Indian Journal of Urology (Indian J Urol )

Publisher: Urological Society of India, Medknow Publications


The Indian Journal of Urology-IJU is the official publication of the Urological Society of India.

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  • Website
    Indian Journal of Urology website
  • Other titles
    Indian journal of urology (online), IJU
  • ISSN
  • OCLC
  • Material type
    Periodical, Internet resource
  • Document type
    Internet Resource, Journal / Magazine / Newspaper

Publisher details

Medknow Publications

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Non-commercial
    • Publisher's version/PDF may be used
    • Creative Commons Attribution Non-Commercial Share Alike License
    • Published source must be acknowledged
    • All titles are open access journals
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Urinary continence is an important outcome parameter after robot assisted radical prostatectomy (RARP). We evaluated the continence outcomes following RARP using a double-layered urethrovesical reconstruction.
    Indian Journal of Urology 10/2014; 30(4):374-7.
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    ABSTRACT: The common sites of metastasis from a urinary bladder carcinoma include lymph nodes, bones, lung, liver, and peritoneum. Only a few cases of small bowel metastasis from urinary bladder malignancy have been reported in the English literature. Only one of these cases presented with bowel intussusception. We report a case of an adult small bowel intussusception due to metastasis from a urinary bladder carcinoma which is extremely rare as small bowel metastasis occur mostly from breast, lungs or melanomas.
    Indian Journal of Urology 10/2014; 30(4):445-7.
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    ABSTRACT: Positive surgical margins (PSM) at the time of radical prostatectomy (RP) result in an increased risk of biochemical recurrence (BCR) and secondary treatment. We review current literature with a focus on stratifying the characteristics of the PSM that may define its significance, the impact of modern imaging and surgical approaches in avoidance of PSM, and management strategies when PSM do occur. We performed a review of the available literature to identify factors associated with PSM and their management. PSM have been repeatedly demonstrated to be associated with an increased risk of BCR following RP. The specific characteristics (size, number, location, Gleason score at the margin) of the PSM may influence the risk of recurrence. Novel imaging and surgical approaches are being investigated and may allow for reductions of PSM in the future. The use of adjuvant treatment for a PSM remains controversial and should be decided on an individual basis after a discussion about the risks and benefits. The goal of RP is complete resection of the tumor. PSM are associated with increased risk of BCR and secondary treatments. Of the risk factors associated with BCR after RP, a PSM is directly influenced by surgical technique.
    Indian Journal of Urology 10/2014; 30(4):423-8.
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    ABSTRACT: We hypothesized that there is a reverse stage migration, or a shift toward operating on higher-risk prostate cancer, in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). We therefore evaluated the stage of disease at the time of surgery for patients with prostate cancer at a large tertiary academic medical center.
    Indian Journal of Urology 10/2014; 30(4):378-82.
  • Indian Journal of Urology 10/2014; 30(4):365.
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    ABSTRACT: Ovarian vein syndrome is defined as obstructive uropathy caused by dilated ovarian vein with or without thrombosis. This is seen in the puerperal period as an acute condition with abdominal pain and fever and in multipara women with chronic recurrent abdominal pain. We report an ovarian vein syndrome caused by a true vascular anomaly in an 8-year-old child. Laparoscopic ureterolysis was performed with ligation of the arteriovenous malformation during the first operation. As ureterolysis was not effective, the patient was reoperated and ureteroureterostomy was performed after 3 months, which emphasizes the importance of removing the diseased segment even if it looks normal.
    Indian Journal of Urology 10/2014; 30(4):448-9.
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    ABSTRACT: Radical prostatectomy is a leading form of treatment for non metastatic prostate cancer. It has been shown to improve survival in the long term as well as delay or prevent the onset of metastatic disease. However, as the treatment of metastatic prostate cancer has evolved in the last few years with the introduction of newer agents, the possible role of 'cytoreductive' radical prostatectomy is now being explored. Preliminary evidence suggests that radical prostatectomy may have a future role in this clinical scenario with a potential to improve quality and quantity of life in selected patients with metastatic disease.
    Indian Journal of Urology 10/2014; 30(4):366-7.
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    ABSTRACT: Ureteritis cystica (UC) is a benign condition. Although it can often be diagnosed with imaging techniques, we report a case of a child for whom we planned nephrectomy and ureteral augmentation cystoplasty, but abandoned the cystoplasty due to extensive UC in the ureter.
    Indian Journal of Urology 10/2014; 30(4):443-4.
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    ABSTRACT: We aimed to evaluate the role of robot-assisted radical prostatectomy (RARP) in the management of high-risk prostate cancer (PCa), with a focus on oncological, functional and perioperative outcomes. Further, we also aimed to briefly describe our novel modification to conventional RARP that allows immediate organ retrieval and examination for intra-operative surgical margin assessment. A literature search of PubMed was performed for articles on the management of high-risk PCa. Papers written in English and concerning clinical outcomes following RARP for locally advanced and high-risk PCa were selected. Outcomes data from our own center were also included. A total of 10 contemporary series were evaluated. Biopsy Gleason score ≥ 8 was the most common cause for classification of patients into the high-risk PCa group. Biochemical failure rate, in the few series that looked at long-term follow-up, varied from 9% to 26% at 1 year. The positive surgical margin rate varied from 12% to 53.3%. Urinary continence rates varied from 78% to 92% at 1 year. The overall complication rates varied from 2.4% to 30%, with anastomotic leak and lymphocele being the most common complications. Long-term data on oncological control following RARP in high-risk patients is lacking. Short-term oncological outcomes and functional outcomes are equivalent to open radical prostatectomy (RP). Safety outcomes are better in patients undergoing RARP when compared with open RP. Improved tools for predicting the presence of organ-confined disease (OCD) are available. High-risk patients with OCD would be ideal candidates for RARP and would benefit most from surgery alone.
    Indian Journal of Urology 10/2014; 30(4):410-7.
  • Indian Journal of Urology 10/2014; 30(4):398.
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    ABSTRACT: Vesicoureteral reflux (VUR) is a common pediatric urologic disorder. After the first urinary tract infection (UTI), imaging studies are recommended, starting with a renal ultrasound (RUS). Voiding cystourethrography (VCUG) and dimercaptosuccinic acid (DMSA) scan are the other main radiologic studies used to detect VUR. We evaluated the use of RUS as a screening method for VUR in children below 2 years of age, in order to avoid unnecessary VCUG.
    Indian Journal of Urology 10/2014; 30(4):383-6.
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    ABSTRACT: Failure of non-surgical primary treatment for localized prostate cancer is a common occurrence, with rates of disease recurrence ranging from 20% to 60%. In a large proportion of patients, disease recurrence is clinically localized and therefore potentially curable. Unfortunately, due to the complex and potentially morbid nature of salvage treatment, radical salvage surgery is uncommonly performed. In an attempt to decrease the morbidity of salvage therapy without sacrificing oncologic efficacy, a number of experienced centers have utilized robotic assistance to perform minimally invasive salvage radical prostatectomy. Herein, we critically evaluate the existing literature on salvage robotic radical prostatectomy with a focus on patient selection, perioperative complications and functional and early oncologic outcomes. These results are compared with contemporary and historical open salvage radical prostatectomy series and supplemented with insights we have gained from our experience with salvage robotic radical prostatectomy. The body of evidence by which conclusions regarding the efficacy and safety of robotic salvage radical prostatectomy can be drawn comprises fewer than 200 patients with limited follow-up. Preliminary results are promising and some outcomes have been favorable when compared with contemporary open salvage prostatectomy series. Advantages of the robotic platform in the performance of salvage radical prostatectomy include decreased blood loss, short length of stay and improved visualization. Greater experience is required to confirm the long-term oncologic efficacy and functional outcomes as well as the generalizability of results achieved at experienced centers.
    Indian Journal of Urology 10/2014; 30(4):429-33.
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    ABSTRACT: Robot-assisted laparoscopic prostatectomy (RALP) has emerged as the most common treatment for localized prostate cancer. With improved surgical precision, RALP has produced hope of improved potency rates, especially with the advent of nerve-sparing and other modified techniques. However, erectile dysfunction (ED) remains a significant problem for many men regardless of surgical technique. To identify the functional outcomes of robotic versus open and laparoscopic techniques, new robotic surgical techniques and current treatment options of ED following RALP. A Medline search was performed in March 2014 to identify studies comparing RALP with open retropubic radical prostatectomy (RRP) and laparoscopic radical prostatectomy, modified RALP techniques and treatment options and management for ED following radical prostatectomy. RALP demonstrates adequate potency rates without compromising oncologic benefit, with observed benefit for potency rates compared with RRP. Additionally, specific surgical technical modifications appear to provide benefit over traditional RALP. Phosphodiesterase-5 inhibitors (PDE5I) demonstrate benefit for ED treatment compared with placebo. However, long-term benefit is often lost after use. Other therapies have been less extensively studied. Additionally, correct patient identification is important for greatest clinical benefit. RALP appears to provide beneficial potency rates compared with RRP; however, these effects are most pronounced at high-volume centers with experienced surgeons. No optimal rehabilitation program with PDE5Is has been identified based on current data. Additionally, vacuum erection devices, intracavernosal injections and other techniques have not been well validated for post RALP ED treatment.
    Indian Journal of Urology 10/2014; 30(4):434-42.
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    ABSTRACT: Vesico-urethral anastomosis (VUA) is a technically challenging step in robotic-assisted laparoscopic prostatectomy (RALP) in obese individuals. We describe technical modifications to facilitate VUA encountered in obese individuals and in patients with a narrow pelvis. A Pubmed literature search was performed between 2000 and 2012 to review all articles related to RALP, obesity and VUA for evaluation of technique, complications and outcomes of VUA in obese individuals. In addition to the technical modifications described in the literature, we describe our own experience to encounter the technical challenges induced by obesity and narrow pelvis. In obese patients, technical modifications like use of air seal trocar technology, steep Trendlenburg positioning, bariatric trocars, alterations in trocar placement, barbed suture and use of modified posterior reconstruction facilitate VUA in robotic-assisted radical prostatectomy. The dexterity of the robot and the technical modifications help to perform the VUA in challenging patients with lesser difficulty. The experience of the surgeon is a critical factor in outcomes in these technically challenging patients, and obese individuals are best avoided during the initial phase of the learning curve.
    Indian Journal of Urology 10/2014; 30(4):418-22.
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    ABSTRACT: With more than 60% of radical prostatectomies being performed robotically, robotic-assisted laparoscopic prostatectomy (RALP) has largely replaced the open and laparoscopic approaches and has become the standard of care surgical treatment option for localized prostate cancer in the United States. Accomplishing negative surgical margins while preserving functional outcomes of sexual function and continence play a significant role in determining the success of surgical intervention, particularly since the advent of nerve-sparing (NS) robotic prostatectomy. Recent evidence suggests that NS surgery improves continence in addition to sexual function. In this review, we describe the neuroanatomical concepts and recent developments in the NS technique of RALP with a view to improving the "trifecta" outcomes.
    Indian Journal of Urology 10/2014; 30(4):399-409.
  • Indian Journal of Urology 10/2014; 30(4):456-7.
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    ABSTRACT: Upper urinary tract urothelial malignancy accounts for 5-10% of urothelial carcinomas. Synchronous bladder carcinoma occurs in 2-4% of patients with upper urinary tract tumors. Urothelial malignancy involving the entire upper urinary tract is an extremely rare entity. Most upper urinary tract malignancies are transitional cell carcinomas (TCC), of which the sarcomatoid variant is very rare. These tumors pose a challenge to the radiologist. We herein report a case of TCC involving the entire collecting system of the left kidney, extending down along the ureter and projecting as a mass in the bladder.
    Indian Journal of Urology 10/2014; 30(4):454-5.
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    ABSTRACT: We report the case of a young man who presented with spontaneous left perinephric hematoma and per-rectal bleeding. Evaluation revealed renal and superior mesenteric arterial aneurysms secondary to polyarteritis nodosa (PAN). Computed tomography and angiographic findings are presented. The aetiology of spontaneous perinephric hemorrhage along with relevant features of PAN are discussed.
    Indian Journal of Urology 10/2014; 30(4):452-3.
  • Indian Journal of Urology 10/2014; 30(4):368.