Novel Paired Normal Prostate and Prostate Cancer Model Cell Systems Derived from African American Patients.

Unlabelled: Prostate cancer is the most frequently diagnosed solid malignancy in men. African American (AA) men are at greater risk for developing prostate cancer, and experience higher mortality rates, as compared with Caucasian American men. However, mechanistic studies to understand this health disparity have been limited by the lack of relevant and models.

Radiotherapy Induces Innate Immune Responses in Patients Treated for Prostate Cancers.

Purpose: Radiotherapy is a curative therapeutic modality used to treat cancers as a single agent or in combination with surgery and chemotherapy. Advanced radiotherapy technologies enable treatment with large fractions and highly conformal radiation doses to effect free-radical damage to cellular DNA leading to cell-cycle arrest, cell death, and innate immune response (IIR) stimulation.

Experimental Design: To understand systemic clinical responses after radiation exposure, proteomic and metabolomic analyses were performed on plasma obtained from patients with cancer at intervals after prostate stereotactic body radiotherapy.

Discovery of Metabolic Biomarkers Predicting Radiation Therapy Late Effects in Prostate Cancer Patients.

Patients presenting with prostate cancers undergo clinical staging evaluations to determine the extent of disease to guide therapeutic recommendations. Management options may include watchful waiting, surgery, or radiation therapy. Thus, initial risk stratification of prostate cancer patients is important for achieving optimal therapeutic results or cancer cure and preservation of quality of life.

Perioperative Outcomes of Robotic and Laparoscopic Simple Prostatectomy: A European-American Multi-institutional Analysis.

Background: Laparoscopic and robotic simple prostatectomy (SP) have been introduced with the aim of reducing the morbidity of the standard open technique.

Objective: To report a large multi-institutional series of minimally invasive SP (MISP).

Design, Setting, And Participants: Consecutive cases of MISP done for the treatment of bladder outlet obstruction (BOO) due to benign prostatic enlargement (BPE) between 2000 and 2014 at 23 participating institutions in the Americas and Europe were included in this retrospective analysis.

Use of "off the shelf" extracellular matrix graft materials for repair of testicular rupture: a novel technique.

Objective: To describe a new technique for repairing traumatic testicular ruptures using readily available graft material.

Materials And Methods: Surgical management of testicular rupture is often associated with loss of testicular parenchyma because of tissue debridement and concerns of pressure-related ischemia. We present our experience with 3 cases using a novel technique using extracellular matrix graft materials for the reconstruction of tunica albuginea in patients with testicular rupture.

Multi-institutional outcomes and cost effectiveness of using alvimopan to lower gastrointestinal morbidity after cystectomy and urinary diversion.

Introduction: Radical cystectomy is associated with significant morbidity and cost, with rates of gastrointestinal complications as high as 30%. Alvimopan is a mu opioid receptor antagonist that has been shown in randomized-control trials to accelerate gastrointestinal recovery in patients undergoing bowel resection with primary anastamosis. We report our experience with gastrointestinal recovery for patients undergoing cystectomy with urinary diversion treated with alvimopan and cost benefit associated.

Robotic-assisted prostatectomy and open radical retropubic prostatectomy for locally-advanced prostate cancer: multi-institution comparison of oncologic outcomes.

Purpose: Robotic-assisted laparoscopic prostatectomy (RALP) offers reportedly comparable oncologic outcomes for localized disease compared with open radical retropubic prostatectomy (ORRP). However, the oncologic efficacy of RALP in locally-advanced prostate cancer (PCa) is less clear. We report and compare our experience with RALP and ORRP in men with locally advanced PCa.

Potency preservation following stereotactic body radiation therapy for prostate cancer.

Background: Erectile dysfunction after prostate radiation therapy remains an ongoing challenge and critical quality of life issue. Given the higher dose of radiation per fraction using stereotactic body radiation therapy (SBRT) there is concern that post-SBRT impotency would be higher than conventional radiation therapy approaches. This study sought to evaluate potency preservation and sexual function following SBRT for prostate cancer.

Predictors of Gleason score upgrading in a large African-American population.

Purpose: Gleason score from biopsy specimens is important for prostate cancer (PCa) risk stratification and influences treatment decisions. Gleason score upgrading (GSU) between biopsy and surgical pathology specimens has been reported as high as 50 % and presents a challenge in counseling low-risk patients. While recent studies have investigated predictors of GSU, populations in these studies have been largely Caucasian.

Stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer: the Georgetown University experience.

Background: Stereotactic body radiation therapy (SBRT) delivers fewer high-dose fractions of radiation which may be radiobiologically favorable to conventional low-dose fractions commonly used for prostate cancer radiotherapy. We report our early experience using SBRT for localized prostate cancer.

Methods: Patients treated with SBRT from June 2008 to May 2010 at Georgetown University Hospital for localized prostate carcinoma, with or without the use of androgen deprivation therapy (ADT), were included in this retrospective review of data that was prospectively collected in an institutional database.

Robot-assisted simple prostatectomy: multi-institutional outcomes for glands larger than 100 grams.

Purpose: To present our experience with robot-assisted simple prostatectomy in patients with large gland adenoma (>100 g) that would not be amenable to transurethral treatments.

Patients And Methods: From August 2009 to May 2011, 13 robot-assisted simple suprapubic prostatectomies were performed in patients with symptomatic large gland (>100 g) prostatomegaly on transrectal ultrasonography (mean 163 cc). Essential aspects of our technique include a transverse cystotomy just proximal to the prostatovesical junction and use of a robotic tenotomy grasper to aid in adenoma dissection.

Low incidence of new biochemical and clinical hypogonadism following hypofractionated stereotactic body radiation therapy (SBRT) monotherapy for low- to intermediate-risk prostate cancer.

Background: The CyberKnife is an appealing delivery system for hypofractionated stereotactic body radiation therapy (SBRT) because of its ability to deliver highly conformal radiation therapy to moving targets. This conformity is achieved via 100s of non-coplanar radiation beams, which could potentially increase transitory testicular irradiation and result in post-therapy hypogonadism. We report on our early experience with CyberKnife SBRT for low- to intermediate-risk prostate cancer patients and assess the rate of inducing biochemical and clinical hypogonadism.

Stone measurement by volumetric three-dimensional computed tomography for predicting the outcome after extracorporeal shock wave lithotripsy.

Objective: To evaluate the efficacy of stone volume measured using a three-dimensional (3D) reconstruction of preoperative non-contrast computed tomography (NCCT) as an independent predictor of success after extracorporeal shock wave lithotripsy (ESWL) of upper urinary tract calculi.

Patients And Methods: We evaluated preoperative NCCT in 94 patients who had ESWL for solitary upper urinary tract calculi of 4-20 mm in diameter. Axial images were used to measure the skin-to-stone distance (SSD), Hounsfield Unit (HU) density and axial stone diameter.

Comparison of traditional enterocystoplasty and seromuscular colocystoplasty lined with urothelium.

Objective: To evaluate long-term outcomes between various methods of augmentation cystoplasty.

Methods: A retrospective analysis was performed of patients undergoing seromuscular colocystoplasty lined with urothelium (SCLU, n=26), and their outcomes compared to a similar population of patients in the same institution who had received traditional forms of bladder augmentation (colocystoplasty and ileocystoplasty, n=32). Measurements included efficacy of the procedure in increasing bladder capacity and achieving urinary continence, and the need of subsequent surgery for complications.

Psoas abscess complicated by vesical fistula in a child managed by non-surgical therapy.

We report an unusual case of a 2-year-old child with a psoas abscess fistulizing to the bladder, managed by non-surgical therapy including urethral catheter drainage, percutaneous abscess drainage and intravenous antibiotics.

Comparison of postoperative pain, convalescence, and patient satisfaction after laparoscopic and percutaneous ablation of small renal masses.

Purpose: To compare the convalescence and patient satisfaction between laparoscopic and percutaneous ablation for management of small renal masses.

Methods: We performed a telephone survey comparing convalescence and operative satisfaction of patients who underwent laparoscopic and percutaneous ablation between October 2000 and June 2006 at our institution. A retrospective chart review was performed to compare perioperative and postoperative convalescence parameters.

Practical approach to metabolic evaluation and treatment of the recurrent stone patient.

Although significant progress has been made during the last 3 decades in the minimally invasive surgical management of stone disease, the medical prevention of urolithiasis still remains challenging as much less progress has been achieved during the same time period. The purpose of this article is to provide the practicing urologist with practical guidelines for the metabolic evaluation and management of the recurrent stone patient. The recommendations are based on the latest available information regarding the pathogenesis, medical treatment options, and decision-making rationale when managing these challenging patients.

Third prize: Effect of hydrocortisone on porcine ureteral contractility in vitro.

Background And Purpose: Corticosteroids have been commonly used in medical expulsive therapy for obstructing ureteral calculi. The exact mechanism of action responsible for facilitation of stone expulsion is unknown, but it is attributed to the anti-inflammatory properties of corticosteroids. Corticosteroids inhibit the production of phospholipase A2 and cyclooxygenase-2, both of which are involved in prostaglandin synthesis.

Identification and preservation of accessory pudendal vessels during robot-assisted laparoscopic radical retropubic prostatectomy.

The introduction of minimally invasive surgery for radical retropubic prostatectomy has increased the incidence of recognition of accessory pudendal arteries. Early identification and preservation of these vessels is paramount for optimal functional outcomes. In this article, we describe our robotic surgical technique for identification and preservation of both lateral and apical accessory pudendal arteries.

Current practice patterns in the management of upper urinary tract calculi in the north central United States.

Purpose: To determine the current practice patterns in the management of upper urinary tract calculi in a large group of urologists in the north central United States.

Materials And Methods: An email survey was sent to 790 practicing members of the North Central Section of the American Urological Association. The survey consisted of questions pertaining to practice and training background, and case scenarios with treatment options for upper urinary tract calculi of different sizes at various locations.

Single center preliminary experience with hand-assisted laparoscopic resection of isolated renal cell carcinoma fossa recurrences.

Objectives: Solitary metastasis to the renal fossa after radical nephrectomy for renal cell carcinoma is uncommon. We report the first series on hand-assisted laparoscopic excision for renal cell carcinoma fossa recurrences.

Methods: We performed a retrospective review of patients who underwent hand-assisted laparoscopic excision of renal cell carcinoma fossa recurrence.

Comparison of blade temperature dynamics after activation of Harmonic Ace scalpel and the Ultracision Harmonic Scalpel LCS-K5.

Purpose: To compare tip temperatures of the vibrating blades of the newer-generation Harmonic Ace device and the older-generation Ultracision Harmonic Scalpel LCS-K5.

Materials And Methods: Comparison of two different harmonic scalpel blades was performed by applying them to 3-mm strips of raw chicken breast at room temperature and measuring the temperature of the tip of the vibrating blade at 0.5-second intervals using a thermocouple.

Current practice patterns in the use of ablation technology for the management of small renal masses at academic centers in the United States.

Objectives: To determine the current practice patterns in the use of ablation technology for the management of small renal masses at academic centers in the United States.

Methods: An email survey was sent to 112 academic urologists subspecializing in minimally invasive management of renal cancer. The survey consisted of 13 questions and 4 clinical scenarios pertaining to the use of ablation technology.

Oncological outcomes of hand-assisted laparoscopic radical nephrectomy for clinically localized renal cell carcinoma: a single-institution study with >or=3 years of follow-up.

Objective: To evaluate the intermediate-term outcomes of hand-assisted laparoscopic radical nephrectomy (HALRN) for clinically organ-confined renal cell carcinoma (RCC).

Patients And Methods: We retrospectively reviewed patients who had HALRN for clinically organ-confined RCC at the University of Wisconsin from 1996 to 2003. All patients with pathologically confirmed RCC and with >or=3 years of follow-up were included in a retrospective chart review of variables before, during and after HALRN, as well as the clinical outcomes.