Editorial Board About Us

Volume 8, Number 3

Review Articles

Management of Overactive Bladder With Transdermal Oxybutynin

Treatment Update

Jonathan S Starkman Roger R Dmochowski

In clinical trials, transdermal oxybutynin (OXY-TDS) has shown comparable efficacy and improved tolerability when compared with conventional pharmacotherapy. Systemic anticholinergic adverse effects are comparable to those with placebo, most likely owing to avoidance of first-pass hepatic metabolism and conversion of oxybutynin to N-desethyloxybutynin. OXY-TDS has predictable pharmacokinetic absorption and elimination parameters, as shown in both in vitro and in vivo studies. Consistent plasma concentrations of oxybutynin avoid labile peak and trough concentrations seen with immediaterelease formulations, paralleling extended-release drug delivery. This novel drug delivery system has unique dermatologic skin application site reactions, including erythema and pruritus. Skin reactions are usually mild and can be minimized by varying the site of patch application. Most eczematous dermatologic reactions can be appropriately treated with a moderately potent topical corticosteroid cream. A small percentage of patients will discontinue therapy as a result of bothersome application site skin reactions. [Rev Urol. 2006;8(3):93-103]

Overactive bladder Tolterodine Anticholinergic medications Oxybutinin

Review Articles

New Generation Tissue Sealants and Hemostatic Agents: Innovative Urologic Applications

Treatment Update

Michael A Traver Dean G Assimos

Control of blood loss during urologic surgery is paramount to the success of patient recovery. Hemostatic agents and tissue sealants are used routinely to prevent excess blood loss and in reconstruction during surgical repair. Some of the available products include thrombin sealant, fibrin glue, bovine serum/ albumin/glutaraldehyde, and gelatin matrix. Each of these agents differs in mechanism, cost, and application. Complications can include allergic reactions or thromboembolism and the risk of contracting bovine spongiform encephalitis or hepatitis. Many new hemostatic agents are being developed and approved. The benefits and risks of use of these agents versus conventional treatment need to be considered on a case-by-case basis by the surgeon. [Rev Urol. 2006;8(3):104-111]

Hemostasis Thrombin sealants Fibrin glue Gelatin matrix Thrombin

Review Articles

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

Diagnostic Review

Mohamad E Allaf H Ballentine Carter Alan W Partin

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 cancer Nomograms Radioimmunoscintigraphy Lymphadenectomy Clinical staging Magnetic resonanceimaging Algorithms

Meeting Reviews

Best of the 2006 AUA Annual Meeting

Meeting Review

Claus G Roehrborn Shachi Tyagi Li-Ming Su Michael E Aldridge Tobias Klatte John P Mulhall John P Stein Arie S Belldegrun Michael K Brawer Jacob Rajfer J Curtis Nickel Victor W Nitti Michael B Chancellor Alan W Partin Ellen Shapiro Danil V Makarov

Highlights from the 2006 Annual Meeting of the American Urological Association May 20–25, 2006 Atlanta, GA

Prostate cancer Infertility Benign prostatic hyperplasia Bladder cancer Kidney cancer Lower urinary tract symptoms Bladder exstrophy Overactive bladder Interstitial cystitis Stress urinary incontinence Peyronie’s disease Spina bifida Neurogenic bladder Erectile dysfunction Chronic pelvic pain syndrome Chronic prostatitis Tumor markers Androgen replacement therapy Ejaculatory dysfunction Anorectal malformations Renal stones Robotic-assisted radical prostatectomy

Reviews in Urology

Spurious Hypocalcemia After Gadodiamide-Enhanced Magnetic Resonance Imaging: A Case Report and Review of the Literature

Case Review

Robert C Newman Christopher D Moore James G Cairidi

Gadolinium-enhanced magnetic resonance imaging is a diagnostic modality widely used in urologic practice. We report on a 54-year-old woman in whom a critically low serum calcium level was measured with standard colorimetric assay after gadodiamide-enhanced magnetic resonance imaging. The same phenomenon was noted in 2 other patients seen in our practice. Repeat serum calcium measurements performed several hours later were within normal limits. Commercially available gadolinium-based contrast agents might precipitate critically low serum calcium values when measured by standard colorimetric assay. Physician awareness of gadodiamide-induced spurious hypocalcemia might prevent unnecessary therapeutic interventions. [Rev Urol. 2006;8(3):165-168]

Magnetic resonance imaging Gadolinium Hypocalcemia

Literature Reviews

Interstitial Cystitis

Reviewing the Literature

J Curtis Nickel

Literature Reviews

Reviewing the Literature

Literature Reviews

Reviewing the Literature