Highlights of Urology Research

Protection Against Kidney Stones?
Enteric colonization with Oxalobacter formigenes, a bacterium whose main energy source is oxalate, has been shown to decrease the risk of recurrent calcium oxalate kidney stone formation. In the current study, Dean Assimos, MD, et al studied the interplay between oxalate and calcium in the diets of individuals colonized and not colonized with the bacterium. Although a diet low in calcium has been shown to increase the risk of calcium oxalate stone formation, these current results suggests that O. formigenes colonization may be protective during periods of low calcium intake and moderate oxalate intake.
(Impact of dietary calcium and oxalate, and Oxalobacter formigenes colonization on urinary oxalate excretion. Jiang J, Knight J, Easter LH, Neiberg R, Holmes RP, Assimos DG.J Urol. 2011 Jul;186(1):135-9. Epub 2011 May 14.)

Definitive Stricture Repair
In this article, Ryan Terlecki, MD, coins the concept of “urethral rest” in preoperative management for patients pursuing definitive repair of urethral strictures. It was determined that strictures in men who had been recently instrumented often become obliterative after a three-month period of rest, often facilitated by suprapubic diversion. Delineation of stricture disease was felt to allow for higher rates of success than would otherwise be expected according to a philosophy of “you need to see it to treat it.”
(Urethral rest: role and rationale in preparation for anterior urethroplasty. Terlecki RP, Steele MC, Valadez C, Morey AF. Urology. 2011 Jun; 77(6):1477-81. Epub 2011
Apr 21. PMID:21513968)

New Robotic Technique
Ashok K. Hemal, MD, et al report what is believed to be the first case series performing robot-assisted nephroureterectomy with bladder cuff excision with lymphadenectomy for upper tract transitional cell carcinoma. All 15 procedures were performed uneventfully with mean operating time of 184 minutes and hospital stay of 2.7 days. There were no positive surgical margins and no oncologic recurrence at short-term follow-up. The technique allows a seamless transition from kidney to the lower part of the ureter and bladder without changing patient position or redocking the robot.
(Robotic-assisted nephroureterectomy and bladder cuff excision without intraoperative repositioning. Hemal AK, Stansel I, Babbar P,  Patel M. Urology. 2011 Aug;78(2):357-64.)

A Future Treatment to Prevent Strictures?
The development of urethral stricture is a fibrotic process associated with increased deposits of collagen after injury or infection. This novel study by Steve Hodges, MD, et al is the first to show that coating a urethral catheter with halofuginone (HF), a potent type 1 collagen inhibitor, is feasible with drug release to the surrounding tissue. In a rat model, HF successfully inhibited periurethral type I collagen deposits after urethral injury, and may become an important therapy to prevent urethral stricture formation or recurrence after endoscopic therapy.
(Halofuginone-coated urethral catheters prevent periurethral spongiofibrosis in a rat model of urethral injury. Krane LS, Gorbachinsky I, Sirintrapun J, Yoo JJ, Atala A, Hodges SJ. J Endourol. 2011 Jan;25(1):107-12. Epub 2011 Jan 4.)
Last Updated: 01-21-2014
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