Latest Updates

Chronic Pelvic Pain: The Neuropathic Pain Basis

    • Provides rapid categorization of the etiology of chronic pelvic pain (CPP) as neurogenic versus nonneurogenic by using an accurate, purposeful physical examination for specific peripheral neuropathies
    • Demonstrates the roles of peripheral neuropathies in the etiology of CPP:
    1. Pudendal neuropathy as the major source
    2. Multiple smaller peripheral neuropathies as associated causes
    • Offers a platform for cooperative patient care among end-organ specialists, neurologists, psychologists, pain clinicians, and interventional radiologists
    • Highlights successful, sequential treatments that can be immediately adopted by any physician
    • Implies that all clinical research studies of CPP should define whether study participants have a peripheral neuropathic basis for their CPP. To date, this has not been done, limiting the value of published study results.

Liposarcoma

    • Limb-sparing surgery with radiation for extremity soft tissue sarcoma is not inferior to amputation in outcome of disease-specific mortality.
    • Completeness of resection (R0, R1, R2) of retroperitoneal soft tissue sarcoma correlates with patient survival.
    • Emerging molecular characterization of subtypes of liposarcoma has provided novel therapeutic targets, such as CDK4 inhibitors.

Headache

    • Targeting calcitonin gene related peptide can improve migraine pain
    • Greater occipital nerve blocks may alleviate migraine acutely
    • Clinical decision rules can be used to exclude subarachnoid hemorrhage

Liposarcoma

    • Limb-sparing surgery with radiation for extremity soft tissue sarcoma is not inferior to amputation in outcome of disease-specific mortality.
    • Completeness of resection (R0, R1, R2) of retroperitoneal soft tissue sarcoma correlates with patient survival.
    • Emerging molecular characterization of subtypes of liposarcoma has provided novel therapeutic targets, such as CDK4 inhibitors.

Local Treatment in the Management of Oligometastatic Prostate Cancer

    • Retrospective studies report a survival benefit for local treatment in metastatic prostate cancer (mPCa) patients.
    • First data from a randomized trial does not show a survival benefit for the addition of external beam radiotherapy to androgen deprivation treatment in mPCa.
    • Local tumor treatment in patients with mPCa should only be offered within trials.

Benign Tumors of the Spleen

    • Laparoscopic approach to splenectomy
    • Frequent incidental finding with increased use of imaging

Coma and Disorders of Consciousness

    • Non-convulsive status epilepticus is an important cause of coma that requires EEG for diagnosis.
    • Basilar artery stroke is a treatable cause of altered mentation
    • Physicians should actively seek to identify treatable structural or metabolic causes of coma

Benign Tumors of the Spleen

    • Laparoscopic approach to splenectomy
    • Frequent incidental finding with increased use of imaging
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