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Publisher: Elsevier   (Total: 3043 journals)

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Showing 1 - 200 of 3043 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 22, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 21, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 84, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 348, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 252, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 23, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Acute Pain     Full-text available via subscription   (Followers: 13)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 135, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 26, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 6)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 41, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 41, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 50, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 35, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 15, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 61)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 353, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 326, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 404, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 39, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 54, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 10, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 8, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 47, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
American Heart J.     Hybrid Journal   (Followers: 49, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 39, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 8, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 45, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 248, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 57, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 57, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 11)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 3, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 166, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 160, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (Followers: 1, SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover Urologic Clinics of North America
  [SJR: 0.764]   [H-I: 65]   [5 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 0094-0143
   Published by Elsevier Homepage  [3043 journals]
  • The Impact of Neurologic Disease on the Urinary Tract
    • Authors: John T. Stoffel; Yahir Santiago-Lastra
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): John T. Stoffel, Yahir Santiago-Lastra


      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.05.001
       
  • The Impact of Neurologic Disease on the Urinary Tract
    • Authors: Samir S. Taneja
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Samir S. Taneja


      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.06.001
       
  • Introducing “The Impact of Neurologic Disease on the Urinary
           Tract”
    • Authors: John T. Stoffel; Yahir Santiago-Lastra
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): John T. Stoffel, Yahir Santiago-Lastra


      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.05.001
       
  • Understanding the Economic Impact of Neurogenic Lower Urinary Tract
           Dysfunction
    • Authors: Isaac D. Palma-Zamora; Humphrey O. Atiemo
      Pages: 333 - 343
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Isaac D. Palma-Zamora, Humphrey O. Atiemo
      Teaser Neurogenic bladder is a chronic and disabling condition associated with multiple comorbidities and a widespread economic impact. Literature on cost of care and resource utilization is sparse and heterogeneous. Nonstandardized approaches, impact perspectives, and types of costs are used to describe the economic implications of neurogenic bladder. The financial toll is difficult to ascertain due to indirect and intangible costs exacerbated by the underlying disability. Health resource utilization based on clinical manifestations of neurogenic bladder may serve as an alternative measure. Understanding the multifold economic implications and health resource utilization patterns of neurogenic bladder may guide improvement of treatment strategies.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.001
       
  • How to Measure Quality-of-Life Concerns in Patients with Neurogenic Lower
           Urinary Tract Dysfunction
    • Authors: Darshan P. Patel; Jeremy B. Myers; Sara M. Lenherr
      Pages: 345 - 353
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Darshan P. Patel, Jeremy B. Myers, Sara M. Lenherr
      Teaser There is an evolving role for quality-of-life measures and patient-reported outcomes in the evaluation of neurogenic lower urinary tract dysfunction. We review available health-related quality-of-life instruments and patient-reported outcomes measures used in the assessment of patients with neurogenic bladder. We also discuss considerations for incorporation of these measures into clinical and patient-reported research. Emphasizing patient-reported outcomes in neurogenic bladder research will guide clinicians and other stakeholders to improve quality of life in this patient population.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.002
       
  • Long-Term Complications of the Neurogenic Bladder
    • Authors: Unwanaobong Nseyo; Yahir Santiago-Lastra
      Pages: 355 - 366
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Unwanaobong Nseyo, Yahir Santiago-Lastra
      Teaser It is widely accepted that neurogenic lower urinary tract dysfunction, when left untreated, has a natural history that has a potential for causing deterioration of renal function over time. However, certain patient profiles are at risk for this and other complications. This can be linked to their underlying neurologic disease process. Identifying risk profiles allows the provider to determine what surveillance strategies might be adopted. Risk factors for upper urinary tract deterioration include loss of bladder compliance, repeated bouts of pyelonephritis, and chronic indwelling catheterization. Other long-term complications include nephrolithiasis, refractory urinary incontinence, and malignancy.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.003
       
  • Surveillance Strategies for Neurogenic Lower Urinary Tract Dysfunction
    • Authors: Randy A. Vince; Adam P. Klausner
      Pages: 367 - 375
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Randy A. Vince, Adam P. Klausner
      Teaser Patients with neurogenic lower urinary tract dysfunction (NLUTD) experience significant morbidity and mortality due to urological complications including upper tract damage and bladder malignancy. This has led to increased surveillance in patients NLUTD. This article discusses the methods available for surveillance of patients with NLUTD and pulls information from the largest and most established organizations that have produced evidence-based surveillance guidelines for NLUTD. These organizations include the Paralyzed Veterans of America (PVA), US Department of Veterans Affairs, European Association of Urology (EAU), The NICE organization from the UK, and cites additional literature not been included in these documents.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.004
       
  • Establishing a Multidisciplinary Approach to the Management of Neurologic
           Disease Affecting the Urinary Tract
    • Authors: Shree Agrawal; Ravi R. Agrawal; Hadley M. Wood
      Pages: 377 - 389
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Shree Agrawal, Ravi R. Agrawal, Hadley M. Wood
      Teaser Neurologic diseases often affect the urinary tract and may be congential or acquired. The progressive nature of many neurologic diseases necessitates routine surveillance and treatment with a multidisciplinary approach. Urologic treatments may interact with pharmacologic or procedural interventions planned by other specialists, mandating close coordination of care and communication among providers. Primary care and nursing often can serve as the quarterbacks of the multidisciplinary team by identifying when a slowly progressive condition warrants further investigation and management by specialists.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.005
       
  • Evaluation and Lifetime Management of the Urinary Tract in Patients with
           Myelomeningocele
    • Authors: Diana Cardona-Grau; George Chiang
      Pages: 391 - 401
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Diana Cardona-Grau, George Chiang
      Teaser In the United States, there are an estimated 25,000 children ages 0 to 19 years and about 166,000 of all ages currently affected by spina bifida. Management is multimodal and can be complex. Management techniques vary throughout a child’s lifetime, but the goals remain the same: prevention of urinary tract infections and establishing acceptable continence. Continence is addressed as the child reaches school age. Additional considerations such as development of urolithiasis and the associated burden are highlighted in adolescence and into adulthood. These complex medical needs become more challenging as patients age and need to transition to adult providers.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.006
       
  • Contemporary Evaluation and Treatment of Poststroke Lower Urinary Tract
           Dysfunction
    • Authors: Zachary Panfili; Meredith Metcalf; Tomas L. Griebling
      Pages: 403 - 414
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Zachary Panfili, Meredith Metcalf, Tomas L. Griebling
      Teaser Stroke is an extremely common clinical entity, and poststroke incontinence is a major cause of morbidity for stroke survivors. Although patients can experience a wide variety of lower urinary tract symptoms, detrusor overactivity is among the most common clinical findings following stroke. All forms of lower urinary tract symptoms can negatively impact physical and psychosocial function for affected patients and their caregivers and loved ones. Careful evaluation is critical for successful management. Treatment is tailored to the goals and needs of each individual patient. Improvements in continence status can help to enhance overall and health-related quality of life.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.007
       
  • Parkinson’s Disease and Its Effect on the Lower Urinary Tract
    • Authors: Benjamin M. Brucker; Sidhartha Kalra
      Pages: 415 - 428
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Benjamin M. Brucker, Sidhartha Kalra
      Teaser Parkinson’s disease (PD) and atypical Parkinsonism are the second most common neurodegenerative movement disorders. Lower urinary tract dysfunction is among the most common types of associated autonomic dysfunctions. Differentiating the subtypes of PD is important for symptom management and understanding prognosis, because Lower urinary tract symptoms (LUTS) can evolve differently depending on the primary disease. LUTS are caused by storage and/or voiding dysfunctions. Urodynamics is a key investigative tool. The complex pathophysiology of this bladder dysfunction is not responsive to levodopa, and add-on therapy is necessary. Newer interventions hold promise as therapy to improve bladder dysfunction.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.008
       
  • Chronic Urinary Retention in Multiple Sclerosis Patients
    • Authors: John T. Stoffel
      Pages: 429 - 439
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): John T. Stoffel
      Teaser Many multiple sclerosis (MS) patients are affected by urinary retention. Common causes include neurogenic underactive bladder and/or bladder outlet obstruction from detrusor sphincter dyssynergia. Systemic review of contemporary MS urodynamic studies demonstrates that 53% of MS patients have detrusor overactivity, 43% have detrusor sphincter dyssynergia, and 12% have atonic bladder (12 studies, 1524 patients). There is no standard definition of MS-related urinary retention, but greater than 300 mL is a proposed threshold value for the condition based on literature review. Treatment should be based on stratifying patients by risk from morbidity from retention and by symptoms caused by retention.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.009
       
  • Identifying Patients with High-Risk Neurogenic Bladder
    • Authors: Elizabeth V. Dray; Anne P. Cameron
      Pages: 441 - 452
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Elizabeth V. Dray, Anne P. Cameron
      Teaser More than 12,000 spinal cord injuries occur annually in the United States; more than 80% of these individuals will experience urinary tract dysfunction. Despite the clinical demand, there is a paucity of guidelines for the care of these patients. Although most urologists are familiar with dangerous urodynamic parameters and the benefits of clean intermittent catheterization, these patients face a myriad of risks that may go unrecognized. In this article, the authors discuss the impact of specific neurologic diseases on the urinary tract, examine the risks inherent to each, and determine strategies for screening, prevention, and treatment of these complications.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.010
       
  • Peripheral and Sacral Neuromodulation in the Treatment of Neurogenic Lower
           Urinary Tract Dysfunction
    • Authors: Paholo G. Barboglio Romo; Priyanka Gupta
      Pages: 453 - 461
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Paholo G. Barboglio Romo, Priyanka Gupta
      Teaser Sacral and peripheral neuromodulation are minimally invasive surgical procedures that are third-line therapy options for the treatment of patients with idiopathic overactive bladder syndrome. There has been interest in their efficacy in the management of neurogenic lower urinary tract dysfunction (NLUTD). Contemporary data suggest promising outcomes for urinary and bowel symptoms in carefully selected patients with spinal cord injury and/or multiple sclerosis. This article reviews the current literature regarding urinary and bowel outcomes in patients with NLUTD and also discusses contemporary studies that suggest that treatment during particular stages of neurologic injury may prevent long-term urinary sequelae.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.011
       
  • Disease-Specific Outcomes of Botulinum Toxin Injections for Neurogenic
           Detrusor Overactivity
    • Authors: Aaron Kaviani; Rose Khavari
      Pages: 463 - 474
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Aaron Kaviani, Rose Khavari
      Teaser Intradetrusor injection of botulinum toxin A (BTX-A) is an effective option for managing patients with neurogenic detrusor overactivity (NDO) who do not respond to or tolerate oral pharmacologic agents. There is level I evidence that intradetrusor injection of onabotulinumtoxinA for refractory NDO in patients with multiple sclerosis and spinal cord injury is associated with a significantly greater achievement of goals and improved performance in urodynamic studies than placebo. Pilot studies or small case series support BTX-A for NDO in patients with Parkinson’s disease and cerebrovascular accident. BTX-A seems to be effective in children with myelomeningocele. However, no adult data exists.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.012
       
  • Surgical Management of Neurogenic Lower Urinary Tract Dysfunction
    • Authors: Ronak A. Gor; Sean P. Elliott
      Pages: 475 - 490
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Ronak A. Gor, Sean P. Elliott
      Teaser Surgery for patients with neurogenic urinary tract dysfunction (nLUTD) is indicated when medical therapy fails, to correct conditions affecting patient safety, or when surgery can enhance the quality of life better than nonoperative management. Examples include failure of maximal medical therapy, inability to perform or aversion to clean intermittent catheterization, refractory incontinence, and complications from chronic, indwelling catheters. Adults with nLUTD have competing risk factors, including previous operations, obesity, poor nutritional status, complex living arrangements, impaired dexterity/paralysis, and impaired executive and cognitive function. Complications are common in this subgroup of patients requiring enduring commitments from surgeons, patients, and their caretakers.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.013
       
  • New Frontiers of Basic Science Research in Neurogenic Lower Urinary
           Tract Dysfunction
    • Authors: Minoru Miyazato; Katsumi Kadekawa; Takeya Kitta; Naoki Wada; Nobutaka Shimizu; William C. de Groat; Lori A. Birder; Anthony J. Kanai; Seiichi Saito; Naoki Yoshimura
      Pages: 491 - 505
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Minoru Miyazato, Katsumi Kadekawa, Takeya Kitta, Naoki Wada, Nobutaka Shimizu, William C. de Groat, Lori A. Birder, Anthony J. Kanai, Seiichi Saito, Naoki Yoshimura
      Teaser The lower urinary tract’s main functions are storage and elimination. The micturition reflex pathway is modulated by the spinobulbospinal reflex pathway as well as higher brain centers involved in the voluntary micturition control. Micturition is sensitive to numerous injuries, resulting in various types of dysfunction. Animal studies indicate that lower urinary tract dysfunction partly depends on plasticity of the neural pathways. Reflex plasticity is associated with changes in ion channels, receptors, and numerous mediators. Animal models may aid in understanding the mechanisms leading to pathologic conditions and the plasticity in reflex pathways to the lower urinary tract after neurogenic lesions.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.014
       
  • Mending Gaps in Knowledge
    • Authors: Jeremy B. Myers; Darshan P. Patel; Sean P. Elliott; John T. Stoffel; Blayne Welk; Amitabh Jha; Sara M. Lenherr
      Pages: 507 - 515
      Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3
      Author(s): Jeremy B. Myers, Darshan P. Patel, Sean P. Elliott, John T. Stoffel, Blayne Welk, Amitabh Jha, Sara M. Lenherr
      Teaser Patient-reported outcomes and quality of life assessments are essential to studying conditions such as neurogenic bladder in which multiple management strategies are approximately equally efficacious. Innovations for the treatment of neurogenic bladder need to be guided by both clinical and patient-reported outcomes that are rigorously tested via high-quality prospective cohort or randomized studies. Collaborative research groups in reconstructive urology are critical to the study of uncommon disease processes because they allow studies to be powered adequately, foster innovative treatment strategies through collaboration, and help moderate the risk of investigator and or institutional biases.

      PubDate: 2017-07-19T20:05:53Z
      DOI: 10.1016/j.ucl.2017.04.015
       
  • Small Renal Mass
    • Authors: Alexander Kutikov; Marc C. Smaldone
      Abstract: Publication date: May 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 2
      Author(s): Alexander Kutikov, Marc C. Smaldone


      PubDate: 2017-04-18T14:51:15Z
      DOI: 10.1016/s0094-0143(17)30007-1
       
  • Small Renal Mass
    • Authors: Samir S. Taneja
      Abstract: Publication date: May 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 2
      Author(s): Samir S. Taneja


      PubDate: 2017-04-18T14:51:15Z
      DOI: 10.1016/j.ucl.2017.03.001
       
  • Risk Assessment in Small Renal Masses
    • Authors: Maxine Sun; Malte Vetterlein; Lauren C. Harshman; Steven L. Chang; Toni K. Choueiri; Quoc-Dien Trinh
      Pages: 189 - 202
      Abstract: Publication date: May 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 2
      Author(s): Maxine Sun, Malte Vetterlein, Lauren C. Harshman, Steven L. Chang, Toni K. Choueiri, Quoc-Dien Trinh
      Teaser The incidence of localized renal cell carcinoma (RCC) has been steadily increasing, in large part because of the increased use of imaging. Optimizing the management of localized RCC has become one of the leading priorities and foremost challenges within the urologic-oncologic community. Adequate risk stratification of patients following the diagnosis of localized RCC has become meaningful in deciding whether to treat, how to treat, and how intensively to treat. This article characterizes the existing risk assessment models that can be useful as treatment decision aids for patients with localized RCC.

      PubDate: 2017-04-18T14:51:15Z
      DOI: 10.1016/j.ucl.2016.12.005
       
  • Comparative Effectiveness of Surgical Treatments for Small Renal Masses
    • Authors: Shree Agrawal; Hillary Sedlacek; Simon P. Kim
      Pages: 257 - 267
      Abstract: Publication date: May 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 2
      Author(s): Shree Agrawal, Hillary Sedlacek, Simon P. Kim
      Teaser In the management of small renal masses (SRMs), treatment options include partial nephrectomy (PN), radical nephrectomy (RN), ablation, renal biopsy, and active surveillance. Large series retrospective and meta-analyses demonstrate PN may confer greater preservation of renal function, overall survival, and equivalent cancer control when compared with RN. As newer therapies emerge, we should critically evaluate the risks and benefits associated with the surgical management of SRMs among patients with competing comorbidities, complex tumors, and high-risk disease. Among younger patients with SRMs amenable to resection, optimization of postoperative patient health should be prioritized.

      PubDate: 2017-04-18T14:51:15Z
      DOI: 10.1016/j.ucl.2016.12.011
       
  • Complications of Renal Surgery
    • Authors: William T. Berg; Jeffrey J. Tomaszewski; Hailiu Yang; Anthony Corcoran
      Pages: 275 - 288
      Abstract: Publication date: May 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 2
      Author(s): William T. Berg, Jeffrey J. Tomaszewski, Hailiu Yang, Anthony Corcoran
      Teaser The incidence of the small renal mass continues to increase owing to the aging population and the ubiquity imaging. Most of these tumors are stage I tumors. Management strategies include surveillance, ablation, and extirpation. There is a wide body of literature favoring nephron-sparing approaches. Although nephron-sparing surgery may yield decreased long-term morbidity, it is not without its drawbacks, including a higher rate of complications. Urologists must be attuned to the complications of surgery and develop strategies to minimize risk. This article reviews expected complications of surgery on renal masses and risk stratification schema.

      PubDate: 2017-04-18T14:51:15Z
      DOI: 10.1016/j.ucl.2016.12.013
       
  • CME Accreditation Page
    • Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3


      PubDate: 2017-07-19T20:05:53Z
       
  • Forthcoming Issues
    • Abstract: Publication date: August 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 3


      PubDate: 2017-07-19T20:05:53Z
       
  • CME Accreditation Page
    • Abstract: Publication date: May 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 2


      PubDate: 2017-04-18T14:51:15Z
       
  • Forthcoming Issues
    • Abstract: Publication date: May 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 2


      PubDate: 2017-04-18T14:51:15Z
       
  • Erratum
    • Abstract: Publication date: May 2017
      Source:Urologic Clinics of North America, Volume 44, Issue 2


      PubDate: 2017-04-18T14:51:15Z
       
  • Renal Ischemia and Functional Outcomes Following Partial Nephrectomy
    • Authors: Joseph R. Zabell; Jitao Wu; Chalairat Suk-Ouichai; Steven C. Campbell
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Joseph R. Zabell, Jitao Wu, Chalairat Suk-Ouichai, Steven C. Campbell
      Teaser Renal function after renal cancer surgery is a critical component of survivorship. Quantity and quality of preserved parenchyma are the most important determinants of functional recovery; type and duration of ischemia play secondary roles. Several studies evaluated surgical techniques to minimize ischemia; however, long-term outcomes and potential benefits over clamped partial nephrectomy (PN) have not been consistently demonstrated. Analysis of acute kidney injury (AKI) after PN suggest that most kidneys recover strongly even if AKI is experienced after surgery. Ongoing study is required to evaluate long-term implications of AKI after PN and further assess impact of ischemia on functional outcomes.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.010
       
  • Renal Tumor Anatomic Complexity
    • Authors: Shreyas S. Joshi; Robert G. Uzzo
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Shreyas S. Joshi, Robert G. Uzzo
      Teaser Anatomic tumor complexity can be objectively measured and reported using nephrometry. Various scoring systems have been developed in an attempt to correlate tumor complexity with intraoperative and postoperative outcomes. Nephrometry may also predict tumor biology in a noninvasive, reproducible manner. Other scoring systems can help predict surgical complexity and the likelihood of complications, independent of tumor characteristics. The accumulated data in this new field provide provocative evidence that objectifying anatomic complexity can consolidate reporting mechanisms and improve metrics of comparisons. Further prospective validation is needed to understand the full descriptive and predictive ability of the various nephrometry scores.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.004
       
  • Ablative Therapy for Small Renal Masses
    • Authors: Benjamin L. Taylor; S. William Stavropoulos; Thomas J. Guzzo
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Benjamin L. Taylor, S. William Stavropoulos, Thomas J. Guzzo
      Teaser The management of small renal masses has become an important public health topic. The increased use of cross-sectional imaging and ultrasound has led to a downward stage migration for the detection of small renal masses. Cancer-specific survival, however, has not reflected this trend accordingly. Although partial nephrectomy has been the mainstay of treatment of small renal masses less than 4 cm, there is growing interest in ablative therapies, such as cryoablation and radiofrequency ablation, due to decreased morbidity. Oncologic outcomes are limited by methodology and length of follow-up, but short-term recurrence rates are low.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.008
       
  • Epidemiology of the Small Renal Mass and the Treatment Disconnect
           Phenomenon
    • Authors: Robert M. Turner; Todd M. Morgan; Bruce L. Jacobs
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Robert M. Turner, Todd M. Morgan, Bruce L. Jacobs
      Teaser The incidence of kidney cancer has steadily increased over recent decades, with most new cases now found when lesions are asymptomatic and small. This downward stage migration relates to the increasing use of abdominal imaging. Three public health epidemics—smoking, hypertension, and obesity—also play roles in the increase. Treatment mirrors the rise in incidence, with increasing interest in nephron-sparing therapies. Despite earlier detection and increasing treatment, the mortality rate has not decreased. This treatment disconnect phenomenon highlights the need to decrease unnecessary treatment of indolent tumors and address modifiable risk factors to reduce incidence and mortality.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.001
       
  • Current Trends in Renal Surgery and Observation for Small Renal Masses
    • Authors: Siri Drangsholt; William C. Huang
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Siri Drangsholt, William C. Huang
      Teaser There has been a rising incidence of small renal masses and concomitant downward stage migration. This has led to an evolution in the management of kidney cancer from radical nephrectomy to nephron-sparing treatment options including observation. The adoption of partial nephrectomy continues to increase but is still incomplete leading to significant disparities in the delivery of care throughout the country. Surgical excision remains the treatment of choice for small kidney cancers; however, ablative therapies and active surveillance are emerging as reasonable options for select patients. With continued refinements in treatment options and improvements in ability to risk stratify SRMs, the current treatment trends will likely continue to evolve.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.003
       
  • The Small Renal Mass and Its Management in Urologic Practice
    • Authors: Marc C. Smaldone; Alexander Kutikov
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Marc C. Smaldone, Alexander Kutikov


      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2017.02.001
       
  • Postoperative Surveillance for Renal Cell Carcinoma
    • Authors: Suzanne B. Merrill
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Suzanne B. Merrill
      Teaser Postoperative surveillance is an integral part of renal cell carcinoma (RCC) care. However, evidence supporting the practice is lacking. RCC guidelines offer disparate recommendations leading to variation in care. Recently, the effectiveness of guidelines has been questioned and a debate has ignited over whether current protocols merit optimization. Guidelines show limitations in RCC risk assessment, protocol stratification, and definition of duration of follow-up. Alternative strategies have addressed some of these limitations, but further analysis is warranted. Until challenges with assessing a survival benefit are negotiated, efforts should be made to optimize and standardize guidelines and learn of more tangible benefits to surveillance.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.016
       
  • Surgical Techniques in the Management of Small Renal Masses
    • Authors: Michael Daugherty; Gennady Bratslavsky
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Michael Daugherty, Gennady Bratslavsky
      Teaser This article provides a review and outline of the various surgical techniques for small renal masses. It covers surgical approaches and compares outcomes of open versus minimally invasive surgery. The article discusses renal nephrometry scoring and renal ischemia at time of resection. Techniques for controlling the renal hilum and controlling blood flow to the kidney are described. Extirpative techniques for small renal masses are reviewed along with a comparison of outcomes. With careful adherence to key oncologic and surgical principles, negative margins, no complications, and no or minimal decline in renal functional outcomes can be achieved.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.009
       
  • Neoadjuvant Targeted Molecular Therapy Before Renal Surgery
    • Authors: Sumi Dey; Henry N. Peabody; Sabrina L. Noyes; Brian R. Lane
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Sumi Dey, Henry N. Peabody, Sabrina L. Noyes, Brian R. Lane
      Teaser Neoadjuvant targeted molecular therapy may benefit select patients with metastatic renal cell carcinoma. The primary use of this therapy in patients with metastatic disease is to reduce tumor burden, prevent distant metastasis, and increase overall survival. Neoadjuvant therapy may reduce tumor size and tumor complexity, facilitate partial nephrectomy rather than radical nephrectomy, downstage tumor thrombus facilitating thrombectomy, and make unresectable tumors resectable when applied to selected patients. These potential benefits of neoadjuvant therapy require further clinical trials to better define the renal function and oncological and survival outcomes in patients receiving each active agent.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.014
       
  • Current Role of Renal Biopsy in Urologic Practice
    • Authors: Miki Haifler; Alexander Kutikov
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Miki Haifler, Alexander Kutikov
      Teaser Most small renal masses (SRMs) are indolent. In fact, only approximately 80% of SRMs are malignant. Furthermore, SRMs are commonly detected in elderly and comorbid patients. Therefore, opportunities for better care intensity calibration exist. Renal mass biopsy (RMB), when appropriately used, is a valuable clinical tool to help with critical clinical decision-making in patients with SRM. In this article, the authors summarize the role of modern RMB in helping gauge care for patients with SRM.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.006
       
  • Lymph Node Dissection for Small Renal Masses
    • Authors: Michael L. Blute; Mohit Gupta; Paul L. Crispen
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Michael L. Blute, Mohit Gupta, Paul L. Crispen
      Teaser Because the majority of small renal masses (SRMs; <4 cm) demonstrate low metastatic potential and can be effectively treated with radical or partial nephrectomy, the role of lymph node dissection (LND) at the time of surgery is unclear. A randomized trial demonstrated no survival benefit of LND in clinically localized renal cell carcinoma. Thus, LND is not recommended routinely for SRMs. For patients with high-risk features or radiographic evidence of lymphadenopathy, however, LND may improve local staging and potentially provide a survival benefit. If performed, a LND template should be based on the known lymphatic drainage of the kidneys.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.012
       
  • Hereditary Kidney Cancer Syndromes and Surgical Management of the Small
           Renal Mass
    • Authors: Kevin A. Nguyen; Jamil S. Syed; Brian Shuch
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Kevin A. Nguyen, Jamil S. Syed, Brian Shuch
      Teaser The management of patients with hereditary kidney cancers presents unique challenges to clinicians. In addition to an earlier age of onset compared with patients with sporadic kidney cancer, those with hereditary kidney cancer syndromes often present with bilateral and/or multifocal renal tumors and are at risk for multiple de novo lesions. This population of patients may also present with extrarenal manifestations, which adds an additional layer of complexity. Physicians who manage these patients should be familiar with the underlying clinical characteristics of each hereditary kidney cancer syndrome and the suggested surgical approaches and recommendations of genetic testing for at-risk individuals.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.002
       
  • Salvage Surgery After Renal Mass Ablation
    • Authors: Brian W. Cross; Daniel C. Parker; Michael S. Cookson
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Brian W. Cross, Daniel C. Parker, Michael S. Cookson
      Teaser Thermal ablative techniques represent treatment options for patients with small renal masses who are not candidates for surgery. The oncologic efficacy of ablation has not been compared in a randomized fashion with nephron-sparing surgery, and the urologist must be knowledgeable regarding the workup and treatment of patients with suspected residual or recurrent tumor following these therapies. Surveillance of patients with tumor recurrence after ablation may be indicated in select circumstances. When patients are deemed appropriate for salvage therapy, most undergo a repeat course of the same ablative modality. Salvage surgery is possible but often complicated by the prior ablative techniques.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.015
       
  • Active Surveillance for the Small Renal Mass
    • Authors: Benjamin T. Ristau; Andres F. Correa; Robert G. Uzzo; Marc C. Smaldone
      Abstract: Publication date: Available online 14 March 2017
      Source:Urologic Clinics of North America
      Author(s): Benjamin T. Ristau, Andres F. Correa, Robert G. Uzzo, Marc C. Smaldone
      Teaser Active surveillance for small renal masses (SRMs) is an accepted management strategy for patients with prohibitive surgical risk. Emerging prospectively collected data support the concept that a period of initial active surveillance in an adherent patient population with well-defined criteria for delayed intervention is safe. Herein, we summarize the literature describing growth kinetics of SRMs managed initially with observation and oncologic outcomes for patients managed with active surveillance. Existing clinical tools to determine and contextualize competing risks to mortality are explored. Finally, current prospective clinical trials with defined eligibility criteria, surveillance schema, and triggers for delayed intervention are highlighted.

      PubDate: 2017-03-21T03:57:33Z
      DOI: 10.1016/j.ucl.2016.12.007
       
 
 
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