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Directory of Authors from the Journal and their last article.

Michael SchulsterView Articles

Volume 20, Number 1Review Articles

Differentiating Molecular Risk Assessments for Prostate Cancer

Risk Assessment Review

Michael SchulsterMarc A BjurlinBenjamin Press

It is critically important to the evolving goals of prostate biopsy to find clinically significant cancer with lethal potential and avoid detection of indolent disease. Better tests and markers are required for improved detection of clinically significant prostate cancer and avoidance of biopsies in men with indolent disease. Currently, there are myriad alternative prostate cancer risk-assessment tests available derived from serum and urine that are designed to improve the specificity for detection of “significant” prostate cancer. Herein we discuss these tests and their clinical implications. [Rev Urol. 2018;20(1):12–18 doi: 10.3909/riu0787] © 2018 MedReviews, LLC®

Prostate cancerScreeningProstate-specific antigenBiomarkersPSA

Michael ScordoView Articles

Volume 19, Number 1Review Articles

Revisiting the Role of Testosterone: Are We Missing Something?

Thereapeutic Update

Vineet TyagiMichael ScordoRichard S YoonFrank A LiporaceLoren Wissner Greene

Testosterone is a pleiotropic hormone that plays an important role in the human body. Classically, testosterone was thought to be predominantly involved in androgenesis and physiology in boys and men. Through its conversion to estrogen, testosterone affects bone health, including bone density. Recently, there has been a renewed interest in the systemic role of testosterone in pain, well-being, and cardiovascular function in women and men alike. In this review, we discuss the historic significance of testosterone, its traditionally known physiology, and its molecular and cellular effects. We also discuss evidence for testosterone’s lesser known effects, including its role in women’s health. We suggest a need to revisit the clinical role of testosterone given its potential for applications to treat mood, cognitive health, and other illnesses, and its anabolic role in bone and muscle; we also suggest consideration of the current debate on risks of its use. [Rev Urol. 2017;19(1):16-24 doi: 10.3909/riu0716] © 2017 MedReviews®, LLC

Coronary heart diseaseTestosterone replacement therapyTestosterone

Michael SkouterisView Articles

Volume 20, Number 1Original Research

Transrectal Ultrasound–guided Versus Transperineal Mapping Prostate Biopsy: Complication Comparison

Transrectal ultrasound guided prostate biopsy • Transperieneal mapping prostate biopsy • Complications

Vladimir MouravievE David CrawfordVassilios M SkouterisPaul AranguaMarios Panagiotis MetsinisMichael SkouterisGeorge ZacharopoulosNelson N Stone

Herein, the authors compare morbidity in men who underwent both transrectal ultrasound–guided (TRUS) prostate biopsy and transperineal mapping biopsy (TPMB) at two institutions with extensive experience in both procedures. We also identified strategies and predictive factors to reduce morbidity for both procedures. In our study, 379 men from two institutions, of which 265 (69.9%) had a prior TRUS-guided biopsy, also had TPMB performed via a template with biopsies taken at 5-mm intervals. Men in the TRUS group had a median of 12 cores sampled whereas the TPMB group had 51.5 (range, 16-151). The median biopsy density was 1.1 core/cc prostate volume. Median age and prostate-specific antigen (PSA) level were 65 years (range, 34-86) and 5.5 ng/mL (range, 0.02-118). Of these men, 11 of 265 (4.2%) who had TRUS biopsy developed urinary tract infection compared with 3 of 379 (0.79%) of those with mapping biopsy. Infection was 14.8% in TRUS biopsy group with 13 or more cores versus 2.9% in those with 12 or less (OR, 5.8; 95% CI, 1.6-21.2; P = 0.003). No men developed retention after TRUS biopsy whereas 30 of 379 (7.9%) did following TPMB. Older age, larger prostate volume (PV), and higher core number were associated with retention. On linear regression only age (P = 0.010) and PV (P = 0.016) remained as significant associations. Men older than 65 years had 12.8% versus 3.9% (OR, 3.7; 95% CI, 1.6-8.4, P = 0.001) and PV greater than 42 cc had 13.4% versus 2.7% (OR, 5.7; 95% CI, 2.1-15.1) retention incidence. In the present study TPMB is rarely associated with infection (0.78%) but more commonly with urinary retention (7.9%). Men older than 65 years and with PV greater than 42 cc were at four to five times greater retention risk. Consideration should be given to discharging these men with a urinary catheter following TPMB. [Rev Urol. 2018;20(1):19–25 doi: 10.3909/riu0785] © 2018 MedReviews, LLC®

ComplicationsTransrectal ultrasound guided prostate biopsyTransperieneal mapping prostate biopsy

Michael W KattanView Articles
Michel PontariView Articles
Michele AnthonyView Articles

Volume 12, Number 4Review Articles

State of the Art in Intravesical Therapy for Lower Urinary Tract Symptoms

State of the Art

Michael B ChancellorJonathan KaufmanVikas TyagiMichele AnthonyPradeep Tyagi

Intravesical therapy is the routine first-line treatment for effectively delaying or preventing the recurrence of bladder cancer. This route of drug administration has also shown tremendous promise in the treatment of interstitial cystitis/painful bladder syndrome (IC/PBS) and potentially overactive bladder to justify investments for further improvements. This review takes a bird’s eye view into the current status of intravesical therapy, with emphasis on liposomal nanoparticles, in diseases associated with lower urinary tract symptoms (LUTS). Ongoing efforts to advance the field of intravesical drug delivery include development of sustained-release drug implants and efforts to improve delivery of biotechnological products including large protein acting as neurotoxins and small interfering RNAs.[Rev Urol. 2010;12(4):e181-e189 doi: 10.3909/riu0496]© 2010 MedReviews®, LLC

Lower urinary tract symptomsInterstitial cystitisIntravesical therapyPainful bladder syndrome

Michele BattagliaView Articles
Michelle BoytimView Articles

Volume 23, Number 1Literature Reviews

Comparison of Methods for Ureteral Patency Visualization

Michelle BoytimMatthew J. JonesAlex S. BartPavel Svintozelskiy

The most common cause of ureteral trauma occurs during open, laparoscopic, or endoscopic procedures across multiple specialties. Ureteral injuries are often unrecognized or mismanaged. Early recognition of ureteral injuries by cystoscopy allows for prompt intervention. Visualization can be enhanced using agents that color or improve the contrast of ureteral flow.

Cystoscopydiagnostic imagingindigo carminemethylene bluefluorescein

Mike HarikView Articles
Mina FamView Articles

Volume 16, Number 4Case Review

The Use of Botulinum Neurotoxin Type A in a Patient With Refractory Urge Incontinence to Facilitate the Intravesical Treatment of Bladder Carcinoma

Mina FamPatricia Gilhooly

Intravesical Bacillus Calmette-Guérin (BCG) has become the preferred initial treatment after resection of high-grade T1 urothelial carcinoma and carcinoma in situ (CIS). We report the case of a patient with high-grade T1 urothelial carcinoma and CIS who was treated with intravesical BCG. Due to the patient’s severe urge incontinence, however, the BCG solution leaked from the bladder immediately upon instillation. We describe our experience of using botulinum neurotoxin A intradetrusor injections to facilitate successful intravesical therapy by increasing bladder capacity to enable the BCG to remain in the patient’s bladder for the appropriate treatment duration. [Rev Urol. 2014;16(4):194-197 doi: 10.3909/riu0621] 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.

Bacillus Calmette-GuérinBladder carcinomaBotulinum neurotoxinGemcitabine

Minoru MiyazatoView Articles

Volume 15, Number 1Review Articles

The Other Bladder Syndrome: Underactive Bladder

Management Review

Michael B ChancellorMinoru MiyazatoNaoki Yoshimura

Detrusor underactivity, or underactive bladder (UAB), is defined as a contraction of reduced strength and/or duration resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span. UAB can be observed in many neurologic conditions and myogenic failure. Diabetic cystopathy is the most important and inevitable disease developing from UAB, and can occur silently and early in the disease course. Careful neurologic and urodynamic examinations are necessary for the diagnosis of UAB. Proper management is focused on prevention of upper tract damage, avoidance of overdistension, and reduction of residual urine. Scheduled voiding, double voiding, al-blockers, and intermittent self-catheterization are the typical conservative treatment options. Sacral nerve stimulation may be an effective treatment option for UAB. New concepts such as stem cell therapy and neurotrophic gene therapy are being explored. Other new agents for UAB that act on prostaglandin E2 and EP2 receptors are currently under development. The pharmaceutical and biotechnology industries that have a pipeline in urology and women’s health may want to consider UAB as a potential target condition. Scientific counsel and review of the current pharmaceutical portfolio may uncover agents, including those in other therapeutic fields, that may benefit the management of UAB. [Rev Urol. 2013;15(1):11-22 doi: 10.3909/riu0558] © 2013 MedReviews®, LLC

Underactive bladderOveractive bladderDetrusor overactivityDiabetic cystopathy

Misop HanView Articles
Mitchell K RauchView Articles
Mitchell M. HuangView Articles

Volume 23, Number 3Prostate Cancer

Advances in Radical Prostatectomy: A Narrative Review

Austin DryschKathryn E. FinkChalairat Suk-OuichaiMitchell M. HuangKent T. PerryHiten D. PatelAshley E. Ross

Radical prostatectomy (RP) is the mainstay surgical treatment for men with localized prostate cancer. The use of robot-assisted RP (RARP) has specifically allowed for the development of novel techniques to improve postoperative quality of life for patients.

Prostatic neoplasmsProstatectomyRobotic-assisted surgeryrobotic surgical procedures

Mohamad E AllafView Articles

Volume 8, Number 3Review Articles

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

Diagnostic Review

Alan W PartinH Ballentine CarterMohamad E Allaf

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

Mohamed A GhafarView Articles
Mohamed AmineView Articles

Volume 13, Number 3Case Review

An Unusual Presentation of Primary Male Genital Tuberculosis

Imane KamaouiMohamed AmineBrahim EddafaliA Ibn SellamZakaria DahamiSaid Mohamed MoudouniIsmail Sarf

Urogenital tuberculosis is a rare disease; however, it is the second most common location for tuberculosis after the lung. Currently, incidence of urogenital tuberculosis is increasing due to factors such as a higher prevalence of immunosuppression (especially that caused by human immunodeficiency virus infection) and drug abuse. Herein a new case of male genital primary tuberculosis is reported presenting as a scrotal tumor; the originality of this observation lies in its unusual pseudotumor form. [Rev Urol. 2011;13(3):176-178 doi: 10.3909/riu0525] © 2011 MedReviews®, LLC

Urogenital tuberculosisEpididymal tuberculosisMale genital tuberculosis

Mohamed Fadl TaziView Articles

Volume 10, Number 2Case Review

Leydig Cell Hyperplasia Revealed by Gynecomastia

Case Review

Mohamed Jamal El FassiMoulay Hassan FarihMohamed Fadl TaziSoufiane Mellas

Leydig cell tumors are rare and represent 1% to 3% of all tumors of the testis. Leydig cell tumors affect males at any age, but there are 2 peak periods of incidence: between 5 and 10 years and between 25 and 35 years. Their main clinical presentation is a testicular mass associated with endocrinal manifestations that are variable according to age and appearance of the tumor. Our patient, a 17-year-old adolescent, presented with an isolated and painless hypertrophy of the right mammary gland. Clinical examination found gynecomastia and no testicular mass. Hormonal levels and tumor markers were normal. Testicular sonography showed an ovular and homogeneous right intratesticular mass 6 mm in diameter. We treated the patient with an inguinal right orchidectomy. The anatomopathological study found a nodule of Leydig cell hyperplasia. The patient recovered without recurrence at 8-month follow-up. The patient opted for mammoplasty 2 months after his orchidectomy rather than wait for the spontaneous gradual regression of his gynecomastia, which requires at least 1 year. Leydig cell hyperplasia manifests in the adult by signs of hypogonadism, most frequently gynecomastia. Although many teams prefer total orchidectomy because of the diagnostic difficulty associated with malignant forms, simple subcapsular orchidectomy should become the first-line treatment, provided it be subsequently followed by close surveillance, as it preserves maximum fertility, and these tumors usually resolve favorably. [Rev Urol. 2008:10(2):164-167]

FertilityTesticular tumorLeydig cell hyperplasiaNonseminomatous germ celltumorsGynecomastia

Mohamed Jamal El FassiView Articles

Volume 10, Number 2Case Review

Leydig Cell Hyperplasia Revealed by Gynecomastia

Case Review

Mohamed Jamal El FassiMoulay Hassan FarihMohamed Fadl TaziSoufiane Mellas

Leydig cell tumors are rare and represent 1% to 3% of all tumors of the testis. Leydig cell tumors affect males at any age, but there are 2 peak periods of incidence: between 5 and 10 years and between 25 and 35 years. Their main clinical presentation is a testicular mass associated with endocrinal manifestations that are variable according to age and appearance of the tumor. Our patient, a 17-year-old adolescent, presented with an isolated and painless hypertrophy of the right mammary gland. Clinical examination found gynecomastia and no testicular mass. Hormonal levels and tumor markers were normal. Testicular sonography showed an ovular and homogeneous right intratesticular mass 6 mm in diameter. We treated the patient with an inguinal right orchidectomy. The anatomopathological study found a nodule of Leydig cell hyperplasia. The patient recovered without recurrence at 8-month follow-up. The patient opted for mammoplasty 2 months after his orchidectomy rather than wait for the spontaneous gradual regression of his gynecomastia, which requires at least 1 year. Leydig cell hyperplasia manifests in the adult by signs of hypogonadism, most frequently gynecomastia. Although many teams prefer total orchidectomy because of the diagnostic difficulty associated with malignant forms, simple subcapsular orchidectomy should become the first-line treatment, provided it be subsequently followed by close surveillance, as it preserves maximum fertility, and these tumors usually resolve favorably. [Rev Urol. 2008:10(2):164-167]

FertilityTesticular tumorLeydig cell hyperplasiaNonseminomatous germ celltumorsGynecomastia

Mohammed HaseebuddinView Articles

Volume 15, Number 2Case Review

Endoscopic Management of Genitourinary Foreign Bodies

Joseph B SongYoussef S TanaghoMohammed HaseebuddinBrian M BenwayAlana C DesaiSam B BhayaniRobert S Figenshau

Retrieval of foreign bodies from the genitourinary system, most commonly inserted for sexual satisfaction or as a result of a psychiatric illness, can pose a significant surgical challenge. Due to their breadth of size, shape, and location within the genitourinary system, endoscopic management can be difficult. Here, we review the management of four cases of foreign object insertion into the genitourinary system and their outcomes and management. [Rev Urol. 2013;15(2):84-91 doi: 10.3909/riu0571] © 2013 MedReviews®, LLC

Foreign body insertionSoundingGenitourinary foreign objectEndoscopic extraction