Prostate cancer is the most common noncutaneous cancer in men in the United States. The current paradigm for screening and diagnosis is imperfect, with relatively low specificity, high cost, and high morbidity. This study aims to generate new image contrasts by learning a distribution of unique image signatures associated with prostate cancer. In total, 48 patients were prospectively recruited for this institutional review board–approved study. Patients underwent multiparametric magnetic resonance imaging 2 weeks before surgery. Postsurgical tissues were annotated by a pathologist and aligned to the in vivo imaging. Radiomic profiles were generated by linearly combining 4 image contrasts (T2, apparent diffusion coefficient [ADC] 0-1000, ADC 50-2000, and dynamic contrast-enhanced) segmented using global thresholds. The distribution of radiomic profiles in high-grade cancer, low-grade cancer, and normal tissues was recorded, and the generated probability values were applied to a naive test set. The resulting Gleason probability maps were stable regardless of training cohort, functioned independent of prostate zone, and outperformed conventional clinical imaging (area under the curve [AUC] = 0.79). Extensive overlap was seen in the most common image signatures associated with high- and low-grade cancer, indicating that low- and high-grade tumors present similarly on conventional imaging.

Purpose: Prostate cancer primarily arises from the glandular epithelium. Histomophometric techniques have been used to assess the glandular epithelium in automated detection and classification pipelines; however, they are often rigid in their implementation, and their performance suffers on large datasets where variation in staining, imaging, and preparation is difficult to control. The purpose of this study is to quantify performance of a pixelwise segmentation algorithm that was trained using different combinations of weak and strong stroma, epithelium, and lumen labels in a prostate histology dataset. Approach: We have combined weakly labeled datasets generated using simple morphometric techniques and high-quality labeled datasets from human observers in prostate biopsy cores to train a convolutional neural network for use in whole mount prostate labeling pipelines. With trained networks, we characterize pixelwise segmentation of stromal, epithelium, and lumen (SEL) regions on both biopsy core and whole-mount H&E-stained tissue. Results: We provide evidence that by simply training a deep learning algorithm on weakly labeled data generated from rigid morphometric methods, we can improve the robustness of classification over the morphometric methods used to train the classifier. Conclusions: We show that not only does our approach of combining weak and strong labels for training the CNN improve qualitative SEL labeling within tissue but also the deep learning generated labels are superior for cancer classification in a higher-order algorithm over the morphometrically derived labels it was trained on.

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Background and Objective: Stress urinary incontinence (SUI) can occur due to a variety of etiologies.For male patients specifically, SUI is typically thought of as iatrogenic secondary to intrinsic sphincter deficiency occurring after prostate surgery. Given the noted negative impact that SUI can have on a man's quality of life, multiple treatment options have been developed to improve symptoms. However, there is no "One-Size-Fits-All" approach to management of male SUI. In this narrative review, we sought to highlight some of the various procedures and devices available to treat men with bothersome SUI.Methods: This narrative review gathered primary resources through Medline search, and secondary resources by cross-referencing citations used in articles of interest. We started our investigation by searching for previous systematic reviews on male SUI and treatments for male SUI. Furthermore, we reviewed societal guidelines, such as the American Urological Association and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction guidelines and the recently published European Urological Association guidelines. Our review focused on English-language full-length manuscripts when available.

require a penile prosthesis. Surgical Complications: two patients (12.5%) showed postoperative neurapraxia, which resolved spontaneously after 12 months (Clavien I), and two other patients (12.5%) suffered extrusion of the receiver block (Clavien IIIb) We observed malfunction/damage of the external hardware in 10pt (62.5%), mostly related to operator misuse.CONCLUSIONS: Success of SARS was 87.5 % for micturition, 94% for defecation and 33% for intercourse. The main limitations were observed in caregiver-dependent quadriplegics due to operator misuse, resulting in damage of the external hardware or symptomatic UTIs. Loss of reflex erections was an undesired side effect in sexually active patients. Although SARS can elicit erections by stimulation, the system may not be reliable enough for intercourse. According to this, we believe the best candidate for SARS is an adult-able independent paraplegic female and also male paraplegics not concerned with loss of reflex erections.

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of the rectum (MANEC). The median follow up from date of diagnosis was 21 months (range 2-49). Two patients (7%) had a diagnosis of Crohn's or Ulcerative Colitis. Five patients (19%) reported a family history of colorectal cancer and 1 (4%) reported a family history of Crohn's disease. Ten patients (37%) reported a positive smoking history. The three most common presenting symptoms included rectal bleeding (n Z 19, 70%), change in bowel habits/stool caliber (n Z 12, 44%) and weight loss (n Z 6, 22%). The median time between initiation of symptoms and tissue diagnosis was 3 months (range 0-12 months). All 27 patients were micro satellite stable. Molecular studies were documented for 12 patients (44%). Of those, 5 were noted to have clinically significant DNA variants, most commonly KRAS (nZ4). 21 patients (78%) were treated with neoadjuvant chemoradiation therapy with Xeloda prior to definitive surgery. Those who were not were either unable to tolerate concurrent Xeloda (n Z 1), received neoadjuvant chemotherapy alone (n Z 2) or did not receive neoadjuvant therapy prior to resection (n Z 3). There were no grade 3 toxicities following neoadjuvant chemoradiation treatment. Eleven patients (41%) had additional neoadjuvant chemotherapy prior to surgery; most commonly with FOLFOX (n Z 6) or CAPOX (n Z4.) Seventeen patients (63%) underwent surgical resection; most commonly Low Anterior Resection (nZ 10), Abdominal Perineal Resection (n Z 6). Twelve patients (44%) received adjuvant chemotherapy, most commonly FOLFOX (n Z 10). Conclusion: Our single-institution retrospective analysis demonstrates that early-onset rectal cancer afflicts almost equally men and women, mostly non-smokers, in their early 40s. These patients predominantly present with rectal bleeding. Most patients received standard neoadjuvant chemoradiation followed by definitive resection and adjuvant chemotherapy, but alternative strategies such as neoadjuvant chemotherapy were often employed. Further study comparing this growing clinical cohort is needed.

concomitant hypercalciuria and hypernaturesis, and may obviate the need for pharmacotherapy for the treatment of hypercalciuria in some patients.