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Urology

Volume 13, No 3 - 2011

Volume 13, No 3 - 2011

Table of Contents

Lower Urinary Tract Injuries Following Blunt Trauma: A Review of Contemporary Management Management Review
Lower urinary tract trauma, although relatively uncommon in blunt trauma, can lead to significant morbidity when diagnosed late or left untreated; urologists may only encounter a handful of these injuries in their career. This article reviews the literature and reports on the management of these injuries, highlighting the issues facing clinicians in this subspecialty. Also presented is a structured review detailing the mechanisms, classification, diagnosis, management, and complications of blunt trauma to the bladder and urethra. The prognosis for bladder rupture is excellent when treated. Significant intraperitoneal rupture or involvement of the bladder neck mandates surgical repair, whereas smaller extraperitoneal lacerations may be managed with catheterization alone. With the push for management of trauma patients in larger centers, urologists in these hospitals are seeing increasing numbers of lower urinary tract injuries. Prospective analysis may be achieved in these centers to address the current lack of Level 1 evidence.[Rev Urol. 2011;13(3):119-130 doi: 10.3909/riu0521] © 2011 MedReviews®, LLC
A Review of Current Hemostatic Agents and Tissue Sealants Used in Laparoscopic Partial Nephrectomy Treatment Review
Laparoscopic partial nephrectomy (LPN) is currently considered to be one of the most challenging procedures in minimally invasive urological surgery. With an increasing number of renal tumors being managed using LPN, there is now a further interest in the development of techniques and agents to reduce complications associated with the procedure. Hemostasis is of paramount importance during LPN, and hemostatic agents and tissue sealants are now being used commonly during LPN. Despite this, there is a dearth of prospective, randomized, human trials in current literature that compare the various agents. This review evaluates hemostatic agents and tissue sealants being used during LPN as an adjuvant to suturing in human studies. [Rev Urol. 2011;13(3):131-138 doi: 10.3909/riu0524] © 2011 MedReviews®, LLC
Peyronie’s Disease: Nonsurgical Therapy Options Treatment Update
Peyronie’s disease (PD) is a fibrous inelastic scar of the tunica albuginea, leading to penile deformity, penile curvature, shortening, narrowing, and painful erections that subsequently lead to painful or unsatisfying sexual intercourse. No consensus exists yet on the ideal management of PD. This fact is a result of our limited knowledge of its etiology and causative factors. The acute presentation of PD is treated conservatively, and surgical approachesare only attempted if severe curvature, narrowing, or indentation persists for more than 1 year; PD stability exists for at least 3 months; curvature impedes sexual intercourse; and severe penile shortening occurs. This review focuses on new developments for conservative treatment strategies for PD. [Rev Urol. 2011;13(3):139-146 doi: 10.3909/riu0528] © 2011 MedReviews®, LLC
Role of Inflammation in Benign Prostatic Hyperplasia Disease State Review
Inflammation of the prostate may represent a mechanism for hyperplastic changes to occur in the prostate. There are a variety of growth factors and cytokines that may lead to a proinflammatory process within the prostate. There are several proposed mechanisms that lead to both the intrinsic and extrinsic basis of inflammation. Prostatic inflammation may represent an important factor in influencing prostatic growth and progression of symptoms. This article reviews the recent literature on inflammation leading to chronic prostatic diseases, such as benign prostatic hyperplasia. [Rev Urol. 2011;13(3):147-150 doi: 10.3909/riu0535] © 2011 MedReviews®, LLC
Concomitant Sertoli and Leydig Cell Tumor of the Testis: A Case Report
A rare intratubular gonadal stromal tumor was present in the testis of a 45-year-old man who was admitted to our hospital with the chief complaint of gradual enlargement of the left testis. Tumoral markers were negative and no extension was observed. The tumor comprised an intratubular mixture of two types of tumor cells with intercellular junctions: the predominant tumor cells were consistent with a Sertoli cell origin and cells comprising the minor population consistent with a Leydig cell origin. The patient is disease free after 6-month follow-up. The case is considered to be a testicular mixed tubular Sertoli-Leydig cell tumor. It highlights a rare type of primary tumor of the testis that features a good prognosis. [Rev Urol. 2011;13(3):173-175 doi:10.3909/riu0495] © 2011 MedReviews®, LLC
An Unusual Presentation of Primary Male Genital Tuberculosis
Urogenital tuberculosis is a rare disease; however, it is the second most common location for tuberculosis after the lung. Currently, incidence of urogenital tuberculosis is increasing due to factors such as a higher prevalence of immunosuppression (especially that caused by human immunodeficiency virus infection) and drug abuse. Herein a new case of male genital primary tuberculosis is reported presenting as a scrotal tumor; the originality of this observation lies in its unusual pseudotumor form. [Rev Urol. 2011;13(3):176-178 doi: 10.3909/riu0525] © 2011 MedReviews®, LLC