Sterile pyuria: a forgotten entity
Sterile pyuria is a common entity. Yet there are no guidelines to address this issue. We have conducted a systematic review over 20 years and reviewed the results. Guidelines for assessment, diagnosis and management are developed based on these results. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - August 25, 2015 Category: Urology & Nephrology Authors: Goonewardene, S., Persad, R. Tags: Reviews Source Type: research
Clinical experience with everolimus in the second-line treatment of advanced renal cell carcinoma
We report data from prospective as well as retrospective and real world data studies and we analyze the safety and efficacy profile of everolimus as second-line therapy for mRCC.
Although different drugs are currently available for the second-line treatment of mRCC, everolimus represents a feasible and safe option in this setting, especially for patients who have experienced high-grade toxicity or are still carrying TKI-related toxicities from first-line treatment. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - August 25, 2015 Category: Urology & Nephrology Authors: Alesini, D., Mosillo, C., Naso, G., Cortesi, E., Iacovelli, R. Tags: Reviews Source Type: research
Cytoreductive nephrectomy and its role in the present-day period of targeted therapy
The beneficial effect of cytoreductive nephrectomy on survival of patients with metastatic renal cell carcinoma in the immunotherapy era was based on two prospective randomized trials. Unfortunately, such evidence does not yet exist in the present-day period of targeted therapy. Despite this, cytoreductive nephrectomy remains integral in the multimodal management of patients with metastatic renal cell carcinoma. Multiple retrospective studies as well as data from prospective studies examining targeted therapy support the continued use of cytoreductive nephrectomy in the properly selected patient. Ongoing studies will hopef...
Source: Therapeutic Advances in Urology - August 25, 2015 Category: Urology & Nephrology Authors: Culp, S. H. Tags: Reviews Source Type: research
Percutaneous biopsy for risk stratification of renal masses
The increased use of abdominal imaging has led to identification of more patients with incidental renal masses, and renal mass biopsy (RMB) has become a popular method to evaluate unknown renal masses prior to definitive treatment. Pathologic data obtained from biopsy may be used to guide decisions for treatment and may include the presence or absence of malignant tumor, renal cell cancer subtype, tumor grade and the presence of other aggressive pathologic features. However, prior to using RMB for risk stratification, it is important to understand whether RMB findings are equivalent to pathologic analysis of surgical speci...
Source: Therapeutic Advances in Urology - August 25, 2015 Category: Urology & Nephrology Authors: Blute, M. L., Drewry, A., Abel, E. J. Tags: Reviews Source Type: research
Tadalafil for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a review of clinical data in Asian men and an update on the mechanism of action
Tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor, is approved worldwide for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH-LUTS). The purpose of this narrative review is to summarize the clinical data on tadalafil 5 mg once-daily, primarily focusing on Asian men with BPH-LUTS, and to update the current understanding of the mechanism of action underlying PDE5 inhibition. Findings from studies have demonstrated that PDE5 is highly expressed in the lower urinary tract and supporting vasculature, and that PDE5 inhibition potentially decreases smooth muscle cell proliferation ...
Source: Therapeutic Advances in Urology - August 25, 2015 Category: Urology & Nephrology Authors: Yokoyama, O., Igawa, Y., Takeda, M., Yamaguchi, T., Murakami, M., Viktrup, L. Tags: Reviews Source Type: research
Clinical use of the {beta}3 adrenoceptor agonist mirabegron in patients with overactive bladder syndrome
Mirabegron is a β3 adrenoceptor agonist licensed for the treatment of overactive bladder symptoms, such as urinary urgency or urgency incontinence. β3 adrenoceptor activation causes detrusor muscle relaxation, but mirabegron may also act by binding other targets in the bladder, and it may also reduce activity in sensory nerves. Phase III clinical trials (SCORPIO, ARIES, and CAPRICORN) evaluated mirabegron at various doses, demonstrating reduction from baseline to endpoint in mean incontinence episodes and mean number of micturitions per 24 h (coprimary endpoints), along with health-related quality of life and a r...
Source: Therapeutic Advances in Urology - August 25, 2015 Category: Urology & Nephrology Authors: Vij, M., Drake, M. J. Tags: Reviews Source Type: research
Is whole gland salvage cryotherapy effective as palliative treatment of haematuria in patients with locally advanced prostate cancer? Results of a preliminary case series
Conclusion:
Our experience has given us good results with minimal intra- and postoperative complications. We think that haemostatic cryotherapy as a palliative approach for locally advanced prostate cancer could represent a valid treatment option and more consideration could be given to its use. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - August 25, 2015 Category: Urology & Nephrology Authors: Magno, C., Mucciardi, G., Gali, A., Pappalardo, R., Lembo, F., Anastasi, G., Buttice, S., Ascenti, G., Lugnani, F. Tags: Original Research Source Type: research
Management of inferior vena cava tumor thrombus in locally advanced renal cell carcinoma
The objective of this clinical review is to outline the preoperative evaluation for, and operative management of patients with locally advanced renal cell carcinoma with venous tumor thrombi involving the inferior vena cava. Cornerstones of the management of these complex patients include obtaining high-quality imaging to characterize the renal mass and tumor thrombus preoperatively, with further intraoperative real-time evaluation using transesophageal echocardiography, careful surgical planning, and a multidisciplinary approach. Operative management of patients with high-level caval thrombi should be undertaken in high-v...
Source: Therapeutic Advances in Urology - July 16, 2015 Category: Urology & Nephrology Authors: Psutka, S. P., Leibovich, B. C. Tags: Reviews Source Type: research
Contemporary diagnosis and management of Fournier's gangrene
Fournier’s gangrene, an obliterative endarteritis of the subcutaneous arteries resulting in gangrene of the overlying skin, is a rare but severe infective necrotizing fasciitis of the external genitalia. Mainly associated with men and those over the age of 50, Fournier’s gangrene has been shown to have a predilection for patients with diabetes as well as people who are long-term alcohol misusers. The nidus for the synergistic polymicrobial infection is usually located in the genitourinary tract, lower gastointestinal tract or skin. Early diagnosis remains imperative as rapid progression of the gangrene can lead...
Source: Therapeutic Advances in Urology - July 16, 2015 Category: Urology & Nephrology Authors: Chennamsetty, A., Khourdaji, I., Burks, F., Killinger, K. A. Tags: Reviews Source Type: research
Abiraterone in the management of castration-resistant prostate cancer prior to chemotherapy
The treatment armamentarium for metastatic castration-resistant prostate cancer (mCRPC) has increased significantly over the past several years. Approved drugs associated with improved survival include androgen pathway-targeted agents (abiraterone acetate and enzalutamide), chemotherapeutics (docetaxel and cabazitaxel), an autologous vaccine (sipuleucel-T) and a radiopharmaceutical (radium-223). Abiraterone acetate, a prodrug of abiraterone, inhibits the CYP17A enzyme, a critical enzyme in androgen biosynthesis. Abiraterone has regulatory approval in mCRPC in both chemotherapy-naïve patients and in the post-docetaxel ...
Source: Therapeutic Advances in Urology - July 16, 2015 Category: Urology & Nephrology Authors: Gartrell, B. A., Saad, F. Tags: Reviews Source Type: research
Effectiveness and safety of nitrofurantoin in outpatient male veterans
Conclusions:
The odds of clinical cure varied with CrCl and with the type of organism causing the UTI, while adverse events did not differ based on renal function. A minimum CrCl of 60 ml/min is suggested for men to achieve an 80% cure rate for UTIs with the most common urinary pathogens. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - July 16, 2015 Category: Urology & Nephrology Authors: Ingalsbe, M. L., Wojciechowski, A. L., Smith, K. A., Mergenhagen, K. A. Tags: Original Research Source Type: research
Urinary tract infections in women with stress urinary incontinence treated with transobturator suburethral tape and benefit gained from the sublingual polibacterial vaccine
Conclusion:
After eliminating bias associated with the tape, the technique and the surgeon’s skills, SUI correction may decrease the number of UTIs and improve the quality of life. UTIs disappeared in 82% of patients with RUTIs after TOT. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - July 16, 2015 Category: Urology & Nephrology Authors: Lorenzo Gomez, M. F., Collazos Robles, R. E., Virseda Rodriguez, A. J., Garcia Cenador, M. B., Miron Canelo, J. A., Padilla Fernandez, B. Tags: Original Research Source Type: research
The efficacy and safety of mirabegron compared with solifenacin in overactive bladder patients dissatisfied with previous antimuscarinic treatment due to lack of efficacy: results of a noninferiority, randomized, phase IIIb trial
Conclusions:
Noninferiority of mirabegron compared with solifenacin for reduction in micturition frequency could not be demonstrated in this population of OAB patients who were dissatisfied with previous antimuscarinic therapy due to lack of efficacy. Both mirabegron and solifenacin improved key OAB symptoms with no statistically significant differences observed between the two treatments. Both drugs were well tolerated. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - July 16, 2015 Category: Urology & Nephrology Authors: Batista, J. E., Kolbl, H., Herschorn, S., Rechberger, T., Cambronero, J., Halaska, M., Coppell, A., Kaper, M., Huang, M., Siddiqui, E., on behalf of the BEYOND study group Tags: Original Research Source Type: research
Clinical experience with temsirolimus in the treatment of advanced renal cell carcinoma
Temsirolimus is an inhibitor of the mammalian target of rapamycin (mTOR) kinase, a protein that has been shown to be particularly active in metastatic renal cell carcinoma (mRCC) with poor prognosis. Therefore, temsirolimus should be considered as the first-line treatment indicated in mRCC patients classified as poor risk. The benefits of temsirolimus are not limited to an increased survival but are also related to a better quality of life, which is certainly one of the most important aspects in the clinical management of these frail patients. Temsirolimus is a well-tolerated treatment, and the most frequent adverse events...
Source: Therapeutic Advances in Urology - May 25, 2015 Category: Urology & Nephrology Authors: Zanardi, E., Verzoni, E., Grassi, P., Necchi, A., Giannatempo, P., Raggi, D., De Braud, F., Procopio, G. Tags: Reviews Source Type: research
Tadalafil therapy for erectile dysfunction following prostatectomy
This article evaluates the existing literature on tadalafil and critically analyzes its impact on erectile function following radical prostatectomy. (Source: Therapeutic Advances in Urology)
Source: Therapeutic Advances in Urology - May 25, 2015 Category: Urology & Nephrology Authors: Kadıoğlu, A., Ortac, M., Dincer, M., Brock, G. Tags: Reviews Source Type: research
