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Re: Complications following Artificial Urinary Sphincter Placement after Radical Prostatectomy and Radiotherapy: A Meta-Analysis
Urological Survey 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57
Trauma, and Genital and Urethral Reconstruction Re: Meta-Analysis of Androgen Insensitivity in Preoperative Hormone Therapy in Hypospadias W. Zhao, J. Yin, Z. Yang, J. Xie, Y. Zhang, W. Xu and J. L. Li Department of Paediatric Urology, Shenzhen Children’s Hospital, Shenzhen and School of Biotechnology, Southern Medical University, Guangzhou, China, and Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom Urology 2015; 85: 1166e1172. doi: 10.1016/j.urology.2015.01.035.
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25805521 Editorial Comment: This literature review examines the prevalence of androgen insensitivity (AI) among patients with hypospadias treated with preoperative testosterone. Micropenis, perineoscrotal hypospadias and bifid scrotum typically manifest in patients with the AI syndrome, many of whom receive androgens before operative reconstruction, with broadly favorable results. This meta-analysis suggests that phallic size increases and surgical outcomes improve after 3 courses of 25 mg intramuscular testosterone monthly, without adverse effects on skeletal growth. AI was noted in roughly 7% of patients. It is interesting to contemplate what, if any, manifestations of hypogonadism exist in our adult reconstructive urological population. Given the withering effects of advanced age, erectile dysfunction, radical pelvic surgery, radiation therapy and androgen deprivation, one wonders whether testosterone supplementation may have similar salubrious effects in elderly men undergoing bulbar urethral surgery. Allen F. Morey, MD
Re: Complications following Artificial Urinary Sphincter Placement after Radical Prostatectomy and Radiotherapy: A Meta-Analysis A. S. Bates, R. M. Martin and T. R. Terry Department of Urology, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, and School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom BJU Int 2015; 116: 623e633. doi: 10.1111/bju.13048.
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25601072 Editorial Comment: This review attempts to definitively evaluate the cumulative evidence of dozens of reports highlighting artificial urinary sphincter complications in cases with and without radiotherapy. Radiated patients had a much higher rate of surgical revisions (roughly one quarter), due mainly to urethral erosion or atrophy, with concomitant persistent stress urinary incontinence. A more rigorous counseling session is advised for radiated patients. Allen F. Morey, MD
0022-5347/16/1951-0001/0 THE JOURNAL OF UROLOGY® Ó 2015 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2015.10.033 Vol. 195, 1-2, January 2016 Printed in U.S.A.
www.jurology.com Dochead: Urological Survey
LIT 5.4.0 DTD JURO12989_proof 13 October 2015 4:44 pm EO:
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Trauma, and Genital and Urethral Reconstruction Re: Meta-Analysis of Androgen Insensitivity in Preoperative Hormone Therapy in Hypospadias W. Zhao, J. Yin, Z. Yang, J. Xie, Y. Zhang, W. Xu and J. L. Li Department of Paediatric Urology, Shenzhen Children’s Hospital, Shenzhen and School of Biotechnology, Southern Medical University, Guangzhou, China, and Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom Urology 2015; 85: 1166e1172. doi: 10.1016/j.urology.2015.01.035.
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25805521 Editorial Comment: This literature review examines the prevalence of androgen insensitivity (AI) among patients with hypospadias treated with preoperative testosterone. Micropenis, perineoscrotal hypospadias and bifid scrotum typically manifest in patients with the AI syndrome, many of whom receive androgens before operative reconstruction, with broadly favorable results. This meta-analysis suggests that phallic size increases and surgical outcomes improve after 3 courses of 25 mg intramuscular testosterone monthly, without adverse effects on skeletal growth. AI was noted in roughly 7% of patients. It is interesting to contemplate what, if any, manifestations of hypogonadism exist in our adult reconstructive urological population. Given the withering effects of advanced age, erectile dysfunction, radical pelvic surgery, radiation therapy and androgen deprivation, one wonders whether testosterone supplementation may have similar salubrious effects in elderly men undergoing bulbar urethral surgery. Allen F. Morey, MD
Re: Complications following Artificial Urinary Sphincter Placement after Radical Prostatectomy and Radiotherapy: A Meta-Analysis A. S. Bates, R. M. Martin and T. R. Terry Department of Urology, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, and School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom BJU Int 2015; 116: 623e633. doi: 10.1111/bju.13048.
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25601072 Editorial Comment: This review attempts to definitively evaluate the cumulative evidence of dozens of reports highlighting artificial urinary sphincter complications in cases with and without radiotherapy. Radiated patients had a much higher rate of surgical revisions (roughly one quarter), due mainly to urethral erosion or atrophy, with concomitant persistent stress urinary incontinence. A more rigorous counseling session is advised for radiated patients. Allen F. Morey, MD
0022-5347/16/1951-0001/0 THE JOURNAL OF UROLOGY® Ó 2015 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2015.10.033 Vol. 195, 1-2, January 2016 Printed in U.S.A.
www.jurology.com Dochead: Urological Survey
LIT 5.4.0 DTD JURO12989_proof 13 October 2015 4:44 pm EO:
j
58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 1 113 114