Primary Small Cell Carcinoma of the Bladder.

A 64-year-old Caucasian man with a 20 to 25-pack-year cigarette smoking history presented to his primary care provider with the chief complaint of gross hematuria after experiencing three to four months of urinary frequency and urgency. His workup consisted of laboratory blood work, a renal/bladder ultrasound (US), a CT scan without contrast, cystoscopy with biopsy (with an attempted transurethral resection of bladder tumor), and a PET scan. He was diagnosed with stage T4 small cell carcinoma of the bladder (SCCB) shortly after seeking medical care with metastases to the liver, bone, and lymph nodes.

Erectile dysfunction in renal failure and transplant patients.

Erectile dysfunction (ED) is a prevalent and pertinent condition in the chronic kidney disease (CKD) population. It has a multifactorial etiology, including disruptions of the hypothalamic-pituitary-gonadal axis, the endothelial paracrine signaling system, calcium and vitamin D homeostasis, along with several other factors. Efficacy of treatment of ED in the CKD population is comparable to non-CKD patients across multiple modalities, including PDE5 inhibitors, vacuum erectile devices, intracavernosal injections and penile prostheses.

Upper tract urothelial carcinoma: Paradigm shift towards nephron sparing management.

Upper tract urothelial carcinoma (UTUC) is relatively rare compared to urothelial carcinoma of the lower tract, comprising only 5%-10% of all urothelial cancers. Although both entities share histologic properties, UTUC tends to be more invasive at diagnosis and portend a worse prognosis, with a 5 year overall mortality of 23%. To date, the gold standard management of UTUC has been radical nephroureterectomy (RNU), with nephron sparing techniques reserved for solitary kidneys or cases where the patient could not tolerate radical surgery.