Over the last 20 years, radical retropubic prostatectomy has evolvedto become the standard of care in men with localized prostate cancer. Becauseof the morbidity of this procedure, however, interest has grown in the developmentof non-surgical modalities. Unfortunately, many of these non-surgical approaches,such as monotherapy with radioactive seed implantation, have resulted indisappointing results or excessive morbidity, as in first-generation cryotherapy.
"At trial, the urology expert testified that the defendant urologist failed to offer the patient alternative treatments before proceeding with the drastic option of removing the testicle," writes Dawn Collins, JD.
Treatment for pregnant women who present with renal or ureteral colic may have become easier for physician and patient alike.
The most recent Urology Times State of the Specialty survey is notable in confirming some widely accepted urologic practice trends, but challenging the significance of others.
None of the comparative studies of robotic radical nephrectomies (RRN) and laparoscopic radical nephrectomies (LRN) has shown benefit of RRN over LRN. Why then are so many minimally invasive RNs performed this way?
The procedure should be of a durationand complexity that will permit the patient to recover and be discharged.
Several approaches have been taken to attenuate lower urinary tract symptoms and improve quality of life in the stented patient.
Patients with nephrolithiasis frequently have metabolic abnormalities that promote calculus formation and, when identified and corrected, may attenuate stone activity.
Montreal--Novel approaches to percutaneous nephrolithotomy, includinguse of a stent instead of a tube and using smaller tubes and stone "cones,"are helping to optimize this procedure. Researchers agree that improvingsafety and reducing morbidity are the goals of these new techniques.
Every urology practice faces this situation eventually: a difficult employee who demands disproportionate time and attention from management.
A relatively simple technique called the spousal lifetime access trust has proven especially advantageous and popular among those who have remarried and want to provide for children from a prior marriage.
Nephron-sparing procedures now have clear advantages over radical nephrectomy for most small renal masses.
Prostate cancer is the most prevalent non-cutaneous cancer diagnosed in men today, still accounting for a significant amount of morbidity and mortality in spite of increased screening efforts and advances in treatment.
"We feel a more appropriate approach would be to retain true Gleason 6 as a cancer of extremely low metastatic potential requiring close follow-up," write Harris et al.
"During these times of uncertainty, panic, and social distancing associated with COVID-19, the American Board of Urology is sensitive to the additional stress this pandemic has placed on urology practices and urologists’ ability to meet their certificate requirements," writes J. Brantley Thrasher, MD.
There is a significant correlation between Comet assay results and the likelihood of pregnancy using ART.
New bladder cancer data are food for thought, but are not conclusive proof that urologists are over-treating early-stage bladder cancer and running up costs.
"This work is important to our field, because it represents an effort to personalize treatment approaches to particular patients’ needs," writes Brian R. Matlaga, MD, MPH.
This article provides a real-world definition of refractory overactive bladder and its prevalence, then examines treatment options, with a focus on percutaneous tibial nerve stimulation as a noninvasive form of neuromodulation “for the masses.”
A recently published population-based study reinforces prior evidence from retrospective studies of the increased survival benefit of partial nephrectomy over radical nephrectomy, and suggests a cancer-specific survival benefit for nephron-sparing approaches as well.
Between 30% and 60% of calcium oxalate stone patients have hypercalciuria in the absence of raised serum calcium levels.
Between 30% and 60% of calcium oxalate stone patients have hypercalciuria in the absence of raised serum calcium levels.
"Perhaps there is another Nobel Prize waiting to be had if we could reduce the cardiovascular effect of ADT and unlock the answer to the controversy surrounding the comparative safety and impact on cardiovascular health between GnRH agonists and antagonists," writes Michael S. Cookson, MD, MMHC.
San Francisco--Even though patients with von Hippel-Lindau disease are at risk for renal tumors and eventual metastatic RCC, parenchymal-sparing surgery can be delayed until the largest tumor reaches 3 cm with minimal concern that the patient will develop metastatic renal cell carcinoma, according to updated data from an ongoing National Institutes of Health study.
The male sling achieves continence by unilateral ventral urethral compression that does not require patient activation, allowing volitional and spontaneous voiding.
The male sling achieves continence by unilateral ventral urethral compression that does not require patient activation, allowing volitional and spontaneous voiding.
In this interview, Seth P. Lerner, MD, discusses current recommendations for managing patients during the BCG shortage, what the FDA is doing to resolve the problem, and a SWOG trial testing a new strain of BCG.
In this "Coding Q&A" column, Ray Painter, MD, and Mark Painter also answer questions regarding bladder instillations and penile modeling during IPP placement.
"An abstract authored by Löppenberg et al is an interesting analysis of information from a respected prospective database examining variations in the quality of care provided to patients undergoing sling placement by gynecologists and urologists," write Seth A. Cohen, MD, and Shlomo Raz, MD.
"The global shortage of ICM has necessitated rapid adaptation of workflows and clinical pathways, which are particularly important for practicing urologists who are evaluating patients for hematuria," write Yair Lotan, MD, and colleagues.