Kidney Xenotransplantation: Are We Ready for Prime Time?
AbstractPurpose of ReviewWith the exponential increase in interest and great strides toward clinical application, many experts believe we are ready for kidney xenotransplant human trials. In this review, we will examine the obstacles overcome and those yet to be conquered, discussing the human trials performed and the questions they raised. Additionally, we will revisit overlooked aspects that may be crucial for improvements and suggest future approaches for xenotransplant research.Recent FindingsImproving survival in pig-to-non-human-primate models with the identification of an ideal immunosuppression regimen led to 3 cas...
Source: Current Urology Reports - April 22, 2023 Category: Urology & Nephrology Source Type: research
Selection and Outcomes for Dissolution Therapy in Uric Acid Stones: A Systematic Review of Literature
AbstractPurpose of ReviewThe prevalence of uric acid (UA) urolithiasis contributes significantly to global disease burden, due to high rates of recurrence and diagnostic challenges. Dissolution therapy plays a valuable role in the conservative management of UA calculi, reducing the requirement for surgical intervention. This review summarises the existing evidence for the efficacy of medical dissolution of uric acid urolithiasis.Recent FindingsA systematic search was conducted of worldwide literature according to PRISMA methodology and Cochrane standards for systematic review. Studies were included if they reported outcome...
Source: Current Urology Reports - April 20, 2023 Category: Urology & Nephrology Source Type: research
Outcomes of Paediatric Cystine Stone Management: Results of a Systematic Review
AbstractPurpose of ReviewWe wanted to analyse the outcomes of surgical (SWL, URS, PCNL) and medical management of cystine stones in the paediatric population in terms of stone-free status and complication rates, based on all the available literature evidence.Recent FindingsA systematic review of literature was performed for all studies with paediatric cystine stone management. Twelve studies met the eligibility criteria, of which 4 analysed outcomes of SWL, 2 of URS and 3 of PCNL and 3 focused on the effect of either alkalising agents (potassium citrate, citric acid) or cysteine-binding thiol (CBT) agents (tiopronin, penic...
Source: Current Urology Reports - April 20, 2023 Category: Urology & Nephrology Source Type: research
Role of the Renin –Angiotensin System Components in Renal Cell Carcinoma: A Literature Review
AbstractPurpose of ReviewThe physiological aspects of renin –angiotensin system (RAS) components are described in this review. Additionally, we present the main results of studies that could indicate an association between alterations in these components and cancer, particularly renal cell carcinoma (RCC).Recent FindingsThe RAS undergoes a series of homeostatic and modulatory processes that extend to hypertrophy, hyperplasia, fibrosis, and remodeling, as well as angiogenesis, pro-inflammatory responses, cell differentiation, stem cell programming, and hematopoiesis.SummaryThe link between cancer-related inflammation and ...
Source: Current Urology Reports - April 19, 2023 Category: Urology & Nephrology Source Type: research
Imaging Techniques to Determine Degree of Sarcopenia and Systemic Inflammation in Advanced Renal Cell Carcinoma
AbstractPurpose of ReviewThe purpose of this review is to provide an up-to-date understanding regarding the literature on sarcopenia and inflammation as prognostic factors in the context of renal cell carcinoma (RCC).Recent FindingsSarcopenia is increasingly recognized as a prognostic factor in RCC. Emerging literature suggests monitoring quantity of muscle on successive imaging and examining muscle density may be additionally informative. Inflammation has prognostic ability in RCC and is also considered a key contributor to development and progression of both RCC and sarcopenia. Recent studies suggest these two prognostic...
Source: Current Urology Reports - April 10, 2023 Category: Urology & Nephrology Source Type: research
Metastasis-Directed Therapy for Oligometastatic Castration-Sensitive Prostate Cancer: An Alternative to ADT?
AbstractPurpose of ReviewThe standard treatment of patients with metastatic prostate cancer is systemic treatment with androgen-deprivation therapy (ADT). The spectrum-based model of metastatic disease includes the presence of an oligometastatic state, an intermediary between localized and widespread metastatic disease, in which radical local treatment might improve systemic control. Our purpose is to review the literature on metastasis-directed therapy in the treatment of oligometastatic prostate cancer.Recent FindingsSeveral prospective clinical trials have reported improvements in ADT-free survival and progression-free ...
Source: Current Urology Reports - April 5, 2023 Category: Urology & Nephrology Source Type: research
Review of Active Surveillance in Underrepresented and High-Risk Populations: Feasibility and Safety
AbstractPurpose of ReviewThe purpose of this review is to investigate the current use and effectiveness of active surveillance (AS) for clinical low-risk prostate cancer (PCa) in men considered to be “high-risk” based on the factors of race, genetics, healthcare access, and socioeconomic status.Recent FindingsAdvances in molecular biomarkers and imaging have improved the detection, risk stratification, and treatment of PCa. Still, overdiagnosis and overtreatment of indolent disease remain a concern. AS is therefore the preferred option for clinical low-risk disease. Yet, because of the variability in PCa presentation b...
Source: Current Urology Reports - March 30, 2023 Category: Urology & Nephrology Source Type: research
Residency Surgical BPH Training Paradigms from MIST to HOLEP
AbstractPurpose of ReviewBenign prostatic hyperplasia (BPH) is a common medical condition of older men that often requires medical or surgical therapy. Surgical options for BPH have grown exponentially over the last two decades. The numerous options and/or lack of access to them can make it challenging for new trainees to gain proficiency. We examine the literature for available BPH surgical simulators, learning curves, and training pathways.Recent FindingsEach BPH surgical therapy has a learning curve which must be overcome. There is an abundance of TURP simulators which have shown face, content, and construct validity in...
Source: Current Urology Reports - March 22, 2023 Category: Urology & Nephrology Source Type: research
Advancing Urology Resident Surgical Autonomy
AbstractPurpose of ReviewThis paper aims to survey current literature on urologic graduate medical education focusing on surgical autonomy.Recent FindingsAffording appropriate levels of surgical autonomy has a key role in the education of urologic trainees and perceived preparedness for independent practice. Recent studies in surgical resident autonomy have demonstrated a reduction in autonomy for trainees in recent years. Efforts to advance the state of modern surgical training include creation of targeted curricula, enhanced with use of surgical simulation, and structured feedback.SummaryDecline in surgical autonomy for ...
Source: Current Urology Reports - March 14, 2023 Category: Urology & Nephrology Source Type: research
Single-Use Ureteroscopy and Environmental Footprint: Review of Current Evidence
This study found that a single-use flexible ureteroscope (LithoVueTM by Boston Scientific) generated an equivalent amount of carbon dioxide per case to a contemporary reusable flexible ureteroscope.SummaryLiterature concerning the environmental footprint of single-use ureteroscopy is worryingly lacking. No conclusions can be definitively drawn from a single study and further research is imperative given the global climate crisis and the significant contribution that healthcare services have to the environmental problem. (Source: Current Urology Reports)
Source: Current Urology Reports - March 14, 2023 Category: Urology & Nephrology Source Type: research
An Update of In Vivo Application of Artificial Intelligence and Robotics for Percutaneous Nephrolithotripsy: Results from a Systematic Review
AbstractPurpose of ReviewKidney puncture is a key step in percutaneous nephrolithotomy (PCNL). Ultrasound/fluoroscopic-guided access to the collecting systems is commonly used in PCNL. Performing a puncture is often challenging in kidneys with congenital malformations or complex staghorn stones. We aim to perform a systematic review to examine data on in vivo applications, outcomes, and limitations of using artificial intelligence and robotics for access in PCNL.Recent FindingsThe literature search was performed on November 2, 2022, using Embase, PubMed, and Google Scholar. Twelve studies were included. 3D in PCNL is usefu...
Source: Current Urology Reports - March 10, 2023 Category: Urology & Nephrology Source Type: research
Prostatitis: A Review
AbstractPurpose of ReviewPathologies of the prostate in men are one of the most prevalent clinical conditions today [1]. Specifically, pelvic inflammatory disease such as prostatitis can cause symptoms and syndromes different from urological ones, such as bowel or nervous system manifestations. This has a largely negative impact on the quality of life of patients. Therefore, it is convenient to know and update the information about the therapeutic approach to prostatitis, which is a challenge that involves different medical specialties. The aim of this article is to provide summarized and focused evidence to help in the th...
Source: Current Urology Reports - March 7, 2023 Category: Urology & Nephrology Source Type: research
Robotic-Assisted Surgery —a Highly Effective Modality for Vesicovaginal Fistula Repairs
AbstractPurpose of ReviewTo summarize recent experience with robotic vesicovaginal fistula repair and describe the contemporary technique.Recent FindingsRobotic vesicovaginal repair has been tested at multiple centers, with similar outcomes to open surgery. It has benefits including decreased hospital stay, less blood loss, and similar long-term outcomes. As long as the surgeon is experienced in robotic surgery, this technique appears to be promising.SummaryRobotic vesicovaginal repair results in similar outcomes to open surgery with decreased morbidity. (Source: Current Urology Reports)
Source: Current Urology Reports - March 1, 2023 Category: Urology & Nephrology Source Type: research
Ergonomic Considerations in Urologic Surgery
AbstractPurpose of ReviewThis paper aims to discuss the various work-related musculoskeletal disorders (WRMDs) among urologists and provide an overview of the latest recommendations to improve awareness of ergonomic principles that can be applied in the operating room, with special consideration of challenges faced during pregnancy.Recent FindingsUrologists suffer from a large burden of WRMDs. The main drivers of pain associated with the various surgical approaches include repetitive movements, static and awkward body positions, and the use of burdensome equipment. Pregnant surgeons are at an even greater risk of WRMDs and...
Source: Current Urology Reports - March 1, 2023 Category: Urology & Nephrology Source Type: research
Should Transperineal Prostate Biopsy Be the Standard of Care?
AbstractPurpose of ReviewWe reviewed the advantages and disadvantages of transperineal prostate biopsy (TP-bx) to evaluate its potential role as the standard of care for prostate biopsy.Recent FindingsStudies have suggested no difference in prostate cancer (PCa) detection rate between TP-bx and transrectal biopsy (TR-bx) but have suggested potentially increased detection of anterior prostate tumors. Advances in anesthetic technique have obviated the need for sedation thus allowing TP-bx to become an office-based procedure, which in turn can decrease the overall cost of TP-bx. Furthermore, given the low rate of infectious c...
Source: Current Urology Reports - March 1, 2023 Category: Urology & Nephrology Source Type: research
