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Directory of Authors from the Journal and their last article.

Tristan KeysView Articles

Volume 13, Number 2Review Articles

Impact of Stone Removal on Renal Function: A Review

Treatment Review

Dean G AssimosKyle WoodPatrick W MufarrijTristan Keys

Stone removal can improve renal function by eradicating obstruction and, in certain cases, an underlying infection. Stone-removing procedures, however, may negatively impact functional integrity. Many things may impact the latter, including the procedures used, the methods of assessing function, the time when these assessments are made, the occurrence of complications, the baseline condition of the kidney, and patient-related factors. In the majority of cases, little significant functional impairment occurs. However, there are gaps in our knowledge of this subject, including the cumulative effects of multiple procedures violating the renal parenchyma and long-term functional outcomes. [Rev Urol. 2011;13(2):73-89 doi: 10.3909/riu0515] © 2011 MedReviews®, LLC

UreteroscopyKidney stonesShock wave lithotripsyRenal functionPercutaneousnephrolithotomy

Truls E Bjerklund JohansenView Articles

Volume 19, Number 4Review Articles

A Head-to-Head Comparative Phase II Study of Standard Urine Culture and Sensitivity Versus DNA Next-generation Sequencing Testing for Urinary Tract Infections

Original Research

Vladimir MouravievDavid AlbalaMichael McDonaldDarian KamehMark E JohnsonTruls E Bjerklund Johansen

Many studies have discussed clinical practice guidelines for the treatment of cystitis and pyelonephritis. Treatment of uncomplicated urinary tract infections (UTIs) can be based on empiric antibiotic therapy. For complicated or recurrent UTIs, therapy can be based on laboratory-controlled culture and sensitivity (C&S) reports. The diagnosis of UTI by clinical criteria alone has an error rate of up to 33%. In addition, positive laboratory culture results do not always indicate a diagnosis of UTI. Comparison of urine in a conventional culture model versus DNA next-generation sequencing (NGS) to accurately identify and provide information on resistance factors (mobile genetic elements) is warranted. Our study was a head-to-head comparative phase II study of standard urine C&S versus DNA NGS testing for the diagnosis and treatment efficacy in patients with symptoms of acute cystitis based on short-term outcomes. [Rev Urol. 2017;19(4):213–220 doi: 10.3909/riu0780] © 2018 MedReviews®, LLC

Urinary tract infectionPyelonephritisCystitisDNA next-generation sequencing

TW JarrettView Articles

Volume 17, Number 3Review Articles

Metabolic Syndrome and Nephrolithiasis Risk: Should the Medical Management of Nephrolithiasis Include the Treatment of Metabolic Syndrome?

Patrick MufarrijJohn Michael DiBiancoTW Jarrett

This article reviews the relationship between metabolic syndrome (MetS) and nephrolithiasis, as well as the clinical implications for patients with this dual diagnosis. MetS, estimated to affect 25% of adults in the United States, is associated with a fivefold increase in the risk of developing diabetes, a doubling of the risk of acquiring cardiovascular disease, and an increase in overall mortality. Defined as a syndrome, MetS is recognized clinically by numerous constitutive traits, including abdominal obesity, hypertension, dyslipidemia (elevated triglycerides, low high-density lipoprotein cholesterol), and hyperglycemia. Urologic complications of MetS include a 30% higher risk of nephrolithiasis, with an increased percentage of uric acid nephrolithiasis in the setting of hyperuricemia, hyperuricosuria, low urine pH, and low urinary volume. Current American Urological Association and European Association of Urology guidelines suggest investigating the etiology of nephrolithiasis in affected individuals; however, there is no specific goal of treating MetS as part of the medical management. Weight loss and exercise, the main lifestyle treatments of MetS, counter abdominal obesity and insulin resistance and reduce the incidence of cardiovascular events and the development of diabetes. These recommendations may offer a beneficial adjunctive treatment option for nephrolithiasis complicated by MetS. Although definitive therapeutic recommendations must await further studies, it seems both reasonable and justifiable for the urologist, as part of a multidisciplinary team, to recommend these important lifestyle changes to patients with both conditions. These recommendations should accompany the currently accepted management of nephrolithiasis. [Rev Urol. 2015;17(3):117-128 doi: 10.3909/riu0650] © 2015 MedReviews®, LLC

Metabolic syndromeNephrolithiasisUric acid nephrolithiasis

Tyler R McClintockView Articles

Volume 15, Number 4Review Articles

Short-, Intermediate-, and Long-term Quality of Life Outcomes Following Radical Prostatectomy for Clinically Localized Prostate Cancer

Management Review

Herbert LeporTed LeeVinay PrabhuTyler R McClintock

Many clinically localized prostate cancers that are diagnosed today are low risk, and prevention of disease-specific mortality may only be realized decades after treatment. Radical prostatectomy (RP) may adversely impact health-related quality of life (HRQOL) by causing both transient or permanent urinary incontinence and erectile dysfunction. In contrast, RP may also improve HRQOL via relief of lower urinary tract symptoms in men suffering from these symptoms prior to surgery. Because the average man treated for prostate cancer has a life expectancy of approximately 14 years, it is imperative to consider the long-term impact of RP on both survival and HRQOL in treatment decision making. This comprehensive literature review examines short-, intermediate-, and long-term HRQOL following RP. In addition, the long-term results of RP are compared with other treatment modalities for treating clinically localized prostate cancer. [Rev Urol. 2013;15(4):161-177 doi: 10.3909/riu0604] © 2014 MedReviews®, LLC

Prostate cancerRadical prostatectomyHealth-related quality of life

Utsav D ReddyView Articles

Volume 17, Number 3Review Articles

Current Status of Hemostatic Agents and Sealants in Urologic Surgical Practice

Management Update

Sashi S KommuRobert McArthurAmr M EmaraUtsav D ReddyChristopher J AndersonNeil J BarberRaj A PersadChristopher G Eden

There has been a recent and near exponential increase in the use of hemostatic agents and sealants to supplement the rapidly evolving methods in the surgical management of urologic patients. This article reviews the use of hemostatic agents and sealants in current urologic practice. [Rev Urol. 2015;17(3):150-159 doi: 10.3909/riu0673] © 2015 MedReviews®, LLC

HemostasisTissue adhesionUrologic surgery

Vahagn R AshughyanView Articles
Vahan KassabianView Articles
Vannita Simma-ChangView Articles

Volume 8, Number 2Review Articles

Pathologic Guidelines for Orthotopic Urinary Diversion in Women With Bladder Cancer: A Review of the Literature

Therapeutic Challenges

John P SteinVannita Simma-ChangSimon D Wu

Orthotopic lower urinary tract reconstruction to the native intact urethra following radical cystectomy for bladder cancer was slower to gain clinical acceptance for women than for men. Until the 1990s, little was known about the natural history of urethral involvement by urothelial carcinoma in women with primary bladder cancer. The increasing availability of pathologic data to define the incidence of and risks for urethral involvement in women sparked an increasing interest in orthotopic diversion in female patients. Pathologic guidelines have been suggested to identify women suitable for orthotopic diversion. Preoperative involvement of the bladder neck is a significant risk factor for secondary tumor of the urethra, but is not an absolute contraindication, as long as full-thickness, intraoperative frozen-section analysis demonstrates no tumor involvement of the proximal urethra. Although less common, anterior vaginal wall tumor involvement may be a significant risk factor for urethral tumor involvement. Other pathologic parameters, including tumor multifocality, carcinoma in situ of the bladder, and tumor grade and stage, do not seem to be absolute contraindications. Long-term follow-up is critical for all patients. Women undergoing orthotopic reconstruction, if appropriately selected, should be assured of an oncologically sound operation and good function with their neobladder. [Rev Urol. 2006;8(2):54-60]

CystectomyOrthotopic urinary diversionOrthotopic neobladderFemale bladdercancerUrethrectomyUrethral recurrence

Vannita Simma-ChiangView Articles

Volume 21, Number 4Review Articles

Long-term Consequences of Medical Therapy for Benign Prostatic Hyperplasia

Management Update

Eric M BortnickVannita Simma-ChiangSteven A Kaplan

Benign prostatic hyperplasia (BPH) is a common disease in men. Although transurethral resection of the prostate (TURP) is the gold standard therapy for treatment of BPH and associated lower urinary tract symptoms (LUTS), many patients choose to avoid surgery and instead choose medical therapy. Until recently, medical therapy for BPH has been thought to be both safe and effective. However, new studies have shown that some of these medications can have significant neurocognitive, psychiatric, and sexual side effects, including dementia and depression. As most patients taking these medications will continue them for the long term, it is vital for physicians to explain these potential risks to the patient prior to prescribing them for a quality-of-life condition. [Rev Urol. 2019;21(4):154–157] © 2020 MedReviews®, LLC

Benign prostatic hyperplasiaMedical therapyDepressionDementia5-Alpha-reductase inhibitorsalpha-blockers

Vassilios M SkouterisView Articles

Volume 20, Number 1Original Research

Transrectal Ultrasound–guided Versus Transperineal Mapping Prostate Biopsy: Complication Comparison

Transrectal ultrasound guided prostate biopsy • Transperieneal mapping prostate biopsy • Complications

Vladimir MouravievE David CrawfordVassilios M SkouterisPaul AranguaMarios Panagiotis MetsinisMichael SkouterisGeorge ZacharopoulosNelson N Stone

Herein, the authors compare morbidity in men who underwent both transrectal ultrasound–guided (TRUS) prostate biopsy and transperineal mapping biopsy (TPMB) at two institutions with extensive experience in both procedures. We also identified strategies and predictive factors to reduce morbidity for both procedures. In our study, 379 men from two institutions, of which 265 (69.9%) had a prior TRUS-guided biopsy, also had TPMB performed via a template with biopsies taken at 5-mm intervals. Men in the TRUS group had a median of 12 cores sampled whereas the TPMB group had 51.5 (range, 16-151). The median biopsy density was 1.1 core/cc prostate volume. Median age and prostate-specific antigen (PSA) level were 65 years (range, 34-86) and 5.5 ng/mL (range, 0.02-118). Of these men, 11 of 265 (4.2%) who had TRUS biopsy developed urinary tract infection compared with 3 of 379 (0.79%) of those with mapping biopsy. Infection was 14.8% in TRUS biopsy group with 13 or more cores versus 2.9% in those with 12 or less (OR, 5.8; 95% CI, 1.6-21.2; P = 0.003). No men developed retention after TRUS biopsy whereas 30 of 379 (7.9%) did following TPMB. Older age, larger prostate volume (PV), and higher core number were associated with retention. On linear regression only age (P = 0.010) and PV (P = 0.016) remained as significant associations. Men older than 65 years had 12.8% versus 3.9% (OR, 3.7; 95% CI, 1.6-8.4, P = 0.001) and PV greater than 42 cc had 13.4% versus 2.7% (OR, 5.7; 95% CI, 2.1-15.1) retention incidence. In the present study TPMB is rarely associated with infection (0.78%) but more commonly with urinary retention (7.9%). Men older than 65 years and with PV greater than 42 cc were at four to five times greater retention risk. Consideration should be given to discharging these men with a urinary catheter following TPMB. [Rev Urol. 2018;20(1):19–25 doi: 10.3909/riu0785] © 2018 MedReviews, LLC®

ComplicationsTransrectal ultrasound guided prostate biopsyTransperieneal mapping prostate biopsy

Veronica AnwuriView Articles
Victor W NittiView Articles
Victoriano RomeroView Articles

Volume 12, Number 3Review Articles

Kidney Stones: A Global Picture of Prevalence, Incidence, and Associated Risk Factors

Disease State Review

Victoriano RomeroHaluk Akpinar

The prevalence and incidence of nephrolithiasis is reported to be increasing across the world. Herein, we review information regarding stone incidence and prevalence from a global perspective. A literature search using PubMed and Ovid was performed to identify peer-reviewed journal articles containing information on the incidence and prevalence of kidney stones. Key words used included kidney stone prevalence, incidence, and epidemiology. Data were collected from the identified literature and sorted by demographic factors and time period. A total of 75 articles were identified containing kidney stone—related incidence or prevalence data from 20 countries; 34 provided suitable information for review. Data regarding overall prevalence or incidence for more than a single time period were found for 7 countries (incidence data for 4 countries; prevalence data for 5 countries). These included 5 European countries (Italy, Germany, Scotland, Spain, and Sweden), Japan, and the United States. The body of evidence suggests that the incidence and prevalence of kidney stones is increasing globally. These increases are seen across sex, race, and age. Changes in dietary practices may be a key driving force. In addition, global warming may influence these trends. [Rev Urol. 2010;12(2/3):e86-e96 doi: 10.3909/riu0459]

DELETE

Vikas TyagiView Articles

Volume 12, Number 4Review Articles

State of the Art in Intravesical Therapy for Lower Urinary Tract Symptoms

State of the Art

Michael B ChancellorJonathan KaufmanVikas TyagiMichele AnthonyPradeep Tyagi

Intravesical therapy is the routine first-line treatment for effectively delaying or preventing the recurrence of bladder cancer. This route of drug administration has also shown tremendous promise in the treatment of interstitial cystitis/painful bladder syndrome (IC/PBS) and potentially overactive bladder to justify investments for further improvements. This review takes a bird’s eye view into the current status of intravesical therapy, with emphasis on liposomal nanoparticles, in diseases associated with lower urinary tract symptoms (LUTS). Ongoing efforts to advance the field of intravesical drug delivery include development of sustained-release drug implants and efforts to improve delivery of biotechnological products including large protein acting as neurotoxins and small interfering RNAs.[Rev Urol. 2010;12(4):e181-e189 doi: 10.3909/riu0496]© 2010 MedReviews®, LLC

Lower urinary tract symptomsInterstitial cystitisIntravesical therapyPainful bladder syndrome

Vikram ChalanaView Articles
Vinay PrabhuView Articles

Volume 15, Number 4Review Articles

Short-, Intermediate-, and Long-term Quality of Life Outcomes Following Radical Prostatectomy for Clinically Localized Prostate Cancer

Management Review

Herbert LeporTed LeeVinay PrabhuTyler R McClintock

Many clinically localized prostate cancers that are diagnosed today are low risk, and prevention of disease-specific mortality may only be realized decades after treatment. Radical prostatectomy (RP) may adversely impact health-related quality of life (HRQOL) by causing both transient or permanent urinary incontinence and erectile dysfunction. In contrast, RP may also improve HRQOL via relief of lower urinary tract symptoms in men suffering from these symptoms prior to surgery. Because the average man treated for prostate cancer has a life expectancy of approximately 14 years, it is imperative to consider the long-term impact of RP on both survival and HRQOL in treatment decision making. This comprehensive literature review examines short-, intermediate-, and long-term HRQOL following RP. In addition, the long-term results of RP are compared with other treatment modalities for treating clinically localized prostate cancer. [Rev Urol. 2013;15(4):161-177 doi: 10.3909/riu0604] © 2014 MedReviews®, LLC

Prostate cancerRadical prostatectomyHealth-related quality of life

Vinay TomarView Articles

Volume 19, Number 1Case Review

Xanthogranulomatous Pyelonephritis Presenting as a Type IV Renal Cyst

Bosniak class IV renal cyst • Radical nephrectomy • Xanthogranulomatous pyelonephritis

Sher Singh YadavIndraneel BanerjeeVinay TomarNachiket VyasShyam Talreja

A 20-year-old woman presented to our outpatient clinic with a 5-week history of recurrent right lumbar back pain. Contrast-enhanced computed tomography scan showed a Bosniak class IV renal cyst. She was treated with radical nephrectomy. Histopathology revealed xanthogranulomatous pyelonephritis. [Rev Urol. 2017;19(1):60-63 doi: 10.3909/riu0715] © 2017 MedReviews®, LLC

Radical nephrectomyBosniak class IV renal cystXanthogranulomatous pyelonephritis

Vincent BirdView Articles

Volume 18, Number 1Review Articles

Nephrolithometric Scoring Systems to Predict Outcomes of Percutaneous Nephrolithotomy

Management Update

Simone L VernezZhamshid OkhunovPiruz MotamediniaVincent BirdZeph OkekeArthur Smith

Currently, there is no single agreement upon an ideal predictive model that characterizes the complexity of renal stones and predicts surgical outcomes following percutaneous nephrolithotomy (PCNL). New predictive tools have recently emerged to systematically and quantitatively assess kidney stone complexity to predict outcomes following PCNL: the Guy’s Stone Score, the CROES nomogram, S.T.O.N.E. nephrolithometry, and S-ReSC score. An ideal scoring system should include variables that both influence surgical planning and are predictive of postoperative outcomes. This review discusses the strengths, weaknesses, and commonalities of each of the above scoring systems. Additionally, we propose future directions for the development and analysis of surgical treatment for stone disease, namely, the importance of assessing radiation exposure and patient quality of life when counseling patients on treatment options. [Rev Urol. 2016;18(1):15-27 doi: 10.3909/riu0693] © 2016 MedReviews®, LLC

Percutaneous nephrolithotomyUrolithiasisScoring systemNomograms

Vincent LinderView Articles

Volume 19, Number 1Review Articles

Use of the 4Kscore Test to Predict the Risk of Aggressive Prostate Cancer Prior to Prostate Biopsy: Overall Cost Savings and Improved Quality of Care to the US Healthcare System

Health Economics

Yan DongVincent LinderJeffrey D VoigtStephen Zappala

The 4Kscore® Test (BioReference Laboratories, Elmwood Park, NJ) is a blood test that accurately determines the risk of aggressive prostate cancer and significantly reduces prostate biopsies and associated overdiagnosis and overtreatment of indolent cancer. A budget impact model was developed to test the hypothesis that the 4Kscore Test can improve quality of care and deliver cost savings for patients who are suspected of having prostate cancer and would otherwise undergo prostate biopsy under the current standard of care (SOC) in the United States. The direct costs (diagnosis plus treatment) utilized in the model are based on Medicare payment data and were calculated over a 1-year time horizon. The model compares SOC, in which all patients have prostate biopsy, to a “4Kscore strategy,” in which the 4Kscore Test is used to guide the decision to biopsy the prostate. A set of one-way sensitivity analyses was conducted to examine the robustness of the findings. Savings of more than $169 million (15.6% of total SOC costs) were realized in the 4Kscore strategy versus SOC ($917 M versus $1,086 M, respectively) in a cohort of 100,000 patients. Sensitivity analyses demonstrated that the findings are robust. Most cost savings for the 4Kscore strategy were realized in patients who, when managed by SOC, are found to have no prostate cancer or Gleason score 6 pathology. The patients with Gleason score 6 exhibited the greatest benefits from the 4Kscore strategy, avoiding both an unnecessary prostate biopsy and subsequent overtreatment. The 4Kscore Test was shown to significantly reduce costs to the healthcare system while improving patients’ quality of care. Providers and their patients suspected of having prostate cancer should consider using the 4Kscore Test prior to proceeding with prostate biopsy. [Rev Urol. 2017;19(1):1-10 doi: 10.3909/riu0753] © 2017 MedReviews®, LLC

Prostate cancerPSA screening4KscoreProstate biopsyCost savings

Vincent S RicchiutiView Articles