Diagnosing Prostate Cancer: The Role of Intravesical Prostatic Gland Protrusion on Accuracy of Prostate Biopsies.

Purpose: We evaluated the association between intravesical prostate protrusion (IPP) and the detection rate of clinically significant prostate cancer (csPCa) on magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) fusion targeted biopsy (TB).

Materials And Methods: A total of 538 consecutive men who underwent MRI-TRUS fusion TB and concomitant systematic biopsy were evaluated. IPP on MRI was independently measured by 4 blinded reviewers.

Clinical Utility of Rigid Blue Light Cystoscopy: Results from a Post Procedure User Survey in a Prospective Multicenter Registry.

Introduction: Despite the effectiveness of blue light cystoscopy (BLC) in the management of bladder cancer, the adoption of BLC since its approval has been limited. We evaluated the perceived clinical utility of BLC and assessed factors associated with higher perceived utility of BLC.

Methods: This study used a prospective multi-institutional registry of patients with known or suspected noninvasive bladder cancer.

MRI/PET Imaging in elevated PSA and localized prostate cancer: a narrative review.

Objective: To review the recent milestones in MRI and PET based imaging and evaluate their evolving role in the setting of elevated PSA as well as localized prostate cancer.

Background: The importance of multiparametric MRI (mpMRI) and PET based imaging for the diagnosis and staging of prostate cancer cannot be understated. Accurate staging has become another significant milestone with the use of PET scans, particularly with prostate specific radiotracers like 68-Gallium Prostate Specific Membrane Antigen (68Ga-PSMA).

Impact of Preoperative Immunonutrition on Perioperative Outcomes following Cystectomy.

Purpose: Radical cystectomy (RC) for the management of muscle-invasive bladder cancer remains a morbid procedure with high rates of perioperative complications. The role of preoperative immunonutritional supplementation (pre-INS) in improving post-RC outcomes is promising and needs further validation.

Materials And Methods: We performed a retrospective review of 204 patients who underwent RC for bladder cancer at a single institution, comparing patients who received oral L-arginine-based pre-INS, and those who did not.

Drain fluid creatinine-to-serum creatinine ratio as an initial test to detect urine leakage following cystectomy: A retrospective study.

Introduction: Urine leak following radical cystectomy is a known complication. Among the various methods to diagnose this, assessment of drain fluid creatinine is a relatively easy procedure. We aimed to ascertain the validity of the drain fluid creatinine-to-serum creatinine ratio (DCSCR) as an initial indicator of urinary leak in patients undergoing radical cystectomy.

Alvimopan as part of the Enhanced Recovery After Surgery protocol following radical cystectomy is associated with decreased hospital stay.

Objective: To study the effect of alvimopan and the Enhanced Recovery After Surgery protocol on length of hospital stay in patients undergoing radical cystectomy.

Methods: Our retrospective study involved 296 consecutive patients undergoing radical cystectomy for bladder cancer at our institution from 2010 through 2018. Patients were grouped according to three stages of the Enhanced Recovery After Surgery protocol implementation: (i) pre-Enhanced Recovery After Surgery (group A; n = 146); (ii) pre-alvimopan Enhanced Recovery After Surgery (group B; n = 102); and (iii) Enhanced Recovery After Surgery plus alvimopan (group C; n = 48).

Management of bladder tumors in pregnancy: A case of tumor prolapse and avulsion during labor.

Pregnancy presents unique obstacles to diagnosis and management of urologic disease. We present a case of a primigravid female with clot retention requiring evacuation in the operating room due to the avulsion of a bladder mass which prolapsed during labor. Tumor pathology demonstrated a low-grade spindle cell lesion positive for progesterone receptor (PR) and high mobility group A2 (HMGA2), suggestive of deep angiomyxoma versus a benign fibroepithelial polyp or inflammatory myofibroblastic tumor.

Risk of Genitourinary Malignancy in the Renal Transplant Patient.

Objective: To better understand the risk of genitourinary malignancies in the renal transplant patient. Currently, no consensus exists regarding screening and intervention, with much of the clinical decision-making based on historical practices established before recent progress in immunosuppression protocols and in genitourinary cancer diagnosis and management.

Methods: A database of all solid organ transplants performed at the University of Minnesota from 1984 to 2019 was queried for renal transplant recipients in whom development of subsequent urologic malignancies (prostate, bladder, renal, penile, and testicular cancer) was found.

Public Perceptions of Artificial Intelligence and Robotics in Medicine.

To understand better the public perception and comprehension of medical technology such as artificial intelligence (AI) and robotic surgery. In addition to this, to identify sensitivity to their use to ensure acceptability and quality of counseling. A survey was conducted on a convenience sample of visitors to the MN Minnesota State Fair ( = 264).

A Large Renal Mass: Dilemmas With Unusual Features on Imaging.

A 50-year-old man presented with palpable abdominal mass which on CT revealed a large tumor replacing the entire right kidney, filling the right hemi-abdomen and travelling down the ureter into the bladder with retroperitoneal lymphadenopathy. Urine cytology and metastatic workup were negative. Ultrasound guided renal biopsy revealed diffuse large B cell lymphoma (DLBCL) and the patient was started on combination chemotherapy.

Urological infections in the developing world: an increasing problem in developed countries.

Purpose: Infectious diseases that often follow geographical distribution patterns are increasingly crossing such boundaries, aided by human travel and commerce. These pose a new challenge to physicians who are required to diagnose previously unseen conditions and address drug-resistant organisms. We review some such common infections.

Immuno-Oncology Approaches to Salvage Treatment for Non-muscle invasive Bladder Cancer.

This article provides a comprehensive review of the available data for immunotherapy being used as a salvage treatment in non-muscle-invasive bladder cancer. The literature demonstrates that the immune system has an important role in bladder cancer progression. Initial results from studies using checkpoint inhibitors, recombinant interferon-α2b protein, and oncolytic adenoviruses have shown promising responses with acceptable toxicities.

Relevance of semen polymerase chain reaction positive for tuberculosis in asymptomatic men undergoing infertility evaluation.

Objective: Male partners of infertile women with genital tuberculosis (TB) are often screened for genital TB. We aimed to evaluate the clinical significance of a positive screening semen polymerase chain reaction (PCR) for Mycobacterium tuberculosis test (TB-PCR) in asymptomatic men undergoing infertility evaluation and determine the need for a detailed investigation and treatment for TB.

Materials And Methods: Between March 2012 and January 2013, male partners of 15 infertile women with a diagnosis of genitourinary TB (GUTB) as the cause of infertility, tested positive either on semen PCR for TB (13 cases), or Mycobacterium Growth Indicator Tube-960 test (2 cases).

Robot-assisted laparoscopic augmentation ileocystoplasty in a tubercular bladder.

Some of the patients with genitourinary tuberculosis (GUTB) present to the urologist with small contracted bladders or with significant renal damage.[1] Additional reconstructive procedures are often required along with anti-tubercular treatment in these patients. These procedures commonly performed via the open approach, now have the advantage of minimally invasive approach provided by laparoscopic and robotic surgery.

Robot assisted laparoscopic retroperitoneal lymph node dissection in testicular tumor.

The treatment options in clinical stage I nonseminomatous germ cell tumor (NSGCT) of testis are either surveillance, chemotherapy or retroperitoneal lymph node dissection (RPLND). While open RPLND still serves as the gold standard, laparoscopic and robot assisted laparoscopic approaches are gaining popularity. In this report, we share our experience and technique of robot assisted laparoscopic RPLND in a patient with clinical stage Ib NSGCT of testis.

Outcome analysis of tumors in undescended testes--a single center experience of 15 years.

Objective: To present our experience in managing tumors in undescended testes (UDT) in the last 15 years at our institute, in an attempt to understand the tumor behavior and the optimum approach to management in these patients.

Methods: This is a retrospective review of all patients with tumors in UDT who had registered and undergone treatment at our institute in the last 15 years. The available records of 50 of these patients were reviewed with respect to the presentation, pathologic type, treatment schedule followed, and the survival and recurrence statistics.

An unusual cause of urinary retention in a young female: a case report.

Inflammatory myofibroblastic tumors are commonly seen in young adults and adolescents and commonly present with painless hematuria. We report a case of a 38-year-old woman who presented to us with urinary retention due to a prolapsing tumor mass from the urethra, which was discovered to be an inflammatory myofibroblastic tumor arising from the bladder base and involving the bladder neck. The patient underwent a successful transurethral resection of the tumor and at 6-month follow-up was continent and symptom-free.

Lower ureteral stones revisited: expanding the horizons of robotics.

Objective: To study the feasibility of robot-assisted laparoscopic ureterolithotomy for large (>2 cm) or impacted lower ureteral stones and the immediate outcome measures such as the stone-free rate and occurrence of intra- and postoperative complications.

Materials And Methods: From April 2010 to August 2012, 52 robotic stone surgeries were performed in our department. Robot-assisted laparoscopic ureterolithotomy was performed in 16 patients for large (>2 cm) or impacted lower ureteral stones.