Comorbid diseases and conditions in people with HIV in the UK.

Objectives: This study aimed to characterize the risk of people living with HIV (PLHIV) in the UK progressing to pre-specified HIV-associated comorbidities, compared with matched, HIV-negative controls.

Methods: Primary and secondary care records from the Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES) were used to identify PLHIV, and a matched cohort from the HIV-negative population. Kaplan Meier curves and Cox proportional hazard models were used to evaluate the risk of developing comorbidities including central nervous system (CNS) disorders, end-stage renal disease, osteoporosis, diabetes, cardiovascular disease (CVD), hypertension, stroke and cancer.

Multiparametric MRI of early tumor response to immune checkpoint blockade in metastatic melanoma.

Background: Immune checkpoint inhibitors are now standard of care treatment for many cancers. Treatment failure in metastatic melanoma is often due to tumor heterogeneity, which is not easily captured by conventional CT or tumor biopsy. The aim of this prospective study was to investigate early microstructural and functional changes within melanoma metastases following immune checkpoint blockade using multiparametric MRI.

Multi-site clonality analysis uncovers pervasive heterogeneity across melanoma metastases.

Metastatic melanoma carries a poor prognosis despite modern systemic therapies. Understanding the evolution of the disease could help inform patient management. Through whole-genome sequencing of 13 melanoma metastases sampled at autopsy from a treatment naïve patient and by leveraging the analytical power of multi-sample analyses, we reveal evidence of diversification among metastatic lineages.

Eight Things Oil & Gas Workers Should Know About Flash Fires.

Flash fires and fuel-fed fires are two different hazards, and it's critical to distinguish between the two for various safety reasons.

'7-flap' perineal urethrostomy: an effective option for obese men with devastated urethras.

Introduction: To present an updated experience using our previously reported lateral perineal '7-flap' technique for perineal urethrostomy (PU), highlighting its role in a variety of patients with advanced urethral stricture disease.

Materials And Methods: All patients who underwent 7-flap PU from 2009-2013 were reviewed. PU was constructed by advancing a "7"-shaped laterally based perineal skin flap into a spatulated, amputated bulbomembranous urethra.

Dorsal plication without degloving is safe and effective for correcting ventral penile deformities.

Objective: To compare the safety and efficacy of patients undergoing dorsal penile plication with patients undergoing ventral and lateral plication.

Methods: A retrospective review was performed of all patients who underwent penile plication between 2007 and 2013. Plication was performed through a 2-cm longitudinal incision in the proximal or midpenile shaft without degloving.

High submuscular placement of urologic prosthetic balloons and reservoirs: 2-year experience and patient-reported outcomes.

Objective: To present our updated experience and patient-reported outcomes of high submuscular (HSM) placement of urologic prosthetic balloons and reservoirs (UPBRs).

Methods: A retrospective review was performed of patients who underwent inflatable penile prosthesis and/or artificial urinary sphincter placement between 2011 and 2013. UPBRs were placed in an HSM location between the transversalis fascia and the rectus abdominis muscle by blunt dissection through the external inguinal ring via a trans-scrotal approach.

High submuscular versus space of Retzius placement of inflatable penile prosthesis reservoirs: results of a surgeon survey.

Introduction: High submuscular (HSM) inflatable penile prosthesis (IPP) reservoir insertion is a new technique that involves placing the reservoir high beneath the muscles of the abdominal wall. We queried a variety of surgeons to assess their impressions of how HSM reservoir placement compares with traditional space of Retzius (SOR) placement.

Materials And Methods: A nationwide group of urologists trained in HSM reservoir placement was surveyed to assess preferences and concerns compared to SOR placement.

3.5 cm artificial urinary sphincter cuff erosion occurs predominantly in irradiated patients.

Purpose: We analyzed our initial 100-case experience with the 3.5 cm artificial urinary sphincter cuff to identify risk factors for cuff erosion.

Materials And Methods: We reviewed the records of a single surgeon, consecutive series of patients treated with 3.

Unintended negative consequences of primary endoscopic realignment for men with pelvic fracture urethral injuries.

Purpose: We evaluated the clinical course of patients with pelvic fracture urethral injury referred to our institution to elucidate the differences between initial management strategies.

Materials And Methods: We retrospectively reviewed our institutional review board approved, prospectively maintained urethroplasty database from 2007 to 2013. Patients with pelvic fracture urethral injury were stratified into 2 groups based on initial treatment before referral.

Decreasing need for artificial urinary sphincter revision surgery by precise cuff sizing in men with spongiosal atrophy.

Purpose: Many patients with persistent incontinence after an artificial urinary sphincter procedure gain improved continence after cuff downsizing. In 2010 a new, smaller (3.5 cm) artificial urinary sphincter cuff was introduced.

High patient satisfaction of inflatable penile prosthesis insertion with synchronous penile plication for erectile dysfunction and Peyronie's disease.

Introduction: Twenty to thirty percent of patients with Peyronie's disease (PD) have erectile dysfunction (ED) refractory to medical therapy and may benefit from a combined procedure addressing both conditions.

Aim: The aim of this study was to show the efficacy of inflatable penile prosthesis (IPP) insertion and synchronous penile plication for correcting penile curvature and ED in patients with PD.

Methods: A retrospective review was performed of all patients who underwent IPP insertion with synchronous penile plication at our tertiary care center between 2010 and 2013.

Pseudospongioplasty using periurethral vascularized tissue to support ventral buccal mucosa grafts in the distal urethra.

Purpose: For ventral buccal mucosa graft onlay during bulbar urethroplasty, spongioplasty with advancement and closure of the corpus spongiosum is ordinarily performed to stabilize the graft. In the pendulous and distal bulbar urethra the spongiosum is often too thin to allow complete graft coverage. We describe the results of what to our knowledge is a novel technique for ventral graft coverage using periurethral vascularized tissue.

Immediate urethral repair during explantation prevents stricture formation after artificial urinary sphincter cuff erosion.

Purpose: We compare stricture outcomes in patients with artificial urinary sphincter cuff erosion managed with and without synchronous urethral repair.

Materials And Methods: Records of patients who underwent artificial urinary sphincter removal for cuff erosion from 2007 to 2013 were retrospectively reviewed. Two cohorts of patients were evaluated, with those in group 1 treated with in situ urethroplasty and those in group 2 treated with a Foley catheter only.

Outcomes after urethroplasty for radiotherapy induced bulbomembranous urethral stricture disease.

Purpose: We recently demonstrated that radiotherapy induced urethral strictures can be successfully managed with urethroplasty. We increased size and followup in our multi-institutional cohort, and evaluated excision and primary anastomosis as treatment for radiotherapy induced urethral strictures.

Materials And Methods: A retrospective review was performed of 72 patients from 3 academic institutions treated for radiotherapy induced bulbomembranous strictures.

Safety of the "drain and retain" option for defunctionalized urologic prosthetic balloons and reservoirs during artificial urinary sphincter and inflatable penile prosthesis revision surgery: 5-year experience.

Objective: To present our 5-year experience using a "drain and retain" option, in which existing urologic prosthetic balloons and reservoirs (UPBR) were emptied but not removed during routine artificial urinary sphincter (AUS)/inflatable penile prosthesis (IPP) reoperation.

Methods: All genitourinary prosthetic surgeries by a single surgeon from July 2007 to September 2012 were reviewed. Patients were included in the study group if they underwent prosthetic replacement (with contralateral new UPBR placement) or subtotal device removal, although having their original UPBR drained and retained.

Deep lateral transurethral incisions for recurrent bladder neck contracture: promising 5-year experience using a standardized approach.

Objective: To evaluate our 5-year experience with deep lateral transurethral incisions of bladder neck contracture (TUIBNC), identify risk factors associated with failure of procedure, and assess outcomes of men subsequently treated for concomitant or de novo stress urinary incontinence (SUI).

Materials And Methods: We reviewed 50 consecutive patients who underwent TUIBNC between June 2007 and January 2012. TUIBNC was standardized to include initial dilation followed by deep transurethral incisions.

Poor quality of life in patients with urethral stricture treated with intermittent self-dilation.

Purpose: We assessed patient perceptions of regular intermittent self-dilation in men with urethral stricture.

Materials And Methods: We constructed and distributed a visual analog questionnaire to evaluate intermittent self-dilation via catheterization by men referred for urethral stricture management at a total of 4 institutions. Items assessed included patient duration, frequency, difficulty and pain associated with intermittent self-dilation as well as interference of intermittent self-dilation with daily activity.

Transcorporal artificial urinary sphincter cuff placement is associated with a higher risk of postoperative urinary retention.

Introduction: To explore the association of artificial urinary sphincter (AUS) cuff sizes and placement techniques with the development of postoperative urinary retention.

Materials And Methods: We analyzed the outcomes of AUS cases performed by a single surgeon at a tertiary referral center from 2007-2010. Outcomes relating to urinary retention and suprapubic tube placement were analyzed in three groups: those with 3.