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A renewed global interest in manned space exploration has emerged, propelled by the challenge of reaching a new frontier: travel to the Red Planet, Mars. As the physiological changes induced by microgravity bear direct relevance to the safety and viability of these goals, we provide a historical narrative of the urologic investigations in space. We review the significant contributions to the understanding...
To evaluate the influence of both repair type and degree of cuff erosion on postoperative urethral stricture rate. Sparse literature exists regarding patient outcomes after artificial urinary sphincter (AUS) cuff erosion. Surgeons from 6 high-volume male continence centers compiled a comprehensive database of post-erosion patients to examine outcomes.This retrospective multi-institution study included...
Herein, we describe a case of a 63-year-old male who underwent magnetic resonance imaging (MRI)-guided biopsy of a suspicious lesion in the prostate followed by focal laser ablation. Radical prostatectomy was performed 15 months following focal laser ablation for persistent cancer adjacent to the treatment zone. We provide images from the initial MRI, postablation MRI, and the whole-mount radical...
To issue a consensus document on the prevention, management, and research of infection associated with penile prostheses, as neither professional associations nor governmental entities have issued guidelines that are specific to this infection.Sixteen North American experts on infection of penile prostheses were identified and assembled to select and discuss certain issues related to infection of...
To determine whether epigenetic changes occur during cyclophosphamide-induced chronic bladder inflammation in mice.Epigenetic changes play a role in the regulation of inflammatory genes in noncancer diseases such as asthma and chronic obstructive pulmonary disease. However, epigenetic (deoxyribonucleic acid [DNA] methylation) changes during chronic bladder inflammation have not been previously described...
Spaceflight-induced microgravity appears to be a risk factor for the development of urinary calculi, resulting in urolithiasis during and after spaceflight. Calcifying nanoparticles, or nanobacteria, multiply more rapidly in simulated microgravity and create external shells of calcium phosphate. The question arises whether calcifying nanoparticles are nidi for calculi and contribute to the development...
Metanephric adenoma and chyluria are rare entities, especially in the pediatric population of North America. To date, no report of chyluria associated with metanephric adenoma has been published. The incidental presentation is most common in the fifth decade of age with this tumor; however, when signs and symptoms are present they include hematuria, palpable mass, flank pain, polycythemia, and hypercalcemia...
Since description of the transverse scrotal approach for artificial urinary sphincter (AUS) placement, simultaneous implantation of an inflatable penile prosthesis (IPP) and AUS through a single incision has been shown to constitute safe, efficient, and cost-effective treatment for men plagued by both erectile dysfunction and urinary incontinence. We present patient satisfaction outcomes after simultaneous...
To examine the outcomes of renal ultrasound studies after subureteral injection of dextranomer/hyaluronic acid copolymer and provide recommendations for postoperative management of vesicoureteral reflux (VUR).Pediatric patients aged 15 years or younger with uncomplicated primary VUR were recruited for endoscopic treatment with dextranomer/hyaluronic acid gel. After undergoing the procedure, patients...
To evaluate the efficiency, safety, and cost-effectiveness of synchronous prosthetic treatment of male urinary incontinence and impotence using a single transverse scrotal incision. A total of 92 inflatable penile prostheses (IPPs), 21 artificial urinary sphincters (AUSs), and 15 combined IPPs/AUSs were implanted in 128 men at Brooke Army Medical Center and the University of Texas Health Science...
Objectives. The use of unconventional medical therapies (UMTs) in the general population has increased dramatically in the past decade. Studies have estimated that 9% to 64% of patients with cancer use UMTs, and many do not disclose this information to their physicians. This study was designed to evaluate the rates of UMT use by patients with prostate cancer revealed by standard versus directed questioning...
Objectives. To determine the significance of Gleason scores 3+4 (GS3+4) versus 4+3 (GS4+3) with respect to biochemical recurrence in a retrospective review of a series of men with clinically localized prostate cancer who underwent radical retropubic prostatectomy (RRP) and to develop and test an artificial neural network (ANN) to predict the biochemical recurrence after surgery for this group of men...
Modifications in radical retropubic prostatectomy that use the deep dorsal vein ligator and either anterior urethropexy or puboprostatic ligament preservation were developed to reduce blood loss and improve continence results. Use of the deep dorsal vein ligator to secure the deep dorsal vein complex also improves visualization of the urethra for transection and the neurovascular bundle for nerve...
Objectives. Ureteral obstruction results in an injury response that can progress to irreversible renal fibrosis and tubular atrophy by apoptosis. The molecular events leading to apoptosis from obstruction are not well understood. We investigated the effect of bioflavonoids and angiotensin II inhibition on apoptotic and inflammatory gene expression in a model of unilateral ureteral obstruction (UUO)...
Objectives. To use pathologic, morphometric, DNA ploidy, and clinical data to develop and test a genetically engineered neural network (GENN) for the prediction of biochemical (prostate-specific antigen [PSA]) progression after radical prostatectomy in a select group of men with clinically localized prostate cancer.Methods. Two hundred fourteen men who underwent anatomic radical retropubic prostatectomy...
Objectives. The risk of a urinary calculus during an extended duration mission into the reduced gravity environment of space is significant. For medical operations to develop a comprehensive strategy for the spaceflight stone risk, both preventive countermeasures and contingency management (CM) plans must be included. Methods. A feasibility study was conducted to demonstrate the potential CM technique...
Dehydroepiandrosterone (DHEA) is being evaluated in the basic science laboratories as a potential treatment for adenocarcinomas, with some initial promise for success. However DHEA can be metabolically converted to androgenic compounds, possessing unwanted side effects. A patient with advanced prostate cancer with progressive symptomatology was treated with DHEA after other treatment regimens failed...
Objectives. To discuss what is currently known about the population prevalence of interstitial cystitis (IC) and demographic characteristics of IC patients.Methods. Changes over time in the criteria for diagnosis of IC are described. The 3 published studies of the population prevalence of IC are reviewed. Epidemiologic issues important in the design of studies of IC are cited.Results. IC is a...
The combined use of total prostate-specific antigen (PSA), clinical stage, and Gleason score accurately predicts final pathologic stage for men with clinically localized prostate cancer. Recently, the free/ total PSA ratio has been proposed as an adjunct for early detection of prostate cancer. We examined the association between free/total PSA and pathologic stage.In a prospective study, 301 consecutive...
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