Standing cough test stratification of moderate male stress urinary incontinence.

Purpose: Patient-reported history of pads per day (PPD) is widely recognized as a fundamental element of decision-making for anti-incontinence procedures. We hypothesize that SUI severity is often underestimated among men with moderate SUI. We sought to compare patient history of incontinence severity versus objective in-office physical examination findings.

Favourable multi-institutional experience with penoscrotal decompression for prolonged ischaemic priapism.

Objectives: To report our multi-institutional experience using penoscrotal decompression (PSD) for the surgical treatment of prolonged ischaemic priapism (PIP).

Materials And Methods: We retrospectively reviewed clinical records for patients with PIP treated with PSD between 2017 and 2020. Priapisms were confirmed as ischaemic based on clinical presentations and cavernosal blood gas abnormalities.

Pressure Regulating Balloon Herniation: A Correctable Cause of Artificial Urinary Sphincter Malfunction.

Objective: To report our experience with isolated pressure regulating balloon (PRB) replacement for artificial urinary sphincter (AUS) malfunction in the setting of PRB herniation.

Methods: A retrospective review of our large single-surgeon male AUS database was completed. We analyzed men with herniated PRBs palpable in the groin within an otherwise intact system.

Dutasteride in the long-term management of stuttering priapism.

Background: The objective of this study is to review our 12-year experience with the 5-α reductase inhibitor dutasteride as a potential long-term treatment option for stuttering priapism. Dutasteride has a uniquely long half-life of 35 days which offers a theoretical advantage as a chronic therapy for management of stuttering priapism.

Methods: We retrospectively reviewed patients with stuttering priapism in our database from 2006-2018 treated with dutasteride.

Preventing the need for revision surgery after penile plication reconstruction of Peyronie's deformities.

Background: The need for repeat penile plication (PP) for persistent penile deformity has previously been associated with (I) poor initial erectile response to intracavernosal injection (ICI), (II) an inadequate number of corrective sutures, and (III) a lack of sutures along the proximal shaft of the penis. We present our current experience with PP after implementing corrective measures to assess whether our need for revision surgery was reduced.

Methods: We performed a retrospective review of patients who underwent PP for Peyronie's disease (PD) between 2009-2018 and had a minimum follow-up of 6 months.

Comparison of 3.5 cm and transcorporal cuffs in high-risk artificial urinary sphincter populations.

Background: The transcorporal (TC) artificial urinary sphincter (AUS) has traditionally been utilized in high-risk patients with urethral atrophy or prior urethral erosion. The 3.5 cm AUS cuff has been developed for use in a similar population.

Urethral atrophy is now a rare cause for artificial urinary sphincter revision surgery in the contemporary 3.5 cm cuff era.

Background: Urethral atrophy has long been suggested as the leading cause of artificial urinary sphincter (AUS) revision. Since the introduction of the 3.5 cm AUS cuff in 2010, precise cuff sizing primarily has been suggested to reduce revisions due to urethral atrophy.

Long-term sequelae of inflatable penile prosthesis: clinical characteristics of patients who develop distal cylinder tip extrusion.

Background: Impending distal cylinder tip extrusions (DCTE) make up approximately 5-33% of all inflatable penile prosthesis (IPP) reoperations. While there have been a few case reports of DCTE in patients with diabetes and trauma, the current literature regarding risk factors for DCTE is limited. In this study, we examined the long-term sequelae among a large cohort of IPP patients to identify clinical risk factors for impending DCTE.

Age ≤40 is an independent predictor of anastomotic urethroplasty and successful repair of bulbar urethral strictures.

Background: Among men with bulbar strictures, we aimed to analyze stricture characteristics, repair type, and treatment success in younger versus older patient cohorts.

Methods: We retrospectively reviewed our single surgeon database with patients undergoing bulbar urethroplasty from 2007 to 2017. This population was then age-stratified into ≤40 and >40-year-old cohorts.

Balloon dilation performs poorly as a salvage management strategy for recurrent bulbar urethral strictures following failed urethroplasty.

Background: The optimal management strategy for recurrent urethral stricture disease (USD) following urethroplasty remains undefined. We aim to evaluate the role and efficacy of endoscopic urethral balloon dilation in temporizing recurrent USD after failed urethroplasty.

Methods: Between 2007-2018 at our institution, 80 patients underwent balloon dilation procedures for bulbomembranous urethral strictures.

Long-term outcomes of anastomotic urethroplasty for radiation-induced strictures.

Purpose: To present our experience with excision and primary anastomosis (EPA) of radiation-induced urethral strictures (RUS) in men, including risk factors for stricture recurrence and long-term recurrence rates.

Methods: A retrospective review was performed of patients who underwent EPA of RUS between 2007 and 2018 at a single tertiary referral center. Demographic information, stricture location and length, complications, and stricture recurrence were analyzed.

Strong correlation between standing cough test and 24-hour pad weights in the evaluation of male stress urinary incontinence.

Aims: We sought to compare in-office physical exam findings via standing cough test (SCT) versus 24-hour pad weights among men seeking treatment for postprostatectomy stress urinary incontinence (SUI).

Methods: A retrospective review of a single surgeon database of incontinence procedures was performed. Documentation of SUI severity (grades 0-4) was completed by SCT preoperatively utilizing the Male Stress Incontinence Grading Scale (MSIGS).

Synchronous Urethral Repair During Prosthetic Surgery: Safety of Planned and Damage Control Approaches Using Suprapubic Tube Urinary Diversion.

Background: Urethral injury during inflatable penile prosthesis (IPP) or artificial urinary sphincter (AUS) placement is rare, and traditionally most prosthetic surgeons abort prosthetic implantation when urethral repair is necessary.

Aim: To report our experience with synchronous urethroplasty (SU) as a planned or damage control surgery during urologic prosthetic surgery, to evaluate the safety and outcomes of the procedure.

Methods: A retrospective review of our IPP and AUS database was completed to identify patients who underwent an SU between 2007 and 2018.

Nephrogenic adenoma of the bladder: a single institution experience assessing clinical factors.

Introduction: Nephrogenic adenoma (NA) was first described by Davis in 1949 as a "hamartoma" of the bladder. There are many proposed predisposing factors for NA including chronic inflammation, renal transplantation, and bladder cancer. We examined our experience with NA to determine predisposing factors and determine if there was any increased risk for development of subsequent malignancy.

Comparative evaluation of physical characteristics of different inflatable penile prostheses.

Objective: The aim of this study was to describe and evaluate existing inflatable penile prostheses (IPPs) in an independent laboratory setting.

Materials And Methods: New IPPs were obtained from two manufacturers: American Medical Systems (AMS) and Coloplast. The AMS 700™ LGX (18 cm), CX (18 cm) and CXR (14 cm), and the Coloplast Titan Touch (18 cm) and Titan Narrow (14 cm) were investigated.

Diversity of patient profile, urethral stricture, and other disease manifestations in a cohort of adult men with lichen sclerosus.

Purpose: Lichen sclerosus (LS) in men is poorly understood. Though uncommon, it is often severe and leads to repeated surgical interventions and deterioration in quality of life. We highlight variability in disease presentation, diagnosis, and patient factors in male LS patients evaluated at a tertiary care center.

Factors Associated With Preventive Pharmacological Therapy Adherence Among Patients With Kidney Stones.

Objective: To determine adherence patterns for thiazide diuretics, alkali citrate therapy, and allopurinol, collectively referred to as preventive pharmacological therapy (PPT), among patients with kidney stones.

Methods: Using medical claims data, we identified adults diagnosed with kidney stones between 2002 and 2006. Through National Drug Codes, we determined those with one or more prescription fills for a PPT agent.

Medication Nonadherence and Effectiveness of Preventive Pharmacological Therapy for Kidney Stones.

Purpose: Among patients with kidney stones rates of adherence to thiazide diuretics, alkali citrate therapy and allopurinol, collectively referred to as preventive pharmacological therapy, are low. This lack of adherence may reduce the effectiveness of secondary prevention efforts, leading to poorer clinical health outcomes in patients with kidney stones. To examine the impact that medication nonadherence has on the secondary prevention of kidney stones, we compared clinical health outcomes between patients who adhered to their regimen and those who did not.

Diagnostic tests in urology: percentage of free prostate-specific antigen (PSA).

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Free to total PSA ratios are commonly used as an adjunct to total PSA levels to better define an individual's risk for prostate cancer; however, its strengths and weaknesses are not well understood. This article illustrates the use of likelihood ratios that can be generated from the reported sensitivities and specificities from given free to total PSA thresholds in either increasing or decreasing an individual patient's probability of prostate cancer. Understanding the strengths and limitations of free to total PSA testing will help clinicians anticipate whether its use is indicated or not.