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Nieder AM. Reluctance of general practitioners to refer gross hematuria patients to urology. Can Urol Assoc J 2013. [DOI: 10.5489/cuaj.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Nieder AM. Editorial comment. Urology 2012. [PMID: 23206775 DOI: 10.1016/j.urology.2012.06.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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M. Nieder A, Nebhnani J, J. Bianco F. The Optimal Diagnosis of Urothelial Carcinoma of the Bladder. CURRENT CANCER THERAPY REVIEWS 2011. [DOI: 10.2174/157339411797642641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Nieder AM. Reluctance of general practitioners to refer gross hematuria patients to urology. Can Urol Assoc J 2011; 5:102. [PMID: 21470534 DOI: 10.5489/cuaj.11049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Nieder AM. Editorial comment. J Urol 2010; 184:2263. [PMID: 21036371 DOI: 10.1016/j.juro.2010.08.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nieder AM. Editorial comment. J Urol 2009; 183:61. [PMID: 19913834 DOI: 10.1016/j.juro.2009.08.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Manoharan M, Ayyathurai R, de Los Santos R, Nieder AM, Soloway MS. Presentation and outcome following radical cystectomy in Hispanics with bladder cancer. Int Braz J Urol 2009; 34:691-8; discussion 698. [PMID: 19111073 DOI: 10.1590/s1677-55382008000600003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2008] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Significant racial and ethnic differences in the epidemiology of bladder cancer (BC) exist. Studies have shown African Americans to have lower incidence of bladder cancer than Caucasians, but higher incidence of invasive BC. Hispanics are the largest minority group in the United States. However, no reported studies on bladder cancer among Hispanics are available to date. As our center is in a unique position to study BC in Hispanic patients we were prompted to assess presentation and outcome of patients undergoing radical cystectomy (RC) for BC. MATERIALS AND METHODS Between January 1992 and May 2006, 448 RC were performed. All relevant data were collected and entered into a database. Patients were categorized by ethnicity as Hispanic and non-Hispanic White. African-American and other minority groups were excluded because of the small number. Comparative analysis of Hispanic and non-Hispanic White patients was performed. RESULTS 67 (17%) patients were Hispanic. Mean follow-up period was 41 (SD +/- 40) months. Clinical and pathological data between these two groups were compared. Pre-cystectomy T stage was not significantly different between both groups. However, after RC incidence of < or = T1 disease in Hispanics was lower (22%) than Caucasians (37%). This difference, statistically significant (P = 0.024) indicates that Hispanics who undergo RC present with higher stage disease. Kaplan-Meier log rank test indicated a difference in disease free survival and disease specific survival between the two groups but however it did not reach statistical significance (Log Rank P = 0.082, P = 0.063). No significant difference in overall survival was observed (P = 0.465). CONCLUSIONS Hispanic patients managed with RC for bladder carcinoma present with higher stage disease.
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Brookfield KF, Cheung MC, Gomez C, Yang R, Nieder AM, Lee DJ, Koniaris LG. Survival disparities among African American women with invasive bladder cancer in Florida. Cancer 2009; 115:4196-209. [DOI: 10.1002/cncr.24497] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Nieder AM. Editorial Comment. J Urol 2009. [DOI: 10.1016/j.juro.2009.02.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tunuguntla HSR, Nieder AM, Manoharan M. Neobladder reconstruction following radical cystoprostatectomy for invasive bladder cancer. MINERVA UROL NEFROL 2009; 61:41-54. [PMID: 19417725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A survey on neobladder reconstruction after radical cystectomy due to invasive bladder cancer is presented. Stress is laid on the selection patients, factors affecting the choice of urinary diversion, contraindications for neobladder, oncological factors influencing selection of neobladder, continence, complications and other factors which may affect a favourable outcome.
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Nieder AM, Lotan Y, Nuss GR, Langston JP, Vyas S, Manoharan M, Soloway MS. Are patients with hematuria appropriately referred to Urology? A multi-institutional questionnaire based survey. Urol Oncol 2008; 28:500-3. [PMID: 19097811 DOI: 10.1016/j.urolonc.2008.10.018] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 10/14/2008] [Accepted: 10/15/2008] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Hematuria is a common finding that may be a sign of serious underlying urologic disease. Thus, the AUA guidelines (written in conjunction with the American Academy of Family Practice) recommend urologic evaluation for patients with both microscopic and gross hematuria. We sought to evaluate practice patterns of the evaluation of hematuria by primary care physicians (PCPs) in two locations in the United States. METHODS Anonymous questionnaires regarding use of urinalysis (UA) and evaluation of hematuria were mailed to 586 PCPs in Miami, Florida and 1,915 in Dallas, Texas. Surveys were mailed to physicians who identified themselves as practitioners of internal medicine, family practice, primary care, or obstetrics and gynecology. RESULTS Surveys were completed by 788 PCPs including 270 (46%) and 518 (26%) PCPs in Miami and Dallas, respectively. Screening UAs were obtained on all patients by 77% and 64%, of physicians in Miami and Dallas, respectively. In both Miami and Dallas, only 36% of PCPs reported referring patients with microscopic hematuria to an urologist. In patients with gross hematuria, referral rates were 77% and 69% in Miami and Dallas, respectively. CONCLUSIONS While many PCPs use UA in many of their patients routinely, few PCPs automatically refer their patients with microscopic hematuria to urology and not all patients with gross hematuria are referred. Further investigations regarding why and when patients are referred to urology is warranted. Increasing awareness of the complete and timely evaluation of hematuria may be beneficial in preventing a delay in bladder cancer.
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Nieder AM, Lee DJ. Re: The Causal Role of Cigarette Smoking in Bladder Cancer Initiation and Progression, and the Role of Urologists in Smoking Cessation. J Urol 2008; 180:2713. [DOI: 10.1016/j.juro.2008.08.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Indexed: 11/25/2022]
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Nieder AM. Commentary on association of clinical prostate and bladder cancers. J Urol 2008; 179:S6. [PMID: 18405754 DOI: 10.1016/j.juro.2008.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ayyathurai R, Luongo T, Nieder AM, Manoharan M, Soloway MS. OUTCOMES OF pT0 AT RADICAL CYSTECTOMY WITHOUT NEOADJUVANT THERAPY. J Urol 2008. [DOI: 10.1016/s0022-5347(08)61625-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nieder AM, Porter MP, Soloway MS. PROSTATE RADIOTHERAPY: WHAT IS THE CONTEMPORARY RISK OF BLADDER AND RECTAL CARCINOMA? J Urol 2008. [DOI: 10.1016/s0022-5347(08)60943-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nieder AM. Editorial Comment. J Urol 2008. [DOI: 10.1016/j.juro.2007.10.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nieder AM, MacKinnon JA, Huang Y, Fleming LE, Koniaris LG, Lee DJ. Florida Bladder Cancer Trends 1981 to 2004: Minimal Progress in Decreasing Advanced Disease. J Urol 2008; 179:491-5; discussion 495. [DOI: 10.1016/j.juro.2007.09.082] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Indexed: 11/25/2022]
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Ayyathurai R, Manoharan M, Nieder AM, Kava B, Soloway MS. Factors affecting erectile function after radical retropubic prostatectomy: results from 1620 consecutive patients. BJU Int 2008; 101:833-6. [PMID: 18190627 DOI: 10.1111/j.1464-410x.2007.07409.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report the return of erectile function in 1620 consecutive men after radical retropubic prostatectomy (RRP), chosen by half of men diagnosed with clinically localized prostate cancer, and the goal of which is to completely excise the tumour while preserving continence and erectile function. PATIENTS AND METHODS From January 1992 to October 2006, one surgeon performed RRP with a nerve-sparing technique where feasible. Men with erectile dysfunction before surgery, salvage RRPs, those not having a nerve-sparing procedure, neoadjuvant or adjuvant therapy within 6 months of RRP and a follow-up of <6 months were excluded from the analyses. Erectile function was evaluated by the surgeon when possible or by an annual questionnaire. Potency was defined as erectile function sufficient for intercourse with or without a phosphodiesterase-5 inhibitor. RESULTS Of 619 men who had a bilateral and of 178 who had a unilateral nerve-sparing RRP, 72% and 53%, respectively, were potent. When stratifying by age groups (<or=49, 50-59, 60-69 and >or=70 years) potency rates were 86%, 76%, 58% and 37%, respectively. Potency was more common after bilateral than unilateral nerve-sparing RRP in all age groups (P < 0.001). Age, bilateral nerve-sparing (odds ratio 2.9) and surgeon experience were associated with potency in a multivariate analysis. CONCLUSION Careful patient selection and meticulous surgical technique are essential to achieve the right balance between cancer control and morbidity. The patient's age, nerve-sparing RRP and the surgeon's experience were the significant predictors of return of potency after RRP.
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Nieder AM. Editorial Comment. J Urol 2007. [DOI: 10.1016/j.juro.2007.05.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nieder AM, Manoharan M, Yang Y, Soloway MS. Intraoperative cell salvage during radical cystectomy does not affect long-term survival. Urology 2007; 69:881-4. [PMID: 17482926 DOI: 10.1016/j.urology.2007.01.060] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Revised: 10/23/2006] [Accepted: 01/22/2007] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate the risk of long-term recurrence for patients who received cell-salvaged blood during radical cystectomy (RC). METHODS We retrospectively analyzed an RC database and compared those who did and did not receive cell-salvaged blood according to baseline parameters, pathologic outcomes, and recurrence. RESULTS A total of 378 patients underwent RC between 1992 and 2005 by one surgeon. Of these, 65 (17.2%) received cell-salvaged blood and 313 (82.8%) did not. The two groups had similar baseline characteristics. There were no differences between the two groups when compared by pathologic stage. The median follow-up for patients who did and did not receive cell-salvaged blood was 19.1 and 20.7 months, respectively (P = 0.464). The 3-year disease-specific survival rate for the two groups was 72.2% and 73.0%, respectively (P = 0.90). CONCLUSIONS Intraoperative cell salvage is a safe blood management strategy for patients undergoing RC. There is no increased risk of metastatic disease or death for those who receive cell-salvaged blood. Concerns about spreading tumors cells by IOCS during RC would seem unwarranted. However, only a prospective, multicenter, randomized trial would provide the most valid assessment of the safety of IOCS.
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Nieder AM, Soloway MS, Herr HW. Reply to Tine Hajdinjak and Nadja Kokalj-Vokač’s Letter to the Editor re: Re: Mecedes Marín-Aguilera, Lourdes Mengual, María José Ribal et al. Utility of Fluorescence In Situ Hybridization as a Non-invasive Technique in the Diagnosis of Upper Urinary Tract Urothelial Carcinoma. Eur Urol 2007;51:409–15 and Alan M. Nieder, Mark S. Soloway and Harry W. Herr. Should We Abandon the FISH Test? Eur Urol 2007;51:1469–71. Eur Urol 2007;52:287–9. Eur Urol 2007. [DOI: 10.1016/j.eururo.2007.02.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Nieder AM, Soloway MS, Jewett MAS. Re: can restaging transurethral resection of T1 bladder cancer select patients for immediate cystectomy? H. W. Herr, S. M. Donat and G. Dalbagni J Urol 2007; 177: 75-79. J Urol 2007; 178:352. [PMID: 17507038 DOI: 10.1016/j.juro.2007.03.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Indexed: 11/16/2022]
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Manoharan M, Ayyathurai R, Nieder AM, Soloway MS. Modified Pfannenstiel approach for radical retropubic prostatectomy: a 3-year experience. Prostate Cancer Prostatic Dis 2007; 11:74-8. [PMID: 17440438 DOI: 10.1038/sj.pcan.4500969] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A modified Pfannenstiel approach for radical retropubic prostatectomy (RRP) has been described previously. We present our experience with this approach for performing a RRP over the past 3 years. Between January 2003 and July 2006, 544 consecutive RRPs by modified Pfannenstiel approach between January 2003 and July 2006 were performed. We analyzed blood loss, transfusions, use of drain, pain score, analgesia and hospital stay. Patients were followed up at 6 weeks, three monthly for a year and six monthly thereafter. All clinical and operative variables were entered into a database and analyzed. A total of 544 men underwent RRP with median follow-up of 11 (s.d.+/-10.5) months. The mean age was 60 (s.d.+/-7) years. About 83, 91 and 95% of patients had nerve sparing, bladder neck preservation and a lymph node dissection, respectively. Fifty-three patients had a concurrent inguinal hernia repair through the same incision. Mean estimated blood loss was 431 (s.d.+/-267) ml. The pathological staging distribution was T2, 82%; T3a, 9%; and T3b, 9%. The mean pain score at days 1 and 7 were 3.7 (s.d.+/-2.5) and 3.3 (s.d.+/-3), respectively. The median hospital stay was 36 h (s.d.+/-24). About 5.5% have had biochemical recurrence. At 12 months 97% were continent and 46% potent. RRP using a modified Pfannenstiel approach offers safety and efficacy. It facilitates repair of associated inguinal hernia through the same incision.
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Ayyathurai R, Manoharan M, Nieder AM, Soloway MS. 558: Factors Affecting Potency Following Radical Retropubic Prostatectomy: Results from 1620 Consecutive Patients. J Urol 2007. [DOI: 10.1016/s0022-5347(18)30798-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Luongo T, Ayyathurai R, Nieder AM, Manoharan M, Soloway MS. 1665: Lymphovascular Invasion in Bladder Cancer - Is it an Important Prognostic Indicator? J Urol 2007. [DOI: 10.1016/s0022-5347(18)31853-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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