Prosthetic joint infection (PJI) and prosthetic valve endocarditis (PVE) are uncommon but serious complications. According to current best practice statements, prior to a genitourinary procedure, patients with prosthetic joints should receive antibiotic prophylaxis if they are within 2 years of arthroplasty, if they are high risk for infection due to their individual comorbidities, or if the procedure poses a high risk for bacteremia. Patients with prosthetic valves should not receive antibiotic prophylaxis for the sole purpose of prevention of endocarditis.
View Article and Find Full Text PDFMuscle-invasive bladder cancer (MIBC) is a potentially fatal disease, especially in the setting of locally advanced or node-positive disease. Adverse outcomes have also primarily been associated with low-income status, as has been reported in other cancers. While the adoption of neoadjuvant cisplatin-based chemotherapy (NAC) followed by radical cystectomy (RC) and pelvic lymph node dissection (PLND) has improved outcomes, these standard-of-care treatments may be underutilized in lower-income patients.
View Article and Find Full Text PDFWe present a case of an appendiceal adenocarcinoma that invaded the urinary bladder, which was preoperatively mistaken for urachal adenocarcinoma. The patient underwent open removal of the umbilicus, urachus, partial cystectomy and bilateral pelvic lymph node dissection. Intraoperatively the tumor was noted to involve the appendix, and so an appendectomy was also performed.
View Article and Find Full Text PDFEnterorenal fistulas can arise from various spontaneous and traumatic etiologies. While nephrectomy is frequently the treatment of choice, renal sparing techniques have been described. We report a case of an enterorenal fistula as a complication of penetrating trauma.
View Article and Find Full Text PDFIntroduction: Historically, the field of medicine has suffered from a lack of diversity. This project examines if urology residency program websites were actively attempting to recruit underrepresented minority applicants with the hypothesis that while some programs would attempt to attract such applicants on their website, the majority would not.
Materials And Methods: A cross-sectional analysis of program webpages for information regarding underrepresented minorities was performed.
Unlabelled: INTRODUCTION Limited information exists regarding parastomal hernia development in bladder cancer patients. The purpose of this investigation was to describe the natural history of parastomal hernias and identify risk factors for hernia development in patients who undergo cystectomy with ileal conduit urinary diversion.
Materials And Methods: A retrospective cohort study was performed of bladder cancer patients who underwent cystectomy with ileal conduit urinary diversion between January 1st 2009 and July 31st 2018 at Dartmouth-Hitchcock Medical Center.
Inflatable penile prosthesis (IPP) surgery is an effective, safe and satisfactory treatment option for medication-refractory erectile dysfunction. Postoperative complications include infection, mechanical failure, erosion, and pain. Current literature suggests the need for a better approach to postoperative pain management after IPP surgery.
View Article and Find Full Text PDFObjective: To characterize penile prosthesis surgery utilization and assess for regional differences in the use of this procedure across the United States.
Materials & Methods: We examined penile prosthesis surgeries (inflatable and semirigid implants) in Medicare beneficiaries with erectile dysfunction (ED) for the years 2006 through 2014. Adjusted utilization rates were calculated per 1000 beneficiaries accounting for age and race.
Objectives: To examine trends in online search behaviours related to prostate cancer on a national and regional scale using a dominant major search engine.
Materials And Methods: Google Trends was queried using the terms 'prostate cancer', 'prostate-specific antigen' (PSA), and 'prostate biopsy' between January 2004 and January 2019. Search volume index (SVI), a measure of relative search volume on Google, was obtained for all terms and examined by region and time period: pre-US Preventive Services Task Force (USPSTF) Grade D draft recommendation on PSA screening; during the active Grade D recommendation; and after publication of the recent Grade C draft recommendation.