A nomogram to predict "pure" vs. "mixed" uric acid urinary stones.

Purpose: Uric acid stones (UAS) can be treated non-invasively by oral chemolysis. However, it is crucial to identify individuals who are most likely to benefit from this approach, specifically, patients with pure UAS. The aim of this study was to develop a nomogram that can differentiate between pure and mixed UAS.

Transformations in Benign Prostatic Hyperplasia Surgical Practices: A Longitudinal Study of Trends and Predictions.

Introduction: The workload for benign prostatic hyperplasia (BPH) surgery is expected to rise with an increase in life expectancy and a growing population. Surgical modalities for BPH have evolved, shifting toward minimally invasive transurethral procedures. This study aimed to investigate the trends in BPH surgical procedures across medical centers in Israel.

Comparison of EEP and TURP long-term outcomes: systematic review and meta-analysis.

Objective: To compare long-term reoperation rate and functional outcomes between EEP (endoscopic enucleation of the prostate) and TURP (transurethral resection of the prostate).

Evidence Acquisition: A systematic literature review of Medline, Scopus, and Web of Science was conducted with primary outcome assessed being reoperation rate and secondary outcomes after a long term (> 3 years) being functional outcomes or related values (prostate volume, PSA level, etc.).

Retrograde intrarenal surgery for lower pole stones utilizing stone displacement technique yields excellent results.

Objective: To evaluate the long-term stone-free rate (SFR) of retrograde intra-renal surgery (RIRS) in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free status.

Methods: All consecutive patients undergoing RIRS lower pole renal calculi at a single high-volume tertiary center were analyzed retrospectively. Lower pole stones were relocated to the upper pole, where laser lithotripsy was performed.

Endoscopic Management of Low-Grade Upper Tract Urothelial Carcinoma: Characterizing the Long-term Burden of Care in Comparison to Radical Nephroureterectomy.

Objective: To compare procedure burden, oncologic, surgical and renal-function outcomes between patients with low-grade upper urothelial cancer (UTUC) who were referred for either radical management (RM) or kidney-sparing endoscopic management (EM).

Patients And Methods: We retrospectively reviewed data of all patients treated for UTUC at our tertiary medical center between 2000 and 2018 and selected patients diagnosed with unilateral low-grade UTUC.

Results: Twenty-four patients were treated with EM and 37 with RM.

Primary Chemoablation of Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer Using UGN-102, a Mitomycin-Containing Reverse Thermal Gel (Optima II): A Phase 2b, Open-Label, Single-Arm Trial.

Purpose: Low-grade intermediate-risk nonmuscle-invasive bladder cancer (LG IR NMIBC) is a recurrent disease, thus requiring repeated transurethral resection of bladder tumor under general anesthesia. We evaluated the efficacy and safety of UGN-102, a mitomycin-containing reverse thermal gel, as a primary chemoablative therapeutic alternative to transurethral resection of bladder tumor for patients with LG IR NMIBC.

Materials And Methods: This prospective, phase 2b, open-label, single-arm trial recruited patients with biopsy-proven LG IR NMIBC to receive 6 once-weekly instillations of UGN-102.

Tubeless supra-costal percutaneous nephrolithotomy is associated with significantly less hydrothorax: a prospective randomized clinical study.

Objectives: To evaluate prospectively whether a tubeless (JJ stent-only) percutaneous nephrolithotomy (PCNL) might reduce the risk of hydrothorax, compared to an approach where a nephrostomy tube is left.

Materials And Methods: We conducted a two-arm open-label prospective randomized study (NCT02036398) comparing tubeless supra-costal PCNL (with a JJ stent only) to standard PCNL (with nephrostomy tube and JJ stent) using intention-to-treat (ITT) and per-protocol (PP) analyses. All patients underwent a standard single-stage prone supra-costal procedure with single-tract access.

Long-Term Adherence to Medications in Secondary Prevention of Urinary Tract Stones.

To reduce the high recurrence rate of nephrolithiasis, patients are routinely prescribed secondary chemoprevention therapy with alkali citrate (Alkasolve; Sam-On Ltd) for uric acid stones and hypocitraturia or hydrochlorthiazide (Disothiazide; Dexcel Ltd) for hypercalciuria. However, data on adherence to these regimens are limited. The aim of this study was to assess rates of long-term adherence to alkali citrate and hydrochlorothiazide and reasons for nonadherence.

Transplant Kidney Retrograde Ureteral Stent Placement and Exchange: Overcoming the Challenge.

Objective: To present a reliable technique for fluoroscopic controlled, large-bore, ureteral stent placement and exchange in transplant kidneys with persistent ureterovesical strictures.

Materials And Methods: We reviewed the medical charts of all patients who underwent kidney transplant with persistent ureterovesical strictures who underwent ureteral stent placement or exchange at our institution between 2005 and 2015 using the new technique. Clinical characteristics and treatment outcomes of the study cohort were analyzed.

A Novel Technique to Improve the Processing of Minute Ureteroscopic Biopsies.

To examine the ability of a new specimen handling technique to improve histopathological yield of ureteroscopic biopsies, performed in patients with suspected upper tract urothelial carcinoma (UTUC). In a bi-center retrospective study we compared the results of the new tissue handling technique (group 1) with the standard technique (group 2). In the new technique, to achieve maximal tissue preservation, the specimen is mounted on filter paper prior to embedding in paraffin.

Advances in the treatment of testicular cancer.

Germ cell tumors (GCT) are relatively uncommon, accounting for only 1% of male malignancies in the United States. It has become an important oncological disease for several reasons. It is the most common malignancy in young men 15-35 years old.

Late relapse of testis cancer.

Most relapses of germ-cell tumors occur within 2 years of initial treatment. In 2 % to 4 % of patients, relapse may occur later. The retroperitoneum is the primary site of late relapses, and alpha-fetoprotein is the predominant marker.

Lymphovascular invasion in testicular germ cell tumors: clinicopathological correlates.

Introduction: We assessed clinical-pathological correlates of lymphovascular invasion in testicular germ-cell tumors.

Material And Methods: Archived pathology specimens from 145 patients treated by radical orchiectomy for testicular germ cell tumors at our institution in 1995-2006 were reanalyzed by a dedicated urologic pathologist, and the corresponding medical records were reviewed. The association of lymphovascular invasion with clinical and pathological parameters was tested using stepwise logistic regression analysis.

Ureteropyelostomy using the native ureter for the management of ureteric obstruction or symptomatic reflux following renal transplantation.

Objective: To evaluate the outcome of ureteropyelostomy using the native ureter for the management of ureteric obstruction or symptomatic reflux after renal transplantation.

Materials And Methods: This is a single-center retrospective review of consecutive patients who underwent ureteropyelostomy after renal transplantation between the years 2000 and 2009. Ureteropyelostomy was performed using the ipsilateral native ureter.

Serum tumor markers in testicular cancer.

Testicular cancer has become a model for a curable neoplasm, where biochemical markers play a critical role. Serum tumor markers are integral in patient management and contributes to the diagnosis, staging, and risk assessment, as well as evaluation of response to therapy and detection of relapse. We review their biochemistry, biology, and clinical use in the setting of localized and metastatic disease.

Division of prostatic anterior fibromuscular stroma reduces urethral resistance in an ex vivo human prostate model.

Objectives: To establish the contribution of the anterior fibromuscular stroma to the urethral resistance in an ex vivo human prostate model. The anterior fibromuscular stroma constitutes the anterior portion of the prostatic surgical capsule.

Methods: An intact bladder and prostate were obtained from 10 patients who had undergone cystoprostatectomy.

Primitive neuroectodermal tumors in patients with testicular germ cell tumors usually resemble pediatric-type central nervous system embryonal neoplasms and lack chromosome 22 rearrangements.

Primitive neuroectodermal tumors (PNETs) are one of the most frequent types of 'non-germ cell' tumor in patients with testicular germ cell tumors and have a guarded prognosis when present in metastatic sites after cisplatin-based chemotherapy. Improved treatments, including targeted therapy, require understanding the biology of these neoplasms. We therefore analyzed the morphologic, immunohistochemical and molecular biologic features of 14 PNETs from 14 patients with concurrent or previous testicular germ cell tumors; 12 tumors were from metastatic sites and 2 were primary in the testis.

Long-term follow-up of Cisplatin combination chemotherapy in patients with disseminated nonseminomatous germ cell tumors: is a postchemotherapy retroperitoneal lymph node dissection needed after complete remission?

Purpose: Controversy arises regarding the optimal management of patients with nonseminomatous germ cell tumor (NSGCT) who achieve a serologic and radiographic complete remission (CR) to systemic chemotherapy. Some authors recommend postchemotherapy retroperitoneal lymph node dissection (PC-RPLND), whereas others omit surgery and observe these patients. In an attempt to address this question, we report the long-term follow-up of patients treated at Indiana University who were observed without PC-RPLND.

Multifocality in testicular germ cell tumors.

Purpose: Standard treatment for testicular germ cell tumor is radical orchiectomy. Several groups have suggested an organ sparing approach in patients with bilateral tumors or tumor in a solitary testis. We determined the prevalence of multifocality in testicular germ cell tumor cases.

Vena caval reconstruction during postchemotherapy retroperitoneal lymph node dissection for metastatic germ cell tumor.

We present our experience with inferior vena cava (IVC) reconstruction in patients undergoing post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) due to metastatic germ cell tumor. Four patients underwent IVC reconstruction with a prosthetic graft. Early postoperative leg edema was prevented in all 4.

Late relapse of testis cancer.

Most relapses of germ-cell tumors occur within 2 years of initial treatment. In 2% to 4% of patients, relapse may occur later. The retroperitoneum is the primary site of late relapse, and alpha-fetoprotein is the predominant marker.