Recovery of pad-free continence in elderly men does not differ from younger men undergoing robot-assisted radical prostatectomy for aggressive prostate cancer.

Purpose: To analyze urinary continence outcome following robot-assisted radical prostatectomy (RARP) for aggressive prostate cancer in men aged ≥ 70 and < 70 years.

Methods: Retrospective analyses of prospectively collected long-term data from a monocentric cohort of 350 men with D'Amico high-risk prostate cancer undergone robot-assisted radical prostatectomy at a single institution between 2005 and 2016. The association between time since operation and zero-pad urinary continence recovery was comparatively analyzed by separate pre-operative and post-operative Cox proportional-hazard regression models.

The Multiple-Slit Technique (MUST) for Penile Length and Girth Restoration.

Background: Patients with severe erectile dysfunction (ED) and penile size issues, especially seen in Peyronie's disease (PD), are candidates for more invasive penile prosthesis insertion techniques that aim for penile length and girth reconstruction.

Aim: To present the feasibility and safety of penile length and girth restoration based on the so-called multiple-slit technique (MUST) for patients with severe ED and significant penile shortening with or without PD.

Methods: From July 2013 through January 2016, 138 patients underwent the MUST.

Outcomes of Early Endoscopic Realignment Versus Suprapubic Cystostomy and Delayed Urethroplasty for Pelvic Fracture-related Posterior Urethral Injuries: A Systematic Review.

Context: The evidence base for optimal acute management of pelvic fracture-related posterior urethral injuries needs to be reviewed because of evolving endoscopic techniques. The current standard of care is suprapubic cystostomy followed by delayed urethroplasty.

Objective: To systematically review the evidence base comparing early endoscopic realignment with cystostomy and delayed urethroplasty regarding stricture rate, the need for subsequent procedures, and functional outcomes.

A prospective multicentric international study on the surgical outcomes and patients' satisfaction rates of the 'sliding' technique for end-stage Peyronie's disease with severe shortening of the penis and erectile dysfunction.

Objectives: To report the results from a prospective multicentric study of patients with Peyronie's disease (PD) treated with the 'sliding' technique (ST).

Patients And Methods: From June 2010 to January 2014, 28 consecutive patients affected by stable PD with severe penile shortening and end-stage erectile dysfunction (ED) were enrolled in three European PD tertiary referral centres. The validated International Index of Erectile Function (IIEF) questionnaire, the Sexual Encounter Profile (SEP) Questions 2 and 3, and the Peyronie's disease questionnaire (PDQ) were completed preoperatively by all patients.

The Egydio geometrical procedure for managing penile curvature using a single relaxing incision: A single-centre experience with 330 patients.

Objective: To present our 3-year experience with the Egydio's geometrical procedure for managing penile curvature with some modifications.

Patients And Methods: In all, 330 patients (mean age 51 years) that underwent the Egydio's procedure as day cases were included in this study.

Results: The mean penile curvature was 45° and 27.

Focused Dual-energy CT Maintains Diagnostic and Compositional Accuracy for Urolithiasis Using Ultralow-dose Noncontrast CT.

Objective: To evaluate the diagnostic accuracy of a new energy and radiation dose-reduced protocol for noncontrast computed tomography (NCCT) with dual-energy CT (DECT) analysis and its potential for the compositional analysis of uric acid (UA)- or non-uric acid (N-UA)-containing calculi.

Methods: A retrospective evaluation was carried out in 61 patients who underwent dose-reduced DECT (tube A: 140 kV/55 mAs; tube B: 80 kV/303 mAs) with a tube current 38.8% lower than that set by the manufacturer.

Sexual function after surgical treatment for penile cancer: Which organ-sparing approach gives the best results?

Introduction: We compared the postoperative sexual function of patients who underwent wide local excision (WLE) and glansectomy with urethral glanduloplasty for penile cancer.

Methods: We retrospectively reviewed clinical data of 41 patients affected by superficial, localized penile cancer (≤cT2a) between 2006 and 2013. Patients with severe erectile dysfunction and not interested in resuming an active sexual life were selected for penile partial amputation.

Long-Term Results of Reconstructive Surgery for Peyronie's Disease.

Introduction: Peyronie's disease (PD) is an acquired benign connective tissue disorder that involves the tunica albuginea of the penis and can cause penile deformity and shortening. Because this condition is frequently associated with cardiovascular risk factors, a degree of erectile dysfunction is frequently present. The surgical management of PD should be offered once the acute phase of the disease has settled and the deformity is stable.

Penile lengthening and widening without grafting according to a modified 'sliding' technique.

Objective: To present the feasibility and safety of penile length and girth restoration based on a modified 'sliding' technique for patients with severe erectile dysfunction (ED) and significant penile shortening, with or without Peyronie's disease (PD).

Patients And Methods: Between January 2013 and January 2014, 143 patients underwent our modified 'sliding' technique for penile length and girth restoration and concomitant penile prosthesis implantation. It is based on three key elements: (i) the sliding manoeuvre for penile length restoration; (ii) potential complementary longitudinal ventral and/or dorsal tunical incisions for girth restoration; and (iii) closure of the newly created rectangular bow-shaped tunical defects with Buck's fascia only.

Review of the current management of upper urinary tract injuries by the EAU Trauma Guidelines Panel.

Context: The most recent European Association of Urology (EAU) guidelines on urological trauma were published in 2014.

Objective: To present a summary of the 2014 version of the EAU guidelines on upper urinary tract injuries with the emphasis upon diagnosis and treatment.

Evidence Acquisition: The EAU trauma guidelines panel reviewed literature by a Medline search on upper urinary tract injuries; publication dates up to December 2013 were accepted.

Review of the current management of lower urinary tract injuries by the EAU Trauma Guidelines Panel.

Context: The most recent European Association of Urology (EAU) guidelines on urologic trauma were published in 2014.

Objective: To present a summary of the 2014 version of the EAU guidelines on urologic trauma of the lower urinary tract with an emphasis on diagnosis and treatment.

Evidence Acquisition: The EAU Trauma Panel reviewed the English-language literature via a Medline search for lower urinary tract injury (LUTI) up to November 2013.

International multicentre psychometric evaluation of patient-reported outcome data for the treatment of Peyronie's disease.

Objective: To compare patient-reported outcomes (PROs) of surgical correction of Peyronie's disease (PD) with the Nesbit procedure, plaque incision and grafting, and the insertion of a malleable penile implant after surgical correction of penile curvature.

Patients And Methods: We performed a retrospective review of men who underwent surgical correction of PD between January 2010 and December 2012 at six international centres. Treatment-related PROs and satisfaction were evaluated with a non-validated questionnaire.

The cumulative analgesic consumption score (CACS): evaluation of a new score to describe postsurgical analgesic consumption as a surrogate parameter for postoperative pain and invasiveness of surgical procedures.

Objective: To validate and evaluate the applicability of a new score to describe postsurgical analgesic consumption in urological and surgical patients across different categories of pain medications and the invasiveness of medical interventions.

Materials And Methods: The cumulative analgesic consumption score (CACS) was determined for two cohorts of patients split into three groups with surgeries involving clinically distinct levels of invasiveness (n = 2 x 60). Nonparametric statistical analyses were performed to determine differences between the CACS among the different groups and to assess the correlation between CACS and numeric rating scale (NRS) values for pain intensity.

Diagnosis of renal tumors by in vivo proton magnetic resonance spectroscopy.

Purpose: To evaluate the diagnostic potential of choline measurements by in vivo magnetic resonance spectroscopy (MR spectroscopy) for diagnosis of renal masses.

Methods: Twenty-eight patients with 29 renal lesions underwent prospectively preoperative 3 T MR spectroscopy of renal masses before diagnostic tissue confirmation. A respiratory-triggered single-voxel MR spectroscopy was performed in these masses using the point-resolved spectroscopy (TR, 2,000 ms, TE, 135 ms) sequence.

Bringing excellence into urology: How to improve the future training of residents?

The Problem: The demographic development of society leads to an increased demand for physicians. Particularly in the surgical disciplines, there is a noticeably declining interest among graduates from medical schools worldwide. For reasons discussed in detail, this applies especially to urology.

Single-Incision Transumbilical Surgery (SITUS) versus Single-Port Laparoscopic Surgery and conventional laparoscopic surgery: a prospective randomized comparative study of performance with novices in a dry laboratory.

Purpose: To evaluate the Single-Incision Transumbilical Surgery (SITUS) technique as compared to an established laparoendoscopic single-site surgery (LESS) technique (Single-Port Laparoscopic Surgery, SPLS) and conventional laparoscopy (CLS) in a surgical simulator model.

Methods: Sixty-three medical students without previous laparoscopic experience were randomly assigned to one of the three groups (SITUS, SPLS and CLS). Subjects were asked to perform five standardized tasks of increasing difficulty adopted from the Fundamentals of Laparoscopic Surgery curriculum.

The STAGE technique (superficial tunica albuginea geometric-based excision) for the correction of biplanar congenital penile curvature.

Introduction: Congenital penile curvature can present with both uniplanar and biplanar defects, the latter of which entails more technically demanding surgery.

Aim: The study aims to demonstrate the efficacy and safety of our novel superficial tunica albuginea geometric-based excision (STAGE) technique based on multiple, small, superficial elliptical tunica albuginea excisions and geometrical principles for correcting biplanar congenital penile curvature.

Methods: The study represents a retrospective analysis of 145 patients with disabling congenital biplanar ventrolateral (n = 131; 90.

The Post-Ureteroscopic Lesion Scale (PULS): a multicenter video-based evaluation of inter-rater reliability.

Purpose: The Post-Ureteroscopic Lesion Scale (PULS) offers a simple grading system for the description of ureteral lesions after ureteroscopy. In this article, we present the results of a video-based multicenter evaluation of the inter-rater reliability of clinically important PULS grades 0-3.

Methods: Video sequences at the end of ureteroscopy (final passage) were recorded for 100 consecutive patients at a single institution and assessed by experienced urologists (n = 20) and senior residents (n = 17) at 19 international centers.

Treatments for fibrosis of the corpora cavernosa.

Introduction: Corporal fibrosis usually occurs after explantation of an infected penile prosthesis, severe penile trauma, refractory low-flow priapism, Peyronie's disease, or the chronic intracavernous injection of vasoactive drugs.

Methods: We analysed current treatmentss for penile fibrosis. We searched PubMed using the keywords 'penile corporal fibrosis', 'treatment' and 'penile fibrosis', resulting in 63 matches, of which 19 articles met the inclusion criteria.