Orthotopic urinary diversions after radical cystectomy for bladder cancer: lessons learned last decade
Purpose of review Orthotopic urinary diversion (OUD), or neobladder, is believed to be the gold standard for surgical bladder reconstruction following radical cystectomy though it is performed far less often than ileal conduits. As both a continent and intracavitary diversion, OUDs offer unique advantages for patients. Their utilization has decreased overall though, especially with the advent of robotic surgery. In this review, we will cover patient selection for OUD, functional outcomes (i.e., continence, sexual activity, quality of life [QoL]), and robotic orthotopic diversions. Recent findings OUDs have seen ...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research

Patient-reported outcomes and health-related quality of life after urinary diversions
Purpose of review To study the recent literature on health-related quality of life (HRQOL) in patients after radical cystectomy followed by urinary diversion. Recent findings General consensus regarding, which urinary diversion is superior in terms of HRQOL has not been reached. Although there is an increase in studies favoring the orthotopic neobladder, overall quality of these studies is poor. Other studies suggest that HRQOL outcomes in different types of urinary diversions is similar and that other factors, such as age, comorbidities and sex are more important instead. Patient choice, in consultation with th...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research

Management of upper urinary tract problems after radical cystectomy for urothelial carcinoma: tips and tricks
Purpose of review After radical cystectomy (RC) patients are at risk for both benign and malignant problems regarding the upper urinary tract (UUT). This review summarizes the recent literature and provides tips on how to manage problems of the UUT after RC. Recent findings Disease recurrence, kidney stones and ureteroenteric strictures (UES) are common after RC. Endourological techniques can be used to treat low-grade disease recurrence, either with a retrograde or antegrade approach. Treatment success depends on getting access to the UUT and on tumor characteristics; selecting the right approach is key. Kidney...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research

The functioning and the complication rate of extreme long existing urinary diversions
This study was performed to investigate the functioning of urinary diversions constructed> 25 years earlier. Recent findings Most studies have a relatively shorter follow-up, mainly focussing on short term postoperative complications. Focussing on the long term, urinary tract infections (UTI) including pyelonephritis are common. Mild kidney function deterioration is described. Summary Retrospective study (2018–2019); 43 patients with regular follow-up at the Radboud University Medical Centre Nijmegen the Netherlands. Ileal conduit (n = 19) and ureterosigmoidostomy (n = 11) are the most common...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research

Urinary diversions for benign and oncologic indications: what did we learn about short term complications in the last 24 months?
Purpose of review Urinary diversion (UD) with or without cystectomy is a procedure with high short term complication rates. In this review, we summarize the most relevant findings of the last 2 years. Recent findings The use of a prophylactic mesh decreases the risk of parastomal hernia after ileal conduit (IC) surgery without adding mesh-related complications according to a recent randomized multicentre trial. Robot-assisted surgery is increasingly applied for UD and is evolving from extra- to intra-corporeal reconstruction in both continent and incontinent diversions, but there is still a need for appropriatel...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research

The feasibility and efficacy of catheterizable stoma's in adults
Purpose of review A continent vesicostomy represents a useful alternative for adult patients with impaired bladder emptying who are unable to perform clean intermittent (self-) catheterization through the urethra. In a pediatric setting, there exists a vast experience in these procedures. But experience with continent catheterizable vesicostomies is less abundant in adult patients. We want to give an overview and discuss recent literature about catheterizable conduits in the adult population. Recent findings Adult patients who undergo continent vesicostomy comprise a diverse cohort. Because of this very heteroge...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research

Success factors for abdominal wall diversions, including ureterocutaneostomy
Purpose of review To review the most recent data on urinary diversions (UD) surgical outcomes performed at time of radical cystectomy (RC). Recent findings Looking at the recent specific literature, the most recent factors introduced in the field of UDs are the preoperative assessment of patient's frailty and the use of the robotic system. According to the available evidence, frailty status is a good preoperative predictor of surgical outcomes and patient recovery. Several questionaries measuring patient's frailty status have been evaluated as a proxy to prevent RC complications and to improve the choice of the ...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research

Editorial: Medical, technical and functional aspect of various types of urinary diversion
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research

Update on robotic cystectomy
This article aims to discuss recently published (2019–2021) studies on robot-assisted radical cystectomy (RARC) with attention to evidence comparing intracorporeal (ICUD) and extracorporeal urinary diversion (ECUD) in terms of intraoperative and perioperative metrics. Recent findings RARC produces equivalent oncological outcomes compared to open radical cystectomy (ORC). The benefits of RARC are most pronounced perioperatively. ICUD has been increasingly used at centers of excellence as it reduces intestinal exposure, which may incrementally minimize morbidity compared to ECUD or ORC. As the learning curve for...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: ROBOTIC SURGICAL TECHNIQUES: Edited by David M. Albala Source Type: research

Robotic sacrocolpopexy in pelvic organ prolapse: a review of current literature
Purpose of review Recently, robotic sacrocolpopexy has become the gold standard for treating genital prolapse. Despite this, there is still much interest in this procedure, and many questions remain unanswered. This review focuses on the most critical articles on this issue that have been published in the last 2 years. Recent findings A summary of 23 articles is provided. There were no differences in total postoperative complications, postoperative stress incontinence, mesh erosion, and the success of the two surgical techniques in long-term investigations. Obesity modestly increases robotic approach difficulty ...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: ROBOTIC SURGICAL TECHNIQUES: Edited by David M. Albala Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

New perspectives on the surgical treatment of posterior urethral obstruction
Purpose of review Posterior urethral obstruction (PUO) from prostate surgery for benign and malignant conditions poses a significant reconstructive challenge. Endoscopic management demonstrates only modest success and often definitive reconstructive solutions are necessary to limit morbidity and firmly establish posterior urethral continuity. This often demands a combined abdominoperineal approach, pubic bone resection, and even sacrifice of the external urinary sphincter and anterior urethral blood supply. Recently, a robotic-assisted approach has been described. Enhanced instrument dexterity, magnified visualization,...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research

Update on the management of complex strictures of the bulbar urethra
Purpose of review This narrative review summarizes the most relevant literature published in 2019–2020 regarding urethroplasty for bulbar strictures. Recent findings We identified relevant papers focussing on new insights in the field of excision and primary anastomosis, graft augmentation urethroplasty and perineostomy for bulbar strictures and bulbomembranous strictures after radiotherapy or surgery for benign prostatic hyperplasia. Summary Respecting the vascularity of the anterior urethra and maintaining the integrity of surrounding structures during bulbar urethroplasty does not appear to deter...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research

The emerging role of robotics in upper and lower urinary tract reconstruction
Purpose of review Developments in robotic reconstructive urology have introduced novel treatments for complex upper and lower urinary tract disease. Short-term and mid-term data demonstrates excellent outcomes and minimal morbidity, suggesting the advanced instrumentation and visualization of robotics represent a new treatment paradigm in patients that are historically difficult to treat. Here we review recent developments in the robotically assisted surgical management of urethral and ureteral strictures. Recent findings The minimally invasive approach, enhanced precision and reach, and near-infrared fluorescen...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research

Advancements in transurethral management of urethral stricture disease
Purpose of review To explore and report the recent evolution of transurethral management of urethral stricture disease. Recent findings In recent years, new promising techniques in the transurethral management of urethral stricture disease have emerged including adjuvant therapies to direct vision internal urethrotomy, regenerative therapy with buccal mucosa cells and minimally invasive transurethral urethroplasty procedures that avoid skin incisions. Summary Although further work is needed, the expanding field of transurethral therapies for urethral stricture disease demonstrates early promising results ...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research

Tissue engineering: recent advances and review of clinical outcome for urethral strictures
Purpose of review Urethrotomy remains the first-line therapy in the treatment of a urethral stricture despite data showing no real chance of a cure after repeated urethrotomies. An anastomotic or an augmentation urethroplasty using oral mucosa can be offered to patients following failed urethrotomy. The potential for a tissue engineered solution as an alternative to native tissue has been explored in recent years and is reviewed in this article. Recent findings More than 80 preclinical studies have investigated a tissue-engineered approach for urethral reconstruction mostly using decellularized natural scaffolds...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research

Update on the management of penile and meatal strictures
Purpose of review Treatment of penile and distal urethral strictures including the fossa navicularis and the meatus remains challenging due to their adverse etiology and lack of ventral tissue support. In this contemporary review, we summarize the available evidence and recent advancements in reconstructive techniques. Recent findings Over the last years, several refinements of already established techniques have been added to the reconstructive armamentarium in the management of penile urethral strictures. These include the single-stage combination of flap and graft, the additional use of tissue glue, or an opt...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research

Update on female urethral reconstruction
Purpose of review Female urethral stricture (FUS) is not frequent but can be the cause of significant morbidity. A somewhat overlooked condition for years, it has received significant attention in recent times. In this review, we update the current evidence surrounding FUS management. Recent findings It is estimated that FUS is present in about 1% of all women having check-ups for lower urinary tract symptoms. Etiology is considered as idiopathic in half of the cases, iatrogenic in one-third, whereas infection/inflammation and trauma account for the rest. Symptoms presented are usually nonspecific and nondiagnos...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research

Long-term outcome of urethral and genital reconstruction in hypospadias and exstrophy-epispadias complex
Purpose of review Although immediate surgical outcomes of genitourinary reconstruction used to be the main focus in hypospadias and exstrophy-epispadias complex (EEC), recent research demonstrates rising concerns about long-term functional and psychosexual outcomes. Recent results about long-term outcomes of complex genitourinary reconstruction in those children transitioning into adulthood are summarized and discussed in this comprehensive review. Recent findings Long-term outcomes in hypospadias focus on psychosexual satisfaction and decisional regret. Interestingly, uncomplicated hypospadias repair results in...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research

Editorial: Advances in reconstructive urology
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research

State of the art on stress incontinence management after benign prostatic obstruction surgery
Purpose of review Stress urinary incontinence (SUI) is mostly seen after prostate surgery (radical prostatectomy or benign prostatic obstruction [BPO] relief). As new surgical techniques (laser, endoscopic enucleation) have been dramatically expanded in the past decade, a focus on postoperative SUI is necessary to provide the best management in this iatrogenic situation. Recent findings Surgery is the main option for curative management of SUI after BPO as no oral medication is recommended. Preoperative work-up is mandatory to assess concomitant bladder dysfunction. All available surgical options (peri-urethral ...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: LUTS, BPH AND BEYOND: Edited by Vincent Misrai and Dmitry Enikeev Source Type: research

Laser endoscopic procedures on the prostate: it is the small details that count
Purpose of review This review aims to highlight the pros and cons of each laser device and to consider additional possible milestones for the development of laser technologies in the surgical treatment of benign prostate hyperplasia. Recent findings Over the last three decades, lasers’ role in endourology has gone from strength to strength. Specifically, the primary techniques where laser surgery for BPO relief is concerned are vaporization and enucleation. The idea behind vaporization is that lasers are able to vaporize substantial amounts of tissue due to deep ablation depth and increased power. The most...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: LUTS, BPH AND BEYOND: Edited by Vincent Misrai and Dmitry Enikeev Source Type: research

Minimally invasive surgery for benign prostatic obstruction: new insights and future technical standards
Purpose of review This review aims to give a brief description of the latest minimally invasive surgical techniques (MISTs) for the treatment of benign prostatic obstruction (BPO). Recent findings In recent years technological advances have made the implementation of MISTs in the armamentarium of BPO surgery possible and in many cases could replace standard procedures. These techniques offer many advantages –short recovery time, rapid symptomatic relief, few adverse effects, lower risk of sexual/ejaculatory dysfunction, acceptable durability and most can be performed as an outpatient procedure. Many ...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: LUTS, BPH AND BEYOND: Edited by Vincent Misrai and Dmitry Enikeev Source Type: research

eLearning and transurethral prostate surgery: virtual tools for a real training
Purpose of review In the recent two decades, technological breakthrough has tremendously expanded the scope of transurethral prostate surgery. New gadgets and energy devices keep emerging to tackle benign prostatic obstruction, which was dealt with mainly by transurethral resection of prostate in the old days. Although this trend appears fascinating, it also means that urologists need quality training to attain surgical safety in performing these new surgeries. E-learning and simulation training may play an important role in modern urology training. Recent findings In this review, we would describe, using up-to-...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: LUTS, BPH AND BEYOND: Edited by Vincent Misrai and Dmitry Enikeev Source Type: research

Postoperative medical treatment of lower urinary tract symptoms after benign prostatic hyperplasia surgery. Are we underestimating the problem?
Purpose of review The aim of this study was to determine whether well timed start of medical and surgical treatment of benign prostatic obstruction (BPO) influences the treatment's effectiveness and thus the patients’ overall functional outcomes and quality of life. Recent findings Pharmacological therapy even in high-volume (>80 cm3) BPH typically begins with α-blockers sole and only subsequently are 5ARI added. Several studies showed that acute urinary retention (AUR) developed more frequently in men who suffered severe lower urinary tract symptoms (LUTS) and who did not start combination ther...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: LUTS, BPH AND BEYOND: Edited by Vincent Misrai and Dmitry Enikeev Source Type: research

Electrosurgery or laser for benign prostatic enlargement: trumpcard or pitfalls
Purpose of review To summarize and comment on publications of the last 2 years in the field of endoscopic surgery for benign prostatic enlargement, focusing on similarities and differences of laser and electrosurgery. Recent findings Because of good hemostasis and safety, invasive endoscopic surgery has evolved to a choice of treatment for vulnerable patients with ongoing antithrombotic medication and in same-day surgery. Recent publications show a good perioperative course and no deterioration in the postoperative outcome. Furthermore, alterations to the original surgical techniques of resection, enucleation, a...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: LUTS, BPH AND BEYOND: Edited by Vincent Misrai and Dmitry Enikeev Source Type: research

The place of robotic-assisted laparoscopy for BPO surgical management in 2021
Purpose of review Robot-assisted laparoscopic simple prostatectomy (RASP) is being used increasingly for the surgical treatment of benign prostatic obstruction (BPO). Our purpose is to review the main outcomes of RASP for the management of BPO. Recent findings A computerised bibliographic search of Medline was performed for articles that included detailed results of RASP, published over the past 2 years. Although RASP seems to be associated with better perioperative and functional outcomes, this procedure remains expensive when compared to open or endoscopic surgery. However, considering the enhanced safety of...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: LUTS, BPH AND BEYOND: Edited by Vincent Misrai and Dmitry Enikeev Source Type: research

Editorial: Lower urinary tract symptoms, benign prostate hyperplasia and beyond
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: LUTS, BPH AND BEYOND: Edited by Vincent Misrai and Dmitry Enikeev Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Bladder-preserving strategies for Bacillus Calmette-Guérin unresponsive non-muscle invasive bladder cancer; where are we and what will be expected?: Erratum
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ERRATUM Source Type: research

Artificial intelligence in prostate histopathology: where are we in 2021?
Purpose of review Artificial intelligence has made an entrance into mainstream applications of daily life but the clinical deployment of artificial intelligence-supported histological analysis is still at infancy. Recent years have seen a surge in technological advance regarding the use of artificial intelligence in pathology, in particular in the diagnosis of prostate cancer. Recent findings We review first impressions of how artificial intelligence impacts the clinical performance of pathologists in the analysis of prostate tissue. Several challenges in the deployment of artificial intelligence remain to be ov...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Radiogenomics in prostate cancer evaluation
Purpose of review Radiogenomics, fusion between radiomics and genomics, represents a new field of research to improve cancer comprehension and evaluation. In this review, we give an overview of radiogenomics and its most recent and relevant applications in prostate cancer management. Recent findings Literature about radiogenomics in prostate cancer emerged last 5 years but remains scarce. Radiogenomics in prostate cancer mainly rely on MRI-based features. Several imaging biomarkers, mostly based on the identification of radiomic features from deep learning studies, have been studied for the prediction of genomic...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Applications of artificial intelligence in prostate cancer imaging
Purpose of review The purpose of this review was to identify the most recent lines of research focusing on the application of artificial intelligence (AI) in the diagnosis and staging of prostate cancer (PCa) with imaging. Recent findings The majority of studies focused on the improvement in the interpretation of bi-parametric and multiparametric magnetic resonance imaging, and in the planning of image guided biopsy. These initial studies showed that AI methods based on convolutional neural networks could achieve a diagnostic performance close to that of radiologists. In addition, these methods could improve seg...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Kidney cancer management 3.0: can artificial intelligence make us better?
Purpose of review Artificial intelligence holds tremendous potential for disrupting clinical medicine. Here we review the current role of artificial intelligence in the kidney cancer space. Recent findings Machine learning and deep learning algorithms have been developed using information extracted from radiomic, histopathologic, and genomic datasets of patients with renal masses. Summary Although artificial intelligence applications in medicine are still in their infancy, they already hold immediate promise to improve accuracy of renal mass characterization, grade, and prognostication. As algorithms beco...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Artificial intelligence in bladder cancer prognosis: a pathway for personalized medicine
Purpose of review This review aims to provide an update of the results of studies published in the last 2 years involving the use of artificial intelligence in bladder cancer (BCa) prognosis. Recent findings Recently, many studies evaluated various artificial intelligence models to predict BCa evolution using either deep learning or machine learning. Many trials evidenced a better prediction of recurrence-free survival and overall survival for muscle invasive BCa (MIBC) for deep learning-based models compared with clinical stages. Improvements in imaging associated with the development of deep learning neural ne...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

The use of artificial intelligence for the diagnosis of bladder cancer: a review and perspectives
Purpose of review White light cystoscopy is the current standard for primary diagnosis and surveillance of bladder cancer. However, cancer changes can be subtle and may be easily missed. With the advancement of deep learning (DL), image recognition by artificial intelligence (AI) proves a high accuracy for image-based diagnosis. AI can be a solution to enhance bladder cancer diagnosis on cystoscopy. Recent findings An algorithm that classifies cystoscopic images into normal and tumour images is essential for AI cystoscopy. To develop this AI-based system requires a training dataset, an appropriate type of DL alg...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Artificial intelligence in stone disease
Purpose of review Artificial intelligence (AI) is the ability of a machine, or computer, to simulate intelligent behavior. In medicine, the use of large datasets enables a computer to learn how to perform cognitive tasks, thereby facilitating medical decision-making. This review aims to describe advancements in AI in stone disease to improve diagnostic accuracy in determining stone composition, to predict outcomes of surgical procedures or watchful waiting and ultimately to optimize treatment choices for patients Recent findings AI algorithms show high accuracy in different realms including stone detection and i...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Artificial intelligence in functional urology: how it may shape the future
Purpose of review The aim of the present manuscript is to provide an overview on the current state of artificial intelligence (AI) tools in either decision making, diagnosis, treatment options, or outcome prediction in functional urology. Recent findings Several recent studies have shed light on the promising potential of AI in functional urology to investigate lower urinary tract dysfunction pathophysiology but also as a diagnostic tool by enhancing the existing evaluations such as dynamic magnetic resonance imaging or urodynamics. AI may also improve surgical education and training because of its automated per...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

How the use of the artificial intelligence could improve surgical skills in urology: state of the art and future perspectives
This article reviews advances in the use of machine learning and artificial intelligence for improvements of surgical skills in urology. Recent findings Six studies have been published, which met the inclusion criteria. All articles assessed the application of artificial intelligence in improving surgical training. Different approaches were taken, such as using machine learning to identify and classify suturing gestures, creating automated objective evaluation reports, and determining surgical technical skill levels to predict clinical outcomes. The articles illustrated the continuously growing role of artificial in...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Future artificial intelligence tools and perspectives in medicine
Purpose of review Artificial intelligence has become popular in medical applications, specifically as a clinical support tool for computer-aided diagnosis. These tools are typically employed on medical data (i.e., image, molecular data, clinical variables, etc.) and used the statistical and machine-learning methods to measure the model performance. In this review, we summarized and discussed the most recent radiomic pipeline used for clinical analysis. Recent findings Currently, limited management of cancers benefits from artificial intelligence, mostly related to a computer-aided diagnosis that avoids a biopsy ...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Editorial: Artificial intelligence will shape the future of urology but good things come to those who wait
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Acute kidney injury in COVID-19: are kidneys the target or just collateral damage? A comprehensive assessment of viral RNA and AKI rate in patients with COVID-19
Purpose of review To investigate the possible effects of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) on kidney function and assess the rate of viral ribonucleic acid (RNA) shedding/detection in urine. Recent findings Most of the research on the topic suggests that for the moment our ability to estimate whether SARS-CoV-2 is a direct causative agent in acute kidney injury (AKI) or whether it has a cytokine storm effect is limited. During our prospective assessment of 333 patients with COronaVIrus Disease 2019 (COVID-19) it was found that frequency of AKI of 9.6% (32 cases). Despite previo...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Contemporary patterns of presentation, diagnostics and management of upper tract urothelial cancer in 101 centres: the Clinical Research Office of the Endourological Society Global upper tract urothelial carcinoma registry
Purpose of review To assess patterns of presentation, diagnostics and treatment in patients with upper tract urothelial carcinoma (UTUC), a multicentre registry was launched. Clinical data of UTUC patients were prospectively collected over a 5-year period. Recent findings Data from 2380 patients were included from 2014 to 2019 (101 centres in 29 countries). Patients were predominantly male (70.5%) and 53.3% were past or present smokers. The majority of patients (58.1%) were evaluated because of symptoms, mainly macroscopic hematuria. Computed tomography (CT) was the most common performed imaging modality (90.5%)...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Association between male infertility and prostate cancer: a systematic review and meta-analysis
Purpose of review Male infertility has been shown to be associated with different maladies. The present systematic review and meta-analysis aimed to summarize the available evidence on the association between male infertility or childlessness and prostate cancer. Recent findings The PubMed, Web of Science, and Scopus databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Studies were deemed eligible if they compared males with known infertility or childlessness to the control group including fertile males with regards to the diagnosis of prostate ca...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

COVID-19 crisis and minimally invasive surgery: a narrative review on intraoperative aerosol viral transmission and their impact on guidelines and clinical practice in Austria
Purpose of review The purpose of this review is to evaluate the risk of intraoperative aerosol viral transmission and the impact of updated COVID-19 guidelines on minimally invasive surgery (MIS) in Austria. Recent findings The current literature does not support the risk of intraoperative viral transmission nor does it suggest a harm of minimally invasive procedures in the context of the COVID-19 pandemic. However, medical societies mostly adopted a precautionary approach with a focus on protective measures. Austrian surgeons considered MIS safe during the pandemic and Austria managed to keep the initial outbre...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Adverse events of systemic immune-based combination therapies in the first-line treatment of patients with metastatic renal cell carcinoma: systematic review and network meta-analysis
Purpose of review To compare the safety profiles of systemic immune checkpoint inhibitor-based combination therapies that were evaluated in the first-line setting of the management of patients with advanced or metastatic renal cell carcinoma (mRCC). Recent findings Six phase III randomized control trials comparing first-line immune-based combination therapies to sunitinib in previously untreated patients with mRCC. Network meta-analyses were conducted to compare treatment-related adverse events (TRAEs), treatment discontinuation, and treatment-related mortality. Summary Lenvatinib plus pembrolizumab was a...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Novel transurethral resection technologies and training modalities in the management of nonmuscle invasive bladder cancer: a comprehensive review
Purpose of review Conventional transurethral resection (TURBT) with tumor fragmentation is the primary step in the surgical treatment of nonmuscle invasive bladder cancer. Recently, new surgical techniques and training modalities have emerged with the aim to overcome short-comings of TURBT and improve oncologic outcomes. In this review, we provide a comprehensive update of recent techniques/techniques that aim to improve upon conventional TURBT and beyond. Recent findings A systemic approach during conventional TURBT that features the use of a surgical checklist has been shown to improve recurrence-free survival...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

The prognostic value of sarcopenia in patients with prostate cancer: a systematic review
Purpose of review Sarcopenia is known to affect perioperative and oncologic outcomes in patients with different urological malignancies. Nevertheless, the use of pretreatment sarcopenia as a predictor of clinical outcomes in patients with prostate cancer is still poorly studied. Therefore, we aimed to conduct a systematic review summarizing the available evidence and identifying the prognostic value of sarcopenia in prostate cancer patients. Recent findings Sarcopenia was not predictive of biochemical recurrence in patients treated with radical prostatectomy. However, it was associated with worse long-term survi...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Health-related quality of life in bladder cancer patients: bladder cancer-specific instruments and domains. Part 2
Purpose of review Several instruments have been designed to evaluate health-related quality of life (HRQoL) in patients with bladder cancer (BC). However, they vary in purpose, domains, and quality. To identify QoL instruments that have been validated for BC patients and to critically assess their domains and limitations. Recent findings Of the 11 instruments identified, seven have been externally validated. Of these, four can be used across all disease states; two are available for QoL assessment in patients with non-muscle invasive bladder cancer (NMIBC); and the European Organisation for Research and Treatmen...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Health-related quality of life in bladder cancer patients: general and cancer-specific instruments. Part 1
Purpose of review Although survival outcomes are the primary outcomes to determine the effectiveness of treatment options, quality of life (QoL) is gaining in importance in addition to classic oncological outcomes. The present review aims to state and critically assess the challenges in health-related QoL (HRQoL) assessment especially in bladder cancer (BC) patients. Recent findings General QoL-instruments do not address concerns specific to cancer patients or BC patients. Domains, such as sexual functioning, embarrassment, self-consciousness, psychological distress, and urinary incontinence, are not adequately ...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research