Urology Commons^™

The Cell's Antenna And Bending With The Flow, Surya M. Nauli, Kimberly F. Atkinson, Sarmed H. Kathem

Pharmacy Faculty Articles and Research

Polycystic kidney disease (PKD) is the most common life-threatening genetic disease worldwide – affecting about 12.5 million people. Patients with the condition have multiple fluid-filled cysts in their kidneys that lead to a massive enlargement of the organ and gradual worsening of its function, as well as complete failure in many cases. The lack of available treatment means patients may eventually require regular dialysis or a kidney transplant.

Endoscopic Lysis Of Bladder Scar Associated With Hunner's Lesions: A New Technique, S. Bahlani, R. Moldwin

Journal Articles

AbstractObjective Five to ten percent of interstitial cystitis/bladder pain syndrome (IC/BPS) patients have Hunner's lesions (HL), areas of non-specific inflammation and scarring. The poor quality of life of patients with HL is entwined in associated pain and loss of bladder capacity. Although the decrease in bladder capacity is usually dependent on pain, it may also be dependent upon scarring and associated compliance changes produced by the inflammatory process. This report reviews the potential role of endoscopic scar lysis using the holmium laser in the management of these patients whose only other therapeutic option is urinary diversion. Methods Two patients with …

Quality Of Life And Symptom Assessment In Randomized Clinical Trials Of Bladder Cancer: A Systematic Review, M. A. Feuerstein, M. Jacobs, A. Piciocchi, B. Bochner, A. Pusic, P. Fayers, J. Blazeby, F. Efficace, Promotion Registry Patient-Reported Outcome Measurements Over Time In Oncology

Journal Articles

OBJECTIVES: Patient-reported outcomes (PRO) help patients, caretakers, clinicians, and policy makers make informed decisions regarding treatment effectiveness. Our objective was to assess the quality of PRO reporting and methodological strengths and weaknesses in randomized controlled trials (RCT) in bladder cancer.; METHODS: A systematic literature search of bladder cancer RCT published between January 2004 and March 2014 was performed. Relevant studies were evaluated using a predetermined extraction form that included trial demographics, clinical and PRO characteristics, and standards of PRO reporting based on recommendations of the International Society for Quality of Life Research.; RESULTS: In total, 9 RCTs enrolling 1,237 patients …

Transurethral Convective Water Vapor As A Treatment For Lower Urinary Tract Symptomatology Due To Benign Prostatic Hyperplasia Using The Rezum((R)) System: Evaluation Of Acute Ablative Capabilities In The Human Prostate, C. M. Dixon, E. Rijo Cedano, L. A. Mynderse, T. R. Larson

Journal Articles

BACKGROUND: The purpose of this study was to assess the acute ablative characteristics of transurethral convective water vapor (steam) using the Rezum((R)) system in men with benign prostatic hyperplasia through histologic and radiographic studies. METHODS: Seven patients were treated with transurethral intraprostatic injections of sterile steam under endoscopic visualization followed by previously scheduled adenectomies. The extirpated adenomas were grossly examined followed by whole mount sectioning and staining with triphenyl-tetrazolium chloride (TTC) to evaluate thermal ablation. Histology was performed after hematoxylin and eosin staining on one prostate. After review of results from the first patient cohort, an additional 15 patients with …

Similarities Between Interstitial Cystitis/Bladder Pain Syndrome And Vulvodynia: Implications For Patient Management, J. Y. Fariello, R. M. Moldwin

Journal Articles

Interstitial cystitis/bladder pain syndrome (IC/BPS) and vulvodynia are chronic pain syndromes that appear to be intertwined from the perspectives of embryology, pathology and epidemiology. These associations may account for similar responses to various therapies.

The Value Of Testicular Ultrasound In The Prediction Of The Type And Size Of Testicular Tumors, A. Shtricker, D. Silver, E. Sorin, L. Schreiber, N. Katlowitz, A. Tsivian, K. Katlowitz, S. Benjamin, A. A. Sidi

Journal Articles

OBJECTIVES: Ultrasound (US) is often used for the work-up of testicular pathology. The findings may implicate on its management. However, there is only scant data on the correlation between US findings and testicular tumor type and size. Herein, we report on a multicenter study, analyzing these correlations. METHODS: The study included patients who underwent orchiectomy between 2000 and 2010. Their charts were reviewed for US echogeneity, lesion size, pathological dimensions, histology, and the presence of calcifications, fibrosis, necrosis and/or intraepithelial neoplasia. The incidence of these parameters in benign versus malignant lesions and seminomatous germ cell tumors (SGCT) versus nonseminomatous germ …

Responses Of Advanced Directives By Jehovah's Witnesses On A Gynecologic Oncology Service, N. P. Nagarsheth, N. Gupta, A. Gupta, E. Moshier, H. Gretz, A. Shander

Journal Articles

OBJECTIVES: To review the responses of advance directives signed by Jehovah's Witness patients prior to undergoing surgery at a gynecologic oncology service. STUDY DESIGN: A retrospective chart review of gynecologic oncology patients undergoing surgery at a bloodless surgery center from 1998-2007 was conducted. Demographic, pathologic, and clinical data were recorded. The proportion of patients who accepted and refused various blood-derived products was determined and was compared to previously published results from a similar study of labor and delivery unit patients. RESULTS: No gynecologic oncology patients agreed to accept transfusions of whole blood, red cells, white cells, platelets, or plasma under …

Comparison Of Multiparametric Mri Scoring Systems And The Impact On Cancer Detection In Patients Undergoing Mr Us Fusion Guided Prostate Biopsies, A. R. Rastinehad, N. Waingankar, B. Turkbey, O. Yaskiv, A. M. Sonstegard, M. Fakhoury, C. A. Olsson, D. N. Siegel, P. L. Choyke, E. Ben-Levi, R. Villani

Journal Articles

INTRODUCTION: Multiple scoring systems have been proposed for prostate MRI reporting. We sought to review the clinical impact of the new Prostate Imaging Reporting and Data System v2 (PI-RADS) and compare those results to our proposed Simplified Qualitative System (SQS) score with respect to detection of prostate cancers and clinically significant prostate cancers. METHODS: All patients who underwent multiparametric prostate MRI (mpMRI) had their images interpreted using PI-RADS v1 and SQS score. PI-RADS v2 was calculated from prospectively collected data points. Patients with positive mpMRIs were then referred by their urologists for enrollment in an IRB-approved prospective phase III trial …

Humoral Immune Response Against Nontargeted Tumor Antigens After Treatment With Sipuleucel-T And Its Association With Improved Clinical Outcome, D. Guhathakurta, N. A. Sheikh, L. Q. Fan, H. Kandadi, T. C. Meagher, S. J. Hall, J. B. Whitmore, M. W. Frohlich, J. B. Trager, C. G. Drake, +7 Additional Authors

Journal Articles

PURPOSE: Antitumor activity of cancer immunotherapies may elicit immune responses to nontargeted (secondary) tumor antigens, or antigen spread. We evaluated humoral antigen spread after treatment with sipuleucel-T, an immunotherapy for asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (mCRPC), designed to target prostatic acid phosphatase (PAP; primary antigen). EXPERIMENTAL DESIGN: Serum samples from patients with mCRPC enrolled in the placebo-controlled phase III IMPACT study (evaluable n = 142) were used to assess humoral antigen spread after treatment with sipuleucel-T. Immunoglobulin G (IgG) responses to self-antigens (including tumor antigens) were surveyed using protein microarrays and confirmed using Luminex xMAP. IgG responses …

Outcomes Of Midurethral Slings In Women With Concomitant Preoperative Severe Lower Urinary Tract Voiding Symptoms, M. S. Ingber, R. M. Krlin, S. P. Vasavada, F. Firoozi, H. B. Goldman

Journal Articles

BACKGROUND: Women with stress urinary incontinence and concomitant obstructive (voiding) lower urinary tract symptoms (LUTS) represent a challenging patient population. Furthermore, their diagnosis and management remain incompletely studied and controversial. We evaluated the outcomes of midurethral sling procedures in women with severe obstructive LUTS. METHODS: We performed a post hoc analysis of women who were part of an institutional review board-approved study of midurethral sling surgery. Preoperatively and at 4-6 weeks postoperatively, patients completed the American Urological Association Symptom Score (AUASS) questionnaire. A postvoid residual urine test was obtained preoperatively, at the time of the voiding trial, and 4-6 weeks …

Long-Term Survival Rates After Resection For Locally Advanced Kidney Cancer: Memorial Sloan Kettering Cancer Center 1989 To 2012 Experience, W. M. Bazzi, D. D. Sjoberg, M. A. Feuerstein, A. Maschino, S. Verma, M. Bernstein, M. F. O'Brien, T. Jang, W. Lowrance, P. Russo, +1 Additional Author

Journal Articles

Purpose: We analyzed the 23-year Memorial Sloan Kettering Cancer Center experience with surgical resection, and concurrent adrenalectomy and lymphadenectomy for locally advanced nonmetastatic renal cell carcinoma. Materials and Methods: We retrospectively reviewed the records of 802 patients who underwent nephrectomy with or without concurrent adrenalectomy or lymphadenectomy for locally advanced renal cell carcinoma, defined as stage T3 or greater and M0. Patients who received adjuvant treatment within 3 months of surgery or had fewer than 3 months of followup or bilateral renal masses at presentation were excluded from analysis. Five and 10-year progression-free and overall survival was estimated by the …

Comparing Open Radical Cystectomy And Robot-Assisted Laparoscopic Radical Cystectomy: A Randomized Clinical Trial, B. H. Bochner, G. Dalbagni, D. D. Sjoberg, J. Silberstein, G. E. K. Paz, S. M. Donat, J. A. Coleman, S. Mathew, A. Vickers, G. C. Schnorr, M. A. Feuerstein, B. Rapkin, R. O. Parra, H. W. Herr, V. P. Laudone

Journal Articles

Background: Open radical cystectomy (ORC) and urinary diversion in patients with bladder cancer (BCa) are associated with significant perioperative complication risk. Objective: To compare perioperative complications between robot-assisted radical cystectomy (RARC) and ORC techniques. Design, setting, and participants: A prospective randomized controlled trial was conducted during 2010 and 2013 in BCa patients scheduled for definitive treatment by radical cystectomy (RC), pelvic lymph node dissection (PLND), and urinary diversion. Patients were randomized to ORC/PLND or RARC/PLND, both with open urinary diversion. Patients were followed for 90 d postoperatively. Intervention: Standard ORC or RARC with PLND; all urinary diversions were performed via …

Development And Preliminary Testing Of Progress: A Web-Based Education Program For Prostate Cancer Survivors Transitioning From Active Treatment, S. M. Miller, S. V. Hudson, S. K. A. Hui, M. A. Diefenbach, L. Fleisher, M. Buyyounouski, C. Denlinger, C. Miyamoto, A. Reese, J. Baman, +6 Additional Authors

Journal Articles

This formative research study describes the development and preliminary evaluation of a theory-guided, online multimedia psycho-educational program (PROGRESS) designed to facilitate adaptive coping among prostate cancer patients transitioning from treatment into long-term survivorship. Guided by the Cognitive-Social Health Information Processing Model (C-SHIP) and using health communications best practices, we conducted a two-phase, qualitative formative research study with early stage prostate cancer patients (n = 29) to inform the Web program development. Phase 1 included individual (n = 5) and group (n = 12) interviews to help determine intervention content and interface. Phase 2 employed iterative user/usability testing (n = 12) …

Decision-Making Processes Among Prostate Cancer Survivors With Rising Psa Levels: Results From A Qualitative Analysis, M. J. Shen, C. J. Nelson, E. Peters, S. F. Slovin, S. J. Hall, M. Hall, P. C. Herrera, E. A. Leventhal, H. Leventhal, M. A. Diefenbach

Journal Articles

Background. Prostate cancer survivors with a rising prostate-specific antigen (PSA) level have few treatment options, experience a heightened state of uncertainty about their disease trajectory that might include the possibility of cancer metastasis and death, and often experience elevated levels of distress as they have to deal with a disease they thought they had conquered. Guided by self-regulation theory, the present study examined the cognitive and affective processes involved in shared decision making between physicians and patients who experience a rising PSA after definitive treatment for prostate cancer. Methods. In-depth interviews were conducted with 34 prostate cancer survivors who had …

Effects Of Saw Palmetto On Lower Urinary Tract Symptoms From Benign Prostatic Hyperplasia, Michael Trimble

Physician Assistant Scholarly Project Posters

• Benign prostatic hypertrophy (BPH) is common in older males and can cause lower urinary tract symptoms (LUTS).

• Saw Palmetto, an herbal supplement, is normally implemented as an alternative medication to treat lower urinary tract symptoms associated with BPH.

• The review of literature evaluated studies comparing the effects and outcomes of Saw Palmetto versus commonly prescribed medications such as antiadrenergic agents.

• There are conflicting studies indicating Saw Palmetto’s efficacy on lower urinary tract symptoms and reduction of BPH.

• Saw Palmetto has no side effects, and is available at a low cost when compared to prescribed medications …

Distal Spermatic Cord Peritoneal Stripping: An Adjunct Technique During Inguinal Orchiopexy, Hubert S. Swana, Rikin Patel, Mark A. Rich

Urology Faculty Publications

No abstract provided.

A Novel Approach For The Treatment Of Radiation-Induced Hemorrhagic Cystitis With The Greenlight™ Xps Laser, Daniel Roberto Martinez, Cesar E. Ercole, Juan Gabriel Lopez, Justin Parker, Mary K. Hall

Urology Faculty Publications

Introduction: The treatment of pelvic malignancies with radiotherapy can develop severe sequelae, especially radiation-induced hemorrhagic cystitis. It is a progressive disease that can lead to the need for blood transfusion, hospitalizations, and surgical interventions. This tends to affect the quality of life of these patients, and management can at times be difficult. We have evaluated the GreenLight Xcelerated Performance System (XPS) with TruCoag, although primarily used for management of benign prostatic hypertrophy (BPH), for the treatment of radiation-induced hemorrhagic cystitis.

Materials and Methods: After International Review Board (IRB) approval, a retrospective chart review was performed in addition to a literature …

Treatment Of Exophytic Renal Cancer Smaller Than 3 Cm: Surgery Versus Active Surveillance., Costas D. Lallas, Edouard J. Trabulsi, Samuel D. Kaffenberger, Karim A Touijer

Department of Urology Faculty Papers

No abstract provided.

Reduction Corporoplasty, Tariq S. Hakky, Daniel Martinez, Christopher Yang, Rafael E. Carrion

Urology Faculty Publications

Objective: Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism.

Introduction: Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature. Materials and Methods: We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement.

Results: The patient tolerated the procedure well and has resolution of his corporal disfigurement.

Conclusions: Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation …

Effect Of Utilization Of Veno-Venous Bypass Vs. Cardiopulmonary Bypass On Complications For High Level Inferior Vena Cava Tumor Thrombectomy And Concomitant Radical Nephrectomy, Ross M. Simon, Timothy Kim, Patrick Espiritu, Tony Kurian, Wade J. Sexton, Julio M. Pow-Sang, Einar Sverrisson, Philippe E. Spiess

Urology Faculty Publications

Purpose: To determine if patients with renal cell carcinoma (RCC) with levels III and IV tumor thrombi are receive any reduction in complication rate utilizing veno-venous bypass (VVB) over cardiopulmonary bypass (CPB) for high level (III/IV) inferior vena cava (IVC) tumor thrombectomy and concomitant radical nephrectomy.

Materials and Methods: From May 1990 to August 2011, we reviewed 21 patients that had been treated for RCC with radical nephrectomy and concomitant IVC thrombectomy employing either CPB (n =16) or VVB (n=5). We retrospectively reviewed our study population for complication rates and perioperative characteristics.

Results: Our results are reported using the validated …

Partial Priapism Treated With Pentoxifylline, Meghan A. Cooper, Rafael E. Carrion, Christopher Yang

Urology Faculty Publications

Main findings: A 26-year-old man suffering from partial priapism was successfully treated with a regimen including pentoxifylline, a nonspecific phosphodiesterase inhibitor that is often used to conservatively treat Peyronie's disease.

Case hypothesis: Partial priapism is an extremely rare urological condition that is characterized by thrombosis within the proximal segment of a single corpus cavernosum. There have only been 36 reported cases to date. Although several factors have been associated with this unusual disorder, such as trauma or bicycle riding, the etiology is still not completely understood. Treatment is usually conservative and consists of a non-steroidal anti-inflammatory and anti-thrombotic.

Promising future …

Bilateral Ureteral-Iliac Artery Fistula In A Patient With Chronic Indwelling Ureteral Stents: A Case Report And Review, Arash Rafiei, Timothy A. Weber, Michael Kongnyuy, Raul Ordorica

Urology Faculty Publications

Ureteral-arterial fistula (UAF) is an exceedingly rare but life-threatening condition warranting emergent intervention. Prompt recognition and management of UAF in suspect patients presenting with gross hematuria are required for a successful outcome. We report a rare subset of UAF involving the bilateral common iliac arteries. The patient underwent successful endovascular stent-grafting to correct the arterial defect and delayed open repair of the ureteral strictures. Timely management has benefited from the collaboration of the involved medical teams, which included emergency medicine, urology, and interventional radiology.

A Rare Case Of A Renal Cell Carcinoma Confined To The Isthmus Of A Horseshoe Kidney, Michael Kongnyuy, Daniel Martinez, Anthony Park, Barrett Mccormick, Justin Parker, Mary Hall

Urology Faculty Publications

Horseshoe kidney (HSK) is the most common renal anomaly. Reports of the incidence of renal cell carcinoma (RCC) in HSK are conflicting. Very few cases of isthmus-located RCC have been reported in the literature. We report a unique case of an isthmus-located RCC. Proper vascular and tumor imaging prior to surgery is key to successful tumor removal.

Mechanisms Of Therapeutic Resistance In Castration Resistant Prostate Cancer, Sarah Katherine Martin

Theses and Dissertations--Molecular and Cellular Biochemistry

Taxane based chemotherapy is an effective treatment for castration-resistant prostate cancer (CRPC) via stabilization of microtubules. Progression to castration-resistant prostate cancer is characterized by increased androgen receptor (AR), elevated intra-prostatic androgens and activated AR signaling despite castrate levels of androgens.

Previous studies identified that the inhibitory effect of microtubule targeting chemotherapy on AR activity was conferred by interfering with AR intracellular trafficking. The N-terminal domain (NTD) of AR was identified as a tubulin interacting domain that can be effectively targeted by the novel small molecular inhibitor, EPI. Taken together, this evidence provided the rationale that targeting AR nuclear translocation and …

Urological Pathology, Andrew Renshaw

All Publications

No abstract provided.

“Looks Can Be Deceiving”: Adrenal Teratoma Causing Diagnostic Difficulty, Mehwash Nadeem, Muhammad Hammad Ather, M Nasir Sulaiman, Shahid Pervez

Department of Pathology and Laboratory Medicine

Teratomas are unusual tumours that derived from totipotent cells with their origin from more than one or usually all three germ cells. Here authors are presenting a case of primary retroperitoneal tumour that is a rare clinical entity. A 19-year-old male presented with right lumbar pain and was found to have complex cyst with large calcification in right adrenal gland on imaging. Intraoperatively, he was found to have a solid mass with areas of soft consistency, which was excised en bloc. On gross examination, the cyst contained pieces of bone, few teeth, and hairs entangled in mucinous material. On histological …

The Promise Of Novel Molecular Markers In Bladder Cancer, Jahan Miremami, Natasha Kyprianou

Urology Faculty Publications

Bladder cancer is the fourth most common malignancy in the US and is associated with the highest cost per patient. A high likelihood of recurrence, mandating stringent surveillance protocols, has made the development of urinary markers a focus of intense pursuit with the hope of decreasing the burden this disease places on patients and the healthcare system. To date, routine use of markers is not recommended for screening or diagnosis. Interests include the development of a single urinary marker that can be used in place of or as an adjunct to current screening and surveillance techniques, as well identifying a …

The Association Between Distances Traveled For Care And Treatment Choices For Pelvic Floor Disorders In A Rural Southwestern Population, Gena Dunivan, Pamela Fairchild, Sara Cichowski, Rebecca Rogers

Journal of Health Disparities Research and Practice

OBJECTIVES: To determine if distance traveled for care influenced patient choice for conservative vs. surgical treatment for pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI).

METHODS: Retrospective chart review of all new patients seen in the Urogynecology clinic at the University of New Mexico Hospital (UNMH) from January 2007 through September 2011. Data collected included medical history, Pelvic Organ Prolapse Quantification (POPQ) examination, and validated quality of life questionnaires.

RESULTS: 1384 women were identified with POP and/or SUI. Women traveled an average of 50 miles to receive care at UNMH. After multivariable analysis, greater distance traveled was associated with …

Antibiotic Prophylaxis And Reflux: Critical Review And Assessment, Bernarda Viteri Baquerizo, Craig A. Peters

Urology Faculty Publications

The use of continuous antibiotic prophylaxis (CAP) was critical in the evolution of vesicoureteral reflux (VUR) from a condition in which surgery was the standard of treatment to its becoming a medically managed condition. The efficacy of antibiotic prophylaxis in the management of VUR has been challenged in recent years, and significant confusion exists as to its clinical value. This review summarizes the critical factors in the history, use, and investigation of antibiotic prophylaxis in VUR. This review provides suggestions for assessing the potential clinical utility of prophylaxis.

The Significance Of Functional Renal Obstruction In Predicting Pathologic Stage Of Upper Tract Urothelial Carcinoma., Michael J. Amirian, Kushan Radadia, Hadley Narins, Kelly A. Healy, Scott G. Hubosky, Demetrius H. Bagley, Edouard J. Trabulsi, Costas D. Lallas

Department of Urology Faculty Papers

BACKGROUND AND PURPOSE: Assessing the severity of upper tract urothelial carcinoma (UTUC) has been difficult because of inadequate biopsy specimens. Additional predictive parameters of disease stage would be useful when deciding a treatment plan; it has been suggested that preoperative hydronephrosis can be a surrogate. We examined the relationship between preoperative ipsilateral renal obstruction identified by imaging with final pathologic stage after nephroureterectomy (NU) for UTUC. We then analyzed those patients with ipsilateral renal obstruction and examined if tumor location is associated with an advanced pathologic stage.

METHODS: Patients who underwent NU for UTUC between the years 2001 to 2013 …