atients undergoing urologic surgery are at risk of acute kidney injury （AKI） and consequently long-term deterioration in renal function. AKI is further associated with signifcantly higher odds of perioperative compl...atients undergoing urologic surgery are at risk of acute kidney injury （AKI） and consequently long-term deterioration in renal function. AKI is further associated with signifcantly higher odds of perioperative complications, prolonged hospital stay, higher mortality and costs. Therefore, better awareness and detection of AKI, as well as identifcation of AKI determinants in the urological surgery setting is warranted to pre-empt and mitigate further deterioration of renal function in patients at special risk. New consensus criteria provide precise definitions of diagnosis and description of the severity of AKI. However, they rely on serum creatinine （SCr）, which is known to be an inaccurate marker of early changes in renal function. Therefore, several newurinary and serum biomarkers promise to address the gap associated with the use of SCr. Novel biomarkers may complement SCr measurement or most likely improve the diagnostic accuracy of AKI when used in combinations. However, novel biomarkers have to prove their clinical applicability, accuracy, and cost effectiveness prior to implementation into clinical practice. Most preferably, novel biomarkers should help to positively improve a patient’s long-term renal functional outcomes. The purpose of this review is to discuss currently available biomarkers and to review their clinical evidence within urologic surgery settings.展开更多
Complete intracorporeal urinar y diversion(ICUD)with an orthotopic neobladder is an emerging procedure.The objective of this article was to assess retrospectively the urodynamic and continence results after robot-assi...Complete intracorporeal urinar y diversion(ICUD)with an orthotopic neobladder is an emerging procedure.The objective of this article was to assess retrospectively the urodynamic and continence results after robot-assisted radical cystectomy(RARC)and ICUD with a modified orthotopic Studer neobladder.After a median follow-up time of 11 months,all patients were socially continent(≤1 pad)at daytime.Median Pouch capacity was 404 ml with a median postvoid residual volume of 0 ml.All patients stated that they would choose the same type of urinary diversion again.RARC and ICUD with orthotopic neobladder provides promising functional and urodynamic results with high patient satisfaction.展开更多
The debate of prostate cancer （PCa） screening has been shaped over decades. There is a plethora of articles in the literature supporting as well as declining prostate-specific antigen （PSA） screening. Does screeni...The debate of prostate cancer （PCa） screening has been shaped over decades. There is a plethora of articles in the literature supporting as well as declining prostate-specific antigen （PSA） screening. Does screening decrease PCa mortality？ With the long-term results of the European Randomized Study of Screening for Prostate （ERSPC） the answer is clearly YES. It moves! However, in medicine there are no benefits without any harm and thus, screening has to be performed in targeted and smart way-or in other words^in a risk-adapted fashion when compared with the way it was done in the past. Here, we discuss the main findings of the ERSPC trials and provide insights on how the future screening strategies should be implemented.展开更多
基金supported by the Professor Walter Morris-Hale Distinguished Chair in Urologic Oncology at the Brigham and Women’s Hospital
文摘atients undergoing urologic surgery are at risk of acute kidney injury （AKI） and consequently long-term deterioration in renal function. AKI is further associated with signifcantly higher odds of perioperative complications, prolonged hospital stay, higher mortality and costs. Therefore, better awareness and detection of AKI, as well as identifcation of AKI determinants in the urological surgery setting is warranted to pre-empt and mitigate further deterioration of renal function in patients at special risk. New consensus criteria provide precise definitions of diagnosis and description of the severity of AKI. However, they rely on serum creatinine （SCr）, which is known to be an inaccurate marker of early changes in renal function. Therefore, several newurinary and serum biomarkers promise to address the gap associated with the use of SCr. Novel biomarkers may complement SCr measurement or most likely improve the diagnostic accuracy of AKI when used in combinations. However, novel biomarkers have to prove their clinical applicability, accuracy, and cost effectiveness prior to implementation into clinical practice. Most preferably, novel biomarkers should help to positively improve a patient’s long-term renal functional outcomes. The purpose of this review is to discuss currently available biomarkers and to review their clinical evidence within urologic surgery settings.
文摘Complete intracorporeal urinar y diversion(ICUD)with an orthotopic neobladder is an emerging procedure.The objective of this article was to assess retrospectively the urodynamic and continence results after robot-assisted radical cystectomy(RARC)and ICUD with a modified orthotopic Studer neobladder.After a median follow-up time of 11 months,all patients were socially continent(≤1 pad)at daytime.Median Pouch capacity was 404 ml with a median postvoid residual volume of 0 ml.All patients stated that they would choose the same type of urinary diversion again.RARC and ICUD with orthotopic neobladder provides promising functional and urodynamic results with high patient satisfaction.
文摘The debate of prostate cancer （PCa） screening has been shaped over decades. There is a plethora of articles in the literature supporting as well as declining prostate-specific antigen （PSA） screening. Does screening decrease PCa mortality？ With the long-term results of the European Randomized Study of Screening for Prostate （ERSPC） the answer is clearly YES. It moves! However, in medicine there are no benefits without any harm and thus, screening has to be performed in targeted and smart way-or in other words^in a risk-adapted fashion when compared with the way it was done in the past. Here, we discuss the main findings of the ERSPC trials and provide insights on how the future screening strategies should be implemented.
