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Directory of Authors from the Journal and their last article.

Ji-Jian ChowView Articles

Volume 16, Number 2Review Articles

Solitary Renal Fossa Recurrence of Renal Cell Carcinoma After Nephrectomy

Treatment Review

Martin SheriffZahoor FaziliMohammed SheikhKamran AhmedJi-Jian Chow

Renal cell carcinoma without metastasis responds well to surgical excision but is known to recur postnephrectomy. In a small but significant number of patients this recurrence is not accompanied by metastasis, which is important as these people benefit from further surgery. We examined 20 articles from the current literature to ascertain how best to treat this condition. Surgical management renders better results than conservative or medical therapies. Readily available investigations such as blood tests and computed tomography can help determine the right patients for surgery in an evidence-based fashion. Current findings have allowed us to suggest a protocol for the treatment of solitary renal fossa recurrence of postnephrectomy renal cell carcinoma. There are further opportunities for study in validating our protocol, and in novel renal cell carcinoma treatment strategies that have not been tested on solitary renal fossa recurrences. [Rev Urol. 2014;16(2):76-82 doi: 10.3909/riu0598] © 2014 MedReviews®, LLC

ComplicationsManagementRenal cancerRecurrenceNephrectomy

Ji-Youl LeeView Articles
Jihad H KaoukView Articles
Jill KorsiakView Articles

Volume 23, Number 2Prostate Cancer

Real-World Comparison of Deep Prostate-Specific Antigen Response in Patients With Metastatic Castration-Sensitive Prostate Cancer Treated With Apalutamide or Enzalutamide

Benjamin H. LowentrittIbrahim KhilfehDominic PilonShawn DuCarmine RossiFrederic KinkeadLilian DiazJill KorsiakPatrick LefebvreGordon A Brown

Deep prostate-specific antigen reduction of at least 90% (PSA90 response) after androgen receptor pathway inhibitor initiation to treat metastatic castration-sensitive prostate cancer (mCSPC) is associated with longer survival. This real-world study evaluated the proportion of androgen receptor pathway inhibitor–naive patients with mCSPC who achieved PSA90 response 6 months after initiating apalutamide or enzalutamide.

Prostatic neoplasmsProstate-specific antigen (PSA)Prostate-specific antigenProstate-specific antigensCastrationAndrogen receptorAndrogen receptor antagoniststreatment effectiveness

Jim AsheadView Articles

Volume 18, Number 3Review Articles

Perioperative Considerations in Metastatic Renal Cell Carcinoma

Management Update

Kate FlavinJim AsheadTim LaneDamian HanburyPaul NathanShanmugasundaram Gowrie-Mohan

Patients with metastatic renal cell carcinoma are complex, with the potential for significant complications, and require extensive pre-, peri-, and postoperative management. This article discusses, in depth, the necessary considerations in the treatment of these patients. [Rev Urol. 2016;18(3):133-142 doi: 10.3909/riu0697] © 2016 MedReviews®, LLC

Renal cell carcinomaRadical nephrectomyCytoreductive nephrectomyMetastasis

Jim GriesserView Articles
Jim HuView Articles
Jim KoukounarasView Articles

Volume 13, Number 2Review Articles

Contemporary Management of Renal Trauma

Management Update

Jennifer J ShoobridgeNiall M CorcoranKatherine A MartinJim KoukounarasPeter L RoyceMatthew F Bultitude

In the management of renal trauma, surgical exploration inevitably leads to nephrectomy in all but a few specialized centers. With current management options, the majority of hemodynamically stable patients with renal injuries can be successfully managed nonoperatively. Improved radiographic techniques and the development of a validated renal injury scoring system have led to improved staging of injury severity that is relatively easy to monitor. This article reviews a multidisciplinary approach to facilitate the care of patients with renal injury. [Rev Urol. 2011;13(2):65-72 doi: 10.3909/riu0512] © 2011 MedReviews®, LLC

NephrectomyRenal injuryBlunt traumaAngiogenesis

Jinghan ZhangView Articles

Volume 23, Number 4Business of Urology

Outpatient Urological Surgery: Outcomes and Cost by Site of Service in Community Practice

Robert A. DowlingJinghan ZhangSong ZhangEvan R GoldfischerDavid M. Albala

Urologic surgery is most commonly performed in 1 of 3 ambulatory settings—a physician office, a hospital outpatient setting, or an ambulatory surgery center—but differences in value among these settings are poorly understood. This study examines real-world practice patterns of community urologists and documents outcomes and costs for a set of common urologic procedures performed in outpatient settings.

Physician practice patternsAmbulatory surgical proceduresurologic diseasesambulatory care

Jody PinkertonView Articles

Volume 23, Number 1Treatment Review

Consistency in Care Opportunities for Prostate Cancer

Wanda WiltNicole SmithKatie GrantJayme NalleyJody Pinkerton

Through data analysis and multiple interviews and insights, this study attempted to address the inconsistency in care for patients with prostate cancer who shared similar journey time points, demographics, and care center expertise. The Consistency of Care Project aimed to evaluate the impact of efforts to improve targeted metrics surrounding crucial clinical interventions of prostate-specific antigen monitoring, surveillance scanning, and pharmacologic interventions over a 9-month period. For comparison, 15 private urology practices of like size, patient population, and demographics were monitored. Ten of the practices benefitted from reviewed workflow training on the PPS Analytics data platform; access to a PPS Analytics Clinical Analyst, who supported education for identification of actionable patients; consistent data analysis; workflow support; and regular check-in meetings to monitor progress. The 5 control sites were monitored without additional, purposeful intervention. Outcomes support the hypothesis that inconsistency in care can begin to be addressed through focused workflows, strong navigation, and attention to key performance indicators. Attrition rate differences of 32% vs 6% improvements (reengaging patients for care who had no next appointment scheduled). On average, the experimental group increased the metastatic castration-sensitive prostate cancer diagnosis rate by 10%. However, the treatment rates measured a relative increase of 35% but an average of 11% absolute improvement at the supported sites vs 6% at the control sites. Patients with metastatic castration-resistant prostate cancer at the supported sites improved by 20%, compared with those in the control group, who improved by 4%. Care teams with strong workflows, supportive resources, and consistent care pathways—when combined with data analytics—can influence care and drive increased, measurable differences.

Prostate cancerProstatic neoplasmsUrologyNeoplasmpatient navigation

Joel KaufmanView Articles
Joel M SumfestView Articles

Volume 16, Number 2Case Review

Solitary Candida albicans Infection Causing Fournier Gangrene and Review of Fungal Etiologies

Joel M SumfestJared M BieniekTiffany A Perkins

Polymicrobial bacterial infections are commonly found in cases of Fournier gangrene (FG), although fungal growth may occur occasionally. Solitary fungal organisms causing FG have rarely been reported. The authors describe a case of an elderly man with a history of diabetes who presented with a necrotizing scrotal and perineal soft tissue infection. He underwent emergent surgical debridement with findings of diffuse urethral stricture disease and urinary extravasation requiring suprapubic tube placement. Candida albicans was found to be the single causative organism on culture, and the patient recovered well following antifungal treatment. Fungal infections should be considered as rare causes of necrotizing fasciitis and antifungal treatment considered in at-risk immunodeficient individuals. [Rev Urol. 2014;16(2):95-98 doi: 10.3909/riu0595] © 2014 MedReviews®, LLC

Fournier gangreneFournier’s Gangrene Severity IndexCandida albicans

Joel MH TeichmanView Articles
Joelle HamiltonView Articles

Volume 23, Number 2Meet The Expert

Meet the Expert: Lillie Shockney, RN, MAS

Joelle Hamilton

Discussions with patients with cancer who are facing metastatic disease progression must be handled with empathy and compassion. In this interview, Lillie Shockney, RN, MAS, the University Distinguished Service Professor of Breast Cancer and a professor of surgery at the Johns Hopkins University School of Medicine, shares her approach to handling delicate end-of-life conversations with her patients.

Neoplasm metastasisadvanced care planningterminal carepatient-centered care

Joesph AlukalView Articles
Johannes ViewegView Articles

Volume 9, Supplement 1Review Articles

Immunotherapy for Advanced Prostate Cancer

New Directions in the Management of Advanced Prostate Cancer

Johannes Vieweg

The absence of curative therapies for advanced or recurrent forms of prostate cancer mandates continued development of novel, more effective treatment regimens. Due to recent advances in basic and translational research, therapeutic vaccines and monoclonal antibody-based therapies are steadily gaining ground as promising treatment modalities against prostate cancer. Several immunotherapeutic products have recently been investigated in later-phase trials and have reported evidence for clinical benefit while maintaining an excellent quality of life for participants. The cumulative clinical results available to date indicate that immune-based therapies will likely play a role in the treatment of patients with prostate and other malignancies. The objective of this article is to increase awareness of contemporary immunologic therapies and clinical trials of new biologic reagents against prostate cancer. We also seek to encourage urologists to actively participate in clinical trials and evaluate the potential of immunotherapeutic drugs for impacting standards of care. [Rev Urol. 2007;9(suppl 1):S29-S38]

Prostate cancerImmunotherapyTumor vaccinesMonoclonal antibodies

John A InglisView Articles

Volume 17, Number 4Case Review

Acromegaly Presenting as Erectile Dysfunction: Case Reports and Review of the Literature

Rousseau GamaJohn A InglisKate E ShipmanJerry A Raju

Erectile dysfunction (ED) is a common yet complex condition. The authors report two cases of acromegaly presenting with ED and hypogonadotropic hypogonadism. Surgical cure of the acromegaly was associated with either an improvement or resolution of hypogonadotropic hypogonadism-associated ED. Active acromegaly should be considered in the differential diagnosis of ED presenting with supporting clinical features, particularly hypogonadotropic hypogonadism. [Rev Urol. 2015;17(4):246-249 doi: 10.3909/riu0676] © 2016 MedReviews®, LLC

Erectile dysfunctionEndocrine dysfunctionEndocrinologyAcromegalyGrowth hormone

John AlbaneseView Articles

Volume 17, Number 1Original Research

Hemostasis During Urologic Surgery: Fibrin Sealant Compared With Absorbable Hemostat

David M. AlbalaJerome B RiebmanRichard KocharianJohn AlbaneseBogdan IlieJonathan BatillerLiza OvingtonJessica Shen

In the United States, fibrin sealants have been used to achieve hemostasis for nearly two decades. Although their clinical utility was first demonstrated in cardiac surgery, their effectiveness and safety have since been demonstrated to extend to a wide array of procedures. Fibrin sealants typically contain two components—fibrinogen and thrombin—that are combined and delivered simultaneously to a target bleeding site in order to achieve hemostasis. However, many commercial formulations contain other additional components, such as antifibrinolytic agents, that have been associated with adverse outcomes. This subanalysis compares the safety and effectiveness of a fibrin sealant versus an absorbable hemostat for achieving hemostasis during urologic procedures with mild to moderate bleeding. [Rev Urol. 2015;17(1):25-30 doi: 10.3909/ricm0647] © 2015 MedReviews®, LLC

BleedingHemostasisHemostaticsFibrin tissue adhesiveUrologic surgical proceduresSurgical technique

John B ForrestView Articles
John C SalikenView Articles