and 2 cases due to urethrocutaneous fistulas (post-TURBT), who presented to our emergency department with acute urinary retention. Emergent suprapubic catheterization was used as a temporary treatment method. [Rev Urol. 2015;17(4):241-245 doi: 10.3909/riu0677] © 2016 MedReviews®, LLC

Bladder tumorsSuprapubic cystostomyInaccessible urethraTract seedling

Jay KrishnanView Articles

Volume 14, Number 1Case Review

Adult Wilms’ Tumor With a Unique Presentation of High-Grade Fever, Photophobia, and Headache

Marcella NachmannJerome PietrasJay Krishnan

Wilms’ tumor is the second most common tumor in children, accounting for 6% to 7% of all childhood tumors. However, in adults, it is a rare occurrence. The true incidence of adult Wilms’ tumor is difficult to ascertain because of its rarity in the adult population. A review of literature demonstrates that fewer than 300 cases have been reported worldwide. Treatment guidelines in adults have not been established, although reported prognosis is worse for adults compared with children because the disease is more advanced in adults at the time of diagnosis. Reported here is a case of adult Wilms’ tumor presenting as high-grade fever and abnormal laboratory values. [ Rev Urol. 2012;14(1/2):31-34 doi: 10.3909/riu0541] © 2012 MedReviews®, LLC

Wilms’ tumorRenal massOpen radical nephrectomyMultimodal therapy

Jay RamanView Articles

Volume 22, Number 1Review Articles

Management of Low-grade Upper Tract Urothelial Carcinoma: An Unmet Need

Management Review

Jay RamanNeal D Shore

Upper tract urothelial cancers (UTUC) are frequently managed by radical nephroureterectomy (RNU), a major operative procedure that may entail short-term morbidity and long-term decline in renal function. Kidney-sparing procedures offer a less invasive alternative to RNU for low-risk, low-grade UTUC (LG-UTUC). They are associated with similar disease-specific survival rates and better long-term renal function, albeit with a potentially increased risk of recurrence. Strategies to decrease LG-UTUC recurrence include improved risk stratification and enhanced endoscopic instrumentation. Chemoablation may represent an alternative, innovative kidney-sparing approach for LG-UTUC. [Rev Urol. 2020;22(1):1–8] © 2020 MedReviews®, LLC

Risk stratificationUpper tract urothelial cancerRadical nephroureterectomyNephron-sparing procedureLow-grade tumors

Jay T BishoffView Articles
Jaya GoudView Articles

Volume 23, Number 3Kidney Cancer

Response to Targeted Therapy and Checkpoint Inhibition in a Patient With Mucinous Tubular and Spindle Cell Carcinoma: A Case Report and Literature Review

Ruchi AgarwalDaniela V. CastroYu Jun LiJaya GoudSalvador Jaime-Casas

Mucinous tubular and spindle cell carcinoma (MTSCC) is a form of renal cell carcinoma characterized by its tubular structure, mucinous stroma, and spindle-shaped cells. It makes up less than 1% of all renal cell carcinoma cases and has been classically described as indolent, although the disease course varies. Here we analyze the case of a 67-year-old woman with metastatic MTSCC with a sarcomatoid component. The course of treatment was extensive and included targeted therapy and immunotherapy. Thus, this case review offers insight into the heterogeneous clinical course of MTSCC and potential therapeutic options for these patients.

Immunotherapyimmune checkpoint inhibitorsCarcinoma, renal cellCarcinomaneoplasms, squamous, mucinous, and serouscarcinoma, tubular

Jayabalan NirmalView Articles