This Month in Adult Urology

You have accessJournal of UrologyThis Month in Adult Urology1 Jun 2021This Urology Joseph A. Smith SmithJoseph More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001688AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Prostate specific membrane antigen/positron emission tomography (PSMA/PET) is becoming increasingly important evaluating and treating patients with prostate cancer. The technology has been widely available parts the world but was only recently approved for use United States. This issue Journal contains 2 papers that help define utility PSMA/PET detecting pelvic lymph node metastasis before radical prostatectomy. Meijer et al (page 1655) from Netherlands correlated findings biochemical recurrence after surgery,1 while Amiel 1663) evaluated a group 434 Germany determine if could influence need dissection.2 Positive predictive values nodal were 64% 82%, respectively, negative 82% 84%. Some differences related variation component patients. Specificity over 94% both studies. also found positive PET predicted early despite surgical removal nodes.1 concluded overall sensitivity 37.9% did not permit elimination extended dissection overall, potentially be used identify some whom necessary, such as those <T3 stage tumor on magnetic resonance imaging intermediate risk disease.2 These studies establish ways clinicians can advances improve care Dutasteride Improves Nocturia Does Not Lead Better Sleep association between nocturia poor sleep long point discussion. It almost “what comes first, chicken or egg” debate. Kuhlmann 1733) REDUCE multicenter clinical trial database, which collected international Symptom Score well MOS (Medical Outcomes Study) Scale.3 While treatment dutasteride had measurable improvement episodes at 4 years followup, corresponding quality observed. Oral therapy drug, then, doesn’t seem useful men whose primary difficulty. Antimicrobial Prophylaxis Transurethral Resection Many guidelines, including American Urological Association, recommend antimicrobial prophylaxis (AMP) transurethral Baten 1748) Belgium enrolled 474 multi-institutional randomized test noninferiority hypothesis AMP vs no antibiotics prostatectomy.4 Postoperative fever occurred 4.4% 4.9% without (p=0.8). There seems benefit preoperative pyuria an indwelling catheter. Effect Erythropoietin Erectile Function Radical Prostatectomy In appropriately named ERECT trial, Patel 1681) Baltimore, Maryland Maywood, Illinois manner impact perioperative erythropoietin (EPO) recovery erectile function nerve sparing prostatectomy.5 Patients control arm received subcutaneous saline rather than EPO. Median 2-week hemoglobin levels higher EPO arm, there difference International Index Erecetile score 6 months other time points. Despite encouraging preclinical data, short dosing offers apparent Prevalence Urinary Incontinence among Nationally Representative Sample Women Although urinary incontinence (UI) life women subject study, prevalence condition still uncertain and, perhaps, underreported. Using data 15,003 National Health Nutrition Examination Survey, Lee 1718) study 53% 2005–2016 reported UI: 26% stress only, 10% urgency 16% mixed incontinence.6 Urgency UI highest aged 60 older, 40–59 years. lower nonHispanic Black women. Of 24% affected their daily life. Seminal Vesical Sparing Cystectomy Bladder Cancer Has Good Functional Results Impairing Oncologic vesicle (SVS) avoid damage nerves, affect functional results cystectomy orthotopic neobladder construction. Furrer 1629) reviewed 470 consecutive retrospective Switzerland, compared various combinations SVS.7 Neither nor SVS showed local recurrence-free survival groups. Cancer-specific more favorable patients, likely patient selection. Both achievement daytime continence better Cystoscopy Systematic Tissue Sampling Predicting pT0 who are scheduled sometimes wonder why surgery necessary chance they may residual disease bladder resection. Zibelman 1605) Philadelphia, Pennsylvania Oklahoma City, performed systematic endoscopic evaluation see cystoscopy tissue sampling reliably T0.8 50.8% visually identifiable biopsies. those, however, 51.6% cancer 25.8% pT2 higher. value biopsy 48.4%. Clearly, methods detection abandoned. Ureteral Stent Placement following Ureteroscopy Increases Emergency Department Visits frequently complain symptoms placement ureteral stents, common ureteroscopy (URS). Hiller all 1710) Michigan report statewide collaborative registry 9,662 URS, stent placed postoperatively 73%.9 Age stone size placement, renal stones less URS. On multivariable analysis, associated 1.25 odds postoperative emergency department visit. Importantly, 0.5% required urgent placement. References 1. : antigen positron metastatic J Urol 2021; 205: 1655. Link, Google Scholar 2. Regional correlates decreased therapy-free prostatectomy: single-center single-arm observational study. 1663. 3. improves does lead sleep: trial. 1733. 4. resection prostate: 1748. 5. 1681. 6. nationally representative sample women, 2005−2016: Urologic Diseases America Project. 1718. 7. vesical feasible good impairing oncological outcomes: longitudinal long-term propensity-matched single center 1629. 8. predicting cancer: prospective 1605. 9. increases visits collaborative. 1710. © 2021 Association Education Research, Inc.FiguresReferencesRelatedDetails Volume 205Issue 6June 2021Page: 1545-1546 Advertisement Copyright & Permissions© Inc.MetricsAuthor Information Expand Loading ...