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Transitional cell carcinomaView Articles
Transmembrane protease,serine 2View Articles

Volume 10, Number 1Review Articles

Clinical Utility of Prostate Carcinoma Molecular Diagnostic Tests

Diagnostic Update

Scott B Shappell

Instead of relying on serum prostate-specific antigen (PSA) to identify patients for prostate biopsy, new laboratory tests are needed that have improved specificity for prostate carcinoma (CaP), allow accurate classification of clinically insignificant CaPs, allow for detection of clinically significant CaP in patients without elevated serum PSA, and allow for identification of aggressive forms of CaP, which may warrant adjunctive or even molecularly targeted therapy in the future. Over the last several years, highthroughput gene expression profiling and proteinomics have led to the identification of genes and proteins that are specifically overexpressed in CaP. Molecular diagnostic techniques readily translated to the clinical laboratory have been incorporated into the development of new tests based on these novel molecular alterations in CaP. Some of these tests already have well-documented clinical utility, such as in facilitating prostate biopsy decisions, and are routinely available. The current review focuses on the biological, clinical, and laboratory aspects of the most promising of these current and nearfuture molecular CaP tests. [Rev Urol. 2008;10(1):44-69]

Molecular diagnosticsProstate carcinomaProstate cancer antigen 3Alpha-methylacyl-CoA racemaseEarly prostate cancer antigenTransmembrane protease,serine 2ERGDNARNA

Transperieneal mapping prostate biopsyView Articles

Volume 20, Number 1Original Research

Transrectal Ultrasound–guided Versus Transperineal Mapping Prostate Biopsy: Complication Comparison

Transrectal ultrasound guided prostate biopsy • Transperieneal mapping prostate biopsy • Complications

Vladimir MouravievE David CrawfordVassilios M SkouterisPaul AranguaMarios Panagiotis MetsinisMichael SkouterisGeorge ZacharopoulosNelson N Stone

Herein, the authors compare morbidity in men who underwent both transrectal ultrasound–guided (TRUS) prostate biopsy and transperineal mapping biopsy (TPMB) at two institutions with extensive experience in both procedures. We also identified strategies and predictive factors to reduce morbidity for both procedures. In our study, 379 men from two institutions, of which 265 (69.9%) had a prior TRUS-guided biopsy, also had TPMB performed via a template with biopsies taken at 5-mm intervals. Men in the TRUS group had a median of 12 cores sampled whereas the TPMB group had 51.5 (range, 16-151). The median biopsy density was 1.1 core/cc prostate volume. Median age and prostate-specific antigen (PSA) level were 65 years (range, 34-86) and 5.5 ng/mL (range, 0.02-118). Of these men, 11 of 265 (4.2%) who had TRUS biopsy developed urinary tract infection compared with 3 of 379 (0.79%) of those with mapping biopsy. Infection was 14.8% in TRUS biopsy group with 13 or more cores versus 2.9% in those with 12 or less (OR, 5.8; 95% CI, 1.6-21.2; P = 0.003). No men developed retention after TRUS biopsy whereas 30 of 379 (7.9%) did following TPMB. Older age, larger prostate volume (PV), and higher core number were associated with retention. On linear regression only age (P = 0.010) and PV (P = 0.016) remained as significant associations. Men older than 65 years had 12.8% versus 3.9% (OR, 3.7; 95% CI, 1.6-8.4, P = 0.001) and PV greater than 42 cc had 13.4% versus 2.7% (OR, 5.7; 95% CI, 2.1-15.1) retention incidence. In the present study TPMB is rarely associated with infection (0.78%) but more commonly with urinary retention (7.9%). Men older than 65 years and with PV greater than 42 cc were at four to five times greater retention risk. Consideration should be given to discharging these men with a urinary catheter following TPMB. [Rev Urol. 2018;20(1):19–25 doi: 10.3909/riu0785] © 2018 MedReviews, LLC®

ComplicationsTransrectal ultrasound guided prostate biopsyTransperieneal mapping prostate biopsy

Transperineal approachView Articles
TransplantationView Articles
TransrectalView Articles
Transrectal ultrasoundView Articles
Transrectal ultrasound (TRUS)View Articles
Transrectal ultrasound guided prostate biopsyView Articles

Volume 20, Number 1Original Research

Transrectal Ultrasound–guided Versus Transperineal Mapping Prostate Biopsy: Complication Comparison

Transrectal ultrasound guided prostate biopsy • Transperieneal mapping prostate biopsy • Complications

Vladimir MouravievE David CrawfordVassilios M SkouterisPaul AranguaMarios Panagiotis MetsinisMichael SkouterisGeorge ZacharopoulosNelson N Stone

Herein, the authors compare morbidity in men who underwent both transrectal ultrasound–guided (TRUS) prostate biopsy and transperineal mapping biopsy (TPMB) at two institutions with extensive experience in both procedures. We also identified strategies and predictive factors to reduce morbidity for both procedures. In our study, 379 men from two institutions, of which 265 (69.9%) had a prior TRUS-guided biopsy, also had TPMB performed via a template with biopsies taken at 5-mm intervals. Men in the TRUS group had a median of 12 cores sampled whereas the TPMB group had 51.5 (range, 16-151). The median biopsy density was 1.1 core/cc prostate volume. Median age and prostate-specific antigen (PSA) level were 65 years (range, 34-86) and 5.5 ng/mL (range, 0.02-118). Of these men, 11 of 265 (4.2%) who had TRUS biopsy developed urinary tract infection compared with 3 of 379 (0.79%) of those with mapping biopsy. Infection was 14.8% in TRUS biopsy group with 13 or more cores versus 2.9% in those with 12 or less (OR, 5.8; 95% CI, 1.6-21.2; P = 0.003). No men developed retention after TRUS biopsy whereas 30 of 379 (7.9%) did following TPMB. Older age, larger prostate volume (PV), and higher core number were associated with retention. On linear regression only age (P = 0.010) and PV (P = 0.016) remained as significant associations. Men older than 65 years had 12.8% versus 3.9% (OR, 3.7; 95% CI, 1.6-8.4, P = 0.001) and PV greater than 42 cc had 13.4% versus 2.7% (OR, 5.7; 95% CI, 2.1-15.1) retention incidence. In the present study TPMB is rarely associated with infection (0.78%) but more commonly with urinary retention (7.9%). Men older than 65 years and with PV greater than 42 cc were at four to five times greater retention risk. Consideration should be given to discharging these men with a urinary catheter following TPMB. [Rev Urol. 2018;20(1):19–25 doi: 10.3909/riu0785] © 2018 MedReviews, LLC®

ComplicationsTransrectal ultrasound guided prostate biopsyTransperieneal mapping prostate biopsy

Transrectal ultrasound prostateView Articles

Volume 12, Number 3Meeting Reviews

Best of the AUA Annual Meeting

Meeting Review

Dean G AssimosEllen ShapiroMichael B ChancellorJ Curtis NickelClaus G RoehrbornMichael K BrawerAkira Furuta

Highlights From the 2010 American Urological Association Meeting, May 29-June 3, 2010, San Francisco, CA [Rev Urol. 2010;12(2/3):e134-e146 doi: 10.3909/riu0500]

Autologous muscle-derived cellsNocturiaBotulinum toxinProstate-specific antigenUrosepsisShock wave lithotripsyTransrectal ultrasound prostateEscherichia coliSynthetic mesh slingProstatic urethral liftPRX3.02

Transrectal ultrasound-guided biopsyView Articles

Volume 5, Number 2Meeting Reviews

Advances in the Medical Treatment of Prostate Cancer, Bladder Cancer, Renal Cell Cancer, and Benign Prostatic Hyperplasia

Highlights from the XVIIth Congress of the European Association of Urology, Birmingham, UK

Claus G RoehrbornBob DjavanMesut RemziChristian Seitz

Prostate cancerBenign prostatic hyperplasiaBladder cancerLower urinary tract symptomsProstate-specific antigenRadical prostatectomyRadical nephrectomyNomogramsTamsulosinAlfuzosinFinasterideDutasterideBicalutamideBacille Calmette-GuerinPermixonRenal cell cancerTransrectal ultrasound-guided biopsyVirtual cystoscopy

TransrectalultrasoundView Articles
TransurethralView Articles
Transurethral electrovaporizationof the prostate (TUVP)View Articles
Transurethral microwave therapyView Articles
Transurethral microwave thermotherapyView 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

Transurethral needle ablation (TUNA)View Articles
Transurethral prostatic resectionView Articles
Transurethral resectionView Articles
Transurethral resection of a bladder tumorView Articles
transurethral resection of bladderView Articles

Volume 23, Number 4Bladder Cancer

Unmet Needs in High-Risk Non–Muscle-Invasive Bladder Cancer From the Patient’s Perspective: Challenges and Potential Solutions

Ashish KamatJason Hafron

Non–muscle-invasive bladder cancer (NMIBC) represents about 75% of bladder cancer cases, often leading to recurrence, considerable emotional distress, and a decline in health-related quality of life for affected patients. There are substantial unmet treatment needs for patients with NMIBC.

Quality of lifenon-muscle invasive bladder neoplasmstransurethral resection of bladderBCG vaccinepatient satisfaction

Transurethral resection of prostateView Articles

Volume 8, Supplement 3Review Articles

Economic Impact of Surgical Intervention in the Treatment of Benign Prostatic Hyperplasia

Photoselective Vaporization of the Prostate

John M HollingsworthJohn T Wei

The economic burden of benign prostatic hyperplasia (BPH) on our health care system is significant and likely to continue to grow given the burgeoning elderly population. Coincident with the rising number of annual physician office visits and expenditures for BPH has been a dramatic shift in the disease’s management, from surgical to medical care. However, long-term cost data call into question the appropriateness of medical therapy as the initial treatment approach for all men with BPH, particularly those with moderate to severe symptoms. Although there has been a paradigm shift away from traditional BPH surgery, there has been renewed interest in the treatment of BPH with novel surgical techniques and minimally invasive surgeries. The economics of surgical interventions for BPH are discussed. [Rev Urol. 2006;8(suppl 3):S9-S15]

Benign prostatic hyperplasiaEconomicsSurgical procedures, minimally invasiveTransurethral resection of prostate

Transurethral resection of the prostateView Articles

Volume 8, Supplement 3Review Articles

The Next Generation In Laser Treatments and the Role of the GreenLight High-Performance System Laser

Photoselective Vaporization of the Prostate

Alexis E Te

Lasers have evolved over the past decade, with technical refinements that have resulted in a procedure that can achieve transurethral-like results in a safe and efficacious manner. The physics and characteristics of the laser light, such as wavelength and power densities, influence efficiency of treatment and safety profiles of various laser techniques and systems. The currently commercially available 80-W potassium-titanyl-phosphate laser used for photoselective vaporization of the prostate gland in men with lower urinary tract symptoms and benign prostatic hyperplasia has been shown to be a safe and effective therapeutic alternative for a wide spectrum of prostate sizes and configurations. Refinements based on clinical experience as well as progress in available technologies have produced an advanced system with improvements in beam quality and an increase in power to provide an increase in vaporization efficiency and flexibility in technique. The refinements require adjustments to current technique. The advanced technological developments enhance the utility of this laser for application in benign prostatic hyperplasia and urology. [Rev Urol. 2006;8(suppl 3):S24-S30]

Benign prostatic hyperplasiaLower urinary tract symptomsLaser prostatectomyPotassium-titanyl-phosphate laserTransurethral resection of the prostate

Transurethral resection of the prostate (TURP)View Articles
Transurethral resection of the prostate(TURP)View Articles
TransvaginalView Articles
Transvaginal tapeView Articles

Volume 17, Number 2Review Articles

Diagnosis, Evaluation, and Treatment of Mixed Urinary Incontinence in Women

Diagnosis and Treatment Update

Steven A KaplanLeanna LaorClaire DunphyRichard LeeBilal ChughtaiAlexis E Te

Mixed urinary incontinence (MUI) is a common clinical problem in the community and hospital setting. The broad definition of the term makes it difficult to diagnose, as well as determine effective treatment strategies. There are no current guidelines recommended for physicians. The estimated prevalence of this condition is approximately 30% in all women with incontinence. It has also been suggested that patients with MUI report more bothersome symptoms than either stress or urge incontinence; approximately 32% of 40- to 64-year-olds with MUI report symptoms of depression. The authors examine the diagnosis, evaluation, and treatment of patients with MUI. [Rev Urol. 2015;17(2):78-83 doi: 10.3909/riu0653] © 2015 MedReviews®, LLC

Mixed urinary incontinenceDetrusor overactivityStress incontinenceUrge incontinenceUrodynamic stress incontinencePelvic organ prolapseTransvaginal tape

TraumaView Articles
TreatmentView Articles
treatment effectivenessView Articles

Volume 23, Number 2Prostate Cancer

Real-World Comparison of Deep Prostate-Specific Antigen Response in Patients With Metastatic Castration-Sensitive Prostate Cancer Treated With Apalutamide or Enzalutamide

Benjamin H. LowentrittIbrahim KhilfehDominic PilonShawn DuCarmine RossiFrederic KinkeadLilian DiazJill KorsiakPatrick LefebvreGordon A Brown

Deep prostate-specific antigen reduction of at least 90% (PSA90 response) after androgen receptor pathway inhibitor initiation to treat metastatic castration-sensitive prostate cancer (mCSPC) is associated with longer survival. This real-world study evaluated the proportion of androgen receptor pathway inhibitor–naive patients with mCSPC who achieved PSA90 response 6 months after initiating apalutamide or enzalutamide.

Prostatic neoplasmsProstate-specific antigen (PSA)Prostate-specific antigenProstate-specific antigensCastrationAndrogen receptorAndrogen receptor antagoniststreatment effectiveness