Year : 2018 | Volume
: 34 | Issue : 4 | Page : 239--240
Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
Department of Urology, Christian Medical College, Vellore, Tamil Nadu
|How to cite this article:|
Kumar S. What's inside.Indian J Urol 2018;34:239-240
|How to cite this URL:|
Kumar S. What's inside. Indian J Urol [serial online] 2018 [cited 2019 Feb 18 ];34:239-240
Available from: http://www.indianjurol.com/text.asp?2018/34/4/239/242481
Tadalafil and Human Ureter
There has been a controversy on the role of smooth muscle relaxants to aid the passage of small ureteric stones. Tamsulosin is the most commonly used drug. However, the density of alpha receptors is maximum in the lower ureter thus precluding its use in upper- and mid-ureteric stones. There is emerging evidence of the use of tadalafil for medical expulsion therapy. In an experimental study on the effect of tadalafil on fresh human ureters from nephrectomy specimens, Sakthivel et al. have shown that tadalafil causes ureteric muscle relaxation and the effect of the same is not dose dependent.
Direct Visualization of Reservoir Placement for Penoscrotal Inflatable Penile Prostheses
Roth et al. describe a modified technique helping in direct visualization of the reservoir placement in patients undergoing inflatable penile prosthesis. They recommend using a Deaver retractor lateral to the penis and over the pubic bone to retract and incise the fascia under vision and then create a space using blunt dissection between the bladder and the pubic bone. The technique is claimed to be quick, safe and effective.
Restage Transurethral Resection for Bladder Tumors
Bladder tumors are one of the costliest tumors to treat due to the risk of recurrence and progression with the need for frequent follow-up with cystoscopy and cytology. Restaging transurethral resection of bladder tumor (TURBT) adds to the cost and is recommended in all patients with T1 and high-grade tumors, to avoid understaging. In a prospective study, Manoharan et al. critically looked at the utility of restage TURBT. About 32% had tumor at restage TURBT with 6% having T2 disease (understaged at first TURBT). Presence of solid tumor, multiple tumors, absence of muscle in the initial TURBT, and place of initial TURBT were risk factors identified. The risk of recurrence and progression was higher in patients who had tumor at restage TURBT.
Urodynamic Profile Postposterior Urethral Valve Fulguration
Many factors predict the overall risk of poor prognosis in patients with posterior urethral valve (PUV). Voiding dysfunction postvalve fulguration has detrimental effect on the upper tract. Mallya et al. in a study looked at the age of PUV fulguration and its relation to development of bladder dysfunction. They found that boys with valve fulguration at <2 years had better urodynamic profiles than those with fulguration after 2 years of age. Delay in fulguration increases the incidence of bladder and renal dysfunction.
Outcome of Treatment for High-Risk Prostate Cancer
Radical prostatectomy for organ-localized prostate cancer has raised more questions than answers. Patients with localized high-risk disease should benefit the most if surgery could cure this disease. Bijalwan et al. looked at the outcome of radical prostatectomy in high-risk prostate cancer in Indian patients. With a mean follow-up of 21 months, the 2- and 5-year biochemical recurrence-free survival (BRFS) was 45% and 35%. The BRFS as even less depending on the number of high-risk factors positive (1–3) as per the D'Amico classification. They conclude that localized high-risk prostate cancer is a heterogeneous group and should be substratified depending on the number of high-risk factors to prognosticate and plan further adjuvant treatment.
Role of Xpert Assay in Urinary Tuberculosis
A century after, it was proved by Robert Koch that tuberculosis (TB) is caused by a bacterium; we still struggle to prove bacteriological evidence in a given patient. Diagnosis of extrapulmonary tuberculosis is, even more, a challenge due to the paucibacillary nature of the specimens. Although the cartridge-based nucleic acid amplification test was endorsed by the WHO in 2010, there are few studies of its role in urinary tuberculosis. Samuel et al. prospectively studied the accuracy of Xpert assay to diagnose urinary tuberculosis compared to a composite gold standard. It could replace microscopy for screening and had a moderate sensitivity of 70% and a specificity of 100%.
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Conflicts of interest
There are no conflicts of interest.
|1||Sakthivel MS, Prabha R, Singh O, Kekre NS, Kumar S. The effect of phosphodiesterase-5 inhibitor, tadalafil, on in vitro potassium chloride-induced contractions of isolated human ureteral tissue. Indian J Urol 2018;34:287-91.|
|2||Roth JD, Monn MF, Shelton TM, Mellon MJ. A novel technique for direct visualization of reservoir placement for penoscrotal inflatable penile prostheses using a single incision. Indian J Urol 2018;34:283-6.|
|3||Manoharan V, Mavuduru RS, Kumar S, Kakkar N, Devana SK, Bora GS, et al. Utility of restage transurethral resection of bladder tumor. Indian J Urol 2018;34:273-7.|
|4||Mallya A, Karthikeyan VS, Vijayganapathy S, Poonawala A, Keshavamurthy R. Urodynamic profile in posterior urethral valve patients following fulguration: Does age at fulguration matter? Indian J Urol 2018;34:278-82.|
|5||Bijalwan P, Pooleri GK, Kalavampara SV, Bhat S, Thomas A, Sundar P, et al. Pathological outcomes and biochemical recurrence-free survival after radical prostatectomy for high-risk prostate cancer in the Indian population. Indian J Urol 2018;34:260-7.|
|6||Samuel BP, Michael JS, Chandrasingh J, Kumar S, Devasia A, Kekre NS. Efficacy and role of Xpert®Mycobacterium tuberculosis/rifampicin assay in urinary tuberculosis. Indian J Urol 2018;34:268-72.|