Management of Chronic Bacterial Prostatitis
AbstractPurpose of ReviewWe conducted a review of the literature describing the most up-to-date diagnosis and treatment options of chronic bacterial prostatitis.Recent FindingsRecurrence after oral antimicrobial therapy is common, due in part to the rising rates of antimicrobial resistance and inability to completely clear the offending bacteria from the prostate following prostatitis. Recent literature has described various treatment options for chronic bacterial prostatitis refractory to conventional antimicrobial agents, including the use of alternative agents such as fosfomycin, direct antimicrobial injections into the...
Source: Current Urology Reports - June 3, 2020 Category: Urology & Nephrology Source Type: research

Update on Implantable PTNS Devices
AbstractPurpose of ReviewThere is growing evidence supporting the use of percutaneous tibial nerve stimulation to manage lower urinary tract symptoms (LUTS) such as urgency, frequency and urge incontinence, in a non-pharmacologic, minimally invasive approach. Given this, there is now an impetus to move this technology forward from an interval (i.e., weekly and/or monthly) toward a continuous dosing, using implantable devices. This review article focuses on the newest implantable devices and the most current data demonstrating safety and efficacy in the management of refractory overactive bladder.Recent FindingsThere are ne...
Source: Current Urology Reports - May 28, 2020 Category: Urology & Nephrology Source Type: research

Fluoroless Endourological Surgery for Stone Disease: a Review of the Literature —Tips and Tricks
AbstractPurpose of ReviewUrologists are at significant risk due to radiation exposure (RE) from endourological procedures for stone disease. Many techniques described have shown a reduction of RE. The purpose of this article is to review available protocols to decrease RE during such procedures and provide tips and tricks for their implementation.Recent FindingsSeveral low-radiation and radiation-free protocols for percutaneous nephrolithotomy and flexible ureteroscopy have been described as an attempt to reduce RE during surgery. Beginning with specific checklists to ensure adequate C-arm usage, fluoroless procedures are ...
Source: Current Urology Reports - May 23, 2020 Category: Urology & Nephrology Source Type: research

The Role of MRI in the Diagnosis of Pelvic Floor Disorders
This article provides an overview of MRI as a dynamic imaging modality as well as recent updates on the role of MRI in the evaluation of female pelvic floor disorders, including pelvic organ prolapse (POP), rectal prolapse, and defecatory dysfunction.Recent FindingsPelvic floor disorders in women are common, and demand for treatment is high. Recently, multidisciplinary guidelines for dynamic MRI have been published to reflect this need. Despite criticisms that MRI is an expensive modality, cost-analysis studies are demonstrating utility for MRI in surgical decision-making trees for patients at risk for treatment failure af...
Source: Current Urology Reports - May 15, 2020 Category: Urology & Nephrology Source Type: research

Correction to: Genomic Subtyping in Bladder Cancer
The original version of this article contained a mistake. The included Conflict of Interest statement was incorrect. (Source: Current Urology Reports)
Source: Current Urology Reports - May 14, 2020 Category: Urology & Nephrology Source Type: research

Systematic Review of Current Ultrasound Use in Education and Simulation in the Field of Urology
AbstractPurpose of the ReviewWe investigate articles in the literature published in the last 5  years (2014–2019) regarding ultrasound education in the specialty of urology.Recent FindingsUltrasound has been touted as the modern day stethoscope. Medical educational governing bodies have encouraged the incorporation of ultrasound in medical school education. However, in this review, we find that there are gaps in educational opportunities and standardization in residency and continuing education for urology practitioners. We have identified several new tools for procedure-specific training published in the last 5...
Source: Current Urology Reports - May 7, 2020 Category: Urology & Nephrology Source Type: research

Disparities in Bladder Cancer Outcomes Based on Key Sociodemographic Characteristics
AbstractPurpose of ReviewA review of the impact of several key patient characteristics on oncologic outcomes in bladder cancer (BC) summarized and analyzed in a narrative fashion.Recent FindingsThe bulk of the published literature suggests that females and blacks have poorer cancer-specific outcomes. Both groups tend to present with worse disease, which may be driven by differences in access to timely and quality care. Attempts to assess the association between smoking status and history and BC outcomes have been hindered by the quality and heterogeneity of the data, although several studies have linked smoking with higher...
Source: Current Urology Reports - May 7, 2020 Category: Urology & Nephrology Source Type: research

Preventing Lethal Prostate Cancer with Diet, Supplements, and Rx: Heart Healthy Continues to Be Prostate Healthy and “First Do No Harm” Part III
AbstractPurpose of ReviewTo discuss the overall and latest observations of the effect of diet, lifestyle, supplements, preventive vaccinations, and some prescription heart healthy medications for prostate cancer prevention within a 3-part series of publications.Recent FindingsThe concept of maximizing heart health to prevent aggressive prostate cancer continues to be solidified with additional prospective observational and randomized controlled trial data. Heart healthy is prostate healthy, but heart unhealthy is prostate unhealthy.SummaryThe primary goal for medical providers of reducing all-cause and cardiovascular disea...
Source: Current Urology Reports - May 4, 2020 Category: Urology & Nephrology Source Type: research

Role of Endourological Procedures (PCNL and URS) on Renal Function: a Systematic Review
AbstractPurpose of ReviewTo present the latest evidence related to the impact of ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) on the renal function.Recent FindingsOur review suggests that the overall renal function is not detrimentally affected by endourological interventions (URS, PCNL). This is however influenced by the preoperative renal function, presence of comorbidities such as diabetes and hypertension. For PCNL procedures, tract multiplicity, preoperative UTI, and postoperative bleeding also contribute to a decline in renal function.SummaryThis review suggests that endourological interventions do not ...
Source: Current Urology Reports - April 21, 2020 Category: Urology & Nephrology Source Type: research

Reducing Opioid Use After Endourologic Procedures
AbstractPurpose of ReviewSurgeons have played a significant role in the current opioid epidemic through overprescribing practices in the postoperative setting. However, contemporary efforts have helped to decrease opioid excess, particularly in the field of urology. Minimally invasive surgery offers a unique avenue to address overuse of narcotics in the postoperative period given its emphasis on enhanced recovery.Recent FindingsHistorically, the majority of the literature characterizing postoperative opioid use and its reduction has focused on non-urological surgery. However, recent studies have shown that patients undergo...
Source: Current Urology Reports - April 20, 2020 Category: Urology & Nephrology Source Type: research

Blue Light Cystoscopy: Indications and Outcomes
AbstractPurpose of ReviewIt has been firmly established that hexaminolevulinate-assisted blue light cystoscopy (HAL-BLC) reduces cancer recurrence rates. This review explores the impact of HAL-BLC on other meaningful outcomes in patients with bladder cancer, including disease progression, and earlier detection of disease at the time of surveillance cystoscopy.Recent FindingsA randomized clinical trial confirmed earlier implementation of HAL-BLC at the time of surveillance cystoscopy increased identification of cancerous lesions, including those of high grade, when compared with white light cystoscopy. In addition, the evid...
Source: Current Urology Reports - April 4, 2020 Category: Urology & Nephrology Source Type: research

Economic Considerations in the Management of Nephrolithiasis
AbstractPurpose of ReviewFrom health systems to individuals, nephrolithiasis is economically burdensome. The aim of the current paper is to characterize the financial burden of disease associated with nephrolithiasis with an emphasis on investigating treatment modality economic efficiency.Recent FindingsFor small volume practices and cases where there is high risk of scope damage, disposable flexible ureteroscope utilization seems to provide economic efficiency.SummaryThe rise in global prevalence of stone disease is a large contributing factor to increasing costs associated with nephrolithiasis. A large proportion of cost...
Source: Current Urology Reports - March 31, 2020 Category: Urology & Nephrology Source Type: research

Predictors of Urinary Infections and Urosepsis After Ureteroscopy for Stone Disease: a Systematic Review from EAU Section of Urolithiasis (EULIS)
AbstractPurpose of ReviewTo present the latest evidence related to the predictors of urinary tract infections (UTIs) and urosepsis after ureteroscopy (URS) for stone disease.Recent FindingsOur review suggests that almost half of all post-URS complications are related to infectious complications although reported rates of urosepsis were low. The use of antibiotic prophylaxis, treatment of pre-operative UTI, and low procedural time seem to reduce this risk. However, the risk is higher in patients with higher Charlson comorbidity index, elderly patients, female gender, long duration of pre-procedural indwelling ureteric stent...
Source: Current Urology Reports - March 24, 2020 Category: Urology & Nephrology Source Type: research

Correlation of Operative Time with Outcomes of Ureteroscopy and Stone Treatment: a Systematic Review of Literature
AbstractPurpose of ReviewTo present the latest evidence related to the impact of increased operative times in retrograde intrarenal surgery and identify possible important factors that can facilitate ureteroscopy procedures.Recent FindingsUreteroscopy constitutes the mainstay treatment of renal stones and is characterized by a huge variation in techniques and instrumentation. It has been suggested that increased operative times can mitigate the outcomes of the procedures by increasing complication rates. Nevertheless, little is known about the time limits, above which complications are likely to occur. Furthermore, complic...
Source: Current Urology Reports - March 24, 2020 Category: Urology & Nephrology Source Type: research

Preventing Lethal Prostate Cancer with Diet, Supplements, and Rx: Heart Healthy Continues to Be Prostate Healthy and “First Do No Harm” Part II
AbstractPurpose of ReviewTo discuss the overall and latest observations of the effect of diet, lifestyle, supplements, and some prescription heart healthy medications for prostate cancer prevention.Recent FindingsThe concept of maximizing heart health to prevent aggressive prostate cancer continues to be solidified with the addition of more prospective observational and randomized controlled trial data. Heart healthy is prostate healthy, and heart unhealthy is prostate unhealthy.SummaryThe primary goal of reducing the risk of all-cause and cardiovascular disease (CVD) morbidity and mortality also coincides with maximizing ...
Source: Current Urology Reports - March 18, 2020 Category: Urology & Nephrology Source Type: research

Genomic Subtyping in Bladder Cancer
AbstractPurpose of ReviewMolecular characterization of cancer allows us to understand oncogenesis and clinical  prognosis as well as facilitates development of biomarkers and treatment. Our aim was to review the current literature on genomic characterization of bladder cancer, and how far we are in implementing genomics into clinical practice.Recent FindingsBladder cancers are molecularly diverse tumors with a high mutational rate. On molecular level, bladder cancer can be categorized into at least six subtypes called luminal-papillary, luminal-unstable, luminal non-specified, basal-squamous, neuroendocrine-like, and ...
Source: Current Urology Reports - March 13, 2020 Category: Urology & Nephrology Source Type: research

Renal Procurement: Techniques for Optimizing the Quality of the Graft in the Cadaveric Setting
AbstractPurpose of ReviewKidney transplantation is the best treatment for end-stage renal disease. However, due to organ shortage, suboptimal grafts are increasingly being used.Recent FindingsWe carried out a review on the methods and techniques of organ optimization in the cadaveric setting.SummaryDonor care is the first link in a chain of care. Right after brain death, there is a set of changes, of which hormonal and hemodynamic changes are the most relevant. Several studies have been conducted to determine which drugs to administer, although in most cases, the results are not definitive. The main goal seems rather achie...
Source: Current Urology Reports - March 13, 2020 Category: Urology & Nephrology Source Type: research

Orthotopic Renal Transplantation: Indication, Technique and Outcomes
AbstractPurpose of ReviewNowadays many ESRD patients awaiting kidney transplantation have known unsuitable iliac vessels for vascular anastomosis, due to severe atheromatosis, occupied iliac fossa, or other uncommon vascular abnormalities. In these cases, orthotopic kidney transplantation (OKT) could be the solution.Recent FindingsSince the update on OKT published in 2010, no more large series have been reported. Some small series or case reports being described in the literature. The orthotopic position has shown good recipient and graft results with acceptable complication rate in selected patients. This technique permit...
Source: Current Urology Reports - March 13, 2020 Category: Urology & Nephrology Source Type: research

Cadaveric Models for Renal Transplant Surgery Education: a Comprehensive Review
AbstractPurpose of ReviewTo evaluate the utility of cadaveric models for kidney transplant (KT) surgery training.Recent FindingsMedline ® and PubMed® databases were searched for English and Spanish language articles published describing different learning models used in KT formation. We evaluated the use of cadavers preserved by Thiel’s embalming method (TEM) as KT simulation models. Students were divided in groups of 4 people: four trainees mentored by an expert in KT surgery. Among the trainees were surgical residents and low-experience surgeons. A total of 39 TEM preserved bodies were used, of which 75 via...
Source: Current Urology Reports - March 13, 2020 Category: Urology & Nephrology Source Type: research

Urinary microRNAs: Looking for a New Tool in Diagnosis, Prognosis, and Monitoring of Renal Cancer
AbstractPurpose of ReviewRenal cell carcinoma (RCC) is the third most common urologic malignancy. First symptoms are usually unspecific and belated causing the stages to be high when diagnosed. As compensation, incidental detection of RCC by abdominal imaging techniques for other medical purposes is a reality that favours a decrease in the stage of new diagnosed tumours. Therefore, identifying novel predictive biomarkers for diagnosis, progression and prognosis of RCC is fundamental.Recent FindingsTo date, several studies have demonstrated that microRNAs (miRNAs) play a role in the particular scenario of urologic tumors, a...
Source: Current Urology Reports - March 13, 2020 Category: Urology & Nephrology Source Type: research

Beyond the Limits: How to Avoid a Surgical Nightmare in the Third and Subsequent Renal Transplantation Procedures
AbstractPurpose of ReviewApproximately, 25% of the patients with ESRD will enter the waiting list for kidney transplantation. Among these patients, almost 15% will require a retransplantation surgery. This review aims to summarize the most recent information on different controversial issues regarding retransplantation, to provide the reader with a clear and updated view on the topic.Recent FindingsDespite current evidence is mainly based on retrospective, small, single-center experiences, it seems clear that retransplantation remains a surgical and immunological challenge, for which the perioperative management still rema...
Source: Current Urology Reports - March 13, 2020 Category: Urology & Nephrology Source Type: research

Management of Renal Cell Carcinoma and Other Renal Masses in the Kidney Graft
AbstractPurpose of ReviewRenal masses in the kidney graft pose an important clinical dilemma, balancing graft function against the need for cancer control.Recent FindingsDonor origin cancers in the renal graft can be classified as ‘donor transmitted’ or ‘donor derived’. The landmark TracerX Renal changed our understanding of renal cell carcinoma oncogenesis, demonstrating that key mutations in childhood lead to clinically apparent tumours in later life. Identified pre-operatively, contemporary evidence suggests that m asses excised prior to transplantation result in acceptable oncologic safety and g...
Source: Current Urology Reports - February 11, 2020 Category: Urology & Nephrology Source Type: research

Troubleshooting Complex Vascular Cases in the Kidney Transplant Recipient: Vascular Anomalies, Challenging Vessel Diseases, and Procedural Disasters
AbstractPurpose of ReviewTo update the most relevant literature regarding complex cases during kidney transplant setting that recipient presents by himself, especially during implantation surgery due to vascular diseases and/or urinary tract anomalies.Recent FindingsIncreasing age of donors and recipients is leading to an increased complexity of kidney transplant implantation surgery. In addition, the high peripheral vascular disease prevalence worldwide increases difficulty of surgery and decreases long-term outcomes as well. Moreover, it also increases transplant morbidity and mortality, both overall and cardiovascular, ...
Source: Current Urology Reports - February 4, 2020 Category: Urology & Nephrology Source Type: research

Which Type of Water Is Recommended for Patients with Stone Disease (Hard or Soft Water, Tap or Bottled Water): Evidence from a Systematic Review over the Last 3 Decades
AbstractPurpose of ReviewThe role of the mineral constituents in water and their role in kidney stone disease (KSD) have been a long-standing subject of debate. The aim of our systematic review was to evaluate the relevance of different types of water in stone disease.Recent FindingsStudies to date have had varying results regarding the importance of hardness of water which is mostly determined by its calcium content. Other elements including magnesium and bicarbonate also play a crucial role in prevention of renal stones. Patients with stone disease are provided varying advice due to a lack of consensus on the types of wa...
Source: Current Urology Reports - February 3, 2020 Category: Urology & Nephrology Source Type: research

Troubleshooting Complex Vascular Cases in the Kidney Graft: Multiple Vessels, Aneurysms, and Injuries During Harvesting Procedures
AbstractPurpose of the ReviewTo update the most relevant literature regarding complex vascular cases in kidney transplant setting involving the graft, especially during the harvesting procedure and back-table preparation from the subsequent implant.Recent FindingsChallenging situations affecting the kidney graft such as multiple vessels, renal artery aneurysms, kidney anatomical anomalies, or major injuries do not contraindicate the transplant, but require an exhaustive graft viability assessment and several bench surgery techniques. Graft vessel conditioning in the back-table might include simple anastomosis between them,...
Source: Current Urology Reports - January 31, 2020 Category: Urology & Nephrology Source Type: research

Kidney Transplantation in Transgender Patients
AbstractPurpose of ReviewKidney transplantation and gender affirmation treatments are becoming increasingly more prevalent due to advances in technology. However, there is a paucity of data regarding kidney transplantation in transgender patients. Interesting considerations must be made in this patient population, since there are many hormonal interactions with kidney function and the transplantation process.Recent FindingsThe diagnosis of estimated glomerular filtration rate (eGFR), preoperative assessment/counseling, decreased testosterone levels in a transgender male to female patient, increased estrogen/progesterone in...
Source: Current Urology Reports - January 18, 2020 Category: Urology & Nephrology Source Type: research

Pelvic Surgery in the Transplant Recipient: Important Considerations for the Non-transplant Surgeon
AbstractPurpose of ReviewClassically, kidney transplantation (KT) consists of heterotopic implantation of the renal graft in the iliac fossa with vascular anastomosis on the iliac vessel and reimplantation of the graft ureter in the bladder of the recipient. However, a wide range of variations exist in both vascular anastomosis and urinary diversion that the non-transplant surgeon should know.Recent FindingsFor any pelvic surgery in a KT patient, the non-transplant surgeon should preoperatively evaluate the anatomy of the graft, its vascularization and its urinary tract. The transplant ureter should be identified and secur...
Source: Current Urology Reports - January 18, 2020 Category: Urology & Nephrology Source Type: research

The Ureter in the Kidney Transplant Setting: Ureteroneocystostomy Surgical Options, Double-J Stent Considerations and Management of Related Complications
AbstractPurpose of ReviewIn the setting of kidney transplantation, the ureter is a common source for complications. As a result, prevention of ureteral complications and their management is of crucial importance. In this context, the purpose of this review is to summarize recent literature on the ureter in the kidney transplant setting with a special focus on new findings. We conducted a PubMed and Medline search over the last 10  years to identify all new publications related to ureteroneoimplantations, stents and management of complications in the kidney transplant setting.Recent FindingsPerformance of the “Li...
Source: Current Urology Reports - January 18, 2020 Category: Urology & Nephrology Source Type: research

The Failing Kidney Transplant Allograft. Transplant Nephrectomy: Current State-of-the-Art
AbstractPurpose of ReviewThis review provides a critical literature overview of the risks and benefits of transplantectomy in patients with a failed allograft. Additionally, it offers a summary of related problems, primarily alloantibody sensitization in the event of nephrectomy and immunosuppression weaning.Recent FindingsTransplant nephrectomy has high morbidity and mortality rates. The morbidity of transplant nephrectomy (4.3 to 82%) is mostly due to hemorrhage or infection. Mortality rates range from 1.2 to 39%, and most are due to sepsis. Transvascular graft embolization has been described as a less invasive alternati...
Source: Current Urology Reports - January 18, 2020 Category: Urology & Nephrology Source Type: research

Novel Education and Simulation Tools in Urologic Training
AbstractPurpose of ReviewPostgraduate medical training has evolved considerably from an emphasis on hands-on, autonomous learning to a paradigm where simulation technologies are used to introduce and augment certain skill sets. This review is intended to provide an update on surgical simulators and tools for urological trainee education.Recent FindingsWe provide an overview of simulation platforms for robotics, endoscopy, and laparoscopic practice and training. In general, these simulators provide face, content, and construct validity. Various educational and evaluation tools have been adopted.SummarySimulation platforms h...
Source: Current Urology Reports - November 28, 2019 Category: Urology & Nephrology Source Type: research

Variant Histology in Bladder Cancer —Current Understanding of Pathologic Subtypes
AbstractPurpose of ReviewUrothelial carcinomas (UC) are characterized by variant morphologies. However, the diagnosis of these variants can be challenging, in part due to their evolving diagnostic criteria. This review discusses the diagnostic criteria, molecular features, and prognostic implications of the UC variants. Evolving subtypes of UC are also briefly discussed.Recent FindingsThe WHO 2016 classification of tumors of the urinary system has refined the morphologic criteria for the diagnosis of UC variants. Many of these follow a more aggressive clinical course, but conclusive data on their effect on survival are lac...
Source: Current Urology Reports - November 28, 2019 Category: Urology & Nephrology Source Type: research

Current Clinical Trials in Non-muscle-Invasive Bladder Cancer: Heightened Need in an Era of Chronic BCG Shortage
AbstractPurpose of ReviewBCG is the gold standard agent used in high-risk non-muscle-invasive bladder cancer (NMIBC) that is amenable to bladder sparing management. However, recent BCG shortages appear to be a chronic problem. There are limited effective intravesical options in lieu of BCG or in patients in whom BCG is not effective. This review aims to highlight emerging bladder sparing therapies and trials for NMIBC.Recent FindingsPatients with high-risk NMIBC who do not respond to BCG are at increased risk for progression and death from bladder cancer. There are a variety of clinical trials exploring different therapeut...
Source: Current Urology Reports - November 28, 2019 Category: Urology & Nephrology Source Type: research

Radical Cystectomy in Female Patients - Improving Outcomes
AbstractPurpose of ReviewTo review the methods of improving surgical, oncological, and functional outcomes in women with bladder cancer treated with radical cystectomy.Recent FindingsΟrthotopic urinary diversion (ONB) is a safe option for well-selected women as it combines high rates of daytime and nighttime continence with exceptional oncologic outcomes. It is considered safe even for patients with limited lymph node disease and trigone involvement, as long as a preoperative b iopsy of the bladder neck or an intraoperative frozen section analysis of distal urethral margin rules out malignant disease. Nerve-sparing...
Source: Current Urology Reports - November 28, 2019 Category: Urology & Nephrology Source Type: research

High-grade T1 Urothelial Carcinoma: Where Do We Stand?
AbstractPurpose of ReviewBladder cancer is a deadly and common malignancy, with 24% of new cases presenting as T1 disease. High-grade T1 in particular represents a difficult entity to treat due to its clinical variability and known risks of recurrence, progression, and cancer-specific mortality. The differences in guidelines from major urologic organizations underscore this variability, and the past year has seen another BCG shortage, further complicating management. Advances have been made in the molecular and genomic characterization of high-grade T1, and new clinical trials are available to investigate alternative thera...
Source: Current Urology Reports - November 28, 2019 Category: Urology & Nephrology Source Type: research

Urology Milestones 2.0: The Future Looks Bright
AbstractPurpose of ReviewOne of the major functions of the Accreditation Council for Graduate Medical Education (ACGME) is to accredit all approved residency programs. This accreditation system is based on both common and program-specific requirements that form the foundation of all ACGME-accredited training programs. Embedded within the program requirements are the essential elements of the Competencies and Milestones. In this review article, we hope to provide the reader with an overview of the current Milestones and a preview of what lies ahead.Recent FindingsMilestones for resident education were implemented approximat...
Source: Current Urology Reports - November 28, 2019 Category: Urology & Nephrology Source Type: research

Imaging in Localized Bladder Cancer: Can Current Diagnostic Modalities Provide Accurate Local Tumor Staging?
AbstractPurpose of ReviewLocal tumor staging is paramount in the evaluation and management of bladder cancer. While neoadjuvant chemotherapy (NAC) followed by radical cystectomy and urinary diversion remains the gold standard for management of muscle-invasive bladder cancer, bladder-sparing regimens involving systemic chemotherapy and pelvic radiotherapy remain a viable option for select patients. Moreover, pre-cystectomy identification of patients with a complete response to NAC may obviate the need for radical cystectomy, but accurate post-therapy staging can be difficult to achieve. Contemporary imaging techniques may p...
Source: Current Urology Reports - November 28, 2019 Category: Urology & Nephrology Source Type: research

The AUA Curriculum for Medical Students: Current Resources and Developments
AbstractPurpose of ReviewTo summarize the advancements and offerings of the American Urological Association ’s (AUA) Medical Student Education Committee (MSEC).Recent FindingsThe AUA MSEC is focused on advocating for urologic education in medical schools by promoting core principles and practices in urology. The origins of the MSEC go back to 2008. With comprehensive support from the AUA Office of Education, the MSEC continues to refine and expand the resources available for medical students through the AUA Medical Student Curriculum website.SummaryThe AUA Medical Student Curriculum website offers a repository of res...
Source: Current Urology Reports - November 28, 2019 Category: Urology & Nephrology Source Type: research

Early Vs. Expectant Management of Spina Bifida Patients —Are We All Talking About a Risk Stratified Approach?
AbstractPurpose of ReviewAdvancements in the care of patients affected by myelomeningocele have flourished in recent years especially with respect to renal preservation and continence. Involvement of urologists both prenatally and early in life has driven many developments in preventative care and early intervention. As of yet, however, the ideal management algorithm that offers these patients the least invasive diagnostic testing and interventions while still preserving renal and bladder function remains ill defined.Recent FindingsIn a shift from prior years where the use of surgical intervention and intermittent catheter...
Source: Current Urology Reports - November 16, 2019 Category: Urology & Nephrology Source Type: research

Pituitary Dysfunction Among Men Presenting with Hypogonadism
AbstractPurpose of ReviewHypogonadism is a common endocrine dysfunction. This review focuses on the most up-to-date guideline for evaluation of pituitary function among men presenting with signs and symptoms of hypogonadism.Recent FindingsThe clinician must differentiate between primary (testicular) and secondary (pituitary-hypothalamic or central) hypogonadisms and be aware of adult-onset hypogonadism. If gonadotropins are low or inappropriately normal, the clinician must consider potential reversible causes in the hypothalamus-pituitary axis. Also, it is critical to understand the pitfalls of testosterone testing. When c...
Source: Current Urology Reports - November 16, 2019 Category: Urology & Nephrology Source Type: research

Advanced Imaging in Female Infertility
AbstractPurpose of ReviewThis review highlights the role of imaging in the diagnosis and management of reproductive disorders. The additional information that imaging studies can contribute to reproductive medicine is emphasized, including the role of pelvic ultrasonography (US, including sonohysterography and contrast-enhanced hysterosalpingosonography), hysterosalpingography (HSG), and magnetic resonance imaging (MRI) of the female reproductive tract. In addition, the implications of congenital causes of infertility on the urinary tract in females are reviewed.Recent Findings SummaryWhile the evaluation of infertility in...
Source: Current Urology Reports - November 16, 2019 Category: Urology & Nephrology Source Type: research

Management Strategies for Nocturia
AbstractPurpose of ReviewNocturia is defined as awakening due to the desire to void during a period of intended sleep. The pathophysiology of nocturia is multifactorial and management remains a challenge. Herein, we provide an overview of the management strategies for nocturia and summarize the existing evidence for treatment of nocturia across the condition ’s broad etiologic categories: nocturnal polyuria, diminished bladder capacity, and global polyuria.Recent FindingsTreatment should begin with behavioral modification. A high level of evidence supports the efficacy of desmopressin in the treatment of nocturnal po...
Source: Current Urology Reports - November 9, 2019 Category: Urology & Nephrology Source Type: research

Female Urethral Strictures: Review of Diagnosis, Etiology, and Management
AbstractPurpose of ReviewIn this review, we describe the incidence, diagnosis, and management of urethral strictures in women.Recent FindingsDefinitive repair of urethral strictures in women traditionally utilizes vaginal and labial flaps. Oral mucosal buccal graft urethroplasty also has high success rates, with larger series demonstrating feasibility and durability.SummaryUrethral strictures in women are very rare. When they do occur, they are often difficult to diagnose, requiring a high index of suspicion. Women with urethral strictures often present with symptoms of obstructed urinary flow, such as incomplete emptying,...
Source: Current Urology Reports - November 8, 2019 Category: Urology & Nephrology Source Type: research

Contrast-Enhanced Ultrasound in Renal Imaging and Intervention
AbstractPurpose of ReviewIn recent years, there has been renewed interest in the use of contrast-enhanced ultrasound (CEUS) in abdominal imaging and intervention. The goal of this article is to review the practical applications of CEUS in the kidney, including renal mass characterization, treatment monitoring during and after percutaneous ablation, and biopsy guidance.Recent FindingsCurrent evidence suggests that CEUS allows accurate differentiation of solid and cystic renal masses and is an acceptable alternative to either computed tomography (CT) or magnetic resonance imaging (MRI) for characterization of indeterminate r...
Source: Current Urology Reports - October 17, 2019 Category: Urology & Nephrology Source Type: research

The Use of Social Media in Pediatric Urology —Forging New Paths or Crossing Boundaries?
AbstractPurpose of ReviewThere has been a remarkable change in how people connect, access, and share professional and medical information over social media. This perspective article describes opportunities, potential pitfalls, and guidelines for social media use by pediatric urology providers.Recent FindingsPediatric urologists have effectively used social media to connect and share expertise, augment scientific conference participation, promote themselves and their research, disseminate guidelines and best practices, participate in virtual journal clubs, and engage with patients and their families. Information shared over...
Source: Current Urology Reports - October 16, 2019 Category: Urology & Nephrology Source Type: research

Management of Pelvic Organ Prolapse After Radical Cystectomy
This article explores the anatomy, management options, and outcomes of pelvic organ prolapse with a female cystectomy patient.Recent FindingsThere is a lack of data on surgical management outcomes for prolapse following radical cystectomy. However, most case series from tertiary referral centers show reasonable results irrespective of route of repair. As expected, the surgical planes and the reorientation of the bowel loop for urinary diversion makes any pelvic reconstruction a potential hazard and requires a high level of expertise and counseling to the patient in regard to the management of expectations.SummaryPelvic org...
Source: Current Urology Reports - October 15, 2019 Category: Urology & Nephrology Source Type: research

Prolapse Repair Using Non-synthetic Material: What is the Current Standard?
AbstractPurpose of ReviewDue to recent concerns over the use of synthetic mesh in pelvic floor reconstructive surgery, there has been a renewed interest in the utilization of non-synthetic repairs for pelvic organ prolapse. The purpose of this review is to review the current literature regarding pelvic organ prolapse repairs performed without the utilization of synthetic mesh.Recent FindingsNative tissue repairs provide a durable surgical option for pelvic organ prolapse. Based on recent findings of recently performed randomized clinical trials with long-term follow-up, transvaginal native tissue repair continues to play a...
Source: Current Urology Reports - October 14, 2019 Category: Urology & Nephrology Source Type: research

Urology in Undergraduate Medical Education
The objective of this article is to review the current state of exposure to urology in medical school, to discuss why it is critical to maintain a urology curriculum, and to review methods in establishing an effective curriculum for all students with limited resources.Recent FindingsUME curriculum in urology should be geared toward the widest group of students, namely those entering primary care or internal medicine, where patients with urologic complaints are most likely to first present. Hands-on teaching should focus on skills such as the genitourinary exam and Foley catheter placement, while ancillary modules should be...
Source: Current Urology Reports - October 12, 2019 Category: Urology & Nephrology Source Type: research

Renal Cell Carcinoma: the Oncologist Asks, Can PSMA PET/CT Answer?
AbstractPurpose of ReviewTo critically review the potential clinical applications of prostate-specific membrane antigen (PSMA) radioactive ligands in renal cell carcinoma (RCC).Recent FindingsRadioactive probes targeting PSMA hold promise in several malignancies in addition to prostate cancer, owing to the expression of PSMA by tumor neovasculature. The majority of clear cell RCCs (ccRCC), the most malignant RCC subtype, express PSMA on tumor-associated neovasculature. The endothelium of less aggressive RCC subtypes is PSMA positive in a lower, but still significant percentage of cases. PSMA might therefore represent an in...
Source: Current Urology Reports - October 11, 2019 Category: Urology & Nephrology Source Type: research

Neobladder-Vaginal Fistula: Surgical Management Techniques
AbstractPurpose of ReviewTo describe the complexities of diagnosis and management of neobladder-vaginal fistula (NVF) following orthotopic urinary diversion in women.Recent FindingsMultiple recent single-institution series confirm the variability of outcomes for NVF repairs and caution regarding comorbid stress urinary incontinence which may necessitate further interventions including conversion to alternate diversions.SummaryAlthough both abdominal and transvaginal approaches have been advocated for surgical management of NVF, contemporary series from reconstructive surgeons favor a vaginal approach to decrease overall op...
Source: Current Urology Reports - October 10, 2019 Category: Urology & Nephrology Source Type: research

The Microbiome and Prostate Cancer Risk
AbstractPurpose of the ReviewThere is an abundance of evidence that the human microbiome plays an important and nuanced role in controlling human metabolism, immunity, and cancer. Herein we aim to review the most current research looking at prostate cancer and its link with the gut and genitourinary microbiome.Recent Findings SummaryThere is now a host of evidence for a unique genitourinary (GU) microbiome. The prostate microbiota, to include viral, bacterial, fungal, and parasitic contributions, as assessed from formalin-fixed tissue is described nicely in the study by Banerjee et al. Further hierarchical analysis by this...
Source: Current Urology Reports - September 7, 2019 Category: Urology & Nephrology Source Type: research