Current urology reports
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Current urology reports · Dec 2016
Observational StudyRenal Complex Cystic Masses: Usefulness of Contrast-Enhanced Ultrasound (CEUS) in Their Assessment and Its Agreement with Computed Tomography.
Around 10 % of renal cell carcinomas (RCC) are cystic, while some benign cysts have complex appearance in conventional diagnostic tests such as computed tomography (CT) or magnetic resonance imaging (MRI). These renal complex cystic masses (RCCMs) are a challenging entity in urological practice and sometimes have a difficult management, requiring surgical removal. Contrast-enhanced ultrasound (CEUS) is a very sensitive test detecting microvascularization in real time, and it has been used in the diagnostic workup of these kinds of lesions. The aim of our study was to assess the diagnostic power of CEUS in the evaluation of RCCM. ⋯ CEUS is a very useful tool for assessing RCCM, with good results in terms of consistency and validity. It has a good diagnostic power, with a sensitivity of 100 % and a negative predictive value of 100 %. Its main limitations are the experience required, a special software, and being observer-dependent.
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Current urology reports · Oct 2016
ReviewOpioid-Induced Androgen Deficiency (OPIAD): Diagnosis, Management, and Literature Review.
Opioid-induced androgen deficiency (OPIAD) was initially recognized as a possible consequence of opioid use roughly four decades ago. Long-acting opioid use carries risks of addiction, tolerance, and systemic side effects including hypogonadotropic hypogonadism with consequent testosterone depletion leading to multiple central and peripheral effects. ⋯ Clomiphene citrate, a selective estrogen receptor modulator (SERM), is a testosterone enhancement treatment which upregulates endogenous hypothalamic function. This review will focus on the pathophysiology, diagnosis, and management of OPIAD, including summary of literature evaluating OPIAD treatment with TRT, and areas of future investigation.
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Current urology reports · Sep 2015
ReviewScreening for Prostate Cancer-Beyond Total PSA, Utilization of Novel Biomarkers.
Urology has been beset by several major trends that have shifted the entire paradigm for prostate cancer screening. These stem from a backlash against overdiagnosis and overtreatment due to prostate-specific antigen (PSA)-based screening efforts and have led national societies to modify their guidelines. More importantly, the public outcry has shifted the focus of early detection from an effort to diagnose any and all prostate cancers to an effort to diagnose clinically significant prostate cancers at an early stage. This review provides an update on contemporary biomarkers for prostate cancer that may be used to supplement PSA-based screening approaches.
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Current urology reports · Apr 2015
ReviewNew perioperative fluid and pharmacologic management protocol results in reduced blood loss, faster return of bowel function, and overall recovery.
Cystectomy and urinary diversion have high morbidity, and strategies to reduce complications are of utmost importance. Epidural analgesia and optimized fluid management are considered key factors contributing to successful enhanced recovery after surgery. ⋯ Recently, a randomized clinical trial focusing on radical cystectomy demonstrated that a restrictive intraoperative hydration combined with a concomitant administration of norepinephrine reduced intraoperative blood loss, the need for blood transfusion and morbidity. The purpose of this review is to highlight specific anesthesiological aspects which have been shown to improve outcome after RC with urinary diversion.
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The objective of this study is to provide a comprehensive overview of the use of smartphone "apps" within the field of female pelvic medicine and reconstructive surgery (FPMRS) and the role they play in improving patient education. The authors conducted a keyword search using the search tab in the Apple App Store. The apps selected were ones that specifically pertained to female pelvic medicine. ⋯ The apps were separated into three categories: patient education (five apps), wellness (four apps), and reference (four apps). The majority of the patient education apps consisted of anatomical diagrams of the pelvis and anatomy videos to help explain the pathophysiology behind different pelvic and voiding disorders. Female pelvic medicine apps have a large focus on patient education, which can help patients achieve a greater understanding of female pelvic disorders and the treatment options that are available.