Laparoscopic Nephrectomy in Patients Undergoing Hemodialysis Treatment

With an experienced laparoscopic team of surgeons, laparoscopic nephrectomy may be performed safely

Epidemiology of Peyronie's Disease

Epidemiological studies of Peyronie's disease (PD) reported the prevalence of this condition as much higher than once thought, highlighting the potential physical and psychosocial impact of the disease on society. For this reason, knowledge of the epidemiology of PD is important for allocating and managing health care resources and assessing intervention strategies. The true prevalence of PD is unknown; it is estimated as between 3.7% and 7.1%, but the actual prevalence of this disease may be higher because of patients' reluctance to report this embarrassing condition to their physicians for cultural and psychological reasons. Several risk factors, such as hypertension, diabetes, hyperlipidemia, and smoking, have been suggested. The estimated prevalence of PD at younger ages is around 8% and shows a more acute onset and a lower incidence of associated erectile dysfunction. This chapter reviews the contemporary state of knowledge of the epidemiology of PD

Alternative therapies in patients with non-muscle invasive bladder cancer

Bladder cancer (BC) is one of the leading causes of cancer-related deaths worldwide. Despite, the majority of the cases were diagnosed as non-muscle invasive bladder cancer (NMIBC) with favorable prognosis, it has tendency to recur or progress to a higher grade or stage. The first line treatment of patients with NMIBC is transurethral resection with adjuvant therapies primarily intravesical Bacillus Calmette-Guerin (BCG) immunotherapy. However, in a portion of patients whose BCG treatment failed, alternative treatments may be required. Furthermore, intravesical BCG may be contraindicated in or untolerated by a group of patients. For these patients, some treatment options are readily available and a variety of them are currently under clinical investigation. In this review, these alternative therapies have been summarized

Current approaches for identifying high-risk non-muscle invasive bladder cancer

Introduction: Management of high risk non-muscle invasive bladder cancer (NMIBC) is challenging. It is vital to detect recurrences early and predict which tumors are likely to progress.Areas covered: This manuscript reviews the current approaches available for detection and surveillance of high risk NMIBCs. A literature review was utilized to evaluate risk factors for recurrence and progression as well as evaluating approaches including pathological aspects of NMIBC, molecular subtyping, methods for tumor visualization, urine cytology, urinary molecular markers, molecular tissue markers as well as the scoring systems and nomograms.Expert commentary: Clinical and pathological factors are still the mainstay of prediction of recurrence and progression. However, genomic information such as molecular subtyping may improve understanding of prognosis. White light cystoscopy is still a dominant approach but enhanced cystoscopy is likely superior for detection of cancer especially carcinoma in situ. Urinary biomarkers are evolving; however, they are not ready to replace cystoscopy and trials are still necessary to determine optimal clinical utility. Prognostic scoring systems and nomograms are available for counseling the patients but there is room to improve predictive accuracy

Current status of the surgical management of Peyronie's disease

Surgery is the standard treatment for patients in the chronic phase of Peyronie's disease. Reconstructive surgeries function by either shortening the convex side of the tunica albuginea (Nesbit procedure, Yachia technique and penile plication) or lengthening the concave side by incision of the plaque with subsequent grafting. Tunical shortening procedures are ideal for men with good erectile capacity, penile curvatures less than 60 and predicted postprocedural length loss of less than 20% of erect penis length. Tunical lengthening procedures with grafting are indicated in patients with severe penile length loss, curvatures greater than 60 and prominent hourglass deformities. Saphenous vein and tunica albuginea are the most commonly used autologous graft materials. Cadaveric or bovine pericardium and 4-layer small intestinal submucosa are promising nonautologous tissues. Penile implantation of a prosthesis is the standard procedure in men with erectile dysfunction who do not respond to conservative treatment. If residual penile curvature is less than 30 after implantation, no further treatment is required. However, residual curve of greater than 30 can be straightened with manual modeling. Additional procedures such as penile plication, the Nesbit procedure, or grafting can be performed if modeling fails to correct the residual deformity

Ga-68-PSMA PET/CT and PET/MRI in high-risk prostate cancer patients

Treatment of high-risk prostate cancer (HRPCa) is challenging. Local staging and metastatic evaluation are important for the patient management. Recently, prostate-specific membrane antigen (PSMA)-based imaging modalities such as PSMA PET/CT and PET/MRI have received significant attention for detection of recurrent prostate cancer sites with elevated prostate-specific antigen levels, after therapy. Current evidence suggests that these imaging modalities may also have a role for the management of patients with HRPCa. In this review, we discuss PSMA-based imaging modalities in the management of patients with HRPCa