3,392 results match your criteria: "Glickman Urological &Kidney Institute[Affiliation]"

Disruption of circadian rhythm as a potential pathogenesis of nocturia.

Nat Rev Urol

November 2024

Department of Biomedical Engineering, Lerner Research Institute and Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.

Increasing evidence suggested the multifactorial nature of nocturia, but the true pathogenesis of this condition still remains to be elucidated. Contemporary clinical medications are mostly symptom based, aimed at either reducing nocturnal urine volume or targeting autonomic receptors within the bladder to facilitate urine storage. The day-night switch of the micturition pattern is controlled by circadian clocks located both in the central nervous system and in the peripheral organs.

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Management of Sacrocolpopexy Mesh Complications-A Narrative Review and Clinical Experience from a Large-Volume Center.

Int Urogynecol J

November 2024

Urogynecology and Reconstructive Pelvic Surgery, Glickman Urologic Institute and Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA.

Introduction And Hypothesis: Despite the reputation of sacrocolpopexy as a highly durable reconstructive surgery for pelvic organ prolapse, mesh-related complications remain a significant deterrent for patients. This review discusses the incidence, presentation, diagnosis, management and prevention of sacrocolpopexy mesh complications.

Methods: We reviewed the literature on sacrocolpopexy focusing on long-term mesh complications and their management.

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Artificial Intelligence for Clinical Management of Male Infertility, a Scoping Review.

Curr Urol Rep

November 2024

Department of Urology, Cleveland Clinic Foundation, Glickman Urological and Kidney Institute, Cleveland, OH, 44195, USA.

Purpose Of Review: Infertility impacts one in six couples worldwide, with male infertility contributing to approximately half of these cases. However, the causes of infertility remain incompletely understood, and current methods of clinical management are cost-restrictive, time-intensive, and have limited success. Artificial intelligence (AI) may help address some of these challenges.

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Background: Psychiatric diagnoses are common among adults with severe obesity (body mass index [BMI] ≥40 kg/m) and may be associated with hypertension.

Objectives: To determine the association between lifetime and current psychiatric diagnoses, separately, with hypertension, uncontrolled blood pressure (BP), and systolic BP (SBP) among adults with severe obesity undergoing metabolic and bariatric surgery (MBS).

Setting: Academic medical center.

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Introduction: We aim to identify factors associated with surgical refusal and non-surgical candidacy in clinical stage I kidney masses and to evaluate their impact on overall survival (OS).

Materials And Methods: We conducted a retrospective cohort study using the National Cancer Database of patients with clinical stage I kidney cancer between 2004 and 2017. Logistic regression was used to determine baseline sociodemographic-, clinical-, and treatment facility-related factors associated with surgical refusal and non-surgical candidacy.

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Objective: To compare neonatal outcomes following URS, stent, or PCN in pregnant women presenting with suspected renal colic.

Methods: Women undergoing a procedure for suspected renal colic during pregnancy at a large multi-center institution between 2008 and 2022 were retrospectively reviewed and categorized by initial intervention. Neonatal outcomes were recorded and linked to maternal and obstetric data.

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Aims: The integration of artificial intelligence (AI) into functional urology management must be assessed for its clinical utility, but hopefully will change, perhaps to revolutionize the way LUTD and other conditions are assessed, the aim being to offer patients more rapid and effective management which enhances patient outcomes. The aim of this proposal, discussed at the ICI-RS annual meeting, is to evaluate the available evidence on AI and the way it might change the approach to urodynamic (UDS) diagnoses, including overactive bladder syndrome (OAB), and perhaps other LUTDs such as bladder outflow obstruction.

Methods: A compendium of discussion based on the current evidence related to AI and its potential applications in UDS and OAB.

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Article Synopsis
  • - The study investigates how the timing of radiotherapy (RT) after radical prostatectomy influences long-term health-related quality of life (HRQOL) in men with prostate cancer, focusing on sexual, urinary, and bowel health.
  • - Researchers analyzed data from two cohorts, comparing outcomes between three groups: men who had just prostatectomy, those who received early RT (within 12 months), and those who had late RT (12 months or later).
  • - Findings revealed that men who underwent RT after prostatectomy experienced greater declines in aspects of HRQOL compared to those who did not receive RT, highlighting the potential negative effects of post-surgery radiation timing.
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Background: Infection remains a significant concern following penile prosthesis (PP) implantation surgery. Published guidelines have indicated the use of pre-operative intravenous (IV) antibiotics but have not provided specific recommendations regarding intra-operative irrigation. For long in our practice, we have been using a combination of antibiotics for irrigation (rifampin 600 mg/L of sterile water, gentamicin 80 mg/L of sterile water).

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Purpose: The objective of this manuscript is to assess the effect of varicocele repair (VR) in patients with clinical varicoceles on serum total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and inhibin B serum levels.

Materials And Methods: The study was performed in compliance with the Meta-Analysis and Systematic Reviews of Observational Studies (MOOSE) guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). All eligible studies were selected following the PICOS (Population, Intervention, Comparison/Comparator, Outcomes, Study design) model.

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Objectives: To characterise the long-term success rate of ventral onlay buccal mucosa graft urethroplasty (vBMG) in the management of bulbar urethral stricture disease (USD), assess patient-reported postoperative satisfaction and decision regret, and delineate clinical factors impacting patient-reported metrics.

Subjects And Methods: Patients with prior vBMG for bulbar USD, performed at Cleveland Clinic between 2003 and 2022, were contacted and brief structured interviews were performed. Stricture recurrence and need for secondary procedures, baseline demographics, and patient-reported outcome surveys were collected.

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Article Synopsis
  • Minimally invasive surgery offers shorter hospital stays, enabling the potential for outpatient (OP) procedures, especially with the introduction of single-port (SP) robotic techniques in urology.
  • A literature review analyzed the safety and feasibility of OP robotic urological surgeries, revealing high same-day discharge rates and lower complication risks compared to inpatient procedures.
  • Overall, the study concludes that outpatient robotic urological surgery is both feasible and safe for selected patients, with SP-RARP procedures showing even better outcomes than multiport options.
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Introduction: Anesthesia choice during the procedural management of suspected renal colic during pregnancy may vary based on available resources and patient or provider preferences, as there are no specific recommendations. Our objective was to evaluate whether preterm birth (<37 weeks) was associated with anesthesia type, anesthesia timing by trimester, or procedure type.

Methods: We retrospectively identified pregnant patients who required procedural management with ureteral stent, percutaneous nephrostomy (PCN), or ureteroscopy (URS) for suspected renal colic based on laboratory and imaging findings from 2009-2021 at our center.

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Article Synopsis
  • In a study of 4011 patients who had unilateral cT1a-b renal mass treated with partial nephrectomy, researchers aimed to explore how a surgeon's experience affects surgical outcomes, specifically acute kidney injury (AKI) and kidney function a year post-surgery.
  • Previously, it was known that complications and ischemia times improved with surgeon experience, but there was limited data on long-term kidney function.
  • The findings revealed no significant association between surgical experience and AKI or recovery of kidney function in either laparoscopic or robot-assisted techniques, suggesting other factors may play a more crucial role in these outcomes.
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To study the effect of switching to a follicle-stimulating hormone (FSH) preparation other than that to which infertile male patients have not had an effective response. Seventy-four normogonadotropinemic, non-obstructive, oligozoospermic patients who were poor responders to the administration of highly purified FSH (hpFSH) (Group 1 (n = 22) and Group 3 (n = 15)) or to recombinant human FSH (rhFSH) (Group 2 (n = 22) and Group 4 (n = 15)) were selected for this prospective study. After 3 months of washout from treatment with the first FSH preparation of choice, rhFSH was administered to patients in Groups 1 and 4 and hpFSH to those in Groups 2 and 3.

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Article Synopsis
  • * The survey had a 28.6% completion rate with 201 responses, revealing that while about half of the institutions using SP platforms have done so for over 2 years, structured training is limited, leading to concerns about hands-on experience and the learning curve associated with SP procedures.
  • * Despite recognizing the clinical benefits of SP surgery, many trainees do not view proficiency in it as essential for career advancement; however, predictors of future SP implementation include academic aspirations and the availability of SP platforms
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Article Synopsis
  • The study aimed to analyze the different microbial biofilms found on various urological devices, including ureteral stents and penile prostheses, by examining data from four separate research studies.
  • The researchers found that microbial communities on these devices were distinct from skin and urine flora, with significant differences in microbial counts and diversity depending on the device type.
  • Key bacteria like Staphylococcus and Pseudomonas were commonly found across devices, and the study highlights the potential for developing new strategies to minimize infection risks associated with these medical devices.
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Article Synopsis
  • The study compares the safety and feasibility of single-port (SP) robotic partial nephrectomy (RPN) to multiport (MP) RPN in patients, as previous evidence on this topic is limited.
  • Data from 286 patients undergoing retroperitoneal RPN between 2017 and 2023 revealed significant differences in ischemia time, with the MP group having shorter times (16 vs. 22 minutes).
  • The findings suggest that while SP RPN shows longer ischemia times, both approaches yield comparable perioperative and postoperative outcomes, indicating SP RPN is a safe option but needs further investigation for potential benefits and long-term results.
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Article Synopsis
  • Micropapillary variant urothelial carcinoma (MPUC) is linked to higher treatment failure risks and occult lymph node metastasis, impacting outcomes after radical cystectomy (RC).
  • The study evaluated 67 patients with MPUC to see how the percentage of MPUC in tissue samples affects lymph node positivity and patient survival following treatment.
  • Results indicated that a higher percentage of MPUC (≥30%) and advanced clinical stage (≥T2) were significant predictors of lymph node metastasis at RC, with patients having cT1 disease showing the lowest metastasis rates.
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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.

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Background: The ventral and distal aspects of the corpora cavernosa are the thinnest, increasing the likelihood of cylinder extrusion or crossover complications pertaining to inflatable penile prosthesis procedures. A double distal corporal anchoring double stitch can be used to robustly secure impending lateral extrusions and crossovers of implant cylinders. It is a novel, effective corrective measure for the uncommon complication of migrated cylinders in inflatable penile prosthesis placement.

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Clinical Microbiome Testing for Urology.

Urol Clin North Am

November 2024

Division of Urology, Children's National Hospital, 111 Michigan Avenue Northwest, Washington, DC 20010, USA. Electronic address:

Article Synopsis
  • * Current culture-independent methods fail to differentiate between live and dead bacteria, and are not yet part of standard clinical guidelines.
  • * Future research may focus on methods like microbiota modulation, fecal transplants, vaginal estrogen, probiotics, and bacteriophage therapy to prevent UTIs.
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