Showing papers in "Urologic Clinics of North America in 2014"

TL;DR: In this new perspective of "infertility as a disease," improvements envisioned in public health that may be gained through improved understanding of the epidemiology of male infertility are envisioned, and a survey of available data on the epidemiological of infertility provided.

TL;DR: An overview of infectious and inflammatory conditions associated with male infertility that may affect several components of the male reproductive tract and therefore have the ability to potentially alter sperm function is provided.

TL;DR: The current state of knowledge regarding environmental factors that affect spermatogenesis and male fertility are enumerated, and the predicted magnitude of these effects over the next 20 years is extrapolated based on current societal trends.

TL;DR: A 12-core systematic biopsy that incorporates apical and far-lateral cores in the template distribution allows maximal cancer detection and avoidance of a repeat biopsy while minimizing the detection of insignificant prostate cancers.

TL;DR: Precision offered by the robotic platform and technical evolution of radical prostatectomy, including enhanced nerve sparing (veil), have led to improved potency and continence outcomes as well as better safety profile in patients undergoing surgical therapy for prostate cancer.

TL;DR: Each guideline statement is examined and clinical context is attempted to provide clinical context for each statement to have a better clinical frame of reference relative to each statement.

TL;DR: The role of surgical therapy, including a discussion of varicocelectomy in men with spermatogenic failure, as well as an in-depth review of surgical sperm retrieval with testicular sperm extraction and microdissection testicular semen extraction, is provided.

TL;DR: The use and interpretation of the cystic fibrosis transmembrane receptor assay are examined in the context of men with clinical bilateral absence of the vas deferens, a karyotype and Klinefelter syndrome, and Y chromosome microdeletions.

TL;DR: Logical, morphologic, and molecular evidence is presented to show that low-grade prostate cancers are correctly classified as cancer, and it is suggested that 6 out of 10 on an aggressiveness scale is inappropriate for indolent cancer.

TL;DR: The currently available, soon to be available, and theoretically possible methods of male contraception are reviewed.

TL;DR: In this paper, the authors reviewed the current English literature regarding readily available nutraceuticals and their potential effects on male infertility and potential side effects with excess intake and found that they are widely available and have many antioxidant properties.

TL;DR: Urodynamics in patients with NLUTD have specific challenges, and the goals are maintaining low bladder pressures, decreasing risk of infection, and maintaining continence.

TL;DR: MRI-ultrasonography fusion allows prostate biopsy to be performed quickly, on an outpatient basis, using the transrectal technique, and targeted biopsies are more sensitive for detection of prostate cancer than nontargeted, systematicBiopsies and detect more significant prostate cancers and fewer insignificant cancers than conventional biopsy.

TL;DR: A screening test is needed with sufficiently good performance characteristics to detect disease at an early stage so treatment may be offered with curative intent, while reducing the number of negative or unnecessary biopsies.

TL;DR: There is increased utilization of robotic surgery in urology with limited comparative effectiveness research demonstrating superiority over conventional, less costly treatment options, so further research into identifying determinants for optimal utilization of robotics and newer technology is needed.

TL;DR: Urodynamics should be performed only when there is a question it can answer that would affect treatment choice or outcome, and findings of detrusor underactivity, overactivity, and reduced compliance are important considerations in deciding how best to treat postprostatectomy incontinence.

TL;DR: Current literature and guidelines outlining the indications for obtaining this specialized study as well as technique are reviewed, and clinicians are mindful of the added cost, safety concerns, and limitations of its use.

TL;DR: Filling cystometry combined with pressure/flow studies has been a cornerstone of the initial evaluation of all patients with neurogenic lower urinary tract dysfunction, although recently that practice has been challenged.

TL;DR: In the future, it is likely to see significant improvements in the ability to select the best sperm for assisted-reproductive-technology procedures and the use of these procedures in routine clinical practice.

TL;DR: The genetic basis underlying prostate cancer is reviewed, and the epidemiology and potential clinical usefulness of both rare and common genetic variations are highlighted.

TL;DR: The traditional roles that the hypothalamic-pituitary-gonadal endocrine axis plays in spermatogenesis and testicular dysfunction are described, as well as other insults that may contribute to hyposperMatogenesis.

TL;DR: This article summarizes the current office-based evaluation of male infertility and offers speculation, based on current research, on the future evolution of this encounter.

TL;DR: The use of robot-assisted laparoscopic surgery has increased rapidly and with it, the need to better define a structured curriculum and credentialing process and a competency-based approach offers a better hope of honoring the principle of "above all, do no harm" and obtaining continued acceptance of new operative technologies.

TL;DR: Shared decision making involving patient decision aids are discussed as approaches that can be used to improve the quality of prostate cancer screening decisions, including a close alignment between a man's values, goals, and preferences and his choice about screening.

TL;DR: The technique of robotic partial nephrectomy continues to evolve, but the goals remain the same: achievement of pentafecta outcomes is difficult to obtain; however, surgeons should continue to strive for this standard of excellence.

TL;DR: This article summarizes the key points to performing a quality UDS study that can evaluate and diagnose disorders of the lower urinary tract.

TL;DR: Why harm-benefit trade-offs based on empirical results may not accurately reflect theTrade-offs expected under long-term population screening under PSA screening are explained.

TL;DR: Techniques for robotic-assisted laparoscopic simple anatomic prostatectomy in a step-by-step manner are described to overcome the limitations of pure laparoscopy.

TL;DR: The utility of urodynamics in the evaluation stress incontinence on prolapse reduction as well as concomitant storage and voiding symptoms in patients with pelvic organ prolapse is discussed.

TL;DR: Recent advances in image-guided surgery and emerging molecular imaging technologies for minimally invasive urologic surgery are explored.