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Krughoff K, Livingston AJ, Inouye B, Peterson AC, Lentz AC. Indications and Outcomes for Intermittent Catheterization following Bulbar AUS Cuff Placement. Urology 2023; 171:216-220. [PMID: 36332702 DOI: 10.1016/j.urology.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the functional and surgical impact of CIC protocols in men with a bulbar AUS in place. Stress urinary incontinence (SUI) and poor bladder emptying are both sequelae of prostate cancer treatment, though there is sparse data to guide concomitant management. The safety of intermittent catheterization (CIC) in men with an artificial urinary sphincter (AUS) at the bulbar urethra remains unclear. METHODS We performed a retrospective review of all bulbar urethral AUS procedures at our institution. Inclusion criteria were patients with a history of prostate cancer treatment, AUS placement for SUI, and a history of CIC before and/or after AUS placement. All eligible cases were retrospectively reviewed. Surgical and continence outcomes were analyzed. RESULTS A total of 57 patients were identified with a history of CIC and AUS placement under the care of two surgeons. Eighteen continued to perform CIC or first initiated CIC after AUS placement and 39 discontinued CIC prior to AUS placement. The incidence of erosion was no different amongst patients who continued or discontinued CIC after AUS placement (17.9% vs 22.2%, P = .79). There was no difference in future AUS removal or replacement (56.4% vs 44.4%, P = .41). Both groups experienced improvement in urinary incontinence after placement of an AUS. CONCLUSION Bulbar AUS placement in the setting of continuous intermittent catheterization can be considered in patients who are not surgical candidates for definitive treatment of their outlet obstruction.
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Affiliation(s)
| | - Austin J Livingston
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Brian Inouye
- Division of Urology, Department of Surgery, Albany Medical College, Albany, NY
| | - Andrew C Peterson
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Aaron C Lentz
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC
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2
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Johnson BE, Morey AF. Surgical Management of Male Stress Urinary Incontinence: Artificial Urinary Sphincter Versus Male Slings. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-022-00349-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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3
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Artificial Urinary Sphincter Considerations in Men With Prior Inflatable Penile Prosthesis Placement. J Sex Med 2022; 19:1495-1498. [DOI: 10.1016/j.jsxm.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/06/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
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4
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Diao L, Nealon SW, Carpinito GP, Badkhshan S, Wolfe AR, Dropkin BM, Sanders SC, Hudak SJ, Morey AF. Presenting signs and symptoms of artificial urinary sphincter cuff erosion. Int Braz J Urol 2022; 48:679-685. [PMID: 35503704 PMCID: PMC9306375 DOI: 10.1590/s1677-5538.ibju.2022.0089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/04/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To characterize the most common presentation and clinical risk factors for artificial urinary sphincter (AUS) cuff erosion to distinguish the relative frequency of symptoms that should trigger further evaluation in these patients. Materials and Methods We retrospectively reviewed our tertiary center database to identify men who presented with AUS cuff erosion between 2007 – 2020. A similar cohort of men who underwent AUS placement without erosion were randomly selected from the same database for symptom comparison. Risk factors for cuff erosion – pelvic radiation, androgen deprivation therapy (ADT), high-grade prostate cancer (Gleason score ≥ 8) – were recorded for each patient. Presenting signs and symptoms of cuff erosion were grouped into three categories: obstructive symptoms, worsening incontinence, and localized scrotal inflammation (SI). Results Of 893 men who underwent AUS placement during the study interval, 61 (6.8%) sustained cuff erosion. Most erosion patients (40/61, 66%) presented with scrotal inflammatory changes including tenderness, erythema, and swelling. Fewer men reported obstructive symptoms (26/61, 43%) and worsening incontinence (21/61, 34%). Men with SI or obstructive symptoms presented significantly earlier than those with worsening incontinence (SI 14 ± 18 vs. obstructive symptoms 15 ± 16 vs. incontinence 37 ± 48 months after AUS insertion, p<0.01). Relative to the non-erosion control group (n=61), men who suffered erosion had a higher prevalence of pelvic radiation (71 vs. 49%, p=0.02). Conclusion AUS cuff erosion most commonly presents as SI symptoms. Obstructive voiding symptoms and worsening incontinence are also common. Any of these symptoms should prompt further investigation of cuff erosion.
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Affiliation(s)
- Linley Diao
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Samantha W Nealon
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Gianpaolo P Carpinito
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Shervin Badkhshan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Avery R Wolfe
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Benjamin M Dropkin
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sarah C Sanders
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Steven J Hudak
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Allen F Morey
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Bole R, Hebert KJ, Gottlich HC, Bearrick E, Kohler TS, Viers BR. Narrative review of male urethral sling for post-prostatectomy stress incontinence: sling type, patient selection, and clinical applications. Transl Androl Urol 2021; 10:2682-2694. [PMID: 34295753 PMCID: PMC8261433 DOI: 10.21037/tau-20-1459] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Male stress urinary incontinence (SUI) following prostate treatment is a devastating complaint for many patients. While the artificial urinary sphincter is the gold standard treatment for male SUI, the urethral sling is also popular due to ease of placement, lack of mechanical complexity, and absence of manual dexterity requirement. A literature review was performed of male urethral sling articles spanning the last zz20 years using the PubMed search engine. Clinical practice guidelines were also reviewed for comparison. Four categories of male urethral sling were evaluated: the transobturator AdVance and AdVance XP, the bone-anchored InVance, the quadratic Virtue, and the adjustable sling series. Well selected patients with mild to moderate urinary incontinence and no prior history of radiation experienced the highest success rates at long-term follow up. Patients with post-prostatectomy climacturia also reported improvement in leakage after sling. Concurrent penile prosthesis and sling techniques were reviewed, with favorable short-term outcomes demonstrated. Male urethral sling is a user-friendly surgical procedure with durable long-term outcomes in carefully selected men with mild stress urinary incontinence. Multiple sling types are available with varying degrees of efficacy and complication rates. Longer follow-up and larger cohort sizes are needed for treatment of newer indications such as climacturia as well as techniques involving dual placement of sling and penile prosthesis.
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Affiliation(s)
- Raevti Bole
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Boyd R Viers
- Department of Urology, Mayo Clinic, Rochester, MN, USA
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Wolfe AR, Ortiz NM, Baumgarten AS, VanDyke ME, West ML, Dropkin BM, Joice GA, Sanders SC, Hudak SJ, Morey AF. Most men with artificial urinary sphincter cuff erosion have low serum testosterone levels. Neurourol Urodyn 2021; 40:1035-1041. [PMID: 33792973 DOI: 10.1002/nau.24663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/11/2022]
Abstract
AIMS To evaluate the relationship between serum testosterone (T) levels and artificial urinary sphincter (AUS) cuff erosion in a population of incontinent men who underwent AUS placement. METHODS A retrospective analysis of our single-surgeon AUS database was performed to identify men with T levels within 24 months of AUS placement. Men were stratified into two groups based on serum testosterone: low serum testosterone (LT) (<280 ng/dl) and normal serum testosterone (NT) (>280 ng/dl). Multivariable analysis was performed to control for risk factors. The outcome of interest was the incidence of and time to spontaneous urethral cuff erosion; other risk factors for cuff erosion were also evaluated. RESULTS Among 161 AUS patients with serum testosterone levels, 84 (52.2%) had LT (mean: 136.8 ng/dl, SD: 150.4 ng/dl) and 77 (47.8%) had NT (mean: 455.8 ng/dl, SD: 197.3 ng/dl). Cuff erosion was identified in 42 men (26.1%) at a median of 7.1 months postoperatively (interquartile range: 3.6-13.4 months), most of whom (30/42, 71.4%) were testosterone deficient. LT levels were less common (54/119, 45.4%) in the non-erosion cohort (p = 0.004). Men with low T were nearly three times as likely to suffer AUS erosion than men with normal T (odds ratio = 2.519, p = 0.021). LT level was the only factor associated with AUS erosion on multivariable analysis. CONCLUSIONS LT is an independent risk factor for AUS cuff erosion. Men with LT are more likely to present with cuff erosion, but there is no difference in time to erosion.
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Affiliation(s)
- Avery R Wolfe
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nicolas M Ortiz
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Adam S Baumgarten
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Maia E VanDyke
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Mary L West
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Benjamin M Dropkin
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Gregory A Joice
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sarah C Sanders
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Steven J Hudak
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Allen F Morey
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Khouri RK, Ortiz NM, Dropkin BM, Joice GA, Baumgarten AS, Morey AF, Hudak SJ. Artificial Urinary Sphincter Complications: Risk Factors, Workup, and Clinical Approach. Curr Urol Rep 2021; 22:30. [PMID: 33779844 DOI: 10.1007/s11934-021-01045-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To review risk factors for AUS complications and present a systematic approach to their diagnosis and management. RECENT FINDINGS Established risk factors for AUS complications include catheterization, channel TURP, pelvic radiation, urethroplasty, anticoagulation, cardiovascular disease, diabetes mellitus, frailty index, hypertension, low albumin, and low testosterone. We present our algorithm for diagnosis and management of AUS complications. Despite being the gold standard of treatment for men with SUI, major and minor complications can occur at any point after AUS insertion. Careful consideration of the urologic, medical, and operative risk factors for each patient can help prevent complications. A systematic approach to early and late complications facilitates their identification and effective management. The evaluating urologist must have a thorough understanding of potential AUS complications in order to restore quality of life in men with bothersome SUI.
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Affiliation(s)
- Roger K Khouri
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA
| | - Nicolas M Ortiz
- Department of Urology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Benjamin M Dropkin
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA
| | - Gregory A Joice
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA
| | - Adam S Baumgarten
- Department of Urology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Allen F Morey
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA
| | - Steven J Hudak
- Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110, USA.
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Carvajal A, Benavides J, García-Perdomo HA, Henry GD. Risk factors associated with penile prosthesis infection: systematic review and meta-analysis. Int J Impot Res 2020; 32:587-597. [PMID: 32015525 DOI: 10.1038/s41443-020-0232-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 12/28/2019] [Accepted: 01/17/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE The aim of this study was to identify the factors associated with infection in patients who undergo penile prosthesis implantation. METHODS We performed a systematic review/meta-analysis, including clinical trials, quasi-experiments, retrospective and prospective cohort studies, and case-control studies. Searching was done in CENTRAL, MEDLINE, and EMBASE databases. Participants were patients who had erectile dysfunction, regardless of the etiology, and underwent penile prosthesis implantation. Two researchers reviewed each reference by title and abstract. The statistical analysis was performed using Review Manager 5.3 (RevMan® 5.3). RESULTS A total of 513 studies were found with the search strategies. After excluding duplicates, 40 studies with a total of 175,592 patients were included in the qualitative and quantitative analysis. Among patient characteristics, we found that diabetes mellitus and immunosuppression appear to have increase odds of infection. Related to the procedure, infection-retardant-coated penile prosthesis and primary (first) surgery appear to lower odds of infection. CONCLUSIONS Diabetes mellitus and immunosuppression were associated with increased infection rates; infection-retardant coating of the prosthesis and primary surgery were associated with reduced infection rates.
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Affiliation(s)
- Alejandro Carvajal
- Department of Urologic Surgery and Andrology, CES University, Medellin, Colombia
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9
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Loh-Doyle JC, Nazemi A, Ashrafi A, Doumanian LR, Ginsberg DA, Boyd SD. Predictors of Device-related Complications After Exchange of the Pressure-regulating Balloon in Men With an Artificial Urinary Sphincter. Urology 2020; 135:154-158. [DOI: 10.1016/j.urology.2019.09.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 11/16/2022]
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10
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Impact of previous urethroplasty on the outcome after artificial urinary sphincter implantation: a prospective evaluation. World J Urol 2019; 38:183-191. [DOI: 10.1007/s00345-019-02756-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/02/2019] [Indexed: 10/27/2022] Open
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Abstract
PURPOSE OF REVIEW After radical cystoprostatectomy, patients often develop erectile dysfunction refractory to first- and second-line treatments. In this review, we summarize and analyze the literature describing the technical considerations and outcomes of penile implant surgery in bladder cancer patients with history of radical cystectomy and urinary diversion. RECENT FINDINGS Penile prosthesis surgery in patients after radical cystectomy and urinary diversion has been infrequently described in the literature. Recent studies have shown that the three-piece inflatable penile prosthesis can be placed safely after significant prior intraabdominal surgery due to the development and refinement of several techniques to place the reservoir. Further studies are needed to objectively determine the impact of penile prosthetic surgery on functional outcomes in this historically undertreated yet increasingly significant patient population. As health-related quality of life outcomes continue to gain increasing importance after radical cystectomy, urologists should offer motivated bladder cancer survivors the inflatable penile prosthesis as the treatment of choice for refractory erectile dysfunction due to its safety and unmatched ability to restore erectile function.
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Affiliation(s)
- Jeffrey C Loh-Doyle
- Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA, 90089-9178, USA.
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12
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Loh-Doyle JC, Ashrafi A, Nazemi A, Ghodoussipour S, Thompson E, Wayne K, Boyd SD. Dual Prosthetic Implantation After Radical Cystoprostatectomy and Neobladder: Outcomes of the Inflatable Penile Prosthesis and Artificial Urinary Sphincter in Bladder Cancer Survivors. Urology 2019; 127:127-132. [PMID: 30664894 DOI: 10.1016/j.urology.2019.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 01/08/2019] [Accepted: 01/12/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To determine the impact of radical cystectomy and orthotopic neobladder (NB) diversion on device-related outcomes in patients who undergo subsequent placement of both, an artificial urinary sphincter (AUS) and 3-piece inflatable penile prosthesis. MATERIALS AND METHODS Using an institutional prosthetic database, we identified 39 patients who underwent radical cystectomy and NB and subsequent implantation of both prosthetic devices from 2003 to 2017. Patient demographics, perioperative data, and postoperative outcomes including prosthetic infection, mechanical failure, revision surgery, and functional outcomes were examined and compared to an appropriate matched group of patients (n = 48, non-neobladder group). RESULTS No intraoperative complications were observed. After median follow-up of 94 months (12-177 months), 1 patient developed an infection of their penile prosthesis and 4 patients developed an erosion of their AUS. In each case, the infection did not involve the other device. Two patients required revision surgery of their penile prosthesis due to mechanical failure (reservoir leak, n = 1; cylinder aneurysm, n = 1). Twenty-one patients underwent elective revision surgery to improve continence (cuff downsizing, n = 18; pressure-regulating balloon exchange, n = 3). There were 6 cases of AUS mechanical failure. No reservoir-related complications such as herniation or erosion were observed. Compared to the control group of non-neobladder patients, there were no significant differences in prosthetic infection, mechanical failure, and revision surgery. CONCLUSION The AUS and 3-piece inflatable penile prosthesis can coexist safely in patients with NB without an increased risk of device-related complications.
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Affiliation(s)
- Jeffrey C Loh-Doyle
- USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Akbar Ashrafi
- USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Azadeh Nazemi
- USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Saum Ghodoussipour
- USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Eli Thompson
- USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Kevin Wayne
- USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Stuart D Boyd
- USC Institute of Urology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
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13
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Abstract
Background We observed that patients with hypogonadism are at higher risk to experience artificial urinary sphincter cuff erosion. Sphincter erosions have been found to be associated with urethral atrophy or compromised urethras subsequent to events limiting its blood supply. We therefore analyzed possible mechanisms how a decrease in testosterone serum levels can result decreased urethral blood flow. Methods In a cohort of >1,200 urethroplasties, tissue specimens obtained during surgeries were analyzed for expression of androgen receptor (AR), AR-responsive TIE-2 associated with angiogenesis, and the endothelial cell marker CD31 for determination of vessel counts were analyzed immunohistochemically. A total of 11 patients were included in whom both tissue and serum testosterone levels within 2 years of the urethroplasty was available. Low serum testosterone level defined as <280 ng/dL. Image J software was used to analyze expression profiles. Results Mean serum testosterone level was significant lower in hypogonadal patients (179.4 ng/dL) compared to eugonadal patients (375.0 ng/dL, P=0.003). Urethral tissue of hypogonadal patients showed decreased AR expression [1.11% high power field (HPF)] compared to eugonadal patients (1.62%, P=0.016), decreased TIE-2 expression (1.84% HPF vs. 3.08%, P=0.006), and also decreased vessel counts (44.47 vessels/HPF vs. 98.33, P=0.004). There was a direct correlation of AR and TIE-2 expression levels with serum testosterone levels (rho 0.685, P=0.029, and rho 0.773, P=0.005, respectively). Of note, we did not detect a difference in age, prior radiation, coronary artery disease or hypertension among hypo- or eugonadal patient. However, higher body mass index was associated with low serum testosterone levels. Conclusions Hypogonadal status is associated with decreased expression of AR and TIE-2 and also reduced vessel count in urethral tissue. We believe that the resulting decreased urethral vascularity subsequent to a hypogonadal state may be an important risk factor for complications of urethral surgery.
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Affiliation(s)
- Matthias D Hofer
- Department of Urology, Northwestern University, Chicago, IL, USA
| | - Allen F Morey
- Department of Urology, UT Southwestern, Dallas, TX, USA
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Kaufman MR, Milam DF, Johnsen NV, Cleves MA, Broghammer JA, Brant WO, Jones LA, Brady JD, Gross MS, Henry GD. Prior Radiation Therapy Decreases Time to Idiopathic Erosion of Artificial Urinary Sphincter: A Multi-Institutional Analysis. J Urol 2018; 199:1037-1041. [DOI: 10.1016/j.juro.2017.11.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2017] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | - Mario A. Cleves
- University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Kretschmer A, Nitti V. Surgical Treatment of Male Postprostatectomy Incontinence: Current Concepts. Eur Urol Focus 2017; 3:364-376. [DOI: 10.1016/j.euf.2017.11.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 11/12/2017] [Accepted: 11/16/2017] [Indexed: 10/18/2022]
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16
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Hofer MD, Kapur P, Cordon BH, Hamoun F, Russell D, Scott JM, Roehrborn CG, Morey AF. Low Testosterone Levels Result in Decreased Periurethral Vascularity via an Androgen Receptor-mediated Process: Pilot Study in Urethral Stricture Tissue. Urology 2017; 105:175-180. [DOI: 10.1016/j.urology.2017.02.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/15/2017] [Accepted: 02/18/2017] [Indexed: 01/07/2023]
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17
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Hofer MD, Morey AF. Reply by the Authors. Urology 2017; 101:176-177. [DOI: 10.1016/j.urology.2016.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 12/21/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022]
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18
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Aydogdu O, Bozkurt IH, Yonguc T. Re: Hofner et al.: Low Serum Testosterone Level Predisposes to Artificial Urinary Sphincter Cuff Erosion (Urology 2016;97:245-249). Urology 2016; 101:175-176. [PMID: 28024964 DOI: 10.1016/j.urology.2016.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 12/14/2016] [Accepted: 12/14/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Ozgu Aydogdu
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | | | - Tarik Yonguc
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
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