Identification of Bladder Diverticular Stone on Tc-Methyl Diphosphonate Bone Scintigraphy and SPECT/CT.

We report a bladder diverticular stone with increased Tc-methyl diphosphonate uptake on bone scintigraphy and SPECT/CT. Diverticular stone is a known risk factor for bladder malignancy. The deposition of Tc-methyl diphosphonate on the crystal surface of the diverticular stone is a rare phenomenon but of clinical significance.

The effect of urinary diversion on long-term kidney function after cystectomy.

Objectives: Cystectomy with urinary diversion is associated with decreased long-term kidney function due to several factors. One factor that has been debated is the type of urinary diversion used: ileal conduit (IC) vs. neobladder (NB).

MRI - ultrasound fusion guided biopsy of the prostate: lesion volume as a predictor of cancer in patients with repeat biopsies.

Introduction: The objective was to analyze the diagnostic value of multiparametric magnetic resonance imaging (MRI) prostate lesion volume (PLV) and its correlation with the subsequent MRI-ultrasound (MRI-US) fusion biopsy results.

Materials And Methods: Between March 2014 and July 2016, 150 men underwent MRI-US fusion biopsies at our institution. All suspicious prostate lesions were graded according to the Prostate Imaging Reporting and Data System (PIRADS) and their volumes were measured.

Analysis of Benign Prostatic Hyperplasia Patients' Perspective Through a Third Party-administered Survey.

Objective: To assess patient-reported functional and quality-of-life (QoL) outcomes associated with various surgical treatments for benign prostate hyperplasia (BPH).

Materials And Methods: An independent third-party survey was sent to all patients who underwent any surgical treatment for BPH at our institution from January 2007 through January 2013. Overall satisfaction and urinary and sexual outcomes were evaluated using Sexual Health Inventory for Men (SHIM), International Prostate Symptoms Score (IPSS) for urinary function, and International Continence Society-Short Form (ICSmaleSF) questionnaires.

Proton beam therapy for localized prostate cancer 101: basics, controversies, and facts.

Proton beam therapy for prostate cancer has become a source of controversy in the urologic community, and the rapid dissemination and marketing of this technology has led to many patients inquiring about this therapy. Yet the complexity of the technology, the cost, and the conflicting messages in the literature have left many urologists ill equipped to counsel their patients regarding this option. This article reviews the basic science of the proton beam, examines the reasons for both the hype and the controversy surrounding this therapy, and, most importantly, examines the literature so that every urologist is able to comfortably discuss this option with inquiring patients.

Marital status and prostate cancer outcomes.

Introduction: To evaluate the influence of marriage on the survival outcomes of men diagnosed with prostate cancer.

Materials And Methods: We examined 115,922 prostate cancer cases reported to the Surveillance, Epidemiology, and End Results (SEER) database between 1988 and 2003. Multivariate Cox regression techniques were used to study the relationship of marital status and prostate cancer-specific and overall mortality.

Outcome and toxicity for patients treated with intensity modulated radiation therapy for localized prostate cancer.

Purpose: We evaluate long-term disease control and chronic toxicities observed in patients treated with intensity modulated radiation therapy for clinically localized prostate cancer.

Materials And Methods: A total of 302 patients with localized prostate cancer treated with image guided intensity modulated radiation therapy between July 2000 and May 2005 were retrospectively analyzed. Risk groups (low, intermediate and high) were designated based on National Comprehensive Cancer Network guidelines.

Anatomic site-specific disparities in survival outcomes for penile squamous cell carcinoma.

Objective: To identify the predictors of cancer-specific mortality of penile squamous cell carcinoma (PSCC) using a population-based database.

Methods: Using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results registry, we performed a time-to-event analysis to determine which clinical parameters were useful in predicting cancer-specific mortality.

Results: Our cohort consisted of 2515 cases of PSCC diagnosed from 1973 to 2007.

Impact of margin status at 37 months after robot assisted radical prostatectomy.

Introduction: We evaluate the impact of margin length, location, and pathologic stage on biochemical recurrence (BCR) after robot assisted radical prostatectomy (RARP) at 37 months of follow up.

Materials And Methods: A total of 1420 patients underwent a robot assisted radical prostatectomy between March 2004 and May 2010. Patients who received adjuvant therapy, those who never achieved an undetectable prostate-specific antigen (PSA), and those who had less than 18 months of follow up were excluded.

Older age does not impact perioperative complications after robot-assisted radical prostatectomy.

To determine whether men aged 70 years and older had more perioperative complications after robot-assisted radical prostatectomy (RARP) compared with younger patients, a retrospective review was performed on patients who underwent RARP between March 2004 and September 2009. Subjects were stratified according to age into four groups (age 30-49, 50-59, 60-69, and ≥70 years). American Society of Anesthesiologists (ASA) scores were obtained.

Preliminary analysis of the feasibility and safety of salvage robot-assisted radical prostatectomy after radiation failure: multi-institutional perioperative and short-term functional outcomes.

Background And Purpose: Open radical prostatectomy after radiation treatment failure for prostate cancer is associated with significant morbidity. The purpose of the study is to report multi-institutional experiences while performing salvage robot-assisted radical prostatectomy (sRARP).

Patients And Methods: We retrospectively identified 15 patients with biopsy-proven prostate cancer after definitive radiotherapy who underwent sRARP in three academic institutions over a 20-month period.

Urinary bladder injuries during vascular surgery.

Urologic complications related to vascular surgery involving the ureter have been well recognized. These include ureteral compression from aneurysms, congenital anomalies such as retrocaval ureter, obstruction from retroperitoneal fibrosis, iatrogenic injury, and ureteric fistulas. Complications involving the bladder are more infrequent.

Accuracy of ultrasound in estimation of prostate weight: comparison of urologists and radiologists.

Introduction: Measurements of prostate size are obtained to contribute in the diagnosis and follow up of patients with a variety of diseases. Since its introduction, transrectal ultrasonography (TRUS) of the prostate has become the most common method for assessment of prostate volumes. Ultrasonography, in general, has been associated with concerns of operator dependent variability.

Radiation dose escalation for localized prostate cancer: intensity-modulated radiotherapy versus permanent transperineal brachytherapy.

Background: In the current study, the effects of dose escalation for localized prostate cancer treatment with intensity-modulated radiotherapy (IMRT) or permanent transperineal brachytherapy (BRT) in comparison with conventional dose 3-dimensional conformal radiotherapy (3D-CRT) were evaluated.

Methods: This study included 853 patients; 270 received conventional dose 3D-CRT, 314 received high-dose IMRT, 225 received BRT, and 44 received external beam radiotherapy (EBRT) + BRT boost. The median radiation doses were 68.

Interval from prostate biopsy to robot-assisted radical prostatectomy: effects on perioperative outcomes.

Objective: To determine whether shorter intervals (<4 and 6 weeks) between prostate biopsy and robot-assisted radical prostatectomy (RARP) have a detrimental effect on perioperative outcomes, as recent studies showed that open RP shortly after prostate biopsy does not adversely influence surgical difficulty or efficacy, but RARP relies solely on visual cues rather than tactile sensation to determine posterior surgical planes of dissection.

Patients And Methods: A series of 559 patients undergoing RARP from March 2004 to July 2007 was retrospectively reviewed. The interval between prostate biopsy and RARP was determined and patients with intervals of 4 weeks.

Does a history of previous surgery or radiation to the prostate affect outcomes of robot-assisted radical prostatectomy?

Objective: To evaluate retrospectively whether or not previous treatment to the prostate alters the perioperative outcomes from robot-assisted radical prostatectomy (RARP) after the initial 'learning curve', as there are conflicting data on outcomes of RP in patients with previous treatment to the prostate.

Patients And Methods: We retrospectively reviewed the charts of patients who had RARP between March 2005 and August 2007, and analysed demographic, perioperative variables and pathological data. In all, 510 patient charts were reviewed, identifying 24 patients with a history of previous treatment to the prostate including transurethral resection or incision of the prostate, transurethral microwave therapy, transurethral needle ablation, photoselective vaporization, simple prostatectomy, external beam radiotherapy, brachytherapy, and open bladder neck reconstruction (group 1) and 486 with no previous treatment (group 2).

Laparoscopic radical nephrectomy for very large renal tumors (> or =10 cm): is there a size limit?

Background And Purpose: The role of laparoscopic radical nephrectomy (LRN) for very large renal tumors remains to be defined. We review our experience with LRN for very large (> or =10 cm) renal malignancies.

Patients And Methods: A retrospective analysis of 360 consecutive patients who underwent LRN for renal tumors between October 1999 and May 2007 in a tertiary academic center identified 11 patients with malignancies > or =10 cm.

Outcomes of laparoscopic radical nephrectomy in the setting of vena caval and renal vein thrombus: seven-year experience.

Purpose: We present our experience with laparoscopic radical nephrectomy for T(3b) disease focusing on thrombus within the vena cava.

Patients And Methods: A total of 14 patients with T(3b) disease were identified from a retrospective laparoscopic renal cancer database from 2000 to 2007. Patient demographics, clinical stage, preoperative imaging, intraoperative parameters, final pathology, and postoperative course were analyzed.

Robot-assisted extended pelvic lymphadenectomy.

Purpose: To evaluate perioperative and pathologic outcomes of patients undergoing robot-assisted extended pelvic lymphadenectomy for bladder cancer.

Materials And Methods: A retrospective chart review was performed for all 27 patients who underwent robotassisted radical cystectomy (RARC) and extended pelvic lymphadenectomy at Tulane University and Mayo Clinic Arizona between March 2005 and April 2007. Baseline demographic, perioperative, and pathologic data were evaluated.

Laparoscopic partial nephrectomy at the Mayo Clinic Arizona: follow-up surveillance of positive margin disease.

Objectives: There is no consensus as to the management of positive surgical margins after laparoscopic partial nephrectomy (LPN). A recent study revealed no evidence of malignancy in radical nephrectomy specimens removed for this reason, pointing out that a positive margin does not always translate to residual disease. We present results from our institution for the first 80 LPN performed with minimum 2 years' follow-up, focusing on patients with malignancy noted to have positive margin on final pathology.

Bilateral laparoscopic nephrectomy for significantly enlarged polycystic kidneys: a technique to optimize outcome in the largest of specimens.

Objective: To present our experience with bilateral laparoscopic nephrectomy (BLN) for symptomatic autosomal-dominant polycystic kidney disease (ADPKD), as surgical management of massively enlarged polycystic kidneys can be a daunting task.

Patients And Methods: The study was a retrospective chart review of all patients undergoing BLN for ADPKD. Patient demographics, indications for the procedure, perioperative data, and pathological data were analysed.

Salvage radiotherapy for isolated prostate specific antigen increase after radical prostatectomy: evaluation of prognostic factors and creation of a prognostic scoring system.

Purpose: This study was performed to evaluate the results and prognostic factors associated with radiotherapy for a detectable serum prostate specific antigen level after radical prostatectomy.

Materials And Methods: From July 1987 through July 2003, 368 patients received radiotherapy for a detectable prostate specific antigen level (biochemical relapse) as the sole evidence of recurrence after radical prostatectomy for node negative prostate cancer. Estimated survival and relapse-free probabilities were obtained via Kaplan-Meier estimation.

Routine postoperative chest x-ray following laparoscopic nephrectomy.

Purpose: To determine whether a routine postoperative chest x-ray is required following uneventful laparoscopic nephrectomy to rule out pneumothorax.

Methods: From June 1999 to May 2003, 308 laparoscopic nephrectomy cases were performed by 5 different surgeons. This consisted of 121 radical nephrectomies, 106 donor nephrectomies, 29 simple nephrectomies, 29 partial nephrectomies, and 23 nephroureterectomies.

The male sling for post-prostatectomy incontinence: mean followup of 18 months.

Purpose: We review our experience with 42 consecutive patients undergoing the bone anchored male sling procedure.

Materials And Methods: A retrospective chart review was performed, and complete data and followup were available in 38 of the 42 patients. Success was defined as wearing 1 thin pad or less per day, or social continence.

Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy: do outcomes differ?

Objectives: To compare, in a retrospective analysis, the outcome of salvage external beam radiotherapy (EBRT) for isolated prostate-specific antigen (PSA) elevation or palpable local recurrence after radical prostatectomy (RP).

Methods: We evaluated 102 men who underwent EBRT from 1993 to 1999, 60 for a rising PSA level alone and 42 for palpable local disease after RP. Biochemical disease-free survival and overall survival were calculated.