Urologic Surgery

A 54-year-old transgender woman presented at Cleveland Clinic with vaginal stenosis. She was seeking surgical revision after complications from gender affirmation surgeries performed at other care centers failed to establish a functional neovagina.

“We know that, in general, cystectomy in women can disrupt pelvic floor support and innervation, as well as hormonal and sexual function, but there are no good prospective data to help us fully understand pelvic floor complications following the procedure,” said Jacqueline Zillioux, MD.

Patients achieving RC-pentafecta had less blood loss, shorter hospital stays, and lower perioperative mortality.

"Open ureteral reimplantation for ureteral obstruction in ileal-conduit has excellent early outcomes, though a 1/3 experienced high grade complications during follow up," wrote the study's authors, led by Zhina Sadeghi, MD, of the University of Michigan in Ann Arbor.

“I think that the most important thing to take home is that we all have implicit biases towards people who are underrepresented, whether it's women or minorities,” says Rena D. Malik, MD.

“In children and youth, there really [hasn’t] been an examination of the impact of gender-affirming care on mental health care use patterns," said Elizabeth Hisle-Gorman, MSW, PhD.

"In my system, if one were to act in an untoward way toward a transgender patient, there would be a significant problem," says 1 urologist.

O’Leary discusses safety related to instillation of the Penuma penile enhancement implant.

O’Leary is 1 of 10 surgeons in the United States capable of performing the surgery to install the FDA-cleared Penuma penile enhancement implant.

Existing evidence does not clarify which patients with acute ureteral colic would benefit most from early surgical intervention.

In this podcast, North discusses the findings of a recent Urology Practice study.

Anne M. Suskind, MD, MS, discusses the findings of the recent study, published in Urology.

Meena Davuluri, MD, MPH, and Kara L. Watts, MD, discuss findings from a study published in Urology Practice.

Andrew J. Cohen, MD, discusses a recent study evaluating treatment of urethral stricture disease in the US.

Minimally invasive surgery was associated with similar overall survival and disease-specific survival outcomes compared with open surgery in patients with early-stage kidney cancer.

A 4-step quality improvement intervention increased compliance with American Urological Association guidelines for periprocedural antibacterial prophylaxis for high-risk patients receiving cystoscopy.

The guidelines are an evidence-based clinical reference for the treatment of patients with lower urinary tract symptoms secondary to BPH.

A real-world analysis found that nerve sparing robot-assisted radical prostatectomy increased the risk of ipsilateral positive surgical margins.

Outpatient artificial urinary sphincter insertion is likely a viable option based on an analysis of immediate postoperative complications and pain control.

Clinicians from the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction, AUA, and American Urogynecologic Society discuss the FDA ban on mesh for pelvic organ prolapse.

"Fake news rules the world today. It certainly applies to the use of mesh in female pelvic health," writes Gopal H. Badlani, MD.

Although mesh has been banned for prolapse repair, midurethral slings remain a crucial treatment option for stress urinary incontinence.

"All we can do as physicians is reach out to patients with dignity and respect for who they recognize themselves to be," says one urologist.

This article highlights some of the emerging endoscopic robotic systems in urology.

In this article, we provide an overview of the key concepts a clinician must take into consideration when consulting with men interested in undergoing a cosmetic surgical procedure.