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Directory of Authors from the Journal and their last article.

Richard E GreenbergView Articles

Volume 10, Number 4Review Articles

Bacillus Calmette-Guérin Failures and Beyond: Contemporary Management of Non–Muscle-Invasive Bladder Cancer

Management Review

Thomas E KeaneMichael A O'DonnellH Barton GrossmanRichard E GreenbergMichael S Cookson

In the United States, bacillus Calmette-Guérin (BCG) is the treatment most used for superficial bladder cancer. Patients with carcinoma in situ (CIS) treated with intravesical BCG plus interferon have a 60% to 70% chance of a complete and durable response if they were never treated with BCG or if they failed only 1 prior induction or relapsed more than a year from induction. Intravesical gemcitabine is safe, but its usefulness for BCG-refractory patients is unclear. Valrubicin, approved for intravesical treatment of BCGrefractory CIS of the bladder, has efficacy and acceptable toxicity. Cystectomy should be considered in high-risk, non–muscle-invasive cancer, particularly if intravesical therapy failed. [Rev Urol. 2008;10(4):281-289]

Bacillus Calmette-GuérinBladder cancerCystectomyGemcitabine

Richard E LinkView Articles
Richard G HarrisView Articles
Richard G TrohmanView Articles

Volume 10, Number 2Review Articles

The QT Interval and Selection of Alpha-Blockers for Benign Prostatic Hyperplasia

Treatment Update

Richard G TrohmanLawrence A HillNorman E LeporHerbert Lepor

The QT interval is the electrocardiographic manifestation of ventricular depolarization and repolarization. Drug-induced long QT syndrome is characterized by acquired, corrected QT (QTc) interval prolongation that is associated with increased risk of torsade de pointes. Every physician must recognize if the drugs he or she prescribes prolongs the QTc interval, especially if the drug is prescribed for a chronic condition in older patients who are on polypharmacy. The evolution of alpha-blockers for the treatment of benign prostatic hyperplasia has allowed the development of drugs that are easier to administer and better tolerated. Because alpha-blockers generally have equivalent efficacy, this class of drugs is typically differentiated by safety and side effects. Studies suggest that alpha-blockers may vary in regard to their effect on the QT interval, and, therefore, on their predisposition to cause potentially life-threatening ventricular arrhythmias. [Rev Urol. 2008;10(2):85-91]

BlockersBenign prostatichyperplasiaDrug-induced long QT syndromeTorsade de pointes

Richard Gerald HarrisView Articles
Richard HumView Articles

Volume 19, Number 1Review Articles

Prostate Biopsy Characteristics: A Comparison Between Pre- and Post-United States Preventive Service Task Force Prostate Cancer Screening Guidelines of 2012

Cancer Screening Assessment

Thomas HuebnerVladimir IoffeNavin ShahRichard Hum

This article compares prostate cancer (PCa) characteristics diagnosed by prostate biopsy in the years before and after the 2012 United States Preventative Service Task Force (USPSTF) recommendations against PCa screening. We completed a retrospective comparative analysis of 402 sequential PCa biopsy-diagnosed patients in 2010 to 2012 (3 years) with 269 PCa patients diagnosed in 2015 to 2016 (18 months). Data were collected on patient age, total number of biopsies performed, prostate-specific antigen level, Gleason sum score, and digital rectal examination results. The data were analyzed to determine whether the 2012 USPSTF screening recommendations affected PCa characteristics. [ Rev Urol. 2017;19(1):25-31 doi: 10.3909/riu0745] © 2017 MedReviews®, LLC

Prostate cancerCancer screening

Richard J CoteView Articles

Volume 10, Number 1Review Articles

Superficial Bladder Cancer: An Update on Etiology, Molecular Development, Classification, and Natural History

Treatment Update

John P SteinErik PasinAnirban P MitraDavid Y JosephsonRichard J Cote

Superficial “non–muscle-invasive” bladder tumors represent a heterogeneous group of cancers, including those that are (1) papillary in nature and limited to the mucosa, (2) high grade and flat and confined to the epithelium, and (3) invasive into the submucosa, or lamina propria. The goal of treatment is 2-fold: (1) to reduce tumor recurrence and the subsequent need for additional therapies and the morbidity associated with these treatments and (2) to prevent tumor progression and the subsequent need for more aggressive therapy. This update reviews important contemporary concepts in the etiology, molecular mechanisms, classification, and natural history of superficial bladder cancer. [Rev Urol. 2008;10(1):31-43]

Transitional cell carcinomaBladder neoplasmsNon–muscle-invasive tumorMolecular mechanismsGenitourinary tumors

Richard K LeeView Articles

Volume 14, Number 3Review Articles

Update on Phosphodiesterase Type 5 Inhibitors for the Treatment of Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia

Treatment Update

Bilal ChughtaiDean S EltermanAlexis E TeRichard K LeeSteven A Kaplan

Many aging men will experience both erectile dysfunction (ED) and benign prostatic hyperplasia (BPH), resulting in lower urinary tract symptoms (LUTS). Basic and clinical evidence suggests common pathogenic mechanisms underlying both LUTS and ED. Decreases in the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway with age result in decreased levels of intracellular cGMP and calcium, leading to diminished smooth muscle relaxation of the bladder and prostate and worsening LUTS. Phosphodiesterase type 5 inhibitors as monotherapy in combination with a-blockers have shown efficacy in treating both LUTS and ED. Tadalafil has recently been approved by the US Food and Drug Administration for the treatment of LUTS secondary to BPH, with or without concomitant ED. [Rev Urol. 2012;14(3/4):79-86 doi: 10.3909/riu0559] © 2013 MedReviews®, LLC

Benign prostatic hyperplasiaLower urinary tract symptomsErectile dysfunctionPhosphodiesterase inhibitorsTadalafilSildenafilVardenafil

Richard KocharianView Articles

Volume 17, Number 1Original Research

Hemostasis During Urologic Surgery: Fibrin Sealant Compared With Absorbable Hemostat

Jonathan BatillerLiza OvingtonJessica ShenJohn AlbaneseBogdan IlieRichard KocharianJerome B RiebmanDavid M. Albala

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

Richard L HsuView Articles

Volume 15, Number 4Review Articles

Anesthetic Challenges in Robotic-assisted Urologic Surgery

Management Review

Richard D UrmanAlan D KayeRichard L Hsu

Robotic-assisted surgery has evolved over the past two decades with constantly improving technology, assisting surgeons in multiple subspecialty disciplines. The surgical requirements of lithotomy and steep Trendelenburg positions, along with the creation of a pneumoperitoneum and limited access to the patient, all present anesthetic management challenges in urologic surgery. Patient positioning requirements can cause significant physiologic effects and may result in many complications. Good communication among team members and knowledge of the nuances of robotic surgery have the potential to improve patient outcomes, increase efficiency, and reduce surgical and anesthetic complications. [Rev Urol. 2013;15(4):178-184 doi: 10.3909/riu0589] © 2014 MedReviews®, LLC

Robotic surgeryUrologic surgeryAnesthesia complicationsPneumoperitoneumPeripheral nerve injuryPatient positioning

Richard LeeView Articles

Volume 13, Number 3Review Articles

Role of Inflammation in Benign Prostatic Hyperplasia

Disease State Review

Alexis E TeBilal ChughtaiRichard LeeSteven A Kaplan

Inflammation of the prostate may represent a mechanism for hyperplastic changes to occur in the prostate. There are a variety of growth factors and cytokines that may lead to a proinflammatory process within the prostate. There are several proposed mechanisms that lead to both the intrinsic and extrinsic basis of inflammation. Prostatic inflammation may represent an important factor in influencing prostatic growth and progression of symptoms. This article reviews the recent literature on inflammation leading to chronic prostatic diseases, such as benign prostatic hyperplasia. [Rev Urol. 2011;13(3):147-150 doi: 10.3909/riu0535] © 2011 MedReviews®, LLC

Benign prostatic hyperplasiaInflammationProstatitisProstatic cytokinesVitamin D

Richard MeyerView Articles

Volume 18, Number 1Review Articles

Falls in the Elderly Secondary to Urinary Symptoms

Prevention and Management Update

Neil BaumRichard MeyerYousef Soliman

Falls and fractures have a significant impact on our patients, their families, and caregivers, and cost the health care system billions of dollars. Each year, millions of adults aged 65 and older fall. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable. Because many patients with falls and subsequent fractures have urologic conditions, urologists are positioned to help with the prevention of these significant and costly injuries. This article discusses the epidemiology of falls and fractures, and the urologic comorbidities that increase their risk. [Rev Urol. 2016;18(1):28-32 doi: 10.3909/riu0686] © 2016 MedReviews®, LLC

NocturiaOveractive bladderFallsFracturesUrinary tract infectionsPrevention

Richard ReznichekView Articles
Richard S MatulewiczView Articles
Richard S PelmanView Articles
Richard S YoonView Articles

Volume 19, Number 1Review Articles

Revisiting the Role of Testosterone: Are We Missing Something?

Thereapeutic Update

Loren Wissner GreeneFrank A LiporaceRichard S YoonMichael ScordoVineet Tyagi

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

Richard SadovskyView Articles
Ridwan AlamView Articles

Volume 19, Number 2Review Articles

Active Surveillance of Prostate Cancer: Current State of Practice and Utility of Multiparametric Magnetic Resonance Imaging

Practice Update

Jeffrey J TosoianRidwan AlamJonathan I EpsteinH Ballentine Carter

Active surveillance (AS) is an alternative to immediate intervention in patients with very low- and low-risk prostate cancer. Ongoing reports from multiple AS programs have consistently demonstrated a very low rate of metastasis and prostate cancer-specific mortality in appropriately selected patients. Accordingly, AS has been adopted by major clinical organizations as a safe and effective management strategy. Clinical focus has now shifted to identifying the optimal approach to selecting and monitoring patients. Multiparametric magnetic resonance imaging (mpMRI) has emerged as one potentially helpful tool in the AS setting. The utility of mpMRI has been well demonstrated in the setting of screening and diagnosis, but its role in AS remains unclear. We summarize the published experience with AS and review pertinent, contemporary data on the use of mpMRI in the setting of AS. [Rev Urol. 2017;19(2):77–88 doi: 10.3909/riu0757] © 2017 MedReviews®, LLC

Prostate cancerActive surveillanceMultiparametric magnetic resonance imaging

RIU JournalView Articles
Robert A ColemanView Articles

Volume 17, Number 2Book Reviews

A Review of Transplantation Practice of the Urologic Organs: Is It Only Achievable for the Kidney?

Treatment Update

Robert A ColemanYaseen RajjoubHarry W RobertsJack Donati-Bourne

Transplantation is a viable treatment option for failure of most major organs. Within urology, transplantation of the kidney and ureter are well documented; however, evidence supporting transplantation of other urologic organs is limited. Failure of these organs carries significant morbidity, and transplantation may have a role in management. This article reviews the knowledge, research, and literature surrounding transplantation of each of the urologic organs. Transplantation of the penis, testicle, urethra, vas deferens, and bladder is discussed. Transplantation attempts have been made individually with each of these organs. Penile transplantation has only been performed once in a human. Testicular transplantation research was intertwined with unethical lucrative pursuits. Interest in urethra, bladder, and vas deferens transplantation has decreased as a result of successful surgical reconstructive techniques. Despite years of effort, transplantations of the penis, testicle, urethra, vas deferens, and bladder are not established in current practice. Recent research has shifted toward techniques of reconstruction, tissue engineering, and regenerative medicine. [Rev Urol. 2015;17(2):69–77 doi: 10.3909/riu0659] © 2015 MedReviews®, LLC

UrologyTransplantationReconstructionTissue engineering