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This is the first prospective multi-institutional study of PFUI. We found no difference in stricture rate between patients treated with primary realignment and SPT with delayed urethroplasty.

Erectile dysfunction and urinary incontinence are well-known side effects of radical prostatectomy that, when refractory to medical therapy, can be addressed by major genitourinary prosthetic surgery (urethral slings, artificial urinary sphincters (AUS), penile prostheses (PP)). Though these procedures have been evaluated in single institution studies, population-based analyses regarding their utilization have been sporadic. Thus, we sought to characterize post-prostatectomy genitourinary prosthetic surgery in a contemporary, population-based cohort of men with private insurance.

We encountered a clinical problem in a young man who presented with a left upper lobe mass and a diffuse reticular-nodular infiltrate. We thought we had appropriately applied Murphy's Law (the famed bank robber who “went where the money is”), and Ockham's Razor (the philosopher William of Ockham [1285 to 1349]—“Entities are not to be multiplied beyond necessity”) as we rapidly diagnosed the lung mass with computed tomography, scintography, and fine-needle aspiration. However, when his invaluable previous chest radiographs arrived, bronchoscopy with transbronchial biopsy, bronchoalveolar lavage, brushings, and postbronchoscopy sputum revealed the more ominous diagnosis in this patient. This case illustrates the complementary nature of current imaging and bronchoscopy techniques; but, even more importantly, it demonstrates the value of the history coupled with the previous radiograph. Even an unusual case can provide lessons in cost containment.