Molecular tumor profiling has become an important diagnostic for prostate cancer, allowing for personalized treatment regimens based on somatic and germline genetic information. We report a 67-year-old patient with metastatic castrate-resistant prostate cancer which was intermittently responsive to androgen-deprivation therapy, docetaxel, abiraterone, radium-223, Sipuleucel-T, and radiotherapy who ultimately demonstrated a remarkable and durable response to pembrolizumab. Our case report underlines the significance of early tumor molecular profiling in aggressive or atypical prostate cancer patients and exhibits the potential for a remarkable clinical response with immunotherapy in candidates with the appropriate tumor profiles.
View Article and Find Full Text PDFWe report the management of a 76-year-old male presenting with primary metastatic melanoma, prostatic carcinoma, and clear cell renal cell carcinoma. Each of the three cancers was identified via PSMA PET-CT, thought to be unique to prostate cancer identification. Management of this patient included axillary lymph node resection, radiation therapy, radical nephrectomy, and immunotherapy.
View Article and Find Full Text PDFWe report a 40-year-old male presenting with right testicular pain. Following right orchiectomy demonstrating pT1bS0N0M0 teratoma with extensive necrosis, the patient opted for surveillance. With new retroperitoneal lymphadenopathy, the patient underwent a robotic-assisted laparoscopic retroperitoneal lymph node.
View Article and Find Full Text PDFIntroduction: Inflatable penile prosthesis (IPP) technology is a mainstay in the treatment of erectile dysfunction refractory to medical management. Technological advancements in the design of 3-piece IPPs have been improved to optimize concealability and surgical placement since the 1980s. Recent advancements over the past 10 years include pump, reservoir, tubing, and cylinder updates.
View Article and Find Full Text PDFWe report a case of malfunction of an inflatable penile prosthesis (IPP) after prostatic urethral lift (PUL) necessitating surgical intervention. A 70 year-old male underwent PUL for benign prostatic hyperplasia after IPP implant for organic erectile dysfunction. After PUL, the patient experienced IPP malfunction where he underwent subsequent IPP removal and replacement.
View Article and Find Full Text PDFIntroduction: We examined temporal trends in urology residency applicant statistics and characteristics through time.
Methods: Match statistics during 2006 to 2016 were obtained from the American Urological Association and examined through time. Additionally applicant self-reported data were obtained from Urologymatch.
Background: Cancer care and end-of-life (EOL) care contribute substantially to health care expenditures. Outside of clinical trials, to our knowledge there exists no standardized protocol to monitor disease progression in men with metastatic prostate cancer (mPCa). The objective of the current study was to evaluate the factors and outcomes associated with increased imaging and serum prostate-specific antigen use in men with mPCa.
View Article and Find Full Text PDFPurpose: The degree to which intraductal carcinoma of the prostate (IDC-P) affects clinical course remains poorly understood owing to small sample sizes from single-center studies. We sought to determine prognostic factors and outcomes associated with IDC-P in radical prostatectomy (RP) specimens.
Materials And Methods: This is a retrospective study of RP during 2004 to 2013 using Surveillance, Epidemiology, and End Results to compare IDC-P with non-IDC-P.
We report surgical management of a disrupted radical prostatectomy vesicourethral anastomosis after bleeding from undiagnosed hemophilia that required re-exploration, pudendal artery embolization, and urinary diversion with nephrostomy and surgical drains. After referral, the 4.5 cm vesicourethral anastomotic defect was reconstructed with a robotic-assisted abdomino-perineal approach.
View Article and Find Full Text PDFIntraductal carcinoma of the prostate (IDC-P), recently defined by the World Health Organization in 2016, is a distinct histologic entity associated with an aggressive clinical course, including increased risk of biochemical recurrence, metastasis, and mortality. Differential diagnosis includes intraductal spread of urothelial carcinoma, prostatic ductal carcinoma, and high-grade prostatic intraepithelial neoplasia. BRCA mutations are associated with an increased risk of IDC-P.
View Article and Find Full Text PDFPurpose: Uptake of active surveillance and changes in prostate cancer care may affect the utilization of and complications following prostate needle biopsy. We characterized recent trends and risk factors for prostate needle biopsy complications using a statewide, all-payer cohort.
Materials And Methods: We used SPARCS (New York Statewide Planning and Research Cooperative System) to identify prostate needle biopsies performed between 2011 and 2014 via the transrectal and the transperineal approach (9,472 and 421 patients, respectively).