Browse Health
Urologist
4 years of experience

Education ?

Medical School Score
Thomas Jefferson University (2006)
  • Currently 2 of 4 apples

Awards & Distinctions ?

Associations
American College of Surgeons
American Urological Association

Publications & Research

Dr. Tomaszewski has contributed to 26 publications.
Title Management of Bladder Cancer Following Solid Organ Transplantation.
Date July 2011
Journal Advances in Urology
Excerpt

Objective. Present our experience managing bladder cancer following liver and renal transplantation. Methods. Single institution retrospective review of patients diagnosed with bladder urothelial carcinoma (BUC) following solid organ transplantation between January 1992 and December 2007. Results. Of the 2,925 renal and 2,761 liver transplant recipients reviewed, we identified eleven patients (0.2%) following transplant diagnosed with BUC. Two patients with low grade T1 TCC were managed by TURBT. Three patients with CIS and one patient with T1 low grade BUC were treated by TURBT and adjuvant BCG. All four are alive and free of recurrence at a mean follow-up of 51 ± 22 months. One patient with T1 high grade BUC underwent radical cystectomy and remains disease free with a follow-up of 98 months. Muscle invasive TCC was diagnosed in four patients at a median of 3.6 years following transplantation. Two patients are recurrence free at 24 and 36 months following radical cystectomy. Urinary diversion and palliative XRT were performed in one patient with un-resectable disease. Conclusions. Bladder cancer is uncommon following renal and liver transplantation, but it can be managed successfully with local and/or extirpative therapy. The use of intravesical BCG is possible in select immunosuppressed patients.

Title Management of Urine Leak After Laparoscopic Cyst Decortication with Retrograde Endoscopic Fibrin Glue Application and Ureteral Stent Placement.
Date April 2011
Journal Journal of Endourology / Endourological Society
Excerpt

Urine leakage is an uncommon complication after renal cyst decortication that typically resolves with adequate drainage. With prolonged large volume urine leakage from a perinephric drain, however, consideration for open surgical repair must be taken into account. We present the successful management of persistent urine leakage after laparoscopic cyst decortication with endoscopic retrograde fibrin glue injection and ureteral stent placement.

Title Cesium 131 Versus Iodine 125 Implants for Prostate Cancer: Evaluation of Early Psa Response.
Date February 2011
Journal The Canadian Journal of Urology
Excerpt

Given the shorter half-life of cesium-131 (Cs-131) compared to iodine-125 (I-125), we hypothesized that initial PSA outcomes may differ. We compare initial PSA outcomes in men undergoing Cs-131 prostate brachytherapy to men treated with I-125.

Title Renal Access by Urologist or Radiologist During Percutaneous Nephrolithotomy.
Date February 2011
Journal Journal of Endourology / Endourological Society
Excerpt

We evaluated percutaneous access for percutaneous nephrolithotomy (PCNL) that was obtained by interventional radiologists or urologists at a single academic institution and compared access outcomes and complications.

Title Outcomes of Percutaneous Nephrolithotomy Stratified by Body Mass Index.
Date July 2010
Journal Journal of Endourology / Endourological Society
Excerpt

Obesity places surgical patients at a greater risk of complications. The effects of obesity on outcomes and complications from percutaneous nephrolithotomy (PCNL) are not well defined.

Title Factors Affecting Blood Loss During Percutaneous Nephrolithotomy Using Balloon Dilation in a Large Contemporary Series.
Date April 2010
Journal Journal of Endourology / Endourological Society
Excerpt

Renal hemorrhage is a common and worrisome complication of percutaneous nephrolithotomy (PNL). We review factors affecting blood loss and transfusion requirements in a large contemporary series of patients undergoing PNL utilizing balloon dilation.

Title Laparoscopic Retroperitoneal Lymph Node Dissection for High-risk Pediatric Patients with Paratesticular Rhabdomyosarcoma.
Date March 2010
Journal Journal of Endourology / Endourological Society
Excerpt

Retroperitoneal lymph node dissection (RPLND) is recommended in children 10 years or older with paratesticular rhabdomyosarcoma (PTRMS). Primary tumors >5 cm are an additional risk factor for disease recurrence in the retroperitoneum. We report our experience with laparoscopic RPLND (LRPLND) in high-risk pediatric patients with PTRMS.

Title Robotic-assisted Laparoscopic Extravesical Ureteroneocystostomy for Management of Adult Ureteral Duplication with Upper Pole Prostatic Urethral Insertion.
Date November 2009
Journal Jsls : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
Excerpt

A 55-year-old male presented with progressive lower urinary tract symptoms and renal colic. The workup revealed a complete left ureteral duplication with a hydronephrotic upper pole moiety inserting into the prostatic urethra. Using a 5-port transperitoneal robotic-assisted laparoscopic technique, an extravesical upper pole ureteroneocystostomy was performed. Clinical follow-up and repeat imaging documented symptomatic and radiographic improvement. Robotic-assisted laparoscopic reconstructive techniques are feasible and efficacious in the management of adult ureteral anomalies.

Title Strategies to Enhance the Efficacy of Intravescical Therapy for Non-muscle Invasive Bladder Cancer.
Date October 2009
Journal Minerva Urologica E Nefrologica = The Italian Journal of Urology and Nephrology
Excerpt

Transitional cell carcinoma (TCC) is the second most common urologic malignancy, and 70% of patients present with superficial, or non-muscle invasive disease (NMIBC). Bacillus Calmette-Guerin (BCG), currently the most effective intravesical agent at preventing disease recurrence, is the only therapy shown to inhibit disease progression. Unfortunately, approximately 20% of patients discontinue BCG due to local and systemic toxicity and more than 30% show evidence of recurrence; this has led to increased interest in alternate chemotherapeutic agents. Induction intravesical chemotherapy has shown comparable efficacy to BCG in select patients and the immediate perioperative instillation of chemotherapeutic agents has become standard of care. Clinical trial evidence demonstrating the efficacy of BCG plus interferon 2B, gemcitabine and anthracyclines (doxorubicin, epirubicin, valrubicin) in patients refractory or intolerant to BCG is accumulating. Phase I trials investigating alternative agents such as apaziquone, taxanes (docetaxel, paclitaxel), and suramin are reporting promising data. Current efforts are also being directed towards optimizing the administration of existing chemotherapeutic regimens, including the use of novel modalities including hyperthermia, photodynamic therapy, magnetically targeted carriers, and liposomes. Despite recent enthusiasm for new intravesical agents, radical cystectomy remains the treatment of choice for patients with NMIBC who have failed intravesical therapy and select patients with naive T1 tumors and aggressive features. Our aim in this report is to provide a comprehensive review of contemporary intravesical therapy options for NMIBC with an emphasis on emerging agents and novel treatment modalities.

Title The Application of Endoscopic Techniques in the Management of Upper Tract Recurrence After Cystectomy and Urinary Diversion.
Date October 2009
Journal Journal of Endourology / Endourological Society
Excerpt

Although nephroureterectomy remains the gold-standard therapy for upper tract recurrence of transitional cell carcinoma after cystectomy and urinary diversion, conservative endoscopic techniques are increasingly being utilized for surveillance and management of recurrent low-grade upper tract lesions. A retrograde or antegrade approach is technically feasible and can be an effective alternative in patients with significant medical comorbidities, chronic renal insufficiency, bilateral disease, or solitary renal units. Recent series have expanded the utility of these procedures to include solitary, low-grade, and completely resectable tumors in patients with normal contralateral kidneys who are willing to accept lifelong surveillance for recurrence. With increasing experience and improvements in endoscopic equipment, the endourologic management of upper tract recurrence after cystectomy and lower urinary tract reconstruction is an appealing option in select patients. The difficulties with urinary tract access, preservation of renal function, and oncologic efficacy must all be taken into consideration in these complex patients. The aims of this report are to review the outcomes of contemporary series of upper tract recurrence of transitional cell carcinoma managed endoscopically, and to discuss the application of endourologic techniques in patients who have undergone cystectomy and lower urinary tract reconstruction.

Title Effect of Carbohydrate-electrolyte Sports Beverages on Urinary Stone Risk Factors.
Date September 2009
Journal The Journal of Urology
Excerpt

We evaluated the effects of consuming carbohydrate-electrolyte sports beverages (Gatorade((R))) on urinary stone risk factors.

Title Endourologic Management of Upper Tract Transitional Cell Carcinoma Following Cystectomy and Urinary Diversion.
Date June 2009
Journal Advances in Urology
Excerpt

Traditionally, nephroureterectomy is the gold standard therapy for upper tract recurrence of transitional cell carcinoma (TCC) following cystectomy and urinary diversion. With advances in endoscopic equipment and improvements in technique, conservative endourologic management via a retrograde or antegrade approach is technically feasible with acceptable outcomes in patients with bilateral disease, solitary renal units, chronic renal insufficiency, or significant medical comorbidities. Contemporary studies have expanded the utility of these techniques to include low-grade, low-volume disease in patients with a normal contralateral kidney. The aim of this report is to review the current outcomes of conservative management for upper tract disease and discuss its application and relevance in patients following cystectomy with lower urinary tract reconstruction.

Title Inguinal Canal Recurrence of Colorectal Adenocarcinoma Following Cytoreductive Surgery and Intraperitoneal Hyperthermic Chemotherapy.
Date March 2009
Journal The Canadian Journal of Urology
Excerpt

Peritoneal carcinomatosis, the second most common cause of death among patients with colorectal carcinoma, may be managed with cytoreductive surgery and adjuvant intraoperative peritoneal hyperthermic chemotherapy (IHPC). We present the case of a 35-year-old male with locally recurrent colorectal adenocarcinoma in the inguinal canal and testis following intraperitoneal debulking and IPHC. When communicating with the peritoneal cavity, the inguinal canal may act as an anatomic sanctuary site and allow peritoneal carcinomatosis to escape the effects of intraperitoneal chemotherapy.

Title Staged Endourologic and Endovascular Repair of an Infrarenal Inflammatory Abdominal Aortic Aneurysm Presenting with Forniceal Rupture.
Date November 2008
Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
Excerpt

We present the case of a 79-year-old female who presented with severe left flank pain and a pulsatile abdominal mass. She was diagnosed with left peripelvic urinary extravasation and forniceal rupture secondary to an intact infrarenal inflammatory abdominal aortic aneurysm with extensive periaortic fibrosis. Successful operative repair was performed with staged ureteral and endovascular stenting with subsequent resolution of periaortic inflammation and ureteral obstruction, and shrinkage of the aneurysm sac. Inflammatory abdominal aortic aneurysms (IAAAs) represent 5% to 10% of all abdominal aortic aneurysms. The distinguishing features of inflammatory aneurysms include thickening of aneurysm wall, retroperitoneal fibrosis, and adhesions to adjacent retroperitoneal structures. The most commonly involved adjacent structures are the duodenum, left renal vein, and ureter. Adhesions to the urinary system can cause hydronephrosis or hydroureter and result in obstructive uropathy. An unusual case of IAAA presenting with forniceal rupture is presented, with successful endovascular and endourologic repair.

Title Bladder Diverticulum Arising Adjacent to an Ectopic Ureter Presenting As a Cystic Mass.
Date August 2008
Journal The Canadian Journal of Urology
Excerpt

Acquired bladder diverticula due to bladder outlet obstruction are not uncommon in the adult male population. Congenital diverticula originate adjacent to the trigone and are rarely diagnosed in adults. We report an unusual case of a diverticulum arising adjacent to an ectopic ureter located on the left lateral wall near the dome of the bladder. Although the diverticulum appeared to be congenital, its large size was likely a result of high pressure voiding. The patient underwent a transurethral resection of the prostate to reduce his bladder outlet obstruction, and subsequently underwent an open diverticulectomy.

Title The Effect of Cyclosporine A and Amlodipine on the Activity of Gamma-glutamyl Transpeptidase in Mouse Cerebral Cortex.
Date January 1998
Journal Pharmacological Research : the Official Journal of the Italian Pharmacological Society
Excerpt

The effect of cyclosporine A (CsA) and dihydropyridine calcium channel blocker (CCB) amlodipine on gamma-glutamyl transpeptidase (GGT; EC 2.3.2.2) activity in mouse cerebral cortex was investigated. Mice received amlodipine (0.07 mg kg-1), CsA (10, 20 and 40 mg kg-1) and CsA in the above doses combined with amlodipine (0.07 mg kg-1) once daily, intraperitoneally for 5 days. The control group received saline. Amlodipine decreased GGT activity when compared to the control group. GGT activity in the cerebral cortex was decreased after treatment with CsA (20 and 40 mg kg-1), but was not changed after treatment with CsA in the 10 mg kg-1 dose as compared to the control group. CsA in doses of 20 and 40 mg kg-1, combined with amlodipine, increased GGT activity as compared to the control group groups received the same doses of CsA without amlodipine and received only amlodipine. However, CsA in the 10 mg kg-1 dose combined with amlodipine decreased GGT activity when compared to the control group, but did not show any statistical difference when compared to the groups treated only with amlodipine or CsA in the same doses. These results suggest that CsA and amlodipine may modulate GGT activity in mouse cerebral cortex.

Title Relation Between Somatic Development and Some Environmental Factors in the Male Population of Vocational Mining Schools in the Lublin Coal Basin.
Date January 1995
Journal Annales Universitatis Mariae Curie-skłodowska. Sectio D: Medicina
Excerpt

Somatic development of a child, although genetically determined, depends also on the influence of biogeographic and socio-economic factors of the environment. The effects of these factors popular in the literature are seen in the differences of somatic development of children brought up in urban and rural environments. In comparison with urban population, country children are characterized by lower growth and body mass, delayed manifestation of sexual maturity, greater amount of incorrect posture features, worse state of nutrition and lower index of mental development. The differences in somatic development of children were also found while comparing the size of agglomeration and socio-professional factors determining parents' level of education and financial situation of the family. One could also observe the improvement of somatic development of children living in regions of quick and intensive urbanization and industrialization.

Title Cardiovascular Diseases Risk Factors in Male Population from Mining Vocational Schools of the Lublin Coal Basin.
Date January 1995
Journal Annales Universitatis Mariae Curie-skłodowska. Sectio D: Medicina
Excerpt

Contrary to certain industrial countries which secure an impressive decrease in coronary heart mortality, Poland has had, especially in the last decade, the significant increase of morbidity and mortality caused by cardiovascular diseases. Although this phenomenon concerns mainly the middle-age mean groups, special care for the whole population should be undertaken. The successful way to decrease the death rate and morbidity attributed to coronary heart disease (CHD) are the long-term prevention programs as for example Multiple Risk Factor Intervention Trial, Belgian Heart Disease Prevention Project, Lipid Research Clinics Coronary Primary Prevention Trial and others. Because there is some evidence that certain risk factors occur also among children, it seems that the effectiveness and efficacy of such prevention programs may be increased when started in the young population.

Title Evaluation of Lung Function in Male Population from Vocational Mining Schools of the Lublin Coal Basin.
Date January 1995
Journal Annales Universitatis Mariae Curie-skłodowska. Sectio D: Medicina
Excerpt

Occupational exposure to dust and other environmental factors in coal miners may impair the lung function of workers. Besides the coal workers' pneumoconiosis, the inhaled dust may cause decreased ventilatory capacity as a due to chronic bronchitis (9, 13). The same diseases, especially chronic bronchitis, are common in general population and may arise not only from occupational reasons (11, 12). The involvement of the genetic factors, environmental pollutions and cigarette smoking should be considered.

Title Evaluation of Nutritional Status of Male Population from Mining Vocational Schools in the Lublin Coal Basin.
Date January 1995
Journal Annales Universitatis Mariae Curie-skłodowska. Sectio D: Medicina
Excerpt

The basic nutritional mistake in Polish population at considerably rare deficiency of proteins and calories is incorrect composition of diet with the excess of animal fat and carbohydrates. Social and economic changes which influence living conditions result in the change of diet whose trends are not always correct. The problem is the quality of food products, contamination of pollution due to industrialization and the use of chemicals in agriculture, and inadequate proportion in the essential food components or supply of the indispensable trace elements. The other problem is overnutrition leading to obesity which is one of risk factors in civilization diseases (8, 11). The nutritional status depends on the level of education and economic situation of different social groups. It is expected that among the pupils of vocational mining schools who usually come from numerous peasant and working class families nutritional mistakes may occur very often. It denotes both malnutrition and incorrect proportion in consumption of proteins, animal fats and carbohydrates. On the other hand, the expected changes in social and economic status due to a good job create new conditions for proper nutrition. An additional factor which should be taken into account are nutritional requirements resulting from specific character of underground work.

Title Some Risk Factors of Coronary Heart Disease in Miners of a New Coal Mining Area.
Date January 1992
Journal Polish Journal of Occupational Medicine
Title [structure and Function of Proteoglycans]
Date October 1989
Journal Postepy Biochemii
Title [apolipoproteins and Lipoprotein Metabolism]
Date January 1988
Journal Przegla̧d Lekarski
Title Interaction of C1q Subcomponent with Immunoglobulin M.
Date March 1987
Journal Acta Biochimica Polonica
Excerpt

The affinity of human C1q subcomponent for IgM of normal human serum and Waldenström macroglobulins of patients Sew and Zuk were investigated by the polyethylene glycol 6,000 immune complexes precipitation test. This test was calibrated with heat-aggregated gamma-globulin (HAGG); maximum fixation of C1q ranged from 60 to 80% (measured as percentage of radioactivity of the immune complexes precipitate) and was observed when the C1q:HAGG concentration ratio was about 1:250. At the ratio of 1:20 the radioactivity of the precipitate was about 43% of the total. The capacity of polyclonal IgM and Waldenström macroglobulins for C1q fixation is low and variable. The percentage of C1q fixed at the C1q:IgM ratio of 1:20 for polyclonal IgM and Zuk macroglobulin was about 9%, whereas for Sew it was only about 1%.

Title The Programme of Teaching Clinical Biochemistry in Medical Studies.
Date January 1983
Journal Zeitschrift Für Medizinische Laboratoriumsdiagnostik
Title Incidentally Discovered Osseous Metaplasia Within High-grade Urothelial Carcinoma of the Bladder.
Date
Journal Urology
Excerpt

A 66-year-old male presented with gross hematuria and acute renal failure secondary to bilateral ureteral obstruction. Further work-up revealed muscle invasive urothelial carcinoma. Pathologic examination following radical cystoprostatectomy revealed high grade urothelial carcinoma with focal tumor-associated stromal osseous metaplasia. Reactive bone formation within urothelial carcinoma is a very rare clinical entity. Although typically benign, the presence of mature bone elements warrants thorough examination for sarcomatoid components.

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