High-Intensity Focused Ultrasound (HIFU) provides comparable oncologic, erectile, and urinary outcomes to standard-of-care options for localized prostate cancer. This study reports the largest United States series of HIFU in veterans for both primary and salvage therapies. We retrospectively analyzed the outcomes of 43 veterans treated at the Michael E.
View Article and Find Full Text PDFIntroduction And Objective: Urodynamic study (UDS) is required to diagnose bladder outlet obstruction (BOO) during evaluation of benign prostatic hyperplasia (BPH) but is seldom performed due to cost and invasiveness. Therefore, anatomic and clinical parameters to predict BOO have been proposed, including the prostate transition zone index (TZI) which is the ratio of prostate transition zone volume (TZV) to whole gland volume (WGV). Historically computed with ellipsoid volume estimation of prostate WGV and TZV from transrectal ultrasound measurements, controversy exists regarding the utility of TZI to predict likelihood of BOO on UDS and clinical outcomes following BPH surgery.
View Article and Find Full Text PDFIn early 2020, as the SARS-Cov-2 (COVID-19) pandemic progressed, many institutions limited nonurgent surgical care. This coincided with a decade-long trend of increasing percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS) and decreasing shock wave lithotripsy (SWL) for surgical management of urolithiasis. Herein, we evaluate temporal stone surgery rates and surgeon volumes in the Medicare population and suggest how COVID-19 contributed to them.
View Article and Find Full Text PDFIntroduction: Complex regional pain syndrome (CRPS) is characterized by extreme pain in a limb disproportional to the clinical history or physical findings accompanied by the signs of autonomic dysfunction. The pathophysiology of CRPS is obscure, making it challenging to treat. Treatment options include medications, physical therapy, and psychological support.
View Article and Find Full Text PDFIntroduction: The erector spinae plane (ESP) block is a regional anesthetic technique that involves injecting a local anesthetic below the erector spinae muscle in an interfascial plane.
Case Presentation: We report a case of a 66-year-old man with cervicothoracic junction pain caused by an advanced Pancoast tumor. The administration of ESP block at the T2-T3 level led to pain relief of more than 50% in this patient after two sessions.
This work aimed to intensively study polypropylene samples (PP) embedded with micro- and nanoparticles of BiO for their application in radiation shielding. Samples were prepared by adding 10%, 20%, 30%, 40%, and 50% of BiO microparticles (mBiO) by weight, and adding 10% and 50% of BiO nanoparticles (nBiO), in addition to the control sample (pure polypropylene). The morphology of the prepared samples was tested, and also, the shielding efficiency of gamma rays was tested for different sources with different energies.
View Article and Find Full Text PDFRecently, polymers have entered into many medical and industrial applications. This work aimed to intensively study polypropylene samples (PP) embedded with micro and nanoparticles of PbO for their application in radiation shielding. Samples were prepared by adding 10%, 30%, and 50% by weight of PbO microparticles (mPbO) and adding 10% and 50% PbO nanoparticles (nPbO), in addition to the control sample (pure polypropylene).
View Article and Find Full Text PDFBackground: The constellation of persistent sexual, neurological, and physical adverse effects in patients who discontinue 5α-reductase inhibitors (5ARIs) has garnered recent concern. The objective of this study was to evaluate potential penile vascular changes and persistent adverse effects of 5ARIs in men treated for androgenic alopecia (AGA).
Methods: This was a prospective case-control study with 25 subjects with a history of 5ARI use for AGA and 28 controls.
Purpose: To assess the frequency, appropriateness, and radiation doses associated with multiphase computed tomography (CT) protocols for routine chest and abdomen-pelvis examinations in 18 countries.
Materials And Methods: In collaboration with the International Atomic Energy Agency, multi-institutional data on clinical indications, number of scan phases, scan parameters, and radiation dose descriptors (CT dose-index volume; dose-length product [DLP]) were collected for routine chest (n = 1706 patients) and abdomen-pelvis (n = 426 patients) CT from 18 institutions in Asia, Africa, and Europe. Two radiologists scored the need for each phase based on clinical indications (1 = not indicated, 2 = probably indicated, 3 = indicated).
Urologic cancer disparities based on race/ethnicity and gender are well-documented across the cancer continuum. Patients cared for by physicians of similar race/ethnicity and gender report better communication, patient satisfaction, and care adherence which has the potential to translate into better health outcomes. We believe that ensuring a diverse Urologic Oncology workforce is an important first step toward eliminating cancer disparities due to the downstream effects of improved communication between concordant patient-physician dyads.
View Article and Find Full Text PDFAngiomyolipoma (AML) is a typically benign renal tumor derived from mesenchymal tissue. Extrarenal occurrences of AML are possible, but the adrenals are an exceedingly rare site. To date, a total of 4 cases of adrenal AML have been documented in the English literature.
View Article and Find Full Text PDFThis case is of a 26 year old female evaluated for gross hematuria and suprapubic pain found to have a large bladder tumor. She subsequently underwent successful robotic assisted laparoscopic partial cystectomy. Pathology revealed pseudosarcomatous fibromyxoid tumor, an uncommon lesion that occurs most frequently among young females and must be distinguished from other malignant lesions, as treatment may differ.
View Article and Find Full Text PDFPurpose Of Review: Management of genitourinary malignancy is likely to encompass a large portion of most of the urologist's practice. The challenge for the modern urologist is not only in understanding the management of commonly seen genitourinary malignancies, but also in recognizing unusual variants and their differences in management. This is evermore important as new technologies have refined the ability to identify rare entities.
View Article and Find Full Text PDFA self-induced, non-traumatic testicular torsion is a rare entity that to our knowledge has not been reported in the literature. We report the case of a 28-year-old male who caused a self-induced testicular torsion during acts associated with cross dressing. Differential diagnosis of the acute scrotum in an adult should always include testicular torsion, as outcomes in this population are worse than in younger populations.
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