Cognitive Behavioral Therapy for Chronic Pelvic Pain: What Is It and Does It Work?

Purpose: Urologic chronic pelvic pain syndrome (UCPPS), which encompasses interstitial cystitis/bladder pain syndrome in women and men and chronic prostatitis/chronic pelvic pain syndrome in men, is a common, often disabling urological disorder that is neither well understood nor satisfactorily treated with medical treatments. The past 25 years have seen the development and validation of a number of behavioral pain treatments, of which cognitive behavioral therapy (CBT) is arguably the most effective. CBT combines strategies of behavior therapy, which teaches patients more effective ways of behaving, and cognitive therapy, which focuses on correcting faulty thinking patterns.

Extensive scrotal lymphangioma circumscriptum: A case report with successful treatment with staged CO2 laser ablation.

Scrotal lymphangioma circumscriptum (LC) is an uncommon, benign skin disorder with multiple treatment modalities. We present staged treatment of extensive LC of the scrotum using staged carbon dioxide (CO2) laser ablation. We achieved near complete resolution of lesions with excellent cosmesis in the span of four months, from presentation to treatment.

Cross-sectional Survey-based Study of Underrepresented Minorities in Urology Academic Leadership Roles.

Objective: To define the current proportion of underrepresented minority (URM) academic urologists in leadership positions.

Methods: A cross-sectional observational study of leadership positions in active United States Urology Residency Programs in 2020 was conducted. Academic urologists in leadership positions were electronically mailed a survey asking about personal and professional demographics.

Large pelvic hematoma following UroLift procedure causing renal failure requiring dialysis.

The prostatic urethral lift procedure is a minimally invasive treatment option for lower urinary tract symptoms due to benign prostatic hyperplasia, with reported benefit of less adverse effects than traditional treatments. While complications are usually minimal, our patient developed a large pelvic hematoma and the first case of organ failure after prostatic urethral lift. He required temporary dialysis during his extended postoperative admission, and his chronic kidney disease permanently progressed from stage III to stage IV.

Internal Validation and Correlation of 2 Different Prostate Specific Antigen Assays for Prostate Cancer Screening in Community Based Men.

Introduction: There are more than 20 prostate specific antigen assays in use in the United States and studies have been mixed regarding correlations among them. The Abbott ARCHITECT Total PSA and the Roche Modular Analytics E170 Total PSA have been used in 2 local hospital systems that recently merged. We defined the comparability of these assays and present it from a clinical perspective.

Lower urinary tract injury: is urology consultation necessary?

Purpose: There is a paucity of data regarding urology involvement in the management of lower urinary tract injuries (LUTI). We seek to analyze the incidence and epidemiology of LUTI with special attention to trends in urology consultation.

Methods: A retrospective review was conducted of patients presenting to our Level I trauma center with LUTI from 2002 to 2016.

Surveillance and management of urologic complications after spinal cord injury.

Purpose: Neurogenic bladder due to spinal cord injury has significant consequences for patients' health and quality of life. Regular surveillance is required to assess the status of the upper and lower urinary lower urinary tracts and prevent their deterioration. In this review, we examine surveillance techniques in neurogenic bladder, describe common complications of this disease, and address strategies for their management.

Urologic Management and Complications in Spinal Cord Injury Patients: A 40- to 50-year Follow-up Study.

Objective: To assess the management and types of urologic complications in spinal cord injury (SCI) patients and to explore the risk factors for these complications.

Methods: A total of 43 SCI patients with a median follow-up of 45 (range 40-50) years were included in this retrospective study. All medical charts were reviewed for demographics, urologic complications, and bladder management.

Management of pelvic organ prolapse in the elderly - is there a role for robotic-assisted sacrocolpopexy?

Abdominal sacrocolpopexy is considered the gold standard treatment for symptomatic pelvic organ prolapse (POP). Since its introduction, robotic-assisted sacrocolpopexy has emerged as a popular minimally invasive alternative to open repair. Epidemiologic data suggest that the number of women seeking surgical treatment for POP will increase to ~50% by 2050, and many of these women will be elderly.

Reduction in hospital admissions with the addition of prophylactic intramuscular ceftriaxone before transrectal ultrasonography-guided prostate biopsies.

Objective: To evaluate the hospitalization rates in 2 pre-prostate biopsy antibiotic protocols.

Methods: Two prebiopsy protocols were compared. CiproAlone required ciprofloxacin 500 mg twice daily starting 1 day before biopsy and continuing for 3 days after biopsy (4 days total).

Robotic sacrocolpopexy.

Pelvic organ prolapse (POP) is a prevalent condition with 1 in 9 women seeking surgical treatment by the age of 80 years. Goals of treatment are relief and prevention of symptoms, and restoration of pelvic floor support. The gold standard for surgical treatment of POP has been abdominal sacrocolpopexy (ASC).

Neurogenic lower urinary tract dysfunction: how, when, and with which patients do we use urodynamics?

Neurogenic lower urinary tract dysfunction (NLUTD) affects many patients and requires close monitoring. Initial studies establishing patients at risk for upper tract disease revealed that high detrusor leak point pressures were predictive of upper tract disease. Urodynamics in patients with NLUTD have specific challenges.

Low incidence of prostate cancer identified in the transition and anterior zones with transperineal biopsy.

Purpose: Determine the incidence of anterior (AZ) and transition (TZ) zone prostate cancers using a transperineal mapping approach.

Methods: A retrospective review of 137 patients with history of previous negative biopsy undergoing transperineal saturation biopsy for an elevated prostate-specific antigen (PSA), high-grade prostate intraepithelial neoplasia, atypical small acinar proliferation history, or abnormal digital rectal exam. The number of biopsy cores was determined by prostate volume and obtained using a predefined template.

Clinical correlates of renal angiomyolipoma subtypes in 209 patients: classic, fat poor, tuberous sclerosis associated and epithelioid.

Purpose: Angiomyolipomas classically present radiographically as fat containing lesions but some fail to demonstrate fat content. Histologically confirmed angiomyolipomas uniformly follow a benign course but rare epithelioid variants of angiomyolipoma can recur and metastasize. We investigated the clinical, radiographic and histological characteristics of each angiomyolipoma subtype.

Conservative management of giant symptomatic angiomyolipomas in patients with the tuberous sclerosis complex.

Objective: To present two patients with the tuberous sclerosis complex in whom giant angiomyolipomas (AMLs) were managed conservatively for >20 years, as large (>4 cm) symptomatic AMLs are generally treated with embolization or nephrectomy because of the risks of haemorrhage.

Patients And Methods: The first patient initially presented with bilateral renal AMLs replacing >70% of his parenchymal volume, and a large left renal cyst. Since presentation he was hospitalized three times, but has had no transfusions or procedures to treat his AMLs.