Urethral Stricture

Researchers are studying men with metastatic castration-resistant prostate cancer (mCRPC) to understand how different PET/CT scans can predict outcomes during radioligand therapy with 177Lu-PSMA-617. This is an exploratory, prospective study conducted at a single center, focusing on imaging tumor heterogeneity to help assess therapy effects and patient response. The study is designed specifically for Veterans undergoing this treatment. Participants will receive several types of PET/CT scans at different times: before starting LuPSMA radioligand therapy (RLT), and then after the 2nd, 4th, and 6th treatment cycles. These scans include 18F-Fluciclovine PET/CT (Axumin), 18F-DCFPyL PET/CT, and 18F-FDG PET/CT. The 18F-Fluciclovine scans will be performed within seven days of the PSMA PET scans to compare imaging results at each time point. During the study, detailed imaging measures such as lesion uptake and tumor volume will be collected and analyzed over time. Patients will be followed at the institution to correlate these imaging results with clinical outcomes. The main outcome measured is the impact of 18F-Fluciclovine PET/CT on predicting outcomes of the 177Lu-PSMA-617 therapy from enrollment through 34 weeks of treatment.

Researchers are investigating why some men with Benign Prostatic Hyperplasia (BPH), a common condition causing urinary problems due to prostate enlargement, do not respond to the typical treatment drug Finasteride. The study focuses on understanding resistance to this treatment and hopes to use noninvasive methods like MRI to detect prostate inflammation and predict which patients will not benefit from Finasteride, allowing for alternative treatments in the future. Men eligible for the study will receive Finasteride as standard care for BPH symptoms, particularly those with moderate urinary symptoms and a prostate size over 40cc. Participants will undergo prostate MRIs and biopsies, along with blood and urine tests, before starting treatment. They will be monitored every six months with symptom assessments and have follow-up MRIs at three years to track changes in prostate size and inflammation, while tissue samples will be analyzed for gene expression and hormonal levels. Throughout the study, participants will attend clinic visits to evaluate urinary symptoms and treatment response, with a key assessment at 12 months to measure the effect of Finasteride. Researchers will collect detailed data including MRI scans, prostate tissue analyses, and hormone tests to understand treatment resistance. The study aims to improve how BPH is managed by identifying patients unlikely to respond to current therapy, with monitoring continuing over several years to gather comprehensive information.

Researchers are evaluating the use of a radiotracer called 64Cu-GRIP B with PET imaging to detect granzyme B, a biomarker produced by immune cells during immunotherapy, in patients with advanced cancers that have spread to nearby tissues or lymph nodes. This phase I/II study focuses on genitourinary cancers, including renal cell carcinoma, urothelial cancer, and metastatic castration-resistant prostate cancer, aiming to assess safety and usefulness of the imaging in monitoring immune response. Participants are divided into four groups based on cancer type: metastatic genitourinary malignancies, renal cell and urothelial carcinoma, metastatic castration-resistant prostate cancer, and other solid tumors. All receive the 64Cu-GRIP B injection followed by PET scans at baseline. Some groups have additional scans at 8 weeks and at disease progression. Imaging methods include PET/CT or PET/MRI, with safety monitoring conducted at multiple time points after tracer injection. During the study, patients undergo scans, blood sampling, and tumor biopsies when applicable. Researchers monitor adverse events, tracer distribution, and tumor uptake patterns over time. Outcomes measured include safety, tracer pharmacokinetics, changes in tumor uptake values, and correlations with clinical outcomes such as response to immunotherapy and progression-free survival. Participants are followed for up to two years to assess long-term effects and disease progression.

Researchers are investigating urethroplasty as a treatment option for urethral stricture disease across all patient groups, including native men, native women, transmen, transwomen, and children. This prospective observational study aims to gather unbiased evidence on urethroplasty's outcomes compared to other treatments like direct vision internal urethrotomy or dilation, which have shown lower long-term success rates. The study is sponsored by the University Hospital, Ghent, and focuses on understanding treatment effectiveness and patient experience over time. The study observes patients undergoing urethroplasty, an open reconstructive surgery designed to restore normal urine flow by repairing urethral strictures. There are no intervention groups or comparators since it is an observational study. The study tracks patient outcomes over several years to measure the surgery's success and impact on various aspects of health and quality of life. Participants will be monitored from the time of surgery up to 10 years to assess failure-free survival, meaning the time until stricture recurrence or death. Additionally, patients will complete questionnaires before surgery and at regular intervals for up to two years afterward to track changes in erectile function, ejaculatory function, urinary function, continence, and quality of life. This long-term follow-up allows researchers to understand both the clinical and personal effects of urethroplasty.

Researchers are studying tumors in the genitourinary (GU) tract, which includes cancers of the kidney, bladder, prostate, testicles, penis, and neuroendocrine cancers. Some of these tumors are rare and not well represented in treatment studies or tissue banks, making it difficult to establish standard care. This research aims to better understand both common and rare GU tumors by collecting detailed patient information over time. Participants in this long-term, multi-center observational study will provide medical history and may undergo physical exams, blood and urine sample collection, and surveys about family cancer history. Imaging scans of the chest, abdomen, and pelvis may be performed, sometimes with contrast injections. Patients may also provide existing tumor samples or optional biopsies. Samples may be used for genetic testing, and various scientific analyses including genomics and immune monitoring will be conducted. Throughout the study, participants will have regular follow-up visits and ongoing monitoring of their health, either at the research site or through coordination with their home doctors. Researchers will track disease patterns, treatment responses, and disease progression to characterize the natural history of GU cancers. This study will continue to follow patients over their lifetime to gather comprehensive data and improve future diagnosis and treatment strategies.

This research evaluates a new imaging method combining electromagnetic tracking with laparoscope and ultrasound probe imaging to improve surgeries for patients with confirmed urologic cancers. These cancers may affect the bladder, prostate, testicle, kidney, urethra, penis, ureter, or scrotum. The study aims to enhance visualization and localization of affected areas during lymph node dissection or organ removal surgeries, potentially reducing complexity, complications, and improving outcomes. Participants will undergo surgeries using a standard laparoscope and ultrasound probe equipped with an electromagnetic sensor to track lymph nodes or organs of interest. This imaging protocol is expected to record data in under 10 minutes during the procedure. The study is a pilot trial involving 10 participants and is supported by Siemens Medical USA. Participants will be monitored through laparoscope and ultrasound images and electromagnetic tracking data over one year. Researchers will assess the accuracy of navigation retrospectively. The involvement includes scheduled surgeries with laparoscopic lymph node dissection and/or organ removal, supported by imaging and tracking to evaluate this novel approach. The study is led by Dana-Farber Cancer Institute and runs until December 2026.

This research aims to compare the safety and effectiveness of three different endoscopic techniques for removing large prostate tissue in men with benign prostatic hyperplasia (BPH) who experience severe urinary symptoms. The study focuses on men with prostate sizes over 100 mL who have not responded to medical treatments and have significant symptoms measured by the International Prostate Symptom Score (IPSS) and urinary flow rates. The trial is a prospective randomized controlled study conducted at Tanta University Hospital, evaluating three surgical methods used to treat large prostates causing lower urinary tract symptoms. Participants will be randomly assigned to one of three groups, each undergoing a different prostate enucleation procedure: Thulium Fiber Laser Enucleation (ThuFLEP) using a 60W thulium fiber laser, Holmium Laser Enucleation (HoLEP) using a 150W holmium YAG laser, or Bipolar Transurethral Enucleation (B-TUEP) using bipolar electrical energy. All procedures are performed transurethrally and involve removing the prostate tissue with a morcellator. Each group will have 30 patients, and the study will run from October 2025 to October 2027. Participants will undergo thorough preoperative assessments including symptom scores, urinary flow tests, ultrasounds, blood tests, and prostate-specific antigen measurements. After surgery, follow-ups at 1, 3, and 6 months will evaluate symptom relief, quality of life, urinary flow rate, residual urine volume, and erectile function. Researchers will also track operative times, blood loss, catheter duration, hospital stay, and complications categorized by the Clavien-Dindo system. The study measures both patient outcomes and surgical efficiency over six months post-operation.

Researchers are studying fetuses with severe kidney failure that causes very low amniotic fluid, a condition called anhydramnios. This lack of fluid can harm lung development and lead to serious health problems or death shortly after birth. The study aims to find out if repeated amnioinfusions, which add fluid to the amniotic sac, can improve survival chances until dialysis or kidney transplant is possible. This research builds on earlier findings and seeks to improve outcomes for families facing this diagnosis. Participants will be divided into two groups: one receiving serial amnioinfusions with routine care, and a control group receiving comfort care without intervention. The amnioinfusions involve injecting sterile fluid into the amniotic cavity using a thin needle guided by ultrasound. The study team will perform these procedures at a specialized fetal care center, adjusting the number of infusions as needed. The trial also includes careful safety monitoring throughout pregnancy and after delivery. During the study, participants will have regular imaging tests like ultrasounds, echocardiograms, and MRIs, along with lab tests to monitor both the fetus and mother. Researchers will track fetal survival to dialysis and transplant, maternal safety up to 30 days after birth, and other pregnancy outcomes such as timing of membrane rupture and delivery. Follow-up will continue until at least two years after birth to assess transplant eligibility and long-term survival.

Benign Prostatic Hyperplasia (BPH) is a common condition in older men characterized by enlargement of the prostate, leading to lower urinary tract symptoms (LUTS) such as frequent urination, urgency, nocturia, difficulty urinating, and feeling of incomplete bladder emptying. This study investigates the levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in urine samples to understand their role in bladder outlet obstruction caused by BPH and the related changes in the bladder. Researchers aim to compare these levels before and after surgical procedures to relieve obstruction, as well as with control patients without obstruction.

Researchers are studying adults with metastatic non-prostate genitourinary cancers, including cancers starting in the bladder, kidneys, or other related organs. The study aims to learn if the drugs M7824 and PDS01ADC, given alone or with Stereotactic Body Radiation Therapy (SBRT), can help the immune system fight cancer more effectively. This is a phase I trial focusing on safety, dosage, and potential benefits of combining these treatments, especially since current immune therapies only help some patients. Participants receive PDS01ADC as a subcutaneous injection every 4 weeks and M7824 as an intravenous infusion every 2 weeks. Treatment cycles last 28 days and continue until participants leave the study. Some participants also receive SBRT radiation either sequentially or concurrently with the drug treatments. The study includes three groups: one with the drugs alone, one with drugs plus sequential SBRT, and one with drugs plus concurrent SBRT. Dose adjustments for PDS01ADC may occur based on side effects. During the study, participants undergo screening and repeated tests including medical history review, physical exams, blood and urine tests, electrocardiograms, body scans, and tumor biopsies or samples. Tissue and saliva samples are also collected. After treatment ends, there is a follow-up visit 30 days later, then ongoing contact every 12 weeks. Researchers primarily measure safety and tolerability of the treatments, while also tracking progression-free survival, overall survival, and tumor response.