New Technologies for Treatment of Benign Prostatic Hyperplasia
BPH is a common disease in aging men which impacts quality of life. With advancing age expectation coupled with the rising demand for BPH therapy, new technologies have been developed that target rapid recovery and symptom relief, low complication rates, and the ability to perform the procedure in an outpatient setting with local anesthesia. MIST technologies have fostered BPH medical care with ejaculation preservation. Techniques and outcomes for BPH technologies including Aquablation, Rez ūm, UroLift, iTind, Optilume BPH, XFLO, Zenflow, and Butterfly are reviewed and evaluated. Given the novelty of these technologies, l...
Source: Urologic Clinics of North America - October 25, 2021 Category: Urology & Nephrology Authors: Dean Elterman, Bruce Gao, Steven Lu, Naeem Bhojani, Kevin C. Zorn, Bilal Chughtai Source Type: research
Future Platforms of Robotic Surgery
Among the various robotic devices that exist for urologic surgery, the most common are synergistic telemanipulator systems. Several have achieved clinical feasibility and have been licensed for use in humans: the standard da Vinci, Avatera, Hinotori, Revo-i, Senhance, Versius, and Surgenius. Handheld and hands-on synergistic systems are also clinically relevant for use in urologic surgeries, including minimally invasive and endoscopic approaches. Future trends of robotic innovation include an exploration of more robust haptic systems that offer kinesthetic and tactile feedback; miniaturization and microrobotics; enhanced v...
Source: Urologic Clinics of North America - October 25, 2021 Category: Urology & Nephrology Authors: Sylvia L. Alip, Jinu Kim, Koon Ho Rha, Woong Kyu Han Source Type: research
Mini Percutaneous Kidney Stone Removal
This article provides an update of all these available techniques of miniaturized PCNL along with its anatomic and physiologic impact. This should assist urologists in providing a personalized approach to the patient based on various patient- and stone-related factors to provide the best of al l available technology for treatment. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - October 25, 2021 Category: Urology & Nephrology Authors: Janak Desai, Hemendra N. Shah Source Type: research
Artificial Intelligence Applications in Urology
The growth and adoption of artificial intelligence has led to impressive results in urology. As artificial intelligence grows more ubiquitous, it is important to establish artificial intelligence literacy in the workforce. To this end, we present a narrative review of the literature of artificial intelligence and machine learning in urology and propose a checklist of reporting standards to improve readability and evaluate the current state of the literature. The listed article demonstrated heterogeneous reporting of methodologies and outcomes, limiting generalizability of research. We hope that this review serves as a foun...
Source: Urologic Clinics of North America - October 22, 2021 Category: Urology & Nephrology Authors: Andrew B. Chen, Taseen Haque, Sidney Roberts, Sirisha Rambhatla, Giovanni Cacciamani, Prokar Dasgupta, Andrew J. Hung Source Type: research
Evolution of Focal Therapy in Prostate Cancer
Organ sparing approaches for the management of localized prostate cancer were developed in part to overcome the morbidity associated with standard, whole gland treatment options. The first description of focal therapy was now over two decades ago and since that time much has changed. The evolution of patient selection, the approach to ablation, and surveillance after focal therapy have mirrored the technologic advancements in the field as well as the improved understanding of the biology of low-grade, low-risk prostate cancer. This review presents the evidence for the basis of focal therapy from the past to the present a...
Source: Urologic Clinics of North America - October 22, 2021 Category: Urology & Nephrology Authors: Rohith Arcot, Thomas J. Polascik Source Type: research
Emerging Intraoperative Imaging Technologies in Urologic Oncology
This article discusses emerging imaging technologies used in prostate, kidney, and bladder cancer surgery, including ultrasound, fluorescence-based, and enhanced endoscopy techniques including their strengths and limitations. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - October 22, 2021 Category: Urology & Nephrology Authors: Parwiz Abrahimi, Timothy McClure Source Type: research
New Stent Technologies
This article provides an update on currently researched and available stents as well as future perspectives. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - October 22, 2021 Category: Urology & Nephrology Authors: Pieter Janssen, Thomas Tailly Source Type: research
The Life and Death of Percutaneous Stone Removal
Although percutaneous nephrolithotomy (PCNL) is less morbid than open surgery, it still carries risks of significant complications as well as injury to the renal parenchyma. Flexible ureteroscopic stone removal, although causes no appreciable damage to the renal parenchyma, has limitations, most notably, a lower stone-free rate than PCNL. Advances in our knowledge regarding ureteral physiology combined with technical developments applied to ureteral access sheath deployment and size may well propel retrograde intrarenal surgery to the forefront of kidney stone removal, regardless of stone size or location. (Source: Urologi...
Source: Urologic Clinics of North America - October 21, 2021 Category: Urology & Nephrology Authors: Pengbo Jiang, Andrew Brevik, Ralph V. Clayman Source Type: research
Disposable Ureteroscopes in Urology
Ureteroscopy is the most common surgical modality for stone treatment. Reusable flexible ureteroscopes are delicate instruments that require expensive maintenance and repairs. Multiple single use ureteroscopes have been developed recently to combat the expensive and time-intensive sterilization and repair of ureteroscopes. Although multiple studies have looked at different aspects of reusable and single use ureteroscopes, there is significant heterogeneity in performance measures and cost between the 2 categories, and neither has a clear advantage. Both can be used successfully, and individual and institution level factors...
Source: Urologic Clinics of North America - October 21, 2021 Category: Urology & Nephrology Authors: Margaret A. Knoedler, Sara L. Best Source Type: research
Technological Advancements for Treating Erectile Dysfunction and Peyronie's Disease
Over the past decade, there have been several advancements in the technologies available to treatment erectile dysfunction and Peyronie's disease. Vacuum erection devices, penile traction devices, low-intensity extracorporeal shockwave therapy, and penile prosthesis surgery have evolved and are changing the way we treat men ’s health. Although significant improvements have been made, further work is needed to standardize treatment, create universal algorithms for technological applications, and simply their use. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - October 21, 2021 Category: Urology & Nephrology Authors: Jeffrey D. Campbell, Danny Matti, Haider Abed, Andrew Di Pierdominico Source Type: research
A Call for Change. Can 3D Printing Replace Cadavers for Surgical Training?
While cadaveric dissection has stood the test of time because of its widely accepted educational value by experienced surgeons, the introduction advances in 3D printing and biomaterial technologies could potentially provide alternative tools for surgical training. This novel concept in simulation (physical reality) would encompass all the benefits of cadavers in terms of realism and clinical relevance without any of its ethical, infection, safety, and financial concerns. (Source: Urologic Clinics of North America)
Source: Urologic Clinics of North America - October 21, 2021 Category: Urology & Nephrology Authors: Ahmed Ghazi Source Type: research
Sexual Dysfunction in Transgender People
Transgender people may choose to affirm their gender identity with gender-affirming hormone therapy (GAHT) and/or gender-affirming surgery (GAS). The effects of GAHT and GAS on sexual health in transgender people have not been well elucidated. This systematic review aimed to appraise the current scientific literature regarding sexual desire, arousal, orgasm, pain, and satisfaction in transmen and transwomen before, during, and after gender transition. Overall, sexual dysfunction is common in both transmen and transwomen. GAHT and GAS may help to improve sexual satisfaction. More studies that focus on sexual health in the t...
Source: Urologic Clinics of North America - October 1, 2021 Category: Urology & Nephrology Authors: Natnita Mattawanon, Kittipat Charoenkwan, Vin Tangpricha Source Type: research
Pharmaceutical and Energy-Based Management of Sexual Problems in Women
This article summarizes and critiques the evidence for use of available pharmacotherapies (vasoactive, psychoactive, and hormonal medications) and energy-based therapies (laser, radiofrequency, shockwave, and neurostimulation) for treatment of female sexual dysfunction. The enthusiasm with which energy-based treatments for sexual dysfunction have been adopted is disproportionate to the amount of data currently available to support their clinical use. Pharmacotherapy for female sexual dysfunction has considerably more research evidence to justify its use. Patients must be empowered to make an informed, autonomous determinat...
Source: Urologic Clinics of North America - October 1, 2021 Category: Urology & Nephrology Authors: Alexandra Siegal, Barbara M. Chubak Source Type: research
Managing Female Sexual Pain
Female sexual pain disorder or genito-pelvic pain/penetration disorder (GPPPD), previously known as dyspareunia, is defined as persistent or recurrent symptoms with one or more of the following for at least 6 months: marked vulvovaginal or pelvic pain during penetrative intercourse or penetration attempts, marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of penetration, and marked tensing or tightening of the pelvic floor muscles during attempted vagin al penetration. In this review, we discuss etiology, diagnosis, and treatment for common disorders that cause GPPD. (Sou...
Source: Urologic Clinics of North America - October 1, 2021 Category: Urology & Nephrology Authors: Maria Uloko, Rachel Rubin Source Type: research
Oncology Survivorship and Sexual Wellness for Women
Sexual dysfunction is extremely common in cancer survivors. Cancer survivors are living longer, and survivorship issues like sexual functioning are now a part of routine cancer care. Oncology providers need to be as comfortable assessing and addressing these issues as they would any other aspect relating to cancer care. Providers should know how to perform an evaluation for sexual dysfunction, understand basic treatment options, and have appropriate referrals available to ensure that the patient ’s needs are met. This review provides an overview of sexual dysfunction pertaining to women who are survivors of cancer and ar...
Source: Urologic Clinics of North America - October 1, 2021 Category: Urology & Nephrology Authors: Mindy Goldman, Mary Kathryn Abel Source Type: research
