Publications by authors named "Luke L Wang"

12 Publications

  • Page 1 of 1

Idiopathic non-ischemic priapism in an infant: A case report.

Urol Case Rep 2020 Nov 23;33:101428. Epub 2020 Sep 23.

Division of Urology, University of Nebraska Medical Center, Omaha, NE, USA.

Priapism is a pathologic erection lasting >4 hours that is unrelated to or persists beyond sexual stimulation. Priapism is rare in children, and rarely reported in infants. Although a small number of cases have been reported in neonates, even fewer have been reported in infants outside of the neonatal period. Due to its rarity and poorly understood pathophysiology, the diagnosis and management of priapism in infants is challenging. We report a rare case of idiopathic non-ischemic priapism in a 9-month-old highlighting some of the challenges in diagnosis and management of priapism in this age group.
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http://dx.doi.org/10.1016/j.eucr.2020.101428DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574272PMC
November 2020

Presentation and Diagnosis of Ureteral Quadruplication: Case Report and Analysis of the Literature.

Urology 2021 Jan 7;147:276-280. Epub 2020 Jul 7.

Section of Pediatric Urology, Children's Hospital and Medical Center, Omaha, NE; Division of Urology, University of Nebraska Medical Center, Omaha, NE. Electronic address:

Ureteral quadruplication is exceedingly rare. All except for 2 cases were symptomatic and nearly all underwent intervention. We present the first case of asymptomatic ureteral quadruplication in the presence of ureteral cyst. The report is first to prove ureteral quadruplication, even with ureteral cyst, can have normal renal function and parenchyma without obstruction or reflux. The report analyzes differences between the 14 cases of ureteral quadruplication in the English literature. It is first to describe bilateral ureteral cysts with ureteral quadruplication and triplication, and is first to accurately characterize the appearance of quadruplicated ureters inside the kidney.
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http://dx.doi.org/10.1016/j.urology.2020.06.044DOI Listing
January 2021

Hemosuccus Pancreaticus: A Rare Bleeding Pseudoaneurysm of the Inferior Pancreaticoduodenal Artery Treated with Embolization.

Case Rep Surg 2018 2;2018:2354169. Epub 2018 Sep 2.

University of Nebraska Medical Center, Trauma, Emergency General Surgery, Critical Care Surgery, Omaha, USA.

Hemosuccus pancreaticus is a very rare cause of gastrointestinal bleeding and can be life-threatening if not managed appropriately. Still thought to be a surgical problem, advances in medical therapy now afford these patients the opportunity to undergo less-invasive angiography techniques to manage this illness when it occurs. Here, we present a case of hemosuccus pancreaticus safely managed with liquid N-butyl-2-cyanoacrylate embolization.
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http://dx.doi.org/10.1155/2018/2354169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139223PMC
September 2018

Patterns of care and outcomes for men diagnosed with prostate cancer in Victoria: an update.

ANZ J Surg 2018 10 25;88(10):1037-1042. Epub 2018 Jul 25.

Australian Urology Associates, Melbourne, Victoria, Australia.

Background: To update patterns of care for men diagnosed with prostate cancer in Victoria, Australia between 2008 and 2015.

Methods: From August 2008 to December 2015, 14 025 men diagnosed with prostate cancer were included. These data were obtained from the Prostate Cancer Outcome Registry - Victoria (PCOR-Vic). Frequencies were used to describe hospital and patient characteristics and treatment types. Comparisons were made between previous period of analysis (2008-2011) to the most recent period (2011-2015). Survival analysis using a stepwise Cox proportional hazards regression model was performed.

Results: Mean age of diagnosis was 66.5 years and 44% of patients were diagnosed with Gleason 7 prostate cancer. Majority of notifications (63.6%) were received from a private institution and 70.2% of patients were diagnosed at a metropolitan institution. Most patients (95.3%) were diagnosed with clinically localized disease. Within 12 months of diagnosis, 55.9% of patients with low-risk disease received no active treatment. Radical prostatectomy was the most common primary treatment with curative intent (47%). When comparing of patterns of care between 2008-2011 and 2011-2015, the proportion of patients diagnosed with Gleason 9-10 disease increased, as has the proportion of patients diagnosed with metastatic disease.

Conclusion: With the PCOR-Vic, we were able to identify that increasing number of patients were diagnosed with high-risk and metastatic disease. There has been an overall decrease in radical treatment rates, likely due to active surveillance playing a significant role especially in patients with low-risk prostate cancer.
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http://dx.doi.org/10.1111/ans.14722DOI Listing
October 2018

Survival outcomes of younger men (< 55 years) undergoing radical prostatectomy.

Prostate Int 2018 Mar 9;6(1):31-35. Epub 2017 Aug 9.

Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.

Background: The aim of the paper is to investigate the outcomes of patients younger than 55 years in Victoria, Australia undergoing radical prostatectomy (RP) for prostate cancer.

Materials And Methods: Data on all men undergoing RP in Victoria between January 1, 2004 and December 31, 2014 were obtained from the Victorian Cancer Registry. Tumor characteristics including Gleason grade, stage of disease (based on final pathology specimen), and cause of death were also obtained. Statistical analysis was performed using Chi-square test, Cox proportional hazards method, and Kaplan-Meier analysis.

Results: A total of 14,686 men underwent RP during the defined period. Of these men 109 were aged 35-44 years and 1,998 were aged 45-54 years. Men aged 35-44 years and 45-54 years were compared against men aged 55-74 years. The majority of men between the ages of 35 years and 44 years, and 45 years and 54 years had higher rates of Gleason ≤ 7 disease compared with men aged between 55 years and 74 years (92.7% vs. 86.8% vs. 79.3%;  < 0.01) and ≤ T2 disease (82.6% vs. 75.6% vs. 49.9%;  < 0.01) but similar median prostate-specific antigen values. On a multivariate analysis adjusting for Gleason score, T stage, and prostate-specific antigen, men aged 45-54 years and 55-64 years had 67% and 46% increase in overall survival, respectively, compared to men aged 65-74 years; but these differences were not seen in the 35-44 year age group. There were no differences in prostate cancer specific deaths between the groups. The 5- and 10-year overall survival outcomes were both higher for men aged 45-54 years compared to mean aged 55-74 years (97.9% vs. 95.9% and 94.9% vs. 85.3).

Conclusion: Men aged 45-54 years undergoing RP had better overall survival compared to men aged 55-74 years, but these effects were not seen in men aged 35-44 years. There were no differences in prostate cancer specific survival in these groups.
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http://dx.doi.org/10.1016/j.prnil.2017.07.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5857187PMC
March 2018

Survival outcomes in elderly men undergoing radical prostatectomy in Australia.

ANZ J Surg 2018 Mar 18;88(3):E189-E193. Epub 2017 Sep 18.

Urology Unit, Austin Health, Melbourne, Victoria, Australia.

Background: To investigate the outcomes of patients older than 75 years of age in Victoria undergoing radical prostatectomy for prostate cancer.

Methods: Data on all men undergoing radical prostatectomy in Victoria between 1 January 2004 and 31 December 2014 were obtained from the Victorian Cancer Registry. Tumour characteristics including Gleason grade, stage of disease and cause of death were obtained. Statistical analysis was performed using chi-squared test, Cox proportional hazards method and Kaplan-Meier analysis.

Results: A total of 14 686 men underwent radical prostatectomy during the defined period, with a median follow-up of 58 months. Of these, 332 were men over the age of 75. All parameters are comparisons between patients >75 years of age and men <75 years of age. Men >75 years had a higher proportion of Gleason grade ≥8 disease (16.6% versus 11.4%, P < 0.001) but had similar stage of disease. Men >75 years had lower rates of 5- and 10-year overall survival (67.3% versus 96.3% and 27.7% versus 89.1%) and lower rates of 5- and 10-year prostate cancer-specific survival (96.2% versus 99.3% and 94.3% versus 97.4%), respectively. Age was an independent risk factor for prostate cancer specific and overall mortality on multivariate analysis (hazard ratio 1.49, 95% confidence interval 1.32-1.68; P < 0.001 and hazard ratio 4.26, 95% confidence interval 2.15-8.42; P < 0.001), when adjusted for stage and grade.

Conclusion: Older men undergoing radical prostatectomy in Victoria had higher-grade disease but similar stage. Age was an independent risk factor for worse prostate cancer-specific and overall survival.
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http://dx.doi.org/10.1111/ans.14166DOI Listing
March 2018

'ProtecTion' from overtreatment: does a randomized trial finally answer the key question in localized prostate cancer?

BJU Int 2017 04 4;119(4):513-514. Epub 2017 Jan 4.

Australian Urology Associates, Malvern, Vic., Australia.

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http://dx.doi.org/10.1111/bju.13734DOI Listing
April 2017

Inflammatory Myofibroblastic Tumor of the Urinary Bladder: A Case Report.

Urol Case Rep 2016 May 5;6:58-9. Epub 2016 Apr 5.

Department of Urology, Monash Health, Bentleigh East, VIC, Australia.

Inflammatory myofibroblastic tumor is a rare but benign clinical entity. Its ability to mimic malignancy poses a diagnostic challenge. Here, we report the first case in Australia, of inflammatory myofibroblastic tumor in the bladder in a 40-year-old male, removed via transurethral resection.
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http://dx.doi.org/10.1016/j.eucr.2016.03.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855986PMC
May 2016

Pulse granuloma mimicking recurrent upper tract urothelial carcinoma.

ANZ J Surg 2018 Jun 16;88(6):E548-E549. Epub 2016 Mar 16.

Department of Urology, Monash Health, Melbourne, Victoria, Australia.

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http://dx.doi.org/10.1111/ans.13462DOI Listing
June 2018

Incidental Finding of a Rare Urachal Pathology: Urachal Mucinous Cystic Tumour of Low Malignant Potential.

Case Rep Urol 2016 3;2016:5764625. Epub 2016 Jan 3.

Department of Urology, Monash Health, 823-865 Centre Road, Bentleigh East, VIC 3165, Australia.

Urachal mucinous cystic tumours are rare pathological findings with only 23 previously reported cases in the literature. We present the case of a 54-year-old man with an incidentally found urachal mucinous cystic tumour laparoscopically excised. With its known potential to cause pseudomyxoma peritonei, complete surgical excision is important. Long-term cystoscopic and radiological surveillance is also required.
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http://dx.doi.org/10.1155/2016/5764625DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735918PMC
February 2016

Three patterns of fronto-orbital remodeling for metopic synostosis: comparison of cranial growth outcomes.

Plast Reconstr Surg 2014 Nov;134(5):787e-795e

Melbourne, Victoria, Australia From the Departments of Plastic and Maxillofacial Surgery and Neurosurgery, Royal Children's Hospital Melbourne; and the Department of Paediatrics, University of Melbourne.

Background: The authors compared cranial growth across three patterns of fronto-orbital remodeling for metopic synostosis.

Methods: The authors reviewed all patients who underwent fronto-orbital remodeling for isolated metopic synostosis between 2006 and 2009. Inclusion criteria consisted of patients with preoperative, short-term postoperative (4 to 12 months), and long-term postoperative (>36 months) three-dimensional photographs. Patients were categorized by fronto-orbital remodeling pattern: group 1, retrocoronal; group 2, partial coronal; and group 3, precoronal. Head circumference, minimum frontal breadth (ft-ft), and maximum cranial length were measured by three-dimensional photographs, converted to standard Z scores, and compared.

Results: Thirty-one patients met inclusion criteria (group 1, n=12; group 2, n=10; and group 3, n=9). Group 1 presented with the greatest phenotypic severity. From preoperative to short-term postoperative assessment, head circumference Z scores rose for group 1 but dropped for groups 2 and 3, and the three groups demonstrated equivalent increases in minimum frontal breadth Z scores. From short-term to long-term postoperatively, the three groups demonstrated similar stability in head circumference Z scores but decreased minimum frontal breadth Z scores. From preoperatively to long-term postoperatively, head circumference Z scores rose for group 1 but fell for groups 2 and 3 (change in Z score, 0.5, -0.5, and -0.7, respectively; p=0.06) and the three groups demonstrated equivalent drops in minimum frontal breadth Z scores. Across preoperative to short-term postoperative and preoperative to long-term postoperative assessment, group 1 displayed the least drop in maximum cranial length Z scores.

Conclusions: Retrocoronal patterns of fronto-orbital remodeling provide long-term gains in head circumference percentile and the least growth impairment in cranial length. Irrespective of osteotomy design, expansion in frontal breadth relapses significantly over time.

Clinical Question/level Of Evidence: Therapeutic, III.
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http://dx.doi.org/10.1097/PRS.0000000000000588DOI Listing
November 2014

Two decades of percutaneous transjejunal biliary intervention for benign biliary disease: a review of the intervention nature and complications.

Insights Imaging 2011 Oct 28;2(5):557-65. Epub 2011 Jul 28.

Department of Surgery, Leiden University Medical Center, P.O. Box 9600, 2300, RC, Leiden, The Netherlands,

Objective: To assess outcomes of percutaneous transjejunal biliary intervention (PTJBI) in terms of success and effectiveness in patients with a Roux-en-Y hepaticojejunostomy for benign biliary strictures and stones.

Methods: Clinical and radiographic records of 63 patients with a Roux-en-Y choledochojejunostomy or hepaticojejunostomy for benign disease who underwent at least one PTJBI between 1986 and 2007 were reviewed. Effectiveness was determined by successful access rate, rates of stricture dilatation and/or stone extraction, morbidity, complications and hospitalisation.

Results: PTJBI was attempted 494 times. Successful access to the Roux-en-Y was accomplished in 93% of interventions. After access to the Roux-en-Y was granted, all strictures were effectively dilated. Ninety-seven percent of extraction attempts of intrahepatic calculi were successful. The median number of interventions per patient was five. The median interval between interventions was 51.5 weeks (range 2.7-1,279.6 weeks). The early complication rate was 3%. Morbidity, measured in terms of cholangitis episodes was 14%, in 25 out of 63 patients. Mean hospitalisation was 4.1 nights per year.

Conclusion: PTJBI is safe and effective in treating benign biliary strictures and/or calculi. High success rates and short hospitalisation periods, together with few complications make it a well-accepted and integral part of managing complex biliary problems.
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http://dx.doi.org/10.1007/s13244-011-0119-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289021PMC
October 2011