European urology
-
Knowledge regarding the lymphatic drainage pattern of penile cancer is the basis for the extent of inguinal lymph node dissection for this disease. ⋯ All sentinel and higher-tier nodes were located in the superior and central inguinal zones and the pelvic region. No lymphatic drainage to the inferior inguinal zones was seen. This suggests that the extent of inguinal node dissection in cN0 patients could be reduced to removal of the superior and central inguinal zones. This may decrease the extensive morbidity associated with this procedure.
-
Neuroanatomical and lesion studies have identified lumbar spinothalamic (LSt) neurons to be essential for ejaculation, but their precise role remains elusive. ⋯ Electrical microstimulation of LSt neurons activates the entire sequence of ejaculation in rats in a coordinated fashion, ie the emission (SV/VD contraction) followed by expulsion (rhythmic BSM contractions) of living spermatozoa. Midcourse interruption of ejaculation following intraspinal muscimol injection establishes that LSt neurons are the SGE. This could help to identify spinal pharmacological targets for the treatment of ejaculatory disorders and provide the rationale for intraspinal stimulation to treat anejaculation in infertile spinal cord injured (SCI) patients.
-
Review
Laparoscopic and robotic assisted radical cystectomy for bladder cancer: a critical analysis.
Interest in laparoscopic assisted radical cystectomy (LRC) and robotic assisted radical cystectomy (RRC) is increasing at select centers worldwide. In this update we present the recent worldwide experience and critically evaluate the role of minimally invasive radical surgery for patients with bladder cancer. ⋯ LRC or RRC with extracorporeally constructed urinary diversion is a safe and effective operation for appropriate patients with bladder cancer. Perioperative and functional outcomes are comparable with open surgery. More focus on extended lymphadenectomy is necessary to routinely achieve higher node yields. Surrogate and intermediate oncological outcomes are encouraging, and long-term assessment is ongoing.
-
To aid clinicians in selecting an outcome measure for the assessment of urinary incontinence (UI), from the perspective of both scientific rigour and clinical utility. ⋯ To elevate the level of outcome assessment for UI to meet that of other urology specialties, it is necessary to reconcile the realities of clinical practice with the scientific rigour of UI research, and to mainstream outcome measures that are reciprocally translatable between the two settings.