Male Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 510

Veröffentlichungsjahr: 2014

Beschreibung

Male Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia provides urologists of all levels with a practical, highly clinical guide to the variety of different symptoms and problems concerning the male lower urinary tract, including benign prostatic hyperplasia, one of the conditions that urologists most regularly encounter.  

Evidence-based throughout and written by the world's leading experts in the topic, it comprehensively reviews the very latest in diagnostics and imaging, patient phenotyping, genetic studies, medical and surgical therapies, and lifestyle management in order to help clinicians best manage their patients.

Highlights include chapters on: 

• Alpha-Adrenergic Antagonists for Lower Urinary Symptoms Secondary to Benign Prostatic Hyperplasia
• Phosphodiesterase Type 5 inhibitors for Male LUTS
• Combination Medical Therapy for Male LUTS
• Open Simple Prostatectomy
• Minimally Invasive Therapies
• Monopolar and Bipolar Transurethral Resection of the Prostate
• GreenLight Laser Therapy

Containing pitfall boxes and key points throughout to aid quick and easy understanding of the key information, this excellent book is an essential read for the modern-day urologist.

Leseprobe

CONTENTS

Cover

Title page

Copyright page

Contributors

Chapter 1: Etiology and Pathogenesis

Introduction

What is BPH/LUTS? The biology

Regulation of the normal prostate

Androgen regulation of the prostate

Estrogens, progesterone, prostatic regulation, and BPH

Growth factors and chemokines in BPH/LUTS

Inflammatory changes associated with BPH

Prostate-associated Gene 4 as a stress modulator within the prostate

The need for biomarkers of BPH

Conclusions

Bibliography

Chapter 2: Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia

Introduction

Descriptive epidemiology, risk factors, and correlates

Measurement and classification of LUTS symptoms in epidemiological research: new concepts and methods

Summary and conclusion

Bibliography

Chapter 3: Clinical Assessment and Diagnosis of Lower Urinary Tract Dysfunction

Introduction

Initial evaluation of men presenting with LUTS

Evaluation of the persistent or complicated LUTS in the male patient with LUTD

Bibliography

Chapter 4: Clinical Assessment and Diagnosis of Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia

Aim of the assessment

Investigational tests

What happens in real life in Europe?

Bibliography

Chapter 5: Clinical Assessment and Diagnosis of Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia

Why should primary care be concerned?

Definitions

What are LUTS?

History, physical, and laboratory evaluation

Other modalities in assessment

Reasons for referral

Assessing bother

Summary

Bibliography

Chapter 6: Watchful Waiting

Introduction

Symptom progression

Acute urinary retention

Prostate size and growth

Bladder function changes in men over time

Renal disease and benign prostatic hyperplasia

Associations in common between chronic kidney disease and benign prostatic hyperplasia

Inflammation

Diabetes

Hypertension

Metabolic syndrome

Autonomic nervous system

Monitoring renal function in men with benign prostatic hyperplasia

End-stage renal disease

Conclusion

Bibliography

Chapter 7: α-Adrenergic Antagonists for Lower Urinary Symptoms Secondary to Benign Prostatic Hyperplasia

Introduction

α-Adrenergic receptors in the prostate

Nonselective α-blockers

Selective α-blockers

α-Adrenergic antagonists and sexual dysfunction

α

1

-blockers and intraoperative floppy iris syndrome

Combination therapy

Adverse effects of combination therapy for benign prostatic hyperplasia

Summary

Bibliography

Chapter 8: 5α-Reductase Inhibitors

Introduction and history of 5α-reductase inhibitors

Hypothetical rationale, preclinical, and early clinical (phase I–II) evidence for the use of 5α-reductase inhibitors in benign prostatic hyperplasia

Clinical evidence (phase III or higher) for the use of 5α-reductase inhibitors in benign prostatic hyperplasia

Side effects of 5α-reductase inhibitor treatment

5α-Reductase inhibitors and prostate cancer

Bibliography

Chapter 9: Antimuscarinics

Introduction

Mechanism of action

Clinical studies

Antimuscarinic safety in men with lower urinary tract symptoms/benign prostatic hyperplasia

Other important treatment issues

Practical aspects of antimuscarinic use

Conclusion

Conflict of interest

Bibliography

Chapter 10: The Use of Phosphodiesterase Type 5 Inhibitors in the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia

Introduction

Epidemiology

Lower urinary tract symptoms treatment

Pathophysiology of lower urinary tract symptoms and the phosphodiesterase-5 signal pathway

Nitric oxide synthase/cyclic guanosine monophosphate pathway

Ras homolog gene family, member A/Ras homolog-kinase signaling

Mechanism of action of phosphodiesterase-5 inhibitors in benign prostatic hyperplasia/lower urinary tract symptoms

Summary of randomized controlled trials of phosphodiesterase-5 inhibitors versus placebo

Summary of randomized controlled trials of phosphodiesterase-5 inhibitors and urodynamics

Safety

Evidence-based outcomes of alpha blocker/phosphodiesterase-5 inhibitor combination on lower urinary tract symptoms

Indications and contraindications

Limitations

Bibliography

Chapter 11: Combination Medical Therapy for Male Lower Urinary Tract Symptoms

Combination medical therapy: alpha receptor blocker + 5α-reductase inhibitor

Alpha adrenergic receptor blocker + antimuscarinics

Alpha adrenergic receptor blocker + phosphodiesterase type 5 inhibitor

Bibliography

Chapter 12: Complementary Therapy

Phytotherapy

Common compounds in phytochemicals

Selected phytotherapeutic agents

Nutrients

Exercise

Bibliography

Chapter 13: Open Simple Prostatectomy

Introduction

Open simple prostatectomy

Surgical techniques

Perioperative antibiotic prophylaxis

Minimally invasive alternatives of simple prostatectomy

Single-port transvesical enucleation of the prostate

Bibliography

Chapter 14: Minimally Invasive Therapies

Overview

Transurethral needle ablation of the prostate

Transurethral microwave thermotherapy

Transurethral ethanol ablation of the prostate

Botulinum toxin A

Bibliography

Chapter 15: Holmium Laser Prostatectomy

Introduction

Laser physics

History

Holmium laser enucleation of the prostate technique

Equipment

Procedure

Patient selection

Outcomes

Learning curve

Conclusion

Bibliography

Chapter 16: Benign Prostatic Hyperplasia

532 nm wavelength laser

60 W data

80 W data

120 W

180 W 532 nm laser

Complications

Conclusion

Bibliography

Chapter 17: Principles of Electrocautery-Based Techniques

Overview

Monopolar transurethral resection of the prostate

Early experience with monopolar electrovaporization technology

Bipolar transurethral resection of the prostate

Bibliography

Index

End User License Agreement

List of Tables

Chapter 02

Table 2.1 Relevant epidemiologic studies of the relationship between LUTS and ED [61]

Chapter 03

Table 3.1 Example of frequency/volume chart and voiding diary

Chapter 04

Table 4.1 Investigational tests used in the clinical assessment of lower urinary tract symptoms in Europe (mean values and range) based on surveys

Chapter 05

Table 5.1 International Prostate Symptom Score Questionnaire

Table 5.2 Male lower urinary tract symptoms

Table 5.3 Lower urinary tract symptoms: differential diagnosis and other causes

Chapter 06

Table 6.1 Various modes of presentation and possible outcomes reflecting benign prostatic hyperplasia progression

Table 6.2 Watchful waiting outcomes at 4 years

Table 6.3 Acute urinary risk factors

Table 6.4 Prostate measurement options

Table 6.5 End-stage renal disease in the US

Chapter 07

Table 7.1 Risk of benign prostatic hypertension progression as measured by American Urological Association-International Prostate Symptom Scores, rates of acute urinary retention, and requirement for surgical Intervention: tamsulosin versus dutasteride versus combination therapy

Table 7.2 Drug-related adverse events occurring in ≥1% of subjects in any treatment group in the Medical Treatment of Prostatic Symptoms trial (McConnell et al.

N Engl J Med

2003; 349:2387–2398.)

Table 7.3 Drug-related adverse events occurring in ≥1% of subjects in any treatment group in the Combination of Avodart and Tamsulosin trial

Chapter 09

Table 9.1 Pivotal 12-week randomized placebo controlled studies investigating antimuscarinics for male lower urinary tract symptoms

Chapter 10

Table 10.1 Comparison of urodynamic parameters measured in placebo versus phosphodiesterase type 5 inhibitor randomized controlled trials [37]

Chapter 11

Table 11.1 α

1

-Adrenoceptor antagonists and 5α-reductase inhibitor combination trial characteristics and subjective outcome measures

Table 11.2 α

1

-Adrenoceptor antagonists and 5α-reductase inhibitor combination objective outcome measures

Table 11.3 α

1

-Adrenoceptor antagonists and 5α-reductase inhibitor combination selected side effects

Table 11.4 α

1

-Adrenoceptor antagonist and antimuscarinic combination: International Prostate Symptom Score outcome and trial characteristics

Table 11.5 α

1

-Adrenoceptor antagonist and antimuscarinic combination side effects, postvoid residual volume increase, and acute urinary retention

Table 11.6 Studies of alpha adrenergic receptor blockers and phosphodiesterase type 5 inhibitors in the treatment of male lower urinary tract symptoms

Chapter 12

Table 12.1 Common phytochemicals used for benign prostatic hyperplasia

Table 12.2 Common compounds within phytochemical extracts

Table 12.3 Mechanisms of action of isoflavones

Table 12.4 Summary of alternative treatment options for benign prostatic hyperplasia

Chapter 13

Table 13.1 Advantages of the various open approaches of prostatectomies

Table 13.2 Surgical outcome after open simple prostatectomy [2]

Table 13.3 Morbidity and mortality rates of open simple prostatectomy [2]

Chapter 14

Table 14.1 Characteristics, efficacy, safety, and costs of minimally invasive procedures analysed

Chapter 17

Table 17.1 Studies comparing monopolar TURP (mTURP) with bipolar TURP (bTURP)

List of Illustrations

Chapter 03

Figure 3.1 Algorithms for diagnosis and management of lower urinary tract dysfunction (LUTD). AUA-SI, American Urological Association-Symptom Index; DRE, digital rectal examination; LUTS, lower urinary tract symptoms. Professor Paul Abrams International Consultation on Urological Diseases (ICUD). Reproduced with permission of Paul Abrams.

Figure 3.2 American Urological Association (AUA) Symptom Index [15]. This is the breakdown of the AUA Symptom Index. The index comprises seven questions that address voiding symptoms, storage symptoms, and nocturia. Patients are classified as having mild (0–7), moderate (8–16), or severe (17–35) urinary-tract symptoms. The International Prostate Symptom Score also includes a question assessing the degree of bother related to urinary symptoms. BPH, benign prostatic hyperplasia. (Permission granted by Elsevier Publishing).

Figure 3.3 Examples of uroflowmetry curves. This schematic shows three theoretical examples of uroflowmetry curves. The

y

-axis represents flow rate (in milliliters per second), and the

x

-axis is time (in seconds). The area under the curve represents the volume voided. A “normal” uroflow curve tends to resemble a “loaf of bread” with a rapid rise in flow rate, followed by constant flow for a time period, until a rapid drop-off in flow at the completion of the void. Patients with obstruction or detrusor underactivity tend to exhibit flattened or interrupted uroflow curves with prolonged voiding times.

Chapter 04

Figure 4.1 Algorithm of male lower urinary tract symptoms (LUTS) assessment. FVC, frequency–volume charts; PCa, prostate cancer; PVR, postvoid residual urine volume; PSA, prostate-specific antigen.

Chapter 07

Figure 7.1 Prevalence of moderate-to-severe lower urinary tract symptoms and lower urinary tract symptoms with a

Q

max

of <15 mL/s, by age. AUA, American Urological Association. Fawzy A, Pool JL. Benign Prostatic Hypertrophy and the Role of Alpha-Adrenergic Blockade. MEDSCAPE 2002. Reproduced with permission of Ahmed Fawzy, MD.

Figure 7.2 Localization of α

1

receptors. Images © Copyright Visible Health, Inc. Images © Copyright Visible Health, Inc. Created using drawMD Urology (www.drawmd.com) and reproduced with permission by Visible Health, Inc.

Figure 7.3 American Urological Association Symptom Index score improvements for medical therapies by duration of follow-up. Missing bars indicate that data were not available.

Figure 7.4 Peak urinary flow rate improvements for medical therapies by duration of follow-up. Missing bars indicate that data were not available.

Chapter 09

Figure 9.1 Overlap between voiding, storage and post-voiding lower urinary tract symptoms (LUTS) in men: most men have both voiding and storage LUTS. Adapted from Coyne KS, Sexton CC, Kopp ZS, Ebel-Bitoun C, Milsom I, Chapple C. The impact of overactive bladder on mental health, work productivity and health-related quality of life in the UK and Sweden: results from EpiLUTS. BJU international. 2011;108(9):1459–71.

Figure 9.2 Relationship between benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO) and Storage lower urinary tract symptoms (LUTS)/overactive bladder (OAB). Storage LUTS/OAB may occur due etiologies affecting bladder function not related to BPH. OAB is commonly associated with detrusor overactivity (DO) in men.

Figure 9.3 Traditional explanation for mechanism of action of antimuscarinics in patients with storage lower urinary tract symptoms (LUTS)/overactive bladder presumed secondary to detrusor overactivity. Antimuscarinics act on both the M

2

and M

3

receptors that are present in the detrusor. M

3

receptors are thought to be most important for detrusor contraction. Acetylcholine (Ach) is released from parasympathetic nerve endings then act on M

2

and M

3

receptors. Activation of M

2

receptors inhibits adenylyl cyclase which causes a reduction in intracellular cyclic AMP which is a mediator of bladder relaxation. M

3

receptor stimulation leads to activation of phospholipase C (PLC) and inositol triphosphate (IP

3

) generation which leads to intracellular Ca

2+

release and activation of the cell contractile apparatus. Reproduced from Karl-Eric Anderesson. Antimuscarinics for the treatment of overactive bladder. The Lancet Neurology. Jan 2004 with permission from Elsevier.

Figure 9.4 At usual doses antimuscarinics have a low plasma concentration allowing anatgonism of the effects of acetylcholine (ACh) in the urothelial and myocyte signaling pathways during bladder filling (“therapeutic window”) whilst not affecting detrsuor voiding contraction. When doses are increased voiding contraction may become impaired resulting in urinary retention. LUTS, lower urinary tract symptoms; OAB, overactive bladder. Adapted from Karl-Erik Andersson. Antimuscarinic Mechanisms and the Overactive Detrusor: An Update.

European Urology

, Volume 59, Issue 3, 2011, 377–386.

Figure 9.5 Simplified male lower urinary tract symptoms (LUTS) pharmacotherapy treatment algorithm.

Chapter 10

Figure 10.1 Graph showing how sexual function declines as the severity of lower urinary tract symptoms (LUTS) increases and with age. Severity of LUTS assessed by International Prognostic Scoring System: none, 0; mild, 1–7; moderate, 8–19; severe, 20–35. Rosen 2003 [3]. Reproduced with permission of Elsevier.

Figure 10.2 Decreased enjoyment of sexual activity due to lower urinary tract symptoms (LUTS): Epidemiology of Lower Urinary Tract Symptoms Study. Wein 2009 [5]. Reproduced with permission of John Wiley & Sons Ltd.

Figure 10.3 Nitric oxide synthase/nitric oxide (NOS/NO) theory of erectile dysfunction and lower urinary tract symptoms (LUTS). SMC, smooth muscle cell. McVary 2005 [27]. Reprinted with permission of MedReviews®, LLC.

Figure 10.4 Masson’s trichrome stain of urothelium in bladder tissues from control, hypercholesterolemia, moderate bladder ischemia, and severe bladder ischemia groups. Chronic moderate bladder ischemia produces marked structural damage in urothelium, causing thickening, disruption of mucosa, vacuolization, and dense fibrosis of the suburothelial layer. Severe bladder ischemia produced more extensive changes causing thickening of urothelium, distortion of mucosa, and more extensive fibrosis in the suburothelial layer. Hypercholesterolemia produced only mild regional thickening of the urothelium but did not produce any destructive changes or fibrosis of the suburothelial layer. Azadozoi 1999 [22]. Reproduced with permission of Elsevier.

Chapter 11

Figure 11.1 International Prostate Symptom Score over time for three treatment groups in the Combination of Avodart and Tamsulosin trial stratified by baseline prostate volume (PV) by tertiles (unpublished data on file at GSK). COMBO, combination; DUT, dutasteride; TAM, tamsulosin.

Figure 11.2 Incidence of acute urinary retention or benign prostatic hyperplasia-related surgery for three treatment groups in the Combination of Avodart and Tamsulosin study stratified by baseline prostate volume (PV) by tertiles. *

P

< 0.001 versus combination therapy (unpublished data on file at GSK).

Figure 11.3 Incidence rates of overall, symptomatic progression, acute urinary retention and invasive therapy in the Medical Therapy of Prostatic Symptoms study by baseline median prostate volume and serum prostate-specific antigen (PSA). AUA-SI, American Urological Association Symptom Index; AUR, acute urinary retention; BPH, benign prostatic hyperplasia; TPV, total prostate volume. Crawford [30]. Reproduced with permission of Elsevier.

Figure 11.4 International Prostate Symptom Score (IPSS) and maximum flow rate changes in studies combining alpha adrenergic receptor blockers and phosphodiesterase type 5 (PDE5) inhibitors [51]. IIEF, International Index of Erectile Function. Gacci M,

et al

. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with alpha-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia.

Eur Urol

. 2012;61(5):994–1003. Epub 2012/03/13. Reproduced with permission of Elsevier.

Chapter 13

Figure 13.1 (A) Incision of the bladder neck mucosa only from the 5- to 7-o'clock position. (B) At the apex, the index finger sweeps ventrally to fracture the anterior prostatic commissure. (C) Both lobes of the adenoma are separated in this fashion up the area of the bladder neck. Modlin C. Open Benign Prostatectomy in Novick AC et al. (eds). Operative Urology at the Cleveland Clinic. 2006 Humana Press. Reproduced with permission of Humana Press Inc.

Figure 13.2 (A) Exposure of anterior surface of the prostate and bladder neck. (B) Horizontal incision through the prostatic capsule with a steel or electric knife. (C) Index finger is inserted through this incision and the adenoma enucleated with a sweeping motion. Modlin C. Open Benign Prostatectomy in Novick AC et al. (eds). Operative Urology at the Cleveland Clinic. 2006 Humana Press. Reproduced with permission of Humana Press Inc.

Chapter 17

Figure 17.1 Schematic diagram of traditional monopolar transurethral resection of the prostate (top) vs. bipolar transurethral resection of the prostate (bottom). Olympus. Reproduced with permission of Olympus America Inc.

Figure 17.2 Olympus PlasmaKinetic™ SuperPulse bipolar current generator with cut and coagulation foot pedal. Olympus. Reproduced with permission of Olympus America Inc.

Figure 17.3 Olympus OES Pro Resectoscope apparatus with continuous flow sheath. Olympus. Reproduced with permission of Olympus America Inc.

Figure 17.4 Olympus PlasmaButton™ vaporization electrode inside of continuous flow resectoscope sheath. Olympus. Reproduced with permission of Olympus America Inc.

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Male Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia

Edited by

Steven A. Kaplan, MD

E. Darracott Vaughan Jr. Professor of Urology

Weill Cornell Medical College

Director, Iris Cantor Men’s Health Center

New York Presbyterian Hospital

New York, NY, USA

Kevin T. McVary, MD, FACS

Professor and Chair

Division of Urology

Southern Illinois University School of Medicine

Springfield, IL, USA

This edition first published 2014 © 2014 by John Wiley & Sons, Ltd

Registered officeJohn Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

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The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

Library of Congress Cataloging-in-Publication Data

Male lower urinary tract symptoms and benign prostatic hyperplasia / edited by Steven A. Kaplan, Kevin T. McVary.  p. ; cm. Includes bibliographical references and index.

 ISBN 978-1-118-43799-5 (cloth) I. Kaplan, Steven A., editor. II. McVary, Kevin T., editor. [DNLM: 1. Lower Urinary Tract Symptoms. 2. Prostatic Hyperplasia. WJ 752] RC877 616.6′5–dc23

2014013140

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: ©iStockphoto/ArtopatCover design by Andy Meaden

Contributors

Aaron M. Bernie, MD, MPHDepartment of UrologyWeill Cornell Medical CollegeNew York-Presbyterian HospitalNew York, NY, USA

Benjamin N. Breyer, MD, MASUniversity of California San FranciscoDepartment of UrologySan Francisco, CA, USA

Reginald Bruskewitz, MDUniversity of WisconsinMadison, WI, USA

Christopher R. Chapple, BSc, MD, FRCS(Urol)Department of UrologyRoyal Hallamshire HospitalSheffield, UK

Bilal Chughtai, MDDepartment of UrologyWeill Cornell Medical CollegeNew York-Presbyterian HospitalNew York, NY, USA

Anne Darves-Bornoz, MDGarden CityNew York, NY, USA

Jean J. M. C. H. de la Rosette, MD, PhDDepartment of UrologyAcademic Medical CenterUniversity of AmsterdamAmsterdam, The Netherlands

Christopher P. Filson, MD, MSUniversity of MichiganDepartment of UrologyDivision of Health Services ResearchAnn Arbor, MI, USA

Nathaly François, MDDivision of UrologySouthern Illinois University School of MedicineSpringfield, IL, USA

Claudius Füllhase, MDDepartment of UrologyGroßhadern HospitalLudwig-Maximilians-UniversityMunich, Germany

Mauro Gacci, MDDepartment of UrologyUniversity of FlorenceCareggi HospitalFlorence, Italy

Robert H. Getzenberg, PhDGTx Inc.Memphis, TN, USA

Peter J. Gilling, MBChB, MD, FRACSUniversity of AucklandUrology BOP LimitedTauranga, New Zealand

Christian Gratzke, MDDepartment of UrologyLMU MunichMunich, Germany

Stavros Gravas, MDDepartment of UrologyUniversity of ThessaliaLarissa, Greece

Annika Herlemann, MDDepartment of UrologyLMU MunichMunich, Germany

Aaron E. Katz, MDGarden CityNew York, NY, USA

Prakash Kulkarni, PhDJames Buchanan Brady Urological InstituteJohns Hopkins University School of MedicineBaltimore, MD, USA

Richard Lee, MD MBADepartments of UrologyWeill Cornell Medical CollegeNew York-Presbyterian HospitalNew York, NY, USA

Casey Lythgoe, MDDivision of UrologySouthern Illinois University School of MedicineSpringfield, IL, USA

Marty M. Miner, MDWarren Alpert School of MedicineBrown University, Providence, RI, USA

Matthias Oelke, MD, FEBUDepartment of UrologyHannover Medical SchoolHannover, Germany

Nadir I. Osman, MBChB, MRCSDepartment of UrologyRoyal Hallamshire HospitalSheffield, UK

Raunak D. Patel, MSDivision of UrologySouthern Illinois University School of MedicineSpringfield, IL, USA

John B. RileyMid Michigan Health CentersJackson, MI, USA

Claus G. Roehrborn, MDDepartment of UrologyUT Southwestern Medical CenterDallas, TX, USA

Raymond C. Rosen, PhDNew England Research InstitutesWatertown, MA, USA

Matt T. Rosenberg, MDMid Michigan Health CentersJackson, MI, USA

Matteo Salvi, MDDepartment of UrologyUniversity of FlorenceCareggi HospitalFlorence, Italy

Arcangelo Sebastianelli, MDDepartment of UrologyUniversity of FlorenceCareggi HospitalFlorence, Italy

Roberto Soler, MD, PhDDivision of UrologyFederal University of São PauloSão Paulo, Brazil

Alexis E. Te, MDDepartment of UrologyWeill Cornell Medical CollegeNew York-Presbyterian HospitalNew York, NY, USA

Simon van Rij, MBChB, FRACSTauranga HospitalTauranga, New Zealand

John T. Wei, MD, MSUniversity of MichiganDepartment of UrologyDivision of Health Services ResearchAnn Arbor, MI, USA