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Male slingView Articles
Male voiding dysfunctionView Articles

Volume 9, Number 3Meeting Reviews

Best of the 2007 AUA Annual Meeting

Meeting Review

Dean G AssimosDanil V MakarovEllen ShapiroAlan W PartinMichael B ChancellorJ Curtis NickelJacob RajferClaus G RoehrbornMichael K Brawer

Highlights from the 2007 Annual Meeting of the American Urological Association May 19-24, 2007 Anaheim, CA [Rev Urol. 2007;9(3):133-154]

Prostate cancerObesityBenign prostatic hyperplasiaAntibiotic prophylaxisNocturiaLower urinary tract symptomsBotulinum toxinProstate-specific antigenBiomarkersPCA3TestosteroneUrinary tract infectionsUrolithiasisLaser ablationEndourologyMale voiding dysfunctionLHRH antagonistsAntimuscarinic agentsCircumcisionRepeat biopsyHuman glandularkallikreinExpectant managementCRISP-3MSPMicrovesseldensityEndoglinSurvivinTelomeresInterleukin-8PDE-5 inhibitorsAcute urinaryretention5Alpha-reductase inhibitorsDoxazosinFinasterideTransurethral microwave thermotherapyTURPPerioperative blood lossMicrobialbiofilmsHIVStem cell injection

MalformationView Articles

Volume 16, Number 3Case Review

Urethral Duplication in a 15-Year-Old: Case Report With Review of the Literature

Mayank BaidArindam Dutta

Urethral duplication is a rare congenital malformation mainly affecting men and boys. Although a number of theories have been proposed to describe this condition, the actual mechanism of this disorder is still not clear. This article highlights a case of urethral duplication in a 15-year-old boy. The malformation was characterized by the presence of continent epispadic and normal apical urethra. Retrograde urethrogram through both urethral tracts simultaneously revealed the malformation as Effmann type IIA2. The patient was not offered surgical intervention as he was asymptomatic and had no problems except for a double stream of urine. [Rev Urol. 2014;16(3):149-151 doi: 10.3909/riu0618] © 2014 MedReviews®, LLC

UrethraDuplicationMalformationAbnormality

Malignant priapismView Articles

Volume 13, Number 2Case Review

Malignant Priapism Secondary to Metastatic Prostate Cancer: A Case Report and Review of Literature

Yu-Hsiang LinJerry J KimNed B SteinMohit Khera

Penile metastasis of cancers from other primary sites is a rare phenomenon that infrequently manifests as malignant priapism. We outline a case of an 84-year-old patient who presented with a 3-month history of painful priapism after radiation therapy for prostate adenocarcinoma. The patient underwent surgical penile exploration and cavernosal biopsy that revealed poorly differentiated cells suggestive of prostate cancer. Postoperative imaging demonstrated extensive regional and distal metastases. A review of the literature on penile metastases returned approximately 400 published cases, with priapism being the initial presentation in 20% to 50% of cases. Regardless of site of origin or subsequent management, most cases have shown very poor prognosis. [Rev Urol. 2011;13(2):90-94 doi: 10.3909/riu0508] © 2011 MedReviews®, LLC

Prostate cancerMalignant priapismPenile metastasis

ManagementView Articles

Volume 16, Number 2Review Articles

Solitary Renal Fossa Recurrence of Renal Cell Carcinoma After Nephrectomy

Treatment Review

Kamran AhmedJi-Jian ChowZahoor FaziliMohammed SheikhMartin Sheriff

Renal cell carcinoma without metastasis responds well to surgical excision but is known to recur postnephrectomy. In a small but significant number of patients this recurrence is not accompanied by metastasis, which is important as these people benefit from further surgery. We examined 20 articles from the current literature to ascertain how best to treat this condition. Surgical management renders better results than conservative or medical therapies. Readily available investigations such as blood tests and computed tomography can help determine the right patients for surgery in an evidence-based fashion. Current findings have allowed us to suggest a protocol for the treatment of solitary renal fossa recurrence of postnephrectomy renal cell carcinoma. There are further opportunities for study in validating our protocol, and in novel renal cell carcinoma treatment strategies that have not been tested on solitary renal fossa recurrences. [Rev Urol. 2014;16(2):76-82 doi: 10.3909/riu0598] © 2014 MedReviews®, LLC

ComplicationsManagementRenal cancerRecurrenceNephrectomy

MarkersView Articles
Marshall-Marchetti-Krantz procedureView Articles
Mast cellsView Articles
MatchingView Articles

Volume 20, Number 2Original Research

Balancing Confounding and Generalizability Using Observational, Real-world Data: 17-gene Genomic Prostate Score Assay Effect on Active Surveillance

Michael J KemeterPhillip G FebboSteven CanfieldJohn Hornberger

Randomized, controlled trials can provide high-quality, unbiased evidence for therapeutic interventions but are not always a practical or viable study design for certain healthcare decisions, such as those involving prognostic or predictive testing. Studies using large, real-world databases may be more appropriate and more generalizable to the intended target population of physicians and patients to answer these questions but carry potential for hidden bias. We illustrate several emerging methods of analyzing observational studies using propensity score matching (PSM) and coarsened exact matching (CEM). These advanced statistical methods are intended to reveal a “hidden experiment” within an observational database, and so refute or confirm a potential causal effect of assignment to an intervention and study outcome. We applied these methods to the Optum™ Research Database (ORD; Eden Prairie, MN) of electronic health records and administrative claims data to assess the effect of the 17-gene Genomic Prostate Score® (GPS™; Genomic Health, Redwood City, CA) assay on use of active surveillance (AS). In a traditional multivariable logistic regression, the GPS assay increased the use of AS by 29% (95% CI, 24%-33%). Upon applying the matching methods, the effect of the GPS assay on AS use varied between 27% and 80% and the matched data were significant among all algorithms. All matching algorithms performed well in identifying matched data that improved the imbalance in baseline covariates. By using different matching methods to assess causal inference in an observational database, we provide further confidence that the effect of the GPS assay on AS use is statistically significant and unlikely to be a result of confounding due to differences in baseline characteristics of the patients or the settings in which they were seen. [Rev Urol. 2018;20(2):69–76 doi: 10.3909/riu0799] © 2018 MedReviews, LLC®

Prostate cancerActive surveillanceEvidence-based practiceComparative effectiveness researchGenomic biomarkerPropensity scoreMatching

Maximal androgen blockadeView Articles
Maximum androgen blockadeView Articles

Volume 9, Supplement 1Review Articles

Androgen Deprivation Therapy in the Treatment of Advanced Prostate Cancer

New Directions in the Management of Advanced Prostate Cancer

Herbert LeporMark A Perlmutter

This article reviews the issues and controversies relevant to the treatment of advanced prostate cancer with androgen deprivation therapy. Initially, diethylstilbestrol was used for achieving androgen deprivation, but was replaced by luteinizing hormone-releasing hormone (LHRH). Adverse events associated with LHRH agonists include the flare phenomenon, hot flashes, loss of libido, erectile dysfunction, depression, muscle wasting, anemia, and osteoporosis. Intermittent therapy has been advocated to reduce morbidity of treatment. The addition of an antiandrogen provides maximum androgen blockade. There remains controversy regarding the timing of the addition of an antiandrogen. Secondary hormonal therapies include antiandrogens, adrenal androgen inhibitors, and estrogens. [Rev Urol. 2007;9(suppl 1):S3-S8]

Androgen deprivation therapyLHRH agonistsAdvanced prostate cancerDiethylstilbestrolMaximum androgen blockade

MDV3100View Articles
Medical applications of 3D printingView Articles

Volume 17, Number 1Review Articles

3D Printing and Its Urologic Applications

Technology Update

3D printing is the development of 3D objects via an additive process in which successive layers of material are applied under computer control. This article discusses 3D printing, with an emphasis on its historical context and its potential use in the field of urology. [Rev Urol. 2015;17(1):20-24 doi: 10.3909/riu0656] © 2015 MedReviews®, LLC

3D printingMedical applications of 3D printingUrologic applications of 3D printing

Medical expulsive therapyView Articles

Volume 19, Number 3Meeting Reviews

Best of the 2017 AUA Annual Meeting

Benjamin M BruckerDean G AssimosEllen ShapiroAlan W PartinMichael B ChancellorJ Curtis NickelMaria J Arcila-RuizSasha C Druskin

[Rev Urol. 2017;19(3):169–179 doi: 10.3909/riu0763] © 2017 MedReviews®, LLC

Percutaneous nephrolithotomyDisorders of sexual developmentBladder exstrophyProstate-specific antigenBiomarkersMicrobiomeOnabotulinumtoxinABladder pain syndromeStem cell therapyInterstitial cystitisStress urinary incontinenceKallikreinZika virusReverse transcription loop-mediated isothermal amplificationRefractory overactive bladderMeshectomyPudendal neuromodulationMedical expulsive therapyGlans groove

Medical management of stone diseaseView Articles

Volume 11, Number 3Review Articles

Hypocitraturia: Pathophysiology and Medical Management

Management Review

Dean G AssimosJack M Zuckerman

Low urinary citrate excretion is a known risk factor for the development ofkidney stones. Citrate inhibits stone formation by complexing with calciumin the urine, inhibiting spontaneous nucleation, and preventing growth andagglomeration of crystals. Hypocitraturia is a common metabolic abnormalityfound in 20% to 60% of stone formers. It is most commonly idiopathic inorigin but may be caused by distal renal tubular acidosis, hypokalemia, boweldysfunction, and a high-protein, low-alkali diet. Genetic factors, medications,and other comorbid disorders also play a role. Hypocitraturia should be managedthrough a combination of dietary modifications, oral alkali, and possiblylemonade or other citrus juice–based therapy. This review concerns thepathophysiology of hypocitraturia and the management of stone formersafflicted with this abnormality.[Rev Urol. 2009;11(3):134-144 doi:10.3909/riu0424]© 2009 MedReviews®, LLC

HypocitraturiaCitrate metabolismCitrate pathophysiologyHypocitraturia etiologiesMedical management of stone diseaseAlkali citratePotassium citrateCitrus juiceLemonade

Medical therapyView Articles
Medical Therapy of Prostatic Symptoms trialView Articles
Medical Therapy ofProstatic Symptoms (MTOPS) studyView Articles

Volume 7, Number 3Meeting Reviews

Best of the AUA 2005 Annual Meeting

Meeting Review

Ellen ShapiroAlan W PartinMichael B ChancellorJ Curtis NickelJacob RajferClaus G RoehrbornMichael K BrawerRandall B MeachamArie S BelldegrunJohn P SteinJohn T LeppertJohn S LamStephen J Freedland

Prostate cancerBenign prostatic hyperplasiaBladder cancerKidney cancerLower urinary tract symptomsBotulinum toxinVesicoureteral refluxProstate-specific antigenOveractive bladderPeyronie’s diseaseNomogramsPediatric urologyCryptorchidismVasectomy reversalChronic prostatitisBlockers5-reductase inhibitorsTrospium chlorideRenal stonesProstate volumeMedical Therapy ofProstatic Symptoms (MTOPS) studyMinimally invasive therapiesPremature ejaculationProstate Cancer Prevention TrialTyrol PSA Screening ProjectUrothelial cancer

Medical treatmentView Articles
MedicareView 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

MelanomaView Articles

Volume 16, Number 1Case Review

Metastatic Urethral Melanoma: Case Report and Review of the Literature

Luiz Ronaldo AlbertiBruno Moraes VasconcelosRafaela Saint-Clair Pimentel Mafra De Oliveira

Melanoma is a cancer that originates from melanocytes, is predominant in adults with white skin, represents 4% of skin cancers, and has high possibility of forming metastasis. This review reports on the case of a young man, age 36 years, previously diagnosed with melanoma. The patient complained of obstructive urinary symptoms and, while he was undergoing a cystoscopy, it was discovered that he had a lesion corresponding with metastatic melanoma of the prostatic urethra, which occluded almost the entire urethra and resulted in blocked urinary flow. He underwent a transurethral resection of the prostate, followed by resection of the lesion. After the procedure, he had good urinary flow and is currently on follow-up. [Rev Urol. 2014;16(1):47-49 doi: 10.3909/riu0584] © 2014 MedReviews®, LLC

UrethraMetastasisMelanomaUrinary obstructionUrethral melanoma

Mesh erosionView Articles

Volume 18, Number 3Case Review

A Novel Approach to Mesh Revision After Sacrocolpopexy

Nima M ShahMelissa L DawsonRebecca RinkoKristene E Whitmore

Pelvic organ prolapse (POP) is the herniation of pelvic organs to or beyond the vaginal walls. POP affects 50% of parous women; of those women, 11% will need surgery based on bothersome symptoms. Transvaginal mesh has been used for vaginal augmentation since the 1990s. Complications from mesh use are now more prominent, and include chronic pelvic pain, dyspareunia, vaginal mesh erosion, and urinary and defecatory dysfunction. Presently, there is no consensus regarding treatment of these complications. Reported herein are two cases of women with defecatory dysfunction and pain after sacrocolpopexy who underwent mesh revision procedures performed with both urogynecologic and colorectal surgery. [Rev Urol. 2016;18(3):174-177 doi: 10.3909/riu0698] © 2016 MedReviews®, LLC

Vaginal meshMesh erosionOmental flap mobilization

Mesh-related complicationsView 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

MeshectomyView Articles

Volume 19, Number 3Meeting Reviews

Best of the 2017 AUA Annual Meeting

Benjamin M BruckerDean G AssimosEllen ShapiroAlan W PartinMichael B ChancellorJ Curtis NickelMaria J Arcila-RuizSasha C Druskin

[Rev Urol. 2017;19(3):169–179 doi: 10.3909/riu0763] © 2017 MedReviews®, LLC

Percutaneous nephrolithotomyDisorders of sexual developmentBladder exstrophyProstate-specific antigenBiomarkersMicrobiomeOnabotulinumtoxinABladder pain syndromeStem cell therapyInterstitial cystitisStress urinary incontinenceKallikreinZika virusReverse transcription loop-mediated isothermal amplificationRefractory overactive bladderMeshectomyPudendal neuromodulationMedical expulsive therapyGlans groove

Metabolic evaluationView Articles
Metabolic stone diseaseView Articles
Metabolic syndromeView Articles

Volume 12, Number 4Review Articles

Metabolic Syndrome and Urologic Diseases

Mangement Review

Haluk AkpinarIlya Gorbachinsky

Metabolic syndrome (MetS) is a complex entity consisting of multiple interrelated factors including insulin resistance, central adiposity, dyslipidemia, endothelial dysfunction and atherosclerotic disease, low-grade inflammation, and in males, low testosterone levels. MetS has been linked to a number of urologic diseases including nephrolithiasis, benign prostatic hyperplasia and lower urinary tract symptoms, erectile dysfunction, male infertility, female incontinence, and prostate cancer. This article reviews the relationships between MetS and these entities. Urologists need to be cognizant of the impact that MetS has on urologic diseases as well as on overall patient health.[Rev Urol. 2010;12(4):e157-e180 doi: 10.3909/riu0487]© 2010 MedReviews®, LLC

ObesityMetabolic syndromeBenign prostatic hyperplasiaNephrolithiasisHypogonadismCardiovascular diseaseInsulin resistanceEndothelial dysfunction

Metabolic targetingView Articles
Metal allergyView Articles

Volume 19, Number 3Case Review

Surgical Solution to an Intracorporeal Nickel Allergy

Andrew StammPaul KozlowskiJared Brandenberger

A previously healthy 30-year-old man with a symptomatic varicocele underwent gonadal vein embolization using nickel vascular plugs. He developed a painful hypersensitivity to his nickel plugs and elected to pursue laparoscopic excision and proximal gonadal vein ligation. In the operating room, the gonadal vein was isolated from the ureter, and ligated proximal to the cephalad plug and distal to the caudal coil. His pain is completely resolved 5 months after surgery. Metal allergies are well documented in orthopedics and cardiology implants, but there are a limited number of case reports of metal allergies after varicocele embolization. Interestingly, nickel is the most common type of metal hypersensitivity. [Rev Urol. 2017;19(3):195–197 doi: 10.3909/riu0769] © 2017 MedReviews®, LLC

VaricoceleMetal allergyNickelCoil embolizationGonadal vein

MetastasisView Articles