Complications and high readmission rates are a persistent challenge following radical cystectomy for the treatment of bladder cancer. The complex, intrabdominal operation, which  includes replacement of the bladder or creation of a stoma, and often includes removal of reproductive organs as well, is associated with a high rate of morbidity. Patients undergoing the procedure often have additional risk factors for venous thromboembolism (VTE), such as pre-operative chemotherapy, older age and a history of smoking, and VTE is estimated to occur in 5.5 to 8.5 percent of patients and cost more than $10,000 per event. In a comprehensive effort to reduce risk of VTE, reduce length of stay and improve other measures of quality of care, Brigham and Women’s Hospital urologists have implemented a perioperative VTE prophylaxis program and analyzed its results, reporting key quality of care improvements. In addition, in collaboration with nurses, anesthesiologists, pharmacists and other members of patients’ care teams, clinicians in the Division of Urology are exploring innovative initiatives to continue to make strides in improving patient care.
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Urologists and oncologists at Dana-Farber/Brigham and Women’s Cancer Center have laid the groundwork for what would be the first Phase III international, randomized trial of a new treatment for patients with high-risk prostate cancer in more than a decade. The treatment involves using novel, potent neoadjuvant hormone therapy for six months prior to prostatectomy surgery, an approach that has been shown to improve both tumor pathology and long-term remission.
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The modification of the androgen axis plays a central role in men’s health, from maintaining vitality to controlling prostate cancer. Trying to balance the side effects and benefits of altering this axis is a fertile area of research.

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Mark A. Preston, MD, MPH, a urologic surgeon in the Division of Urology at Brigham and Women’s Hospital, is co-lead author of a study focused on improving prostate cancer (PCa) screening for African American men. The results were recently published in European Urology.
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Investigators in the Center for Surgery and Public Health (CSPH) at Brigham and Women’s Hospital (BWH) – in conjunction with colleagues from Stanford University Medical Center – compared the use, outcomes and costs between robotic-assisted and laparoscopic approaches, two common minimally surgical techniques, for radical nephrectomy. They studied surgeries in 23,753 patients across hundreds of US hospitals between 2003 and 2015.
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Studies have consistently demonstrated that conventionally-fractionated high dose external beam radiation therapy, consisting of daily treatment for two months, decreases prostate cancer recurrence and improves metastasis-free survival. Previous studies also demonstrate that moderate hypo-fractionated radiation therapy, consisting of daily treatment for one month using a larger dose per treatment, provides a similar low risk of recurrence. The risk may even be lower with hypo-fractionated radiation therapy than conventionally fractionated high dose external beam radiation therapy. Read More

Recent research led by Brigham and Women’s Hospital suggests that the likelihood of a patient getting prostate-specific antigen (PSA) testing for the early detection of prostate cancer depends on the type of physician he sees.

In October 2011, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation against the use of PSA testing for prostate cancer screening for all men. In its assessment, the task force concluded that, overall, the harms of PSA testing outweigh its benefits. The study authors, however, hypothesized that adoption of the USPSTF recommendation would vary according to a physician’s specialty. Read More

Researchers at Brigham and Women’s Hospital (BWH) and Massachusetts General Hospital (MGH) have developed a home-based diagnostic test that can be used to measure semen quality using a smartphone-based device. The analyzer can identify abnormal semen samples based on sperm concentration and motility criteria with approximately 98 percent accuracy. These findings were published online on March 22, 2017 in Science Translational Medicine.   Read More