Medical Therapy in Urology (eBook)

Anchor 1 1
Anchor 2 1
About the Editors 1
Shergill_Ch01_O.pdf 14
Chapter 1 14
Bladder Cancer 14
Introduction 14
Medical Therapies in Bladder Cancer 16
Intravesical Mitomycin Chemotherapy 16
Other Intravesical Chemotherapy Agents 20
Optimizing Intravesical Mitomycin 21
Intravesical Bacillus Calmette-Guerin (BCG) Immunotherapy 22
Accurate Detection and Clearance of NMIBC 24
Clinical Application of Medical Therapies 24
Key Points 26
References 26
Shergill_Ch02_O.pdf 30
Chapter 2 30
Renal Cell Cancer 30
Introduction 30
Molecular Pathogenesis of Renal Cancer 30
Prognostic Factors 31
Medical Therapies in Renal Cancer 33
The Immunotherapy Era (1984–2004) 33
Interferon-.a. (IFN.a.) 33
Interleukin-2 (IL-2) 33
Targeted Therapies in Renal Cell Carcinoma (2004 to Present) 34
Sorafenib 34
Sunitinib 34
Bevacizumab 35
Temsirolimus 36
Everolimus 37
Cytotoxic Chemotherapy 37
Cytoreductive Nephrectomy 37
Adjuvant Therapy 38
Current Treatment Strategies and Ongoing Investigations 38
Key Points 42
References 42
Shergill_Ch03_O.pdf 45
Chapter 3 45
Prostate Cancer 45
Introduction 45
Anatomy and Pathophysiology of the Prostate 45
Hormonal Control of the Prostate 46
Medical Therapies in Prostate Cancer 47
Luteinizing Hormone-Releasing Hormone (LHRH) Agonists 50
Antiandrogens 51
Antiandrogen Monotherapy in Locally Advanced or Metastatic Disease 51
LHRH Antagonists 51
Combined Androgen Blockade 52
Antiandrogen Withdrawal Syndrome and Secondary Hormonal Manipulations 52
Additional Treatments 53
Neoadjuvant and Adjuvant Androgen Deprivation Therapy to Radiotherapy 54
Long-Term vs. Short-Term Adjuvant Androgen Deprivation Therapy to Radiotherapy 54
Intermittent Hormone Therapy (IHT) 55
Hormone Refractory or Androgen Independent PCa 56
Key Points 56
References 57
Shergill_Ch04_O.pdf 60
Chapter 4 60
Testicular Cancer 60
Introduction 60
Medical Therapies in Testicular Cancer 63
Seminoma Clinical Stage I 66
Non-Seminoma Clinical Stage I 66
Seminoma Clinical Stage II A/B (Metastatic Disease) 68
Non-Seminoma Clinical Stage II A/B (Metastatic Disease) 68
Seminoma and Non-Seminoma Clinical Stage IIC/III (Advanced Metastatic Disease) 69
Restaging and Further Treatment 70
Salvage Chemotherapy in Relapse/Refractory Disease 70
Late Toxicity of Chemotherapy in Testis Cancer 71
Key Points 72
Further Reading 73
Shergill_Ch05_O.pdf 74
Chapter 5 74
Penile Cancer 74
Introduction 74
Medical Therapies in Penile Cancer 76
Single-Agent Chemotherapy 76
Combination Chemotherapy 79
Adjuvant Chemotherapy 79
Neoadjuvant Chemotherapy for Fixed Inguinal Nodes 80
Key Points 82
References 83
Shergill_Ch06_O.pdf 84
Chapter 6 84
LUTS/Benign Prostatic Hyperplasia 84
Introduction 84
Terminology 84
Anatomy, Physiology, and Pathology of Prostate Relevant to LUTS/BPH 84
Assessment of LUTS/BPH Relevant to Medical Management 86
Medical Therapies in LUTS/BPH 88
a. Blockers 88
5.a. Reductase Inhibitors 93
Combination Therapy – .a. Blockers and 5.a. Reductase Inhibitors 94
Combination Therapy – .a. Blockers and ACh Medication 95
Management Algorithm for Medical Treatment of LUTS/BPH 96
Key Points 97
References 97
Shergill_Ch07_O.pdf 99
Chapter 7 99
Overactive Bladder and Incontinence 99
Introduction 99
Classification and Terminology 99
Anatomy and Physiology of Bladder Dysfunction 101
Clinical Assessment 101
Conservative Management 102
Medical Therapies in Overactive Bladder and Incontinence 102
Antimuscarinic (Anticholinergic) Therapies 102
Botulinum Toxin 108
Transdermal Oxybutynin Patch 108
Intravaginal Estrogens 109
Medical Management of Stress Incontinence 109
How to Choose Medical Therapies in OAB and UUI 110
Key Points 111
References 112
Shergill_Ch08_O.pdf 114
Chapter 8 114
Urinary Tract Infections 114
Introduction 114
Definitions and Terminology 114
Risk Factors for UTI 115
Epidemiology 116
Uropathogens 116
Diagnosis 119
Medical Therapies in Urinary Tract Infections 119
Uncomplicated UTI 120
UTI in Pregnancy 120
Recurrent UTI 124
Asymptomatic UTI 125
Complicated UTI 125
Septicemia 126
Acute Prostatitis 126
Healthcare-Associated Infections 127
Reduce Resistance Development 127
Key Points 128
Further Reading 128
Shergill_Ch09_O.pdf 130
Chapter 9 130
Bladder Pain Syndrome/Interstitial Cystitis 130
Introduction 130
Clinical Assessment 131
Overview of Management 131
Medical Therapies in BPS/IC 132
Pentosan Polysulfate (PPS) – Elmiron 135
Hyaluronic Acid (Cystistat) 135
Chondroitin Sulfate (Uracyst) 136
Dimethyl Sulfoxide (DMSO) 136
Amitryptiline 137
Gabapentin 137
Botulinum Toxin 137
Analgesics 138
Other Medical Treatments 138
Management Algorithm – Based on EAU Guidelines 138
Key Points 139
References 139
Chapter 10 1
Chronic Prostatitis/Chronic Pelvic Pain Syndrome 1
Introduction 1
Pathophysiology and Anatomy 1
Assessment 1
Medical Therapies in CP/CPPS 1
Antibiotics 1
a. Blockers (AB) 1
5.a. Reductase Inhibitors 1
Other Medications 1
Key Points 1
References 1
Shergill_Ch11_O.pdf 155
Chapter 11 155
Urinary Tract Stones 155
Introduction 155
Prevention of Stone Formation 156
Medical Therapies in Urinary Tract Stones 158
Calcium Stones 158
Uric Acid Stones 164
Infection Stones 164
Xanthine Stones 166
2,8-Dihydroxyadenine (2,8-DHA) Stones 167
Silica Stones 167
Ammonium Urate Stones 167
Iatrogenic Stones 168
Key Points 168
References 169
Shergill_Ch12_O.pdf 171
Chapter 12 171
Erectile Dysfunction 171
Introduction 171
Physiology of Erection 171
Etiology 172
Medical Therapies in Erectile Dysfunction 174
Establishing the Diagnosis 174
Identify Reversible Risk Factors, Which Can Be Treated 174
Medical Therapies 175
Oral Pharmacological Agents 175
Injection Therapy – Intracavernosal or Intraurethral Options 181
Special Considerations 182
Testosterone Replacement Therapy 182
Combination Therapy 184
Once Daily PDE5 Inhibitors 184
Key Points 184
References 185
Shergill_Ch13_O.pdf 188
Chapter 13 188
Male Hypogonadism 188
Introduction 188
Anatomy and Physiology 188
Classification and Causes of Hypogonadism 190
Clinical Assessment and Diagnosis 190
Medical Therapies in Male Hypogonadism 194
Key points 201
References 202
Shergill_Ch14_O.pdf 204
Chapter 14 204
Renal Transplantation 204
Introduction 204
Principles and History of Anti-Rejection Therapies 205
Immunomodulatory Modalities, Protocols, and Clinical Trials 206
Acute Rejection 206
Adverse Effects of Immunosuppression 210
Infections 211
Malignancy 211
Cardiovascular Disease 212
Diabetes 212
Bone Disease 213
Hyperuricemia and Gout 213
Anemia 214
Key Points 214
Further Reading 215
Shergill_Ch15_O.pdf 216
Chapter 15 216
Analgesia for Urological Procedures 216
Introduction 216
Medical Therapies used in Urological Analgesia 217
Spinal Anesthesia 218
Caudal Analgesia 218
Dorsal Penile Nerve Block 221
Spermatic Cord Block 222
Inguino-Scrotal Surgery 222
Transrectal Ultrasound (TRUS) Guided Prostate Biopsies 223
Flexible Cystoscopy 223
Extracorporeal Shock-Wave Lithotripsy 224
Postoperative Analgesia 224
Patient-Controlled Analgesia (PCA) 224
Emergency Management of Renal (Ureteric) Colic 225
Key points 226
References 227
Shergill_Ch16_O.pdf 228
Chapter 16 228
Alternative or Complementary Treatments in Urology 228
Introduction 228
Benign Prostatic Hyperplasia 230
Saw Palmetto 230
African Plum Tree 230
South African Stargrass 232
Pumpkin Seed 232
Rye Pollen 232
Stinging Nettle 233
Prostate Cancer 233
Selenium 234
Lycopene 234
Pomegranate Juice 235
Chronic Prostatitis 235
Quercetin 235
Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) 235
Urinary Tract infection 237
Cranberry Juice 237
Peyronie’s Disease 237
Erectile Dysfunction 237
Korean Red Ginseng 238
Conclusions 238
Key Points 238
Further Reading 239
Chapter 10 142
Chronic Prostatitis/Chronic Pelvic Pain Syndrome 142
Introduction 142
Pathophysiology and Anatomy 143
Assessment 145
Medical Therapies in CP/CPPS 145
Antibiotics 150
a Blockers (AB) 150
5a Reductase Inhibitors 151
Other Medications 151
Key Points 152
References 153
Anchor 1 5
Anchor 2 9
About the Editors 13