Persistent Lower Urinary Tract Symptoms After BPH Surgery
AbstractPurpose of ReviewLower urinary tract symptoms (LUTS) after surgical management for BPH pose a significant clinical challenge for urologists. Despite high success rates in relieving LUTS, there is a subset of patients who experience persistent symptoms after intervention. In this review article, we describe the management of patients with new or persistent LUTS after endoscopic bladder outlet surgery.Recent FindingsPreviously, the goal for BPH management was to remove as much adenomatous tissue as possible. While potentially effective, this may lead to unwanted side effects. There has been a recent paradigm shift fo...
Source: Current Urology Reports - April 5, 2024 Category: Urology & Nephrology Source Type: research
Flaps and Grafts in Robotic Reconstructive Surgery
AbstractPurpose of ReviewThe robotic approach is increasingly popular in reconstructive urology. Reconstructive surgeons have commonly used flaps and grafts for obliterating dead space including tissue interposition or as an alternative to mesh in addressing lower urinary tract dysfunction. Advantages of the robotic approach are less incisional pain, excellent visualization in the deep pelvis, and improved surgeon ergonomics. In this literature review, we describe flaps and grafts used in lower urinary tract robotic reconstructive urology, serving as an almanac for these techniques.Recent FindingsOmental, peritoneal, verti...
Source: Current Urology Reports - March 22, 2024 Category: Urology & Nephrology Source Type: research
Evaluation of Current Surgical BPH Interventions for Young and Elderly Men
AbstractPurpose of ReviewBenign prostatic hyperplasia affects the quality of life of a significant number of men, especially as they age. There are continuous innovations in the surgical management of benign prostatic hyperplasia, but many of these innovations are studied in the core population of men 50 –70 years of age. This review focuses on the outliers of men aged 18–50 and 70 and older.Recent FindingsOlder populations have more comorbidities, higher rates of antithrombotic medications, and advanced symptoms. Properly selected older men can safely have significant objective and subjective improvement in their sym...
Source: Current Urology Reports - March 12, 2024 Category: Urology & Nephrology Source Type: research
Medical Advancements in Benign Prostatic Hyperplasia Treatments
AbstractPurpose of ReviewThis review aims to identify and summarize the current literature on the most recent therapeutic agents and combination strategies for the medical management of lower urinary tract symptoms resulting from benign prostatic hyperplasia.Recent FindingsThe latest advancements in BPH therapy have been in combination strategies. Alpha blockers continue to be the mainstay of treatment, but research is exploring the synergistic benefits of combining them with 5-alpha reductase inhibitors (5-ARIs), phosphodiesterase-5 (PDE5) inhibitors, and beta-3 agonists.SummaryThe alpha-blocker + 5-ARI combination r...
Source: Current Urology Reports - March 7, 2024 Category: Urology & Nephrology Source Type: research
The Use of Uroflowmetry as a Diagnostic Test
AbstractPurpose of ReviewUroflowmetry is widely used for initial non-invasive evaluation of lower urinary tract disorders. Current clinical use is mostly restricted to a scrutiny of the maximum flow rate and uroflow pattern recorded by a conventional flowmeter in a health care facility. There are several advancements in our understanding and in available technologies that promise to transform clinical utilization of this simple test.Recent FindingsSeveral aspects of the uroflow test in addition to maximum flow rate and uroflow pattern show potential diagnostic utility. This includes flow acceleration, uroflow indices, urof...
Source: Current Urology Reports - February 28, 2024 Category: Urology & Nephrology Source Type: research
Laser Technology Advancements in the Treatment of Benign Prostatic Hypertrophy
This article attempts to distill the advancements in laser technology for the treatment of benign prostatic hypertrophy (BPH) into key and understandable points to help make this topic more accessible to urologists.Recent FindingsThe holmium:yttrium –aluminum-garnet (YAG) laser, one of the most significant lasers in the field of urology, has recently been improved with pulse modulating technology (Moses™ technology). New thulium:YAG technology allows both pulsed and continuous wave modes. The thulium fiber laser is one of the newer lasers t o come to market and has been shown to have effective and safe outcomes. GreenL...
Source: Current Urology Reports - February 13, 2024 Category: Urology & Nephrology Source Type: research
Pediatric Robot-Assisted Laparoscopic Pyeloplasty: Where Are We Now?
AbstractPurpose of ReviewThis review aims to provide an in-depth exploration of the recent advancements in robot-assisted laparoscopic pyeloplasty (RALP) and its evolving landscape in the context of infant pyeloplasty, complex genitourinary (GU) anatomy, recurrent ureteropelvic junction (UPJ) obstruction, cost considerations, and the learning curve.Recent FindingsRecent literature highlights the safety and efficacy of RALP in treating the infant population, patients with complex GU anomalies, and recurrent UPJO which were all traditionally managed using the open approach. Cost considerations are evolving, with the potentia...
Source: Current Urology Reports - February 7, 2024 Category: Urology & Nephrology Source Type: research
Adult Hypospadias Outcomes for the Pediatric Urologist
AbstractPurpose of ReviewThis review article will examine the current literature on hypospadias-related complications in adult patients.Recent FindingsIn this article, we will review the most recent studies evaluating hypospadias-related stricture disease, erectile function, fertility, and psychosexual outcomes in adult men with history of hypospadias repair in childhood.SummaryManaging hypospadias-related complications in adult patients is challenging to reconstructive urologists due to the compounded complexity of innate tissue deficiency and history of prior surgical repairs. In this review, we explore overall functiona...
Source: Current Urology Reports - February 6, 2024 Category: Urology & Nephrology Source Type: research
Reconstruction Techniques After Partial Nephrectomy: Classic vs. Sutureless Approach —A Narrative Review
AbstractPurpose of ReviewThe purpose of this review is to update the information about the different types of reconstruction after partial nephrectomy, with special emphasis on the new methods of suture-free hemostasis currently available.Recent FindingsThe aim of renal reconstruction is to avoid bleeding and leakage of the collecting system, but now the renorrhaphy technique used is considered one of the modifiable determinants of renal function after surgery. In an attempt to avoid the loss of renal function implicit in classic reconstruction, new techniques have been described to control hemostasis and urinary leakage, ...
Source: Current Urology Reports - December 29, 2023 Category: Urology & Nephrology Source Type: research
Smart Diagnosis of Urinary Tract Infections: is Artificial Intelligence the Fast-Lane Solution?
AbstractPurpose of ReviewArtificial intelligence (AI) can significantly improve physicians ’ workflow when examining patients with UTI. However, most contemporary reviews are focused on examining the usage of AI with a restricted quantity of data, analyzing only a subset of AI algorithms, or performing narrative work without analyzing all dedicated studies. Given the preceding, the goal of this work was to conduct a mini-review to determine the current state of AI-based systems as a support in UTI diagnosis.Recent FindingsThere are sufficient publications to comprehend the potential applications of artificial intelligenc...
Source: Current Urology Reports - December 19, 2023 Category: Urology & Nephrology Source Type: research
Assessment of Prostate and Bladder Cancer Genomic Biomarkers Using Artificial Intelligence: a Systematic Review
AbstractPurpose of ReviewThe aim of the systematic review is to assess AI ’s capabilities in the genetics of prostate cancer (PCa) and bladder cancer (BCa) to evaluate target groups for such analysis as well as to assess its prospects in daily practice.Recent FindingsIn total, our analysis included 27 articles: 10 articles have reported on PCa and 17 on BCa, respectively. The AI algorithms added clinical value and demonstrated promising results in several fields, including cancer detection, assessment of cancer development risk, risk stratification in terms of survival and relapse, and prediction of response to a specifi...
Source: Current Urology Reports - December 15, 2023 Category: Urology & Nephrology Source Type: research
Hydrometrocolpos: a Contemporary Review of the Last 5 Years
AbstractPurpose of ReviewThe goal of this review is to provide a comprehensive overview of hydrometrocolpos, covering disease etiology, pathophysiology, clinical presentation, and diagnostic and management techniques, and known outcomes.Recent FindingsThis narrative review presents the literature on hydrometrocolpos in the pediatric population from the past 5 years. We highlight the 69 reported cases of hydrometrocolpos and classify them based on type of obstruction or associated anomaly, discuss new diagnostic algorithms based on imaging, and present novel and underutilized surgical techniques for definitive management....
Source: Current Urology Reports - December 1, 2023 Category: Urology & Nephrology Source Type: research
Exploring the Enigma of 5-ARIs Resistance in Benign Prostatic Hyperplasia: Paving the Path for Personalized Medicine
AbstractPurpose of ReviewDespite the widespread utilization of 5-alpha reductase inhibitors (5-ARIs) for managing benign prostatic hyperplasia (BPH), certain BPH patients exhibit unresponsiveness to 5-ARIs therapy. This paper provides a comprehensive overview of the current perspectives on the mechanisms of 5-ARIs resistance in BPH patients and integrates potential biomarkers and underlying therapeutic options for 5-ARIs resistance. These findings may facilitate the development of novel or optimize more effective treatment options, and promote personalized medicine for BPH.Recent FindingsThe pathways contributing to resist...
Source: Current Urology Reports - November 21, 2023 Category: Urology & Nephrology Source Type: research
Duplex Kidney in Adults: a Systematic Review of the Literature
This study offers urologists and emergency care practitioners a great overview of the variety of manifestations, anatomic differences, and therapeutic approaches for similar patients.Recent Findingsmodified reconstructive strategy could be a method of choice when addressing particular anatomies, such as incomplete duplex kidneys with ureteropelvic junction obstruction in both upper and lower poles when the obstruction is close to the confluence of the two ureters.SummaryThere is a spectrum of acute presentations and management strategies in adult patients with duplex collecting systems. The majority of patients presenting ...
Source: Current Urology Reports - November 9, 2023 Category: Urology & Nephrology Source Type: research
Overview of Benchtop Models for Comparison of Surgical Treatments for Benign Prostatic Hyperplasia
AbstractPurpose of ReviewBenign prostatic hyperplasia (BPH) is a disease of the lower urinary tract which often requires surgical treatment. Recently, there has been a deluge of new treatment options, rarely validated or compared to current treatments on a benchtop model. The purpose of this review is to examine the literature and report which benchtop models are currently being used, which therapies have been tested on them, and what outcomes are being studied on each model.Recent FindingsThere are various benchtop models to choose from, each with their unique benefits and drawbacks. Perfused porcine kidney models are use...
Source: Current Urology Reports - November 9, 2023 Category: Urology & Nephrology Source Type: research
