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Introduction
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Publications
Publications (190)
Low testosterone (T), common in aging men, associates with cardiovascular disease. We investigated whether follicle-stimulating hormone (FSH), which is affected by T, modulates the cardiovascular effects associated with low T or castration. FSHβ−/−:low-density lipoprotein receptor (LDLR)−/− mice, untreated or castrated (orchiectomy, gonadotropin-re...
Background High variability in prostate MRI quality might reduce accuracy in prostate cancer detection. Purpose To prospectively evaluate the quality of MRI scanners taking part in the quality control phase of the global PRIME (Prostate Imaging Using MRI ± Contrast Enhancement) trial using the Prostate Imaging Quality (PI-QUAL) standardized scoring...
Background:
Age-related changes in multiparametric magnetic resonance imaging (mpMRI) of the prostate have been reported in the general population but not in screening cohorts.
Objectives:
To evaluate age-related changes on prostatic mpMRI in a screening cohort of BRCA1/2 mutation carriers.
Methods:
Asymptomatic BRCA1/2 mutation carriers under...
The optimal therapy for patients with non-metastatic biochemically relapsed prostate cancer (BRPC-M0) after local therapy is elusive. Thus, the evaluation of new non-toxic compounds in BRPC-M0 patients is warranted. PectaSol®-Modified citrus pectin (P-MCP) is a food supplement categorized as GRAS (Generally Recognized As Safe) by the FDA. It is a c...
Background
Androgen deprivation therapy is the cornerstone of treatment for patients with advanced prostate cancer. Meta-analysis of small, oncology-focused trials suggest gonadotropin-releasing hormone (GnRH) antagonists may be associated with fewer adverse cardiovascular outcomes compared with GnRH agonists.
Objectives
This study sought to deter...
The optimal therapy for patients with non-metastatic biochemically relapsed prostate cancer (BRPC-M0) after local therapy is elusive. Thus, the evaluation of new non-toxic compounds in BRPC-M0 patients is warranted. PectaSol® modified citrus pectin (P-MCP) is a food supplement generally recognized as safe (GRAS) by the Food and Drug Administration...
162
Background: 30% of patients with localized PC will have a biochemical relapse post local therapy. Their optimal treatment remains elusive. While androgen deprivation therapy is effective in reducing PSA level, its long-term benefit remains undefined, and it is toxic. Thus, evaluation of new nontoxic compounds in these patients is warranted. Pec...
Background
High-risk localized prostate cancer (HRLPC) has a substantial risk of disease progression despite local treatment. Neoadjuvant systemic therapy before definitive local therapy may improve oncological outcomes by targeting the primary tumor and micrometastatic disease.
Objective
To evaluate whether a lutetium-177 prostate-specific membra...
545
Background: Intravesical bacillus Calmette Guerin (BCG) is the standard of care adjuvant therapy for high risk non-muscle invasive bladder cancer (NMIBC), yet many patients experience recurrence or disease progression. The mechanism of action of BCG is believed to be related to stimulation of immune surveillance. Relatedly, systemic immune chec...
Optimal therapy of biochemically relapsed prostate cancer (BRPC) after local treatment is elusive. An established modified citrus pectin (PectaSol®, P-MCP), a dietary polysaccharide, is an established antagonist of galectin-3, a carbohydrate-binding protein involved in cancer pathogenesis. Based on PSA dynamics, we report on the safety and the prim...
Background Gallium 68 (68Ga) prostate-specific membrane antigen (PSMA) PET/MRI may improve detection of clinically significant prostate cancer (CSPC). Purpose To compare the sensitivity and specificity of 68Ga-PSMA PET/MRI with multiparametric MRI for detecting CSPC. Materials and Methods Men with prostate specific antigen levels of 2.5-20 ng/mL pr...
Purpose:
Recent studies demonstrated reduced cardiovascular risk with GnRH antagonist, yet the underlying mechanism remains undetermined. The objective of this study was to examine longitudinal changes over time in established cardiovascular related proteins, among men treated with GnRH agonists Vs. GnRH antagonist.
Materials and methods:
We per...
Prostate cancer and metabolic syndrome are common among men in the Western world. As the population grows older and life expectancy increases, the rates of both diseases are expected to increase. We now recognize that metabolic syndrome and prostate cancer interact. Metabolic syndrome may be a risk factor for prostate cancer and may also worsen out...
Prostate Multiparametric Magnetic Resonance Imaging (mp‐MRI) is a well‐established tool for detection of clinically suspected prostate cancer following negative systematic biopsy. Studies published over the last decade have shown that performing mp‐MRI prior to the first biopsy increases the detection rates of clinically significant prostate cancer...
In the prostate, water diffusion is faster when moving parallel to duct and gland walls than when moving perpendicular to them, but these data are not currently utilized in multiparametric magnetic resonance imaging (mpMRI) for prostate cancer (PCa) detection. Diffusion tensor imaging (DTI) can quantify the directional diffusion of water in tissue...
Magnetic resonance imaging (MRI) and ultrasound (US) fusion prostate-biopsies can be performed in a transrectal (TR-fusion) or transperineal (TP-fusion) approach. Prospective comparative evidence is limited. In this study we compared the detection rate of clinically-significant prostate-cancer (csPCa) within an index lesion between TR and TP-fusion...
Background:
Male-carriers of BRCA1/2 gene mutations have an increased risk of prostate cancer (PCa) with a more aggressive phenotype. Current screening-guidelines suggest the use of prostate-specific antigen (PSA) only among BRCA2 carriers. Female carriers have extensive guidelines that include imaging. Our objective was to test the prevalence of...
Background
Gonadotrophin releasing hormone (GnRH) agonists and antagonists reduce testosterone levels for the treatment of advanced and metastatic prostate cancer. Androgen deprivation therapy (ADT) is associated with increased risk of cardiovascular (CV) events and CV disease (CVD), especially in patients with preexisting CVD treated with GnRH ago...
Women who carry the BRCA mutation are at high lifetime risk of breast cancer, but there is no consensus regarding an effective and safe chemoprevention strategy. A large body of evidence suggests that 3,3-diindolylmethane (DIM), a dimer of indole-3-carbinol (I3C) found in cruciferous vegetables, can potentially prevent carcinogenesis and tumor deve...
1556
Background: Women who carry the BRCA mutation are at high lifetime risk of breast cancer, but there is no consensus regarding an effective and safe chemoprevention strategy. A large body of evidence suggests that 3,3-diindolylmethane (DIM), a dimer of indole-3-carbinol (I3C) found in cruciferous vegetables, can potentially prevent carcinogenes...
The COVID-19 pandemic has changed the world. Urology needs to overcome these challenges. Our duty is to provide care under any circumstances and our privilege is to re-examine and advance our field. The use of novel communication and health technologies will ensure safety while maintaining high-quality care.
Purpose:
Men with germline mutations in DNA-repair genes have a higher risk of developing prostate cancer. Active surveillance (AS) is the preferred treatment modality for low-risk prostate cancer. However, many fear to offer this alternative to men with germline mutations. We now describe the short-term oncologic outcomes of active surveillance i...
Objectives
To evaluate prospectively whether a tubeless (JJ stent‐only) percutaneous nephrolithotomy (PCNL) might reduce the risk of hydrothorax, compared to an approach where a nephrostomy tube is left.
Materials and Methods
We conducted a two‐arm open‐label prospective randomized study (NCT02036398) comparing tubeless supra‐costal PCNL (with a J...
Background:
MRI-US fusion prostate biopsies are becoming a common procedure to diagnose prostate cancer. There is a paucity of information regarding the learning curve for fusion biopsies. We aim to study the amount of experience needed to be both accurate and time-efficient in this procedure.
Methods:
We prospectively collected data on all MRI-...
Objectives:
Malignant ureteral obstruction (MUO) is a devastating complication of cancer, and it is commonly treated by drainage via a percutaneous nephrostomy (PCN). The objective of this study was to determine the efficacy, safety, and functional outcome of tandem ureteral stents (TUS) in the management of MUO.
Materials and methods:
The medic...
Introduction:
We aimed to investigate the association between stone composition and recurrence rate in a well-characterized group of patients.
Methods:
From our prospectively assembled database of 1328 patients undergoing ureteroscopy and percutaneous nephrolithotomy (PCNL) between 2010 and 2015, we identified 457 patients who met the inclusion...
Background: Breast cancer susceptibility genes 1&2 (BRCA1&2) mutations hinder DNA-repair. Germline mutations in these genes are known to cause cancer; however, they may have other consequences. In this study we evaluated for the first time, the effect of the BRCA mutations on the vascular endothelium of young healthy males.
Results: The study inclu...
Purpose:
Androgen-deprivation therapy (ADT) may increase risk of cardiovascular-disease (CVD). Limited data suggest that gonadotrophin-releasing hormone (GnRH)-antagonist may be associated with lower risk of CVD compared to GnRH-agonist.
Patients and methods:
We conducted a phase-II randomized open-label study among men with prostate-cancer and...
Purpose
To compare surgical site infections (SSI) rate after radical cystectomy (RC) over time and ascertain whether antibiotic prophylaxis should be enhanced.
Methods
All medical records of RC patients in a single tertiary uro-oncology center between 2007 and 2017 were analyzed. SSI was defined using the criteria of the US Centers for Disease Con...
5015
Background: Androgen-deprivation therapy (ADT) used in prostate-cancer may increase risk of cardiovascular disease (CVD). Limited preclinical and retrospective clinical data suggest that use of gonadotrophin-releasing hormone (GnRH)-antagonist may be associated with lower risk of CVD compared to GnRH-agonist. Methods: We conducted a randomized...
e16609
Background: 30% of pts with localized PC will have a biochemical relapse post local tx. Their optimal tx remains elusive. While androgen deprivation therapy is effective in reducing PSA level, its long-term benefit remain undefined, and it is associated with significant toxicities. Thus, evaluation of new non-toxic compounds in this pt popul...
Male carriers of BRCA mutations are at higher risk of developing prostate cancer. Many issues are still unanswered and are currently being studied, including differences between BRCA1 and BRCA2, screening and specific protocols, the role of active surveillance, and the choice of definitive treatment.
Renal stone patients are routinely prescribed secondary chemoprevention therapy with potassium citrate (Alkasolve® , Sam-On Ltd., Israel) and Hydrochlorthiazide (Disothiazide®; Dexcel Ltd., Israel) based on the results of metabolic evaluiation. However, data on
adherence to these regimens are limited. The aim of this study was to assess rates of lo...
Objectives:
High-grade nonmuscle-invasive urothelial tumors of the bladder that fail intravesical Bacillus Calmette-Guérin (BCG) immunotherapy are at the highest risk of progression. Initial evidence links heat shock protein expression levels and outcome of bladder cancer after BCG treatment. We aimed to determine the association between HSP60, 70...
Objective:
To assess patient adherence to intravesical instillation therapy for non-muscle invasive urothelial carcinoma outside of clinical trials.
Methods:
We reviewed the records of patients from 2000-2013 who received intravesical therapy for non-muscle invasive urothelial carcinoma. Patients with evidence of tumor recurrence or progression...
Men with germline mutations in BRCA1 and BRCA2 genes have a higher risk of developing malignant abnormalities of the prostate, pancreas, breast, colon, and melanoma.¹⁻³ Moreover, germline BRCA mutations are associated with higher stage, grade, and poor survival rates in patients with prostate cancer.
Objectives:
To compare the incidence rate of urinary tract infections and associated pathogens between patients with an ileal conduit and an orthotopic neobladder urinary diversion.
Methods:
The medical records of 179 patients treated with radical cystectomy between 2006-2011 were reviewed and data pertaining to postoperative UTI was collected....
Purpose
Though former evidence implies a correlation of breast cancer susceptibility gene (BRCA) mutation with reduced ovarian reserve, the data is yet inconsistent. Our aim was to investigate biomarkers of ovarian aging in a cohort of young healthy carriers of the BRCA mutation. We hypothesized that the role played by BRCA genes in aging pathways...
14
Background: 30% of pts with localized PC will have a biochemical relapse post local tx. The optimal tx of these pts remains elusive. While androgen deprivation therapy is effective in reducing PSA level, its long-term benefit on survival remain undefined, and it is associated with significant cumulative toxicities.Thus, evaluation of new non-tox...
Prostate cancer, due to its high prevalence and long-latency period, is an ideal candidate for prevention. Considerable efforts have been placed on prevention strategies utilizing 5-α(alpha)-reductase inhibitors (5-ARIs), statins, and metformin. In this chapter, we will review the rationale, mechanism of action, and key studies examining the role o...
Objectives:
To measure needle tip deflection during TRUS prostate biopsy and evaluate predictors for needle tip deflection.
Methods:
Analysis of 568 prostate biopsies obtained from 51 consecutive patients who underwent a standard 12-core TRUS guided prostate biopsy. TRUS guided prostate biopsies were performed using BK flex500, with a side-fire...
Background
Male BRCA mutation carriers are at risk for an early onset aggressive prostate cancer. No data exist on the association of testosterone levels among these patients. We aimed to analyze testosterone and associated hormonal levels among male BRCA carriers and non-carriers.
Patients and methods
Overall 87 male carriers and 43 non-carriers...
Objective:
To present a reliable technique for fluoroscopic controlled, large-bore, ureteral stent placement and exchange in transplant kidneys with persistent ureterovesical strictures.
Methods:
We reviewed the medical charts of all transplant kidney patients with persistent ureterovesical strictures who underwent ureteral stent placement or ex...
e16588
Background: 30% of pts with localized PC will have a biochemical relapse post local tx. The optimal tx of these pts remains elusive. While androgen deprivation therapy is effective in reducing PSA level, its long term benefit on survival remain undefined, and it is associated with significant cumulative toxicities.Thus evaluation of new non-...
Objective
To analyze lower urinary tract symptoms (LUTS) and benign prostate hyperplasia (BPH) features among male BRCA 1 and 2 carriers and an age matched control group.
Patients and Methods
Male BRCA carriers and non-carriers aged 40-70 were enrolled in our cross sectional study. Relevant clinical data was collected and patients filled the inter...
Background
Catheter-Associated Hospital-Acquired Infections (HAI's) are caused by biofilm-forming bacteria. Using a novel approach, we generated anti-infective barrier on catheters by charging them with Nitric Oxide (NO), a naturally-produced gas molecule. NO is slowly released from the catheter upon contact with physiological fluids, and prevents...
Electrolytes, metabolites, renal function and liver function parameters–change from baseline within groups.
Changes in parameters values from baseline levels during the study within both study groups were evaluated at the 1st day of catheterization, at hospital discharge, at catheter removal day and at follow-up visit. Paired T-test was applied for...
Individual data.
Individual participant data for all parameters evaluated during the study.
(XLSX)
Comparison of electrolytes, metabolites, renal function and liver function parameters–CT versus NO Group.
A comparison of parameters values between the CT group and the NO group at 1st day of catheterization, at hospital discharge, at catheter removal day and at follow-up visit. Non-parametric Mann-Whitney U-test for independent samples was applied...
Clinical trial protocol.
(PDF)
Trend statement checklist.
(PDF)
To examine the ability of a new specimen handling technique to improve histopathological yield of ureteroscopic biopsies, performed in patients with suspected upper tract urothelial carcinoma (UTUC). In a bi-center retrospective study we compared the results of the new tissue handling technique (group 1) with the standard technique (group 2). In th...
Introduction:
Androgens have been implicated in both male pattern baldness (MPB) and prostate cancer (PCa). We set out to prospectively determine if men with independently assessed MPB are at higher risk for PCa at biopsy and determine if any grade associations exist.
Methods:
We prospectively enrolled 394 eligible patients presenting for prosta...
Background:
Women who carry the BRCA gene mutation have an up to 80% chance of developing cancer, primarily of breast and ovarian origin. Confirmation of carrier status is described by many women as an overwhelming, life-changing event. Healthy individuals harboring a BRCA mutation constitute a high risk population with unique needs, often overloo...
Data on genetic anticipation in breast cancer are sparse. We sought to evaluate age at diagnosis of breast cancer in daughters with a BRCA mutation and their mothers. A review of all carriers of the BRCA mutation diagnosed with breast cancer at the Genetics Institute of a tertiary medical center in 2000-2013 yielded 80 women who could be paired wit...
Oncotype-DX assay has never been validated for BRCA mutation carriers. This study compares the recurrence score (RS) distribution in BRCA-positive breast cancer patients with that of a general population (GP) of patients and reports their outcomes. Eligible patients were BRCA carriers who performed the Oncotype-DX assay. Two sets of databases were...
Background:
Tumour hypoxia, which is frequent in many cancer types, is associated with treatment resistance and poor prognosis. The role of hypoxia in surgically treated bladder cancer (BC) is not well described. We studied the role of hypoxia in two independent series of urothelial bladder cancers treated with radical cystectomy.
Methods:
279 p...
The purpose of this study was to compare the postoperative course of patients with positive stone culture (SC) to patients with sterile SC, and to analyze the predictors for post percutaneous nephrolithotomy (PCNL) sepsis; and to describe the type and resistance patterns of bacteria responsible for post PCNL sepsis. From a cohort of 206 consecutive...
Germ cell tumors (GCT) are relatively uncommon, accounting for only 1% of male malignancies in the United States. It has become an important oncological disease for several reasons. It is the most common malignancy in young men 15-35 years old. GCTs are among a unique numbers of neoplasms where biochemical markers play a critical role. Finally, it...
In this study, we estimated the time from first detectable prostate-specific antigen (PSA) following radical prostatectomy (RP) to commonly used definitions of biochemical recurrence (BCR). We also identified the predictors of time to BCR.
We identified subjects who underwent a RP and had an undetectable PSA after surgery followed by at least 1 det...
Background
Statistical models developed using administrative databases are powerful and inexpensive tools for predicting survival. Conversely, data abstraction from chart review is time-consuming and costly. Our aim was to determine the incremental value of pathological data obtained from chart abstraction in addition to information acquired from a...
