In spite of the fact that vasectomy is currently the most commonly utilized form of male contraception and it has been in use for more than 50 years, very little has been written regarding standards of practice, procedure, and follow up. This issue addresses these issues in such a way to allow the reader to evaluate what works best for their individual practice utilizing evidence-based medicine when it exists. It is not surprising in a society with a divorce rate of aproximately 50 % and an excess of 500,000 vasectomies per annum, that there is demand for vasectomy reversal. Approximately 6% of vasectomies are reversed. Although the most common indication for vasectomy reversal is remarriage, there are other indications. This issue addresses issues that are of concern when reversal is discussed with the patient seeking to restore his fertility.

Pelvic Floor Dysfunction is reviewed in this issue of Obstetrics and Gynecology Clinics, guest edited by Dr. Joseph Schaffer. Authorities in the field have come together to pen articles on Anatomy of the Pelvic Floor Dysfunction; Epidemiology of Pelvic Floor Dysfunction; Clinical Approach and Office Evaluation of the Patient with Pelvic Floor Dysfunction; Pathophysiology of Urinary Incontinence, Voiding Dysfunction, and Overactive Bladder; Behavioral Management of Urinary Incontinence, Voiding Dysfunction, and Overactive Bladder; Pharmacologic Management of Urinary Incontinence, Voiding Dysfunction, and Overactive Bladder; Surgery for Urinary Incontinence and Overactive Bladder; Pathophysiology of Pelvic Organ Prolapse; Non-Surgical Management of Pelvic Organ Prolapse; Vaginal Surgery for Pelvic Organ Prolapse Repair; Abdominal, Laparoscopic, and Robotic Surgery for Pelvic Organ Prolapse Repair; Use of Mesh and Materials in Pelvic Floor Surgery; Obliterative Surgery for Pelvic Organ Prolapse Repair; Pathophysiology of Anal Incontinence, Constipation, and Defecatory Dysfunction; Evaluation and Treatment of Anal Incontinence, Constipation, and Defecatory Dysfunction Pathophysiology of Pelvic Floor Related Pelvic Pain; and Evaluation and Treatment of Pelvic Floor Related Pelvic Pain.

Acute kidney injury (AKI), defined as an abrupt decrease in renal function over a period of hours to days, is a common complication among hospitalised patients with different acute diseases. Its incidence has been increasing in recent years and is reported to be very high especially in the acute settings. Since clinical signs and symptoms of acute renal damage are not specific, it is difficult to promptly distinguish AKI at the time of patient presentation. Currently the diagnosis of AKI requires serial assessment of laboratory tests over a period of several days, and is based mainly on the evaluation of serum creatinine (sCr) and decrease in urine output as supported by Risk, Injury, Failure, Loss, and End-Stage Kidney Disease (RIFLE) criteria, Acute Kidney Injury Network (AKIN) criteria, and the recent Kidney Disease: Improving Global Outcomes (KDIGO) practice guidelines for AKI. Such a need for repeated sCr evaluations and monitoring of urinary output for too long time after admission could therefore result in a diagnostic delay. With delays in diagnosis, clinicians miss opportunities to start appropriate treatment to minimise damage, and patients incur more severe AKI with subsequent greater risk of developing progression of renal damage leading to chronic kidney disease (CKD), dialysis and increased risk of severe cardiovascular diseases and death.

The clinical management of urolithiasis is now in a new era of ureteroscopic lithotripsy. Ureteroscopic lithotripsy has become an effective and safe treatment for both renal and ureteral stones, and its indications have been expanding. The advantages of ureteroscopy over shock-wave lithotripsy are its ability to directly access stones throughout the entire urinary collecting system either unilaterally or bilaterally, and to actively remove stone fragments. For large renal stones, percutaneous nephrolithotomy is now a standard treatment, but its major complication rates are not negligible. Ureteroscopic lithotripsy is a type of endoscopic surgery that is performed through the natural orifice, which thus avoids the onset of any renal parenchymal damage. New surgical techniques which combine percutaneous and transurethral approaches have been developed. Ureteroscopes and their working devices have rapidly improved, and further improvements will lead to even better outcomes in the next decade. This book presents the latest knowledge and the skills used for ureteroscopic surgery for urolithiasis. It consists of four sections (Indications, Instrumentations, Techniques and Evaluations). This book provides essential information for urologists who want to learn the techniques of this type of endourological surgery.

Urethroplasty is a surgical procedure to repair an injury or defect within the walls of the urethra. This atlas is a concise guide to urethroplasty. Beginning with an introduction to basic anatomy and the etiology and pathophysiology of urethral disease, the following chapters describe urethroplasty procedures for different disorders. With contributions from many US-based experts, this step by step guide is well-illustrated with nearly 300 images, diagrams and tables. The accompanying DVD presents 11 videos of surgical procedures described in the book. Key points Step by step guide to urethroplasty Includes nearly 300 images, diagrams and tables Accompanying DVD presents videos of surgical procedures US-based contributors

From a renowned specialist at the Cleveland Clinic and medical and surgical experts in this growing field comes an up-to-date, multidisciplinary resource on transgender health care and surgery. Comprehensive Care of the Transgender Patient, by Dr. Cecile Unger, covers all aspects of transgender health care, beginning with epidemiology and history and progressing to an in-depth review of the complex transition for patients, including mental health services, endocrine and hormone therapy treatment, and surgical options. Incorporates all of the latest guidelines for providers and patients, written by experts from a wide variety of disciplines involved in transgender patient care. Contains outstanding surgical chapters contributed by prominent surgeons who regularly perform these procedures, providing clear guidance on male-to-female and female-to-male surgical options. Features high-quality, full-color illustrations throughout. Covers key topics in every area of transgender health care, including Mental Health Care for the Adult and for the Child and Adolescent Transgender Patient; Hormone Treatment for the Adult and Adolescent Transgender Patient; Facial Surgery for Transgender Patients; Breast and Genital Surgeries for Transgender Patients; and Primary, Preventive, and Gynecologic Care. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, Q&As, and references from the book on a variety of devices.

The aim of this book is twofold: to promote an awareness of cultural differences in connection with sexual medicine among health care providers, and to demonstrate how such differences are relevant to the care and treatment of patients with sexual issues. Individual sexuality represents the cumulative effects of biological, psychological, and cultural influences. Yet much of the study of sexuality-including issues ranging from sexual identity to sexual response-has been conducted through a Western lens. Although a substantial body of work in anthropology has taken up the study of human sexuality from a cross-cultural perspective, two points are notable. First, this work seldom crosses the desks of medical and psychological health practitioners, and second, the relevance of specific cultural differences is rarely apparent to the typical sexual health practitioner. To address this situation, this book adopts a global perspective, focusing on how cultural practices and values can impact health care, treatment, and outcomes. In this regard, it covers three broad domains: Sexual Identity and Orientation; Sexual Response and Dysfunction; and Sexual Diversity. Each chapter consists of two parts: a general description of the relevant issues, and a discussion of how these issues can be relevant to clinical practice. The book offers a valuable, practical tool for specialists in sexual medicine and sexual psychology, for sexual healthcare givers, and for sexological researchers who want to better serve their patients by developing an awareness of and sensitivity to cultural differences, and by providing a framework for dealing with issues of sexuality and sexual health that takes cultural values into consideration, while adhering to best practices in patient care.

Cushing's Disease: An Often Misdiagnosed and Not So Rare Disorder reviews the epidemiology of Cushing's, including statistics on the incidence and prevalence of this disease. There are discussions of the signs and symptoms and the most common co-morbidities, such as diabetes mellitus, hypertension, osteoporosis, amenorrhea, and infertility. Surgical, medical, and radiotherapeutic treatments, including indications, results, risks, and complications, are reviewed. Also featured is a chapter on the patient's perspective, coping with Cushing's, quality of life, and psychosomatic issues. This book is essential reading for the wide range of physicians who treat patients with Cushing's disease symptoms, as well as biomedical researchers who investigate the etiology and mechanisms of rare genetic diseases, in particular rare endocrine disorders.

Something's up down below ... Urinary tract infections result in 8.1 million visits to a doctor every year, and between 50 per cent and 60 per cent of adult women will have at least one UTI in their lifetime. Meanwhile, overactive bladder affects nearly one in five of the over-40, yet many people wait up to 15 years before seeking treatment. Maybe it's time we started taking pee a bit more seriously ... Home and Dry is the ultimate guide to the bladder; not only will it help you to overcome problems such as recurrent infections or needing the bathroom all the time, it will also inspire wonder for a fascinating part of the body that we usually try to ignore. Using the latest research, Birgit Bulla explores the biggest problem area for women's health, and shows how taking care of your bladder will make you feel a whole lot better.

This book retains the core contents of the successful first edition and covers all the practical issues related to prostate biopsy diagnosis in day-to-day practice. It uses abundant algorithms, flow charts, and tables to simulate a pathologist's thought process and assist decision making during evaluation of prostate biopsies. Chapters address the most effective ways to evaluate a prostate biopsy and how to formulate a diagnostic approach upon encountering a specific clinical problem. Pertinent new information is incorporated in all chapters, particularly in how novel diagnostic tools such as MRI and genomic tests may affect prostate biopsy practice and diagnosis. An entirely new chapter on pattern-based approaches to prostate biopsy interpretation has been added. The second edition of Prostate Biopsy Interpretation: An Illustrated Guide is not meant to be an all-encompassing, definitive bibliography of pathology of prostate cancer. Instead, it provides practicing surgical pathologists and trainees a quick and handy reference for all the practical issues relevant to day-to-day interpretation of prostate biopsy.

The treatment of prostate cancer continues to be problematic owing to serious side-effects, including erectile dysfunction and urinary incontinence. Robotic radiosurgery offers a novel, rapid, non-invasive outpatient treatment option that combines robotics, advanced image-guided spatial positioning, and motion detection with submillimeter precision. This book examines all aspects of the treatment of prostate cancer with robotic radiosurgery. It explains how image-guided robotic radiosurgery overcomes the problem of patient motion during radiation therapy by continuously identifying the precise location of the prostate tumor throughout the course of treatment. Hypofractionated radiation delivery by means of robotic radiosurgery systems is also discussed in detail. The book closes by examining other emerging genitourinary applications of robotic radiosurgery. All of the authors are experts in their field who present a persuasive case for this fascinating technique.

This book outlines the approach to comprehensive men's health deployed at three of the most successful American men's health centers. It demonstrates the ways in which multidisciplinary care allows patients to easily access their doctors via coordination of care, same day add-on visits, and streamlining of office logistics such as sharing of charts, reports, and results. Guiding readers in establishing an evidence-based, multidisciplinary approach to the management of male patients of all ages, this volume shows how prevention, rapid intervention, cost efficiency, and coordinated care are at the forefront of a health center's care strategy. The authors of this volume are thought leaders in the disciplines of cardiology, gastroenterology, dermatology, psychiatry, and preventative medicine. Design and Implementation of the Modern Men's Health Center: A Multidisciplinary Approach enables urologists, medical subspecialists, and surgical subspecialists to both manage basic patient issues and also to understand how multidisciplinary care enables the success of a men's health center.

This book describes up-to-date information on the pathogenesis and molecular biology of human papillomaviruses and describes the mechanistic role of the viruses in epithelial cancers. Included in the book are chapters on the epidemiology of human papillomaviruses, the factors that control replication and transcription and the viral proteins, which are involved in modulating the biology of the host cell leading to cancer. Details of the immune response to the viruses and potential vaccine strategies are discussed.

Translational research is of great importance for clinical practice. Therefore, this book provides comprehensive information on an important gap in pediatric urology: the description of basic concepts that allow a better understanding of urinary and genital anomalies. The content encompasses personal experience and research topics developed at Rio de Janeiro State University's Urogenital Research Unit over the past 25 years. Throughout the chapters, the main aspects of embryology and fetal anatomy as applied to the various congenital malformations that most often affect newborns and children are described. Neural tube defects and Prune Belly Syndrome, two rare but highly relevant conditions that alter the structure of the urinary and genital system, are discussed in detail. In addition, the diagnosis and treatment of genital anomalies are addressed. Given its scope, the book offers a valuable resource for a wide audience including urologists, pediatricians, pediatric surgeons, and medical students.

This book presents the latest insights into all the critical aspects of Klinefelter's Syndrome, in order to promote a more homogeneous a medical approach to this condition, leading to better and more "evidence-based" support, and improving patient satisfaction. It offers physicians and all health professionals involved in treating these patients (andrologists, pediatricians, endocrinologists, psychologists) a comprehensive overview and a useful tool for their daily clinical practice.

This book is intended for urologists and pathologists who practice in an office setting. In this setting, bladder and prostate diseases are most commonly encountered. Therefore, bladder and prostate biopsy and urine cytology specimens are frequently obtained by urologists, which require pathologists assistance to interpret. In the office setting, communication between urologists and pathologists becomes feasible, which is paramount for accurate diagnosis and better patient management. For this purpose, this book includes clinically relevant information for pathologists, concise pathology terminology, and diagnostic tests for urologists. This book describes the common clinical and pathological entities, and is written in a bullet format for easy and quick reference. For visual review, over 150 diagrams, histologic images, and other images are included. The first and second chapters describe bladder and prostate diseases, focusing on clinical-pathological correlation. Therefore, this book is also useful for pathology and urology residents in training, in preparation for board examination(s), or as a refresher reference for recertification. The third chapter is dedicated to office-based pathology laboratory services, which outlines laboratory instrumentation, procedures, and regulatory requirements. This information is useful for urologists and pathologists who are involved in the management of an office-based pathology laboratory. Finally, I greatly appreciate Josephine Wu DDS, Esq. and Miao Cui MD, MS, who contributed to this excellent third chapter.

These proceedings of the 2018 XIII International Symposium on Spermatology focus on comparative biology, and encourages discussion and the exchange of ideas. The aim of this Symposium was to provide a unique opportunity and bring together scientists from a wide spectrum of research fields - human, domestic animals and other mammals, vertebrates, insects, and plants. The underlying focus is on the function of the spermatozoon - a common feature for sexual reproduction, but extremely varied. By exploring the variability, a better understanding of male reproductive functions can develop. These proceedings address the mechanisms of physiology and pathophysiology, rather than diagnosis and treatment. The symposium featured keynote lectures by invited speakers, followed by presentations on specific aspects of the general topic of the session. Experimental studies are given priority over clinical studies of patient populations. The proceedings comprise both keynote speakers' texts and selected free communications. Posters were considered for publication in the proceedings, and the volume includes exhibited materials on the work of prominent spermatologists, highlighting their important past achievements in the field.

The aim of the updated book is to include new developments and update the literature in relation to sentinel node biopsy, new radiology techniques and long term epidemiological data. This book is useful for urologists, dermatologists, sexual health physicians as well as those with an interest in virology and genomics related to squamous cell cancers. The surgical techniques are all well illustrated with a step by step guide in order to allow those individuals in centres which are not expert centres to undertake the management of this devastating tumour.

This updated title is the ideal reference book for residents and fellows, with step-by-step pictures and only the essential prose. The major part of the book is illustrated with magnificent photographs and diagrams depicting every step of a particular procedure. Instruments are clearly shown and have been photographed from both outside and inside the body. Chapters demonstrate accepted laparoscopic techniques that are the new gold standard in urology. Outcome analyses show that with laparoscopy one can achieve the same oncologic success as with open surgery but will less morbidity.

Now in a revised second edition, this comprehensive text covers all aspects of male hypogonadism from the basic science to clinical management, comprehensively explaining and applying new insights to the treatment of hypogonadal men. Chapters covering neuroendocrine control of testicular function, Leydig cell function, spermatogenesis, and normal and delayed puberty open the book. The focus then turns to the pathophysiology and treatment of hypogonadism and other forms of testicular dysfunction, such as Klinefelter syndrome, cryptorchidism, and disorders of the pituitary, as well as reproductive and endocrine consequences of cancer treatment, environmental factors, obesity and aging. Next are chapters that describe the available options for androgen replacement therapy, and the outcomes when men with hypogonadism of various causes are treated with testosterone, as well as a chapter devoted to current approaches to stimulating spermatogenesis in gonadotropin-deficient men. Highly practical and updated with the latest available data, this second edition of Male Hypogonadism: Basic, Clinical and Therapeutic Principles cogently presents a large body of scientific information on male reproductive endocrinology to provide a thorough understanding of the pathophysiology, clinical characteristics, and treatments for disorders that adversely affect testicular function.

This new edition provides the most up to date, state-of-the art review of current literature which provides an introduction to pelvic floor imaging, as well as a resource to be used during initial and more advanced practice. The book features new chapters on Vaginal mesh imaging, ultrasound of implanted material, pelvic floor trauma, and ultrasound in pelvic floor therapy. The reader will gain competence in performing transperineal, endovaginal and endoanal 3D/4D ultrasound evaluation of the pelvic floor including anal sphincter and levator ani complex. The text provides a basic understanding of how to perform a transperineal, an endovaginal and endoanal pelvic floor ultrasound and use the desktop 3D/4D softwares to obtain basic measurements. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor, followed by 1) 3D/4D transperineal imaging, 2) 3D endovaginal imaging of the urethra and the bladder, Levator ani muscles, the anorectal area, and 3) 3D endoanal imaging. Measurement protocols and case reviews are demonstrated at the conclusion. Written entirely by experts in their fields, the second edition of Practical Pelvic Floor Ultrasonography: A Multicompartmental Approach to 2D/3D/4D Ultrasonography of the Pelvic Floor is a comprehensive resource that will be of great value to urogynecologists, colorectal surgeons, obstetrician and gynecologists, female urologists, ultrasonographers, radiologists, physiotherapists, as well as fellows in urogynecology and colorectal surgery.