Artificial urinary sphincter.

Although currently still the gold standard treatment for post-prostatectomy urinary incontinence, the artificial urinary sphincter (AUS) (AMS800) is an invasive procedure with associated risks factors. In this paper, we aim to outline what the scientific literature and what we personally believe are the factors that are useful and/or necessary to mitigate these risks, including both patient factors and surgeon factors. We also review special populations, including transcorporal (TC) AUS approach, AUS with inflatable penile prosthesis, AUS after male urethral sling, AUS erosion management, and AUS after orthotopic urinary diversion.

The safety and efficacy of clomiphene citrate in hypoandrogenic and subfertile men.

Our objective was to evaluate the safety and efficacy of clomiphene citrate (CC) in infertile and hypoandrogenic men through a retrospective study between September 2013 and May 2014. We identified 47 men between 18 and 55 years placed on 50 mg CC every other day. We evaluated the effect of CC on testosterone after 2 weeks, rates of adverse effects and predictors of CC response.

Patient-Reported Sexual Function After Staged Penile Urethroplasty.

Objective: To evaluate sexual function after staged penile urethroplasty with oral mucosal graft (OMG).

Methods: We identified men with completed staged penile urethroplasty with OMG from the Trauma and Urologic Reconstruction Network of Surgeons database between January 1, 2010 and May 1, 2014. Our primary outcome was change in total Sexual Health Inventory for Men (SHIM) and total Male Sexual Health Questionnaire Ejaculatory Domain (MSHQ-EjD) Short Form at baseline vs after the second stage of the procedure.

Sperm concentration is poorly associated with hypoandrogenism in infertile men.

Objective: To evaluate the utility of routine hormone evaluation in all men presenting for infertility by understanding the relationship between sperm concentration and hypoandrogenism.

Methods: We performed a retrospective cross-sectional study between September 2013 and May 2014 at a tertiary referral center in Utah. Ninety-four men presenting for infertility consecutively between the ages of 18 and 55 years were identified.

Patient reported outcomes measures in neurogenic bladder and bowel: A systematic review of the current literature.

Aim: To describe existing bladder and bowel specific quality of life (QoL) measurement tools, QoL in patients with multiple sclerosis (MS), spinal cord injury (SCI), Parkinson's Disease (PD), stroke, or spina bifida (SB) affected by bladder or bowel dysfunction, and the impact of specific bladder and bowel management on QoL.

Methods: We performed a systematic review in PubMed/Medline databases in accordance with the PRISMA statement for English publications between January 1, 2000 and January 1, 2014. Articles were first screened based on their abstract and select full-text articles were then reviewed for eligibility.

Intralesional injection of mitomycin C at transurethral incision of bladder neck contracture may offer limited benefit: TURNS Study Group.

Purpose: Injection of mitomycin C may increase the success of transurethral incision of the bladder neck for the treatment of bladder neck contracture. We evaluated the efficacy of mitomycin C injection across multiple institutions.

Materials And Methods: Data on all patients who underwent transurethral incision of the bladder neck with mitomycin C from 2009 to 2014 were retrospectively reviewed from 6 centers in the TURNS.

Urologic problems in spina bifida patients transitioning to adult care.

Objective: To identify the urologic needs of adult patients with spina bifida (SB) at the time of their transition from pediatric to adult care. We hypothesized that delays in transition to adult care would be associated with higher rates of active problems.

Methods: We retrospectively reviewed patients seen at adult dedicated SB clinics at the Universities of Utah and Minnesota from April 2011 to April 2012.

Management of adults with prior failed hypospadias surgery.

Hypospadias is one of the most prevalent anomalies of the male genitalia. Contemporary hypospadias repair is very successful, but patients that have the surgery fail often require multiple surgeries throughout their life. Complications from failed hypospadias repairs have a significant impact on patients both psychologically and physically.

Multi-institutional 1-year bulbar urethroplasty outcomes using a standardized prospective cystoscopic follow-up protocol.

Objective: To evaluate multi-institutional outcomes of bulbar urethroplasty utilizing a standardized cystoscopic follow-up protocol.

Methods: Eight reconstructive surgeons prospectively enrolled urethral stricture patients in a multi-institutional study and performed postoperative cystoscopy at 3 and 12 months. Anatomic failure was defined as the inability to pass a flexible cystoscope without force.

Short-term outcomes of Chait Trapdoor for antegrade continence enema in adults.

Objective: To examine our short-term experience of antegrade continence enema (ACE) delivered via a Chait Trapdoor (Cook Medical, Bloomington, IN) in adults with intractable neurogenic bowel.

Methods: We performed a retrospective review at the Universities of Utah and Minnesota of 15 patients with Chait Trapdoor placed for the purpose of ACE from 2011 to 2013. Our primary outcome was continued utilization of the Chait Trapdoor.

High-grade renal injuries: radiographic findings correlated with intervention for renal hemorrhage.

With the advent of advanced trauma critical care, and precise methods of assessing renal trauma with computed tomography, most patients with high-grade renal trauma can be managed conservatively. Some patients, however, do not do well with conservative management. This article evaluates specific radiographic characteristics that have recently been associated with intervention for renal hemorrhage after trauma.

Process improvement in trauma: compliance with recommended imaging evaluation in the diagnosis of high-grade renal injuries.

Background: Appropriate imaging in renal trauma can avoid delayed recognition of collecting system injuries, allowing for prompt intervention and less morbidity. Current recommendations include obtaining abdominal and pelvic computed tomographic scans with intravenous contrast, followed by excretory images for high-grade injury or perinephric fluid. The purpose of this study was to evaluate compliance with this recommendation among adult Level I trauma centers in Utah.

Process improvement in trauma: traumatic bladder injuries and compliance with recommended imaging evaluation.

Background: We hypothesized that our compliance was low with recommended imaging for evaluation of traumatic bladder injury, which includes either a computed tomographic (CT) cystogram or plain cystogram. We sought to determine if poor compliance impacted diagnosis, management, and outcome of patients with bladder injury.

Methods: Patients with bladder injury were identified from all Level 1 hospital trauma registries in Utah from 1996 to 2010.