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The Journal of Urology® contains 3 sections: Adult Urology, Pediatric Urology and Urological Survey. Original clinical and translational research studies will be considered for publication in the Adult and Pediatric Urology Sections. Translational research manuscripts must have a clear and proximate translation to patient care, and only preclinical scientific studies that have the direct potential to translate into new and improved standards of care will be reviewed.
Patient Reported Outcome Measures for transperineal template prostate mapping biopsies in the PICTURE study
Transperineal prostate mapping (TTPM) biopsy is an increasingly utilized method of procuring tissue from men with suspected prostate cancer. We sought to report the patient related outcome measures (PROMs) and adverse events in men undergoing this diagnostic test within the PICTURE trial.
To evaluate the psychosocial outcomes, psychosexual development and sexual function in adolescents operated for proximal hypospadias, which we hypothesized would be impaired compared to peers.
Metformin Use Is Associated with Improved Survival in Patients with Advanced Prostate Cancer on Androgen Deprivation Therapy
Metformin is commonly prescribed for patients with type 2 diabetes mellitus (DM). We hypothesize that metformin plus androgen deprivation therapy (ADT) may be beneficial in combination. The objective was to assess this combination in a retrospective cohort of patients with advanced PCa.
The artificial urinary sphincter (AUS) is a common treatment for male urinary incontinence. We sought to characterize long-term rates of AUS revision/removal, reimplantation and associated risk factors.
Changeable conditional survival rates and associated prognosticators in patients with metastatic renal cell carcinoma receiving first-line targeted therapy
This study aimed to evaluate conditional survival (CS) probabilities in patients with metastatic renal cell carcinoma (mRCC) who undergo first-line tyrosine kinase inhibitor (TKI) therapy and identify the predictors for CS over time.
Short term changes in urinary relative supersaturation predict recurrence of kidney stones: a tool to guide preventive measures in urolithiasis
Kidney stone disease is characterized by a relatively high rate of recurrence. In our study, we analyzed the association between RSS and the risk of stone recurrence. Additionally, we examined the association between changes in RSS and of urinary composition after 1 week of medical treatment and the risk of recurrence.
Treatment and Prevention of Recurrent Lower Urinary Tract Infections in Women: A Rapid Review with Practice Recommendations
Recurrent lower urinary tract infections (rUTI) in women are a highly prevalent and burdensome condition for which best practice guidelines for treatment and prevention that minimize harm and optimize well-being are greatly needed. To inform development of practice recommendations, a rapid literature review of original research, systematic reviews, meta-analyses and practice guidelines was conducted.
Comparison of Elastic and Rigid Registration During Magnetic Resonance Imaging/Ultrasound Fusion-Guided Prostate Biopsy: A Multi-Operator Phantom Study
The relative value of rigid or elastic registration during Magnetic Resonance Imaging (MRI)/Ultrasound (US) fusion guided prostate biopsy (FBx) has been poorly studied. This study compared registration error (RE) between rigid and elastic registration during FBx using a prostate phantom model.
Anterior localization of prostate cancer suspicious MRI lesions in patients undergoing initial and repeat biopsy: Results from 1,161 patients undergoing MRI/ultrasound fusion-guided targeted biopsies
Based on findings from transrectal ultrasound guided (TRUS) biopsies series, standard sampling of the prostate targets the posterior/peripheral zone. However, a substantial proportion of PCa suspicious MRI PI-RADS ≥3 lesions is located in the anterior segment of the prostate, requiring a deeper placement and targeting of the biopsy needle.
Intraoperative cyst rupture of partial nephrectomy for cystic renal masses: does it increase the risk of recurrence?
Our objective was to assess the prevalence of intraoperative cyst rupture (CR) and its impact on oncological outcomes.
In this issue of The Journal Friedmacher et al present their results on endoscopic injection of dextranomer/hyaluronic acid (Dx/HA) copolymer in children with grade IV to V vesicoureteral reflux (VUR).1 The results are impressive: 100% of the children were successfully treated and not a single postoperative complication (other than rapidly resolving gross hematuria in 2 children) occurred during a median followup of 8.5 years. Taken at face value, these results seem to imply that we should be pushing families toward endoscopic management.
This was a small, nonrandomized, proof of concept study with a number of limitations. We agree that using 10 mg prednisone remains the standard of care for castration resistant prostate cancer. Most patients in IMAAGEN did report AEs, including these of special interest such as hypertension, fluid retention and hypokalemia. While AEs were manageable (mainly grade 1/2 with no patient discontinuing therapy due to mineralocorticoid excess or requiring prednisone dose escalation), using a lower dose of prednisone required careful monitoring and timely management.
We appreciate the comments on our study. There is clearly a road ahead and paths to tread to find the exact place of ultrasound SWE in the detection and phenotypic characterization of prostate cancer. There may be a place of combining this with MRI. However, publications in this area to date show promising results. What should be considered a discriminatory diagnostic cutoff level for benign and malignant lesions can be debated but there is some confidence that all studies in this area show differences in the relative stiffness estimates not only of cancer and noncancerous tissues but also of different Gleason grades (reference 12 in article).
PCa detection remains a problem. Random TRUS biopsies have been the standard of care but they can often miss cancers and under grade the cancers that are identified. MRI has had success in identifying clinically significant PC and it may be helpful in active surveillance.1 SWE is a new technique that evaluates tissue stiffness.2 As most PCa is stiffer than normal prostate it can be detected by SWE and the stiffness appears to correlate with Gleason scores. However, benign prostatic nodules are also stiff, making evaluation of the central gland problematic with SWE.
Imaging in localized prostate cancer is gaining importance. Specifically multiparametric MRI is frequently used for diagnosis, active surveillance, targeted biopsy and focal therapy. A major step in the acceptance and widespread use of MRI was the establishment of the standardized reporting system, PI-RADS® (Prostate Imaging-Reporting and Data System).1 Research on new techniques such as SWE should aim to establish comparable classification systems to catch up with MRI (reference 11 in article).
The Journal of Urology® improves patient care by delivering to our readers the most current advances in the field, especially those with clinical implications and translation. Most often, this information is provided in the form of original scientific articles, review articles and guidelines. The Urological Survey section of The Journal broadens the focus to include pertinent papers published in other journals.
In recent years there has been a dramatic increase in the number and availability of tools that assess risk following the diagnosis of PCa. These developments have occurred largely in 2 parallel tracks, including optimization of mpMRI, and discovery and validation of tissue based genomic tests (reference 4 in article).1 With little comparative study it has remained unclear whether these modalities are redundant or new prognostic value can be gleaned from additional testing (reference 17 in article).