Review ArticlesChallenges and Opportunities in Radiation-induced Hemorrhagic CystitisTherapeutic Strategy UpdateLaura E LambHeinz G NicolaiBernadette MM ZwaansMichael B ChancellorAs diagnosis and treatment of cancer is improving, medical and social issues related to cancer survivorship are becoming more prevalent. Hemorrhagic cystitis (HC), a rare but serious disease that may affect patients after pelvic radiation or systemic chemotherapy, has significant unmet medical needs. Although no definitive treatment is currently available, various interventions are employed for HC. Effects of nonsurgical treatments for HC are of modest success and studies aiming to control radiation-induced bladder symptoms are lacking. In this review, we present current and advanced therapeutic strategies for HC to help cancer survivors deal with long-term urologic health issues. [Rev Urol. 2016;18(2):57-65 doi: 10.3909/riu0700] © 2016 MedReviews®, LLCHemorrhagic cystitisRadiation-induced cystitisHematuriaCancer survivorship
Review ArticlesThe Role of Estrogen Modulators in Male Hypogonadism and InfertilityDisease State ReviewJesse N MillsJacob RajferAmarnath RambhatlaEstradiol, normally considered a female hormone, appears to play a significant role in men in a variety of physiologic functions, such as bone metabolism, cardiovascular health, and testicular function. As such, estradiol has been targeted by male reproductive and sexual medicine specialists to help treat conditions such as infertility and hypogonadism. The compounds that modulate estradiol levels in these clinical conditions are referred to as selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs). In a certain subset of infertile men, particularly those with hypogonadism, or those who have a low serum testosterone to estradiol ratio, there is some evidence suggesting that SERMs and AIs can reverse the low serum testosterone levels or the testosterone to estradiol imbalance and occasionally improve any associated infertile or subfertile state. This review focuses on the role these SERMs and AIs play in the aforementioned reproductive conditions. [Rev Urol. 2016;18(2):66-72 doi: 10.3909/riu0711] © 2016 MedReviews®, LLCSelective estrogen receptor modulatorAromatase inhibitorMale infertilityHypogonadism
Review ArticlesReducing Infectious Complications Following Transrectal Ultrasound-guided Prostate Biopsy: A Systematic ReviewSystematic ReviewClaus G RoehrbornJordon T WalkerNirmish SinglaA rise in antimicrobial resistant uropathogens has generated a global increase in infections following transrectal ultrasound-guided prostate biopsy (TRUS-Bx). We performed a systematic search of Ovid MEDLINE® and PubMed to comprehensively review strategies to mitigate infections. Of 1664 articles retrieved, 62 were included. The data suggest that augmented prophylaxis and povidone-iodine bowel preparation warrant consideration in regions with high rates of antimicrobial resistance. Transperineal biopsy may be a safer, equally effective alternative to TRUS-Bx in select cases. Recent international travel appears to increase patients’ risk for experiencing infections. These findings can aid clinicians in minimizing post-TRUS-Bx infectious complications. [Rev Urol. 2016;18(2):73-89 doi: 10.3909/riu0713] © 2016 MedReviews®, LLCUrinary tract infectionProstate biopsyTransrectal ultrasoundSystematic review
Review ArticlesUrethral Strictures and Stenoses Caused by Prostate TherapyTreatment UpdateRichard A SantucciMang L ChenAndres F CorreaThe number of patients with prostate cancer and benign prostatic hyperplasia is on the rise. As a result, the volume of prostate treatment and treatment-related complications is also increasing. Urethral strictures and stenoses are relatively common complications that require individualized management based on the length and location of the obstruction, and the patient’s overall health, and goals of care. In general, less invasive options such as dilation and urethrotomy are preferred as first-line therapy, followed by more invasive substitution, flap, and anastomotic urethroplasty. [Rev Urol. 2016;18(2):90-102 doi: 10.3909/riu0685] © 2016 MedReviews®, LLCProstate cancerBenign prostatic hyperplasiaComplicationsStrictureStenosis
LUGPA NewsAre Independent Urology Practices Embracing Business and Clinical Integration to Prepare for the Coming Era of Value-based Payment?Gary M Kirsh[Rev Urol. 2016;18(2):103-105 doi: 10.3909/riu0719] © 2016 MedReviews®, LLC
Practice ProfileRadium Ra 223 Dichloride Therapy in the Private Practice EnvironmentJeffrey C Seeber[Rev Urol. 2016;18(2):106-109 doi: 10.3909/riu0720] © 2016 MedReviews®, LLC
Coding CornerICD-10 Changes for October 1, 2016 of Interest to UrologistsJonathan Rubenstein[Rev Urol. 2016;18(2):110-113 doi: 10.3909/riu0718] © 2016 MedReviews®, LLC
Case ReviewEndoscopic Management of Bladder DiverticulaJohn M CormanThomas HeftyKhanh N PhamClaudio JeldresA 50-year-old man with benign prostatic hyperplasia and urinary retention had a very large diverticulum on the posterior wall of the bladder. The patient was managed with transurethral resection of the prostate and endoscopic fulguration of the bladder diverticulum mucosa using the Orandi technique. There was near-complete resolution of the bladder diverticulum following endoscopic management, obviating the need for bladder diverticulectomy. The patient now empties his bladder, with a postvoid residual 50 mL and the absence of urinary tract infection after 6-month follow-up. We report the successful treatment of a large bladder diverticulum with endoscopic fulguration to near-complete resolution. This minimally invasive technique is a useful alternative in patients unfit for a more extensive surgical approach. [Rev Urol. 2016;18(2):114-117 doi: 10.3909/riu0701] © 2016 MedReviews®, LLCBladder diverticulumEndoscopicFulguration
Case ReviewTubulocystic Renal Cell Carcinoma: A Great ImitatorTubulocystic renal cell carcinoma (TCRC) is a rare renal tumor. Patients are usually asymptomatic; it is usually detected incidentally, during imaging studies for Bosniak type III and type IV renal cysts. These tumors rarely metastasize. The role of targeted therapy in such rare tumors is still controversial. We report a case of TCRC initially presented as a Bosniak type II renal cyst and was discovered ultimately to be a metastatic disease. This type of presentation might broaden our understanding of this rare disease. [Rev Urol. 2016;18(2):118-121 doi: 10.3909/riu0692] © 2016 MedReviews®, LLCTubulocystic renal cell carcinomaBosniak type II cystTargeted therapy