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Heat shock proteinsView Articles
HematomaView Articles

Volume 10, Number 3Case Review

Shock Wave Lithotripsy and Renal Hemorrhage

Case Review

J Kellogg ParsonsJonathan SilbersteinCharles M Lakin

Although shock wave lithotripsy is a safe and efficacious treatment for nephrolithiasis, the most common acute complication is renal hemorrhage. Shock wave–induced renal hemorrhage is a potentially devastating injury if not promptly recognized and treated appropriately. The authors report a large perirenal hematoma occurring after shock wave lithotripsy and review the causes, prevention, and treatment of shock wave–induced renal hemorrhage. [Rev Urol. 2008;10(3):236-241]

NephrolithiasisShock wave lithotripsyHematoma

HematuriaView Articles
Hemorrhagic cystitisView 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

HemostasisView Articles

Volume 5, Number 1Review Articles

Laparoscopic Total and Partial Nephrectomy-- The New Standard?

Technique Update

Benjamin R Lee

Laparoscopic radical nephrectomy has been shown in long-term follow-up to provide shorter patient hospitalization and effective cancer control with no significant difference in survival compared with open radical nephrectomy. The major technical issue for success of laparoscopic partial nephrectomy is hemostatic control, and several techniques have been developed to improve control. Laparoscopic partial nephrectomy continues to evolve along two therapeutic technical avenues: hilar clamping with ischemia versus no hilar clamping. The benefits of laparoscopy for the kidney have clearly been demonstrated in terms of less pain, decreased convalescence, and decreased narcotic requirements. With short-term outcomes demonstrating laparoscopic partial nephrectomy as an efficacious procedure, the role of laparoscopic partial nephrectomy should continue to increase. [Rev Urol. 2003;5(1):9–14]

HemostasisLaparoscopic radical nephrectomyRenal neoplasmsPartial nephrectomyRadiofrequency ablation

Hemostatic agentsView Articles

Volume 13, Number 3Review Articles

A Review of Current Hemostatic Agents and Tissue Sealants Used in Laparoscopic Partial Nephrectomy

Treatment Review

I GalanakisN VasdevN Soomro

Laparoscopic partial nephrectomy (LPN) is currently considered to be one of the most challenging procedures in minimally invasive urological surgery. With an increasing number of renal tumors being managed using LPN, there is now a further interest in the development of techniques and agents to reduce complications associated with the procedure. Hemostasis is of paramount importance during LPN, and hemostatic agents and tissue sealants are now being used commonly during LPN. Despite this, there is a dearth of prospective, randomized, human trials in current literature that compare the various agents. This review evaluates hemostatic agents and tissue sealants being used during LPN as an adjuvant to suturing in human studies. [Rev Urol. 2011;13(3):131-138 doi: 10.3909/riu0524] © 2011 MedReviews®, LLC

Laparoscopic partial nephrectomyRenal tumorsHemostatic agentsTissue sealantsSuturing adjuvant

HemostaticsView Articles

Volume 17, Number 1Original Research

Hemostasis During Urologic Surgery: Fibrin Sealant Compared With Absorbable Hemostat

David M. AlbalaJerome B RiebmanRichard KocharianBogdan IlieJohn AlbaneseJessica ShenLiza OvingtonJonathan Batiller

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

Heparin-binding epidermal growth factor-like growth factor (HB-EGF)View Articles
Herbal medicineView 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

Hereditary nonpolyposis colon cancerView Articles
HerniaView Articles
HerniorrhaphyView Articles
Herpes simplex virusView Articles
hidradenitis suppurativaView Articles

Volume 21, Number 1Review Articles

Skin Grafting Applications in Urology

Treatment Review

Andrew J CohenGerman PatinoMicha Yin ZhengBenjamin Breyer

Skin grafting is a closure technique widely used in plastic surgery. Urologists may encounter patients with diseases that lead to severe tissue loss due to infection, trauma, burns, malignancy, skin maladies, or primary lymphedema. The development and study of skin harvesting techniques to manage tissue coverage of burns has allowed for great advances and the widening application of skin grafting. As such, there is a growing recognition and application of skin grafts within urology. The aim of surgical treatment and skin grafting within urology is to preserve genital function, improve quality of life, and restore cosmetic damage. In addition to basic technique, this article reviews specific surgical methods employed in reconstruction for patients with Fournier gangrene, buried penis, and hidradenitis suppurativa. Urologists must be aware of these techniques in order to provide adequate counseling for patients considering these operations and when encountering complications. [Rev Urol. 2019;21(1):8–14] © 2019 MedReviews®, LLC

Fournier gangreneSkin grafting techniquesburied penishidradenitis suppurativa

High-doseView Articles
High-energy transurethral microwave thermotherapyView Articles

Volume 8, Number 4Meeting Reviews

Advances in the Treatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia

Meeting Review

Claus G Roehrborn

Highlights from the 21st European Association of Urology Congress, April 5–8, 2006, Paris, France [Rev Urol. 2006;8(4):216-225]

Benign prostatic hyperplasiaNocturiaLower urinary tract symptomsAlfuzosinProstatectomyPDE-5 inhibitorsTURPDutasterideSexual dysfunctionAcute urinary retentionChronic inflammatory infiltratesPVPHigh-energy transurethral microwave thermotherapy

High-grade PINView Articles
High-grade prostate cancerView Articles

Volume 17, Number 1Review Articles

Finding the Wolf in Sheep’s Clothing: The 4Kscore Is a Novel Blood Test That Can Accurately Identify the Risk of Aggressive Prostate Cancer

Diagnosis and Screening Update

Dipen J ParekhSanoj PunnenMASNicola Pavan

Better biomarkers that can discriminate between aggressive and indolent phenotypes of prostate cancer are urgently needed. In the first 20 years of the prostate-specific antigen (PSA) era, screening for prostate cancer has successfully reduced prostate cancer mortality, but has led to significant problems with overdiagnosis and overtreatment. As a result, many men are subjected to unnecessary prostate biopsies and overtreatment of indolent cancer in order to save one man from dying of prostate cancer. A novel blood test known as the 4Kscore® Test (OPKO Lab, Nashville, TN) incorporates a panel of four kallikrein protein biomarkers (total PSA, free PSA, intact PSA, and human kallikrein-related peptidase 2) and other clinical information in an algorithm that provides a percent risk for a high-grade (Gleason score ≥ 7) cancer on biopsy. In 10 peer-reviewed publications, the four kallikrein biomarkers and algorithm of the 4Kscore Test have been shown to improve the prediction not only of biopsy histopathology, but also surgical pathology and occurrence of aggressive, metastatic disease. Recently, a blinded prospective trial of the 4Kscore Test was conducted across the United States among 1012 men. The 4Kscore Test replicated previous European results showing accuracy in predicting biopsy outcome of Gleason score ≥ 7. In a recent case-control study nested within a population-based cohort from Västerbotten, Sweden, the four kallikrein biomarkers of the 4Kscore Test also predicted the risk for aggressive prostate cancer that metastasized within 20 years after the test was administered. These results indicate that men with an abnormal PSA or digital rectal examination result, and for whom an initial or repeat prostate biopsy is being considered, would benefit from a reflex 4Kscore Test to add important information to the clinical decision-making process. A high-risk 4Kscore Test result may be used to select men with a high probability of aggressive prostate cancer who would benefit from a biopsy of the prostate to prevent an adverse and potentially lethal outcome from prostate cancer. Men with a low 4Kscore Test result may safely defer biopsy. [Rev Urol. 2015;17(1):3-13 doi: 10.3909/riu0668] © 2015 MedReviews®, LLC

Prostate cancerBiomarkerScreeningHigh-grade prostate cancer

High-grade prostatic intraepithelial neoplasiaView Articles
High-intensityView Articles
High-intensity focused ultrasoundView Articles
High-risk, localized prostate cancerView Articles

Volume 9, Supplement 2Review Articles

High-Risk, Clinically Localized Prostate Cancer: Is Monotherapy Adequate?

Androgen-Independent Prostate Cancer

Mark H KatzJames M McKiernan

High-risk, clinically localized prostate cancer represents a diverse disease entity. Patients who are considered to be at highest risk for biochemical failure after localized treatments may not be at significant risk for diseasespecific mortality. In this review, an attempt will be made to define high-risk status and help identify patients at high risk for mortality after a diagnosis of localized prostate cancer. Subsequently, a review of monotherapy approaches as well as previously successful strategies utilizing multimodality therapy for high-risk disease will be presented. Finally, a synopsis will be given of several ongoing randomized clinical trials using the most effective systemic therapies in the adjuvant setting following thorough local treatments such as radical prostatectomy. This review will provide a glimpse into the future and describe the tools that it is hoped will improve further upon the results of surgical monotherapy for high-risk, localized prostate cancer. [Rev Urol. 2007;9(suppl 2):S19-S27]

Prostate cancerRadical prostatectomyHigh-risk, localized prostate cancerMortality riskMultimodality therapy

HistopathologyView Articles
HIVView Articles

Volume 23, Number 2Case of the Quarter

Case of the Quarter: Kaposi Sarcoma in a Patient With Testicular Germ Cell Tumor and HIV: A Case Report and Literature Review

Daniela V. CastroDonald HannounTanya B. DorffAlexander Chehrazi-RaffleWesley YipAbhishek TripathiBenjamin MercierRegina Barragan-CarrilloHedyeh EbrahimiSalvador Jaime-Casas

Testicular germ cell tumors are the leading cause of cancer in male patients 15 to 39 years old. Extensive treatments are available, and the regimen of choice depends on clinical, laboratory, and histopathologic characteristics. Patients with HIV are at increased risk of developing solid malignancies, including testicular germ cell tumors. All patients with HIV should start on highly active antiretroviral therapy, but the drug interactions between chemotherapy for testicular germ cell tumor and highly active antiretroviral therapy have not been extensively evaluated. This case review highlights the importance of optimal therapeutic agent selection in patients with HIV and solid malignancies.

Testicular neoplasmGerm cellHIVTesticular neoplasmsSarcoma

HMOView Articles

Volume 8, Number 2Review Articles

The Business of Urology - Your First Job

Special Feature

Paul Brower

Young doctors nearing the end of their residency must begin to consider how to chart the course of their careers. Most residents will go into private practice. This requires a huge leap, from academia into the business world of medicine. Young doctors, long preoccupied with the clinical and academic aspects of medicine, are frequently ill-prepared for this process, having no insight as to what they can do to match themselves to the right practice or multi-specialty group. This article discusses the stages of this process, from initial geographic decisions to securing interviews, to assessing the health of a given practice, to the details of contract negotiation. [Rev Urol. 2006;8(2):71-75]

CompensationResidentsEmploymentPrivate practiceMedicarePPOHMOContract negotiation

Holmium laser enucleation of the prostate (HoLEP)View Articles

Volume 17, Number 3Review Articles

The Role of Minimally Invasive Surgical Techniques in the Management of Large-gland Benign Prostatic Hypertrophy

Management Update

Ojas ShahHerbert LeporGanesh SivarajanMichael S BorofskyJames E Lingeman

Lower urinary tract symptoms (LUTS) secondary to benign prostatic hypertrophy (BPH) are among the most common medical issues for aging men. Population-based studies suggest that 13.8% of men in their 40s and more than 40% of men over age 60 have BPH. When LUTS are refractory to medical therapy and bothersome enough to warrant surgical intervention, transurethral resection of the prostate and open simple prostatectomy have been the historical reference-standard procedures for decades. Both procedures are highly effective and offer durable improvements in urinary functional outcomes. However, they also have the potential for considerable perioperative complications and morbidity. In an effort to limit surgical morbidity, a variety of minimally invasive surgical techniques to treat BPH have been introduced. Herein we present a comprehensive, evidence-based review of the efficacy and safety profile of modern minimally invasive treatments for large-gland BPH. [Rev Urol. 2015;17(3):140-149 doi: 10.3909/riu0675] © 2015 MedReviews®, LLC

Lower urinary tract symptomsRobotic simple prostatectomyBenign prostatic hypertrophyGreenLight photovaporizationHolmium laser enucleation of the prostate (HoLEP)

Hormonal agentsView Articles
Hormonal therapyView Articles
Hormone deprivation therapyView Articles

Volume 11, Number 4Review Articles

The Impact of Prostate Cancer and Hormonal Therapy on Bone

Management Review

Gerald L Andriole

Large-scale studies agree that the observed decline in prostate cancer mortality that began in the early 1990s, shortly after prostate-specific antigen testing was introduced in the United States, is most likely explained by more widespread treatment of prostate cancer, including hormonal therapy. Practitioners should be aware of the risk of the development of osteoporosis and of skeletal side effects related to hormonal therapy to optimize the care of men with prostate cancer.[Rev Urol. 2009;11(4):185-189 doi: 10.3909/riu0469]© 2009 MedReviews®, LLC

Androgen deprivation therapyHormone deprivation therapyBonedestructionOsteoporosisOsteopenia

Hormone replacementView Articles

Volume 23, Number 1Men's Health

Contemporary Management of Male Hypogonadism

Andrew Y Sun

Male hypogonadism affects up to 40% of men and is becoming more prominent because of increasingly prevalent medical comorbidities. Because various forms of treatment are available today, physicians should discuss drug efficacy and safety while simultaneously ensuring that therapy forms are in alignment with patient preferences. Treatment adherence is critical to sustaining patient health outcomes.

HypogonadismHormone replacementtestosterone deficiency