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Directory of Authors from the Journal and their last article.

Prateek MendirattaView Articles

Volume 9, Supplement 1Review Articles

Current Standard and Investigational Approaches to the Management of Hormone-Refractory Prostate Cancer

New Directions in the Management of Advanced Prostate Cancer

Prateek MendirattaDaniel J GeorgeAndrew J Armstrong

Prostate cancer is a common cause of death in men and remains incurable in the metastatic setting. In 2004, 2 landmark trials using docetaxel-based chemotherapy, TAX 327 and SWOG 99-16, showed a survival benefit for the first time in metastatic, hormone-refractory prostate cancer. Current research suggests that several distinct mechanisms of androgen-refractory disease may converge in patients with disease progression on androgen deprivation therapy. These findings have identified several potential targets for therapeutic intervention. Current standard and investigational treatment options for this disease are discussed, including chemotherapy and rapidly evolving therapies in phase II/III trials involving antiangiogenic therapies, signal transduction inhibitors, immunomodulatory agents, and nuclear receptor targets. In light of a growing array of treatment options and an increasingly chronic natural history, this review supports a multidisciplinary care approach to these patients, including medical oncologists, urologists, and radiation oncologists, to optimize survival and quality of life. [Rev Urol. 2007;9(suppl 1):S9-S19]

ChemotherapyZoledronic acidHormone-refractory prostate cancerAntiangiogenic therapySignal transduction inhibitorsImmunomodulatory agents

Pratibha ShuklaView Articles

Volume 17, Number 2Case Review

Juxta-adrenal Ancient Schwannoma: A Rare Retroperitoneal Tumor

William C HuangJonathan MelamedPratibha ShuklaDaniel A WollinGanesh Sivarajan

Retroperitoneal schwannoma is a rare tumor that is often misdiagnosed as malignancy due to a concerning appearance on cross-sectional imaging. Pathology and immunohistochemistry form the gold standard for diagnosis; as such, local excision is the treatment of choice for this disease. We present two cases of juxta-adrenal ancient schwannoma that were treated with adrenalectomy and discuss the current literature regarding this entity. [Rev Urol. 2015;17(2):97-101 doi: 10.3909/riu0669] © 2015 MedReviews®, LLC

Ancient schwannomaAdrenal tumorAdrenalectomy

Pravin K RaoView Articles

Volume 11, Number 2Case Review

Genitourinary Sarcoidosis

Pravin K RaoEdmund S Sabanegh

Genitourinary involvement of sarcoidosis can mimic many common urologic conditions. Although sarcoidosis is a benign inflammatory condition, it can present much like malignant or infectious conditions; thus, failed diagnosis can lead to unnecessary medications or surgical procedures. In addition, management choices for patients with scrotal findings have important implications for future fertility. Thus, this uncommon condition should be on the differential diagnosis for any urologic patient. The authors report on a patient with a scrotal mass as his presenting symptom of sarcoidosis and review the diagnosis, implications, and management of sarcoidosis involving all potential sites in the urinary tract.[Rev Urol. 2009;11(2):108-113]

UrologySarcoidosisGenitourinaryScrotal mass

Przemyslaw TwardowskimView Articles

Volume 20, Number 2Original Research

Effectiveness of Subcutaneously Administered Leuprolide Acetate to Achieve Low Nadir Testosterone in Prostate Cancer Patients

Scott EggenerStuart AtkinsonDeborah M Boldt-HoulePrzemyslaw TwardowskimJoseph Renzulli IIJason HafronChristopher M Pieczonka

Evidence suggests lower nadir testosterone levels during the first year of androgen deprivation therapy improve advanced prostate cancer clinical outcomes. We evaluated pivotal trials for subcutaneously administered leuprolide acetate (1-, 3-, 4-, and 6-month doses) to determine nadir testosterone levels. Pooled analysis showed 99%, 97%, and 91% of patients reached nadir testosterone ≤20, ≤10, and ≤5 ng/dL respectively (median ≤3 ng/dL). Across all available categories, ≥88% of patients reached nadir testosterone ≤5 ng/dL, and <3% experienced a microsurge. Achievement and maintenance of low nadir testosterone levels may improve progression-free survival and time to onset of castrate-resistant prostate cancer. [Rev Urol. 2018;20(2):63–68 doi: 10.3909/riu0798] © 2018 MedReviews®, LLC

Prostate cancerAndrogen deprivation therapyLHRH agonistsLeuprolide acetateNadir testosterone

Qutub AliView Articles

Volume 15, Number 3Case Review

Ureteral Metastasis as the Presenting Manifestation of Pancreatic Carcinoma

Shilpi GuptaQutub AliNand Kishore ArvindOnkar Singh

We recently cared for a patient with adenocarcinoma of the pancreas who presented with ureteral metastasis followed by hydroureteronephrosis long before the appearance of any symptoms related to the primary lesion. The entity is extremely rare; only seven similar cases are on record in the scientific literature. No recent review exists on this topic. This encouraged us to present our case along with the previous cases of adenocarcinoma of the pancreas with ureteral metastasis that have been reported. [Rev Urol. 2013;15(3):124-130 doi: 10.3909/riu0575] © 2013 MedReviews®, LLC

MetastasisHydronephrosisUreterUreteral metastasisPancreatic adenocarcinoma

R Duane CespedesView Articles
R Jonathan HendersonView Articles
R RamasamyView Articles

Volume 21, Number 4Case Review

Using 17-OHP as Serum Biomarker to Monitor Therapy in Patients With Hypogonadotropic Hypogonadism

R RamasamyP PatelM NarasimmaA Mouzannar

Exogenous testosterone administration decreases intratesticular testosterone (ITT) significantly, an essential hormone for spermatogenesis. Therefore, treatment of patients with hypogonadotropic hypogonadism (HH) who desire infertility can be challenging. These patients are treated with recombinant follicle-stimulating hormone (FSH), clomiphene citrate, and human chorionic gonadotropin (hCG) to increase their ITT. However, there is no approved serum biomarker for ITT and it can only be measured via invasive testicular biopsy or aspiration. Previous authors have speculated that serum 17-hydroxyprogestrone (17-OHP) can be used as serum biomarker for ITT. In our case report, we demonstrate increase in 17-OHP associated with spermatogenesis after commencing treatment for infertility in patient with HH. [Rev Urol. 2019;21(4):180–182] © 2020 MedReviews®, LLC

BiomarkerInfertility17-HydroxyprogesteronIntratesticular testosteroneHypogonadotropic hypogonadism

R Scott BraithwaiteView Articles
Raavi GuptaView Articles

Volume 11, Number 1Case Review

Renal Involvement by Chronic Myelomonocytic Leukemia Requiring Nephroureterectomy

Elias S HyamsOjas D ShahRaavi GuptaSamir S TanejaJonathan Melamed

Chronic monomyelocytic leukemia (CMML) is a relatively rare clonal hematologic disorder with features of myelodysplastic syndrome and myeloproliferative disease. Renal impairment from CMML is infrequent and can result from both direct (ie, infiltrative) and indirect (eg, vasculitis, infarction) mechanisms. This case report describes a patient with refractory gross hematuria requiring nephroureterectomy with diffuse involvement of the upper tract by CMML and accompanying extramedullary hematopoiesis. Underscored are the need to maintain a broad differential diagnosis for upper tract lesions in the setting of gross hematuria, and the potential need for drastic measures to control upper tract bleeding if conservative measures fail.[Rev Urol. 2009;11(1):33-37]

Gross hematuriaSecondary malignancy of kidneyLeukemia

Rachael D SussmanView Articles

Volume 21, Number 2Review Articles

Primary Bladder Neck Obstruction

Disease State Review

Alice DrainRachael D SussmanBenjamin M Brucker

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

Rachel VancavageView Articles

Volume 23, Number 3Pediatric Urology

Recent Advances in Managing Pediatric Neurogenic Bladder due to Spina Bifida

Rachel VancavageAlexandra Rehfuss

Spina bifida is the most prevalent permanently disabling birth defect in the world. It results in damage to nerve endings that negatively affect bladder function and can potentially lead to kidney failure. Management of spina bifida continues to evolve, however, improving outcomes for patients with this condition.

Neurogenic bladderUrinary bladderSpinal dysraphismMyelomeningocele

Rafaela Saint-Clair Pimentel Mafra De OliveiraView Articles

Volume 16, Number 1Case Review

Metastatic Urethral Melanoma: Case Report and Review of the Literature

Rafaela Saint-Clair Pimentel Mafra De OliveiraBruno Moraes VasconcelosLuiz Ronaldo Alberti

Melanoma is a cancer that originates from melanocytes, is predominant in adults with white skin, represents 4% of skin cancers, and has high possibility of forming metastasis. This review reports on the case of a young man, age 36 years, previously diagnosed with melanoma. The patient complained of obstructive urinary symptoms and, while he was undergoing a cystoscopy, it was discovered that he had a lesion corresponding with metastatic melanoma of the prostatic urethra, which occluded almost the entire urethra and resulted in blocked urinary flow. He underwent a transurethral resection of the prostate, followed by resection of the lesion. After the procedure, he had good urinary flow and is currently on follow-up. [Rev Urol. 2014;16(1):47-49 doi: 10.3909/riu0584] © 2014 MedReviews®, LLC

UrethraMetastasisMelanomaUrinary obstructionUrethral melanoma

Ragi DoggweilerView Articles
Rahul K NathView Articles
Raj A PersadView Articles

Volume 17, Number 3Review Articles

Current Status of Hemostatic Agents and Sealants in Urologic Surgical Practice

Management Update

Christopher G EdenRaj A PersadNeil J BarberChristopher J AndersonUtsav D ReddyAmr M EmaraRobert McArthurSashi S Kommu

There has been a recent and near exponential increase in the use of hemostatic agents and sealants to supplement the rapidly evolving methods in the surgical management of urologic patients. This article reviews the use of hemostatic agents and sealants in current urologic practice. [Rev Urol. 2015;17(3):150-159 doi: 10.3909/riu0673] © 2015 MedReviews®, LLC

HemostasisTissue adhesionUrologic surgery

Rajeev KumarView Articles

Volume 9, Number 4Review Articles

Extending the Rationale of Combination Therapy to Unresponsive Erectile Dysfunction

Treatment Update

Rajeev KumarChristopher ReeceDiedre NienowAjay Nehra

Combination therapies aim to overcome the limitations of individual drugs by selecting diverse targets of action to enhance effectiveness synergistically. This article reviews the principles of combination therapy and its applications for benign prostatic hyperplasia and overactive bladder. It then examines pathophysiological, pharmacological, and clinical evidence for currently available drug and device combinations for erectile dysfunction that has not responded to first-line, single-agent therapy. [Rev Urol. 2007;9(4):197-206]

Benign prostatic hyperplasiaOveractive bladderErectile dysfunctionCombination therapyIntracavernosal therapyIntraurethral therapy

Rajeev MathurView 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

Ralf HerwigView Articles

Volume 13, Number 3Review Articles

Peyronie’s Disease: Nonsurgical Therapy Options

Treatment Update

Franklin E KuehhasRalf HerwigTosev GeorgiPeter WeiblNenad Djakovic

Peyronie&rsquo;s disease (PD) is a fibrous inelastic scar of the tunica albuginea, leading to penile deformity, penile curvature, shortening, narrowing, and painful erections that subsequently lead to painful or unsatisfying sexual intercourse. No consensus exists yet on the ideal management of PD. This fact is a result of our limited knowledge of its etiology and causative factors. The acute presentation of PD is treated conservatively, and surgical approachesare only attempted if severe curvature, narrowing, or indentation persists for more than 1 year; PD stability exists for at least 3 months; curvature impedes sexual intercourse; and severe penile shortening occurs. This review focuses on new developments for conservative treatment strategies for PD. [Rev Urol. 2011;13(3):139-146 doi: 10.3909/riu0528] © 2011 MedReviews®, LLC

Peyronie’s diseaseNonsurgical therapyOral medicationIntralesionaltherapyExtracorporeal shock wave therapyIontophoresisPenile traction systems

Raman TanwarView Articles

Volume 16, Number 1Case Review

Bladder Leiomyoma Presenting With LUTS and Coexisting Bladder and Uterine Leiomyomata: A Review of Two Cases

Aparajita MitraRaman TanwarSudhir Kumar Jain

Mesenchymal tumors of the urinary bladder are a rare occurrence, the most common among them being leiomyoma of the bladder. These tumors commonly present with irritative urinary symptoms progressing gradually to obstructive symptoms as the size increases. We report on two patients who presented with lower urinary tract symptoms (LUTS). One of the patients also had concomitant bladder and uterine leiomyomata, which is the first such case to be reported in the literature. It is essential to differentiate leiomyoma from other common causes of LUTS. Cold cup biopsy has a significant false-negative rate and, in such cases, a wide local excision provides an optimal cure with excellent results. [Rev Urol. 2014;16(1):50-54 doi: 10.3909/riu0586] © 2014 MedReviews®, LLC

Lower urinary tract symptomsBladder leiomyomaUterine fibroid