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Renal imagingView Articles
Renal injuryView 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

Renal massView Articles

Volume 14, Number 1Review Articles

LHRH Agonists for the Treatment of Prostate Cancer: 2012

Management Review

Neal D ShoreHerbert Lepor

The most recent guidelines on prostate cancer screening from the American Urological Association (2009), the National Comprehensive Cancer Network (2011), and the European Association of Urology (2011), as well as treatment and advances in disease monitoring, have increased the androgen deprivation therapy (ADT) population and the duration of ADT usage as the first-line treatment for metastatic prostate cancer. According to the European Association of Urology, gonadotropin-releasing hormone (GnRH) agonists have become the leading therapeutic option for ADT because they avoid the physical and psychological discomforts associated with orchiectomy. However, GnRH agonists display several shortcomings, including testosterone (T) surge (“clinical flare”) and microsurges. T surge delays the intended serologic endpoint of T suppression and may exacerbate clinical symptoms. Furthermore, ADT manifests an adverse-event spectrum that can impact quality of life with its attendant well-documented morbidities. Strategies to improve ADT tolerability include a holistic management approach, improved diet and exercise, and more specific monitoring to detect and prevent T depletion toxicities. Intermittent ADT, which allows hormonal recovery between treatment periods, has become increasingly utilized as a methodology for improving quality of life while not diminishing chronic ADT efficacy, and may also provide healthcare cost savings. This review assesses the present and potential future role of GnRH agonists in prostate cancer and explores strategies to minimize the adverse-event profile for patients receiving ADT. [ Rev Urol. 2012;14(1/2):1-12 doi:10.3909/riu0547 ] © 2012 MedReviews®, LLC

Wilms’ tumorRenal massOpen radical nephrectomyMultimodal therapy

Renal mass biopsyView Articles

Volume 22, Number 1Review Articles

Active Surveillance for Small Renal Masses

Management Review

Shagnik RayJoseph G CheaibPhillip M Pierorazio

Active surveillance (AS) is a safe and reasonable management strategy for many patients with small renal masses (SRM) suspicious for a clinical T1a renal cell carcinoma based on excellent metastasis-free and cancer-specific survival. However, the expansion of robotic extirpation of SRM has outpaced the adoption of AS, resulting in the possibility of overtreatment for select patients with SRM, especially the elderly and comorbid. In this review of AS for SRM, with a focus on the Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) Registry, we detail the rationale behind AS, review lessons learned from the past decades of literature, and offer suggestions for appropriate patient selection and follow-up. An improved understanding of the data supporting AS will empower physicians and patients to more comfortably pursue AS to avoid overtreatment and provide individualized care to patients with SRM. [Rev Urol. 2020;22(1):9–16] © 2020 MedReviews®, LLC

Renal cell carcinomaSmall renal massActive surveillanceRenal mass biopsyChest imaging

renal massesView Articles
Renal neoplasmView Articles

Volume 9, Number 1Reviews in Urology

Solitary Fibrous Tumor of the Kidney: A Case Report and Review of the Literature

Case Review

Imane KamaouiAfaf AmartiSanae BennisLaila ChbaniHinde El FatemiTaoufik HarmouchFadl TaziKaoutar Znati

A solitary fibrous tumor (SFT) is an unusual spindle cell neoplasm that usually occurs in the pleura but has recently been described in diverse extrapleural sites. Urogenital localization is rare, and only 19 cases of SFT of the kidney have been described. We report a case of a large SFT clinically thought to be renal cell carcinoma arising in the kidney of a 70-year-old man. The tumor was well circumscribed and composed of a mixture of spindle cells and dense collagenous bands, with areas of necrosis or cystic changes noted macroscopically and microscopically. Immunohistochemical studies revealed reactivity for CD34, CD99, and Bcl-2 protein, with no staining for keratin, S-100 protein, or muscle markers, confirming the diagnosis of SFT. This tumor is benign in up to 90% of cases. The immunohistochemical study is the key to diagnosis. [Rev Urol. 2007;9(1):36-40]

KidneyImmunohistochemical studyRenal neoplasmSpindle cells

Renal neoplasmsView Articles

Volume 5, Number 1Review Articles

Laparoscopic Total and Partial Nephrectomy-- The New Standard?

Technique Update

Benjamin R Lee

Laparoscopic radical nephrectomy has been shown in long-term follow-up to provide shorter patient hospitalization and effective cancer control with no significant difference in survival compared with open radical nephrectomy. The major technical issue for success of laparoscopic partial nephrectomy is hemostatic control, and several techniques have been developed to improve control. Laparoscopic partial nephrectomy continues to evolve along two therapeutic technical avenues: hilar clamping with ischemia versus no hilar clamping. The benefits of laparoscopy for the kidney have clearly been demonstrated in terms of less pain, decreased convalescence, and decreased narcotic requirements. With short-term outcomes demonstrating laparoscopic partial nephrectomy as an efficacious procedure, the role of laparoscopic partial nephrectomy should continue to increase. [Rev Urol. 2003;5(1):9–14]

HemostasisLaparoscopic radical nephrectomyRenal neoplasmsPartial nephrectomyRadiofrequency ablation

Renal replacement lipomatosisView Articles

Volume 12, Number 4Case Review

Chronic Spontaneous Nephrocutaneous Fistula Associated With Renal Replacement Lipomatosis

Abdelhak KhalloukMoulay Hassan FarihMohamed Fadl Tazi

Chronic spontaneous nephrocutaneous fistula is a rare renal disease. Renal replacement lipomatosis (RRL) is the result of the atrophy and destruction of renal parenchyma with massive increases in the amount of fat in the sinus and perirenal space. The 2 conditions can be associated because they may have the same etiology. Indeed, urolithiasis is the most common cause of these diseases. We report a case of chronic nephrocutaneous fistula associated with RRL due to both urolithiasis and renal tuberculosis.[Rev Urol. 2010;12(4):e190-e192 doi: 10.3909/riu0458]© 2010 MedReviews®, LLC

Nephrocutaneous fistulaRenal replacement lipomatosisRenal tuberculosis

Renal salvageView Articles

Volume 13, Number 4Review Articles

Changing Patterns in Iatrogenic Ureteral Injuries

Treatment Review

Dean G AssimosVictoriano RomeroHaluk AkpinarJohn Smith III

Advances in laparoscopic and endoscopic surgery over the past 25 years have changed the preferred methods for performing many operations. We previously reported an increase in the number of patients treated for ureteral injury at our institution that paralleled the introduction of minimally invasive techniques. Since that report, more advanced endoscopic procedures have been introduced. We sought to determine whether the latter influenced the number of ureteral injuries managed at our institution. Reported here are the results of our retrospective study, which sought to determine if the rate of treatment of major iatrogenic ureteral injuries has changed. [Rev Urol. 2011;13(4): e179-e183 doi: 10.3909/riu0537] © 2011 MedReviews®, LLC

UreteroscopyUreteral injuryLaparoscopic cholecystectomyProximal ureterRenal salvage

Renal scarringView Articles
Renal stonesView Articles

Volume 7, Number 3Meeting Reviews

Best of the AUA 2005 Annual Meeting

Meeting Review

Ellen ShapiroAlan W PartinMichael B ChancellorJ Curtis NickelJacob RajferClaus G RoehrbornMichael K BrawerRandall B MeachamArie S BelldegrunJohn P SteinJohn T LeppertJohn S LamStephen J Freedland

Prostate cancerBenign prostatic hyperplasiaBladder cancerKidney cancerLower urinary tract symptomsBotulinum toxinVesicoureteral refluxProstate-specific antigenOveractive bladderPeyronie’s diseaseNomogramsPediatric urologyCryptorchidismVasectomy reversalChronic prostatitisBlockers5-reductase inhibitorsTrospium chlorideRenal stonesProstate volumeMedical Therapy ofProstatic Symptoms (MTOPS) studyMinimally invasive therapiesPremature ejaculationProstate Cancer Prevention TrialTyrol PSA Screening ProjectUrothelial cancer

Renal synovial sarcomaView Articles

Volume 21, Number 2Case Review

Intraperitoneal Rupture of a Synovial Sarcoma of the Kidney

Andrew StammPaul KozlowskiNeal ContiSemra OlgacJohn Paul FloresMichael J Wagner

Primary renal synovial sarcoma is an aggressive, extremely rare disease. Nearly all reported cases are characterized by SYT-SSX gene translocation (X;18)(p11;q11). We describe the case of a 43-year-old woman who presented with an intraperitoneal rupture of this rare sarcoma followed by a right radical nephrectomy. Follow-up imaging 1 month after surgery revealed peritoneal carcinomatosis. She began systemic chemotherapy with doxorubicin and dacarbazine, progressed after 3 months, and is currently receiving single-agent ifosfamide. Only one instance of intraperitoneal rupture has been reported previously. This case report contributes to the characterization of this rare disease. [Rev Urol. 2019;21(2/3):141–143] © 2019 MedReviews®, LLC

Kidney cancerOncologyRenal synovial sarcoma

Renal transplantationView Articles
Renal tuberculosisView Articles

Volume 12, Number 4Case Review

Chronic Spontaneous Nephrocutaneous Fistula Associated With Renal Replacement Lipomatosis

Abdelhak KhalloukMoulay Hassan FarihMohamed Fadl Tazi

Chronic spontaneous nephrocutaneous fistula is a rare renal disease. Renal replacement lipomatosis (RRL) is the result of the atrophy and destruction of renal parenchyma with massive increases in the amount of fat in the sinus and perirenal space. The 2 conditions can be associated because they may have the same etiology. Indeed, urolithiasis is the most common cause of these diseases. We report a case of chronic nephrocutaneous fistula associated with RRL due to both urolithiasis and renal tuberculosis.[Rev Urol. 2010;12(4):e190-e192 doi: 10.3909/riu0458]© 2010 MedReviews®, LLC

Nephrocutaneous fistulaRenal replacement lipomatosisRenal tuberculosis

Renal tumorView Articles

Volume 15, Number 1Review Articles

Physiologic and Anesthetic Considerations in Octogenarians Undergoing Laparoscopic Partial Nephrectomy

Management Review

Nikhil VasdevElizabeth ToddNaeem A Soomro

The number of small renal tumors detected is increasing as imaging becomes both more available and advanced, and as the population ages, with a greater proportion of patients in their 80s emerging with small and treatable renal tumors. The technique of laparoscopic partial nephrectomy is emerging and becoming ever more popular in some centers, and is potentially a safer alternative for the elderly due to improved postoperative pain, shorter hospital stay with faster return to preoperative activities, and lower rates of morbidity and mortality. We present a systematic review of the physiologic and anesthetic considerations in octogenarians undergoing the procedure, highlighting special considerations and the need for expertise throughout the multidisciplinary team when dealing with these patients, in order to minimize risk and optimize outcome. [ Rev Urol. 2013;15(1):23-31 doi: 10.3909/riu0565] © 2013 MedReviews®, LLC

Renal cell carcinomaRadical nephrectomyLaparoscopic partial nephrectomyRenal tumorOctogenarian

Renal tumorsView Articles

Volume 13, Number 3Review Articles

A Review of Current Hemostatic Agents and Tissue Sealants Used in Laparoscopic Partial Nephrectomy

Treatment Review

I GalanakisN VasdevN Soomro

Laparoscopic partial nephrectomy (LPN) is currently considered to be one of the most challenging procedures in minimally invasive urological surgery. With an increasing number of renal tumors being managed using LPN, there is now a further interest in the development of techniques and agents to reduce complications associated with the procedure. Hemostasis is of paramount importance during LPN, and hemostatic agents and tissue sealants are now being used commonly during LPN. Despite this, there is a dearth of prospective, randomized, human trials in current literature that compare the various agents. This review evaluates hemostatic agents and tissue sealants being used during LPN as an adjuvant to suturing in human studies. [Rev Urol. 2011;13(3):131-138 doi: 10.3909/riu0524] © 2011 MedReviews®, LLC

Laparoscopic partial nephrectomyRenal tumorsHemostatic agentsTissue sealantsSuturing adjuvant

Renal ultrasoundView Articles
Repeat biopsyView Articles
Repeat TURView Articles

Volume 9, Number 4Meeting Reviews

Best of the 2007 AUA Annual Meeting (2)

Meeting Review

John P Stein

Bladder Cancer Highlights from the 2007 Annual Meeting of the American Urological Association, May 19-24, 2007, Anaheim, CA [Rev Urol. 2007;9(4):220-234]

Bladder cancerQuality of lifeRisk factorsAgeCystectomyLaparoscopic surgeryIntravesical therapyPrognosisCystoscopyGenderInvasive cancerLymph node dissectionLymphovascular invasionMetastatic cancerOutcomesRepeat TURRobotic-assisted surgerySuperficial cancer

ResearchView Articles

Volume 16, Number 3Review Articles

The Emerging Role of Social Media in Urology

Technology Update

Michael J Leveridge

Social media have become so integrated into modern communications as to be universal in our personal and, increasingly, professional lives. Recent examples of social media uptake in urology, and the emergence of data to quantify it, reveal the expansion of conventional communication routes beyond the in-person forum. In every domain of urologic practice, from patient interaction through research to continuing professional development, the move online has unlocked another layer of conversation, dissemination, and, indeed, caveats. Social media have a democratizing effect, placing patients, trainees, practitioners, and thought leaders in the same arena and on equal footing. If uptake of social media in medicine even remotely parallels its rise to ubiquity in other areas, it will only expand and evolve in the coming years. For these reasons, this article presents an overview of the most recent data on the impact and potential complications of social media usage in the urologic community. [Rev Urol. 2014;16(3):110-117 doi: 10.3909/riu0640] © 2014 MedReviews®, LLC

Social mediaUrologic practiceEducationContinuing professional developmentResearch

ResectionView Articles
ResidentsView Articles

Volume 8, Number 2Review Articles

The Business of Urology - Your First Job

Special Feature

Paul Brower

Young doctors nearing the end of their residency must begin to consider how to chart the course of their careers. Most residents will go into private practice. This requires a huge leap, from academia into the business world of medicine. Young doctors, long preoccupied with the clinical and academic aspects of medicine, are frequently ill-prepared for this process, having no insight as to what they can do to match themselves to the right practice or multi-specialty group. This article discusses the stages of this process, from initial geographic decisions to securing interviews, to assessing the health of a given practice, to the details of contract negotiation. [Rev Urol. 2006;8(2):71-75]

CompensationResidentsEmploymentPrivate practiceMedicarePPOHMOContract negotiation

ResinferatoxinView Articles

Volume 15, Number 3Review Articles

Use of Herbal Supplements for Overactive Bladder

Management Update

Steven A KaplanRichard LeeBilal ChughtaiAlexis E TeElizabeth KavalerFranklin C Lowe

Anticholinergics, specifically antimuscarinic agents, are the most common medications prescribed for overactive bladder (OAB). The most common side effects of these agents are dry mouth and constipation, although other more concerning effects include changes in blood pressure, pulse rate, or heart rhythm when treatment is initiated. Herbal treatments are an increasingly popular alternative for treating OAB. A 2002 survey of US adults aged ≥ 18 years conducted by the Centers for Disease Control and Prevention indicated that 74.6% of those with OAB had used some form of complementary and alternative medicine. The World Health Organization estimates that 80% of the world’s population presently uses herbal medicine for some aspect of primary health care. Women were more likely than men to use complementary and alternative medicine. The authors review the most commonly used herbal medications for OAB. [Rev Urol. 2013;15(3):93-96 doi: 10.3909/riu0587] © 2013 MedReviews®, LLC

Overactive bladderHerbal medicineGosha-jinki-ganHachi-mi-jio-ganBuchu (Barosma betuline)Cleavers (Galium aparine)Cornsilk (Zea mays)Horsetail (Equisetum)Ganoderma lucidumResinferatoxinCapsaicin

ResiniferatoxinView Articles
ResiniferitoxinView Articles
Response predictionView Articles
Retained foreign bodiesView Articles

Volume 14, Number 3Review Articles

Lap Pak for Abdominal Retraction

New Technology Review

Gary D SteinbergHerbert LeporGanesh SivarajanSam S ChangAmr FerganyS Bruce Malkowicz

Retraction of the bowels during abdominal surgery is generally facilitated by the use of a combination of various retractors along with surgical towels or sponges. The use of surgical towels and sponges may lead to retained foreign bodies or adhesions. In addition, these towels and sponges often require manipulation during long surgical procedures. The ideal way to avoid these problems in abdominal surgery is to develop a technique for retraction of the abdominal contents that eliminates the requirement for these foreign bodies. This article presents the results of a small trial for Lap Pak (Seguro Surgical, Columbia, MD), a disposable radio-opaque device that is made of silicone and retracts the bowels in a cephalad orientation without the need for towels or sponges. [Rev Urol. 2012;14(3/4):41-47 doi: 10.3909/riu0572] © 2013 MedReviews®, LLC

RetractionPostoperative adhesionsRetained foreign bodiesLap Pak

RetractionView Articles

Volume 14, Number 3Review Articles

Lap Pak for Abdominal Retraction

New Technology Review

Gary D SteinbergHerbert LeporGanesh SivarajanSam S ChangAmr FerganyS Bruce Malkowicz

Retraction of the bowels during abdominal surgery is generally facilitated by the use of a combination of various retractors along with surgical towels or sponges. The use of surgical towels and sponges may lead to retained foreign bodies or adhesions. In addition, these towels and sponges often require manipulation during long surgical procedures. The ideal way to avoid these problems in abdominal surgery is to develop a technique for retraction of the abdominal contents that eliminates the requirement for these foreign bodies. This article presents the results of a small trial for Lap Pak (Seguro Surgical, Columbia, MD), a disposable radio-opaque device that is made of silicone and retracts the bowels in a cephalad orientation without the need for towels or sponges. [Rev Urol. 2012;14(3/4):41-47 doi: 10.3909/riu0572] © 2013 MedReviews®, LLC

RetractionPostoperative adhesionsRetained foreign bodiesLap Pak

Retrograde ejaculationView Articles

Volume 8, Supplement 4Review Articles

Current Concepts in Ejaculatory Dysfunction

Advances in Alpha-Blocker Therapy in the Management of Urological Disorders

Wayne JG HellstromJeffrey P Wolters

Although erectile dysfunction has recently become the most well-known aspect of male sexual dysfunction, the most prevalent male sexual disorders are ejaculatory dysfunctions. Ejaculatory disorders are divided into 4 categories: premature ejaculation (PE), delayed ejaculation, retrograde ejaculation, and anejaculation/anorgasmia. Pharmacologic treatment for certain ejaculatory disorders exists, for example the off-label use of selective serotonin reuptake inhibitors for PE. Unfortunately, the other ejaculatory disorders are less studied and not as well understood. This review revisits the physiology of the normal ejaculatory response, specifically explores the mechanisms of anejaculation, and presents emerging data. The neurophysiology of the ejaculatory reflex is complex, making classification of the role of individual neurotransmitters extremely difficult. However, recent research has elucidated more about the role of serotonin and dopamine at the central level in the physiology of both arousal and orgasm. Other recent studies that look at differing pharmacokinetic profiles and binding affinities of the 1-antagonists serve as an indication of the centrally mediated role of ejaculation and orgasm. As our understanding of the interaction between central and peripheral modulations and regulation of the process of ejaculation increases, the probability of developing centrally acting pharmaceutical agents for the treatment of sexual dysfunction approaches reality. [Rev Urol. 2006;8(suppl 4):S18-S25]

TamsulosinAlfuzosinRetrograde ejaculationAnejaculationEjaculatory disorders

Retroperitoneal fibrosisView Articles

Volume 8, Number 4Reviews in Urology

Robotic Ureterolysis, Retroperitoneal Biopsy, and Omental Wrap for the Treatment of Ureteral Obstruction Due to Idiopathic Retroperitoneal Fibrosis

Case Review

Patrick W MufarrijMichael D Stifelman

Retroperitoneal fibrosis (RPF) is a rare disorder of unclear etiology characterized by chronic inflammation of the retroperitoneum, which can involve any of the retroperitoneal structures, most notably the ureters, aorta, and vena cava. Historically, open biopsy, ureterolysis, and transpositioning or omental wrapping of the involved ureter(s) have been the preferred surgical treatments of RPF, with success rates greater than 90%. More recently, successful laparoscopic biopsy, ureterolysis, and ureteral omental wrapping and intraperitonealization have been described. We report the first case in the literature of idiopathic RPF managed with robotic ureterolysis and laparoscopic omental ureteral wrapping. [Rev Urol. 2006;8(4):226-230]

Retroperitoneal fibrosisRobotic ureterolysisOmental wrap