Urologic Clinics of North America
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Integration of surgery and systemic therapy for renal cell carcinoma.
Proper integration of surgery and systemic therapy is essential for improving outcomes in renal cell carcinoma (RCC). There is no current role for adjuvant therapy after nephrectomy for clinically localized disease. The potential benefits of neoadjuvant therapy for locally advanced n...
Management goals for the spina bifida neurogenic bladder: a review from infancy to adulthood.
Patients with spina bifida require longitudinal urological care as they transition from childhood to adolescence and then to adulthood. Issues important to urological health, such as protection of the upper tracts and prevention of incontinence, need vigilant follow-up throughout the patient's life....
Hypospadias: etiology and current research.
Hypospadias is one of the most common congenital defects in humans. The molecular events required in the genitourinary tract for normal development of the external genitalia are just beginning to be elucidated. Identifying the cause of hypospadias may be relevant not only in the fiel...
Treatment strategy for the adolescent varicocele.
A varicocele is a dilatation of the testicular vein and the pampiniform venous plexus within the spermatic cord. Although rare in pediatric populations, the prevalence of varicoceles markedly increases with pubertal development. Varicoceles are progressive lesions that may hinder tes...
Hemostatic agents and tissue glues in urologic injuries and wound healing.
Biosurgical preparations designed to promote surgical hemostasis and tissue adhesion are now available to the urologist and are increasingly being used across all surgical disciplines. Fibrin sealant and gelatin thrombin matrix are the two most widely used bio-surgical adjuncts in urology. Complex r...
Management of pyelonephritis and upper urinary tract infections.
The most frequent cause of upper urinary tract infection remains E. coli. Other organisms are found in complicated infections associated with diabetes mellitus, instrumentation, stone, and immunosuppression. The pathogenesis of acute pyelonephritis is reviewed herein, with an emphasis on the virulen...
Urinary tract infections in pregnancy.
Although pregnancy does not increase the prevalence of ASB in women, it does enhance the progression rate from asymptomatic to symptomatic disease. Furthermore, ASB is associated with preterm delivery. Given the fact that identification and eradication of ASB in pregnant women can lower the likeliho...
Ureteropelvic junction obstruction in children. Unique considerations for open operative intervention.
The treatment of UPJ obstruction in children should be approached in a fashion that recognizes the differences between children and adults. Radiographic definition of the urinary tract is different in children than in adults because of the size of the child and technical difficulties with instrument...
Stomal construction, complications, and reconstruction.
This article reviews stomal complications and their management. To accomplish this goal, the authors review techniques used for planning and creating the stomas for both continent reservoirs and incontinent conduits.
Supracostal approach for percutaneous ultrasonic lithotripsy.
The supracostal approach to renal access for ultrasonic lithotripsy continues to be used with good results at The Oregon Health Sciences University when indicated, because it provides better access to much of the kidney collecting system and proximal ureter. The complication rate is acceptably low i...