right to continuing care. Treatment models right to continuing care. Treatment models are geared to the needs of older patients are geared to the needs of older patients with chronic conditions, reinforcing the with chronic conditions, reinforcing the pessimism inherent in the concept of pessimism inherent in the concept of schizophrenia. Community ignorance, stigschizophrenia. Community ignorance, stigma (operating in the larger community ma (operating in the larger community and within mental health services), poor and within mental health services), poor mental health literacy, and the isolation of mental health literacy, and the isolation of psychiatry from the rest of medicine and psychiatry from the rest of medicine and healthcare add to the obstacles to reforming healthcare add to the obstacles to reforming systems to focus on early intervention. A systems to focus on early intervention. A special focus on the early phases of psyspecial focus on the early phases of psychotic disorders is justified on three major chotic disorders is justified on three major grounds: grounds: . . The clinical care of people with firstThe clinical care of people with firstepisode psychosis is often delayed or episode psychosis is often delayed or inadequate, and sometimes crude or inadequate, and sometimes crude or harmful. Some people never receive harmful. Some people never receive treatment.

International clinical practice guidelines International clinical practice guidelines

Conservative Management Following Complete Clinical Response to Neoadjuvant Chemotherapy of Muscle Invasive Bladder Cancer: Contemporary Outcomes of a Multi-Institutional Cohort Study.

Improving patient outcomes from major urological surgery requires not only advancement in surgical technique and technology, but also the practice of patient-centered, multidisciplinary, and integrated medical care of these patients from the moment of contemplation of surgery until full recovery. This review examines the evidence for recent developments in preoperative assessment and optimization that is of relevance to major urological surgery. Current perioperative medicine recommendations aim to improve the short-term safety and long-term effectiveness of surgical treatments by the delivery of multidisciplinary integrated medical care. New strategies to deliver this aim include preoperative risk stratification using a frailty index and cardiopulmonary exercise testing for patients undergoing intra-abdominal surgery (including radical cystectomy), preoperative management of iron deficiency and anemia, and preoperative exercise intervention. Proof of the utility and validity for improving surgical outcomes through advances in preoperative care is still evolving. Evidence-based developments in this field are likely to benefit patients undergoing major urological surgery, but further research targeted at high-risk patients undergoing specific urological operations is required.

/pdf/the-preoperative-assessment-and-optimization-of-patients-20tu4ac74a.pdf

The Preoperative Assessment and Optimization of Patients Undergoing Major Urological Surgery.

Background:The aim of our study was to compare perioperative and functional outcomes of two different prostatic laser enucleation techniques performed in two high-volume centers: 100 W holmium lase...

https://journals.sagepub.com/doi/pdf/10.1177/1756287218779784

Holmium laser versus thulium laser enucleation of the prostate: a matched-pair analysis from two centers.

In recent years, new endoscopic techniques have been developed to reduce the morbidity of transurethral resection of the prostate. Nonetheless, complications are still frequently encountered and bladder neck contracture (BNC) is a well-described complication after endoscopic surgery for benign prostatic obstruction (BPO). Our aim is to review and discuss the contemporary incidence, the relevant treatment strategies, and their outcomes. Findings suggest that BNC is a common complication with an acceptably low incidence but can range in complexity. Most contractures were usually managed successfully with conservative measures; nevertheless, in patients with refractory BNC, various valuable management strategies were employed with different kinds of success and re-treatment rates. In consideration of these challenging possibilities, the treatment of BNC requires a tailored approach with patient-specific management that can range from simple procedures to complex surgical reconstruction.

Bladder Neck Contracture After Endoscopic Surgery for Benign Prostatic Obstruction: Incidence, Treatment, and Outcomes

In 2005, the high power thulium laser was introduced for the surgical treatment of benign prostatic obstruction. It has several properties that confer theoretical advantages over other lasers used for the same indication, such as technical versatility and a relatively small zone of thermal damage. Studies using the 70-150 W thulium laser systems demonstrate good efficacy of these procedures with low morbidity and few complications even in higher risk patients. Different techniques have been employed to treat the prostate with this technology, including enucleation, vapoenucleation, vaporization and resection. Comparative studies have been published comparing thulium laser prostatectomy to monopolar transurethral resection of prostate (TURP), bipolar TURP and holmium laser enucleation of prostate (HoLEP). In this review we discuss the current literature on the safety and efficacy of various thulium techniques for the treatment of benign prostatic hyperplasia and examine comparative studies.

https://journals.sagepub.com/doi/pdf/10.1177/1756287216632429

Evidence of the efficacy and safety of the thulium laser in the treatment of men with benign prostatic obstruction.

Urinary tract infections are among the most common infections seen in both the ambulatory inpatient and nursing facility settings. Due to unique characteristics of the geriatric population, including physiology, comorbidities, and social history, incidences of these infections increase with age requiring special attention. Here, we provide an overview of the etiology, diagnosis, treatment, and prevention of urinary tract infections with focus on the geriatric patient.

Lower Urinary Tract Infections in the Elderly

4537Background: Approximately 30-40% of patients with muscle-invasive bladder cancer (MIBC) who undergo neoadjuvant chemotherapy (NAC) have a complete pathologic response at radical cystectomy. It ...

Natural history of clinical complete response to neoadjuvant chemotherapy for urothelial carcinoma of the bladder: Updated single-institution experience.

Marissa C. Velez

Papers

Evidence of the efficacy and safety of the thulium laser in the treatment of men with benign prostatic obstruction.

Lower Urinary Tract Infections in the Elderly

Natural history of clinical complete response to neoadjuvant chemotherapy for urothelial carcinoma of the bladder: Updated single-institution experience.

Pd01-09 understanding detrusor contraction duration: what are normal parameters? and what are determining factors?

Mp08-01 perioperative blood transfusion and radical prostatectomy: analysis of the national surgical quality improvement program database