189 results on '"Gregory A. Broderick"'
Search Results
2. Small cell carcinoma of the prostate in an elderly patient: a case report and review of the literature
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Dale Alan Whitaker Jr., Daniel H. Miller, Niveditha Jagadesh, Gerald W. Strong, Lauren Hintenlang, William B. Schenk, Gregory A. Broderick, Katherine S. Tzou, and Steven J. Buskirk
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Small cell carcinoma ,Prostate cancer ,Radiotherapy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Prostate cancer is the most common malignancy of men in the United States. Small-cell carcinoma (SCC), which typically presents as an aggressive lung malignancy, is a rare diagnosis within the setting of prostate cancer pathology. Due to its limited prevalence, little information regarding the treatment and prognosis of this disease in large populations is available. To date our current knowledge base is largely limited to case reports and retrospective case reviews. The mainstay of treatment for this particular histology most often involves a multimodality approach utilizing chemotherapy in conjunction with radiation therapy, androgen deprivation therapy, or prostatectomy. Here we present the case of an elderly 89- year-old Caucasian male who was diagnosed with SCC of the prostate. Despite proceeding with a course of definitive radiotherapy, the patient experienced rapid progression of disease and ultimately elected to discontinue radiation therapy and receive hospice care.
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- 2016
- Full Text
- View/download PDF
3. Orthotopic ureterocele masquerading as a bladder tumor in a woman with pelvic pain
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David D. Thiel, Steven P. Petrou, and Gregory A. Broderick
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bladder ,ureterocele ,bladder neoplasms ,ureteral calculi ,pelvic pain ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Single system orthotopic ureteroceles often present in adulthood are associated with characteristic radiographic findings. We present the case of a 54 year old woman with 8 months of urgency/frequency and pelvic pain that has the cystoscopic appearance of a bladder tumor. Cystoscopic images, radiographs and intraoperative photos demonstrate the work-up, evaluation, and treatment of this unique single system orthotopic ureterocele containing a calculus. This patient demonstrates the need for cystoscopy accompanied by upper tract imaging in patients with new onset pelvic pain, urgency/frequency, and frequent urinary tract infections.
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- 2005
- Full Text
- View/download PDF
4. Priapism or Prolonged Erection: Is 4 – 6 Hours of Cavernous Ischemia the Time Point of Irreversible Tissue Injury?
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Snir, Dekalo, Noah, Stern, Gregory A, Broderick, and Gerald, Brock
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Male ,Urology ,Endocrinology, Diabetes and Metabolism ,Obstetrics and Gynecology ,Nitric Oxide ,Rats ,Psychiatry and Mental health ,Dogs ,Endocrinology ,Erectile Dysfunction ,Reproductive Medicine ,Ischemia ,Animals ,Humans ,Rabbits ,Priapism ,Retrospective Studies - Abstract
Introduction Ischemic priapism remains a significant cause of morbidity among men. To date, the precise time when penile ischemia results in permanent, non-reversible cavernosal smooth muscle injury, compromising subsequent erectile integrity, remains ill-defined. Objectives To review the medical literature pertaining to ischemic priapism, focusing on factors that predict the exact timeline of irreversible cavernous tissue injury. Methods A comprehensive literature search was performed. Our search included both publications on animal models and retrospective clinical series through January 2022. Articles were eligible for inclusion if they contained original data regarding nonreversible tissue injury on histology and/or provided a timeline of erectile function loss or preservation and had full text available in English. Results Innovative studies in the 1990s using invitro models with strips of rabbit, rat, canine and monkey corpus cavernosal tissue demonstrated that anoxia eliminated spontaneous contractile activity and reduced tissue responsiveness to electrical field stimulation or pharmacological agents. The same models demonstrated that the inhibitory effects of field stimulated relaxation, were mediated by nitric oxide. Subsequent studies using similar models demonstrated that exposure of corpus cavernosum smooth muscle to an acidotic environment impairs its ability to contract. A pH of 6.9 was chosen for these experiments based on a case series of men with priapism, in whom a mean pH of 6.9 was measured in corporal blood after 4–6 hours of priapism. Invivo animal studies demonstrated that after erection periods of 6–8 hours, microscopy shows sporadic endothelial defects but otherwise normal cavernous smooth muscle. In these studies, greater durations of ischemic priapism were shown to result in more pronounced ultrastructural changes and presumably irreversibility. In studies involving human corporal tissues, samples were obtained from men who had experienced priapism for at least 12 hours. Overall, erectile function outcome data is deficient in priapism reporting, especially within treatment windows less than 6 hours. Some reports on ischemic priapism have documented good erectile function outcomes with reversal by 12 hours. Conclusion Based on our extensive review of animal models and clinical reports, we found that many clinical papers rely on the same small set of animal studies to suggest the time point of irreversible ischemic damage at 4–6 hours. Our review suggests an equal number of retrospective clinical studies demonstrate that ischemic priapism reversed within 6–12 hours may preserve erectile function in many patients.
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- 2022
5. The Diagnosis and Management of Recurrent Ischemic Priapism, Priapism in Sickle Cell Patients, and Non-Ischemic Priapism: An AUA/SMSNA Guideline
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Trinity J, Bivalacqua, Bryant K, Allen, Gerald B, Brock, Gregory A, Broderick, Roger, Chou, Tobias S, Kohler, John P, Mulhall, Jeff, Oristaglio, Leila L, Rahimi, Zora R, Rogers, Ryan P, Terlecki, Landon, Trost, Faysal A, Yafi, and Nelson E, Bennett
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Male ,Ischemia ,Penile Erection ,Urology ,Humans ,Anemia, Sickle Cell ,Priapism ,Penis - Abstract
Priapism is a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation and results in a prolonged and uncontrolled erection. Given its time-dependent and progressive nature, priapism is a situation that both urologists and emergency medicine practitioners must be familiar with and comfortable managing.A comprehensive search of the literature on acute ischemic priapism and non-ischemic priapism (NIP) was performed by Emergency Care Research Institute for articles published between January 1, 1960 and May 1, 2020. A search of the literature on NIP, recurrent priapism, prolonged erection following intracavernosal vasoactive medication, and priapism in patients with sickle cell disease was conducted by Pacific Northwest Evidence-based Practice Center for articles published between 1946 and February 19, 2021. Searches identified 4117 potentially relevant articles, and 3437 of these were excluded at the title or abstract level for not meeting inclusion criteria. Full texts for the remaining 680 articles were ordered, and ultimately 203 unique articles were included in the report.This Guideline provides a clinical framework for the treatment (non-surgical and surgical) of NIP, recurrent ischemic priapism, and priapism in patients with sickle cell disease. The treatment of patients with a prolonged erection following intracavernosal vasoactive medication is also included. The AUA guideline on the diagnosis of priapism and the treatment of acute ischemic priapism was published in 2021.All patients with priapism should be evaluated emergently to identify the sub-type of priapism (acute ischemic versus non-ischemic) and those with an acute ischemic event should be provided early intervention when indicated. NIP is not an emergency and treatment must be based on patient objectives, available resources, and clinician experience. Management of recurrent ischemic priapism requires treatment of acute episodes and a focus on future prevention of an acute ischemic event. Sickle cell disease patients presenting with an acute ischemic priapism event should initially be managed with a focus on urologic relief of the erection; standard sickle cell assessment and interventions should be considered concurrent with urologic intervention. Treatment protocols for a prolonged, iatrogenic erection must be differentiated from protocols for true priapism.
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- 2022
6. Management of Priapism
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Christian Ericson, Bryce A. Baird, and Gregory A. Broderick
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medicine.medical_specialty ,Ischemic priapism ,business.industry ,Urology ,medicine.medical_treatment ,Priapism ,medicine ,Penile prosthesis ,urologic and male genital diseases ,business ,medicine.disease ,Shunt (electrical) ,Surgery - Abstract
Priapism is defined as a persistent penile erection lasting more than 4 hours. Priapism is a rare condition but when present it requires prompt evaluation and definitive diagnosis. Priapism has 2 pathophysiologic subtypes: ischemic and nonischemic. Ischemic priapism accounts for a majority of cases reported. Ischemic priapism is a urologic emergency and requires intervention to alleviate pain and prevent irreversible damage to erectile tissues. This article highlights current guidelines and the contemporary literature on priapism.
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- 2021
7. Acute Ischemic Priapism: An AUA/SMSNA Guideline
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Jeff Oristaglio, Faysal A. Yafi, Ryan Terlecki, Zora R. Rogers, Landon Trost, Gregory A. Broderick, Tobias S. Köhler, Bryant Allen, Gerald B. Brock, John P. Mulhall, Leila L. Rahimi, Nelson E. Bennett, and Trinity J. Bivalacqua
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Adult ,Male ,Time Factors ,Ischemic priapism ,Urology ,Priapism ,MEDLINE ,urologic and male genital diseases ,Phenylephrine ,Erectile Dysfunction ,Ischemia ,medicine ,Humans ,Sexual stimulation ,Emergency Treatment ,Societies, Medical ,business.industry ,Penile Erection ,musculoskeletal, neural, and ocular physiology ,Ultrasonography, Doppler ,Guideline ,medicine.disease ,Combined Modality Therapy ,Sexual dysfunction ,Erectile dysfunction ,Anesthesia ,Acute Disease ,North America ,medicine.symptom ,business ,Penis ,circulatory and respiratory physiology - Abstract
Priapism is a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation and results in a prolonged and uncontrolled erection. Given its time-dependent and progressive nature, priapism is a situation that both urologists and emergency medicine practitioners must be familiar with and comfortable managing. Acute ischemic priapism, characterized by little or no cavernous blood flow and abnormal cavernous blood gases (ie, hypoxic, hypercarbic, acidotic) represents a medical emergency and may lead to cavernosal fibrosis and subsequent erectile dysfunction.A comprehensive search of the literature was performed by Emergency Care Research Institute for articles published between January 1, 1960 and May 1, 2020. Searches identified 2948 potentially relevant articles, and 2516 of these were excluded at the title or abstract level for not meeting inclusion criteria for any key question. Full texts for the remaining 432 articles were reviewed, and ultimately 137 unique articles were included in the report.This Guideline was developed to inform clinicians on the proper diagnosis and surgical and non-surgical treatment of patients with acute ischemic priapism. This Guideline addresses the role of imaging, adjunctive laboratory testing, early involvement of urologists when presenting to the emergency room, discussion of conservative therapies, enhanced data for patient counseling on risks of erectile dysfunction and surgical complications, specific recommendations on intracavernosal phenylephrine with or without irrigation, the inclusion of novel surgical techniques (eg, tunneling), and early penile prosthesis placement.All patients with priapism should be evaluated emergently to identify the sub-type of priapism (acute ischemic versus non-ischemic) and those with an acute ischemic event should be provided early intervention. Treatment of the acute ischemic patient must be based on patient objectives, available resources, and clinician experience. As such, a single pathway for managing the condition is oversimplified and no longer appropriate. Using a diversified approach, some men may be treated with intracavernosal injections of phenylephrine alone, others with aspiration/irrigation or distal shunting, and some may undergo non-emergent placement of a penile prosthesis.
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- 2021
8. Survivorship, Version 1.2021
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William F. Pirl, Tara Sanft, Michelle E. Melisko, Karen L. Syrjala, Debra L. Friedman, Patricia A. Ganz, Halle C. F. Moore, Norah Lynn Henry, Phyllis C. Zee, Nazanin Khakpour, Divya Koura, Gregory A. Broderick, Natalie Moryl, M. Alma Rodriguez, Kristin Dickinson, Mindy Goldman, K. Scott Baker, Sophia K. Smith, Saro H. Armenian, Amye J. Tevaarwerk, Deborah A. Freedman-Cass, Linda Overholser, Kathryn J. Ruddy, Melissa M. Hudson, Kathi Mooney, Andrew T. Day, Lindsay L. Peterson, Lillie D. Shockney, Christine E. Hill-Kayser, Chirayu G. Patel, Tracey O'Connor, Electra D. Paskett, Allison L. McDonough, Wendy Demark-Wahnefried, Lidia Schapira, Javid Moslehi, Crystal S. Denlinger, Shannon M. Ansbaugh, and Nicole R. McMillian
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medicine.medical_specialty ,Health professionals ,business.industry ,MEDLINE ,Cancer ,medicine.disease ,Return to work ,humanities ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Survivorship curve ,Family medicine ,Weight management ,medicine ,030212 general & internal medicine ,business - Abstract
The NCCN Guidelines for Survivorship are intended to help healthcare professionals working with cancer survivors to ensure that each survivor’s complex and varied needs are addressed. The Guidelines provide screening, evaluation, and treatment recommendations for consequences of adult-onset cancer and its treatment; recommendations to help promote healthful lifestyle behaviors, weight management, and immunizations in survivors; and a framework for care coordination. This article summarizes the recommendations regarding employment and return to work for cancer survivors that were added in the 2021 version of the NCCN Guidelines.
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- 2021
9. Revision Surgery for Inflatable Penile Prosthesis (IPP): A Single-Center Experience and Pictorial Representation
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Kevin Parikh, Ronak J. Patel, Robert R A Wilson, Gregory A. Broderick, and Ram A. Pathak
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Male ,Reoperation ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Penile Implantation ,Prosthesis Design ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,Blood loss ,Patient age ,Humans ,Medicine ,Aged ,Retrospective Studies ,business.industry ,Penile implant ,Single surgeon ,Surgery ,Inflatable penile prosthesis ,030220 oncology & carcinogenesis ,Etiology ,Implant ,Penile Prosthesis ,business - Abstract
Objective To elucidate factors influencing Inflatable Penile Prosthesis (IPP) revision and describe outcomes associated with revision surgery. Methods A single surgeon, retrospective review of all patients who underwent IPP revision between 2008-2016, was performed. Patient age, BMI, operative duration, blood loss, hospital duration, time from most recent penile implant to revision surgery, etiology of revision, and whether the patient had a prior failed revision surgery were all collected and analyzed. Results A total of 57 patients, who had undergone IPP revision between the years 2008-2016, with at least 3 years of follow-up, were included in the investigation. Mean patient age and BMI were 68 and 29.2 kg/m2, respectively. The mean time between the most recent implant operation to revision was 8.4 years. Four patients (7%) reported IPP revision failure within a 3-year follow-up period. Conclusion IPP revision demonstrates a relatively high success rate, in the short term, and should be offered to patients as a safe and effective option.
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- 2021
10. Complete pathologic response of bulbar urethral squamous cell carcinoma in situ to topical 5-fluorouracil with urethral milking
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Bryce A, Baird, Timothy D, Lyon, Kevin, Wu, Augustus, Anderson, and Gregory A, Broderick
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Male ,Urethral Stricture ,Urologic Surgical Procedures, Male ,Urethra ,Carcinoma, Squamous Cell ,Humans ,Female ,Fluorouracil - Abstract
Primary urethral carcinoma is a rare oncologic condition with limited data to support organ-sparing therapies. Herein, we present a case of primary urethral squamous cell carcinoma in situ of the bulbar urethra treated with intraurethral 5-fluorouracil (5-FU) who exhibited a complete pathologic response observed at the time of dismembered urethroplasty. The clinical features, diagnosis, and treatment course of our case are reviewed. These data may support the use of intraurethral 5-FU for similar cases in the future.
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- 2022
11. Impact of Antimicrobial Dipping Solutions on Postoperative Infection Rates in Patients with Diabetes Undergoing Primary Insertion of a Coloplast Titan Inflatable Penile Prosthesis
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Ross Guillum, Linda M. Huynh, Ricardo Munarriz, Daniar Osmonov, Jessica Connor, Amir Shareza Patel, Faysal A. Yafi, Jeffrey D. Campbell, Kevin Parikh, Jay Simhan, Mohamad M. Osman, Lawrence C. Jenkins, Kook Bin Lee, Christopher Koprowski, Sung Hun Park, Amy I. Guise, T. Hsieh, Aaron C. Lentz, Gregory A. Broderick, Farouk M. El-Khatib, Gregory J. Barton, Arthur L. Burnett, Martin S. Gross, Hossein Sadeghi-Nejad, Shu Pan, Run Wang, Robert Andrianne, Maxime Sempels, Gerard D. Henry, Paul Perito, Georgios Hatzichristodoulou, Maxwell Towe, and Jonathan Clavell-Hernandez
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Male ,medicine.medical_specialty ,medicine.drug_class ,Urology ,Endocrinology, Diabetes and Metabolism ,Antibiotics ,Population ,030232 urology & nephrology ,Penile Implantation ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Humans ,In patient ,education ,Retrospective Studies ,education.field_of_study ,030219 obstetrics & reproductive medicine ,business.industry ,Penile implant ,medicine.disease ,Antimicrobial ,Surgery ,Psychiatry and Mental health ,Reproductive Medicine ,Inflatable penile prosthesis ,Implant ,Gentamicins ,Penile Prosthesis ,business - Abstract
Background Modern-day penile prostheses use infection retardant coating to decrease rates of postoperative infection, subsequently reducing explantation and revision rates as well. The Coloplast Titan models are dipped into antimicrobial solutions right before implantation, and the components used for dipping can be tailored toward the patient. Aim To compare infection, explantation, and revision rates among different dipping solutions used before implantation for patients with diabetes receiving a Coloplast Titan implant. Methods We systematically reviewed 932 patients with diabetes receiving a primary penile implant across 18 different centers from the period April 2003 to August 2018. Of those patients, 473 received a Coloplast device, whereas 459 received an AMS device. Data regarding the type of antimicrobial solution used before implantation were recorded for 468 patients receiving a Coloplast Titan, including whether or not they suffered a postoperative infection and if they underwent explantation and/or revision. Outcome rates were compared using Fisher’s exact and Pearson’s chi-square tests, and logistic regression modeling was performed to account for covariates. Outcomes The main outcome measures of this study were postoperative infection, explantation, and revision rates. Results Of the total 932 patients reviewed, 33 suffered a postoperative infection. Of 468 patients receiving Coloplast implants, there was a 3.4% infection rate. The most commonly used antibiotic combination before dipping was vancomycin + gentamicin (59.0%). There was a significantly lower rate of postoperative infection, explantation, and revision when vancomycin + gentamicin was used than those associated with the use of all other dipping solutions ([1.4% vs 6.4%; P = .004], [1.1% vs 8.3%; P < .001], and [2.5% vs 12.5; P < .001], respectively). After adjusting for age, body mass index, preoperative blood glucose level, and hemoglobin A1c, the use of other dips was an independent predictor of postoperative infection (odds ratio: 0.191; P = .049). The inclusion of rifampin in the dipping solution trended toward being a significant risk factor for infection (P = .057). Including antifungals in the dipping solution did not affect infection (P = .414), explantation (P = .421), or revision (P = .328) rates. Clinical Implications Vancomycin + gentamicin was the most efficacious combination of antibiotics used for dipping in terms of preventing postoperative infection and subsequent explantation and revision. Strengths and Limitations Data were sampled across multiple institutions providing a large sample that may be more representative of the population of interest. A key limitation of the study was its retrospective nature, which prevented us from controlling certain variables. Conclusion The use of rifampin did not provide the same type of protection, possibly representing a shift in resistance patterns of common bacteria responsible for device infection.
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- 2020
12. NCCN Guidelines Insights: Survivorship, Version 2.2020
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Allison L. McDonough, Chirayu G. Patel, Nazanin Khakpour, Saro H. Armenian, Phyllis C. Zee, Divya Koura, Debra L. Friedman, Halle C. F. Moore, K. Scott Baker, Melissa M. Hudson, Amye J. Tevaarwerk, M. Alma Rodriguez, William F. Pirl, Kathi Mooney, Tara Sanft, Linda Overholser, Michelle E. Melisko, Lindsay L. Peterson, Javid Moslehi, Crystal S. Denlinger, Christine E. Hill-Kayser, Nicole R. McMillian, Sophia K. Smith, Electra D. Paskett, Wendy Demark-Wahnefried, Natalie Moryl, Deborah A. Freedman-Cass, Kathryn J. Ruddy, Mindy Goldman, Karen L. Syrjala, Tracey O'Connor, Norah Lynn Henry, Gregory A. Broderick, and Lillie D. Shockney
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medicine.medical_specialty ,Health professionals ,business.industry ,MEDLINE ,Physical activity ,Primary care ,humanities ,Oncology ,Survivorship curve ,Family medicine ,Weight management ,Disease risk ,Medicine ,business - Abstract
The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for consequences of adult-onset cancer and its treatment, with the goal of helping healthcare professionals who work with survivors, including those in primary care. The guidelines also provide recommendations to help clinicians promote physical activity, weight management, and proper immunizations in survivors and facilitate care coordination to ensure that all of the survivors’ needs are addressed. These NCCN Guidelines Insights summarize additions and changes made to the guidelines in 2020 regarding cardiovascular disease risk assessment and screening for subsequent primary malignancies.
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- 2020
13. Immediate preoperative blood glucose and hemoglobin a1c levels are not predictive of postoperative infections in diabetic men undergoing penile prosthesis placement
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Ross Guillum, Farouk M. El-Khatib, Amy I. Guise, Gerard D. Henry, Daniar Osmonov, Christopher Koprowski, Paul Perito, Arthur L. Burnett, Martin S. Gross, T. Hsieh, Jessica Connor, Faysal A. Yafi, Aaron C. Lentz, Lawrence C. Jenkins, Jeffrey D. Campbell, Gregory J. Barton, Jonathan Clavell-Hernandez, Run Wang, Hossein Sadeghi-Nejad, Jay Simhan, Georgios Hatzichristodoulou, Maxime Sempels, Robert Andrianne, Sung Hun Park, Maxwell Towe, Ricardo Munarriz, Amir Shareza Patel, Kook Bin Lee, Huang Wei Su, Gregory A. Broderick, Kevin Parikh, Shu Pan, Mohamad M. Osman, and Linda M. Huynh
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Blood Glucose ,Male ,medicine.medical_specialty ,Multivariate analysis ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Penile Implantation ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Primary outcome ,Belgium ,Germany ,Diabetes mellitus ,Republic of Korea ,Diabetes Mellitus ,Postoperative infection ,Humans ,Medicine ,Retrospective Studies ,Glycated Hemoglobin ,030219 obstetrics & reproductive medicine ,business.industry ,Penile prosthesis ,medicine.disease ,United States ,Surgery ,Increased risk ,Preoperative hemoglobin ,Hemoglobin ,Penile Prosthesis ,business - Abstract
Defining the risks associated with diabetes mellitus in patients undergoing penile prosthesis implantation remains controversial. Our study aims to assess whether preoperative hemoglobin a1c and preoperative blood glucose levels are associated with an increased risk for postoperative infection in diabetic men. We performed a retrospective review of 932 diabetic patients undergoing primary penile prosthesis implantation from 18 high-volume penile prosthesis implantation surgeons throughout the United States, Germany, Belgium, and South Korea. Preoperative hemoglobin a1c and blood glucose levels within 6 h of surgery were collected and assessed in univariate and multivariate models for correlation with postoperative infection, revision, and explantation rates. The primary outcome is postoperative infection and the secondary outcomes are postoperative revision and explantation. In all, 875 patients were included in the final analysis. There were no associations between preoperative blood glucose levels or hemoglobin a1c levels and postoperative infection rates; p = 0.220 and p = 0.598, respectively. On multivariate analysis, a history of diabetes-related complications was a significant predictor of higher revision rates (p = 0.034), but was nonsignificant for infection or explantation rates. We conclude preoperative blood glucose levels and hemoglobin a1c levels are not associated with an increased risk for postoperative infection, revision, or explantation in diabetic men undergoing penile prosthesis implantation.
- Published
- 2020
14. Management of Priapism: 2021 Update
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Christian, Ericson, Bryce, Baird, and Gregory A, Broderick
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Male ,Practice Guidelines as Topic ,Humans ,Priapism - Abstract
Priapism is defined as a persistent penile erection lasting more than 4 hours. Priapism is a rare condition but when present it requires prompt evaluation and definitive diagnosis. Priapism has 2 pathophysiologic subtypes: ischemic and nonischemic. Ischemic priapism accounts for a majority of cases reported. Ischemic priapism is a urologic emergency and requires intervention to alleviate pain and prevent irreversible damage to erectile tissues. This article highlights current guidelines and the contemporary literature on priapism.
- Published
- 2021
15. Penile implant infection factors: a contemporary narrative review of literature
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Bryce A. Baird, Kevin Parikh, and Gregory A. Broderick
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medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,MEDLINE ,Penile implant ,Penile prosthesis ,Review Article ,medicine.disease ,law.invention ,Erectile dysfunction ,Reproductive Medicine ,Randomized controlled trial ,law ,Medicine ,Narrative review ,business ,Complication ,Intensive care medicine ,Diabetic control - Abstract
OBJECTIVE: We aim to review and summarize published literature that features implanted penile devices and details infection of these devices as a complication. In particular, we will detail the factors that influence infection of penile implants. BACKGROUND: Types of penile prostheses (PP) include inflatable implants and semirigid implants; these are utilized for treatment of erectile dysfunction. Likely the most feared complication of penile implants is infection. There are a handful of factors that are implicated in device infection. METHODS: Searches were performed using MEDLINE and PubMed databases using keywords and phrases ‘penile implant AND infection’; ‘penile prosthesis AND infection’; ‘penile implant infection’. We have presented results from our literature search. We divided these into ‘Surgical Elements’ and ‘Patient Selection and Factors.’ Each topic is discussed in its own section. CONCLUSIONS: Strides have been made since the initial penile prosthesis (IPP) surgeries to improve infection rates including diabetes control, antibiotic coating of devices, and antibiotic implementation. Going forward, more studies, especially randomized control trials, need to focus on defining levels of diabetic control (sugar control and A1C control), determining the role of metabolic syndrome in infection promotion and determining laboratory values which could be predictive of infection. We present a discussion of important factors to consider in the realm of PP infections. In addition, we include studies which discuss topics for future directions in decreasing the number of infections seen with PP.
- Published
- 2021
16. Restorative Therapies for Erectile Dysfunction: Position Statement From the Sexual Medicine Society of North America (SMSNA)
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Gerald B. Brock, Kelvin P. Davies, James Liu, Trinity J. Bivalacqua, Ranjith Ramasamy, Andrew T. Gabrielson, John P. Mulhall, Run Wang, Landon Trost, Gregory A. Broderick, and Kevin Y. Chu
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Position statement ,medicine.medical_specialty ,LiSWT, Low-intensity shock wave therapy ,Restorative therapies ,Stromal vascular fraction ,Urology ,Endocrinology, Diabetes and Metabolism ,030232 urology & nephrology ,Dermatology ,Disease ,IIEF, International Index of Erectile Function ,03 medical and health sciences ,Behavioral Neuroscience ,Other systems of medicine ,0302 clinical medicine ,Endocrinology ,Sexual medicine ,Medicine ,Society Report ,EHS, Erection Hardness Score ,Erectile dysfunction ,Intensive care medicine ,Adverse effect ,Stem cell therapy ,030219 obstetrics & reproductive medicine ,SVF, Stromal vascular fraction ,business.industry ,Outcome measures ,medicine.disease ,SHIM, Sexual Health Inventory for Men ,SCT, stem cell therapy ,Clinical trial ,Psychiatry and Mental health ,Reproductive Medicine ,ED, Erectile dysfunction ,PDE5i, phosphodiesterase type 5 inhibitor ,PRP, Platelet-rich plasma ,Platelet rich plasma ,business ,Sexual function ,Low intensity shock wave therapy ,RZ201-999 - Abstract
Introduction Current non-invasive treatments for erectile dysfunction (ED) include oral medications, intracavernosal injections, and vacuum-assisted devices. Though these therapies work well for many, a subset of patients have contraindications or are unsatisfied with these options. Restorative therapies for ED are a new frontier of treatments focused on regenerating diseased tissue and providing a potential “cure” for ED. Aim The aim of this position statement is to examine existing clinical trial data for restorative therapies and identify elements that require further research before widespread adoption. Methods A literature review was performed to identify all clinical trials performed with regenerative therapy for ED. This includes treatments such as stem cell therapy (SCT), platelet rich plasma (PRP), and restorative related technologies like low-intensity shockwave therapy (LiSWT). Main Outcome Measures Most clinical trials in restorative therapies were assessed for safety, feasibility, or efficacy. This included recording adverse events, changes in sexual function and erectile function questionnaires, and diagnostics measures. Results To date there is an absence of robust clinical data supporting the efficacy of restorative therapies regarding ED, though technologies such as LiSWT have established relative safety. Conclusions Restorative therapies are a promising technology that represents a new frontier of treatment geared towards reversing disease pathology rather than just treating symptoms. However, current published clinical studies are limited. Future work needs to be adequately powered, multi-center, randomized, sham/placebo-controlled trials in well-characterized patient populations to ensure safety and demonstrate efficacy. Until these studies are done, restorative therapies should be reserved for clinical trials and not offered in routine clinical practice.
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- 2021
17. NCCN Guidelines Insights: Survivorship, Version 2.2019
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Javid Moslehi, Crystal S. Denlinger, Kathryn J. Ruddy, Nicole R. McMillian, Kathi Mooney, Tara Sanft, M. Alma Rodriguez, Nazanin Khakpour, Linda Overholser, Melissa M. Hudson, Karen L. Syrjala, Terry S. Langbaum, Lindsay L. Peterson, Robin M. Lally, Mindy Goldman, Electra D. Paskett, Deborah A. Freedman-Cass, Susan G. Urba, Amye J. Tevaarwerk, Debra L. Friedman, William F. Pirl, Allison L. McDonough, Saro H. Armenian, Michelle E. Melisko, K. Scott Baker, Gregory A. Broderick, Sophia K. Smith, Tracey O'Connor, Phyllis C. Zee, Divya Koura, Halle C. F. Moore, and Wendy Demark-Wahnefried
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education.field_of_study ,medicine.medical_specialty ,Health professionals ,business.industry ,Population ,MEDLINE ,Physical activity ,Pain management ,humanities ,Cancer treatment ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Survivorship curve ,Family medicine ,Weight management ,Medicine ,030212 general & internal medicine ,business ,education - Abstract
The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for consequences of cancer and cancer treatment to aid healthcare professionals who work with survivors of adult-onset cancer. Guidance is also provided to help promote physical activity, weight management, and proper immunizations in survivors and to facilitate care coordination to ensure that all needs are addressed. These NCCN Insights summarize some of the topics discussed by the NCCN Survivorship Panel during the 2019 update of the guidelines, including the survivorship population addressed, ways to improve care coordination, and pain management.
- Published
- 2019
18. A Multicenter Investigation Examining American Urological Association Recommended Antibiotic Prophylaxis vs Nonstandard Prophylaxis in Preventing Device Infections in Penile Prosthesis Surgery in Diabetic Patients
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Robert Andrianne, Faysal A. Yafi, Gerard D. Henry, Michael E. Rezaee, Jonathan Clavell-Hernandez, Jay Simhan, Paul Perito, Linda M. Huynh, Mohamad M. Osman, Sung Hun Park, Arthur L. Burnett, Amy I. Guise, T. Hsieh, Run Wang, Maxime Sempels, Aaron C. Lentz, Hossein Sadeghi-Nejad, Martin S. Gross, Georgios Hatzichristodoulou, Maxwell Towe, Ricardo Munarriz, Daniar Osmonov, Lawrence C. Jenkins, Farouk M. El-Khatib, and Gregory A. Broderick
- Subjects
Male ,Reoperation ,medicine.medical_specialty ,Prosthesis-Related Infections ,medicine.medical_treatment ,Urology ,Treatment outcome ,030232 urology & nephrology ,Prosthesis Implantation ,03 medical and health sciences ,0302 clinical medicine ,Erectile Dysfunction ,Republic of Korea ,medicine ,Diabetes Mellitus ,Humans ,Prospective Studies ,Antibiotic prophylaxis ,Societies, Medical ,Aged ,Retrospective Studies ,business.industry ,Penile prosthesis ,Surgical procedures ,Antibiotic Prophylaxis ,Middle Aged ,United States ,Surgery ,Anti-Bacterial Agents ,Europe ,Treatment Outcome ,Practice Guidelines as Topic ,Drug Therapy, Combination ,Penile Prosthesis ,business - Abstract
American Urological Association (AUA) antibiotic prophylaxis recommendations may be insufficient for covering organisms commonly found in penile prosthesis infections. In this study we assess the difference between AUA recommended antibiotic prophylaxis and nonstandard prophylaxis in preventing device infections in penile prosthesis surgery performed in diabetic patients.A multicenter, retrospective cohort study of diabetic patients undergoing primary penile prosthesis surgery was performed between April 2003 and August 2018. Eighteen institutions from the United States, Europe and Korea contributed. The association between antibiotic prophylaxis type and postoperative penile prosthesis infections, device explantations and revision surgeries was assessed.Standard AUA antibiotic prophylaxis was followed in 48.6% (391) of cases while nonstandard prophylaxis was used in 51.4% (413). Common nonstandard antibiotic prophylaxis included vancomycin-gentamycin-fluoroquinolone, clindamycin-fluoroquinolone, and vancomycin-fluoroquinolone among other combinations. Patients who received AUA prophylaxis had significantly more postoperative device infections (5.6% vs 1.9%, p0.01) and explantations (8.3% vs 2.0%, p0.001) compared to those who received nonstandard prophylaxis. Patients who received AUA prophylaxis had significantly higher odds of a postoperative device infection (OR 2.8, 95% CI 1.1-7.3) and explantation (OR 3.6, 95% CI 1.4-9.1) compared to those who received nonstandard prophylaxis.Diabetic men with erectile dysfunction who received standard AUA prophylaxis for penile prosthesis surgery had significantly greater odds of experiencing a postoperative device infection and device explantation compared to patients who received nonstandard prophylaxis. Our study provides a strong rationale for a prospective investigation to establish the most appropriate prophylaxis strategy in penile prosthesis surgery.
- Published
- 2020
19. MP45-18 PREDICTING INTRACAVERNOSAL INJECTION THERAPY FAILURE BY EVALUATING MEDICAL RISK FACTORS IN MEN WITH ERECTILE DYSFUNCTION
- Author
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Patrick Houghton, Peter Cannizzo, Colleen T. Ball, Grace Edwards, Kevin Parikh, Steven Lomax, and Gregory A. Broderick
- Subjects
medicine.medical_specialty ,Erectile dysfunction ,business.industry ,Medical risk ,Urology ,Emergency medicine ,Injection therapy ,Medicine ,business ,medicine.disease - Published
- 2020
20. MP39-14 IS A PREOPERATIVE POSTIVE URINE CULTURE A PREDICTOR OF PENILE PROSTHESIS INFECTION?
- Author
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Gregory A. Broderick, Kevin Parikh, Steven Lomax, Jordan Bullock, and James Schnell
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine ,Urine ,business ,Penile prosthesis infection ,Surgery - Published
- 2020
21. MP36-10 DOES DOPPLER CLASSIFICATION OF PEYRONIE’S DISEASE AFFECT SURGICAL INTERVENTION PURSUED BY PATIENT?
- Author
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James Schnell, Andrew Hendrix, Jordan Bullock, Gregory A. Broderick, and Katherine Cockerill
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Intervention (counseling) ,Physical therapy ,Medicine ,Peyronie's disease ,business ,medicine.disease ,Affect (psychology) - Published
- 2020
22. 049 Does the Clasification of Peyronie's Disease with Doppler US Affect Surgical Intervention Pursued by the Patient?
- Author
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G. Gonzalez Albo, K. Cockerill, B. Baird, Gregory A. Broderick, and C. Thomas
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Endocrinology, Diabetes and Metabolism ,Affect (psychology) ,medicine.disease ,Psychiatry and Mental health ,Endocrinology ,Reproductive Medicine ,Intervention (counseling) ,Physical therapy ,medicine ,Doppler ultrasound ,Peyronie's disease ,business - Published
- 2021
23. Survivorship, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology
- Author
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Jose G. Montoya, Phyllis C. Zee, Wendy Demark-Wahnefried, Mark T. Wakabayashi, Shrujal S. Baxi, Tracey O'Connor, Karen L. Syrjala, Nazanin Khakpour, Terry S. Langbaum, Allison A. King, Gregory A. Broderick, Susan G. Urba, Kathryn J. Ruddy, Tara Sanft, Elizabeth Kvale, Melissa M. Hudson, Jeffrey Peppercorn, Amye J. Tevaarwerk, Sophia K. Smith, Robin M. Lally, Mindy Goldman, Deborah A. Freedman-Cass, Paula Silverman, Debra L. Friedman, Michelle E. Melisko, M. Alma Rodriguez, Kathi Mooney, Linda Overholser, Electra D. Paskett, Javid Moslehi, Crystal S. Denlinger, Nicole R. McMillian, Divya Koura, and K. Scott Baker
- Subjects
Pediatrics ,medicine.medical_specialty ,medicine.medical_treatment ,Survivorship ,Medical Oncology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Survivorship curve ,medicine ,Humans ,030219 obstetrics & reproductive medicine ,business.industry ,Oophorectomy ,Cancer ,social sciences ,Guideline ,Middle Aged ,medicine.disease ,humanities ,Menopause ,Distress ,Sexual dysfunction ,Oncology ,030220 oncology & carcinogenesis ,Quality of Life ,population characteristics ,Female ,medicine.symptom ,business ,human activities - Abstract
Many cancer survivors experience menopausal symptoms, including female survivors taking aromatase inhibitors or with a history of oophorectomy or chemotherapy, and male survivors who received or are receiving androgen-ablative therapies. Sexual dysfunction is also common in cancer survivors. Sexual dysfunction and menopause-related symptoms can increase distress and have a significant negative impact on quality of life. This portion of the NCCN Guidelines for Survivorship provide recommendations for screening, evaluation, and treatment of sexual dysfunction and menopausal symptoms to help healthcare professionals who work with survivors of adult-onset cancer in the posttreatment period.
- Published
- 2017
24. Superior Cost Effectiveness of Penile Plication vs Intralesional Collagenase Injection for Treatment of Peyronie’s Disease Deformities
- Author
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Gregory A. Broderick, Matthias D. Hofer, Ryan Hutchinson, Allen F. Morey, Billy H. Cordon, and Yair Lotan
- Subjects
medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,Cost effectiveness ,Collagenase injection ,Urology ,Office visits ,030232 urology & nephrology ,Severe disease ,medicine.disease ,Surgery ,Probability of success ,03 medical and health sciences ,0302 clinical medicine ,Collagenase clostridium histolyticum ,Cost analysis ,Medicine ,Peyronie's disease ,business ,medicine.drug - Abstract
Introduction In 2013 injection of collagenase clostridium histolyticum became the first nonsurgical FDA (Food and Drug Administration) approved treatment for Peyronie’s disease. We evaluated the cost effectiveness of collagenase injection compared to penile plication. Methods A decision tree model using TreeAge Pro Healthcare (TreeAge Software, Inc., Williamstown, Massachusetts) was developed for cost analysis comparing collagenase clostridium histolyticum and penile plication. Treatment success was defined as penile curvature of 30 degrees or less. Data from IMPRESS (Investigation for Maximal Peyronie’s Reduction Efficacy and Safety Studies) I and II were used to calculate the probability of success, and stratified by severity of disease (moderate defined as 30 to 60 degrees and severe as 61 to 90 degrees). We assumed that 50% of injection failures proceeded to secondary plication. Material costs of medications, office visits, and facility and surgical fees, and predicted costs of complications were obtained from our billing department using real-world patient data. For penile plication 90% success was assumed based on published series. All failed plications were assumed to undergo repeat plication. Results The calculated probability of treatment success after injection was 49.5% for moderate curvature (30 to 60 degrees) and 12% for severe curvature (61 to 90 degrees). Per patient plication cost was $3,039, while injection pathway was $25,856 for moderate disease and $26,375 for severe disease. One-way sensitivity analyses revealed cost equivalence at $2,558 for injection. No increase in efficacy of collagenase injection accomplished cost equivalence at current pricing. Conclusions Collagenase clostridium histolyticum treatment was at least 8 times more expensive than penile plication. Achieving cost equivalence would require a significant decrease in drug cost. Collagenase clostridium histolyticum appears to be most appropriate for men with moderate, as opposed to severe, penile deformities.
- Published
- 2017
25. Multispecialty retrospective review of the clinical utility of pelvic magnetic resonance imaging in the setting of pelvic pain
- Author
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Caroline Snowden, Gregory A. Broderick, Ram A. Pathak, Paul R. Young, John R Moore, and Candice W. Bolan
- Subjects
medicine.medical_specialty ,Urology ,Testicular pain ,Prostatitis ,Prostate magnetic resonance imaging (Prostate MRI) ,chronic pelvic pain ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,prostatitis ,medicine ,Rectal Pain ,Penile pain ,male pelvic pain ,business.industry ,Pelvic pain ,medicine.disease ,Reproductive Medicine ,030220 oncology & carcinogenesis ,Joint pain ,Original Article ,Radiology ,Diagnosis code ,medicine.symptom ,business ,Scrotal Pain - Abstract
Background: Pelvic pain is a common complaint, and management of it is often difficult. We sought to evaluate the utility of magnetic resonance imaging (MRI) in the diagnosis of male pelvic pain. Though MRIs are commonly ordered to evaluate pelvic pain, there are very few studies obtaining the efficacy of pelvic MRI in determining a definitive diagnosis. The primary aim of our study was to evaluate the clinical utility of pelvic MRI for a diagnosis code that included pain. Methods: After receiving institutional review board approval, a retrospective study was performed of all pelvic MRIs completed at our institution from January 2, 2010 to December 31, 2014. These were further delineated into ordering providers by specialty and urology-specific International Classification of Diseases, Ninth Revision (ICD-9) code diagnoses (male pelvic pain, prostatitis, groin pain, scrotal pain, testicular pain, and penile pain). Clinical utility was defined as positive if MRI findings resulted in a change in management. Subanalysis was performed on patients with an ICD-9 co-diagnosis of previous oncologic concern. Results: A total of 2,643 pelvic MRIs were ordered at our institution over a 5-year period. Of these, 597 pelvic MRIs (23%) were ordered for a diagnosis code that included pain (hip pain, rectal pain, joint pain, penile pain, scrotal pain, male pelvic pain and orchitis). Total utility for MRIs to find anatomic abnormalities potentially responsible for the present pain was 34% (205/597). When ordered by urologic providers, utility was 23%. Oncologists represented the highest positivity rate at 57%. Conclusions: Chronic pelvic pain is a multispecialty complaint that is difficult to treat. We were surprised to find the large number of both specialists and generalists invested in the management of pelvic pain. The increasing availability of MRI technology makes it a likely candidate to test for a clinically significant anatomic reason for pain. Though MRI is a test with minimal adverse effect and no increased risk of radiation exposure, the cost on the healthcare system should be offset by a clear clinical utility. We found total utility to be 34% across all ordering providers and an increase in positivity with concern of oncologic disease. Therefore, we would recommend pelvic MRIs in the evaluation of patients with refractory pelvic pain.
- Published
- 2017
26. Impact of Minimally Invasive Benign Prostatic Hyperplasia Therapies on 30- and 90-Day Postoperative Office Encounters
- Author
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Michael J. Wehle, Paul R. Young, Steven P. Petrou, Kandarp Shah, Michael G. Heckman, Ram A. Pathak, Nancy N. Diehl, David D. Thiel, Emily R. Vargas, Todd C. Igel, and Gregory A. Broderick
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Office Visits ,Urology ,medicine.medical_treatment ,Prostatic Hyperplasia ,030232 urology & nephrology ,Risk Assessment ,03 medical and health sciences ,Bladder outlet obstruction ,Postoperative Complications ,0302 clinical medicine ,Prostate ,American Urological Association Symptom Score ,Humans ,Minimally Invasive Surgical Procedures ,Medicine ,Aged ,Retrospective Studies ,Transurethral resection of the prostate ,Aged, 80 and over ,business.industry ,Incidence ,Transurethral Resection of Prostate ,Retrospective cohort study ,Emergency department ,Middle Aged ,Prognosis ,United States ,Surgery ,Urinary Bladder Neck Obstruction ,Catheter ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Laser Therapy ,business ,Body mass index ,Follow-Up Studies - Abstract
To compare the frequency of postoperative encounters in the 30-day and 90-day postoperative periods for various bladder outlet obstruction surgical therapies.All patients who underwent transurethral resection of the prostate (TURP), GreenLight laser photovaporization of the prostate (GL-PVP) (American Medical Systems Inc.), and holmium laser enucleation of the prostate (HoLEP) from January 1, 2012 to December 31, 2014 were followed for 6 months postoperatively. All postoperative encounters such as patient calls or questions, catheter exchanges or removals, and hospital-based readmissions or emergency department visits were recorded in the electronic medical record.Two hundred and ninety-one consecutive patients underwent outlet procedures during the study period: TURP (N = 199; mean age, 71 years; mean body mass index [BMI], 28.5), HoLEP (N = 60; mean age, 68 years; mean BMI, 28.1), or GL-PVP (N = 32; mean age, 72 years; mean BMI, 29.3). No statistically significant difference was observed for age, BMI, preoperative American Urological Association symptom score, or preoperative maximum flow velocity between the 3 groups. Thirty-day postoperative encounters differed significantly between the 3 surgery types (P .001). Specifically, there were fewer encounters within 30 days of surgery for TURP compared to both HoLEP (≥1 encounter: TURP = 48.7%, HoLEP = 66.7%; P = .006) and GL-PVP (≥1 encounter: TURP = 48.7%, GL-PVP = 93.7%; P .001). The number of encounters within 90 days postoperatively was also significantly lower for TURP patients (P .001).TURP results in fewer postoperative encounters in both the 30-day and 90-day postoperative periods compared to HoLEP and GL-PVP. Laser prostate therapies may place increased burden on clinic staff during the 30-day and 90-day postoperative periods.
- Published
- 2017
27. Effect of antimicrobial dipping solutions on post-operative infection rates in diabetic patients undergoing primary insertion of a Coloplast titan inflatable penile prosthesis
- Author
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Ricardo Munarriz, R. Wang, Gerard D. Henry, Robert Andrianne, M. Gross, T. Hsieh, Paul Perito, Daniar Osmonov, Amy I. Guise, F.M. El-Khatib, P. Sung Hun, Lawrence C. Jenkins, Arthur L. Burnett, M.M. Osman, J. Simhan, L.M. Huynh, Hossein Sadeghi-Nejad, Aaron C. Lentz, J. Clavell-Hernandez, Maxwell Towe, Georgios Hatzichristodoulou, F.A. Yafi, and Gregory A. Broderick
- Subjects
medicine.medical_specialty ,business.industry ,Post operative infection ,Urology ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Antimicrobial ,lcsh:RC254-282 ,Surgery ,symbols.namesake ,Inflatable penile prosthesis ,symbols ,Medicine ,business ,Titan (rocket family) - Published
- 2020
28. 319 Predicting Intracavernosal Injection Therapy Failure by Evaluating Medical Risk Factors in Men with Erectile Dysfunction
- Author
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Kevin Parikh, Gregory A. Broderick, S. Lomax, P. Houghton, and C. Ball
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Endocrinology, Diabetes and Metabolism ,Injection therapy ,medicine.disease ,Psychiatry and Mental health ,Endocrinology ,Erectile dysfunction ,Reproductive Medicine ,Medical risk ,Emergency medicine ,medicine ,business - Published
- 2020
29. 391 Revision Inflatable Penile Prosthesis (IPP) Failure Rates and Risk Factors for Failure
- Author
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J. Schnell, J. Bullock, Kevin Parikh, Ram A. Pathak, S. Lomax, and Gregory A. Broderick
- Subjects
Psychiatry and Mental health ,medicine.medical_specialty ,Endocrinology ,Reproductive Medicine ,Inflatable penile prosthesis ,business.industry ,Urology ,Endocrinology, Diabetes and Metabolism ,Medicine ,business ,Surgery - Published
- 2020
30. Adult-onset hypogonadism: evaluation and role of testosterone replacement therapy
- Author
-
Gregory A. Broderick and Andrew J. Davidiuk
- Subjects
Pediatrics ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,medicine.drug_class ,Hypogonadism ,Urology ,030232 urology & nephrology ,Testosterone (patch) ,Signs and symptoms ,Review Article ,testosterone replacement ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,testosterone deficiency (TD) ,Reproductive Medicine ,Testosterone deficiency ,Internal medicine ,medicine ,Testosterone replacement ,Gonadotropin ,business ,Reproductive health - Abstract
Testosterone deficiency (TD) has become a growing concern in the field of men’s sexual health, with an increasing number of men presenting for evaluation of this condition. Given the increasing demand for testosterone replacement therapy (TRT), a panel of experts met in August of 2015 to discuss the treatment of men who present for evaluation in the setting of low or normal gonadotropin levels and the associated signs and symptoms of hypogonadism. This constellation of factors can be associated with elements of both primary and secondary hypogonadism. Because this syndrome commonly occurs in men who are middle-aged and older, it was termed adult-onset hypogonadism (AOH). AOH can be defined by the following elements: low levels of testosterone, associated signs and symptoms of hypogonadism, and low or normal gonadotropin levels. Although there are significant benefits of TRT for patients with AOH, candidates also need to understand the potential risks. Patients undergoing TRT will need to be monitored regularly because there are potential complications that can develop with long-term use. This review is aimed at providing a deeper understanding of AOH, discussing the benefits and risks of TRT, and outlining each modality of TRT in use for AOH.
- Published
- 2016
31. Color Doppler Duplex Ultrasound Parameters in Men Without Organic Erectile Dysfunction
- Author
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Gregory A. Broderick and Ram A. Pathak
- Subjects
Adult ,Male ,medicine.medical_specialty ,Aging ,Organic erectile dysfunction ,Urology ,Phenylephrine ,Young Adult ,Erectile Dysfunction ,Internal medicine ,medicine ,Sexual stimulation ,Humans ,Treatment Failure ,Young adult ,Ultrasonography, Doppler, Color ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Penile Erection ,Ultrasound ,Age Factors ,Retrospective cohort study ,Color doppler ,Middle Aged ,Phosphodiesterase 5 Inhibitors ,medicine.disease ,Erectile dysfunction ,Duplex (building) ,Cardiology ,Urological Agents ,business ,circulatory and respiratory physiology ,Penis - Abstract
Objective To define age-specific normal Color Doppler Duplex Ultrasound (CDDU) parameters based on a large institutional database of men referred for vascular erectile testing, but found to have normal and sustained rigidity following penile injection of alprostadil. Methods A retrospective review of patients who underwent CDDU from January 1, 2005 to December 31, 2014 was conducted. The indications for CDDU assessments included complaint of erectile dysfunction refractory to PDE-5 inhibitors, new-onset penile curvature, or secondary consultation for erectile dysfunction. Pearson correlation test was used to evaluate the association between ordinal age groups with peak systolic velocity (PSV) and resistive index (RI) measurements to determine the effect of age on erectile response. Results A total of 2043 patients underwent CDDU from January 1, 2005 to December 31, 2014. 259 patients (12.7%) with a mean age 53.7 and a mean BMI of 27.2 were noted to have normal erectile rigidity and normal Doppler parameters (PSV >35 cm/s, RI >0.90). Prolonged erection, defined by need to inject phenylephrine reversal agent at 1-2 hours, occurred in 93% of patients. When age was categorized by decade, a negative correlation coefficient was obtained for previsual sexual stimulation PSV (−0.09, P = .164) and postvisual sexual stimulation PSV (−0.23, P = .005). Conclusion In men with normal vascular erections there appears to be a significant, age-related decline in postvisual sexual stimulation PSV without compromise to cavernous venous occlusion as measured by RI. We have used Doppler parameters in patients without vascular ED to define age-specific normalcy.
- Published
- 2019
32. MP27-06 IMMEDIATE PREOPERATIVE BLOOD GLUCOSE AND HEMOGLOBIN A1C LEVELS ARE NOT PREDICTIVE OF POST-OPERATIVE INFECTIONS IN DIABETIC MEN UNDERGOING PENILE PROSTHESIS PLACEMENT
- Author
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Gregory A. Broderick, Jonathan Clavell Hernandez, Jeffrey D. Campbell, Amir Shareza Patel, Shu Pan, Amy I. Guise, Lawrence C. Jenkins, Maxwell Towe, Linda Huynh, Ross Guillum, Farouk M. El-Khatib, Ricardo Munarriz, Hossein Sadeghi-Nejad, Run Wang, Kevin Parikh, Mohamad M. Osman, Georgios Hatzichristodoulou, Tung-Chin Hsieh, Gerard D. Henry, Paul Perito, Gregory Barton, Aaron C. Lentz, Arthur L. Burnett, Daniar Osmonov, Kook Bin Lee, Wayne J.G. Hellstrom, Faysal A. Yafi, Christopher Koprowski, Martin S. Gross, Jay Simhan, and Sung Hun Park
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Penile prosthesis ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Hemoglobin ,Post operative ,business ,Diabetic control - Abstract
INTRODUCTION AND OBJECTIVES:Recent reports have suggested that pre-operative diabetic control may be predictive of infection rates following penile prosthesis (PP) implantation. In this study, we s...
- Published
- 2019
33. PD44-09 ADHERENCE TO THE AUA ANTIBIOTIC PROPHYLAXIS GUIDELINES IN DIABETIC PATIENTS IS ASSOCIATED WITH SIGNIFICANTLY HIGHER RISKS OF PENILE PROSTHESIS INFECTION
- Author
-
Christopher Koprowski, M.M. Osman, Kevin Parikh, Tung-Chin Hsieh, Arthur L. Burnett, Amy I. Guise, Gerard D. Henry, Jeffrey D. Campbell, Paul Perito, Daniar Osmonov, Ross Guillum, Faysal A. Yafi, Jonathan Clavell Hernandez, Farouk M. El-Khatib, Martin S. Gross, Georgios Hatzichristodoulou, Linda Huynh, Gregory A. Broderick, Run Wang, Gregory Barton, Kook Bin Lee, Ricardo Munarriz, Maxwell Towe, Aaron C. Lentz, Jay Simhan, Wayne J.G. Hellstrom, Shu Pan, Sung Hun Park, Lawrence C. Jenkins, Hossein Sadeghi-Nejad, and Amir Shareza Patel
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Medicine ,Penile prosthesis ,Antibiotic prophylaxis ,Complication ,business ,Penile prosthesis infection ,Surgery - Abstract
INTRODUCTION AND OBJECTIVES:The most devastating complication following penile prosthesis (PP) implantation is an infection requiring device explantation. Current AUA guidelines recommend antibioti...
- Published
- 2019
34. 103 Diabetes and Erectile Dysfunction: Does Evidence based Testing Inform Us?
- Author
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C. Ball, Gregory A. Broderick, J. Bullock, and A. Myers
- Subjects
medicine.medical_specialty ,Evidence-based practice ,business.industry ,Urology ,Endocrinology, Diabetes and Metabolism ,medicine.disease ,Psychiatry and Mental health ,Endocrinology ,Erectile dysfunction ,Reproductive Medicine ,Diabetes mellitus ,medicine ,Intensive care medicine ,business - Published
- 2021
35. 165 Pre-operative Imaging for Revision Penile Prosthesis Surgery: When Exam Alone is not Enough
- Author
-
Robert R A Wilson, Kevin Parikh, Ram A. Pathak, and Gregory A. Broderick
- Subjects
Psychiatry and Mental health ,medicine.medical_specialty ,Endocrinology ,Reproductive Medicine ,business.industry ,Urology ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,medicine ,Penile prosthesis ,business ,Pre operative ,Surgery - Published
- 2021
36. Novel Evidence-Based Classification of Cavernous Venous Occlusive Disease
- Author
-
Ram A. Pathak, Zhuo Li, Bhupendra Rawal, and Gregory A. Broderick
- Subjects
Adult ,Male ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Intracavernous injection ,Impotence, Vasculogenic ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Ultrasonography, Doppler, Color ,Young adult ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Penile Erection ,Occlusive ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Erectile dysfunction ,Regional Blood Flow ,030220 oncology & carcinogenesis ,Cohort ,business ,Body mass index ,Penis - Abstract
The primary aim of our study was to determine whether an evidence-based rationale could categorize cavernous venous occlusive disease into mild, moderate and severe erectile dysfunction.A total of 863 patients underwent color duplex Doppler ultrasound from January 2010 to June 2013 performed by a single urologist. We identified a cohort of 75 patients (8.7%) with a diagnosis of cavernous venous occlusive disease based on a unilateral resistive index less than 0.9, and right and left peak systolic velocity 35 cm per second or less after visual sexual stimulation. At a median followup of 13 months patients were evaluated for treatment efficacy.A total of 75 patients with a median age of 60 years (range 19 to 83) and a mean body mass index of 26.3 kg/m(2) (range 19.0 to 39.3) satisfied the criteria of cavernous venous occlusive disease. When substratified into tertiles, resistive index cutoffs were obtained, including mild cavernous venous occlusive disease-81.6 to 94.0, moderate disease-72.6 to 81.5 and severe disease-59.5 to 72.5. Using these 3 groups the phosphodiesterase type 5-inhibitor failure rate (p = 0.017) and SHIM (Sexual Health Inventory for Men) score categories (1 to 10 vs 11 to 20, p = 0.030) were statistically significantly different for mild, moderate and severe cavernous venous occlusive disease. Treatment satisfaction was also statistically significantly different. Penile prosthetic placement was a more common outcome among patients with erectile dysfunction and more severe cavernous venous occlusive disease.Our retrospective analysis supports a correlation between the phosphodiesterase type 5 inhibitor failure rate, SHIM score and the rate of surgical intervention using resistive index values. Our data further suggest that an evidence-based classification of cavernous venous occlusive disease by color Doppler ultrasound is possible and can triage patients to penile prosthetic placement.
- Published
- 2016
37. Evidence-Based Management Guidelines on Peyronie's Disease
- Author
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Trinity J. Bivalacqua, Eric Chung, Guilio Garaffa, Lawrence S. Hakim, David Ralph, Ates Kagioglu, Ahmed Shamsodini, Gregory A. Broderick, Sidney Glina, and Hossein Sadeghi-Nejad
- Subjects
Male ,medicine.medical_specialty ,Urology ,Endocrinology, Diabetes and Metabolism ,Penile Induration ,030232 urology & nephrology ,MEDLINE ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Sexual medicine ,medicine ,Humans ,Evidence-Based Medicine ,030219 obstetrics & reproductive medicine ,business.industry ,Evidence-based management ,Evidence-based medicine ,Guideline ,medicine.disease ,Psychiatry and Mental health ,Reproductive Medicine ,Family medicine ,Practice Guidelines as Topic ,Physical therapy ,Peyronie's disease ,business ,Psychosocial - Abstract
Introduction Despite recent advances in our knowledge and treatment strategies in Peyronie's Disease (PD), much remained unknown about this disease. Aim To provide a clinical framework and key guideline statements to assist clinicians in an evidence-based management of PD. Methods A systematic literature search was conducted to identify published literature relevant to PD. The search included all relevant articles published up to June 2015, including preclinical studies and published guidelines. References used in the text were assessed according to their level of evidence, and guideline recommendations were graded based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Owing to the paucity of larger series and randomized placebo-controlled trials with regard to surgical intervention, guideline statements are provided as clinical principle or expert opinion. Main Outcome Measures This literature was discussed at a panel meeting, and selected articles with the highest evidence available were used to create consensus guideline statements for the Fourth International Consultation on Sexual Medicine guidelines on PD. Results In addition to existing Third International Consultation on Sexual Medicine guidelines on PD, seven new summary recommendations were created. Conclusion A greater understanding of the scientific basis of PD is greatly needed to address our understanding of the pathophysiology, clinical epidemiology, psychosocial, and diagnostic assessment as well as treatment strategies.
- Published
- 2016
38. Urologic-Induced Complications of Prophylactic Ureteral Localization Stent Placement for Colorectal Surgery Cases
- Author
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David D. Thiel, Michael J. Wehle, Todd C. Igel, Gregory A. Broderick, Steven P. Petrou, Ram A. Pathak, Abby S. Taylor, Paul R. Young, and Scott Alford
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Single Center ,Young Adult ,Ureter ,medicine ,Humans ,Fluoroscopy ,Intraoperative Complications ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Incidence ,Incidence (epidemiology) ,Stent ,Retrospective cohort study ,Cystoscopy ,Middle Aged ,Colorectal surgery ,Surgery ,medicine.anatomical_structure ,Female ,Stents ,Radiology ,business ,Colorectal Surgery ,Ureteral Obstruction - Abstract
A prophylactic ureteral localization stent (PULSe) placed by urologists aids in intraoperative localization and detection of suspected ureteral injury during complex colorectal surgery (CRS) cases. We evaluated the incidence and management of urologic-induced complications secondary to PULSe placement during CRS cases at a single center.We performed a retrospective review of all patients who underwent cystoscopy and PULSe placement at the time of CRS over a 12-month period. Bilateral 5 French ×70-cm TigerTail® (Bard Medical Division, Covington, GA) PULSe devices were placed without assistance of routine fluoroscopy.Ninety-nine patients (mean age, 58.1 years; range, 17-88 years) underwent bilateral PULSe placement, with a male:female ratio of 44:55 and a mean body mass index of 26.8 (17.0-38.6) kg/m(2). Mean pre- and postprocedural creatinine levels were 0.91 and 1.01 mg/dL, respectively. Twenty-two of 99 (22%) cases utilized a guidewire to aid in placement of PULSe. Four Clavien grade IIIb complications occurred: mucosal edema, reflex anuria, ureteral perforation, and ureteral obstruction secondary to significant clot burden. Three of the grade IIIb complications were managed endoscopically with double-J stent placement. The ureteral perforation case required percutaneous nephrostomy tube placement. Subgroup analysis of the four grade IIIb complications revealed a mean age of 62.3 years, body mass index of 26.98 kg/m(2), and pre- and postprocedural creatinine levels of 0.95 and 4.83 mg/dL, respectively. Only one of the four grade IIIb complications utilized a guidewire prior to PULSe placement.The incidence of Clavien grade III urologic-induced complications during PULSe placement is approximately 2% (4/188). Mandatory adoption of fluoroscopy and guidewires may be required to minimize complications of PULSe placement.
- Published
- 2015
39. PD20-10 EFFECT OF ANTIMICROBIAL DIPPING SOLUTIONS ON POST-OPERATIVE INFECTION RATES IN DIABETIC PATIENTS UNDERGOING PRIMARY INSERTION OF A COLOPLAST TITAN INFLATABLE PENILE PROSTHESIS
- Author
-
Robert Andrianne, Daniar Osmonov, Georgios Hatzichristodoulou, Ricardo Munarriz, Lawrence C. Jenkins, Amy I. Guise, Arthur L. Burnett, Maxwell Towe, Mohamad M. Osman, Martin S. Gross, Gerard D. Henry, Tung-Chin Hsieh, Farouk M. El-Khatib, Linda M. Huynh, Jay Simhan, Paul Perito, Faysal A. Yafi, Jonathan Clavell-Hernandez, Sung Hun Park, Hossein Sadeghi-Nejad, Aaron C. Lentz, Gregory A. Broderick, Run Wang, and Dips (Diabetes)
- Subjects
medicine.medical_specialty ,Inflatable penile prosthesis ,business.industry ,Post operative infection ,Urology ,Medicine ,business ,Antimicrobial ,Surgery - Abstract
INTRODUCTION AND OBJECTIVE:Penile prostheses (PP) that are dipped in antimicrobial solutions can be specially selected by the implanter and tailored towards the patient. The best choice for antimic...
- Published
- 2020
40. 037 Preoperative Urine Culture and its Affect on Penile Prosthesis Infection
- Author
-
Kevin Parikh, J. Bullock, Gregory A. Broderick, S. Lomax, and J. Schnell
- Subjects
Psychiatry and Mental health ,medicine.medical_specialty ,Endocrinology ,Reproductive Medicine ,business.industry ,Urology ,Endocrinology, Diabetes and Metabolism ,Medicine ,Urine ,business ,Penile prosthesis infection ,Affect (psychology) ,Surgery - Published
- 2020
41. Survivorship, Version 2.2018: Clinical Practice Guidelines in Oncology
- Author
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Deborah A. Freedman-Cass, Electra D. Paskett, Allison A. King, Sophia K. Smith, Allison L. McDonough, Kathryn J. Ruddy, Phyllis C. Zee, Debra L. Friedman, Divya Koura, Jose G. Montoya, Javid Moslehi, Gregory A. Broderick, Crystal S. Denlinger, Nicole R. McMillian, Robin M. Lally, Susan G. Urba, Melissa M. Hudson, Wendy Demark-Wahnefried, Tara Sanft, Kathi Mooney, Karen L. Syrjala, Tracey O'Connor, Terry S. Langbaum, Mindy Goldman, William F. Pirl, Paula Silverman, Michelle E. Melisko, Mark T. Wakabayashi, Nazanin Khakpour, Amye J. Tevaarwerk, Jeffrey Peppercorn, K. Scott Baker, M. Alma Rodriguez, and Linda Overholser
- Subjects
medicine.medical_specialty ,MEDLINE ,Survivorship ,030204 cardiovascular system & hematology ,Medical Oncology ,Risk Assessment ,Article ,03 medical and health sciences ,Immunocompromised Host ,0302 clinical medicine ,Antineoplastic Agents, Immunological ,Cancer Survivors ,Survivorship curve ,Neoplasms ,medicine ,Humans ,Mass Screening ,Anthracyclines ,Lymphedema ,Societies, Medical ,Cardiotoxicity ,Antibiotics, Antineoplastic ,business.industry ,Vaccination ,Cancer ,Bacterial Infections ,medicine.disease ,humanities ,United States ,Cancer treatment ,Clinical Practice ,Oncology ,Virus Diseases ,030220 oncology & carcinogenesis ,Family medicine ,business ,Psychosocial - Abstract
The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for common physical and psychosocial consequences of cancer and cancer treatment to help healthcare professionals who work with survivors of adult-onset cancer in the posttreatment period. This portion of the guidelines describes recommendations regarding the management of anthracycline-induced cardiotoxicity and lymphedema. In addition, recommendations regarding immunizations and the prevention of infections in cancer survivors are included.
- Published
- 2018
42. PD27-02 PENILE DOPPLER ULTRASOUND AT A TERTIARY REFERRAL CENTER FOR ERECTILE DYSFUNCTION: WHAT WE LEARNED OVER A 12 YEAR PERIOD
- Author
-
Rishubh Shah, Colleen S. Thomas, Zachary McNulty, John R Moore, Eric Schommer, and Gregory A. Broderick
- Subjects
medicine.medical_specialty ,Erectile dysfunction ,business.industry ,Urology ,medicine ,Referral center ,Doppler ultrasound ,medicine.disease ,business ,Surgery - Published
- 2018
43. PD27-05 ERECTILE FUNCTION AND LOWER URINARY TRACT SYMPTOMS FOLLOWING MRI FUSION-GUIDED PROSTATE BIOPSY
- Author
-
Ashley Shumate, Colleen S. Thomas, Neil Sood, and Gregory A. Broderick
- Subjects
medicine.medical_specialty ,Prostate biopsy ,medicine.diagnostic_test ,business.industry ,Urology ,030232 urology & nephrology ,Erectile function ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Lower urinary tract symptoms ,030220 oncology & carcinogenesis ,medicine ,business - Published
- 2018
44. Cystadenoma of the Rete Testis in a Patient With von Hippel-Lindau Disease
- Author
-
Candice W. Bolan, Jacob I. Lewis, David D. Thiel, and Gregory A. Broderick
- Subjects
Adult ,Male ,endocrine system ,Pathology ,medicine.medical_specialty ,von Hippel-Lindau Disease ,endocrine system diseases ,Urology ,Cystadenoma ,Testicle ,urologic and male genital diseases ,Endolymphatic sac ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Broad spectrum ,0302 clinical medicine ,Testicular Neoplasms ,Rete testis ,medicine ,Humans ,Von Hippel–Lindau disease ,neoplasms ,Ultrasonography ,Rete Testis ,business.industry ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Pancreatic cysts ,business ,Orchiectomy - Abstract
von Hippel-Lindau disease is a rare, inherited multicystic disorder that is characterized by several benign and malignant neoplasms (Odrzywolski, 2010). Classically, the disease manifests itself in a broad spectrum, including renal cell carcinomas, intracranial and spinal hemangioblastomas, endolymphatic sac tumors, renal and pancreatic cysts, and pheochromocytomas. Another important, but commonly forgotten manifestation is the cystadenoma of the rete testis.
- Published
- 2017
45. MP56-08 CANDIDATES FOR COLLAGENASE CLOSTRIDIUM HISTOLYTICUM THERAPY: A RETROSPECTIVE REVIEW OF THE STRUCTURAL AND HEMODYNAMIC CHARACTERISTICS OF MEN WITH PEYRONIE'S DISEASE (PD)
- Author
-
Ram A. Pathak and Gregory A. Broderick
- Subjects
medicine.medical_specialty ,Retrospective review ,Collagenase clostridium histolyticum ,business.industry ,Urology ,medicine ,Hemodynamics ,Peyronie's disease ,medicine.disease ,business ,medicine.drug ,Surgery - Published
- 2017
46. MP92-17 USE OF GUIDEWIRE DURING PLACEMENT OF PROPHYLACTIC URETERAL LOCALIZATION STENTS (PULSE) FOR COLORECTAL SURGERY (CRS) CASES DECREASES UROLOGIC-INDUCED OPERATIVE COMPLICATIONS
- Author
-
Paul R. Young, Ram A. Pathak, David D. Thiel, Steven P. Petrou, Ciarra Boyne, Nicolette T. Chimato, Gregory A. Broderick, Raymond Pak, Todd C. Igel, Kasey Cockerill, and Ryan D. Frank
- Subjects
medicine.medical_specialty ,business.industry ,Pulse (signal processing) ,Urology ,Medicine ,Radiology ,business ,Colorectal surgery ,Surgery - Published
- 2017
47. Small Cell Carcinoma of the Prostate in an Elderly Patient: A Case Report and Review of the Literature
- Author
-
William B. Schenk, Gerald Strong, Gregory A. Broderick, Steven J. Buskirk, L. Hintenlang, Niveditha Jagadesh, Dale Alan Whitaker, Katherine S. Tzou, and Daniel H. Miller
- Subjects
Oncology ,medicine.medical_specialty ,Histology ,medicine.medical_treatment ,030232 urology & nephrology ,Case Report ,Malignancy ,Small-cell carcinoma ,lcsh:RC254-282 ,Androgen deprivation therapy ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate ,Internal medicine ,medicine ,Carcinoma ,Small cell carcinoma ,Radiotherapy ,business.industry ,Prostatectomy ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Radiation therapy ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,business - Abstract
Prostate cancer is the most common malignancy of men in the United States. Small-cell carcinoma (SCC), which typically presents as an aggressive lung malignancy, is a rare diagnosis within the setting of prostate cancer pathology. Due to its limited prevalence, little information regarding the treatment and prognosis of this disease in large populations is available. To date our current knowledge base is largely limited to case reports and retrospective case reviews. The mainstay of treatment for this particular histology most often involves a multimodality approach utilizing chemotherapy in conjunction with radiation therapy, androgen deprivation therapy, or prostatectomy. Here we present the case of an elderly 89-year-old Caucasian male who was diagnosed with SCC of the prostate. Despite proceeding with a course of definitive radiotherapy, the patient experienced rapid progression of disease and ultimately elected to discontinue radiation therapy and receive hospice care.
- Published
- 2016
48. 207 Single Center Experience Using Doppler Assessment for Erectile Dysfunction (ED) Complaint in More Than 500 Patients
- Author
-
Z. McNulty, Ram A. Pathak, R. Shah, Gregory A. Broderick, and E. Schommer
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Endocrinology, Diabetes and Metabolism ,medicine.disease ,Single Center ,Psychiatry and Mental health ,symbols.namesake ,Endocrinology ,Erectile dysfunction ,Reproductive Medicine ,Internal medicine ,Cardiology ,Complaint ,symbols ,Medicine ,business ,Doppler effect - Published
- 2018
49. 194 Diabetes and Erectile Dysfunction: A Special Population Analysis from a Penile Doppler Cohort of 1000 Patients
- Author
-
Gregory A. Broderick, E. Schommer, G. Edwards, P. Cannizzo, C. Thomas, A. Shumate, and K. Custer
- Subjects
Pediatrics ,medicine.medical_specialty ,Special populations ,business.industry ,Urology ,Endocrinology, Diabetes and Metabolism ,medicine.disease ,Psychiatry and Mental health ,Endocrinology ,Erectile dysfunction ,Reproductive Medicine ,Diabetes mellitus ,Cohort ,medicine ,business - Published
- 2019
50. 279 Comparing Vascular Diagnoses using Color Doppler Duplex Ultrasound Evaluation Before and After Treatment of Peyronie’s disease using Intralesional Collagenase Clostridium Histolyticum
- Author
-
Gregory A. Broderick, K. Cockerill, P. Cannizzo, and G. Edwards
- Subjects
business.industry ,Urology ,Endocrinology, Diabetes and Metabolism ,Ultrasound ,Color doppler ,medicine.disease ,Psychiatry and Mental health ,Endocrinology ,Collagenase clostridium histolyticum ,Reproductive Medicine ,Duplex (building) ,medicine ,Peyronie's disease ,business ,Nuclear medicine ,After treatment ,medicine.drug - Published
- 2019
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