Surgical Management of Peyronie’s Disease
We present a review of the disease process, preoperative evaluation, operative planning, surgical treatments with outcomes and complications, and nascent developments in surgical management and graft development. Options include tunical lengthening procedures, tunical shortening procedures, and penile prosthesis. Decision-making is governed by degree of curvature, erectile function, and associated penile deformities. In cases with curvature of less than 60–70 degrees, adequate penile length, and no hourglass deformity, patients are candidates for tunical shortening procedures. Patients with curvature greater than 60&...
Source: Current Urology Reports - August 15, 2014 Category: Urology & Nephrology Source Type: research

Robotic-Assisted Simple Prostatectomy: Is there Evidence to go Beyond the Experimental Stage?
Abstract Open simple prostatectomy (OSP) is an effective and durable treatment for select patients with symptomatic benign prostatic hyperplasia (BPH) and large-volume prostate glands (>80 cc), yet is associated with clinically significant risk of bleeding, transfusion, prolonged hospital length of stay (LOS), and complications. Robotic-assisted simple prostatectomy (RASP) potentially reduces intraoperative blood loss and improves perioperative outcomes. Thirteen non-comparative series (Level 3 evidence) of RASP have established its safety and efficacy and have demonstrated substantially decreased risk of...
Source: Current Urology Reports - August 14, 2014 Category: Urology & Nephrology Source Type: research

Lower Urinary Tract Symptoms in Women with Diabetes Mellitus: A Current Review
Abstract A literature review of the most current publications studying lower urinary tract symptoms (LUTS) and findings in diabetic women was conducted including articles from January 2013 to April 2014. Current reports consistently note that aging and obesity are significantly associated with worsened LUTS in diabetic women. Glucosuria has variable effects on urodynamic parameters and LUTS, but has a significant association with urinary tract infection (UTI) and incontinence at clinically relevant numbers, such as HbA1C values. The presence of severe nocturia in diabetic patients warrants careful surveillance fo...
Source: Current Urology Reports - August 14, 2014 Category: Urology & Nephrology Source Type: research

Neurogenic Bladder: from Diagnosis to Management
Abstract Patients with spinal cord injury (SCI) present with a wide range and variety of urologic manifestations, depending upon the level of injury. Historically, patients with spinal cord injury experienced significant mortality related to renal failure. Greater knowledge of the pathophysiology of SCI, however, has contributed to a reduction in mortality. It is essential to perform a thorough initial evaluation and regular follow-up of these patients to achieve the primary goal of preservation of renal function, with the secondary goal of optimizing the patient’s quality of life. (Source: Current Urology Reports)
Source: Current Urology Reports - August 14, 2014 Category: Urology & Nephrology Source Type: research

Optimizing Urology Group Partnerships: Collaboration Strategies and Compensation Best Practices
This article outlines collaboration strategies for creating an effective culture, governance, and leadership, and provides practical suggestions for optimizing the performance of the urology group practice. (Source: Current Urology Reports)
Source: Current Urology Reports - August 14, 2014 Category: Urology & Nephrology Source Type: research

The Evaluation and Management of Refractory Neurogenic Overactive Bladder
This article reviews the non-pharmacologic treatment options for neurogenic OAB, mainly botulinum toxin, neuromodulation, and lower urinary tract reconstruction, and discusses important relevant studies. (Source: Current Urology Reports)
Source: Current Urology Reports - August 14, 2014 Category: Urology & Nephrology Source Type: research

Impact of Alpha Blockers, 5-alpha Reductase Inhibitors and Combination Therapy on Sexual Function
Abstract Medical treatments for lower urinary tract symptoms due to benign prostatic hyperplasia are frequently associated with changes in sexual function. While these medications are generally well-tolerated and have both reduced and delayed more invasive surgical options, the ramifications of long-term chronic use are largely unknown. Sexual side effects of these medications are frequently either reported as part of a short-term initial drug study or have inflexible endpoints that are not able to gauge more subtle changes in sexual performance. This review will delineate the currently known effects of these med...
Source: Current Urology Reports - August 14, 2014 Category: Urology & Nephrology Source Type: research

UTIs in Patients with Neurogenic Bladder
Abstract Urinary tract infections (UTI) remain one of the most prevalent and frustrating morbidities for neurogenic bladder patients, and death attributed to urosepsis in the spinal cord injury (SCI) patient is higher when compared to the general population. Risk factors include urinary stasis, high bladder pressures, bladder stones, and catheter use. While classic symptoms of UTI include dysuria, increased frequency and urgency, neurogenic bladder patients present differently with increased spasticity, autonomic dysreflexia, urinary incontinence, and vague pains. Multiple modalities have been assessed for preven...
Source: Current Urology Reports - August 12, 2014 Category: Urology & Nephrology Source Type: research

Bladder Outlet Obstruction in Women: Functional Causes
Abstract Bladder outlet obstruction (BOO) in women has received less focus in the past, as compared with BOO in men; however, more recently, studies have further examined BOO and voiding dysfunction in women to define the various etiologies, diagnostic criteria, and treatment strategies. The differential diagnosis in women is broad and includes anatomic, neurologic, and functional etiologies. This review focuses on the functional etiologies, including dysfunctional voiding, Fowler’s syndrome, and primary bladder neck obstruction in adult women. (Source: Current Urology Reports)
Source: Current Urology Reports - July 25, 2014 Category: Urology & Nephrology Source Type: research

Evaluation and Management of Post-Transurethral Resection of the Prostate Lower Urinary Tract Symptoms
Abstract Transurethral resection of the prostate (TURP) continues to be the most common treatment in the operative management of benign prostatic hypertrophy (BPH). Several other modalities have shown equivalence to TURP. However, even after surgical treatment, up to one third of patients have bothersome lower urinary tract symptoms (LUTS). This review discusses the pathophysiology, evaluation, and management options for patients with LUTS after TURP. (Source: Current Urology Reports)
Source: Current Urology Reports - July 19, 2014 Category: Urology & Nephrology Source Type: research