Differentiation of Solid Renal Tumors with Multiparametric MR Imaging.

Characterization of renal tumors is critical to determine the best therapeutic approach and improve overall patient survival. Because of increased use of high-resolution cross-sectional imaging in clinical practice, renal masses are being discovered with increased frequency. As a result, accurate imaging characterization of these lesions is more important than ever.

Scrotal Ultrasound for Pain: Low Frequency of Absolute Surgical Indications.

Objective: To examine the results of scrotal ultrasounds (US) conducted for scrotal or testicular pain and review the pathologic findings of orchiectomies done for lesions that were suspicious for malignancy on US.

Materials And Methods: We retrospectively reviewed the indications and findings of all scrotal US completed at our institution from 2002 to 2014. If a patient underwent an orchiectomy for an intratesticular lesion that was concerning for malignancy on US, the pathology report was also reviewed.

Extraprostatic Extension Is Extremely Rare for Contemporary Gleason Score 6 Prostate Cancer.

Background: A significant proportion of men with Gleason score 6 (GS6) prostate cancer undergo treatment with radiation or surgery.

Objective: To assess pathologic stage of pure GS6 at radical prostatectomy (RP).

Design, Setting, And Participants: In the period 2003-2014, 7817 patients underwent RP at two institutions.

Dramatic increase in the utilization of multiparametric magnetic resonance imaging for detection and management of prostate cancer.

Purpose: Multiparametric MRI (mpMRI) of the prostate is an evolving technology that provides functional information of the prostate that helps distinguish benign from malignant lesions. We hypothesized that mpMRI is rapidly adopted in the US to fill the unmet need for a non-invasive, accurate screening tool. The aim of this study is to assess the increasing utilization of mpMRI for the diagnosis and management of prostate cancer.

High-Risk of Adverse Pathologic Features in Patients With Clinical T1 High-Grade Bladder Cancer Undergoing Radical Cystectomy.

Background: Radical cystectomy (RC) is used to treat select patients with T1 high-grade (T1HG) bladder cancer. However, population-level utilization trends and outcomes for these patients are not well-known. We sought to evaluate treatment patterns and clinicopathologic outcomes of RC for T1HG bladder cancer.

The Gender Divide: The Impact of Surgeon Gender on Surgical Practice Patterns in Urology.

Purpose: There is a perception in urology that female urologists encounter gender based role assignments and are often pigeonholed into caring for more female patients and female specific urological issues than their male colleagues. We assessed the influence of surgeon gender on patient gender demographics by exploring the surgical case logs of American urologists.

Materials And Methods: Six-month case logs of certifying urologists from 2003 to 2012 were obtained from the ABU (American Board of Urology).

Genomic characterization of high-risk non-muscle invasive bladder cancer.

The genetic mechanisms associated with progression of high-risk non-muscle-invasive bladder cancer (HR-NMIBC) have not been described. We conducted selective next-generation sequencing (NGS) of HR-NMIBC and compared the genomic profiles of cancers that responded to intravesical therapy and those that progressed to muscle-invasive or advanced disease. DNA was extracted from paraffin-embedded sections from 25 HR-NMIBCs (22 with T1HG; 3 with TaHG with or without carcinoma in situ).

The Evolving Management of Patients With Clinical Stage I Seminoma.

Objective: To determine trends in management and factors associated with men receiving either chemotherapy or radiation therapy post orchiectomy for clinical stage I (CSI) seminoma in a contemporary setting.

Patients And Methods: The National Cancer Data Base was queried for all patients with CSI seminoma from 1998 to 2012. Adjuvant treatment after orchiectomy was classified into 3 groups: surveillance, radiotherapy, and chemotherapy.

Bladder Pneumatosis From a Catastrophic Vascular Event.

Air within the bladder wall, or bladder pneumatosis, is a very rare finding typically resulting from an infectious etiology, as in emphysematous cystitis (EC). However, there have been reports of bladder pneumatosis occurring without clear infectious origins. We present a case of a female patient found to have concurrent bladder and ileal pneumatosis secondary to a catastrophic vascular event.

Lower Urinary Tract Symptoms Secondary to Mass Lesion of the Brain: A Case Report and Review of the Literature.

Lower urinary tract symptoms (LUTS) secondary to neurologic disorders are well-established, but intracranial mass lesions are rare causes of LUTS with very few case reports described in the literature. We present a 28-year old man with urinary urgency, frequency and incontinence which were revealed to be secondary to a large thrombosed intracranial aneurysm. Any unusual clinical presentations of LUTS such as new onset neurologic symptoms need to be explored to rule out potentially treatable causes.

Diagnostic Value of Guided Biopsies: Fusion and Cognitive-registration Magnetic Resonance Imaging Versus Conventional Ultrasound Biopsy of the Prostate.

Objective: To better assess the increased utilization of multiparametric magnetic resonance imaging (mpMRI) and fusion biopsy of the prostate, we compared prostate cancer detection rates among (a) men undergoing MR-ultrasound (US) fusion biopsy, (b) mpMRI cognitive-registration biopsy, and (c) conventional transrectal US-guided biopsy for the detection of prostate cancer.

Materials And Methods: We present a retrospective review of consecutive patients undergoing mpMRI of the prostate with subsequent prostate biopsy from October 2013 to September 2015. Lesions concerning for prostate cancer visualized on mpMRI were targeted with cognitive-registration or MR-US fusion biopsies.

The effect of minimally invasive prostatectomy on practice patterns of American urologists.

Introduction And Objectives: To determine how robotic prostatectomy affects practice patterns of urologists, we examined the case volume characteristics among certifying urologists for the surgical treatment of prostate cancer. We hypothesized that the utilization of open and robotic prostatectomy as well as lymph node dissection changed dynamically over the last 10 years.

Methods: A total of 6-month case log data of certifying urologists from 2003 to 2013 were obtained for the American Board of Urology.

Characteristics of Certifying Urologists Performing Cystectomies in the United States.

Introduction: The surgical volume and training of the surgeon performing radical cystectomy can have a significant impact on bladder cancer outcomes. We hypothesize significant variability in the training and volume of surgeons performing radical cystectomy in the United States.

Methods: The 6-month case log data of urologists certifying between 2003 and 2013 were obtained from the American Board of Urology.

An Analysis of Case Logs From American Urologists in the Treatment of Peyronie's Disease.

Objective: To review recent trends in the treatment of Peyronie's disease (PD), we assess surgical practice patterns of urologists in the United States with emphasis on specialty training, demographics, and temporal changes.

Methods: Six-month case log data of American urologists between 2004 and 2013 were obtained from the American Board of Urology. Current Procedural Terminology (CPT) codes were used to identify surgical procedures, including plaque injection.

Management of pediatric pyocele using percutaneous imaging-guided aspiration.

Introduction: Pyocele of the scrotum is a rare clinical entity not well-described in the pediatric literature. With the exception of those patients who cannot undergo surgery, all published cases have been treated definitely with surgical drainage with severe cases leading to orchiectomy.

Presentation Of Case: A 12 day-old full-term boy with no significant medical history presented to the emergency department with a two-day history of fever, right hemiscrotal redness, swelling and discomfort.

Male Sling and Artificial Urethral Sphincter for Male Stress Urinary Incontinence Among Certifying American Urologists.

Objective: To examine case volume characteristics among certifying urologists performing male sling and artificial urinary sphincter (AUS) procedures to evaluate practice patterns in male stress urinary incontinence (SUI).

Materials And Methods: Six-month case log data of certifying urologists (2003-2013) were obtained from the American Board of Urology. Cases specifying Current Procedural Terminology code for male sling, AUS, and removal or revision of either procedure in males ≥18 years were analyzed.

Practice Patterns in the Treatment of Urethral Stricture Among American Urologists: A Paradigm Change?

Objective: To examine surgical case volume characteristics among certifying urologists associated with treatment of urethral stricture to compare practice patterns of recent graduates to recertifying attending urologists and trends over time.

Materials And Methods: Six-month case log data of certifying and recertifying urologists (2003-2013) were obtained from the American Board of Urology. Cases specifying a CPT code for urethral dilation, direct vision internal urethrotomy (DVIU), urethroplasty, and graft harvest in males ≥18 years were analyzed for surgeon-specific variables.

The effect of surgical duration of transurethral resection of bladder tumors on postoperative complications: An analysis of ACS NSQIP data.

Introduction: Transurethral resection of bladder tumor (TURBT) is a common procedure used in the diagnosis and treatment of bladder cancer. Despite how often it is performed, not much is known about the risk factors for complications. Traditional surgery has an increase in morbidity and mortality with increasing operative duration.

Testosterone replacement therapy and the internet: an assessment of providers' health-related web site information content.

Objective: To compare how providers of testosterone replacement therapy (TRT) in large metropolitan cities promote androgen replacement on their patient-oriented Web sites.

Materials And Methods: TRT provider Web sites were identified using Google search and the terms "Testosterone replacement" and the name of the 5 most populous US cities. These Web sites were assessed for (1) type or specialty of medical provider, (2) discussion of the benefits and risks of TRT, and (3) industry affiliations.