Paul C. Boutros, PhD, MBA, examines germline genetics and urine characteristics of prostate cancer and how these relate to aggression.Paul C. Boutros, PhD, MBA, examines germline genetics and urine characteristics of prostate cancer and how these relate to aggression.
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Jesse N. Mills, MD, Associate Clinical Professor and Director of the Men’s Clinic at UCLA, discusses techniques for Xiaflex on and off label, and when and how it can be used to treat Peyronie’s disease. These include alternative injection techniques, plaques involving the penile urethra, use for men on anticoagulation treatments, and non-goniometric deformity.
Read MoreIn conversation with A. Lenore Ackerman, MD, PhD, Assistant Professor of Urology and Director of Research in the Division of Female Pelvic Medicine and Reconstructive Surgery at the University of California, Los Angeles, Gerard D. Henry, MD, a urologist with WK Advanced Urology in Shreveport, Louisiana, and President of the Louisiana Urological Society, provides an update on his research into the detection of penile implant infections. Dr. Henry explains that bacterial infection is more common than urologists realized, noting how, 20 years ago, he and his colleagues found a biofilm on the penile implants of patients who appeared to just be experiencing mechanical failure. He then describes a study comparing next generation sequencing (NGS) versus traditional culture in penile implants and suggests that NGS might be the new gold standard for assessing penile implant infections since it can identify not only what bacteria are present, but also the abundance of bacteria. Dr. Henry highlights that NGS has demonstrated that the main form of bacteria affecting penile implants is not Staphylococcus epidermidis, as long believed, and that Escherichia coli and Pseudomonas are more common. He argues that by more specifically identifying these bacteria, urologists may be able to better treat patients and avoid having to remove implants. Dr. Henry then introduces a new, currently-recruiting, prospective, randomized study of next generation sequencing versus traditional cultures for clinically infected penile implants and the impact of culture identification on outcomes. The discussion concludes with a question-and-answer session in which Dr. Ackerman asks about outcomes in the upcoming trial, other potential applications of NGS in urology, and the potential source of the bacteria identified by NGS.
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In conversation with A. Lenore Ackerman, MD, PhD, Assistant Professor of Urology and Director of Research in the Division of Female Pelvic Medicine and Reconstructive Surgery at the University of California, Los Angeles, Gerard D. Henry, MD, a urologist with WK Advanced Urology in Shreveport, Louisiana, and President of the Louisiana Urological Society, provides an update on his research into the detection of penile implant infections. Dr. Henry explains that bacterial infection is more common than urologists realized, noting how, 20 years ago, he and his colleagues found a biofilm on the penile implants of patients who appeared to just be experiencing mechanical failure. He then describes a study comparing next generation sequencing (NGS) versus traditional culture in penile implants and suggests that NGS might be the new gold standard for assessing penile implant infections since it can identify not only what bacteria are present, but also the abundance of bacteria. Dr. Henry highlights that NGS has demonstrated that the main form of bacteria affecting penile implants is not Staphylococcus epidermidis, as long believed, and that Escherichia coli and Pseudomonas are more common. He argues that by more specifically identifying these bacteria, urologists may be able to better treat patients and avoid having to remove implants. Dr. Henry then introduces a new, currently-recruiting, prospective, randomized study of next generation sequencing versus traditional cultures for clinically infected penile implants and the impact of culture identification on outcomes. The discussion concludes with a question-and-answer session in which Dr. Ackerman asks about outcomes in the upcoming trial, other potential applications of NGS in urology, and the potential source of the bacteria identified by NGS.
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In conversation with A. Lenore Ackerman, MD, PhD, Assistant Professor of Urology and Director of Research in the Division of Female Pelvic Medicine and Reconstructive Surgery at the University of California, Los Angeles, Ja-Hong H. Kim, MD, Associate Professor in the Division of Pelvic Medicine and Reconstructive Surgery at the University of California, Los Angeles, and Victoria C. Scott, MD, Associate Program Director of the FPMRS Fellowship at Cedars-Sinai Medical Center, discuss a recent study of the experience of women with recurrent urinary tract infections (rUTIs). Dr. Scott explains that 29 women were recruited to participate in 1 of 6 focus group discussions to investigate the perspective of women suffering from rUTIs. She then lists some preliminary themes from the discussions with the women, including fear of development of antibiotic resistance, widespread knowledge of the collateral damage from antibiotics, concern about taking unnecessary antibiotics, anger at physicians for “throwing” antibiotics at them, a feeling that the medical profession underestimates the impact of rUTIs, a need for research on nonantibiotic options for prevention and treatment, and resentment towards the medical system for not dedicating more research efforts to providing more timely diagnosis. Dr. Scott synthesizes these themes into two emergent concepts: fear about the overuse of antibiotics and frustration at the medical system for not providing alternative treatments or taking rUTI symptoms seriously. Dr. Kim then notes that this initial study has produced two additional studies on the current management of rUTIs that take expert and personal care provider experiences into account. Dr. Ackerman highlights the importance of data capturing that patients are not seeking antibiotics necessarily in the way doctors assume they are, though Dr. Kim does add the caveat that the women in the study were a relatively homogeneous group of college-educated white women. Dr. Ackerman also muses that the attitudes expressed in this study suggest that this population may be interested in a vaccine for rUTIs. Drs. Ackerman, Scott, and Kim conclude by noting that the study made evident the importance to patients with rUTIs of focusing on their experience rather than merely the clearance of bacteria.
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