Erectile dysfunction is an underdiagnosed consequence of low anterior resection and abdominoperineal resection for colorectal cancer.

To explore the frequency and predictive factors of erectile dysfunction diagnosis after colorectal cancer surgery. The Surveillance, Epidemiology, and End Results-Medicare database was used to identify a national sample of men undergoing surgery for colorectal cancer from 2004 to 2015. Men aged > 65 years with any index surgery within 1 year of diagnosis of colorectal cancer were included.

Imaging in Diagnosis and Active Surveillance for Prostate Cancer: A Review.

Importance: Active surveillance (AS) has become an increasingly important option for managing low-risk and select intermediate-risk prostate cancer. Although imaging, particularly multiparametric magnetic resonance imaging (mpMRI), has emerged in the prebiopsy pathway for the diagnosis of prostate cancer, the role of mpMRI in patient selection for AS and the necessity of prostate biopsies during AS remain poorly defined. Despite well-founded biopsy schedules, there has been substantial investigation into whether imaging may supplant the need for prostate biopsies during AS.

The oncologic risk of magnetic resonance imaging-targeted and systematic cores in patients treated with radical prostatectomy.

Background: Magnetic resonance imaging (MRI)-targeted prostate biopsy (MRI-biopsy) detects high-Grade Group (GG) prostate cancers not identified by systematic biopsy (S-biopsy). However, questions have been raised whether cancers detected by MRI-biopsy and S-biopsy, grade-for-grade, are of equivalent oncologic risk. The authors evaluated the relative oncologic risk of GG diagnosed by S-biopsy and MRI-biopsy.

Taking PI-QUAL beyond the prostate: Towards a standardized radiological image quality score (RI-QUAL).

Purpose: To compare the interreader agreement of a novel quality score, called the Radiological Image Quality Score (RI-QUAL), to a slighly modified version of the existing Prostate Imaging Quality (mPI-QUAL) score for magnetic resonance imaging (MRI) of the prostate.

Methods: A total of 43 consecutive scans were evaluated by two subspecialized radiologists who assigned scores using both the RI-QUAL and mPI-QUAL methods. The interreader agreement was analyzed using three statistical methods: concordance correlation coefficient (CCC), intraclass correlation coefficient (ICC), and Cohen's kappa.

2022 Update on Prostate Cancer Epidemiology and Risk Factors-A Systematic Review.

Context: Prostate cancer (PCa) is one of the most common cancers worldwide. Understanding the epidemiology and risk factors of the disease is paramount to improve primary and secondary prevention strategies.

Objective: To systematically review and summarize the current evidence on the descriptive epidemiology, large screening studies, diagnostic techniques, and risk factors of PCa.

A Novel Expert Coaching Model in Urology, Aimed at Accelerating the Learning Curve in Robotic Prostatectomy.

Introduction/background: The surgical residency model assumes that upon completion, a surgeon is ready to practice and grow independently. However, many surgeons fail to improve after reaching proficiency, which in certain instances has correlated with worse clinical outcomes. Coaching addresses this problem and furthers surgeons' education post-residency.

A systematic review of outcomes after thermal and nonthermal partial prostate ablation.

We sought to compare oncologic and functional outcomes between thermal and nonthermal energy partial gland ablation (PGA) modalities. We conducted comprehensive, structured literature searches, and 39 papers, abstracts, and presentations met the inclusion criteria of pre-PGA magnetic resonance imaging, oncologic outcomes of at least 6 months, and systematic biopsies after PGA. Twenty-six studies used thermal ablation: high-intensity focused ultrasound (HIFU), cryotherapy, focal laser ablation, or radiofrequency ablation.

Does neoadjuvant chemotherapy diminish the sex disparity in bladder cancer survival after radical cystectomy?

Introduction: Sex-specific survival disparities for bladder cancer outcomes after radical cystectomy (RC) have been demonstrated in several studies. However, these studies predate the widespread adoption of neoadjuvant chemotherapy (NAC). We evaluated the differences in sex-specific survival between patients who received NAC with those who did not, using a contemporary national outcomes database.

Immune Deficiency Does Not Increase Inflatable Penile Prosthesis Reoperation Rates.

Introduction: Immunocompromised patients are postulated to have higher rates of post-operative infection. We sought to determine if inflatable penile prosthesis (IPP) reoperation rates (due to infection, erosion, device malfunction or patient dissatisfaction) are higher among immunocompromised men.

Methods: We analyzed men who underwent initial IPP insertion from 2000 to 2016 in the New York Statewide Planning and Research Cooperative System database.

Outcome of penile lengthening of adolescents and young adults born with bladder exstrophy and epispadias.

Background: The decreased penile length in patients born with BE results partly from pubic symphysis diastasis and the separation of the corporal bodies, which causes a shortened penis as the corporal length is lost in traversing the distance between the pubic rami. However, in some cases there is an intrinsic penile abnormality and dorsal chordee. Furthermore, multiple surgeries has in some cases, resulted in cutaneous and subcutaneous scarring, which contributed to the problem of the short phallus and dorsal tethering to the abdominal wall (figure).

Defining the index lesion for potential salvage partial or hemi-gland ablation after radiation therapy for localized prostate cancer.

Background: Salvage partial gland ablation (sPGA) has been proposed to treat some localized radiorecurrent prostate cancer. The role of prostate biopsy and magnetic resonance imaging (MRI) characteristics to identify patients eligible for sPGA is unknown.

Objective: To evaluate the ability of MRI and prostate biopsy characteristics to identify an index lesion suitable for sPGA and validate this selection using detailed tumor maps created from whole-mount slides from salvage radical prostatectomy (sRP) specimens.

Survival Outcomes in Neoadjuvant Chemotherapy for High-grade Upper Tract Urothelial Carcinoma: A Nationally Representative Analysis.

Objective: To assess the impact of neoadjuvant chemotherapy (NAC) on survival outcomes in a contemporary cohort of patients with in upper tract urothelial carcinoma (UTUC).

Methods: The National Cancer Database was queried from 2004 to 2015 to identify subjects who underwent nephroureterectomy for UTUC. Kaplan-Meier method with log-rank test was performed to compare all-cause mortality between patients who received preoperative chemotherapy to those who did not at each pathologic (p) TNM stage group: T1-4N0, N+, and M+ disease.

Role of Changes in Magnetic Resonance Imaging or Clinical Stage in Evaluation of Disease Progression for Men with Prostate Cancer on Active Surveillance.

Background: Active surveillance (AS) protocols rely on rectal examination, prostate-specific antigen, imaging, and biopsy to identify disease progression.

Objective: To evaluate whether an AS regimen based on magnetic resonance imaging (MRI) or clinical stage changes can detect reclassification to grade group (GG) ≥2 disease compared with scheduled systematic biopsies.

Design, Setting, And Participants: We identified a cohort of men initiated on AS between January 2013 and April 2016 at a single tertiary-care center.

Patient-reported pain, discomfort, and anxiety during magnetic resonance imaging-targeted prostate biopsy.

Introduction: The addition of targeted prostate biopsy to systemic biopsy impacts patient experience. We examined patient-reported pain, discomfort, anxiety, and tolerability among men undergoing magnetic resonance imaging (MRI)-targeted prostate biopsy in addition to transrectal ultrasound-guided systematic biopsy compared to those undergoing systematic biopsy alone.

Methods: All patients underwent transrectal systematic 14-core biopsies.

Fertility management of Klinefelter syndrome.

: Klinefelter syndrome (KS) represents the most common chromosomal abnormality in the general population, and one of the most common genetic etiologies of nonobstructive azoospermia (NOA) and in severe oligospermia. Once considered untreatable, men with KS and NOA now have a variety of treatment options to obtain paternity.: The cornerstone of treatment for both KS and NOA patients remains the surgical retrieval of viable sperm, which can be used for intracytoplasmic sperm injection to obtain pregnancy.

What Is Underlying Resident Burnout in Urology and What Can Be Done to Address this?

Physician burnout-a constellation of depersonalization, emotional exhaustion, reduced feelings of personal attachment, and a low sense of accomplishment-is a term that has been around since the 1980s. Burnout rates among residents and fellows are higher than medical students, attending physicians, and age-matched college graduates, with rates ranging from 40-80% of trainees across subspecialties. Unfortunately, burnout among residents and trainees has been linked to lower scores on in-service examinations for internal medicine residents as well as poorer overall health and exercise habits.

Association of Smoking and Death from Genitourinary Malignancies: Analysis of the National Longitudinal Mortality Study.

Purpose: We explored the association between tobacco use and genitourinary cancer specific survival in a contemporary, nationally representative sample of the United States civilian population.

Materials And Methods: A total of 493,282 participants in the National Longitudinal Mortality Study who provided detailed tobacco information from 1993 to 2005 were included in study. Our primary outcome was death from bladder, kidney or prostate cancer.

Recent advances in understanding and managing male infertility.

Infertility is a prevalent condition affecting an estimated 70 million people globally. The World Health Organization estimates that 9% of couples worldwide struggle with fertility issues and that male factor contributes to 50% of the issues. Male infertility has a variety of causes, ranging from genetic mutations to lifestyle choices to medical illnesses or medications.