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Current Trends...FYI Did You Know
1. For patients with asymptomatic microhematuria, renal ultrasound and cystoscopy are recommended for the first diagnostic survey of patients with unexplained microhematuria, and subsequent diagnostic studies are recommended only for symptomatic patients.
2. None of the present antibiotics on the market are approved for single dose therapy for urinary tract infections (UTIs); however, the fluoroquinones are very effective with three-day treatment of uncomplicated UTIs in women.
3. Renography is recommended for stones larger than 5 mm, for stones in the middle and upper ureters, and for patients discharged with stones in situ.
4. CT is better in diagnosing blunt renal trauma than MRI or ultrasound. Penetrating injuries, active hemorrhage, or major tissue destruction are reasons for mandatory renal exploration.
5. In pregnant women with acute ureteric obstruction, the use of a double-pigtail stent allows the pregnancy to continue without the need for external drainage and the risk of infection.
6. Immunotherapy with intravesical Bacillus Calmette-Guerin has been remarkably successful in the treatment of superficial bladder tumors.
7. Prostatic intraepithelial neoplasia (PIN) is a premalignant change in the human prostate. When grade 2 or 3 PIN is found on needle biopsy of the prostate, repeat biopsy should be performed due to the high rate of flank cancer detected on subsequent ultrasound-guidance needle biopsy of the prostate (approximately 60%).
8. The pregnancy rate after vasectomy is inversely related to the duration of the obstructive interval. There is no magic cut off for performing a vas reversal. The pregnancy rate varies from 30 -70% using microscopic techniques.
9. Heterosexual transmission of HIV appears to be affected by the frequency of intercourse and the use of condoms. Anal sex is an important mechanism of HIV transmission. The woman's awareness of her partner's seropositivity is an important preventive factor. Oral contraceptives may decrease risk whereas use of an intrauterine device appears to increase risk.
10. Treatment of chronic testis pain (orchialgia) is best managed by a multidisciplinary approach involving a urologist and a pain-clinic environment.
11. "Nitric-oxide" has been discovered as a relaxing substance as well as a neurotransmitter causing relaxation of smooth muscle of the corpus cavernosum in the penis, which may eventually result in improved therapy for impotence.
12. Color-coded duplex sonography is an excellent diagnostic modality for the differential diagnosis of torsion of the spermatic cord (testis). It should significantly reduce the number of patients who require exploratory surgery to diagnose scrotal pain.
13. Children who have undergone a ureterosigmoidoscopy for exstrophy are at risk for subsequent development of a malignant tumor at the ureterocolic anastomosis. Annual colonoscopy should be performed on these patients.
14. For patients with invasive bladder cancer that requires surgical removal of the bladder, new forms of urinary diversion are available that do not require the wearing of a urinary appliance (bag, i.e., continent urinary diversions).
15. The source of elevated blood pressure is often the kidney and adrenals. When empiric therapy for essential hypertension fails, consult your urologist. |
