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Directory of Authors from the Journal and their last article.

Paul H LangeView Articles

Volume 9, Number 4Review Articles

Newer Potential Biomarkers in Prostate Cancer

Diagnostic Update

Jonathan L WrightPaul H Lange

Prostate-specific antigen (PSA) screening has led to a significant rise in the number of men diagnosed with prostate cancer and an associated increase in biopsies performed. Despite its limitations, including a positive predictive value of only 25%-40%, PSA remains the only generally accepted biomarker for prostate cancer. There is a need for better tools to not only identify men with prostate cancer, but also to recognize those with potentially lethal disease who will benefit from intervention. A great deal of work has been done worldwide to improve our knowledge of the genetics behind prostate cancer and the specificity of PSA by developing assays for different PSA isoforms. Common genetic alterations in prostate cancer patients have been identified, including CpG hypermethylation of GSPT1 and TMPRSS2:ERG gene fusion. Serum and urine detection of RNA biomarkers (eg, PCA3) and prostate cancer tissue protein antibodies (eg, EPCA) are being evaluated for detection and prognostic tools. This article reviews some of the promising developments in biomarkers. [Rev Urol. 2007;9(4):207-213]

Prostate-specific antigenPCA3Alpha-methylacyl-CoA racemaseAutoantibody arraysEpigenetic markersGene fusion proteinsHuman kallikreinsPSA isoformsRNA biomarkers

Paul HoffmanView Articles
Paul KozlowskiView Articles

Volume 19, Number 3Case Review

Surgical Solution to an Intracorporeal Nickel Allergy

Jared BrandenbergerPaul KozlowskiAndrew Stamm

A previously healthy 30-year-old man with a symptomatic varicocele underwent gonadal vein embolization using nickel vascular plugs. He developed a painful hypersensitivity to his nickel plugs and elected to pursue laparoscopic excision and proximal gonadal vein ligation. In the operating room, the gonadal vein was isolated from the ureter, and ligated proximal to the cephalad plug and distal to the caudal coil. His pain is completely resolved 5 months after surgery. Metal allergies are well documented in orthopedics and cardiology implants, but there are a limited number of case reports of metal allergies after varicocele embolization. Interestingly, nickel is the most common type of metal hypersensitivity. [Rev Urol. 2017;19(3):195–197 doi: 10.3909/riu0769] © 2017 MedReviews®, LLC

VaricoceleMetal allergyNickelCoil embolizationGonadal vein

Paul NathanView Articles

Volume 18, Number 3Review Articles

Perioperative Considerations in Metastatic Renal Cell Carcinoma

Management Update

Jim AsheadKate FlavinTim 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

Paul R SieberView Articles

Volume 16, Number 1Review Articles

Emerging Therapeutic for the Treatment of Skeletal-related Events Associated With Metastatic Castrate-resistant Prostate Cancer

CME-certified Article

Paul R Sieber

Prostate cancer is the most prevalent cancer in US and European men and the second leading cause of cancer death in those populations. It is somewhat unique in that nearly all patients who succumb to the disease will ultimately develop bone metastasis. Morbidity from bone metastasis—referred to as skeletal-related events, which include fractures, cord compression, radiation to bone, and surgery to bone—leads to significant costs and impaired quality of life. This article reviews three agents and the roles they play in the ever-changing armamentarium of treatments for metastatic castrate-resistant prostate cancer (mCRPC). The potential benefits of these agents are discussed, as well as the continuing use of these agents and their earlier introduction in the patient with progressive mCRPC with bone metastasis. [Rev Urol. 2014;16(1):10-20 doi: 10.3909/riu0609] © 2014 MedReviews®, LLC

Metastatic castrate-resistant prostate cancerSkeletal-related eventsBone metastasisZoledronic acidDenosumabRadium Ra 223 dichloride

Pavel SvintozelskiyView Articles

Volume 23, Number 1Literature Reviews

Comparison of Methods for Ureteral Patency Visualization

Michelle BoytimMatthew J. JonesAlex S. BartPavel Svintozelskiy

The most common cause of ureteral trauma occurs during open, laparoscopic, or endoscopic procedures across multiple specialties. Ureteral injuries are often unrecognized or mismanaged. Early recognition of ureteral injuries by cystoscopy allows for prompt intervention. Visualization can be enhanced using agents that color or improve the contrast of ureteral flow.

Cystoscopydiagnostic imagingindigo carminemethylene bluefluorescein

Payal KapurView Articles

Volume 22, Number 2Case Review

First Do No Harm: A Cautious, Risk-adapted Approach to Testicular Cancer Patients

Aditya BagrodiaPayal KapurDavid FetzerJohn LafinHersh M TrivediNirmish Singla

Current guidelines regarding treatment for germ-cell tumors (GCTs) emphasizes cautious progression focusing on stage-specific treatments. Presented herein is the case of a 30-year-old man who, through monitoring of serum alpha-fetoprotein (AFP) levels and surveillance imaging, avoided excessive treatment. This case demonstrates how an experienced clinician, familiar with natural history of GCTs, can appropriately classify level of risk and allow a patient to preserve natural fertility. Furthermore, we highlight the potential for miRNA analysis in staging and management of GCTs. This case serves to underscore the importance of acting with caution in the pursuit of the best outcome for our patients. [Rev Urol. 2020;22(2):85–89] © 2020 MedReviews®, LLC

Peder LarsonView Articles

Volume 23, Number 4Prostate Cancer

Deep Learning for Magnetic Resonance Imaging–Based Radiation Therapy for Prostate Cancer: Current Status

Jessica E. ScholeyAbhejit RajagopalJulian HongPeder LarsonKe Sheng

Magnetic resonance imaging (MRI) is increasingly being used for external beam radiation therapy in the treatment of prostate cancer because of its excellent soft tissue contrast and ability to provide functional and physiologic information about tumor behavior. At the same time, deep learning has seen widespread applications in medical imaging, including for MRI-based classification and synthesis. Deep learning–based approaches are being incorporated into the MRI-guided clinical external beam radiation therapy workflow for patient simulation, contouring of targets and critical structures, treatment planning, and treatment delivery. In this review, we examine the current status of deep learning for MRI-guided prostate external beam radiation therapy.

Artificial intelligenceProstatic neoplasmsRadiotherapyMagnetic resonance imaging (MRI)Deep Learning

Perinchery NarayanView Articles
Peter GrimmView Articles
Peter H GannView Articles
Peter K SandView Articles

Volume 9, Number 1Review Articles

Diagnosis of Interstitial Cystitis/ Painful Bladder Syndrome in Patients With Overactive Bladder Symptoms

Diagnosis Update

Peter K SandScott MacDiarmid

Overactive bladder (OAB) and interstitial cystitis (IC) have similar symptoms, including urinary urgency/frequency and nocturia, making them difficult to differentiate on the basis of clinical presentation alone. Both conditions may represent a clinical manifestation of a hypersensitive bladder and should be included in the differential diagnosis for patients who present with urgency/ frequency. It is especially important that IC be considered in patients with OAB that is refractory to treatment. The proposed diagnostic framework may be useful for differentiating IC from OAB and for facilitating appropriate treatment. [Rev Urol. 2007;9(1):9-16]

Overactive bladderInterstitial cystitisPainful bladder syndrome

Peter L RoyceView Articles

Volume 13, Number 3Review Articles

Lower Urinary Tract Injuries Following Blunt Trauma: A Review of Contemporary Management

Management Review

Jennifer KongNiall CorcoranAlex CatoRussell GruenMatthew F BultitudePeter L Royce

Lower urinary tract trauma, although relatively uncommon in blunt trauma, can lead to significant morbidity when diagnosed late or left untreated; urologists may only encounter a handful of these injuries in their career. This article reviews the literature and reports on the management of these injuries, highlighting the issues facing clinicians in this subspecialty. Also presented is a structured review detailing the mechanisms, classification, diagnosis, management, and complications of blunt trauma to the bladder and urethra. The prognosis for bladder rupture is excellent when treated. Significant intraperitoneal rupture or involvement of the bladder neck mandates surgical repair, whereas smaller extraperitoneal lacerations may be managed with catheterization alone. With the push for management of trauma patients in larger centers, urologists in these hospitals are seeing increasing numbers of lower urinary tract injuries. Prospective analysis may be achieved in these centers to address the current lack of Level 1 evidence.[Rev Urol. 2011;13(3):119-130 doi: 10.3909/riu0521] © 2011 MedReviews®, LLC

UrethraMultiple traumaRuptureUrinary bladderWounds

Peter M SadowView Articles

Volume 16, Number 2Case Review

Immunoglobulin G4–related Retroperitoneal Fibrosis of the Pelvis

Erika BracamonteAnthony DyerPeter M SadowMatthew Gretzer

Retroperitoneal fibrosis (RPF) is a rare disease characterized by the replacement of normal tissue with fibrosis and/or inflammation. In this case, a 68-year-old man presented with RPF in the pelvis, a rare location for this disease. Biopsies were performed, which showed elevated levels of C-reactive protein, erythrocyte sedimentation rate, and, most importantly, immunoglobulin G4 (IgG4). It has been postulated that IgG4-related sclerosing disease is a systemic disease. Treatment has been successful with systemic corticosteroids. [Rev Urol. 2014;16(2):92-94 doi: 10.3909/riu0594] © 2014 MedReviews®, LLC

Retroperitoneal fibrosisSerum immunoglobulin G4

Peter R CarrollView Articles

Volume 8, Supplement 1Review Articles

Magnetic Resonance Imaging and Spectroscopy of Prostate Cancer

Prostate Cancer Imaging

Peter R CarrollJohn KurhanewiczFergus V Coakely

Magnetic resonance imaging may improve the staging of prostate cancer compared with clinical evaluation alone, computerized tomography, or transrectal ultrasound, and it allows simultaneous and detailed evaluation of prostatic, periprostatic, and pelvic anatomy. Endorectal magnetic resonance imaging and magnetic resonance spectroscopic imaging (endoMRI/MRSI) allow better visualization of the zonal anatomy of the prostate and better delineation of tumor location, volume, and extent (stage). Metabolic criteria used to identify and localize prostate cancer with endoMRI/MRSI have been standardized, thus improving the accuracy of the examination and limiting interobserver variations in interpretation. Evidence is now emerging that endoMRI/MRSI may also be helpful in assessing response to prostate cancer treatment, most commonly with radiation and/or androgen-deprivation therapy. [Rev Urol. 2006;8(suppl 1):S4-S10]

Prostate cancerMagnetic resonance imagingMagnetic resonance spectroscopyEndorectal MRI

Peter S AlbertView Articles
Peter SchulamView Articles
Peter T ScardinoView Articles

Volume 11, Number 3Review Articles

Predictive Models for Newly Diagnosed Prostate Cancer Patients

Management Update

William T LowrancePeter T Scardino

[Rev Urol.2009;11(3):117-126 doi: 10.3909/riu0456]2009 MedReviews®, LLC©Accurate risk assessment is of paramount importance to newly diagnosedprostate cancer patients and their physicians. Risk prediction models helpidentify those at high (or low) risk of disease progression and guide discussionsabout prognosis and treatment. Widely used, well-validated predictiontools are based on standard, readily available clinical and pathologic parameters,but do not include biomarkers, some of which may have an importantrole in predicting prognosis or determining therapeutic options. A newapproach, known as systems pathology, may improve the accuracy of traditionalprediction methods and provide patients with a more personalized riskassessment of clinically relevant outcomes. The ultimate goal of predictionmodels is to improve medical decision making.

Prostate cancerPrognosisStatistical modelNomogram

Peter WeiblView Articles

Volume 13, Number 3Review Articles

Peyronie’s Disease: Nonsurgical Therapy Options

Treatment Update

Ralf HerwigTosev GeorgiPeter WeiblNenad DjakovicFranklin E Kuehhas

Peyronie’s disease (PD) is a fibrous inelastic scar of the tunica albuginea, leading to penile deformity, penile curvature, shortening, narrowing, and painful erections that subsequently lead to painful or unsatisfying sexual intercourse. No consensus exists yet on the ideal management of PD. This fact is a result of our limited knowledge of its etiology and causative factors. The acute presentation of PD is treated conservatively, and surgical approachesare only attempted if severe curvature, narrowing, or indentation persists for more than 1 year; PD stability exists for at least 3 months; curvature impedes sexual intercourse; and severe penile shortening occurs. This review focuses on new developments for conservative treatment strategies for PD. [Rev Urol. 2011;13(3):139-146 doi: 10.3909/riu0528] © 2011 MedReviews®, LLC

Peyronie’s diseaseNonsurgical therapyOral medicationIntralesionaltherapyExtracorporeal shock wave therapyIontophoresisPenile traction systems

Philip C BoschView Articles

Volume 16, Number 2Review Articles

Treating Interstitial Cystitis/Bladder Pain Syndrome as a Chronic Disease

Management Review

David C BoschPhilip C Bosch

The management of interstitial cystitis/bladder pain syndrome (IC/BPS) is both frustrating and difficult. The etiology is uncertain and there is no definitive treatment. Consequently, both patients and doctors tend to be unhappy and unsatisfied with the quality of care. The American Urological Association (AUA) provides a guideline for the diagnosis and treatment of IC/BPS. Recommended first-line treatments include patient education, self-care practices, behavior modifications, and stress management. Management of IC/BPS may be also improved if both patients and doctors treat this condition as a chronic disease. This article reviews the AUA first-line treatments for IC/BPS and considers the benefits of treating this condition as a chronic disease. [Rev Urol. 2014;16(2):83-87 doi: 10.3909/riu0603] © 2014 MedReviews®, LLC

Bladder pain syndromeInterstitial cystitisChronic diseaseAutoimmune diseases