Correlation of Prostate High-Resolution Microultrasound With Multiparametric Magnetic Resonance Imaging.

Objective: To assess the correlation between high-resolution microultrasound (microUS) and multiparametric magnetic resonance imaging (MP-MRI) in clinically significant prostate cancer (csPCa) lesion identification.

Methods: We reviewed our prospectively maintained database of 267 consecutive patients who underwent MP-MRI and transperineal microUS-guided biopsy between February 2021 and April 2023. The Prostate Risk Identification using MicroUS (PRI-MUS) protocol was utilized to risk stratify prostate lesions, with PRI-MUS 3-5 defined as positive.

Preoperative prostate magnetic resonance imaging does not impact surgical outcomes of radical prostatectomy.

Objective: We reviewed our institutional experience of radical prostatectomy with and without preoperative multiparametric magnetic resonance imaging (mpMRI) to assess the impact of preoperative prostate mpMRI on surgical outcomes of radical prostatectomy.

Methods: We identified patients at our institution who underwent radical prostatectomy for prostate cancer (PCa) between January 2012 and December 2017 ( = 1044). Using propensity scoring analysis, patients who underwent preoperative mpMRI ( = 285) were matched 1:1 to patients who did not receive preoperative mpMRI ( = 285).

A Hybrid Approach to Hood-Sparing Robotic Prostatectomy to Maximize Functional Outcomes and Maintain Early Oncologic Efficacy.

We detail our approach and experience with a hybrid version of the endopelvic hood-sparing (HS) robot-assisted radical prostatectomy (RARP) using the da Vinci robotic platform. We retrospectively reviewed the records of 200 patients who underwent RARP by a single surgeon. Patients were propensity-matched into three cohorts depending on biopsy and prostatectomy Gleason Grade Groups: traditional retropubic (RP) ( = 80), retzius-sparing (RS) ( = 40), and HS ( = 80).

Comparing Bladder Neck Contracture Rate Between Robotic Intracorporeal and Extracorporeal Neobladder Construction.

Robot-assisted radical cystectomy (RARC) has become more accessible to surgeons worldwide, and descriptions of intracorporeal urinary diversion techniques, such as orthotopic neobladder construction, have increased. In this study, we aim to compare the rate of bladder neck contracture (BNC) formation between RARC and two different urinary diversion techniques. We retrospectively reviewed our institutional database for patients with bladder cancer who underwent RARC with intracorporeal neobladder (ICNB) construction (n = 11) or extracorporeal neobladder (ECNB) construction (n = 11) between 2012 and 2020.

Comparison of Three Approaches to Single-Port Robot-Assisted Radical Prostatectomy: Our Institution's Initial Experience.

We aimed to compare three robot-assisted radical prostatectomy (RARP) approaches-Retzius sparing (RS), extraperitoneal (EP), and transperitoneal (TP)-performed at our institution using the da Vinci single-port (SP) platform (Intuitive Surgical, Sunnyvale, CA). We retrospectively reviewed the records of 101 patients who underwent SP-RARP at our institution and stratified them into three cohorts based on the RARP approach: RS ( = 32), EP ( = 30), and TP ( = 39). Data regarding preoperative patient characteristics, perioperative characteristics, oncologic outcomes, and early functional outcomes were collected.

Factors Associated with Ureteral Stent Failure in Patients with Malignant Ureteral Obstruction.

Management of malignant ureteral obstruction (MUO) with ureteral stents remains a clinical challenge, often involving frequent stent exchanges attributable to stent failure or other urological complications. We report our institutional experience with ureteral stents for management of MUO, including analysis of clinical factors associated with stent failure. We performed a retrospective review of patients treated with indwelling ureteral stents for MUO in nonurothelial malignancies at our tertiary-care institution between 2008 and 2019.

Clustering of patients with overactive bladder syndrome.

Background: Overactive bladder is a heterogenous condition with poorly characterized clinical phenotypes. To discover potential patient subtypes in patients with overactive bladder (OAB), we used consensus clustering of their urinary symptoms and other non-urologic factors.

Methods: Clinical variables included in the k-means consensus clustering included OAB symptoms, urinary incontinence, anxiety, depression, psychological stress, somatic symptom burden, reported childhood traumatic exposure, and bladder pain.

Role of the androgen, estrogen, and progesterone receptors in adherent perinephric fat in robotic partial nephrectomy.

To determine whether androgen, estrogen, and/or progesterone signaling play a role in the pathophysiology of adherent perinephric fat (APF). We prospectively recruited patients undergoing robotic assisted partial nephrectomy during 2015-2017. The operating surgeon documented the presence or absence of APF.

Initial Experience with Single-Port Robot-Assisted Radical Cystectomy: Comparison of Perioperative Outcomes Between Single-Port and Conventional Multiport Approaches.

The surgical techniques and devices used to perform radical cystectomy have evolved significantly with the advent of laparoscopic and robotic methods. The da Vinci Single-Port (SP) platform (Intuitive Surgical, Inc., Sunnyvale, CA) is an innovation that allows a surgeon to perform robot-assisted radical cystectomy (RARC) through a single incision.

Factors associated with higher prostate biopsy yield: when is software-assisted fusion MRI-targeting necessary?

Objective: To evaluate the addition of software-assisted fusion magnetic resonance imaging (MRI) targeted biopsy to systematic biopsy and determine clinical and imaging factors associated with improved prostate cancer (PCa) detection.

Methods: We analyzed 454 patients who had prostate MRI and underwent combined systematic and software-assisted fusion MRI-targeted biopsy at 2 academic centers between July 2015 and December 2017. For our analysis, we compared the Gleason grade group of cores obtained systematically to cores obtained using MRI-targeting.

Positive Surgical Margins After Robot-Assisted Partial Nephrectomy Predict Long-Term Oncologic Outcomes for Clinically Localized Renal Masses.

For patients with clinically localized renal masses, positive surgical margins (PSMs) after robotic partial nephrectomy (RPN) have been associated with a higher risk of disease recurrence, although some studies have challenged this conclusion. Owing to inconsistent reports and a lack of long-term robotic data, the clinical impact of PSM after RPN remains uncertain. We evaluate long-term (>6 years) survival outcomes after RPN in patients with clinically localized disease with respect to surgical margin status.

Laparoscopic cytoreductive nephrectomy is associated with significantly improved survival compared with open cytoreductive nephrectomy or targeted therapy alone.

The aim of the present study was to compare the survival outcomes for patients with metastatic renal cell carcinoma (mRCC) who underwent laparoscopic cytoreductive nephrectomy (CN) vs. open CN vs. targeted therapy (TT) alone at our institution.

Ten-Year Experience with Percutaneous Cryoablation of Renal Tumors: Tumor Size Predicts Disease Progression.

Percutaneous cryoablation (PCA) has emerged as an alternative to extirpative management of small renal masses (SRMs) in select patients, with a reduced risk of perioperative complications. Although disease recurrence is thought to occur in the early postoperative period, limited data on long-term oncologic outcomes have been published. We reviewed our 10-year experience with PCA for SRMs and assessed predictors of disease progression.

Hunner Lesion Phenotype in Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review and Meta-Analysis.

Purpose: We compared demographics, clinical presentation, comorbidities, urinary profiles, and treatment responses between patients with interstitial cystitis/bladder pain syndrome with and without Hunner lesions.

Materials And Methods: We performed a systematic review of the literature in PubMed® in February 2019. Publications were included if they compared data between patients with interstitial cystitis/bladder pain syndrome with and without Hunner lesions, yielding 59 articles.

Dual-frequency setting for urinary stone fragmentation during shock wave lithotripsy: an in vitro study.

Extracorporeal shock wave lithotripsy (SWL) is less invasive compared to the other invasive modalities of stone treatment that are gaining popularity. Hence, methods to improve the efficacy of SWL are desirable. We studied the effectiveness of dual frequency on the efficacy of stone fragmentation, but minimizing treatment time.

Diagnostic Performance of Prostate Multiparametric Magnetic Resonance Imaging in African-American Men.

Objective: To compare test performance of multiparametric magnetic resonance imaging (mpMRI) for detection of prostate cancer (PCa) in African-American men (AAM) and white men (WM) using the Prostate Imaging Reporting and Data System in unmatched groups as well as a cohort matched for clinical factors.

Methods: We examined our database of men who underwent prostate mpMRI prior to biopsy between October 2014 and June 2017 (n = 601; 60 AAM, 541 WM). Test performance was defined using Prostate Imaging Reporting and Data System classification 4 or 5 considered test positive and Gleason grade group 2 or greater from any biopsy core considered outcome positive.

The Accuracy of Prostate Magnetic Resonance Imaging Interpretation: Impact of the Individual Radiologist and Clinical Factors.

Objective: To compare test performance of multiparametric magnetic resonance imaging (mpMRI) for detection of prostate cancer between individual radiologists using the Prostate Imaging Reporting and Data System (PI-RADS) and to identify clinical factors that may predict test performance.

Materials And Methods: We examined our database of consecutive men who received prostate mpMRI prior to biopsy between September 2014 and December 2016 (n = 459). Test performance (eg, sensitivity, specificity, positive predictive value [PPV] and negative predictive value) were defined with PI-RADS classification 4 or 5 considered test positive and Gleason score ≥7 on biopsy from any targeted core considered outcome positive.

Comparing Off-clamp and On-clamp Robot-assisted Partial Nephrectomy: A Prospective Randomized Trial.

Objective: To determine whether performing robot-assisted partial nephrectomy without warm ischemia "off-clamp" results in favorable postoperative renal functional outcomes compared with the on-clamp method.

Methods: We conducted a prospective trial of 80 patients who underwent robot-assisted partial nephrectomy. They were randomized in a 1:1 ratio to undergo the procedure with renal artery clamping or without clamping.

Magnetic Resonance Imaging-Defined Prostate-Specific Antigen Density Significantly Improves the Risk Prediction for Clinically Significant Prostate Cancer on Biopsy.

Objective: To evaluate the predictive value of magnetic resonance imaging (MRI)-defined prostate-specific antigen (PSA) density and MRI interpretation for the detection of clinically significant prostate cancer (PCa).

Methods: We retrospectively reviewed our institutional database of men who received prostate MRI prior to biopsy at our institution between September 2014 and December 2016, excluding those on active surveillance (n = 372). Logistic regression models to predict clinically significant PCa on biopsy were developed using (1) MRI-defined PSA density; (2) PSA alone; and (3) the Prostate Cancer Prevention Trial (PCPT) risk calculator.

Urinary aquaporin 1 and perilipin 2: Can these novel markers accurately characterize small renal masses and help guide patient management?

Objective: To evaluate the role of urine aquaporin 1 and perilipin 2 as biomarkers adjunct to renal mass biopsy in guiding the management of patients with small renal masses.

Methods: Preoperative aquaporin 1 and perilipin 2 levels in 57 patients with small renal masses undergoing partial nephrectomy were analyzed and compared with postoperative tumor histology. An algorithm was created utilizing aquaporin 1 and perilipin 2 in conjunction with renal mass biopsy.