Abstract:
OBJECTIVE:To provide an update on SpaceOAR System, a Food and Drug Administration-approved hydrogel indicated to create distance between the prostate and the rectum which has been studied in phase 2 and 3 clinical trials. Here, we review and summarize these clinical results including the safety of prostate-rectum spacer application technique, the implant quality and resulting rectal dose reduction, acute and long-term rectal, urinary, and sexual toxicity, as well as patient-reported outcomes. MATERIALS AND METHODS:A prospective, randomized patient-blinded clinical study was performed comparing image-guided intensity modulated prostate radiotherapy (79.2 Gy in 44 fractions) in men with or without prostate-rectum hydrogel spacer. Patients were followed up for 3 years, allowing assessment of long-term safety and efficacy. RESULTS:Spacer application was well tolerated with a 99% technical success rate. The mean additional space created between the prostate and the rectum was just over 1 cm, which allowed significant rectum and penile bulb radiation dose reduction, resulting in less acute pain, lower rates of late rectal toxicity, and improved bowel and urinary quality of life (QOL) scores from 6 months onward. Improvements in sexual QOL were also observed at 37 months in baseline-potent men, with 37.5% of control and 66.7% of spacer men capable of "erections sufficient for intercourse." CONCLUSION:Prostate-rectum hydrogel spacer application is a relatively safe technical procedure that is well tolerated and has a high technical success rate. Spacer application significantly reduces rectal radiation dose and results in long-term reductions in rectal toxicity, as well as improvements in bowel, urinary, and sexual QOL.
journal_name
Urologyjournal_title
Urologyauthors
Karsh LI,Gross ET,Pieczonka CM,Aliotta PJ,Skomra CJ,Ponsky LE,Nieh PT,Han M,Hamstra DA,Shore NDdoi
10.1016/j.urology.2017.11.016subject
Has Abstractpub_date
2018-05-01 00:00:00pages
39-44eissn
0090-4295issn
1527-9995pii
S0090-4295(17)31213-Xjournal_volume
115pub_type
杂志文章,评审相关文献
UROLOGY文献大全abstract::Splenogonadal fusion is a rare condition wherein splenic tissue is found attached to or within the testis. There are two anatomic types: continuous and discontinuous. We report a case of splenogonadal fusion that presented in an adult man with bilateral cryptorchid testes. ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(94)80027-8
更新日期:1994-07-01 00:00:00
abstract::Genital cutaneous involvement with Crohn disease is an uncommon complication which has been described only recently. A case is presented of a young man with Crohn disease involving the penile and scrotal skin four years after total colectomy for Crohn disease. The histopathology and management are discussed. While the...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(80)90376-3
更新日期:1980-06-01 00:00:00
abstract:OBJECTIVES:Recent evidence indicates that ischemia and reperfusion (free radical generation) are major etiologic factors in the rabbit bladder subjected to partial outlet obstruction. The current investigation was designed to determine the time course of damage caused by reactive oxygen species (ROS) and reactive nitro...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2007.09.047
更新日期:2007-12-01 00:00:00
abstract::Scrotal skin was employed to cover skin defects resulting from palliative groin and suprapubic dissections designed to remove large masses of tumor which had eroded the skin. This technique provides a simple and effective alternative to more complex procedures using rotational skin and myocutaneous flaps to achieve pr...
journal_title:Urology
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract::Nifedipine, a calcium channel blocker, was tested for its in vivo effect on the ureter and kidney during acute obstruction. There was no discernible effect on peristalsis but glomerular filtration rate was improved. Thus, nifedipine would not be expected to decrease renal colic from obstruction. ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(93)90516-d
更新日期:1993-05-01 00:00:00
abstract::In an attempt to solve the problem of chemosensitivity testing of renal cell carcinoma in vitro, a modified short-term culture technique was developed. The kinetic study of hypernephroma cells and normal renal cells showed that the uptake of H3-uridine and H3-thymidine is at its maximum after eighty hours. The effect ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(88)90150-1
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVES:Recent studies have shown that growth factors may play a role in the etiology of benign prostatic hyperplasia (BPH) and prostatic carcinoma. Several growth factors have been reported to be expressed by prostatic tissues, but these growth factors have never been examined in human fetal prostate and compared w...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(96)00376-7
更新日期:1996-12-01 00:00:00
abstract::Distal ureterectomy with direct ureteroneocystostomy facilitated by the psoas bladder hitch procedure has been used in 6 patients for management of low-grade, noninvasive primary ureteral carcinoma. All patients are alive, two to ninety-six months postoperatively. Recurrent ipsilateral urothelial malignant disease has...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(79)90331-5
更新日期:1979-04-01 00:00:00
abstract:OBJECTIVE:To examine the association between kidney size and renal cell carcinoma (RCC) death among patients with Stage pT1 clear cell RCC undergoing surgery. METHODS:We used a case-cohort design and evaluated 191 patients from our Nephrectomy Registry who had undergone open radical nephrectomy for unilateral, sporadi...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2012.04.013
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:To describe a novel, low-cost, online health-related quality of life (HRQOL) survey that allows for automated follow-up and convenient access for patients in geographically diverse locations. Clinicians and investigators have been encouraged to use validated HRQOL instruments when reporting outcomes after ra...
journal_title:Urology
pub_type: 临床试验,杂志文章
doi:10.1016/j.urology.2011.08.075
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVES:Since the beginning of the 1980s, when gene technology provided sufficient amounts of cytokines, numerous Phase II studies in metastatic renal cell carcinoma were carried out mostly with interferon alfa (IFN-alpha) and interleukin-2 (IL-2). So far, no randomized prospective trials including untreated control...
journal_title:Urology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/S0090-4295(99)80079-X
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:To investigate the expression of hyperpolarization-activated cyclic nucleotide-gated (HCN) protein in the interstitial cells of Cajal (ICCs) of the human bladder and to determine the relative expression of the HCN subtypes. METHODS:A total of 30 bladder specimens were obtained, and each bladder sample was di...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2012.04.005
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety of a novel ureteral occlusion device and compare its performance with that of other devices and guidewires. METHODS:The XenX (Xenolith Medical) was tested in an ex vivo porcine model to determine the percentage of denuded urothelium because of manipulation within the ureter, the capaci...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2012.03.018
更新日期:2012-07-01 00:00:00
abstract::The functional sequelae of 131 patients with urogenital tuberculosis were examined. At the time of diagnosis, more than half of the patients already suffered from global renal failure which was moderate in 42.7 per cent and severe in 15.5 per cent. We believe that the primary functional damage occurs at the medullary ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(78)90156-5
更新日期:1978-05-01 00:00:00
abstract::Alveolar rhabdomyosarcoma is an aggressive cancer that can metastasize to a variety of organs. We present what we believe to be the first reported case of metastatic intratesticular rhabdomyosarcoma in a patient presenting with testicular pain shortly after the induction of systemic chemotherapy. The published data re...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2007.02.023
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy of dietary management for the treatment of idiopathic hyperoxaluria in a large tertiary care center and examine the influence of patient factors, compliance, and follow-up on oxalate reduction, which has not been previously investigated. METHODS:Retrospectively, 149 patients with kidne...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2013.08.002
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVES:Excessive formation of reactive oxygen species (ROS) in human semen has been associated with impaired sperm function and fertility potential. The presence of ROS in semen specimens from normal fertile men emphasizes the importance of defining a normal range of ROS formation. The purpose of this study was to ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(95)97088-6
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To determine whether occult megarectum remains a commonly unrecognized cause of enuresis and whether treating it will cure enuresis in most children. A landmark study proved constipation was a commonly unrecognized cause of enuresis in 1986 in which constipation was defined as abnormal rectal distension. Howe...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2011.10.015
更新日期:2012-02-01 00:00:00
abstract::Urethral adenocarcinoma of males is a rare disease with limited prospective data to define optimal treatment. Surgical excision remains the primary treatment for early-stage disease. Multimodality therapy with a combination of chemotherapy, radiation, or surgery has been explored in patients with locally advanced dise...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2017.11.033
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:Laser tissue soldering (LTS) in the urinary tract provides an immediate leak-free seal and may avoid complications seen with conventional repair (such as fistula and stricture). We have begun a Phase I clinical trial investigating the use of LTS in performing urologic reconstructive surgery. METHODS:Ten pat...
journal_title:Urology
pub_type: 临床试验,杂志文章
doi:10.1016/s0090-4295(99)80206-4
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVES:To evaluate periurethral silicone injection in the treatment of female stress urinary incontinence due to intrinsic sphincter deficiency (ISD) and assess whether coexisting urethral hypermobility has an impact on treatment outcome. METHODS:A total of 29 female patients with stress urinary incontinence under...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(02)01996-9
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:To describe clinical and treatment characteristics of renal soft tissue sarcomas in children, we analyzed a series of patients enrolled in the protocols coordinated by the Italian Soft Tissue Sarcoma Committee (STSC). METHODS:From 1979 to 2011, 2138 patients with soft tissue sarcomas were registered in diffe...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2012.05.019
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of frailty on adverse perioperative outcomes in patients treated with radical cystectomy for bladder cancer. MATERIAL AND METHODS:We identified 9459 adults (age ≥18) in the Nationwide Readmission Database who underwent radical cystectomy in 2014 for bladder cancer. We defined patients'...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2019.04.057
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:To assess feasibility of laparoscopic nephrectomy completed entirely by way of the vagina in the porcine model. METHODS:Six transvaginal laparoscopic nephrectomies were performed in female farm pigs. Two acute and two 1-week survival animals were used for the study. Before killing the survival animals, a se...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(01)01568-0
更新日期:2002-03-01 00:00:00
abstract::Merkel cell carcinoma is an uncommon cutaneous neoplasm of neuroendocrine origin. We report the case of a 71-year-old man with Merkel cell carcinoma metastases to the prostate and bladder presenting with lower urinary tract obstruction. Efforts should be made to optimize the patient's quality of life with the finding ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2004.03.027
更新日期:2004-07-01 00:00:00
abstract::Three prepubertal males were treated with daily applications to the penis of 5 per cen topical testosterone cream. Penile growth occurred in all 3 patients. Serum testosterone values rose dramatically in 2 of the patients. Topical testosterone probably causes penile growth via its systemic action, not merely through i...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(75)90801-8
更新日期:1975-12-01 00:00:00
abstract:OBJECTIVE:To characterize the contemporary management of prostate cancer patients in large community practices. The optimal management of incident prostate cancer has changed in the last decades to include active surveillance for a large number of men. At the same time, many community practices have merged into larger ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2019.01.061
更新日期:2019-07-01 00:00:00
abstract::A classification of the various ganglionic stimulants and blockers is presented, and their pharmacologic effects on the urinary bladder and urethra are discussed. Ganglionic stimulating drugs are of considerable interest in investigational work but are not presently used therapeutically. Ganglionic blockers include he...
journal_title:Urology
pub_type: 杂志文章,评审
doi:10.1016/0090-4295(78)90252-2
更新日期:1978-04-01 00:00:00
abstract::A literature review of PubMed reveals that 1 case report is found of a retained Foley catheter for 3 years. We report a case of a straight catheter lost in the urethra and forgotten for 20 years and its safe surgical removal. The calcified straight catheter was removed through a perineal urethrostomy and incision at t...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2010.01.063
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:To describe our initial experience with the laparoscopic technique of sliding-clip renorrhaphy applied to open surgery for small renal masses. METHODS:Knotless renorrhaphy with the sliding-clip technique is performed by securing suture with Hem-o-lok clips slid under tension against the renal capsule and lo...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2010.10.025
更新日期:2011-03-01 00:00:00