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Directory of Authors from the Journal and their last article.

Alex WangView 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

Alexander D DoudtView Articles

Volume 20, Number 4Review Articles

Male Slings for Post-prostatectomy Incontinence

Treatment Review

Jack M ZuckermanAlexander D Doudt

Stress urinary incontinence following radical prostatectomy can have a significant impact on a man’s quality of life. Male slings offer a perceived minimally invasive treatment option and do not require the manual dexterity necessary to operate an artificial urinary sphincter. In this review, we outline the history of male slings and discuss the various fixed and adjustable slings that are available on the market. It is important for the general urologist to understand the technical differences, outcomes, and common complications of suburethral slings. [Rev Urol. 2018;20(4):158–169 doi: 10.3909/riu080] © 2019 MedReviews®, LLC. This article is a US Government work and, as such, is in the public domain in the United States of America.

Suburethral slingMale slingPost-prostatectomy incontinence

Alexander FarrView Articles
Alexander SzpytkoView 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

Alexandre PeltierView Articles

Volume 17, Number 2Review Articles

Penile Rehabilitation Strategies Among Prostate Cancer Survivors

Treatment Update

Fouad AounAlexandre PeltierRoland van Velthoven

Despite advances in technical and surgical approaches, erectile dysfunction (ED) remains the most common complication among prostate cancer survivors, adversely impacting quality of life. This article analyzes the concept and rationale of ED rehabilitation programs in prostate cancer patients. Emphasis is placed on the pathophysiology of ED after diagnosis and treatment of prostate cancer to understand the efficacy of rehabilitation programs in clinical practice. Available evidence shows that ED is a transient complication following prostate biopsy and cancer diagnosis, with no evidence to support rehabilitation programs in these patients. A small increase in ED and in the use of phosphodiesterase type 5 (PDE5) inhibitors was reported in patients under active surveillance. Patients should be advised that active surveillance is unlikely to severely affect erectile function, but clinically significant changes in sexual function are possible. Focal therapy could be an intermediate option for patients demanding treatment/refusing active surveillance and invested in maintaining sexual activity. Unlike radical prostatectomy, there is no support for PDE5 inhibitor use to prevent ED after highly conformal external radiotherapy or low-dose rate brachytherapy. Despite progress in the understanding of the pathophysiologic mechanisms responsible for ED in prostate cancer patients, the success rates of rehabilitation programs remain low in clinical practice. Alternative strategies to prevent ED appear warranted, with attention toward neuromodulation, nerve grafting, nerve preservation, stem cell therapy, investigation of neuroprotective interventions, and further refinements of radiotherapy dosing and delivery methods. [Rev Urol. 2015;17(2):58-68 doi: 10.3909/riu0652] © 2015 MedReviews®, LLC

Prostate cancerErectile dysfunctionPenile rehabilitationPhosphodiesterase type 5 inhibitorProstaglandin E

Alexis E TeView Articles
Alfred E BentView Articles
Ali ZiadaView Articles
Alice DrainView Articles

Volume 21, Number 2Review Articles

Primary Bladder Neck Obstruction

Disease State Review

Benjamin M BruckerAlice DrainRachael D Sussman

Primary bladder neck obstruction (PBNO) is a functional obstruction caused by abnormal opening of the bladder neck during the voiding phase of micturition. PBNO may present with a variety of symptoms including voiding symptoms (slow urinary stream, intermittent stream, incomplete emptying), storage symptoms (frequency, urgency, urgency incontinence, nocturia), and/or pelvic pain and discomfort. The diagnosis of PBNO can be made with videourodynamic testing, which demonstrates elevated voiding pressures with low flow, and fluoroscopic imaging demonstrating obstruction at the level of the bladder neck. Treatment options include conservative management with watchful waiting, pharmacologic management, and surgical intervention. In this article, we review the etiology, presentation, diagnosis, and treatment of PBNO in men, women, and children. [Rev Urol. 2019;21(2/3):53–62] © 2019 MedReviews®, LLC

Lower urinary tract symptomsBladder outlet obstructionPrimary bladder neck obstruction

Alison M RasperView Articles

Volume 18, Number 4Prostate Cancer Academy

Prostate Cancer Survivorship: Implementation of Survivorship Care Plans to Meet the Mandate and Enhance Urologic Practice Through Collaborative Care

Alison M RasperRyan P Terlecki

Prostate cancer is the most common malignancy among the male survivorship population in the United States, representing 44% of approximately 7 million survivors. In the era of modern medicine and value-based care, successfully treating only the cancer is not sufficient. The cancer survivor represents an individual in need of restoration and protection against future events. A well-designed and well-supported survivorship program not only meets a mandate for accreditation, it logically translates into better patient care. This review summarizes the history of the survivorship movement, outlines some key elements of a survivorship program, and highlights the opportunity to apply these principles to improve cancer-related care, develop relationships with colleagues that may allow increased identification of men at risk, and expand both the experience and outcomes of individual specialists within men’s health. [Rev Urol. 2016;18(4):214-220 doi: 10.3909/riu0733] © 2016 MedReviews®, LLC

Cancer, prostateSurvivorship care planCancer surveillance

Allan GordonView Articles
Allan J PantuckView Articles
Allen F MoreyView Articles

Volume 19, Number 1Case Review

Penile Ossification: A Reconstructive Challenge

Nirmish SinglaArthi SatyanarayanAllen F Morey

Penile 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®, LLC

Peyronie’s diseasePenile ossificationInflatable penile prosthesisCorporoplasty

Allyson HaleView Articles

Volume 21, Number 1Case Review

Use of Spermatic Cord Block Systematically Identifies a Paraspinal Tumor as Source of Orchialgia

Mason HoltelRobert J Baranello JrAllyson HalePatrick Springhart

Orchialgia is a common urologic complaint with a myriad of etiologies. Workup for orchialgia requires a broad differential diagnosis and a thorough understanding of relevant anatomy. We report the case of a 43-year-old man who presented to a urologist with right testicular pain. Following a negative workup, the patient received a spermatic cord block for therapeutic and diagnostic purposes. Two months after the block, the patient returned with new complaints of ipsilateral inner thigh paresthesias, suggesting a pathologic process proximal to the genital branch of the genitofemoral nerve. A subsequent MRI of the lumbosacral spine revealed a paraspinal mass involving nerve roots at L1-2. We highlight the utility of the spermatic cord block and its role in the diagnosis of a paraspinal tumor as an uncommon cause of orchialgia. [Rev Urol. 2019;21(1):49–52] © 2019 MedReviews®, LLC

OrchialgiaNeuropathic painTesticular painSpermatic cord blockGenitofemoral nerveParaspinal tumor

Alon LazarovichView 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)

Alon Y MassView Articles

Volume 16, Number 3Review Articles

Taxi Cab Syndrome: A Review of the Extensive Genitourinary Pathology Experienced by Taxi Cab Drivers and What We Can Do to Help

Disease State Review

Alon Y MassDavid S GoldfarbOjas D Shah

This review consolidates knowledge regarding the extensive genitourinary pathology experienced by taxi cab drivers. Taxi cab, livery, truck, and other drivers all objectively and subjectively may have more voiding dysfunction, infertility, urolithiasis, bladder cancer, and urinary infections as compared with nonprofessional drivers; this is called taxi cab syndrome. Together with governmental and medical assistance, simple interventions—such as education, the addition of taxi relief stations, and possibly the use of sanitary urinary collection devices—to curb the progression of genitourinary disease in taxi drivers should be prospectively studied. It is postulated that many of these interventions may also benefit other groups of occupationally related infrequent voiders. [Rev Urol. 2014;16(3):99-104 doi: 10.3909/riu0627] This article is a US Government work, and, as such, is in the public domain in the United States of America. Published by MedReviews®, LLC

InfertilityUrolithiasisTaxi cab syndromeInfrequent voiders syndromeOccupational hazardVoiding dysfunctionProstodynia

Alon Z WeizerView Articles
Alvin M MatsumotoView Articles
Alyssa N. GiannascaView Articles

Volume 23, Number 1Literature Reviews

Methods for Prostate Cancer Risk Stratification: Serum-Based and Urine-Based Biomarkers for Biopsy Consideration

Alex S. BartRyan D. T. Badre-HumeMeghan E. RobertsGriffen KempskieAlyssa N. Giannasca

Prostate cancer (PCa) is one of the most commonly occurring cancers in men globally. In 2024, it is estimated that there will be 99 010 PCa diagnoses and 35 250 PCa-related deaths in American patients. Given the high incidence and virulence of the disease, proper screening methods are crucial to reduce overdiagnosis and overtreatment of PCa. Using biomarkers with high tumor sensitivity and specificity is therefore crucial to effectively distinguish PCa from benign tissue.

Prostate cancer

Amanda Feige SaltzmanView Articles

Volume 18, Number 4Case Review

Collateral Urethral Duplication in an Adult With Adult Polycystic Kidney Disease

Dunia Taufiq KhaledAmanda Feige SaltzmanLester Joesph Prats

Duplications of the lower urinary tract are rare congenital anomalies that are usually accompanied by concomitant nonurologic anomalies; they are typically diagnosed in early childhood. In more rare cases these are isolated, leading to diagnosis later. We describe a 50-year-old man who remained asymptomatic and therefore undiagnosed for five decades. His is one of fewer than 20 cases in the literature describing urethral duplication in the coronal (collateral) plane, the more common variant being sagittal (dorsal-ventral) duplication. He is one of only four cases reported without concomitant midline anomaly. Furthermore, he is the sole case associated with adult polycystic kidney disease. [Rev Urol. 2016;18(4):242-245 doi: 10.3909/riu0705] © 2016 MedReviews®, LLC

Collateral duplicationCoronal duplicationDuplicate urethraUrethral anomalyDuplication of lower urinary tract