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financial managementView Articles

Volume 23, Number 1Business of Urology

Physician-Owned Hospitals: A Look at the Numbers

Robert A. DowlingMara Holton

Physician-owned hospitals are sometimes characterized as examples of inappropriate self-referral. This perception contributes to legislation and regulation that constrain physician ownership. The true scope of physician ownership and its impact are incompletely understood. This study aimed to better define the current landscape of physician ownership in US hospitals to inform policy making in this area.

Ownershipfinancial managementproprietaryhospitals

FinasterideView Articles
FlareView Articles
fluoresceinView 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

Focal ablationView Articles

Volume 20, Number 4Review Articles

Focal Ablation of Prostate Cancer

Treatment Update

Herbert LeporJames WysockSamuel Gold

The challenge to the urology community is to reduce the risks of screening and treatment by reducing the number of men undergoing unnecessary biopsy and whole-gland curative treatment of low-risk disease. There is compelling evidence that focal ablation of prostate cancer is truly minimally invasive and offers major functional advantages over whole-gland treatment. [Rev Urol. 2018;20(3):145–157 doi: 10.3909/riu0809] © 2019 MedReviews®, LLC

Prostate cancer screeningHigh-intensity focused ultrasoundIrreversible electroporationFocal ablationProstate cancer treatmentVascular targeted photodynamic therapy

Focal cryoablationView Articles

Volume 13, Number 4Review Articles

A Review of Focal Therapy Techniques in Prostate Cancer: Clinical Results for High-Intensity Focused Ultrasound and Focal Cryoablation

Treatment Review

Colin IbertiNihal MohamedMichael Palese

The advancement of focal therapy technology for the treatment of prostate cancer (PCa) is emerging as an option for a middle ground between radical therapies and active surveillance for individuals identified with localized, low-grade PCa. Two promising techniques are high-intensity focused ultrasound (HIFU) and focal cryoablation. Both focal cryoablation and HIFU show promise, but additional prospective trials are necessary before any definitive conclusions can be made on either method’s viability. [Rev Urol. 2011;13(4):e196-e202 doi: 10.3909/riu0540] © 2011 MedReviews®, LLC

Prostate cancerHigh-intensity focused ultrasoundFocal cryoablation

Focal therapyView Articles

Volume 10, Number 2Meeting Reviews

Best of the 2008 AUA Annual Meeting

Meeting Review

Dean G AssimosDanil V MakarovAlan W PartinMichael B ChancellorJ Curtis NickelClaus G RoehrbornMichael K BrawerNaoki YoshimuraShing-Hwa Lu

Highlights from the 2008 Annual Meeting of the American Urological Association, May 17-22, 2008, Orlando, FL [Rev Urol. 2008;10(2):136-156]

Focal therapyProstate-specific antigenShock wave lithotripsyTumor markersOveractive bladder syndromeBlockersEarly prostate cancer antigenTMPRSS2-ERGCryotherapyUltrasound-estimated bladder weightElocalcitolLithium triboride laserStone formation

Follicle-stimulating hormoneView Articles
Foreign body insertionView 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

formationView Articles

Volume 21, Number 2Meeting Reviews

Best of the 2019 AUA Annual Meeting: Highlights From the 2019 American Urological Association Annual Meeting, May 3-6, 2019, Chicago, IL

Benjamin M BruckerDean G AssimosEllen ShapiroAlan W PartinMichael B ChancellorGregory VurtureZeyad R Schwen

[Rev Urol. 2019;21(2/3):109–117] © 2019 MedReviews®, LLC

UrodynamicsFebrile urinary tract infectionUnderactive bladderAutologous muscle-derived cellsFemale sexual dysfunctionPrenatal hydronephrosisCalcium oxalate kidney stoneformationFecal microbiomeUrinary oxalate excretionOpioid utilization and kidney stonesSuper pulse thulium fiber laserPediatric hypospadias repairGut microbiomeOveractive bladder symptomsVibegronMesh-related complicationsAcupunctureRobot-assisted sacrocolpopexy

Four kallikrein assayView Articles

Volume 18, Number 3Meeting Reviews

Highlights From the 2016 American Urological Association Annual Meeting

Benjamin M BruckerDean G AssimosEllen ShapiroAlan W PartinMichael B ChancellorStacy LoebJ Curtis NickelMichael A GorinMichael K Brawer

More than 2000 posters, abstracts, and videos were presented at the 2016 American Urological Association (AUA) Annual Meeting, held in San Diego, CA, from May 6 to 10, 2016. The editors of Reviews in Urology have culled an enormous volume of information from this premier source and present the findings that are most relevant to the practicing urologist. [Rev Urol. 2016;18(3):159-173 doi:10.3909/riu0717] © 2016 MedReviews®, LLC

Prostate cancerActive surveillanceDisorders of sexual developmentNephrolithiasisOveractive bladderMicrobiomeOnabotulinumtoxinAHemorrhagic cystitisInflammationFour kallikrein assayGenomic prostate score

Fournier gangreneView Articles

Volume 16, Number 2Case Review

Solitary Candida albicans Infection Causing Fournier Gangrene and Review of Fungal Etiologies

Tiffany A PerkinsJared M BieniekJoel M Sumfest

Polymicrobial bacterial infections are commonly found in cases of Fournier gangrene (FG), although fungal growth may occur occasionally. Solitary fungal organisms causing FG have rarely been reported. The authors describe a case of an elderly man with a history of diabetes who presented with a necrotizing scrotal and perineal soft tissue infection. He underwent emergent surgical debridement with findings of diffuse urethral stricture disease and urinary extravasation requiring suprapubic tube placement. Candida albicans was found to be the single causative organism on culture, and the patient recovered well following antifungal treatment. Fungal infections should be considered as rare causes of necrotizing fasciitis and antifungal treatment considered in at-risk immunodeficient individuals. [Rev Urol. 2014;16(2):95-98 doi: 10.3909/riu0595] © 2014 MedReviews®, LLC

Fournier gangreneFournier’s Gangrene Severity IndexCandida albicans

Fournier’s gangreneView Articles

Volume 10, Number 1Case Review

Use of a Vacuum-Assisted Device for Fournier’s Gangrene: A New Paradigm

Case Review

Julia GrabowskiJ Kellogg ParsonsJonathan Silberstein

Fournier’s gangrene is a necrotizing infection of the scrotum or perineum that requires aggressive surgical debridement. Radical debridement of perineal necrotizing fasciitis can leave extensive tissue defects that are difficult to close and often require multiple surgical interventions. Vacuum-assisted closure (VAC) devices have been shown to assist in a more rapid closure of these wounds, but placement of such devices in the perineum can pose significant challenges. We have had success with use of VAC devices and report our techniques for their placement. [Rev Urol. 2008;10(1):76-80]

Fournier’s gangreneVacuum-assisted closure devices

Fournier’s Gangrene Severity IndexView Articles

Volume 16, Number 2Case Review

Solitary Candida albicans Infection Causing Fournier Gangrene and Review of Fungal Etiologies

Tiffany A PerkinsJared M BieniekJoel M Sumfest

Polymicrobial bacterial infections are commonly found in cases of Fournier gangrene (FG), although fungal growth may occur occasionally. Solitary fungal organisms causing FG have rarely been reported. The authors describe a case of an elderly man with a history of diabetes who presented with a necrotizing scrotal and perineal soft tissue infection. He underwent emergent surgical debridement with findings of diffuse urethral stricture disease and urinary extravasation requiring suprapubic tube placement. Candida albicans was found to be the single causative organism on culture, and the patient recovered well following antifungal treatment. Fungal infections should be considered as rare causes of necrotizing fasciitis and antifungal treatment considered in at-risk immunodeficient individuals. [Rev Urol. 2014;16(2):95-98 doi: 10.3909/riu0595] © 2014 MedReviews®, LLC

Fournier gangreneFournier’s Gangrene Severity IndexCandida albicans

FracturesView Articles

Volume 18, Number 1Review Articles

Falls in the Elderly Secondary to Urinary Symptoms

Prevention and Management Update

Yousef SolimanRichard MeyerNeil Baum

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

FragmentationView Articles

Volume 12, Number 3Case Review

Risk Factor Analysis and Management of Ureteral Double-J Stent Complications

Case Review

Abdelhak KhalloukYounes AhallalMohamed Jamal El FassiMoulay Hassan Farih

Double-J ureteral stents are commonly used to manage urinary obstructions. Pain, bladder irritative symptoms, and fever are usually signs of early complications related to double-J stents; late complications are more troublesome. We review 4 cases that highlight a variety of late complications with double- J stents (encrustation, migration, and fragmentation). Following a review of the literature, guidelines are established for monitoring potential risk factors as well as management strategies for prevention of possible complications when using double-J stents. [Rev Urol. 2010;12(2/3):e147-e151 doi:10.3909/riu0447]

Double-J stentExtracorporeal shock wave lithotripsyStent migrationFragmentationEncrustation

Free prostate-specificantigenView Articles
FrequencyView Articles
FulgurationView Articles

Volume 18, Number 2Case Review

Endoscopic Management of Bladder Diverticula

Claudio JeldresKhanh N PhamThomas HeftyJohn M Corman

A 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®, LLC

Bladder diverticulumEndoscopicFulguration

GadoliniumView Articles

Volume 8, Number 3Reviews in Urology

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

Case Review

James G CairidiChristopher D MooreRobert C Newman

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 imagingGadoliniumHypocalcemia

Ganoderma lucidumView Articles

Volume 15, Number 3Review Articles

Use of Herbal Supplements for Overactive Bladder

Management Update

Steven A KaplanRichard LeeBilal ChughtaiAlexis E TeElizabeth KavalerFranklin C Lowe

Anticholinergics, specifically antimuscarinic agents, are the most common medications prescribed for overactive bladder (OAB). The most common side effects of these agents are dry mouth and constipation, although other more concerning effects include changes in blood pressure, pulse rate, or heart rhythm when treatment is initiated. Herbal treatments are an increasingly popular alternative for treating OAB. A 2002 survey of US adults aged ≥ 18 years conducted by the Centers for Disease Control and Prevention indicated that 74.6% of those with OAB had used some form of complementary and alternative medicine. The World Health Organization estimates that 80% of the world’s population presently uses herbal medicine for some aspect of primary health care. Women were more likely than men to use complementary and alternative medicine. The authors review the most commonly used herbal medications for OAB. [Rev Urol. 2013;15(3):93-96 doi: 10.3909/riu0587] © 2013 MedReviews®, LLC

Overactive bladderHerbal medicineGosha-jinki-ganHachi-mi-jio-ganBuchu (Barosma betuline)Cleavers (Galium aparine)Cornsilk (Zea mays)Horsetail (Equisetum)Ganoderma lucidumResinferatoxinCapsaicin

Gelatin matrixView Articles

Volume 8, Number 3Review Articles

New Generation Tissue Sealants and Hemostatic Agents: Innovative Urologic Applications

Treatment Update

Dean G AssimosMichael A Traver

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]

HemostasisThrombin sealantsFibrin glueGelatin matrixThrombin

GemcitabineView Articles

Volume 10, Number 4Review Articles

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

Management Review

Michael S CooksonRichard E GreenbergH Barton GrossmanThomas E KeaneMichael A O'Donnell

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

GenderView Articles

Volume 9, Number 4Meeting Reviews

Best of the 2007 AUA Annual Meeting (2)

Meeting Review

John P Stein

Bladder Cancer Highlights from the 2007 Annual Meeting of the American Urological Association, May 19-24, 2007, Anaheim, CA [Rev Urol. 2007;9(4):220-234]

Bladder cancerQuality of lifeRisk factorsAgeCystectomyLaparoscopic surgeryIntravesical therapyPrognosisCystoscopyGenderInvasive cancerLymph node dissectionLymphovascular invasionMetastatic cancerOutcomesRepeat TURRobotic-assisted surgerySuperficial cancer

Gender differencesView Articles
Gene fusion proteinsView Articles

Volume 9, Number 4Review Articles

Newer Potential Biomarkers in Prostate Cancer

Diagnostic Update

Paul H LangeJonathan L Wright

Prostate-specific antigen (PSA) screening has led to a significant rise in the number of men diagnosed with prostate cancer and an associated increase in biopsies performed. Despite its limitations, including a positive predictive value of only 25%-40%, PSA remains the only generally accepted biomarker for prostate cancer. There is a need for better tools to not only identify men with prostate cancer, but also to recognize those with potentially lethal disease who will benefit from intervention. A great deal of work has been done worldwide to improve our knowledge of the genetics behind prostate cancer and the specificity of PSA by developing assays for different PSA isoforms. Common genetic alterations in prostate cancer patients have been identified, including CpG hypermethylation of GSPT1 and TMPRSS2:ERG gene fusion. Serum and urine detection of RNA biomarkers (eg, PCA3) and prostate cancer tissue protein antibodies (eg, EPCA) are being evaluated for detection and prognostic tools. This article reviews some of the promising developments in biomarkers. [Rev Urol. 2007;9(4):207-213]

Prostate-specific antigenPCA3Alpha-methylacyl-CoA racemaseAutoantibody arraysEpigenetic markersGene fusion proteinsHuman kallikreinsPSA isoformsRNA biomarkers

Gene splicingView Articles
Gene therapyView Articles