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Journal Cover Journal of Clinical Urology
  [SJR: 0.149]   [H-I: 6]   [15 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2051-4158 - ISSN (Online) 2051-4166
   Published by Sage Publications Homepage  [853 journals]
  • Editorial
    • Authors: Pearce; I.
      Pages: 360 - 360
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816675527
      Issue No: Vol. 9, No. 6 (2016)
  • Non-clinical research - laboratory based
    • Authors: Salji, M; Ahmad, I, Winchester, C. L.
      Pages: 362 - 364
      Abstract: Venturing into the world of laboratory-based research can be an extremely rewarding but also daunting step for clinicians. Combining our everyday clinical practice with cutting-edge laboratory research bridges our understanding of the basis of disease processes, and we can play a key role in translating such knowledge into better treatment for patients. Here, we discuss some important factors to take into consideration before putting on your lab coat.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816650134
      Issue No: Vol. 9, No. 6 (2016)
  • SURG 2015 selected abstracts
    • Pages: 365 - 368
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816669481
      Issue No: Vol. 9, No. 6 (2016)
  • Clinical management and research priorities for high-risk prostate cancer
           in the UK: Meeting report of a multidisciplinary panel in conjunction with
           the NCRI Prostate Cancer Clinical Studies Localised Subgroup
    • Authors: Gnanapragasam; V., Hori, S., Johnston, T., Smith, D., Muir, K., UK high-risk prostate cancer consensus group panel NCRI Prostate Cancer Clinical Studies Localised Subgroup, Alonzi, R., Winkler, M., Warren, A., Staffurth, J., Khoo, V., Tree, A., Macneill, A., McMenemin, R., Mason, M., Cathcart, P., de Souza, N., Sooriakumaran, P., Weston, R., Wylie, J., Hall, E., Lane, A., Cross, W., Syndikus, I., Koupparis, A.
      Pages: 369 - 379
      Abstract: The management of high-risk prostate cancer has become increasingly sophisticated, with refinements in radical therapy and the inclusion of adjuvant local and systemic therapies. Despite this, high-risk prostate cancer continues to have significant treatment failure rates, with progression to metastasis, castrate resistance and ultimately disease-specific death. In an effort to discuss the challenges in this field, the UK National Clinical Research Institute’s Prostate Cancer Clinical Studies localised subgroup convened a multidisciplinary national meeting in the autumn of 2014. The remit of the meeting was to debate and reach a consensus on the key clinical and research challenges in high-risk prostate cancer and to identify themes that the UK would be best placed to pursue to help improve outcomes. This report presents the outcome of those discussions and the key recommendations for future research in this highly heterogeneous disease entity.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816651362
      Issue No: Vol. 9, No. 6 (2016)
  • Surveillance of Bosniak IIF renal cysts: Rationalising follow-up policy
    • Authors: Raslan, M; Tolofari, S. K, Bromby, A, Costa, D, Maddineni, S. B, Cowie, A, ODwyer, C, OFlynn, K. J.
      Pages: 380 - 384
      Abstract: Objectives:To assess the clinical outcomes of patients diagnosed with Bosniak IIF renal cysts, in order to rationalise our surveillance policy.Patients and methods:We identified all patients diagnosed with a Bosniak IIF cyst between September 2011 and September 2014. Patient demographics, duration, frequency and modality of surveillance were recorded. Changes in the size, appearance or characteristics of the cyst(s) were recorded, as well as any subsequent surgery and histology. We also estimated the overall cost of imaging and follow up.Results:We identified 198 patients. The majority of IIF cysts were incidental findings (86.5%), with 56% of cysts > 3 cm at diagnosis. Median follow-up time was 27 months. We found that 98% of cysts were unchanged in their Bosniak score and 66% did not change in size. We followed up on 86 patients (43%) beyond two years: None had radiological progression. Four patients (2%) underwent partial nephrectomy secondary to radiological progression: One (0.5%) had histological malignancy. Features of malignancy were noticed in the first 24 months of the follow-up period.Conclusions:Radiological progression of Bosniak IIF cysts is low and progression to malignancy lower still, typically occurring within 24 months of diagnosis. Our data suggested that ceasing radiological follow-up surveillance after a minimum of two years of stable surveillance could be considered. Rational follow-up protocols for Bosniak IIF cysts would have significant cost-saving implications for the National Health Service (NHS) and alleviate pressure on radiology and urology services.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816655080
      Issue No: Vol. 9, No. 6 (2016)
  • Urology higher specialist training in North London and North West England:
           a comparison of two training regions in the UK
    • Authors: Babu, A; Alleemudder, A, Kavia, R, Datta, S, Maan, Z.
      Pages: 385 - 391
      Abstract: Introduction:Local education training boards (LETBs) and deaneries are under pressure to demonstrate delivery of high quality specialist urology training. There is at present no quality tool used routinely to demonstrate this quality regionally or nationally. Differences in training could therefore exist between different regions, and locally between different training units. A trainer/trainee questionnaire tool previously piloted by the specialist advisory committee was used to evaluate urology training posts in the North London LETB over 3 years. The findings were used to compare trainee scores in North London with those in the North West region of England.Materials and methods:Questionnaires were circulated electronically to all higher surgical urology trainees in the 18 training units affiliated to the North London LETB. Three years of trainee data were collated, statistically analysed and compared to those collected by Oates and colleagues, looking for any differences in regional trainee scores for higher surgical training posts in North London and North West of England regions.Results:The mean trainee response rate was 28 questionnaires per year from all 18 units in the North London region. Combined mean and median scores were 83.3 and 84, respectively. This compares to 86.2 and 88.1 from North West England region comprising eight units. There was no statistically significant difference in scores between the two regions (two-tailed t test, P=0.31).Conclusion:There is no statistical difference in trainee scores for the evaluation of urological training posts between the two regions. The questionnaire tool can be used effectively to look at overall differences in training standards between geographically distinct regions from a trainee perspective. Both regions offer higher surgical training with high levels of trainee satisfaction. This questionnaire tool can provide insight into subjective differences in training posts within a region.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816654072
      Issue No: Vol. 9, No. 6 (2016)
  • Fluoroquinolone resistance colonization from initial to repeat prostate
    • Authors: Liss, M. A; Gillis, K, Sakamoto, K, Fierer, J.
      Pages: 392 - 396
      Abstract: Purpose:Fluoroquinolone (FQ) resistant (FQR) bacteria are a major cause of infection after transrectal prostate biopsy (TRPB). We determined the prevalence of FQR in initial and subsequent rectal cultures from men undergoing repeat prostate biopsies.Materials and methods:After IRB approval, men presenting for TRPB at the San Diego Veterans Affairs Medical Center between January 1, 2010, and February 6, 2014, underwent pre-TRPB rectal culture. The rectal swab was collected from the patient immediately prior to TRPB. Rectal swabs were streaked onto locally prepared ciprofloxacin-supplemented (4 mg/L) MacConkey agar plates. A representative colony was selected for identification and susceptibility testing.Results:Of 617 patients who had rectal cultures done, 7% (43/617) had a repeat rectal culture performed in relation to a second prostate biopsy. All cipro-resistant bacteria isolated were Escherichia coli. The median time and interquartile range between first and second biopsy was 2.3 years (range 1.2–3.6 years). On first biopsy, 16.3% (7/43) had FQR, which was not statistically different from the 18.6% of patients who had FQR on their second biopsy (p=0.78). Overall, 74% (32/43) of patients tested absent for FQR at both prostate biopsies, and 9.3% (4/43) tested present at both (p=0.015). However, 9.3% (4/43) converted from absent to present FQR, and 7.0% (3/43) converted from present FQR to absent (p=0.69). Seventy percent of the FQR E. coli were also resistant to gentamicin, and 22% were resistant to cefepime.Conclusions:Patients undergoing prostate biopsy should be examined for FQR prior to each individual biopsy because prior culture results do not always predict whether a patient will be colonized with FQR E. coli.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816651376
      Issue No: Vol. 9, No. 6 (2016)
  • Preoperative PDE5i use is a prognostic metric for poor postoperative
           erectile function in men undergoing radical prostatectomy: An addition to
           patient counseling
    • Authors: Akinola, O; Ginsburg, L, Welliver, C, Mechlin, C. W, Fisher, H. A, Mian, B. M, Kaufman, R. P, McCullough, A. R.
      Pages: 397 - 403
      Abstract: Objective:In patients scheduled for radical prostatectomies (RP), preoperative (pre-op) erectile function (EF) characterization may be complicated by social and medical factors. We investigated pre-op use of phosphodiesterase type 5 inhibitor (PDE5i) as a simple metric for predicting long-term postoperative EF.Materials and methods:Electronic medical records (EMRs) for consecutive men who underwent RP between January 2004 and March 2009 at our institution were retrospectively reviewed. Data extracted included demographics, pre-op PDE5i use, cancer treatment details, post-op EF and ED treatment. Predictor variable data were categorical pre-op PDE5i use (pre-op PDE5i use vs. pre-op PDE5i naïve). ANOVA and Chi squared test were used.Results:A total of 250 individuals out of 436 charts met inclusion criteria. Mean follow-up length was 4.2 years (range 2–7). Thirty-seven men (15%) used PDE5i preoperatively. There were no differences in mean age at RP, type of nerve-sparing surgery (NSS), or medical comorbidities between groups. No men with pre-op PDE5i use regained unassisted EF but 37% regained PDE5i-assisted EF after bilateral nerve sparing (BNS). No men with pre-op PDE5i use regained unassisted or PDE5i-assisted EF after unilateral (UNS) or non-nerve-sparing surgery (NNS).Conclusions:Pre-op PDE5i use predicts poor long-term EF outcomes after RP and should be included in pre-op patient counseling.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415815612630
      Issue No: Vol. 9, No. 6 (2016)
  • Transurethral biopsy of the prostatic urethra is associated with final
           apical margin status at radical cystoprostatectomy
    • Authors: von Rundstedt, F.-C; Mata, D. A, Shen, S, Li, Y, Godoy, G, Lerner, S. P.
      Pages: 404 - 408
      Abstract: Purpose:Biopsy of the prostatic urethra is an integral part of clinical staging in patients prior to radical cystoprostatectomy (RC) and urinary diversion. We examined whether preoperative transurethral resection (TUR) biopsy was associated with final apical urethral margin status and hypothesized that a negative biopsy could replace intraoperative frozen section for decision making regarding the feasibility of orthotopic neobladder reconstruction.Methods:TUR biopsy, frozen section, urethrectomy, and final apical urethral margin pathologic data were extracted from the charts of men who had undergone RC at the Houston Methodist Hospital between 1987 and 2013. TUR biopsies were performed at five and seven o’clock adjacent to the verumontanum. A positive biopsy was defined as the presence of in situ or invasive urothelial carcinoma. Clinical and perioperative variables were analyzed using descriptive and inferential statistics.Results:We reviewed the medical records of 272 men. Preoperative TUR biopsies of the prostatic urethra were negative in 74% (200/272) and positive in 26% (72/272) of men. The overall incidence of apical urethral margin positivity on final pathology was 2.2% (six of 272). Four men underwent primary or secondary urethrectomy. TUR biopsy negative and positive predictive values for apical urethral margin positivity were 99.5% (95% confidence interval (CI): 97.2 to 99.9) and 6.9% (95% CI: 2.3 to 15.5), respectively.Conclusions:The incidence of a positive apical urethral margin was low in patients undergoing RC. A negative preoperative TUR biopsy of the prostatic urethra was reliably associated with a negative final margin, obviating the need for intraoperative frozen section. Furthermore, a positive biopsy was not reliably associated with final margin status. These data will aid in the counseling of patients regarding the feasibility of neobladder reconstruction.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415815617876
      Issue No: Vol. 9, No. 6 (2016)
  • Global urology: A survey of members of the British Association of
           Urological Surgeons
    • Authors: Campain, N. J; Venn, S, Biyani, C. S, MacDonagh, R. P, McGrath, J. S, on behalf of BAUS Urolink
      Pages: 409 - 416
      Abstract: Objective:The objective of this article is to establish current levels of activity and interest in global urology amongst British urologists, in order to inform BAUS Urolink and guide future strategic decision making.Subjects and methods:Voluntary online surveys were sent to all BAUS members in May 2014.Results:This survey demonstrated a significant level of interest and engagement by BAUS members in global urology. Over 40% of respondents had participated in overseas work, predominantly in the form of short-term visits. Motivating factors for involvement included a desire to help, but personal and organisational benefits were also noted.Conclusion:There was consensus that Urolink represents an important part of BAUS, with a clear desire for improvements in dissemination of opportunities to widen engagement amongst the BAUS membership.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816664274
      Issue No: Vol. 9, No. 6 (2016)
  • A practical approach to investigating a man with a raised
           prostate-specific antigen in the modern era
    • Authors: Langley, S; Uribe, J, Challacombe, B, Bott, S.
      Pages: 417 - 427
      Abstract: Urologists in the UK are encouraged to follow the National Institute for Health and Care Excellence (NICE) guidelines for patient management. In 2014, members of the British Association of Urological Surgeons (BAUS) were asked in a survey what diagnostic pathway they would follow for themselves or their relatives if they had a raised prostate-specific antigen (PSA). It was found that only a quarter would follow NICE guidance. The current recommendations rely on pathological assessment of prostate tissue obtained at a transrectal ultrasound guided biopsy. Increasing evidence indicates that pre-biopsy multiparametric magnetic resonance imaging (mp-MRI) coupled with targeted biopsy approaches outperform random biopsies in the detection of clinically significant disease. Herein we discuss the role of magnetic resonance imaging and targeted biopsy approaches to diagnose prostate cancer in the modern era.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816654596
      Issue No: Vol. 9, No. 6 (2016)
  • Surgical excision and urethroplastsy of a giant acquired urethral
           diverticulum in an adult male
    • Authors: Murphy, G; Rubino, S, Kershen, R.
      Pages: 428 - 430
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415814548259
      Issue No: Vol. 9, No. 6 (2016)
  • Basaloid carcinoma of prostate (BCP) in a patient with previous history of
           pelvic radiotherapy treated with total pelvic exenteration and
           abdominoperineal resection
    • Authors: Salji, M; Payne, S, Fraser, S, Lamb, C, Wallace, J, Qureshi, K, Duff, M, Hendry, D, Leung, H.
      Pages: 431 - 433
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415814531575
      Issue No: Vol. 9, No. 6 (2016)
  • 'Blu-Tack as an intravesical foreign body: Overcoming a sticky situation
    • Authors: Boyle, J. M; Cleaveland, P, Mokete, M.
      Pages: 434 - 435
      Abstract: Intravesical foreign bodies can pose a significant urological challenge. An unusual intravesical foreign body described within the literature is ‘Blu-Tack’. This unique material with its distinct physical properties presents a particular challenge in its management. We describe our novel endoscopic approach to the removal of an intravesical ‘Blu-Tack’ mass and suggest this method as a means of facilitating successful extraction of this particular foreign body.
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816630211
      Issue No: Vol. 9, No. 6 (2016)
  • Reply: Non-parasitic chyluria: A rare cause of acute urinary retention in
           a young Caucasian male
    • Authors: Wijayarathna, S; Abeygunasekera, A.
      Pages: 436 - 436
      PubDate: 2016-11-02T04:52:01-07:00
      DOI: 10.1177/2051415816630184
      Issue No: Vol. 9, No. 6 (2016)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
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