The Epidemiology of Cancer Among Homeless Adults in Metropolitan Detroit.

Background: Homeless individuals suffer and die disproportionately from chronic diseases and disorders. We describe the epidemiology of cancer among homeless persons in metropolitan Detroit.

Methods: A retrospective cohort study was performed using 1973-2014 data from the Metropolitan Detroit Cancer Surveillance System, a population-based cancer registry and member of the National Institutes of Health-National Cancer Institute's Surveillance, Epidemiology, and End Results program.

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.

Ureterocele misdiagnosed as pelvic inflammatory disease in an adolescent.

Background: Acute pelvic pain in reproductive-aged women presents a diagnostic challenge. In the case that follows, we report the management of a patient initially misdiagnosed with pelvic inflammatory disease.

Case: A 14-year-old nulligravida who presented with acute pelvic pain was diagnosed with pelvic inflammatory disease and possible tuboovarian abscess.

Nephrectomy in the management of metastatic osteosarcoma.

This report discusses a rare case of nephrectomy for metastatic osteosarcoma, the first performed laparoscopically, and proposes such management as a standard of care. A 21-year-old woman with a history of metastatic osteosarcoma involving her right kidney was referred to our institution for evaluation. She was managed with a hand-assisted laparoscopic nephrectomy.

Bladder erosion by an intraperitoneal chemotherapy catheter resulting in catheter protrusion through the external urethral meatus.

Background: Chemotherapy remains an essential part of the treatment of advanced ovarian cancer. Intraperitoneal (IP) administration has been demonstrated to provide a survival advantage over intravenous chemotherapy in three phase 3 studies. However, IP catheter complications have been a significant factor in aborting IP therapy.

A contemporary evaluation of the auditory hazard of extracorporeal shock wave lithotripsy.

Objectives: Previous publications have suggested that prolonged exposure to extracorporeal shock wave lithotripsy (ESWL) may lead to hearing damage and that hearing protection should be used. We sought to determine the auditory risk associated with ESWL in regard to patients and operating room personnel in a contemporary setting.

Methods: A single day study was performed during which 5 patients were treated with ESWL via a Dornier Compact Delta lithotripter (Dornier MedTech America Inc, Kennesaw, Georgia).

Anuric renal failure after same-session bilateral atraumatic flexible ureteroscopy.

We report the first known case of anuric renal failure after same-session bilateral atraumatic flexible ureteroscopy for renal calculi. Although, there is no consensus about stenting patients who undergo same-session bilateral ureteroscopy due to the lack of prospective randomized studies; strong consideration should be given to stenting the ureter at least one side to avoid this complication.

Lift-assisted offset lithotomy: positioning for transurethral operations in morbidly obese.

The incidence of morbid obesity is rapidly increasing in the United States. This presents a unique challenge in the diagnosis, management, and surgical treatment of urologic disease. The use of the lithotomy position for transurethral procedures is often not possible because of the body habitus and equipment-specific weight limitations.

Patient opinion of urologists' reimbursement.

Objectives: To determine patient assumptions and opinions of the billing and reimbursement process in an urban urologic practice. Healthcare policy and physician reimbursement has been discussed in political and economic forums; however, few studies exist that reflect a patient's perspective of reimbursement issues.

Methods: An anonymous, voluntary 11-question survey was given to 825 patients during a 10-week interval.

Stent-change therapy in advanced malignancies with ureteral obstruction.

Background And Purpose: To determine if patients with advanced malignancies and resultant ureteral obstruction who are managed with chronic ureteral stent changes have adequate preservation of renal function and an acceptable rate of complications.

Patients And Methods: A retrospective review was conducted on 28 patients who had a stent to relieve ureteral obstruction caused by cancer.

Results: During the study period, 201 stents were placed, a median of 4 (range 1-34) per patient.