Extent of Pelvic Lymph Node Dissection During Radical Cystectomy: Is Bigger Better?
Debasish Sundi, MD, Robert S. Svatek, MD, MSCI, Matthew E. Nielsen, MD, MS, Mark P. Schoenberg, MD, Trinity J. Bivalacqua, MD, PhD
Pelvic lymph node dissection (PLND) is a standard component of radical cystectomy (RC) for bladder cancer. The optimal anatomic PLND template remains undefined. An extended PLND template can potentially improve survival through the eradication of micrometastatic disease and improved pathologic staging. However, this benefit could be compromised by a potential increase in perioperative complications and cost. Two randomized controlled clinical trials that will clarify this question are ongoing. Many important retrospective studies have provided insights into the optimal PLND extent. Here the authors review the key evidence that informs how urologists may tailor the PLND template during RC depending on patient and tumor characteristics.
Erectile Dysfunction and Essential Hypertension: The Same Aging-related Disorder?
Raul I. Clavijo, MD, Martin M. Miner, MD, Jacob Rajfer, MD
This review highlights what we know about the corporal smooth muscle cell and demonstrates that what occurs to the corporal smooth muscle cell also occurs to its embryologic sibling, the smooth muscle cell within the media of the peripheral vascular system. As a result of this relationship, changes in the function of the penis can reflect changes in the vascular system.
A Guide for Clinicians in the Evaluation of Emerging Molecular Diagnostics for Newly Diagnosed Prostate Cancer
Steven E. Can field, MD, Adam S. Kibel, MD, Michael J. Kemeter, MSP AS, Phillip G. Febbo, MD, H. Jeffrey Lawrence, MD, Judd W. Moul, MD
This review outlines aspects of assay development, clinical and analytic validation and clinical utility studies, and regulatory issues, which collectively determine whether tests (1) are actionable for specific clinical indications, (2) measurably influence treatment decisions, and (3) are sufficiently validated to warrant incorporation into clinical practice.
Post-Radical Prostatectomy Incontinence: Etiology and Prevention
Kimberley Hoyland, MBBS, Nikhil Vasdev, ChM (Urol), FRCS (Urol), Ahmed Abrof, FRCS (Urol), Gregory Boustead, FRCS (Urol)
All patients undergoing a radical prostatectomy (RP) using any surgical approach, be it open, laparoscopic, or robotic, are at risk of developing postprostatectomy urinary incontinence. This side effect of RP has an effect on the patient's quality of life and can be associated with moderate to severe postoperative morbidity. The authors present a review of the etiology and prevention strategies of postprostatectomy urinary incontinence.
From the President’s Desk
Gary M. Kirsh, MD
Testicular Sclerosing Sertoli Cell Tumor: A Case Report and Review of the Literature
Sarah Coleman, MD, Yagil Barazani, MD, Andres A. Roma, MD, Edmund Sabanegh, Jr, MD
Sertoli cell tumors are very rare testicular tumors, representing 0.4% to 1.5% of all testicular malignancies. They are subclassified as classic, large-cell calcifying, and Sclerosing Sertoli cell tumors (SSCT) based on distinct clinical features. Only 42 cases of SSCTs have been reported in the literature. We present a case of a 23-year-old man diagnosed with SSCT.
The Use of Botulinum Neurotoxin Type A in a Patient With Refractory Urge Incontinence to Facilitate the Intravesical Treatment of Bladder Carcinoma
Mina Fam, MD, Patricia Gilhooly, MD
The authors describe the use of botulinum neurotoxin type A intradetrusor injections to facilitate the use of intravesical Bacillus Calmette-Guérin in a patient with severe urge incontinence refractory to first-line therapy.
Intratesticular Epidermoid Cyst Masquerading as Testicular Torsion
Jeremy Slawin, BA, Kevin Slawin, MD
Epidermoid cysts are benign tumors that comprise approximately 1% of all testicular masses. They usually present as painless masses that can be identified on scrotal ultrasound as well-demarcated intratesticular lesions with mixed echogenicity. This case report describes a rare presentation of an extremely large intratesticular epidermoid cyst with clinical and radiologic findings more consistent with testicular torsion.
Prostate Cancer
Stacy Loeb, MD, H. Ballentine Carter, MD, Mark Schwartz, MD, Angela Fagerlin, MD, R. Scott Braithwaite, MD, Herbert Lepor, MD
Extent of Pelvic Lymph Node Dissection During Radical Cystectomy: Is Bigger Better?
Debasish Sundi, MD, Robert S. Svatek, MD, MSCI, Matthew E. Nielsen, MD, MS, Mark P. Schoenberg, MD, Trinity J. Bivalacqua, MD, PhD
Pelvic lymph node dissection (PLND) is a standard component of radical cystectomy (RC) for bladder cancer. The optimal anatomic PLND template remains undefined. An extended PLND template can potentially improve survival through the eradication of micrometastatic disease and improved pathologic staging. However, this benefit could be compromised by a potential increase in perioperative complications and cost. Two randomized controlled clinical trials that will clarify this question are ongoing. Many important retrospective studies have provided insights into the optimal PLND extent. Here the authors review the key evidence that informs how urologists may tailor the PLND template during RC depending on patient and tumor characteristics.
Erectile Dysfunction and Essential Hypertension: The Same Aging-related Disorder?
Raul I. Clavijo, MD, Martin M. Miner, MD, Jacob Rajfer, MD
This review highlights what we know about the corporal smooth muscle cell and demonstrates that what occurs to the corporal smooth muscle cell also occurs to its embryologic sibling, the smooth muscle cell within the media of the peripheral vascular system. As a result of this relationship, changes in the function of the penis can reflect changes in the vascular system.
A Guide for Clinicians in the Evaluation of Emerging Molecular Diagnostics for Newly Diagnosed Prostate Cancer
Steven E. Can field, MD, Adam S. Kibel, MD, Michael J. Kemeter, MSP AS, Phillip G. Febbo, MD, H. Jeffrey Lawrence, MD, Judd W. Moul, MD
This review outlines aspects of assay development, clinical and analytic validation and clinical utility studies, and regulatory issues, which collectively determine whether tests (1) are actionable for specific clinical indications, (2) measurably influence treatment decisions, and (3) are sufficiently validated to warrant incorporation into clinical practice.
Post-Radical Prostatectomy Incontinence: Etiology and Prevention
Kimberley Hoyland, MBBS, Nikhil Vasdev, ChM (Urol), FRCS (Urol), Ahmed Abrof, FRCS (Urol), Gregory Boustead, FRCS (Urol)
All patients undergoing a radical prostatectomy (RP) using any surgical approach, be it open, laparoscopic, or robotic, are at risk of developing postprostatectomy urinary incontinence. This side effect of RP has an effect on the patient's quality of life and can be associated with moderate to severe postoperative morbidity. The authors present a review of the etiology and prevention strategies of postprostatectomy urinary incontinence.
From the President’s Desk
Gary M. Kirsh, MD
Testicular Sclerosing Sertoli Cell Tumor: A Case Report and Review of the Literature
Sarah Coleman, MD, Yagil Barazani, MD, Andres A. Roma, MD, Edmund Sabanegh, Jr, MD
Sertoli cell tumors are very rare testicular tumors, representing 0.4% to 1.5% of all testicular malignancies. They are subclassified as classic, large-cell calcifying, and Sclerosing Sertoli cell tumors (SSCT) based on distinct clinical features. Only 42 cases of SSCTs have been reported in the literature. We present a case of a 23-year-old man diagnosed with SSCT.
The Use of Botulinum Neurotoxin Type A in a Patient With Refractory Urge Incontinence to Facilitate the Intravesical Treatment of Bladder Carcinoma
Mina Fam, MD, Patricia Gilhooly, MD
The authors describe the use of botulinum neurotoxin type A intradetrusor injections to facilitate the use of intravesical Bacillus Calmette-Guérin in a patient with severe urge incontinence refractory to first-line therapy.
Intratesticular Epidermoid Cyst Masquerading as Testicular Torsion
Jeremy Slawin, BA, Kevin Slawin, MD
Epidermoid cysts are benign tumors that comprise approximately 1% of all testicular masses. They usually present as painless masses that can be identified on scrotal ultrasound as well-demarcated intratesticular lesions with mixed echogenicity. This case report describes a rare presentation of an extremely large intratesticular epidermoid cyst with clinical and radiologic findings more consistent with testicular torsion.
Prostate Cancer
Stacy Loeb, MD, H. Ballentine Carter, MD, Mark Schwartz, MD, Angela Fagerlin, MD, R. Scott Braithwaite, MD, Herbert Lepor, MD
Extent of Pelvic Lymph Node Dissection During Radical Cystectomy: Is Bigger Better?
Debasish Sundi, MD, Robert S. Svatek, MD, MSCI, Matthew E. Nielsen, MD, MS, Mark P. Schoenberg, MD, Trinity J. Bivalacqua, MD, PhD
Pelvic lymph node dissection (PLND) is a standard component of radical cystectomy (RC) for bladder cancer. The optimal anatomic PLND template remains undefined. An extended PLND template can potentially improve survival through the eradication of micrometastatic disease and improved pathologic staging. However, this benefit could be compromised by a potential increase in perioperative complications and cost. Two randomized controlled clinical trials that will clarify this question are ongoing. Many important retrospective studies have provided insights into the optimal PLND extent. Here the authors review the key evidence that informs how urologists may tailor the PLND template during RC depending on patient and tumor characteristics.
Erectile Dysfunction and Essential Hypertension: The Same Aging-related Disorder?
Raul I. Clavijo, MD, Martin M. Miner, MD, Jacob Rajfer, MD
This review highlights what we know about the corporal smooth muscle cell and demonstrates that what occurs to the corporal smooth muscle cell also occurs to its embryologic sibling, the smooth muscle cell within the media of the peripheral vascular system. As a result of this relationship, changes in the function of the penis can reflect changes in the vascular system.
A Guide for Clinicians in the Evaluation of Emerging Molecular Diagnostics for Newly Diagnosed Prostate Cancer
Steven E. Can field, MD, Adam S. Kibel, MD, Michael J. Kemeter, MSP AS, Phillip G. Febbo, MD, H. Jeffrey Lawrence, MD, Judd W. Moul, MD
This review outlines aspects of assay development, clinical and analytic validation and clinical utility studies, and regulatory issues, which collectively determine whether tests (1) are actionable for specific clinical indications, (2) measurably influence treatment decisions, and (3) are sufficiently validated to warrant incorporation into clinical practice.
Post-Radical Prostatectomy Incontinence: Etiology and Prevention
Kimberley Hoyland, MBBS, Nikhil Vasdev, ChM (Urol), FRCS (Urol), Ahmed Abrof, FRCS (Urol), Gregory Boustead, FRCS (Urol)
All patients undergoing a radical prostatectomy (RP) using any surgical approach, be it open, laparoscopic, or robotic, are at risk of developing postprostatectomy urinary incontinence. This side effect of RP has an effect on the patient's quality of life and can be associated with moderate to severe postoperative morbidity. The authors present a review of the etiology and prevention strategies of postprostatectomy urinary incontinence.
From the President’s Desk
Gary M. Kirsh, MD
Testicular Sclerosing Sertoli Cell Tumor: A Case Report and Review of the Literature
Sarah Coleman, MD, Yagil Barazani, MD, Andres A. Roma, MD, Edmund Sabanegh, Jr, MD
Sertoli cell tumors are very rare testicular tumors, representing 0.4% to 1.5% of all testicular malignancies. They are subclassified as classic, large-cell calcifying, and Sclerosing Sertoli cell tumors (SSCT) based on distinct clinical features. Only 42 cases of SSCTs have been reported in the literature. We present a case of a 23-year-old man diagnosed with SSCT.
The Use of Botulinum Neurotoxin Type A in a Patient With Refractory Urge Incontinence to Facilitate the Intravesical Treatment of Bladder Carcinoma
Mina Fam, MD, Patricia Gilhooly, MD
The authors describe the use of botulinum neurotoxin type A intradetrusor injections to facilitate the use of intravesical Bacillus Calmette-Guérin in a patient with severe urge incontinence refractory to first-line therapy.
Intratesticular Epidermoid Cyst Masquerading as Testicular Torsion
Jeremy Slawin, BA, Kevin Slawin, MD
Epidermoid cysts are benign tumors that comprise approximately 1% of all testicular masses. They usually present as painless masses that can be identified on scrotal ultrasound as well-demarcated intratesticular lesions with mixed echogenicity. This case report describes a rare presentation of an extremely large intratesticular epidermoid cyst with clinical and radiologic findings more consistent with testicular torsion.