The Role of Imaging in the Diagnosis, Staging, Response to Treatment, and Surveillance of Patients with Germ Cell Tumors of the Testis.
This article reviews the indications for imaging and performance characteristics of modalities in the diagnosis, staging, surveillance, and follow-up of patients with GCTs. We also highlight the current guideline recommendations for imaging in treatment of patients with GCTs. PMID: 31277727 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Thomas LJ, Brooks MA, Stephenson AJ Tags: Urol Clin North Am Source Type: research

Management of Primary Testicular Tumor.
Abstract In any man with a solid testicular mass, cancer should be considered until proven otherwise. Radical inguinal orchiectomy is the treatment of choice in patients with testis mass. Placement of a testicular prosthesis is safe with a very low complication rate and should be offered to all patients undergoing radical orchiectomy. In patients with widespread or life-threatening advanced disease, delayed orchiectomy following chemotherapy is recommended. Testis-sparing surgery can be performed in highly selected patients with solitary testicle mass, bilateral testicular tumors, or strong suspicion of a benign l...
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Ghoreifi A, Djaladat H Tags: Urol Clin North Am Source Type: research

Preservation of Fertility in Testis Cancer Management.
This article outlines testicular cancer and its treatment's effects on fertility, fertility preservation options, and barriers to accessing this specialized care. PMID: 31277729 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Sineath RC, Mehta A Tags: Urol Clin North Am Source Type: research

Management of Clinical Stage I Germ Cell Tumors.
Abstract Experience demonstrates multiple paths to cure for patients with clinical stage I testicular cancer. Because all options should provide a long-term disease-free rate near 100%, overall survival is no longer relevant in decision making, allowing practitioners to factor in quality of life, toxicity, cost, and impact on compliance. Surveillance for clinical stage I seminoma and clinical stage I nonseminoma has become the preferred option. The contrarian view is that a risk-adapted approach should persist, with surveillance for low-risk individuals and active therapy high-risk individuals. However, results ob...
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Roth BJ Tags: Urol Clin North Am Source Type: research

Management of Stage II Germ Cell Tumors.
This article discusses contemporary management strategies for stage II GCTs, including chemotherapy, radiotherapy, retroperitoneal lymph node dissection (RPLND), and surveillance. Patient selection, histology, and extent of lymphadenopathy drive management, and, as both treatment and detection strategies continue to emerge and be refined, the management of patients with stage II GCT continues to evolve. PMID: 31277731 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Ghandour RA, Singla N, Bagrodia A Tags: Urol Clin North Am Source Type: research

Current Management of Disseminated Germ Cell Tumors.
This article reviews the evidence supporting its use as well as common alterations based on prognostic grouping or contraindications to bleomycin. Special topics around the management of intermediate/poor prognosis choriocarcinoma and brain metastases are included. The management of residual masses for both seminoma and nonseminoma is discussed as well as long-term follow-up care of patients. Finally, the management of relapsed disseminated GCT is addressed. PMID: 31277732 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Lavoie JM, Kollmannsberger CK Tags: Urol Clin North Am Source Type: research

Indications for Surgery in Disseminated Seminoma.
Abstract Seminoma is commonly diagnosed in young men, and it has therefore become a disease of long-term survivors. As the late toxic effects of radiation and chemotherapy are better understood, it is becoming imperative to focus management advancements on reducing exposure to toxic agents. Retroperitoneal lymph node dissection (RPLND) currently is indicated as a salvage procedure in postchemotherapy patients with residual masses. Primary RPLND currently is being further explored in patients with clinical stage IA and clinical stage IB disease in 2 prospective studies. PMID: 31277734 [PubMed - in process] (So...
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Pierorazio PM, Biles MJ Tags: Urol Clin North Am Source Type: research

The Role of Robotic Retroperitoneal Lymph Node Dissection for Testis Cancer.
Abstract Retroperitoneal lymph node dissection (RPLND) is complex; however, recent advances in technology have allowed adoption of the robotic platform for highly select cases. Initial case series have shown improved cosmesis, less blood loss, and decreased length of stay compared with open RPLND. Our preference for performing robotic RPLND is via a transperitoneal approach with the patient in the supine position, thus facilitating a bilateral template dissection identical to that used in all our open procedures. Robotic RPLND should mimic the open approach with regard to oncologic principles and should only be pe...
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Klaassen Z, Hamilton RJ Tags: Urol Clin North Am Source Type: research

Complications of Retroperitoneal Lymph Node Dissection.
This article discusses the known surgical complications related to this operation and their relative incidence reported throughout the literature. PMID: 31277737 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Cary C, Foster RS, Masterson TA Tags: Urol Clin North Am Source Type: research

High-Dose Chemotherapy and Autologous Stem Cell Transplant.
This article reviews the current knowledge on high-dose chemotherapy (HDCT) and stem cell transplant for salvage treatment of patients with relapsed metastatic GCT. Furthermore, the authors attempt to dissect the controversy of using standard-dose versus high-dose therapy as initial salvage and identify patients who are most likely to benefit from HDCT and peripheral blood stem cell transplant. PMID: 31277738 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Adra N, Abonour R Tags: Urol Clin North Am Source Type: research

MicroRNAs as Biomarkers for Germ Cell Tumors.
Abstract Two clusters of microRNAs have been discovered highly expressed by seminoma and nonseminoma germ cell tumors. They are secreted in blood of patients with testicular germ cell tumors and can be extracted from the serum or plasma and quantified by real-time-polymerase chain reaction. Results have confirmed the feasibility of the technique and demonstrated that sensitivity and specificity of those microRNAs in detecting viable germ cell tumors are higher than with current methods. If operation characteristics are confirmed in larger studies, those microRNAs will be valuable to manage equivocal clinical scena...
Source: The Urologic Clinics of North America - July 7, 2019 Category: Urology & Nephrology Authors: Nappi L, Nichols C Tags: Urol Clin North Am Source Type: research

Next-Generation Fiberoptic and Digital Ureteroscopes.
This article provides an overview on emerging technologies in the light of past achievements, current limitations, and possible future directions. Instrument size reduction, pressure and temperature control, active suction of stone dust, multiple-axis tip deflection, variable working channel positions, robotics, ergonomics, image quality, enhanced imaging technology, three-dimensional visualization, and the competition between reusable and single-use ureteroscopes are detailed. The twentieth century has opened an exciting path for future discoveries in ureteroscopy. PMID: 30961849 [PubMed - indexed for MEDLINE] (Sourc...
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Keller EX, De Coninck V, Traxer O Tags: Urol Clin North Am Source Type: research

Single-Use Ureteroscopes.
Abstract A PubMed search using the terms "single use" and "ureteroscope" was performed to identify published studies on this topic. In addition, the abstracts of the annual meeting of the World Congress of Endourology and the American Urologic Association since 2010 were reviewed. Here we present a review of published studies on single-use ureteroscopes. PMID: 30961850 [PubMed - indexed for MEDLINE] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Moore B, Proietti S, Giusti G, Eisner BH Tags: Urol Clin North Am Source Type: research

Innovations in Disposable Technologies for Stone Management.
Abstract Disposable stone retrieval devices are an inherent element of modern-day stone management. Efforts are being made in several different areas to improve the efficiency of stone removal. Ureteral access sheaths with pressure control features as well as suction capabilities are being explored as one such mechanism. Additional efforts are being made to improve stone basket design, grasping capabilities, and deployment mechanisms. Finally, bioadhesives are being developed to potentially improve the capability to extract otherwise difficult small stone fragments and debris from the kidney. PMID: 30961851 [...
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Khaleel SS, Borofsky MS Tags: Urol Clin North Am Source Type: research

Laser Fibers for Holmium:YAG Lithotripsy: What Is Important and What Is New.
Abstract Holmium:YAG laser is currently the dominant lithotripter used during retrograde intrarenal surgery. The laser energy is delivered to the target via flexible optical laser fibers. The performance characteristics of laser fibers vary. The diameter, flexibility, resistance to fracture with bending, and tip configuration are all important factors that contribute to a fiber's overall performance. Understanding these characteristics assists the end user with proper fiber selection for procedures. PMID: 30961852 [PubMed - indexed for MEDLINE] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Knudsen BE Tags: Urol Clin North Am Source Type: research

Emerging Technologies in Ultrasonic and Pneumatic Lithotripsy.
This article discusses the mechanisms of basic pneumatic and ultrasonic devices, and examines the data regarding current and novel combination lithotrites. PMID: 30961854 [PubMed - indexed for MEDLINE] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Wollin DA, Lipkin ME Tags: Urol Clin North Am Source Type: research

Emerging Technologies in Lithotripsy.
Abstract This comprehensive review updates the advances in extracorporeal lithotripsy, including improvements in external shockwave lithotripsy and innovations in ultrasound based lithotripsy, such as burst wave lithotripsy, ultrasonic propulsion, and histotripsy. Advances in endoscopic technology and training have changed the surgical approach to nephrolithiasis; however, improvements and innovations in extracorporeal lithotripsy maintain its status as an excellent option in appropriately selected patients. PMID: 30961855 [PubMed - indexed for MEDLINE] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Large T, Krambeck AE Tags: Urol Clin North Am Source Type: research

New Technologies to Aid in Percutaneous Access.
This article provides a high-level overview of recent advances in percutaneous renal access. The techniques are organized based on approach (antegrade or retrograde) and the imaging modality used, such as fluoroscopy, ultrasonography, computed tomography, and other novel techniques (laser, electromagnetic, and robotics). PMID: 30961856 [PubMed - indexed for MEDLINE] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Hajiha M, Baldwin DD Tags: Urol Clin North Am Source Type: research

Innovations in Ureteral Stent Technology.
This article reviews recent technological advances in stent design and how they have attempted to tackle issues that urologists and patients face with ureteral stents. PMID: 30961857 [PubMed - indexed for MEDLINE] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Forbes C, Scotland KB, Lange D, Chew BH Tags: Urol Clin North Am Source Type: research

New Imaging Techniques in the Management of Stone Disease.
This article reviews innovations in imaging technology in the contemporary management of urinary stone disease. PMID: 30961858 [PubMed - indexed for MEDLINE] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Koo K, Matlaga BR Tags: Urol Clin North Am Source Type: research

Radiation Mitigation Techniques in Kidney Stone Management.
Abstract Patients with nephrolithiasis are exposed to significant quantities of ionizing radiation with the potential to cause secondary malignancy. This risk is magnified by the high recurrence rate of nephrolithiasis. In this article, we identify the risks of ionizing radiation as they pertain to patients with nephrolithiasis. We then identify evidence-based techniques for mitigating patient radiation exposure in the preoperative, intraoperative, and postoperative settings. Key factors include limiting the use of computed tomographic imaging, appropriate modulation of fluoroscopy settings, and minimizing rates o...
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Yecies TS, Semins MJ Tags: Urol Clin North Am Source Type: research

Innovations in Ultrasound Technology in the Management of Kidney Stones.
This article reviews new advances in ultrasound technology for urinary stone disease. Recent research to facilitate the diagnosis of nephrolithiasis, including use of the twinkling signal and posterior acoustic shadow, have helped to improve the use of ultrasound examination for detecting and sizing renal stones. New therapeutic applications of ultrasound technology for stone disease have emerged, including ultrasonic propulsion to reposition stones and burst wave lithotripsy to fragment stones noninvasively. The safety, efficacy, and evolution of these technologies in phantom, animal, and human studies are reviewed herein...
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Dai JC, Bailey MR, Sorensen MD, Harper JD Tags: Urol Clin North Am Source Type: research

Emerging Mobile Platforms to Aid in Stone Management.
Abstract Nephrolithiasis is an increasingly common condition worldwide and mobile technology is revolutionizing how patients with kidney stone are being diagnosed and managed. Emerging platforms include software applications to increase adherence to stone prevention, mobile compatible hardware, online social media communities, and telemedicine. Applications and hardware specifically relevant to increasing hydration, diet modification, medication adherence, and rapid diagnosis (ie, mobile ultrasound and endoscopy) have the greatest potential to reduce stone recurrence and expedite treatment. Social media and online...
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Small AC, Thorogood SL, Shah O, Healy KA Tags: Urol Clin North Am Source Type: research

Assessing Cost-Effectiveness of New Technologies in Stone Management.
Abstract Diagnosis, treatment, and follow-up are all influential in determining the overall cost to the health care system for kidney stones. New innovations in the field of nephrolithiasis have been abundant, including disposable ureteroscopes, ultrasound-guided approaches to percutaneous nephrolithotomy, and advanced laser lithotripters. Identifying cost-effective treatment strategies encourages practitioners to be thoughtful about providing value-based high-quality care and remains on important principle in the treatment of urinary stone disease. PMID: 30961862 [PubMed - indexed for MEDLINE] (Source: The U...
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Bayne DB, Chi TL Tags: Urol Clin North Am Source Type: research

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Urol Clin North Am. 2019 May;46(2):xiii Authors: Taneja SS PMID: 30961863 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Taneja SS Tags: Urol Clin North Am Source Type: research

A Vision of the Future of Stone Management.
PMID: 30961864 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - April 11, 2019 Category: Urology & Nephrology Authors: Shah O, Matlaga BR Tags: Urol Clin North Am Source Type: research

Injection of Urethral Bulking Agents.
This article aims to describe the mechanism of action and properties of various agents, patient selection factors, available techniques for injection, outcomes of urethral injections, and complications associated with the procedure. PMID: 30466694 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Li H, Westney OL Tags: Urol Clin North Am Source Type: research

Surgery for Apical Vaginal Prolapse after Hysterectomy: Transvaginal Mesh-Based Repair.
Abstract Several transvaginal mesh products have been marketed to address vaginal vault prolapse. Although data are limited, prolapse recurrence rates and subjective outcome measures seem to be equivalent for vaginal mesh compared with native tissue apical prolapse repair, and the different vaginal meshes have not proven superior to one another. Given the known unique complications specific to vaginal mesh with equivalent outcomes for the apical vaginal prolapse, it is reasonable to reserve mesh use for specific high-risk cases, such as patients with large apical prolapse recurrence after native tissue repair who ...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Wallace SL, Syan R, Sokol ER Tags: Urol Clin North Am Source Type: research

Surgery for Apical Vaginal Prolapse After Hysterectomy: Abdominal Sacrocolpopexy.
Abstract The number of surgeries for pelvic organ prolapse in the United States is increasing. Abdominal sacrocolpopexy has become the gold standard for women desiring a restorative repair of their apical pelvic organ prolapse. Despite the associated morbidity of abdominal sacrocolpopexy, advances in minimally invasive approaches have safely increased the number of these surgeries performed, especially among urologists. Moreover, a number of studies have demonstrated superior objective outcomes after abdominal sacrocolpopexy when compared with vaginal approaches. Variations in the technique are described, but no c...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Lee W, Tam J, Kobashi K Tags: Urol Clin North Am Source Type: research

Vaginal Approach to Vesicovaginal Fistula.
Abstract Vesicovaginal fistula is the most commonly encountered sequela of genitourinary trauma. Although the etiology differs between developed and developing countries, the principles of fistula repair must be strictly adhered to for success. Timing and route of repair remain contentious, because of a lack of randomized data. Evaluation and management is dictated by the surgeon's experience. Minimally invasive techniques with laparoscopy and robotic technology are generating wider interest with reduced postoperative morbidity, but a transvaginal technique should be in the arsenal of all pelvic reconstructive sur...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Lee D, Zimmern P Tags: Urol Clin North Am Source Type: research

Abdominal Approach to Vesicovaginal Fistula.
Abstract Principles of abdominal vesicovaginal fistula (VVF) repair include good exposure of the fistulous tract, double-layer bladder closure, retrograde fill of the bladder to ensure a water-tight seal, tension-free closure and continuous postoperative bladder drainage. Minimally invasive approaches, particularly robot-assisted laparoscopy, have demonstrated shorter operative times, decreased blood loss, improved visibility, and similar cure rates without increased adverse events. These techniques are therefore rising in popularity among surgeons. Ultimately, surgical approach to VVF repair depends upon the indi...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: McKay E, Watts K, Abraham N Tags: Urol Clin North Am Source Type: research

Synthetic Midurethral Slings: Roles, Outcomes, and Complications.
Abstract Synthetic midurethral sling placement is the most studied anti-incontinence procedure available. Multiple randomized trials demonstrate its safety and efficacy, with results out to 5 years. With long-term follow-up, it seems there may be some benefit in efficacy to retropubic sling placement compared with the transobturator approach. Single-incision slings are a newer modification to multi-incision sling placement, and the data regarding safety and efficacy are not as mature as other forms of sling placement. Complications may occur with mesh midurethral sling placement and surgeons performing these ...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Linder BJ, Elliott DS Tags: Urol Clin North Am Source Type: research

Management of the Exposed or Perforated Midurethral Sling.
This article highlights preoperative, perioperative, and postoperative factors to minimize the chance of vaginal wall mesh exposure or perforation of mesh into the lower urinary tract. It also summarizes common presenting symptoms, suggested evaluation and a range of treatment options. PMID: 30466700 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Giusto LL, Zahner PM, Goldman HB Tags: Urol Clin North Am Source Type: research

Surgery for Stress Urinary Incontinence: Autologous Fascial Sling.
This article describes the operative technique of autologous fascial pubovaginal sling (AFPVS) surgery, examines the senior author's outcomes with AFPVS, compares these outcomes with those of other large studies and meta-analyses, and compares the safety and efficacy of AFPVS with those of the synthetic midurethral sling (SMUS). Recently, the SMUS has become the treatment of choice for most surgeons. The efficacy of the SMUS remains unchallenged and comparable with that of AFPVS, but SMUS are associated with more severe complications. In the author's opinion, the AFPVS should remain the gold standard for treating SUI. ...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Blaivas JG, Simma-Chiang V, Gul Z, Dayan L, Kalkan S, Daniel M Tags: Urol Clin North Am Source Type: research

Burch Colposuspension.
Abstract The Burch colposuspension has a 50-plus year history demonstrating strong long-term outcomes with minimal complications. Iterations of the procedure, including laparoscopic, robotic, and mini-incisional approaches, appear to have equal efficacy to the open procedure. Although the current use of the Burch colposuspension has waned with the growing shift toward sling surgery, it continues to have a role in the treatment of stress urinary incontinence. Specifically, a Burch procedure should be considered when vaginal access is limited, concurrent intra-abdominal surgery is planned, or mesh is contraindicated...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Sohlberg EM, Elliott CS Tags: Urol Clin North Am Source Type: research

Surgery for Anterior Compartment Vaginal Prolapse: Suture-Based Repair.
Abstract Native tissue anterior compartment prolapse repair remains an important surgical procedure for pelvic prolapse. Native tissue repair has been well-studied and is successful in relieving vaginal bulge symptoms and reducing prolapse within the vagina. Native tissue cystocele repair has been performed safely since the advent to modern vaginal surgery for prolapse. Reoperation rates are low and the contribution of apical support in the durability of vaginal wall defect repair surgery has been well-established. Native tissue cystocele repair addresses symptom relief for women, and should continue to be a part ...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Amin K, Lee U Tags: Urol Clin North Am Source Type: research

Surgery for Anterior Compartment Prolapse Synthetic Graft-Augmented Repair.
Abstract Pelvic organ prolapse is a common and bothersome problem that affects women's work, traveling, physical exercise, sleep, and sexual function. Synthetic implants show superiority in reducing recurrence of pelvic organ prolapse. However, inserting foreign materials carries an increased risk of complications. In this article containing the most updated available literature, we look back at the history of synthetic mesh repair, examine its efficacy and advantages, assess common complications, review current opinions, and look at the future for ways to improve the use of mesh for better results and fewer compl...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Israeli O, Weintraub AY Tags: Urol Clin North Am Source Type: research

Posterior Vaginal Wall Prolapse: Suture-Based Repair.
This article reviews the management strategies and draws conclusions about suture-based and site-specific techniques. PMID: 30466705 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Guzman-Negron JM, Fascelli M, Vasavada SP Tags: Urol Clin North Am Source Type: research

Surgery for Posterior Compartment Vaginal Prolapse: Graft Augmented Repair.
Abstract Posterior compartment vaginal prolapse can be approached with multiple surgical techniques, including transvaginally, transperineally, and transanally, repaired with either native tissue or with the addition of an augment. Augment material for posterior compartment prolapse includes biologic graft (dermal, porcine submucosal), absorbable mesh (Vicryl polyglactin), or nonabsorbable synthetic mesh (polypropylene). Anatomic success rates for posterior compartment repair with augment has ranged from 54% to 92%. Augmented posterior compartment repair has not been shown to have superior outcome to native tissue...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Kim S, Pollock GR, Twiss CO, Funk JT Tags: Urol Clin North Am Source Type: research

Transvaginal Suture-Based Repair.
Abstract An estimated 300,000 women undergo pelvic organ prolapse (POP) surgery in the United States every year at a cost of more than 1 billion dollars per year. The prevalence of POP is approximately 2.9% to 8%, and increases with age. Apical support is required to achieve successful prolapse repair. As the search for the safest, most durable, surgical repair continues, transvaginal native tissue repairs have the advantage of providing minimally invasive surgical repairs without the added risk of abdominal, laparoscopic, or robotic surgery while avoiding the risk of mesh augmentation. PMID: 30466707 [PubMed...
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Enemchukwu EA Tags: Urol Clin North Am Source Type: research

Reconstruction of the Female Pelvis: A Fundamental Pillar of Urology.
PMID: 30466708 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Taneja SS Tags: Urol Clin North Am Source Type: research

Controversies in Vaginal Surgery.
PMID: 30466709 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - November 24, 2018 Category: Urology & Nephrology Authors: Comiter CV Tags: Urol Clin North Am Source Type: research

Continuous Antibiotic Prophylaxis in Pediatric Urology.
Abstract Continuous antibiotic prophylaxis (CAP) for urinary tract infection prevention in children with vesicoureteral reflux, hydronephrosis, and hydroureteronephrosis is reviewed. A more selective use of CAP is advocated based on a review of known individual risk factors in each of these conditions that subsequently helps identify the children most likely to benefit from CAP. Both short-term and potential long-term side effects of CAP are reviewed, including the impact of prophylactic antibiotics on bacterial resistance and the microbiome. Alternatives to continuous antibiotic prophylaxis including Vaccinium ma...
Source: The Urologic Clinics of North America - October 15, 2018 Category: Urology & Nephrology Authors: Storm DW, Braga LH, Cooper CS Tags: Urol Clin North Am Source Type: research

Pediatric Stone Disease.
Abstract Once considered rare, pediatric nephrolithiasis has become a critical field of study in the last decade due to the rapid increase in incidence. Understanding the changing epidemiology and lifelong implications of pediatric stone disease is critically important to effectively manage the individual patient as well as identify risk factors for childhood onset that could be modified. Determining the role of diagnostic imaging in children is a unique challenge as limiting radiation and imaging stewardship should be priorities. Approaches to management have also changed, as technology continues to evolve and bo...
Source: The Urologic Clinics of North America - October 15, 2018 Category: Urology & Nephrology Authors: Bowen DK, Tasian GE Tags: Urol Clin North Am Source Type: research

Anesthesia in the Pediatric Patient.
Abstract Improvements in anesthetic drugs and monitoring techniques over the past several decades have significantly reduced the anesthetic risks for pediatric patients. Neonates and infants are at increased risk for cardiovascular and pulmonary complications, and recent reports have led to concern that these young patients may be at risk for long-term detrimental neurodevelopmental effects as well. Although studies are currently under way to answer the question of anesthetic neurotoxicity in children, surgeons and anesthesiologists must work with parents to determine the best course of action for these vulnerable...
Source: The Urologic Clinics of North America - October 15, 2018 Category: Urology & Nephrology Authors: Brockel MA, Polaner DM, Vemulakonda VM Tags: Urol Clin North Am Source Type: research

Urologic Evaluation and Management of Pediatric Kidney Transplant Patients.
Abstract Urologic causes of end-stage renal disease are estimated between 25% and 40% of causes. The goal of renal transplantation in chronic kidney disease patients is to provide renal replacement therapy with less morbidity, better quality of life, and improved overall survival compared with dialysis. A patient's urologic history can be a significant source of problems related to infections, recurrence of disease, and surgical complications. Many of the urologic risks are modifiable. Proper evaluation and management can mitigate the potential problems after transplantation, and these patients with complex urolog...
Source: The Urologic Clinics of North America - October 15, 2018 Category: Urology & Nephrology Authors: Palmer B, Kropp B Tags: Urol Clin North Am Source Type: research

Neuropathic Bladder and Augmentation Cystoplasty.
Abstract Surgical indications for individuals with neuropathic bladder include unsafe urinary storage pressures, progressive upper tract deterioration, and continued urinary incontinence that is recalcitrant to oral pharmacologic or intradetrusor injection therapy and intermittent catheterization. Bladder augmentation is currently the gold standard surgical procedure used to increase bladder capacity and reduce storage pressures but has significant long-term risks. The medical and surgical management of neuropathic bladder, as well as long-term consequences of bladder augmentation, are reviewed. PMID: 3031631...
Source: The Urologic Clinics of North America - October 15, 2018 Category: Urology & Nephrology Authors: Roth JD, Cain MP Tags: Urol Clin North Am Source Type: research

Fertility Issues in Pediatric Urology.
Abstract Improved understanding of the pathogenesis and natural history of many urologic disorders, as well as advances in fertility preservation techniques, has increased the awareness of and options for management of fertility threats in pediatric patients. In children, fertility may be altered by oncologic conditions, by differences in sexual differentiation, by gonadotoxic drugs and other side effects of treatment for nonurologic disorders, and by urologic conditions, such as varicocele and cryptorchidism. Although fertility concerns are best addressed in a multidisciplinary setting, pediatric urologists shoul...
Source: The Urologic Clinics of North America - October 15, 2018 Category: Urology & Nephrology Authors: Kieran K, Shnorhavorian M Tags: Urol Clin North Am Source Type: research

Transitional Urology.
This article reviews the transitional process itself including barriers to successful transition and the consequences of failing to properly transition. Also provided is a broad overview of the urologic issues faced by patients who may benefit from lifelong care and the providers who will be helping them with transition and assuming their care. PMID: 30316314 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - October 15, 2018 Category: Urology & Nephrology Authors: Kovell RC, Skokan AJ, Wood DN Tags: Urol Clin North Am Source Type: research

Minimally Invasive Surgery in Pediatric Urology: Adaptations and New Frontiers.
Abstract As the frontiers of minimally invasive surgery (MIS) continue to expand, the availability and implementation of new technology in pediatric urology are increasing. MIS is already an integral part of pediatric urology, but there is still much more potential change to come as both recent and upcoming advances in laparoscopic and robotic surgery are surveyed. PMID: 30316315 [PubMed - in process] (Source: The Urologic Clinics of North America)
Source: The Urologic Clinics of North America - October 15, 2018 Category: Urology & Nephrology Authors: Sheth KR, Van Batavia JP, Bowen DK, Koh CJ, Srinivasan AK Tags: Urol Clin North Am Source Type: research