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HypogonadismView 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

Hypogonadotropic hypogonadismView Articles

Volume 21, Number 4Case Review

Using 17-OHP as Serum Biomarker to Monitor Therapy in Patients With Hypogonadotropic Hypogonadism

A MouzannarM NarasimmaP PatelR Ramasamy

Exogenous testosterone administration decreases intratesticular testosterone (ITT) significantly, an essential hormone for spermatogenesis. Therefore, treatment of patients with hypogonadotropic hypogonadism (HH) who desire infertility can be challenging. These patients are treated with recombinant follicle-stimulating hormone (FSH), clomiphene citrate, and human chorionic gonadotropin (hCG) to increase their ITT. However, there is no approved serum biomarker for ITT and it can only be measured via invasive testicular biopsy or aspiration. Previous authors have speculated that serum 17-hydroxyprogestrone (17-OHP) can be used as serum biomarker for ITT. In our case report, we demonstrate increase in 17-OHP associated with spermatogenesis after commencing treatment for infertility in patient with HH. [Rev Urol. 2019;21(4):180–182] © 2020 MedReviews®, LLC

BiomarkerInfertility17-HydroxyprogesteronIntratesticular testosteroneHypogonadotropic hypogonadism

HypokalemiaView Articles
HypospadiasView Articles
HypoxiaView Articles

Volume 8, Number 4Review Articles

Penile Rehabilitation After Radical Prostatectomy: Important Therapy or Wishful Thinking?

Management Update

Jesse N MillsRandall B MeachamJoseph E Dall'EraHari K Koul

On the basis of data accumulated thus far, it is reasonable to discuss the implementation of a “penile rehabilitation” program with patients undergoing radical prostatectomy. Central to discussions of penile rehabilitation after radical prostatectomy is evidence demonstrating significant fibrotic changes in the corpus cavernosum that occur postoperatively. Several studies have been published evaluating the efficacy of various pro-erectogenic agents. The limited data regarding intracavernous injections and vacuum constriction devices suggest that an increased percentage of treated patients experienced a return of natural erections compared with patients who received no treatment. Longer, prospective, randomized, placebo-controlled studies will be needed to confirm the utility of these treatments. Data from contemporary studies evaluating the chronic use of oral phosphodiesterase type 5 inhibitors suggest a beneficial effect on endothelial cell function among men suffering from erectile dysfunction due to a variety of causes. Limited data suggest that this effect might be seen among post-prostatectomy patients, implying a possible role for these agents in enhancing the return of sexual function in such individuals. [Rev Urol. 2006;8(4):209-215]

Radical prostatectomyErectile dysfunctionPenile rehabilitationPDE-5 inhibitorsHypoxiaIntracorporeal injectionVacuum constriction device

IC, in childrenView Articles
IC, in menView Articles
IdiopathicView Articles

Volume 13, Number 2Case Review

Idiopathic Scrotal Calcinosis: A Non-Elucidated Pathogenesis and Its Surgical Treatment

Abdelhak KhalloukMohamed Jamal El FassiMoulay Hassan FarihOussama El YazamiMohamed Fadl TaziSoufiane Mellas

Scrotal calcinosis (SC) is a rare, benign entity defined as the presence of multiple calcified nodules within the scrotal skin. In most cases, there are no associated symptoms. We report the case of 27-year-old man with a massive SC. Treatment was surgical with complete excision of the affected part of the scrotum wall. Histopathologically, there was no epithelial lining around the calcified nodules and no cystic structure. Therefore, our case was considered idiopathic SC [Rev Urol. 2011;13(2):95-97 doi: 10.3909/riu0481] © 2011 MedReviews®, LLC

TreatmentCalcinosisIdiopathicScrotumSurgery

IGF-IView Articles
IleocystoplastyView Articles
Image co-registrationView Articles

Volume 8, Supplement 1Review Articles

The Emergence of Radioimmunoscintigraphy for Prostate Cancer

Prostate Cancer Imaging

David G McLeodThomas E KeaneInger L RosnerM Scott Wingo

The ability to label tissue-specific antibodies has long been of interest for improving detection and guidance for therapeutic applications. The most studied target for prostate cancer is the prostate-specific membrane antigen, which is upregulated in prostate cancer, hormone-refractive disease, and prostate cancer metastases. Investigations using radioimmunoscintigraphy with the radiolabeled 7E11 antibody capromab pendetide have significantly improved sensitivity for prostate cancer detection compared with standard cross-sectional imaging, based on tissue confirmation of pathologic results. Over the past 5 years, significantly greater image resolution from improved camera technology and the use of co-registration to fuse functional and anatomic (computerized tomography and magnetic resonance imaging) images have dramatically enhanced prostate cancer localization. Outcomes data from several sources have spurred a resurgence in interest in this imaging modality. [Rev Urol. 2006;8(suppl 1):S20-S28]

Prostate cancerProstaScintProstate-specific membrane antigenRadioimmunoscintigraphyCapromab pendetideImage co-registrationLymph node metastasis

Image-guided biopsyView Articles

Volume 22, Number 2Review Articles

The Role of Multiparametric MRI and MRI-targeted Biopsy in Detecting Clinically Significant Prostate Cancer in the Community Setting: A Retrospective Study

Original Research

Kenneth E SchmankeJordan J StiversonRosalee E ZackulaSerge G SrourMatthew P LierzFadi N Joudi

Multiparametric MRI and the Prostate Imaging-Reporting and Data System (PI-RADS) have emerged as tools to reveal suspicious prostate lesions and MRI-targeted biopsy has shown potential to avoid repeat prostate biopsies and miss fewer significant cancers. This retrospective study sought to assess the differences in diagnostic yield and sampling efficiency between MRI-targeted and standard biopsies in a community urology practice. We concluded that MRI-targeted biopsy was more efficient than a standard biopsy, although neither technique achieved a superior diagnostic yield of clinically significant cancer in our community setting. We recommend that a standard biopsy be performed alongside targeted biopsy. [Rev Urol. 2020;22(2):57–66] © 2020 MedReviews®, LLC

Health services researchProstatic neoplasmsImage-guided biopsyMultiparametric MRIAmbulatory care facilities

Imaging techniquesView Articles
ImipramineView Articles

Volume 13, Number 1Review Articles

Infantile Enuresis: Current State-of-the-Art Therapy and Future Trends

Disease State Review

Franklin E KuehhasNenad DjakovicMarkus Hohenfellner

"Enuresis nocturna is a widespread problem among children, with up to 25% of all children possibly suffering from this condition. Several therapeutic modalities are currently available. This article reviews current state-of-the-art therapies, highlights current literature, and provides an update on recent developments within the field of enuresis nocturna. [Rev Urol. 2011;13(1):1-5 doi: 10.3909/riu0498]"

DesmopressinEnuresis nocturnaAlarm therapyImipramineReboxetineGiggle incontinenceMethylphenidatePelvic floor muscle exercise

immune checkpoint inhibitorsView Articles

Volume 23, Number 3Bladder Cancer

Immune Checkpoint Inhibitors for the Treatment of Non–Muscle-Invasive Bladder Cancer: An Overview of Ongoing Clinical Trials

Neal D Shore

Treatment of non–muscle-invasive bladder cancer (NMIBC) is evolving, seeking new treatments to overcome the limitations of bacille Calmette-Guérin therapy and alternatives to radical cystectomy. Studies are currently evaluating the safety and efficacy of immune checkpoint inhibitors in combination with bacille Calmette-Guérin vs bacille Calmette-Guérin monotherapy for patients with high-risk NMIBC that is bacille Calmette-Guérin naive or recurrent after bacille Calmette-Guérin induction. We briefly summarize 4 studies that are evaluating intravenous immune checkpoint inhibitors (atezolizumab, durvalumab, and pembrolizumab) and 1 subcutaneous immune checkpoint inhibitor (sasanlimab). These studies may substantially change standard-of-care treatment for patients with high-risk NMIBC.

immune checkpoint inhibitorsMonoclonal antibodiesClinical trialsnon-muscle invasive bladder neoplasms

ImmunoCyt/uCyttestView Articles

Volume 8, Number 4Review Articles

Diagnostic Utility of the ImmunoCyt/uCyt+ Test in Bladder Cancer

Diagnostic Update

Badrinath R KonetyAnna BerryKirsten L Greene

Bladder cancer is a common malignancy in the United States. Although urine cytology is a useful adjunct in both diagnosis and follow-up and is highly sensitive for detecting high-grade tumors, it is limited by decreased sensitivity in detecting low-grade tumors, which constitute the majority of new diagnoses. Additional screening tests with high sensitivity and specificity for urothelial tumors of all grades are indicated to help improve the diagnostic ability of urine cytology as well as to reduce the need for frequent cystoscopies, especially in those with low-risk disease. Several assays have been developed, with the ImmunoCyt/uCyt test (DiagnoCure, Inc., Québec, Canada) being especially promising. Recent studies on the applicability and efficacy of ImmunoCyt/uCyt testing are reviewed, as are its sensitivity, specificity, and predictive value in the follow-up and screening of urothelial malignancies. [Rev Urol. 2006;8(4):190-197]

Bladder cancerCystoscopyImmunoCyt/uCyttestUrothelial malignancies

Immunohistochemical stainingView Articles

Volume 9, Number 2Reviews in Urology

Angiomyolipoma of the Left Ureterovesical Junction

Case Review

Elias S HyamsJohn Provet

Angiomyolipoma (AML) is a benign tumor that typically consists of 3 tissue elements: thick-walled blood vessels, smooth muscle cells, and adipocytes. The most common location for AML is renal; however, extrarenal AML has been described. Reports of extrarenal AML within the genitourinary tract are rare. We report a case of AML at the left ureterovesical junction and the evaluation and management decisions regarding this lesion. [Rev Urol. 2007;9(2):84-88]

AngiomyolipomaImmunohistochemical stainingUreterovesical junction

Immunohistochemical studyView Articles

Volume 9, Number 1Reviews in Urology

Solitary Fibrous Tumor of the Kidney: A Case Report and Review of the Literature

Case Review

Imane KamaouiAfaf AmartiSanae BennisLaila ChbaniHinde El FatemiTaoufik HarmouchFadl TaziKaoutar Znati

A solitary fibrous tumor (SFT) is an unusual spindle cell neoplasm that usually occurs in the pleura but has recently been described in diverse extrapleural sites. Urogenital localization is rare, and only 19 cases of SFT of the kidney have been described. We report a case of a large SFT clinically thought to be renal cell carcinoma arising in the kidney of a 70-year-old man. The tumor was well circumscribed and composed of a mixture of spindle cells and dense collagenous bands, with areas of necrosis or cystic changes noted macroscopically and microscopically. Immunohistochemical studies revealed reactivity for CD34, CD99, and Bcl-2 protein, with no staining for keratin, S-100 protein, or muscle markers, confirming the diagnosis of SFT. This tumor is benign in up to 90% of cases. The immunohistochemical study is the key to diagnosis. [Rev Urol. 2007;9(1):36-40]

KidneyImmunohistochemical studyRenal neoplasmSpindle cells

ImmunomodulationView Articles
Immunomodulatory agentsView Articles

Volume 9, Supplement 1Review Articles

Current Standard and Investigational Approaches to the Management of Hormone-Refractory Prostate Cancer

New Directions in the Management of Advanced Prostate Cancer

Andrew J ArmstrongDaniel J GeorgePrateek Mendiratta

Prostate cancer is a common cause of death in men and remains incurable in the metastatic setting. In 2004, 2 landmark trials using docetaxel-based chemotherapy, TAX 327 and SWOG 99-16, showed a survival benefit for the first time in metastatic, hormone-refractory prostate cancer. Current research suggests that several distinct mechanisms of androgen-refractory disease may converge in patients with disease progression on androgen deprivation therapy. These findings have identified several potential targets for therapeutic intervention. Current standard and investigational treatment options for this disease are discussed, including chemotherapy and rapidly evolving therapies in phase II/III trials involving antiangiogenic therapies, signal transduction inhibitors, immunomodulatory agents, and nuclear receptor targets. In light of a growing array of treatment options and an increasingly chronic natural history, this review supports a multidisciplinary care approach to these patients, including medical oncologists, urologists, and radiation oncologists, to optimize survival and quality of life. [Rev Urol. 2007;9(suppl 1):S9-S19]

ChemotherapyZoledronic acidHormone-refractory prostate cancerAntiangiogenic therapySignal transduction inhibitorsImmunomodulatory agents

Immunomodulatory genesView Articles
ImmunoscintigraphyView Articles
ImmunotherapyView Articles

Volume 23, Number 3Kidney Cancer

Response to Targeted Therapy and Checkpoint Inhibition in a Patient With Mucinous Tubular and Spindle Cell Carcinoma: A Case Report and Literature Review

Ruchi AgarwalDaniela V. CastroYu Jun LiJaya GoudSalvador Jaime-Casas

Mucinous tubular and spindle cell carcinoma (MTSCC) is a form of renal cell carcinoma characterized by its tubular structure, mucinous stroma, and spindle-shaped cells. It makes up less than 1% of all renal cell carcinoma cases and has been classically described as indolent, although the disease course varies. Here we analyze the case of a 67-year-old woman with metastatic MTSCC with a sarcomatoid component. The course of treatment was extensive and included targeted therapy and immunotherapy. Thus, this case review offers insight into the heterogeneous clinical course of MTSCC and potential therapeutic options for these patients.

Immunotherapyimmune checkpoint inhibitorsCarcinoma, renal cellCarcinomaneoplasms, squamous, mucinous, and serouscarcinoma, tubular

Immunotherapy, cancer vaccineView Articles
Implications of childhood malignanciesView Articles
ImpotenceView Articles
In vitro fertilizationView Articles

Volume 15, Number 4Review Articles

The Use of In Vitro Fertilization in the Management of Male Infertility: What the Urologist Needs to Know

Management Review

Randall B MeachamSahar M StephensDaniel M Arnett

Infertility affects approximately 10% to 20% of reproductive-age couples, many of whom may present initially to a urologist. Some couples may be treated medically to increase spontaneous conception rates; however, many will require more aggressive management with in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI). IVF involves ovarian stimulation, oocyte retrieval, and fertilization outside of the body; ICSI involves injecting one sperm into the oocyte to promote fertilization. Here we provide a brief overview of IVF and ICSI along with a discussion of the risks involved to facilitate the counseling and care of the infertile couple. [Rev Urol. 2013;15(4):154-160 doi: 10.3909/riu0588] © 2014 MedReviews®, LLC

Male infertilityIn vitro fertilizationIntracytoplasmic sperm injection

In-capromab pendetide scanView Articles
Inaccessible urethraView Articles

Volume 17, Number 4Case Review

Effectiveness of Antegrade Access in Bladder Tumors With Inaccessible Urethra

Abdul Rouf KhawajaTanveer Iqbal DarSajad MaikJavaid MagrayAshiq BhatArif Hameed BhatMohdSaleem WaniBaldev Singh Wazir

Inaccessible urethra with no retrograde endoscopic access due to multiple/diffuse strictures or multiple urethrocutaneous fistulas with acute urinary retention due to posturethral instrumentation (transurethral resection of bladder tumor [TURBT], or TURBT with transurethral resection of the prostate [TURP]), is a rare entity. Management of such a case with a bladder tumor for TURBT/surveillance cystoscopy poses a great challenge. The authors present 12 cases of bladder tumor with inaccessible urethra, 10 cases due to multiple strictures (post-TURBT and/or TURP), and 2 cases due to urethrocutaneous fistulas (post-TURBT), who presented to our emergency department with acute urinary retention. Emergent suprapubic catheterization was used as a temporary treatment method. [Rev Urol. 2015;17(4):241-245 doi: 10.3909/riu0677] © 2016 MedReviews®, LLC

Bladder tumorsSuprapubic cystostomyInaccessible urethraTract seedling

IncidenceView Articles