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Directory of Authors from the Journal and their last article.

Jim HuView Articles
Jim KoukounarasView Articles

Volume 13, Number 2Review Articles

Contemporary Management of Renal Trauma

Management Update

Niall M CorcoranKatherine A MartinJim KoukounarasPeter L RoyceMatthew F BultitudeJennifer J Shoobridge

In the management of renal trauma, surgical exploration inevitably leads to nephrectomy in all but a few specialized centers. With current management options, the majority of hemodynamically stable patients with renal injuries can be successfully managed nonoperatively. Improved radiographic techniques and the development of a validated renal injury scoring system have led to improved staging of injury severity that is relatively easy to monitor. This article reviews a multidisciplinary approach to facilitate the care of patients with renal injury. [Rev Urol. 2011;13(2):65-72 doi: 10.3909/riu0512] © 2011 MedReviews®, LLC

NephrectomyRenal injuryBlunt traumaAngiogenesis

Jody PinkertonView Articles

Volume 23, Number 1Treatment Review

Consistency in Care Opportunities for Prostate Cancer

Wanda WiltNicole SmithKatie GrantJayme NalleyJody Pinkerton

Through data analysis and multiple interviews and insights, this study attempted to address the inconsistency in care for patients with prostate cancer who shared similar journey time points, demographics, and care center expertise. The Consistency of Care Project aimed to evaluate the impact of efforts to improve targeted metrics surrounding crucial clinical interventions of prostate-specific antigen monitoring, surveillance scanning, and pharmacologic interventions over a 9-month period. For comparison, 15 private urology practices of like size, patient population, and demographics were monitored. Ten of the practices benefitted from reviewed workflow training on the PPS Analytics data platform; access to a PPS Analytics Clinical Analyst, who supported education for identification of actionable patients; consistent data analysis; workflow support; and regular check-in meetings to monitor progress. The 5 control sites were monitored without additional, purposeful intervention. Outcomes support the hypothesis that inconsistency in care can begin to be addressed through focused workflows, strong navigation, and attention to key performance indicators. Attrition rate differences of 32% vs 6% improvements (reengaging patients for care who had no next appointment scheduled). On average, the experimental group increased the metastatic castration-sensitive prostate cancer diagnosis rate by 10%. However, the treatment rates measured a relative increase of 35% but an average of 11% absolute improvement at the supported sites vs 6% at the control sites. Patients with metastatic castration-resistant prostate cancer at the supported sites improved by 20%, compared with those in the control group, who improved by 4%. Care teams with strong workflows, supportive resources, and consistent care pathways—when combined with data analytics—can influence care and drive increased, measurable differences.

Prostate cancerProstatic neoplasmsUrologyNeoplasmpatient navigation

Joel KaufmanView Articles
Joel M SumfestView 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

Joel MH TeichmanView Articles
Joelle HamiltonView Articles

Volume 23, Number 2Meet The Expert

Meet the Expert: Lillie Shockney, RN, MAS

Joelle Hamilton

Discussions with patients with cancer who are facing metastatic disease progression must be handled with empathy and compassion. In this interview, Lillie Shockney, RN, MAS, the University Distinguished Service Professor of Breast Cancer and a professor of surgery at the Johns Hopkins University School of Medicine, shares her approach to handling delicate end-of-life conversations with her patients.

Neoplasm metastasisadvanced care planningterminal carepatient-centered care

Joesph AlukalView Articles
Johannes ViewegView Articles

Volume 9, Supplement 1Review Articles

Immunotherapy for Advanced Prostate Cancer

New Directions in the Management of Advanced Prostate Cancer

Johannes Vieweg

The absence of curative therapies for advanced or recurrent forms of prostate cancer mandates continued development of novel, more effective treatment regimens. Due to recent advances in basic and translational research, therapeutic vaccines and monoclonal antibody-based therapies are steadily gaining ground as promising treatment modalities against prostate cancer. Several immunotherapeutic products have recently been investigated in later-phase trials and have reported evidence for clinical benefit while maintaining an excellent quality of life for participants. The cumulative clinical results available to date indicate that immune-based therapies will likely play a role in the treatment of patients with prostate and other malignancies. The objective of this article is to increase awareness of contemporary immunologic therapies and clinical trials of new biologic reagents against prostate cancer. We also seek to encourage urologists to actively participate in clinical trials and evaluate the potential of immunotherapeutic drugs for impacting standards of care. [Rev Urol. 2007;9(suppl 1):S29-S38]

Prostate cancerImmunotherapyTumor vaccinesMonoclonal antibodies

John A InglisView Articles

Volume 17, Number 4Case Review

Acromegaly Presenting as Erectile Dysfunction: Case Reports and Review of the Literature

Rousseau GamaJohn A InglisKate E ShipmanJerry A Raju

Erectile dysfunction (ED) is a common yet complex condition. The authors report two cases of acromegaly presenting with ED and hypogonadotropic hypogonadism. Surgical cure of the acromegaly was associated with either an improvement or resolution of hypogonadotropic hypogonadism-associated ED. Active acromegaly should be considered in the differential diagnosis of ED presenting with supporting clinical features, particularly hypogonadotropic hypogonadism. [Rev Urol. 2015;17(4):246-249 doi: 10.3909/riu0676] © 2016 MedReviews®, LLC

Erectile dysfunctionEndocrine dysfunctionEndocrinologyAcromegalyGrowth hormone

John AlbaneseView Articles

Volume 17, Number 1Original Research

Hemostasis During Urologic Surgery: Fibrin Sealant Compared With Absorbable Hemostat

David M. AlbalaJerome B RiebmanJonathan BatillerLiza OvingtonJessica ShenJohn AlbaneseBogdan IlieRichard Kocharian

In the United States, fibrin sealants have been used to achieve hemostasis for nearly two decades. Although their clinical utility was first demonstrated in cardiac surgery, their effectiveness and safety have since been demonstrated to extend to a wide array of procedures. Fibrin sealants typically contain two components—fibrinogen and thrombin—that are combined and delivered simultaneously to a target bleeding site in order to achieve hemostasis. However, many commercial formulations contain other additional components, such as antifibrinolytic agents, that have been associated with adverse outcomes. This subanalysis compares the safety and effectiveness of a fibrin sealant versus an absorbable hemostat for achieving hemostasis during urologic procedures with mild to moderate bleeding. [Rev Urol. 2015;17(1):25-30 doi: 10.3909/ricm0647] © 2015 MedReviews®, LLC

BleedingHemostasisHemostaticsFibrin tissue adhesiveUrologic surgical proceduresSurgical technique

John B ForrestView Articles
John C SalikenView Articles
John D DeanView Articles
John EiflerView 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)

John F WardView Articles
John GraffView Articles

Volume 21, Number 1Case Review

Ureteral Polyp Managed by Endoscopic Techniques

Tal CohenMark MemoJohn GraffShyam Patnaik

Fibroepithelial polyps (FEPs) are rare benign tumors of mesodermal origin. They are found in the ureters 85% of the time, with the remainder located in the renal pelvis and occasionally the bladder. FEPs can present as flank pain, lower abdominal pain, and/or gross hematuria. Previous literature reports management of these benign lesions using open surgical techniques, laparoscopic techniques, and endoscopic management. In this article, the authors present their pure endoscopic management of a large ureteral polyp and a review of the current literature outlining the etiology, clinical presentations, and management techniques for FEP of the ureter. [Rev Urol. 2019;21(1):45–48] © 2019 MedReviews®, LLC

Ureteral polypEndoscopic managementUreteral filling defect

John HornbergerView Articles

Volume 19, Number 4Review Articles

Active Surveillance Use Among a Low-risk Prostate Cancer Population in a Large US Payer System: 17-Gene Genomic Prostate Score Versus Other Risk Stratification Methods

Original Research

Michael J KemeterPhillip G FebboSteven CanfieldJohn Hornberger

Many men with low-risk prostate cancer (PCa) receive definitive treatment despite recommendations that have been informed by two large, randomized trials encouraging active surveillance (AS). We conducted a retrospective cohort study using the Optum™ Research Database (Eden Prairie, MN) of electronic health records and administrative claims data to assess AS use for patients tested with a 17-gene Genomic Prostate Score™ (GPS; Genomic Health, Redwood City, CA) assay and/or prostate magnetic resonance imaging (MRI). De-identified records were extracted on health plan members enrolled from June 2013 to June 2016 who had ≥1 record of PCa (n = 291,876). Inclusion criteria included age ≥18 years, new diagnosis, American Urological Association low-risk PCa (stage T1-T2a, prostate-specific antigen ≥10 ng/mL, Gleason score = 6), and clinical activity for at least 12 months before and after diagnosis. Data included baseline characteristics, use of GPS testing and/or MRI, and definitive procedures. GPS or MRI testing was performed in 17% of men (GPS, n = 375, 4%; MRI, n = 1174, 13%). AS use varied from a low of 43% for men who only underwent MRI to 89% for GPS-tested men who did not undergo MRI (P<001). At 6-month follow-up, AS use was 31.0% higher (95% CI, 27.6%-34.5%; P<001) for men receiving the GPS test only versus men who did not undergo GPS testing or MRI; the difference was 30.5% at 12-month follow-up. In a large US payer system, the GPS assay was associated with significantly higher AS use at 6 and 12 months compared with men who had MRI only, or no GPS or MRI testing. [Rev Urol. 2017;19(4):203–212 doi: 10.3909/riu0786] © 2018 MedReviews®, LLC

Prostate cancerActive surveillanceEvidence-based practiceComparative effectiveness researchGenomic biomarkerMagnetic resonance imaging

John J AzzolinaView Articles
John KimView Articles