Urology Commons^™

Non-Dre Voided Urine Test To Diagnose Prostate Cancer: Updated Results, Patrick T. Gomella, Joon Yau Leong, Leonard G. Gomella, Vivek S. Tomar, Hector Teran, Edouard J. Trabulsi, Mathew L. Thakur

Department of Urology Faculty Papers

Background: The standard diagnostic approach for prostate cancer (PCa) diagnosis consists of serum prostate-specific antigen (PSA) testing, digital rectal examination (DRE) and image-guided targeted biopsies. Given the invasive nature, potential adverse events and costs associated with these techniques, alternative approaches have been investigated, specifically with serum and urine assays. The work presented here is intended to further validate a novel noninvasive optical technique for PCa detection, targeting the VPAC genomic receptors that are overexpressed on prostate cancer's malignant cells (MC), in non-DRE voided urine. Methods: Patients (N = 62) who had image-guided biopsy and histologically confirmed localized PCa, and …

Impact Of Postprogression Therapies On Overall Survival: Recommendations From The 2023 Kidney Cancer Association Think Tank Meeting, Stephanie A Berg, Salvatore La Rosa, Tian Zhang, Phillip M Pierorazio, Laurence Albiges, Kathryn E Beckermann, Matthew T Campbell, Maria I Carlo, Katie Coleman, Daniel J George, Daniel M Geynisman, Ritchie Johnson, Eric Jonasch, Jodi K Maranchie, Bradley A Mcgregor, Daniel D Shapiro, Eric A Singer, Brian M Shuch, Walter M Stadler, Nizar M Tannir, Yousef Zakharia, Ulka N Vaishampayan, Peter F Thall, Pavlos Msaouel

Faculty, Staff and Student Publications

Modern advances in systemic and localized therapies for patients with renal cell carcinoma (RCC) have significantly improved patients' outcomes. If disease progression occurs after initial treatment, clinicians often have multiple options for a first salvage therapy. Because salvage and initial treatments both may affect overall survival time, and they may interact in unanticipated ways, there is a growing need to determine sequences of initial therapy and first salvage therapy that maximize overall survival while maintaining quality of life. The complexity of this problem grows if a second salvage therapy must be chosen for patients with treatment-resistant disease or a second …

Nephrostomy Tubes For Management Of A Bladder Occupying Embryonal Rhabdomyosarcoma In A 2-Year-Old: A Case Report And Review Of The Literature., Simren Jayaraman, Joel F Koenig, Kristen M. Meier, Lindsey Fricke, Kevin Campbell

Manuscripts, Articles, Book Chapters and Other Papers

Local control approaches for bladder/prostate rhabdomyosarcoma (RMS) may include surgery and/or radiation after neoadjuvant chemotherapy, with goal of maximizing long term function. We report a case of bladder RMS presenting with acute renal complications in a 2-year-old female necessitating bilateral nephrostomy tube placement before administration of chemotherapy. As local control for RMS is delayed until after 12 weeks of neoadjuvant chemotherapy has been given, management of medical complications prior to surgery is not protocolized, making case reports and discussion helpful to future patients and providers.

Supraclavicular Nodal Metastasis At Primary Staging Of Prostate Cancer Using 18f-Psma-1007 Pet/Ct, Samuel Gitau, Jasmit Shah, William Olwit, Saeed Samnakay, Manel Haj Mansour, Khalid Makhdomi

Brain and Mind Institute

Background: The most common sites of metastasis in prostate cancer are bone, pelvic and retroperitoneal lymph nodes, liver and lungs. This study aimed to evaluate the prevalence of supraclavicular nodal metastasis in newly diagnosed prostate cancer using 18F-PSMA-1007 PET/CT which has hitherto been understudied.

Methods: 18F-PSMA-1007 PET/CT examinations performed at our institution between June 2020 and June 2022 for primary staging of prostate cancer were reviewed to identify supraclavicular nodal metastasis from prostate cancer. Data variables included age, stage of disease, PSA level, Gleason score and ISUP/WHO grade group and how these compare with the presence of supraclavicular …

Periodontitis Linked With Urinary Tract Infections- Coincidence Or Causality?, Ali Shariff, Shankargouda Patil, Shilpa Bhandi, Frank Licari

Annual Research Symposium

Urinary tract infection is a cumulative term used to describe an infection of any part of the urinary system. Periodontitis is a chronic inflammatory condition of the tooth-supporting structures. The literature points towards an inter-relationship between periodontitis and other systemic diseases such as metabolic syndrome, diabetes mellitus, coronary heart diseases, etc. Several studies indicate a pathophysiologic inter-relationship between periodontitis and urinary tract infections. Considering the inflammatory nature of periodontitis and urinary tract infections, a common link of causality may be present between the two diseases. P. gingivalis, a key periodontal pathogen, is a significant agent in disseminating infection …

Novel Intraoperative Applications Of Fluorescence Imaging Using Indocyanine Green In Pediatric Urology, Albert S T Lee, Ching Man Carmen Tong

Faculty, Staff and Students Publications

PURPOSE OF REVIEW: Near-infrared fluorescence imaging (NIRF) with the use of indocyanine green (ICG) has been recently adopted in pediatric urology after its well-published use in the adult population. As a powerful tool that can help delineate complex anatomy and congenital anomalies, we discuss the various applications of this imaging in minimally invasive and open surgery in pediatric urology.

RECENT FINDINGS: The most reported applications of ICG in pediatric urology are within minimally invasive surgery, particularly varicoceles, renal surgery such as nephrectomies and renal tumor excision, mimicking its use in adult urology. ICG has also been applied to reconstructive urology …

Coexisting Renal Artery Stenosis And Large Angiomyolipoma In A Solitary Kidney: A Therapeutic Dilemma, Yohannes B. Tilahun, Arjun Sekar

Advances in Clinical Medical Research and Healthcare Delivery

Title: Coexisting Renal Artery Stenosis and Large Angiomyolipoma in a Solitary Kidney: A Therapeutic Dilemma

Authors: Tilahun YB, Mentor/Attending: Sekar A

Background: Angiomyolipomas (AMLs) are the most common benign renal tumors, typically presenting as incidental findings. However, large AMLs can lead to life-threatening complications such as retroperitoneal hemorrhage, particularly in the setting of a solitary kidney. The presence of concomitant renal artery stenosis (RAS) further complicates management, posing a unique therapeutic challenge in balancing the need to prevent hemorrhage, preserve renal function, and optimize renovascular perfusion.

Case: A 77-year-old African American woman with a history of left nephrectomy for renal …

Effect Of Implementing An Educational Program About Post Kidney Transplant Care On Critical Care Nurses' Knowledge, Marwa Abdo, Asmaa Ibrahim Aboseda

Nursing

Background: Critical care nurses (CCNs) play a pivotal role in post-kidney transplant care, necessitating a comprehensive understanding of transplantation procedures, complications, and patient management. So, any knowledge gaps among CCNs may impact the quality of care provide to kidney transplant program. Aim: This study aimed to assess the effect of implementing an educational program about post-kidney transplant care on critical care nurses’ knowledge. Methods: A quasi-experimental study was conducted among 50 critical care nurses. A structured educational program was implemented, and nurses’ knowledge was assessed pre- program, post- program, and three months follow-up. Data was collected using a kidney transplantation …

Multidisciplinary Emergent Control Of Traumatic Neovaginal Bleeding After Foreign-Body Insertion In The Early Postoperative Period After Gender-Affirming Vaginoplasty., Tanisha S Kashikar, Christopher D Mcclung, Michal A Radomski, Anand K Joshi, David C Evans

Trauma and Acute Care Articles

As gender-affirming surgery becomes more widespread, it is important that healthcare providers recognize complications related to gender-affirming surgery. Although rates of postoperative bleeding after gender-affirming vaginoplasty are relatively low, it is imperative that this potentially life-threatening complication is recognized and managed quickly. This case highlights the importance of a multidisciplinary approach to the management of neovaginal bleeding that was unable to be controlled intraoperatively by suture ligation.

Adenomatoid Tumor Of The Testis: A Report Of Two Cases And Literature Review, Amadadin Alhlib, Trudea Juma, Shahin Sayed

General Surgery, East Africa

Testicular adenomatoid tumor is a rare benign condition that can resemble testicular malignancies in its clinical presentation, potentially leading to overtreatment, such as radical orchidectomy. In our two case reports, we aim to better understand the behavior of this disease by examining its clinical presentation, as well as radiological, intraoperative, and pathological findings.

Leveraging Clinical Standards To Improve The Translational Relevance Of Therapies For Experimental Spinal Cord Injury, Aaron L. Silverstein

Theses and Dissertations--Neuroscience

Efforts to improve treatment of spinal cord injury (SCI) often use animals to develop effective therapeutics, intending to improve the survival and the quality of life of persons with SCI. Over half of all SCIs in the United States occur at the cervical level and often cause locomotor deficits and life-threatening breathing dysfunction. Thus, my dissertation is focused on this important patient population.

After beginning with a description of translational research and surveying SCI from a clinical standpoint, I turned to describe experimental models of cervical SCI and more detailed neuroimmunological findings relevant to my work. Then, I conducted a …

Successful Treatment Of An Atypical Presentation Of Disseminated Retroperitoneal Seminoma: A Case Report, Mahmoud Abd-El-Hafez, Kylie Johnson, Joe Cates, Alosh Madala

HCA Healthcare Journal of Medicine

Background

Testicular seminoma is the most common malignant tumor of the testis. It occurs at a rate of 5 per 100 000 men, primarily between the ages of 15 to 34. While seminomas typically occur in the testis, other primary sites include the mediastinum, the retroperitoneum, or other extra-gonadal sites. Due to the curable nature of the malignancy (5-year survival rate > 95%), detection at early stages of the disease is key. This case presentation explores the delayed diagnosis and treatments of an atypical presentation of disseminated seminoma.

Case Presentation

We present the unusual case of a 56-year-old male who had …

High-Intensity Focused Ultrasound Ablation For Primary Or Salvage Prostate Cancer Therapy: Initial Outcomes In The Veteran Healthcare Setting, Sagar Patel, Ali Antar, Aly Alrabaa, Gal Saffati, Broderick Fleming, Neel Srikishen, Jeremy Slawin, Jennifer Taylor, Jeffrey Jones

Faculty, Staff and Students Publications

High-Intensity Focused Ultrasound (HIFU) provides comparable oncologic, erectile, and urinary outcomes to standard-of-care options for localized prostate cancer. This study reports the largest United States series of HIFU in veterans for both primary and salvage therapies. We retrospectively analyzed the outcomes of 43 veterans treated at the Michael E. DeBakey Veterans Affairs Medical Center from 2018 to 2022. Primary endpoints included prostate-specific antigen (PSA) reduction and local recurrence rates. Secondary endpoints included 30-day complications, Sexual Health Inventory for Men (SHIM), and American Urological Association Symptom Score (AUASS). In our study, 31 veterans (72.1%) received primary treatment and 12 (27.9%) received …

Broad And Diverse Roles Of Sphingosine-1-Phosphate/Sphingosine-1-Phosphate Receptors In The Prostate., Daoquan Liu, Jianmin Liu, Yan Li, Lu Du, Qingqiong Cao, Liang Yang, Yongying Zhou, Ping Chen, Yuming Guo, Guang Zeng, Michael E. Disanto, Weidong Hu, Xinhua Zhang

Cooper Medical School of Rowan University Departmental Research

Benign prostatic hyperplasia (BPH) is a common condition in aging males, but its underlying pathogenesis remains unclear. Sphingosine-1-phosphate (S1P) and its receptors (S1PRs) play important roles in various diseases, while less studied in prostate. Current study attempts to clarify the expression and functional activities of S1P/S1PRs in the prostate. We discovered that S1P/S1PRs were richly expressed in the prostate, with S1PR1/2/3 localized in the epithelial/stromal compartments, while S1PR4/5 were less expressed. In vitro, S1P/S1PR1/S1PR3 promoted cell proliferation via AKT and ERK1/2 pathways, S1P/S1PR2/S1PR3 enhanced contraction of WPMY-1 cells and human prostate via RhoA/ROCK pathway, while S1P/S1PR1/S1PR2/S1PR3 alleviated the inflammation …

The Rise, Fall, And Resurgence Of Phage Therapy For Urinary Tract Infection, Jacob J Zulk, Kathryn A Patras, Anthony W Maresso

Faculty, Staff and Students Publications

In the face of rising antimicrobial resistance, bacteriophage therapy, also known as phage therapy, is seeing a resurgence as a potential treatment for bacterial infections including urinary tract infection (UTI). Primarily caused by uropathogenic Escherichia coli, the 400 million UTI cases annually are major global healthcare burdens and a primary cause of antibiotic prescriptions in the outpatient setting. Phage therapy has several potential advantages over antibiotics including the ability to disrupt bacterial biofilms and synergize with antimicrobial treatments with minimal side effects or impacts on the microbiota. Phage therapy for UTI treatment has shown generally favorable results in recent …

Fournier's Gangrene Severity Index And Charlson Comorbidity Index Predict Mortality, Intensive Care Unit Admission, And Length Of Hospital Stay In Patients With Fournier's Gangrene: An Analysis Of 264 Consecutive Patients, Nicholas Hauser, Chenlin Huang, Girija Vaidya, Timothy Chrusciel, Krithika Narayana Kumarasan, John Culhane, Sameer Siddiqui

Faculty, Staff and Students Publications

Introduction

Fournier’s gangrene (FG) is a rapidly progressing necrotizing fasciitis. The Fournier's Gangrene Severity Index (FGSI), in conjunction with the Charlson Comorbidity Index (CCI), has been used as a mortality predictor during hospitalization. Patients with diabetes have also been shown to be at an increased risk for the development of FG. This study explores the potential of using FGSI, CCI, and patient diabetes status in predicting more extensive patient outcomes, including intensive care unit (ICU) admission and length of hospital stay.

Methods

From 2013 to 2023, inpatient admissions with the diagnosis of FG were selected from the EPIC Clarity database …

Implementation Of Delirium Screening In The Emergency Department: A Qualitative Study With Early Adopters, Anita N Chary, Annika R Bhananker, Elise Brickhouse, Beatrice Torres, Ilianna Santangelo, Kyler M Godwin, Aanand D Naik, Christopher R Carpenter, Shan W Liu, Maura Kennedy

Faculty, Staff and Students Publications

Introduction: Delirium affects 15% of older adults presenting to emergency departments (EDs) but is detected in only one-third of cases. Evidence-based guidelines for ED delirium screening exist, but are underutilized. Frontline staff perceptions about delirium and time and resource constraints are known barriers to ED delirium screening uptake. Early adopters of ED delirium screening can offer valuable lessons about successful implementation.

Methods: We conducted semi-structured interviews with clinician-administrators leading ED delirium screening initiatives from 20 EDs in the United States and Canada. Interviews focused on experiences of planning and implementing ED delirium screening. Interviews lasted 15 to 50 minutes and …

Development Of A New Peyronie’S Disease Self-Assessment Screening App, Gregory A Broderick, Jesse N Mills, Lisa Bathish, Christopher Davis, Mohit Khera

Faculty, Staff and Students Publications

Peyronie's disease (PD) is an underdiagnosed and undertreated fibroproliferative disorder associated with the formation of plaques that results in penile curvature and discourages some men from seeking medical consultation. The PD self-assessment app, a digital application (app), was developed to increase PD awareness, provide men with a self-screening and educational tool for PD, and help eliminate barriers to seeking consultation with a physician. Prior to deployment, 4 board-certified urologists provided qualitative reviews on the app's usability and utility as a screening tool. The PD self-assessment app features a questionnaire that addresses penile curvature, challenges with penetration, partner distress, and the …

The Role Of Kctd13 In Androgen Receptor Ubiquitination​, Faith Abraham, Ahmed Chahdi, Phd, Carolina Jorgez, Phd, Abhishek Seth

HCA-NSU MD Research Day

The Role of KCTD13 in Androgen Receptor Ubiquitination Faith Abraham1, Ahmed Chahdi, PhD2, Caroline Jorgez, PhD3, and Abhishek Seth, MD2 1Class of 2024, Dr. Kiran C. Patel College of Osteopathic Medicine, 2Urology, Nemours Children’s Hospital, Orlando, FL 3Urology, Baylor College of Medicine, Houston, TX Objective: This study was conducted to determine the effect of the KCTD13 gene on major protein effectors of common genitourinary (GU) defects. Background: Hypospadias, characterized by the ventral positioning of the urethral opening, occurs in approximately 1 out of 125 live births. Cryptorchidism, or undescended testes (UDT), is the most common GU birth defect, affecting around …

2024 Cua-Kcrnc Expert Report: Management Of Non-Clear Cell Renal Cell Carcinoma, Jeffrey Graham, Ardalan E Ahmad, Naveen S Basappa, Jean-Christophe Bernhard, Bimal Bhindi, Dominick Bossé, Rodney H Breau, Christina M Canil, Vincent Castonguay, Antonio Finelli, Daniel Y C Heng, Brant A Inman, Christian Kollmannsberger, Aly-Khan A Lalani, Luke T Lavallée, Pavlos Msaouel, Susan Prendeville, Maryam Soleimani, Simon Tanguay, Lori Wood, Patrick O Richard

Faculty, Staff and Student Publications

No abstract provided.